Coronavirus

[jerry33]

Tidbit. While checking the mail today, there was a hand addressed blue envelope from Washington State. Turned out to be a Costco advertising letter. Why am I not impressed.

 

[wdolson]

This is only because nobody has paid for them. This can all happen very quickly if funding is committed to it. China was performing over 300k tests per day over a month ago.

Every country should be ordering as many tests and masks as possible from every domestic company with capacity and also from China. It is not difficult to have enough in 2 -3 weeks time.

They should have ordered these 2 months ago admittedly. The reason they didn't was due to extremely false economies. But now it should be clear tests and masks are far far cheaper than the shutdown measures they are implementing.

The US has had a bad breakdown in leadership over this. Individual jurisdictions are doing everything they can, but the only coordination is informal between governors.

The countries that fared the best so far are the ones that hit the ground running with a coordinated effort on every level.

Washington became the epicenter of this because they defied the CDC and started making their own test kits. California fought the CDC about buying test kits from South Korea, and I think they finally told the CDC to stuff it. The CDC was forbidding anyone use anything but their test kits initially. The ones that turned out to be faulty.

I could go into detail about the political leadership failures, but that probably belongs in the Market Politics thread.

In any case, we need to move forward from where we are now. We'll decide whose fault it was that the US is so behind on critical supplies in November. Right now we need to deal with the crisis at hand with what we have. As inadequate as it is.

The main reason people don't freak out about it is that it seems like almost ever person that lives beyond the average life span dies of heart disease. My wife's grandmother died at 98. Cause of death? Heart disease.

I seriously hope heart disease gets me at 98!! So no I ain't panicking about heart disease (although I eat healthy to avoid it if I can).

My father just turned 100 last month. He's never had heart disease, but he is in heart failure. Several other organs are failing too and its a crap shoot which failure will get him in the end. They wrote him off last summer when he came down with a cold. But he came back from it.

Heart disease doesn't run on either side of my family. The only documented death from it is my great grandfather who died in 1935 of it after eating lamb chops fried in mutton fat every morning for 80 years. My mother was there (her family was homeless and living with her father's parents at the time) and she later became an RN. He lingered for several days and she said that he would have been saved if he had access to even what a city hospital had in the 1950s.

Yes - its the second case that they could trace and found out only because of the Seattle Flu study.

Its possible many other states had fatalities in Feb that were never attributed to Covid19. Even recently King county has been testing Feb deaths from LifeCenter and finding Covid19.

Our doctor is pretty sure that my SO and I had it back in late February here in Clark County. We both mostly work from home and haven't gotten out much lately, so we probably picked it up when out shopping or eating sometime in February. In the first week of February we were at the shopping center near the airport. My best guess is we crossed paths with an international traveler who had just come in from China.

I suspect there were vectors into the US from China during that time that didn't take root because the person infected may only have been contagious for a short time, and/or did the smart thing and isolated when they were sick with a mild case. The few people they infected also had mild cases and didn't happen to cross paths with someone very vulnerable.

My doctor is trying to get some anti-body test kits and I'm on the list to get one. That should confirm it, but who knows when she'll get them in.

 

[nwdiver]

People will spend it on TP. TP will normalize at $5 a roll.

Temporarily but supplies are going to quickly catch-up as panic buying subsides.

In all seriousness this is the component libertarian economists like Stephen Moore ignore in terms of inflation. It takes two to tango. You need an increase in Demand AND and a supply chain unable to meet it. As Industry 4.0 accelerates the available supply curve is increasing logarithmically while demand will typically only increase linearly. The limit of our ability to produce TP FAR... FAAAAR exceeds our ability or desire to buy it. As this applies to more and more products inflation is becoming increasingly ~impossible regardless of how much money we put into circulation.

#moneyisfake

 

[SageBrush]

If this is true, would a homemade mask with several layers of cotton treated with, say, bleach spray or alcohol, provide any sort of increased protection for a quick grocery run?

Bleach sounds like a bad idea and I personally would not 'treat' with anything, but otherwise sure.

 

[shinytop]

Lockdown county by county, surely you jest. My county has 1 confirmed case. I am 7 miles from a county to the west, 35 minutes from a county to the north and 15 minutes from a county to east. The south is the Gulf of Mexico. So those that want to ignore good advice or even lockdowns can drive short distances to break the rules to the heart's content. We need national rules and strict enforcement or we are all whistling in the wind.

 

[EVNow]

Lockdown county by county, surely you jest. My county has 1 confirmed case. I am 7 miles from a county to the west, 35 minutes from a county to the north and 15 minutes from a county to east. The south is the Gulf of Mexico. So those that want to ignore good advice or even lockdowns can drive short distances to break the rules to the heart's content. We need national rules and strict enforcement or we are all whistling in the wind.

If the counties are all together and fairly dense, lock them all down.

In WA for eg, because of the mountains the western and eastern counties can be treated differently.

 

[SageBrush]

US is ramping up with 45m automated tests:

A company in Israel is trying to get approval for a pooled test strategy. It is a simple idea that makes good sense: instead of testing one sample at a time per test, pool multiple samples per test and then testing is continued only for those pooled samples that are positive.

E.g., if the fraction of positive samples in a population is 1/8, then a pool of 8 samples would be negative on average (7/8)^8 ~ 1/3 of the time. Instead of 24 tests to screen 24 samples, no more than 18 tests would be required * The method has the very nifty characteristic of scaling with ever wider testing since the fraction of positive samples will decrease, thus allowing the pool size to grow.

Since these samples are PCR amplified the risk of diluting a positive sample to below detection limits seems unlikely, or another cycle of amplification could be included.

* In practice less than 18 since the same strategy can be applied to the positive pool using smaller pools. E.g. the 8pool+ would be split into two 4pools. Two tests have reduced 8 samples down to ~ four, and of the 24 starting samples, 8 samples remain after 3 tests and 4 samples remain after 4 tests. That example implies ~ 8 tests to screen 24 samples for a 3x increase in throughput.

 

[EVNow]

793 deaths in Italy should be put in context to see the severity of the situation.

Daily avg death is 1,800 - for all causes.

In Lombardy 600 deaths yeasterday compared to ~300 avg from all causes.

So, no, not just like flu.

 

[EVNow]

People will spend it on TP. TP will normalize at $5 a roll.

At least around here stores are rationing. Costco apparently allows one tp case per person. Whole Foods had a bunch of rationing poster I saw yesterday. Also, they are allowing only certain number of people inside the store at a time.

 

[X Fan]

North Carolina may be a state that will need a lockdown in the near future. Charlotte area has jumped above 100 cases.

My sons tell me that in the Triangle people are out in droves (weather nice) with social distancing not being observed.

There is a case now in a Cary, NC (Raleigh-Durham area) nursing home and ONLY TODAY have they enacted a no-visitor policy. After what happened in Washington State & NY (3 96-97-97 yr olds died in a Long Island nursing home) that’s negligent. Florida has had policy in place for weeks.

Some NC beach communities are getting ahead of this and forbidding visitors but.....unfortunately, the Governor of NC is asleep at the switch....

btw: NY State note (young folks take heed): from Gov. Cuomo: "Fifty-five percent of people who have tested positive in New York State are between the ages of 18 and 49".

 

[ZeApelido]

If you take a look at that thermometer website County by county, you start seeing the Bay Area may be ahead en route to stabilizing.

Sport Biomechanics on Twitter

 

[Cherry Wine]

I have a half mask respirator with P100 organic vapor cartridges (which look like the below image). 3M's cleaning/disinfecting guide recommends disposal of cartridges after use. That's not practical in my case since I only have the one pair and I'd like to retain it for critical trips that I deem at high risk of exposure. Anyone experienced with, or care to offer thoughts on, a disinfecting regimen for such a set-up? Of course I would feel absolutely ridiculous going out in such a device...

Here is 3M's guide for anyone curious.

 

[X Fan]

45 minute test now approved: well done!

New test that could detect COVID-19 in about 45 minutes approved by FDA

 

[Johnny Ma]

793 deaths in Italy should be put in context to see the severity of the situation.

Daily avg death is 1,800 - for all causes.

In Lombardy 600 deaths yeasterday compared to ~300 avg from all causes.

So, no, not just like flu.

It's definitely not the flu. The danger from this virus is very real. But you need to stop taking the worst case and trying to make people panic.

The data are awful, but slowly getting better. I am not a physician and in no position to give medical advice. But it is clear that certain populations are more likely to be at risk than others (take action accordingly).

I really wish the mods didn't nuke @KarenRei into self (posting) isolation, because she's been putting out a lot of good data that should be informative to the general TMC poster on how to think about this all.

I have a lot more to say about your post but I'll bite my tongue -- for now.

 

[SageBrush]

I really wish the mods didn't nuke @KarenRei into self (posting) isolation

What happened ?

 

[AlanSubie4Life]

Ah... maybe it was the 2nd case then; IIRC they had a case they couldn't trace back outside the US very soon after and were forced to make the assumption it had been circulating undetected possibly for weeks

Yes - its the second case that they could trace and found out only because of the Seattle Flu study.

Its possible many other states had fatalities in Feb that were never attributed to Covid19. Even recently King county has been testing Feb deaths from LifeCenter and finding Covid19.

Our doctor is pretty sure that my SO and I had it back in late February here in Clark County. We both mostly work from home and haven't gotten out much lately, so we probably picked it up when out shopping or eating sometime in February. In the first week of February we were at the shopping center near the airport. My best guess is we crossed paths with an international traveler who had just come in from China.

I suspect there were vectors into the US from China during that time that didn't take root because the person infected may only have been contagious for a short time, and/or did the smart thing and isolated when they were sick with a mild case. The few people they infected also had mild cases and didn't happen to cross paths with someone very vulnerable.

Nextstrain on Twitter

Here's the phylogenetic tree for Washington State. Only recently (this past week) have cases shown up in WA state (in the sampling that has been done - not nearly every case is sequenced) which are from other locations other than the "Washington Patient 0" case (imports).

So it's reasonable to think that nearly all of the infections in Washington State (to date) are due to that traveler from Wuhan in mid-January who was identified and quarantined and contact-traced (but the virus escaped in spite of those efforts). That virus circulated undetected for a couple weeks. The Flu Study picked it up after a couple weeks, knew it was likely COVID-19, but was not allowed to run a test to confirm it. They finally were allowed to confirm it at the end of February. There was a story in Seattle Times that gives all the details on the timeline; I'm too lazy to look it up right now.

 

[SageBrush]

45 minute test now approved: well done!

New test that could detect COVID-19 in about 45 minutes approved by FDA

Cepheid’s test will only make a small dent in the number of diagnostic tests available for the coronavirus, known as SARS-CoV-2, or the disease it causes, Covid-19. Persing said that Cepheid will produce millions of tests over the next few months. For comparison, Thermo Fisher, another test manufacturer, has said it will be able to produce 5 million tests a week by April. LabCorp can currently conduct 20,000 tests a day, and is increasing capacity further.

But the Cepheid test plays a very different role. Other tests must be brought to a centralized lab, sometimes in a hospital but often in a geographically distant location or at a testing facility such as those owned by Quest Diagnostics and LabCorp. These other tests are run in batches, meaning that all the tests are run at once over a period of hours. That means getting a test result back can take a day — or several days.

It is not a faster test, it is a faster turn-around for a small number of tests at point of care. In terms of epidemic control it is negligible.

 

[Pras]

It is not a faster test, it is a faster turn-around for a small number of tests at point of care. In terms of epidemic control it is negligible.

Still better because individuals can get results sooner. The question is how can they distribute it around individual doctors office.

 

[PhaseWhite]

A company in Israel is trying to get approval for a pooled test strategy. It is a simple idea that makes good sense: instead of testing one sample at a time per test, pool multiple samples per test and then testing is continued only for those pooled samples that are positive.

E.g., if the fraction of positive samples in a population is 1/8, then a pool of 8 samples would be negative on average (7/8)^8 ~ 1/3 of the time. Instead of 24 tests to screen 24 samples, no more than 18 tests would be required * The method has the very nifty characteristic of scaling with ever wider testing since the fraction of positive samples will decrease, thus allowing the pool size to grow.

Since these samples are PCR amplified the risk of diluting a positive sample to below detection limits seems unlikely, or another cycle of amplification could be included.

* In practice less than 18 since the same strategy can be applied to the positive pool using smaller pools. E.g. the 8pool+ would be split into two 4pools. Two tests have reduced 8 samples down to ~ four, and of the 24 starting samples, 8 samples remain after 3 tests and 4 samples remain after 4 tests. That example implies ~ 8 tests to screen 24 samples for a 3x increase in throughput.

Love this idea, it’s essentially a binary search applied to testing and should scale near log(n) of the total test need which would flatten the testing demand curve quite literally.

 

[DanCar]

What happened ?

I was banned for posting U.S. doubling rate info here: Coronavirus The banner claimed my post was histrionics. Not sure why I was unbanned. Here is someone quoting my earlier post that got deleted by a mod: Coronavirus Suspect @KarenRei was banned also because the banner doesn't like the truth.

Been tracking in this spreadsheet: Coronavirus doubling of deaths every x days
Since my initial post on March 7, U.S. deaths have been doubling at a rate of 3.25 days.