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*** OFFICIAL *** COVID-19 CoronaVirus Thread. Fresh epidemic fears as child pneumonia cases surge in Europe after China outbreak. NOW in USA (20 Viewers)

cap'n grunge said:
Dang. Other articles I've read say no need to do this. We haven't been. What a PITA. Not sure if I will.
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I do think the odds are very low of getting infected from groceries.

However, groceries and mail/packages are pretty much the only "contact" I physically have right now with items that were recently handled by someone who could have the virus.

To me, it's worth the small amount of extra effort to try to prevent getting infected from one of those items, even though the risk is likely small.

 
[scooter] said:
Or.....just quarantine the groceries for 24-72 hours (depending on whether they're encased in cardboard or plastic).
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Good point... that's my first choice for any groceries that don't need to be refrigerated, or any mail/packages that can wait a few days before being opened.

 
gianmarco said:
Actually, that's not even what he said. He said he only wears it during an interaction that would aersolize the virus. He didn't clarify what that is, but I can for you:

1. Intubation -- Inserting a breathing tube to help them breathe and get them on a ventilator

2. CPR/code, which often involves number 1 if they aren't intubated already.

3. Endoscopy/bronchoscopy 

4. Nebulized medications administration like albuterol. We've actually switched to given albuterol mostly with inhalers however there is a shortage of them (prior to COVID, fwiw).

That's pretty much it. Those procedures don't happen often for a single patient. A critical care doctor like him might be doing 5-10 intubations/day with this going on (maybe even more), but the rest of the time, even direct contact isn't what he was describing.

Just talking to a patient or examining a patient is not what he was describing as needing an N95 mask. Now, if someone comes into the ER or gets transferred to the ICU, if they are really sick, he may start wearing it due to the anticipation of possibly having to emergently perform one of those procedures, but that's it.

Hope that clarifies.
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I think you’re a nurse, correct?  Just an FYI: some have argued NP swabs used for COVID diagnostics are aerosol-generating. High flow oxygen, noninvasive ventilation and induced sputum collection too.

 
Watched my Connecticut governor's briefing today.  Saw a video where a CT doctor has come up with a way to allow 7 patients per ventilator.  Would be huge if it works.

 
gianmarco said:
@Terminalxylem

Came across this and it's an interesting/plausible theory.  Thought you might be interested in reading through it.
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Holy crap, that is circuitous and highly fueled by anecdotal, unreferenced data. He mentions a lot of stuff I've heard and read about Covid-19, and quite a bit I've never seen.

His basic hypothesis of endothelial dysfunction being the common pathway of severe Covid disease is interesting. But ED is kinda a research buzzword; like oxidative stress and mitochondrial dysfunction, it's postulated to cause/be involved in just about every disease state. I looked up his bio on Pubmed, and see he has a few publications, but is in no way a world authority on the topic. The drugs he's advocating aren't without risk, especially anticoagulants and thrombolytics. And he mentions ACE inhibitors multiple times, though there is no clear data suggesting they are helpful or harmful. FWIW ARBS are getting more attention as potentially therapeutic, though that is also a very controversial topic.

In summary, it's an interesting read. He clearly has an advanced knowledge of biochemistry/physiology and has put some thought into plausible mechanisms for many Covid findings. But there is nothing clinically actionable based on his premise, at least until a LOT more research is done.

 
The Captain said:
Personally, if you are not wearing a mask when you are at the grocery store or anywhere public you are taking a risk that just not may be worth it in the end. We still don’t know enough a about this virus. Why take the chance? 
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I was out grocery shopping here in Denmark yday, three different stores in two different municipalities. Did not see one mask. Closest I got to any human was about 6 ft, in the check out lane

 
I’m a government employee also, and I heard the same rumor yesterday. I didn’t post it because it’s probably the fifth or sixth time I’ve heard it in the past two weeks. Wake me when it happens :yawn:

 
With 1 MM cases worldwide, hopefully we have more data on the contagion pathways. Have there been any instances of someone catching covid-19 via:

- grocery store packaging?

- walking outdoors without broaching 20 feet of another human?

I'd be curious if anyone comes across anything.  Seems like we are in an escalation of prevention measures without a lot of data to back this up - if there is data, I'd be curious in seeing it. 

 
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Terminalxylem said:
I think you’re a nurse, correct?  Just an FYI: some have argued NP swabs used for COVID diagnostics are aerosol-generating. High flow oxygen, noninvasive ventilation and induced sputum collection too.
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Terminalxylem said:
Holy crap, that is circuitous and highly fueled by anecdotal, unreferenced data. He mentions a lot of stuff I've heard and read about Covid-19, and quite a bit I've never seen.

His basic hypothesis of endothelial dysfunction being the common pathway of severe Covid disease is interesting. But ED is kinda a research buzzword; like oxidative stress and mitochondrial dysfunction, it's postulated to cause/be involved in just about every disease state. I looked up his bio on Pubmed, and see he has a few publications, but is in no way a world authority on the topic. The drugs he's advocating aren't without risk, especially anticoagulants and thrombolytics. And he mentions ACE inhibitors multiple times, though there is no clear data suggesting they are helpful or harmful. FWIW ARBS are getting more attention as potentially therapeutic, though that is also a very controversial topic.

In summary, it's an interesting read. He clearly has an advanced knowledge of biochemistry/physiology and has put some thought into plausible mechanisms for many Covid findings. But there is nothing clinically actionable based on his premise, at least until a LOT more research is done.
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No, not a nurse. You can add things like laparoscopic procedures and even suctioning, but I was listing things that he was more than likely to actually partake in, not the full list of procedures. I should have clarified that.

As for the read, I wasn't sharing that with you to see if it could be applied clinically. But you clearly have a good handle on biochemical mechanisms and pathways and thought you'd be interested in some of the proposed mechanisms of the pathophysiology of COVID he was theorizing. 

 
mr roboto said:
Judge Smails said:
OMG. I’m in Eden Prairie office often. Can’t imagine taking summer away for those folks who have been hunkered down for the winter. Rough 
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I live in EP. If summer is shut down Minnesotans will riot. It’s all we have here
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I imagine most places in the twin cities will be closing their pools and beaches. My kids are small so we can buy a small Inflatable pool for the backyard, but lots of people can't. Looks like we'll also be buying/building a swing set since most of the parks nearby are closed. 

 
BobbyLayne said:
“Every State will look like New York; it’s just that right now our curve is ahead of other states curves. We have cases in all 62 counties, and that includes rural areas with no cities. Every suburb will look like Westchester County & Nassau County. Every city will see their hospital systems stressed as they go up toward the apex of the curve. In many ways we are a microcosm of the country with respect to spread.”
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I've been seeing this in my line of work. Seems like the coasts took the first hit, probably because of more international travel landing in LA/NY than say Akron, OH. What I'm seeing is this is like a wave and it's heading West from NY. Detroit fittin' to blow up and I imagine Chicago won't be far behind.

mr roboto said:
I live in EP. If summer is shut down Minnesotans will riot. It’s all we have here. 
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Luckily summer is about 2 months so while tough, I think you guys can tough it out. Starts to snow what? Around August up there?

I keed, I keed. Love me some MN, you are good people up there. Hope it lightens up before then, not being able to enjoy the land of lakes would suck.

 
Lowly Clerk said:
No idea what Utah is doing. Stay safe stay home. Most of the state is just moving along. We reopened the golf courses in Salt Lake County. I think we are on our own. 
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I gotta be honest; golf is one of those activities that should theoretically ok to leave open if the people playing it would be responsible and take careful measures (one per cart, don't pull the flag, don't congregate).   Unfortunately, in my experience, I'm not confident the folks playing golf would be the ones to be extra careful there.  My Dad is in his low 80s and really needs golf in the Spring/Summer/Fall for his mental health.  But, I'm awfully uneasy the old farts at the course would do the right things. :doh:

 
Even if these "my friend works for the government and I trust her - national lockdown is coming in 72 hours" turns out to be true. Why the hell would we have to rush to the grocery store? Every quarantine we have seen allows for food runs. For, you know, millions would die if they didn't allow that. 

 
Sooo... 

I think we have tens of millions of cases in the US at this point. 

Ive been closely following this model since mid February and it's been extremely accurate on deaths, with US fatalities only recently accelerating from ~1 day lag to ~1 day ahead. 

The only curious part about that model is it showed massive infection numbers that would presumably be hard to hide. Unless, as some studies show, truly asymptomatic cases are prevalent (~30-50%)... which some studies are starting to confirm.

Now we have THIS STUDY which hypothesizes we had 10MM cases as of 2 weeks ago. If that's the case we could be looking at ~15-20% of the US population being infected at this point.

What does that mean? Good news would be confirmation that many folks are completely asymptomatic, we may be further down the line toward herd immunity than expected, and fatality rate is significantly lower than we thought.

Downside would be that the risk of catching it, if you're not already infected, is much higher as you're likely surrounded by infected people when you're out. 

Very interesting read. I look forward to results of Widespread antibody testing Down the road to confirm/debunk this. 

 
I was trying to find a resource to look at daily growth rate by U.S. state and came across this resource.  91-DIVOC. Pretty nice graphics that help visualize which states are doing better than others on containment. 

 
[icon] said:
Sooo... 

I think we have tens of millions of cases in the US at this point. 

Ive been closely following this model since mid February and it's been extremely accurate on deaths, with US fatalities only recently accelerating from ~1 day lag to ~1 day ahead. 

The only curious part about that model is it showed massive infection numbers that would presumably be hard to hide. Unless, as some studies show, truly asymptomatic cases are prevalent (~30-50%)... which some studies are starting to confirm.

Now we have THIS STUDY which hypothesizes we had 10MM cases as of 2 weeks ago. If that's the case we could be looking at ~15-20% of the US population being infected at this point.

What does that mean? Good news would be confirmation that many folks are completely asymptomatic, we may be further down the line toward herd immunity than expected, and fatality rate is significantly lower than we thought.

Downside would be that the risk of catching it, if you're not already infected, is much higher as you're likely surrounded by infected people when you're out. 

Very interesting read. I look forward to results of Widespread antibody testing Down the road to confirm/debunk this. 
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I really don’t think that many cases are asymptotic. Everything I have read is that very small percentage is and that most people do develop system. 
 

I do think rate of infection much much higher then reported but not as high as that model. This is especially true in NYC. I know numerous people showing symptons but they aren’t getting tested and are told to just stay at home unless have serious shortness of breath. 

 
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[icon] said:
Sooo... 

I think we have tens of millions of cases in the US at this point. 

Ive been closely following this model since mid February and it's been extremely accurate on deaths, with US fatalities only recently accelerating from ~1 day lag to ~1 day ahead. 

The only curious part about that model is it showed massive infection numbers that would presumably be hard to hide. Unless, as some studies show, truly asymptomatic cases are prevalent (~30-50%)... which some studies are starting to confirm.

Now we have THIS STUDY which hypothesizes we had 10MM cases as of 2 weeks ago. If that's the case we could be looking at ~15-20% of the US population being infected at this point.

What does that mean? Good news would be confirmation that many folks are completely asymptomatic, we may be further down the line toward herd immunity than expected, and fatality rate is significantly lower than we thought.

Downside would be that the risk of catching it, if you're not already infected, is much higher as you're likely surrounded by infected people when you're out. 

Very interesting read. I look forward to results of Widespread antibody testing Down the road to confirm/debunk this. 
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If it’s true we’ve had 24M infected and only 5k deaths than we are in way better shape than any of us figure. Obviously some of those infected could still turn to death but likely not a large %

He or she still has that number doubling every 3-4 days though which I can’t imagine at this point. That’s my problem with those numbers. 

 
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gianmarco said:
No, not a nurse. You can add things like laparoscopic procedures and even suctioning, but I was listing things that he was more than likely to actually partake in, not the full list of procedures. I should have clarified that.

As for the read, I wasn't sharing that with you to see if it could be applied clinically. But you clearly have a good handle on biochemical mechanisms and pathways and thought you'd be interested in some of the proposed mechanisms of the pathophysiology of COVID he was theorizing. 
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I wasn’t trying to be critical, but wanted to add a couple common things many C-19 patient undergo during hospitalization which produce aerosols. 
 

The GI guy’s thoughts were definitely interesting. Early in my career I did translational research, but now I’m purely clinical, so I’m biased to always think how basic science is applicable to practice.

 
[icon] said:
Sooo... 

I think we have tens of millions of cases in the US at this point. 

Ive been closely following this model since mid February and it's been extremely accurate on deaths, with US fatalities only recently accelerating from ~1 day lag to ~1 day ahead. 

The only curious part about that model is it showed massive infection numbers that would presumably be hard to hide. Unless, as some studies show, truly asymptomatic cases are prevalent (~30-50%)... which some studies are starting to confirm.

Now we have THIS STUDY which hypothesizes we had 10MM cases as of 2 weeks ago. If that's the case we could be looking at ~15-20% of the US population being infected at this point.

What does that mean? Good news would be confirmation that many folks are completely asymptomatic, we may be further down the line toward herd immunity than expected, and fatality rate is significantly lower than we thought.

Downside would be that the risk of catching it, if you're not already infected, is much higher as you're likely surrounded by infected people when you're out. 

Very interesting read. I look forward to results of Widespread antibody testing Down the road to confirm/debunk this. 
Click to expand...
That model assumes no behavior changes correct?

Regarding the study, they are looking at doctor visits.  I have two issues with that.  First off, people are much more likely to go to the doctor when there's a global pandemic.  I don't know if this is a nationwide phenomena, but our spring allergy season is about two weeks ahead of schedule.  If the study is correct, then this really is just a highly contagious version of the flu and our measures in place won't stop it.

 
Brony said:
With 1 MM cases worldwide, hopefully we have more data on the contagion pathways. Have there been any instances of someone catching covid-19 via:

- grocery store packaging?

- walking outdoors without broaching 20 feet of another human?

I'd be curious if anyone comes across anything.  Seems like we are in an escalation of prevention measures without a lot of data to back this up - if there is data, I'd be curious in seeing it. 
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I think it would be near impossible to tell either way. We come in indirect contact with so many people that is near impossible to tell exactly where one gets it. Its obviously easier to identify if 20 people were at a specific gathering together. 

 
Redwes25 said:
I really don’t think that many cases are asymptotic. Everything I have read is that very small percentage is and that most people do develop system. 
 

I do think rate of infection much much higher then reported but not as high as that model. This is especially true in NYC. I know numerous people showing symptons but they aren’t getting tested and are told to just stay at home unless have serious shortness of breath. 
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What is discouraging is that people can put the time into developing models and theories like @icon is sharing and I doubt we'll ever sort out the aftermath to figure out how many people actually had it.  It's ashamed because without that information it will be hard to learn lessons for the next time.

 
Olaf said:
True. In her defense, I think she was trying to say go now before the official statement so the grocery stores aren’t sold out or are chaos from a pre-quarantine run. But ambiguously worded texts are yet another reason to not trust women or Harris.
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The stores here have nothing, you have to get in early and get lucky to get some items. Wife went to Sam's yesterday and they had no meat and the freezer section of the store was empty. Interesting thought about was now that everyone is home and everything is shut down, people are cooking a lot more meals at home hence no meat available.

I don't think a stay at home order is going to move the needle in our area, might be different elsewhere.

 
BassNBrew said:
What is discouraging is that people can put the time into developing models and theories like @icon is sharing and I doubt we'll ever sort out the aftermath to figure out how many people actually had it.  It's ashamed because without that information it will be hard to learn lessons for the next time.
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Hoping wide scale antibody testing will provide true better case:infection numbers down the road. Will be really interesting to see. This is all fascinating. 

 
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