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Untitled grundle COVID-19 thread

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Untitled grundle COVID-19 thread

Old 03-29-20, 04:51 PM
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Re: Untitled grundle COVID-19 thread

Originally Posted by grundle View Post
I admire your skepticism.

You're right. Elizabeth Holmes was able to attract billions of dollars of investment before it was revealed that she was a con artist.

It's certainly possible that some of these new tests for COVID-19 will be just as bad as Holmes's product.

That being said, I think that the international medical community will be able to reach a consensus as to which tests work and which ones do not, and that this consensus will be reached within in a relatively short period of time. Peer review is a very powerful and beneficial tool.

It's also worth noting that when this all started, the only COVID-19 test that had legal approval for use in the U.S. was the defective test that was developed by the CDC. A special waiver had to be put in place to allow these other, privately developed tests. Without this waiver, there would be no legal way in the U.S. to accurately test for COVID-19.

Which brings us back to ... there already was a test. Why are we reinventing the wheel ... again ... and again ... and again ...?
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Old 03-29-20, 04:54 PM
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Re: Untitled grundle COVID-19 thread

Originally Posted by Decker View Post
Speaking of doing better research, this is Governer Sisolak :
She looks terrible.
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Old 03-29-20, 04:55 PM
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Re: Untitled grundle COVID-19 thread

Originally Posted by Decker View Post
Speaking of doing better research, this is Governer Sisolak :


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Old 03-29-20, 06:40 PM
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Re: Untitled grundle COVID-19 thread

Originally Posted by Abob Teff View Post
Which brings us back to ... there already was a test. Why are we reinventing the wheel ... again ... and again ... and again ...?
The current situation is that there is a shortage of tests. Perhaps these newer test are easier to manufacture.
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Old 03-29-20, 09:10 PM
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Re: Untitled grundle COVID-19 thread

Originally Posted by Abob Teff View Post
I lol'd.
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Old 03-29-20, 10:25 PM
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Re: Untitled grundle COVID-19 thread

Originally Posted by grundle View Post
The current situation is that there is a shortage of tests. Perhaps these newer test are easier to manufacture.

So instead of putting resources into manufacturing known tests that work ... we don’t manufacture anything and instead f—k around with trying to find new proprietary tests we can charge more for.

I know you need bullets for your war, but we are putting our resources into a new patentable bullet. We’ll get back to you when it’s done.

Last edited by Abob Teff; 03-29-20 at 10:36 PM.
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Old 03-30-20, 12:32 AM
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Re: Untitled grundle COVID-19 thread

Originally Posted by Abob Teff View Post
So instead of putting resources into manufacturing known tests that work ... we don’t manufacture anything and instead f—k around with trying to find new proprietary tests we can charge more for.

There's nothing in that article that says the new tests cost more. It does say they are faster.
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Old 03-30-20, 12:44 AM
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Re: Untitled grundle COVID-19 thread

Here's that scientific paper on the success of using hydroxychloroquine to treat COVID-19 patients:

https://www.mediterranee-infection.c...ID-IHU-2-1.pdf

And here's a brand new article which says the FDA has just approved the drug for treatment of COVID-19..

It says there is "scant evidence" that the drug works, but it does not mention the study at the link that I posted.


https://www.politico.com/news/2020/0...ia-drug-155095

FDA issues emergency authorization of anti-malaria drug for coronavirus care

March 29, 2020

The Food and Drug Administration on Sunday issued an emergency use authorization for hydroxychloroquine and chloroquine, decades-old malaria drugs for coronavirus treatment despite scant evidence

The agency allowed for the drugs to be "donated to the Strategic National Stockpile to be distributed and prescribed by doctors to hospitalized teen and adult patients with COVID-19, as appropriate, when a clinical trial is not available or feasible," HHS said in a statement, announcing that Sandoz donated 30 million doses of hydroxychloroquine to the stockpile and Bayer donated 1 million doses of chloroquine.

... part of a larger Trump-backed effort to speed the use of anti-malaria drugs as a potential therapy for a virus that has no proven treatment or cure. FDA already has allowed New York state to test administering the medication to seriously ill patients, and some hospitals have added it to their treatment protocols.

Career scientists have been skeptical of the effort, noting the lack of data on the drug’s efficacy for coronavirus care and worried that it would siphon medication away from patients who need it for other conditions, calling instead for the agency to pursue its usual clinical trials.

Three officials told POLITICO that FDA’s planned move would facilitate more access to the drug by allowing more manufacturers to produce or donate it.

Hydroxychloroquine, which is already available commercially in the United States, is commonly used to treat malaria, lupus and rheumatoid arthritis. The drug also has been touted as a therapy for coronavirus by an unusual assortment of investors, TV correspondents and even some advisers to the White House — including some advocates who overstated their claims and credentials — and been championed by guests on Fox News.

However, a growing number of lupus and arthritis patients have complained that they've been unable to fill their prescriptions amid ongoing shortages, and reports have emerged that some physicians are hoarding the drug for themselves.
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Old 03-30-20, 02:07 AM
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Re: Untitled grundle COVID-19 thread

In the past, the DVD Talk mods have said that I am not allowed to post a link to my blog, but I am allowed to post content that I have written on my blog. These are the results of a poll that I conducted on my blog. The poll itself had the answers listed in alphabetical order. These results from the poll are listed in order by the number of votes.



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Old 03-30-20, 02:51 AM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by grundle View Post
It's possible that most of the U.S. population has already been infected, but hasn't gotten sick, and so hasn't gotten tested.

The death rate is calculated by dividing the number of people who die by the number who are infected. So far they're saying that it's a few percent.

But while we do have accurate information about the numerator, we really have no idea what the denominator is. It's possible that the real denominator is magnitudes bigger than what is being reported, because most infected people have no symptoms, and thus, don't get tested. If this is indeed the case, then it's possible that the real death rate is far, far lower than the few per cent that is being reported.

Iceland tested a large segment of its population, including people with no symptoms, and found that 6.3% of them have COVID-19

The U.S. has 328 million people. If we extrapolate Iceland's test to the U.S., it would suggest that 20 million people in the U.S. have COVID-19. I realize that extrapolating Iceland's test results to the U.S. is not the ideal way to determine the rate of infection in the U.S., but given the absence of this particular type of widespread testing in the U.S., it's probably the most accurate guess that we can make at this point in time.

By comparison, the number of people who tested positive in the U.S. is currently being reported as "only" 142,735.

So, the real denominator may be 140 times bigger than the one that is being reported.

Which, if true, would indicate that the death rate (so far) is more than two magnitudes smaller than what is being reported.


https://fortune.com/2020/03/27/coron...ovid-19-tests/

Why Iceland’s approach to coronavirus testing may be better than America’s

March 27, 2020

In the two months since COVID-19 began its rampage across the world, most countries, including the U.S., have opted to test only those people with active symptoms, telling others to self-isolate if they suspect they are infected with the coronavirus. Based on that approach, more than 480,000 people have tested positive for the virus since it first appeared in Wuhan, China, last December, including more than 68,500 in the U.S.

But what might authorities learn if people were tested randomly instead? Some early clues may be found in the tiny country of Iceland. So far, the country has tested 11,727 people—about 3.2% of its population of 364,000. It has done so in part by enlisting the country’s prized biopharma company deCODE Genetics to help tackle the crisis.

Since March 14 deCODE, a subsidiary of the California biotech giant Amgen, has offered a free coronavirus test to any Icelander, sick or healthy, who simply fills out an online form. DeCODE joined forces this month with Iceland’s public health authorities, which had been screening high-risk or sick people for the coronavirus since early February, weeks before even the first Icelander tested positive for the virus.

By screening healthy as well as sick people, say scientists, Iceland and deCODE have assembled a far more accurate picture of COVID-19. And the results are sobering. “The virus had a much, much wider spread in the community than we would have assumed, based on the screening of high-risk people,” deCODE’s founder and CEO Kári Stefánsson told Fortune by phone from his office in Reykjavík on Wednesday. As of Thursday, 737 have tested positive, or roughly 6.3% of all people tested in the country. Of those, 15 are in hospitals, two of them in intensive care. The rest—many of whom are asymptomatic—have been ordered to self-quarantine.

Stefánsson says the company aims in the end to test about one-third of Iceland’s population—the equivalent of the U.S. testing about 115 million people. He adds that deCODE’s testing has slowed down this week, as the company scrambles to restock its supply of cotton swabs, but will ramp up again within days. “Let’s assume about 3,000 people in the community are infected,” Stefánsson says. The idea, he explains, is to track every case. “To contain the infection for some period of time, we need to screen more, find those individuals, and quarantine them.”

The value of random testing

DeCODE’s model stands in sharp contrast to that of the U.S. and most countries in Europe, where only those who show clear signs of infection have been tested for the coronavirus. “If you don’t have symptoms, you don’t need a test,” Vice President Mike Pence said in a press conference on Sunday. Similar advice comes from the Centers for Disease Control and Prevention, whose website notes, “[N]ot everyone needs to be tested. Most people have mild illness and are able to recover at home.”

Stefánsson, 70, who was a professor of neurology at Harvard University before returning to his homeland to launch his company in 1996, rejects that strategy. He believes it leaves governments unable to understand how to control the spread of the coronavirus, since they have too little data to track its origins.

Until they do random testing, he says, “they do not have the faintest idea of how and why it is spreading in the society,” he says. “It is as simple as that.”

Stefánsson says that when Iceland began testing people in February, it expected to find infections among those who had returned from skiing trips to the Alps during the winter vacation, because an outbreak was then beginning in Italy and France’s Alpine region. Indeed, public health authorities did find infected vacationers. But Iceland also found a cluster of infections among people who had returned from England, as well as one from the U.S.—each of which presented with a separate mutation of the coronavirus. “As of yesterday, we have sequences for about 380 viruses,” Stefánsson says. The company plans to release the data on those mutations in the form of public databases this week.
Amid the fraught debate over self-quarantining, Iceland has remained curiously calm. It has no lockdown laws in place, simply urging people to remain at home if possible. Elementary schools remain open.

Rather than stress self-distancing above all, the focus has been on testing. “All countries should listen to the World Health Organization and follow the example of Iceland when it comes to the mantra ‘Test, test, test,’” former Prime Minister David Gunnlaugsson wrote in Britain’s The Spectator on Tuesday. He called the country’s testing strategy “virtually unparalleled anywhere in the world.”

Of course, Iceland’s minuscule population makes it far easier to test there than in most other countries—including even South Korea, where the swift control of the coronavirus among its 50 million people is credited in large part to the government’s aggressive testing and quarantine strategy. In an email, Iceland’s Health Ministry tells Fortune the country has tested a far higher proportion of its population than South Korea has, “yielding valuable insights into the behavior of the virus.”

DeCODE—and Iceland in general—is in an exceedingly rare position in its ability to analyze its findings on the coronavirus, and perhaps detect what makes some people more susceptible to infection and illness. That could be hugely valuable for scientists as they race to develop treatments and vaccines, and try to stave off any future coronavirus outbreak.

Since launching 24 years ago, deCODE has mapped the DNA of more than half the population of Iceland, “and we can infer data from the other half,” Stefánsson says. “We are in a reasonably good position to begin to explore if the susceptibility to the infection is in part genetically dictated,” he says. As scientists compare the DNA in deCODE’s data banks with the results of Iceland’s random coronavirus testing, the possibilities might begin to emerge.
“We are working on that, trying to generate a set of overlapping data,” Stefánsson says. “I don’t think there is another place where there is data like this.”
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Old 03-30-20, 08:48 AM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by grundle View Post
Iceland tested a large segment of its population, including people with no symptoms, and found that 6.3% of them have COVID-19

The U.S. has 328 million people. If we extrapolate Iceland's test to the U.S., it would suggest that 20 million people in the U.S. have COVID-19. I realize that extrapolating Iceland's test results to the U.S. is not the ideal way to determine the rate of infection in the U.S., but given the absence of this particular type of widespread testing in the U.S., it's probably the most accurate guess that we can make at this point in time.
What leads you to that conclusion? Viral epidemiologists the world over work incredibly hard on modeling these things based on rigorous scientific standards, so I'm curious if you have a source as to why this method is "probably the most accurate guess" or if it's a purely layman's approach.
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Old 03-30-20, 12:29 PM
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Re: Untitled grundle COVID-19 thread

In Iceland, we're gonna have to have the same types of people (culturally speaking), the same age groups in geographic areas, the same female and male percentages, and a lot of other constants that resemble the US.

We can't just go by numbers alone (i.e., a canvass quantitative analysis).
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Old 03-30-20, 01:20 PM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by WallyOPD View Post
What leads you to that conclusion? Viral epidemiologists the world over work incredibly hard on modeling these things based on rigorous scientific standards, so I'm curious if you have a source as to why this method is "probably the most accurate guess" or if it's a purely layman's approach.
Sure they do, and not a single one of them has enough data to do more than guesstimate and every single one of them knows it. I have yet to see anyone offer anything more than a wild guess as to how many people are infected in the United States right now. The only consistent indications are that the official numbers are far too low. No formula, no computer model, no doodling on the back of a cocktail napkin is going to come close to numbers derived from actual testing of a large cross-section of a population as Iceland appears to have just done.

Here is the kind of precision we have been getting from some very bright people:

Marc Lipsitch, head of the Harvard T.H. Chan School of Public Health’s Center for Communicable Disease Dynamics, has been running projections to figure out how many adults across the world will be infected before a vaccine hits the market (one won’t be available for at least a year) or herd immunity kicks in — when enough people have developed immunity to the virus, from having caught it, so that it can’t easily be transmitted any more. He concluded that between 20% and 60% of adults worldwide will ultimately get infected.
The reason estimates like this, or certainly one of the main reasons, are so imprecise is because of how imprecise estimates of how many are currently infected are. Even if you nail down the R0 and find a way to quantitatively measure the salubrious impact of containment measures in place and numerous other factors, you still need a "total infected right now" value to put into the equation.

All that said, comparing us with Iceland is not going to be apples to apples for more than just the reasons DVD Polizei mentioned. Here are two more impactful factors:
  1. Iceland has one of the most urbanized populations in the world (94 percent) with the vast majority living in the capital region. On the other hand, population density even in the heart of Reykjavik is pretty low compared to what we think of as major cities. I've been there twice and it is not a bustling metropolis except for a fairly small area filled with restaurants, smaller hotels and tourists.
  2. Iceland has one of the busiest tourist economies in the world, with 3600+ tourists per year per 1000 inhabitants. Only Monaco, Bahrain and a handful of tropical island destinations are higher. It's also nineteen times higher than the United States.
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Old 03-30-20, 01:31 PM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by jfoobar View Post
Sure they do, and not a single one of them has enough data to do more than guesstimate and every single one of them knows it. I have yet to see anyone offer anything more than a wild guess as to how many people are infected in the United States right now. The only consistent indications are that the official numbers are far too low. No formula, no computer model, no doodling on the back of a cocktail napkin is going to come close to numbers derived from actual testing of a large cross-section of a population as Iceland appears to have just done.
Among the other issues that you and DVD Polizei highlighted, this is another one I'm unsure about. According to the article grundle shared they didn't test a random sample of Iceland's population, they tested anyone who wanted a test and filled out an online form. That's obviously a much broader pool than we're testing for in the US, but the selection bias is going to be strongly weighted toward people who have reason to believe that they may be infected.
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Old 03-30-20, 01:33 PM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by WallyOPD View Post
Among the other issues that you and DVD Polizei highlighted, this is another one I'm unsure about. According to the article grundle shared they didn't test a random sample of Iceland's population, they tested anyone who wanted a test and filled out an online form. That's obviously a much broader pool than we're testing for in the US, but the selection bias is going to be strongly weighted toward people who have reason to believe that they may be infected.
A fair point.
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Old 03-30-20, 03:34 PM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by WallyOPD View Post
What leads you to that conclusion? Viral epidemiologists the world over work incredibly hard on modeling these things based on rigorous scientific standards, so I'm curious if you have a source as to why this method is "probably the most accurate guess" or if it's a purely layman's approach.
Because real world data is more accurate than computer models.

Yes, the real world data is for Iceland, whereas the computer models are for the U.S.

But I have to wonder what the computer models would show if they were applied to Iceland. Would they agree with Iceland's real world data, or not? I'd be curious to see the results of their computer model being applied to Iceland, and to see how it compares to the real world data in Iceland.
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Old 03-30-20, 03:42 PM
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Re: Untitled grundle COVID-19 thread

All of you raise good points.

In my opinion, the U.S. needs to test a truly random sample of the population, which is large enough to be statistically significant. A lot of the national polls that get reported in the media usually involve polling approximately 1,000 people. Of course the bigger the sample size, the smaller the margin of error. I'd like to see such polling done, but instead of asking questions about their opinions, they would conduct a test for COVID-19. I'd be curious to see the results of such a test. In fact, I'm curious to see why such a test has not already been done.
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Old 03-30-20, 03:57 PM
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Re: Untitled grundle COVID-19 thread

This is awesome news. I totally support this. And I'm curious to read about the results.

And yes, I realize that this is one small town, and so the numerical results cannot necessarily be extrapolated to the rest of the country. However, if this allows the shutdowns to be ended in this one town, then perhaps similar results could happen if testing is done in other towns. This could, perhaps, serve as a role model, and perhaps be copied and duplicated all over the country.


https://abcnews.go.com/Health/antibo...ry?id=69856623

Why coronavirus antibody testing in one Colorado town could provide a way forward

Testing in the ski town Telluride could allow for fewer restrictions nationwide.

March 28, 2020

While it might be impossible to figure out who is going to become sick with novel coronavirus, some public health experts believe the more critical question may be who has already been exposed.

In Telluride, Colorado, last week, one biotech company put that idea to work.

United Biomedical is now working with San Miguel County, which includes the famous Rocky Mountain ski destination, to test all 8,000 residents for COVID-19 antibodies -- making it the first community in the country to do widespread antibody testing. The idea, officials said, is to learn from an individual’s blood whether there is evidence the person has already been exposed. With that information, officials can then make decisions about whether quarantines and restrictions would need to continue and whether they need to be as widespread as they are in states and cities across the country right now.

"The goal of this is to show you can predictably get an entire county back to its new normal as quickly as possible by using testing," said Lou Reese, co-CEO of United Biomedical and its COVAXX subsidiary.

Reese stressed that, if successful, the testing program could be expanded, "starting at the hot-spot areas right now to solve this problem, stop the panic and get people to their lives and back to work."

The science behind the testing concept is not complicated. Every person who contracts the coronavirus will develop antibodies in their blood, usually within 10 days, even if the individual has such a mild case that there are no symptoms. Antibodies are proteins that help the body fight off an intruding virus -- but they’re also unmistakable forensic evidence of where the virus has been.

Because it is generally believed that someone who’s had an infection has at least a temporary immunity, a person who already had COVID-19 may not need to remain locked down the way millions of Americans -- in New York, California, Washington state and other places around the country -- are this weekend. What remains unknown is whether the immunity is long-lasting or whether someone who has coronavirus antibodies can continue carrying the virus, potentially posing a threat to others. For instance, people with a MERS infection -- a virus from the same family -- are unlikely to be reinfected shortly after recovery, but according to the CDC, "It is not yet known whether similar immune protection will be observed for patients with COVID-19."

As the coronavirus pandemic rages, killing thousands of its victims and tearing apart families, some political and health care leaders view antibody testing as a way to start reopening cities and allow people to return to work and play.

"This could be a big breakthrough," New York Gov. Andrew Cuomo said of antibody testing during a briefing Saturday.

Reese said it could be a silver bullet.

"Antibody testing specifically is the fastest path of scientifically and mathematically getting to a new normal," Reese said.

Since the Food and Drug Administration announced an Emergency Use Authorization policy for antibody testing last week, laboratories across the U.S. have been rushing to develop their own antibody tests.

United Biomedical initially validated the accuracy of its COVID-19 antibody diagnostic test in China, where the coronavirus pandemic originated late last year.

"We found it was a very clean profile, there was no cross reactivity," said United Biomedical co-CEO Mei Mei Hu. "So when we saw COVID-19, it was COVID-19, and could differentiate between other coronaviruses circulating in the U.S."

Having developed diagnostic tools and vaccines for SARS, another type of coronavirus, Reese and Hu said their team was ready to move fast on coronavirus. They said their company has already deployed approximately 100,000 tests globally, mostly to China and Taiwan.

"Now we are on the front lines," Reese said.

Reese and Hu said they decided to pilot the program in Telluride because it’s home. But they insist that the test can be just as useful in places like New York City, New Orleans and Los Angeles, where officials fear hospitals could be overrun with COVID-19 patients.

San Miguel County, currently under a shelter-at-home order, is not the usual site for a drug trial. But it is the type of place that could be hit extremely hard in a viral outbreak.

"We are a rural community in southwest Colorado with no hospital of our own," said county spokeswoman Susan Lilly. The largest local medical facility, Telluride Medical Center, is not an overnight hospital and would be unable to treat a surge of COVID-19 patients. And, with the county sitting 9,000 feet above sea level, any respiratory contagion could have even more deadly results among residents because humans have a harder time breathing in higher altitudes.

United Biomedical’s testing program began last week, starting with first responders, health care workers, teachers, essential workers and their families. So far, no one has tested positive. Records show one San Miguel resident, who has not yet taken the new antibody test, was confirmed to have COVID-19 by a test that looks for the virus' genetic material, not bloodborne antibodies.

From Telluride, United Biomedical plans to work with officials to expand testing to as many as five states with virus hot spots, like New York and California, on the priority list.

"These are the places that are most likely to have the community spread so it's important to detect, know what the actual outbreak prevalence is and then to categorize the people that have developed some immunity back out," Hu said, adding that the company expects to be producing 1 million tests a day by the end of April.

Officials said they’re optimistic, but caution that an antibody test is only one piece of an overall strategy of dealing with a disease as resilient as COVID-19.

"This blood test is a tool that alone won’t work," Lilly said. "It is a tool that will only work in combination with the stay-at-home model and the social distancing. One without the other doesn’t give us the full capacity to employ a strategy that we think will work."
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Old 03-30-20, 04:17 PM
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Re: Untitled grundle COVID-19 thread

CBS News showed footage from an Italian hospital, but claimed it was from a New York City hospital.


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Old 03-31-20, 07:11 AM
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Re: Untitled grundle COVID-19 thread

I certainly hope that the shutdowns won't end up killing more people than they save.

It's possible that these predictions of increased suicide and drug overdoses due to higher unemployment won't come true. However, the writers do cite statistics from the past to back up their predictions.

https://thefederalist.com/2020/03/30...-of-americans/

How Shutting Down The Economy Much Longer Could Kill Tens Of Thousands Of Americans

It is vitally important, literally life and death, that the proper costs and benefits are weighed with the decision on how much and how long to shut down economic activity through the pandemic.

By Thomas K. Duncan and Audrey Redford

March 30, 2020

As the coronavirus pandemic continues across the world, leaders and policymakers have scrambled to respond to the growing health crisis. In the United States, multiple state governors have issued statements urging their citizens to follow social distancing guidelines.

Other governors have taken more extreme measures, issuing orders to effectively lock down entire state economies. The current goal of these responses has been to slow the spread of the virus in the hope of reducing the strain on the health-care system. Discussion over the proper precautions is a necessity in such a time.

There have been forecasted estimates of virus-related death totals for the United States from as high as 10 million, to 2.2 million, to more conservative estimates of 5,000. The models used to estimate the potential death rates are not without criticism and repeated adjustment. Sampling bias may be a significant problem. These data errors are an important problem to resolve as policymakers use these models to inform their responses.

Lives Depend on Economic Activity

The difference between social distancing and complete economic shutdowns is too dramatic not to be taken seriously. It is imperative that more testing be conducted to provide better access to data, as well as the health benefits that come with knowing who does and does not have the virus. However, as important as it is to get the cost of not shutting down right, it is also important that policymakers properly weigh the cost of the economic shutdowns themselves.

Getting the cost right is not simply a matter of valuing “profits over people,” as the social media memes may suggest. Rather, even in times of crisis, the ability to operate in a functioning economy is important for the people within it.

The economy is the people, and the people are the economy. The ability to continue to function in a market system does matter to individuals within the system, particularly when the ability of business to remain open and continue to employ them is in question.

We have already started to see some of these human effects as the unemployment has quickly rocketed beyond even the early initial projections. A rise in unemployment is correlated with a number of negative socio-economic effects. For some, these effects can be quite deadly, particularly when the changes are rapid, as is currently the case.

The Longer the Shutdown, the More People Will Be Hurt

The economic predictions for the shutdowns may be as varied as those for the virus itself. The Federal Reserve’s James Bullard has noted that unemployment may rise to as much as 30%. Treasury Secretary Steven Mnuchin has estimated a possible unemployment rate of 20%.

Bullard’s number is higher than the unemployment seen in the United States during the Great Depression (25%), and both estimates are significantly higher than the unemployment during the Great Recession (11%). Even if we take the more conservative estimate of 20% unemployment, that is a 16.5% rise in unemployment from its recent historic lows of 3.5% unemployment.

Although it is difficult to estimate how long this downturn may linger, that is a severe shock to the economic system. It is possible that people return to work and economic activity returns in strength in short order after the shutdowns are lifted.

Even then, the costs of shutting down will have been quite large. However, it is also possible that some businesses who had to pause activity for a month or more may not be able to return at all. The recession could be longer than some economists are projecting. If the economy does linger in its downturn, the human costs to the shutdown will inevitably begin to increase.

Possibly 28,797 More Deaths from Opioids

A 2017 National Bureau of Economic Research paper finds a 3.6% increase in the opioid death rate per 100,000 people for a 1% rise in unemployment. There were 14.6 opioid death rates per 100,000 in the United States in 2018. If we use the more conservative estimate of a 20% unemployment rate without a quick return to lower levels, then there would be an estimated 59.4% rise in deaths per 100,000, leading to an increase of 8.7 deaths for a total of 23.3 for opioids.

With a current U.S. population of 331 million, there are 3,310 groups of 100,000, meaning there is potential for an additional 28,797 deaths from opioids annually. Consider that for 2018, the Centers for Disease Control reports that there were 67,367 deaths from all-drug deaths, with 46,802 of those coming from opioid use. The 46,802 deaths were considered an opioid crisis. A possible 75,599 should not be dismissed quickly.

The negative effects will not be felt just through opioid use either. The numerical increase in deaths provided above is only for opioid users, but the all-drug death number will rise as well. In a 2018 study, Bruguera, et al, found that of the 180 drug users they surveyed about use during the Great Recession, 58.3% reported an increase in use while only 25.6% reported decreasing use, resulting in greater all-drug use for the period.

Similarly, Mulia, et al, (2014) connects a rise in alcoholism to economic loss during the Great Recession. The CDC estimates that 2,200 people die in the United States just from alcohol poisoning annually, not to mention the additional alcohol-related deaths that occur. In 2017 alone, there were also 22,246 deaths resulting from alcoholic liver disease. As the jobless rate increases and the economic losses continue to mount, these numbers are likely to rise.

Unemployment Increases Suicide, Homicide

The deaths related to economic downturns go beyond those from chemical dependency, also. The mental toll is not inconsequential. For example, Blakely, et al, (2003) find that being unemployed may also increase the risk of suicide two to threefold. Milner, et al. (2014) similarly finds that unemployment is associated with a higher relative risk of suicide, with prior mental health issues being a key factor in that association. While a study by Kerr, et al, (2018) did not find that unemployment is directly linked to suicides, it did find a significant link between poverty, suicide, and alcoholism.

When breaking the population into age groups, Lin and Chen (2018) do find that unemployment does have a direct impact on older portions of the population, the portion of the population many of the current shutdowns are most meant to protect. Whether it is the direct unemployment effect or the potential poverty produced from the economic shutdown that leads to greater suicides, an increase from the 48,344 suicides and 1,400,000 suicide attempts in the United States in 2018 should give decision-makers pause during their response to this pandemic.

Increased harm to oneself is not the only harm caused by economic downturns. There is also the threat of rising crime in general. Ajimotokin, et al, (2015) estimate that a 1 percent change in unemployment will increase the property crime rate by 71.1 per 100,000 people and the violent crime rate by 31.9 per 100,000 people.

With our estimated 16.5% rise in unemployment, we could see a significant increase in both property and violent crimes. The violent crime also may add to the death toll in this period. Kposowa and Johnson (2016) find that unemployed workers are more than 50% more likely to become homicide victims than those who are employed. They also find people not in the labor force are 1.3 times more likely to be victims than those who are employed. As workers become discouraged due to an inability to find jobs during a recession, their lives as well as their livelihoods are called into question.

The future during such a pandemic is largely uncertain, and misinformation is rampant in the current panic. Policymakers face tough decisions as they navigate the issues of data collection, virus transmission, and economic ramifications of doing too little or too much. It is vitally important, literally life and death, that the proper costs and benefits are weighed with the decision on how much and how long to shut down economic activity through the pandemic.

This article originally appeared from the American Institutes for Economic Research and is reprinted with permission, with slight alterations to implement AP style plus an editor-chosen title and subheds, as is the industry norm.

Thomas K. Duncan, Ph.D., is an associate professor of economics at Radford University. He received his Ph.D. from George Mason University. Audrey Redford is the assistant professor of economics at Western Carolina University. She earned her Ph.D. in agricultural and applied economics from Texas Tech University.
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Old 04-01-20, 06:12 AM
  #196  
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Re: Untitled grundle COVID-19 thread

I'm just not believing China’s claims regarding the lock-down, and other nations that initially followed the WHO’s guidelines based on their claims.

This was pointed out during yesterday's task force briefing during the Q and A on 3-31 (starts at 1:27 and goes to 1:32)


“The medical community interpreted the data from China that this was much more like SARS because you had 50k out of 80 million” - Dr Birx
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Old 04-01-20, 11:27 AM
  #197  
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Re: Untitled grundle COVID-19 thread

Originally Posted by grundle View Post
I certainly hope that the shutdowns won't end up killing more people than they save.

It's possible that these predictions of increased suicide and drug overdoses due to higher unemployment won't come true. However, the writers do cite statistics from the past to back up their predictions.
What else are people going to do if they are unemployed, and can't pay bills. They literally have nothing to lose. I would hope the US government sees this being very real, coming around the corner to a community near everyone if we aren't up and running in less than a month. 30 days of this same shit is going to break the back of the economy in the US. And not getting a stimulus check for another 3 weeks, is just a joke. Not to mention how many will be stealing mail now, thinking they can forge a check.

We will have more suicides, more crimes across all types (from property crimes on up to murder), and probably more stock shortages at stores only this time, people will be taking what they need...not paying for it. All this because at every government level from city to state to national...there's no consensus on how to deal with varying degrees of cities who are at risk and those who are not. For those that are not at risk we MUST keep businesses open.

The amount of ineptness at all levels from everyone, is staggering. I've never seen such passive irresponsibility and just plain being afraid to do anything for fear of being called for being "too extreme" or "not extreme enough".
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Old 04-01-20, 02:02 PM
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Re: Untitled grundle COVID-19 thread

This is from the New England Journal of Medicine. The bolding is mine:


https://www.nejm.org/doi/full/10.105...OjcWd2Li-xXZHs

Covid-19 — Navigating the Uncharted

List of authors. Anthony S. Fauci, M.D., H. Clifford Lane, M.D., and Robert R. Redfield, M.D.

March 26, 2020

N Engl J Med 2020; 382:1268-1269

DOI: 10.1056/NEJMe2002387

The latest threat to global health is the ongoing outbreak of the respiratory disease that was recently given the name Coronavirus Disease 2019 (Covid-19). Covid-19 was recognized in December 2019.1 It was rapidly shown to be caused by a novel coronavirus that is structurally related to the virus that causes severe acute respiratory syndrome (SARS). As in two preceding instances of emergence of coronavirus disease in the past 18 years2 — SARS (2002 and 2003) and Middle East respiratory syndrome (MERS) (2012 to the present) — the Covid-19 outbreak has posed critical challenges for the public health, research, and medical communities.

In their Journal article, Li and colleagues3 provide a detailed clinical and epidemiologic description of the first 425 cases reported in the epicenter of the outbreak: the city of Wuhan in Hubei province, China. Although this information is critical in informing the appropriate response to this outbreak, as the authors point out, the study faces the limitation associated with reporting in real time the evolution of an emerging pathogen in its earliest stages. Nonetheless, a degree of clarity is emerging from this report. The median age of the patients was 59 years, with higher morbidity and mortality among the elderly and among those with coexisting conditions (similar to the situation with influenza); 56% of the patients were male. Of note, there were no cases in children younger than 15 years of age. Either children are less likely to become infected, which would have important epidemiologic implications, or their symptoms were so mild that their infection escaped detection, which has implications for the size of the denominator of total community infections.

On the basis of a case definition requiring a diagnosis of pneumonia, the currently reported case fatality rate is approximately 2%.4 In another article in the Journal, Guan et al.5 report mortality of 1.4% among 1099 patients with laboratory-confirmed Covid-19; these patients had a wide spectrum of disease severity. If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.2

The efficiency of transmission for any respiratory virus has important implications for containment and mitigation strategies. The current study indicates an estimated basic reproduction number (R0) of 2.2, which means that, on average, each infected person spreads the infection to an additional two persons. As the authors note, until this number falls below 1.0, it is likely that the outbreak will continue to spread. Recent reports of high titers of virus in the oropharynx early in the course of disease arouse concern about increased infectivity during the period of minimal symptoms.6,7

China, the United States, and several other countries have instituted temporary restrictions on travel with an eye toward slowing the spread of this new disease within China and throughout the rest of the world. The United States has seen a dramatic reduction in the number of travelers from China, especially from Hubei province. At least on a temporary basis, such restrictions may have helped slow the spread of the virus: whereas 78,191 laboratory-confirmed cases had been identified in China as of February 26, 2020, a total of 2918 cases had been confirmed in 37 other countries or territories.4 As of February 26, 2020, there had been 14 cases detected in the United States involving travel to China or close contacts with travelers, 3 cases among U.S. citizens repatriated from China, and 42 cases among U.S. passengers repatriated from a cruise ship where the infection had spread.8 However, given the efficiency of transmission as indicated in the current report, we should be prepared for Covid-19 to gain a foothold throughout the world, including in the United States. Community spread in the United States could require a shift from containment to mitigation strategies such as social distancing in order to reduce transmission. Such strategies could include isolating ill persons (including voluntary isolation at home), school closures, and telecommuting where possible.9

A robust research effort is currently under way to develop a vaccine against Covid-19.10 We anticipate that the first candidates will enter phase 1 trials by early spring. Therapy currently consists of supportive care while a variety of investigational approaches are being explored.11 Among these are the antiviral medication lopinavir–ritonavir, interferon-1β, the RNA polymerase inhibitor remdesivir, chloroquine, and a variety of traditional Chinese medicine products.11 Once available, intravenous hyperimmune globulin from recovered persons and monoclonal antibodies may be attractive candidates to study in early intervention. Critical to moving the field forward, even in the context of an outbreak, is ensuring that investigational products are evaluated in scientifically and ethically sound studies.12

Every outbreak provides an opportunity to gain important information, some of which is associated with a limited window of opportunity. For example, Li et al. report a mean interval of 9.1 to 12.5 days between the onset of illness and hospitalization. This finding of a delay in the progression to serious disease may be telling us something important about the pathogenesis of this new virus and may provide a unique window of opportunity for intervention. Achieving a better understanding of the pathogenesis of this disease will be invaluable in navigating our responses in this uncharted arena. Furthermore, genomic studies could delineate host factors that predispose persons to acquisition of infection and disease progression.

The Covid-19 outbreak is a stark reminder of the ongoing challenge of emerging and reemerging infectious pathogens and the need for constant surveillance, prompt diagnosis, and robust research to understand the basic biology of new organisms and our susceptibilities to them, as well as to develop effective countermeasures.

Disclosure forms provided by the authors are available with the full text of this editorial at NEJM.org.

This editorial was published on February 28, 2020, at NEJM.org.

Author Affiliations

From the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD (A.S.F., H.C.L.); and the Centers for Disease Control and Prevention, Atlanta (R.R.R.).
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Old 04-01-20, 02:10 PM
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Re: Untitled grundle COVID-19 thread

You need to at least bold the whole sentence and the sentence before it for context there, grundle
If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.
The fatality rate might be considerably less than 1% IF the number of total cases is several times higher than the reported rate. The case fatality rate is much closer to a normal flu pandemic than it is to SARS or MERS which had a fatality rate much, much higher (but killed people so fast that they really couldn't spread it much).
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Old 04-01-20, 02:13 PM
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Re: Untitled grundle COVID-19 thread

Originally Posted by grundle View Post
There's nothing in that article that says the new tests cost more. It does say they are faster.

I’m not talking about higher costs ... I’m talking about any costs.

Abob’s Labs (insert any real manufacturer there) can’t charge you for tests provided by WHO ... we can charge for the tests we quickly pushed through R&D and then made, though.
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