OT: Coronavirus

Tony Romo Predicts This Warehouse Debacle

TURN SOUND ON 🔈🔈 pic.twitter.com/yZPa2oUYRZ

— Frank Caliendo (@FrankCaliendo) April 21, 2020

I assume at some point they'll get this testing better, but as of April???

FDA warns against use of unproven COVID-19 antibody tests
The U.S. Food and Drug Administration (FDA) recommends that health care providers continue to use serological tests intended to detect antibodies to SARS-CoV-2 to help identify people who may have been exposed to the SARS-CoV-2 virus or have recovered from the COVID-19 infection. Health care providers should also be aware of the limitations of these tests and the risks to patients and the community if the test results are used as the sole basis to diagnose COVID-19.The FDA is not aware of an antibody test that has been validated for diagnosis of SARS-CoV-2 infection. While the FDA remains open to receiving submissions for these tests for such uses, based on the underlying scientific principles of antibody tests, the FDA does not expect that an antibody test can be shown to definitively diagnose or exclude SARS-CoV-2 infection
https://www.fda.gov/medical-devices/letters-health-care-providers/important-information-use-serological-antibody-tests-covid-19-letter-health-care-providers?utm_campaign=FDA%20MedWatch%20Use%20of%20Serological%20%28Antibody%29%20Tests%20for%20COVID-19&utm_medium=email&utm_source=Eloqua

The above is a popular meme making the rounds...It can certainly get nit-picked, but I thought interesting how these are occurring around the same time, every century or close to it...

• Beginning in 1720, an outbreak of bubonic plague in Marseille, France (known as The Great Plague of Marseille) killed an estimated 100,000 people in that city and surrounding provinces and towns. However, that particular outbreak was far from the first, last, or most severe instance of bubonic plague in history. In particular, the Black Death — a bubonic plague epidemic that hit Eurasia in the 14th century — is estimated to have killed 30% to 60% of Europe’s human population (up to 50 million people), primarily from 1347 to 1351.

• The first of several cholera pandemics recorded in modern history spread from India to Southeast Asia, the Middle East, Europe, and Eastern Africa in the early 19th century. However, that pandemic did not begin in 1820. It persisted from 1817 until 1824, and six more cholera pandemics were charted over the following 150 years.

• The so-called “Spanish flu” or 1918 flu pandemic (influenza caused by an H1N1 virus) spread in the early 20th century, killing upwards of 50 million people worldwide. (Despite the name, most modern scholarship suggests the pandemic did not actually originate in Spain.) Once again, although that pandemic did encompass the year 1920, it began much earlier, continuing roughly from January 1918 to December 1920.

• The COVID-19 coronavirus disease outbreak that made this image of interest in 2020 was initially reported at the end of 2019, but it was not officially characterized as a pandemic by the World Health Organization until March 2020.

https://apnews.com/a5077c7227b8eb8b0dc23423c0bbe2b2

@"RS Express" said: https://apnews.com/a5077c7227b8eb8b0dc23423c0bbe2b2

386 is a still a relatively small sample size and VA hospital patients are representative of what I'm not sure. 

But its a reminder that this med could have harmful effects and supports doing the research right and rapidly with a large, controlled sample size.

I think there are larger, controlled,  more representative tests underway by US Dr's and researchers that should be definitive. Not sure the FDA will approve this for Covid-19 treatment until that testing is done in our borders?"

An association of increased overall mortality was identified in patients treated with hydroxychloroquine alone. These findings highlight the importance of awaiting the results of ongoing prospective, randomized, controlled studies before widespread adoption of these drugs," wrote the authors, who work at the Columbia VA Health Care System in South Carolina, the University of South Carolina and the University of Virginia. 

This stuff is blowing up in my county. These aren't huge numbers but this is a rural community. The biggest town in the county is only 2,800 people. Everybody is related to everybody.

Population of my county is like 22,000 and we've gone from 0 confirmed cases to 101 in 11 days.  No deaths yet probably because it hasn't had time to finish them off. 

2 coworkers in the cafeteria tested positive so now I have to get tested as well. At least I haven't been around them since Saturday.

@"purplefaithful" said:

@"RS Express" said: https://apnews.com/a5077c7227b8eb8b0dc23423c0bbe2b2

Yah, I saw that too.

386 is a still a relatively small sample size and VA hospital patients are representative of what I'm not sure. 

But its a reminder that this med could have harmful effects and supports doing the research right and rapidly with a large, controlled sample size.

I think there are larger, controlled,  more representative tests underway by US Dr's and researchers that should be definitive. Not sure the FDA will approve this for Covid-19 treatment until that testing is done in our borders?"

An association of increased overall mortality was identified in patients treated with hydroxychloroquine alone. These findings highlight the importance of awaiting the results of ongoing prospective, randomized, controlled studies before widespread adoption of these drugs," wrote the authors, who work at the Columbia VA Health Care System in South Carolina, the University of South Carolina and the University of Virginia. 

Researchers also looked at whether taking hydroxychloroquine or a combination of hydroxychloroquine and the antibiotic azithromycin, had an effect on whether a patient needed to go on a ventilator. 

"In this study, we found no evidence that use of hydroxychloroquine, either with or without azithromycin, reduced the risk of mechanical ventilation in patients hospitalized with Covid-19," the authors wrote. 

There are currently no products approved by the US Food and Drug Administration to prevent or treat Covid-19, although research is underway on many drugs.

This is from a co-worker that tested positive:
Words from the IDPH. The organization that is supposed to care about our health, is also the same organization that is telling my fiancé that he can go back to work tomorrow.... as a CNA... at a NURSING HOME!!!
Because the “health care workers are exceptions to the Health department’s rules”
“As long as he doesn’t have a fever, he’s fine” (even though I never had a temp over 99.7)
Even though he is a household contact with a positive COVID-19 case (me) and my symptoms aren’t gone, and the health department recommended he stayed in quarantine.
Is the state really protecting the vulnerable? The at risk? Shouldn’t health care workers be isolated LONGER, not shorter? Especially when they’re around ELDERLY PEOPLE!
The symptoms, the regulations, the “numbers” and predictions have been contradicting this whole time.

@"Hidalgo" said: This is from a co-worker that tested positive: Words from the IDPH. The organization that is supposed to care about our health, is also the same organization that is telling my fiancé that he can go back to work tomorrow.... as a CNA... at a NURSING HOME!!! Because the “health care workers are exceptions to the Health department’s rules” “As long as he doesn’t have a fever, he’s fine” (even though I never had a temp over 99.7) Even though he is a household contact with a positive COVID-19 case (me) and my symptoms aren’t gone, and the health department recommended he stayed in quarantine. Is the state really protecting the vulnerable? The at risk? Shouldn’t health care workers be isolated LONGER, not shorter? Especially when they’re around ELDERLY PEOPLE! The symptoms, the regulations, the “numbers” and predictions have been contradicting this whole time.

. 

@"Hidalgo" said: This is from a co-worker that tested positive: Words from the IDPH. The organization that is supposed to care about our health, is also the same organization that is telling my fiancé that he can go back to work tomorrow.... as a CNA... at a NURSING HOME!!! Because the “health care workers are exceptions to the Health department’s rules” “As long as he doesn’t have a fever, he’s fine” (even though I never had a temp over 99.7) Even though he is a household contact with a positive COVID-19 case (me) and my symptoms aren’t gone, and the health department recommended he stayed in quarantine. Is the state really protecting the vulnerable? The at risk? Shouldn’t health care workers be isolated LONGER, not shorter? Especially when they’re around ELDERLY PEOPLE! The symptoms, the regulations, the “numbers” and predictions have been contradicting this whole time.

Yeah, Gov. Reynolds seems to be out of her league, but then she always has seemed that way to me.  I read she is now getting pressured to reduce the restrictions soon, there is a story in the paper today.  

@"Hidalgo" said: This is from a co-worker that tested positive: Words from the IDPH. The organization that is supposed to care about our health, is also the same organization that is telling my fiancé that he can go back to work tomorrow.... as a CNA... at a NURSING HOME!!! Because the “health care workers are exceptions to the Health department’s rules” “As long as he doesn’t have a fever, he’s fine” (even though I never had a temp over 99.7) Even though he is a household contact with a positive COVID-19 case (me) and my symptoms aren’t gone, and the health department recommended he stayed in quarantine. Is the state really protecting the vulnerable? The at risk? Shouldn’t health care workers be isolated LONGER, not shorter? Especially when they’re around ELDERLY PEOPLE! The symptoms, the regulations, the “numbers” and predictions have been contradicting this whole time.

@"bigbone62" said:

@"Hidalgo" said: This is from a co-worker that tested positive: Words from the IDPH. The organization that is supposed to care about our health, is also the same organization that is telling my fiancé that he can go back to work tomorrow.... as a CNA... at a NURSING HOME!!! Because the “health care workers are exceptions to the Health department’s rules” “As long as he doesn’t have a fever, he’s fine” (even though I never had a temp over 99.7) Even though he is a household contact with a positive COVID-19 case (me) and my symptoms aren’t gone, and the health department recommended he stayed in quarantine. Is the state really protecting the vulnerable? The at risk? Shouldn’t health care workers be isolated LONGER, not shorter? Especially when they’re around ELDERLY PEOPLE! The symptoms, the regulations, the “numbers” and predictions have been contradicting this whole time.

If healthcare workers were not the exceptions to these rules far more than just people who catch COVID-19 would be dying off. If everyone of my co-workers or myself stayed home and quarantined because we were exposed to someone with it there wouldn't be anyone running the hospitals or clinics.  Company policy dictates a specific department reaches out to employees to inform them they have been exposed to someone with COVID-19. People now send those calls direct to VM and delete messages without listening because there isn't enough time to do the job and waste time talking to HR.

A VERY GOOD interview with Michael Osterholm Infectious Disease Expert. This is just a part of it (link below)
=============================

@"JimmyinSD" said:

@"bigbone62" said:

@"Hidalgo" said: This is from a co-worker that tested positive: Words from the IDPH. The organization that is supposed to care about our health, is also the same organization that is telling my fiancé that he can go back to work tomorrow.... as a CNA... at a NURSING HOME!!! Because the “health care workers are exceptions to the Health department’s rules” “As long as he doesn’t have a fever, he’s fine” (even though I never had a temp over 99.7) Even though he is a household contact with a positive COVID-19 case (me) and my symptoms aren’t gone, and the health department recommended he stayed in quarantine. Is the state really protecting the vulnerable? The at risk? Shouldn’t health care workers be isolated LONGER, not shorter? Especially when they’re around ELDERLY PEOPLE! The symptoms, the regulations, the “numbers” and predictions have been contradicting this whole time.

If healthcare workers were not the exceptions to these rules far more than just people who catch COVID-19 would be dying off. If everyone of my co-workers or myself stayed home and quarantined because we were exposed to someone with it there wouldn't be anyone running the hospitals or clinics.  Company policy dictates a specific department reaches out to employees to inform them they have been exposed to someone with COVID-19. People now send those calls direct to VM and delete messages without listening because there isn't enough time to do the job and waste time talking to HR.

valid point,   I would wonder if nursing home workers should be the exception though.  most all NHs have been on lock down for a while now and have taken extreme precautions to keep their employees clear and their inmates safe (I cant remember what people that live there are called)  I can see in hospital or clinical settings telling the staff to keep coming to work as long as they are able because that is where everybody is pretty much exposed,  but I would still think staff at dedicated nursing homes would be self reporting and be told to quarantine if they know they have been exposed.

@"purplefaithful" said: A VERY GOOD interview with Michael Osterholm Infectious Disease Expert. This is just a part of it (link below)

=============================

BERGEN: What should that long-term strategy look like?

OSTERHOLM: The first step is to acknowledge the need for a long-term strategy. We're so focused on "the here and now" of this issue -- the idea of just getting over this wave and flattening this curve. And I agree with that. It's an immediate issue, particularly if you are in one of the places that's on fire right now like New York, Detroit, Chicago, New Orleans. But people have handled these local hot spots almost like they were faced with a hurricane that has now made landfall. Now we can get into remediation and recovery from this first round of crisis. 

So, the first thing we need is a plan. That's critical.

The second thing we need to address is: What is our long-term strategy? I believe we have really two choices at the edges and some additional options in between. One choice is to try to lock down our society and economy like Wuhan did. Most of us understand that adopting that approach means we're not only destroying the economy but also destroying society as we know it.

The other alternative is to let viral transmission go willy-nilly until it burns through the population. I am strongly against that approach for two reasons. First, that would mean we could potentially experience millions of deaths just in the United States. It would bring down our health care system as we know it; it would mean severely compromised care for Covid-19 patients and fewer care options for anyone else with other serious health issue such as a heart attack, acute asthma attack, cancer or an injury from an accident. So, that is not a viable alternative.

There's got to be an approach in the middle. I call it "threading the rope through the needle," where we open our economy and everyday life in a way that is capable of rapidly detecting the emergence of new waves of infection. Then we do whatever we can again with physical distancing to limit the new infection's spread.

By the way, I find the term "social distancing" unfortunate. It is physical distancing that we need in order to stop the virus transmission.

Let's never social distance. Let's try in our modern age of the Internet, to do a better job with staying social.So how do we get the younger, otherwise healthy demographic back to work, a group we know will be at much lower risk of serious disease and death if they get infected? How do we bring a substantial number of these individuals back into society and at the same time try to protect those who have the highest risk of a severe outcome?

 Remember we have to get them through the next 16 to 20 months, or until we get a safe and effective vaccine. 

For those who are vulnerable, it is imperative that we minimize the risk of infection and the likelihood of ending up in a hospital and dying. And please know this approach will never be perfect; some younger people will get sick and even die. But the rate of serious illness and deaths will be many times lower for the young than for older individuals or those with underlying health risk factors. 

Our strategy can't be the outcomes of day-to-day press conferences. It can't be 30-day plans to "social" or "physically" distance. It's got to address how we're going to incorporate day-to-day prevention actions, and what we ask the public to do must be realistic. 

For example, everybody wants to do widescale coronavirus testing today. Talking heads without any experience in testing declare, "We'll test millions of people each week, and then we'll know who is infected and can follow up." Very few people realize that the testing community in this country can't do that. We don't have adequate international manufacturing capacity and supply chains for reagents, the chemicals needed to run these tests.

The reagent capability -- meaning securing those chemicals that are key for running many of these tests, whether you're testing for virus or antibody -- before the pandemic was more or less, adequately supported by a "garden hose of production." Then Covid-19 came along and the Asian countries, specifically China, demanded a major increase in reagent supplies.

No matter how you slice it, on the most basic back-of-the-envelope estimate, this is a really bad situation.

Finally, the whole world caught the pandemic, and now there are billions of people who need to be tested. We need a firehose to meet that demand but we can't build reagent manufacturing facilities overnight. I urge that whatever we do going forward has to be based on reality. We're not going to test your way out of this thing when we don't have tests. 

I paraphrase a quote from former US Secretary of Defense (Donald) Rumsfeld who said, "When you go to war, you don't get to go with what you want. You have to go with what you have." 

So, we're going to have this reagent issue for some time to come, and we must understand that and come up with a plan based on reality. 

Entire Interview Here:
https://www.cnn.com/2020/04/21/opinions/bergen-osterholm-interview-two-opinion/index.html

1. Controlled reopening of economy with a plan in place for rapid responses and re-closures of the micro breakouts (like in Sioux Falls or similar situations)
2. Law of average testing,  the tests need to be done randomly and use math to calculate out from there the potential for any given area or demographic.
3. Most imporantly,  this thing isnt going away until an anti virus is discovered, developed, and mass distributed,  we are going to live with this thing for at a minimum of another 12 months and most likely more.  Start to return to life but a new normal must be established to maintain the safe spacing and other practices we are currently doing.