Originally Posted by Bwana:
Once again, don't come in this thread with some kind of political agenda, or you will be shown the door. If you want to go that route, there is a thread about this in DC.
Originally Posted by Dartgod:
People, there is a lot of good information in this thread, let's try to keep the petty bickering to a minimum.
We all have varying opinions about the impact of this, the numbers, etc. We will all never agree with each other. But we can all keep it civil.
Thanks!
Click here for the original OP:
Spoiler!
Apparently the CoronaVirus can survive on a inanimate objects, such as door knobs, for 9 days.
California coronavirus case could be first spread within U.S. community, CDC says
By SOUMYA KARLAMANGLA, JACLYN COSGROVE
FEB. 26, 2020 8:04 PM
The Centers for Disease Control and Prevention is investigating what could be the first case of novel coronavirus in the United States involving a patient in California who neither recently traveled out of the country nor was in contact with someone who did.
“At this time, the patient’s exposure is unknown. It’s possible this could be an instance of community spread of COVID-19, which would be the first time this has happened in the United States,” the CDC said in a statement. “Community spread means spread of an illness for which the source of infection is unknown. It’s also possible, however, that the patient may have been exposed to a returned traveler who was infected.”
The individual is a resident of Solano County and is receiving medical care in Sacramento County, according to the state Department of Public Health.
The CDC said the “case was detected through the U.S. public health system — picked up by astute clinicians.”
Officials at UC Davis Medical Center expanded on what the federal agency might have meant by that in an email sent Wednesday, as reported by the Davis Enterprise newspaper.
The patient arrived at UC Davis Medical Center from another hospital Feb. 19 and “had already been intubated, was on a ventilator, and given droplet protection orders because of an undiagnosed and suspected viral condition,” according to an email sent by UC Davis officials that was obtained by the Davis Enterprise.
The staff at UC Davis requested COVID-19 testing by the CDC, but because the patient didn’t fit the CDC’s existing criteria for the virus, a test wasn’t immediately administered, according to the email. The CDC then ordered the test Sunday, and results were announced Wednesday. Hospital administrators reportedly said in the email that despite these issues, there has been minimal exposure at the hospital because of safety protocols they have in place.
A UC Davis Health spokesperson declined Wednesday evening to share the email with The Times.
Since Feb. 2, more than 8,400 returning travelers from China have entered California, according to the state health department. They have been advised to self-quarantine for 14 days and limit interactions with others as much as possible, officials said.
“This is a new virus, and while we are still learning about it, there is a lot we already know,” Dr. Sonia Angell, director of the California Department of Public Health, said in a statement. “We have been anticipating the potential for such a case in the U.S., and given our close familial, social and business relationships with China, it is not unexpected that the first case in the U.S. would be in California.”
It is not clear how the person became infected, but public health workers could not identify any contacts with people who had traveled to China or other areas where the virus is widespread. That raises concern that the virus is spreading in the United States, creating a challenge for public health officials, experts say.
“It’s the first signal that we could be having silent transmission in the community,” said Lawrence Gostin, director of the World Health Organization Collaborating Center on National and Global Health Law. “It probably means there are many more cases out there, and it probably means this individual has infected others, and now it’s a race to try to find out who that person has infected.”
On Tuesday, the CDC offered its most serious warning to date that the United States should expect and prepare for the coronavirus to become a more widespread health issue.
“Ultimately, we expect we will see coronavirus spread in this country,” said Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases. “It’s not so much a question of if, but a question of when.”
According to the CDC’s latest count Wednesday morning, 59 U.S. residents have tested positive for the new strain of coronavirus — 42 of whom are repatriated citizens from a Diamond Princess cruise. That number has grown by two since Messonnier’s last count Tuesday, although the CDC was not immediately available to offer details on the additional cases.
More than 82,000 cases of coronavirus have been reported globally, and more than 2,700 people have died, with the majority in mainland China, the epicenter of the outbreak.
But public health leaders have repeatedly reminded residents that the health risk from the novel coronavirus to the general public remains low.
“While COVID-19 has a high transmission rate, it has a low mortality rate,” the state Department of Public Health said in a statement Wednesday. “From the international data we have, of those who have tested positive for COVID-19, approximately 80% do not exhibit symptoms that would require hospitalization. There have been no confirmed deaths related to COVID-19 in the United States to date.”
CDC officials have also warned that although the virus is likely to spread in U.S. communities, the flu still poses a greater risk.
Gostin said the news of potential silent transmission does not eliminate the possibility of containing the virus in the U.S. and preventing an outbreak.
“There are few enough cases that we should at least try,” he said. “Most of us are not optimistic that that will be successful, but we’re still in the position to try.”
Originally Posted by 'Hamas' Jenkins:
It's not a random sample. It's a sample of one of the hardest hit places on Earth in people who are healthy enough to qualify as blood donors. We don't know the gender split, age range, or underlying demographics of this group at all.
I would assume just being able to donate in that area would be pretty random but without knowing the specifics it’s hard to say [Reply]
Is there a chance the Ro is like 4.5 or 5 and it was just passed along with all the asymptomatic people for a while and we didn’t know what we were actually looking at these past few months? [Reply]
Originally Posted by O.city:
I would assume just being able to donate in that area would be pretty random but without knowing the specifics it’s hard to say
That's not really randomness, though. This is really just a series of case reports. No control groups, no randomization process, very small sample size in the area with the highest density of cases on Earth (over 60 percent of Italy's deaths are in Lombardy). And that's all assuming the data itself is accurate (haven't seen it reported elsewhere). [Reply]
Originally Posted by 'Hamas' Jenkins:
If it's that contagious the growth in hospitalizations would have started sooner, and it's unlikely so many healthcare workers would have fallen ill and died because the mortality rate would be extremely low.
There are a few models that fit the current reality by increasing the R0 and decreasing mortality rates. Regarding healthcare workers, I'm not sure what the actual numbers there are. We hear sensationalized media reports but I really haven't seen any hard numbers. As was pointed out, viral dosage can play a huge role as well. That alone could account for a higher mortality rate among health care workers.
Too many unknowns still, it would be a very good start for us to get random serology testing rolled out.
(and yes the Italian report is not very random at all) [Reply]
Originally Posted by tk13:
This goes right back to the testing discussion. Even if half of America has already had it and is immune right now, we're never going to know. It's a legit issue. People who know they've had it and are now fine are going to act a lot of different than the people who've had it, don't know it and will spend the next 4-5 months behaving like someone who doesn't want to catch it.
how are we supposed to move on without testing? It’s one thing to not know how many people have it right now, who’s died from it before testing began but, we need millions of tests before we can get out of the mitigation phase and at least try to be pro-active and get in front of this virus. Waiting for a cure, vaccine is not an option. [Reply]
Originally Posted by O.city:
Is there a chance the Ro is like 4.5 or 5 and it was just passed along with all the asymptomatic people for a while and we didn’t know what we were actually looking at these past few months?
Highly doubtful if you look at excess deaths in some of the regions of Italy. Bergamo was something like +450%, and many others were +250-280%. Anything that causes deaths to be that much higher than baseline with an average symptomatic onset of a few days and death within 8-14 days would have been causing deaths sooner (and a massive increase in hospitalizations as well).
In addition to R0, there is also the serial interval, which is the measurement of how long it takes someone to transmit the disease to everyone they infect, which is somewhere around 5 days according to a paper in NEJM.
If you have an R of 5 with a serial interval of 5, then after three generations a single person will have infected, on average, 125 people after 15 days and 15625 people after 30 days. That seems...high. [Reply]
Originally Posted by AustinChief:
There are a few models that fit the current reality by increasing the R0 and decreasing mortality rates. Regarding healthcare workers, I'm not sure what the actual numbers there are. We hear sensationalized media reports but I really haven't seen any hard numbers. As was pointed out, viral dosage can play a huge role as well. That alone could account for a higher mortality rate among health care workers.
Too many unknowns still, it would be a very good start for us to get random serology testing rolled out.
(and yes the Italian report is not very random at all)
We don't really know if viral dosage plays a role or not. That's an operating hypothesis, but it's not definitive.
Regarding healthcare workers, over 60 physicians in Italy have died of COVID-19. Of those, about 38% were GPs and would not have been performing intubations or other aerosolizing procedures that would induce a large viral load into the air, which potentially complicates the theory that initial viral load determines your clinical course. [Reply]
Originally Posted by 'Hamas' Jenkins:
If it's that contagious the growth in hospitalizations would have started sooner, and it's unlikely so many healthcare workers would have fallen ill and died because the mortality rate would be extremely low.
I was thinking the same thing but this could partially explain that point away...
Originally Posted by Chief Pagan:
I'm with HJ on this. If that many people already had it and no one noticed, then how do you explain the huge spike in deaths NYC is going through?
Either NYC shouldn't be spiking now or other places should have seen death rates spike.
It would be great news if true but I'm not buying.
I think the bottom line is anyone hoping for some quick miracle fix to this should watch a movie. It is simply going to take time for us to beat this which is why it is so important we practice social distancing so the peak isn't as bad as it could be because there is simply no way to stop this anytime soon we can only slow it down. [Reply]
Originally Posted by PAChiefsGuy:
I think the bottom line is anyone hoping for some quick miracle fix to this should watch a movie. It is simply going to take time for us to beat this which is why it is so important we practice social distancing so the peak isn't really bad because there is simply no way to stop this anytime soon we can only slow it down.
Evidently health care workers and others getting very sick may be due to the amount of virus they’re being exposed to...
It's certainly possible, and honestly likely, but it's not a certainty. The article you referenced makes very good points about higher levels of inoculation leading to worse outcomes, but there are also places where it couches its language around that, avoiding absolutism.
It's an operating hypothesis, but not definitive. [Reply]
Originally Posted by PAChiefsGuy:
I think the bottom line is anyone hoping for some quick miracle fix to this should watch a movie. It is simply going to take time for us to beat this which is why it is so important we practice social distancing so the peak isn't really bad because there is simply no way to stop this anytime soon we can only slow it down.
Hoping this wouldn’t be the solution but agree that half measures aren’t going to accomplish much to solve the long-term issues. [Reply]
Originally Posted by 'Hamas' Jenkins:
It's certainly possible, and honestly likely, but it's not a certainty. The article you referenced makes very good points about higher levels of inoculation leading to worse outcomes, but there are also places where it couches its language around that, avoiding absolutism.
It's an operating hypothesis, but not definitive.
It wouldn’t surprise me if it’s correct, but you’re right that we just don’t know. [Reply]