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 BigRedChief:
they have a plan to set up field hospitals. Use hotel rooms, high school gyms etc. for the overflow. They have huge generators and O2 generating machines in reserve. Or at least they did when I served on the emergency board in KC.
I'm not doubting you, but god damn you have literally seen/done it all. [Reply]
Originally Posted by suzzer99:
From what I've read - most of the critical people need respirators, which is the biggest bottleneck. Setting up new beds ICU in a tent or whatever isn't that hard.
If you get this in the US you may be a lot better off getting it now vs. in a month from now.
if you wait until the existing system is swamped, people will die waiting for ventilators to breathe for them until the virus runs its course. [Reply]
Originally Posted by suzzer99:
From what I've read - most of the critical people need respirators, which is the biggest bottleneck. Setting up new beds ICU in a tent or whatever isn't that hard.
If you get this in the US you may be a lot better off getting it now vs. in a month from now.
Or in a month this thing may have peaked and we might be heading in a good direction. We don't know. [Reply]
Originally Posted by : Singapore Wins Praise For Its COVID-19 Strategy. The U.S. Does Not
Hong Kong and Singapore were hit early with the coronavirus. But each now has fewer than 200 cases, while France, Germany and Spain, which were hit late, all have more than 10 times that number.
Three weeks ago, Italy had only three cases. Now it has more than 10,000.
These dramatic differences show that how governments respond to this virus matters, says Mike Ryan, the World Health Organization's head of emergencies.
"Hope is not a strategy," says Ryan, who is an epidemiologist. "We are still very much in the up cycle of this epidemic."
The veteran of numerous global health crises, from SARS to bird flu to Ebola, Ryan points out that incredibly aggressive measures by China, South Korea and Japan appear to be bringing outbreaks in those countries under control.
"There's clearly an indication that a systematic government-led approach using all tactics and all elements available seems to be able to turn this disease around," he says.
He has been pleading with governments around the world to prepare for the new coronavirus before it shows up at their door — or to spring into action when it does arrive.
That's what Hong Kong and Singapore did.
Both quickly set up systems to try to identify and treat every case in their territory. Hong Kong developed diagnostic tests and rapidly deployed them to labs at every major hospital in the city. At one point in February, Hong Kong had 12,000 people in quarantine. Singapore's prime minister called for calm and assured residents that all health care related to the disease would be free.
Both Hong Kong and Singapore continue to find a few new cases each week, but they've avoided the explosive outbreaks that have occurred elsewhere.
Ashish Jha, who runs the Harvard Global Health Institute, says the response to the coronavirus has varied dramatically around the world. "Some countries have been very aggressive and have actually done quite a good job," he says. "Other countries have been quite lackadaisical and, I think, have suffered immensely from it. And I think there are lessons to be learned for all of us."
Italy and Iran both fall in the latter category. Jha says that before cases of COVID-19 were first diagnosed, Italy and Iran appeared to be in denial about the disease.
"I mean, you had the Iran deputy health minister coughing on national television talking about coronavirus," Jha says. "But really not taking it seriously."
That deputy health minister later tested positive for the virus.
As people started to get sick, neither Italy nor Iran did much testing. They were slow to stop mass gatherings. Eventually both countries were overwhelmed with cases.
So how has the United States' response been?
"Our response is much, much worse than almost any other country that's been affected," Jha says.
He uses the words "stunning," "fiasco" and "mind-blowing" to describe how bad it is.
"And I don't understand it," he says incredulously. "I still don't understand why we don't have extensive testing. Vietnam! Vietnam has tested more people than America has." (He's citing data from earlier this week. The U.S. has since started testing more widely, although exact figures still aren't available at a national level.)
The Centers for Disease Control and Prevention started screening overseas travelers for coronavirus in mid-January. But the initial test kits developed by the CDC were flawed, and it took weeks to sort out the problems. It's only this week that wide-scale testing has started to become available in the United States.
Jha believes that the weekslong delay in deploying tests — at a time when numerous other tests were available around the world — has completely hampered the U.S. response to this crisis.
"Without testing, you have no idea how extensive the infection is. You can't isolate people. You can't do anything," he says. "And so then we're left with a completely different set of choices. We have to shut schools, events and everything down, because that's the only tool available to us until we get testing back up. It's been stunning to me how bad the federal response has been."
He says right now there are probably five to 10 times as many cases out in the community as have actually been detected. Until these individuals are found, they are likely to infect more people, he says, and the outbreak in the United States is just going to continue to grow.
Hong Kong, which began testing in January and has been right up against the epicenter of the global outbreak, had only confirmed 126 cases through March 10. On that same day the U.S. reported twice that number for the previous 24 hours.
Originally Posted by RockChalk:
I'm not doubting you, but god damn you have literally seen/done it all.
I worked at Truman Medical center. At the time it was the only level one trauma center in the area. They wanted an expert Respiratory Therapist on the board. I was the only one who volunteered since you wouldn’t get paid for attending meetings. [Reply]
Originally Posted by Monticore:
My big problem is the more people tell me to not touch my face but more I want to, it's the whole penis thing all over again.
Originally Posted by Beef Supreme:
So who runs these new remote testing locations? Are medical professionals just sitting around on their asses with nothing to do right now? It seems like it would require more manpower to just add testing stations, not just to administer the tests but to build the damn testing stations.
I really don't see how the "government can make a difference" here. "Just activate the emergency protocols?" Yeah, I'm not buying it.
This is the issue.
Italy has been asking retired doctors to unretire.
Keep in mind most healthcare providers cannot run a ventilator [Reply]
The latest research shows the genome of the new virus is 96% identical to a coronavirus found in bats, making them the most likely source – as was the case with SARS. It is not yet clear how the virus made its way into the human population. Zhong Nanshan, head of a National Health Commission expert panel and a member of the Chinese Academy of Sciences, has suggested bamboo rats or badgers may have been an intermediate host. Research published on 7 February by the South China Agricultural University claims that pangolins – one of the most trafficked mammals in Asia – could also be a link. There is as yet no definitive conclusion, but close contact between humans and an intermediate host would have allowed the virus to jump the species barrier.
A price list from the Huanan market, circulated online, shows that prior to its closure on 31 December, meat from animals such as the bamboo rat and civet cat were openly on sale. The civet cat is believed to have been the intermediate host in the SARS epidemic.
Bushmeat is an important part of the cuisine of the mountainous south-east of China. Consuming wild animal meat to improve health is also connected to traditional Chinese medicine. But this tradition has been taken to extremes, with beliefs that the meat of animals with certain characteristics, such as strength, will boost that characteristic in the consumer, and that the “wilder” an animal is the more health benefits it provides. Civet cats are the most prized of all. [Reply]
Since that NPR article was oh so helpful outlining what Singapore did, here's one that explains what they did three days after transmission was recognized in country.
I think I've asked this in the thread before, but never got an answer. Maybe someone can answer now.
If the outbreak is so bad in the US. And we're so far in the shadows about the actual number of the population that have the virus, why aren't healthcare facilities already overrun? Why aren't old people dying at alarming rates all over the country due to people visiting with the virus like they did in Washington? Forget the testing - how would someone miss all of these obvious signs?
Could it be because it isn't being spread everywhere at an alarming rate? [Reply]
Originally Posted by SupDock:
This is the issue.
Italy has been asking retired doctors to unretire.
Keep in mind most healthcare providers cannot run a ventilator
Our hospital doesn't even have 1 ventilator, 80 bed hospital mostly chronic care, retirement community, with 2 referral Hospitals who currently are running over capacity, once we start getting hit (only 1 positive) in the area we are fucked. [Reply]
Originally Posted by TLO:
I think I've asked this in the thread before, but never got an answer. Maybe someone can answer now.
If the outbreak is so bad in the US. And we're so far in the shadows about the actual number of the population that have the virus, why aren't healthcare facilities already overrun? Why aren't old people dying at alarming rates all over the country due to people visiting with the virus like they did in Washington? Forget the testing - how would someone miss all of these obvious signs?
Could it be because it isn't being spread everywhere at an alarming rate?
Most likely it isn't widespread yet, or if it is, the fatality rate isn't as high as we expect.
It's possible that there were cases not initially identified as Covid-19 as well. [Reply]
Originally Posted by TLO:
I think I've asked this in the thread before, but never got an answer. Maybe someone can answer now.
If the outbreak is so bad in the US. And we're so far in the shadows about the actual number of the population that have the virus, why aren't healthcare facilities already overrun? Why aren't old people dying at alarming rates all over the country due to people visiting with the virus like they did in Washington? Forget the testing - how would someone miss all of these obvious signs?
Could it be because it isn't being spread everywhere at an alarming rate?
The median incubation period was estimated to be 5.1 days (95% CI, 4.5 to 5.8 days), and 97.5% of those who develop symptoms will do so within 11.5 days (CI, 8.2 to 15.6 days) of infection. These estimates imply that, under conservative assumptions, 101 out of every 10 000 cases (99th percentile, 482) will develop symptoms after 14 days of active monitoring or quarantine. [Reply]