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:
There are some peculiar things in their data sets.
Those started on azithromycin alone were quite a bit sicker on average. Those started on hydroxychloroquine were healthier on average.
More people on hydroxychloroquine were admitted to the ICU, where mortality is highest, yet overall mortality was substantially lower than those who took neither hydroxychloroquine or azithromycin. Those on hydroxychloroquine or hydroxychloroquine + azithromycin spent more time on a vent, where mortality is again increased, and more were on a vent overall.
But here's the real difference:
Those on hyroxychloroquine were given steroids 78.9% of the time. Those on both hydroxychloroquine and azithromycin were given steroids 74.3% of the time. Those on neither hydroxychloroquine nor azithromycin were given steroids 35.7% of the time.
Given what we know about the dexamethasone trials, that is your likely culprit for decreased mortality.
What mechanism is at play if, all things being equal, XYZ drug is administered as aprophylactic in a confirmed non-infected person and administered as soon as a person is confirmed infected if XYZ has no effect as a prophylactic but does have an effect as a treatment? [Reply]
Thread on that new HCQ study. I'd add that these two results are red flags. White race was an independent predictor of mortality (1.7-2.1x the risk), and BMI ≥ 30 had a protective effect (0.62-0.96x the risk). That is not what anyone else's data shows. https://t.co/q4KIfEF8IDpic.twitter.com/egmwIJMmwT
Originally Posted by Discuss Thrower:
What mechanism is at play if, all things being equal, XYZ drug is administered as aprophylactic in a confirmed non-infected person and administered as soon as a person is confirmed infected if XYZ has no effect as a prophylactic but does have an effect as a treatment?
Depends entirely upon the pathophysiology of the disease in question, the mechanism of the drug, and how one defines "infected".
Take something like HIV. There are multiple stages in the viral life cycle, many of which provide specific targets for therapy.
There are drugs you can use for pre-exposure prophylaxis (PrEP), post-exposure prophylaxis, and treatment. Once you are past the stage of acute infection where viral reservoirs are established in places like memory cells and the DNA of T-cells, dendrites, etc, you can only treat for the remainder of the patient's life, but outside of a bone marrow transplant for someone with two alleles of the CCR5 delta 32 mutation, you aren't going to eliminate the virus.
AZT has a 30+ year history of efficacy in preventing transmission from mother to child, but is only effective for treatment of seropositive individuals when used in combination with other agents.
In the case of COVID, if you had a therapeutic that could prevent fusion of the viral spike to the ACE2 receptor, you might be able to prevent enough replication in the initial phases to prevent the virus from establishing a foothold within the body. However, past a certain phase, that same therapeutic may not have equal efficacy, because drugs are not always evenly distributed in all tissues and fluids of the body--the blood brain barrier being the best example, but there are several others (you don't want to use an antibiotic that has poor concentration in the urine in treating a UTI).
In contrast, the proposed beneficial mechanism for steroids is reduction in cytokine storm and acute inflammation as part of the disease process. Their use will not help with infection (and use over a week will cause both adrenal and immune suppression), but they can lessen the damaging sequelae of the disease. [Reply]
That looks like cherry-picked data missing clear matching examples and with the wrong inputs.
CFR and IFR should be used if analyzing the protective effect of Vitamin D, not deaths/million, because a country with no infections and a prevalence of Vitamin D deficiency will have far better numbers than a country with infections and no Vitamin D deficiency.
If you are going to include Norway and Finland, why not include Sweden, where the deaths/million are 10x greater, especially given their other similarities? [Reply]
If anyone has some time to look at an article, (Hamas) I'd like to know what your opinion is on this. I don't give a shit about the hydroxycloriquine part. I think their "risk factors" seem wonky.
Originally Posted by 'Hamas' Jenkins:
Depends entirely upon the pathophysiology of the disease in question, the mechanism of the drug, and how one defines "infected".
Take something like HIV. There are multiple stages in the viral life cycle, many of which provide specific targets for therapy.
There are drugs you can use for pre-exposure prophylaxis (PrEP), post-exposure prophylaxis, and treatment. Once you are past the stage of acute infection where viral reservoirs are established in places like memory cells and the DNA of T-cells, dendrites, etc, you can only treat for the remainder of the patient's life, but outside of a bone marrow transplant for someone with two alleles of the CCR5 delta 32 mutation, you aren't going to eliminate the virus.
AZT has a 30+ year history of efficacy in preventing transmission from mother to child, but is only effective for treatment of seropositive individuals when used in combination with other agents.
In the case of COVID, if you had a therapeutic that could prevent fusion of the viral spike to the ACE2 receptor, you might be able to prevent enough replication in the initial phases to prevent the virus from establishing a foothold within the body. However, past a certain phase, that same therapeutic may not have equal efficacy, because drugs are not always evenly distributed in all tissues and fluids of the body--the blood brain barrier being the best example, but there are several others (you don't want to use an antibiotic that has poor concentration in the urine in treating a UTI).
In contrast, the proposed beneficial mechanism for steroids is reduction in cytokine storm and acute inflammation as part of the disease process. Their use will not help with infection (and use over a week will cause both adrenal and immune suppression), but they can lessen the damaging sequelae of the disease.
Thanks. Makes sense with whatever biology lessons I've received over the years. [Reply]
