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 petegz28:
You mean you don't know? After you made 2 assumptions on why I reported was wrong you don't even know what you are referring too, do you? I told you which ones haven't. I think you should be able to figure out which ones had. WOW!
Yes, I go there too. I see the blanks for states, too. What isn't known is if those blanks have been updated today yet or not. This isn't hard. [Reply]
Originally Posted by RINGLEADER:
It took me awhile to finally have this all connect in my head, and I wish someone would have laid it out like this early on to get people to stay inside. We are about to experience something horrible in NYC and the fear is it will be duplicated around the country because some people just aren’t getting it yet. I know this has been said but it isn’t the mortality rate or the groups being impacted or any of that. It’s the fact that hundred then thousands then tens of thousands are going to need hospitalization and there will be no beds or ventilators available:
Let me paint you a bleak picture...
The rate of infection will follow a standard equation governing the spread and other factors called the R-Naught.
Currently, with the exception of Asian countries that are taking draconian steps, we are seeing this doubling occur approximately every 2-3 days.
Currently we have around 5,000 per day in US.
2 days ago it was approximately 2,500.
2 days before that it was approximately 1,250.
It works the other way too - even with the limited social distancing slowing it:
In 4 days from now it will be 10,000.
4 days from then it will be 20,000 (we’re talking next weekend).
And so on.
This is if we did not shelter or develop “herd” immunity.
Herd immunity, as you all know, happens over time as more people are infected, become immune, and come into contact with fewer and fewer susceptible people who haven’t developed immunity.
So the spread will naturally slow over time.
And sheltering in place can slow down the rate of doubling. But this takes time to catch-up in the numbers since it can take a week or longer for the symptoms to manifest in new patients.
Why they are having everyone shelter in place is because 2 out of every 10 cases, on average, will require medical care at a hospital.
And on average 25% of those cases will need ventilators/life support to survive.
We have a limited number of beds and ICUs can be quickly overrun.
We’re seeing this in Italy at the moment.
Here’s where it gets scary:
In two weeks we will have the ICUs in NYC and possibly other major American cities filled.
But the spread of infection will continue to double (again, unless we are successful in sheltering in place and idiots aren’t going to beaches and out to parties) for a period of time before leveling off and hopefully falling.
What happens when the hospitals are full and can take no new patients?
Yet there are now 10,000 20,000 30,000 new infected each day?
And 5% of those require hospitalization to have a good chance to live?
We will have 500, 1,000, 1,500 or more people a day who need ventilators and critical care to deal with pneumonia and other ailments who simply won’t be able to get it.
And we will not have the beds, the equipment, or the staff to treat these sick people.
In Italy, where this is happening right now, people in this most dire group are being told to go home - many to die. Doctors and nurses are being forced to pick who gets a ventilator when one becomes available.
Some beds will become available but since the sick are sometimes on these machines for long periods the turnover isn’t great and capacity is reached quickly.
So unless we slow the rate of infection or the percentage of people who need hospitalization is reduced (which hasn’t happened quickly in other hot spots where the effects of staying home aren’t seen until weeks after it begins) you are going to be facing a reality in weeks where thousands of Americans are dying every day because the health care system is overrun. It will happen suddenly and it will be a shock to many who haven’t realized that this is why we are staying home.
As long as we are going out the spread will continue. Staying at home will slow it. Assembling more beds with more ventilators run by more medical professionals can mitigate it. But given that many of our doctors and nurses have no where near the level of protection that their Chinese counterparts had we are going to see the availability of doctors and nurses reduced as well as they get sick — further magnifying the problem.
The sheltering orders will stunt it, but we are now in a race against time that I fear we have already lost
Few seem to be feeling what is coming right now. Few seem to realize the math that’s involved and that the growing numbers of overall new cases will have around 20% of that total number requiring hospitalization to save their lives. Hospitalization that won’t be available in mere days and weeks in NYC.
Few seem to feel it. In two weeks it will be impossible not to feel it.
Yes. Fucking stay inside as much as possible. People with issues besides corona won't be able to be helped. We need to make sure hospitals, medical buildings are not overrun. Fucking hang out in your front yard, watch Netflix. Listen to health professionals...they need our help and we need them. [Reply]
Originally Posted by Donger:
Yes, I go there too. I see the blanks for states, too. What isn't known is if those blanks have been updated today yet or not. This isn't hard.
Originally Posted by 'Hamas' Jenkins:
Average March temperature in Australia is fairly close to Florida and they have over 1000 cases with an upward trajectory.
Yea I know. It’s really fucking weird. I just can’t think of why else it isn’t spreading down here by now. [Reply]
Originally Posted by Bearcat:
It's actually pretty efficiently run in non-apocolyptic times... granted, I never went to the one in KC.
I got into a spat with Sams club in 2001 and cancelled my membership. I just assumed Costco was the same so I didn’t go there either. Since then I haven’t had a need to buy anything in bulk so I never tried them out. [Reply]
Originally Posted by petegz28:
Until you test 340 mil people, the asymptomatic thing is nothing more than speculation. We cannot let that paralyze us which it will at some point if we keep speculating.
Even testing everyone doesn't really tell you who's had it and recovered already.
We're in such early stages of this we just don't know alot yet. [Reply]
Originally Posted by O.city:
You don't need to test everyone, but doing random testing of asymptomatic people would give you some good data.
I don't disagree but we can't do it. We don't test everyone who has or thinks they have or might have the flu. Yet we estimate millions get it each year. [Reply]
Originally Posted by staylor26:
Yea I know. It’s really fucking weird.
I think it's more a function of introduction and density. We know it was introduced into that nursing home in Washington (a place with at-risk people in a densely populated environment) and that it ravaged it. We can see what is happening in New York. Many countries in the EU are densely populated and it's spreading at exponential rates.
We also can't assume that a lack of symptoms right now means a lack of cases, given a variable incubation period of days to weeks. There is just too little that we know right now, unfortunately.
The only thing I can compare it to is AIDS. By the time the first cases were identified, 250,000 people already had HIV. Although I think the initial response to AIDS was a national failure, there was also no way that it was going to be stopped. Fortunately, HIV was much harder to transmit. Unfortunately, its long latency period meant that people were infected for years while transmitting the virus to others because they were largely asymptomatic. We need to try and learn from that.
Asymptomatic carriers will spread SARS-CoV-2. Even if they aren't affected or a high-risk group, they're a risk to everyone they come in contact with, and because they're asymptomatic, we don't know who they are. That's why we need to limit interaction as much as possible. [Reply]
There is obviously a critical shortage of RTs in the US for this. I know that anesthesiologists and CRNAs can help fill some of that gap, but could an RT working remotely monitor multiple vents at once, giving instructions to lesser-trained healthcare workers (nurse's aids, LPNs) for the appropriate adjustments to serve as a sort of force multiplier?
Possibly......
Doctor says change the vent to "this" number. I'm sure you can show someone how to change that setting relatively easy. Turn a dial or put in a new number in the LED display. That part could obviously be monitored remotely.
but the reason you have RT's running vents and not RN's is the specialty to pick up on something before it sends the patient down a bad path.
One example:
Doctors are busy. They miss the dietitian increased the patients caloric intake. ABG's come back with increased Co2. Doc is not aware of the incresed caloric intake, freaks out and starts ordering "stuff" that will send the patient down a really bad path. But, if you see what the dietitian ordered all we need to do is to increase the frequencies of breaths per minute to blow off the dangerous Co2 created by the increase in calories. I caught that at least once a week. They are already on a vent, Hanging on to life very precariously. Not going to take much to send them into organ failure. That was in "normal" times. In a crisis.... Yikes.
Remote we would not be able to hear breath sounds on the lungs as the vent pushes the air in and out. Sure, nurses and doctors listen to breath sounds but we are the experts. Thats our bread and butter. We can pick up on the smallest change in the lungs before most. How did the breath sounds change after suctioning? Start the intervention going earlier to avoid that bad outcome.
It is a crisis. We would just hope everyone is paying attention to the chart changes, The RN's giving more detailed breath sounds. Ability to communicate with the RN to double check an area of the lungs etc. so I guess in crisis, yes, its doable. [Reply]
Originally Posted by Spott:
I got into a spat with Sams club in 2001 and cancelled my membership. I just assumed Costco was the same so I didn’t go there either. Since then I haven’t had a need to buy anything in bulk so I never tried them out.
Costco is to Sam's Club what Target is to Walmart. You know where you'd rather shop given the option.
It is a big bulk store and you need to be willing to buy large quantities of whatever, but it's well run and their selection on most everything is pretty good. [Reply]
Originally Posted by petegz28:
I am not saying this is the flu so don't go there. But do keep these numbers in mind:
So far this flu season we have had almost 150 pediatric deaths and 16,000 deaths in this country alone.
We are at 277 from Covid-19 in this country so far.
So as the media keeps printing headlines to stir up the most drama and hysteria, please keep this in mind.
Again, I am not saying this is the flu, just trying to provide some perspective of some "other things" going on besides coronavirus.
Originally Posted by petegz28:
I said I wasn't comparing it to the flu. Just focusing on some raw numbers.
If you were just focusing on raw numbers and not comparing it to the flu you simply would have posted CoronaVirus' numbers so get out of here w that crap.
Look there's a reason everything is shut down and it isn't because this Virus is simply the flu. That doesn't mean everyone should panic but it's best to isolate at this time so our hospitals are not overun and this virus doesn't continue to spread. [Reply]
