COVID-19 Update - 04/05/2020

My own workup | 04/05/2020 | DoughtyOne

[DoughtyOne]

Gotcha...

Makes me angry.

[GOP Poet]

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[familyop]

That’s a good summary and good information. You might also find this interesting from a FReeper who is a retired epidemiologist: good information for personal planning.

https://www.freerepublic.com/focus/f-news/3831814/posts?page=233#233

Also, the people most vulnerable might be those with diabetes, including the many who are diabetic and unaware of it (overweight, obese). Maybe that’s why we’ve see more young people and women more severely affected in the States than in some of the other countries.

COVID-19 Disease: ORF8 and Surface Glycoprotein Inhibit Heme
Metabolism by Binding to Porphyrin
https://s3-eu-west-1.amazonaws.com/itempdf74155353254prod/11938173/COVID-19_Disease__ORF8_and_Surface_Glycoprotein_Inhibit_Heme_Metabolism_by_Binding_to_Porphyrin_v2.pdf

[MayflowerMadam]

“The CDC screwed up on testing”? What does that mean? “

I don’t know for sure, but a couple things reported were (if I understood correctly): (1) They had a test that they put out too early that turned out to be “bad”, so had to recall it and start over; and (2) CDC “forbade” other entities besides themselves to research, invent, and distribute tests.

I could be totally wrong, and I guess there are articles from a month or so ago that go in to more detail.

[wastoute]

If you go back you can find where I posted, it seems like a month ago now. “The thing that strikes me is this ‘first guy’, the doctor who initially recognized this as new, unique, and urgent did so on the basis of his experience with 4 patients. He was ‘impressed’. Which immediately brought to my mind how impressed I was by my first malaria patient.”

These patients were obviously “Seriously ill” patients who were rapidly decompensating and deteriorating passed any salvation.

Although I am not seeing patients any longer and have no direct, “first hand”, personal observations it sound like this is what the ER docs and ICU docs are seeing. Patients who are just transitioning from the “worst part” of “mildly ill” are suddenly deteriorating over a course of hours into very stiff lung ventilated patients that are very difficult to manage.

From what I am hearing this is what it sounds like to me.

[familyop]

The enormous testing effort wasn’t done early enough, because there were operations problems (bad test kits for one). But it is happening now. And no, there aren’t so many positives in the population beyond what’s been found.

Look at the number of positive cases compared to the large number tested here. Those many negatives were traced from positive cases they had contact with.

https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/results.php

That was also explained here by someone qualified to do so.

https://www.freerepublic.com/focus/f-news/3831814/posts?page=233#233

Some of my neighbors have also been quarantined because of contacts with positives, been tested and found to be negatives.

[Presbyterian Reporter]

On Wednesday April 1 I began tracking the number of ‘serious, critical’ cases being reported in the USA.

These are the people who may likely die in the next few days. If the ‘serious, critical’ number goes up, we will likely see more deaths. On the other hand if the various drugs being tested are effective in treating the virus, the ‘serious, critical’ number should go down.

Here are the numbers:

Apr 1 Wed 5005
Apr 2 Thu 5421
Apr 3 Fri 5787
Apr 4 Sat 8206

I will update the numbers each day on your posting so you do not have to.

[Jim Noble]

Thanks for the great work you are doing with the numbers.

Just to clear some of the fog around testing: HOW MANY TESTS we have done compared to another country is meaningless.

We do not even have the ability to test rapidly when the diagnosis is in question, which leads to overconsumption of ICU negative pressure rooms and critically short supplies of PPE.

But that’s not the problem.

The problem is our failure to find and to isolate all the presymptomatic infections, and to isolate THEM to prevent the explosive spread we are seeing now. Countries that have stayed ahead of the curve and stayed in business (Taiwan, South Korea, Hong Kong) have tested huge fractions of their populations and intervened on spreaders before they got to third and fourth generation spread.

Take little New Hampshire, which has around 500 cases this morning. We do not know how many infections not yet showing symptoms those 500 people have caused. We don’t know where those presumably thousand or so asymptomatic spreaders live, where they go, what they do, or how many people they infect before they themselves develop symptoms.

NH has geographic and demographic advantages not present in NY NJ CT or Massachusetts. We have socially minded people sitting at home sewing masks for their local hospitals and making do with their stockpiled food. Everybody is more polite than normal, nicer than normal. Children in local communities are writing letters to our hospitals to thank us,

The only thing we don’t have is what we need, which is information to stop the 2-10 people getting infected today from each infected person without symptoms.

Leaders saying “we have tested more people than any other country” are saying something meaningless. If we had done 50 million tests by March 5 we might have gotten ahead of this thing. Now, we won’t, and it’s not because of the advisory panel, its because of FDA resistance, and I would not be surprised if that resistance had a political motivation.

[ballplayer]

Just to compare,So called regular flu 2018-2019 cases,between 37.4 and 42.9 million people contracted the flu,those led to between 531,000 and 647,000 hospitalization and 36,400-61,200 deaths.
2019-2020 flu illnesses 39million-55 million,18 million-26 million medical visits,400,000-730,000 hospitalizations,
24,000-63,000 flu deaths.
Don’t know if Corona virus numbers should be added to this year’s flu numbers of not,you tell me.
Corona virus total cases 311,658, recovered 14,967, deaths 8,492.
So is all this necessary or what?

[SuperSonic]

How many bones are there in a giraffe’s neck? Just like humans, giraffes have seven neck vertebrae. For giraffes, however, each one can be over 10 inches (25.4 centimeters) long!

[Jim Noble]

CDC “forbade” other entities besides themselves to research, invent, and distribute tests.

Not that it matters any more (until the trials), but it was FDA all the way and still is that is responsible for both the testing disaster and the PPE problem.

I was so excited last night when I read (work has me 24 hours behind) that FDA had been forced to allow KN95 masks that were rotting on the piers and at airports to enter the country, only to learn that they have to be stored in FDA-approved warehouses and that it takes 90 days to get approval of a warehouse.

The more I get into this, the more it appears that the many, many things that do not make sense where regulators keep intervening to keep us unsafe and/or ignorant (two sides of the same coin, really) are down to #resistance.

So, so many deep staters throughout the government. So, so much hatred for the President (and, curiously, especially for Pence).

They just won't do ANYTHING if it could have adverse political consequences for their faves, and some of them are clearly monkeywrenching as hard as they can.

We need to put bandanas on some of them and send them to NYC to wash COVID patients for a week or so to make any progress at this point.

[wastoute]

Thank you! So my point is we have to remember something that gradually I slowly began to understand after decades of practicing clinical medicine is, “Numbers are THE THING. Numbers are an abstraction that attempts to define THE THING.” So, and thank you for the illustrative information that proves my point because based on # one would expect a giraffe to have a neck no longer than mine.

Sorry. It was a rhetorical trap and it snared you nicely. Did you honestly think that after doing a 7 year Neurosurgery Residency I did not know how many bones there are in a giraffe neck? Seriously?

[Jim Noble]

Word on the street is that one of the the remdesivir salvage trials has been stopped, is being analyzed, and will be announced as a “go” soon, AND that Gilead has enough remdesivir for an EUA expanded access program.

If true, it could lead to testing and use of other nucleoside analogs, which are in plentiful supply.

Because rapid resistance occurs in other RNA viral infections treated this way, when to start and how to use remdesivir will not become apparent for a while.

[DoughtyOne]

I understand and agree with your thoughts.

We had H1N1 so we knew what was possible. Did we do
anything to be ready? Hell no!

It is shocking how unprepared they were.

Abbott took just a few weeks to come up with a rapid testing
system. If the CDC had put it’s mind to it and commissioned
work over the last ten years, we would have something that
would give test results in seconds, not days.

My family member that had to be tested, waited about five
days for the results.

South Korea came up with testing almost immediately. We
took weeks after that.

It honestly makes me quit angry.

WTH were they doing after mid January until mid March?

I don’t have a single clue.

One thing I’m sure of, is that those professionals had
even less of one than I did.

Any idiot with an IQ of 10 (I know, I know...) would have
known by mid January that virus was coming to the United
States, and they were still rolling out 1990s(?) tech until mid March.

I honestly think some folks should be charged with criminal
negligence, and endangering the nation’s populace at large.

[Jim Noble]

One thing you are missing (perhaps) is that all public health people, from the best to the worst, are employed at the end of the day by politicians (Democrats AND Republicans), and that, if you work for a politician and want to keep your job, you must:

1) Never say or do anything to make anyone mad or sad
2) Never say or do anything to discourage shopping
3) Never say or do anything to keep kids from public indoctrination centers, BECAUSE
4) You must never prevent women from going to work because otherwise, they would be available to strengthen their families’ home life, their children would watch less TV, and they all would consume less product.

[freedom1st]

The mortality rate continues to go up. As more testing is done I expected this rate to decline. This is troubling. This virus is more deadly than I first thought it would be.

[henkster]

Thanks for posting the “serious critical” numbers. I think they are extremely important as they show where medical resources are under the most strain.

Question: Are your number for new admissions each day or total numbers in critical care?

[exDemMom]

Nice analysis, thank you for posting.

I have only been keeping track of worldwide numbers and making a couple of graphs. The reason I have focused on worldwide is that there are many places with very poor healthcare; Covid-19 can sweep uncontrolled there, causing many deaths. It also presents the risk that even if the developed countries control the virus such that no new cases emerge, it can sweep right back in from those third world cesspools. If I were doing my own analysis, I'd break out northern hemisphere from southern hemisphere countries. This is because the common cold is seasonal, and this killer cold may behave in a similar fashion. If that is so, then new cases will decrease in the northern hemisphere as spring progresses into summer, but they will increase in the southern hemisphere as it approaches winter.

Anyway, here are my graphs, updated daily at 23-25 hour intervals:

Covid-19 4/5/2020

The trendlines on this graph show that the case load continues to expand exponentially, with a very strong R square value showing that the data aligns very well with the theoretical numbers. I do not have projected case numbers to compare it to, so cannot give an assessment of how well the control measures are working. The worldwide death rate is now 5.41%, and 73.8% of cases remain unresolved. These numbers differ from the US numbers.

Daily change in case count.

I have not done any further analysis on the daily changes.

[Presbyterian Reporter]

“””””Question: Are your number for new admissions each day or total numbers in critical care?””””

---

These are the numbers posted by Worldometer at the end of each day. It is the total number in critical care. I am not aware of any website that is posting the number of new admissions to critical care each day.

[SueRae]

bkmk