Miscellaneous And Off Topic Subjects

[iam416]

[Dr. Strangelove]

Hoo boy. The FAA telling airlines to cancel all flights departing to any of the three NYC airports, Philadelphia, or the smaller regional airports in eastern PA, New Jersey, and Southern New York.They've had a positive test in the NYC area air traffic control center and now have staffing issues and have to take time to disinfect.

EDIT: looks like the grounding order has been lifted now

[Jeff Buchanan]

I have a different way to look at this .......

With a 5% rate of serious/critical cases and a 95% rate of mild symptoms that would be 500,000 seriously or critically ill patients from COVID-19 infection and 9,500,000 patients with a cold.

Assuming a case fatality rate of 3.5%, 350,000 deaths by the end of April.

This exercise isn't intended to minimize the impact on the public health secondary to the COVID-19 pandemic. It's only to contextualize what those numbers mean in terms of the world population, somewhere around 8B.

I also think your 10M figure by the end of April, could conceivably, as you say, be a LOT higher than that if the GF remains constant (It's hovering around 1.15 or 15% increase per day) for the next 40d. Right now there's absolutely nothing that says the GF won't stay there. I've got a gut feeling it won't (herd immunity and regionally running out of new hosts to infect) ..... TIFIWIW.

[iam416]

[Jeff Buchanan]

Hoo boy. The FAA telling airlines to cancel all flights departing to any of the three NYC airports, Philadelphia, or the smaller regional airports in eastern PA, New Jersey, and Southern New York.They've had a positive test in the NYC area air traffic control center and now have staffing issues and have to take time to disinfect.

EDIT: looks like the grounding order has been lifted now

Yep, TBC, it wasn't a "grounding order." It was a ground stop. The regional ATC will direct local ATC (guys in the tower) to not let any aircraft taxi. Airborne aircraft will be diverted and short-haul back to where they came from.

Still, it's another threat to front line, critical infrastructure personnel - air traffic controllers - who become ill or through contact tracing get called into quarantine.

[Jeff Buchanan]

I can go with 20-30M tops. Here's another thing. Epidemiologists who write the stuff that is supposed to inform public health policy globally are infuriated by 2 things: (1) The variance in both the testing strategies and reliability of the data reported to the agencies that collect it. (2) The increasing divergence between confirmed cases and estimated total cases. Total case are unknown ..... no agency knows and any one saying they know if FOS. They're screaming TEST.....TEST.....TEST and not enough countries are mobilizing to do it.

If you don't test thoroughly and by extension don't know total cases, most of the rates one tries to calculate, predictive modeling one tries to do, the more a waste of time that kind of effort is .....garbage in garbage out applies. You simply can't make accurate preparation for the number of ventilators you need, hospital beds, deaths ..... it's guess work.

One site I'm reading extensively that is doing data studies dumped WHO as source data input on March 18th. That's because there are recognizable errors in their data when they compare it with ECDC and JUH. They don't like CDC's reporting either ......They've taken about as strong as a position as they can take without being accused of politicizing their findings criticizing the lack of transparency in data reporting from the US. It's bad and on March 6th, they enlisted a journalist on the staff of the Atlantic to write a blistering report on the errors the US made, and continues to make,in selecting testing strategies after the first confirmed case on January 20th. Much speculation about obfuscation which the Trump administration has tried to combat. This organization points out in it's updates that the US has done better but in comparison to most other nations and with the expectation that the US would be the global leader in accurate and transparent public health reporting, it has not done well at all.

[iam416]

[Ghengis Jon]

Capture.JPG

[Jeff Buchanan]

This could be something. Caveats: GF changes daily, data reliability I spoke of up thread...... I am the bearer of optimistic news when ever it appears. Remember nobody knows the total # of COVID-19 infected persons. The numbers are best guesses. As the divergence between speculated total cases and confirmed cases grows, the data becomes less reliable. According to one source I'm reading the divergence varies by country..... some have good data, some bad. The bad data inappropriately skews the numbers, so these statistical calculation are, well, they are what they are.

GF has declined for 5 straight days and was 0.96 on 3/21.

GF.PNG

[iam416]

I'm still pretty much assuming the worst right now. I saw two things from Italy that could be cause for optimism. First, they're reporting all Wuhan deaths as virus-caused. However, about 88% of their deaths have one or multiple underlying conditions. In contrast, apparently Germany is reporting Wuhan deaths as only those caused strictly by the virus (no underlying conditions). So, that may explain the huge discrepancy in death rates between the two countries. Second, I think the NEJM finally did a breakdown of Italy's first 1600 deaths and the age distribution is consistent with what the Chinese reported. It's below 1% until you get to 50 and then when you ge to 70 it skyrockets.

Finally, I'm semi-optimistic that the few days extra lead time that DeWine bought Ohio is paying off a little. We're not really testing so the numbers are surely higher, but other states are passing Ohio. And Franklin County (Columbus) remains relatively low. The latter is my prime concern. Right now I'm assuming that I'm going to contract this Wuhan curse at some point, so my eye is focused squarely on what sort of medical resources will be available to me when that happens.

On the down side, I'm borderline hypertension. However, it's recent (and, as noted, borderline). So, I haven't started taking any medicine. My guess (and hope) is that the increased risk factor associated with hypertension is a result of taking ACE inhibitors -- perhaps increasing vulernability to the plague.

[AlabamAlum]

For a while it was proposed that ACE and ARB meds actually helped with COVID-19. I think that theory has been put to bed. The last paper I saw suggested no benefit or harm. And that is likely way more basic: respiratory issues exacerbate coronary disease.

[iam416]

killjoy

[Jeff Buchanan]

Agree, AA. I read an incredibly in the weeds discussion of this done in the UK. More study is needed to determine if ACE/ARBs are a positive or negative factor in the management of COVID-19 in the setting on an ICU. It's recommendation for providers: don't stop them if a patient with COVID-19 presents and is admitted to the ICU as long as hemocynamic stability can be maintained.

I also felt the UK study shaded to the side of the argument that if you are on one, it might convey less susceptibility to COVID-19 because these drugs both block a protein in the Renin/Angiotensin system that the virus (probably - the testing was done with rats) uses to penetrate human cell membranes.

BTW, just walked around our neighborhood for a little over an hour. A few folks out and about, dog walking but overall quiet. The exercise and seeing some form of normality was good - of course it's sunny and 80 here. Where it's March weather in the mid-west maybe that won't have the same positive mental impact.

I also had a sail scheduled on Key Biscayne today. I would have loved to do it however, others use the boat; there are a lot of surfaces, head and galley to worry about contamination. Didn't go. Over-reaction? Maybe but I'm taking the risk of infection in my age group pretty seriously. No need to take unnecessary ones.

[AlabamAlum]

killjoy

This social isolation is nothing more than us as sheep hiding from a pack of ravenous wolves. We have not killed the wolves or even driven them away. They are still there. Waiting. And as the economy collapses, society will unravel, and hunger will drive us from from our hiding places and into the waiting, saliva-dripping jowls of our predators.

[iam416]

This social isolation is nothing more than us as sheep hiding from a pack of ravenous wolves. We have not killed the wolves or even driven them away. They are still there. Waiting. And as the economy collapses, society will unravel, and hunger will drive us from from our hiding places and into the waiting, saliva-dripping jowls of our predators.

Correct. Probably a little optimistic, but I'm basically there.