Coronavirus practical issues

[Naio]

I thought it might be nice to have a thread to talk about practical concerns. I'll start :).

What should a solo traveler do, if they are camped somewhere they don't know anybody, and get seriously ill -- too sick to shop for groceries, but not sick enough to be hospitalized?

Besides concern for my parents, this is the other thing that is sending me home early. I imagined myself lying in bed in my RV, calling local churches to see if some volunteer would bring me some food. I didn't want to do that.

Obviously this is something that could happen with many diseases or injuries. But honestly, it's not something I had thought about before now.

[MEXICOWANDERER]

Old people with health issues die

Since I am one

That caught my eye

Burma Shave

[bid_time]

YUP - Good Catch! - I got caught up in the same trap. The big take away is - every time some one try to lay some number out about this, its all just speculation with no basis in fact. Just like I originally said.

[BCSnob]

Question:

If as you posted “ Since 80% of the people that get the disease have symptoms so mild that they don't require hospitalization and don't get tested,.......” how do you know it’s 80%, if they don’t get tested?:h

If the number of infected people is required to calculate mortality rate, “those that succumb”, and some unknown percentage of infected people are not being tested; how is the 0.3% a fact?

[bid_time]

TechWriter wrote:
In the most effective mitigation strategy examined, which leads to a single, relatively short epidemic (case isolation, household quarantine and social distancing of the elderly), the surge limits for both general ward and ICU beds would be exceeded by at least 8-fold under the more optimistic scenario for critical care requirements that we examined. In addition, even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US.

BCSnob wrote:

bid_time wrote:
By my calculation 1.2 million deaths is 0.3%, 10 times less then the 3% death rate you predicted earlier.

mortality rate for a disease is the number of deaths caused the the disease divided by the number of infected people (not the total population).

Since 80% of the people that get the disease have symptoms so mild that they don't require hospitalization and don't get tested, the only reliable data you have is -

What are your chances of succumbing to the disease. 0.3%.

Those are the only known facts, All else is nothing but speculation.

[Naio]

pnichols wrote:

Naio wrote:
The numbers are based in fact, but the facts are incomplete.

All we really know is that a lot of people have died, and that people with very mild cold symptoms are infectious and kill other people.

So if you get a cold, stay home for 14 days.

And it will help your neighbors if you stay home as much as possible even when you don't have a cold. If we can all just sort of hibernate for a bit, this thing will die down. Not completely, but enough for the medical system to catch up.

Well stated, Naio!

I'm scratching my head and wondering if the nasty "flu something" that the DW and myself picked up in Arizona in January (and lived through) wasn't in fact a very, very, early U.S. instance of Covid-19.

As I stated earlier in a post - we both got our high-powered geezer flu shots last fall, and do every fall. So I wonder what strain of "regular of flu" that we caught is new this year that was not included in these flu shots? :h

i.e. Has anyone heard of how effective last fall's flu shots are turning out to be during this year's "regular flu" season?

---

I was hoping that, too. Maybe we have already had it!

But I spoke with a friend who is in biomedical research and she said no.

----

Edit: This year's flu vaccine was only 45% effective. They have to make a guess, a year in advance, of which strains will be most common, and include those in the vaccine. Out of 4 strains that are common this year, 2 of them are well covered by the vaccine and 2 not so much.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6907a1.htm

https://www.cdc.gov/flu/weekly/index.htm, scroll way down to "Influenza Virus Characterization"

[Optimistic_Para]

This appeared on the Atlantic site.

What It Really Means To Cancel Elective Surgery

Three weeks ago, Robert Cruickshank went to the ER in Seattle with terrible abdominal pain. The diagnosis? Gallstones. The hospital gave him strong painkillers and urged him to come back again—and soon—to have his gallbladder removed. “It doesn’t have to happen tonight,” he recalls the doctors saying, “but get it scheduled as soon as possible.” No one yet knew that the coronavirus was already spreading undetected through the city. Cruickshank briefly wondered if this virus in the news would affect things when scheduling the surgery for yesterday, but his doctor didn’t seem worried.
By this past Friday, everything had changed. The doctor’s office called to say that his gallbladder-removal surgery would be postponed indefinitely.
All over the country, patients are finding their nonemergency surgical appointments canceled as hospitals prepare for a spike in coronavirus cases. Surgeries for early-stage cancer, joint replacements, epilepsy, and cataracts are all getting pushed back—to ration much-needed personal protective equipment, keep hospital beds open, and to shield patients from the virus. On Friday, the American College of Surgeons recommended that hospitals reschedule elective surgeries as needed. Hospitals in outbreak hot spots such as Seattle, New York, and Boston were the first to act, but more are likely to follow suit.
Some patients are left wondering if they have a ticking time bomb inside them
Others are upending carefully made plans for life-altering surgeries with long recovery times.
/Elective surgery/ does not mean optional surgery. It simply means nonurgent, and what is truly nonurgent is not always so obvious. Gerard Doherty, the chair of the surgery department at Brigham and Women’s Hospital in Boston, which began postponing elective surgeries on Friday, says surgical procedures can fall into one of three categories. About 25 percent of the surgeries performed at his hospital can be delayed without much harm. These might include joint replacements and bariatric surgeries for weight loss. Another 25 percent are for life-threatening emergencies that need to be treated right away: perforated bowels, serious heart problems, bones that have broken through the skin.
The last 50 percent are the tricky ones. These cases, Doherty says, have “some potential for harm to delay”; they might include cancer and problems in the blood vessels of the arms and legs. Brigham and Women’s is postponing some of these surgeries now on a case-by-case basis.
In Cruickshank’s case, for example, the initial bout of acute pain has passed. (That might have been when a gallstone got stuck.) He still feels “a little something” every now and then, and he worries that a flare-up might send him to the ER again. “Now I’m concerned,” he says. “If I go to the ER, are they going to have to turn me away and say, ‘Sorry, we have a bunch of coronavirus patients’?” The middle of a pandemic is a bad time to have a health emergency.
For other patients, the canceled appointments have meant rescheduling long-anticipated and life-changing surgeries. Sherrie Kumm, 33, of Ellensburg, Washington, has epilepsy that causes her to have a petit-mal seizure nearly every day. She can’t drive. For the past six months, she has been preparing to have a small section of her brain removed to stop the seizures—a two-part surgery that would require a two-to-four-week hospital stay. She took a semester off from her online degree, took time off from her job at a school, and arranged for her mother to watch her two sons while she was hospitalized.
As late as Thursday, her doctor’s office had called to confirm the surgery. She had packed a suitcase, complete with the front-opening nightgowns she had specially ordered to wear in the hospital. On Friday morning, her doctor’s office called again, this time to postpone the appointment. “I had been mentally preparing and physically preparing myself and my children for six months,” she says. The sudden cancellation has been hard for her, and she’s unable to plan or reschedule her surgery for now.
Kumm’s neurosurgeon at the University of Washington, Andrew Ko, told me that the policy to postpone elective surgeries came down from the hospital administration on Thursday evening. On Friday morning, he and his office started to cancel some 30 surgeries scheduled for the following two weeks. That included surgeries like Kumm’s, as well as implants for movement disorders and removals of slow-growing brain tumors that patients may have had for years. Brain-cancer surgeries, though, are going ahead. Ko said his hospital is prioritizing surgeries in which “the length of your life is affected.” The “quality of life” surgeries are the ones now getting postponed.
Canceling surgical appointments is also meant to limit the number of people circulating through hospitals. Surgeries like Kumm’s, which require a long hospital stay, during which visitors might be coming in and out, Ko said, may be particularly risky from the point of view of spreading the coronavirus. Hospitals around the country are also limiting patients to one adult visitor.
In general, doctors and nurses are being more careful about conserving personal protective equipment in the operating room. Doherty says his hospital is having nurses stay in the operating room after they set up, so that they don’t have to reenter and use a new set of surgical masks, gloves, and gowns.
At some point, depending on how long the coronavirus outbreak lasts, some nonurgent surgeries could very well become urgent. “Right now, most people are planning for a time period of four to six weeks for the peak to hit, but nobody really knows,” says David Hoyt, the executive director of the American College of Surgeons. “We’re using our best judgment on the fly.” And when hospitals do have capacity again, they will have a backlog of postponed surgeries to go through. Hospitals are going to be busy for a while.
With confirmed coronavirus cases varying so much from state to state, some patients are in a bit of a limbo. Cody Lawrence, 27, of Fort Myers, Florida, needs major thoracic surgery to fix a birth defect that has left him in too much pain to work recently. He and his wife are planning to drive three hours and stay at a hotel in Orlando, where he is scheduled to have surgery in less than two weeks. The specific surgery requires deflating one of his lungs, and he will need to be on a ventilator, which may soon be in short supply. With the coronavirus going around, he’s concerned for his wife, who just finished chemotherapy, and for himself. “If I catch it,” he worries, “I’m pretty much a goner.”

[Optimistic_Para]

This appeared in today's New York Post. FYI.

It will take about two years for the coronavirus pandemic to run its course — but that depends on how fast a vaccine becomes available, according to Germany’s public health agency.
Dr. Lothar Wieler, president of the Robert Koch Institute, said that between 60 percent and 70 percent of the global population will eventually become infected before recovering and acquiring immunity, Reuters reported.
“Our working assumption is that it will take about two years,” he told a news conference Tuesday, adding that the timing also depends on the speed at which a vaccine is developed and deployed.
“We do not yet know what the death rate will look like in the end,” he said.
Wieler said the institute was raising the risk level in Germany to “high,” noting that without the strict social distancing measures that Chancellor Angela Merkel announced Monday, the country could see millions of cases.

[BCSnob]

bid_time wrote:

TechWriter wrote:

bid_time wrote:

TechWriter wrote:

covered wagon wrote:
I don't understand did someone with all knowledge suddenly say this flu is the end of the world or something? It's weird because it's no worse than a common yearly flu season flu.

Seasonal flu has a 0.1% death rate. Currently, COVID-19 has over a 3% death rate. That makes COVID-19 30 times more deadly.

And if you're over 70, the death rate jumps to 8%, and over 80, the death rate is 15%.

Finally, there isn't any vaccine or treatment for this new flu.

How do you know what the death rate is when they don't even know how many cases there are. If there are 3 times as many cases as being reported (remember 80% no symptoms or mild symptoms), then your death rate goes down dramatically. Only 16,500 people out of 333 million have been tested. You numbers are pure speculation and have no basis in fact.

My numbers came from the March 3rd WHO report, but, unfortunately, it's old news now.

Here's the "most significant conclusion" from the March 16 Imperial College Report:

In the most effective mitigation strategy examined, which leads to a single, relatively short epidemic (case isolation, household quarantine and social distancing of the elderly), the surge limits for both general ward and ICU beds would be exceeded by at least 8-fold under the more optimistic scenario for critical care requirements that we examined. In addition, even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US.

By my calculation 1.2 million deaths is 0.3%, 10 times less then the 3% death rate you predicted earlier.

mortality rate for a disease is the number of deaths caused the the disease divided by the number of infected people (not the total population).

[bid_time]

TechWriter wrote:

bid_time wrote:

TechWriter wrote:

covered wagon wrote:
I don't understand did someone with all knowledge suddenly say this flu is the end of the world or something? It's weird because it's no worse than a common yearly flu season flu.

Seasonal flu has a 0.1% death rate. Currently, COVID-19 has over a 3% death rate. That makes COVID-19 30 times more deadly.

And if you're over 70, the death rate jumps to 8%, and over 80, the death rate is 15%.

Finally, there isn't any vaccine or treatment for this new flu.

How do you know what the death rate is when they don't even know how many cases there are. If there are 3 times as many cases as being reported (remember 80% no symptoms or mild symptoms), then your death rate goes down dramatically. Only 16,500 people out of 333 million have been tested. You numbers are pure speculation and have no basis in fact.

My numbers came from the March 3rd WHO report, but, unfortunately, it's old news now.

Here's the "most significant conclusion" from the March 16 Imperial College Report:

In the most effective mitigation strategy examined, which leads to a single, relatively short epidemic (case isolation, household quarantine and social distancing of the elderly), the surge limits for both general ward and ICU beds would be exceeded by at least 8-fold under the more optimistic scenario for critical care requirements that we examined. In addition, even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US.

By my calculation 1.2 million deaths is 0.3%, 10 times less then the 3% death rate you predicted earlier.

[RambleOnNW]

MEXICOWANDERER wrote:
Google the mortality rate in Taiwan and scratch your head

Taiwan was ready and didn’t dismantle their response teams they developed after the SARS outbreak. They restricted flights starting Dec. 31 and were actively screening travelers.

https://www.sfgate.com/bayarea/article/Why-Taiwan-s-COVID-19-death-rate-is-shockingly-low-15130341.p...

[MEXICOWANDERER]

Google the mortality rate in Taiwan and scratch your head

[TechWriter]

bid_time wrote:

TechWriter wrote:

covered wagon wrote:
I don't understand did someone with all knowledge suddenly say this flu is the end of the world or something? It's weird because it's no worse than a common yearly flu season flu.

Seasonal flu has a 0.1% death rate. Currently, COVID-19 has over a 3% death rate. That makes COVID-19 30 times more deadly.

And if you're over 70, the death rate jumps to 8%, and over 80, the death rate is 15%.

Finally, there isn't any vaccine or treatment for this new flu.

How do you know what the death rate is when they don't even know how many cases there are. If there are 3 times as many cases as being reported (remember 80% no symptoms or mild symptoms), then your death rate goes down dramatically. Only 16,500 people out of 333 million have been tested. You numbers are pure speculation and have no basis in fact.

My numbers came from the March 3rd WHO report, but, unfortunately, it's old news now.

Here's the "most significant conclusion" from the March 16 Imperial College Report:

In the most effective mitigation strategy examined, which leads to a single, relatively short epidemic (case isolation, household quarantine and social distancing of the elderly), the surge limits for both general ward and ICU beds would be exceeded by at least 8-fold under the more optimistic scenario for critical care requirements that we examined. In addition, even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US.

[John_Joey]

This thread started 8 days ago. This just came to my attention:

THE FOLLOWING WAS WRITTEN BY ONE OF THE PHYSICIANS IN THE ER AT NORTH MEMORIAL

Friends:
I try hard not to be an alarmist, but I’m going to join my other physician colleagues in saying it is time for everyone to listen up. I’ve been living this up close and personal as an ER physician during this very unique time. We are not joking when we say you need to stay home and cancel non essential gatherings. This is not a drill. If we don’t act now we are looking at a lot of the same problems that are facing our Italian colleagues and our colleagues in Seattle- they are running out of beds, ventilators, doctors, nurses, supplies. We need to #flattenthecurve and slow the spread of this virus. And if you really want to use argument “but flu kills so many more people than coronavirus...” great news, all of these measures will help to stop the spread of flu too-bonus! YOU can help in so many ways.
How can you help? Glad you asked!!!
#1 STAY HOME AND AWAY FROM OTHERS as much as possible (I feel like I need to say it again and again and again) Introverts it is your time! If you can work from home, great. If you can stagger your work day also great. If you have to go to work, keep your distance. Cover your cough. Wash your hands. Wash your hands again. Keep washing your hands. Repeat. Do not go to work sick. For sure Minnesotans need to be told this as we all try to “muscle” through. Now is not the time.
#2 Support locally owned restaurants, order take out or delivery. Now is the time to use grubhub, door dash, Uber eats, etc. I’ve already decided where I’m getting my birthday takeout! (And for those of you who know me well, no, it’s not Taco Bell ??) Brasa I’m coming for you!
#3 Support small businesses. Call them and ask to buy gift cards. They could use the sale right now. Buy local whenever possible.
#4 Donate to food banks- my North Minneapolis crowd is going to be hit disproportionately hard by the school closures and there are a lot of really vulnerable kids out there. Make sure everyone in your community has enough to eat. PS: food banks can do astonishing things with even small amounts of money- every bit helps.
#5 Call/text/FT/Skype your friends/elders. Everyone will need social support in the coming days/weeks/months. Make sure your neighbors are holding up ok. Call your loved ones who live in care facilities, many are not allowing visitors right now.
#6 Get outside-keep yourself healthy both physically and mentally (it’s relatively easy to stay away from people while going for a walk, run, or bike ride and may give you a little stress relief and change of scenery). Thank goodness it’s warming up around here!
#7 Offer to watch the kids of a healthcare worker. We can’t stop going to work and our younger kids can’t stay home alone. My own kids are covered but a lot of my colleagues will need help in the upcoming days, weeks, and even months.
#8 Don’t stress at the schools for not being ready to go with online learning tomorrow-everyone is scrambling to do the best they can. We’ve all had to make big changes in big plans in a very short amount of time. Don’t sweat the small stuff.
#9 Buy some Girl Scout cookies. Those Girl Scouts had to cancel a lot of their booths and selling events. They are all left with tons of cookies to sell. Buy a few boxes. They last forever in the freezer, and personally if you’re going to stock up on anything...
#10 That brings me to #10, for the love of god, stop buying all of the toilet paper. This is a RESPIRATORY illness. Unless you plan on TPing your neighbors, or turning into mummies, or overdosing on sugar free candy, I cannot figure out what the TP obsession is all about. And I’m a doctor.
Instead of going out- read a book, watch some Netflix, talk to your kids, play board games, do art projects, clean your closets, start that puzzle, write letters, learn to cook. Download the Libby app so you can download ebooks and audiobooks from the library, organize your photos, start a journal. You can stay busy without leaving your homes.
I have worked in my ER the last 5 days in a row. Tensions are high. But there are SO many amazing people working around the clock trying to plan and adjust, rolling with the many punches being thrown our way, and showing up as we try to make sure we have enough health care for everyone. This has been an extremely tough week for everyone and I hope that all of these distancing measures will make the upcoming weeks and months better... please, I beg you, DO YOUR PART. Together we can do this. And if we get this right, we’ll be able to look back and say that it wasn’t as bad as we all thought it would be. If we still feel we overreacted at the end of all of this, then we did something right.

[pianotuna]

"COVID-19 rapidly spread from a single city to the entire country in just 30 days. The sheer speed of both the geographical expansion and the sudden increase in numbers of cases surprised and quickly overwhelmed health and public health services in China, particularly in Wuhan City and Hubei Province."


https://jamanetwork.com/journals/jama/fullarticle/2762130?fbclid=IwAR05vjBGbW_4xKqsK4sVCKCbkH14VBOij...

[kellem]

Naio wrote:
The numbers are based in fact, but the facts are incomplete.

All we really know is that a lot of people have died, and that people with very mild cold symptoms are infectious and kill other people.

So if you get a cold, stay home for 14 days.

And it will help your neighbors if you stay home as much as possible even when you don't have a cold. If we can all just sort of hibernate for a bit, this thing will die down. Not completely, but enough for the
medical system to catch up.

Precisely.
It's the sole purpose for the current lock-down and makes complete sense.......let's let health care providers ramp up supplies then people can come out and play with a better understanding, receive better care and better hygiene concept.

Perhaps not popular to some but rather simple logic to me.