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The Covid-19 thread


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  • A breathing machine requires having a tube in your throat; and, because of this, additional procedures are required before you can talk or eat (not to mention the gagging problem).  It’s not clear that a breathing machine can be more effective than a Oxygen nasal cannula when a Covid patient is able to breathe on his own.

 

 

 

 

 

 

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14 hours ago, baa99 said:

The ventilator is used on COVID-19 patients when their O2 levels are too low even with supplemental O2 therapy. 

Is that doing more harm than good? That is the gray area it seems.

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The following is a "worth reading"  treatment of,  the Covid-19 virus and responses. 

Should be required reading, as it's from a research scientist at the Mayo clinic. And is written from a USA centric viewpoint.

 

Research Scientist at Mayo Clinic
 

You asked for possibilities, so I’ll give you four:

TOTAL ERADICATION

This is how SARS ended. Despite reaching multiple countries, rapid and severe action by multiple governments cut the case count to zero. Once the virus disappeared from the last human host, SARS was declared eradicated.

SARS was about as contagious as COVID-19 and certainly more deadly. But it didn’t have the ability to hide in mild cases like COVID-19 does.

If the world had gotten its act together two months ago, total eradication of COVID-19 would have been a real possibility. Today, it is looking very very difficult. It may be taking up residence in rural towns in Africa, 200 miles away from the nearest hospital, away from easy government intervention. So do we just throw up our hands into the air and give up now? That brings us to …

THE “HERD IMMUNITY” STRATEGY

Historically, major plagues (think Black Death) infected and infected until we reached herd immunity. If half the world has already experienced and recovered from COVID-19, then the virus will have a hard time spreading because it will hit the wall of an immune patient as often as a vulnerable one. This is the basis of the modeling that says 70% of the world will eventually be infected by COVID-19. (Note that these models usually assume that we stand back and do nothing at all, which is the worst case scenario)

There’s no question that herd immunity would work. After all, it DID work with the Black Death. But it’ll cost us millions of lives to get there, our hospitals will definitely overflow, and moreover, a vaccine is probably just a year away. We can do better than this.

LET’S JUST HOPE IT GOES AWAY IN THE SUMMER

This has become popular in certain circles. The flu is seasonal, so maybe COVID-19 will be also? Can’t we hope?

There are two problems here. The first is geographical. When it’s summer in the Northern Hemisphere, it’s winter in the Southern Hemisphere. So let’s say you live in Europe or the USA. Even if you don’t care about the people below the equator, they would experience outbreaks during their winter (our summer), and some carriers would inevitably fly back to the Northern Hemisphere around September and we’ll face the disease again. This year it was easy to travel ban China in January, a few more countries in February. What are we going to do this fall? Travel ban the entire Southern Hemisphere? Travel ban the rest of the world two months later when it takes root across the globe? You still have to survive all the way to next summer.

The other problem is more subtle and has to do with R0, the basic reproductive number. Seasonal flu has an R0 between 1.1 and 1.5, so it grows exponentially. We don’t have to push it down very far to get it less than 1, where it will decay exponentially (that’s what makes it seasonal). COVID-19 has an R0 of 2 or 3. It might take an R0 beating but still stay above one. This means it would slow down, but nonetheless continue to expand in spite of the added sunlight.

ENHANCED SURVEILLANCE AND CONTACT TRACING AS A BRIDGE TO VACCINE

I think this is the hope of many developed countries today. It goes like this: declare a national emergency to cut the case load way down, buy time, and raise awareness about social distancing and hand hygiene. Put drive-through test locations in every major city (Korea). Pass a law saying that every hospitalized patient with pneumonia must be tested for COVID-19 (Singapore). And mobilize teams of epidemiologists, preferably hundreds of them, to spring into action once you lift restrictions.

Now with this infrastructure in place, you are guaranteed to catch outbreaks before they become large. 20% of COVID-19 patients need to be hospitalized, so even if you are only testing people who report to the hospital you should still catch outbreaks when they are on average five people in size. Once you’ve identified a case, deploy one of your teams. Get the 30 closest individuals to each patient, isolate them all for two weeks and test all of them. If any of them test positive, repeat the process again and grab another 30 individuals.

This process of contact tracing is a targeted lockdown. Rather than shutting down the entire country, you shut down a small community of about 30. China found that 85% of transmission occurs in family clusters. By drawing a larger net of about 30, you might stop something like 95% of all transmission. In Singapore, they will call you at home three times a day if you are in isolation, and if you run outside against the rules, they attach a GPS bracelet on you.

Sometimes, people get through contact tracing (or arrive from a different country) and you’ll see another outbreak, but you’ll catch it again when this happens. China used this process at scale in Wuhan, having mobilized 1800 such contact tracing teams with 5 or more people each.

Oh yes, ideally you do this all WITHOUT declaring a national emergency and closing every restaurant in the nation for three weeks. Countries around the world had time to prepare, but didn’t. We are paying the price now.

Keep this up for a year and then the vaccine is ready. Now you can get your herd immunity without sacrificing 2% of your countrymen, and you can go on with your life like nothing ever happened.

SOURCES

For those curious, here’s further reading straight from the experts.

Recommendations from the WHO Infectious Hazards Advisory Group

Contact tracing as applied in Singapore

Report of the WHO-China Joint Mission on COVID-19 (summary recommendations on page 21)

UPDATE March 26: An article in The Atlantic appeared titled “How the Pandemic Will End” that spells out much the same possibilities that I wrote above. The writer picked out three possible scenarios that exactly match mine (except for the “seasonal flu” part, which I mainly wrote as a mythbuster), so if you liked this answer and want more, you can check that out too.

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Meanwhile, back in Wuhan ...

Backlash in China after front-line doctor dies

The death of a front-line doctor in central China is provoking a backlash against the authorities' handling of the coronavirus pandemic.

Dr Hu Weifeng passed away on 2 June, after a four-month fight with Covid-19.

He made headlines in March, when his skin turned black "due to liver dysfunction" during his treatment.

The exact cause of his death has not been made public but the news has triggered an outpouring of anger on Chinese social media sites.

Who was Hu Weifeng?

Dr Hu Weifeng was an urologist, who was treating patients at the Wuhan Central Hospital - where Covid-19 was originally identified.

He tested positive for the virus in January, during the early stages of the Chinese outbreak, and was transferred to different hospitals for treatment the following two months.

His condition initially improved in mid-March; however, he then suffered cerebral haemorrhages in late April and May.

Dr Hu Weifeng, and a colleague, cardiologist Yi Fan, went viral in April after official media publicised their "tough battle against the virus".

Users of the popular Sina Weibo microblog were stunned at the time to see that the pigmentation had changed in their faces, which media said "could be due to abnormal liver functions".

The two became known as "the two black-faced Wuhan doctors", and they won nationwide praise for fighting back against the virus, as both had been critically ill.

The Communist Youth League called them "angels who had fought with death", and Weibo users sympathised with just how much they had to endure on the front-line.

Social media users commented at the time on how their skin was a physical "scar" that they had to live with, after fighting on China's front line.

China Daily says that Dr Yi was only discharged on 6 May, whereas Dr Hu appeared never to recover.

Worked at same hospital as 'whistleblower'

Many papers, including the national Global Times newspaper, have been noting that Dr Hu "worked in the same hospital as Li Wenliang".

Dr Li became known as China's "whistle-blower" doctor, who first warned colleagues about the virulence of the virus back in late December.

His death sparked national outrage, as it became clear that the authorities had tried to silence him by giving him a reprimand.

It is unclear whether the two knew each other, as the two doctors worked in different departments. There are reportedly more than 4,200 hospital employees at the Wuhan Central Hospital.

It's also unclear whether they could have caught the virus off one another - both Li Wenliang and Hu Weifeng contracted the virus in mid-January, but Global Times says that some 68 members of staff tested positive for Covid-19, and more than 200 underwent medical observation.

The reaction to Dr Hu Weifeng's death, however, has been similar to that of Dr Li Wenliang's: pure anger.

The cause of his death has not been made public; however, Global Times says that "his situation was severe and he became emotionally unstable".

Tens of thousands of Sina Weibo users have used the hashtag #WuhanCentralHospitalDoctorHuWeifengPassesAway. While many are posting candle emojis - a common practice to mark the respects of anyone who has died - others are questioning how he died, and are calling for top officials at the hospital to be sacked.

"When will the leaders of the Wuhan Central Hospital be held accountable?" one user asked. "This is the fifth medical worker to pass away at the Wuhan Central Hospital due to the coronavirus," another said.

The anti-establishment newspaper Epoch Times, which is blocked in mainland China, says that senior staff at the hospital "severely suppressed the early warnings [of Covid-19] to medical staff, and forced them to be exposed to huge cases of the virus without protection".

Some Weibo users are dismissing Dr Hu's "instability", and questioning how the hospital's leadership team are feeling.

Concerns about transparency

There are also many on Weibo questioning the transparency of the hospital's data, following Dr Hu's death.

"Hadn't the patients in Wuhan been cleared a long time ago?" one Weibo user asks, receiving more than 400 likes.

This has led to alarm that there may still be many patients undergoing treatment for health problems that are a direct consequence of Covid-19, but have since tested negative.

On 27 April, the National Health Commission said that Wuhan had discharged all of its coronavirus patients.

There were more than 50,000 confirmed cases of Covid-19 in Wuhan. And the Wuhan Central Hospital was one of the worst affected hospitals.

The official Xinhua news agency says that "the number of deaths and the infection rate were the highest of any Wuhan hospital" during China's outbreak.

 

https://www.bbc.com/news/world-asia-china-52897017

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https://www.the-scientist.com/news-opinion/lancet-retracts-surgispheres-study-on-hydroxychloroquine-67613

Two controversial studies of COVID-19 patients have been retracted after the authors failed to demonstrate that the data were reliable. The first study to be retracted, published last month (May 22) in The Lancet, had found harmful effects associated with the antimalarial drug, hydroxychloroquine, but quickly drew fire after scientists raised questions about the massive database supposedly underpinning it, and about that database’s owner, Surgisphere Corporation.

...

Hundreds of scientists have raised questions about the provenance of Surgisphere’s dataset. The Scientist reached out to some of the largest health systems in the states hit hardest by COVID-19, but could not find any that contributed data to Surgisphere, and the company has declined to name any participants, citing privacy agreements.

Several institutions once listed as collaborators on Surgisphere’s website, including the University of Minnesota and Stanford University, tell The Scientist they have no record of anyone at their institutions working with Surgisphere. The mentions of the collaborations have since been removed from Surgisphere’s website.

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baa99 - thank you for this confirmation.

I'm not sure if the Trumpanzees, have or will, promote this one yet, the one that goes :: 

"5G cellphone towers cause Covid-19, which is harmless anyway, and really only here, because the planet isn't warming fast enough, not fast enough, because, 5G cellphone towers, distort the surface of the planet, making it curve more, from it's normal flat state and thereto cooling the surface of the earth, which results in Covid-19, so there!"

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Unfortunately, the Covid virus does not care about public acceptance of wearing masks etc, it just tries to expand whereever it can. Some areas are lucky, others not. Last weekend many a German people went on holiday seaside, the result shall be seen later next week. Many did not care. Stateside the last 2 days showed increasing numbers of fatalities. Bubi man from Germany still on alert. It is far away from over.

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