Coronavirus: What questions do you have?

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A terrible day for Georgia yesterday. We had a night report that showed over 75 deaths in 24 hours. The curve seemed to be blunting and then we skyrocketed. Hopefully, this is the peak and the home isolation order makes a difference.
 
A terrible day for Georgia yesterday. We had a night report that showed over 75 deaths in 24 hours. The curve seemed to be blunting and then we skyrocketed. Hopefully, this is the peak and the home isolation order makes a difference.
Sorry to here. In Indiana the cases continue to rise at nearly 5000, but the deaths seem to be moderating; for the past four days, at least, we'll see.
Screenshot_20200407-073454.jpg
 
I like that second one. Too bad it doesn't read my location right (and I can't figure out how to enter it manually).
Forget it, I found it. Interestingly, the Infection2020 data for Indiana does not match the State of Indiana data. The count for the former is 20% too low (both reporting through 4/6).
 
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A terrible day for Georgia yesterday. We had a night report that showed over 75 deaths in 24 hours. The curve seemed to be blunting and then we skyrocketed. Hopefully, this is the peak and the home isolation order makes a difference.

I know, it's not much of a consolidation, but some of those cases might be late reports from the weekend. I've seen it multiple times that on Saturdays and Sundays the situation starts to look promising, but by Monday or Tuesday the numbers are higher again, so I've stopped trusting weekend data. Also, on those sites that provides plots, if the current day is shown it looks optimistic, because not all data of the day has been received. However it seems that by now most sites have switched to only plotting past data to avoid that.

Reinhard
 
I know, it's not much of a consolidation, but some of those cases might be late reports from the weekend. I've seen it multiple times that on Saturdays and Sundays the situation starts to look promising, but by Monday or Tuesday the numbers are higher again, so I've stopped trusting weekend data. Also, on those sites that provides plots, if the current day is shown it looks optimistic, because not all data of the day has been received. However it seems that by now most sites have switched to only plotting past data to avoid that.

Reinhard

I think that's also true for testing, particularly where you need a doctor's referral for a test. Sunday and Monday look good and then you get the backlog from the weekend.
 
I was exposed to a patient that might have had COVID. How do I get tested?

Screening with our current test is not appropriate. Screen is done by a questionnaire and testing is done by risk level. Low or no risk should not be tested.

Our current test is a PCR is a great test to rule-in an infection. It is terrible to rule-out and infection. I get a lot of folks wanting the be tested for a trip or to ensure they are “safe”. This type of testing it just not possible with out current test. We have testing due out in late May that might change it.
 
My question is about contact tracing. If thousands are going to be infected, where is the manpower to perform extensive and effective contact tracing going to come from?
An article in today's local paper mentions a paper by a couple of researchers here that cites the possible need to draft idled police detectives, teachers and government workers to staff a more aggressive contact tracing program.
 
The very first vaccine ever developed was for smallpox, and it worked by intentionally infecting a person with the milder cowpox virus, and that provided some immunity to the deadlier smallpox virus. You were given a live virus that made you a little bit sick, but it helped guard you against something more dangerous. Now I don’t think they do those kinds of live virus vaccinations anymore for any kind of diseases — definitely not for smallpox.

Now I’ve heard some reporting that there may be multiple strains of the novel coronavirus, and some may be more or less deadly than others. If that is true, and if exposure to one form could provide immunity for other forms, I wonder if it would make any sense to intentionally expose people to a milder form to vaccinate against the more severe forms. Old-school style vaccination. You could do it under a controlled condition and with medical monitoring in case the person had a severe illness. And you could pre-screen people for risk factors. There would be a lot of ethical issues, depending on the risks, but I wonder if it would be worth considering in order to get a population of immune people.
 
My question is about contact tracing. If thousands are going to be infected, where is the manpower to perform extensive and effective contact tracing going to come from?
An article in today's local paper mentions a paper by a couple of researchers here that cites the possible need to draft idled police detectives, teachers and government workers to staff a more aggressive contact tracing program.

It is a challenge. It takes time to do a good contact tracing. As a military physician, I have learned to do it while deployed. I had a PA once think that we have an outbreak of food poisoning. After a diligent review and 3 days of questioning just under 400 cases, I tied it to a pullup bar outside the chow hall, a common virus, and a group of Soldiers with poor post defecation hygiene.

The technique is starting with open-ended questions and knowing when to hone in on a specific answer. A good public health nurse can do it in under an hour.
 
The very first vaccine ever developed was for smallpox, and it worked by intentionally infecting a person with the milder cowpox virus, and that provided some immunity to the deadlier smallpox virus. You were given a live virus that made you a little bit sick, but it helped guard you against something more dangerous. Now I don’t think they do those kinds of live virus vaccinations anymore for any kind of diseases — definitely not for smallpox.

Now I’ve heard some reporting that there may be multiple strains of the novel coronavirus, and some may be more or less deadly than others. If that is true, and if exposure to one form could provide immunity for other forms, I wonder if it would make any sense to intentionally expose people to a milder form to vaccinate against the more severe forms. Old-school style vaccination. You could do it under a controlled condition and with medical monitoring in case the person had a severe illness. And you could pre-screen people for risk factors. There would be a lot of ethical issues, depending on the risks, but I wonder if it would be worth considering in order to get a population of immune people.

The Cow Pox or vaccinia is still used today. I have had it 3 times (lasts 8-10 years).

The CDC is a good reference site. Coronavirus is a common virus. They suspect two strains but there is not evidence that all of the strains are equally deadly. There are approximately 7 know human infecting varients.

References:
https://www.cdc.gov/coronavirus/types.html
https://www.newscientist.com/articl...are-there-two-strains-and-is-one-more-deadly/

I would hedge this by saying that the multiple virus theory comes from the WHO and is not universally accepted. The WHO helped suppress news on the Coronavirus infections in China and is one of the reasons were are where we are. It is either purposeful suppression or incompetence. I hope it was not intentional but it happened. They missed an opportunity to highlight the problem and they missed the opportunity.
 
Going forward we could adopt the Chinese app that they use to track locations, scan to get on the bus, scan to enter a building, etc. On second thought, though effective, I don't think it would go over very well here.
 
Week 4 of the Coronavirus has not been kind to the State of Georgia. We have nearly 10K infections and 350 deaths. The predicted peak is 21-22 April. I sure hope not.
 
Week 4 of the Coronavirus has not been kind to the State of Georgia. We have nearly 10K infections and 350 deaths. The predicted peak is 21-22 April. I sure hope not.

Ga seemed to ramp up fast. Indiana has 5500 cases and 173 deaths. I heard a report yesterday that we have 700+ people admitted to the ICU AND on vents, with just over 500 of those being confirmed Covid cases. We were hoping the peak would be around the 15th or 16th, but it may be later.
 
As stated in this thread or another, poorer health, lower income, and less access to medical care could make the deep south particularly vulnerable
 
It is a challenge. It takes time to do a good contact tracing. .

If most people have a smartphone, Google and Apple know where everyone has been. If you test positive the data exists to determine whose other phones you have been near in the last x days.
 
Chuck, if everybody DOESN’T immediately get this (we don’t get the 80% infection rate required for “herd immunity”) then the GOOD news is that we don’t overwhelm the medical system. That is our appropriate immediate numero uno priority. Does that also however mean that this is going to either “smolder” for months to years or demonstrate flare ups when large sub populations not previously exposed GET exposed? I don’t understand why in China cases seem to be precipitously dropping, I am happy for the Chinese people, but until a vaccine is fielded isn’t it just going to flare up again unless they can maintain lockdown until vaccine comes out?

Seems we’ve switched from “containment” (isolating the sick, we lost our chance on that really early) to “sequestering” (isolating the non-infected population, particularly the elderly and those with medical conditions at most risk.) I guess we are hoping to “sequester” until a vaccine comes out?
 
Chuck, on a 2 or 3 layer, quilting cotton face mask what is a sufficient way of cleaning and making safe again? No metal.
Thanks.
 
As stated in this thread or another, poorer health, lower-income, and less access to medical care could make the deep south particularly vulnerable

Very true and very unfortunate.
 
If most people have a smartphone, Google and Apple know where everyone has been. If you test positive the data exists to determine whose other phones you have been near in the last x days.

True. Not readily available yet. but they are working on it.

The fortunate thing we are finding is not everyone is getting it. Even though it can be passed by vapor, it is usually passed by hands. The air spreads the virus on surfaces.
 
Chuck, on a 2 or 3 layer, quilting cotton face mask what is a sufficient way of cleaning and making safe again? No metal.
Thanks.

Washing in hot water or UV light. Heck 5 days in a paper bag is probably enough.
 
Ga seemed to ramp up fast. Indiana has 5500 cases and 173 deaths. I heard a report yesterday that we have 700+ people admitted to the ICU AND on vents, with just over 500 of those being confirmed Covid cases. We were hoping the peak would be around the 15th or 16th, but it may be later.

We have yet to see much VENT usage.
 
Chuck, if everybody DOESN’T immediately get this (we don’t get the 80% infection rate required for “herd immunity”) then the GOOD news is that we don’t overwhelm the medical system. That is our appropriate immediate numero uno priority. Does that also however mean that this is going to either “smolder” for months to years or demonstrate flare ups when large sub populations not previously exposed GET exposed? I don’t understand why in China cases seem to be precipitously dropping, I am happy for the Chinese people, but until a vaccine is fielded isn’t it just going to flare up again unless they can maintain lockdown until vaccine comes out?

Seems we’ve switched from “containment” (isolating the sick, we lost our chance on that really early) to “sequestering” (isolating the non-infected population, particularly the elderly and those with medical conditions at most risk.) I guess we are hoping to “sequester” until a vaccine comes out?

Sequester is pretty much what we are doing right now. The shedders are something we don't have a good number on. Everything is conjecture and the news is inflaming the numbers.
 
Chuck
I need some advice it's for my daughter. She is a supervisor in a medical drug testing lab here WI. For the last few weeks she was able to work from home. Now her manager is telling her she needs to come back to work on Monday. They need her in the lab to help police the employees to make sure they doing proper safe distancing and other C19 safety recommendations. Their are about 500 people a day who leave and enter the building a day. She has a 4 year old and husband who have asthma. She is scared she will bring C19 back home. What would you recommend she do to keep her self safe and family safe.
Thanks so much
Gary
 
Chuck, is part of the screening questionnaire still "have you traveled to x in the last 14 days or been around someone who has?". At this stage of the game, I fail to see how relevant those questions are, yet that is still what we are being asked here in Canada.
 
Agreed. We no longer ask about travel - that is immaterial at this range.
 
Chuck
I need some advice it's for my daughter. She is a supervisor in a medical drug testing lab here WI. For the last few weeks she was able to work from home. Now her manager is telling her she needs to come back to work on Monday. They need her in the lab to help police the employees to make sure they doing proper safe distancing and other C19 safety recommendations. Their are about 500 people a day who leave and enter the building a day. She has a 4 year old and husband who have asthma. She is scared she will bring C19 back home. What would you recommend she do to keep her self safe and family safe.
Thanks so much
Gary

Gary: It is always a risk. The highest risk is touching people or surfaces in public. You just must assume that everyone has it. If she used universal precaution plus everyone wears a mask, her is risk much less. Not a single patient has caught this working as a medical provider or nurse in my region (to this point). Nearly all patients that I have traced caught COVID through physical contact from a loved one or friend and not a coworker.

Personally, I wear a mask, wash diligently, remove my clothes before going home, and change clothing in my garage at home. I am very protecting of myself and my family but I still will go home. My family visits me and I am not worried about them catching it.

Suggestions reiterated:
  1. Wear a mask at all times - to protect others and hopefully this Is the standard in her worksite.
  2. Never touch your face, nose, mouth, or eyes without washing your hands first.
  3. Wash you hands after touching 2.
  4. Change clothes before coming home or before entering house.
  5. Wash your hands, wash your hands, washing your hands.
  6. If you can’t do 5, use Purell.
 
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