Coronavirus Outbreak

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PXR5

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I could be wrong, but I don't think an N95 mask offers much protection here.
We have N99s at work at the hospital and are told they may or may not work.

But, as most know, the mask should be worn by the infected.
 

Nytrunner

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The fact that the makers of corona beer are experienceing a non-negligible drop in sales is a little depressing. People are seriously unable to separate two fokpletely different things that sound the same
 

Winston

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I could be wrong, but I don't think an N95 mask offers much protection here.
We have N99s at work at the hospital and are told they may or may not work.

But, as most know, the mask should be worn by the infected.
FAR better than nothing for prevention of droplet inhalation. Death from this comes from lung issues, so it's best not to allow it directly into where it eventually wants to go. To prevent droplets from contacting eyes, goggles are required. Surgical masks are adequate for the infected to prevent their droplets from becoming airborne when they cough.
 

Winston

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As of yesterday, no one flying in from the new COVID-19 hotspots of South Korea and Italy are even being so much as questioned about their travel upon their return. Two US college students returning from Italy because of the cancellation of the program in Italy by their college due to COVID-19 reported this to the media.

Of course, this would be using a half-assed method anyway to stop something that's already here. As an example, there are 390,000 Chinese college students in the US and the CDC announced weeks ago that up to that point, 30,000 US citizens had returned to the US from China.

The barn door has long been open and the horses have already left the barn or, in this case, entered the barn.

A nearly useless filter method:

FEBRUARY 27, 2020
Korean Air says it will not allow passengers with fever to fly to U.S.

https://www.reuters.com/article/us-...engers-with-fever-to-fly-to-u-s-idUSKCN20M070

SEOUL (Reuters) - Korean Air Lines Co Ltd (003490.KS) said on Friday it plans to check temperatures of passengers traveling to the United States before boarding and would not allow anyone with a temperature higher than 37.5 Celsius to fly.

A Korean Air flight attendant who worked on flights between Seoul and Los Angeles subsequently tested positive for the coronavirus, South Korea’s disease control agency and sources said on Thursday.

The country’s top airline said in a statement that it also plans to expand these procedures to other routes.


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The other day I saw some bragging being done about the John Hopkins Global Health Security Index #1 rating for the US, a study which I'd already downloaded and looked at a week before.

I had heard an epidemic expert who was involved in the MERS, SARS, and Ebola outbreaks say that Singapore had by far the best system for epidemic detection and containment in the world due to their SARS experience and if they couldn't succeed in stopping an outbreak, no country could.

So, I took a look at the JH report and saw that the US was rated 1/195 [best of 195 countries evaluated] while Singapore was rated 59/195.

Of course, the JH report didn't consider the US's near total dependence on China for PPE (we have 30 million masks in reserve, need another 270 million ASAP according to a recent fedgov announcement, and previous studies have shown we might need billions in an outbreak) and essential drugs OR the lack of test kits which other countries seem to have no problem making and using in huge quantities [is it US regulatory BS that prevents us from making and using THEIR kits?].

Next week the word is that 10,000+ test kits will finally be available here and that's when we actually start to get an idea of how many people in the US are actually COVID-19 infected with that number getting more accurate as the kits filter out and the flu surveillance system adapts.

The third "unknown source" case has been found in Oregon even with the ridiculously low amount of testing being done. He or she works in an elementary school. Fortunately, kids don't die from this bug, but they can serve as vectors.

Good news: it has been found that lung CT scans are even more accurate and MUCH faster for COVID-19 detection than the test kits due to the unique presentation of the affects on the lungs.

Update just heard: the problem with the CDC/FDA approved test kit was that they were trying to make it a multi-flu detection kit and once they removed that feature, it worked reliably enough for COVID-19. Trying to save money by making the kit a generic one for flu type detection?

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Coronavirus (COVID-19): Underappreciated unknowns & inexplicable failures

https://www.paloaltoonline.com/blog...erappreciated-unknowns--inexplicable-failures

Faulty test kits:

The Chinese test kits have an estimated 50% false-negative rate, that is, when testing an infected person, 50% of the time, the test will say he isn't infected. In an experiment on a person known to be infected, only one of the four tests administered return a positive result. You might think that the CDC would take note. Apparently not. The first set of kits distributed to the states and counties had to be recalled because of a manufacturing defect (ineffective chemical reagent). Was this a mistake in testing or QA (quality assurance)? The replacement kit has a lesser defect: The last of the three tests is reportedly beyond the skill set of most to the people intended to administer it. Not a big problem, yet: There is such a limited supply of the kits that few actually have them.

The Chinese finally admitted to themselves that the persistent shortage and unreliability of their test kits called for alternative diagnosis measures. In the reporting of the testing delay of the Solano County case and the CDC's continuing problems with its testing kits, it was reported that the CDC had started developing its own alternative methods. Way to not learn from others' mistakes!

In my previous coronavirus blog, I enumerated similar shortcomings by the CDC to Ebola reaching the US, despite many, many months to prepare.


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Unfortunately, since China apparently buried the outbreak allowing it to spread massively, I think there is absolutely no way this will not become a common, seasonal flu just like H1N1 did. See my H1N1 post below. That's not a good thing for a flu that may be 23 times as deadly as the common influenzas. That and the probably higher transmission rate is why this is being treated the way it is by China and any other affected country.

Study of 72,000 COVID-19 patients finds 2.3% death rate
24 Feb 2020

http://www.cidrap.umn.edu/news-perspective/2020/02/study-72000-covid-19-patients-finds-23-death-rate

Researchers from China's Center for Disease Control and Prevention today describe the clinical findings on more than 72,000 COVID-19 cases reported in mainland China, which reveal a case-fatality rate (CFR) of 2.3% and suggest most cases are mild, but the disease hits the elderly the hardest.
The study, published in JAMA, is the largest patient-based study on the novel coronavirus, which was first connected to seafood market in Wuhan, China, in December, and has since traversed the globe.


Another just released study gives a 1.4% death rate which would be 14 times as deadly as the common influenzas.
 
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Winston

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Comparison of methods to Estimate Basic Reproduction Number (R0) of influenza, Using Canada 2009 and 2017-18 A (H1N1) Data

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6670001/

Results:

The AR method obtained a R0 (95% confidence interval [CI]) value of 1.116 (1.1163, 1.1165) and an EG (95%CI) value of 1.46 (1.41, 1.52). The R0 (95%CI) estimate was 1.42 (1.27, 1.57) for the obtained ML, 1.71 (1.12, 2.03) for the obtained TD, 1.49 (1.0, 1.97) for the gamma-distributed GT, and 1.00 (0.91, 1.09) for the final size of the epidemic. The minimum and maximum vaccination coverage were related to AR and TD methods, respectively, where the TD method has minimum mean squared error (MSE). Finally, the R0 (95%CI) for 2018 data was 1.52 (1.11, 1.94) by TD method, and vaccination coverage was estimated as 34.2%.

Let's just say the now common H1N1 flu has an Ro = 1.5

Estimation of the reproductive number of Novel Coronavirus (COVID-19) and the probable outbreak size on the Diamond Princess cruise ship: A data-driven analysis
18 February 2020

https://www.ijidonline.com/action/showPdf?pii=S1201-9712(20)30091-6

We estimated that the Maximum-Likelihood (ML) value of reproductive number (R0) was 2.28 for COVID-19 outbreak at early stage on the ship.

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The last pandemic was a ‘quiet killer.’ Ten years after swine flu, no one can predict the next one
JUNE 11, 2019

https://www.statnews.com/2019/06/11/h1n1-swine-flu-10-years-later/

On June 11, 2009 — 10 years ago today — the World Health Organization declared that the swine flu virus we now simply call H1N1 had indeed triggered a pandemic, the first time in four decades a new flu virus had emerged and was triggering wide-scale illness around the globe.

Since it started circulating in the spring of 2009, H1N1 has infected about 100 million Americans, killing about 75,000 and sending 936,000 to the hospital, the CDC estimates. Another virus, H3N2, is responsible for more infections, but “in terms of the severity, H1 is kind of this quiet killer,” said Dr. Daniel Jernigan, head the CDC’s flu division.

Fortunately, though the infection could be severe, it was not devastating in most cases. A study published in 2013 suggested between 123,000 and 200,000 people globally may have died as a result of the 2009 H1N1 pandemic:


Global Mortality Estimates for the 2009 Influenza
Pandemic from the GLaMOR Project: A Modeling Study
2013

https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.1001558&type=printable

This was certainly not nothing. But it was also not what people had feared would be in store, and it was a substantially lower death toll than was seen in the 1957 and 1968 pandemics, which each killed about 1 million people at a time of lower global populations. In fact, the H1N1 death toll was lower than the global death toll for typical flu seasons, as estimated by the WHO.

But just looking at the number of deaths masks the full impact of the pandemic, because the people who died were younger than those influenza normally claims. (The elderly, whose immune systems had seen viruses similar to this one long ago, weathered the pandemic pretty well.) A group of researchers who analyzed the deaths based on years of life lost concluded the pandemic’s toll in the United States was at least as bad as an average H3N2 flu season and potentially as severe as the 1968 pandemic.

That picture of the 2009 pandemic was only painted after the fact. At the time, the WHO faced pressure from some key member countries not to declare H1N1 a pandemic at all, because of the apparent lack of severity of the situation. The outbreak seemed, well, wimpy after years of warnings of a bad pandemic. Supply chains didn’t break; global air travel was not disrupted.


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H1N1 is now called Type A seasonal influenza. Note its prevalence in this current bar graph:

 

Winston

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Just released:

Policy for Diagnostics Testing in Laboratories Certified to Perform High Complexity Testing under CLIA prior to Emergency Use Authorization for Coronavirus Disease-2019 during the Public Health Emergency
Immediately in Effect Guidance for Clinical Laboratories and Food and Drug Administration Staff
Document issued on the web on February 29, 2020

https://www.fda.gov/media/135659/download
 

Winston

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JUST the n95 mask is not fully effective, but with goggle use much more so. Without that caveat people will wonder, "How then are they effective for medical workers, but somehow not for me?"

BTW, our government has been warned by experts for many years about relying on China for our medical supplies and as part of established pandemic preparation guidelines the medical system is supposed to have significant reserves, but as always, money talks much louder than common sense and preparing for the future.

https://twitter.com/Surgeon_General/status/1233725785283932160

29 Feb 2020
U.S. Surgeon General
@Surgeon_General
Seriously people- STOP BUYING MASKS!

They are NOT effective in preventing general public from catching Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!
 

Winston

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Estimates for case fatality rates (CFR) are available from recent, decent case studies and range from 1.4 to 2.3% and that's with modern medicine versus the 1918 flu's similar CFR. Also, the 1918 flu didn't exhibit asymptomatic transmission.

 
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Winston

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Uh-oh.

New Covid-19 death raises concerns about virus spread in nursing homes
FEBRUARY 29, 2020

https://www.statnews.com/2020/02/29...concerns-about-virus-spread-in-nursing-homes/

Washington state reported on Saturday the first death in the U.S. from the new coronavirus, the first health care worker to be infected with the disease, and most worrying, the first known outbreak in a long-term care facility.

At a nursing facility in Kirkland, Wash, approximately 27 of the 108 residents and 25 of the 180 staff have some symptoms, health officials said during a teleconference with the Centers for Disease Control and Prevention.

“We are very concerned about an outbreak in a setting where there are many older people,” said Jeff Duchin, health officer for public health for Seattle and King County.

The deceased, a man in his 50s with underlying health conditions, was not a resident of the facility, and officials have not yet found a link between his case and the outbreak in the nursing facility.


WA Gov. Inslee declares state of emergency
29 Feb 2020

https://www.kiro7.com/news/local/de...-washington-state/XIDPHMLVOJAAREQ5YCL75367PU/

Gov. Jay Inslee declared a state of emergency Saturday afternoon in response to the new cases of COVID-19, telling agencies to use all resources necessary to respond to the outbreak. He also authorized the use of the Washington National Guard if necessary.

“This will allow us to get the resources we need,” Inslee said. “This is a time to take common-sense, proactive measures to ensure the health and safety of those who live in Washington state. Our state agency directors have been actively preparing since the nation’s first case appeared in Snohomish County. Washingtonians can be assured we’ve taken this threat seriously and have been working in collaboration with our health care partners to develop plans and procedures to prepare for what could likely be a world-wide pandemic.”
 

Winston

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China Orders Owners Of Closed Factories To Boost Electricity Usage, Pretend Economy Is Back To Normal
29 Feb 2020

https://www.zerohedge.com/economics...electricity-usage-pretend-economy-back-normal

Why must the owner of the empty factory pretend the factory is operating? Because "Higher ups are watching the electricity numbers." And why are higher ups watching the electricity numbers? Because they know that not only the rest of the world is also watching these numbers, but so is China's population. And absent a rebound in electricity usage, even if it is to power unused machines in empty factories, China can't hold out hope to pretend that February was the kitchen sink month as the level of economic activity simply will not rise for months... unless of course Beijing orders the local population to simply consume for the sake of giving the outside world it is consuming as if things were back to normal.

https://twitter.com/jenniferatntd/status/1233788224100818944

Jennifer Zeng
@jenniferatntd

In Wenzhou, factory manager told they must consume 3000 kWh electricity by midnight, as authorities use electricity usage as a criterion of re-open rate. Even the factory has not re-opened for lack of supply and manpower due to COVID2019, the manager had to switch on all the air conditioners and other equipment to ensure they achieve the quota.

 

Winston

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Better idea than his for shoe protection when booties made for that purpose cannot be had: small trash bags or plastic shopping bags. Too small for me:

Shoe Covers Disposable -100 Pack(50 Pairs) Disposable Shoe & Boot Covers Waterproof Slip Resistant Shoe Booties (Large Size - up to US Men's 11 & US Women’s 12.5)

https://www.amazon.com/Disposable-Pack(50-Waterproof-Resistant-Booties/dp/B07CWV59QR

Podcast: James Wesley Rawles: Practical Coronavirus Preparation


 
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Winston

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https://twitter.com/jaycreynolds/status/1233710406805475330

Laura Bicker
@BBCLBicker
29 Feb 2020

In Daegu, 1900 Shincheonji Church members have been tested for coronavirus.
1300 had symptoms & 600 did not.

Among those 1300 with symptoms, 87.5% were confirmed with the virus.

BUT out of the 600 WITHOUT symptoms, 70% were confirmed with coronavirus.


Jay Reynolds
@jaycreynolds

Put another way:

Out of a population of 1,900
1,300 were symptomatic
600 asymptomatic
420 tested positive but asymptomatic
1,131 tested positive and symptomatic
= 1,551 infections out of 1,900 = 81%
 

NateB

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A major part of the effectiveness of an N-95 is wearing it and taking it off properly as well as a proper fit which includes fit testing. With airborne precautions, I wear my N-95 and place a surgical mask over the patient. It the patient is intubated, a filter on the exhale side of the vent circuit helps. I don't wear goggles or a face shield as a general rule unless I am performing procedures which increase exposure. In my area I am still more concerned with influenza and TB than Covid-19.
 

cwbullet

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JUST the n95 mask is not fully effective, but with goggle use much more so. Without that caveat people will wonder, "How then are they effective for medical workers, but somehow not for me?"

BTW, our government has been warned by experts for many years about relying on China for our medical supplies and as part of established pandemic preparation guidelines the medical system is supposed to have significant reserves, but as always, money talks much louder than common sense and preparing for the future.

https://twitter.com/Surgeon_General/status/1233725785283932160

29 Feb 2020
U.S. Surgeon General
@Surgeon_General
Seriously people- STOP BUYING MASKS!

They are NOT effective in preventing general public from catching Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!
That is not true. N95 is effective. It is especially effective if worn by the ill patient.

It really depends on how you define effective. The flu vaccine is effective 47% of the time. The M95 is better than that. Effective does not mean perfect. The only perfect means is to build a bunker in your back lawn and never coming out.
 

DAllen

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I wonder if I am on Winstons ignore list yet.

Oh wait.

No one cares. Carry on.
 

Daddyisabar

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That is not true. N95 is effective. It is especially effective if worn by the ill patient.

It really depends on how you define effective. The flu vaccine is effective 47% of the time. The M95 is better than that. Effective does not mean perfect. The only perfect means is to build a bunker in your back lawn and never coming out.
To be perfect you would need an underground workshop to build rockets and a silo to launch from. Robotic recovery so you don't have to go outside. Yeah, I think most of the folks on this forum could live with that! :)
 

DAllen

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So I was stuck in a huge line at WalMart and I coughed a couple of times and said, "This cough has gotten a lot worse since I got back from China."

And just like that - no more line.
 

Mushtang

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I'm still waiting to find out what I did in this thread for Winston to accuse me of being a major problem from the start of it.

Anyone have an idea?
 

Winston

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That is not true. N95 is effective. It is especially effective if worn by the ill patient.

It really depends on how you define effective. The flu vaccine is effective 47% of the time. The M95 is better than that. Effective does not mean perfect. The only perfect means is to build a bunker in your back lawn and never coming out.
Your response implies that you didn't read my post prior to that one:

https://www.rocketryforum.com/threads/coronavirus-outbreak.157220/page-12#post-1969318

Also, as I heard explained by an epidemiologist which I didn't get into in the quoted post, moisture from breath swells and expands N95 mask fibers allowing more unfiltered air to flow through. There is a study I've seen of a mask with a NaCl impregnated middle layer that is as effectively as close to 100% as possible, but that's just a study.

As I stated in that original post, it is recommended (officially) that an n95 should not be wasted on the already ill; plus, they restrict airflow which is bad for people with breathing difficulties. A surgical mask is recommended instead. That's what they're made for, for the surgeon to avoid infecting the patient.
 
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Winston

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Silver Linings Playbook: 119 People Quarantined In A Brothel In Spain
1 Mar 2020

https://www.zerohedge.com/health/silver-linings-playbook-119-people-quarantined-brothel-spain

Of all the places to be quarantined, a brothel in Valencia, Spain, might not be the worst. You've got booze, you've likely got a small buffet of fried foods and you've got entertainment.

But in all seriousness, that was exactly the case a day ago when authorities found that a woman working at the "La Selva Negra" brothel had tested positive for coronavirus. The findings forced authorities to quarantine the premises and the 86 customers that were inside.

The employee, who is now in the hospital, had "slept with several clients that same night," according to a translated blog post on the story.

In addition to the customers, the club's owners, waitresses, security and cleaning crew were also quarantined. When added to the total of 86 customers, it makes 119 people under quarantine. They have been asked to "keep calm" and to just "live a normal life" inside the premises.

That may be easier for some of the patrons than they'd like to admit.

And for all those guys who told their wives they were going to a wine tasting with their buddies and instead went to the brothel, the news may be worse than coronavirus - you're officially busted.
 
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