Coronavirus: What questions do you have?

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les

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I have it stuck in my head from the start of the pandemic that COVID was somewhere between 5-10 times more deadly than the flu.

CDC states there are 12K~50K annual deaths due to the flu
So far the stats show about 840K deaths over 2 years in the US due to Covid, or an average of 420K per year

But I am not certain if there is data to show the rates of death vs infection for the flu, as many people who get the flu (especially a minor case) may not be reported....
 

NateB

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Off the top of my head, I think the mortality rate for influenza is 0.1%. I'm not sure if that is adjusted for assumed cases of the flu or only the known cases. You're right, that most cases are probably self treated at home and no lab tests done to confirm it.
 

NateB

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Chuck, it looks like our area covid cases have peaked and are just beginning to trend down. Our hospital is still full, but the covid and vent numbers are heading down. Are you seeing the same trends in larger regions?
 

cwbullet

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Chuck, it looks like our area covid cases have peaked and are just beginning to trend down. Our hospital is still full, but the covid and vent numbers are heading down. Are you seeing the same trends in larger regions?

It varies state by state. We may be starting to trend down in GA. I sure hope so. Our Local NAR club canceled the launch because the landowner wants us to be below 15% positivity. I have to respect their wishes.
 

Rob Campbell

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It varies state by state. We may be starting to trend down in GA. I sure hope so. Our Local NAR club canceled the launch because the landowner wants us to be below 15% positivity. I have to respect their wishes.
We appear to have peaked in Florida. Here is the latest from the NYT. I hope this is the light at the end of the tunnel.
florida covid.PNG
 

ThirstyBarbarian

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We appear to have peaked in Florida. Here is the latest from the NYT. I hope this is the light at the end of the tunnel.View attachment 499673

A friend of mine who tracks cases in the Bay Area counties much more diligently than I do thinks we peaked here locally around 1/6. The data isn’t always updated in real-time, and it takes awhile to be certain of a trend, so he thinks we should know in another week or so, but he’s optimistic we are on the down slope.
 

cwbullet

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We appear to have peaked in Florida. Here is the latest from the NYT. I hope this is the light at the end of the tunnel.View attachment 499673

I would not rest on your laurels. This thing could be over, but we need to be vigilant and protect ourselves and our families.
 

RocketDestroyer

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Idaho doesn't appear to have peaked yet. The hospitals are starting to talk about going back to crisis standards of care. To make matters worse there are about 18,000 confirmed cases that have not yet been added to the graph below.

1642222231615.png
 

jderimig

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Dr. Chuck,
On Wednesday Dr.Welenski said that about 75% of the recent Covid deaths occurred in people with 4 OR MORE co-morbidities. To me that sounds astounding and new information I haven't heard before.

So my first question is what exactly counts as a morbidity? Is that list on a CDC website somewhere?

Then my second question is that since this statistic is tracked, how can we find how many deaths occur in unvaccinated people with no comorbidity as per the CDC definition?
 

Marc_G

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Dr. Chuck,
On Wednesday Dr.Welenski said that about 75% of the recent Covid deaths occurred in people with 4 OR MORE co-morbidities. To me that sounds astounding and new information I haven't heard before.

So my first question is what exactly counts as a morbidity? Is that list on a CDC website somewhere?

Then my second question is that since this statistic is tracked, how can we find how many deaths occur in unvaccinated people with no comorbidity as per the CDC definition?
While we await Chuck's reply, see detailed discussion on these matters here:


Short story: it's not news, it's been that way since the beginning, and most of the comorbidities listed on the death certificates are issues caused by having COVID.
 

NateB

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So my first question is what exactly counts as a morbidity?

Other factors or disease which affect someone's health and ability to recover from disease or injury. Broad answer, yes. The most common are going to be obesity, diabetes, COPD (which in itself is not a single disease) and heart disease. Those all make recovering from anything more difficult, but there can be many more. Think of other chronic illnesses that impact breathing or mobility like pulmonary fibrosis, multiple sclerosis, ALS, prior stroke, brain injury, etc.. Conditions that affect the immune system, conditions that effect whether someone clots too easily or not enough , thyroid problems. Would also include medications that effect your bodies ability to fight disease.

You get the idea.

The body is a complicated machine and the body systems work to do their job but also effect each other. Changes in one part cause changes in the others.
 

ThirstyBarbarian

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Idaho doesn't appear to have peaked yet. The hospitals are starting to talk about going back to crisis standards of care. To make matters worse there are about 18,000 confirmed cases that have not yet been added to the graph below.

View attachment 499782

I think Idaho is the last state to start its omicron surge, so it will probably peak later too.

NY Times has a map of “hot spots” which color codes the states for their infection rates. A few weeks ago I started checking it now and then, and it definitely showed a lot of variation across the country. High rates in the northeast were orange and red, maybe even purple, and then there were regions where most of the states, including Idaho were yellow, or maybe orange, showing lower rates. Over the days, you could watch the rates go up, and it seemed the the map got redder from the edges, moving in toward the center, and the area with the lightest shade was centered on Idaho. A couple of days ago, the entire map was a monochrome purple with no variation at all, except Idaho, which was still red. It really stood out visually that that was the last state to surge. Now that other areas have probably peaked, I wonder if the process is going to reverse, and the map is going to fade from the edges.
 

jderimig

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Short story: it's not news, it's been that way since the beginning, and most of the comorbidities listed on the death certificates are issues caused by having COVID.

Its not news that comorbidities elevates the death risk. What IS news is that 75% of the deaths had 4 or more (not one or 2). What is the elevated death risk if you are unvaccinated and have no comorbidities?
 

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Dr. Chuck,
On Wednesday Dr.Welenski said that about 75% of the recent Covid deaths occurred in people with 4 OR MORE co-morbidities. To me that sounds astounding and new information I haven't heard before.

So my first question is what exactly counts as a morbidity? Is that list on a CDC website somewhere?

Then my second question is that since this statistic is tracked, how can we find how many deaths occur in unvaccinated people with no comorbidity as per the CDC definition?

This is not news at all. No one has asked me but I have known this since the first spike. Deaths in the zero comorbidity are rare but not unheard of and this finding is more pronounced with Omicron.

Morbidity is suffering from a disease or medical condition. Mortality is dying. Comorbidity is suffering from multiple illnesses that might exacerbate one another.

https://www.verywellhealth.com/what-is-morbidity-2223380

The percentage without comorbidites is somewhere between 5-10%. It increases with age. Then again, age may be considered a comorbidity. The number I have seen is 6% overall.
 

cwbullet

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Its not news that comorbidities elevates the death risk. What IS news is that 75% of the deaths had 4 or more (not one or 2). What is the elevated death risk if you are unvaccinated and have no comorbidities?

About 6% of those that die of COVID are without a comorbid condition and nearly all are unvaccinated. That is about as close as I can come to answer to your question. The predicitive models for risk determination are not very good with Omicron.
 

jderimig

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About 6% of those that die of COVID are without a comorbid condition and nearly all are unvaccinated. That is about as close as I can come to answer to your question. The predicitive models for risk determination are not very good with Omicron.
Chuck, do we have an estimate of what percentage of the population (not hospital visitors) may have 4 or more comorbidities ( all 4 or more in one individual)?
 

Marc_G

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Chuck, do we have an estimate of what percentage of the population (not hospital visitors) may have 4 or more comorbidities ( all 4 or more in one individual)?
The problem with this question is that when someone dies of covid, many or most of the comorbidities are due to the COVID. Pneumonia, respiratory disorders, and so on.

So, sure, some of the comorbidities are pre-existing things like diabetes or COPD or alzheimer's or cancer ("malignant neoplasms"), but take a look a the list in the other thread, and you will see that most of the common ones listed on a covid death certificate are things actually caused by the covid itself. I haven't seen a good analysis of comorbidities as a function of age, but it would be very interesting.

The CDC even states that the few covid deaths listed without comorbidities are likely due to missing information at the time of death. Just listing "covid" as cause of death isn't great; the specifics of how death occurred such as respiratory failure or some other effect should ideally be there.
 
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Its not news that comorbidities elevates the death risk. What IS news is that 75% of the deaths had 4 or more (not one or 2).
After a little digging, it seems that the social media amateurs left out one important piece of information: The 75% rate refers to deaths in FULLY VACCINATED individuals, not all deaths. It confirms the effectiveness of the vaccines.
Read the details here:
Do 75% of All Covid Deaths Involve People With 4 Comorbidities? | Snopes.com
I believe this is the study the FDA director cited:
Risk Factors for Severe COVID-19 Outcomes Among Persons Aged ≥18 Years Who Completed a Primary COVID-19 Vaccination Series — 465 Health Care Facilities, United States, December 2020–October 2021 | MMWR (cdc.gov)
Excerpt:
"Risk factors for severe outcomes included age ≥65 years, immunosuppressed, and six other underlying conditions. All persons with severe outcomes had at least one risk factor; 78% of persons who died had at least four."

What does this mean for unvaxxed people with zero comorbidities? Certainly the data shows that the unvaxxed have a higher risk of hospitalization or death from Covid than the vaxxed.. Also keep in mind that one could have a comorbidity and not know it. And as MarcG alluded to, there are what is referred to as downstream comorbidities that only manifest after contracting the illness, since they are caused by the illness. For example, if a death certificate says cause of death was by "Covid and respiratory failure" and the patient did not have signs of respiratory problems prior to the infection, then it would be likely that Covid caused the respiratory failure.
 

cwbullet

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After a little digging, it seems that the social media amateurs left out one important piece of information: The 75% rate refers to deaths in FULLY VACCINATED individuals, not all deaths. It confirms the effectiveness of the vaccines.
Read the details here:
Do 75% of All Covid Deaths Involve People With 4 Comorbidities? | Snopes.com
I believe this is the study the FDA director cited:
Risk Factors for Severe COVID-19 Outcomes Among Persons Aged ≥18 Years Who Completed a Primary COVID-19 Vaccination Series — 465 Health Care Facilities, United States, December 2020–October 2021 | MMWR (cdc.gov)
Excerpt:
"Risk factors for severe outcomes included age ≥65 years, immunosuppressed, and six other underlying conditions. All persons with severe outcomes had at least one risk factor; 78% of persons who died had at least four."

What does this mean for unvaxxed people with zero comorbidities? Certainly the data shows that the unvaxxed have a higher risk of hospitalization or death from Covid than the vaxxed.. Also keep in mind that one could have a comorbidity and not know it. And as MarcG alluded to, there are what is referred to as downstream comorbidities that only manifest after contracting the illness, since they are caused by the illness. For example, if a death certificate says cause of death was by "Covid and respiratory failure" and the patient did not have signs of respiratory problems prior to the infection, then it would be likely that Covid caused the respiratory failure.

Very true. The percentage is probably higher in unvaccinated. It is high in both groups reguardfless.
 

jderimig

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After a little digging, it seems that the social media amateurs left out one important piece of information: The 75% rate refers to deaths in FULLY VACCINATED individuals, not all deaths. It confirms the effectiveness of the vaccines.
Read the details here:
Do 75% of All Covid Deaths Involve People With 4 Comorbidities? | Snopes.com
I believe this is the study the FDA director cited:
Risk Factors for Severe COVID-19 Outcomes Among Persons Aged ≥18 Years Who Completed a Primary COVID-19 Vaccination Series — 465 Health Care Facilities, United States, December 2020–October 2021 | MMWR (cdc.gov)
Excerpt:
"Risk factors for severe outcomes included age ≥65 years, immunosuppressed, and six other underlying conditions. All persons with severe outcomes had at least one risk factor; 78% of persons who died had at least four."

What does this mean for unvaxxed people with zero comorbidities? Certainly the data shows that the unvaxxed have a higher risk of hospitalization or death from Covid than the vaxxed.. Also keep in mind that one could have a comorbidity and not know it. And as MarcG alluded to, there are what is referred to as downstream comorbidities that only manifest after contracting the illness, since they are caused by the illness. For example, if a death certificate says cause of death was by "Covid and respiratory failure" and the patient did not have signs of respiratory problems prior to the infection, then it would be likely that Covid caused the respiratory failure.
Thanks for digging into this, the clip played on the radio station I was listening to did not provide this detail.
 

Marc_G

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Chuck, a question:

Short version: based on what we've learned and observed in the last two years, and now extrapolating for delta and omicron, what is the maximum reasonable incubation period between exposure and getting symptoms?

The reason I ask is that early on in the pandemic we heard the incubation period could be as long as 21 days, and I and many others were skeptical that a coronavirus would have such a long incubation period. My personal theory at the time was that those 2-3 week incubation cases might well have been due to not to the original exposure but due to unknown second exposures perhaps to asymptomatic spreaders. Some months into it, say spring 2020, it became clear that there were a lot of asymptomatic infections and that it was possible for these people to spread to some extent. I saw some articles speculating that the 2+week incubation cases may well not actually have been due to the original known exposure, but it wasn't very definitive at the time.

So, fast forward to 2022... we've learned a lot in general and now have much more contagious variants than we originally did. Based on your research and first hand experience, what's the longest reasonable incubation period for the variants we are dealing with?

Thanks!
 

cwbullet

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Chuck, a question:

Short version: based on what we've learned and observed in the last two years, and now extrapolating for delta and omicron, what is the maximum reasonable incubation period between exposure and getting symptoms?

The reason I ask is that early on in the pandemic we heard the incubation period could be as long as 21 days, and I and many others were skeptical that a coronavirus would have such a long incubation period. My personal theory at the time was that those 2-3 week incubation cases might well have been due to not to the original exposure but due to unknown second exposures perhaps to asymptomatic spreaders. Some months into it, say spring 2020, it became clear that there were a lot of asymptomatic infections and that it was possible for these people to spread to some extent. I saw some articles speculating that the 2+week incubation cases may well not actually have been due to the original known exposure, but it wasn't very definitive at the time.

So, fast forward to 2022... we've learned a lot in general and now have much more contagious variants than we originally did. Based on your research and first hand experience, what's the longest reasonable incubation period for the variants we are dealing with?

Thanks!

I have not seen any research that is conclusive. From what my data is showing in my 2-3K positive tests with tracing information, healthy people typically show symptoms within 72 hours after exposure. It can be up to 5 days after exposure (understand that day 0 is exposure). This does not include patients who are immunocompromised.
 
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