Coronavirus: What questions do you have?

[cwbullet]

Update: Today the numbers might be leveling off in GA. The unfortunate thing is that out ICUs are bove 80% at 85-100% filled and the death rate jumped to 78 in a single day. Today is a day in which I think the Chaplains might be more successful at treating this illness.

 

[Marc_G]

Update: Today the numbers might be leveling off in GA. The unfortunate thing is that out ICUs are bove 80% at 85-100% filled and the death rate jumped to 78 in a single day. Today is a day in which I think the Chaplains might be more successful at treating this illness.

Hi Chuck,

I'm with you in spirit, sending good vibes.

I've been watching Georgia for some time and saw the huge spike in cases, following closely on your reports there in the trenches so to speak. I'm a bit surprised that overall the deaths per day seems to have remained relatively stable over this time. Here's a chart from Worldometers which may not yet include the deaths from today (78, but dates of death spread over a week or more):



Looking at the chart I see some ups and downs but essentially stable since April. I'm presuming it is just lag between case spike and deaths spike, but other states like TX, FL, AZ and even CA seemed to have closer coupling of cases to death surges. Is there some GA-specific factor to explain this, or am I missing something in the analysis?

Thanks for all you do, Chuck! Stay safe!

 

[Peartree]

Update: Today the numbers might be leveling off in GA. The unfortunate thing is that out ICUs are bove 80% at 85-100% filled and the death rate jumped to 78 in a single day. Today is a day in which I think the Chaplains might be more successful at treating this illness.

Unfortunately, our patients usually don't listen to us any better than they listen to their doctors.

 

[cwbullet]

Hi Chuck,

I'm with you in spirit, sending good vibes.

I've been watching Georgia for some time and saw the huge spike in cases, following closely on your reports there in the trenches so to speak. I'm a bit surprised that overall the deaths per day seems to have remained relatively stable over this time. Here's a chart from Worldometers which may not yet include the deaths from today (78, but dates of death spread over a week or more):

View attachment 425441

Looking at the chart I see some ups and downs but essentially stable since April. I'm presuming it is just lag between case spike and deaths spike, but other states like TX, FL, AZ and even CA seemed to have closer coupling of cases to death surges. Is there some GA-specific factor to explain this, or am I missing something in the analysis?

Thanks for all you do, Chuck! Stay safe!

Thank you. I can use the support. The command is pushing us hard.

 

[cwbullet]

Unfortunately, our patients usually don't listen to us any better than they listen to their doctors.

I appreciate your efforts. I spend a lot of my time playing chaplain and social worker for people that screwed up not listening to me the first time.

Folks, just wear a mask and stay home when you are not.

 

[NateB]

The unfortunate thing is that out ICUs are bove 80% at 85-100%

That sounds rough. Can you share about what percentage of the ICU beds are Covid cases or is that not being disclosed?

We still plenty of patients admitted with Covid or waiting results. Testing is slow again and we are still dealing with supply issues for essential items. Aside from Covid, our trauma admits are quite a bit higher than average with severe TBIs requiring lengthy stays. We are also finding more trauma cases or other medical cases also testing positive and/or showing Covid symptoms.

 

[cwbullet]

That sounds rough. Can you share about what percentage of the ICU beds are Covid cases or is that not being disclosed?

We still plenty of patients admitted with Covid or waiting results. Testing is slow again and we are still dealing with supply issues for essential items. Aside from Covid, our trauma admits are quite a bit higher than average with severe TBIs requiring lengthy stays. We are also finding more trauma cases or other medical cases also testing positive and/or showing Covid symptoms.

Not for specific hospitals (especially mine) but I can give a range of numbers I am seeing across the state. A lot are not giving numbers but they range from 40-70%. One facility has 0% listed but I doubt that is accurate unless they have a separate COVID facility.

Nationwide: Some facilities have set up COVID only wards and ICUs and others have taken over old hospitals to convert to COVID facilities. A lot of variety of solutions.

I have started wearing a mask all the time even when not at work. I wear Hanes Masks or these cotton mask. They come in a 50 pack.

 

[cwbullet]

Update: Numbers at 3400-3500 per day. Deaths are up to 80 per day for the past 2 days. That is the highest for any two days since it started.

 

[Nytrunner]

Are any of the numbers corrected for re-tests of the same positive individual?

 

[cwbullet]

Are any of the numbers corrected for re-tests of the same positive individual?

We have stopped retesting. We will not retest a patient who is positive until 90 days have passed. See the CDC. That recommendation is research-backed.

 

[Nytrunner]

We have stopped retesting. We will not retest a patient who is positive until 90 days have passed. See the CDC. That recommendation is research-backed.

Which sounds reasonable.

Im trying to sort through family chats that are fond of statements like:
-TX, FL, OH, VA, others are all counting multiple tests of the same individual as new cases (because someone may be required to test negative again to go back to work or leave quarantine?)
-Death counts aren't trustworthy because if you die by car crash, gunshot, Alzheimers, etc...but test positive for covid-19, youll be added to the covid deaths statistic
-(i wont go into the follow on points because they quickly get political/conspiratorial)

 

[Peartree]

In Ohio at least, that charge is pretty solidly denied and there is no real evidence to the contrary. The rumor seems to have been started by the Ohio Speaker of the House in order to throw smoke after his arrest by federal agents for a $60 million bribery scam.

https://www.dispatch.com/news/20200...nting-multiple-coronavirus-tests-as-new-cases

 

[OverTheTop]

A few extra cases counted in that manner will not make up for the number of cases that people have and have not been confirmed by testing. Noise in the data only.

 

[cwbullet]

Which sounds reasonable.

Im trying to sort through family chats that are fond of statements like:
-TX, FL, OH, VA, others are all counting multiple tests of the same individual as new cases (because someone may be required to test negative again to go back to work or leave quarantine?)
-Death counts aren't trustworthy because if you die by car crash, gunshot, Alzheimers, etc...but test positive for covid-19, youll be added to the covid deaths statistic
-(i wont go into the follow on points because they quickly get political/conspiratorial)

You can test positive for 120 days after infections. There is no evidence that these patient are infective past 10 days so retesting is not indicated Except in a very small group of immunocompromised patients.

 

[Marc_G]

Hi Chuck,

I've been surprised that the # deaths/day in Georgia has remained relatively flat despite huge case surge that has been going on for some time. I know they had two high # deaths days this week but today I see it's down to 25.

It seems a little bit inconsistent with the pattern seen in other sun belt states.

Do you have faith in the death numbers being reported by GA?

 

[cwbullet]

Hi Chuck,

I've been surprised that the # deaths/day in Georgia has remained relatively flat despite huge case surge that has been going on for some time. I know they had two high # deaths days this week but today I see it's down to 25.

It seems a little bit inconsistent with the pattern seen in other sun belt states.

Do you have faith in the death numbers being reported by GA?

They are pretty consistent. I think the deaths will rise. I see more success at treating ti this time around. We have already discharged a few that I thought would have exited by another means. I think the drug cocktail we are using has been highly successful at preventing death.

 

[Marc_G]

They are pretty consistent. I think the deaths will rise. I see more success at treating ti this time around. We have already discharged a few that I thought would have exited by another means. I think the drug cocktail we are using has been highly successful at preventing death.

Great! What is that cocktail, if I may ask?

 

[cwbullet]

Remdesvir, dexamethasone, and an inhaled drug that shall not be named.

 

[MikeT]

CV-19 a virus so deadly you need a test to know if you have it.
Enough already time for everyone to go back to work.

Mike

 

[cwbullet]

CV-19 a virus so deadly you need a test to know if you have it.
Enough already time for everyone to go back to work.

Depends on how you define deadly. COVID is not really that deadly when compared to Ebola or Naegleria fowleri. On the terms of Ebola, this is a walk in the park.

Why do you need a test? If you not going to be admitted, how does it change treatment? If you need a test to know t protect others, that sounds like a problem with our society. If you are sick you shoudl stay home regardless. I am not attacking you, I am just illustrating a problem. Over 98% of folks will get other this without a hitch and not news admission. The test at this time does nto inform treatment unless you need admission. All it does is give us a data point. We have plenty of data points.

 

[Marc_G]

Hi Chuck,

Despite widespread concerns with early data from China, I recall they did in late May a "test every person in WuHan" campaign due to a second surge there at the time. Do you know if anything was ever published about that? Even if they only were able to reach 75% the data would be very interesting.

 

[cwbullet]

Hi Chuck,

Despite widespread concerns with early data from China, I recall they did in late May a "test every person in WuHan" campaign due to a second surge there at the time. Do you know if anything was ever published about that? Even if they only were able to reach 75% the data would be very interesting.

It has been a very hush-hush situation. I cannot share what I know because it is sensitive information that may reveal sources. What i can tell you about Wuhan is what the news has already released. They have reported that millions of cell phones went dead in a short span of months and Urns were sold at a higher rate than would be expected. The data the news reported in not accurate, but the situation was much direr than China admitted.

Testing: They attempt to test, but I do not think they made it to 75% due to a second wave. Hopefully, they release the data and we know the truth.

 

[MikeT]

Depends on how you define deadly. COVID is not really that deadly when compared to Ebola or Naegleria fowleri. On the terms of Ebola, this is a walk in the park.

Why do you need a test? If you not going to be admitted, how does it change treatment? If you need a test to know t protect others, that sounds like a problem with our society. If you are sick you shoudl stay home regardless. I am not attacking you, I am just illustrating a problem. Over 98% of folks will get other this without a hitch and not news admission. The test at this time does nto inform treatment unless you need admission. All it does is give us a data point. We have plenty of data points.

Bottom line. Recovery's are way up and deaths way down. Time to put this too bed. I've ( along with millions others) been back at work ( part time retirement gig at the LHS) dealing with the public for months and I'm 67 ( at risk) I take all the precautions and go about my daily life. You can too.

Mike

 

[Mushtang]

Hopefully, they release the data and we know the truth.

China can release data all day long and we still won't know the truth. We can't trust anything China says about China - this has shown to be true over and over.

 

[afadeev]

So, my and the neighboring towns, have publicly disclosed plans for the fall semester school reopening.
Bounding constraints in deciding on the final course of action were:

• Minimize probability of CV19 spread, implement local State recommendations (there is no Federal guidance to speak of), and get as many kids back into the classroom as possible, safely.
• Restrict student capacity to ~50% of total, to be able to enforce 6" social distancing between kids.
• Masks for everyone (teachers, kids), sanitizers all around, cleaning at the end of the day, regular testing for teachers.
• Minimize uncontrolled intermingling and virus spread opportunities, so no way to safely serve lunch on premises, and thus no way to keep kids in school for the full day.

There are some mild variations on the details across towns, but the net result is the same - a hybrid model:

1. Students will be split-up into groups A (roughly half), B (roughly half), and C (remote only for medical or parental request reasons).
2. On alternating days, either group A or B students will attend classes in person (the other group will connect via Zoom) for half a day, with early dismissal in place of lunch.
3. After lunch, obligatory remote learning sessions will fill in the gaps in classes for all groups (everyone got an iPad already).
4. Group A and Group B students who are in the same class will have simultaneous instruction whether at home or in-person.

Subjectively, I am not thrilled with the results. I wanted more in-class instruction.
Objectively, I understand the logic, and find no fault with the plans.
Since I can't solve for a better outcome subject to the stated constraints, I am OK living with this arrangement. Though it will be a headache.

A few friends with kids in private schools are fairing no better, with enrollment down as much as 50%. Many private schools are teetering on the edge of not reopening at all, which may have an impact on the public schools' capacity constraints.

The critical working presumption is that CV19 spreads as easily and as rapidly among kids, as it does among the older populations.
There are a few reports that support such an assertion:
https://www.wsj.com/articles/how-ri...mission-varies-for-kids-and-teens-11595261592https://www.nature.com/articles/s41591-020-0962-9
Chuck, a few Qs for you:

1. Have you run across any reports that quantify CV19 community transmission potential across age groups (school age kids, in particular)?
2. Any evidence on whether or not kids are less likely to catch CV19 vs. less likely to show clinical symptoms vs. transmit CV19 to others while remaining subclinical?
3. Any research on whether the viral load is similar in both clinical and subclinical cases?

Thanks

 

[cwbullet]

Chuck, a few Qs for you:

1. Have you run across any reports that quantify CV19 community transmission potential across age groups (school age kids, in particular)?
2. Any evidence on whether or not kids are less likely to catch CV19 vs. less likely to show clinical symptoms vs. transmit CV19 to others while remaining subclinical?
3. Any research on whether the viral load is similar in both clinical and subclinical cases?

Thanks

Most of the research is very preliminary.

1. I think school-age kids are hard to quantify. So far the estimate is up to 1/3 of children in some areas have already had it based on AB testing.
2. The evidence I am seeing shows they are less symptomatic. That being said, I am only tracking data in FL and GA at this time.
3. It is suspected but no proof that viral load likely has to do with the more severe cased of the cytokine storm. Most of the quick onset and most fatal cases I have seen have been indoor infections that were exposed to heavy aerosolization - IE singing.

It is difficult to do research at this time with the focus on treatment but there are pockets going on all over the place. Does this help?

 

[cwbullet]

Update: Two straight days below 3K. I hope we are out f the woods.

 

[Marc_G]

Update: Two straight days below 3K. I hope we are out f the woods.

I hope so, but maybe just weekend effect?

 

[cwbullet]

I hope so, but maybe just weekend effect?

I hope not. The CDC thinks it is a slight slow down.

 

[cwbullet]

Non-COVID Public service announcement: Another reason to get an Influenza Vaccine: less Alzheimers. Although, it might be a cause rather than an effect: Go get the shot this year!