Coronavirus: What questions do you have?

[BABAR]

What's interesting to me is that:
- enough people are doing enough isolating/mask wearing/sanitizing so as to create historically low Flu infection rates,
- we are in the middle of an upswing of COVID-19 with daily new infection rates higher than anything we've seen, even in the early days when no one was wearing masks,

COVID-19 must be amazingly transmissible for both of these to be true.

Nor does the fact that the death rate is as high as 2.5% - I was really expecting it to be significantly lower.
- My reading of one of the graphs says that 95% of the deaths are in people over 50, with 80% of the deaths in people over 65
Good time to be young.
https://covid.cdc.gov/covid-data-tracker/#demographics

Covid is weird in that it is contagious BEFORE it is symptomatic (I am a physician and initially I didn’t believe it, it is not logical or intuitive, but apparently it is true. ) Usually really sick patients stay home or go into hospital, they don’t circulate at bars and restaurants and buses and subways, sharing the gift that keeps on giving.

Definitely good time to be young, but the young and particularly obese young patients don’t get off scot free, mortality in obese patients is 3-4x non obese.

Good time to slim down.

 

[cwbullet]

For what it's worth, CDC has never counted influenza deaths in the US in the past.
I'm not certain why (lack of uniform testing? testing error rates?). Perhaps, medical professionals on this forum can provide insights on this subject.
Instead, CDC has always relied on the estimates for counting instances of influenza illnesses, hospitalizations, and deaths. Details, including methodology for deriving those estimates, is here:
https://www.cdc.gov/flu/about/burden/past-seasons.html


In our area (NJ), we've hit the 2nd highest monthly infection rate this October, since April.
In April, all kids were already 100% schooling from home, and virtually all non-essential employees were working from home.
Now, the 2/3rd of the school districts have opened back up for full, or part-time schooling. Virtually everyone I know, including all my neighbors up and down the street (all professionals), are back to going to work part-time or full-time.

Every week, I've been getting an email from the school district that reads: "another kid tested positive for CV19, but wasn't infected on school grounds, and contact tracing did not identify any likely infections in school".
Every adult I know who has gotten CV19 this fall, got it either at work, or (most likely) on the way to work. Then immediately spread it within the family.

Many in the US are taking more precautions, including wearing masks (though not everyone, and clearly not those attending political rallies), but we are DEFINITELY not socially isolating as much as we did in the spring.

And that's in New England / Yankee land.
In many other cultural regions, folks are putting more trust into politicians who claim that "Doctors are inflating Covid deaths", and that "we are rounding the corner".
And they are acting accordingly.
So does a sizeable proportional of TRF participants.

Thus we get what we've got.

US is tracking 5x cases/1M pop and 2.65 x deaths/1M population vs. Canada.
Mexicans are also better off than US citizens w.r.t. Covid-19 outcomes.
But Peruvians and Belgians are worse off, so hooray to us !
https://www.worldometers.info/coronavirus/
You can blame our leaders, or our Doctors, for the above.
Take you pick.

True. many flu numbers are estimates based on positive tests. COVID is a count of positive tests alone.

 

[cwbullet]

Covid is weird in that it is contagious BEFORE it is symptomatic (I am a physician and initially I didn’t believe it, it is not logical or intuitive, but apparently it is true. ) Usually really sick patients stay home or go into hospital, they don’t circulate at bars and restaurants and buses and subways, sharing the gift that keeps on giving.

Definitely good time to be young, but the young and particularly obese young patients don’t get off scot free, mortality in obese patients is 3-4x non obese.

Good time to slim down.

Very true. It is thought to be more contagious when symptomatic, but ho the heck do you test that.

A study showed that — after adjusting for age, gender, body mass index, and diabetes mellitus diagnosis — COVID-19 hospitalized patients who had a previous positive test result for a coronavirus had significantly less severe levels of illness than those without prior infection. This finding is not surprising and is 100% expected. This result is from being "immunized" with the live virus.

 

[cwbullet]

Singing vs speaking: A new study released indicates that is not the act of singing but the volume that increased the spread of COVID. The high volume seen in singing or similar volume speaking produces 30% aerosol that normal toned speaking. One thing this study does nto take into account that I think most of the church or choir singing includes - a lack of social distancing while aerosolizing and poor ventilation indoors. It is definitely more complex than just the aerosol.

I would recommend people carefully think through if gatherings are needed indoors. We need to carefully decide what safe distancing is needed and maybe we should sing outdoors with proper spacing.

 

[Stefan2k4]

Very true. It is thought to be more contagious when symptomatic, but ho the heck do you test that.

A study showed that — after adjusting for age, gender, body mass index, and diabetes mellitus diagnosis — COVID-19 hospitalized patients who had a previous positive test result for a coronavirus had significantly less severe levels of illness than those without prior infection. This finding is not surprising and is 100% expected. This result is from being "immunized" with the live virus.

I guess that correlates with this study.
https://www.nih.gov/news-events/nih...ne-cells-common-cold-may-recognize-sars-cov-2
It found that blood samples taken before the pandemic had immune cells that showed reactivity to SARS-CoV-2 and those cells seemed to be memory cells from past common cold corona virus. So, could this perhaps make it a bit easier to achieve herd immunity? We should have vaccines coming in the next year right? If we have a combination of this, the vaccines, and people who've already recovered from Covid, would the combination of all 3 help us to achieve herd immunity quicker?

 

[John Kemker]

Chuck, I remember reading something about findings that those wearing eyeglasses had a lower rate of infection/reported infection than those who didn't, leading some scientists to believe that COVID-19 may be transmissible through the eyes. If true, this would definitely make not touching your face, especially your eyes, even more important. Thoughts? Info?

 

[GuyNoir]

We need to carefully decide what safe distancing is needed and maybe we should sing outdoors with proper spacing.

I would normally be singing tenor in our church choir, and the only proper spacing I will accept is a vaccine. I like singing in our choir, but being over 65, I can't afford to take any chances.

(aside: the choir quit singing back in March and hasn't been back since.)

 

[cwbullet]

I guess that correlates with this study.
https://www.nih.gov/news-events/nih...ne-cells-common-cold-may-recognize-sars-cov-2
It found that blood samples taken before the pandemic had immune cells that showed reactivity to SARS-CoV-2 and those cells seemed to be memory cells from past common cold corona virus. So, could this perhaps make it a bit easier to achieve herd immunity? We should have vaccines coming in the next year right? If we have a combination of this, the vaccines, and people who've already recovered from Covid, would the combination of all 3 help us to achieve herd immunity quicker?

I think that depends on how you define herd immunity.

 

[cwbullet]

Chuck, I remember reading something about findings that those wearing eyeglasses had a lower rate of infection/reported infection than those who didn't, leading some scientists to believe that COVID-19 may be transmissible through the eyes. If true, this would definitely make not touching your face, especially your eyes, even more important. Thoughts? Info?

Yes. I am not sure if they confirmed an ocular route do spread, but research has been suggestive.

 

[cwbullet]

I would normally be singing tenor in our church choir, and the only proper spacing I will accept is a vaccine. I like singing in our choir, but being over 65, I can't afford to take any chances.

(aside: the choir quit singing back in March and hasn't been back since.)

I will b e first in the line when it is available. I have researched the safety and immunity data and I am comfortable with all GOV subsidized projects. Of course, I will review it again before they stick me.

 

[BABAR]

Singing vs speaking: A new study released indicates that is not the act of singing but the volume that increased the spread of COVID. The high volume seen in singing or similar volume speaking produces 30% aerosol that normal toned speaking.

Now think about Bars (the alcoholic kind.)

Can’t wear a mask while drinking.
Noisy as heck, so have to speak loudly or yell to be heard, AND be close to the listener.
Frequent trips to restroom, touching doorknobs, etc,
Judgement and rational thought inversely proportional to blood alcohol level.

Can you say, “Petri Dish”?
How about , “SuperSpreader”?

 

[BABAR]

Yes. I am not sure if they confirmed an ocular route do spread, but research has been suggestive.

Makes sense. I suspect this is the major route of common cold (also Corona Virus) transmission.

Start with infected person.

RHINOVIRUS (means nose, not endangered mammalian species)

Runny nose to fingers or sneezes.

Fingers or sneezes to surfaces such as doorknobs or handrails or phones.

Now the victim.

Finger to surface picks up Virus on finger.

Finger to eyelid.

Eyelid to eye surface.

Eye surface to tears.

Tears to NASOLACRIMAL DUCT directly into nose (this is why your nose runs when you cry.)

Nose infected and you have a cold.

Another of the many things weird about Covid is the absence of runny nose symptoms. But loss of sense of SMELL (which also indirectly but GREATLY impairs subjective sense of TASTE) is a common and I believe frequently EARLY symptom.

Anyway, I wear a mask, face shield, and my glasses when I am around anybody but my two blondes (wife and Yellow Lab.)

 

[Peartree]

I would normally be singing tenor in our church choir, and the only proper spacing I will accept is a vaccine. I like singing in our choir, but being over 65, I can't afford to take any chances.

(aside: the choir quit singing back in March and hasn't been back since.)

Our organist records our choir music in advance, then our music director emails it to the choir. Choir members (about half of them) then record themselves, individually or by family groups, singing to that accompaniment and email it back. Those recordings are edited together for our weekly online worship services. Usually, this is just for two hymns and only involve a handful of singers representing four part harmony but appoximately once per month, they manage to edit together an entire anthem. The bell choir is doing something similar, but it's more difficult and cannot be done at all under our current state COVID guidelines (our county is currently at "level 3 - RED"). We anticipate that this will be how the choirs continue, even after we return to some kind of socially distanced in-person worship, until most of the congregation has received a vaccine.

 

[Blast it Tom!]

Our organist records our choir music in advance, then our music director emails it to the choir. Choir members (about half of them) then record themselves, individually or by family groups, singing to that accompaniment and email it back. Those recordings are edited together for our weekly online worship services. Usually, this is just for two hymns and only involve a handful of singers representing four part harmony but appoximately once per month, they manage to edit together an entire anthem. The bell choir is doing something similar, but it's more difficult and cannot be done at all under our current state COVID guidelines (our county is currently at "level 3 - RED"). We anticipate that this will be how the choirs continue, even after we return to some kind of socially distanced in-person worship, until most of the congregation has received a vaccine.

I highly commend them for that effort! There's just something wonderful about everyone making the most of the technology; hymnody is so important to shared worship (IMHO). Keeping a sense of community, sharing the hope, seeing one another even if by screen has to be healthy. "He has not given us a spirit of fear..."

 

[cwbullet]

Now think about Bars (the alcoholic kind.)

Can’t wear a mask while drinking.
Noisy as heck, so have to speak loudly or yell to be heard, AND be close to the listener.
Frequent trips to restroom, touching doorknobs, etc,
Judgement and rational thought inversely proportional to blood alcohol level.

Can you say, “Petri Dish”?
How about , “SuperSpreader”?

Alcohol suppresses the immune response over time plus it make people do stupid stuff. Bad idea during a pandemic.

 

[cwbullet]

We are struggling to get out patients back in the building.

Problem: the test missed some positives as negative but the predictive value is high since the incidence is low. Our local incidence is less than 5% right now. I have to try to find a way to keep our staff safe and our patients happy. Tough juggling lesion.

 

[rocketsaway]

Received a msg the other day from the national transportation co. that provides school buses for the district. 11 employees tested positive. Because of this, the Dept of Health closed bus operations for 2 weeks. Its a large New England school district, not any relation to where I am. This in turn closed the schools because of no transportation.
However, even after this app msg was sent to everyone nationwide, people inside my location terminal were still not wearing masks. Most are over 60. I dont understand this mentality.

 

[kuririn]

I dont understand this mentality.

Perhaps for the same reason that a certain percentage of people don't buckle up when driving.
"It's uncomfortable"
"It won't happen to me"
Yada, yada.

 

[Rocketjunkie]

Perhaps for the same reason that a certain percentage of people don't buckle up when driving.

However, not using seat belts doesn't risk others. Not wearing a mask increases chances of transmitting to others.

 

[SecondRow]

However, not using seat belts doesn't risk others.

Not wearing seat belts puts others’ lives at risk. https://pubmed.ncbi.nlm.nih.gov/14734597/

 

[Mushtang]

The number of known cases is most definitely increasing, but does that mean that the number of actual cases is increasing, or only that we're now aware of more than we were previously aware of and the total number hasn't increased at all?

I think the way to find out is to look at the deaths from Covid. If the number of deaths has also increased a lot recently then there would clearly be more cases recently. In the graphs below I see that there is no increase in deaths following this "increase" like there was during the increase back in the summer. The top graph is Cases, the bottom is Deaths.

Or am I missing something? Possibly it's too early to see the increase and it will appear as we get deeper into November. The increase in Deaths followed the summer spike by weeks, and we're already many weeks beyond the number of cases equaling the summer spike again. The deaths haven't increased, or only barely have.

These are found at: https://covid.cdc.gov/covid-data-tracker/#trends_dailytrendscases

 

[boatgeek]

Chuck and others have said that we've gotten a lot better at treating COVID since the beginning of the pandemic, so deaths might be a skewed measure. I'd guess that hospitalizations would be a better proxy of how widespread the infection is, with the ratio of hospitalizations to deaths indicating how good our treatments are. Unfortunately, hospitalization data seems to be hard to come by in many places.

 

[Marc_G]

In Indiana we are at 25% Covid ICU use and about 30% free space in ICU (rest is routine icu usage). That's I think as bad as we have seen in the whole pandemic, or close to it.

 

[NateB]

Our hospitalizations, ICU admission, and ventilator use due to Covid are all increasing. We aren't full yet, but close.

 

[cwbullet]

Our hospitalizations, ICU admission, and ventilator use due to Covid are all increasing. We aren't full yet, but close.

We are stair-stepping up and down here. I think we are about to skyrocket.

 

[cwbullet]

I got a complaint about not being able to launch a rocket on our field. The bottom line is that launch rockets take an agreement with local officials, the landowner, and the club. We need to stop being selfish and stop focusing on me me me. We cancelled our launch because 2 of the 3 baulked. The group is trying to keep YOU safe.

 

[cwbullet]

PPIs may increase the risk of a bad outcome:

https://www.mdlinx.com/news/ppi-use... Morning Alert&utm_source=iPost&?show_order=1

 

[cwbullet]

Rapid Covid Antigen Tests Have higher false-positive rate:
https://www.mdlinx.com/news/us-fda-... Morning Alert&utm_source=iPost&?show_order=2

 

[rocketsaway]

Here's a link to PA hospitalizations dashboard. COVID-19 Early Warning Monitoring System Dashboard

 

[rocketsaway]

The Centre for Evidence-Based Medicine
Are you infectious if you have a positive PCR test result for COVID-19?

"...PCR results may lead to restrictions for large groups of people who do not present an infection risk."
"The results indicate that viral RNA load cut-offs should be used: to understand who is infectious, the extent of any outbreak and for controlling transmission."

What is your understanding of this study ?