Another great research article that has shown that asymptomatic test is no the answer to buy down risk in the military. '
https://www.cdc.gov/mmwr/volumes/69/wr/mm6922e2.htm
https://www.cdc.gov/mmwr/volumes/69/wr/mm6922e2.htm
Coronavirus: What questions do you have?
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That is exactly what I was thinking Kurt!
Like it.
Not a question, just an observation but it seems that Florida & SC had a pretty big bump in new cases since they’ve relaxed the restrictions. My own observations are probably half the people I see shopping wear no masks and the beaches are packed.
Is that a jump in hospitalizations, or jump in new cases because they increased testing and found a lot of asmyptomatic people who were infected?
New cases.
Our team is working on a data review for a future publication. Symptomatic patients who present early have a lower fatality rate. Followed by symptomatic patients that present late. I am curious about what the fatality rate is for those that never present. How many are we missing?
Pre look for the next CDC recommendation?
https://medicalxpress.com/news/2020-06-shields-masks-covid-.html
https://medicalxpress.com/news/2020-06-shields-masks-covid-.html
Speaknoevil
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In less than two months the CDC and the medical community as a whole have gone from "masks don't help and instead make you more at risk" to "masks are recommended" to now this?! I have a hard time believing anything from those "on high" anymore so forgive me for not holding my breath on this "new revelation."
I have a different take on this.
1. This is a brand new disease and all the doctors had to go on were previous experiences which might not directly translate.
2. All science is based on adjusting beliefs as data accumulate. The scientific community is still accumulating a huge amount of data over a period of time during which they can test their hypotheses. As odd as it might seem, this has been an excellent opportunity to learn what works. Will that help with future viruses? Maybe.
3. I would much rather have the scientific community quickly adjust their beliefs based on the feedback they’re receiving. That might be embarrassing to them, but it’s responsible.
4. Finally, they didn’t really say masks don’t help. They said that the masks which help the most (n95) should be reserved for the professionals who must deal with the threat. They said that surgical masks which are similar to dust masks are not intended to protect the wearer, but are intended to protect others from transmission of bodily fluids from the wearer. Nearly every meme seems to disregard the details. Face shields are not porous and may offer more protection for the wearer as well as others.
Speaknoevil
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Steve, there are numerous pictures of people wearing masks during the Spanish Flu outbreak. The medical community has had 100 years to study virus transmission and implement best practices.
I agree with you on both of those statements, but it’s obvious that best practices must evolve with the differing circumstances that surround each new disease.
Medicine is ever-evolving based on data. Thirty years ago, we knew that heart disease was directly tied to saturated fat. That evaluated to maybe or not so much when we found that partially hydrogenated fats were most fo the elevation we toied so strongly to saturated fats. It is nto as strong as we originally thought. Give it time and we will find out more about COVID.
This article confirms what we alreayd knew, barriers are more efefctiove than a breathable fabric at stopping bacteria.
I think any organization, health related or not, always has to weigh its' recommendations against the consequences of those recommendations.
If the only criteria was what is best to curb the spread of this virus then the recommendation would have been N95 masks for everybody, as well as the other measures.
Of course, there weren't enough N95 masks and that kind of recommendation would have started a run that would have left front line workers without that resource.
Same thing with the testing.
Recommendation was to get tested only if you exhibit symptoms.
That would leave the asymptomatic spreaders undetected.
But that constraint was needed because there weren't enough tests to get everyone screened.
Better method might have been extensive testing and aggressive contact tracing.
But we did not have those resources. Still don't.
Gotta work with what you have.
But it would have been nice if that was explained to the public.
Might have cut down on the confusion.
If the only criteria was what is best to curb the spread of this virus then the recommendation would have been N95 masks for everybody, as well as the other measures.
Of course, there weren't enough N95 masks and that kind of recommendation would have started a run that would have left front line workers without that resource.
Same thing with the testing.
Recommendation was to get tested only if you exhibit symptoms.
That would leave the asymptomatic spreaders undetected.
But that constraint was needed because there weren't enough tests to get everyone screened.
Better method might have been extensive testing and aggressive contact tracing.
But we did not have those resources. Still don't.
Gotta work with what you have.
But it would have been nice if that was explained to the public.
Might have cut down on the confusion.
Well all, it's been 2 weeks since I was in a room with 2 co-workers that tested positive.
And I feel fine!!!
Yay!
You may be a good candidate for AB testing. Your friends should donate plasma.
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I like this section
The findings in this report are subject to at least two limitations. First, the interventions were implemented in a highly structured and sufficiently resourced military base. Therefore, the success of these interventions in preventing transmission of SARS-CoV-2 at JBSA might not be transferrable to other settings
In other words, basic recruits do what you tell them to do. Your average Joes and Josephines do whatever they want.
True. The comparison to another location that tested all basic trainees twice at onset and at the end. That is a lot of tests in a resource restrained environment. The positive rate was nearly 1/4. It delayed training and created holdovers. If you do nto test unless symptomatic, you can greatly reduce the impact on training. The most important thing about the study is that they found limited proof of passage from asymptomatic spreaders.
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This seems to contradict prevailing opinions, that much of current spread is from asymptomatic carriers (of course, I think with testing we are finding that a lot of cases ARE completely asymptomatic, so even if small probability of spread from asymptomatic people, if there are lots and lots of asymptomatic people, still significant.)
Any guesstimates on what percent of Covid cases go completely clinically undetected? (Meaning how many people were/are either completely asymptomatic or so minimally symptomatic they didn’t think they had anything?)
Also, perhaps same concept could be present with seasonal flu, perhaps there are a lot more people “carrying and transmitting” flu virus without ever knowing they have it,
Reason is in calculating mortality rates. Denominator management. If your denominator is deaths divided by symptomatic cases, you get a much higher calculated mortality rate compared to deaths divided by all seropositive cases if there are a lot of asymptomatic seropositive cases. This would be true for ANY disease, including flu, so comparing Covid to flu may be like comparing apples to kumquats.
I don't think it does. They did not find proof. That does not mean that there was not spread. I suspect that the contained population allowed it to spread and the population is less likely to be symptomatic because of the age and fitness level. More research is needed. This was started before newer testing.
QUOTE="BABAR, post: 2008454, member: 8312"]
Any guesstimates on what percent of Covid cases go completely clinically undetected?
[/QUOTE]
This is probably phase 2 or another study to come.
Check out this reference:
https://news.iu.edu/stories/2020/05...ings-impact-covid-19-indiana-coronavirus.html
In late April >4600 people in Indiana were randomly tested; only 1 in 11 infections were clinically diagnosed. Of the remainder nearly half were asymptomatic. At that time the total positive tests (active + antibody) was 2.8%.
Some excerpts:
"After analyzing these test results, IUPUI public health researchers determined that during the last week of April, 1.7 percent of participants tested positive for the novel coronavirus and an additional 1.1 percent tested positive for antibodies -- bringing the estimated population prevalence of the virus in the state to 2.8 percent, or approximately 186,000 Hoosiers who were actively or previously infected as of May 1, Menachemi said.
As of the same date, the state's testing showed about 17,000 cumulative cases -- not including deaths -- suggesting that only about one out of every 11 true infections were identified by tests focused on symptomatic or high-risk people."
"Menachemi said the research team found that about 45 percent of people who tested positive for active viral infection reported no symptoms at all. "
Also:
"IUPUI scientists estimate the infection-fatality rate for the novel coronavirus in Indiana to be 0.58 percent, making it nearly six times more deadly than the seasonal flu, which has an infection-fatality rate of 0.1, according to the U.S. Centers for Disease Control and Prevention. "
Another phase of testing happened in late May and I'm looking forward to hearing the results.
Wow, Hoosiers have smart scientists
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Okaaaay. So the number for Covid death rate is deaths per infection (symptomatic AND asymptomatic.)
BUT, the number for FLU, is THAT based on deaths per SYMPTOMATIC cases alone, or symptomatic AND asymptomatic cases? My guess is the FORMER (not sure but guessing nobody was doing antibody or other tests for ASYMPTOMATIC flu cases. I do not know if there is data on asymptomatic cases.). So we may still be comparing apples and kumquats.
IFR for the flu is based on statistical projections translating cases (clinical presentation) into estimates of infections. Many studies have looked at infection of flu so yearly infection stats are reasonable. I read once about asymptomatic influenza carriers: random testing showed 20% of flu positives were asymptomatic.
Flu is 100% projection based in general. I would suspect you are right, but flu is less often asymptomatic.
rharshberger
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My sister is a bit worried about the increased chance of Covid when her husband gets a new batch of recruits at Ft. Jackson pretty soon, not that she or any of her family have issues which may make it any more or less life threatening.
boatgeek
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I really like the visualization graphs at 91-DIVOC, particularly the state breakdowns of new cases and the ability to show 1-week rolling averages so the low numbers on weekends get averaged out. One thing I would like to be able to do is look at states/countries by where the new cases or deaths are trending upward. On 91-DIVOC, you can sort by the highest numbers, but not trends. Is there a good source for that kind of data?
She should be concerned. We might be better off not testing this group.
Chuck, my wife had flu symptoms in mid to late March (as well as loss of taste before that was recognized as a Covid 19 symptom). She did not qualify for testing at the time, so she wasn’t tested. I got sick about 2 weeks after she did, and I also didn’t qualify for testing since I didn’t know anyone who had been diagnosed. My wife just got back a positive antibody test, so I suspect I had the virus as well. We’re both fully recovered. Can we donate plasma even though we were never diagnosed with Covid 19?
That depends on your local policy. Call or email you local blood bank. Many local blood beck have to use a positive PCR test because they cannot to antibody titer tests yet.
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