Neverending Covid-19 Coronavirus

[Djxfactor511]

Brazilian President Jair Bolsonaro Tests Positive For Coronavirus

The 65-year-old leader revealed the result Tuesday on national TV. Bolsonaro has repeatedly downplayed the virus's dangers, despite Brazil suffering the world's second-largest outbreak.

www.npr.org

 

[Turbo]

July 4th, at the US Embassy in Brazil. This is going to be interesting.

 

[Goatfish]

Some more hopeful, but far from confirmed postulating around herd immunity which has been assumed to be only achieved at 60-70% previously:

Coronavirus: could it be burning out after 20% of a population is infected?

 

[Tillman]

I know comparing Sweden to the US isn't exactly apples to apples, but an interesting read regarding letting things remain "normal" vs taking aggressive steps towards spread reduction and its effect on mortality and economy amongst Scandinavian countries.

Sweden Has Become the World’s Cautionary Tale

 

[Goatfish]

I know comparing Sweden to the US isn't exactly apples to apples, but an interesting read regarding letting things remain "normal" vs taking aggressive steps towards spread reduction and its effect on mortality and economy amongst Scandinavian countries.

Sweden Has Become the World’s Cautionary Tale

Interesting take, and doesn’t seem to square up with the data.

Sweden cases and deaths are falling, so they appear to have reached some sort of herd immunity or else this virus is extremely seasonal, since there was no lockdown and new cases continue to decline.

GDP for Q1 actually GREW 0.4% vs much of the world that had negative GDP amidst lockdowns.

Deaths per million are better than Italy, Spain, UK and Belgium. 89% of Sweden’s deaths were 70+ years old. ~70% were split between care home residents and home care recipients. IF Sweden avoids a second wave in the fall and they reached herd immunity and their economy stayed positive and their citizens maintained freedoms, all while staying in line with deaths per capita similar to their European neighbors with deaths concentrated towards the most vulnerable, they may have taken the right approach. We won’t know for quite awhile, though.

 

[Turbo]

There is too much focus on death rates.

There is a high incidence of secondary effects in living patients. Brain damage, for example.

SARS-CoV-2 infection is associated with a wide spectrum of neurological syndromes affecting the whole neuraxis, including the cerebral vasculature and, in some cases, responding to immunotherapies. The high incidence of acute disseminated encephalomyelitis, particularly with haemorrhagic change, is striking.

The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings

Paterson, Brown et al. present a case series of 43 patients with neurological complications of SARS-CoV-2 infection. The neurological syndromes include encephal

academic.oup.com

 

[nolalady]

Interesting take, and doesn’t seem to square up with the data.

Sweden cases and deaths are falling, so they appear to have reached some sort of herd immunity or else this virus is extremely seasonal, since there was no lockdown and new cases continue to decline.

GDP for Q1 actually GREW 0.4% vs much of the world that had negative GDP amidst lockdowns.

Deaths per million are better than Italy, Spain, UK and Belgium. 89% of Sweden’s deaths were 70+ years old. ~70% were split between care home residents and home care recipients. IF Sweden avoids a second wave in the fall and they reached herd immunity and their economy stayed positive and their citizens maintained freedoms, all while staying in line with deaths per capita similar to their European neighbors with deaths concentrated towards the most vulnerable, they may have taken the right approach. We won’t know for quite awhile, though.

And we have to be careful when looking at Sweden to compare it to the US. Sweden has a much more robust medical system and even their poorest citizen can get medical care. One of the reasons we can't just let the virus spread here is due to the large number of uninsured americans--uninsured americans are people without Medicaid, Medicare or private insurance and roughly total 44M the last time I looked at numbers, but this was pre-pandemic, so this number has definitely gone up. We cannot NOT have a social safety net and let a virus run rampant, unless we want a lot more civil unrest.

 

[Goatfish]

There is too much focus on death rates.

There is a high incidence of secondary effects in living patients. Brain damage, for example.

The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings

Paterson, Brown et al. present a case series of 43 patients with neurological complications of SARS-CoV-2 infection. The neurological syndromes include encephal

academic.oup.com

I have yet to see data supporting that there is a "high incidence" of secondary effects. The link you posted had a sample size of 43, 1/3 of which were not confirmed SARS-CoV-2 positive (could have had another viral illness). Many of the patients in that study made a full recovery from the secondary symptoms with treatment, and most with worst complications were over the age of 50.

[I hate that I feel I must preface my posts by stressing I think this virus is very serious and do not think it's "not a big deal", but here I go again. Focusing on death rates IS important. When Imperial College said USA was going to have 2.2 million dead, that was the reason for nationwide lockdowns and panic. It was the right thing to do at the time.]

Now that we know this disease is much, much less fatal (especially in young and healthy), AND that it won't burn itself out like SARS-CoV-1, we must learn to live with this.

This. Virus. Is. Not. Going. Away.

Having the population understand secondary effects and remaining diligent with hand washing/hygiene, smart distancing, limiting mobility where possible, wearing masks, taking care of our bodies and immune systems more than normal, and protecting at-risk people around us at all costs is what we need to focus on.

There are incidences of secondary effects in surviving patients of any disease. Pneumonia, influenza, even the common cold. Anecdotally, I had a nasty cold 3-4 years ago that left me without a sense of taste or smell, body aches/fatigue, and lingering cough for 6 weeks. It was freaking miserable, and who knows what a detailed workup of my organs at that time would have shown.

We also don't know:

1. Prevalence of the long term effects in people, since counts of actual infected could be understated by 10-20-30x in some populations.
2. Comorbidities and underlying conditions of people suffering these secondary effects.
3. How long these "long term effects" will last, since this virus is only a few months old.

 

[Goatfish]

And we have to be careful when looking at Sweden to compare it to the US. Sweden has a much more robust medical system and even their poorest citizen can get medical care. One of the reasons we can't just let the virus spread here is due to the large number of uninsured americans--uninsured americans are people without Medicaid, Medicare or private insurance and roughly total 44M the last time I looked at numbers, but this was pre-pandemic, so this number has definitely gone up. We cannot NOT have a social safety net and let a virus run rampant, unless we want a lot more civil unrest.

I agree. Our medical system and population is not conducive to doing what Sweden did, but I think it'd be a shame to not take the results to heart going forward in deciding whether subsequent nationwide lockdowns make sense.

Post initial lockdowns (which, again I agreed and agree with), I think the USA needs to be mindful of the massive heterogeneity of the country in terms of demographics, population density and seasonality (multiple studies have shown seasonality of SARS-CoV-2 being similar to other respiratory illnesses). This points to the importance of differing policies by locality which will be extremely hard to implement, but important to avoid further irreversible damage to our economy, populace's mental health, education, etc., etc.

My hope is that we can learn from other countries mistakes and successes and get out of this with a measured, calculated approach that focuses on data and not out-and-out fear as we learn more. I also am hopeful that we can work towards bolstering access to healthcare for all, and I really really hope and pray that this disaster leads us to universal healthcare.

 

[Indymisanthrope]

My hope is that we can learn from other countries mistakes and successes and get out of this with a measured, calculated approach that focuses on data and not out-and-out fear as we learn more. I also am hopeful that we can work towards bolstering access to healthcare for all, and I really really hope and pray that this disaster leads us to universal healthcare.

Those seem like reasonable hopes that any rational group of people could rally behind. Has anyone ever accused you of being a masochist?

 

[Smansmith]

My hope is that we can learn from other countries mistakes and successes and get out of this with a measured, calculated approach that focuses on data and not out-and-out fear as we learn more. I also am hopeful that we can work towards bolstering access to healthcare for all, and I really really hope and pray that this disaster leads us to universal healthcare.

This. I hate to come in as the Canadian and talk healthcare in a US-centric forum but I am a huge proponent and believer for full access to healthcare. We (Canadians) don't have a perfect healthcare system either but I was hospitalized the first week of February (non-Covid related); Emergency room overnight and then private room for 3 nights and a shared room (1 other person) for 2 nights. Medication, meals and at the end, I just signed the discharge sheet and walked out, no huge pile of forms...nothing. No insurance needed. One signature and the only contact afterwards was for checkups and surveys on how my stay was. Hell, even the food was ordered off a menu, like selections for all meals - I mean it is hospital food but still. The only other time was similar and that time even included surgery (Gallbladder removal) - one signature and done.

I truly hope there can be a change due to this pandemic in the US to focus on healthcare for all. It is a massive undertaking but hopefully November can bring a change!

 

[RenegadeMonster]

Louisiana governor says progress against coronavirus has been wiped out in past three weeks | CNN

The gains the people of Louisiana made against Covid-19 in June have been wiped out over the past three weeks, Gov. John Bel Edwards said Wednesday.

www.cnn.com

 

[Tyr]

This. I hate to come in as the Canadian and talk healthcare in a US-centric forum but I am a huge proponent and believer for full access to healthcare. We (Canadians) don't have a perfect healthcare system either but I was hospitalized the first week of February (non-Covid related); Emergency room overnight and then private room for 3 nights and a shared room (1 other person) for 2 nights. Medication, meals and at the end, I just signed the discharge sheet and walked out, no huge pile of forms...nothing. No insurance needed. One signature and the only contact afterwards was for checkups and surveys on how my stay was. Hell, even the food was ordered off a menu, like selections for all meals - I mean it is hospital food but still. The only other time was similar and that time even included surgery (Gallbladder removal) - one signature and done.

I truly hope there can be a change due to this pandemic in the US to focus on healthcare for all. It is a massive undertaking but hopefully November can bring a change!

Brb, changing my citizenship.

 

[Goatfish]

Louisiana governor says progress against coronavirus has been wiped out in past three weeks | CNN

The gains the people of Louisiana made against Covid-19 in June have been wiped out over the past three weeks, Gov. John Bel Edwards said Wednesday.

www.cnn.com

We want cases and recoveries up and death rate to continue to go down. This would indicate being closer to herd immunity since a vaccine may never come, and would indicate healthier people are contracting the virus and treatment options are getting better.

Case count is only one small part of the story anymore. Case positivity % is up marginally, but not anywhere close to the previous peaks. Younger, healthier people being infected, gigantic number more being tested, antibody testing being lumped into PCR numbers, backlogged data being dumped, all hospital admissions being tested, multiple positives for one individual counting as multiple new daily cases, track and trace is up in certain areas, suspected cases included by many states as new cases, etc., etc.

Messaging needs to be fixed by media so we can better manage risks and reduce societal panic/anxiety while still being mindful that this isn’t going away.

 

[Enaz Fox]

Increase in delirium, rare brain inflammation and stroke linked to COVID-19

Neurological complications of Covid-19 can include delirium, brain inflammation, stroke and nerve damage, finds a new UCL and UCLH-led study.

medicalxpress.com

 

[dhodo]

We want cases and recoveries up and death rate to continue to go down. This would indicate being closer to herd immunity since a vaccine may never come, and would indicate healthier people are contracting the virus and treatment options are getting better.

Case count is only one small part of the story anymore. Case positivity % is up marginally, but not anywhere close to the previous peaks. Younger, healthier people being infected, gigantic number more being tested, antibody testing being lumped into PCR numbers, backlogged data being dumped, all hospital admissions being tested, multiple positives for one individual counting as multiple new daily cases, track and trace is up in certain areas, suspected cases included by many states as new cases, etc., etc.

Messaging needs to be fixed by media so we can better manage risks and reduce societal panic/anxiety while still being mindful that this isn’t going away.

You keep saying we, but I'm not seeing anyone in my state or federal government showing the slightest interest in doing what you're suggesting. All I'm seeing is a bunch of threats to force everything back to normal as soon as possible from Trump and promises to not shut anything down again (no matter what the data shows in the coming months) from my governor. They haven't announced plans for how school will work, but I'm not too optimistic.

I appreciate your perspective and I agree with your hopes, but I don't think it matters what the media does, there's got to be a plan that is based on the actual data from the people in charge that uses data and expert opinions and I'm not seeing it. I hope some states are able to do better than mine, but they have to deal with threats of cut funding from the Feds if they don't do what Trump wants.

That's what's freaking me out and keeping me from seeing a light at the end of the tunnel.

 

[Goatfish]

Increase in delirium, rare brain inflammation and stroke linked to COVID-19

Neurological complications of Covid-19 can include delirium, brain inflammation, stroke and nerve damage, finds a new UCL and UCLH-led study.

medicalxpress.com

Study was posted a few up and I addressed it. Any viral infection can result in encephalitis. The report showed a small number of people presenting symptoms, and only 2/3 had confirmed COVID diagnoses. They were also older (median age ~60) and many recovered.

Again, not that it isn't a concern, but as of now it appears rare like it does with other viral infections.

 

[Enaz Fox]

Study was posted a few up and I addressed it. Any viral infection can result in encephalitis. The report showed a small number of people presenting symptoms, and only 2/3 had confirmed COVID diagnoses. They were also older (median age ~60) and many recovered.

Again, not that it isn't a concern, but as of now it appears rare like it does with other viral infections.

Wasn't sure if it was the same study as the links were different. All I can say is I have no faith in our government to do the right thing in regards to this virus. We don't know the long term effects of this disease and this is the main reason I cannot support the concept of herd immunity as the answer. I hope you are right and your positive outlook rings true, I just see things getting worse and worse for awhile.

 

[Turbo]

Study was posted a few up and I addressed it. Any viral infection can result in encephalitis. The report showed a small number of people presenting symptoms, and only 2/3 had confirmed COVID diagnoses. They were also older (median age ~60) and many recovered.

Again, not that it isn't a concern, but as of now it appears rare like it does with other viral infections.

The fact that something is rare, has a low rate, etc only matters if you only care about things on an individual level. Sure, you or the people you know have a low chance of serious complications or deaths on an individual level.

But at a policy level, these rates need to be multiplied by the actual number of people that can get sick. That's what results in costly hospitalizations and increased risk to health care workers, even if there is full recovery at the end. How much does a 2-4 week hospitalization cost in your country? In ICU?

It makes me cringe when I see people focus on individual rates, because this is exactly what deniers everywhere are using as an excuse to do little. Hey, why do we need to worry if there is only a 0.6% chance of dying and it's skewed towards old people anyway?

 

[bother]

My hope is that we can learn from other countries mistakes and successes and get out of this with a measured, calculated approach that focuses on data and not out-and-out fear as we learn more. I also am hopeful that we can work towards bolstering access to healthcare for all, and I really really hope and pray that this disaster leads us to universal healthcare.

UH I READ ON FACEBOOK THAT THERE'S A NEW LUNG MOLD GROWING FROM MASK USE SO I DON'T KNOW WHERE YOU GET YOUR "FACTS"

Seriously though, I did read that, and it made me very sad. I wish we could just straight up ban Facebook sometimes.

Keep posting, I really enjoy your takes.