Fear and Loathing, a Rat Flu Odyssey

[summit]

I'm not a COVID skeptic. I'm not an expert and I defer to the experts who say we have a problem. But the measures we are taking to contain the virus are causing enormous damage and it would be foolish to ignore the skeptics. We should be asking over and over again--are we doing too much, are we doing the right thing, or is there more we should be doing. We should be ready to change course if and when the facts change. Shoot me if you want, but one of the questions we should be asking is what damage are we doing to the lives of young people in order to protect the elderly. I don't have an answer but the question has to be asked, and asked publicly.

Re the accuracy of the tests. I don't know what the accuracy is. The tests are new, the disease is new, and there isn't an easily checked gold standard like a biopsy that confirm a positive test in a living patient. As the article Spats posted says, if you take a test with a significant false positive rate and test a large group of people few of whom have the disease, most of your positives will be false, with a significant impact on people's lives and at significant expense. Testing should be focused, not widespread screening of low risk people, even if we had the means to do it. I don't know the actual numbers for this particular disease and test, but I understand the reasoning. Tests can do harm. The accuracy of tests and who should get one is a constant problem in medicine.

At CDC quarantine sites they serial tests until two negative PCRs... and this was the standard for release of quarantine in most areas of US until they ran out of tests/testing capacity. A false positive would have quickly stood out.

So for false positive filtering, inclusion criteria is being sick. So we tested for other causes to avoid as well.

Usually we are testing for strep peumoniae and legionella in sick patients. We were doing RVP on anyone we tested for COVID. Then the RVP was having delayed TAT so we just did Flu AB RSV PCR unless sick enough to admit... but now we are literally running out of flocked nasal swabs for NP samples and the state doesn't want throat anymore.

We aren't testing anyone who isn't hospital sick because we can't. And we are still seeing 4-5 day TAT, can't even get priority for ICU patients

The testing situation is an absolute disgrace

[Deebased]

Apparently deebased judges a country if they have a Little Caesers chain or not.

I wish that was true. Peppes is a step down if that's even possible.

[MultiVerse]

Everything multiverse is true. I'm not saying we shouldn't test people. I'm saying we need to decide who to test based on the accuracy of the test, the prevalence of the disease in the population, and individual risk factors. We also have to remember that a negative test is only good until the next time the test subject encounters another human being and is potentially exposed. We have to assume that every human being we encounter is infected.

Currently the CDC is only recommending testing of symptomatic people. My non expert opinion is that all symptomatic people be tested, regardless of exposure history. Asymptomatic close contacts of a patient should probably be tested if they are no longer going to be in contact with the patient; no point in testing if they're going to continue to be exposed.

It was clear to me that Doc was only recommending clear thinking and good science.

Fair enough. And I didn't mean to suggest the Doc's questions aren't valid.

The main thing is based on what we know right now—things could change but that's a bad bet—is the math just doesn't care. The only way to slow the rate of exponential growth before the disease tops out somewhere around 70% of the population is to implement wide-scale testing and social distancing.

[LeeLau]

Attachment 320702

All the above 4 diseases either had such high fatality rates (Ebola is a classic example, MERS another) it killed the host before it could spread significantly past the growth spread rate (R0) of 1. A particularly ironic way for a contagion outbreak to be contained.

For that reason these diseases were geographically contained.

COVID is in the unfortunate sweet spot of having a relatively high R0 and a relatively low fatality rate (still substantially higher than flu but is in the median for hospitalization and intensive care rates). This supports a wide geographic spread of the contagion plus a rate of spread that, at between 20 - 33%, serves to infect a host population in enough absolute numbers to overwhelm a health-care system (case in point Italy).

[iceman]

hence, flatten the curve

[carpathian]

All this talk of dying from pneumonia made me think of this.

From Tool's latest album 'Fear Inoculum' which means Injection of Fear

Song called 'Pneuma'

We are spirit bound to this flesh
We go round one foot nailed down
But bound to reach out and beyond this flesh
Become Pneuma
We are will and wonder
Bound to recall, remember
We are born of one breath, one word
We are all one spark, sun becoming
Child, wake up
Child, release the light
Wake up now
Child, wake up
Child, release the light
Wake up now, child
(Spirit)
(Spirit)
(Spirit)
(Spirit)
Bound to this flesh
This guise, this mask
This dream
Wake up…

[Deebased]

This. We visited in '99 for 10 days and saw a shit-ton of the country by train and boat.

Gotta move that oil around somehow.

[The SnowShow]

A few questions for people smarter than I:

-Why can’t the necessary test kits be massed produced fast by every private lab out there and get them out ASAP so we can increase the testing numbers faster? I cannot understand how this hasn’t been happening faster.

-Can companies right now mass produce ventilators so when there’s huge demand soon, we’ll have more than we have now.

- I know nothing about masks other than they are made in China and are in low supply? Can we in the US not mass produce masks? Also, my understanding is they don’t work to protect the wearer of the mask from outside particles but protects others from an infected mask wearer. So what If every person was issued a mask to be used in public, then maybe the social distancing at work, restaurants, etc could be relaxed because, theoretically, everyone would be protecting each other with everyone wearing the masks?

[idahospud]

A few questions for people smarter than I:

-Why can’t the necessary test kits be massed produced fast by every private lab out there and get them out ASAP so we can increase the testing numbers faster? I cannot understand how this hasn’t been happening faster.

-Can companies right now mass produce ventilators so when there’s huge demand soon, we’ll have more than we have now.

- I know nothing about masks other than they are made in China and are in low supply? Can we in the US not mass produce masks? Also, my understanding is they don’t work to protect the wearer of the mask from outside particles but protects others from an infected mask wearer. So what If every person was issued a mask to be used in public, then maybe the social distancing at work, restaurants, etc could be relaxed because, theoretically, everyone would be protecting each other with everyone wearing the masks?

On the last point: the tooling required to create the materials for the masks is incredibly specialized, it's not machinery that can be created from scratch in a day or two. My limited understanding is that that's maybe the single biggest hold-up in mask manufacturing right now.

[BmillsSkier]

This fall is gonna be a banger.

Kentucky Derby, Masters, Football, 3rd month of Baseball...

Tailgate at my house.

[ill-advised strategy]

flatten the curve

My wife tries to do that at the gym, but she remains curvy.

[ill-advised strategy]

If this is still going on during wildland fire season it’s going to be a real conundrum with fire camps and smoke inhalation and evacuations and all that.

[AK47bp]

A few questions for people smarter than I:

-Why can’t the necessary test kits be massed produced fast by every private lab out there and get them out ASAP so we can increase the testing numbers faster? I cannot understand how this hasn’t been happening faster.

-Can companies right now mass produce ventilators so when there’s huge demand soon, we’ll have more than we have now.

- I know nothing about masks other than they are made in China and are in low supply? Can we in the US not mass produce masks? Also, my understanding is they don’t work to protect the wearer of the mask from outside particles but protects others from an infected mask wearer. So what If every person was issued a mask to be used in public, then maybe the social distancing at work, restaurants, etc could be relaxed because, theoretically, everyone would be protecting each other with everyone wearing the masks?

The masks can be double edged swords. Everyone wearing them means everyone will have a concentrated germ/virus receptacle attached to their face. Then they are constantly adjusting it, taking it on and off and contaminating their hands, leaving it places, etc.




Sent from my iPhone using TGR Forums

[The SnowShow]

On the last point: the tooling required to create the materials for the masks is incredibly specialized, it's not machinery that can be created from scratch in a day or two. My limited understanding is that that's maybe the single biggest hold-up in mask manufacturing right now.

And is that machinery is short supply?

I’d think someone could make a huge fortune if they were able to create a mask everyone could wear.

Elon? Screw the space station.

[Flyoverland Captive]

My wife is a home-health nurse in Bend. Here’s a text she sent to a friend today.

“Yep, it may be 5 covids in Bend; here we go. We are getting notices every 12 hours. We don’t have enough PPE. I have 4 masks left, and we are now required to use one for every visit. I see 3
or 4 patients a day; this is not sustainable. I have 4 scrub jackets, I change between each patient and will wash them every evening because we don’t have enough gowns. I am swabbing my shoes between visits. ....”

[The SnowShow]

Some optimism for this thread:

https://virologyj.biomedcentral.com/...422X-2-69#Fig2

https://www.technologyreview.com/s/6...reatments/amp/

https://www.google.com/amp/s/kfor.co...tion-says/amp/

[LeeLau]

A few questions for people smarter than I:

-Why can’t the necessary test kits be massed produced fast by every private lab out there and get them out ASAP so we can increase the testing numbers faster? I cannot understand how this hasn’t been happening faster.

-Can companies right now mass produce ventilators so when there’s huge demand soon, we’ll have more than we have now.

- I know nothing about masks other than they are made in China and are in low supply? Can we in the US not mass produce masks? Also, my understanding is they don’t work to protect the wearer of the mask from outside particles but protects others from an infected mask wearer. So what If every person was issued a mask to be used in public, then maybe the social distancing at work, restaurants, etc could be relaxed because, theoretically, everyone would be protecting each other with everyone wearing the masks?

Test kits require RNA and reagents and skilled assembly. All in short supply ironically because of COVID

Ventilators are an extremely specialized piece of equipment. See above comment

Others have spoken to masks. They aren't easy to make

[KQ]

Crikey. Reached out to a friend to see how things were going with her on her farm in Woodinville. I was just making conversation and mentioned how much we relied on tourist dollars and that this would seriously impact our local economy because spring release probably wouldn't happen among other events. This was her reply:


Walla Walla can join the rest of the world in suffering economically without tourism.


Okay then...guess she's in a bad place right now...backing away.....

[Cono Este]

The masks can be double edged swords. Everyone wearing them means everyone will have a concentrated germ/virus receptacle attached to their face. Then they are constantly adjusting it, taking it on and off and contaminating their hands, leaving it places, etc.




Sent from my iPhone using TGR Forums

Jesus, there is no win. I wash my hands 10 times a day but when I get home from the store I question if the stock boy had dirty hands.


Sent from my iPhone using TGR Forums

[splat]

If this is still going on during wildland fire season it’s going to be a real conundrum with fire camps and smoke inhalation and evacuations and all that.

And eating in mess tents, sharing showers, bathrooms and sinks, and doing briefings.

[Spats]

Some optimism for this thread:

https://virologyj.biomedcentral.com/...422X-2-69#Fig2

https://www.technologyreview.com/s/6...reatments/amp/

https://www.google.com/amp/s/kfor.co...tion-says/amp/

Optimism isn't allowed!
A common, dirt-cheap drug can't possibly do anything against this disease that has killed nearly as many Americans as (checks database) just committed suicide in the last 12 hours! (Meanwhile, this season's flu knocks off its 20,000th victim)
The entire might of the world's medical system in 2020 is completely helpless!
We definitely won't come up with any drugs that have any effect, or better testing, or a vaccine!
WE'RE DOOMED!
(oh god please let everyone be doomed, I can't bear the thought of not being able to blame this on #orangemanbad, what if the economy recovers before the election, I would rather see tens of thousands die than admit I was wrong on a message board once)</sarc>

[bennymac]

Video emerges showing Trump talking about cutting pandemic team in 2018, despite saying last week 'I didn't know about it'

- Video appears to contradict president's claim of ignorance about the cuts

https://www.independent.co.uk/news/w...-a9405191.html

"I didn't cut them! But I can bring them back in. I mean I never let them go - but we can get them back when we need them. I'm sure they are just sitting at home doing nothing awaiting my call. And when I call they can't refuse - they have to come back. Again, I'm talking about the team we didn't cut."

[bennymac]

Optimism isn't allowed!
A common, dirt-cheap drug can't possibly do anything against this disease that has killed nearly as many Americans as (checks database) just committed suicide in the last 12 hours! (Meanwhile, this season's flu knocks off its 20,000th victim)
The entire might of the world's medical system in 2020 is completely helpless!
We definitely won't come up with any drugs that have any effect, or better testing, or a vaccine!
WE'RE DOOMED!
(oh god please let everyone be doomed, I can't bear the thought of not being able to blame this on #orangemanbad, what if the economy recovers before the election, I would rather see tens of thousands die than admit I was wrong on a message board once)</sarc>

JFC this is just stupid. I bet you felt like you nailed it when you pressed enter to post this.

Some viruses show exponential spread. Suicide does not. Vibes to you for not understanding the difference. Or should I say vibes to your family and coworkers for having to deal with someone with such a simple way of looking at things.

And when you reply please post the R0 of suicide. And influenza. And Covid.

[LeeLau]

Optimism isn't allowed!
A common, dirt-cheap drug can't possibly do anything against this disease that has killed nearly as many Americans as (checks database) just committed suicide in the last 12 hours! (Meanwhile, this season's flu knocks off its 20,000th victim)
The entire might of the world's medical system in 2020 is completely helpless!
We definitely won't come up with any drugs that have any effect, or better testing, or a vaccine!
WE'RE DOOMED!
(oh god please let everyone be doomed, I can't bear the thought of not being able to blame this on #orangemanbad, what if the economy recovers before the election, I would rather see tens of thousands die than admit I was wrong on a message board once)</sarc>

Vaccines take 12 to 18 months to commission.

Various other treatments for COVID variants have treated only symptons and not resulted in efficacious treatments. There is sufficient data from China, Singapore and Taiwan that's long-dated sufficiently. That doesn't mean that health authorities aren't trying but there's not been success.

Sometimes a new variation of a pathogen doesn't have a treatment. It's happened before. It'll happen again. It's evidently happening right now

[old goat]

That would be part of "clear thinking", Doc.

yes it would be.