Coronavirus COVID-19 - Global Health Pandemic #56

[Henry2326]

"COVID TRACKING PROJECT

Our daily update is published. We’ve now tracked 9.7 million tests, up 306k from yesterday.
Note that we can only track tests that a state reports."
For details, see: https://t.co/PZrmH4bl5Y The COVID Tracking Project on Twitter

 

[Henry2326]

COVID TRACKING PROJECT

"The U.S. situation continues to be highly influenced by the regional decline in the NY metro area—while the rest of the country shows a different pattern". The COVID Tracking Project on Twitter

 

[Teche]

I think it's interesting how hypertension is associated with more diagnosed cases of CoVid - it must have something to do with hypertension causing more severe symptoms, which makes sense (ACE-2 receptors and all).

Something to really think about.

I think that a large majority of people 60+ have HBP and it can be related to kidney disease. Wasn’t it just a few years ago that the guidelines for HBP have been revised to include a lower range to be considered a HBP diagnosis.

Do you believe that an individual with a stable BP on medication reduce the risk? It’s so common to see individuals with HBP to have uncontrolled readings. Shoots, I have HBP which is stable on medication and on the low end of normal BMI. I may have to spend the rest of my life in quarantine.

 

[10ofRods]

Guess I'm grateful to be on a beta blocker. Jmo

I just renewed my Rx - am going to start tomorrow.

Sweden's government has been striving for herd immunity. This philosophy has not paid off for that country.

Well, as KatyDid pointed out, it's too soon to tell. My fears are that Sweden is actually no where near actual herd immunity (60% testing for antibodies is a good start). Stockholm has been the hardest hit, and apparenty 30% have antibodies. The antibodies vary from small amounts to large amounts, and that seems to be connected to severity of infection. I can post some citations later.

And Stockholm has had the highest number of cases, which means the rest of Sweden is still vulnerable. That means, without slowing the rate of infection, Sweden must climb to a rate of 630/million in the more populated areas. That's twice as many deaths as what they have right now.

I don't believe all of Sweden is at 30% immunity. I think some people will have weak immunity and that the nationwide rate is probably closer to 20%, which means they will need to triple their infection rate (and the 40% not yet infected will get it in little clusters over the next 5 years or so).

It's true that each person living in Stockholm can feel safer, as only 7 out of 10 people walking around are contagious and by August, with twice as many deaths as right now, it will be only 4 out 10 people who might be contagious.

If there's actually a vaccine by September, then many of us will be glad we waited to get CoVid, I think. More likely, it'll be January-February of next year (but other treatments will be on line sooner).

 

[otto]

I think I heard that most medical plans will cover the test IIRC, but you need approval though your doctor. I saw an opening available tomorrow so I didn't want to wait days to find out if it is approved. So I just went to the website and paid by credit card. No doubt the best purchase I have made this week (but it's also the only purchase I've made this week).

People who can't pay, do they wait longer or go without the test?

 

[The Night Watchman]

Well, as KatyDid pointed out, it's too soon to tell. My fears are that Sweden is actually no where near actual herd immunity (60% testing for antibodies is a good start). Stockholm has been the hardest hit, and apparenty 30% have antibodies. The antibodies vary from small amounts to large amounts, and that seems to be connected to severity of infection. I can post some citations later.

And Stockholm has had the highest number of cases, which means the rest of Sweden is still vulnerable. That means, without slowing the rate of infection, Sweden must climb to a rate of 630/million in the more populated areas. That's twice as many deaths as what they have right now.

I don't believe all of Sweden is at 30% immunity. I think some people will have weak immunity and that the nationwide rate is probably closer to 20%, which means they will need to triple their infection rate (and the 40% not yet infected will get it in little clusters over the next 5 years or so).

It's true that each person living in Stockholm can feel safer, as only 7 out of 10 people walking around are contagious and by August, with twice as many deaths as right now, it will be only 4 out 10 people who might be contagious.

If there's actually a vaccine by September, then many of us will be glad we waited to get CoVid, I think. More likely, it'll be January-February of next year (but other treatments will be on line sooner).

Sweden publicly dismisses the idea that they are going for herd immunity, but many have their doubts including me. It's not really what you would want to say, because of the blowback.

30% of AB positive in Stockholm is still pretty significant. The effective Ro of the virus is dampened by this level, which is pretty important in a high population density area. To me this means they are very unlikely to see a NYC-type health care overrun, even with the mythical 2nd wave that is forecast. And Sweden got to this infection level pretty fast, the ramp up in deaths started 2 months ago. Will they get to something close to herd immunity in the populated areas by fall?

Not according to today's IHME model, which accounts for Sweden's limited social distancing efforts to remain in place. Infections continue to drop going forward...

 

[The Night Watchman]

People who can't pay, do they wait longer or go without the test?

I'm not sure otto. I'll try to remember to ask at the test center.

 

[Tigerlily75]

It seems Vietnam is doing very well

How has Vietnam, a developing nation in South-East Asia, done so well to combat COVID-19? - ABC News

 

[Seattle1]

I think there is good news for Sweden. In the end, when all the numbers are in, it might be in Sweden's favour, for 2 reasons.

One, Sweden is taking it's death toll upfront. It's neighbours are locking down, and POSTPONING their upcoming deaths. Their numbers will go up too, eventually, when they come out of lockdown.

Sweden , meanwhile, is building up it's immunity, and learning how to avoid infection, and how to best treat infected patients.

So when the 2nd waves hit, I don't think Sweden will bet hit as hard as it's neighbours. Only time will tell.

On top of that, they will not have the massive economic hit that comes with total lockdown for many months.

So I think the reaL test will be a few months down the road, and beyond. Will Sweden's decision to 'frontload ' the damage be an effective strategy?


I know people are criticising them ans saying they are 'choosing death' by their strategy. But ion reality, the deaths will come to the other countries as well. Some are delaying it much longer, but no one can lock down entire country until a successful vaccine is available for millions of citizens.

I think there's a significant difference between phasing out of lockdown with keen public awareness of the virus compared to 60 days ago and simply leaving home and going back to things-- business as usual.

Whereas I agree it will most likely be months before a vaccine for COVID hits the market, I think there's much better knowledge in the health community as to which Rx are helpful in arresting the deadly lung inflammation early as opposed to immediately ventilating patients which almost seemed to accelerate their demise. As the epicenter of the virus in the western USA, I'm amazed at how quickly Seattle's health community tweaked treatment methods depending on the severity, age, etc..

No way can we resort to business as usual without deadly ramifications! It's going to take a concentrated and cooperative effort to function outside of lockdown while the world waits for a vaccine. I'm also equating, for example, the new order to protocols my essential workplace had to adopt to keep the office a virus-free zone including daily temperatures by employees and two negative tests for anybody presenting with symptoms. A virus free zone also required the cooperation of building management (LEED Silver and Gold facilities) to change HVAC systems for 24/7 full operations versus low energy consumption. Even the hot water temperature for handwashing was elevated. Workforce cooperation is also critical where nobody leaves the workplace after arrival, lunch provided, and return to your residence at day end for limited exposure.

Cliche or not, we're all in this together. Our lives depend on it. MOO

 

[imstilla.grandma]

Guess I'm grateful to be on a beta blocker. Jmo

Me too. I’ve been taking Norvasc and Carvedilol for five years. The blood pressure medicine keeps my hypertension under control but it doesn’t last for 24 hours unless I take the beta blocker with it.

 

[Inthedetails]

Sweden publicly dismisses the idea that they are going for herd immunity, but many have their doubts including me. It's not really what you would want to say, because of the blowback.

30% of AB positive in Stockholm is still pretty significant. The effective Ro of the virus is dampened by this level, which is pretty important in a high population density area. To me this means they are very unlikely to see a NYC-type health care overrun, even with the mythical 2nd wave that is forecast. And Sweden got to this infection level pretty fast, the ramp up in deaths started 2 months ago. Will they get to something close to herd immunity in the populated areas by fall?

Not according to today's IHME model, which accounts for Sweden's limited social distancing efforts to remain in place. Infections continue to drop going forward...

I'm curious how many people in USA (and similar first-world countries) are dying from health issues that are not being addressed because of the virus vs. that number in Sweden.

This is a true question - I have no idea what the answer is and have no preconceived opinion.

Are there are large number of people whose non-Covid health issues are not currently being addressed in USA cities in lockdown....or is that a non-issue and people are getting necessary care just as if we weren't in lockdown? IDK

And same with Sweden - I am assuming that they are not having issues with people avoiding hospitals and healthcare is handling everything? Or, are their healthcare providers overwhelmed?

Not sure if that number could be accurately counted - it's like counting something you don't see, but I think it's a valid number to include, especially in decisions about when to open up locations.

jmo

 

[Seattle1]

I'm not sure otto. I'll try to remember to ask at the test center.

One example of a small city in Colorado (about 100,000) and the testing implemented at no charge.

Leroy Garcia‏Verified account @Leroy_Garcia
The Pueblo Department of Public Health has launched a drive-thru #COVID19 testing site! If you are experiencing any of the symptoms below, please come to the Colorado State Fairgrounds and get tested. Let's work together and stop the spread.

10:27 AM - 11 May 2020

 

[gngr~snap]

Serious question. If it was you and you were a kid, would you want to go back to school with all of these ridiculous distancing rules?
No playground, no lunchroom, no library...
I get it!
Parents have to work, but yuck.
I just can't imagine how they are gonna manage all the kids in the space they have.
Maybe build tent schools? Like the temporary hospitals?
Moo

 

[imstilla.grandma]

The international humanitarian organization Doctors Without Borders, which rarely operates in the United States, has dispatched medical workers to the Navajo Nation to help with the coronavirus pandemic.

The Navajo Nation Reservation, located in the Southwest and covering the corners of Arizona, New Mexico and Utah, has experienced some of the highest infection rates in the country.

Social distancing and sanitary measures required during the pandemic have been a challenge because of the communal living traditionally exercised on the country’s largest reservation.

TRIBAL NATIONS FACE UNIQUE CHALLENGE IN BATTLE AGAINST CORONAVIRUS

Situationally, the Native American communities are at a much higher risk for complications from COVID-19 and also from community spread because they don't have access to the variety of things that make it possible to self-isolate,” Jean Stowell, head of the organization's U.S. COVID-19 Response Team, told CBS News in an interview Monday.

“You can't expect people to isolate if they have to drive 100 miles to get food and water," Stowell said.

IRISH SEND FUNDS TO CORONAVIRUS-HIT NATIVE AMERICAN COMMUNITY, RETURNING NEARLY 200-YEAR-OLD FAVOR

The Navajo Nation Reservation has a population of nearly 175,000, many of whom do not have access to running water. And the reservation has seen more than 3,120 coronavirus cases since March, with over 100 deaths.

The rate of infection is nearly 18 percent, and the lack of accessible resources is why Doctors Without Borders is stepping in to assist the community, it said.

The Navajo Nation has extended an order declaring a state of emergency and closure of all government offices until June 7.

"As the rest of our nation begins to open up, we need to remember that this virus came to our nation much later than the rest of our country, so that means we'll exit this COVID-19 crisis later than the rest, this is just common sense," Navajo Nation Vice President Myron Lizer said from a town hall Tuesday.
Doctors Without Borders heads to coronavirus-stricken Navajo Nation Reservation | Fox News

Doctors w/o Borders (@MSF_USA) | Twitter

 

[The Night Watchman]

I'm curious how many people in USA (and similar first-world countries) are dying from health issues that are not being addressed because of the virus vs. that number in Sweden.

This is a true question - I have no idea what the answer is and have no preconceived opinion.

Are there are large number of people whose non-Covid health issues are not currently being addressed in USA cities in lockdown....or is that a non-issue and people are getting necessary care just as if we weren't in lockdown? IDK

And same with Sweden - I am assuming that they are not having issues with people avoiding hospitals and healthcare is handling everything? Or, are their healthcare providers overwhelmed?

Not sure if that number could be accurately counted - it's like counting something you don't see, but I think it's a valid number to include, especially in decisions about when to open up locations.

jmo

Here is a CDC article kind of addressing the topic of collateral damage. There were 5300 excess deaths of undetermined cause in NYC from March 11–May 2, 2020.

During March 11–May 2, 2020, a total of 32,107 deaths were reported to DOHMH; of these deaths, 24,172 (95% confidence interval = 22,980–25,364) were found to be in excess of the seasonal expected baseline. Included in the 24,172 deaths were 13,831 (57%) laboratory-confirmed COVID-19–associated deaths and 5,048 (21%) probable COVID-19–associated deaths, leaving 5,293 (22%) excess deaths that were not identified as either laboratory-confirmed or probable COVID-19–associated deaths (Figure).

The 5,293 excess deaths not identified as confirmed or probable COVID-19–associated deaths might have been directly or indirectly attributable to the pandemic. The percentages of these excess deaths that occurred in persons infected with SARS-CoV-2 or resulted from indirect impacts of the pandemic are unknown and require further investigation.

 

[Deleted member 158085]

Do shutdowns work or are they a useless maneuver that doesn’t much change the outcome?

To help me figure this out I looked at Worldometer data for similar nations, as far as population, location when possible, development, health care, etc.

I analyzed Brazil, Mexico and Sweden, none of which employed shut downs.

Here I will focus on Sweden as it is a “westernized democracy” more like ours, as opposed to Brazil and Mexico which are still developing, poorer nations.

I compared Sweden with its Nordic neighbors- Norway, Denmark and Finland. These are comparable nations with similar demographics, economic structures and health care structures. However these other nations all employed shut downs.

The data used was the rates of infection, rates of deaths and rates of testing, based on a million people. So what is the infection rate per million people, what is the death rate from COVID per million people and what is the testing rate per million.

Based on today’s data:

Norway- Sweden has almost double the rate of infection as Norway. Norway has only 13% of the death rate from the disease as Sweden.

Finland- Finland has 40% of the case rate as Sweden. That means Sweden has 60% more cases per million inhabitants. Finland has 15% of the COVID19 death rate of Sweden’s.

Denmark - Sweden’s infection rate is 32% higher than Denmark’s. Denmark has 28% of the COVID19 death rate of Sweden’s.

Sweden has a rate of 2,700 infections per million inhabitants and a rate of 328 deaths per million.

Norway has a rate of 1,504 infections per million inhabitants and a rate of 50 deaths per million.

Finland has a rate of 1,083 infections per million inhabitants and a rate of 50 deaths per million.

Denmark has a rate of 1,828 infections per million inhabitants and a rate of 42 deaths per million.

But what’s significant is the comparable test rates of these nations. Because if Sweden had a much higher test rate than those other nations, then of maybe those results aren’t that significant. Right? If Sweden tests more, then of course they will have higher rates of everything.

Rates of testing = how many tests per million inhabitants:

Finland has a rate of 22,831 tests per million.
Norway has a rate of 37,858 per million.
Denmark has a rate of 57,709 tests per million.

Sweden has a rate of 14,704 tests per million.

Finland has a test rate 1.5 times as high as Sweden’s.
Norway has a test rate 2.5 times as high as Sweden’s.
Denmark has a test rate almost four times as high as Sweden’s.

The news isn’t good for Sweden. Their rates far exceed those of their neighboring nations and are likely much higher than we know given the disparity in testing, compared to those other nations.

Coronavirus Update (Live): 4,337,563 Cases and 292,451 Deaths from COVID-19 Virus Pandemic - Worldometer

I’m so glad to have you back with your sensible posts!

 

[The Night Watchman]

One example of a small city in Colorado (about 100,000) and the testing implemented at no charge.

Leroy Garcia‏Verified account @Leroy_Garcia
The Pueblo Department of Public Health has launched a drive-thru #COVID19 testing site! If you are experiencing any of the symptoms below, please come to the Colorado State Fairgrounds and get tested. Let's work together and stop the spread.

@otto

It kind of got lost in the multiple replies, but the topic was CV antibody testing- to see if you have the virus in the past. I think most insurances will cover it, but I doubt it would be a freebie to anyone, at least right now. I will follow up if I learn anything.

 

[anneg]

I think that a large majority of people 60+ have HBP and it can be related to kidney disease. Wasn’t it just a few years ago that the guidelines for HBP have been revised to include a lower range to be considered a HBP diagnosis.

Do you believe that an individual with a stable BP on medication reduce the risk? It’s so common to see individuals with HBP to have uncontrolled readings. Shoots, I have HBP which is stable on medication and on the low end of normal BMI. I may have to spend the rest of my life in quarantine.

Re your first paragraph, yes, the recommendations have changed. Now normal BP is considered to be less than 120 systolic and less than 80 diastolic, and 120-129 systolic AND below 80 diastolic is "elevated".

"Hypertension Stage 1 is when blood pressure consistently ranges from 130-139 systolic or 80-89 mm Hg diastolic."

Here is a chart from the American Heart Association:

 

[10ofRods]

Serious question. If it was you and you were a kid, would you want to go back to school with all of these ridiculous distancing rules?
No playground, no lunchroom, no library...
I get it!
Parents have to work, but yuck.
I just can't imagine how they are gonna manage all the kids in the space they have.
Maybe build tent schools? Like the temporary hospitals?
Moo

I think it's odd that there are no systematic studies of how much human virus (any type) is left on playground equipment. We know CoVid likes metal - but dislikes UV-B/sunshine. At least I can't find any.

 

[10ofRods]

Do shutdowns work or are they a useless maneuver that doesn’t much change the outcome?

To help me figure this out I looked at Worldometer data for similar nations, as far as population, location when possible, development, health care, etc.

I analyzed Brazil, Mexico and Sweden, none of which employed shut downs.

Here I will focus on Sweden as it is a “westernized democracy” more like ours, as opposed to Brazil and Mexico which are still developing, poorer nations.

I compared Sweden with its Nordic neighbors- Norway, Denmark and Finland. These are comparable nations with similar demographics, economic structures and health care structures. However these other nations all employed shut downs.

The data used was the rates of infection, rates of deaths and rates of testing, based on a million people. So what is the infection rate per million people, what is the death rate from COVID per million people and what is the testing rate per million.

Based on today’s data:

Norway- Sweden has almost double the rate of infection as Norway. Norway has only 13% of the death rate from the disease as Sweden.

Finland- Finland has 40% of the case rate as Sweden. That means Sweden has 60% more cases per million inhabitants. Finland has 15% of the COVID19 death rate of Sweden’s.

Denmark - Sweden’s infection rate is 32% higher than Denmark’s. Denmark has 28% of the COVID19 death rate of Sweden’s.

Sweden has a rate of 2,700 infections per million inhabitants and a rate of 328 deaths per million.

Norway has a rate of 1,504 infections per million inhabitants and a rate of 50 deaths per million.

Finland has a rate of 1,083 infections per million inhabitants and a rate of 50 deaths per million.

Denmark has a rate of 1,828 infections per million inhabitants and a rate of 42 deaths per million.

But what’s significant is the comparable test rates of these nations. Because if Sweden had a much higher test rate than those other nations, then of maybe those results aren’t that significant. Right? If Sweden tests more, then of course they will have higher rates of everything.

Rates of testing = how many tests per million inhabitants:

Finland has a rate of 22,831 tests per million.
Norway has a rate of 37,858 per million.
Denmark has a rate of 57,709 tests per million.

Sweden has a rate of 14,704 tests per million.

Finland has a test rate 1.5 times as high as Sweden’s.
Norway has a test rate 2.5 times as high as Sweden’s.
Denmark has a test rate almost four times as high as Sweden’s.

The news isn’t good for Sweden. Their rates far exceed those of their neighboring nations and are likely much higher than we know given the disparity in testing, compared to those other nations.

Coronavirus Update (Live): 4,337,563 Cases and 292,451 Deaths from COVID-19 Virus Pandemic - Worldometer

Great post - have missed you.