Coronavirus COVID-19 - Global Health Pandemic #80

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Very concerning
 
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sds71 said:
@abbydphillip
·
WH pool reports the President Trump is going to Walter Reed Medical Center shortly.
Will fly and spend a few days there.
Click to expand...

SeattleStew said:
Trump going to Walter Reed per NBC news.
Click to expand...



NBC News
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@NBCNews
BREAKING: President Trump will go to Walter Reed National Military Medical Center for further medical evaluation. nbcnews.to/2Sm7fEg
2:20 PM - 2 Oct 2020
Trump is to be transported to Walter Reed Medical Center in Marine One helicopter
The move was a precautionary measure recommended by the president’s physician, officials said.
NBC News @NBCNews
 
  • #668
Lilibet said:
CNN link

Trump to head to Walter Reed hospital following Covid-19 diagnosis
Click to expand...


What we know now
  • JUST IN: President Trump is headed to Walter Reed hospital.
  • Trump has had a fever since this morning, a source said. He received a dose of Regeneron, according to a memo from the President’s physician.
  • “The memo also says first lady Melania Trump remains well with only a mild cough and headache, and the remainder of the first family are well and tested negative for SARS-CoV-2 today.”
 
  • #669
What's the difference between a "mild" case and a "moderate" case?

White House says Trump has ‘mild symptoms.’ What do mild, moderate and severe mean for COVID-19? | WITF

[A] "mild" infection starts normally with a fever, although it may take a couple of days to get a fever. You will have some respiratory symptoms; you have some aches and pains. You’ll have a dry cough. This is what the majority of individuals will have.”


Symptoms of being "moderately ill" with COVID-19 include coughing, fever above 100.4, chills and a feeling that you don’t want to or can’t get out of bed, says Adalja.

With shortness, of breath, that “is a wide spectrum and whether we consider treatment will be based on how short of breath they are, their age and other health conditions,” says Galea.”
 
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margarita25 said:
BBM:


Interesting, marking to research this cocktail. (Eta: I recall much discussion about monoclonal antibodies via Dr. Swaminathan, but not polyclonal.)
Click to expand...

Regeneron's REGN-COV2 Antibody Cocktail Reduced Viral Levels and Improved Symptoms in Non-Hospitalized COVID-19 Patients | Regeneron Pharmaceuticals Inc.

snipped...

After months of incredibly hard work by our talented team, we are extremely gratified to see that Regeneron's antibody cocktail REGN-COV2 rapidly reduced viral load and associated symptoms in infected COVID-19 patients," said George D. Yancopoulos, M.D., Ph.D., President and Chief Scientific Officer of Regeneron. "The greatest treatment benefit was in patients who had not mounted their own effective immune response, suggesting that REGN-COV2 could provide a therapeutic substitute for the naturally-occurring immune response. These patients were less likely to clear the virus on their own, and were at greater risk for prolonged symptoms. We are highly encouraged by the robust and consistent nature of these initial data, as well as the emerging well-tolerated safety profile, and we have begun discussing our findings with regulatory authorities while continuing our ongoing trials. In addition to having positive implications for REGN-COV2 trials and those of other antibody therapies, these data also support the promise of vaccines targeting the SARS-CoV-2 spike protein."
 
  • #672
Duluth, MN (rally site) is setting up a testing center at the Duluth Entertainment Convention Center.
 
  • #673
Simply Southern said:
Regeneron's REGN-COV2 Antibody Cocktail Reduced Viral Levels and Improved Symptoms in Non-Hospitalized COVID-19 Patients | Regeneron Pharmaceuticals Inc.

snipped...

After months of incredibly hard work by our talented team, we are extremely gratified to see that Regeneron's antibody cocktail REGN-COV2 rapidly reduced viral load and associated symptoms in infected COVID-19 patients," said George D. Yancopoulos, M.D., Ph.D., President and Chief Scientific Officer of Regeneron. "The greatest treatment benefit was in patients who had not mounted their own effective immune response, suggesting that REGN-COV2 could provide a therapeutic substitute for the naturally-occurring immune response. These patients were less likely to clear the virus on their own, and were at greater risk for prolonged symptoms. We are highly encouraged by the robust and consistent nature of these initial data, as well as the emerging well-tolerated safety profile, and we have begun discussing our findings with regulatory authorities while continuing our ongoing trials. In addition to having positive implications for REGN-COV2 trials and those of other antibody therapies, these data also support the promise of vaccines targeting the SARS-CoV-2 spike protein."
Click to expand...

Thanks.

The article seems to have been written only a few days ago, Sept. 29.
 
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  • #674
tresir2012 said:
Average people who are hospitalised get them at present. There has been a lot of info and studies and posts about it. They are all part of clinical trials
Click to expand...


I'm sorry but clinical trial treatments are not what average people get. And once again, I am not talking about people who need to be hospitalized. Obviously they receive treatment. Apparently I am not making myself clear. I'm sorry I'm not doing so. Maybe an example?

If I find out someone I was in contact with has tested positive, and I go get a test and they tell me I'm positive, I will be told to go home, isolate and monitor my symptoms. Even though I have asthma, I will not be given a cocktail of antivirals. Neither will most anyone else in this nation who has standard health care, even if they are super high risk for severe complications.

If I show symptoms and become sick, I will still not receive a cocktail of medications to try to halt viral replication. Maybe a few people in a clinical trial will in that situation, but that is NOT an average American. That's a research study. Not clinical treatment protocols.

For me and every other average American with standard health care, the only way we will get aggressive treatment to stop the virus in its tracks is if we present at the hospital with an inability to get enough oxygen.

That's it.
 
  • #675
President Trump has had a fever since this morning
19 mins ago - Trump announced on Twitter he tested positive for coronavirus early ... White House economic adviser says Trump has a "very moderate case".

Much of the President’s care for Covid-19 can be managed at the White House, a source familiar with the White House Medical Unit said.

However, if the President did require critical care – for example, if he required intubation or proning, where a patient is positioned on his stomach – he would likely then be moved to the presidential suite at Walter Reed National Military Medical Center, the source said.

The source also added the unit is responsible for contact tracing involving the first and second families, as well as cabinet officials and senior administration officials, all of which are overseen by the unit.

President Trump has had a fever since this morning
 
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Trump taken to hospital after testing positive

US President Donald Trump has been taken to hospital less than 24 hours after testing positive for coronavirus.

Mr Trump began exhibiting "mild symptoms" of Covid-19 on Thursday after disclosing that he and his wife had gone into quarantine late Wednesday.

He received a cocktail of drugs as a "precautionary measure", the White House said, and was feeling "fatigued but in good spirits".

He was transported to Walter Reed National Military Medical Centre.

The news comes just over a month before presidential elections, where he will face Democratic challenger Joe Biden.

A White House spokesperson said in a statement: "President Trump remains in good spirits, has mild symptoms, and has been working throughout the day.

"Out of an abundance of caution, and at the recommendation of his physician and medical experts, the president will be working from the presidential offices at Walter Reed for the next few days.

"President Trump appreciates the outpouring of support for both he and the first lady."

Walter Reed, in the Washington DC suburbs, is one of America's largest and most renowned military medical centres. It is where US presidents usually go there for annual check-up.

Continued at link.

Hopes and prayers winging across the pond.
 
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  • #679
President Donald Trump going to Walter Reed medical center - CNNPolitics
(CNN)President Donald Trump will be taken to Walter Reed National Military Medical Center and remain there for several days, according to the White House.

In a statement, the White House said Trump "remains in good spirits, has mild symptoms, and has been working throughout the day."
"Out of an abundance of caution, and at the recommendation of his physician and medical experts, the President will be working from the presidential offices at Walter Reed for the next few days," the White House said. "President Trump appreciates the outpouring of support for both he and the First Lady."
 
  • #680
<modsnip: Quoted post was removed> there is ample evidence that masks indeed work.

<modsnip>

This is about protecting the public. We have heard and seen masks being mocked by those in power and their utility downplayed. That's horrible. Indeed, the spread among our actual administration is indeed a reminder of how important that step is in keeping ourselves and each other safe.

This is the research I did back in late May. Since then we have much more evidence that masks indeed, are crucial to stopping the spread:


Do masks work?/Is it a violation of my constitutional rights?


Many stores and other businesses are requiring either employees or patrons or both, to wear masks.

Many states or local governments are requiring or encouraging people to wear masks when around others in public places or private businesses. Why? I have compiled some legal info (based on my personal knowledge as an attorney) and some scientific info that I researched. I hope this is of benefit.


LEGAL INFORMATION:

First, is it a violation of my rights to force me to wear a mask?


Just as there are laws that require people to wear clothes in public, or to wear seat belts in cars, helmets when on a motorcycle, etc., laws can be passed, even at the local level, especially during an emergency crisis, if the benefit to public health, safety and welfare, outweighs the liberty being denied.


However, store policies aren’t law. So shouldn’t we have the right to choose to wear a mask or not?


No. Private entities can create their own policies, like no shirt, no shoes, no service, or no pets, or even requiring people to keep their kids from roaming, etc., as long as those policies aren’t discriminatory. So they have the right to kick you out and refuse you service if you don’t abide by the policy.


But isn’t it discrimination to force me to wear a mask?


No. Unless they are only forcing a certain “protected class” to wear a mask, it is legal for them to require it.


What’s a protected class?

Gender, sex, age, race, ethnicity, religion, disability.


But I have a condition that makes wearing a mask hard or impossible for me. So aren’t they violating the ADA by requiring me to wear one?

Only if they’re not providing you with a reasonable accommodation like a personal shopper or online shopping.


If they ask me for a note to prove I have a condition that makes wearing a mask dangerous or impossible for me, isn’t that a violation of HIPAA?

No. The same way you have to show proof of disability at Disneyland to get certain accommodations, or to get a “handicapped” placard, it is not a violation of HIPAA to require proof of disability in this instance.


SCIENTIFIC INFORMATION:


But what the heck, the CDC changed it’s tune about masks. So aren’t we “sheeple” for wearing them? Where is the proof that they work and why if they work did the CDC day they weren’t effective and we should not wear them?


Need to Preserve Certain Masks for Health Care Workers:


At the beginning of this we had a run on N-95’s and surgical masks leaving front line health care workers without enough PPE’s. A case in point is a 61 year old nurse working with COVID patients who died after having contracted COVID from a patient because she rushed to give him emergency care (chest compressions) with only a surgical mask. She died 14 days after treating him, trying to save his life:


Hollywood nurse died 14 days after rushing into room to save COVID-19 patient — without an N95 mask


So initially, the CDC wanted to preserve masks for those who need them more than others.

They also didn't realize at first how airborne this virus is.


Efficacy Depends on Type and Circumstance:


But wait, doesn’t that prove that masks are ineffective if she got COVID awhile wearing a surgical mask?

No. Transmission of COVID19 depends on exposure to a certain amount of viral load, apparently. Surgical masks offer some protection but if a person is forcefully exhaling or spewing aerosol droplets right in your face, it might not be enough.


Study Showing No One Wearing Masks Was Infected by COVID:

In an investigative study in China by epidemiologists investigating an outbreak among bus passengers, tracing showed that one person infected 13 people after a four hour bus ride.


The bus was enclosed. No open windows. The person who spread the virus was feeling sick, however it was on 1-22-20, before the Chinese government had declared the virus a national emergency. The sick person was not wearing a mask.


At least one of the passengers who contracted the virus got it within 30 minutes of boarding AFTER the infected person GOT OFF the bus. That led the researchers to determine that, based on various factors, the aerosol droplets can linger for up to 30 minutes in an enclosed space.


The epidemiologists were able to determine exactly who infected whom and how far apart they were because all buses in China carry cameras and they watched everything on video and had traced the infected patients to the bus.


Importantly, people in China often wear surgical masks in public. And some did on the bus as well.


NOT ONE PERSON WEARING A MASK ON THE BUS BECAME INFECTED.


So for normal exhalations in an enclosed area, or even more forceful ones, a surgical mask may help people around the infected person.


Study Comparing N-95's and Surgical Masks During SARS:

And of course we all have seen doctors and dentists or other medical staff wearing masks during procedures and surgeries. We’ve also seen cancer patients wearing masks and people in the hospital visiting the patient wearing masks as well. Why is that?


A 2007 study during the SARS outbreak provides some of the answers:


[In a ]study comparing the in vivo protective performance of surgical masks and N95 respirators [1] [the] authors found that N95 respirators filtered out 97% of a test aerosol while surgical masks did almost as well, filtering out 95% of the aerosol.

Methods

The authors used a KCl-fluorescein solution aerosol as a viral simulant. KCl is the test challenge aerosol recommended by the National Institute for Occupational Safety and Health (NIOSH), and fluorescein was added as a visual marker to gauge the degree of KCl penetration. Each of 10 subjects (half men and half women) was tested wearing each kind of mask. The masks were fitted properly, and the subjects were tested at rest and while walking on a treadmill up to 6.4 km/hr (4 miles/hour). The KCl solution was sprayed on the mask twice every 10 minutes, for a total of 14 times, from a distance of 1 meter away using an atomizer.

The degree of filtration of the challenge aerosol was measured in two ways. First, the concentration of KCl in the 4 layers of the exposed N95 and the 3 layers of the exposed surgical mask was determined. Second, the degree of fluorescein staining on the portion of a subject’s face covered by the mask was quantified.

Results

The estimated size of the most penetrating aerosol particles reaching the mask was 0.1-0.3µm. By each method, the N95 performed significantly better than the surgical mask, but the difference was small (2%).

Droplet vs. Aerosol

Surgical masks have long been the recommended respiratory protection for diseases transmitted by large droplets (>5µ) such as plague or meningococcal meningitis. For diseases such as TB that are transmitted by small droplet aerosols, an N95 (or better) respirator or powered air purifying respirators (PAPRs) with high efficiency particulate absorbing (HEPA) filter is recommended. It has been generally assumed that a surgical mask provided little protection from aerosols. With SARS and influenza, both droplet and aerosol transmission may occur, although the relative importance of each is debated.

During the SARS epidemic, in most circumstances, surgical masks were effective in protecting healthcare workers (HCW) from infection. In a case-control study of five hospitals in Hong Kong affected by SARS, W. H. Seto and colleagues found that consistent use of surgical masks was associated with a significant reduction in risk of infection. In fact, of 51 HCW with documented SARS exposure while wearing a surgical mask, none became infected. In contrast, 13 of 198 exposed HCWs (6.5%) who did not wear a surgical mask or N95 were infected. [2]


Similar results were found in Toronto during the SARS outbreak, where consistent use of surgical masks reduced the risk of infection by 50% among 32 critical care nurses who entered the room of a SARS patient. Consistent use of an N95 resulted in an 80% risk reduction. [3]

The experience with the SARS epidemic clearly demonstrated a relationship between the risk of infection to HCWs and certain aerosol-generating medical procedures. The highest risk was associated with endotracheal intubation, airway suctioning, and non-invasive positive pressure ventilation[4]. In these settings, the highest degree of respiratory protection possible is warranted.


02-15-2007: Surgical Masks May Provide Significant Aerosol Protection



Emphasized by me.


This shows that when attending to a patient and walking in a room with not only droplets, but viral aerosols, a surgical masks offers the wearer protection. However when doing more invasive procedures like chest compressions, where there are forceful exhalations in the worker’s face, a surgical mask would not necessarily be enough protection.


Study of Homemade vs. Surgical Masks

Here’s a study of cloth masks and surgical masks from 2012 which studied the efficacy of reduction in transmission of influenza from those who were wearing masks. It found that while cloth masks weren’t as effective at preventing microorganisms from spreading, both did contain a significant amount and that cloth masks were better than nothing in preventing infection BY the wearer:


“The median-fit factor of the homemade masks was one-half that of the surgical masks. Both masks significantly reduced the number of microorganisms expelled by volunteers, although the surgical mask was 3 times more effective in blocking transmission than the homemade mask.”



Testing the Efficacy of Homemade Masks: Would They Protect in an Influenza Pandemic? - PubMed


Note also that the homemade masks in the study did not have any filters or other barriers in them.



But I’ve heard that COVID 19 particles are maybe smaller than other viruses or more contagious and in studies, can penetrate masks and thus masks are no use? Is that true?


Study of 4 COVID Patients and Masks

There was a recent study of four (4) COVID19 patients that showed that the coronavirus was found on the OUTSIDE of both surgical and cloth masks when people were told to cough forcefully into the mask. This led to an indication that masks are ineffective.

New study questions the effectiveness of masks against SARS-CoV-2


However, the presence of the virus on the outside of the masks doesn’t indicate that it spread throughout the room in either droplet or aerosol form and thus that the masks do nothing to prevent transmission. Tests of the air, or distance tests were not done. And this indication is contrary to actual tests involving spread in the room and contagion by others (on a bus or healthcare workers wearing various masks).


We don’t know the exact size but in my inexpert opinion it seems it’s unlikely to be smaller than the coronavirus that caused SARS. We do know that apparently, higher viral load is what matters.


Whether Airborne or Aerosol - Conditions Seem to Matter

There is no indication thus far that this virus is airborne in the true sense of the word. [ETA: WE NOW KNOW THIS IS PROBABLY WRONG. IT IS BELIEVED NOW TO BE AIRBORNE] It spreads mainly by droplets. But there is evidence that aerosolized droplets can be spread by close talking or singing. The chances increase in small or poorly ventilated areas and thus higher exposure to “minimal infectious load”:


Studies of Aerosol Spread/Mask Efficacy

Another paper, recently published in the New England Journal of Medicine, showed that infectious SARS-CoV-2 virus can remain in aerosols for at least three hours—and for several days on various surfaces—in a laboratory setting. But the amount of viable virus diminished significantly during that time. Scientists do not know the infectious dose of SARS-CoV-2. (For influenza, studies have shown that just three virus particles are enough to make someone sick.)

Overall, most of the evidence that SARS-CoV-2 can become airborne comes from clinical settings—which tend to have a lot of sick people and may host invasive procedures, such as intubations, that can cause patients to cough, generating aerosols. It is not clear how representative of everyday environments these areas are. “There is not much convincing evidence that aerosol spread is a major part of transmission” of COVID-19, Perlman says.


Cowling hypothesizes that many respiratory viruses can be spread through the airborne route—but that the degree of contagiousness is low. For seasonal flu, the basic reproduction number, or R0—a technical designation for the average number of a people a sick person infects—is about 1.3. For COVID-19, it is estimated to be somewhere between two and three (though possibly as high as 5.7). Compared with measles, which has an R0 in the range of 12 to 18, these values suggest most people with the disease caused by SARS-CoV-2 are not extremely contagious.

But there are seeming exceptions, such as the choir practice in Washington State, Cowling says.

[The article goes on the explain that ventilation, exposure by a “super spreader”, size of the room and forcefulness/type of the exhalations can impact the contagion risk].


Cowling co-authored a study, published in early April in Nature Medicine, of patients with respiratory infections at an outpatient clinic in Hong Kong between 2013 and 2016. This research detected RNA from seasonal coronaviruses—the kind that cause colds, not COVID-19—as well as seasonal influenza viruses and rhinoviruses, in both droplets and aerosols in the patients’ exhaled breath. The paper, led by Nancy Leung, an assistant professor at the University of Hong Kong’s school of public health, found that wearing surgical masks reduced the amounts of influenza RNA in droplets and of seasonal coronavirus RNA in aerosols.


Although the study did not look at COVID-19 specifically, the findings support mask wearing as an effective way to limit transmission of the virus from an infected person—known in medical parlance as source control. There is not much evidence that masks convey protection to healthy people, although it is possible (and may depend on the type of mask). Given the prevalence of asymptomatic infection with COVID-19, however, there is some justification for universal mask wearing to prevent those who do not know they are sick from infecting others. In Hong Kong, which has kept its outbreak relatively under control, masks are worn by the vast majority of the population, Cowling says.”


How Coronavirus Spreads through the Air: What We Know So Far


CDC Did Not Know That Asymptomatic Carriers Spread COVID. Now We Know


Evidence that COVID19 can be contracted by asymptomatic coronavirus carriers was not known when the CDC issued its statement that masks were not required. Once it was determined that asymptomatic carriers can infect others and cause them to develop COVID19, the advice changed, in regard to homemade masks.


CONCLUSION

Being required to wear a mask is not a violation of our constitutional rights.


And it appears that doing so lowers the risk of spread to the wearer and to others.


In the final analysis it appears that a cloth mask is better than nothing in protecting the wearer from some amount of viral load. Surgical masks are three times more effective but a cloth mask does offer some protection. I think it’s not unreasonable to suggest that wearing a filter in the mask might protect the wearer even more.

But while surgical masks are much more effective than cloth, they don’t provide the protection of an N95 and can allow a health care provider to become infected when exposed to forceful exhalations from a sick person who is inches from their face, or maybe by being in a small space for a lengthy period in which a sick person or persons has or have been coughing, sneezing or undergoing procedures. (I have also seen that amount of time exposed also has a bearing on transmission).


N95’s provide the wearer with the most protection but as health care workers desperately need them, no one is recommending that the rest of us wear them.


Importantly, it also appears that homemade masks can protect others from being infected by the wearer. Yes, if someone forcefully coughs, virus microorganisms will be present on the front of the mask. That’s even true for surgical masks. But it seems even cloth masks can prevent the aerosolized droplets from spreading in the air around the person. It is a barrier that can protect others.


And while most won’t become sick from COVID and fewer will become seriously ill or die, this is a small inconvenience to protect some of our most vulnerable and to prevent the impact on our health care system and economy of so many people getting sick at around the same time. Those numbers add up and have devastated nations. And it will enable others to feel more confident going back out into the world of everyone does their part and follows some basic guidelines. So wearing a mask when possible, in close proximity to others, in my opinion, is both wise and ethical. It's a responsibility we should all have in a civilized society. And it just might help our economy get back on track as it will make more people comfortable venturing out if this becomes the norm for the present.

ETA:
 
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