Coronavirus COVID-19 - Global Health Pandemic #81

[Medstudies]

Well I just took a short trip down memory lane. This was posted by. @dixiegirl1035

(RBBM)

“My above MOO post was incorrect, I was wrong. Things are moving so fast, Sorry about that.

5 US coronavirus cases now confirmed; infection can spread before symptoms show

"China Health Minister Ma Xiaowei said Sunday that it appeared the "ability of the virus to spread is getting stronger” and that it is infectious before symptoms show, a characteristic that could make it harder to contain.

“From observations, the virus is capable of transmission even during incubation period” of one to 14 days, Ma said. “There are hidden carriers.”


"That makes this outbreak different from severe acute respiratory syndrome, SARS, a virus that was not contagious during incubation."

Containing new coronavirus may not be feasible, experts say - STAT

Tools like quarantine and isolation — which were key to controlling SARS — are unlikely stop spread of a virus that can transmit during the period from infection to symptoms, experts say.

Last edited: Jan 26, 2020
Jan 26, 2020Report
Like

(thread 1 post #119)

 

[dixiegirl1035]

I have been doing "Contact Tracing". It is done by the county health department. I do maybe 5 or 6 cases a week. Most people, now, only have 3 or 4 contacts. Some people have had 2 pages.

Contact Tracing only works, if the contacts to the "main case" immediately follow the rules, and stay quarantine for two weeks. (No getting on airplanes.)

What is going to be very interesting for scientists to follow, if they can, is to document that it perhaps is less than the 15 minutes exposure.

Egads though... but I'm not doing 14:45 minutes face to face with a positive person. No way in heck! Yet.. what is the CDC/WHO and others to do as there are soooooooooooo many extenuating circumstances on face to face.

 

[tresir2012]

Since Trump has begun his treatments doing videos, I do hope he continues to do so daily. Interesting that as someone posted above, the photos that the media captured showed the EXIF data (us WS folks know what that is!) and relayed the two photos were 10 minutes apart.

What does that mean if they were 10 minutes apart?

Also, here's a "what if " BBC article.
Pretty interesting.

What if Trump became too ill to be president?

 

[Deleted member 39678]

Since Trump has begun his treatments doing videos, I do hope he continues to do so daily. Interesting that as someone posted above, the photos that the media captured showed the EXIF data (us WS folks know what that is!) and relayed the two photos were 10 minutes apart.

I don't find that as being interesting at all.

 

[mickey2942]

How busy do you stay with 5 or 6 cases?

I believe that the county hired about 30 people, and 3 full time staff. Contact Tracing for the school age group is done by school nurses. Most of the people are retired, several retired nurses, doctors, and teachers were in my class. Along with others who have full time jobs. Personally, I was planning on getting furloughed from work. This was part of my "back up" plan. I didn't get furloughed, but who knows any more...

 

[dixiegirl1035]

Well I just took a short trip down memory lane. This was posted by. @dixiegirl1035

(RBBM)

“My above MOO post was incorrect, I was wrong. Things are moving so fast, Sorry about that.

5 US coronavirus cases now confirmed; infection can spread before symptoms show

"China Health Minister Ma Xiaowei said Sunday that it appeared the "ability of the virus to spread is getting stronger” and that it is infectious before symptoms show, a characteristic that could make it harder to contain.

“From observations, the virus is capable of transmission even during incubation period” of one to 14 days, Ma said. “There are hidden carriers.”


"That makes this outbreak different from severe acute respiratory syndrome, SARS, a virus that was not contagious during incubation."

Containing new coronavirus may not be feasible, experts say - STAT

Tools like quarantine and isolation — which were key to controlling SARS — are unlikely stop spread of a virus that can transmit during the period from infection to symptoms, experts say.

Last edited: Jan 26, 2020
Jan 26, 2020Report
Like

(thread 1 post #119)

Whoa, how the heck did you come across that from the blast from the past from my January 26 post when a few were here following science.

Yes, that is when I realized that it was unlike the other viruses that ONLY were transmitted AFTER symptoms. That was the day I took personal actions, and have ever since.

The issue perhaps was many *didn't believe China*... yet for those that believe in the science, this was a red red flag that it could be/and now shown to be transmitted BEFORE symptoms. The earlier BAAAAAD stuff ONLY was transmitted after symptoms.

Science understood this IMMEDIATELY MOO the repercussions of a pandemic on that day - but so many to this day do not.

I do understand also the hope back then of many that it would die out as so many awful ones did... but the transmission PRIOR to symptoms made tracing back and isolation after also quarantine so important.

I do do do hope that the MSM focuses on such now, but it may be too late as folks are just so done with it and don't want to deal with anymore? Such a shame. But hopefully they WILL focus on, yet unfortunately have to use the WH transmissions as an example as the US hasn't been doing testing/tracing/quarantine as WHO has suggested is #1 to do.

How this is going to be an educational moment for so many, I don't know as so many perhaps have dug in their heels?

I do have hope though...

 

[ilovewings]

I was exiting the grocery store just as a middle-age woman came in without a mask and the greeter asked if she'd like a complimentary one. She said she had been one of the first people in the county to become infected and it was now two months since she had recovered according to the guidelines.

That made me start wondering how many of the people I see without masks fit into that category? I guess the more people who are infected and then recover, the more people who will no longer need a mask to protect themselves or others.

I don't think we know enough about the virus to know if you can get it again. In fact I have read of people who did get the virus again- at least that is what the thinking was by physicians. So bottom line, just because a person had it once, i think it would be kind of foolish to think you can't get it again and I think they should wear a mask. Information on this virus keeps changing because it is so new: Caution should be the word of the day with this virus.

 

[Simply Southern]

I haven't seen any mention of IV's either. Yet we know was required for Remdesivir.

MOO

So that the president doesn't have a new injection for an IV every.single.day for the 5 day regimine, its logical he has an arm port vs. a new line inserted every day.. and also for other monitoring.

Remdesivir is REQUIRED to be administered by IV

"This EUA is for the use of Veklury (remdesivir) to treat COVID-19.Veklury must be administered by intravenous (IV) infusion"

Health care providers must submit a report on all medication errors and ALL SERIOUS ADVERSE EVENTSrelated to Veklury. See Sections 8 and 9 of the Full EUA Prescribing Information for reporting requirements. •See the Full EUA Prescribing Information for complete dosage, administration, and preparation instructions.•Veklury (remdesivir) is available as a lyophilized powder and concentrated solution.•The recommended dose for adult and pediatric patients weighing 40 kg and higher is a single loading dose of 200 mg on Day 1 followed by once-daily maintenance doses of 100 mg from Day 2.•..... •The optimal duration of treatment for COVID-19 is unknown.•For patients requiring invasive mechanical ventilation and/or extracorporeal membrane oxygenation (ECMO), the recommended total treatment duration is 10 days.•For patients not requiring invasive mechanical ventilation and/or ECMO, the recommended total treatment duration is 5 days. If a patient does not demonstrate clinical improvement, treatment may be extended for up to 5 additional days for a total treatment duration of up to 10 days. •Administer Veklury via IV infusion over 30 to 120 minutes.

https://www.gilead.com/-/media/files/pdfs/remdesivir/eua-fact-sheet-for-hcps.pdf

MOO, the white house doc didn't mention as the iv site isn't a drug?

ETA: BUBM

The dosage is so small.
First does 200mg equals 200 drops or .0070 of on ounce.
2nd -5th dose 100 mg

The manufacture doesn't list if mixed with saline or how much used during delivery.

I think it would be one of the "mini" IV bags, used with some IV antibiotics.

 

[tresir2012]

'We sprang Grandma from the care home'

It's late on a Saturday night, and a private ambulance pulls up outside a care home in Norwich. Rita Perrott, a frail 95-year-old, is helped out of the home in a wheelchair.

"Grandma!" shouts her granddaughter, Anna, delightedly. They give each other a long hug and a kiss. It's the first time in months such normal physical contact has been possible.

Anna appears almost giddy with the audacity of what they're doing.

"We've stolen grandma!" she proclaims.

"A kidnap?" Rita asks, playing along with the joke.

"It's a heist!" says Anna. "We've come late at night to steal grandma back!"

"I think they noticed," observes Ethan, one of the ambulance crew. The care home, of course, has agreed for her to be discharged.

Continued at link.

 

[oceanblueeyes]

Only time will tell, but it's not unusual for presidents (or other officials) to fudge when it comes to their health. I remember reading that when FDR died a good number of Americans didn't even know he had been paralyzed from polio decades earlier.

True, just like most didn't know at the time JFK had Addison disease or a serious degenerative spinal condition.

I totally understand why somethings are kept confidential when it comes to our presidents.

Since PT is a very transparent president. I believe this is why they came out to say his vitals were poor on Friday, and he's greatly improved since then. I pray it continues. PT did not want to keep this information hidden from the American people like other presidents have done in the past.

Jmho

 

[dixiegirl1035]

RSBM
The manufacture doesn't list if mixed with saline or how much used during delivery.

I think it would be one of the "mini" IV bags, used with some IV antibiotics.

Thanks for the question and the opportunity to expound and share with others!

Yes, the manufacturer does indeed state such...if you look at the link (I will repost so you can look) it says that it is presented as "Veklury (remdesivir) is available as a lyophilized powder and concentrated solution"

That is defined lyophilized as "a free dried" substance... think the old Sanka coffee if you are old enough. It MUST be reconstituted and given over a period of time "Administer Veklury via IV infusion over 30 to 120 minutes"

Within the link I posted... yes.. here are instructions for reconstitution etc.

"Veklury (remdesivir) for Injection, 100 mg: Reconstitute Veklury for injection lyophilized powder with 19 mL of Sterile Water for Injection and further dilute in 0.9% sodium chloride infusion bag prior to administration.•Veklury (remdesivir) Injection, 100 mg/20 mL (5 mg/mL): Dilute Veklury injection concentrated solution in 0.9% sodium chloride infusion bag prior to administration.•Prepare solution for infusion on same day as administration. •Administer diluted Veklury as an IV infusion over 30 to 120 minutes.•After infusion is complete, flush with 0.9% sodium chloride."

https://www.fda.gov/media/137566/download

 

[Tiff23fr]

Video in the article of super spreader event shows extreme carelessness in my opinion. There was a lot of hugging, handshaking and leaning into others. Flat out irresponsible in my opinion. How many will become sick in the coming week due to this as those that attended then unknowingly spread it further?

Personal assistant to Trump tests positive for coronavirus - CNNPolitics

 

[tresir2012]

Apologies if I or someone else has posted this Remdesivir study.

https://www.nejm.org/doi/full/10.1056/NEJMoa2007764

Preliminary results of this trial suggest that a 10-day course of remdesivir was superior to placebo in the treatment of hospitalized patients with Covid-19. This benefit was seen in the number of days to recovery (median, 11 days, as compared with 15; rate ratio for recovery, 1.32 [95% CI, 1.12 to 1.55]) and in recovery according to the ordinal scale score at day 15 (odds ratio, 1.50; 95% CI, 1.18 to 1.91). Even though the trial was ongoing, the data and safety monitoring board made the recommendation to unblind the results to the trial team members from the NIAID, who subsequently decided to make the results public. Given the strength of the results about remdesivir, these findings were deemed to be of immediate importance for the care of patients still participating in the trial as well as for those outside the trial who might benefit from treatment with remdesivir.

The benefit was most apparent in patients with a baseline ordinal score of 5 (requiring oxygen), a finding most likely due to the larger sample size in this category (since the interaction test of treatment by baseline score on the ordinal scale was not significant). Confidence intervals for baseline ordinal scores of 4 (not receiving oxygen), 6 (receiving high-flow oxygen), and 7 (receiving ECMO or mechanical ventilation) are wide. We note that the median recovery time for patients in category 7 could not be estimated, which suggests that the follow-up time may have been too short to evaluate this subgroup. Additional analyses of outcomes such as the time to a one- or two-point improvement on the ordinal scale score will be conducted after the full cohort has completed 28 days of follow-up and may provide additional insight into the treatment of this critical subgroup. Our findings highlight the need to identify Covid-19 cases and start antiviral treatment before the pulmonary disease progresses to require mechanical ventilation.

The findings in our trial should be compared with those observed in a randomized trial from China in which 237 patients were enrolled (158 assigned to remdesivir and 79 to placebo).13The time to clinical improvement, defined as the time to a two-point improvement in the score on the ordinal scale, was 21.0 days (95% CI, 13.0 to 28.0) in the remdesivir group and 23.0 days (95% CI, 15.0 to 28.0) in the control group, with a hazard ratio (for clinical improvement) of 1.23 (95% CI, 0.87 to 1.75). The six-category ordinal scale used in that trial yielded a common odds ratio for improvement in the ordinal score scale of 1.25 (95% CI, 0.76 to 2.04) at day 14. That trial failed to complete full enrollment (owing to the end of the outbreak), had lower power than the present trial (owing to the smaller sample size and a 2:1 randomization), and was unable to demonstrate any statistically significant clinical benefits of remdesivir.

Continued at link.

So with a little luck he could be out in less than 10 days.

 

[sds71]

Medical briefing from the president’s hospital team at 11:30.

 

[Medstudies]

Not sure if y'all still follow the IHME graphs which the Pres was using with his team which has been pretty well on target.

Oh my, I am really having a hard time believing the uptick that is projected in December. Even the best case scenario I'm having true difficulty with. (not sure which page this will land on, but you can drill down on global, US, and states themselves).

For many of us following since inception, it's been eerily on target.

IHME | COVID-19 Projections

(Discounting the graph for "easing")

Sobering, isn’t it?

Hmmm, this reminds me of group projects in school. You know, where only one or two people generally did all the work, while the rest got to take credit.

in this case though, the slackers (MOO) are causing the “group” to fail.

 

[drama_farmer]

Whoa, how the heck did you come across that from the blast from the past from my January 26 post when a few were here following science.

Yes, that is when I realized that it was unlike the other viruses that ONLY were transmitted AFTER symptoms. That was the day I took personal actions, and have ever since.

The issue perhaps was many *didn't believe China*... yet for those that believe in the science, this was a red red flag that it could be/and now shown to be transmitted BEFORE symptoms. The earlier BAAAAAD stuff ONLY was transmitted after symptoms.

Science understood this IMMEDIATELY MOO the repercussions of a pandemic on that day - but so many to this day do not.

I do understand also the hope back then of many that it would die out as so many awful ones did... but the transmission PRIOR to symptoms made tracing back and isolation after also quarantine so important.

I do do do hope that the MSM focuses on such now, but it may be too late as folks are just so done with it and don't want to deal with anymore? Such a shame. But hopefully they WILL focus on, yet unfortunately have to use the WH transmissions as an example as the US hasn't been doing testing/tracing/quarantine as WHO has suggested is #1 to do.

How this is going to be an educational moment for so many, I don't know as so many perhaps have dug in their heels?

I do have hope though...

I have a sneaking suspicion that many members of the public don't know what "asymptomatic" means. Imo

 

[ilovewings]

I have a sneaking suspicion that many members of the public don't know what "asymptomatic" means. Imo

I have a sneaking suspicion your are right !!!!

 

[Medstudies]

Whoa, how the heck did you come across that from the blast from the past from my January 26 post when a few were here following science.

Yes, that is when I realized that it was unlike the other viruses that ONLY were transmitted AFTER symptoms. That was the day I took personal actions, and have ever since.

The issue perhaps was many *didn't believe China*... yet for those that believe in the science, this was a red red flag that it could be/and now shown to be transmitted BEFORE symptoms. The earlier BAAAAAD stuff ONLY was transmitted after symptoms.

Science understood this IMMEDIATELY MOO the repercussions of a pandemic on that day - but so many to this day do not.

I do understand also the hope back then of many that it would die out as so many awful ones did... but the transmission PRIOR to symptoms made tracing back and isolation after also quarantine so important.

I do do do hope that the MSM focuses on such now, but it may be too late as folks are just so done with it and don't want to deal with anymore? Such a shame. But hopefully they WILL focus on, yet unfortunately have to use the WH transmissions as an example as the US hasn't been doing testing/tracing/quarantine as WHO has suggested is #1 to do.

How this is going to be an educational moment for so many, I don't know as so many perhaps have dug in their heels?

I do have hope though...

I have hope too, most of the time.

And lol, just catching up on this thread and thinking, dang “we were talking about all this stuff ages ago”

I don’t know how I randomly landed on page 6, but your post just jumped out at me. It is still so relevant. It seemed so simple then. That was a time when I thought, “okay we as a country, really pulled together after 9/11. We’ve got this.”

but yea, we don’t.
Here we are,upticks, weather here getting colder. The poor restaurant owners just getting back to quasi normal...

 

[Simply Southern]

Thanks for the question and the opportunity to expound and share with others!

Yes, the manufacturer does indeed state such...if you look at the link (I will repost so you can look) it says that it is presented as "Veklury (remdesivir) is available as a lyophilized powder and concentrated solution"

That is defined lyophilized as "a free dried" substance... think the old Sanka coffee if you are old enough. It MUST be reconstituted and given over a period of time "Administer Veklury via IV infusion over 30 to 120 minutes"

Within the link I posted... yes.. here are instructions for reconstitution etc.

"Veklury (remdesivir) for Injection, 100 mg: Reconstitute Veklury for injection lyophilized powder with 19 mL of Sterile Water for Injection and further dilute in 0.9% sodium chloride infusion bag prior to administration.•Veklury (remdesivir) Injection, 100 mg/20 mL (5 mg/mL): Dilute Veklury injection concentrated solution in 0.9% sodium chloride infusion bag prior to administration.•Prepare solution for infusion on same day as administration. •Administer diluted Veklury as an IV infusion over 30 to 120 minutes.•After infusion is complete, flush with 0.9% sodium chloride."

https://www.fda.gov/media/137566/download

Thanks, clearly scanning the article while watching Sunday morning TV I failed to pick that up.

 

[JerseyGirl]

I still want to know more about Ronna McDaniel.... Chair, Exec Repub committee... She was with T on Friday before the Rose Garden Party, and tested positive on Wednesday.... Lots of tracking necessary for her too!

RNC chairwoman tests positive for coronavirus - CNNPolitics

"After a member of her family tested positive for COVID-19, the Chairwoman was tested for the virus.

McDaniel frequently interacts with the President and other top Republican lawmakers. She was last with the President last Friday (9/25).

She has been at her home in Michigan since last Saturday (9/26, Rose Garden event).

On Wednesday afternoon (9/30), she received confirmation she was COVID-19 positive.”

RNC chairwoman tests positive for coronavirus