outbreak! (ebola, sars, coronavirus, etc)

It's almost 2 weeks since the Italy lockdown started so that figures

is there any possibility of getting prepared for another not fully expected widespread disease.

The countries that have had the best containment response (travel restrictions, testing, contact tracing, quarantine) are those that experienced the worst of 2003 SARS (China, Hong Kong, Taiwan, Singapore, Vietnam), and South Korea (which only had 3 cases, no deaths). And those countries, because they were so urgent about containment, will return to normal life long before the rest

I think its fair to say every pandemic changes minds about the value of public health for a generation or two of those effected. The West had been spared for a century from anything of this potential scale, which lead to complacency.

We had FDA administrators who were sending out letters to COVID-19 test developers in mid-February to halt their work, when they should have flown out the same administrators to every university and state lab to do the emergency use authorization applications for them. We could have had 20 labs competing to be the first with the best, instead of waiting for CDC to resolve the technical issues with its test. That's complacency of the highest order, and it all came from the top, the administration and political appointees who weren't mentally prepared to recognize the gravity of this, when the epidemiologists have been screaming about it since January.

Next pandemic, if it comes in the next 20 years, won't be faced with this sort of complacency. Rational travel restrictions will be instated early. There will be a national reserve of old but functional mechanical ventilators, hundreds of millions of masks, and the testing and contact tracing capacity of the CDC and state labs will be beefed up.

Axios: Sen. Rand Paul tests positive for coronavirus

Still asymptomatic.

rip big man, heaven needed a nightmare neighbour

We are now at a new stage. .@DrAmyActon just signed a statewide #StayHome order for Ohioans.

— Governor Mike DeWine (@GovMikeDeWine) March 22, 2020

My new favourite thing is Italian mayors and regional presidents LOSING IT at people violating quarantine. Here's an eng subtitled compilation. "I hear you wanna throw graduation parties. I'm gonna send the police over. With flamethrowers." #Covid19 #coronavirus pic.twitter.com/NbYuWePIVt

— 🌈 (@protectheflames) March 21, 2020

seriously, I think it was reported that healthcare workers were 10% of the infected numbers in Lombardy. The US needs to get it's shit together in protecting them and it's not looking good.

This crisis has made me realise I like a bit of authoritarianism in a pinch. Given the choice between Boris pleading with us to try to follow the advice of blah blah blah and mad Italians threatening me with flamethrowers I'll take Vincenzo De Luca every time.

xp no it is not

the nurses and staff at my oncologist's are heroic ppl and it pains me to know theyre in mortal danger

Draconian measures are the only solution now. Fuck it, I want the military delivering food supplies to people's houses.

Problem is that politicians tend to get very attached to authoritarianism once they've had a go on it.

in MAGAmerica I expect to be eventually removed from my house by the military, in what biological state I can't say

Your fellow citizens have stockpiled enough AR-15s to take down at least three successive tyrannical governments so you're golden.

the idiots don't have armed drones though

This is a very good piece by the people who did the Vo study.

The nature of this crisis means that establishing a structured response like this is key, while widespread testing is crucial in telling an accurate story of how many people are affected, and what the mortality rate of the virus actually is. In Italy, we have struggled with a rampant rise of mortality (the number of casualties divided by the number of infected people), which has reached an apparent value of 8% – far higher than the mortality rate in China and grimly close to that during the 2002-2003 Sars outbreak.

This high rate is misleading, though. After the first few days of the initial outbreak, cases were classed as all of those found to be infected by the virus. Yet since then, only the obviously symptomatic subjects – those needing medical care – have been tested for the virus and thus counted as cases

651 deaths in Italy in the last 24 hours. Down from the day before for the first time.

― Le Bateau Ivre, Sunday, 22 March 2020 18:08

It'll probably fluctuate for a while but this is still quite a relief after seeing yesterday's and thinking they could go over a thousand in one day before the curve flattens.

xp you mean that the data informing the 'mortality rates' are not counting what one might expect, or that widespread testing is crucial?
Afaik only people hospitalised here (UK) are getting tested (even then I don't know if it's everyone with symptoms?). Healthcare workers, people flying in from abroad, people who are sure they have the symptoms - are not. I would have no idea how to extrapolate meaningful data with that to go on.

xpost my friend is losing her mind because they have nonunionized people hired to admit people into the hospital she works now and they were not given masks or gloves and are not allowed to wear them.

I think they are all preparing for the time when they will not be allowed to go home for fear of infecting their families.

sorry they are not admitting people i went back and it's
"They are using young nonunionized people who are not clinicians to screen people as they walk into the hospital. They are providing them with neither masks nor gloves and have told them they will be let go if they wear either. They are not having them check temperatures but instead simply ASKING people how they feel, on the assumption that everyone is presumed positive."

As a friend of mine is fond of saying, the demand for certainty greatly outstrips the supply. At this point, I trust that the technically skilled and experienced people who are responsible for the response to this outbreak (as opposed to the political figures, whose abilities are all over the map) are doing their jobs at a high level and under great duress. My job is damned simple: follow their expert advice and try not to be an obstacle to them.

yeah, she wrote a very long thing entitled The Fun with Neoliberal Healthcare Fuckery Report:

So once we get over Covid 19 how ready would anybody be for the next whatever.
Is this going to be like multi hundred year storms were a couple of years ago.

The climate crisis is still very much with us it, didn’t disappear and we are still 30-40 years behind where we need to be with this. We just turned the world on a dime to confront Corona and now have a unique opportunity to rebuild our economies in much more sustainable way. If we’re going to spend trillions on restarting the economy, we have to do it right or this will be the next thing that kills us.

If anyone says ‘now is not the time to deal with this’ or ‘it can’t be done’; the rage should and will be immense.

Just like after WW2 nations built a new social compact with their people, social safety nets were build , health services came into being... We have to build a better world than the one we dismantled in the last few weeks.

extremely otm

yep

Re: Rand Paul testing positive

The Coronavirus Hoaxhttps://t.co/BUai4gGt2d pic.twitter.com/qJ1f04jZm8

— Ron Paul (@RonPaul) March 16, 2020

Yerac that is nuts. Do you mind sharing where that is? I’m an ICU nurse in the Seattle area and not only do we have RNs screening everyone at entrance (inc temp), wearing masks and gloves, but often hospital executives are there to help out as well.

BREAKING: Harvey Weinstein has reportedly been placed into isolation in a New York prison after testing positive for COVID-19. https://t.co/4k6J8yNkfJ

— The Daily Beast (@thedailybeast) March 22, 2020

thoughts and prayers

xp you mean that the data informing the 'mortality rates' are not counting what one might expect, or that widespread testing is crucial?
Afaik only people hospitalised here (UK) are getting tested (even then I don't know if it's everyone with symptoms?). Healthcare workers, people flying in from abroad, people who are sure they have the symptoms - are not. I would have no idea how to extrapolate meaningful data with that to go on.

― kinder, Sunday, March 22, 2020 7:36 PM (two hours ago) bookmarkflaglink

I spoke to someone this evening whose friend had symptoms, only rang emergency services when they became unmanageable. was taken to hospital by paramedics, hospital examined and said that the symptoms weren't bad enough to keep them in the hospital and therefore sent them home without being tested - they only test those who are admitted. paramedics dropped her back home and said 'well yes you've got it that's clear from your symptoms'. NHS rationing the testing kits?

The reason so many of these rich scumbags are testing positive is because they're the only fuckers actually being tested!

This is how I think the last 24hrs went in Australia. The various states decided they were going to go different ways on border closures and lock downs but all further than Scotty wanted. They announced what they were going to do. They then had national cabinet Scott threw his toys out of the pram and said I’m going to announce We’re not going as far as all that. He announces and the states ploughing on regardless with more announcements this morning.

Everyone is confused. The state websites are crashing. No one seems to know what is open or not.

A least the compromise on schools is the least confused. Everyone finishes term 1 and some states have brought the end of term forward to tomorrow except where they haven’t and in those places sending you kids to school is optional.

You couldn’t fucking make it up.

The reason so many of these rich scumbags are testing positive is because they're the only fuckers actually being tested!

Pretty much, yeah. It's fucking vile.

wtev wow, that's awful but I'm guessing pretty much the new normal now? Hope she's ok.
I thought we were increasing testing to 25,000 a day, Boris

I think the tests are fairly complicated; but then again South Korea seems to be getting on with it.

per the Shithead, testing for the rich is "the story of life"

We need to revise some future chapters of that story. Near future, if possible.

jack, it's in San Diego. xpost

wtev thats currently state of play over here too

not that its a comfort, or anything, but the strictness of admission does seem to be getting applied across the board and its the current pressure point in our own battle

I think the tests are fairly complicated

For clinicians, the tests aren't complicated. A sealed sterile tube, and sterile nasopharangeal swab that they shoot all the way to the back of your sinuses, https://www.rapidmicrobiology.com/rmbdata/userfiles/suppliers/copan_diagnostics_inc/news/copan-2023h4p.jpg, which collects mucus etc to be deposited in the tube.

Sample handling at labs is difficult, because its assumed infectious, and everyone has to wear positive pressure suits and work under lab negative pressure hoods (for SARS-CoV-2, biosafety level 3 is required).

But the actual test, rtPCR, is fairly routine these days. Sample tubes are loaded into a heating block, most commonly 96 at a time. Some probably used for negative controls. Robots pipette the reagents into the tubes, the viral RNA is reverse transcribed (hence the 'rt') to singled stranded DNA, and then the whole array is cycled hot and warm, hot and warm, with each cycle doubling DNA that matches highly selective primers, until a threshold for double stranded DNA is detected by a fluorescent probe in the tubes. A high viral loading may reach a 'positive' test threshold in 26 cycles, while a lower viral loading with only one thousandth of the initial load will hit the threshold in 36 cycles. The number of cycles before the threshold is reached is common to report relative viral loads in the literature (smaller: much worse).

PCR is weird. Nobel laureate and all around cool guy Kary Mullis (who passed this August) claimed that LSD use was instrumental in its discovery.

ok look this is a very serious fuckin illness and all

but id rather fuckin die than have that picture happen me, load me up now idgaf

Yeah, I guess I just won't leave my house for the next six months if that's the alternative.

man they have to take your face off in order to test? oh shit i'm done

fwiw, I've had a long swab inserted deep into my sinuses and in the hands of an experienced and careful clinician it was not particularly unpleasant. they just need to go slow and have a clear understanding of and feeling for the physical space they are probing.

I did 2 flu studies in college where I was quarantined in a hotel for 2 weeks, one time with a catheter in my arm so they could take blood on a regular basis/in the middle of the night. We had to do nutty stuff. It was fine, the pics look worse than it is.

god bless ye both

theres ppl on the planet who pay good money to be probed all sorts of places but listen i dont judge em i can only tell you ill jumpstart a hearse get it rolling toward the graveyard fling myself into the back of it and will myself to room temperature before i become fig a in the nightmare above

not if it was my last hope

i dont like me that much

I've had five colonoscopies in the past 13 years, and I'm staying inside!

that new report about covid positive people losing their sense of taste and smell as a marker (and sometimes with no other symptoms) is kind of wild. Even if you are not congested and are breathing totally normally. https://www.nytimes.com/2020/03/22/health/coronavirus-symptoms-smell-taste.html

National Guard being called to CA, WA, and NY

send them here too pls