outbreak! (ebola, sars, coronavirus, etc)

so deaths in NYC were declining earlier this week, and then spiked over the past two days, with over a thousand dead in one day; was that due to a change in classifications and attribution of deaths to the virus, or were there really more numbers in aggregate?

just asking the question here first, as this is sort of like central command for all the covid19 threads:

can i start a thread about people dedicated to people protesting the stay-at-home orders? there are endless stories of people doing it already, we've got a president who urges people to do it (in the name of gun rights!), there's a growing sense of "identity" among the people who feel the urge to do it, and also it's going to kill a lot of people, if it hasn't already. is this the thread? is there another thread? can ilx stand another covid19 thread? can ilx remain united when there's not a dedicated place for powerful thoughts such as

Stephen Moore says the right-wing activists protesting stay-at-home orders are — I’m not joking — “modern-day Rosa Parks” https://t.co/m8eXpLQ2R0 pic.twitter.com/3CldS6H0Vb

— Amanda Terkel (@aterkel) April 18, 2020

go for it, it seems like Our Capitalist Masters astroturfing yet again but I dunno

I don’t think those people deserve a dedicated thread

At all

Karl just use the "Freemen" thread

"I'm a sovereign human being, I stand under common law only" - Thread of Freemen

had to fucking use the example below to try and get things through to a dunderhead who actually told me it was ridiculous that we are shutting down because more people die from heart disease (good to know heart disease is a communicable disease now!). Please, if you're a math person, poke holes in this if I made mistakes, cos....these idiots will seize on any misstep.
-------------------------------------------------------------------------------------

I go to the bar. Since each patient infects an average of a little over 2 other people, let's assume I infect two people at the bar. Watch how the number of cases grow if EACH PERSON who gets infected also infects two new people.

1x 2 = 2 (plus you, = 3 cases)
2 x2 = 4 new infections (plus 3 original infections = 7 cases)
4x2 = 8 new infections (plus 7 original = 15 cases)
8x2 = 16 new infections (plus 15 original = 31 cases)
16x2 = 32 new (plus 31 original = 63 cases)
32x2=64 new (plus 63 original = 127 cases)
64x2=128 new (plus 127 original = 255 cases)
128x2=256 new (plus 255 original = 511 cases)
256x2=512 new (plus 511 original = 1023 cases)
512x2=1024 new (plus 1023 original = 2047 cases)
1024x2=2048 new (plus 2047 original = 4095 cases)
2048x2=4096 new (plus 4095 original = 8191 cases)
4096x2=8192 new (plus 8191 original = 16383 cases)
8192 x 2 = 16384 (plus 16383 original = 32767 cases)

This shows how very quickly, the infections can spread from just one person to over 30,000 people if there is no social distancing. That is exponential growth. Each person might infect two others. Then those two people infect two others...each. and you add that to the existing cases.

If I stayed home, I'm the only person infected. Since I didn't, 32767 people have it, including me.

If 1% die of it, 327 people have died. even if only 0.1% die, 32 people have died instead of 1.

People keep losing sight of where *all* the issues are because infection/death numbers and your own health related to covid are only part of it. In some places if you die at home of anything right now, your family may have to live with the body for days until someone can deal with it.

yeah, that's the infuriating part. this isn't an equation with just one piece.

xp neanderthal, i think an easier thing to do is just point them toward the good ol' "rice doubling on the chessboard" story, which is often used to illustrate the power of exponential growth

There was once a king in India who was a big chess enthusiast and had the habit of challenging wise visitors to a game of chess. One day a traveling sage was challenged by the king. The sage having played this game all his life all the time with people all over the world gladly accepted the Kings challenge. To motivate his opponent the king offered any reward that the sage could name. The sage modestly asked just for a few grains of rice in the following manner: the king was to put a single grain of rice on the first chess square and double it on every consequent one. The king accepted the sage’s request.

Having lost the game and being a man of his word the king ordered a bag of rice to be brought to the chess board. Then he started placing rice grains according to the arrangement: 1 grain on the first square, 2 on the second, 4 on the third, 8 on the fourth and so on.

Following the exponential growth of the rice payment, the king quickly realized that he was unable to fulfill his promise because on the twentieth square the king would have had to put 1,000,000 grains of rice. On the fortieth square, the king would have had to put 1,000,000,000 grains of rice. And, finally, on the sixty-fourth square, the king would have had to put more than 18,000,000,000,000,000,000 grains of rice which is equal to about 210 billion tons and is allegedly sufficient to cover the whole territory of India with a meter thick layer of rice.

It was at that point that the sage told the king that he doesn’t have to pay the debt immediately but can do so over time. And so the sage became the wealthiest person in the world.

unfortunately, the other person isn't going to get it or change their mind on anything, no matter how you try to illustrate exponential growth

don't know much about history
don't know much biology
don't know much immunology
don't know bout epidemiology

but I know more than doctors do
COVID-19 is just the flu
I am such a smart guy, yay for me

lol u probably right Karl.

i stopped trying cos it was getting my BP up

Used to use a variation as intro to two or three different math units (patterning, usually): you get a job for a month somewhere, and you're given a choice between $10,000 a day or 2 cents on the first day, 4 cents on the second, etc. (The idea of starting with 2 cents instead of 1 had to do with the powers of 2.) You'd do a survey ahead of time, and all but one or two kids of course opted for the $10,000--and the one or two who didn't weren't answering that way because of any mathematical reasoning, they were just smart enough to know it was too obvious a trap.

yeah, i'm actually the very least qualified person on earth to be offering that advice (to just give up, it's pointless), because i've spent my entire life NOT giving up on that, and yes, the more you put into the venture, the harder you fall, every single time

xp

a friend of mine used that example the other day. it was pretty effective.

the person I argued with just told me that millions dying was worth the herd immunity we'd get from all being exposed so I promptly ate my keyboard

yeah, i mean I just talked to my mom who was talking to our family in Taiwan and I am really following these speculations that it might lead to a chronic permanent condition that sometimes becomes asymptomatic. I think the words the phrase they were saying to her was "permanent lung damage".

I used that so many times, I still remember that it's the 25th day where you exceed the $10,000, and by the 30th the difference is huge. And the really neat thing is that 30th day isn't even the end--with a little nudging, they then realize that you have to add up all the individual days to get your total remuneration for the month. (Sorry for detour...miss this stuff!)

the phrase they were saying to her was "permanent lung damage"

Yes. There was an article from the WaPo a couple of days ago that addressed this. There is also mounting evidence of permanent kidney damage or heart muscle damage in some survivors who had bad cases as well. This virus is extremely nasty; it doesn't confine itself to any one part of the body and can do permanent damage to several major organs.

links to this evidence aimless?

It was reprinted off the wire by The Oregonian newspaper, so I haven't got a link, but here is a C&P of the article:

Patient damage more widespread

Lenny Bernstein, Carolyn Y. Johnson, Sarah Kaplan and Laurie McGinley

Washington Post - The new coronavirus kills by inflaming and clogging the tiny air sacs in the lungs, choking off the body’s oxygen supply until it shuts down the organs essential for life.

But clinicians around the world are seeing evidence that suggests the virus also may be causing heart inflammation, acute kidney disease, neurological malfunction, blood clots, intestinal damage and liver problems. That development has complicated treatment for the most severe cases of COVID-19, the illness caused by the virus, and makes the course of recovery less certain, they said.

Almost half the people hospitalized because of COVID-19 have blood or protein in their urine, indicating early damage to their kidneys, said Alan Kliger, a Yale University School of Medicine nephrologist who co-chairs a task force assisting dialysis patients who have COVID-19.

Even more alarming, he added, is early data that shows 14 to 30% of intensive-care patients in New York and Wuhan, China, have lost kidney function and require dialysis, or its in-hospital cousin, continuous renal replacement therapy. New York intensive care units are treating so much kidney failure, he said, they need more personnel who can perform dialysis and have issued an urgent call for volunteers from other parts of the country. They also are running dangerously short of the sterile fluids used to deliver that therapy, he said.

“That’s a huge number of people who have this problem. That’s new to me,” Kliger said. “I think it’s very possible that the virus attaches to the kidney cells and attacks them.”

But in medicine, logical inferences often do not prove true when research is conducted. Everyone interviewed for this story stressed that with the pandemic still raging, they are speculating with much less data than is normally needed to reach solid conclusions.

Many other possible causes for organ and tissue damage must be investigated, they said, including respiratory distress, the medications patients received, high fever, the stress of hospitalization in an ICU and the impact of so-called cytokine storms.

Still, when researchers in Wuhan conducted autopsies on people who died of COVID-19, they found nine of 26 had acute kidney injuries and seven had particles of the coronavirus in their kidneys, according to a paper by the Wuhan scientists published April 9 in the medical journal Kidney International.

“It does raise the very clear suspicion that at least a part of the acute kidney injury that we’re seeing is resulting from direct viral involvement of the kidney, which is distinct from what was seen in the SARS outbreak in 2002,” said Paul Palevsky, a University of Pittsburgh School of Medicine nephrologist and president of the National Kidney Foundation.

The virus also may be damaging the heart. Clinicians in China and New York have reported myocarditis, an inflammation of the heart muscle, and, more dangerous, irregular heart rhythms that can lead to cardiac arrest in COVID-19 patients.

“They seem to be doing really well as far as respiratory status goes, and then suddenly they develop a cardiac issue that seems out of proportion to their respiratory issues,” said Mitchell Elkind, a Columbia University neurologist and president-elect of the American Heart Association.

One review of severely ill patients in China found that about 40% suffered arrhythmias and 20% had some form of cardiac injury, Elkind said. “There is some concern that some of it may be due to direct influence of the virus,” he said.

The new virus enters the cells of people who are infected by latching onto the ACE2 receptor on cell surfaces. It unquestionably attacks the cells in the respiratory tract, but there is increasing suspicion that it is using the same doorway to enter other cells. The gastrointestinal tract, for instance, contains 100 times more of these receptors than other parts of the body, and its surface area is enormous.

“If you unfurl it, it’s like a tennis court of surface area — this tremendous area for the virus to invade and replicate itself,” said Brennan Spiegel, co-editor in chief of the American Journal of Gastroenterology.

In a subset of COVID-19 cases, researchers have found, the immune system battling the infection goes into hyperdrive. The uncontrolled response leads to the release of a flood of substances called cytokines that, in excess, can result in damage to multiple organs.

The unfettered response, also called “cytokine release syndrome,” has long been recognized in other patients, including those with autoimmune diseases such as rheumatoid arthritis or in cancer patients. For COVID-19 patients, cytokine storms are a major reason that some require intensive care and ventilation, said Jeffrey Weber, deputy director of the Perlmutter Cancer Center at NYU Langone Medical Center.

Yikes. Thanks

so deaths in NYC were declining earlier this week, and then spiked over the past two days, with over a thousand dead in one day; was that due to a change in classifications and attribution of deaths to the virus, or were there really more numbers in aggregate?

There was a revision to the count:
https://www.theguardian.com/us-news/2020/apr/15/new-york-city-coronavirus-death-toll-jumps-revised-count

we went from "the flu kills more people" to being damn close to the last flu's season high end body count pretty fast huh

we were barely eclipsing 10k not that long ago

This graph might work on the not totally closed minded?

https://www.thenewatlantis.com/imgLib/20200414_CovidweeklydeathsUSv2.jpg

from: https://www.thenewatlantis.com/publications/not-like-the-flu-not-like-car-crashes-not-like

'we don't shut down the economy for cancer'

yeah, i just sent that to my mom. she will probably just repeat the last thing she said ("Apprec ur input...thnx")

they would shut down the economy if places had bedbugs that started eating at your lungs.

if two people die in a terror attack, they'll shut down for weeks and change the way we board transportation forever

uh oh

I— https://t.co/7KnTb0saIB pic.twitter.com/gxhHTaOs7t

— Matt Pearce 🦅 (@mattdpearce) April 18, 2020

Obvious time to list all the Republicans who buckled to Trump: Cruz, Graham, Rubio... You're all immune!

Frantically castrating myself

No big loss, I am done with mine

https://www.theguardian.com/world/2020/apr/17/ftse100-optimism-potential-coronavirus-drug-remdesivir#maincontent

This seems like good news?

― Matt DC, Friday, April 17, 2020 2:04 PM (yesterday) bookmarkflaglink

lots of talk about this on doctor twitter. this study had no control group and enrolled patients who weren’t very sick, so it’s hard to draw any conclusions about this one way or another

a lot of Trumpers keep citing the Remdesivir trials as evidence that we can open the country, and have been pointing to it for over a month.

definitely have to recognize that the study is being misrepresented

Some history.

Sentiment was so strong against the mask that several influential San Franciscans, including a few physicians as well as a member of the Board of Supervisors, formed “The Anti-Mask League” which held at least one public meeting to denounce the ordinance and to discuss ways to put an end to it. Over 2,000 people attended the event.

The epidemic brought nearly 45,000 cases of influenza to San Francisco and killed over 3,000 of its residents in the fall of 1918 and the winter of 1919. On numerous occasions throughout the fall of 1918 and winter of 1919, Hassler had made statements that San Francisco was the only large city in the entire world to check its epidemic so quickly. By mid-February 1919, however, when the United States Public Health Service released figures on the nation’s epidemic, it became clear that Hassler had been wrong: San Francisco was reported as having suffered the most of all major American cities, with a death rate approaching 30 deaths per 1,000 people.

interesting. with this epidemic London Breed was the first mayor in the country to issue a stay-at-home order

I’ve heard second-hand that SF will issue a face mask in public order like NY. don’t know if it’s true, hope it is

South Carolina is re-opening beaches and retail on Monday. Going first in 1860 went so well for them, they're gonna stick with it this time too.

There isn't a facemask order in SF? Hell, we even are required to wear face masks here in Texas. Today was the first time I went to the grocery and 100% of shoppers had masks.

no at least as of four days ago (the last time I ventured significantly outside) there was not, most people were wearing masks, mostly those who were not were young people, of which there a lot in SF

haven’t ever wanted to complain about all of the young people in SF, I think they have been a major good force in this city

The mask requirement went into effect at midnight early this morning:

https://sf.gov/information/masks-and-face-coverings-coronavirus-outbreak

You must wear a face covering when you are:

Waiting in line to go inside a store
Shopping at a store
On public transportation (or waiting for it)
In a taxi or rideshare vehicle
Seeking healthcare
Going into facilities allowed to stay open, like government buildings
Working an essential job that interacts with the public

good luck SC

No face mask order in the UK, people seem to think they're soft or something. Several people I have seen wearing them haven't bothered covering their noses, so maybe nationwide training is in order if the decree does come in.

i get how people have a difficult time consistently taking care of themselves (exercise, sleep, water, nutritious food) but holy shit about not even being able to wear a mask in public when there is an immediate health crisis.

we can't get them where I am and if you can get effective ones you're told they should go to healthcare workers instead. there is no set guidance on making masks that are actually effective.

Everyone is guessing and risk- assessing for themselves based on information that has been guessed and risk- assessed by other people, is my general experience of this whole thing. (what activity is acceptable etc)

As I said last week, on my trip to the local supermarket last week, I counted maybe 1 person in 8 wearing a mask or face covering - most of the supermarket staff weren't wearing anything either. I have no idea where in the UK anyone is getting proper masks from and the government are not advising the wearing masks either - and that includes the Scottish government.

I suspect they’re ordering them online? I’ve seen basic disposable masks for sale in a North London newsagents for £1.30 apiece and my nearest chemist is selling more complicated 3M ones for £7.99 each. I’ll stick with clean cotton or rayon scarves to wear over nose and mouth when I’m in an enclosed space. It’s still more crowded in Zone 2 London than here in the centre, more queues for shops etc.

I'm dubious about ordering anything online now, I no longer have any confidence in stuff get delivered. And I haven't been near a chemist for about a month, the last trip was so traumatic.