outbreak! (ebola, sars, coronavirus, etc)

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.

I've looked online and the only ones I could find were unaffordable (50 quid for 3 etc) or had dubious reviews about arriving dirty etc. I am not going out to multiple physical shops in surrounding towns to try and get them.

local chemist has been out of masks since before the lockdown

Ours are pretty good but they are also close to GOSH and the UCL Neurological Hospital. Queen’s Square is locked shut to protect patients in both hospitals.

I am fine with going out to get various provisions because I’m living alone but I am really not fine with ordering for delivery because I think it’s just loading risk onto a class of worker (and me not taking up a delivery slot frees it up for someone who can’t go out).

I'm lucky to have the one shop that's open for the few hours a week I can go without taking the kids, so I'm trying to go there to get everything and/or get friends to get stuff and vice versa, yet still go as infrequently as possible. I don't know how even more rural people, or single parents, do it - they just have to bring children I guess.

I've mentioned the one small grocery store I go to a few times in this thread. Found out last night that the only death we've had in town--a man in his '60s a couple of weeks ago--was the owner of that store. I found an article online; didn't recognize him from the photo, so, even though I've only been here since November, my guess is he wasn't in the store all that often.

well there goes the Grifter's theory

https://www.jpost.com/HEALTH-SCIENCE/Coronavirus-can-survive-prolonged-exposure-to-high-temperatures-study-625118

“Two semi-trailer trucks, cleverly marked as food-service vehicles, met us at the warehouse. When fully loaded, the trucks would take two distinct routes back to Massachusetts to minimize the chances that their contents would be detained or redirected.” #COVID19

— NEJM (@NEJM) April 18, 2020

We got a box of n95 masks in from China at my work; no idea how they swung that, I guess somebody has a connect? I nabbed a couple which I put in ziplock bags & will reuse. We are used to wearing particulate respirators for operating mills so know how to wear them, this one feels like a much better fit than those (for my face at least) and I feel way more secure wearing this - certainly more than with my homemade effort

I do feel bad that I have one while my cousin who is a nurse is posting that they are about to run out and my dad works in a supermarket and has nothing (except that perspex screen they put up I guess, big whoop) and I’m gonna get it anyway from rubbing my eye or whatever, but I tell myself I’m doing my part to stop it spreading by wearing one

that's the real to look at it really. if you have them, you can use them to stop spread

really not feeling mega confident after I had to go to a Walmart to get a bathroom commode and just about everybody there wasn't wearing masks, was ignoring the arrows (which clearly said on them SHOP THIS WAY on one side, and DO NOT ENTER on the other), and weren't about to give me no six feet.

xp: The paper Morbs pointed to. It's mostly geared to labs that want to conduct SARS-CoV-2 rtPCR testing with only BSL-2 biosafety protocols (hoods+ordinary PPE+lim. access), who want to inactivate the virus in tubes before handling them. In solution, 92°C-15min reduced viral counts more than 1 million fold (below detection limits) but damaged the RNA; 56°C-30min and 60°C-60min reduced counts about 100,000 fold. Solutions with guanidinium thiocyanate inactivated the virus but didn't damage the RNA.

It's perhaps not so relevant for either mask disinfection (where repiratory droplets/aerosols would become dessicated) or for Trump's idea that summer heat will end the pandemic. The crazy wave 2 Singapore is experiencing in their foreign worker dorms pretty much nixes the latter idea.

The Danish Government has just become the 1st to announce that companies that are registered in tax havens won’t be eligible for bailout. 👍https://t.co/BlAd6ZUE1b pic.twitter.com/gqPyUXaNFM

— Economics in Bricks (@econinbricks) April 19, 2020

Way to go, Fred!

that’s my shit

antibody "test" clusterfuck

The Food and Drug Administration has allowed about 90 companies, many based in China, to sell tests that have not gotten government vetting, saying the pandemic warrants an urgent response. But the agency has since warned that some of those businesses are making false claims about their products; health officials, like their counterparts overseas, have found others deeply flawed.

Tests of “frankly dubious quality” have flooded the American market, said Scott Becker, executive director of the Association of Public Health Laboratories. Many of them, akin to home pregnancy tests, are easy to take and promise rapid results.

And the federal guidance that does exist is so confusing that health care providers are administering certain tests unaware that they may not be authorized to do so. Some are misusing antibody test results to diagnose the disease, not realizing that they can miss the early stages of infection.

“People don’t understand how dangerous this test is,” said Michael T. Osterholm, an infectious disease expert at the University of Minnesota. “We sacrificed quality for speed, and in the end, when it’s people’s lives that are hanging in the balance, safety has to take precedence over speed.”

https://www.nytimes.com/2020/04/19/us/coronavirus-antibody-tests.html