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3 minutes ago, Raz'r said:

can't sterilize it unless you have a UV sterlizer, whatever that is.

UV steriliser? 

https://www.amazon.com.au/Disinfection-Lamp-GermicidalPortable-Instrument-Ultraviolet-Kindergarten/dp/B07KY7YK75/ref=asc_df_B07KY7YK75/?tag=googleshopdsk-22&linkCode=df0&hvadid=341793407486&hvpos=&hvnetw=g&hvrand=6293201117963165469&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9071437&hvtargid=pla-749149834452&psc=1

But They are probably unavailabe Made in China.

Still, I think this whole thing has to be put in perspective. . China with millions in the effected ares have lost 3000?

I think our imaginations envisage scenes from the black death.

Still ..good to keep and eye on your elderly neighbours.

And our less fortunate neighbouring countries.

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BTW, I gave Mikey a time out, which will be the same response anyone gets for calling the coronavirus response measures 'hysteria' or peddling misinformation that could hurt someone.

I'm day 9 of symptoms and still in the middle if it. Let me tell you,  getting a viral load from convience store handle much less than getting it from being in a maskless patients face coughing on you

It is not whether it offends, it is whether it is dangerous. Spreading false information about the dangers of a pandemic can kill people. Most forums have a ratio of between 10 and 100 lurkers to ever

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4 hours ago, Clove Hitch said:

I know!!  The variation in the protein envelope!  And different RNA

Every different coronavirus common cold in the history of genetic measurement has those variations.

But what makes COVID-19 so different from all the other coronaviruses?

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4 hours ago, Clove Hitch said:

@mikewof

Covid19 destroys lung tissue and causes pnemonia. If a PT with covid19 dies from pnemonia I'm going to say it was the covid19 that was root cause. However, I am open to the idea that a splinter in their finger from years ago migrated to the patient's lung and caused the fatal pnemonia while they happened to have covid19.

Are you trolling? Or are you really such a tedious sophist?

P.s. I think there is an opportunity for you to learn something else. Just like you didn't know that a virus destroys cells you seem to think pnemonia is a germ in and of itself. Pnemonia can be caused by a lot of things. It does not need a virus or bacteria to cause it. If you get food in your lungs ("aspirate") then you could get pnemonia. This happens with stroke victims that have trouble chewing-swallowing. 

And MOB's who are otherwise fine will come down with pneumonia from asprating seawater.

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3 minutes ago, mikewof said:

Every different coronavirus common cold in the history of genetic measurement has those variations.

But what makes COVID-19 so different from all the other coronaviruses?

Ah, so you are just babbling and showing yourself to be a tedious sophist. 

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2 hours ago, phillysailor said:

I just spent a few hundred on workplace N95 type dust masks. Got some extra filter packs and eyeglass covering goggles. I figure we'll have enough gowns and gloves, since we use those in abundance already. The disposable masks though? They might run out if we've a real outbreak since they are either made in China, or made with materials from China. So I've some durable ones for myself and few spares for buds. 

As long as we’re improvising, how about this, with multiple hankerchiefs underneath of a high thread count- at least you could wash/ sterilize them, or how about breathing through sponges, like 3m scotchbrite?  They don’t melt under anything, and will stand up to sterilizing in a dishwasher.  Maybe under the face plate of this?  The face plate might ward off enough big particles?  This is a bit steampunk, no?

 

17B28063-CD84-4A43-BDF2-6A04E69C94E0.jpeg

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3 hours ago, Clove Hitch said:

Ok Mikey, if someone gets a disease that destroys lung tissue and causes pneumonia and they die of pneumonia--- maybe it was something else that killed them.  

The difference between a common cold and covid19 is the structure of their protein membrane, RNA and case-related-fatalities, among other things.  Or were you looking for a Mikeowof sort of answer? 

Lots of viruses and microbes can and do damage lung tissue. If someone has weakened lungs from existing pneumonia, or emphysema or COPD then even a very modest and unassuming infection can push that poor devil into death.

You're making an unscientific mistake. You assume that the last thing for which someone was measured is what killed that person. So by your own pseudo-logic, upon watching someone stumble near the edge of death from dehydration in Death Valley, he finally collapses from exhaustion and heat stroke, then falls and hits his nearly-dead, dried out brain on a rock and finally dies. Clove Hitch: "Yup that was one nasty rock, it killed that man in the prime of his life. We gotta be careful about rocks like that."

Without actual measurement, you don't know what if what you're writing there is true or false. Without measurement, science can only be pseudo-science.

Since COVID-19 was identified about two months ago, some 30,000 people in China have died from pneumonia and lung failure. Of that 30,000, about 3,000 happened to have the COVID-19 virus. Now, does that mean that without the virus there would have been about 27,000 pneumonia deaths?

We don't know yet, because the relative sample size is the COVID-19 group is barely 10% of the group and the sample time is only 2 months.

You can keep writing your opinion here, and you certainly are entitled to it, but opinions are like assholes right? Without measurement, everyone's got one.

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On 3/7/2020 at 11:52 AM, The Joker said:

18,000 Americans have already died from the flu.  Where are the screaming headlines.  
The threat is nowhere near as bad as the media would like you to believe.

The Joker appears to be distancing hisself from his own, ironically titled, thread. 

But ya gotta understand, the Reich is never wrong, and never apologizes. 

They got that from Roy Cohn, aka Mr. Nice Guy

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4 hours ago, bhyde said:

I reckon about 3800 deaths. 

How do you know that? Do you have access to data?

You're obviously using the global count of deaths by COVID-19, so, in that same time frame, how many global deaths have there been from the other coronoviruses that cause the common cold?

Actually a number ... how many?100? 1,000? 10,000?

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3 hours ago, phillysailor said:

The difference is, 16 million people in Italy alone are under quarantine. Tourism is down, our stock market is tumbling, fears are growing, and Trump agrees with you. To wit, this ain't normal.

The case hospitalization rate, requirement for oxygen support and rapid development of ARDS (Acute Respiratory Distress Syndrome) is all different than the natural course of most pneumonias. One big difference from COVID-19 is there are antibiotics for most causes of pneumonia, established treatment algorithms, and those rendering care aren't as likely to end up needing quarantine and (possibly) healthcare themselves because they were exposed when the patient was most ill and required intensive support. 

As the guy whose job it will be to intubate these patients, to care for their airway while they are at the peak of their potential to infect others, let me tell you that this sure seems different. I've got a family, with an elderly mother in law staying in our house, kids, and my own elderly mother living nearby. 

 

From various sources:

"The Civil Protection agency said 345 of all the coronavirus sufferers were in hospital, of whom 64 were in intensive care. Some 412 had few or no symptoms and were at home, while 46 people were declared fully recovered. All those who died were elderly patients, many with serious underlying health problems. 

Lombardy said that on average each patient was infecting two other people. It added that in the worst-affected area around 4% of the population had come down with the illness. 

The economic impact of the health crisis is being felt in places barely touched by the virus. 

Italy’s tourism federation, Assoturismo, said up to 90% of hotel and travel agency bookings had been canceled in Rome and up to 80% in Sicily for March, as school trips and conferences were called off and foreigners decided to stay away."

 

"As of the beginning of March, Italy was hit harder than anywhere else in the EU by the outbreak,[6] and is the country with the second-highest number of positive cases as well as number of deaths in the world, after China. Eleven municipalities in northern Italy have been identified as the epicentres of the two main Italian clusters and placed under quarantine. The majority of positive cases in the other regions lead back to these two clusters.[7] By 7 March, Italy had performed 42,062 tests for the virus.[8]

On 8 March 2020, Prime Minister Giuseppe Conte extended the quarantine to all of Lombardy and 14 other northern provinces, putting more than a quarter of the national population (ca. 16 million people) under lockdown.[9] As of that day, there have been 7,375 confirmed cases, 366 deaths, and 622 recoveries in Italy.[1]"

Okay, so we know that COVID -19 is virulent, we have good data on that. We know that it's new, only identified less than 2 months ago, and we know that we are still learning how to treat it.

We can say "COVID-19 pneumonia has killed 19 people in the USA." But in that same time frame, pneumonia without COVID-19 has killed about 8,000.

So, is 19 a sufficient sample size in a field of 8,000 to build a statistically meaningful picture of how COVID-19 adds to the mortality of pneumonia more than a common cold?

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3 hours ago, Shortforbob said:

42

how many phillips head screws in a 2000 year old Indonesian ossuary box?

In other words, you have nothing to add here.

I'll try to respond to you if you eventually do have anything more than cutting and pasting.

 

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2 hours ago, Steam Flyer said:

Sure, and there are tens of millions... possibly billions, of types of microorganisms that live inside us and we're all fine.

OTOH we have identified a few types that are not.

I'm glad to hear you state that the CoVid-19 virus "seems to cause very little problem." That will be a huge relief to the families of the people who've died of it.

- DSK

Lessee ...

5 week COVID-19 pneumonia death score in USA = about 20

5 week pneumonia death score in USA = about 8,000.

Looks like pneumonia is about 400 times worse. So do tell, which one is the "bigger problem" to all those families who don't want to lose a loved-one?

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Just now, mikewof said:

Lessee ...

5 week COVID-19 pneumonia death score in USA = about 20

5 week pneumonia death score in USA = about 8,000.

Looks like pneumonia is about 400 times worse. So do tell, which one is the "bigger problem" to all those families who don't want to lose s loved-one?

pneumonia by what cause?   

Sorry, mikey, you are insufferable.  Into the ignore bin with you. 

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Here’s an interesting site, assuming the info is reliable

https://smartairfilters.com/en/blog/diy-homemade-mask-protect-virus-coronavirus/

at least you can clean these in between uses

i messed about with some sponges- hard to breathe through, and who knows what size participants would get through them....:lol:

What the hell are tea towels?

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1 hour ago, mikewof said:

Lessee ...

5 week COVID-19 pneumonia death score in USA = about 20

5 week pneumonia death score in USA = about 8,000.

Looks like pneumonia is about 400 times worse. So do tell, which one is the "bigger problem" to all those families who don't want to lose a loved-one?

The usual pneumonia to which you are referring are caused by known pathogens and insults.

The COVID-19 is a "pandemic", and so can show exponential growth. It is a novel pathogen for which we have no cure and can only offer supportive therapies. Most deaths are from the initial pathogen, secondary infections have been few, probably because the virus kills so quickly. A week of malaise and aches, then shortness of breath leading to hospitalization in 7-10 days, death in two weeks or so. Patients can apparently transmit the virus after just two days of illness. 

The elderly and those with immunocompromised status and comorbidities could quickly consume our immediately available resources, so that when young folks start showing up we may not have ICU rooms and vents available, and might have to make "who is actually going to survive this disease and have a functional life and therefore deserves the ventilator more" decisions.

Current causes of pneumonia which you describe as "400 times worse" is static in terms of growth. 

The COVID-19 is deadly out of the gate and is accelerating its spread at a geometric pace. A few doublings and it will rival your bogeyman and a few more would leave it in the dust. If the case fatality rate is 1.4%, as soon as you have a death in an area, you can assume that 10-16 days ago you had 140 cases. They will have been infecting people since then, average is 2 infections per case. after a few days, you've got 280 cases, soon after that over 500, then 1000, then 2K, 4K, 10K, 20K... In a few weeks there can easily be 100,000 cases if quarantine measures fail to stop the spread. Then it tapers off over the summer before going nuts in the fall.

Doubling the number of infected persons every few days is scary math.

Tens of millions could end up being infected by the elections. Start multiplying that by 10-20% needing hospitalization, 5-10% intubation and ventilation, 1-2% death which could start climbing as healthcare workers fail to show up for work without hazard pay, better gear and guaranteed death benefits.

What part of this is difficult to comprehend? I think it must be the power of exponential growth. But that's what viruses do.

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1 hour ago, phillysailor said:

The usual pneumonia to which you are referring are caused by known pathogens and insults.

The COVID-19 is a "pandemic", and so can show exponential growth. It is a novel pathogen for which we have no cure and can only offer supportive therapies. Most deaths are from the initial pathogen, secondary infections have been few, probably because the virus kills so quickly. A week of malaise and aches, then shortness of breath leading to hospitalization in 7-10 days, death in two weeks or so. Patients can apparently transmit the virus after just two days of illness. 

The elderly and those with immunocompromised status and comorbidities could quickly consume our immediately available resources, so that when young folks start showing up we may not have ICU rooms and vents available, and might have to make "who is actually going to survive this disease and have a functional life and therefore deserves the ventilator more" decisions.

Current causes of pneumonia which you describe as "400 times worse" is static in terms of growth.

The COVID-19 is deadly out of the gate and is accelerating its spread at a geometric pace. A few doublings and it will rival your bogeyman and a few more would leave it in the dust. If the case fatality rate is 1.4%, as soon as you have a death in an area, you can assume that 10-16 days ago you had 140 cases. They will have been infecting people since then, average is 2 infections per case. after a few days, you've got 280 cases, soon after that over 500, then 1000, then 2K, 4K, 10K, 20K... In a few weeks there can easily be 100,000 cases if quarantine measures fail to stop the spread. Then it tapers off over the summer before going nuts in the fall.

Doubling the number of infected persons every few days is scary math.

Tens of millions could end up being infected by the elections. Start multiplying that by 10-20% needing hospitalization, 5-10% intubation and ventilation, 1-2% death which could start climbing as healthcare workers fail to show up for work without hazard pay, better gear and guaranteed death benefits.

What part of this is difficult to comprehend? I think it must be the power of exponential growth. But that's what viruses do.

I don't disagree with much of what you wrote up there, but some of what you wrote is measurable, and some of it has not been measured and can't be measured yet.

What you wrote in bold up there.

1. How do you know that?

2. If "regular" pneumonia is "static" then you have essentially staked your claim that total pneumonia cases (i.e. "regular" plus COVID-19 pneumonia) will thus significantly exceed the average "static" numbers right? Has that happened yet? Do you have any data to show that this had happened?

We are fairly confident, based on existing data, that COVID-19 makes some people very ill, occasionally enough to die. Does this "rapid onset" you describe set COVID-19 apart from regular community pneumonia? Maybe, but we know that the "rapid collapse" type of pneumonia that you describe actually happens to some 3,000 "regular" pneumonia patients every year in the USA, and these 3,000 are dead in less than 30 days,  https://www.uptodate.com/contents/pneumonia-in-adults-beyond-the-basics.

So, what data do you have of the less-than-20 U.S. deaths were with people who didn't already have compromised lung function and then died in the rapid timeframe you describe?

I have zero problem with the infection rates, those are actually measured and reliable. But it would be a mistake to assume that infection rate is correlated to a specific death rate without the measurement, and we don't have that measurement.

Now, above, you have predicted that we will see some ADDITIONAL 400,000 deaths from COVID-19 pneumonia (20 million infected times 2% death rate.)

So we have our "static" pneumonia deaths at about 4,000 per month, and then this coming 400,000 annual deaths, which is a 8x more, right? So based on the exponential increase, when would you expect that COVID-19 pneumonia would match our current 4,000/month from regular pneumonia, and when will it reach 2x if we're going to hit the 8x that you predict in time for the election?

I did an graph estimate using an exponential, for 8x our current average of 4,000 deaths per month. (So 8 more months.) If what you're saying has merit, then we should already be looking at 1,000 total COVID-19 pneumonia deaths.

But in fact, we're still at less than 20. So what happened? We know that this virus is virulent, but when the measured data doesn't match the prediction, what needs to be revised? The data or the prediction? For all we know, 2020 may end with roughly the same number of pneumonia deaths as any average year, about 50,000. And if that happens, then we will thus suspect that the COVID-19 didn't change the "static" rate at all, and other than some varying symptoms, it is no more likely to lead to lung collapse than any other coronavirus.

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Next weeks thread in GA.

Anyone know wtf is up with my chest?

By mikewof, March 14, 2020 in General Anarchy

 

Power out all over my county for hours, no big deal. Except I fired up the 4WD, and the county facilities are all running on bare-necessity generator power.

I've been through a lot of power outs here, but I've never seen that.

No big deal but I've been coughing a lot lately and think maybe I should go over to the Docs and have it checked out.

Mrleft8

  • Mrleft8
  • What power outs?

    Grande Mastere Dreade

    Super Anarchist
    Grande Mastere Dreade

     

    well Mike, we're not sure what planet you're on ,  but this is on the web

     

    "

    Coronavirus19 over runs central U.S. Thousands of essential services Employees quarantined. Gas Rationed and Power outages planned.

    mikewof

    •  
    •  

    ,No power, AT&T out, but I don't see downed lines, I assume that they're blacking us out to save power for the denser areas. My land line is dead too. I drove about 12 miles to rescue someone from a hotel, same thing, a hundred guests milling around a darkened lobby.

    But I have a battery backup for the gas fireplace, lots of beer, even more booze, a ridiculously snow worthy Isuzu Rodeo, a rapidly diminishing 20 pack of Hebrew Nationals. They'll get the power back on in a few days, maybe even tonight.

    ?

     

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4 hours ago, Raz'r said:

can't sterilize it unless you have a UV sterlizer, whatever that is.

Oh. BTW..I didn't go out and buy them. Had them in my "workshop" 1 slightly used for sanding.

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5 hours ago, phillysailor said:

The usual pneumonia to which you are referring are caused by known pathogens and insults.

The COVID-19 is a "pandemic", and so can show exponential growth. It is a novel pathogen for which we have no cure and can only offer supportive therapies. Most deaths are from the initial pathogen, secondary infections have been few, probably because the virus kills so quickly. A week of malaise and aches, then shortness of breath leading to hospitalization in 7-10 days, death in two weeks or so. Patients can apparently transmit the virus after just two days of illness. 

The elderly and those with immunocompromised status and comorbidities could quickly consume our immediately available resources, so that when young folks start showing up we may not have ICU rooms and vents available, and might have to make "who is actually going to survive this disease and have a functional life and therefore deserves the ventilator more" decisions.

Current causes of pneumonia which you describe as "400 times worse" is static in terms of growth. 

The COVID-19 is deadly out of the gate and is accelerating its spread at a geometric pace. A few doublings and it will rival your bogeyman and a few more would leave it in the dust. If the case fatality rate is 1.4%, as soon as you have a death in an area, you can assume that 10-16 days ago you had 140 cases. They will have been infecting people since then, average is 2 infections per case. after a few days, you've got 280 cases, soon after that over 500, then 1000, then 2K, 4K, 10K, 20K... In a few weeks there can easily be 100,000 cases if quarantine measures fail to stop the spread. Then it tapers off over the summer before going nuts in the fall.

Doubling the number of infected persons every few days is scary math.

Tens of millions could end up being infected by the elections. Start multiplying that by 10-20% needing hospitalization, 5-10% intubation and ventilation, 1-2% death which could start climbing as healthcare workers fail to show up for work without hazard pay, better gear and guaranteed death benefits.

What part of this is difficult to comprehend? I think it must be the power of exponential growth. But that's what viruses do.

 

From what I've read about it, the time from infection to symptoms is 9 ~ 14 days; and the infected person is contagious for several days before showing symptoms.

More cheeful news

- DSK

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8 hours ago, mikewof said:

Every different coronavirus common cold in the history of genetic measurement has those variations.

But what makes COVID-19 so different from all the other coronaviruses?

Dr. Jen Ashton for one thing. ABC News. Looking particularly hot this morning. Cue: Bright side of life.

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5 hours ago, Shortforbob said:

Next weeks thread in GA.

Anyone know wtf is up with my chest?

By mikewof, March 14, 2020 in General Anarchy

 

Power out all over my county for hours, no big deal. Except I fired up the 4WD, and the county facilities are all running on bare-necessity generator power.

I've been through a lot of power outs here, but I've never seen that.

No big deal but I've been coughing a lot lately and think maybe I should go over to the Docs and have it checked out.

Mrleft8

  • Mrleft8
  • What power outs?

    Grande Mastere Dreade

    Super Anarchist
    Grande Mastere Dreade

     

    well Mike, we're not sure what planet you're on ,  but this is on the web

     

    "

    Coronavirus19 over runs central U.S. Thousands of essential services Employees quarantined. Gas Rationed and Power outages planned.

    mikewof

    •  
    •  

    ,No power, AT&T out, but I don't see downed lines, I assume that they're blacking us out to save power for the denser areas. My land line is dead too. I drove about 12 miles to rescue someone from a hotel, same thing, a hundred guests milling around a darkened lobby.

    But I have a battery backup for the gas fireplace, lots of beer, even more booze, a ridiculously snow worthy Isuzu Rodeo, a rapidly diminishing 20 pack of Hebrew Nationals. They'll get the power back on in a few days, maybe even tonight.

    ?

     

Lovely. So now you've quoted me about a bomb cyclone from last year but then outright falsifying it about a coronovirus?

That's about as funny as a proctology exam.

But you're at least trying to be amusing, I guess I have to give you a little credit. 

 

 BTW, the USA still holding at less than 20 COVID-19 deaths. This "American pandemic" is so far about as lethal as a couple days of agricultural accidents.

Imagine if we all got this worked up over ACTUAL pandemics, like the million-some children who die each year from diarrhea. Oh wait, those children have brown skin and don't live in a multi million dollar home in downtown Melbourne, never mind.

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5 hours ago, mikewof said:

I don't disagree with much of what you wrote up there, but some of what you wrote is measurable, and some of it has not been measured and can't be measured yet.

What you wrote in bold up there.

1. How do you know that?

2. If "regular" pneumonia is "static" then you have essentially staked your claim that total pneumonia cases (i.e. "regular" plus COVID-19 pneumonia) will thus significantly exceed the average "static" numbers right? Has that happened yet? Do you have any data to show that this had happened?

We are fairly confident, based on existing data, that COVID-19 makes some people very ill, occasionally enough to die. Does this "rapid onset" you describe set COVID-19 apart from regular community pneumonia? Maybe, but we know that the "rapid collapse" type of pneumonia that you describe actually happens to some 3,000 "regular" pneumonia patients every year in the USA, and these 3,000 are dead in less than 30 days,  https://www.uptodate.com/contents/pneumonia-in-adults-beyond-the-basics.

So, what data do you have of the less-than-20 U.S. deaths were with people who didn't already have compromised lung function and then died in the rapid timeframe you describe?

I have zero problem with the infection rates, those are actually measured and reliable. But it would be a mistake to assume that infection rate is correlated to a specific death rate without the measurement, and we don't have that measurement.

Now, above, you have predicted that we will see some ADDITIONAL 400,000 deaths from COVID-19 pneumonia (20 million infected times 2% death rate.)

So we have our "static" pneumonia deaths at about 4,000 per month, and then this coming 400,000 annual deaths, which is a 8x more, right? So based on the exponential increase, when would you expect that COVID-19 pneumonia would match our current 4,000/month from regular pneumonia, and when will it reach 2x if we're going to hit the 8x that you predict in time for the election?

I did an graph estimate using an exponential, for 8x our current average of 4,000 deaths per month. (So 8 more months.) If what you're saying has merit, then we should already be looking at 1,000 total COVID-19 pneumonia deaths.

But in fact, we're still at less than 20. So what happened? We know that this virus is virulent, but when the measured data doesn't match the prediction, what needs to be revised? The data or the prediction? For all we know, 2020 may end with roughly the same number of pneumonia deaths as any average year, about 50,000. And if that happens, then we will thus suspect that the COVID-19 didn't change the "static" rate at all, and other than some varying symptoms, it is no more likely to lead to lung collapse than any other coronavirus.

Yes, background pneumonia rates due to seasonal flu, COPD exacerbations, aspirations, other causes are occurring at a steady rate. We are at the beginning of this disease pandemic, and have seen other health systems overwhelmed by the sudden influx of patients. In China, the following article show how hospitals were challenged by Coronavirus patients: TimeBloomberg reported on the long term need for ventilators, and this article in NYPost shows how in Wuhan, Chinese authorities built two 1,000 bed hospital inspired by a SARS epidemic model to handle the sudden influx of patients.

I'm not saying that our death rates WILL climb to the numerically impressive numbers quoted, I'm saying that's how pandemics work, and how this could grow out of control and exhaust our normal resources. For all its initial hesitancy to admit it had a problem, once the central government decided controlling the Wuhan outbreak was of national concern, China clamped down on its society in ways a democracy will be hard pressed to emulate, especially one with as dysfunctional a government as ours. That made a difference, and vastly slowed the escalation of disease and deaths.

Look, I hope your numbers are right, and mine are wrong. That'd be great. But the response America brings to the issue is a deciding factor impacting which way this pandemic goes. If we can isolate early cases and investigate their sick contacts quickly, great. If we can reduce our social exposure and bring the number infected per case to less than one or at least dramatically slow the doubling time of virus cases, fantastic. 

But saying everything is fine? Yeah, not so much. That sounds like an argument for complacency and failure. For our president to come out and say that everything is fine, go to work even if sick... that could cost thousands of live. Your optimistic numbers predicting no increase in the total number of pneumonia deaths are a best case scenario which policy makers and healthcare workers would best ignore. Fear is an excellent motivator for best practices and hard decisions.

Your model would argue, for instance, that closing schools is an unnecessary hardship for parents and communities, and we would be best served by keeping them open as long as possible. Yet no other single decision by state and federal authorities would likely have a similar impact on disease spread. That's the question our policy makers are facing, and they should make the decision pretty much now, before the disease has spread far and wide. It may actually be too late, I don't know. Given that spread is possible before symptoms? Perhaps we should do it today. 

The thing is, Mikey, you are risking only your personal prognostication reputation by going out on this statistical limb. The deadly pandemic isn't common and we've little experience dealing with it, and none in recent generations. Getting the response wrong can occasionally lead to thousands (or hundreds of thousands) of deaths. I'd say the stakes are far too high to just hope for good luck and happy statistical modeling.

I think you've started this argument not thinking about the potential downside of making it, and are now stuck defending it as an ego thing. Just promise me you will self isolate if you feel sick and will tell those you've had close contact with for the past few days that you may have spread Coronavirus to them, so be on the lookout, as should we all. 

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"Who would have thought?" - President Trump

Actually, quite a few people would have thought, and did — including the officials in his own White House who were in charge of preparing for just such a pandemic only to have their office shut down in a reorganization in 2018. “The threat of pandemic flu is the No. 1 health security concern,” one of the officials said the day before that happened two years ago. “Are we ready to respond? I fear the answer is no.”

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48 minutes ago, Bus Driver said:

"Who would have thought?" - President Trump

Actually, quite a few people would have thought, and did — including the officials in his own White House who were in charge of preparing for just such a pandemic only to have their office shut down in a reorganization in 2018. “The threat of pandemic flu is the No. 1 health security concern,” one of the officials said the day before that happened two years ago. “Are we ready to respond? I fear the answer is no.”

Because I am a bit of a masochist, I compulsively watch most of Trumps press conferences, rallies, meetings, etc.  

It is a sign of Trump's rampant narcissism that any time he hears something he didn't know, which is almost anything, he says "Who would have thought" or "Nobody ever though of that", or something similar.  Because he truly believes that he knows almost everything, and nobody else knows as much as he does.  And the folks that surround him, knowing that flattery is the best way to advance in Trump's world enable him constantly, instead of calling out his bullshit.

Really smart people in powerful positions always have at least one trusted person on their staff to stand up to them and call them out when they go astray.  Really smart powerful people know that they need that to keep them grounded.

Trump is the worst kind of autodidact.

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10 hours ago, mikewof said:

How do you know that? Do you have access to data?

You're obviously using the global count of deaths by COVID-19, so, in that same time frame, how many global deaths have there been from the other coronoviruses that cause the common cold?

Actually a number ... how many?100? 1,000? 10,000?

I'm using the numbers published by Johns Hopkins for worldwide deaths (see above chart), because (A) Johns Hopkins knows more than anyone here and (B) viruses don't give crap about borders. I don't give a shit about the "common cold" because, in general, it doesn't kill at a 3-4% rate like COVID-19.

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30 minutes ago, bhyde said:

I'm using the numbers published by Johns Hopkins for worldwide deaths (see above chart), because (A) Johns Hopkins knows more than anyone here and (B) viruses don't give crap about borders. I don't give a shit about the "common cold" because, in general, it doesn't kill at a 3-4% rate like COVID-19.

Okay, so of people who already have compromised lung function, what rate does the common cold (a coronavirus, btw) kill?

Are you sure that it's not even higher than 10%? And when it kills them, do we say "Mrs. Snyders died of Coronovirus X"? Or do we say "Mrs. Snyders died from complications due to pneumonia"?

Yet, when someone tests positive for COVID-19, and then dies of anything from lung failure, to kidney failure to heart failure, the statistics will always record it as a COVID-19 death.

What part of the Johns Hopkins study are you referencing? Do you have a link? 

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1 hour ago, phillysailor said:

Yes, background pneumonia rates....   ...    ...

The thing is, Mikey, you are risking only your personal prognostication reputation by going out on this statistical limb. The deadly pandemic isn't common and we've little experience dealing with it, and none in recent generations.   ...      ...

 I admire your patience, but you would have just as much effect yelling at the trees. Maybe more.

The best thing might be to back up a few steps and explain the difference between tissue, cells, bacteria, viruses, and pathogens. Not that he'll pay attention, but it might help clear up some bizarre misconceptions that seem to be common (especially among the Trumpian elk)

- DSK

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19 minutes ago, mikewof said:

Okay, so of people who already have compromised lung function, what rate does the common cold (a coronavirus, btw) kill?

Are you sure that it's not even higher than 10%? And when it kills them, do we say "Mrs. Snyders died of Coronovirus X"? Or do we say "Mrs. Snyders died from complications due to pneumonia"?

Yet, when someone tests positive for COVID-19, and then dies of anything from lung failure, to kidney failure to heart failure, the statistics will always record it as a COVID-19 death.

What part of the Johns Hopkins study are you referencing? Do you have a link? 

I've posted the link twice above. If you would like to look at each case being tracked by Johns Hopkins, you are more than welcome to contact them directly and ask for the information. They are really good at ignoring ridiculous requests.

Stop conflating the common cold (a coronavirus) with COVID-19 (a coronavirus). They are different things, just like falling off a building (blunt force trauma) is different from getting hit by a car (blunt force trauma).

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2 hours ago, phillysailor said:

Yes, background pneumonia rates due to seasonal flu, COPD exacerbations, aspirations, other causes are occurring at a steady rate. We are at the beginning of this disease pandemic, and have seen other health systems overwhelmed by the sudden influx of patients. In China, the following article show how hospitals were challenged by Coronavirus patients: TimeBloomberg reported on the long term need for ventilators, and this article in NYPost shows how in Wuhan, Chinese authorities built two 1,000 bed hospital inspired by a SARS epidemic model to handle the sudden influx of patients.

I'm not saying that our death rates WILL climb to the numerically impressive numbers quoted, I'm saying that's how pandemics work, and how this could grow out of control and exhaust our normal resources. For all its initial hesitancy to admit it had a problem, once the central government decided controlling the Wuhan outbreak was of national concern, China clamped down on its society in ways a democracy will be hard pressed to emulate, especially one with as dysfunctional a government as ours. That made a difference, and vastly slowed the escalation of disease and deaths.

Look, I hope your numbers are right, and mine are wrong. That'd be great. But the response America brings to the issue is a deciding factor impacting which way this pandemic goes. If we can isolate early cases and investigate their sick contacts quickly, great. If we can reduce our social exposure and bring the number infected per case to less than one or at least dramatically slow the doubling time of virus cases, fantastic. 

But saying everything is fine? Yeah, not so much. That sounds like an argument for complacency and failure. For our president to come out and say that everything is fine, go to work even if sick... that could cost thousands of live. Your optimistic numbers predicting no increase in the total number of pneumonia deaths are a best case scenario which policy makers and healthcare workers would best ignore. Fear is an excellent motivator for best practices and hard decisions.

Your model would argue, for instance, that closing schools is an unnecessary hardship for parents and communities, and we would be best served by keeping them open as long as possible. Yet no other single decision by state and federal authorities would likely have a similar impact on disease spread. That's the question our policy makers are facing, and they should make the decision pretty much now, before the disease has spread far and wide. It may actually be too late, I don't know. Given that spread is possible before symptoms? Perhaps we should do it today. 

The thing is, Mikey, you are risking only your personal prognostication reputation by going out on this statistical limb. The deadly pandemic isn't common and we've little experience dealing with it, and none in recent generations. Getting the response wrong can occasionally lead to thousands (or hundreds of thousands) of deaths. I'd say the stakes are far too high to just hope for good luck and happy statistical modeling.

I think you've started this argument not thinking about the potential downside of making it, and are now stuck defending it as an ego thing. Just promise me you will self isolate if you feel sick and will tell those you've had close contact with for the past few days that you may have spread Coronavirus to them, so be on the lookout, as should we all. 

Two days ago Mike didn't know that viruses destroy cells.  Now he's lecturing us on epidemiology.   He really takes Duning-Krueger to a new level. 

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Headline from a story about how Milwaukee handled the Spanish flu epidemic those many years ago.  All I can say is that’s a community with the proper priorities.

How did Milwaukee fight off Spanish flu? It closed churches and schools. But not saloons

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17 minutes ago, Clove Hitch said:
2 hours ago, phillysailor said:

The thing is, Mikey, you are risking only your personal prognostication reputation...    ...

Two days ago Mike didn't know that viruses destroy cells.  Now he's lecturing us on epidemiology.   He really takes Duning-Krueger to a new level. 

 

Well, he's also an excellent example of the difference between INFORMATION, or DATA, and KNOWLEDGE.

Wofsey is fairly smart on some topics, and he's firmly convinced this makes him an expert in everything. Some of the data points he rakes together into a pile are valid (others are not, but he can't sort them), but a raked-together pile of info is not KNOWLEDGE of the topic.

My own biology is relatively scant but I at least paid attention in high school science class, so I do know the difference between tissue, cells, bacteria, viruses, and pathogens. Wofsey is apparently a little fuzzy on this and believes himself to be reasoning with hi-powered logic but falling far short of producing any useful result (which is the goal of science, after all).

FWIW I don't think he's part of the right-wing bullshit machine, just trying to ride along.

- DSK

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30 minutes ago, Steam Flyer said:

 

Well, he's also an excellent example of the difference between INFORMATION, or DATA, and KNOWLEDGE.

Wofsey is fairly smart on some topics, and he's firmly convinced this makes him an expert in everything. Some of the data points he rakes together into a pile are valid (others are not, but he can't sort them), but a raked-together pile of info is not KNOWLEDGE of the topic.

My own biology is relatively scant but I at least paid attention in high school science class, so I do know the difference between tissue, cells, bacteria, viruses, and pathogens. Wofsey is apparently a little fuzzy on this and believes himself to be reasoning with hi-powered logic but falling far short of producing any useful result (which is the goal of science, after all).

FWIW I don't think he's part of the right-wing bullshit machine, just trying to ride along.

- DSK

He's not a bad guy he's just pedantic and a tedious sophist.   I couldn't take it anymore so into the ignore heap he went. 

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2 hours ago, bhyde said:

I've posted the link twice above. If you would like to look at each case being tracked by Johns Hopkins, you are more than welcome to contact them directly and ask for the information. They are really good at ignoring ridiculous requests.

Stop conflating the common cold (a coronavirus) with COVID-19 (a coronavirus). They are different things, just like falling off a building (blunt force trauma) is different from getting hit by a car (blunt force trauma).

Okay, then how are they different?

Biologically, they are so similar that it would take a computer and a very good microscope to characterize them, that's really hard.

And epidemiologically, the difference is well-established, we have a reasonably clear picture of how fast the virus traveled in China, We can presumably use some of their results here to how is spreads.

But how are they different in terms of mortality? This is what you really need to think about with some logic, instead of trying to compare it to "falling off a building" versus "being hit with a car." That's just hyperbole, it adds nothing to understanding the actual virus.

So, how are they different in terms of mortality? We have about three weeks of data on this in the USA, with about 500 people who have tested positive for the virus, and of those, about 20 people have died. What do you do with that data? Do you say "Aha, my calculator says that the mortality rate is 4%"? Because you see the problem here right? We don't know how many of those 20 people who died while being positive from COVID-19 actually died from the results of the virus. All 20? 15? 14? How many? You can guess of course, but without actual data, it's just a guess. For all we know, maybe only 10 of those 20 deaths would have not died if it wasn't for the COVID-19. So you say "look at the Johns Hopkins data." Okay but that's clinical data. It has to be, because 20 is too small of a sample size to build up a statistically-meaningful profile of deaths by pneumonia when in that same time frame, about 7,000 Americans have died from pneumonia while not testing positive for COVID-19.

And then look at it from the side of the bigger number ... how many people are actually infected with COVID-19 in the USA? About 500? Where did that 500 number come from? Is that an estimate of the number of people in the USA who have it? Or is that the number of clinical cases which have been tested and confirmed to have COVID-19? It's the latter. So, how many Americans actually have COVID-19? About 1,000? About 5,000? About 10,000? Until an actual study is done to get a handle on this number, all we can do is guess. The only thing we know for sure is that it's at least 500, but it could be 5,000. A virus that has only been in the USA for just a touch over a month can't be characterized too easily for total undiagnosed cases.

If COVID-19 is so virulent, then we do we only show 500-some cases? Wouldn't it make sense that there are in fact tens of thousands of cases by now? For all we know, there are five thousand cases with the vast majority showing no symptoms. How do we know? We do a study of a random sampling of Americans and find out how many swab positive for the virus and then compare that to the population that has been diagnosed. That study will be done, but has it been done yet, all of five weeks into this thing?

And here we are. You're comparing things to "blunt force trauma" without having much of any data to actually make that knee-jerk decision. Unlike the nonsense you wrote up there, we can characterize the living fuck out of blunt force trauma by measuring things like velocity, impact area, time of collision, etc.. So what have we as a country actually measured to tell us if we should be concerned about this or not?

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1 hour ago, Clove Hitch said:

He's not a bad guy he's just pedantic and a tedious sophist.   I couldn't take it anymore so into the ignore heap he went. 

C'est la vie. You're a nice guy, but you're dumber than bag of broken pencils.

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2 hours ago, Clove Hitch said:

Two days ago Mike didn't know that viruses destroy cells.  Now he's lecturing us on epidemiology.   He really takes Duning-Krueger to a new level. 

You're a smart guy, that's good.

Then why are you debating nonsense? What's our current COVID-19 American death count from this pandemic?

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2 hours ago, Clove Hitch said:

Two days ago Mike didn't know that viruses destroy cells.  Now he's lecturing us on epidemiology.   He really takes Duning-Krueger to a new level. 

He suffers from chronic gasbaggery.  There’s not a single subject he’s not an expert on.

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2 minutes ago, Fakenews said:

He suffers from chronic gasbaggery.  There’s not a single subject he’s not an expert on.

You have the over for 100 COVID-19 victims by the end of the week, Gaston.

Just like your established lousy ability to pick NCAA winners, we'll see how you come out by the end of the week. Until then, perhaps you should shut the fuck up and not again demonstrate how effective you are at getting yourself kicked the fuck out of this shithole.

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1 minute ago, mikewof said:

You have the over for 100 COVID-19 victims by the end of the week, Gaston.

Just like your established lousy ability to pick NCAA winners, we'll see how you come out by the end of the week. Until then, perhaps you should shut the fuck up and not again demonstrate how effective you are at getting yourself kicked the fuck out of this shithole.

My, my, such language.  Shithole is only allowed to be spoken by POTUS.  Fuck is another no, no unless you have a pecker to use for a willing lass.

Let's just imagine you are literate.  What would you say?

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5 minutes ago, mikewof said:

You have the over for 100 COVID-19 victims by the end of the week, Gaston.

Just like your established lousy ability to pick NCAA winners, we'll see how you come out by the end of the week. Until then, perhaps you should shut the fuck up and not again demonstrate how effective you are at getting yourself kicked the fuck out of this shithole.

I advise you read the 2019 NCAA football thread for understanding.  Check out my prognostication especially for the Gators and kindly STFU.  No ones kicking me out because unlike you I don’t post like a complete asshole.

Bonus NCAA pick for 2020. UF rolls UGA.

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4 hours ago, phillysailor said:

Yes, background pneumonia rates due to seasonal flu, COPD exacerbations, aspirations, other causes are occurring at a steady rate. We are at the beginning of this disease pandemic, and have seen other health systems overwhelmed by the sudden influx of patients. In China, the following article show how hospitals were challenged by Coronavirus patients: TimeBloomberg reported on the long term need for ventilators, and this article in NYPost shows how in Wuhan, Chinese authorities built two 1,000 bed hospital inspired by a SARS epidemic model to handle the sudden influx of patients.

I'm not saying that our death rates WILL climb to the numerically impressive numbers quoted, I'm saying that's how pandemics work, and how this could grow out of control and exhaust our normal resources. For all its initial hesitancy to admit it had a problem, once the central government decided controlling the Wuhan outbreak was of national concern, China clamped down on its society in ways a democracy will be hard pressed to emulate, especially one with as dysfunctional a government as ours. That made a difference, and vastly slowed the escalation of disease and deaths.

Look, I hope your numbers are right, and mine are wrong. That'd be great. But the response America brings to the issue is a deciding factor impacting which way this pandemic goes. If we can isolate early cases and investigate their sick contacts quickly, great. If we can reduce our social exposure and bring the number infected per case to less than one or at least dramatically slow the doubling time of virus cases, fantastic. 

But saying everything is fine? Yeah, not so much. That sounds like an argument for complacency and failure. For our president to come out and say that everything is fine, go to work even if sick... that could cost thousands of live. Your optimistic numbers predicting no increase in the total number of pneumonia deaths are a best case scenario which policy makers and healthcare workers would best ignore. Fear is an excellent motivator for best practices and hard decisions.

Your model would argue, for instance, that closing schools is an unnecessary hardship for parents and communities, and we would be best served by keeping them open as long as possible. Yet no other single decision by state and federal authorities would likely have a similar impact on disease spread. That's the question our policy makers are facing, and they should make the decision pretty much now, before the disease has spread far and wide. It may actually be too late, I don't know. Given that spread is possible before symptoms? Perhaps we should do it today. 

The thing is, Mikey, you are risking only your personal prognostication reputation by going out on this statistical limb. The deadly pandemic isn't common and we've little experience dealing with it, and none in recent generations. Getting the response wrong can occasionally lead to thousands (or hundreds of thousands) of deaths. I'd say the stakes are far too high to just hope for good luck and happy statistical modeling.

I think you've started this argument not thinking about the potential downside of making it, and are now stuck defending it as an ego thing. Just promise me you will self isolate if you feel sick and will tell those you've had close contact with for the past few days that you may have spread Coronavirus to them, so be on the lookout, as should we all. 

I'm with you on being prepared to handle dangerous situations. As it stands though, we have to use the data we have, and not pretend that it says something it doesn't.

This is not a "better safe than sorry" kind of thing, because the impact of our economy from the response we choose does mean something. If we're spending vast public resources to save ourselves from a sky that is in no danger of falling down, then those are public resources that we could have a should have spent on actual opportunities to save lives.

As we get access to better data, we then should adjust our approach. Making decisions in public health based on politics is as bad as making decisions based on faith. As this thing unfolds, I hope that you and I can continue to discuss this and let the baboons fall back to playing with their genitals.

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1 minute ago, mikewof said:

I'm with you on being prepared to handle dangerous situations. As it stands though, we have to use the data we have, and not pretend that it says something it doesn't.

This is not a "better safe than sorry" kind of thing, because the impact of our economy from the response we choose does mean something. If we're spending vast public resources to save ourselves from a sky that is in no danger of falling down, then those are public resources that we could have a should have spent on actual opportunities to save lives.

As we get access to better data, we then should adjust our approach. Making decisions in public health based on politics is as bad as making decisions based on faith. As this thing unfolds, I hope that you and I can continue to discuss this and let the baboons fall back to playing with their genitals.

Data is good.  I can show you my bikes, runs, walks and eating habits for years.  I don't really look back.  But what you don't measure, you can't change.

The little don fell on his fat ass in getting ahead of this issue.

 

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1 minute ago, hasher said:

My, my, such language.  Shithole is only allowed to be spoken by POTUS.  Fuck is another no, no unless you have a pecker to use for a willing lass.

Let's just imagine you are literate.  What would you say?

If I was literate? Okay, kind of a stretch, I guess this is what I would say to Bull Gator ...

1 minute ago, Fakenews said:

I advise you read the 2019 NCAA football thread for understanding.  Check out my prognostication especially for the Gators and kindly STFU.  No ones kicking me out because unlike you I don’t post like a complete asshole.

Okay, I'm trying to pretend that I'm literate here ...

If only Georgia and LSU weren't so much better than UF, I think I could really think of something good to write, but when I try, my mind then wanders to how poorly UF stacks up to actual football competence.

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7 minutes ago, mikewof said:

If I was literate? Okay, kind of a stretch, I guess this is what I would say to Bull Gator ...

Okay, I'm trying to pretend that I'm literate here ...

If only Georgia and LSU weren't so much better than UF, I think I could really think of something good to write, but when I try, my mind then wanders to how poorly UF stacks up to actual football competence.

Apparently better than Bama and we sucked less vs LSU than did  UGA and Clemson. It’s the only program to go to back to back New Years Six bowls in the first two years of a new head coach.   You don’t know this because of all the things you don’t know college football is near the top (along with physics).

SAD!

 

 

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Just now, Fakenews said:

Apparently better than Bama and we sucked less vs LSU than UGA and Clemson.  You don’t know this because of all the things you don’t know college football is near the top (along with physics).

SAD!

 

 

Michigan State Spartans are the preseason favorite to win the national championship.  Place your bets here.  I have an account in Panama that will facilitate all transactions.

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2 hours ago, mikewof said:

I'm with you on being prepared to handle dangerous situations. As it stands though, we have to use the data we have, and not pretend that it says something it doesn't.

This is not a "better safe than sorry" kind of thing, because the impact of our economy from the response we choose does mean something. If we're spending vast public resources to save ourselves from a sky that is in no danger of falling down, then those are public resources that we could have a should have spent on actual opportunities to save lives.

As we get access to better data, we then should adjust our approach. Making decisions in public health based on politics is as bad as making decisions based on faith. As this thing unfolds, I hope that you and I can continue to discuss this and let the baboons fall back to playing with their genitals.

You’re right there are trade offs with any decisions having societal impact. The cost of not acting before the numbers have convinced all persons (including you) is that Pandora’s Box is either kept shut, or allowed to open wide until even Trump can tell its bad.

By then, of course, it’s too late. The cat’s out of the bag, the horses have left the barn, and you can’t put the Genie back in the bottle. Analogy heaven.

From some Italian anesthesiologist in northern Italy: 


Here is like a war. The big cluster is in my region, in our hospital we have 25 patients in our ICU with severe ARDS, something like 240more patients in pneumology or inf disease ward. 50 new cases per day, no more beds. I don’t know how we can cope with this situatione in the next days. There are patients that in other situation would be intubated in ICU, and we’re forced to leave them in norma ward with PF ratio of 100. It’s a total mess, and I don’t wann think if it’ll spread in the other parts of the country. Remember that I live in the richest part of Italy, with the best health system. It can be only worse. For the moment north italy is a red zone, everything is closed

 

Edit: PF ratio measures the amount of oxygen found in arterial blood for a given fraction of inspired oxygen. Normal is approaching 500. Below 100 is part of diagnostic criteria for ARDS which is essentially lung failure with an ugly looking CT scan.

These patients should be intubated, both for their protection (not dying by oxygen starvation) and for Hosptial staff, since intubating a patient stops them from spraying droplets around the room. Typically patients can be sedated and confined to a bed at that point. 

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58 minutes ago, phillysailor said:

You’re right there are trade offs with any decisions having societal impact. The cost of not acting before the numbers have convinced all persons (including you) is that Pandora’s Box is either kept shut, or allowed to open wide until even Trump can tell its bad.

By then, of course, it’s too late. The cat’s out of the bag, the horses have left the barn, and you can’t put the Genie back in the bottle. Analogy heaven.

From some Italian anesthesiologist in northern Italy: 


Here is like a war. The big cluster is in my region, in our hospital we have 25 patients in our ICU with severe ARDS, something like 240more patients in pneumology or inf disease ward. 50 new cases per day, no more beds. I don’t know how we can cope with this situatione in the next days. There are patients that in other situation would be intubated in ICU, and we’re forced to leave them in norma ward with PF ratio of 100. It’s a total mess, and I don’t wann think if it’ll spread in the other parts of the country. Remember that I live in the richest part of Italy, with the best health system. It can be only worse. For the moment north italy is a red zone, everything is closed

 

Edit: PF ratio measures the amount of oxygen found in arterial blood for a given fraction of inspired oxygen. Normal is approaching 500. Below 100 is part of diagnostic criteria for ARDS which is essentially lung failure with an ugly looking CT scan.

These patients should be intubated, both for their protection (not dying by oxygen starvation) and for Hosptial staff, since intubating a patient stops them from spraying droplets around the room. Typically patients can be sedated and confined to a bed at that point. 

Take care of yourself. People don’t have enough respect for the “soldiers” placing themselves at risk during this sort of thing. Everyone from the doctors right down to the hospital janitors are in a lousy place right now. Nothing but respect for all of you!  The rest of us can hide from the problem, but you poor bastards have to watch it walk in the front door. 

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Well, we’ve the training and usually the tools. I just hope we don’t run out of the gowns, masks, supplies and equipment. Making our current system deal with massive shortages is gonna be the problem.

If we, as a population, take quarantining seriously, we will weather the storm.

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3 minutes ago, phillysailor said:

Well, we’ve the training and usually the tools. I just hope we don’t run out of the gowns, masks, supplies and equipment. Making our current system deal with massive shortages is gonna be the problem.

If we, as a population, take quarantining seriously, we will weather the storm.

That’s the hard part, getting people to take it seriously, while not doing the stupid panic buying. 
 

I’m actually mad at my dad. He officially retired last Friday, but chose to maintain privileges at the local hospital and stay on the call schedule because of all this. 

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4 hours ago, mikewof said:

C'est la vie. You're a nice guy, but you're dumber than bag of broken pencils.

 

4 hours ago, mikewof said:

You're a smart guy, that's good.

 

Both of these statements were made about Clove Hitch within minutes of each other.  

By a man that is pretending to know more about the corona virus than anyone else here, including medical doctors.

Excuse me, I need to run to the bathroom now, I am experiencing a bit of cognitive dissonance.

3 hours ago, hasher said:

My, my, such language.  Shithole is only allowed to be spoken by POTUS.  Fuck is another no, no unless you have a pecker to use for a willing lass.

Let's just imagine you are literate.  What would you say?

That's one of the finest put downs I think I have ever seen here.  Bravo!

You're from the South aren't you.

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4 hours ago, mikewof said:

Okay, then how are they different?

Biologically, they are so similar that it would take a computer and a very good microscope to characterize them, that's really hard.

And epidemiologically, the difference is well-established, we have a reasonably clear picture of how fast the virus traveled in China, We can presumably use some of their results here to how is spreads.

But how are they different in terms of mortality? This is what you really need to think about with some logic, instead of trying to compare it to "falling off a building" versus "being hit with a car." That's just hyperbole, it adds nothing to understanding the actual virus.

So, how are they different in terms of mortality? We have about three weeks of data on this in the USA, with about 500 people who have tested positive for the virus, and of those, about 20 people have died. What do you do with that data? Do you say "Aha, my calculator says that the mortality rate is 4%"? Because you see the problem here right? We don't know how many of those 20 people who died while being positive from COVID-19 actually died from the results of the virus. All 20? 15? 14? How many? You can guess of course, but without actual data, it's just a guess. For all we know, maybe only 10 of those 20 deaths would have not died if it wasn't for the COVID-19. So you say "look at the Johns Hopkins data." Okay but that's clinical data. It has to be, because 20 is too small of a sample size to build up a statistically-meaningful profile of deaths by pneumonia when in that same time frame, about 7,000 Americans have died from pneumonia while not testing positive for COVID-19.

And then look at it from the side of the bigger number ... how many people are actually infected with COVID-19 in the USA? About 500? Where did that 500 number come from? Is that an estimate of the number of people in the USA who have it? Or is that the number of clinical cases which have been tested and confirmed to have COVID-19? It's the latter. So, how many Americans actually have COVID-19? About 1,000? About 5,000? About 10,000? Until an actual study is done to get a handle on this number, all we can do is guess. The only thing we know for sure is that it's at least 500, but it could be 5,000. A virus that has only been in the USA for just a touch over a month can't be characterized too easily for total undiagnosed cases.

If COVID-19 is so virulent, then we do we only show 500-some cases? Wouldn't it make sense that there are in fact tens of thousands of cases by now? For all we know, there are five thousand cases with the vast majority showing no symptoms. How do we know? We do a study of a random sampling of Americans and find out how many swab positive for the virus and then compare that to the population that has been diagnosed. That study will be done, but has it been done yet, all of five weeks into this thing?

And here we are. You're comparing things to "blunt force trauma" without having much of any data to actually make that knee-jerk decision. Unlike the nonsense you wrote up there, we can characterize the living fuck out of blunt force trauma by measuring things like velocity, impact area, time of collision, etc.. So what have we as a country actually measured to tell us if we should be concerned about this or not?

They only show 500 cause they aren't testing...

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6 hours ago, Fakenews said:

Apparently better than Bama and we sucked less vs LSU than did  UGA and Clemson. It’s the only program to go to back to back New Years Six bowls in the first two years of a new head coach.   You don’t know this because of all the things you don’t know college football is near the top (along with physics).

SAD!

Gatey, buddy, you never let me down buddy. Like grains of sand through the hour glass ...

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4 hours ago, phillysailor said:

You’re right there are trade offs with any decisions having societal impact. The cost of not acting before the numbers have convinced all persons (including you) is that Pandora’s Box is either kept shut, or allowed to open wide until even Trump can tell its bad.

By then, of course, it’s too late. The cat’s out of the bag, the horses have left the barn, and you can’t put the Genie back in the bottle. Analogy heaven.

From some Italian anesthesiologist in northern Italy: 


Here is like a war. The big cluster is in my region, in our hospital we have 25 patients in our ICU with severe ARDS, something like 240more patients in pneumology or inf disease ward. 50 new cases per day, no more beds. I don’t know how we can cope with this situatione in the next days. There are patients that in other situation would be intubated in ICU, and we’re forced to leave them in norma ward with PF ratio of 100. It’s a total mess, and I don’t wann think if it’ll spread in the other parts of the country. Remember that I live in the richest part of Italy, with the best health system. It can be only worse. For the moment north italy is a red zone, everything is closed

 

Edit: PF ratio measures the amount of oxygen found in arterial blood for a given fraction of inspired oxygen. Normal is approaching 500. Below 100 is part of diagnostic criteria for ARDS which is essentially lung failure with an ugly looking CT scan.

These patients should be intubated, both for their protection (not dying by oxygen starvation) and for Hosptial staff, since intubating a patient stops them from spraying droplets around the room. Typically patients can be sedated and confined to a bed at that point. 

There is an art to this. We have to adjust our response to the threat. We use statistics to assess the threat. Obviously, we can't get it right every time. But you seem to side with the better-safe-than-sorry approach. That's a functional approach, but it's not free. President Trump just put some $8 billion into it, and the global exports are on track to see a $50 billion hit.

Is all this money and loss making a difference? Ultimately, at least one side is going to pull a Bull Gator retrospective on the final death toll, and if this thing is barely a blip in the annual pneumonia death rates, then they'll say something like "See? Our rain dance to the gods of the Coronavirus have shown us favor and spared us from their vengeance." Or "See? All those dust masks and not flying on airplanes stopped that global pandemic in its tracks." The truth a very flexible thing here.

We're now at some 26 deaths from COVID-19 in the USA and less than 4,000 globally. There is a lot about these numbers that suggests something other than "pandemic."

 

Is $8 billion enough? Is $80 billion enough?

What if we spent some of that mad money on medical radiation treatments for pediatric cancer wards in public, poorly-funded hospitals? Oh, why in the fuck would we do something so crazy, the boys and girls of the people who have good health insurance will get radiation treatment if necessary, and this COVID-19 is so darn scary, because it seems to attack people with money just as much as the people without money. We better do something fast, we can't risk well-off people dying can we?

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3 hours ago, Ed Lada said:

 

Both of these statements were made about Clove Hitch within minutes of each other.  

By a man that is pretending to know more about the corona virus than anyone else here, including medical doctors.

Excuse me, I need to run to the bathroom now, I am experiencing a bit of cognitive dissonance.

That's one of the finest put downs I think I have ever seen here.  Bravo!

You're from the South aren't you.

Clove Hitch inspires contradiction.

You don't.

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3 hours ago, Raz'r said:

They only show 500 cause they aren't testing...

Yeah, that's what it seems.

So if they did test, what's your guess to the total infections? I'm guessing there are about 10,000 people infected at this point, which would put the mortality to around 0.25%. But without data, my guess is really no better than anyone else's.

What's your guess to total infections in the USA?

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5 minutes ago, mikewof said:

Yeah, that's what it seems.

So if they did test, what's your guess to the total infections? I'm guessing there are about 10,000 people infected at this point, which would put the mortality to around 0.25%. But without data, my guess is really no better than anyone else's.

What's your guess to total infections in the USA?

No idea. That’s why we should test, no?

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1 hour ago, bhyde said:

Fuck. This is getting old.

https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

1875018586_ScreenShot2020-03-09at6_59_39PM.thumb.png.e85a85bcf358f1222c872a50f95d3a33.png

4K death in 133K cases = 3%

No. The mortality rate is the number of deaths divided by the number of people in a given population, in this case, the population infected with COVID-19.

You've just divided the number of deaths by the number of people clinically confirmed to be infected. Is that 50% of the total? 20% of the total? 23.67% of the total?

To get an estimate of the number of people infected, you would need to test a random sample, or at minimum, correlate your clinical confirmations to some reasonable correction factor.

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1 hour ago, Raz'r said:

No idea. That’s why we should test, no?

Of course, but then the orangutans would have to go back to playing with their nuts if the morality rate was less than 0.5%.

Isn't it more fun to think the world is about to end?

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1 hour ago, Fakenews said:

As of a few minutes ago we’re up to 722 cases

You have an over/under bet with a guy that thinks it is impossible to tell if people with covid19 actually died from covid19. I say you win no matter what. 

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33 minutes ago, mikewof said:

Of course, but then the orangutans would have to go back to playing with their nuts if the morality rate was less than 0.5%.

Isn't it more fun to think the world is about to end?

No.  I live in Washington State.  I don’t want the world to end.  I still have some sailing to do. At least I’d like to sail some more.  There are some older guys and gals we’d like to go sailing with.  The mortality rate is real- my FIL died in an assisted living home 4 months ago a couple miles from the Kirkland facility.  Death is not easy, ever, but it has to be more than just a statistic.

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7 minutes ago, Amati said:

No.  I live in Washington State.  I don’t want the world to end.  I still have some sailing to do. At least I’d like to sail some more.  There are some older guys I’d like to go sailing with. 

I'd like to go sailing with anyone right now. It's been a long winter.

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6 minutes ago, Ishmael said:

I'd like to go sailing with anyone right now. It's been a long winter.

Seems that way, doesn’t it?  Today was more than gorgeous though.  Northwest weather is like golf, one good day, and you’re good for years. :)  Even if you don’t get out on the water. 

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On 3/8/2020 at 10:18 AM, Saorsa said:

Sunlight and people beng more active and spending more time outside.

UV kills viruses and unless you are in a city or attending crowded events you are less likely to be exposed.

The virus itself is not a killer.  But, it does make you susceptible to pneumonia which does kill those with weakened vascular and respiratory systems.

WHO says not to count on this.   

On 3/8/2020 at 1:14 PM, Saorsa said:

And, after a mild infection the lungs can recover and heal that damage unless your lungs are already in bad shape from other problems.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3378727/

From the cite:

Recently, it has become increasingly clear that in addition to control of excess inflammation and virus elimination, the resolution of infection requires an active repair process, which is necessary to regain normal respiratory function and restore the lungs to homeostasis. The repair response must re-establish the epithelial barrier and regenerate the microarchitecture of the lung. Emerging areas of research have highlighted the importance of innate immune cells, particularly the newly described innate lymphoid cells, as well as alternatively activated macrophages and pulmonary stem cells in the repair process. The mechanisms by which respiratory viruses may impede or alter the repair response will be important areas of research for identifying therapeutic targets aimed at limiting virus and host mediated injury and expediting recovery.

 

Since the pissing match ended prematurely, Saorsa and Mikewof were on the right track.    But in this case it isn’t secondary bacterial pneumonia like we often see with other viruses.    This was initially described as an interstitial pneumonia.   The walls of the air sacs are damaged, the air sacs (alveoli) aren’t  just filled with fluid.   Reality seems to be a cascade of changes over time, and the nature of the disease shifts.     As is often the case, the immune system causes collateral damage.   This report describes not only interstitial changes but also fluid in the lungs (Air bronchogram), fluid outside of the lungs (pleural effusion) preventing full inflation and pleuritis. making breathing painful.   The report is a couple weeks old, apparently before numbers accumulated to show the virus’s affinity for age.   https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30086-4/fulltext

This report was two cancer patients who had lung tumors removed.   They had already been infected but didn’t get sick with coronavirus until after their surgery,   One died of the virus.

The article describes two patients who recently underwent lung lobectomies for adenocarcinoma and were retrospectively found to have had  COVID-19 at the time of surgery. Pathologic examinations revealed that, apart from the tumors, the lungs of both patients exhibited edema, proteinaceous exudate, focal reactive hyperplasia of pneumocytes with patchy inflammatory cellular infiltration, and multinucleated giant cells. Fibroblastic plugs were noted in airspaces.  

The virus destroys cells.   The immune reaction is very aggressive, partially because sick people cough up virus particles and spread it, so the virus wants it that way.   The immune system actually causes more damage then the virus does directly.   One thing these reports show is this virus doesn’t limit itself to a head cold initially like I assumed.    It appears to go straight for the lungs, even in mild cases.     Age related chronic damage to lungs from smoking, fiberglass dust, coal, etc may be the tipping point in older people,    I hate to think what will happen in Appalachia with black lung disease.   

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23 minutes ago, Amati said:

No.  I live in Washington State.  I don’t want the world to end.  I still have some sailing to do. At least I’d like to sail some more.  There are some older guys and gals we’d like to go sailing with.  The mortality rate is real- my FIL died in an assisted living home 4 months ago a couple miles from the Kirkland facility.  Death is not easy, ever, but it has to be more than just a statistic.

Absolutely. It should never be a statistic. So if this pandemic turns into little more than a blip, and our own skins are no longer in danger, are we going to collectively decide to start funding the low-hanging fruit of American health? Currently, for children, it's car crashes, firearms, cancer, and lung disorders.

Or do you think we'll just get right back into yakking about sports and politics?

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3 minutes ago, mikewof said:

Absolutely. It should never be a statistic. So if this pandemic turns into little more than a blip, and our own skins are no longer in danger, are we going to collectively decide to start funding the low-hanging fruit of American health? Currently, for children, it's car crashes, firearms, cancer, and lung disorders.

Or do you think we'll just get right back into yakking about sports and politics?

Depends how many people know how many infected.  The concern is palpable here.  (And our Governor is not a snake, if anyone on the Trumpian right is interested.)

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51 minutes ago, Clove Hitch said:

You have an over/under bet with a guy that thinks it is impossible to tell if people with covid19 actually died from covid19. I say you win no matter what. 

It's impossible to know without a sufficient sample.

But I just go with the CDC stat, so you're still full of shit. You might want to look into that.

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2 minutes ago, Amati said:

Depends how many people know how many infected.  The concern is palpable here.  (And our Governor is not a snake, if anyone on the Trumpian right is interested.)

Infected? Died. That's the stat.

But I think that we didn't give a collective rat's ass about actual childhood disease before this, we won't care afterward either.

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13 minutes ago, Lark said:

WHO says not to count on this.   

Since the pissing match ended prematurely, Saorsa and Mikewof were on the right track.    But in this case it isn’t secondary bacterial pneumonia like we often see with other viruses.    This was initially described as an interstitial pneumonia.   The walls of the air sacs are damaged, the air sacs (alveoli) aren’t  just filled with fluid.   Reality seems to be a cascade of changes over time, and the nature of the disease shifts.     As is often the case, the immune system causes collateral damage.   This report describes not only interstitial changes but also fluid in the lungs (Air bronchogram), fluid outside of the lungs (pleural effusion) preventing full inflation and pleuritis. making breathing painful.   The report is a couple weeks old, apparently before numbers accumulated to show the virus’s affinity for age.   https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30086-4/fulltext

This report was two cancer patients who had lung tumors removed.   They had already been infected but didn’t get sick with coronavirus until after their surgery,   One died of the virus.

The article describes two patients who recently underwent lung lobectomies for adenocarcinoma and were retrospectively found to have had  COVID-19 at the time of surgery. Pathologic examinations revealed that, apart from the tumors, the lungs of both patients exhibited edema, proteinaceous exudate, focal reactive hyperplasia of pneumocytes with patchy inflammatory cellular infiltration, and multinucleated giant cells. Fibroblastic plugs were noted in airspaces.  

The virus destroys cells.   The immune reaction is very aggressive, partially because sick people cough up virus particles and spread it, so the virus wants it that way.   The immune system actually causes more damage then the virus does directly.   One thing these reports show is this virus doesn’t limit itself to a head cold initially like I assumed.    It appears to go straight for the lungs, even in mild cases.     Age related chronic damage to lungs from smoking, fiberglass dust, coal, etc may be the tipping point in older people,    I hate to think what will happen in Appalachia with black lung disease.   

Ahh, so Mike is right, it’s not the virus that kills, but the immune response. 
 

(where’s that purple font again?)

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10 minutes ago, Lark said:

 Age related chronic damage to lungs from smoking, fiberglass dust, coal, etc may be the tipping point in older people,    I hate to think what will happen in Appalachia with black lung disease.   

Okay, what is the average weekly death toll from pneumoconiosis in Appalachia without COVID-19? How many deaths would we have to see to roughly double the existing deaths with COVID-19 infections?

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2 minutes ago, Raz'r said:

Ahh, so Mike is right, it’s not the virus that kills, but the immune response. 
 

(where’s that purple font again?)

You don't seem to understand lung function. It's a kind of hybrid exterior organ, the immune response is often the killer.

For instance with asbestosis, the asbestos fibers are non-reactive. The damage tends to come from the natural immune response to the barbed fibers.

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10 minutes ago, mikewof said:

Infected? Died. That's the stat.

But I think that we didn't give a collective rat's ass about actual childhood disease before this, we won't care afterward either.

Right now the difference between the two up here isn’t that big a distinction, the way that the virus is tearing through the assisted living facility, and the medics who responded to the situation there.  If attention is as deadened as collective attention span seems to indicate?  As usual this will happen again and again and again.  The medium is the message.  And so it goes.....

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