Fear and Loathing, a Rat Flu Odyssey

[The Tortoise]

So yea or nay on the Filet o Fish? I'm really hungry.

It might be now or never!

On the plus side, you get that Filet of Fish

On the other plus side, if you get the virus now you get a two week staycation and then access to all the cheap travel your heart desires.

[mdblows]

I know what Twitter is. It's a social media platform where among other things people can post links to "news" sources of dubious reliability so that other people who are too lazy to seek out reliable news sources can pretend to be informed.

Does the fact that the link sources a video from Fox News somehow change what is said on the video? Are you claiming that the video is being misinterpreted in some way?

[Deebased]

It really, really matters whether the true mortality rate of this virus is 0.5% or 1% or 2% or 3+%. The difference is literally millions of dead people. The only way to know the true mortality rate is to test everyone who might possibly have it so that the denominator in the dead/infected equation is accurate.



Every credible source I've seen is minimum 12-18 months for a vaccine, and even at that point you're probably talking limited distribution to at-risk populations. Mass distribution to the general public a la seasonal flu vaccine could be 2-3 years.

There's 3-4 vaccines going into trials this month and next. I'm expecting due to the emergency that we will see the a massively expedited process getting anything that looks promising on the market.. But who knows with the current leadership in the executive and legislative branch.

[basinbeater]

I'm being completely serious. A coworker just said that she, her husband and her children got together with a big group of friends last night for "ice cream and hugs" because they all found the requested social distancing to be so troubling. They're just "social people" and they feel "totally safe." Oh, and her husband has flown to and attended two conferences in California in the last two weeks.

We just got invited to a party, a last hurrah, before hunkering down.

I said to the people, (relatively smart friends of ours) "not be a downer, but you probably should not have the party."

She said, "oh we know it's serious, but it will be the last hurrah."

"Ok," I said, "Well, we have possible exposure, and the only reason we know about it is because of the UT jazz guy on TV. Our daughter is classmates with another Jazz Player's Daughter. If it had been a regular joe schmoe, we wouldn't know about it, and we would potentially be at your party exposing everyone. See how this works? So we will not be attending."

She said "Oh".

[Mazderati]

Let's hope any expedited vaccine doesn't make things worse.

https://www.reuters.com/article/us-h...-idUSKBN20Y1GZ

[Cruiser]

Quick, experts, please answer this question: Can coronavirus survive on surfaces or in the air in the dry sauna or the steam room? Cuz I wanna go sweat for a bit but I wanna know if the heat kills the bugs?

[TNKen]

so what about jury duty?? seems like i shouldn't go.

The Tennessee Supreme's just ordered all hearings and trials cancelled.

[The SnowShow]

We just got invited to a party, a last hurrah, before hunkering down.

I said to the people, (relatively smart friends of ours) "not be a downer, but you probably should not have the party."

She said, "oh we know it's serious, but it will be the last hurrah."

"Ok," I said, "Well, we have possible exposure, and the only reason we know about it is because of the UT jazz guy on TV. Our daughter is classmates with another Jazz Player's Daughter. If it had been a regular joe schmoe, we wouldn't know about it, and we would potentially be at your party exposing everyone. See how this works? So we will not be attending."

She said "Oh".

Yeah, ppl don’t seem to grasp the concept that it’s everywhere already.

I’m assuming I’m not being too paranoid by keeping my daughter from playing with friends from school during the shutdown?

[klauss]

https://www.linkedin.com/pulse/notes...EOBU51_k1qBGAQ

University of California, San Francisco BioHub Panel on COVID-19

March 10, 2020

Top takeaways
At this point, we are past containment. Containment is basically futile. Our containment efforts won’t reduce the number who get infected in the US.

Now we’re just trying to slow the spread, to help healthcare providers deal with the demand peak. In other words, the goal of containment is to "flatten the curve", to lower the peak of the surge of demand that will hit healthcare providers. And to buy time, in hopes a drug can be developed.

How many in the community already have the virus?
No one knows.
We are moving from containment to care.

We in the US are currently where at where Italy was a week ago. We see nothing to say we will be substantially different.

40-70% of the US population will be infected over the next 12-18 months. After that level you can start to get herd immunity. Unlike flu this is entirely novel to humans, so there is no latent immunity in the global population.

[We used their numbers to work out a guesstimate of deaths— indicating about 1.5 million Americans may die. The panelists did not disagree with our estimate. This compares to seasonal flu’s average of 50K Americans per year. Assume 50% of US population, that’s 160M people infected. With 1% mortality rate that's 1.6M Americans die over the next 12-18 months.]

The fatality rate is in the range of 10X flu.

This assumes no drug is found effective and made available.

The death rate varies hugely by age. Over age 80 the mortality rate could be 10-15%. [See chart by age Signe found online, attached at bottom.]

Don’t know whether COVID-19 is seasonal but if is and subsides over the summer, it is likely to roar back in fall as the 1918 flu did

I can only tell you two things definitively. Definitively it’s going to get worse before it gets better. And we'll be dealing with this for the next year at least. Our lives are going to look different for the next year.

What should we do now? What are you doing for your family?
Appears one can be infectious before being symptomatic. We don’t know how infectious before symptomatic, but know that highest level of virus prevalence coincides with symptoms. We currently think folks are infectious 2 days before through 14 days after onset of symptoms (T-2 to T+14 onset).

How long does the virus last?
On surfaces, best guess is 4-20 hours depending on surface type (maybe a few days) but still no consensus on this
The virus is very susceptible to common anti-bacterial cleaning agents: bleach, hydrogen peroxide, alcohol-based.

Avoid concerts, movies, crowded places.
We have cancelled business travel.

Do the basic hygiene, eg hand washing and avoiding touching face.

Stockpile your critical prescription medications. Many pharma supply chains run through China. Pharma companies usually hold 2-3 months of raw materials, so may run out given the disruption in China’s manufacturing.

Pneumonia shot might be helpful. Not preventative of COVID-19, but reduces your chance of being weakened, which makes COVID-19 more dangerous.

Get a flu shot next fall. Not preventative of COVID-19, but reduces your chance of being weakened, which makes COVID-19 more dangerous.

We would say “Anyone over 60 stay at home unless it’s critical”. CDC toyed with idea of saying anyone over 60 not travel on commercial airlines.

We at UCSF are moving our “at-risk” parents back from nursing homes, etc. to their own homes. Then are not letting them out of the house. The other members of the family are washing hands the moment they come in.

Three routes of infection
Hand to mouth / face
Aerosol transmission
Fecal oral route

What if someone is sick?
If someone gets sick, have them stay home and socially isolate. There is very little you can do at a hospital that you couldn’t do at home. Most cases are mild. But if they are old or have lung or cardio-vascular problems, read on.
If someone gets quite sick who is old (70+) or with lung or cardio-vascular problems, take them to the ER.
There is no accepted treatment for COVID-19. The hospital will give supportive care (eg IV fluids, oxygen) to help you stay alive while your body fights the disease. ie to prevent sepsis.

If someone gets sick who is high risk (eg is both old and has lung/cardio-vascular problems), you can try to get them enrolled for “compassionate use" of Remdesivir, a drug that is in clinical trial at San Francisco General and UCSF, and in China. Need to find a doc there in order to ask to enroll. Remdesivir is an anti-viral from Gilead that showed effectiveness against MERS in primates and is being tried against COVID-19. If the trials succeed it might be available for next winter as production scales up far faster for drugs than for vaccines. [More I found online.]

Why is the fatality rate much higher for older adults?
Your immune system declines past age 50

Fatality rate tracks closely with “co-morbidity”, ie the presence of other conditions that compromise the patient’s hearth, especially respiratory or cardio-vascular illness. These conditions are higher in older adults.

Risk of pneumonia is higher in older adults.

What about testing to know if someone has COVID-19?
Bottom line, there is not enough testing capacity to be broadly useful. Here’s why.
Currently, there is no way to determine what a person has other than a PCR test. No other test can yet distinguish "COVID-19 from flu or from the other dozen respiratory bugs that are circulating”.

A Polymerase Chain Reaction (PCR) test can detect COVID-19’s RNA. However they still don’t have confidence in the test’s specificity, ie they don’t know the rate of false negatives.

The PCR test requires kits with reagents and requires clinical labs to process the kits.

While the kits are becoming available, the lab capacity is not growing.

The leading clinical lab firms, Quest and Labcore have capacity to process 1000 kits per day. For the nation.

Expanding processing capacity takes “time, space, and equipment.” And certification. ie it won’t happen soon.

UCSF and UCBerkeley have donated their research labs to process kits. But each has capacity to process only 20-40 kits per day. And are not clinically certified.

Novel test methods are on the horizon, but not here now and won’t be at any scale to be useful for the present danger.

How well is society preparing for the impact?
Local hospitals are adding capacity as we speak. UCSF’s Parnassus campus has erected “triage tents” in a parking lot. They have converted a ward to “negative pressure” which is needed to contain the virus. They are considering re-opening the shuttered Mt Zion facility.

If COVID-19 affected children then we would be seeing mass departures of families from cities. But thankfully now we know that kids are not affected.

School closures are one the biggest societal impacts. We need to be thoughtful before we close schools, especially elementary schools because of the knock-on effects. If elementary kids are not in school then some hospital staff can’t come to work, which decreases hospital capacity at a time of surging demand for hospital services.

Public Health systems are prepared to deal with short-term outbreaks that last for weeks, like an outbreak of meningitis. They do not have the capacity to sustain for outbreaks that last for months. Other solutions will have to be found.

What will we do to handle behavior changes that can last for months?
Many employees will need to make accommodations for elderly parents and those with underlying conditions and immune-suppressed.
Kids home due to school closures

[Dr. DeRisi had to leave the meeting for a call with the governor’s office. When he returned we asked what the call covered.] The epidemiological models the state is using to track and trigger action. The state is planning at what point they will take certain actions. ie what will trigger an order to cease any gatherings of over 1000 people.

Where do you find reliable news?
The John Hopkins Center for Health Security site. Which posts daily updates. The site says you can sign up to receive a daily newsletter on COVID-19 by email. [I tried and the page times out due to high demand. After three more tries I was successful in registering for the newsletter.]
The New York Times is good on scientific accuracy.

Observations on China
Unlike during SARS, China’s scientists are publishing openly and accurately on COVID-19.

While China’s early reports on incidence were clearly low, that seems to trace to their data management systems being overwhelmed, not to any bad intent.

Wuhan has 4.3 beds per thousand while US has 2.8 beds per thousand. Wuhan built 2 additional hospitals in 2 weeks. Even so, most patients were sent to gymnasiums to sleep on cots.

Early on no one had info on COVID-19. So China reacted in a way unique modern history, except in wartime.

Every few years there seems another: SARS, Ebola, MERS, H1N1, COVID-19. Growing strains of antibiotic resistant bacteria. Are we in the twilight of a century of medicine’s great triumph over infectious disease?

"We’ve been in a back and forth battle against viruses for a million years."

But it would sure help if every country would shut down their wet markets.

As with many things, the worst impact of COVID-19 will likely be in the countries with the least resources, eg Africa. See article on Wired magazine on sequencing of virus from Cambodia.

[Jong Lafitte]

I know what Twitter is. It's a social media platform where among other things people can post links to "news" sources of dubious reliability so that other people who are too lazy to seek out reliable news sources can pretend to be informed.

you’re now just describing Fox News. I guess it’s how u use it, I can get (very) up to date news from agencies and reporters that I consider credible from places like AP, NPR, BBC using Twitter. Killer for up to date sports news too, back when sports was a thing.

[garyfromterrace]

Canada's PM suggests Canadians avoid all non-essential international travel. Damn, this shit is so incredibly real. Take care everyone.

[Mofro261]

yeah. not so much. My understanding they are NOT testing for approval at this point. They are still testing to even see if the vaccines work. Then they have to test to see which works best and whether they are safe. They are still a LONG way from any sort of FDA testing for approval. Doubtful the virus will still be the same virus then as coronavirudae are known for mutating.

This is incorrect. All of the vaccine approaches are based on the generation of neutralizing antibodies to the virus. The main target being the outercoat protein for SARS-2, aka the Spike protein. Most of the known coronavirus neutralizing ab's bind a sub-region of the Spike called the Receptor Binding Domain, which targets SARS-2 to it's cell receptor ACE2. Blocking this intereaction is what neutralizes the virus and doesn't let it replicate inside a cell. In over 330+ sequenced genomes there have been no mutations within the RBD interface so far, meaning vaccine development should not be hampered by the medium-low mutation rate of SARS-2 outside the RBD.

Challenge models in NHPs are underway right now, but the fastest approaches (RNA/DNA vaccines) also also the ones with the least history in humans and it's important to demostrate safety as well as efficacy when putting something new into healthy people.

[powdork]

250 new deaths in Italy today. To get an idea how bad this can get, future numbers of 60%+ infected are regularly being thrown about. Italy is currently at .03% infected. While I'm sure the actual number of infected is much much higher, there is still a lot of room for things to get much worse.

[Dantheman]

There's 3-4 vaccines going into trials this month and next. I'm expecting due to the emergency that we will see the a massively expedited process getting anything that looks promising on the market.. But who knows with the current leadership in the executive and legislative branch.

Every credible source I've read has said there's a limited ability to expedite the process if you want to ensure that the vaccine is both effective and safe before it's distributed. It's completely independent of politics.

[powdork]

This is incorrect. All of the vaccine approaches are based on the generation of neutralizing antibodies to the virus. The main target being the outercoat protein for SARS-2, aka the Spike protein. Most of the known coronavirus neutralizing ab's bind a sub-region of the Spike called the Receptor Binding Domain, which targets SARS-2 to it's cell receptor ACE2. Blocking this intereaction is what neutralizes the virus and doesn't let it replicate inside a cell. In over 330+ sequenced genomes there have been no mutations within the RBD interface so far, meaning vaccine development should not be hampered by the medium-low mutation rate of SARS-2 outside the RBD.

Challenge models in NHPs are underway right now, but the fastest approaches (RNA/DNA vaccines) also also the ones with the least history in humans and it's important to demostrate safety as well as efficacy when putting something new into healthy people.

good to know.
Clinical trials in humans may start next month, but are expected to take at least 14 months.

[powdork]

also relating to something from 75 pages ago. there is now a note on the bottom of the nytimes' coronavirus update page that important covid updates will not be paywalled.
https://www.nytimes.com/interactive/...-us-cases.html

[Kinnikinnick]

Do we have a coronavirus theme song yet?


How about this:


https://m.youtube.com/watch?v=jlxmKsTvcLg


Sent from my iPhone using TGR Forums

[east or bust]

I got bitch slapped by something nasty basically overnight. Cancelled my ski plans for today and I’ll be shocked if I feel good enough to go tomorrow.

What do you do? So most of the COVID symptoms resemble a common cold. Do I continue to go about day to day life? Sure as fuck not getting tested if what I heard about the costs are correct. Though I’d love 2 weeks off work after this week long vaca.

We had a quick bite in Logan last night and at least 75% of the people in there we coughing, blowing nose etc. Dropped my bud at the bird today and same experience. Seems like a lot of moderately sick people out and about.

[MiddleOfNight]

Yeah, ppl don’t seem to grasp the concept that it’s everywhere already.

yep.

I just figure at this point, all we can really hope to do is slow the spread so at least victims are staggered.

If my whole team goes down at the same time that would .. be bad.

[Norseman]

...

[wooley12]

Looking at the US outbreak map I see very few cases of flue in American Redoubt. And pickups from Idaho and Montana have left my town full of TP and market shelves empty.

Mrs Wooley has a little cough and aches a bit but that's kinda normal. No fever. No way to test for trump flu anyway.

[iceman]

So yea or nay on the Filet o Fish? I'm really hungry.

Haven't you been seeing those Arby's fish sandwich commercials? 2 for $6 and each like twice as big as a F'oF. Report back after, if you are able.

[Diamond Joe]

Quick, experts, please answer this question: Can coronavirus survive on surfaces or in the air in the dry sauna or the steam room? Cuz I wanna go sweat for a bit but I wanna know if the heat kills the bugs?

Heat destroys virus bugs. Virus need cold dry air to survive

[Deebased]

Every credible source I've read has said there's a limited ability to expedite the process if you want to ensure that the vaccine is both effective and safe before it's distributed. It's completely independent of politics.

We are in total agreement. When we start seeing Italy death numbers in all of the larger states efficacy and safety will dissolve on the alter of hope

[iceman]

Killer for up to date sports news too, back when sports was a thing.

Remember sports? I miss them.