Random Thoughts

[broncos_fan _from _uk]

5 minutes ago, germ-x said:

That sucks.  Well if there was a positive from your posts it’s that what I’d seen about 80% having a relatively mild case was true.  

Yeah most people will be fine. The odds of anyone you know actually dying is low. My biggest concern is the sheer numbers that this could potentially affect resulting in an overwhelmed hospital system.

[germ-x]

3 minutes ago, broncos_fan _from _uk said:

Yeah most people will be fine. The odds of anyone you know actually dying is low. My biggest concern is the sheer numbers that this could potentially affect resulting in an overwhelmed hospital system.

No doubt.  Which is scary as there will still be people having accidents, strokes and the like.  It could get crazy, hopefully we’re able to somehow avoid all of that. 

[BroncoBruin]

Thank you, @broncos_fan _from _uk

Really appreciate this. 

[AKRNA]

11 hours ago, broncos_fan _from _uk said:

Yeah most people will be fine. The odds of anyone you know actually dying is low. My biggest concern is the sheer numbers that this could potentially affect resulting in an overwhelmed hospital system.

The math is an eye opener. I've been following the Johns Hopkins CSSE site and logging US infected every morning. The rate of expansion is nuts, over 30% per day and quite consistent.

In the five day period from March 6th to this morning confirmed cases went from 256 to 1,101. A 430% increase in 5 days. Unless something happens to derail the rate of expansion  we'll surpass 1,000,000 by April 5th. 

Eewww

[Broncofan]

Sorry late to the party as work & family has me run ragged  yesterday.  I don’t have much to add except to say that containment is not the same as prevention of spread.   Slowing the spread and reducing the peak is the realistic goal.   When the term containment is used, ppl think prevention of spread, like Ebola.   We are beyond that now - but managing the spread is still a crucial goal.  
 

Diseases like MERS and SARS had low infectivity rates.  They could be contained because of that.  H1N1 and COVID-19 are much more contagious.   But H1N1 was easier to limit spread in a more controlled fashion because symptoms coincided with infectivity.   You see a sick person - you know they are potentially contagious.   Covid-19’s 2-week period of infectivity before being symptomatic is a huge reason to why it’s able to spread at high rates.  It’s also why outright prevention was never a realistic hope in this era of global travel.  
 

The steps taken now are really meant to make sure the system doesn’t overload.   Covid-19 is far closer to the flu mortality wise than SARS/MERS - the death rates are likely way lower than the original published because mild cases never got tested in China.   We’re seeing much lower death rates in countries that test everyone.  But it’s still likely a death rate that’s 5-10x greater than seasonal flu.   It’s just really lethal to the elderly / immunosuppressed.  
 

Covid-19 still a risk to healthy ppl by sheer numbers but the odds are so long ppl shouldn’t lose their minds as individuals or as parents.   The healthy guy in NJ is the unlucky case - there will be the odd case because of the sheer numbers.  But almost everyone who’s healthy is a home isolation case in Canada.    
 

But to emphasize the point - even if it’s just a “really bad flu”, the risk to the system and population with a crippled health care system are very real, and it’s happening already in many countries.   The US is also at a much higher risk given the 2-tiered health care system.   Ppl who don’t seek care or who can’t seek care are more likely to pass it along to others without even knowing they have it.   

Outbreaks with the elderly or immunosuppressed are an outright disaster scenario - because the numbers there who die or get so sick it could crash the system are very real.   So even if the death / critical illness rate is “only” 1 percent & 2 percent overall - because the infectivity rate is so high,  that 5-10x increase can absolutely flood the system.  And that’s before you worry if you are covered.   So the measures now being used are legitimately there to protect the population and system as a whole from having a spike like Italy and China had.  Because the system can’t handle that kind of volume.  

The term “flatten the curve” should have been the message from the get-go.   Instead there’s been a horrific message that it was and still is preventable.   The reality is that the world has been exposed to H1N1 over time.   Everyone will likely be exposed to Covid-19 over time.   Most won’t get sick - the 80 percent figure is absolutely fair.   But if everyone gets exposed all at once no system can handle it.  

So mitigation, managing it, flattening the curve - should have always been the messaging all along.   That’s what the medical & scientific community has been trying to message for the past 1-2 months.   The sad part is that the US messaging has been so poor.   And withholding of testing and info disclosure is exactly the opposite of how to effectively manage & mitigate the spread.  

Changing expectations should have been the goal - eventually everyone in every community is likely getting exposed.   But exposing everyone all at once is the disaster scenario.    The measures now are meant to achieve the goal of spreading the exposure over time.   That’s the goal that’s do-able.   But it’s also going to take a while.   

Hope that helps. 

 

Edited March 12, 2020 by Broncofan

[Broncofan]

7 hours ago, AKRNA said:

The math is an eye opener. I've been following the Johns Hopkins CSSE site and logging US infected every morning. The rate of expansion is nuts, over 30% per day and quite consistent.

In the five day period from March 6th to this morning confirmed cases went from 256 to 1,101. A 430% increase in 5 days. Unless something happens to derail the rate of expansion  we'll surpass 1,000,000 by April 5th. 

Eewww

Here’s the part the public isn’t going to like - the cases are for sure going to keep spiking.   Simply because the testing has been so limited it’s hiding the true extent of the outbreak that’s already here.      The spike is simply a result of more testing showing how widespread community exposure is already.   That’s where a ton of misinformation has resulted.   Graphs that show which areas are affected are so misleading - the extent of the spread with such little testing can only lead to the logical conclusion that it’s likely present in all but the most remote areas of the US.    The risk isn’t spread from outside - spread from within is already present.    The job is now is to limit the extent of spread so all the cases don’t happen at once.   
 

The number being reported is a gross underestimate of the current situation.    Fortunately most of the under-reported cases are likely very mild.  But the 2-week infectivity period without symptoms also means those ppl are at risk of exposing others in mass numbers and those who are vulnerable.   That’s the greatest risk to overloading the system.   It’s also why not getting the testing out is a huge fail in the efforts to manage the outbreak.  

Edited March 12, 2020 by Broncofan

[broncos_fan _from _uk]

23 minutes ago, Broncofan said:

the 2-week infectivity period without symptoms 

I’ve seen many news outlets and 2 JAMA papers claim this but I don’t think it’s true. I can’t find any data to support this. Everything says it’s spread via droplet (and fomite) and the only article to date discussing actual transmission dates has it as the first 8 days of symptoms ( wolfel er al.)

that’s not to say you can’t get it by making out or sharing a drink with an asymptomatic person but simply being next to one shouldn’t be a transmission factor if they don’t have symptoms (ie sneezing/coughing/runny nose) that would facilitate transmission.

otherwise all very good points.

Edited March 12, 2020 by broncos_fan _from _uk

[Broncofan]

21 minutes ago, broncos_fan _from _uk said:

I’ve seen many news outlets and 2 JAMA papers claim this but I don’t think it’s true. I can’t find any data to support this. Everything says it’s spread via droplet (and fomite) and the only article to date discussing actual transmission dates has it as the first 8 days of symptoms ( wolfel er al.)

that’s not to say you can’t get it by making out or sharing a drink with an asymptomatic person but simply being next to one shouldn’t be a transmission factor if they don’t have symptoms (ie sneezing/coughing/runny nose) that would facilitate transmission.

otherwise all very good points.

The problem with confirmation on the 2-week asymptomatic infectivity - China’s lack of testing non-hospitalized patients.  Without understanding the overall incidence it’s been impossible to confirm the mechanism.  But that’s a fair comment that it’s a hypothesis that’s unconfirmed.  But yes it’s able to live longer on fomites then it’s an alternate explanation.   The cruise ship experience may be more due to inability to separate symptomatic ppl and food sharing, as an example.  

The thing though is that if 80 percent of Covid-19 cases are asymptomatic - the risk of spread by droplet contact is low by standing 3+ feet away - but the difference between mild symptoms that don’t affect a person’s overall health or day to day life, but that poses a risk of spread, and a patient with no symptoms at all, are likely indistinguishable for most of the public.  H1N1 was easy to attribute infectivity to symptoms.   Covid-19’s mild illness in healthy patients may in fact be part of its ability to spread unchecked.   It’s why I don’t dispute JAMA’s premise because practically speaking in how to manage the outbreak, it likely is a moot point.  
 

Either way though - the message should be that it’s here and we have to manage it. Focusing on preventing it outright (and again the issue now that it’s here is community spread - not travel from Europe or elsewhere - that horse left the barn a loooong time ago) is a terrible message because increasing numbers = failure perception-wise.   Sadly I don’t see that message changing in the US anytime soon after last night’s events.  

 

Edited March 12, 2020 by Broncofan

[germ-x]

24 minutes ago, Broncofan said:

Here’s the part the public isn’t going to like - the cases are for sure going to keep spiking.   Simply because the testing has been so limited it’s hiding the true extent of the outbreak that’s already here.      The spike is simply a result of more testing showing how widespread community exposure is already.   That’s where a ton of misinformation has resulted.   Graphs that show which areas are affected are so misleading - the extent of the spread with such little testing can only lead to the logical conclusion that it’s likely present in all but the most remote areas of the US.    The risk isn’t spread from outside - spread from within is already present.    The job is now is to limit the extent of spread so all the cases don’t happen at once.   
 

The number being reported is a gross underestimate of the current situation.    Fortunately most of the under-reported cases are likely very mild.  But the 2-week infectivity period without symptoms also means those ppl are at risk of exposing others in mass numbers and those who are vulnerable.   That’s the greatest risk to overloading the system.   It’s also why not getting the testing out is a huge fail in the efforts to manage the outbreak.  

Yeah, I read that the Seattle doctor who handled the first case said that there had been community spread for weeks, which puts it hitting the US in early January at the latest.....which makes complete sense with all of the travel in December.  

The testing has to improve.  Take Rudy Gobert and Tom Hanks cases, if they were average working joes who didn’t travel even if they’d went to the doctor wouldn’t have been tested.  Gobert was about to suit up and play last night because his symptoms had reportedly went away.  Hanks and his wife claim to have had a fever, chills, and body aches and last I read improving.

I live in Colorado Springs and those symptoms would not have gotten you tested.  For example El Paso county only has 1 confirmed case.  There will be more as testing ramps up, but I 100% guarantee there are/have been far more than 1 in 2020.  Though I have read the person in El Paso county did a fabulous job minimizing contact with others and self quarantined immediately.

[Broncofan]

18 minutes ago, germ-x said:

Yeah, I read that the Seattle doctor who handled the first case said that there had been community spread for weeks, which puts it hitting the US in early January at the latest.....which makes complete sense with all of the travel in December.  

The testing has to improve.  Take Rudy Gobert and Tom Hanks cases, if they were average working joes who didn’t travel even if they’d went to the doctor wouldn’t have been tested.  Gobert was about to suit up and play last night because his symptoms had reportedly went away.  Hanks and his wife claim to have had a fever, chills, and body aches and last I read improving.

I live in Colorado Springs and those symptoms would not have gotten you tested.  For example El Paso county only has 1 confirmed case.  There will be more as testing ramps up, but I 100% guarantee there are/have been far more than 1 in 2020.  Though I have read the person in El Paso county did a fabulous job minimizing contact with others and self quarantined immediately.

In Canada, right now if you have unexplained symptoms and any travel anywhere - you get tested.   I even think that distinction is pointless.   Everyone who comes in with flu-like illness gets tested for the flu.   It's only a matter of time before Covid-19 is added to that practice paradigm.   Until you have easy access to testing, any efforts that are aimed at limiting spread are going to be ineffective.   If you don't have testing, you might as well then go full Italy-mode - but the practicality of that is nil in the US, especially in big cities and industry-related workforces.   So testing access is paramount.

Without getting into politics, but to keep it on topic, I'll just say that a 2-tiered system where ppl don't have access to testing is a HUGE obstacle to effective pandemic response, where you can't realistically prevent a fair portion of ppl from having to keep working, keep sending kids to schools, etc.    It's a major challenge for the US.   To focus on outside travel, and to keep using terms like "beating the virus"....it's here, and it's not breast cancer.   Each time a new case is reported, ppl see it as a failure.   When the focus should be on flattening the curve, and avoiding system overload.   

Edited March 12, 2020 by Broncofan

[germ-x]

2 minutes ago, Broncofan said:

In Canada, right now if you have unexplained symptoms and any travel anywhere - you get tested.   I even think that distinction is pointless.   Everyone who comes in with flu-like illness gets tested for the flu.   It's only a matter of time before Covid-19 is added to that practice paradigm.

Without getting into politics, but to keep it on topic, I'll just say that a 2-tiered system where ppl don't have access to testing is a HUGE obstacle to effective pandemic response.    It's a major challenge for the US.   To focus on outside travel, and to keep using terms like "beating the virus"....it's here, and it's not breast cancer.   Each time a new case is reported, ppl see it as a failure.   When the focus should be on flattening the curve, and avoiding system overload.   

For sure.  Denver just opened a drive up test which is great.  El Paso county is only testing severe symptoms that would require hospitalization, people showing symptoms who’ve had contact with another case or recent travel to infected areas....so far 1 case.

Not going to lie, not a lot bothers me, but this has me on edge.  Don’t like that you can’t see it hahaha.

[broncofan48]

2 hours ago, germ-x said:

For sure.  Denver just opened a drive up test which is great.  El Paso county is only testing severe symptoms that would require hospitalization, people showing symptoms who’ve had contact with another case or recent travel to infected areas....so far 1 case.

Not going to lie, not a lot bothers me, but this has me on edge.  Don’t like that you can’t see it hahaha.

Y’all stay safe out there.  Haven’t had anything happen in MT yet, one of the perks of sparse populations

[BroncoBruin]

Support your favorite local Chinese restaurants. Unfortunately, they're going to be hurt badly by this. They will need your business. 

[champ11]

6 hours ago, germ-x said:

For sure.  Denver just opened a drive up test which is great.  El Paso county is only testing severe symptoms that would require hospitalization, people showing symptoms who’ve had contact with another case or recent travel to infected areas....so far 1 case.

Not going to lie, not a lot bothers me, but this has me on edge.  Don’t like that you can’t see it hahaha.

i've been on edge too bro. it's a little overwhelming just not knowing what's going to happen and what I really need to do to prepare. my parents were gonna come to austin this weekend and they cancelled. just gonna chill and try to be smart about watching my hands and touching stuff i guess

[AKRNA]

On 3/11/2020 at 9:21 AM, broncos_fan _from _uk said:

Yeah most people will be fine. The odds of anyone you know actually dying is low. My biggest concern is the sheer numbers that this could potentially affect resulting in an overwhelmed hospital system.

I know more old farts than most of you though.