Cont: 2019-nCoV / Corona virus Pt 3

Status
Not open for further replies.
Bubba said:
Dr Oz tells us rheumatologists report no covid in Lupus patients already taking hydrochloraquil. Oz says this should be tested to find whether or not hydrochloraquil could safely be used as a prophylactic.
Click to expand...

So what do rheumatologists actually say?
https://rheumatology.medicinematter...on-on-chloroquine-hydroxychloroquine/17862288

And the Lupus people?
https://www.lupus.org/blog/are-people-with-lupus-protected-against-covid19

I will listen to them before any mad TV quack out to make a buck.

And are you really happy to promote nonsense that could kill people? Really?
 
Doghouse Reilly said:
Why would the lungs become stiff? Why would this low oxygenation cause the diaghram and accesory breathing muscles to weaken?
Click to expand...
Technically because the receptor for SARS-CoV-2 (ACE 2) is highly represented on type 2 pneumocytes. Type 2 pneumocytes produce surfactant, loss of surfactant means surface tension in the alveoli is high which decreases lung compliance and increases the work of breathing. Once work of breathing crosses a limit respiratory muscles rapidly fail. Like any other muscles as load increases stamina decreases.

ETA
There are other reasons for increased stiffness of lungs, e.g. infiltration with inflammatory cells, with a probable degree of fibrosis. The point is oxygenation failure per se is not the critical issue in many of these patients at the time they go on the ventilator it is respiratory muscle failure. They have rapid shallow breathing with rates > 40 bpm but we are able to maintain oxygenation. technically they have ventilatory failure rather than respiratory failure precipitating ventilation (though respiratory failure is present).

ETA 2 although we use the technical term 'falling off the perch' in this situation this is physiologically incorrect. canaries fell off the perch due to hypoxia, low levels of oxygen as it was replaced by fire damp. Their lungs and breathing were normal it was just the oxygen in the air that fell.
 
Last edited:
Thanks.

marting said:
Let's take just a single date, March 27.

First add all the numbers of crescent's USA deaths for the 3 days on either side and including March 26. Then do the same for March 27.

These are 2125 and 2576 deaths respectively. 2576/2125=1.22 or daily ratio, 1.22^6= 3.3 or R for a 6 day latency between generations.

Apply to each date where you have 3 days on each side. This reduces variations where there is some unevenness in care/reporting based on some variation like weekend reporting differing from weekday reporting.

If, for instance you apply the same formula to crescent's 20% daily increase projection you will get a daily increase factor of 1.20 and an R of 3.
Click to expand...
I can now reproduce the "US" numbers in your table, modulo rounding; I'll have a go at the "Italy" ones later.

I'll also play around with different approaches to reducing the scatter in the data.

How set in stone is the value 6 ("generation delay [...] between infection and infection of others")?
 
Planigale said:
Technically because the receptor for SARS-CoV-2 (ACE 2) is highly represented on type 2 pneumocytes. Type 2 pneumocytes produce surfactant, loss of surfactant means surface tension in the alveoli is high which decreases lung compliance and increases the work of breathing. Once work of breathing crosses a limit respiratory muscles rapidly fail. Like any other muscles as load increases stamina decreases.

ETA
There are other reasons for increased stiffness of lungs, e.g. infiltration with inflammatory cells, with a probable degree of fibrosis. The point is oxygenation failure per se is not the critical issue in many of these patients at the time they go on the ventilator it is respiratory muscle failure. They have rapid shallow breathing with rates > 40 bpm but we are able to maintain oxygenation. technically they have ventilatory failure rather than respiratory failure precipitating ventilation (though respiratory failure is present).

ETA 2 although we use the technical term 'falling off the perch' in this situation this is physiologically incorrect. canaries fell off the perch due to hypoxia, low levels of oxygen as it was replaced by fire damp. Their lungs and breathing were normal it was just the oxygen in the air that fell.
Click to expand...

Very interesting, thank you for explaining so well.
 
Belz... said:
What are the stakes?

You know you're losing this one, right? Should've listened to me.
Click to expand...

I said fewer than 85k US deaths, combined flu and coronavirus by the end of 2020. Roboramma says more than 85k. The stakes are an avatar for 1 year.
 
Last edited:
JeanTate said:
Thanks.

How set in stone is the value 6 ("generation delay [...] between infection and infection of others")?
Click to expand...

It's based on the effective number of days an infection takes to become symptomatic. It's somewhat arbitrary but it seems COVID-19 is spread once it replicates enough, generally between 2 days before symptoms, to when symptoms subside but it's clearly a distribution, not fixed time period. It also seems likely people are more cautious once symptomatic reducing spread. In any case the daily increase fraction is the most important as it incorporates R as well as this time between generations and is the driver behind both the exponential growth, and exponential decline of the epidemic.
 
Captain_Swoop said:
UK seaths in last 24 hours 786 compared with with 439 the day before.
Click to expand...

Still well off the high.

I'm keeping an eye on UK numbers, because they aren't as bad as I would have expected, given the idiotic early response and very late shutdown.

Early days, but both new infections & deaths seem to be falling when any modelling says they should be rocketing. I'll accept severe under-testing and slow reporting might be an issue, but it will be a big tick in the seasonality stakes of Covid if they continue falling.

Planigale said:
Technically because the receptor for SARS-CoV-2 (ACE 2) is highly represented on type 2 pneumocytes. Type 2 pneumocytes produce surfactant, loss of surfactant means surface tension in the alveoli is high which decreases lung compliance and increases the work of breathing. Once work of breathing crosses a limit respiratory muscles rapidly fail. Like any other muscles as load increases stamina decreases.
Click to expand...

Three things:

1 - thanks yet again for the perspective from the front line and also the superior technical information you're giving. I know several media favourites in this country alone are being paid money for something you're sharing with us for free. Quite astonishing.

2 - is anyone collating victims' blood type data that you know of?

3 you are a ******* legend!
 
Samson said:
Yes entirely preventable if China had closed the markets.
It would be farcical to suggest this was not plausible in a totalitarian state.
Click to expand...
You would likely, then, be surprised at how hard it has been for even the most totalitarian of states to eliminate centuries old cultural traditions (other than by genocide).

I did not discover that review of thousands of (mainly Chinese and Hong Kong research papers?), someone upthread did.

Imagine had the resource going to reeducating Chinese muslims gone to the project of shutting the markets for ever.
Click to expand...
In the past few months there have been quite a few mainstream press articles like this, from SCMP: "Coronavirus: One virus caused Covid-19. Scientists say thousands more are in waiting" (link).

In addition to bats, camels, pigs, birds, and at least two non-human primates (HIV1 and HIV2) have "given" us zoonotic viral diseases.

It is highly unlikely that we humans can prevent yet another virus "jumping" to infect us, even as we continue our relentless efforts to make the sixth mass extinction one of the most destructive. The best we can do is be vigilant and react swiftly and appropriately.
 
The Atheist said:
...

1 - thanks yet again for the perspective from the front line and also the superior technical information you're giving. I know several media favourites in this country alone are being paid money for something you're sharing with us for free. Quite astonishing.

2 - is anyone collating victims' blood type data that you know of?

3 you are a ******* legend!
Click to expand...

seconded. I've sent one of Plan's posts to my family.

My ex's response: "Wow."
 
The Atheist said:
Still well off the high.

I'm keeping an eye on UK numbers, because they aren't as bad as I would have expected, given the idiotic early response and very late shutdown.

Early days, but both new infections & deaths seem to be falling when any modelling says they should be rocketing. I'll accept severe under-testing and slow reporting might be an issue, but it will be a big tick in the seasonality stakes of Covid if they continue falling.



Three things:

1 - thanks yet again for the perspective from the front line and also the superior technical information you're giving. I know several media favourites in this country alone are being paid money for something you're sharing with us for free. Quite astonishing.

2 - is anyone collating victims' blood type data that you know of?

3 you are a ******* legend!
Click to expand...

2 not that I know of why?

3 Although trite this is the job. This was always a possibility. You join a peace time army; you don't complain when there is a war.
 
Doghouse Reilly said:
I said fewer than 85k US deaths, combined flu and coronavirus by the end of 2020. Roboramma says more than 85k. The stakes are an avatar for 1 year.
Click to expand...

No, that is not what I was refering to, and you should know this considering the post you just responded to. I responded specifically to your claim, via proxy, that UK deaths will not exceed 8K. They were at 3k at the time and are now at 6k, five days later.

Do you now see that this prediction was ludicrous?
 
Last edited:
Planigale said:
2 not that I know of why?

3 Although trite this is the job. This was always a possibility. You join a peace time army; you don't complain when there is a war.
Click to expand...

Number 2 is starting here at the "university" of hawaii. They are trying to see if there may be a gene based reason for the extreme differences in the way people progress through the disease
 
Belz... said:
No, that is not what I was refering to, and you should know this considering the post you just responded to. I responded specifically to your claim, via proxy, that UK deaths will not exceed 8K. They were at 3k at the time and are now at 6k, five days later.

Do you now see that this prediction was ludicrous?
Click to expand...

I am looking forward to new excuse why COVID-19 is not big deal when he loses that bet. He seems to be really invested in that for some reason. :rolleyes:
 
pipelineaudio said:
Number 2 is starting here at the "university" of hawaii. They are trying to see if there may be a gene based reason for the extreme differences in the way people progress through the disease
Click to expand...

For us obesity is a big issue (and being male). Obesity may relate to increased work of breathing. The sex difference is interesting what we see is man flu++.
 
Planigale said:
2 not that I know of why?
Click to expand...

Just a follow-on from the disputed Chinese research that found A more problematic than O.

Regardless of the value of that study, I would have thought it was worth looking at - there are several diseases that are blood type specific.

Planigale said:
3 Although trite this is the job. This was always a possibility. You join a peace time army; you don't complain when there is a war.
Click to expand...

Sure, but I bet none of you get medals as a result.

Must be an enormously challenging, tiring, sad, satisfying and fascinating time all at once.

Also, it's not just your medical work - nobody's paying you to give progress reports here, but you're doing it and it's highly informative and may even save lives of people reading your words.
 
pipelineaudio said:
Number 2 is starting here at the "university" of hawaii. They are trying to see if there may be a gene based reason for the extreme differences in the way people progress through the disease
Click to expand...

I'm interested in any research in this area. With cheap genetic testing together with a pretty large population of COVID-19 victims with wide ranging outcomes, there should be a wealth of data available and compute power is pretty cheap these days.
 
Thanks.

marting said:
It's based on the effective number of days an infection takes to become symptomatic. It's somewhat arbitrary but it seems COVID-19 is spread once it replicates enough, generally between 2 days before symptoms, to when symptoms subside but it's clearly a distribution, not fixed time period. It also seems likely people are more cautious once symptomatic reducing spread. In any case the daily increase fraction is the most important as it incorporates R as well as this time between generations and is the driver behind both the exponential growth, and exponential decline of the epidemic.
Click to expand...
I used 5 instead of 6, and also 7.

As expected, the estimated R changes, in the direction you'd expect. However, for the US the conclusion doesn't (still some ways to go before the plateau); haven't done Italy yet.

I think a better set of numbers to use would be New York city, or perhaps New Jersey or Westchester county (NY), as a "pure" hotspot. The overall US numbers are currently dominated by the NY (+NJ+CT) ones; in the weeks to come I think it likely a different hotspot (or hotspots) will dominate. IOW, an estimate for R for the whole of the US is pretty meaningless unless the numbers of deaths is dominated by just one mega-cluster.
 
JeanTate said:
<snip>

I'll also play around with different approaches to reducing the scatter in the data.

<snip>
Click to expand...
Not so much an attempt to reducing the scatter as a way to present the trends in a different way. My data is from the daily WHO situation reports, for US cumulative deaths.

I estimated the number of days for deaths to double.

For example, the 21 March number is 201, and the 23 March one is 402. So the number of days to double is 2.0. The next doubling? That would be when deaths (cumulative) were 804. 25 March: 673; 26 March: 884. So I did a linear interpolation, and the number of days to double is 2.6.

Here are my results:
Date|Deaths|x2|
Date|Cum|days
21 Mar|201|x
23 Mar|402|2
24 Mar|471|
25 Mar|673|2.6
26 Mar|884|2.5
27 Mar|991|2.2
28 Mar|1243|3.2
29 Mar|1668|2.7
30 Mar|2112|
31 Mar|2398|3.2
1 Apr|2850|3.5
2 Apr|3846|3.5
3 Apr|4793|3.4
4 Apr|5854|3.1
5 Apr|7020|3
6 Apr|8358|2.9
7 Apr|9559|3.5

Still rather a lot of scatter, obviously. However, the doubling time is in a farily narrow range.

The best news would be when it takes forever for the cumulative total to double; clearly we are not there yet.

A hint that good news is coming would be a clear trend that the time taken to double is increasing. Sadly, even if you squint hard, I don't think you can see such a hint in the data presented in this form. :(
 
The Atheist said:
Still well off the high.

I'm keeping an eye on UK numbers, because they aren't as bad as I would have expected, given the idiotic early response and very late shutdown.

Early days, but both new infections & deaths seem to be falling when any modelling says they should be rocketing. I'll accept severe under-testing and slow reporting might be an issue, but it will be a big tick in the seasonality stakes of Covid if they continue falling.
Click to expand...

I'm not seeing them falling yet. Latest prediction from the IHME is that we'll see two and a half thousand deaths a day before the numbers start to fall.

https://www.theguardian.com/world/2...ropes-worst-hit-by-coronavirus-study-predicts
 
JeanTate said:
Not so much an attempt to reducing the scatter as a way to present the trends in a different way. My data is from the daily WHO situation reports, for US cumulative deaths.

I estimated the number of days for deaths to double.

For example, the 21 March number is 201, and the 23 March one is 402. So the number of days to double is 2.0. The next doubling? That would be when deaths (cumulative) were 804. 25 March: 673; 26 March: 884. So I did a linear interpolation, and the number of days to double is 2.6.

Here are my results:
Date|Deaths|x2|
Date|Cum|days
21 Mar|201|x
23 Mar|402|2
24 Mar|471|
25 Mar|673|2.6
26 Mar|884|2.5
27 Mar|991|2.2
28 Mar|1243|3.2
29 Mar|1668|2.7
30 Mar|2112|
31 Mar|2398|3.2
1 Apr|2850|3.5
2 Apr|3846|3.5
3 Apr|4793|3.4
4 Apr|5854|3.1
5 Apr|7020|3
6 Apr|8358|2.9
7 Apr|9559|3.5

Still rather a lot of scatter, obviously. However, the doubling time is in a farily narrow range.

The best news would be when it takes forever for the cumulative total to double; clearly we are not there yet.

A hint that good news is coming would be a clear trend that the time taken to double is increasing. Sadly, even if you squint hard, I don't think you can see such a hint in the data presented in this form. :(
Click to expand...

Thanks :) I like the idea of presenting the numbers in terms of doubling or halving. It's pretty clear that most folks don't have an intuitive idea of exponential growth/decay re different exponents but doubling/halving is more intuitive.

Scatter noise is always a problem in these models. Especially in the earlier days whith small numbers. And then there are actual changes in timeline that complicate things. The WHO data, for instance, changed between 10:00 CET and 23:59 CET at various times messing up projections that assume a 24 hr delta between reports.
 
China has lifted lockdown restrictions in Wuhan and neighbouring provinces, allowing travel in and out.
It will be interesting to se if there is a second wave of infections or if, indeed, the Chinese got it right.
 
zooterkin said:
I'm not seeing them falling yet. Latest prediction from the IHME is that we'll see two and a half thousand deaths a day before the numbers start to fall.
Click to expand...

The numbers are looking a bit patchy, too. That famed British efficiency at work?

EHocking said:
China has lifted lockdown restrictions in Wuhan and neighbouring provinces, allowing travel in and out.
It will be interesting to se if there is a second wave of infections or if, indeed, the Chinese got it right.
Click to expand...

Jury is definitely out on that still: https://www.newshub.co.nz/home/worl...rds-surge-in-asymptomatic-covid-19-cases.html
 
Mader Levap said:
I am looking forward to new excuse why COVID-19 is not big deal when he loses that bet. He seems to be really invested in that for some reason. :rolleyes:
Click to expand...

I wouldn't have an excuse, I would just admit I'd been wrong. Pretty anticlimactic, I'm afraid.
 
Doghouse Reilly said:
I said fewer than 85k US deaths, combined flu and coronavirus by the end of 2020. Roboramma says more than 85k. The stakes are an avatar for 1 year.
Click to expand...

Are flu deaths even counted in a way that would allow you to settle that bet?
 
Belz... said:
Well in that case I'm still waiting for you to admit that the prediction that UK deaths would not pass 8k was wrong.
Click to expand...

I never said it was right, I was sharing that guy's opinion. I didn't claim the UK would have fewer than 8,000 deaths.
 
Scientists in Australia making some serious claims:

A vaccine likely won’t be available in large amounts for another 18-24 months, and countries need to do more frequent testing, Peter Collignon, a professor at the Australian National University Medical School, told Bloomberg News.

People also aren’t likely to travel abroad for at least the next six months as nations try to contain the virus’ spread, Collignon said. Eradication of the virus is unrealistic, he said.
Click to expand...

https://www.bloomberg.com/news/arti...deadliest-days-virus-update?srnd=premium-asia
 
abaddon said:
So what do rheumatologists actually say?
https://rheumatology.medicinematter...on-on-chloroquine-hydroxychloroquine/17862288

And the Lupus people?
https://www.lupus.org/blog/are-people-with-lupus-protected-against-covid19

I will listen to them before any mad TV quack out to make a buck.

And are you really happy to promote nonsense that could kill people? Really?
Click to expand...

I saw one of his YT videos. He didn't mention the side-effects or how easy it is to overdose on it. Also failed to explain what a pilot study is. Left me wondering if he really is a MD. I blocked the channel so I won't have to watch such rubbish again.
 
Belz... said:
Hard to tell. I don't trust China's numbers one bit.
Click to expand...
Regardless, China's economy must be hurting enough for them to lift travel restrictions with 55,000 "escaping" Wuhan by train on the very first day.
Many restrictions still apply, but workers are being given priority to travel to work by the looks of things.

Also they seem to be letting tourists to leave as they open their airport and a number of Chinese medical workers who were brought in at the start of the outbreak are also leaving.

Whether China has learned its lesson regarding covering up infection numbers after today and report any resurgence of infections is yet to be seen.
 
Status
Not open for further replies.

Back
Top Bottom