DawgTalkers.net Forums DawgTalk Everything Else... Resident Evil: COVID-19

Yes, and no.
For one, I question his number. A lot. The 100,000 just makes no sense in any capacity when viewed with the rest of the world and what we are NOT seeing... namely, lots of hospitalizations.

But, say that his number is accurate, and we assume that 18.5% hospitalization stat holds up. Quite simply, the state of Ohio will be filling 18,500 additional hospital beds within the next 14 days.

On average, in the US, we have 2.77 hospital beds for every 1,000 citizens.
Ohio has 11.69 million people. That means we should have roughly 32500 beds, total, in Ohio. The average hospital occupancy rate is 66%... so that means there are only, on average, 11,050 beds open at any one time.

So, IF his number is correct and all current infection rates and stuff hold true, then in the next 14 days we can expect that the state of Ohio will have a shortfall of about 8,500 hospital beds. All of which will require separation from "normal" patients. Every last hospital would be full to about 130% capacity without any extra staff or equipment.


So, I am both seriously questioning that number as well as praying like Hell they misspoke.... because if there is/was 100,000 at the time they collected the data, there will be an easy half million and more by the time we get two weeks down the road.

Yes, and no.
For one, I question his number. A lot. The 100,000 just makes no sense in any capacity when viewed with the rest of the world and what we are NOT seeing... namely, lots of hospitalizations.

But, say that his number is accurate, and we assume that 18.5% hospitalization stat holds up. Quite simply, the state of Ohio will be filling 18,500 additional hospital beds within the next 14 days.

On average, in the US, we have 2.77 hospital beds for every 1,000 citizens.
Ohio has 11.69 million people. That means we should have roughly 32500 beds, total, in Ohio. The average hospital occupancy rate is 66%... so that means there are only, on average, 11,050 beds open at any one time.

So, IF his number is correct and all current infection rates and stuff hold true, then in the next 14 days we can expect that the state of Ohio will have a shortfall of about 8,500 hospital beds. All of which will require separation from "normal" patients. Every last hospital would be full to about 130% capacity without any extra staff or equipment.


So, I am both seriously questioning that number as well as praying like Hell they misspoke.... because if there is/was 100,000 at the time they collected the data, there will be an easy half million and more by the time we get two weeks down the road.

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.

My prepping is done.

I have 6 months worth of food.
4 months worth of dog food.
2 months worth of booze.
A full gas tank.
An extra tank of gasoline. (the lawnmower filler)
Ammo.
All I need to do is clean my gun.

The only problem I have is I have to get my Meds filled on the regular. I will have to look into the 90 day supply thing.

What's with the toilet paper thing anyway? Do people think they are going to poop more because they are at home?

What's with the toilet paper thing anyway? Do people think they are going to poop more because they are at home?

well, taco bell delivers here with grubhub so.....

The service industry is gonna take a huge hit. Bars, restaurants, hotels, airlines, ubers, etc. Some retail like malls. Lots of people gonna lose their jobs. And then it goes upstream to impact suppliers. And then more people lose their jobs. It could have a very large impact on the economy if this goes on for an extended period of time. And very many people dont have the funds to be unemployed for long. And then the new problems start.

All of that is going to happen.
One problem at a time, though.

My church just canceled services for the next 2 weeks. Given the average age of my church, it's a good idea. No sense taking chances.

no sense in panicking.

One thing.........Africa is not a country. It's a continent w/multiple countries. LOL

I've spent more time today on church issues than I did work.

Our church - was going to cancel everything for 3 weeks, then changed and was only going to cancel this Sunday, and the Tuesday community meal, and the Bible studies, etc.

Finally settled on this: We will have church Sunday. If you are feeling sick, have a cough, stay home. If you are uncomfortable being around people, stay home. We have increased our cleaning, will have hand sanitizer everywhere, will not pass the offering plates.........and a lot more.

No sense taking chances, but really, no sense in panicking.

j/c...

Hadn't seen this posted anywhere from the other day. Nicely done Rep. Porter. Worth watching...

Thanks. I think they quarantined him this morning or last night. Not sure of which.

I have 4 pork butts and a crap ton of cornbread and desserts that I was going to smoke and cook for the church youth group Saturday. Now it's cancelled. I'll probably smoke the pork and freeze it.