COVID-19 Coronavirus current events

While discussing this the other day online and Australia vs. The U.S. situation, the person that I was talking to threw out 'ah but you're an island nation its easier to isolate!' It was only afterwards that I realised how ridiculous the argument was. Covid didn't get into the States by infected Mexicans or Canadians pouring across the border, it came in on flights and cruise ships just like it did for us. But Australia took things seriously and locked down early, and now we have only 6000 cases and 70 deaths.
 
'ah but you're an island nation its easier to isolate!'
I'd say that's a correct observation, but incomplete logic.
The British Isles are islands as well, the Faroer islands were hit badly, the UK is badly hit (Ireland not yet?).
But still, Australia probably has a much lower flow of people in and out because it is expensive to get to, and it's not as well connected as a result of that and because its global economic importance isn't as great as, say, that of the US or China. It's no coincidence that New York, Washington and California were hit first and hit hard in the US: these states have many connections globally.

In Germany, a huge source of infections was people going on holiday in Italy (or Austria close to Italy), and they do that because they can simply drive there. And then there is truck traffic and people working across the border, and all of that helps spread outbreaks internationally.

Connectedness is the important factor here, and having land borders with other countries increases this a lot. That's why we do European coordination in these issues. For islands, connectedness is measured in daily passenger numbers. Being an island helps Australia to not be as connected epidemiologically to the rest of the world in the first place, and that slowed the influx of infections.
 
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I see the conspirasphere has become quite excited by a speech Dr Fauci gave a few years ago in which he said:
"There is no question that there will be a challenge to the coming administration in the arena of infectious diseases, both chronic infectious diseases in the sense of already ongoing disease, and we already have certainly a large burden of that, but also there will be a surprise outbreak."
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The full speech and Q&A is over 50 minutes long; I'm not sure how many will have watched the whole thing to put it into correct context.

Relevant quote is from 3:15 in this video:


Source: https://www.youtube.com/watch?v=DNXGAxGJgQI
 
can't you just tell us the correct context?
it is long and boring. so watching the first 20mins or so, the context as I understand it is:
around 7:45 he says hes gonna explain what he means by surprise outbreak. he says since he started in 1984 there have been 250 outbreaks. he names some:
"some reemerging".
hiv,zika,etc ebola,h5n1, antibiotic resistence,west nile, anthrax, SARS, bird flu,chickengunya (sp?)

the wiki page of outbreaks in US have more examples: (not full list)
https://en.wikipedia.org/wiki/Category:Medical_outbreaks_in_the_United_States

1981-1993 measles,
1993 cryptosporidium,
2010,2014 whooping cough
1993 1996 2006 etc ecoli
2003 monkeypox
2008 salmonella
2014 enterovirus
2015 Bronx Legionnaires
2015 H5N2
2016 Elizabethkingia
Content from External Source
during Trumps time wiki link shows
2017–2018 United States flu season
2018 United States adenovirus outbreak
2019 Pacific Northwest measles outbreak
2019 United States hepatitis A outbreak
2019–2020 United States flu season
2019–2020 vaping lung illness outbreak
2020 coronavirus pandemic in the United States
Content from External Source
 
he says since he started in 1984 there have been 250 outbreaks.

I just learned that there is an email list for epidemics. Their homepage has a world map where you can find out more about current outbreaks. (I looked at a few notes and now know that koalas in Australia are getting infected by something akin to koala AIDS.)
https://promedmail.org/
Promed map.jpg
The Program for Monitoring Emerging Diseases (ProMED) is a program of the International Society for Infectious Diseases (ISID). ProMED was launched in 1994 as an Internet service to identify unusual health events related to emerging and re-emerging infectious diseases and toxins affecting humans, animals and plants. ProMED is the largest publicly-available system conducting global reporting of infectious diseases outbreaks. It is used daily by international public health leaders, government officials at all levels, physicians, veterinarians and other healthcare workers, researchers, private companies, journalists and the general public. Reports are produced and commentary provided by a multidisciplinary global team of subject matter expert (SME) moderators in a variety of fields including virology, parasitology, epidemiology, entomology, veterinary and plant diseases. ProMED operates 24 hours a day, 7 days a week and has nearly 80,000 subscribers, representing almost every country in the world.
Content from External Source
I found a Dec 30 message about the Wuhan virus.
Published Date: 2019-12-30 23:59:00
Subject: PRO/AH/EDR> Undiagnosed pneumonia - China (HU): RFI
Archive Number: 20191230.6864153
UNDIAGNOSED PNEUMONIA - CHINA (HUBEI): REQUEST FOR INFORMATION
**************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

[1]
Date: 30 Dec 2019
Source: Finance Sina [machine translation]
https://finance.sina.cn/2019-12-31/detail-iihnzahk1074832.d.html?from=wap


Wuhan unexplained pneumonia has been isolated test results will be announced [as soon as available]
---------------------------
On the evening of [30 Dec 2019], an "urgent notice on the treatment of pneumonia of unknown cause" was issued, which was widely distributed on the Internet by the red-headed document of the Medical Administration and Medical Administration of Wuhan Municipal Health Committee.

On the morning of [31 Dec 2019], China Business News reporter called the official hotline of Wuhan Municipal Health and Health Committee 12320 and learned that the content of the document is true.

12320 hotline staff said that what type of pneumonia of unknown cause appeared in Wuhan this time remains to be determined.

According to the above documents, according to the urgent notice from the superior, some medical institutions in Wuhan have successively appeared patients with pneumonia of unknown cause. All medical institutions should strengthen the management of outpatient and emergency departments, strictly implement the first-in-patient responsibility system, and find that patients with unknown cause of pneumonia actively adjust the power to treat them on the spot, and there should be no refusal to be pushed or pushed.

The document emphasizes that medical institutions need to strengthen multidisciplinary professional forces such as respiratory, infectious diseases, and intensive medicine in a targeted manner, open green channels, make effective connections between outpatient and emergency departments, and improve emergency plans for medical treatment.

Another piece of emergency notification, entitled "City Health and Health Commission's Report on Reporting the Treatment of Unknown Cause of Pneumonia" is also true. According to this document, according to the urgent notice from the superior, the South China Seafood Market in our city has seen patients with pneumonia of unknown cause one after another.

The so-called unexplained pneumonia cases refer to the following 4 cases of pneumonia that cannot be diagnosed at the same time: fever (greater than or equal to 38C); imaging characteristics of pneumonia or acute respiratory distress syndrome; reduced or normal white blood cells in the early stages of onset The number of lymphocytes was reduced. After treatment with antibiotics for 3 to 5 days, the condition did not improve significantly.

It is understood that the 1st patient with unexplained pneumonia that appeared in Wuhan this time came from Wuhan South China Seafood Market.

12320 hotline staff said that the Wuhan CDC went to the treatment hospital to collect patient samples as soon as possible, specifically what kind of virus is still waiting for the final test results. Patients with unexplained pneumonia have done a good job of isolation and treatment, which does not prevent other patients from going to the medical institution for medical treatment. Wuhan has the best virus research institution in the country, and the virus detection results will be released to the public as soon as they are found.
[...]

[Moderator note:]Having been involved in moderating the SARS-CoV (Severe acute respiratory syndrome - coronavirus) and the MERS-CoV (Middle Eastern Respiratory Syndrome - coronavirus), the type of social media activity that is now surrounding this event, is very reminiscent of the original "rumors" that accompanied the SARS-CoV outbreak. The exception is the transparency of the local government in responding to this currently undiagnosed outbreak. While this report does not contain the tweets, there have been numerous tweets about this as yet undiagnosed outbreak. [..]
Content from External Source
https://promedmail.org/promed-post/?id=20191230.6864153
In Yellowstone, cougars are facing an epidemic of their own: Bubonic plague.

The flea-borne disease, most famous for killing half of Europe during the medieval ages, is showing up in the cougar population inhabiting the Greater Yellowstone Ecosystem [GYE], according to a recent study.

Findings suggest it could be widespread. Of the 28 big cats researchers tested, 12 were infected or had been infected, according to the study published in Environmental Conservation.
Content from External Source
https://promedmail.org/promed-post/?id=7224404
 
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Comparing Belgium to the US is not that useful, better to compare it to a more similar US state like those in the North East.

There's an article on the BBC today about why comparing countries in difficult:

https://www.bbc.com/news/52311014

To summarise the main differences they highlighted: population sizes; population densities; demographics; how deaths are recorded; testing differences; preparedness; accurate and honest figure reporting; and a few others.

Conclusion? "Comparisons are difficult".
 
There's an article on the BBC today about why comparing countries in difficult:

https://www.bbc.com/news/52311014

To summarise the main differences they highlighted: population sizes; population densities; demographics; how deaths are recorded; testing differences; preparedness; accurate and honest figure reporting; and a few others.

Conclusion? "Comparisons are difficult".

Another complication is that according to some recent reports, based on Chinese research, different regions or countries are getting infected by different versions of the virus, which has mutated about 30 times. It is claimed that Europe has got a more deadly form of the virus than the United States. (I'm not sure they'll believe this in New York.)

If genetic variation in the virus is important, we should not rule out genetic variation in the victims as another factor. The disproportionate impact on black and other ethnic minorities in the UK and US has already attracted attention, though of course there are many possible non-genetic explanations for this. Looking at the very low death rates per million population for all the East Asian countries (not just mainland China, but Hong Kong, Singapore (with its largely Chinese ethnic population), Taiwan, Japan and South Korea), I can't help wondering if their populations are more resistant to respiratory infections of this kind than those elsewhere. This particular virus may be new, but similar infections may have ravaged the area repeatedly over the last few millennia, during which the populations there have generally been denser than in other parts of the world. So natural selection may have pre-adapted the populations for resistance to Covid-19. For comparison, Japan has a reported death rate per million of only 2, while in Europe even Germany, which is praised for the efficiency of its testing and contract-tracing methods, currently has a rate of 60. Can Japan really be that much better at controlling the disease?
 
Another complication is that according to some recent reports, based on Chinese research, different regions or countries are getting infected by different versions of the virus, which has mutated about 30 times.
how about a source for that.
 
It is claimed that Europe has got a more deadly form of the virus than the United States. (I'm not sure they'll believe this in New York.)

If genetic variation in the virus is important, we should not rule out genetic variation in the victims as another factor. The disproportionate impact on black and other ethnic minorities in the UK and US has already attracted attention, though of course there are many possible non-genetic explanations for this.
I'm in Europe, and I don't believe this, either. Viruses mutate a lot without changing what they do, and I heard this directly from a virologist. To put the impact of different mortalities by demographic on genetics, you'd first need to ascertain the actual infection rates in these groups, and these studies are under way now.

There is now significant discussion that different ICU treatment plans affect the outcomes significantly: how to ventilate, when to ventilate, why to ventilate. I was going to write a post about that, but haven't found the time yet.

For comparison, Japan has a reported death rate per million of only 2, while in Europe even Germany, which is praised for the efficiency of its testing and contract-tracing methods, currently has a rate of 60. Can Japan really be that much better at controlling the disease?
Yes, why not? Are you arguing from incredulity?
On the 17th, Japan had a case fatality rate of 2.1%, Germany had 3.0%. That's reasonably close.
 
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Yes, why not? Are you arguing from incredulity?
On the 17th, Japan had a case fatality rate of 2.1%, Germany had 3.0%. That's reasonably close.

I would prefer to call it curiosity rather than incredulity. If Japan (or South Korea, or Singapore, etc) really are so good at controlling the disease, the rest of us should be very curious to know how they do it. In the case of Japan, it can't be the size of their testing programme, because they have the lowest rate of tests per million of any developed country. That also casts doubt on your 'case fatality rate' comparison, because if Japan is only testing people with serious symptoms, we would expect their CFR to be relatively high. We have been led to believe that the CFR in Germany is relatively low, by European standards, because Germany tests so many people. Yet Japan has a lower CFR with fewer tests.

I'm not suggesting the 'East Asian preadaptation' hypothesis as a very likely explanation, just as something that shouldn't be dismissed a priori on the grounds that all populations are genetically the same. It should be testable by examining the data on respiratory diseases (not just Covid-19) among ethnic East Asians in other countries (USA, Canada, UK, France, etc). On a quick look through recent commentary on ethnic factors in Covid-19 in the UK (including the report by the Intensive Care National Audit and Research Centre) I don't see any specific mention of Chinese and other East Asian groups. NB in UK statistics the term 'Asian' sometimes means specifically South Asian, while 'Chinese' may be a separate category.
 
NPR have released a "Trump Timeline".
With near-daily task force briefings, President Trump has delivered an ever-evolving message to the American public about the coronavirus pandemic.

The constant is the inconsistency. At times he has been in sync with the public health experts advising him on the response and with actions initiated by his administration. But often he has undercut or even contradicted his experts or White House policy.
[...]
Below, we compare Trump's remarks and actions to those of his administration:
Content from External Source
https://www.npr.org/2020/04/21/8373...nd-done-about-the-coronavirus?t=1587567170055

Example:
image.jpeg

@DavidB66 My assumption regarding Japan was that common mask use and greater physical distance in e.g. greetings lead to lower base rate of spread compared to other countries.
 
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I don't understand your example.
But often he has undercut or even contradicted his experts or White House policy.


Azar agrees America has done a pretty good job at that point.
Azar, Feb 26 press briefing

We’re grateful for the hard work that healthcare workers, first responders, communities, and state and local leaders have put into the response so far. Because of this hard work and the President’s leadership, the immediate risk to the American public has been and continues to be low. Our containment strategy has been working.

At the same time, what every one of our experts and leaders have been saying for more than a month now remains true: The degree of risk has the potential to change quickly, and we can expect to see more cases in the United States. That is why we’ve been reminding the American public and our state, local, and private sector partners that they should be aware of what a broader response would look like.
Content from External Source
and Messionner in that quote does not seem to be saying America hadn't done a good job at that point. what am i missing?
 
I don't understand your example.
It's an example of what the timeline looks like. The columns are "Date", "Happening elsewhere", "Administration remarks", "Administration actions".

The screenshot is also an example where the administration communication was at odds with each other regarding the future outlook:
Messonier: "need to be preparing for significant disruption"
Trump: "going to be down to close to zero"
Azar: "potential to change quickly, expect to see more cases"​
"going to be close to zero" contradicts "expect more cases",
"prepare for disruption" is more drastic than "potential to change".
That is not a unified communication strategy.

It's also a convenient timeline to look up when key communitions were made and actions were taken, relative to the known cases and deaths. This makes it valuable if you want to debunk people who confront you with alternate timelines that didn't really happen.
 
The screenshot is also an example where the administration communication was at odds with each other regarding the future outlook:
Messonier: "need to be preparing for significant disruption"
Trump: "going to be down to close to zero"
Azar: "potential to change quickly, expect to see more cases""going to be close to zero" contradicts "expect more cases",
"prepare for disruption" is more drastic than "potential to change".
That is not a unified communication strategy.

oh. I do know trump (like me) was expressing his hope the virus wouldn't take off in the US. But im just confused about the specific NPR quotes allegedly showing "a not unified strategy". because im pretty sure it was the same press conference when Trump expressed that hope that "it might just go away". they should have used that quote.
Theres a big difference (to me) between saying [paraphrasing]"it might just go away" and [paraphrasing]"those 15 cases are almost all recovered, we've done a good job". they were almost all recovered and azar agreed they did a good job.
trump feb 26 press conference

trump:"Of the 15 people — the “original 15,” as I call them — 8 of them have returned to their homes, to stay in their homes until fully recovered. One is in the hospital and 5 have fully recovered. And one is, we think, in pretty good shape and it’s in between hospital and going home.
So we have a total of — but we have a total of 15 people, and they’re in a process of recovering, with some already having fully recovered."
Content from External Source
But it is a nice example of "interpretation is in the eye of the beholder".
 
I do know trump (like me) was expressing his hope the virus wouldn't take off in the US.
Precisely.
But he's stating it as a fact, "going to be close to zero", referring to the number of cases.
Azar is saying that there will be more cases, not less.
Messonier says there will be many more.

So, what was the administration communication that day? "It's going to go away? Wait and see? It will get worse?" It seems like a "take your pick" strategy of all available options.

And today, the communication on "liberating" states is similarly disjointed, with the addition of the governors in the mix. That's one reason why some states have formed coalitions (e.g. California, Washington Oregon) to try and coordinate actions and public communication.

To put the quote the npr selected in context:

Q Mr. President, should Americans be going out getting protective equipment such as masks and so forth? And if so, what is the U.S. doing to boost production of masks?

THE PRESIDENT: Well, we can get a lot of it. In fact, we’ve ordered a lot of it just in case we need it. We may not need it; you understand that. But in case — we’re looking at worst-case scenario. We’re going to be set very quickly.

But we — I don’t think we’re going to ever be anywhere near that. I really don’t believe that we’re going to be anywhere near that. Our borders are very controlled. Our flights in from certain areas that we’re talking about are very controlled. I don’t think we’ll ever be anywhere near that.

Please, go ahead.

Q Back to the stock market for a second. Travel-related stocks have especially been —

THE PRESIDENT: Yeah.

Q — hammered here —

THE PRESIDENT: Sure.

Q — in the last couple days. What would you say to Americans out there who right now are looking forward to the summer or the upcoming months and saying to themselves, “Should I make my summer plans? Should I go travel abroad?”?

Well, hopefully, they’re going to be able to do that. We think — we hope — that it’s going to be in good shape by that time. But, you know, they’re going to have to remain a little bit flexible.

Yeah, I would say travel-related company, certainly right now, that would be — that would be — they would be hurt.

At the same time, this ends. This is going to end. Hopefully it’ll be sooner rather than later. And I think the business that they lost will be picked up at a later date.

But, you know, right now, I think they’re not going to be — probably not going to be going to China; they’re not going to be going to certain countries where the problem is far greater than it is in the United States.

What it’s going to do is keep people home, and they’re going to travel to places that we have. We have the greatest — it’s the greatest tourism country in the world. So instead of leaving our country, leaving our shores, they’ll stay here.

And again, when you have 15 people, and the 15 within a couple of days is going to be down to close to zero, that’s a pretty good job we’ve done.
Content from External Source
https://www.whitehouse.gov/briefing...bers-coronavirus-task-force-press-conference/
 
70% did not have fever

this will get lost in the thread but seems important to share. 5,700 patients in New York. 70% of patients sick enough to be hospitalized did not have fever.

Fever is one of the top symptoms currently listed for Covid. But do not wait for fever before calling your doctor if you are feeling unwell, and do not wait for fever if you are having trouble breathing!
See paper for limitations on comorbidities stats.



Results

A total of 5700 patients were included (median age, 63 years [interquartile range {IQR}, 52-75; range, 0-107 years]; 39.7% female). The most common comorbidities were hypertension (3026; 56.6%), obesity (1737; 41.7%), and diabetes (1808; 33.8%). At triage, 30.7% of patients were febrile, 17.3% had a respiratory rate greater than 24 breaths/minute, and 27.8% received supplemental oxygen. The rate of respiratory virus co-infection was 2.1%.
Content from External Source
https://jamanetwork.com/journals/jama/fullarticle/2765184
 
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do not wait for fever if you are having trouble breathing!
Many Covid-19 patients who are low on oxygen do not always have trouble breathing!
They get something like high altitude sickness, being up a mountain with no oxygen, or a pilot in a jet plane where the pressurisation failed. Lack of oxygen is called hypoxia, and mild hypoxia destroys your ability to think straight. (Severe hypoxia makes you unconscious.)

Symptoms

Symptom statistics in Germany (when physians report a case, they include the symptoms):
cough 51 %
fever 42 %
runny nose 22 %
pneumonia 2 %
Also: throat ache, loss of breath, headache, limb ache, loss of appetite, loss of wreight, nausea, stomach ache, vomiting, diarrhea, conjunctivitis, rash, lymph node swelling, apathy, sleepiness
Content from External Source
translated from https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Steckbrief.html#doc13776792bodyText2

Basically, if you're sick, call your physician!
Also, there's been a study that 7 in 8 patients noticed a loss of smell and/or taste for a few days, 1 in 8 even before other symptoms occurred.

When to Seek Medical Attention
If you develop any of these emergency warning signs* for COVID-19 get medical attention immediately:

Trouble breathing
Persistent pain or pressure in the chest
New confusion or inability to arouse
Bluish lips or face

*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning to you.

Call 911 if you have a medical emergency: Notify the operator that you have, or think you might have, COVID-19. If possible, put on a cloth face covering before medical help arrives.
Content from External Source
https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
These are signs you may be suffering from pneumonia.
 
The first results from the New York antibody count are in:
image.png
https://www.6sqft.com/new-york-covid-antibody-test-preliminary-results/

Apparently there's no science going with that yet, just data that Cuomo shared on his press conference. I wouldn't necessarily trust the low numbers too much, but the double digits ought to be in the ballpark, unless something weird comes to light, like the test severely cross-reacting to something unexpected.
image.png
Good mortality estimates will consider that older people are underrepresented in this survey.
 
The first results from the New York antibody count are in:
But what is that? I didn't watch him today. are those antibodies of asymptomatic people with exposure? hospital staff? of random people in the population with no known exposure?

did he say what test was used? yesterday Birx said there was only 1 'trustworthy' (airquotes, not birx quote) test so far but it didn't sound like it was being used yet.
 
But what is that? I didn't watch him today. are those antibodies of asymptomatic people with exposure? hospital staff? of random people in the population with no known exposure?
They tested people randomly at grocery stores and big box stores, probably with a lateral flow assay. These are the numbers of people they tested positive. I'm not sure why they call them "weighted results", I wouldn't expect they'd need to do much weighing, but I think they are trying to account for demographics.
These tests are pretty bad, but if they hadn't done any weighing I'd have said the false positive error rate must be lower than 3% because of the "rest of state" result, which means an "11.7%" result should be taken as "9-14% or thereabouts". Since the numbers are comparatively big here, this isn't a huge deal; in Santa Clara, we had 1.5%, and such an adjustment would completely wipe out the result's accuracy.

If you adjust the NYC reported deaths upward some for unreported non-hospital deaths, and factor in a delay for sick people who are not dead yet, you'd get something on the order of 0.5%-0.8% for a fatality rate, which is well within the old WHO estimate of 0.3-1.0% of February 19th.
 
I was just doing the math myself and my figures are:

https://www1.nyc.gov/site/doh/covid/covid-19-data.page


Regarding the data on deaths provided below:

  • Confirmed deaths: People who had a positive COVID-19 laboratory test.
  • Probable deaths: People who did not have a positive COVID-19 laboratory test, but their death certificate lists as the cause of death "COVID-19" or an equivalent.
Confirmed deaths:10,290
Probable deaths:5,121
Content from External Source

population of NYC = 8.4 M

21.2 percent = 1.78M


based on 10,290 deaths

0.0057808 = 0.58%



based on 15,411 total deaths

0.0086578 = 0.87%


Not at all compatible with the Stanford/Santa Clara County Study
 
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If you adjust the NYC reported deaths upward some for unreported non-hospital deaths, and factor in a delay for sick people who are not dead yet, you'd get something on the order of 0.5%-0.8% for a fatality rate, which is well within the old WHO estimate of 0.3-1.0% of February 19th.
but both rates China and NYC (provided one believes not-science-rigorous antibody tests) are based on severe lockdown/stay-at-home measures? (which to me mimic vaccine protection rates).
 
Another touted but unproven cure.......
Madagascar’s president (Andry Rajoelina) surprised many observers when he announced that certain traditional plants grown on the large island country have the potential to cure Covid-19.
https://news.mongabay.com/2020/04/madagascars-president-promotes-unproven-herbal-cure-for-covid-19/

_111885005_afpmada.jpg

It is surprising that a country's leader would promote unsubstantiated claims (even beyond Trump's hopeful claims or suggestions for other drugs/cures).
But the President of Madagascar seemed to give confidence to his populace that a cure is at hand... or could be used as a preventative or natural "vaccine"..
The cure/vaccine touted is a concoction derived from the plant "Artemisia annua "... aka "Sweet Wormwood".... sometimes used as a treatment for Malaria.
No studies have been produced, but the claim is that 2 sufferers of Covid were cured by the use of the bottled remedy.

Further reporting reveals,
School pupils in Madagascar have been told they face expulsion if they refuse to drink a herbal tea their president claims prevents and cures COVID-19.
Andry Rajoelina, Madagascar’s populist leader, this week launched “COVID-organics” amid great fanfare, particularly on the radio and television stations he owns.
Not only would the product stop anyone who drank it from developing the virus, it would heal anyone who had caught it within seven days, the president told reporters. "Two people had already been cured", he added.
Source, UK Telegraph
 
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but both rates China and NYC (provided one believes not-science-rigorous antibody tests) are based on severe lockdown/stay-at-home measures?
I was talking about how many people die who get infected. The lockdown affects how many get infected, not how many of those die.

This is the two-months-old WHO estimate I mentioned:
Modeling is a helpful tool to try to account for missed cases, such as those that are mild cases potentially missed in current surveillance activities, and the time lag between onset and death. Using an estimated number of total infections, the Infection Fatality Ratio can be calculated. This represents the fraction of all infections (both diagnosed and undiagnosed) that result in death. Based on these available analyses, current IFR estimates range from 0.3% to 1%. Without population-based serologic studies, it is not yet possible to know what proportion of the population has been infected with COVID-19.
Content from External Source
https://www.who.int/docs/default-so...ation-reports/20200219-sitrep-30-covid-19.pdf

Not at all compatible with the Stanford/Santa Clara County Study
Well, it would be compatible, if Ioannidis had gotten the maths right. :p (I'm singling him out because he is the author who holds a courtesy chair of statistics.)
Also note that the fatality rate depends a lot on demographics (mostly older people die) and possibly unknown factors, and these tests aren't all that precise.
 
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Lateral-Flow Immunoassay
For everybody who enjoyed my explanation of the ELISA antibody test back in post #340, here's a nice picture of the principle behind a lateral-flow immunoassay, such as is being used all over the country. I've mentioned them before, they're the ones that look like pregancy tests. You put a drop of blood in at one end, then you add a solvent and wait a set time (usually 15 minutes), and then you check in the window for colored stripes. If the control stripe (C) does not appear, the test failed. If you can see a line at M, the test detected IgM antibodies. If you can see a line at G, the test detected IgG antibodies. The test is usually taken to be positive if it detects just one, weakly. In this picture, only test 15 is considered negative, all others are positive.
Lateral Flow Assay CGM.png
In the schematic below, the hole for the blood with the antibodies Y is on the left; the fluid gets "sucked" through the test by the spongy pads past the antigens, who bind to specific antibodies only and have color markers, and at the test lines, antibody-antibodies are glued that capture the antibodies including the colored ones that come by. There's also a rabbit antibody that is supposed to be swept through the cartridge and deposited on the control strip.
Lateral Flow Assay.png
One common problem with these kinds of tests is a bad choice of antigen. A badly chosen antigen might also glue to some "normal" coronaviruses that only cause the common cold and create a false positive. And it might glue to SARS-Cov-2 antibodies that are not very effictive at neutralizing the virus: in that case, the test would be true positive, but you would still not have immunity.

Another problem is, if you're currently infected with something else (e.g. a flu or a cold), you might have plenty of other antibodies in your blood, and they all glue to the test strip leaving not enough space for the Covid-19 antibodies to turn the strip red, creating a false negative. Or you might simply not have enough of these antibodies left in your blood; this test needs rather a lot, unlike the more sensitive ELISA test.
And of course some people fight the virus without ever developing antibodies, using the innate immune response with T-cells.

The tests currently in use in the US probably all have these kinds of errors built in. For example, the test used in Miami has a specificity of 90.6%, which means it had 90.6% true negatives (of all negative samples) and 9.4% false positives when they tested it before release. This is a huge problem, because if you only have 3 people with antibodies, you could have 12 positive results, and then 9 of these 12 people think they have antibodies when they don't. So these tests are fairly useless for diagnostic purposes, and that's why they're not sold in pharmacies.
(You can improve the specificity with a trick: if you require both IgG and IgM to be positive, both strips must show a false positive at the same time, and that rarely happens. Of course, then more true positives fail the test, which means the selectivity suffers: you get less positives overall.)

You could use a test like that to identify people who might have antibodies, and then use a more thorough neutralization test on them. This kind of test mixes your blood plasma with virus, and then the lab tries to infect lung tissue with it. If that doesn't work, you're immune. Obviously you need a very secure facility for that, so the aim is to develop ELISA tests that can detect such neutralizing antibodies that cause immunity at very low levels, and that can be run by machines. Unfortunately, they take quite a while to develop.

tl;dr the current antibody tests have a large amount of error! Any numbers from surveys with these things are bound to be inaccurate!

P.S. The pictures in this post come from a paper written about the test that Miami-Dade uses. https://www.researchgate.net/public...ibody_Test_for_SARS-CoV-2_Infection_Diagnosis
Miami-Dade found 6% antibody prevalence, and it should be obvious at this point that this number tells us nothing except that Miami hasn't yet been overrun with infections.
 
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Here's a daft question: if everyone's been in lockdown the last 4-6 weeks, where have all the hundreds of thousands of new cases come from?
 
Here's a daft question: if everyone's been in lockdown the last 4-6 weeks, where have all the hundreds of thousands of new cases come from?

from the hundreds of thousands who haven't been obeying the lockdown rules adequately.
and the ones who go to the grocery store unprotected.
or the ones who infect their family members at home. (or in nursing homes).
or medical personnel who get it due to high exposure.
or the thousands of essential workers who get it from the workplace.
In singapore it seems to be spreading in overcrowded housing conditions where they can't properly isolate.
 
Here's a daft question: if everyone's been in lockdown the last 4-6 weeks, where have all the hundreds of thousands of new cases come from?
Well, worldwide it's 100 000 per day, and not all countries are on lockdown! Germany went from 5000 cases a day pre-measures to ~2000 cases daily. During the last 7 days, we had 1500 new cases among hospital workers, so that is definitely a big source, as well as nursing homes. If a German tells you they got infected in a hospital, chances are much higher you're talking to a staff rather than a patient!

My county hasn't had a single registered case for two weeks, and we have 90000 people! Here's a map of the German counties and the number of cases per 100,000 inhabitants during the last 7 days. As you can see, we only have a few hotspots left where serious transmission is going on; as outbreaks are caught and contained, counties turn from red to yellow. We do have "an army of contact tracers".
image.jpeg

There are just a lot of delays with this: until an infection turns symptomatic, until the symptomatic person gets tested, until the test result comes back and is registered there may be delays. Cases you see now in the statistics may have become infected a week ago, from household members themselves infected another week back.

And there may be another effect: if you live in a region that is currently undertesting, you have a reserve of sick people that didn't get tested, and as the epidemic subsides, they can be tested. For example, if you used to have 200 infected per day, but only tested 100 of these, then all you had was 100 cases. If you now have 100, but test 95, it seems like your numbers haven't come down much! So some effect like that might also contribute.

P.S.: Personally, I don't expect many people will contract Covid-19 in a grocery store, even from an unprotected person. Once the "real" Heinsberg study comes out, we'll know more, because that is something the researchers have been looking at: where the transmissions occurred in that outbreak.
 
Here's a daft question: if everyone's been in lockdown the last 4-6 weeks, where have all the hundreds of thousands of new cases come from?

Chart from a page on the BBC showing cumulative deaths since 10th death:

Source: https://www.bbc.com/news/world-512351051588108273035.png

So judging by that, it looks to be about 20 days after the lockdowns were implemented that the death rates fell to below "doubling every three days".
 
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Are you noticing more wildlife...... ??

One thing many people note online, is the observation that some wild animals seem to be "reclaiming" their former habitats because more than half of us humans are now constantly hibernating inside. We are busy sheltering in our homes and staying out of formerly "humanized areas".
I think this has good, and also unfortunate results.
Many funded scientific surveys have been halted.....
https://www.audubon.org/news/for-scientists-who-study-birds-spring-without-precedent
He’s just one of many scientists around the world who have called off field research during the COVID-19 pandemic in a global effort to slow the virus's deadly spread. The stoppages come at a critical time as birds migrate, breed, nest, hatch, and take their first flight this spring. “Lab experiments can stop and wait,” says Anne Charmantier, an evolutionary ecologist in Montpellier, France, who studies Blue Tits and Great Tits and has also canceled her field season. “The birds are not going to wait for us.”
...... Not all surveying projects have come to a halt. This is the first of five years for the New York Breeding Bird Atlas III, a project that taps volunteers to census all the birds breeding in the state. April is when activities pick up and resident birds start nesting, says coordinator Julie Hart—and data are indeed rolling in. “People are going out and taking advantage of that little bit of time outside,” Hart says. “There are a lot more people watching for leaves and flowers and birds coming back. It’s bringing a lot of comfort.”

But.....
"New re-appropriation of open-space" is not a term a Tern would use on the mostly closed West Coast.,..... but it is how they might feel or react.
Less humanic impact in open spaces must surely be noticed by many animals who usually pay way-more attention to us -- than we normally do of them.

There are real instances.... Like when wildlife begins to newly-roam the valley floor at Yosemite, without troops of people. This is the popular example, but not necessarily the only example.....


Source: https://www.youtube.com/watch?v=qKWLHVLViQ8

https://www.yosemite.com/yosemite-webcams/
 
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In the April 29 WHO press briefing, after 36:40, Maria van Kerkhove talked a little about the way the WHO assimilates new evidence using “living reviews”.
There are studies that are coming out, particularly on therapeutics but in all aspects of this novel coronavirus, this new coronavirus causing this pandemic. It’s something within the scientific community; what we try to do when we evaluate the evidence is we look at what we call the weight of the evidence where we pull together all available evidence, all available studies on any particular topic, whether these studies are conducted in a laboratory through experimental conditions, whether they’re done in observational studies or epidemiologic studies in people, whether they’re done through clinical trials.
[..]
Then we go one step beyond that. Then we debate the results with our global expert networks and this is a healthy debate, it’s a constructive debate where we actually look again and we say, what does this tell us and what does this mean in terms of our guidance to our member states, to all people all over the world.
[..]
Right now what we are doing at WHO is we’re working with our science division and we’re working with partners at GOARN who are conducting living reviews for us so every day we are looking at the publications that come out in the peer-reviewed journals and the publications that are being sent to us before they reach the journals and we’re conducting living reviews on about 30 topics right now so that we can stay in tune with what is coming out.
Content from External Source
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/media-resources/press-briefings

“GOARN has grown to now have over 600 partners in the form of public health institutions, networks, laboratories, and United Nations and non-governmental organizations.” (Wikipedia)
 
Carrying on from my last post about "cures supported by govt officials..."
There is a good overview of "official" suggestions of cure ideas or treatments... by various political heads.....

https://www.npr.org/sections/goatsa...e-questionable-health-claims-do-people-listen

One notable factoid in the article is,
Trump has a couple of things going for him when it comes to lengthening the life of at least some erroneous information he espouses, Viswanath says. "For a myth to endure, it requires two types of people: a large group of people who are a ready-made, enthusiastic audience; and enablers — another group of people who are unwilling to challenge false ideas. I'm concerned the misinformation and disinformation will spread because we're not going to change Trump's behavior."
 
Some of you might have heard about the press conference given by Dr. Dan Erickson and Dr. Artin Massihi on Covid-19 that went viral on YouTube before YouTube removed it. In it, they argued that the death rates of Covid-19 are lesser than that of seasonal flu and that shelter in place rules are not necessary. Except, Dr. Erickson makes this claim very confidently while using bad statistics and unscientific methods. Basically, the reasoning goes something like this: 12% of Covid-19 tests in California have come back positive, California has about a population of about 40 million, that means that 12% of all Californians are positive and we have millions of cases but only about 2,000 deaths, that means you have a 0.04% chance of dying from Covid-19. Again, he says this with confidence. I'm shocked that such misinformation was given by two DO's. I made a video about the topic where I go over all of this.
Source: https://www.youtube.com/watch?v=FeRDaPKNko0&t=0s

Obviously Dr. Erickson's statistics are extremely inaccurate, but to add to the video and give a little more detail on how epidemiologists actually estimate cases for diseases like influenza, here is an example of one of their mathematical models. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4349859/
The ratio of deaths to hospitalizations (D:H) represents the expected number of influenza deaths relative to the number of influenza hospitalizations and was calculated algebraically for each age group as:

D:H= # reported deaths# reported hospitalizations×1% of deaths that occur in hospital
Content from External Source
There is more to it in the paper, but the point is that Dr. Erickson's calculations are way too simple and are using data that is way too limited in order to be accurate.
 
This place is just a few miles from my house:

https://www.kcra.com/article/califo...wide-order-opens-for-dine-in-service/32349998
California restaurant defies statewide order, opens for dine-in service
Updated: 1:17 AM PDT May 2, 2020

EL DORADO COUNTY, Calif. —
At a tiny roadside diner in El Dorado, where the sign promises home cooking, people are not staying home any longer.

Café El Dorado opened its doors for dine-in service on Friday for the first time since the statewide stay-at-home order went into effect March 19.

“We either run around in fear of getting a virus or we're homeless,” said owner Cherie Baldridge. “I'm going to be homeless if I don't open my business back up.”
...
The quaint restaurant along Pleasant Valley Road serves breakfast and lunch and only seats about 25 people. Nearly 100 people made their way through for the diner's reopening. Baldridge said social distancing is just not possible.

“If you want to come in, come in. If you don't, you don't,” she said.

“I was about two feet from someone and I'm not concerned at all,” said customer Charlene Ossont. “It's time that we open California up.”
Content from External Source
 
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