What do I need to know about coronavirus?

[miacomet]

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@Birdstrike

My main point of disagreement is that we will forget about this in a year. I doubt it. The Italian health system is collapsing, and apparently Spain and France are soon to follow. That's hard to forget.

I agree we may be beyond containment, and (like the flu) it's really hard to control the spread of any respiratory virus. I agree isolation and testing are going to rapidly become much less useful (except for healthcare workers for fitness-for-duty).

 

[Birdstrike]

@Birdstrike

My main point of disagreement is that we will forget about this in a year. I doubt it. The Italian health system is collapsing, and apparently Spain and France are soon to follow. That's hard to forget.

Well, that brings up an interesting question. When this is all said and done, there will be a lot to learn from why certain places got hit so hard, and why others didn't. That's assuming it doesn't hit hard everywhere.

Right now it's obvious that areas with more dense population are being hit less hard, and those with dense populations and less developed health care systems (China) are getting hit the hardest. But I'm sure they'll find other factors. Like, why Italy, and Iran, but not other densely populated areas in Europe and the Middle East?

Fun fact: Most of the surgical masks people are buying, hoarding and putting on their faces are made in China.

 

[miacomet]

Well, that brings up an interesting question. When this is all said and done, there will be a lot to learn from why certain places got hit so hard, and why others didn't. That's assuming it doesn't hit hard everywhere.

Right now it's obvious that areas with more dense population are being hit less hard, and those with dense populations and less developed health care systems (China) are getting hit the hardest. But I'm sure they'll find other factors. Like, why Italy, and Iran, but not other densely populated areas in Europe and the Middle East?

Fun fact: Where are all those surgical masks people are buying, hoarding and putting on their faces, made?
China.

Sure. China and Korea took containment seriously. Italy, Spain and France did not, and now they are on the verge of collapse. We have not, and we will see where the US falls.

But forget? No more, and no less, than Ebola, the 1918 flu, or HIV. My point is- it's big, and it's hitting places with excellent health systems and educated, well-nourished people.

 

[calvnandhobbs68]

Who said it could never be a breeding ground?

Apolloyn is somehow implying that it's more likely that the Chinese government manufactured this as a bioweapon that they've unleashed on the public (including their own public to tank their own economy apparently?) rather than it just being a random event which occurred in the context of the many different factors which would contribute to natural cross species transmission that I stated.

2/3 of human viruses are zoonotic. It seems much more plausible that these this a natural progression of viral mutation when incubated among many species of genetically similar but not identical hosts in close contact with each other and humans than it's some new Chinese bioweapon they decided to unleash on their own population first and then shut down huge sections of their country to contain.

 

[Birdstrike]

But forget? No more, and no less, than Ebola...

People and the media, have forgotten and have stopped panicking about Ebola. The Ebola panic is long gone, but Ebola isn't. There's a frickin' Ebola outbreak going on right now in Congo that's one of the biggest outbreaks of all time, and has killed thousands. Yet none of the people that were freaking out about it a few years back, nor the media, are freaking out about it now. No one is even talking about it. Why? I remember being on this exact forum arguing with people who along with the media, wanted to let people with, or potentially exposed to Ebola, into the country. I was in the "Shut down the flights" camp, on that one. Yet some of the same people currently most vigilant about coronavirus were the ones saying, "Let Ebola in. It's cool. We'll just 'contain it.'" Wtf?! Ebola has a death rate of 90%. Ebola was "big" too, yet I haven't heard any US person or any US media outlet panicking about it lately, have you? And none of the people responsible for hoarding Americas toilet paper due to coronavirus, who were freaking out about Ebola a few years ago, are freaking out about Ebola right now. Why not?

Interesting you bring up the 1918 flu which killed 50 million people. That was "big." And yes, coronavirus is "big." The current H1N2 and H3N2 flu outbreak has killed an estimated 1 million worldwide and 20,000-30,000 in the USA, to 4,000 from coronavirus. And 100% of the attention must go only to corona? Where is the media on this?

Again, coronaviurs is important. Wash hands, isolate, take precautions, prevent, prepare. But all of the attention must go only to the disease killing 4,000 and none to the one that's killing 1,000,000? And Ebola, which was the media darling of 2014, has killed near the same magnitude as coronavirus during its current outbreak at a rate of 90%, yet suddenly neither the media nor people who cared to panic about it before, care on speck of dust about it now?

Seriously. Why? These questions need to be asked? Do people see nothing more than what the media feeds them?

 

[miacomet]

People and the media, have forgotten and have stopped panicking about Ebola. The Ebola panic is long gone, but Ebola isn't. There's a frickin' Ebola outbreak going on right now in Congo that's one of the biggest outbreaks of all time, has killed thousands. Yet none of the people that were freaking out about it a few years back, nor the media, are freaking out about it now. No one is even talking about it. Why? I remember being on this exact forum arguing with people who wanted to let people with, or potentially exposed to Ebola, in the country. I was in the "Shut down the flights" camp, on that one. Yet some of the same people currently most vigilant about coronavirus were the ones saying, "Let Ebola in. It's cool. We'll just 'contain it.'" Ebola has a death rate of 90%. Ebola was "big" too, yet I haven't heard anyone panicking about it lately, have you? And none of the people responsible for hoarding Americas toilet paper due to coronavirus, who were freaking out about Ebola a few years ago, are freaking out about Ebola right now. Why not?

Interesting you bring up the 1918 flu which killed 50 million people. That was "big." And yes, coronavirus is "big." The current H1N2 and H3N2 flu outbreak has killed an estimated 1 million worldwide and 20,000-30,000 in the USA, to 4,000 from coronavirus. And 100% of the attention must go only to corona?

Again, prevention. Wash hands, isolate, take precautions, prepare. But all of the attention to the disease killing 4,000 and none to the one that's killing 1,000,000? And Ebola, which was the media darling of 2014, has killed near the same magnitude as coronavirus yet suddenly neither the media nor people who cared before, care on speck of dust about it now?

Seriously. Why? These questions need to be asked?

LOL! I guess I remember. Your points are well taken. There are disasters everywhere, you are right- war, hunger, poverty, violence. And this is one. A bad one.

 

[Birdstrike]

LOL! I guess I remember. Your points are well taken. There are disasters everywhere, you are right- war, hunger, poverty, violence. And this is one. A bad one.

Yeah. It's just mind-blowing to me, that the media picks a crisis, feeds off of it, stokes panic, stokes fear, whipping it up, up and up into the highest anxio-frenzy they can for ratings, far beyond the point of public safety and awareness. Then once people reach emotional fatigue and the crisis is no longer of any use to the media, they drop it rarely if ever to be spoken of again. It doesn't matter if the crisis is ongoing, hasn't gone away and its victims still suffering in just as much. The media will drop it like old fish wrap once something they perceive as better for them, comes along. And people fall for it, over, and over, and over, again.

 

[Apollyon]

Apolloyn is somehow implying that it's more likely that the Chinese government manufactured this as a bioweapon that they've unleashed on the public (including their own public to tank their own economy apparently?) rather than it just being a random event which occurred in the context of the many different factors which would contribute to natural cross species transmission that I stated.

2/3 of human viruses are zoonotic. It seems much more plausible that these this a natural progression of viral mutation when incubated among many species of genetically similar but not identical hosts in close contact with each other and humans than it's some new Chinese bioweapon they decided to unleash on their own population first and then shut down huge sections of their country to contain.

I don't know anything about you, but that is now two posts you made about me. Is my theory most likely? No, but, also, for you to posit that it is "much more plausible" that it is random mutation, and wholly discount that this could be man-made, is shrill and narrow minded. Ever hear of Joseph Stalin? Pol Pot? Mao Zedong? They all had literal millions of their population murdered. It's not unheard of, even in the modern age.

 

[bravotwozero]

Apolloyn is somehow implying that it's more likely that the Chinese government manufactured this as a bioweapon that they've unleashed on the public (including their own public to tank their own economy apparently?) rather than it just being a random event which occurred in the context of the many different factors which would contribute to natural cross species transmission that I stated.

Yeah this is where the Chinese government screwed up royally. SARS started out the same way with these 'wet markets', full of stacked cages of wild animals with like a bat on top of a pangolin on top of a raccoon, with fecal matter, and blood, and water everywhere. They clearly didn't learn their lesson and shut these filth peddlers down, and now here we are. Vox has a really great video on it in youtube.

 

[calvnandhobbs68]

I don't know anything about you, but that is now two posts you made about me. Is my theory most likely? No, but, also, for you to posit that it is "much more plausible" that it is random mutation, and wholly discount that this could be man-made, is shrill and narrow minded. Ever hear of Joseph Stalin? Pol Pot? Mao Zedong? They all had literal millions of their population murdered. It's not unheard of, even in the modern age.

It could be man-made. And unicorns could exist and I could always find that pot of gold at the end of the rainbow. Anything is possible I guess.

This is how conspiracy theorists think, not scientists. "Can you prove that unicorns DON'T exist? Gotcha"

 

[Apollyon]

It could be man-made. And unicorns could exist and I could always find that pot of gold at the end of the rainbow. Anything is possible I guess.

This is how conspiracy theorists think, not scientists. "Can you prove that unicorns DON'T exist? Gotcha"

This is where you sound shrill. You put all your eggs in one basket, and you dispose of bioterrorism whole cloth, without even considering it. You know something the IDSA doesn't? And, when you invoke magical thinking like "gold at the end of the rainbow", that makes you sound screechy and blustery. I'm not wearing a tinfoil hat. But, you appear to be wearing a dunce cap, or, at least, blinders.

 

[GeneralVeers]

I'm definitely with birdstrike. Ebola was truly terrifying. A disease with 90% death rate that makes your insides liquify? Count me out. With a serious outbreak of that I wouldn't go to work.

For Corona virus, the media wants ratings, but 90% of the American media is on record wanting a specific political outcome in November. To many of them a recession is the only way to accomplish that at this point. They'd be happy with millions of Americans out of jobs, and an economy in ruins if it meant they got a Biden presidency.

 

[calvnandhobbs68]

This is where you sound shrill. You put all your eggs in one basket, and you dispose of bioterrorism whole cloth, without even considering it. You know something the IDSA doesn't? And, when you invoke magical thinking like "gold at the end of the rainbow", that makes you sound screechy and blustery. I'm not wearing a tinfoil hat. But, you appear to be wearing a dunce cap, or, at least, blinders.

What are you talking about? Where did the IDSA say they thought COVID was a bioweapon?

And hard for me to take being called "shrill" and "screechy" seriously by the person who thinks this is a bioweapon conspiracy with no proof of this. This is the classic "I'm just asking questions" junk that 9/11 conspiracy theorists do.

You're really backpedaling hard from your prior post. So do you think this is Chinese bioterrorism or not?

"I am not worried about the corona virus, because I know the stats and victim types. I still think that this one is Chinese bioterrorism. If they could (I don't have any security clearance, to know if they actually have) weaponize rabies, I would not be surprised if they have tried it out already."

 

[hoot504]

Waiting for the first "sheeple" to be dropped in this thread.

 

[Apollyon]

What are you talking about? Where did the IDSA say they thought COVID was a bioweapon?

And hard for me to take being called "shrill" and "screechy" seriously by the person who thinks this is a bioweapon conspiracy with no proof of this. This is the classic "I'm just asking questions" junk that 9/11 conspiracy theorists do.

SARS, as I wrote above.

And, when someone says "classic", I think of movies from the 80s, and someone who doesn't have anything else to say.

But, I'll ask you - is it possible, from a country known to kill it's own citizens, to use biological or chemical weapons? Tell me why, in your absolute terms, why, affirmatively, this CAN'T be engineered? And, can you do it without embellishment or insult?

 

[Birdstrike]

This is where you sound shrill. You put all your eggs in one basket, and you dispose of bioterrorism whole cloth, without even considering it. You know something the IDSA doesn't? And, when you invoke magical thinking like "gold at the end of the rainbow", that makes you sound screechy and blustery. I'm not wearing a tinfoil hat. But, you appear to be wearing a dunce cap, or, at least, blinders.

My personal opinion is that it was likely a natural mutation, because that happens all the time. That's the norm. But I agree that one has to at least consider the possibility the virus was modified. It's also my opinion it's exceedingly unlikely that COVID-19 was created in a lab, from scratch, as a bioweapon. However, existing viruses and other organisms can be genetically modified and that's done all the time now. That's not even new. And to assume rogue governments haven't figured out that opens up the possibility to make a potent bioweapon, is absurd. It's equally as absurd to assume such governments wouldn't at least try it in secret. None of that is evidence COVID-19 was a bioweapon experiment gone awry. It also doesn't say it was not.

Like I said, my personal opinion is that COVID-19 is likely just another natural mutation. That being said, I find it amusing that anyone living in a country that secretly infected it's own citizens with syphilis just to watch them get sick and die without treatment then covered it up, wouldn't at least consider the possibility of a government initiated misadventure, however unlikely it might be.

 

[calvnandhobbs68]

SARS, as I wrote above.

And, when someone says "classic", I think of movies from the 80s, and someone who doesn't have anything else to say.

But, I'll ask you - is it possible, from a country known to kill it's own citizens, to use biological or chemical weapons? Tell me why, in your absolute terms, why, affirmatively, this CAN'T be engineered? And, can you do it without embellishment or insult?

Again, quote me where IDSA says they think SARS was a bioweapon.

Also again, I'm not saying it CAN'T be engineered. Governments are trying to weaponize biologic agents all the time. What I'm saying is it's far more likely that these are natural mutations causing inter species transmission accelerated by the fact that tons of animals that would normally never be in such close contact with each other are stacked in cages in markets in China. You're saying, and I quote, "I know the stats and victim types. I still think that this one is Chinese bioterrorism"

 

[Birdstrike]

Waiting for the first "sheeple" to be dropped in this thread.

"Sheeple"
There. Glad we got out the the way and can now move on.

 

[calvnandhobbs68]

My personal opinion is that it was likely a natural mutation, because that happens all the time. That's the norm. But I agree that one has to at least consider the possibility the virus was modified. It's also my opinion it's exceedingly unlikely that COVID-19 was created in a lab, from scratch, as a bioweapon. However, existing viruses and other organisms can be genetically modified and that's done all the time now. That's not even new. And to assume rogue governments haven't figured out that opens up the possibility to make a potent bioweapon, is absurd. It's equally as absurd to assume such governments wouldn't at least try it in secret. None of that is evidence COVID-19 was a bioweapon experiment gone awry. It also doesn't say it was not.

Like I said, my personal opinion is that COVID-19 is likely just another natural mutation. That being said, I find it amusing that anyone living in a country that secretly infected it's own citizens with syphilis just to watch them get sick and die without treatment then covered it up, wouldn't at least consider the possibility of a government initiated misadventure, however unlikely it might be.

You're taking words that my good pal Apollyon put in my mouth. Where did I say I just couldn't "consider the possibility of a government initiated misadventure"? Bioterrorism has been on people's radar for decades. Most people on the planet could consider this possibility. This is very unlikely to be that event. If it is, it's the worlds crappiest bioterrorist weapon. Make people just sick enough so that you drain a bunch of your country's resources putting a bunch of them in the ICU and watching only 3000 die? Shutting down a huge chunk of your economy to try to contain it? The Chinese government actually currently runs concentration camps for Uyghurs and no country in the world does anything about it. Why wouldn't they just round up a few thousand of them and infect them with the virus to see what happens? Nobody would be the wiser.

I guess your response would be it wasn't intentional but leaked out of some lab somewhere. Fine, but again a claim with no real evidence. And what good does it do to sit around wondering if it escaped from some lab? Just to make oneself feel better that this didn't actually happen because of the ridiculous Chinese market animal conditions? Why don't we work on shutting down these markets that are the breeding ground for these viruses in the first place.

 

[Apollyon]

Again, quote me where IDSA says they think SARS was a bioweapon.

Also again, I'm not saying it CAN'T be engineered. Governments are trying to weaponize biologic agents all the time. What I'm saying is it's far more likely that these are natural mutations causing inter species transmission accelerated by the fact that tons of animals that would normally never be in such close contact with each other are stacked in cages in markets in China. You're saying, and I quote, "I know the stats and victim types. I still think that this one is Chinese bioterrorism"

Even if I am "off my rocker", I'm not pushing it on anyone. Your "gotcha" quote isn't a "gotcha". Opinions are like dinguses - everyone's got one, and most of them stink. But, when you equate "bioengineered" to "unicorns" and "gold at the end of the rainbow", you sound like you're not looking at geopolitics. You walk back now, but you started out saying what sounded like that there was NO possibility (or as much as unicorns and leprechauns). I'll give props to @Birdstrike - his analysis enumerated more clearly than I explained.

But, again, I'll ask this question - why in China? Why not in central Africa, where EVERYTHING - from viruses on up to the largest animals, crocodiles, hippos, rhinos, and elephants - is passively, or actively trying to kill you? The last wild case of smallpox was in Somalia, in 1977. Why not India or Pakistan?

 

[Birdstrike]

You're taking words that my good pal Apollyon put in my mouth. Where did I say I just couldn't "consider the possibility of a government initiated misadventure"? Bioterrorism has been on people's radar for decades. Most people on the planet could consider this possibility. This is very unlikely to be that event. If it is, it's the worlds crappiest bioterrorist weapon. Make people just sick enough so that you drain a bunch of your country's resources putting a bunch of them in the ICU and watching only 3000 die? Shutting down a huge chunk of your economy to try to contain it? The Chinese government actually currently runs concentration camps for Uyghurs and no country in the world does anything about it. Why wouldn't they just round up a few thousand of them and infect them with the virus to see what happens? Nobody would be the wiser.

I guess your response would be it wasn't intentional but leaked out of some lab somewhere. Fine, but again a claim with no real evidence. And what good does it do to sit around wondering if it escaped from some lab? Just to make oneself feel better that this didn't actually happen because of the ridiculous Chinese market animal conditions? Why don't we work on shutting down these markets that are the breeding ground for these viruses in the first place.

If you're saying that the Chinese government doesn't hesitate to violate their citizens' human rights, and at the same time the evidence isn't currently there to say COVID-19 necessarily has any connection to that, then I guess we agree.

 

[Apollyon]

You're taking words that my good pal Apollyon put in my mouth. Where did I say I just couldn't "consider the possibility of a government initiated misadventure"? Bioterrorism has been on people's radar for decades. Most people on the planet could consider this possibility. This is very unlikely to be that event. If it is, it's the worlds crappiest bioterrorist weapon. Make people just sick enough so that you drain a bunch of your country's resources putting a bunch of them in the ICU and watching only 3000 die? Shutting down a huge chunk of your economy to try to contain it? The Chinese government actually currently runs concentration camps for Uyghurs and no country in the world does anything about it. Why wouldn't they just round up a few thousand of them and infect them with the virus to see what happens? Nobody would be the wiser.

I guess your response would be it wasn't intentional but leaked out of some lab somewhere. Fine, but again a claim with no real evidence. And what good does it do to sit around wondering if it escaped from some lab? Just to make oneself feel better that this didn't actually happen because of the ridiculous Chinese market animal conditions? Why don't we work on shutting down these markets that are the breeding ground for these viruses in the first place.

Remember the movie "Red Planet", with Val Kilmer? He has the robotic "dog" that gets zapped, and goes into its "killing mode", and one is the guerilla maneuver (which is real) to injure - not kill - a team member. That slows down the entire team. That's why it WOULDN'T be "the world's crappiest bioterrorist weapen". Mortality leads to expectant conditions. Morbidity leads to much more active intervention, with rehabilitation, and hope/belief that the victims will get better. That uses a lot more resources.

As to the Uyghurs, as I said above, "you can kill 10 million people out in the country, and not even put a dent in the poplulation".

I don't have any proof, but theoretical pieces fall into place. I'm not militant about this, because it doesn't have any effect on me. But I'm not so naive as to dismiss it out of hand.

 

[bravotwozero]

But, again, I'll ask this question - why in China? Why not in central Africa, where EVERYTHING - from viruses on up to the largest animals, crocodiles, hippos, rhinos, and elephants - is passively, or actively trying to kill you? The last wild case of smallpox was in Somalia, in 1977. Why not India or Pakistan?

Well, Ebola did come from Africa, and was believed to come from animals...

 

[Apollyon]

Well, Ebola did come from Africa, and was believed to come from animals...

The filoviridae have been around for thousands of years, in primates. HIV, Marburg, Ebola, all from primates. There are no non-pathogenic filoviruses.

But none have mutated twice in less than 20 years.

 

[calvnandhobbs68]

If you're saying that the Chinese government doesn't hesitate to violate their citizens' human rights, and at the same time the evidence isn't currently there to say COVID-19 necessarily has any connection to that, then I guess we agree.

Agree

I'm also saying the way COVID happened would be a very bizarre way to test a bioweapon. Why not just try it out on all the Uyghurs they literally have in concentration camps?

 

[calvnandhobbs68]

Even if I am "off my rocker", I'm not pushing it on anyone. Your "gotcha" quote isn't a "gotcha". Opinions are like dinguses - everyone's got one, and most of them stink. But, when you equate "bioengineered" to "unicorns" and "gold at the end of the rainbow", you sound like you're not looking at geopolitics. You walk back now, but you started out saying what sounded like that there was NO possibility (or as much as unicorns and leprechauns). I'll give props to @Birdstrike - his analysis enumerated more clearly than I explained.

But, again, I'll ask this question - why in China? Why not in central Africa, where EVERYTHING - from viruses on up to the largest animals, crocodiles, hippos, rhinos, and elephants - is passively, or actively trying to kill you? The last wild case of smallpox was in Somalia, in 1977. Why not India or Pakistan?

You're the one walking back. Do you support your assertion multiple people quoted that "I know the stats and victim types. I still think that this one is Chinese bioterrorism" or not? You went from this is Chinese terrorism to "maybe it is maybe it isn't".

 

[Apollyon]

You're the one walking back. Do you support your assertion multiple people quoted that "I know the stats and victim types. I still think that this one is Chinese bioterrorism" or not? You went from this is Chinese terrorism to "maybe it is maybe it isn't".

Yes, I think that. But, I also gave you the value of my opinion. I have no direct proof. I may be misinformed. Wouldn't be the first time today.

But you sound like you're still looking for a "gotcha". I don't know why you are so aggressively on me, for this.

 

[hoot504]

Yes, I think that. But, I also gave you the value of my opinion. I have no direct proof. I may be misinformed. Wouldn't be the first time today.

But you sound like you're still looking for a "gotcha". I don't know why you are so aggressively on me, for this.

Apollyon, you called the guy shrill.

How about everyone goes for a run, meditates, has a cup of tea, whatever.

 

[Apollyon]

Apollyon, you called the guy shrill.

Maybe I was right. Guess I got my answer!

 

[RustedFox]

Brother-in-law just got an email from his University telling him that his spring break is hereby extended by five days due to the Coronavirus hysteria.

 

[calvnandhobbs68]

Yes, I think that. But, I also gave you the value of my opinion. I have no direct proof. I may be misinformed. Wouldn't be the first time today.

But you sound like you're still looking for a "gotcha". I don't know why you are so aggressively on me, for this.

We'll all hang up our tin hats and dunce caps for the day I think.

 

[Birdstrike]

Brother-in-law just got an email from his University telling him that his spring break is hereby extended by five days due to the Coronavirus hysteria.

The virus is going be so severe an entire University needs to be shutdown on one day, then suddenly not be an issue 5 days later? Regardless, I suppose if there's the option of moving classes to an online-only setting for a while that could help reduce person-to-person spread. Of course, that does assume the college students will realize they're not invincible and isolate as instructed as opposed to using the time to schedule extra keg parties and orgies at which bodily fluid will be rampantly and wantonly exchanged.

 

[doctalaughs]

for those of you who think it’s not going to be that bad- what do you make of this crit care doc tweeting from Italy (claiming they are so overwhelmed that people over 65 are just being left to die and pathologists and orthopedic surgeons are being asked to manage vents)

 

[Apollyon]

for those of you who think it’s not going to be that bad- what do you make of this crit care doc tweeting from Italy (claiming they are so overwhelmed that people over 65 are just being left to die and pathologists and orthopedic surgeons are being asked to manage vents)

I don't know what it is with the Italians and viral outbreaks. I say this because of another Ebola breakout several years ago, which killed a bunch of the health care providers, who were Italian doctors and nurses, working without masks or gloves.

 

[Birdstrike]

for those of you who think it’s not going to be that bad- what do you make of this crit care doc tweeting from Italy (claiming they are so overwhelmed that people over 65 are just being left to die and pathologists and orthopedic surgeons are being asked to manage vents)

“What I make of that” is that we should wash hands, isolate presumed positives and make sure we have adequate ED/ICU staffing, preparation and equipment. What we should not do is either panic or this:

“Number of hospital beds in Italy 2007-2017
Published by Statista Research Department, Jan 14, 2020
Between 2000 and 2017, the number of hospital beds in Italy considerably decreased, from 268,057 to 192,548 units. It comes as no surprise that the number of hospitals and more specifically the number of public hospitals in the country also declined during the same time range.  

Closing of hospitals

Between 2014 and 2016, some hospitals were closed or converted into outpatient care facilities in Italy. Some regions have been affected by these cuts more than others. Apulia was the region with the highest number of hospital closures, during the period considered.  

Patients using hospital services

Over the last few years, the share of individuals using hospital services steadily grew . More specifically, the percentage of people going to the hospital because of minor health issues only slightly increased. The growth was more remarkable among patients who were admitted to the hospital in order to be treated for severe diseases or to undergo major surgeries. As a matter of fact, the share of the latter group of patients increased from 21.6 percent in 2007 to 30.8 percent in 2018. ”

Italy: number of hospital beds 2007-2017 | Statista

Between 2000 and 2017, the number of hospital beds in Italy considerably decreased, from 268,057 to 192,548 units.

www.statista.com

 

[Janders]

So coming from the perspective of someone who thinks this virus IS terrifying, here are my thoughts--

It crushed a massive Chinese city's medical infrastucture, requiring draconian measures and a total-society push of very impressive quality and quantity to regain control.
It is decimating the medical system in Lombardy, which is modern, Western, and not horribly dissimilar to areas in the USA.
South Korea and Japan controlled relatively small nidus outbreaks with a varied approach, but both requiring significant societal buy-in, and in the case of Korea amazing volume of testing and contact tracing.

The US has largely decided to buy toilet paper and canned beans, and not implement massive active viral surveillance, testing, and quarantine/contact tracing. Not precisely the initial Italian response, but not exactly the Chinese / Korean response either.

The R0 / infectivity and doubling times are holding strong around 2 and 6 days, respectively.

Unlike Ebola, or even Influenza, this little disease sheds asymptomatically, or with mild URI symptoms in many patients.

Without some degree of control, 1,000 cases in an area are 8k in 24 days. Yawn. But over the next cycles they are 16k, 32k, 64k, 128k. Basically 6 weeks to go from 1,000 cases with 5-50 deaths and 50-100 ICU admissions, to 128k cases with 2500 deaths and 15,000 ICU admissions (largely requiring vents). Losing control, after a handful of replication cycles, leads to obvious collapse of the medical system.

As proof of its danger, the nursing home in the US hit by it had 50% of its patients hospitalized, and 25% dead (rough numbers). Image that hitting the little nursing homes near your hospital.

So to me, this little bug passes the sniff test that it ISN'T flu or H1N1.

To those that say "everyone can order a test for Covid" please call the DPH here. We haven't had a test approved. They can do a few dozen a day. For the entire state.

So, I believe this is a real/present threat. I believe because of doubling times, it isn't presenting as a big deal TODAY. But in 4-6 cycles (a month or so) the numbers are rather petrifying. I don't really want to spend a couple months converting random closets in the hospital to ICU beds, hand-bagging patients because we are out of vents, and attending the funerals of my colleagues. Clearly if this goes hot, I'm losing nurses, docs, and RTs I've work with for years (they aren't all 30yo healthy triathletes).

Logically then, I am interested in ways we can slow/control the burn of this disease. Sadly, it seems at this moment social distancing, with massive economic impacts, is the most logical was to achieve this goal. Maybe it is too early, and here in the US we have another 2 weeks until it is "necessary". Lacking testing, we are blindfolded to the real nature of the problem we are dealing with, making it VERY easy to both overreact, or under react.

Or the data is wrong. Maybe the CFR is really .1% (but why is Lombardy burning then?). Maybe it'll just melt away in the summer (does it come back in the fall?).

But I find this head-in-the-sand "its no big deal" a strange mix of cognitive dissonance, normalcy bias, outright narcissism, and good old fashioned ignorance.

 

[Angry Birds]

So coming from the perspective of someone who thinks this virus IS terrifying, here are my thoughts--

It crushed a massive Chinese city's medical infrastucture, requiring draconian measures and a total-society push of very impressive quality and quantity to regain control.
It is decimating the medical system in Lombardy, which is modern, Western, and not horribly dissimilar to areas in the USA.
South Korea and Japan controlled relatively small nidus outbreaks with a varied approach, but both requiring significant societal buy-in, and in the case of Korea amazing volume of testing and contact tracing.

The US has largely decided to buy toilet paper and canned beans, and not implement massive active viral surveillance, testing, and quarantine/contact tracing. Not precisely the initial Italian response, but not exactly the Chinese / Korean response either.

The R0 / infectivity and doubling times are holding strong around 2 and 6 days, respectively.

Unlike Ebola, or even Influenza, this little disease sheds asymptomatically, or with mild URI symptoms in many patients.

Without some degree of control, 1,000 cases in an area are 8k in 24 days. Yawn. But over the next cycles they are 16k, 32k, 64k, 128k. Basically 6 weeks to go from 1,000 cases with 5-50 deaths and 50-100 ICU admissions, to 128k cases with 2500 deaths and 15,000 ICU admissions (largely requiring vents). Losing control, after a handful of replication cycles, leads to obvious collapse of the medical system.

As proof of its danger, the nursing home in the US hit by it had 50% of its patients hospitalized, and 25% dead (rough numbers). Image that hitting the little nursing homes near your hospital.

So to me, this little bug passes the sniff test that it ISN'T flu or H1N1.

To those that say "everyone can order a test for Covid" please call the DPH here. We haven't had a test approved. They can do a few dozen a day. For the entire state.

So, I believe this is a real/present threat. I believe because of doubling times, it isn't presenting as a big deal TODAY. But in 4-6 cycles (a month or so) the numbers are rather petrifying. I don't really want to spend a couple months converting random closets in the hospital to ICU beds, hand-bagging patients because we are out of vents, and attending the funerals of my colleagues. Clearly if this goes hot, I'm losing nurses, docs, and RTs I've work with for years (they aren't all 30yo healthy triathletes).

Logically then, I am interested in ways we can slow/control the burn of this disease. Sadly, it seems at this moment social distancing, with massive economic impacts, is the most logical was to achieve this goal. Maybe it is too early, and here in the US we have another 2 weeks until it is "necessary". Lacking testing, we are blindfolded to the real nature of the problem we are dealing with, making it VERY easy to both overreact, or under react.

Or the data is wrong. Maybe the CFR is really .1% (but why is Lombardy burning then?). Maybe it'll just melt away in the summer (does it come back in the fall?).

But I find this head-in-the-sand "its no big deal" a strange mix of cognitive dissonance, normalcy bias, outright narcissism, and good old fashioned ignorance.

Yeah I agree with you, Janders. I think we will look irresponsible for not taking this seriously as ER doctors.

 

[alpinism]

Make no mistake this will probably be one of the worst natural disasters in the history of the United States.

 

[GeneralVeers]

Or we are on the down-slope due to the end of flu season and cases are diminishing. An alternative reason for the "increase" in cases is that we are ramping up testing. As we increase testing of people who normally we would label "viral URI or viral syndrome" we will of course find increasing numbers of cases. It's highly possible that millions of Americans were already infected this year, recovered (or died) and no one noticed.

 

[miacomet]

Or we are on the down-slope due to the end of flu season and cases are diminishing. An alternative reason for the "increase" in cases is that we are ramping up testing. As we increase testing of people who normally we would label "viral URI or viral syndrome" we will of course find increasing numbers of cases. It's highly possible that millions of Americans were already infected this year, recovered (or died) and no one noticed.

Look at Italy and France and Spain. Italy's cases increased exponentially. We are following suit.

 

[deleted497653]

Look at Italy and France and Spain. Italy's cases increased exponentially. We are following suit.

So you predict the infection rate will increase or are looking to plateau? You seem to know stuff...

 

[TelemarketingEnigma]

The filoviridae have been around for thousands of years, in primates. HIV, Marburg, Ebola, all from primates. There are no non-pathogenic filoviruses.

But none have mutated twice in less than 20 years.

I shouldn't be stirring this pot, but if we're talking humans this is false - reston virus is nonpathogenic in humans.

 

[rokshana]

The last wild case of smallpox was in Somalia, in 1977. Why not India or Pakistan?

Actually the last case of naturally occurring variola major ( the more deadly form of smallpox) WAS in Bangladesh in 1975 ( family from Bangladesh and I’m a fount of trivia 🙂 )...Somalia was last case of variola minor.

 

[rokshana]

The virus is going be so severe an entire University needs to be shutdown on one day, then suddenly not be an issue 5 days later? Regardless, I suppose if there's the option of moving classes to an online-only setting for a while that could help reduce person-to-person spread. Of course, that does assume the college students will realize they're not invincible and isolate as instructed as opposed to using the time to schedule extra keg parties and orgies at which bodily fluid will be rampantly and wantonly exchanged.

Harvard cancelled the rest of the semester for classes and instead will have everything online...Princeton told students not to come back after spring break...remote leaning to be offered.

 

[Apollyon]

I shouldn't be stirring this pot, but if we're talking humans this is false - reston virus is nonpathogenic in humans.

TIL that there is a filovirus that devastes nonhuman primates! God's honest truth, thank you!

 

[Apollyon]

Actually the last case of naturally occurring variola major ( the more deadly form of smallpox) WAS in Bangladesh in 1975 ( family from Bangladesh and I’m a fount of trivia 🙂 )...Somalia was last case of variola minor.

See, I was quoting Professor Wikipedia. I, personally, thought the last wild case of Variola major was in Pakistan, in 1971! Again, thank you for that!

 

[GeneralVeers]

I'm not worried.....may a dread disease strike me down if I'm wrong.

 

[CoolRanchDoritos]

My father is a respiratory ICU doc and director at one of the NY hospitals taking coronavirus patients and was yelling his head off yesterday and thinks we are essentially dysfunctional at multiple levels. Mostly worried about bedside rationing that is coming since some of the areas hit already, at least in NY, are already elderly-population dense and have a number of pre-existing conditions, especially of the respiratory kind like COPD. Administrative issues are also a large one. To make room for more patients, some were discharged only to come to the ER days later sick and then taken to isolation and the testing is delayed and can take over a day sometimes which is a lot given that new patients have to be admitted. Don't want to scare anyone, but I've honestly never seen him this worried, since some of these patients were not taken seriously before as potentially positive and discharged, and now he is really concerned about how many people they had contact with, and of course staff security.

Also thinks it's too late that schools are closing now and that we have around 10 days max before ICUs are at full capacity.

 

[dchristismi]

I'm not worried.....may ebola strike me down if I'm wrong.

Fixed that for you.
😉

 

[rokshana]

Holy crap! WHO just announced pandemic level...

Discuss!