[Health] The Infectious Diseases Thread

[$iljanus]

This is fine.

Did he lose the number for the CDC? (Unless it’s not really him but with this White House the benefit of the doubt kind of went out the window back when the Toddler in Chief was claiming those crowd numbers at his inauguration and it just went downhill from there)

[Dogstar]

Did he lose the number for the CDC? (Unless it’s not really him but with this White House the benefit of the doubt kind of went out the window back when the Toddler in Chief was claiming those crowd numbers at his inauguration and it just went downhill from there)

Unless someone has hijacked his account, it's real. I've gone to his account and it's still up.

[$iljanus]

Did he lose the number for the CDC? (Unless it’s not really him but with this White House the benefit of the doubt kind of went out the window back when the Toddler in Chief was claiming those crowd numbers at his inauguration and it just went downhill from there)

Unless someone has hijacked his account, it's real. I've gone to his account and it's still up.

I can come up with some forgiving explanations for his tweet but Ken is a tool so nah.

[LordMortis]

What's strange about the timing of the markets decision to react is that we just lifted our travel in a plane for work ban. We had put a 100% moratorium on getting on a plane for work until today.

[LawBeefaroni]

You’re Likely to Get the Coronavirus

The virus has raised alarm not despite that low fatality rate, but because of it.

[gameoverman]

From the article

“I think the likely outcome is that it will ultimately not be containable.”

If it's in 24 countries, hasn't that bridge been crossed a long time ago? If it dies out, it won't be because of anything humans did, it'll be due to the virus itself not being able to spread so easily. If does spread easily then we'll all be exposed to it sooner or later. I know nothing about this kind of thing, so maybe I'm very wrong. I suspect that this will just be another flu type illness that makes the rounds every year. We'll most likely have a flu shot for it too, which may or may not work well.

[gilraen]

It's more likely to mutate than to die out. According to some expert theories, the virus would become less fatal as it mutates, not more (since the most virulent strands, that kill their host, wouldn't get a chance to spread to other hosts).

[gameoverman]

It's more likely to mutate than to die out. According to some expert theories, the virus would become less fatal as it mutates, not more (since the most virulent strands, that kill their host, wouldn't get a chance to spread to other hosts).

By 'die out' I meant it would only sporadically pop up every now and again, I should have been more clear on that. It would cease to be something people freak out over. I think it will always be around, in the sense that the common cold or flu are always around. To me, the only real question to resolve is how deadly is it? So far I'm not impressed.

Mutation is another story. If it mutates then we will be back to square one and all bets are off.

[Z-Corn]

My Wife went to the dentist today and he's so concerned about things he gave her a 'script for Amoxicillin 1k mg tabs x30.

I mean, we'll fill and all it but I swim outdoors when it's cold so I'm not too worried about some kinda flu that comes from eating bats or whatever.

[Madmarcus]

I'm not sure I can fault South Korea. It looks like a cult member brought the virus from China. Due to the cult's mass meetings it spread tremendously during the asymptomatic phase and by the time the cases started showing up it was well past containment.

I figure the same thing is probably happening in some other countries (Indonesia, parts of Africa) and they aren't testing or announcing so no one hears about it.

[gilraen]

My Wife went to the dentist today and he's so concerned about things he gave her a 'script for Amoxicillin 1k mg tabs x30.

Concerned about "things"? If she had a procedure where there's a legitimate risk of infection, that's one thing (even then, 30 tablets is a LOT of antibiotics for "just in case"). But I hope he didn't seriously suggest that amoxicillin can help against a virus.

[Daehawk]

The cult forced the members to meet and denied them masks and such too. Fake religion should just be stomped along with all the weak minded members. Stupid cults..

[Blackhawk]

The cult forced the members to meet and denied them masks and such too. Fake religion should just be stomped along with all the weak minded members. Stupid cults..

Not the place, but the problem with this is that it involves someone getting to decide which religions are fake. Does a Christian decide that? A Universalist? An atheist?

[Holman]

The cult forced the members to meet and denied them masks and such too. Fake religion should just be stomped along with all the weak minded members. Stupid cults..

Not the place, but the problem with this is that it involves someone getting to decide which religions are fake. Does a Christian decide that? A Universalist? An atheist?

Plus it's not a specifically religious issue. Rapid spread could happen in any public gathering. (Rub your eyes, touch a doorknob.)

Our largest public public gatherings are commercial spaces, schools, and offices. How does society function when we close those down?

[Blackhawk]

...days-long gaming conventions...

[Z-Corn]

My Wife went to the dentist today and he's so concerned about things he gave her a 'script for Amoxicillin 1k mg tabs x30.

Concerned about "things"? If she had a procedure where there's a legitimate risk of infection, that's one thing (even then, 30 tablets is a LOT of antibiotics for "just in case"). But I hope he didn't seriously suggest that amoxicillin can help against a virus.

Sounds to me that you are just jealous that your dentist isn't a prepper. Hope to see you on the other side bruh.

[Smoove_B]

I legitimately can't even on the Acting Deputy Director of Homeland Security. I mean Jesus Tapdancing Christ.

Latest data I've seen from JAMA study, summarized here:

Researchers from China's Center for Disease Control and Prevention today describe the clinical findings on more than 72,000 COVID-19 cases reported in mainland China, which reveal a case-fatality rate (CFR) of 2.3% and suggest most cases are mild, but the disease hits the elderly the hardest.

This is expected. I did see some chatter about how it was disproportionately worse for men than women (outcomes), but I'm not sure if that was an official study or someone's observation. Also of importance:

In other research news, a study in the International Journal of Infectious Diseases uses data from the Diamond Princess cruise ship to calculate COVID-19's reproductive number (R0, or R-naught), or the number of people a single infected person is likely to infect.

Among the 355 passengers who contracted the virus, the researchers calculated an R0 of 2.28, similar to other R0 modeling published in the past several weeks.

This is also good as it matches earlier calculations suggesting the same number (or thereabouts). These cruise ships are excellent environments to cull data from, so it's nice to see consistency in the numbers.

Again, still not panic time. Absolutely make sure if you regularly take medications you're doing everything you can to get an "emergency" supply to that can cover you for 2-4 weeks of disruptions. I still don't think healthy adults (or kids) have anything to worry about yet and I certainly haven't seen anything from my people suggesting to brace for impact.

[Smoove_B]

Sounds to me that you are just jealous that your dentist isn't a prepper. Hope to see you on the other side bruh.

It was a test and you failed. She should have told him she has plenty of fish antibiotics stashed away and was ready. For you - I'd recommend getting a spare bottle or two of Qui tequila.

[Madmarcus]

I still don't think healthy adults (or kids) have anything to worry about yet and I certainly haven't seen anything from my people suggesting to brace for impact.

I'm not looking forwards to something that has a mortality rate of 2 percent even if it is mostly elderly men. I am bracing for the impact of a huge spike in socially enforced self quarantine and disrupted daily life as a potentially a significant fraction of the population is sick and the rest actively tries not to get sick.

[Smoove_B]

From earlier, it has a mortality rate of 2% because of the current numbers in the equation. As this continues to spread that number will likely go down. Or if it mysteriously and suddenly stops (like SARS), it will forever be an outbreak impacting whatever the final count is (100K? 150K?) with the tallied death rate associated. This is the difficulty with understanding how it all works - you're seeing rolling calculations from a story that hasn't finished yet. We're only seeing the numbers from identified cases and comparing how many of them died. Spoiler: We haven't identified 100% of the cases of novel coronovirus so that denominator is likely much larger. Why? Because it's highly likely there are people with the virus that are sub-clinical in presentation.

Calls for social distancing and government plans in the U.S. for voluntary self-quarantine are possible. I remember helping to review proposed plans at a State and County level 17+ years ago as part of a committee. I personally worked on a plan for a community college ~15 years ago trying to cover the same elements. The point is, there are absolutely plans out there. How your locals are going to deal with it, I can't say - but it shouldn't cause stress to think that's part of the plan. instead, do what you can to be prepared because the locals/county/state/feds can't be everywhere at once.

[Anonymous Bosch]

I still don't think healthy adults (or kids) have anything to worry about yet and I certainly haven't seen anything from my people suggesting to brace for impact.

I'm not looking forwards to something that has a mortality rate of 2 percent even if it is mostly elderly men.

FWIW, I suspect this has much to do with the reason Covid-19 has been deadlier for elderly men in China:

Cigarettes are an increasingly gendered health risk in China, according to a new study that reports 68% of Chinese men smoke, compared to just 3.2% of women.

[Smoove_B]

That's definitely one of the working theories - and it's likely a good one. Here the comorbidity would be complications related to chronic smoking.

The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome.

I imagine Dana Scully telling me these things and go to my happy place.

[Madmarcus]

I'm sure that is a big part of the difference. I wouldn't be surprised if there is also a difference due to more men involved in (or previously involved in) outdoor work in polluted environments.

[disarm]

My Wife went to the dentist today and he's so concerned about things he gave her a 'script for Amoxicillin 1k mg tabs x30.

Concerned about "things"? If she had a procedure where there's a legitimate risk of infection, that's one thing (even then, 30 tablets is a LOT of antibiotics for "just in case"). But I hope he didn't seriously suggest that amoxicillin can help against a virus.

That's not really a lot of amoxicillin...1000mg pill, 3x/day for ten days is the standard dosing regimen for an adult. Amoxicillin is also a totally accepted first-line choice for treating just about any dental infection.

I have no idea what Z-corn's wife has going on, but I highly doubt it has anything to do with coronavirus.

[Daehawk]

The couple from Chattanooga that was taken off the ship and is in quarantine until March 2 will be home then. They finally got tested after demanding it. For some reason the US or CDC simply locked them away and wouldn't even test them...just monitored their temps. Seems stupid. Everyone should have been tested so they could get a jump on treatment instead of waiting so long. They should have their results soon. Hope its before they come home.

[Z-Corn]

Sounds to me that you are just jealous that your dentist isn't a prepper. Hope to see you on the other side bruh.

It was a test and you failed. She should have told him she has plenty of fish antibiotics stashed away and was ready. For you - I'd recommend getting a spare bottle or two of Qui tequila.

This guy preppers...

[Smoove_B]

The couple from Chattanooga that was taken off the ship and is in quarantine until March 2 will be home then. They finally got tested after demanding it. For some reason the US or CDC simply locked them away and wouldn't even test them...just monitored their temps. Seems stupid. Everyone should have been tested so they could get a jump on treatment instead of waiting so long. They should have their results soon. Hope its before they come home.

In short, this is protocol. There was concern because they were exposed but had not yet been showing signs of illness. Offering them a test is pointless if they're not actually ill. So instead, they're held for a period of time in observation covering the suspected incubation period of the disease to see if anything happens to them (i.e. they develop illness). Why this wasn't communicated clearly to them or why there's confusion over what was happening is a better question. "Testing everyone" isn't feasible or necessarily useful. Detaining people until it can be demonstrated they likely aren't ill is the plan and how quarantine works. "Simply locked away" is disingenuous; we've come a long way since Mary Mallon.

[malchior]

From earlier, it has a mortality rate of 2% because of the current numbers in the equation. As this continues to spread that number will likely go down. Or if it mysteriously and suddenly stops (like SARS), it will forever be an outbreak impacting whatever the final count is (100K? 150K?) with the tallied death rate associated. This is the difficulty with understanding how it all works - you're seeing rolling calculations from a story that hasn't finished yet. We're only seeing the numbers from identified cases and comparing how many of them died. Spoiler: We haven't identified 100% of the cases of novel coronovirus so that denominator is likely much larger. Why? Because it's highly likely there are people with the virus that are sub-clinical in presentation.

I think it'll also matter what the distribution of infected actually ends up. I saw some early numbers that it was around 0.2% up to about 50+ and was in the mid-teens at 80%. So a mortality rate with a severe skew as age increases. And those numbers don't include the mild non-reported cases.

[$iljanus]

That's definitely one of the working theories - and it's likely a good one. Here the comorbidity would be complications related to chronic smoking.

The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome.

I imagine Dana Scully telling me these things and go to my happy place.

And I wonder if the notoriously bad air quality in parts of China also contributes to complications. (it really is cooler when the voice of Dana Scully is telling us all these things!)

Ooh a Lancet article. Thanks Smoove!

[Daehawk]

From the videos in China Ive watched of the guys who live there Chinese smoke like Americans of the 1930s and 1940s. They also spit everywhere and let their kids pee on the sidewalks. Nasty ass place.

[Blackhawk]

In short, this is protocol. There was concern because they were exposed but had not yet been showing signs of illness. Offering them a test is pointless if they're not actually ill. So instead, they're held for a period of time in observation covering the suspected incubation period of the disease to see if anything happens to them (i.e. they develop illness).

Out of curiosity, how does this account for asymptomatic carriers?

[Blackhawk]

As far as preparedness goes, is it ever a bad idea to be prepared for an unforeseen problem in the supply lines? I know around here if you just say the word snow, milk and bread disappear like it's a magic trick. What's the line from MIB ? A person is smart, but people are dumb, panicky, scared animals? When I think of preparedness, I think about what the folks around me might do when they panic.

It is when you have so little space that a week's worth of supplies for four people could only be stored in boxes in the middle of the floor. There just isn't any space for storage in my house, and laying in a week's worth of extra provisions is going to require that I take stuff I use regularly and put it into storage across town. And there's also the issue of the cost when you're living paycheck to paycheck.

It's never a bad idea, but it does come with some significant costs for some of us.

Y'all eat peanut butter anyway? Oats? Water is definitely tough. If I'm willing to eat crap and carbs I usually stock my small pantry with sustaining if not healthy foods for a week.
Ramen, PB, pasta, baking needs flour, salt, water yeast, sugar.
Speaking of I think I'm going to go ahead and get a 4th larger water jug. We got a cooler for my in-laws because they won't drink tap. But I will say having 15 gallons of drinking water on hand at all times is nice. k

Yeah, yeah. I went and picked up a few bags of this and that, stuff that will last at least a year without spoilage. I'll supplement it a bit more over the next couple of shopping trips. With care, it should give us enough to skip a weekly shopping trip or two in a pinch.

[Smoove_B]

It doesn't. *But* if you had an asymptomatic carrier in quarantine with other people and you then started seeing newly emerging cases of illness, that would support the theory that asymptomatic carriers exist and that they could be a major problem. Without a reliable test that can demonstrate exposure and circulating antibodies (or some other sub-clinical indicator), all we can do is watch.

So for example, we know that exposure occurred on Day 4 of the month, so we want to keep people in quarantine then until Day 18 at a minimum to make sure they're outside the period of time where we'd be concerned they'd be developing illness. However, let's say all of a sudden you start seeing half a dozen people getting sick on Day 17 and the historical math is telling you that you'd expect most infections for people in quarantine to appear somewhere around Day 11 on average. To have a large number appearing so far at the end of the expected range suggests either your sample calculations are wrong -or- there's something else going on with the quarantined people.

In truth the asymptomatic people might develop something useful (elevated white blood cell counts, slight fever, some type of detectable protein or waste product in their blood) that wouldn't cause visible signs or symptoms but that can be used to identify them.

That's why it's so important for us to follow these quarantine protocols - so we can experiment on people. I mean, uhh..so that we can learn new things about disease etiology. Carry on.

[Smoove_B]

Needs to be repeated, far and wide:

The CDC urged American businesses and families to start preparing for the possibility of a bigger outbreak. Messonnier said that parents should ask their children’s schools about plans for closures. Businesses should consider whether they can offer telecommuting options to their employees, while hospitals might need to look into expanding telehealth services, she said.

“Disruption to everyday life might be severe,” Messonnier said, adding that she talked to her children about the issue Tuesday morning. “While I didn’t think they were at risk right now, we as a family ought to be preparing for significant disruption to our lives.”

Hopefully it's just preparation, but better to start thinking about this now than panicking and trying to figure out something if the situation gets nutty.

[Jeff V]

Without a reliable test that can demonstrate exposure and circulating antibodies (or some other sub-clinical indicator), all we can do is watch.

But has anyone attempted the tried-and-true method of lashing their feet to a heavy stone and seeing if they can float?

[Alefroth]

The cult forced the members to meet and denied them masks and such too. Fake religion should just be stomped along with all the weak minded members. Stupid cults..

Classic Dae.

[gameoverman]

Needs to be repeated, far and wide:

The CDC urged American businesses and families to start preparing for the possibility of a bigger outbreak. Messonnier said that parents should ask their children’s schools about plans for closures. Businesses should consider whether they can offer telecommuting options to their employees, while hospitals might need to look into expanding telehealth services, she said.

“Disruption to everyday life might be severe,” Messonnier said, adding that she talked to her children about the issue Tuesday morning. “While I didn’t think they were at risk right now, we as a family ought to be preparing for significant disruption to our lives.”

Hopefully it's just preparation, but better to start thinking about this now than panicking and trying to figure out something if the situation gets nutty.

It would be more helpful of the CDC if they'd say what the trigger point is. If they just say "X might happen" that's almost useless. It's the bare minimum statement required to qualify as pure speculation. Information on how big an outbreak in any given city is unacceptable, or how many cities need to be involved to start the shutdown, and how long the disruption can be expected to last, etc would give their warning more credibility.

[LawBeefaroni]

Happened to be out of the county on Friday and picked up a few thousand rounds of ammo. I stock up because of the insane tax here and it's a 2 hour round trip, so when I find myself out there I take advantage.

But the guy at the register was like, "Coronavirus, ammirite?". He said they were selling a ton of ammo, dry rations, and water purifier supplies.

[Smoove_B]

It would be more helpful of the CDC if they'd say what the trigger point is. If they just say "X might happen" that's almost useless. It's the bare minimum statement required to qualify as pure speculation. Information on how big an outbreak in any given city is unacceptable, or how many cities need to be involved to start the shutdown, and how long the disruption can be expected to last, etc would give their warning more credibility.

Short answer: No one knows (level of disruption, exact trigger point). Or if they do, it's information above my pay grade. Kinda like pornography you know it when you see it.

Longer answer: The trigger point will be when this novel coronavirus starts popping up in multiple (I'll say 3+), distant locations all within a few days. So cases in NYC, and major metro areas of Texas and then California all within a 5 day period. That's my unofficial educated guess.

How long will disruptions last? Again, no one knows. They might ask for voluntary self-quarantines to last a week and recommend public facilities (schools, movie theaters, etc...) close. They might stretch it to two weeks. We are in uncharted waters at this point, quite frankly. We have plans and models, but nothing on this scale has ever been enacted in the United States.

Everyone is thinking about their health, but the bigger issues associated with disruption (loss of wages over inability to work, potential issues with maintenance of power/water/solid waste collection services, maintaining police/fire/EMT/medical readiness, supply chain disruptions (food, medications), etc...) is going to really be the challenge.

I still don't think the disease is the concern here. Panic is still the issue in the short term and then any panic that bubbles up from anything that's done to mitigate overwhelming our systems.

[Alefroth]

Happened to be out of the county on Friday and picked up a few thousand rounds of ammo. I stock up because of the insane tax here and it's a 2 hour round trip, so when I find myself out there I take advantage.

But the guy at the register was like, "Coronavirus, ammirite?". He said they were selling a ton of ammo, dry rations, and water purifier supplies.

What's the best round for a virus?