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Coronavirus Covid-19 (Read 681063 times)

Will Hunt

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#1075 Re: Coronavirus Covid-19
March 26, 2020, 10:35:41 am
Just heard some interesting info from a doctor friend working in anaesthetics in the south-west. He is currently self-isolating for 14 days because his partner has symptoms. Neither of them are being tested, which I questioned the sense of.

Apparently the test has a relatively high false negative rate of about 30%. Which makes me consider that the testing of healthcare professionals at this stage could be a dangerous thing leading to practitioners being sent back to work when they are infectious. The quality of the test does improve as the disease progresses.


I've had a low level headache for about 4 days now, in spite of drinking a lot of water, exercising, eating well and sleeping more than usual. Not bad enough to need paracetamol. I wonder if it's the only symptom I'm showing, or if I'm paranoid.

I think this is symptomatic of spending more time with your wife and children?  ;)

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#1076 Re: Coronavirus Covid-19
March 26, 2020, 10:38:11 am
Hence the need to regularly test Will....

Will Hunt

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#1077 Re: Coronavirus Covid-19
March 26, 2020, 10:43:30 am
Is there any data on how many tests can be globally manufactured and how this might compare with global demand? As dunnyg delights in pointing out, I am in no position of knowledge to criticise government's decision making, but if demand is outstripping supply (which it almost certainly is - vastly) then perhaps it makes sense to keep your powder dry for when you really need it (in a scenario where the lid is blown off the situation and the virus is widespread in the population, this might be approaching and during the peak)?

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#1078 Re: Coronavirus Covid-19
March 26, 2020, 10:44:51 am
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30232-2/fulltext

On this subect of viral load I thought I should maybe be clearer on what this might likely mean. A very high viral load (say from a seriously ill patient coughing in someone's face) might well kill young healthy people with no underlying conditions. It has clear implications for front line NHS staff as well as some for carers and those dealing with a family member in home quarantine. It's why PPE for front line medical staff is so important and even with it some younger healthy medical staff will probably die in overrun wards.

Another good Guardian article on why balancing economics against deaths,  as Trump suggested, is a bad idea right now

https://www.theguardian.com/commentisfree/2020/mar/25/there-is-no-trade-off-between-the-economy-and-health

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#1079 Re: Coronavirus Covid-19
March 26, 2020, 10:50:56 am
Is there any data on how many tests can be globally manufactured and how this might compare with global demand? As dunnyg delights in pointing out, I am in no position of knowledge to criticise government's decision making, but if demand is outstripping supply (which it almost certainly is - vastly) then perhaps it makes sense to keep your powder dry for when you really need it (in a scenario where the lid is blown off the situation and the virus is widespread in the population, this might be approaching and during the peak)?

Its hardly what they decided that is a key concern but what they said. We are now ramping up testing..... etc. It turns out to be significantly bs.

It's not just these tests that are running short.  On a more mundane level Lynn just had her normal March prescription for inhalers, to help get her through some fairly serious spring pollen allergy  problems, refused as a huge spike in demand has led to a need for rationing.

SA Chris

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#1080 Re: Coronavirus Covid-19
March 26, 2020, 10:51:45 am
I think this is symptomatic of spending more time with your wife and children?  ;)

Now we are getting used to it, life stress is actually becoming lower than usual. No commute, no getting kids ready for school, no taxi service for the to numerous activities, no getting clothes sorted. If it wan't such a horrific reason for it, I could adapt to life like this.

Ru

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#1081 Re: Coronavirus Covid-19
March 26, 2020, 11:00:52 am
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30232-2/fulltext

On this subect of viral load I thought I should maybe be clearer on what this might likely mean. A very high viral load (say from a seriously ill patient coughing in someone's face) might well kill young healthy people with no underlying conditions.

I've heard that said before (from doctors), but this papers doesn't seem to say that. It just says that patients with a more severe condition had a higher viral load when tested than those with a less severe condition. I'm not saying you're wrong, just that that isn't a conclusion you can draw from the paper. Disclaimer - I only skim read it.
« Last Edit: March 26, 2020, 11:06:45 am by Ru »

Will Hunt

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#1082 Re: Coronavirus Covid-19
March 26, 2020, 11:12:26 am
And there seems to be confusion about what is meant by viral load. The viral load is just the number of individual viruses that you have in your body. We know that people who achieve a higher viral load will generally be more unwell and will take longer to rid themselves of the infection, but nothing is said about whether this correlates with the infectious dose (a term I just got from a Sky News article), which apparently describes the amount of the virus that you're exposed to at first infection.

So a higher infectious dose could lead to a more severe illness, but that isn't what the linked article is saying.

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#1083 Re: Coronavirus Covid-19
March 26, 2020, 11:18:47 am
I think this is symptomatic of spending more time with your wife and children?  ;)

Now we are getting used to it, life stress is actually becoming lower than usual. No commute, no getting kids ready for school, no taxi service for the to numerous activities, no getting clothes sorted. If it wan't such a horrific reason for it, I could adapt to life like this.

I’m almost enjoying the break, as long as I don’t think about why I’m getting it.

Polly and I have been in a continuous state of sore throat and headache for over a week. No fever. Don’t believe it’s C19.
Royal Marines from Lympstone, have been in confinement for 14 days, with no cases. They have been sent home!

Stu Littlefair

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#1084 Re: Coronavirus Covid-19
March 26, 2020, 11:29:08 am
Stu - the Korean data shows 25% of positive tested <25’s were asymptomatic.

All of the testing been done to date has gaps and flaws that make drawing firm conclusions about anything to do with the virus hard. Tests are not allocated randomly. They're not given often enough, the tests have unknown reliability and specificity. The Diamond Princess is interesting because it's a closed system where nearly everyone was tested, but even then not everyone and not frequently enough.

From what I can gather it is not yet possible to draw solid conclusions about things like the asymptomatic fraction or death rate, and the range of uncertainty allows for epidemiological models to be out by an order of magnitude in terms of outcomes right now.

For those wondering I checked out how my interpretation of the Oxford study matches with people who really do know about epidemiology*. See this thread https://twitter.com/adamjkucharski/status/1242569554171179008?s=21.

*i.e not someone who once wrote a toy model of a zombie apocalypse and is therefore now an "expert".

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#1085 Re: Coronavirus Covid-19
March 26, 2020, 11:34:19 am
Afaik the Koreans have tested far wider than others.

I’d suggest diamond princess js a weak example in many ways  - not a representative set of ages - spurious types of transmission (crew or ventilation) etc.. eg very different contexts of transmission from a city.

Will Hunt

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#1086 Re: Coronavirus Covid-19
March 26, 2020, 11:37:25 am
Using absolutely no data or expertise whatsoever, I have arrived at the conclusion that the most outlandish modelling scenarios, which predict that we're either going to be fine or extinct are those that will be picked up by the press and trend best on social media. The truth is likely to be somewhere in the middle and the best analysis will be done retrospectively when we're all talking about Brexit again.
So probably just best to stay at home, wash your hands, and be jolly careful about going to the shops.

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#1087 Re: Coronavirus Covid-19
March 26, 2020, 11:43:18 am
Will - suggest you are bang on the money.

Tomtom - the point of the Diamond Princess data is not that it's representative or unbiassed, it's that its (relatively) easy to understand and therefore correct for the biasses. For example, the age distribution is skewed, but it's known. And there are enough people on-board to measure the death rates and asymptomatic proportions as a function of age. For example it seems old people are much more likely to be asymptomatic than the young.

However, the key message is not that one dataset is better than another, it is that no dataset currently allows model predictions with any confidence.

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#1088 Re: Coronavirus Covid-19
March 26, 2020, 11:59:04 am
Using absolutely no data or expertise whatsoever, I have arrived at the conclusion that the most outlandish modelling scenarios, which predict that we're either going to be fine or extinct are those that will be picked up by the press and trend best on social media. The truth is likely to be somewhere in the middle and the best analysis will be done retrospectively when we're all talking about Brexit again.
So probably just best to stay at home, wash your hands, and be jolly careful about going to the shops.

I suspect that was the aim of the Oxford paper (a little bit..) :)

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#1089 Re: Coronavirus Covid-19
March 26, 2020, 12:25:34 pm
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30232-2/fulltext

On this subect of viral load I thought I should maybe be clearer on what this might likely mean. A very high viral load (say from a seriously ill patient coughing in someone's face) might well kill young healthy people with no underlying conditions.

I've heard that said before (from doctors), but this papers doesn't seem to say that. It just says that patients with a more severe condition had a higher viral load when tested than those with a less severe condition. I'm not saying you're wrong, just that that isn't a conclusion you can draw from the paper. Disclaimer - I only skim read it.

It's evidence for looking in  the reverse direction..... risk is almost  certainly higher around  those who are seriously ill.

Info on the whistle blowing doctor

https://en.m.wikipedia.org/wiki/Li_Wenliang

More research info on  viral load...
http://www.cidrap.umn.edu/news-perspective/2020/03/italian-doctors-note-high-covid-19-death-rate-urge-action
« Last Edit: March 26, 2020, 12:36:34 pm by Offwidth »

Will Hunt

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#1090 Re: Coronavirus Covid-19
March 26, 2020, 12:47:05 pm
http://www.cidrap.umn.edu/news-perspective/2020/03/italian-doctors-note-high-covid-19-death-rate-urge-action

Could you quote from that article, which bit it is that evidences this statement? I've just read it and can't see anything that indicates such.

A very high viral load [I assume you mean infectious dose] (say from a seriously ill patient coughing in someone's face) might well kill young healthy people with no underlying conditions.

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#1091 Re: Coronavirus Covid-19
March 26, 2020, 01:11:30 pm
https://edition.cnn.com/2020/03/24/europe/austria-ski-resort-ischgl-coronavirus-intl/index.html

Another example of an epicentre that is, in hindsight, easy to understand.

Read the bit at the bottom about whistles and oral beer pong....

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#1092 Re: Coronavirus Covid-19
March 26, 2020, 01:15:59 pm
Your misreading what it evidences: high viral loads in the seriously ill, those who need healthcare. If you have a high viral load you are more likely to infect others seriously when coughing etc, and young healthy doctors have died in such situations. The other research link evidences the early stages of hospitalisation are the periods of highest risk.

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#1093 Re: Coronavirus Covid-19
March 26, 2020, 01:19:58 pm
From how the virologist I worked with on a grant proposal a couple of months back described it to me:

Its not that one virus is going to get you. The body is quite good at fighting them off. But if there is sufficient load (enough viruses) to overwhelm the body’s ability to get rid of them then the get a foothold - multiply rapidly and etc.. etc.. etc..

So if you have a big dollop of viral load - it (a) makes the chance of you getting it higher and (b) makes the impact likely to be higher as your body will have less time to engineer its defences to it.

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#1094 Re: Coronavirus Covid-19
March 26, 2020, 01:22:54 pm
Is there any data on how many tests can be globally manufactured and how this might compare with global demand? As dunnyg delights in pointing out, I am in no position of knowledge to criticise government's decision making, but if demand is outstripping supply (which it almost certainly is - vastly) then perhaps it makes sense to keep your powder dry for when you really need it (in a scenario where the lid is blown off the situation and the virus is widespread in the population, this might be approaching and during the peak)?

It will be more widespread the less testing takes place now.

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#1095 Re: Coronavirus Covid-19
March 26, 2020, 01:23:35 pm
Hence the need to regularly test Will....

Why do we have to regularly test Will? :-\ :-\

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#1096 Re: Coronavirus Covid-19
March 26, 2020, 01:24:43 pm
Hence the need to regularly test Will....

Why do we have to regularly test Will? :-\ :-\

:D

Because.....

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#1097 Re: Coronavirus Covid-19
March 26, 2020, 01:26:45 pm
Let’s eat Grandma.

Or
Let’s eat, Grandma.

Punctuation saves lives.

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#1098 Re: Coronavirus Covid-19
March 26, 2020, 01:27:31 pm
Will/Offwidth/TT

With infections such as this, isn't it well established that the dose (viral load, infectious dose etc. etc.) makes the poison?

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#1099 Re: Coronavirus Covid-19
March 26, 2020, 01:31:40 pm
Will/Offwidth/TT

With infections such as this, isn't it well established that the dose (viral load, infectious dose etc. etc.) makes the poison?

Layman’s comment alert: I don’t really know but what I’ve read suggests that when its in the lungs the body goes into some total immune system overload that swamps it and the kings with fluid. Hence Pneumonia.

 

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