Covid19

[j44ke]

I thought this article was a really interesting summary of recent shifts in medical approaches and the evolution of “proning” as an effective way to delay the use of ventilators.

What Doctors on the Front Lines Wish They’d Known a Month Ago - The New York Times

[Chik]

Doug, more later, but first, those 2 pics are identical.

[Too Tall]

I thought this article was a really interesting summary of recent shifts in medical approaches and the evolution of “proning” as an effective way to delay the use of ventilators.

What Doctors on the Front Lines Wish They’d Known a Month Ago - The New York Times

Good stuff Jorn. Thanks

[j44ke]

Doug, more later, but first, those 2 pics are identical.

Think Doug was suggesting that with or without any commuting regulation, the crowds looked the same. Wry humor in other words.

Or as our neighbor in the city put it, also with a bit of wry humor, "If everyone is working from home, who will operate the fax machine?" His wife is Japanese and they have this very large fax machine in their home office, because everything she does (she runs gourmet tours in Japan) requires faxing things back and forth.

[j44ke]

Good stuff Jorn. Thanks

You betcha.

This is the first article where I have seen a doctor refer specifically to obesity as being a risk factor - though perhaps obesity is a general condition that contains within it many different risk factors.

[crumpton]

Stupid question for the folks with this kind of knowledge. I respectfully request the speculators pass on a response unless it is to point just how stupid I am but please no need to speculate that, it's already a widely known fact.

You know the old saying, you can't get a little bit pregnant? With a virus like this, does volume of exposure matter? I mean if you catch a tad of exposure say from a bit of virus on the hand to your face or a small whiff vs. having a huge amount blown right into your face while taking a deep breathe... is it the same either way or can a larger exposure have a more dire consequence?

[Bobonli]

Stupid question for the folks with this kind of knowledge. I respectfully request the speculators pass on a response unless it is to point just how stupid I am but please no need to speculate that, it's already a widely known fact.

You know the old saying, you can't get a little bit pregnant? With a virus like this, does volume of exposure matter? I mean if you catch a tad of exposure say from a bit of virus on the hand to your face or a small whiff vs. having a huge amount blown right into your face while taking a deep breathe... is it the same either way or can a larger exposure have a more dire consequence?

Google “viral load”. And then realize that it’s impossible I think for anyone to know what the precise load is for any particular person. My immune system is different from yours etc. Is it one sneeze, three, spit in the face? I don’t know that. I know within a reasonable degree of medical certainty that I’ve been exposed and am not sick. I know I’ve been in direct contact via needle sticks as an ED nurse and medic with Hep and HIV yet I’ve never tested positive or been sick because the amount of exposure was insufficient to cause a conversion.

I’m working from the position that everyone has been exposed at this point but maybe not with sufficient effect to create a positive test or provoke illness.

[beeatnik]

Stupid question for the folks with this kind of knowledge. I respectfully request the speculators pass on a response unless it is to point just how stupid I am but please no need to speculate that, it's already a widely known fact.

You know the old saying, you can't get a little bit pregnant? With a virus like this, does volume of exposure matter? I mean if you catch a tad of exposure say from a bit of virus on the hand to your face or a small whiff vs. having a huge amount blown right into your face while taking a deep breathe... is it the same either way or can a larger exposure have a more dire consequence?

How Does the Coronavirus Behave Inside a Patient? | The New Yorker

[Paul Jacobs]

Stupid question for the folks with this kind of knowledge. I respectfully request the speculators pass on a response unless it is to point just how stupid I am but please no need to speculate that, it's already a widely known fact.

You know the old saying, you can't get a little bit pregnant? With a virus like this, does volume of exposure matter? I mean if you catch a tad of exposure say from a bit of virus on the hand to your face or a small whiff vs. having a huge amount blown right into your face while taking a deep breathe... is it the same either way or can a larger exposure have a more dire consequence?

It is a really good question. The suggestion has been made that the mortality among some relatively fit healthcare workers can be explained because they received a very high initial load of the virus, from close contact with their patients, resulting in more severe disease than if the initial load of virus had been smaller, say from passing an infected person in the street. Diseases like mumps can effect the second and third child in a family more severely than the first. The argument is that the first child is infected by a low load of virus from outside the family. The virus then replicates in the first child who then infects his or her siblings with a higher initial load resulting in more severe disease.

I would be interested if anyone has any more evidence about these ideas which initially are just anecdotal.

[crumpton]

It is a really good question. The suggestion has been made that the mortality among some relatively fit healthcare workers can be explained because they received a very high initial load of the virus, from close contact with their patients, resulting in more severe disease than if the initial load of virus had been smaller, say from passing an infected person in the street. Diseases like mumps can effect the second and third child in a family more severely than the first. The argument is that the first child is infected by a low load of virus from outside the family. The virus then replicates in the first child who then infects his or her siblings with a higher initial load resulting in more severe disease.

I would be interested if anyone has any more evidence about these ideas which initially are just anecdotal.

This is exactly why I asked. It was sort of a question about those folks who are working in ICUs. Yes, I understand their risk of exposure is MUCH higher than ours staying at home. I'm curious about the odds of exposure vs the volume of virus in a given exposure. Thanks for the response.

[Paul Jacobs]

You betcha.

This is the first article where I have seen a doctor refer specifically to obesity as being a risk factor - though perhaps obesity is a general condition that contains within it many different risk factors.

Good article thanks Jorn. About three weeks ago I decided to reduce my alcohol intake and also reduce my body weight to improve my chances. I am not very worried but, at the age of 68, any little I could do to help seemed sensible. So far I have succeeded rather better at cutting alcohol than reducing my weight. Restricted opportunities for outside exercise do not help.

[Matthew Strongin]

Good read on the importance of testing.

Coronavirus tests: Why the US needs millions of tests per day - Vox

[Chik]

Think Doug was suggesting that with or without any commuting regulation, the crowds looked the same. Wry humor in other words.

Or as our neighbor in the city put it, also with a bit of wry humor, "If everyone is working from home, who will operate the fax machine?" His wife is Japanese and they have this very large fax machine in their home office, because everything she does (she runs gourmet tours in Japan) requires faxing things back and forth.

Doh!

It just so happens I spent about an hour today discussing just this with a Tokyo-based client. It's a complicated situation, to put it mildly.

I don't think there is anyone doubting that the Olympics, before and after the official announcement for a postponement, had impact on the actions, and their timing thereof, to date. Ergo, they got off to a bad start.

Thanks to the constitutional changes that the US imposed shortly after WW II, the Japanese government cannot restrict movement of people. That makes an enforceable lockdown a legal impossibility, which obviously means that there is no consequence for non-compliance. Similarly, they cannot force nonessential businesses to shut down. All they can do is to request people to keep a distance, work from home, etc.

Essentially, it boils down to societal / peer pressure to get the job done. It probably means that it needs to be a phased approach.

Major retailers, such as department stores, not just in the 7 prefectures where emergency was declared but nationally, have shuttered except for food halls at branches where there are few alternatives to buy food in the area. Although some non-essential shops are still open, the shopping traffic has almost evaporated in Tokyo.

The issue has been with jobs. Many companies are not set up for people to work remotely. Policies & procedures are not in place. Hardware, software and network infrastructure are not necessarily in place. The whole remote-working thing is so alien culturally. So, people still go to work. Some companies have cut down on hours to avoid rush hours and have staff clock in every other day.

Government subsidies have been announced, but it's not clear to everyone how they are going to work. For SMEs, it is reasonably clear, but a basic requirement for receiving payroll aid is that the employers be able to show proper payroll records, which not every SME has and therefore cannot qualify for aid. That in turn keeps them operating as usual.

The streets are basically deserted aside from commuter rush hours as a result. So, yes, depending on the time of day, it looks like that in front of a main station.

There are signs of residents applying pressure to those that are obviously flaunting the "request", for example, uploading on Twitter photos of cars with Tokyo plates spotted in the provinces.

As Jorn made a good point about 3 weeks being the limit for people to be cooped up, the speculation, in the absence of a legal lockdown, is that the government will be declaring state of emergency in the remainder of the country just before the start of Golden Week to limit domestic holiday travels by enabling provincial governors to tell metropolitan residents to stay the f away. The hypothesis is that if they had done it nationwide at the start, by the time the holiday week (starting 29 April) came around, people throughout the country will have suffered cabin fever, likely causing a complete failure during that week with people just going places in all directions during that week.

I'm not being particularly articulate this evening, worse than usual, but the speculation is that "requests" for restrictions by the Tokyo governor will go up a few notches by the end of this month, and once that's announced, the rest of the country will follow. (Nothing will happen unless Tokyo does it.)

Long story short, no, the progress is appallingly slow. There is a lot of cultural reasons being cited for the phased approach, but I still think they are just excuses when lives are at stake. Some clearly don't have the sense of urgency. It doesn't help that there is no legal way to enforce a solution, however.

On balance, I still think that economic concerns are taking precedence over public health concerns, which we all know that they have it backwards. Otherwise, I think the useless PM would be using stronger words to persuade residents to get their shit together.

[beeatnik]

Around here a lot of people are staying home all the time; some are not.

SIPs are so weird.

I know people are hurting financially. I know people want to get back to work. I know people are bored out of their minds and feeling trapped.

But why are they being selfish jerks?

My wife and I live in a large apartment building on a higher floor and can see (and hear when windows are open) cars on a major local road known as the Riverway. The traffic is 10x more this morning than it has been in a few weeks. We also can see 10x more people getting on and off the local T (aka subway).

We live down the street from a few major hospitals (many doctors and nurses live in our building) and can tell the difference between medical professionals going to work and people who should still be at home under the local stay-at-home-order. Most of these people are not "essential" workers who suddenly needed to go back to work today.

WTF people? Do you all want to die and make the rest of us sick? I am so tired of people, of all ages, not respecting the stay at home order, not respecting physical distancing, and generally not giving a damn. They are the reason more people are getting sick and dying.

[Chik]

There's been some noise about the BCG vaccine being effective against our fave bug. It would have been good news, but this McGill prof is being a bit more rational:

BCG Against Coronavirus: Less Hype And More Evidence, Please

On the other hand, this is delightful news from Taiwan. Yes, curtailing of privacy is controversial, but I'm inclined to think that there are times when it's necessary for the benefit of the general public.

Taiwan Reports No New Coronavirus Cases, Adding To Success In Fighting Pandemic : Coronavirus Live Updates : NPR

[Too Tall]

There's been some noise about the BCG vaccine being effective against our fave bug. It would have been good news, but this McGill prof is being a bit more rational:

BCG Against Coronavirus: Less Hype And More Evidence, Please

On the other hand, this is delightful news from Taiwan. Yes, curtailing of privacy is controversial, but I'm inclined to think that there are times when it's necessary for the benefit of the general public.

Taiwan Reports No New Coronavirus Cases, Adding To Success In Fighting Pandemic : Coronavirus Live Updates : NPR

Apparently Google et. al. is on it.

For the record I want my Antibody Cert bracelet to be purple metal flake.

[ides1056]

There's been some noise about the BCG vaccine being effective against our fave bug. It would have been good news, but this McGill prof is being a bit more rational:

BCG Against Coronavirus: Less Hype And More Evidence, Please

On the other hand, this is delightful news from Taiwan. Yes, curtailing of privacy is controversial, but I'm inclined to think that there are times when it's necessary for the benefit of the general public.

Taiwan Reports No New Coronavirus Cases, Adding To Success In Fighting Pandemic : Coronavirus Live Updates : NPR

I passed a woman from Taiwan as I rode along Rt 98 on the Gulf Coast on March 15th. She was heading East, and we stopped and chatted for a bit. I told her what to expect ahead, and she told me how Taiwan had handled the prospect of pandemic. Night and day. As chance would have it, we had the same name, spelled completely differently.

[davids]

There's been some noise about the BCG vaccine being effective against our fave bug. It would have been good news, but this McGill prof is being a bit more rational:

BCG Against Coronavirus: Less Hype And More Evidence, Please

On the other hand, this is delightful news from Taiwan. Yes, curtailing of privacy is controversial, but I'm inclined to think that there are times when it's necessary for the benefit of the general public.

Taiwan Reports No New Coronavirus Cases, Adding To Success In Fighting Pandemic : Coronavirus Live Updates : NPR

One of my asst directors is Cambodian-born and got this as a child. He think it's what saved him from infection from another staffperson who has COVID.

Hey, it makes him feel good!

[Chik]

One of my asst directors is Cambodian-born and got this as a child. He think it's what saved him from infection from another staffperson who has COVID.

Hey, it makes him feel good!

Yeah, I have one too, have the scar to prove it, but not sure about relying on it for immunity, especially since I don't think I ever got a booster.

[NYCfixie]

At this point, it seems like everyone with resources should have a mask.

The people who are pissing me off are the people who are not wearing masks. Especially the young couple having a loud video chat with a friend while walking down Centre St Sunday afternoon, or the young couple walking their dog towards the Public Garden this morning.

Hey, I don't like looking like some paranoid loser in my bike helmet, facemask and nylon jacket over knickers (even though my luxurious Zank gives me so much street cred...) but I am doing what is necessary to protect myself and everyone else I encounter.

Get over yourselves and comply for all of us!

Not trying to sound like a broken record and not trying to beat a dead horse but...

Traffic today is as busy as yesterday so this is not an anomaly. (Many) people are not staying home anymore as they should. And there are far fewer people in the muddy river walking, jogging, running, and cycling on this nice and sunny weekday, as there have been the past 3 weeks, so I assume it is related and they all went back to work (yesterday).

MA has a stay-at-home-advisory (not order) so its not like officials can do anything about it.