Pause for thought

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3 days 23 hours ago #44223 by Isamorph
Replied by Isamorph on topic Pause for thought
Unfortunately, given the devastation done by Covid-19 to the elderly Italian population, the average age of Italians has probably already gone down.

"One factor in the high death toll so far is the high median age in Italy, which is 47 years, compared to 37 in China and 38 in the U.S. Stated as a percentage of the total population, Italy has more people over the age of 80, 90, or 100 than any other major industrialized country except Japan. "

www.usatoday.com/story/news/world/2020/03/19/coronavirus-italy-now-has-more-covid-19-deaths-than-china/2873835001/
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3 days 20 hours ago - 3 days 20 hours ago #44226 by Soteria 2.0
Replied by Soteria 2.0 on topic Pause for thought

PEW wrote:

y4vix wrote: Hydroxychloroquine

Hydroxychloroquine did very well against the Coronavirus in reported usage by doctors in China and France (with a very small sample size)
Now, President Trump and Gov. Cuomo are working together to give it a truly substantive trial in New York State
A relatively large number of dosages (750,000) will be administered in NY State beginning today.
The reported results in China and France showed significant improvement in about 6+ days. So, about a week or so from now, we should have some evidence (pro or con).
Fingers crossed!


thehill.com/policy/healthcare/489097-man-dies-after-taking-chloroquine-phosphate-in-effort-to-prevent-coronavirus[/quote


A man thought aquarium cleaner with the same name as the anti-viral drug chloroquine would prevent coronavirus. It killed him.


A medical staffer displays packets of tablets containing chloroquine and hydroxychloroquine, drugs that have shown signs of effectiveness against the coronavirus.
By Katie Shepherd
March 24, 2020 at 6:09 AM EDT
In Maricopa County, Ariz., a couple in their 60s watched politicians and news anchors on TV tout chloroquine, an anti-malaria drug that has shown the ability to disrupt some viruses but that has not yet been proved effective against the novel coronavirus.

That pharmaceutical name matched the label on a bottle of chemicals they used to clean their koi pond, NBC News reported. The fish tank solvent that treats aquatic parasites contains the same active ingredient as the drug, but in a different form that can poison people.


“I saw it sitting on the back shelf and thought, ‘Hey, isn’t that the stuff they’re talking about on TV?’ ” the wife, who was not named, told the network.


“We were afraid of getting sick.”

The couple reportedly poured some of the fish tank cleaning chemical, chloroquine phosphate, into soda and drank it. They hoped it would stave off a coronavirus infection.


Maybe, one should not mix koi pond cleaner with soda.

And expect a different outcome.

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1 day 9 hours ago - 1 day 8 hours ago #44251 by y4vix
Replied by y4vix on topic Pause for thought
This article appeared in yesterday's New England Journal of Medicine.

It is authored by Anthony S. Fauci, M.D., H. Clifford Lane, M.D., and Robert R. Redfield, M.D.

I've read it several times . And the following paragraph has given me pause for thought:

On the basis of a case definition requiring a diagnosis of pneumonia, the currently reported case fatality rate is approximately 2%.4 In another article in the Journal, Guan et al.5 report mortality of 1.4% among 1099 patients with laboratory-confirmed Covid-19; these patients had a wide spectrum of disease severity. If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.2

( Note: all the above bold highlighting was done by me, and did not appear that way in the actual article. This bold highlighting was the only alteration I made)

www.nejm.org/doi/full/10.1056/NEJMe2002387
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1 day 8 hours ago - 1 day 7 hours ago #44252 by Isamorph
Replied by Isamorph on topic Pause for thought
Let's hope that the CFR ends up much less than 1% because even at 0.5%, other things being equal, it would be 5x more deadly than the seasonal flu.

"Coronavirus vs. the Flu: The Difference Between a 1% and 0.1% Fatality Rate Is Huge".... What does “ten times more lethal” mean? — the math is simple. If 40 million Americans get the seasonal flu, a 0.1 percent fatality rate means 40,000 deaths. If 40 million Americans get the new coronavirus, a 1 percent fatality rate means 400,000 deaths."

Not to mention the RO or "R nought", transmission rate, of Covid-19 is likely greater or worse, other things being equal, than the seasonal flu. Need more stats, which are always in flux.

www.vox.com/science-and-health/2020/3/18/21184992/coronavirus-covid-19-flu-comparison-chart

"To answer Limbaugh’s question — What does “ten times more lethal” mean? — the math is simple. If 40 million Americans get the seasonal flu, a 0.1 percent fatality rate means 40,000 deaths. If 40 million Americans get the new coronavirus, a 1 percent fatality rate means 400,000 deaths."

ourworldindata.org/coronavirus#what-do-we-know-about-the-risk-of-dying-from-covid-19

www.nationalreview.com/corner/coronavirus-vs-the-flu-the-difference-between-a-1-and-0-1-fatality-rate-is-huge/

www.cebm.net/covid-19/global-covid-19-case-fatality-rates

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1 day 7 hours ago #44254 by st3fx
Replied by st3fx on topic Pause for thought
Seasonal influenza does not present this challenge of a large volume of patients requiring medical care simultaneously (not to mention there are vaccines for seasonal influenza that afford some protection).

When hospitals/providers are at capacity or lacking necessary medical supplies/equipment, the fatality rate will be higher than if every patient can be treated appropriately.

Also, providers will have to make tough choices if beds/ventilators are unavailable or if they are unable to safely resuscitate a patient.

Even with experimental drugs, drug combinations or even potential vaccines, there will be supply shortages due to overwhelming demand. Drug companies are not likely to boost production to sustainable levels for "compassionate care" until they have formal FDA approval.

The quality of patient care will likely degrade rapidly as the infection rate moves toward the apex of the curve. Many will die that could have been saved.

Stay safe.
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1 day 2 hours ago #44260 by Soteria 2.0
Replied by Soteria 2.0 on topic Pause for thought

Isamorph wrote: Unfortunately, given the devastation done by Covid-19 to the elderly Italian population, the average age of Italians has probably already gone down.

"One factor in the high death toll so far is the high median age in Italy, which is 47 years, compared to 37 in China and 38 in the U.S. Stated as a percentage of the total population, Italy has more people over the age of 80, 90, or 100 than any other major industrialized country except Japan. "

www.usatoday.com/story/news/world/2020/03/19/coronavirus-italy-now-has-more-covid-19-deaths-than-china/2873835001/



Wonderful news!

The Miraculous ‘Mr. P’: 101-Year-Old Italian Man Beats Coronavirus
Carlie PorterfieldForbes Staff
Business
I cover breaking news.
Tre Martiri Square in Rimini - Italy
A 101-year-old coronavirus survivor in Rimini, [+]
GETTY
Topline: A 101-year-old man in Rimini, Italy, was released from the hospital Thursday after recovering from the coronavirus—putting him among the oldest people on record to survive the virus, believed to be far more deadly for the elderly.
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23 hours 31 minutes ago #44261 by PEW
Replied by PEW on topic Pause for thought
With seasonal flu, those who needs a bed (MSU or ICU) get a bed, thus the mortality rate. With COVID-19, the sick may not have a bed, so even if "only 5-10x" more deadly, the fact that those needing a bed do not get one, the actual mortality will be much higher.

Also, seems the patients linger on much longer with COVID-19 vs normal, thus taking up even more resources (bed-days).

Hard to be optimistic without access to a time machine to go back a few years. ;)

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11 hours 38 minutes ago #44265 by Soteria 2.0
Replied by Soteria 2.0 on topic Pause for thought
101-year-old Italian man, born amid Spanish flu pandemic, survives coronavirus illness, official says
RYAN W. MILLER | USA TODAY | 19 hours ago



USA TODAY,

A 101-year-old Italian man has reportedly survived his battle with COVID-19, the disease caused by the new coronavirus spreading around the globe.


An official from the city of Rimini on the northeast coast of Italy says the man, identified publicly as only Mr. P., was released from the hospital earlier this week.

"He made it. Mr. P. made it," said Gloria Lisi, vice mayor of Rimini, according to ANSA, the Italian news agency.

"Even at 101 years, the future is not written," she added, per CNN.

Italy, particularly the northern part of the country, has faced a severe public health crisis amid the COVID-19 outbreak as hospitals have been pushed to their limits with the mass influx of patients sickened by the highly contagious virus.




The entire country was ordered to stay locked down to fight the spread of the coronavirus, and as of Friday, more than 80,000 people are known to have tested positive, leading to more than 8,200 deaths, according to a Johns Hopkins University tracker.

Per ANSA, Lisi said that the 101-year-old was admitted to a hospital in Rimini last week after testing positive for the virus.




She also noted the man, born in 1919, entered the world during another pandemic: The Spanish flu, an H1N1 virus that spread from 1918 to 1919 and killed at least an estimated 50 million people worldwide, according to the U.S. Centers for Disease Control and Prevention.

"He saw everything, Mr. P. War, hunger, pain, progress, crisis and resurrections," Lisi said.


Mr. P
has survived two pandemics, it is incredible.
Rimini,
is overjoyed.

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11 hours 6 minutes ago #44267 by Soteria 2.0
Replied by Soteria 2.0 on topic Pause for thought
HEALTH
Blood Plasma Treatment for Coronavirus Set to Get Its First Trial Run in New York

ALICE PARK March 26, 2020
The New York Blood Center (NYBC) is the first blood-gathering organization in the U.S. to collect plasma from COVID-19 patients to use as a possible treatment for the disease.

Before antibiotics rendered the practice moot, it was common to treat infectious bacterial diseases by infusing the blood of recovered patients into those struggling with infection. That approach has also been tried against viral infections like H1N1 influenza, SARS and MERS, with inconsistent success. Some patients benefited, but other did not and doctors don’t have a clear understanding of why. But during an evolving pandemic like COVID-19, plasma-based treatments can provide a critical stop-gap while therapies and vaccines are developed.

The idea is relatively simple, and based on the concept of passive immunity. People who have recovered from an COVID-19 infection have likely done so because their immune systems developed strong immune responses to SARS-CoV-2, the virus that causes the illness. As a key part of their response, they make antibodies, including both general microbial killers and specialized cells that target just the proteins found on SARS-CoV-2. In theory, these antibodies could be taken from a recovered COVID-19 patient, and infused into someone recently infected with the virus. “The thought is that if you passively infuse someone who is actively sick, the antibodies may temporarily help a sick person fight infection more effectively, and get well a little bit quicker,” says Dr. Bruce Sachais, chief medical officer of New York Blood Center Enterprises.


While the therapy is still experimental, the U.S. Food and Drug Administration on March 24 allowed doctors to use plasma from recovered patients to treat those with “serious or immediately life-threatening COVID-19 infections” under an emergency approval system. Doctors can apply to the FDA to use it for their patients, and the agency will review the requests quickly and make decisions on a case by case basis.

Sachais says NYBC is ready to begin collecting blood from recovered patients who have tested negative for active viral infection, and met other requirements to ensure their plasma is safe to infuse. The first donors will likely come from hospitals who have successfully treated patients, and the donated plasma will go back to those hospitals to treat their sickest patients. This week, Mount Sinai Health System announced that it would begin working with NYBC to start treating some of its more severely ill patients with the therapy. But Sachais says he is working with other blood centers and hospitals to create a system where donated plasma can be stored and shared among them.

For now, each patient will likely receive one unit of plasma, which is about 200-250 cubic centimeters. But because the amount of antibody in donors may vary, researchers are currently seeking ways to produce a more concentrated and consistent dose. Emergent BioSolutions, a biopharmaceutical company in Maryland, is working on a way to pool plasma from recovered patients and use that to create concentrated doses of antibodies, for example. That way, scientists don’t have to select out donors with the highest amount of antibodies, and can accept plasma from a wide pool of recovered patients, according to Laura Saward, head of Emergent’s therapeutic business unit.

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