The pages from this morning’s papers could not be clearer about out what’s likely to happen next as the government tries to dampen the impact of the coronavirus epidemic. To confine large numbers of people in the homes is a big step but it might be the only way that it can be controlled at this stage.
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HAppy birthday PB,
Happy Birthday to thee-ee;
Happy birthday PB!
(Sung twice, while using hot soapy water followed by thorough drying with a paper towel and then a dermatological cream.)
https://jakartaglobe.id/news/six-indonesian-doctors-die-from-covid19-cases-exceed-500
Officially only 48 deaths, believe that if you like, as Italy has only suffered 19 deaths of doctors among far higher stats.
Lots of stupidity, a mob pulled down a public health covid-19 banner from a mosque shouting 'allahu akbar', and others saying 'I'd rather die from covid-19 than from Allah's wrath'. Local politicians saying 'don't you know who I am? I can't be tested, I'm an official'.
Political parties gathering in big groups, some not wearing masks, to hand out masks (usually at election time they hand out food, rice, and often cash).
Local health secretaries saying 'don't worry, the patient didn't have a temperature of 40C+, so can't have Covid-19'. National police have banned large groups but everything is devolved here, and law enforcement optional on a regional area (in practice if not theory)
I'm sure no PBer would be so selfish or shortsighted:
https://twitter.com/DCMS/status/1241844873482960898?s=20
We have a national infrastructure which dates back to the world wars, the Industrial revolution, the civil war, Magna Carta, even 1066. With every layer built upon another, and rarely a point to be able to start again with a blank state.
Italy has "only" suffered 19 deaths of doctors.
Central Government has been slow, but no worse than many others - many local governments are criminally culpable. Left Jakarta 5 days ago & no way back now.
https://www.thejakartapost.com/news/2020/03/22/covid-19-inadequate-medical-supplies-take-toll-on-lives-of-indonesian-medical-workers.html
https://www.youtube.com/watch?v=P6kj-Ixpil4
Auf all deinen Wegen
Gesundheit und Frohsinn
Sei auch mit dabei
The Department for Transport will temporarily suspend normal franchise agreements and transfer all revenue and cost risk to the government for a limited period, initially 6 months. Operators will continue to run services day-to-day for a small predetermined management fee. Terms and conditions of employment for rail workers will not change.
This will allow us to ensure that trains necessary for key workers and essential travel continue to operate. No other passengers should travel. As we have already announced, services will be reduced from today (23 March 2020).
Anyone holding an advance ticket will be able to refund it free of charge. All season ticket holders can claim a refund for time unused on their tickets free of administrative charges. Ticket holders should contact their operator for details.
https://www.gov.uk/government/news/government-ensures-ticket-refunds-and-protects-services-for-passengers-with-rail-emergency-measures
Ms Vance, we had to advise a relation...... wife's relation...... that the Welsh County Council where they have such a home were asking holiday home owners NOT to come. Relation & spouse were planning to go and self-isolate in it.
We shall find out tonight what they've done.
If they fall ill the local, rural health services will have to take up the load.
If you were an IC doctor with one bed and two ill patients, one with a local GP, the other with a London GP, everything else being equal, who gets the bed?
Not only selfish, these people may have put their families at risk.
I'm in the last two months of my annual season ticket. I wouldn't be surprised if I'm told that I'm not entitled to a refund.
What did Britons sing on birthdays before Happy Birthday to You? Can the pb historians enlighten us?
xx
Congratulations and felicitations to Mike (and Robert) for reaching another milestone with this excellent site.
Why was that a surprise? Given the evident disconnect between his brain and his voice-box?
Even just a few days ago there were young people saying they were better off here than in the UK and they were going to chill in a hostel doing yoga or whatever it is these people do.
The reality: There are a LOT of such people floating around SE Asia living on minimal funds. All well and good till things go wrong and don't speak the language and no money no treatment is normal.
I have seen people complaining that the police had told them to leave an island, days from civilization and wondering if this was legal (who cares), and whether their embassy could help (no).
Bali is a disaster zone in that there is NO testing facility (sent to Jakarta) There was a Brit who died 2 weeks ago and the local government said 'don't worry she had underlying health conditions', as if somehow a woman w/4 kids would fly off to Bali in serious condition. Since then a French man was found dead on top of a motorbike. The locals filmed this and uploaded it to social media (photographing dead is not taboo) but nobody wanted to get close. DAYS later it turned out he was positive for covid-19. It is probably unlikely that he died from it BUT he had been in the provincial hospital (for reasons unspecified) where all the Covid-19 patients/suspects were sent and had caught it there.
Official (ludicrous) Bali figures are 3 cases/2 deaths.
Is it not obvious that there is a distinction between going outside for some fresh air and exercise on your own, trying not to get too close to people, and going for afternoon out in Richmond Park?
“Why do we need to shut places where people group?
Remember this: VIRAL LOAD
There will be a lot about this. Why is it important? With this virus, the amount of virus in your blood at first infection directly relates to the severity of the illness you will suffer. This isn’t unusual - HIV management is all about reducing viral load to keep people alive longer. BUT it’s very important in COVID-19.
So if you are in, say, a pub or religious building or entertainment venue with 200 people and a large number don’t have symptoms but are shedding, you are breathing in lots of droplets per minute and absorbing a high load of the virus. In a crowded space. They become ill over the next 48 hours. You then three days later wonder why you can’t breathe and end up in hospital. You’d decided because you were young and healthy it wasn’t going to be a problem. Wrong.
Fortunately but unfortunately because the elderly are isolating quite well, the initial UK data suggests that all age groups above 20 are almost equally represented in ITUs in England. Most of the cases are in London but the wave is moving outwards. This means that being under 60 and fit and well doesn’t seem to be as protective as we thought. Why? Viral load.
This may be skewed simply by the fact that too many Londoners didn’t do as asked and congregated in large groups in confined spaces and got a large initial viral load. They then went home and infected their wider families. Which is why, as London is overwhelmed, we need to shut everything down to save the rest of the UK. We are a week at most behind London.
Our sympathies go out to the families affected in London and the critical care teams battling right now to save as many as they can.
If I sit with one person and catch this virus, I get a small viral load. My immune system will start to fight it and by the time the virus starts replicating, I’m ready to kill it.
No medicines will help this process meaningfully hence there is no “cure” for this virus. All we can do is support you with a ventilator and hope your immune system can catch up fast enough.
If I sit in the same room with six people, all shedding I get six times the initial dose. The rise in viral load is faster than my immune system can cope with and it is overrun. I then become critically ill and need me (or an ITU/HDU specialist) to fix it instead of just being at home and being ok in the end.
REMEMBER: THINK ABOUT VIRAL LOAD
In that context one it is reasonable to ask whether the transmission effects of people going to parks (usually in family groups which they would have been in anyway) is actually likely to have any material effect (positive or negative) on the progress of the virus. In which case, what’s the point, except to give the appearance of decisiveness shortly to be followed by a perception that the Govt is impotent in the face of the threat as numbers continue to rise amongst the “excepted” individuals?
Thankfully there are quite a few birthday songs in Germany including the one I posted before
On topic (for the last thread) I wouldn't be at all surprised to see the DNC ditch Biden. Let's be somewhere - he isn't picking up all these delegates because people want him. It's because he isn't Sanders and they don't want Trump. Even Biden knows they don't care about him hence the "I am a stepping stone" position.
Desperate times call for desperate measures. The DNC is conniving enough to simply bin the whole primary process (we can't complete it due to the national e,urgency, not fair, let's have a brokered conventiom) and select someone who isn't either of the dodderers to defeat Trump.
"The mean viral load of severe cases was around 60 times higher than that of mild cases, suggesting that higher viral loads might be associated with severe clinical outcomes."
2. The goal of the lockdown is to slow the virus spread down and prevent the health services from being overwhelmed.
The answer to your question is yes - very negative material effects with more people dying who might otherwise live.
If you are generally self isolating, but catch it in some chance encounter, it is unlikely to be particularly dangerous to you, and, as you are generally self isolating, there is unlikely to be significant risk of onward transmission.
I have not found anywhere with such an interesting range of voices, genuine expertise and such a good sense of humour. I especially value the last element in these times.
Bravo to our free press.
https://www.telegraph.co.uk/global-health/science-and-disease/terrifying-data-behind-government-coronavirus-lockdown/
I'll repeat: thank god for our journalists.
https://www.buzzfeed.com/alexwickham/10-days-that-changed-britains-coronavirus-approach
I think the the UK health system has better national coordination but starts off with less capacity, I'm pretty scared it will be more seriously overloaded. My sister is a doctor in a London hospital and the next few weeks look pretty grim. My wife is a doctor in a NRW hospital and things sound quite similar. The Germans seem hopeful that there is enough capacity, and the lock down will slow things enough, to avoid things getting as bad as in Lombardy hospitals, but it's still going to be a nightmare.
The viral load point is absolutely critical. We all thought this was binary and it isn't. This means herd immunity theory in its crudest form is nonsense.
Clearly if you are in a large group you are more likely to be exposed to that critical mass of virus. But does more make a difference? I really have my doubts.
Seems to be quite a bit of evidence that relatives who get the illness second in a household get the illness worse than the person who caught it first, which is probably due to this.
As for viral load, lets see how long the Dutch carry on as normal.
The viral load referred to in the Lancet is for those who had been infected for some time, so far more likely to be just those unable to fight it off.
Carlotta's point is entirely valid, though, even if there aren't any exact figures behind it. It's why (for example) medical professionals intubating infected patients are at such high risk, as the resulting aerosolised virus is present in very high quantities.
Or why conference rooms or family homes see it pass on extremely easily.
With HIV the point is that once you get it, you get it. That's it. But whether you go through the all-important sero conversion depends on the viral load of the contact point (host) and your own state of health. So, if your own immunity is good and/or you are for instance taking PrEP then even if the viral load in the host is high you stand a better chance: nearly 100% safe if you're taking PrEP.
So are we sure that's the same here with CV? We can take on a small viral load but kick it out the system before it gains traction?
Happy Birthday, PB, and best wishes to all PBers and their loved ones.
Assumptions:
1. 1% mortality
2. It takes 10 days from contracting the virus to death
3. The number of cases doubles every 2.5 days
So, take the current number of deaths, multiply by 100 then double it four times.
So when there were 100 deaths, there were 160,000 cases.
If the doubling is every 3.33 days, then 1 fewer doubling, so 80,000 cases in the above example. I reckon it is within that range.
300 deaths equates to 240,000 to 480,000 cases.
So best not mingle in the park.
My wife sent me a picture from the bus on the way to work as a key worker today. Normally the bus wouldn't be full but she'd be lucky to get a seat on her own (ie people occupying every row). This morning she was the only person on the bus.
If the buses stop she'll be unable to get to work, unless I drive her.
https://www.worldometers.info/coronavirus/coronavirus-cases/#case-tot-outchina
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
I know that some people have tried to dilute that figure by saying there are far more people with it than currently tested, but then if (entirely plausible) rumours from China are true the same can be said for the number of fatalities.
We can only work with the official statistics we have: 341,524 confirmed cases and 14,747 deaths = 4.3%
Even more reason to heed your very wise words about avoiding social contact.
All the rest, as far as I know is just social media speculation.
All things are poison, and nothing is without poison, the dosage alone makes it so a thing is not a poison. —Paracelsus
Meanwhile an initial promising treatment lowers viral load:
http://www.virology.ws/2020/03/19/hydroxychloroquine-reduces-viral-load-and-symptoms-in-covid-19-patients/
Look at Senator Paul. He had no symptoms whatsoever and clearly only got tested because he is a senator and considered important. To his surprise, he is a carrier.
I think a lockdown is inevitable, if only because many people appear to be infecting others without realising it.
If my understanding is correct, some 50% of the ‘not so young’ Diamond Princess passengers who tested positive were asymptomatic. It is also my understanding that children and young people are often asymptomatic. Elsewhere I read that people who do develop symptoms are asymptomatic during the preceding 24 hours, but they are shedding viruses by that point.
Everybody is avoiding the guy with a cough, but I get the impression that your are more likely to be infected by somebody who appears to be perfectly healthy.
It is impossible to really know as it is almost universally used on media.
'doubt'
Rather, that is, from a couple of armchair pundits with degrees in PPE postulating on PB
(that's light-hearted by the way before Felix jumps on me again)
WHO and John Hopkins CSSE currently have the mortality figure at 4.3%.
https://www.coca-cola.co.uk/marketing/launches-and-innovation/introducing-aquarius
"It's the dose that makes the poison" Perhaps with viruses its different. Perhaps not.
https://news.sky.com/story/coronavirus-extraordinary-uk-effort-to-produce-thousands-more-ventilators-11961559
This is why if a husband gets it mildly his wife who catches it from him is more likely to get it severely (or vice-versa), because they've caught more of a load. Its also why isolating works even if you still catch it.