SARS-CoV-2; CoVID-19; Coronavirus; Updates and Information

Very interesting baal, as always from you. Any thoughts on false negatives?

False negatives could come from swabbing the nose if someone doesn't have virus particles there ( as opposed to lower down). This would seem to me to be the most likely reason.

This could also depend on how the swab is handled. RNA is notoriously easily degraded (or as we are taught RNase is everywhere, including inside the nose). So maybe if a swab is not processed immediately, that could cause problems. Also extraction of RNA from the swab could conceivably fail. The kits would presumably be designed to minimize that, but maybe not 100%.

RT-PCR procedures designed for clinical labs (as opposed to what we do in research labs) are probably designed to require the bare minimum of human liquid sample handling or parameter choices in the thermal cycling machine, but I suppose even there someone could screw up. I say probably because I have not seen an RT-PCR kit or apparatus designed for SARS-CoV-2 detection. I've done a lot in the lab, of all sorts; genomic, RT-PCR, and qRT-PCR. I'm old enough to have done these things when they were brand new methods. In my experience, some people trained more recently take it all for granted and dont entirely understand how it works (especially with respect to how to make sure an assay is quantitative, or best practices for primer design). What that can mean in practice is they can't troubleshoot or sometimes they believe in their results too much, or make too much out of small changes in signal..

https://thehill.com/homenews/state-...ounty-beaches-as-region-experiences-heat-wave

Thousands of people poured onto beaches in Orange County over the weekend as Southern California experienced its first major heat wave of the year, even as officials continue to urge visitors to avoid mass gatherings and practice social distancing due to the coronavirus outbreak.


Photos and videos showed Huntington Beach and Newport Beach lined with crowds on Saturday. More than 40,000 people were estimated to have visited Newport Beach on Friday.

MAGA!

Often there are breezes on the beach. Maybe helps dilute viruses more?

I am more worried about behavior Carl just mentioned inside cities. I see it too. One reason mask requirements are good is that it reinforces the idea that things arent yet normal. Also people are clueless about how this spreads

One famous person predicted that this would magically disappear in April or when it got hot. But that could make things worse if people's behavior becomes more maladaptive.

Asymptomatic Transmission, the Achilles’ Heel of Current Strategies to Control Covid-19

In four U.S. state prisons, nearly 3,300 inmates test positive for coronavirus -- 96% without symptoms

You can have the virus, not know it, and be contagious. In fact, COVID-19 may be most contagious one to two days before symptoms appear. Some experts think more than 70% of transmission is via asymptomatic (or pre-symptomatic) people.

That's why you should go out of your way to keep your distance if possible, and always wear a mask in public. You're probably lowering your risk of being exposed by a little. But far more important, you're protecting yourself from becoming a link in a chain of transmission.

Baal said:

Often there are breezes on the beach. Maybe helps dilute viruses more?

I am more worried about behavior Carl just mentioned inside cities. I see it too. One reason mask requirements are good is that it reinforces the idea that things arent yet normal. Also people are clueless about how this spreads

One famous person predicted that this would magically disappear in April or when it got hot. But that could make things worse if people's behavior becomes more maladaptive.

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Does playing TT with people worry you more than walking around in a NYC setting as described by Carl?

I’ve opted out from going into the city but I’ve continued to train as it’s the same group of 10-12 people that are continuing to train despite the crisis and we have some basic rules (one ball per table, an orgy of alcogel when switching tables, not hanging out in the hall prior or after practice etc).

UpSideDownCarl said:

Actually, in the walk through the park, I thought this was interesting. There was one point where we passed a man sitting on a blanket in the grass with his daughter. Seeing so many people with masks, the kid was saying, "Dad, I want to wear a mask." And the father was saying something like, "No, we don't wear masks." So.....humans are befuddling.

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There are even doctors who work with COVID-19 patients who claim to not wear masks in public. This is a 55 minute video, not sure where in the video they state it, but they do claim to not wear masks in public.

I'm not saying I necessarily agree with that stance, but in terms of befuddlement, it seems even among doctors there is disagreement... not just folks we may otherwise consider ignorant/foolish.

One excerpt:
"Sheltering in-place decreases the immune system. When we all come out of shelter in place with a lower immune system and start trading viruses and bacteria what do you think is going to happen? Disease is going to spike. And then you've got disease spike amongst a hospital system with furloughed doctors and nurses. This is not a combination we want to setup for a healthy society. It does not make any sense."

https://www.youtube.com/watch?v=xfLVxx_lBLU

mart1nandersson said:

Does playing TT with people worry you more than walking around in a NYC setting as described by Carl?

I’ve opted out from going into the city but I’ve continued to train as it’s the same group of 10-12 people that are continuing to train despite the crisis and we have some basic rules (one ball per table, an orgy of alcogel when switching tables, not hanging out in the hall prior or after practice etc).

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To Mart: Yes, TT scares me much more. I summarized some reasons earlier, but the main reasons is anyone infected is going to lead to a concentration of virus that will stay in the air. Your partners may not know they are infected. You can't tell either. And remember, it is not just distance, it is time. You could be within a couple of meters of someone who is infected for long periods of time in an indoor space. The virus can infect you by inhalation or by contact with your eyes (or your hands if it is transferred to nose or eyes). I've played TT for a very substantial portion of my life but I'm not going to play for quite a long time. I hate it. Other people may evaluate their risks differently. But that's how I see it.

To Takyu: I would argue that those doctors saying that are pretty ignorant about immunology, certainly in respect to adults, with one caveat: Vitamin D can enhance immune responses and people generally need exposure to sunlight (UV radiation) for the first step in making active forms of Vitamin D. But you can get around that with a Vitamin D supplement. I also think complete and total shelter in place is bad because aerobic exercise can increase immune surveillance, and people can't be treated as prisoners all the time. All the same, I have seen physicians say some pretty dumb things about basic science before, so this doesn't surprise me. Regarding their refusal to wear masks in public, based on their job they are the most likely people to be infected, and they may not know it, so that seems especially irresponsible since the mask protects people around the wearer as much or more than the wearer!

To Carl: The "we don't wear masks" comment is weird. Why the hell not? These are strange times, you need to do strange things. (And not strange in many parts of the world). I actually suspect why someone would say that, but I won't break the rules of the thread.

Baal said:

To Takyu:. All the same, I have seen physicians say some pretty dumb things about basic science before, so this doesn't surprise me.

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I'm in total agreement with this (not necessarily disagreeing with your other comments, but this one is in my sweet spot).

For example, I have seen too many doctors exhibit complete ignorance concerning blood sugar issues, to the point where they are harming patients.

NextLevel has commented on that, and I am in total agreement with what he has stated. I was tempted to share some of the incredible ignorance I have seen, but it is OT for this thread.

However he did mention IV drips, which raises a question.

Does anybody know whether COVID patients are given IV drips? Needless to say a "pre-diabetic" or diabetic should not receive a drip containing caloric substances such as glucose, fructose, lactose, saline with added glucose (unless blood sugars drop too low, of course), etc., etc. I've read normal saline solution should be adequate for routine hydration. But I wonder what hospitals are using these days. It would be beyond stupid to give such an IV to someone with blood sugar control issues, but I have no idea what hospitals are doing these days.... just wondering.

Takkyu_ga_suki said:

I'm in total agreement with this (not necessarily disagreeing with your other comments, but this one is in my sweet spot).

For example, I have seen too many doctors exhibit complete ignorance concerning blood sugar issues, to the point where they are harming patients.

NextLevel has commented on that, and I am in total agreement with what he has stated. I was tempted to share some of the incredible ignorance I have seen, but it is OT for this thread.

However he did mention IV drips, which raises a question.

Does anybody know whether COVID patients are given IV drips? Needless to say a "pre-diabetic" or diabetic should not receive a drip containing caloric substances such as glucose, fructose, lactose, saline with added glucose (unless blood sugars drop too low, of course), etc., etc. I've read normal saline solution should be adequate for routine hydration. But I wonder what hospitals are using these days. It would be beyond stupid to give such an IV to someone with blood sugar control issues, but I have no idea what hospitals are doing these days.... just wondering.

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There are many different IV drips given for different reasons. There is not just one size fits all, certainly not!! Different IV drips are used to correct blood volume issues, or acid-base issues, or various electrolyte issues, and things of that nature, which are frequently encountered in critically ill patients or in perioperative situations. Which one you use depends on the thing you are trying to correct. There are times when a glucose/NaCl drip is useful because it is the most immediately usable form of energy for cells in patients unable to get it any other way. It is definitely not universally a bad thing. Normally physicians would know from patient's history if they have issues with poor glucose tolerance.

Covid-19 patients who are seriously ill can have all sorts of problems, including weird electrolyte disturbances that may need correcting. Again they would not all be treated the same way. Chinese physicians saw a lot of Covid-19 patients seem to have low potassium (hypokalemia) which may need to be corrected by a potassium infusion. (The virus seems to disrupt the signaling systems that regulate water, sodium and potassium). Some physicians in the US say they are not seeing that very much.

Baal said:

There are many different IV drips given for different reasons. There is not just one size fits all, certainly not!! Different IV drips are used to correct blood volume issues, or acid-base issues, or various electrolyte issues, and things of that nature, which are frequently encountered in critically ill patients or in perioperative situations. Which one you use depends on the thing you are trying to correct. There are times when a glucose/NaCl drip is useful because it is the most immediately usable form of energy for cells in patients unable to get it any other way. It is definitely not universally a bad thing. Normally physicians would know from patient's history if they have issues with poor glucose tolerance.

Covid-19 patients who are seriously ill can have all sorts of problems, including weird electrolyte disturbances that may need correcting. Again they would not all be treated the same way.

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Thx for the response.

I know in the past, based on some doctors' statements, hospitals in the past have not managed or been negligent of blood sugar control issues. Hopefully that situation has improved.

Takkyu_ga_suki said:

Thx for the response.

I know in the past, based on some doctors' statements, hospitals in the past have not managed or been negligent of blood sugar control issues. Hopefully that situation has improved.

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Not all doctors and hospitals everywhere are equally good.

Another thing I should add is that my nephrology colleagues are seeing that "drying out" seriously and critically patients with strong diuretics and maximum tolerable doses of anti-clotting drugs like heparin (all given by infusion) are producing better outcomes and are improving pulmonary function. But lots of patients are getting severe kidney problems (AKI). With an accumulation of experience, outcomes improve.

Baal said:

Not all doctors and hospitals everywhere are equally good.

Another thing I should add is that my nephrology colleagues are seeing that "drying out" seriously and critically patients with strong diuretics and maximum tolerable doses of anti-clotting drugs like heparin (all given by infusion) are producing better outcomes and are improving pulmonary function. But lots of patients are getting severe kidney problems (AKI). With an accumulation of experience, outcomes improve.

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Of course not all hospitals and doctors are going to be all-stars, but in the past based on some doctors' complaints, mismanagement of blood sugar issues was not unusual. Hopefully things have improved.

Your second paragraph is interesting. Had not heard that. I would hazard a guess that diabetics do not fare as well as others since many of them already have chronic kidney disease which would make it harder to recover from that stress. But as you say we are learning more and more, quite rapidly it seems.

When front line healthcare workers or hospitals say "we have enough masks/PPE", "the general public don't need to wear masks", they just tell white lies. Or, lies. It has been discussed here that even masks don't reduce one's chance to get infected, they reduce one's chance to infect others. And if masks don't reduce one's chance to get infected, why do front line doctors and nurses plea for masks? Some of them already protested in US.

My institution sends daily update of COVID situation in affiliated hospitals. The number of confirmed + suspected cases dropped from 40+ in early Apr to 10+ now. My institution reinforces universal masking for all hospital and clinic clinicians and staff, 1 per day, and all unworn masks need to be recycled by the end of day by H2O2 sterilization. And my institution is still begging for PPE donation, including surgical/procedure/N95/KN95 masks. They are just in short.

It is ironic to me that many people in charge dare not to admit masks are in short, and try really hard to find some "scientific evidence" to prove masks are useless.

mart1nandersson said:

Does playing TT with people worry you more than walking around in a NYC setting as described by Carl?

I’ve opted out from going into the city but I’ve continued to train as it’s the same group of 10-12 people that are continuing to train despite the crisis and we have some basic rules (one ball per table, an orgy of alcogel when switching tables, not hanging out in the hall prior or after practice etc).

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The problem with table tennis is really that if one person is spreading the disease, you are exposed to them and their environment for a sufficiently long time that you are at a much higher risk of contacting the disease than if you were just walking through a crowd. Obviously, you are mixing with fewer people, but you are at a much higher risk if any one of them is contagious as you will be with them for a long time.

Being exposed longer can lead to more serious cases it seems because you can get a larger dose of the virus in your infection. That said, it comes back to what you think about your health status. While no one 100% knows what the consequences of having the disease will be in the long term, many people have had and recovered from this disease and barring comorbidities, the likelihood of having the disease and recovering is higher than the probability of having the disease and falling into serious illness. That said, you may have loved ones and other people you need to protect. Manage as you know best.

UpSideDownCarl said:

Unfortunately in NYC, when I walk to and through Prospect Park, or to the grocery store, many people don't understand that what they are doing is definitely not anywhere near maintaining 6 feet distancing (2 meter). My sister and brother in law don't get it either. I keep trying to stay 6 feet away and they will both walk towards me as I move away. I is a bit of a comedy show.

Yesterday on a walk through Prospect Park there were about 15 young adults, people in their 20s acting like teenagers. They were arm in arm, loud, obnoxious, blocking the path....things that normal teenagers would do. I stopped and waited. My sister asked: "what's wrong?" I told her I was not going to walk through that. I waited till there was grass on the sides of the path so I could walk 50 feet off the path to pass.

People just are not getting it. Somehow, it registers on one level and then it does not register. Or something.

So, I am not sure the beach itself is the problem. Like, if people maintained social distancing guidelines, (really it is physical distancing but....we call it social distancing) then it would be fine. But clearly, people, when they go out, are not maintaining those distances.

Actually, in the walk through the park, I thought this was interesting. There was one point where we passed a man sitting on a blanket in the grass with his daughter. Seeing so many people with masks, the kid was saying, "Dad, I want to wear a mask." And the father was saying something like, "No, we don't wear masks." So.....humans are befuddling.

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So you won't call these people stupid or idiots?
You know I would.
I am still isolated because I am a high risk person.
I am beginning to think we should simply let people get their Darwin awards and pay for their hospital care.
Most people my age are probably on social security and medicare so they will get enough money to live on. Hopefully they have their houses paid for.
I have my condo paid for. I qualified for social security and medicate years ago but I still work and have a business. My employees don't want me to retire. Even thought I am a high risk person I still think we must get tough or die. ( my foot ball and wrestling coach ). The world does not owe you a living ( my mother ).
We need to open up the economy. In my county we can not sacrifice the economy for the 16 that have died when 3600 die each year.
I live in a condo association. There is only one way in and one way out. We gather in the streets and talk about the current situation while keeping 6 ft or more apart.

Dr Evil said:

Asymptomatic Transmission, the Achilles’ Heel of Current Strategies to Control Covid-19

In four U.S. state prisons, nearly 3,300 inmates test positive for coronavirus -- 96% without symptoms

You can have the virus, not know it, and be contagious. In fact, COVID-19 may be most contagious one to two days before symptoms appear. Some experts think more than 70% of transmission is via asymptomatic (or pre-symptomatic) people.

That's why you should go out of your way to keep your distance if possible, and always wear a mask in public. You're probably lowering your risk of being exposed by a little. But far more important, you're protecting yourself from becoming a link in a chain of transmission.

Click to expand...

That title makes it sound to a 3rd person that the average person not getting sick with corona, but exposed to it is society's biggest problem. That title looks a lot like blaming normal people for the mess.

You could walk around in a hazmat suit all insulated and get zero virus inside your suit, but if you are in the area with virus, the outside of your suit can and will get it and you can still spread a virus around.

The outside of a hazmat suit does not magically neutralize virus. You do not see the dudes wearing hazmat suits take them off and clean them by licking it or rubbing it on their bare bellies like a teenage internet challenge.

Even people fully vaccinated for measles can be in contact with the thing and spread it (heck, they can still get measles, the shot isn't 100% perfect), but for this case in USA, govt + we citizens are not using the same argument (that the Vaccinated people are responsible for Unvaccinated getting measles or making it worse) with same conviction.

Who knows exactly how much a person not infected with corona actually "sheds" how much corona compared to someone who has it and is incubating?

If we want as a world to better off around a newer virus, we need our immune systems to be strong and have exposure to all kind of stuff to maintain it, along with all the other things it takes to build and maintain a strong immune system. National and world focus would be a lot better served to do much better in that area.

Hiding out for months at a time is not gunna be helpful in that perspective.

So let's go forward, immagine and say a vaccine is available and practically 100% effective... so are you saying someone who is immune through this future vaccination is also a problem in the spread of corona in the future? (because they are asymptomatic) Do you believe that once someone get a vaccine against a virus, that the target virus just hits the vaccinated person and bounces off that person like in a video game just because they got a vaccine? No, even someone who is vaccinated and gets immunity through a vaccine will have the virus get to where that virus goes, does not multiply much (due to vaccinated immune response) and for whatever time can spread that virus (but we would think at a much lower rate than someone who is real sick incubating)

Are you by this logic implying that the entire world should receive the vaccine in mail, self administer on the same day and hour, wait a time, then all be safe to go out in public and all is good in the world? (since an asymptomatic person is gunna infect the world, we gotta wait to ALL are asymptomatic?) (or at those vaccinated would at a minimum thwart the govt efforts like the title implies, because they have immunization and no symptoms)

There is zero way to identify who is in day one or two of their immune system figuring out how to deal with virus. The "Lockdown" that is going on anywhere from a few weeks to over a month was to address that.

Next year's flu, if it kills 50,000 in USA like flu has killed in some years, are we gunna blame it on normal healthy people, because they have no symptoms and are suspected of spreading it?

I don't like wearing masks either, but this is a very specific purpose, a limited time frame (a few weeks or so), limited area of use (only when in public around people)... I am going to wear my mask and politely inform with hand signals to others who are not wearing mask... It is a reasonable request or order to wear the mask the next few weeks when around people. Anyone can make one. I struggled yesreday for hours with a $1 needle and thread and cut two pieces of a $1 hand towel, but I made my second mask and can no rotate and wash them seperately. If I did it, and I so totally suck with a needle and thread, anyone is capable of making a mask, even if they cut up a sock or hand towel that is long enough.

USA people need to quit griping and get together on this. It is a very easy matter of self-discipline... I know USA people want to do what they want to do without restriction and love freedom, but USA may actually be supporting freedom doing this.

I cannot tell anyone in this forum the degree, length and intensity of loss of personal freedom I experienced in my former profession for decades consecutively, all for commanded reasons that made sense or no sense at all.

Wearing a mask for a few weeks is a reasonable action. USA should not act all violated constitutional rights on this (wearing a mask for a few weeks) just yet, this isn't that territory. The ones who have a better ability with a sewing machine should (and many are doing) making for those who cannot (like the 90 yr olds or whoever) This is how you show you are American. I bet a lot of other nations do better than this without trying hard.