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

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I also share a lot of Baal's frustration with the degree of inefficiency we have in our medical care in USA.

I would be very receptive to hear a longer assessment and his ideas of corrective plan of action if time and effort permit and he is willing.

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I also share a lot of Baal's frustration with the degree of inefficiency we have in our medical care in USA.

I would be very receptive to hear a longer assessment and his ideas of corrective plan of action if time and effort permit and he is willing.

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This would trend far into politics. There are lots of models around the world of how things can work better than here.

Partly we need to remake medical education at all levels to stop making it seem like primary care medicine is for losers.
 
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With all due respect, too many people are stating stuff that is not evidence-based. There is real evidence and not so real evidence. Evidence we have to date on this is not allowing many conclusions except that it isn't anything like a miracle cure given later on in the course of the disease. Rumors or "things I've heard" are not very helpful, especially when they come from people who don't really have the professional background to evaluate it and to discern plausible stuff from what is pretty nonsensical. With all due respect, what DerEchte has to say about chloroquine is not even remotely authoritative. He knows a lot about other stuff undoubtedly and he has always been one of my favorite posters.

I will add that most physicians are not generally trained in statistics.

In terms of political trends, I am worried about the tendency of certain forces out there to demonize people who actually know what they are talking about if it doesn't align with their hopes and desires. As an aside, I think that government health experts are getting too much air time. They have an inherent and undeclared conflict of interest (not wanting to lose their jobs). In my view the main people being interviewed ought to be university experts on epidemiology, infectious disease, etc.

That includes Fauci. He's a great scientist but he is far from the only one. There are many people in the US equally qualified who can speak freely without having to worry about who they piss off.

I agree with a lot of this (much more than my response communicates) but I also know that people who often claim something is evidence based are often stating their own opinion because their evidence is not strong enough to convince people with ease. I have much more training in math and statistics than the average physician and I can say that sometimes, statistics is abused as well to provide the veneer of evidence when really, the goal should be to establish stronger causal chains. You can't always use a regression to correctly control for the effect of something. Lots of people confuse correlation with causation and run amok saying all kinds of things.

Sometimes the demand for evidence is used to cherry pick which study you want to listen to and which one you don't. In my more cynical moments, I wonder whether RCT trial demands or such evidence standards are not just barriers to entry created by large pharmaceuticals to discourage decent treatments. Because the standard is not consistently applied to various forms of trials and research.

For example the study that found that hydroxychloroquine may hurt more than than it helps was the kind of study that if it found a conclusion that was the opposite of what it found, more people in the media would have said there were issues with it.
 
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I was actually referring more to high schools - I am guessing universities have it a little more under control but the transition for a lot of high schools or middle schools has not been good.
I know, but even at our level it is not been great. It is has to be a lot harder for younger kids. I have no idea how they do it.
 
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I was actually referring more to high schools - I am guessing universities have it a little more under control but the transition for a lot of high schools or middle schools has not been good.
In the UK we have been told not to use any real time teaching formats such as Zoom etc due to GDPR issues For my pupils ( age 11 -16) I put all work on google classroom which might be powerpoints or work books. I set a quiz on a site called Educake and maybe an assignment on another site called Seneca. The two sites are self marking and give me some idea of who is engaging with the work. The other work I put up marksheets the following week for pupils to self assess. Some kids respond well and the self learning may have some benefits. Some are doing little or no work and apart from trying to encourage participation there's not a lot I can do. I could've told you which kids are in which group before the stay at home was enforced.
 
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What does Wuhan lockdown mean to solve the problem? Divide and conquer. If you don't have the capacity like Wuhan did to isolate all COVID cases into designated hospitals/makeshift hospitals/stadium hospitals/isolation hotels, track them - let them report symptoms every day, construct them to go to ER when feeling worse, etc. You don't need to release the location of confirmed cases to public for the sake of privacy though it was a very powerful way to warn people, report to public health authorities and policy makers, if a certain area gets worse, make new measures for that area. If you cannot send healthcare workers to the epicenter like China did, make telemedicine available, please try to make it available on chat apps not phone call only! It is 2020 and let new technology lead.

Does Wuhan lockdown really mean regular people cannot get out of the house and once out, no return? Take grocery shopping as an example. Did Wuhan people go to grocery's stores at all? I guess many people say NO because Wuhan got lockdown! The answer is not that absolute. For a quite a period of time, Wuhan's measure was not as quick and stringent as other provinces outside Hubei (I will compare with my hometown later). Grocery stores in Wuhan during lockdown were less crowded, but still OPEN, for several reasons. (1) mindset. People were afraid to go and most people were cautious and responsible - dare not to risk their own lives and their loved ones' (2) shopping permits which allow people to go out (3) suspension of public transportation (4) online shopping and delivery (5) resident community shopping and delivery. That's nothing hard for US to adapt accordingly: online grocery shopping, online order and self-pickup at grocer stores, people avoid doing frequent shopping and keep social distancing at the stores, etc. What I don't see is (1) and I think there is nothing to do with "freedom". The right to life is the most basic human rights.


Give you a more personal story of how my parents were affected by COVID crisis. They live in a big city with <200 COVID cases in total by now. What did COVID affect them most? (1) Chinese New Year celebration (2) my mother's elective surgery which was scheduled right after Chinese New Year holiday. Western people may never understand the importance of Chinese New Year. When many Chinese people didn't celebrate Chinese New Year to combat COVID, they were really serious. My parents visited my grandmother who lives by herself on Chinese New Year Eve (Jan 24) and other get-together dinners with relatives/friends, either in restaurant or at home during the holiday were all canceled. The silver lining was that my parents and grandmother had plenty of food as they were prepared for the holiday. Wuhan announced that all residents communities had to be tightly controlled (you can call it community lockdown, but residents can get permits to get in/out) on Feb 11. My hometown made a similar announcement on Feb 6. My parents usually visit my grandmother twice a week and they decided to visit her once a week during the crisis. They didn't need to apply for any permit from where they live, they got temperature check in their car at the gate (1 out of 3 remained open) when leaving, left their phone number for emergency purpose, got temperature check again when returning. For grocery shopping, believe it or not, my parents in their 60s have been using online grocery shopping (mobile apps) for years. They don't go to a supermarket 5-min drive away often because (1) if they buy a lot, they have to drive and the parking is a headache. (2) if they don't buy a lot, the online grocery order can be delivered to the door within 2 hours. During the crisis, they just ate what they had stocked up and did all new grocery shopping online, the only difference being no delivery to the door - they had to pick up at the gate because non-residents were not allowed to enter. My grandmother usually walks to a nearby wet market every day to buy fresh food and we all told her to stay home during the crisis. Of course when my parents visited her, they brought fresh food they ordered online. Their community lockdown was lifted in March and delivery to the door was allowed.

I knew the situation in my hometown was really under control when my mother was finally admitted to hospital for surgery in the first week of Mar. In early Feb, the surgeon told my mother the surgery had to be postponed. We were quite concerned because we didn't know how long we would wait and we had no other choice like changing to another hospital (the one she went to is the best in that field in town; other hospitals also postponed elective surgeries). We understood hospital could be a hot spot for community spreading. Also, we heard that the hospital sent their best anesthetists, ICU doctors to Wuhan along with PPE from the surgery rooms. In early Mar, besides all standard examination before surgery, my mother got CT scan to exclude that she had pneumonia! All people got temperature check before entering the hospital and were given masks. Only one companion was allowed to stay with the patient during hospitalization. I had planned to visit my parents but I gave it up because the chance was not low that I could catch the virus on my way from US to China (so ironic) and I definitely did not want to infect them. Nevertheless, the surgery was successful and my mother is doing rehab now.
 
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What does Wuhan lockdown mean to solve the problem? Divide and conquer. If you don't have the capacity like Wuhan did to isolate all COVID cases into designated hospitals/makeshift hospitals/stadium hospitals/isolation hotels, track them - let them report symptoms every day, construct them to go to ER when feeling worse, etc. You don't need to release the location of confirmed cases to public for the sake of privacy though it was a very powerful way to warn people, report to public health authorities and policy makers, if a certain area gets worse, make new measures for that area. If you cannot send healthcare workers to the epicenter like China did, make telemedicine available, please try to make it available on chat apps not phone call only! It is 2020 and let new technology lead.

Does Wuhan lockdown really mean regular people cannot get out of the house and once out, no return? Take grocery shopping as an example. Did Wuhan people go to grocery's stores at all? I guess many people say NO because Wuhan got lockdown! The answer is not that absolute. For a quite a period of time, Wuhan's measure was not as quick and stringent as other provinces outside Hubei (I will compare with my hometown later). Grocery stores in Wuhan during lockdown were less crowded, but still OPEN, for several reasons. (1) mindset. People were afraid to go and most people were cautious and responsible - dare not to risk their own lives and their loved ones' (2) shopping permits which allow people to go out (3) suspension of public transportation (4) online shopping and delivery (5) resident community shopping and delivery. That's nothing hard for US to adapt accordingly: online grocery shopping, online order and self-pickup at grocer stores, people avoid doing frequent shopping and keep social distancing at the stores, etc. What I don't see is (1) and I think there is nothing to do with "freedom". The right to life is the most basic human rights.


Give you a more personal story of how my parents were affected by COVID crisis. They live in a big city with <200 COVID cases in total by now. What did COVID affect them most? (1) Chinese New Year celebration (2) my mother's elective surgery which was scheduled right after Chinese New Year holiday. Western people may never understand the importance of Chinese New Year. When many Chinese people didn't celebrate Chinese New Year to combat COVID, they were really serious. My parents visited my grandmother who lives by herself on Chinese New Year Eve (Jan 24) and other get-together dinners with relatives/friends, either in restaurant or at home during the holiday were all canceled. The silver lining was that my parents and grandmother had plenty of food as they were prepared for the holiday. Wuhan announced that all residents communities had to be tightly controlled (you can call it community lockdown, but residents can get permits to get in/out) on Feb 11. My hometown made a similar announcement on Feb 6. My parents usually visit my grandmother twice a week and they decided to visit her once a week during the crisis. They didn't need to apply for any permit from where they live, they got temperature check in their car at the gate (1 out of 3 remained open) when leaving, left their phone number for emergency purpose, got temperature check again when returning. For grocery shopping, believe it or not, my parents in their 60s have been using online grocery shopping (mobile apps) for years. They don't go to a supermarket 5-min drive away often because (1) if they buy a lot, they have to drive and the parking is a headache. (2) if they don't buy a lot, the online grocery order can be delivered to the door within 2 hours. During the crisis, they just ate what they had stocked up and did all new grocery shopping online, the only difference being no delivery to the door - they had to pick up at the gate because non-residents were not allowed to enter. My grandmother usually walks to a nearby wet market every day to buy fresh food and we all told her to stay home during the crisis. Of course when my parents visited her, they brought fresh food they ordered online. Their community lockdown was lifted in March and delivery to the door was allowed.

I knew the situation in my hometown was really under control when my mother was finally admitted to hospital for surgery in the first week of Mar. In early Feb, the surgeon told my mother the surgery had to be postponed. We were quite concerned because we didn't know how long we would wait and we had no other choice like changing to another hospital (the one she went to is the best in that field in town; other hospitals also postponed elective surgeries). We understood hospital could be a hot spot for community spreading. Also, we heard that the hospital sent their best anesthetists, ICU doctors to Wuhan along with PPE from the surgery rooms. In early Mar, besides all standard examination before surgery, my mother got CT scan to exclude that she had pneumonia! All people got temperature check before entering the hospital and were given masks. Only one companion was allowed to stay with the patient during hospitalization. I had planned to visit my parents but I gave it up because the chance was not low that I could catch the virus on my way from US to China (so ironic) and I definitely did not want to infect them. Nevertheless, the surgery was successful and my mother is doing rehab now.

What do you think of this video?

https://www.youtube.com/watch?v=aXw3XqwSZFo
 
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This is no excuse to lift what? The lockdown on businesses? Maybe one should consider how many people are wearing masks compared to how many didn't before. Compliance has gone way up. And there was evidence that before shutdowns that social distancing was working.

How people look at the US is not much of my concern since I have my own views on that issue. What I care about is that a balance is being continually sought between the benefits and costs of what is happening. You said Wuhan took 76 days - how long do you think it will take in the US since Wuhan needed that much time?

For me, all I have to say to explain why the public doesn't wear masks is to watch the press conference at the White House. The leaders are not communicating the urgency by example.

Social distancing wasn't enough before shutdowns. As I've repeatedly stressed, you want to halt this wave ASAP, not slow it. Slowing it will only extend the pain. This is going to take longer than 76 days if people don't work together. It's been a month and the Rt for most states went down from 1.2 to 0.8 on average. You want it to go down to 0.3, the value for Wuhan after lockdown.

There's a 10-to-14-day delay between onset of symptoms and a positive test, which means the effect of your action today will not happen until 10-14 days later. PA stay-at-home order was on Apr 1 and new cases finally started trending downward on April 12, with the Rt dropping below 1 since. Same for NY, stay-at-home order on Mar 20, new cases started plateauing on Apr 6 and dropping on Apr 10, when the Rt hit below 0.85.
 
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My local community invited a family doctor to give a lecture on COVID in early Apr. He talked about how important Vitamin D is to keep a good immune system. Then he said COVID was a big flu and didn't kill many.

Well, I am not against taking VC and VD for COVID prevention. I believe healthy diet and life style will help one's immune system. But the question still remains, can we avoid getting COVID and avoid spreading COVID to the vulnerable?
 
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Social distancing wasn't enough before shutdowns. As I've repeatedly stressed, you want to halt this wave ASAP, not slow it. Slowing it will only extend the pain. This is going to take longer than 76 days if people don't work together. It's been a month and the Rt for most states went down from 1.2 to 0.8 on average. You want it to go down to 0.3, the value for Wuhan after lockdown.

There's a 10-to-14-day delay between onset of symptoms and a positive test, which means the effect of your action today will not happen until 10-14 days later. PA stay-at-home order was on Apr 1 and new cases finally started trending downward on April 12, with the Rt dropping below 1 since. Same for NY, stay-at-home order on Mar 20, new cases started plateauing on Apr 6 and dropping on Apr 10, when the Rt hit below 0.85.

So what is the value in Sweden now for comparison?
 
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My local community invited a family doctor to give a lecture on COVID in early Apr. He talked about how important Vitamin D is to keep a good immune system. Then he said COVID was a big flu and didn't kill many.

Well, I am not against taking VC and VD for COVID prevention. I believe healthy diet and life style will help one's immune system. But the question still remains, can we avoid getting COVID and avoid spreading COVID to the vulnerable?

OOOps, wrong video...

https://www.youtube.com/watch?v=LKcFJ1Yporo
 
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So what is the value in Sweden now for comparison?

Somewhere around 1 for the nation, likely higher for Stockholm. Perhaps that's what prompted them to start cracking down on pubs.

https://epiforecasts.io/covid/posts/national/sweden/
CyviPbS.png


https://www.theguardian.com/world/2...ens-light-touch-on-covid-19-yet-says-minister
https://www.sbs.com.au/news/sweden-...-restaurants-as-virus-death-toll-passes-2-000
 
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I guess it was not unacceptable, right? She was able to get eggs and beef with community bulk purchase and get bread from the inner convenience store. I am not sure if she has a car. With suspended public transportation, it was hard to get around.
I just did a quick search on youtube for wuhan grocery shopping in Chinese, below is a video in Mar when the blogger's coworker bought some expired snacks (oops) from a grocery store and drove there again for return. They were given double amount of the snacks lol
https://www.youtube.com/watch?v=3iv5KyYqH8o
 
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