COVID 19 Facts and Science

This weeks Osterholm update.
https://www.cidrap.umn.edu/covid-19/podcasts-webinars/episode-14

biggill wrote:

<div class=”d4p-bbt-quote-title”>b-curtis wrote:</div>
I have seen this posted about a million times today. I’m not sure the Department of Ocean and Mechanical Engineering at FAU would be considered experts but still an interesting read, at least what I think I understood.

visualizing effectiveness of a face mask

A couple quick thoughts right off the bat. I recently Found out that the virus is approximately 0.1-0.2 µm. This study estimates their particle to be 1-10 µm. They estimate that because particles stayed suspended for around 3 minutes. I do believe they’ve found RNA from this virus for several hours. This study and most out there explain how they can help capture water droplets from coughs and sneezes. I don’t know about you but I haven’t heard another human being cough in 6 months.

I think the consensus right now is to wear a mask in spite of good evidence. It won’t hurt. what could hurt is what I heard on the radio yesterday. The Edina mayor was on Wcco talking about their new mask mandate. He said that masks are going to be one of the keys to opening the economy. Then immediately after he stated that even if they are wrong about masks, they can’t do any harm.

That’s completely false. If we even admit that they are effective we still have no clue how effective. If we use them as justification to open up more or reduce other effective measures, we’re making a horrible decision NOT based on science.

While I agree that policy shouldn’t be based on the science around masks I would assume the plan is more that the reopening is based on numbers in the state and masks will hopefully be one part of it not spiking back up

At this point we may be beyond worrying about infection numbers but to see if the hospitalizations and deaths rise because of the current spikes.

If there isn’t a successful immunization China and some other countries are in for bad things in the near future if the virus doesn’t vanish on its own

Texas and Arizona are already seeing huge increases in hospitalizations, fairly likely deaths will increase there as well. Florida is finally going to start publishing their hospitalization numbers……don’t know how much I would trust the info out of that state right now though

Fish To Escape wrote:

While I agree that policy shouldn’t be based on the science around masks I would assume the plan is more that the reopening is based on numbers in the state and masks will hopefully be one part of it not spiking back up

Definitely agree with that although most of the country including MN opened up in spite of the guidelines laid out by the White House COVID task force.

Bars, restaurants and hair salons all defy the social distancing orders because they feel that masks give us the edge to make that leap. I think they’re wrong. I should clarify. They think the mask mandate is enough to reduce distancing measures. We all know how well people are wearing masks these days. It’s pretty hard to find someone doing it correctly.

Agreed. There are a lot of comparisons between areas that have required masks and those that haven’t and they are at the very least, encouraging. It is not going to be perfect but if it helps at all it is worth it.

Side Note: Arizona ICU capacity is now at 100% and they are not going to publicize it anymore. Former classmates of mine are talking about plans in place to start the process of black tagging. Surge capacity is being rolled out

biggill wrote:

<div class=”d4p-bbt-quote-title”>Angler II wrote:</div>
Look back at the numbers of infected, add four weeks and finish the equation. Your lagging factor doesn’t add up….

You’re right. It actually looks more like 2 weeks.

If you argue that a rise in cases doesn’t equate to a lagging rise in deaths than how do you explain a lagging drop in deaths relative to a drop in cases? Especially when there’s so much talk about an increase in testing being the reason for a rise in cases.

One of the links I posted, I think the first one definitely shows a 2 week lag of rising cases to a rise in deaths. This is in spite of a spike in case positivity rate due to low testing capacity.

Still waiting for the surge in deaths….

Angler II wrote:

Still waiting for the surge in deaths….

Have to see a rise in cases first.

biggill wrote:

<div class=”d4p-bbt-quote-title”>Angler II wrote:</div>
Still waiting for the surge in deaths….

Have to see a rise in cases first.

Like what’s been happening world/nationwide for 3 weeks?

Angler II wrote:

Like what’s been happening world/nationwide for 3 weeks?

What exactly has been happening the last 3 weeks?

biggill wrote:

<div class=”d4p-bbt-quote-title”>Angler II wrote:</div>
Like what’s been happening world/nationwide for 3 weeks?

What exactly has been happening the last 3 weeks?

I assume he is referring to the 8 to 10k invisible enemy cases in Florida Arizona Texas Florida and Cali. Seems to be a rise in the past week?

While I do agree that there is a “spike” currently occurring, it’s only due to the increase in testing. Sounds miserably obvious, and Trump gets nabbed for it, but he’s absolutely right. Check out the graph below. CDC themselves said that the # of positive cases is likely to be 10x higher than we currently know. That’s great news!

Either way, deaths continue to plummet. Last week was 10 straight weeks of a decline in # of deaths. The 7 day moving average peaked on April 21st with 2,225 deaths/day nationwide. Todays 7 day moving average? 511. It goes without saying that 0 is the goal here, but the news should be mentioning positives instead of trying to freak everyone out again. IMO cases shouldn’t be the big concern, its deaths and hospitalizations. Professionals are projecting 30-40% of covid positives are asymptomatic, most others have flu-like symptoms that can be treated at home, and a very, very select few need a hospitalization stay. This 2nd surge has been going on for 3 weeks now. They say symptoms last for 10-14 days. Don’t you think we’d be seeing a spike in deaths by now too?

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Dear IDO members… please don’t look to IDO for COVID facts and science.

Charlie Vaughan wrote:

Dear IDO members… please don’t look to IDO for COVID facts and science.

So instead of sharing verified, factual information about COVID you’d rather everyone blurt out their non-educated but extremely opinionated thoughts?

Yep, sounds like you’ll fit in well here. Welcome to the chat, Charlie.

The reason the number of deaths trail the number of cases by three-plus weeks is because the worst Covid-19 patients are placed on mechanical ventilation support. Most also need blood pressure support medications called vasopressors that are delivered by continuous IV drip to keep blood pressures up. These two interventions can keep the majority of the patients alive for a long time.

Their death often comes after a decision by family to transition the patient to hospice after it has become clear to the team of doctors that the patient is not improving and continues to be entirely dependent on the vent for breathing/oxygenation and the vasopressors to keep the blood pressure high enough to perfuse oxygenated blood to the organs. Understandably, the patients are given many weeks to try and recover before these tough decisions need to be made, hence the delay. Sometimes the two interventions just don’t work effectively enough to maintain life, and that leads to cardiac arrest.

Rarely is Covid killing people quickly, and that usually occurs only in elderly patients who do not wish to be intubated/ventilated, which they state either in person, if able, or in their advance directive/POLST. These are my experiences.

This is a good thread. Let’s keep it that way.

Bass Thumb wrote:

The reason the number of deaths trail the number of cases by three-plus weeks is because the worst Covid-19 patients are placed on mechanical ventilation support. Most also need blood pressure support medications called vasopressors, that are delivered by continuous IV drip to keep blood pressures up. These two interventions can keep the majority of the patients alive for a long time.

Their death often comes after a decision by family to transition the patient to hospice after it has become clear to the team of doctors that the patient is not improving and continues to be entirely dependent on the vent for breathing/oxygenation and the vasopressors to keep the blood pressure high enough to perfuse oxygenated blood to the organs. Understandably, the patients are given many weeks to try and recover before these tough decisions need to be made, hence the delay.

Rarely is Covid killing people quickly, and that usually occurs only in elderly patients who do not wish to be intubated/ventilated, which they state either in person, if able, or in their advance directive/POLST. These are my experiences.

This is a good thread. Let’s keep it that way.

Not only that, there is a 1-2 week lag in finalizing a death certificate.

The last two posts are correct. Average time from exposure to death is 5 weeks and that includes people that have a DNR that doesn’t quickly. People languish for weeks in ICU until it becomes obvious to the family that they won’t recover

Tbro

Theres absolutely no doubt that testing capacity has increased significantly over the past couple months. It appears to be increasing at a pretty steady rate too. The problem is the positivity rate is climbing as well and has been climbing since mid June in spite of an increasing testing rate. If the number of cases was solely due to increased testing capacity, the positive rate would stay the same or fall.

Furthermore, It appears about 1/2 the sates are below the 5% positive test rate recommended by the WHO. Notably the stares seeing the highest positive rate are the same states seeing an explosion of cases.

If a positivity rate is too high, that may indicate that the state is only testing the sickest patients who seek medical attention, and is not casting a wide enough net to know how much of the virus is spreading within its communities. A low rate of positivity in testing data can be seen as a sign that a state has sufficient testing capacity for the size of their outbreak and is testing enough of its population to make informed decisions about reopening. Which U.S. states are testing enough to meet the WHO’s goal?

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Angler II wrote:

Like what’s been happening world/nationwide for 3 weeks?

In case you are interested, here’s a pretty thorough explanation of the lagging indicators like hospitalizations and deaths. It also hypothesizes the potential reasons for a falling mortality rate.

https://covidtracking.com/blog/hospitalization-data

Some key points:

Some media accounts treat deaths as the ultimate measure of whether a state’s response is succeeding or failing, but it takes a long time to die of COVID-19—nearly three weeks from the date of infection, on average, and another week beyond that for the states to report the deaths. This means that reported death numbers are often a measure of an outbreak’s severity up to a month in the past.

But there’s reason to hope that hospital mortality rates are declining. That’s the news from Milan, where hospital fatality rates fell from 24 percent to 2 percent from March to May (and the percentage of hospitalized patients who needed to be admitted to intensive care units also dropped). In England, the hospital fatality rate fell from 6 percent in April to 1.5 percent in June.

Researchers have suggested a variety of reasons for this decline in hospital deaths. The authors of the Milan paper suggested several factors, including a better understanding of the disease’s effects, a reduction in the severity of the local outbreak, and a decline in simultaneous infections with seasonal illnesses. “Patients with COVID-19 in late March and early April included a significant proportion of patients who caught the infection in hospital,” the authors of the British Medical Journal report on the decline in hospital mortality rate in England wrote. “These patients, because they were in hospital, were more likely to be sicker and more vulnerable than patients who acquired infection in the community and so more likely to die from COVID-19.”

But as the share of patients with infections from community transmission increases, the mortality rate has still declined. Several factors might explain this: Current patients are younger and less likely to die, hospitals are admitting less severe cases because more beds are available, and doctors and nurses have learned from experience. Bob Wachter, chair of the University of California-San Francisco Department of Medicine, posted a list of “Things We’ve Gotten Better At Since March”; it includes a number of improvements that could affect in-hospital mortality, such as better monitoring of vital signs and a more effective use of prone (face-down) positioning, which has been observed to improve oxygen levels in severely ill COVID-19 patients.

biggill wrote:

<div class=”d4p-bbt-quote-title”>Angler II wrote:</div>
Like what’s been happening world/nationwide for 3 weeks?

In case you are interested, here’s a pretty thorough explanation of the lagging indicators like hospitalizations and deaths. It also hypothesizes the potential reasons for a falling mortality rate.

https://covidtracking.com/blog/hospitalization-data

Some key points:

Some media accounts treat deaths as the ultimate measure of whether a state’s response is succeeding or failing, but it takes a long time to die of COVID-19—nearly three weeks from the date of infection, on average, and another week beyond that for the states to report the deaths. This means that reported death numbers are often a measure of an outbreak’s severity up to a month in the past.

But there’s reason to hope that hospital mortality rates are declining. That’s the news from Milan, where hospital fatality rates fell from 24 percent to 2 percent from March to May (and the percentage of hospitalized patients who needed to be admitted to intensive care units also dropped). In England, the hospital fatality rate fell from 6 percent in April to 1.5 percent in June.

Researchers have suggested a variety of reasons for this decline in hospital deaths. The authors of the Milan paper suggested several factors, including a better understanding of the disease’s effects, a reduction in the severity of the local outbreak, and a decline in simultaneous infections with seasonal illnesses. “Patients with COVID-19 in late March and early April included a significant proportion of patients who caught the infection in hospital,” the authors of the British Medical Journal report on the decline in hospital mortality rate in England wrote. “These patients, because they were in hospital, were more likely to be sicker and more vulnerable than patients who acquired infection in the community and so more likely to die from COVID-19.”

But as the share of patients with infections from community transmission increases, the mortality rate has still declined. Several factors might explain this: Current patients are younger and less likely to die, hospitals are admitting less severe cases because more beds are available, and doctors and nurses have learned from experience. Bob Wachter, chair of the University of California-San Francisco Department of Medicine, posted a list of “Things We’ve Gotten Better At Since March”; it includes a number of improvements that could affect in-hospital mortality, such as better monitoring of vital signs and a more effective use of prone (face-down) positioning, which has been observed to improve oxygen levels in severely ill COVID-19 patients.

I thought you said it was two weeks?

Fish To Escape wrote:

Side Note: Arizona ICU capacity is now at 100% and they are not going to publicize it anymore. Former classmates of mine are talking about plans in place to start the process of black tagging. Surge capacity is being rolled out

False. There likely are some individual hospitals that are at capacity, but they are not nor have ever been at 100% ICU capacity.

http://www.azdhs.gov/preparedness/epidemiology-disease-control/infectious-disease-epidemiology/covid-19/dashboards/index.php

Meanwhile, despite AZ cases spike really picking up back on June 16th, deaths are still declining.

http://www.azdhs.gov/preparedness/epidemiology-disease-control/infectious-disease-epidemiology/covid-19/dashboards/index.php

Also, anyone have any reasonable explanation for no jump in MN post-protests? Still no discernible jump in cases, hospitalizations or deaths from the 10’s of thousands taking to the streets for a week straight. (sorry if this was covered already, but I’ve been off the grid for a week and don’t have time to go back and read each page).

http://www.health.state.mn.us/diseases/coronavirus/situation.html

Cases up and deaths declining sound like the virus could be weakening?

The lag in MN appeared to be around 2 weeks on the initial wave. Originally I said 4 weeks.

biggill wrote:

<div class=”d4p-bbt-quote-title”>Angler II wrote:</div>
Even though cases continue to rise the death toll has dropped considerable.

Deaths are a lagging indicator. What happens in cases today shows up in deaths 4 weeks from now.

BigWerm wrote:

Also, anyone have any reasonable explanation for no jump in MN post-protests? Still no discernible jump in cases, hospitalizations or deaths from the 10’s of thousands taking to the streets for a week straight. (sorry if this was covered already, but I’ve been off the grid for a week and don’t have time to go back and read each page).

Osterholm has been saying a lack of surge from protests is likely due to the fact it is difficult to transmit outdoors. While others point as masks being the saving grace. All of the documented super spreader events have occurred indoors in poorly ventilated areas. Not to mention the anecdotal evidence out of meat packing plants, long term care centers and Amazon fulfillment centers.

When you look at the current surge it’s happening in places that opened up very early. Quite a few of them before Memorial Day.

It’s important to note that MN cases are no longer declining. We’ve sort of plateaued in the past week or so.

Anyone hoping for a mask mandate will probably get their wish by the end of the week. State health officials already support it.

Who was actually getting tested in the first couple months of the pandemic? I believe it was almost entirely people who were symptomatic enough to be hospitalized or close to that designation.

Who is being tested now and why? I believe almost entirely people that are mildly symptomatic or not at all for the purpose of tracing the virus and isolating it.

Are we drawing the same conclusions from that initial tested population? ie, hospitalization rate, icu rate, deaths?

Another Dad that I coach baseball with was umpiring a town ball game. In that game there were 2 asymptomatic players that were tested for work purposes. They came back positive. my friend got tested along with as many people involved with that game that could be contacted. i don’t know how many positives came of it. Great for those who could know and isolate. Entirely different POSITIVE test than a sick-about-to-be-hospitalized POSITIVE test from April.

food for thought.

BigWerm wrote:

Also, anyone have any reasonable explanation for no jump in MN post-protests?

The percentage of folks wearing masks at these events is quite high. They do their best to maintain distance as well.

My oldest has gone to dozens of these and she’s quite happy with people following guidelines. She’s at that age and a lil snowflakeish on things so if she says it’s pretty good in that regard I believe her.

biggill wrote:

<div class=”d4p-bbt-quote-title”>BigWerm wrote:</div>
Also, anyone have any reasonable explanation for no jump in MN post-protests? Still no discernible jump in cases, hospitalizations or deaths from the 10’s of thousands taking to the streets for a week straight. (sorry if this was covered already, but I’ve been off the grid for a week and don’t have time to go back and read each page).

Osterholm has been saying a lack of surge from protests is likely due to the fact it is difficult to transmit outdoors. While others point as masks being the saving grace. All of the documented super spreader events have occurred indoors in poorly ventilated areas. Not to mention the anecdotal evidence out of meat packing plants, long term care centers and Amazon fulfillment centers.

When you look at the current surge it’s happening in places that opened up very early. Quite a few of them before Memorial Day.

It’s important to note that MN cases are no longer declining. We’ve sort of plateaued in the past week or so.

Anyone hoping for a mask mandate will probably get their wish by the end of the week. State health officials already support it.

I think you are correct. All democratic states will have public masking mandates put in place with absolutely no plan for removal. Also, there will be no chance democratic states will be going to school in the fall.

by the way, How come no one has an explanation for the proud mask wearing, blue state, that had the most draconian lockdown measures???? how come their numbers are skyrocketing??? you know, California.

As you where saying all along Matt, Masks won’t being saving you. If you are vulnerable and WANT TO isolate then that is the only way to ensure your safety.

joe-winter wrote:

Who was actually getting tested in the first couple months of the pandemic? I believe it was almost entirely people who were symptomatic enough to be hospitalized or close to that designation.

Who is being tested now and why? I believe almost entirely people that are mildly symptomatic or not at all for the purpose of tracing the virus and isolating it.

Are we drawing the same conclusions from that initial tested population? ie, hospitalization rate, icu rate, deaths?

Another Dad that I coach baseball with was umpiring a town ball game. In that game there were 2 asymptomatic players that were tested for work purposes. They came back positive. my friend got tested along with as many people involved with that game that could be contacted. i don’t know how many positives came of it. Great for those who could know and isolate. Entirely different POSITIVE test than a sick-about-to-be-hospitalized POSITIVE test from April.

food for thought.

Which is exactly why the positive rate is critical to evaluate current trends. A rise or fall in cases doesn’t necessarily relate to rise or fall in community spread. If the % positive rises or falls, there’s a story to be told.

I think currently, pretty much anyone who wants a test can get one. In March and April you had to be a first responder, have symptoms, in the hospital or LTC or a few other reasons.

They are doing some strategic testing where they roll in mobile sites to high risk areas and large businesses with an outbreak. That may account for a good portion of tests.

We don’t even know if there is that much demand for tests. The Gov said we would be getting to that 20k per day but we’ve only come close to that once. Maybe people just aren’t wanting to get tested. The fact that the positive rate is holding steady tells me we just haven’t seen any real increase in community spread lately.

I just hope if we do the mask thing they take a step back and see what Texas is doing. When cases rise above X per 100K, masks become mandatory in that county.