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For most people Coronavirus is like the flu or even a cold, but for 20% it’s something awful. Even in younger patients — a few seemingly fit and healthy 40 and 50 year olds are gasping for air as their lungs fill with blood and fluid and it’s “like a near death drowning” or “inhaling caustic gas”. Forgive the language in the headline — those were this docs exact words. He’s working at a New Orleans hospital and his whole attitude to the virus has changed dramatically.
h/t Analitik
A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients
by Lixzzie Presser, ProPublica
“It first struck me how different it was when I saw my first coronavirus patient go bad. I was like, Holy shit, this is not the flu. Watching this relatively young guy, gasping for air, pink frothy secretions coming out of his tube and out of his mouth. The ventilator should have been doing the work of breathing but he was still gasping for air, moving his mouth, moving his body, struggling. We had to restrain him. With all the coronavirus patients, we’ve had to restrain them. They […]
Look at State by State outcomes: visit Covid Act Now
Its an excellent display of modeled outcomes across the US*. Click on each state in the US to find out predicted death tolls and the day hospitals will be overwhelmed with too little action.
Dear readers, get out of the way of this virus. My advice is to stay home. Order online. Wear masks if you have to venture out. Keep kids home from school. Don’t visit anyone or allow visitors in to your home who have not strictly quarantined for the last two weeks. We started this last week.
h/t Bill in Oz.
Eg It’s too late now for New York State to avoid losing control of hospitals
But they could still Crush the Curve and save a lot of people, but even that action now will have far higher death tolls that it would if it had been started last week.
New York State has a population of 20 million. So the figures in the table below are directly comparable to Australian outcomes with a population of 25m (with the hope that lower population density, warmer weather, and two weeks warning could be an […]
The wave coming is not just a “bit bigger” than hospitals can handle
Western Australian specialists estimate that at present rate, in 45 days Coronavirus cases will fill up their entire state hospital system. Two weeks later Covid patients will also fill all the beds in the extra two copies of their entire state hospital network that haven’t been built yet.
Hospitals will need 20 times as many ventilators as they have.
“Peak need for ventilators will be over four thousands in a system where we have less than two hundred. Again, most of those needing a ventilator will die. “
Perhaps we are overreacting?
Western Australia is an example of what the rest of the West faces. There are 2.5m people here, but only 120 confirmed cases. In a state which took six years to build one hospital all we need to do is triple our hospital capacity in 6 weeks. Laughing…
The Doctors call for the immediate closure of borders. Which was impossible a few days ago, in a state that only has two sealed roads out, but is now happening on Tuesday “at 1:30pm”. (Presumably the new border guards have to drive out from […]
The first epicentre in Italy was Vò, a little town of 3,000. It was shut down, fully tested and twice and nine days apart. By testing, isolating, and tracking, they reduced the spread to almost nothing, and this is despite the extraordinary discovery that when the first death happened, already 3% of the town had the disease.
At that point surely the Italian government should have immediately closed everything?
https://www.livescience.com/small-italian-town-cuts-coronavirus-cases-testing.html
Italian village reports no new infections for days after blanket testing
Zoe Tidman, Independent
Mr Zaia, Veneto’s governor, said the trial was “criticised by most sides” but that isolating numbers of undetected positive cases has resulted in Vo Euganeo being today “the safest place in Italy”.
h/t Bill H
In one Italian town, we showed mass testing could eradicate the coronavirus
Andrea Crisanti and Antonio Cassone, The Guardian, March 20.
Our experiment came to be by chance. The Italian authorities had a strong emotional reaction to news of the country’s first death – which was in Vò. The whole town was put into quarantine and every inhabitant was tested.
In the first round of testing, 89 people tested positive. In […]
Australian Medical Association WA President Andrew Miller said Western Australia was headed for a situation like Italy and are 8 – 10 days behind Sydney. Read his scathing comments below.
The tally in Australia is now about 900, the same as Italy had on Feb 28th, just three weeks ago. Now Italy has 41,000 cases and 3,405 people have died. Their population is three times larger than Australia and slightly older, it’s colder and packed in closer. At a guess, with the present SlowMo/SlowState response, maybe only 10-20,000 Australians will catch this in the next three weeks? “Great”.
UPDATE: Hospitals in Italy are no longer intubating anyone over 60 years old. h/t nezy
Italian politicians could have been better prepared, but there’s no excuse for the rest of the world now.
Coronavirus crisis: Australian Medical Association WA President Andrew Miller slams WA Government response to COVID-19 pandemic
John Flint The West Australian
[Miller said:] …“And we’re not doing any of the things that the countries that are being successful are doing like Hong Kong.
“They are using fever monitoring in public, they lock people down away from their families if they’re positive, whereas here we send […]
Dithering politicians push the fatality from 0.5% toward 5%
A gritty analysis by Tomas Pueyo shows how leaders inertia is killing people every day. Some of the victims of tomorrows Virus Get-Togethers won’t die for a few weeks, but the next batch starts tomorrow (and every day until the nation self-isolates, stops the pox-parties, the cough-shopping, and pneumonia-planes. ). And each day there are more than the day before. Sounds macabre, but at this point in an exponential epidemic, it’s just how it is. Since we didn’t stop the Airbussed virus, we’re going to have to shut everything down anyhow, the later we do it, the larger the cost, and the longer it takes. We have to get ahead of this virus.
Meanwhile in Australia, the average punter seems to realize this and the mood is hitting feverish notes with tramplings in supermarkets — The government is calling for calm, but doctors are calling for borders to close, and schools to go online, they’re standing outside schools with signs telling parents not to send their children to school. Doctors are warning that we are the next “Italy” if we don’t get our act together. But the government says it’s too […]
I seem to have the uncanny ability to predict what frontline experts will recommend days in advance. It’s not genius. Just medical training and that the solution to this is so Bleeding Obvious, and politicians are still 2 to 3 weeks behind an exploding epidemic of an inanimate nucleic acid code.
WA hospitals call for state border closures to deal with coronavirus fears (COVID-19)
Top doctors across WA’s biggest hospitals are sensationally calling for the state to effectively close its borders to protect West Australians from the coronavirus pandemic.
In a remarkable letter obtained by The West Live to be discussed exclusively on this morning’s show, it can be revealed the Combined Medical Leads Advisory Group has raised concerns about the “extremely limited” availability of testing infrastructure and supplies in WA.
The group, which includes senior medicos from FSH, RPH and SCGH, also warns there is “limited evidence of effective anti-viral treatment”, “no effective vaccine” and that rationing is already in place at hospitals.
It recommends that to “flatten the curve” that attention should be paid to “extending isolation restrictions to all personal interstate travel”.
Just to spell this out, all states […]
BREAKING NEWS: Since writing this Scott Morrison has finally moved to quarantine all arrivals including planes and ships. He’s still two weeks behind the virus, and playing catch up with Jacinda Ardern, the real leader. But finally the bleeding obvious has dawned.
He won’t close schools, and perhaps, suddenly that will now be a viable option, though Sydney still needs short sharp major action to save lives. Could they bear doing no sport or social events for two weeks?
The big risk to most states are now flights from Sydney. Will NSW aim for the “slow bleed” eking out infections over months, hoping none accidentally go wild, or will it aim to wipe this out in three weeks so life gets back to normal, and Australia can play sport again against New Zealand, asap?
With this news, just in the nick of time, the future is now looking better. My prediction: Watch as leaders all round the world pick this up. This is a good boost for nation states and sovereign borders. All eyes are on the EU now where the open border policy has been disastrous — Spain (6,300), Germany (4500) […]
Get out of the way of this virus.
Could Italy be suffering from a different and nastier strain?
Figures from South Korea and the Diamond Princess may not be a good guide to what’s happening in Italy and Iran. There something seriously different going on there. Death rates are much higher than expected. Three weeks ago, Italy officially had three cases, now a thousand people are dead and 12,000 have the virus. The hospital system is already at the point of being overwhelmed. Reports say that even stroke patients are now missing out on help, the ICU wards are overflowing, and the staff are prioritizing younger people because they have a better chance of survival.
Perhaps Italians hug more and spread more, perhaps it’s worse because they have an older demographic. But perhaps this is a deadlier strain than the one Japan, Hong Kong, Taiwan, Singapore and South Korea appear to be containing. The Italian strain, whatever it is, is from the Iranian strain. Every country that has imported infected passengers from Iran will likely also have the Iranian strain.
Do we really want to follow Iran and Italy?
It’s not impossible — Just stop feeding the virus fresh bodies […]
And so it begins.
Suddenly there are no more weddings for a quarter of all of Italy. No more movies, pubs, dance halls or trains to some parts of the country either. Italy is about to overtake South Korea for the number two spot on the list no country wants to lead, unless Iran beats Italy to it (which it almost certainly has already). Today 16 million Italians are not free to go about their business, or go to school.
On Feb 21st, Italy had three cases, now 366 people are dead, and 7353 are infected (at least). How life has changed in two weeks and three days. Suddenly France and Germany are about to reach the 1,000 mark. This is what exponential curves feel like.
“We are facing an emergency, a national emergency,” Prime Minister Giuseppe Conte said in announcing the government decree in a news conference after 2 a.m. — NY Times
The Frankfurt and London exchanges dropped by 8 percent in early Monday trading, while in Paris stocks were trading 4 percent lower. An index of Europe’s 50 biggest companies was down nearly 6 percent.
Oil prices lost nearly a quarter […]
Watching South Korea — it appears to have stopped the exponential spread of Coronavirus
Heartening. At its peaks last Saturday and Tuesday, South Korea acquired 800 new infections per day. Since then, whatever it is doing, South Korea has managed to keep the new daily cases between 300-800. That may not sound like much, but in exponential terms it could have been a lot worse. Is this the future for us in the West? Perhaps with aggressive action, and local or statewide lockdowns, wealthy western nations may get outbreaks under control. Will we spend the next year with periodic major lockdowns as outbreaks occur, but manage to keep the virus from en masse spread without hospitals being overwhelmed? But can poor countries achieve this? If not, we will have to close flights to stop repeated debilitating and deadly outbreaks, while doing our best to help them. The world will become divided into nations which have this controlled, and those who don’t. This is still the pandemonium I’ve been talking about for six weeks; we could have avoided it, but it’s better than other scenarios. It’s a middle-run scenario.
We are fortunate that this is not as airborne and infectious as […]
Sobering
This 25 year old British man caught the virus in Wuhan on November 25. He must have been one of the earliest cases, and it was only recognised belatedly that he had Coronavirus. Twice, he thought he was well, only to relapse. But he does recover. I suspect this is the rarer “severe” type case in an otherwise healthy young man. Theoretically 80% of people get the easier five day version and recover. Notably, for him it’s 24 days before he feels well properly. Can this disease affect pets, which is very ususual? If so, can it affect other mammals, like livestock?
What it’s REALLY like to catch coronavirus: First British victim, 25, describes how ‘worst disease he ever had’ left him sweating, shivering, and struggling to breathe as his eyes burned and bones ached
Day 5: I’m over my cold. It really wasn’t anything.
Day 7: I spoke too soon. I feel dreadful. This is no longer just a cold. I ache all over, my head is thumping, my eyes are burning, my throat is constricted. The cold has travelled down to my chest and I have a hacking cough.
[…]
The irony: while Australia blocks fruit flies, China blocks deadly viruses
How long before China bans flights from the US, UK and Australia? Count the days…
Coronavirus: China orders travellers quarantined amid outbreak
[BBC] Travellers from countries with severe coronavirus outbreaks who arrive in some parts of China will have to undergo a 14-day quarantine, state media say.
Travellers from the virus hotspots of South Korea, Japan, Iran and Italy arriving in the capital will have to be isolated, a Beijing official has said.
Shanghai and Guangdong announced similar restrictions earlier.
Authorities are worried the virus might be imported back into the country.
Although most virus deaths have been in China, Monday saw nine times more new infections outside China than in.
Shanghai said it would require new arrivals from countries with “relatively serious virus conditions” to be isolated, without naming the countries.
Chinese official statistics suggest they are getting the outbreak under control, which is hard to believe, but they are acting like they do. If most of their population is still at risk of further outbreaks, then they would care about risky incoming flights.
Meanwhile our […]
Leading the pack, at about number 92, Australia bans flights from South Korea
South Korea added to Australia’s coronavirus travel ban list, restrictions for travellers from Italy
[ABC News] The Federal Government has expanded its coronavirus travel ban to include South Korea, and added additional precautions for travellers from Italy, amid fears about the spread of the disease.
The revised bans will be in place until Saturday, March 14 but the Government will review the situation within a week to determine if the travel restrictions need to be extended further.
Since the government was at least one week too late with the Iranian block, how will the medical experts stay ahead of the curve on other countries with no testing? Eg Indonesia? Or in this case, Europe and Dubai?
First case of Coronavirus in Western Australia that was brought in accidentally:
The woman in her 30s from Perth’s southern suburbs returned a positive result after holidaying in Iceland and the UK, and returning to WA via Dubai on Monday.
It’s still a soft loopholey quarantine:
9.5 out of 10 based on 51 ratings […]
In a word: bum.
WHO announced their estimates of 3.4% global mortality today. All the caveats apply — it includes rubbery-figures-from-China and comes from the Useless UN and a group headed by a star apologist-for-Xi. But here’s the thing, look at the numbers outside China (see the big table below), and its a similar ballpark. Sorry to rant on about this virus.
The World Health Organization had said last week that the mortality rate of COVID-19 can differ, ranging from 0.7% to up to 4%, depending on the quality of the health-care system where it’s treated.
Don’t look now: Big Numbers Coming. Assuming 60% of people catch it before some treatment appears, a death rate of 0.7% – 4% means bad news for some furry number from 100,000 to 600,000 Australians. Double that for the UK. And 1.4m – 8m in the United States. There is a wide range of mortality rates, which may reflect that there are two kinds of mortality rates here — one where people get great ICU care, and one where hospitals are overrun and they don’t. We’ll probably pin that to the low end if we keep cases limited, we eat well, don’t […]
In the new pandemic era with a global social media, people are not waiting for governments to tell them travel is risky.
According to IATA’s press release, airlines are experiencing serious declines in demand:
A carrier’s 26% reduction across their entire operation in comparison to last year. A hub carrier reporting bookings to Italy down 108% as bookings collapse to zero and refunds grow. Many carriers reporting 50% no-shows across several markets. Future bookings are softening and carriers are reacting with measures such as crew being given unpaid leave, freezing of pay increases, and plans for aircraft to be grounded.
It almost gives me hope that people are smart enough to outwit their governments and protect themselves despite the incompetence at the top. But it doesn’t get the governments off the hook — it just shows how easy it would have been to stop the flights. The problem is that while the people who are afraid of getting sick are staying home, the people who are surrounded by the sick would want to fly in if they could. Therefore countries that want to stop their hospitals being overrun still need to stop those flights.
With only two cases of Covid-19 […]
It’s too expensive to close borders, they say, but who can afford to import this virus?
Should we stop holidays and conferences, or most of the economy?
The monthly PMI figures show that in February about four fifths of China’s economy was shut down. Locking people in apartments and hospitals being not very productive. Strangely, all the economists watching the mainstream news and official Chinese figures did not expect this. They were shocked when the monthly PMI result was announced. The drop from 50 to 35 was more than twice as bad as the economists expected.
China PMI horror show to trigger Q1 downgrades
Umesh Desai, Asia Times
China’s Purchasing Managers’ Index in February plunged to 35.7 from 50 in January. This is the lowest reading since January 2005 when it was first released and even lower than November 2008’s figure of 38.8 during the Global Financial Crisis.
The market had expected a reading of around 46, according to a Reuters poll and this shocking data had analysts recalibrating their numbers.
The ANZ economists said this implied the utilization of only a fifth of the country’s full economic capacity, much lower than […]
Fun subject of the day: How Coronavirus kills
No seriously, this is matter-of-fact, youtube-at-its-best, concise, cartoony, and smart.
Think of doctors as Body-Engineers. The problem to solve today Engineer-readers — is how to keep blood supply oxygenated when lungs are highly inflamed, filling with fluid, and the delicate thin membranes of lung tissue can’t cope with the sheer forces of rapid collapse and expansion. As well, if oxygen levels drop, even unconscious patients will breathe involuntarily — out of synch with artificial ventilation machines. The sensation of suffocation creates the urge to breath faster and harder. . The great news is ICU staff are getting much better at keeping people alive when they get ARDS (Acute Respiratory Distress Syndrome) which can happen with other diseases (like Influenza). Seems, the ICUs can keep 84% alive while they wait for the inflammation to subside and the damage to heal. Though the DIY version at home probably won’t be so effective.
Not enough beds
Obviously, this explains my obsessive interest in the percentage needing ICU care and also the Ro (rate of reproduction or spread). With a shortage of ICU beds, slowing the spread makes a life-and-death difference to state the bleeding obvious. […]
Amazing. Sinbad reports on the situation in Iran. He is a commenter here who speaks the language. I can’t confirm this except to say that #Coronavirusupdates Iran looks like everything he is describing. Officially there are only 388 cases and 34 deaths. But on twitter, just like China, censorship and denial and so much more. Mass graves. Corrupt officials. Mass spraying of the streets. But if there is no attempt to stop it spreading (no lockdown like China has done) this will truly run wild. Those poor people. Germany closed flights in January, related to other problems in Iran. In the last week Iraq, Oman, Turkey, Pakistan, Afghanistan, Tajikistan, UAE, Kuwait all closed borders with Iran. Australia, with lower medical standards imported a case from Iran today instead. – Jo
UPDATE: Finally, today the Australian government banned arrivals from Iran without a two week holiday stopover somewhere. That’s a lot better but should be mandatory proper quarantine. The government now has the arduous job of tracking the 40 people (or more) she may have infected and the people those victims may have infected (their families). Those 40+ people now have the stressful wait to find out if they got “lucky”. […]
Overnight, people woke up to the real threat and markets crashed appropriately. Unless we take massive action immediately, the exponential curve is about to lift off. And if we don’t act now then massive action is coming anyway in a month, along with major disruption, pandemonium, and worse.
There are now 5,300 cases outside China. If it doubles every 5 days (as it just has) then 40 days from now 5 million people will be infected.
What does massive action look like? A bit like this:
Japan closes all its schools til early April 5 million people in Hakkaido in Northern Japan are told to stay home South Korea is preparing to test 200,000 people UK schools and offices are warned they could close for up to two months EasyJet and British Airways canceled many flights to Italy Iran has cancelled Friday Prayers in Tehran Italy has quarantined 11 towns Switzerland cancelled the Geneva Car Show UAE Canceled the rest of their bike race.
In Japan some are in uproar — they’re the ones who don’t understand how 226 infections becomes a national hospital crisis in weeks. Japan (like most nations) is theoretically only 19 […]
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