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RE: OT: Corona virus - 3/4/2020 3:08:15 PM   
witpqs


Posts: 26087
Joined: 10/4/2004
From: Argleton
Status: offline
quote:

ORIGINAL: Chickenboy
If media is responsible, they need to dial down...






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Post #: 211
RE: OT: Corona virus - 3/4/2020 3:11:42 PM   
Chickenboy


Posts: 24520
Joined: 6/29/2002
From: San Antonio, TX
Status: offline
quote:

ORIGINAL: PaxMondo
When a virus is in the general population, testing is kinda moot except for people are really ill to determine what (which virus/secondary infection) they have.


Exactly right.

From an interventional / treatment perspective, diagnostic tests are a tool that will help dictate the next course of action. Too many people think that testing for testing sake is worthwhile. Usually it's not. Unless one is trying to determine the next course of action for a choice of available treatments or gain in-depth understanding of disease incidence/prevalance, the information gathered by diagnostic testing is often overrated.

In the case of COVID-19, I have scientific curiosity about how many Americans have been exposed to the virus. But we wouldn't know that unless we had a broad profile of the population tested. So, how many of the 330 million Americans do we need to test for that? Is that the right thing to do now-test millions of people across the board-to assess the trajectory of this virus in the population? Can our laboratories handle that throughput and provide meaningful real-time information based on that study design. I think the answer is no.

We have to assume that the genie is out of the bottle on this thing. Assume that most everyone could have contact with someone that may have been shedding virus at some point or another. Eventually, I'd like to see a big study looking at seroconversion in the population, but that may take months or years to see how many people (or a representative sample) have been exposed. Assume 'lots' and go with that for the time being.

Diagnostics in the face of an outbreak-what we have here-are better suited for interventional strategies. Think flow chart or decision tree. If someone tests positive for X, we assign treatment/prevention Y. What happens if there IS NO treatment/prevention Y? The value of the test and the rationale for the test diminishes.

So with COVID-19, what would we do *differently* with the patient if they test positive with RT-PCR? Perhaps one could argue that there is greater scrutiny about self-quarantine or imposed quarantine procedures. Several health departments have been remitting positive cases or positive contact cases to self-quarantine. I guess I'm OK with that rationale. But would our instructions to 'wash hands, stay home, drink plenty of fluids, avoid social gatherings, etc.' be any different for someone with a high fever and respiratory disease (ala influenza) be so radically different between someone that tested positive versus someone that tested negative on that given diagnostic test? Probably not.

We've got this virus running around. Take heed. Take precautions to limit its spread. Prepare yourselves accordingly. In the absence of a specific treatment or preventive measure (e.g., vaccine), the panacea of widespread testing won't do much to inflect the epidemic curve.

< Message edited by Chickenboy -- 3/4/2020 3:25:38 PM >

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Post #: 212
RE: OT: Corona virus - 3/4/2020 3:24:06 PM   
Chickenboy


Posts: 24520
Joined: 6/29/2002
From: San Antonio, TX
Status: offline
quote:

ORIGINAL: witpqs


quote:

ORIGINAL: Chickenboy
If media is responsible, they need to dial down...







My car gets 40 rods to the hogshead and that's the way I likes it!

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Post #: 213
RE: OT: Corona virus - 3/4/2020 3:34:33 PM   
Chickenboy


Posts: 24520
Joined: 6/29/2002
From: San Antonio, TX
Status: offline
quote:

ORIGINAL: obvert


quote:

ORIGINAL: RangerJoe


quote:

ORIGINAL: JohnDillworth

The statistics are not giving a good picture of what may be going on. So the U.S. does not look so bad with 100 cases. The problem is is that only 500 people in the U.S. have been tested! 500! So, 20% of all people tested have test positive. I suspect there is a lot more than 100 cases. https://www.theatlantic.com/technology/archive/2020/03/how-many-americans-really-have-coronavirus/607348/


But who needs to be tested? As far as I know, I've had no contact with anyone who has or had it. I have not traveled. That is the problem, it takes a lot of money to test and without a good reason to do so it will not be done.


One big difference between the US and Europe (and many other places in the world) is the profit oriented healthcare industry in the States.

If containment is improved by testing and self-or-imposed quarantines of known cases, then a profit oriented medical system ends up being very ineffective. It will end up costing more in the long run of course not to splash out on the early stage efforts to test and contain (through increased hospital stays, more missed work time and general panic if numbers go way up, etc).

The large segment of the populace who don't have health insurance will also end up spreading the disease through their reluctance or inability to go in to a doctor and incur fees to be tested. It will also likely hit the poor and uninsured harder due to a higher prevalence of pre-existing conditions.


Meh.

The merits of a profit-oriented healthcare system versus that of a state-run healthcare system are too broad to start a thread about here. There is a role in a public health system / policy system that cannot be filled well by profit-oriented healthcare systems-outbreak disease investigations being a prominent difference in favor of the former.

But you can't look past the 'one size fits all' approach associated with the single-payer systems. These are more prone to rationing of care, decreased expenditures for R&D, decreased expenditures for novel treatment/interventional strategies and overstepping of state rights into individual rights than a more tailored individualistic 'for profit' healthcare system provides.


< Message edited by Chickenboy -- 3/4/2020 4:02:37 PM >

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Post #: 214
RE: OT: Corona virus - 3/4/2020 4:14:12 PM   
MakeeLearn


Posts: 4278
Joined: 9/11/2016
Status: offline 		Chinese scientists identify two strains of the Coronavirus, indicating it’s already mutated at least once
Published Wed, Mar 4 20207:35 AM ESTUpdated 3 hours ago
https://www.cnbc.com/2020/03/04/coronavirus-chinese-scientists-identify-two-types-covid-19.html


"The more aggressive type of virus was found to be prevalent in the early stages of the outbreak in Wuhan — the Chinese city where COVID-19 was first detected late last year. "




Structural basis for human coronavirus attachment to sialic acid receptors

https://www.nature.com/articles/s41594-019-0233-y
Published: 03 June 2019

"Coronaviruses cause respiratory tract infections in humans and outbreaks of deadly pneumonia worldwide. Infections are initiated by the transmembrane spike (S) glycoprotein, which binds to host receptors and fuses the viral and cellular membranes."

"Currently, no specific antiviral treatments or vaccines are available to combat any human coronavirus. Furthermore, future cross-species transmission events of coronaviruses seem likely, given the large reservoir found in bats. Studying coronaviruses will therefore help in understanding the principles governing cross-species transmission and adaptation to humans and in preparing for putative future zoonotic outbreaks."








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Post #: 215
RE: OT: Corona virus - 3/4/2020 4:29:00 PM   
MakeeLearn


Posts: 4278
Joined: 9/11/2016
Status: offline 		Schematic representation of a coronavirus particle.
https://www.futuremedicine.com/doi/10.2217/fvl-2018-0144






Attachment (1)

< Message edited by MakeeLearn -- 3/4/2020 4:30:41 PM >

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Post #: 216
RE: OT: Corona virus - 3/4/2020 4:29:43 PM   
MakeeLearn


Posts: 4278
Joined: 9/11/2016
Status: offline 		The coronavirus replication cycle highlighting areas where membrane interaction occurs.
https://www.futuremedicine.com/doi/10.2217/fvl-2018-0144








1) Most Coronaviruseses enter by receptor mediated endocytosis. The positive sense genomic RNA is released into the cytoplasm and translated into the initial virus polyproteins which encode the nsp.

(2) The nsp stimulate the production of DMVs and establish the replication transcription complexes (RTC), which produce the -ve strand replicative intermediate from which more +ve strand genomes and mRNAs are produced. Translation of the N mRNA produces the N protein in the cytoplasm which combines with the new genomes to form RNPs while translation of the remaining structural proteins, M, E and S occurs in the ER where they accumulate in the ERGIC and cis-Golgi.

(3) Virus assembly begins and completes as the protein cargos migrate through the Golgi stacks resulting in new virus particles in vesicles
(4), which eventually fuse with the plasma membrane.

Attachment (1)

< Message edited by MakeeLearn -- 3/4/2020 4:32:56 PM >

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Post #: 217
RE: OT: Corona virus - 3/4/2020 5:15:32 PM   
Canoerebel


Posts: 21100
Joined: 12/14/2002
From: Northwestern Georgia, USA
Status: offline 		That's what happened on the few occasions I was invited to a high school party. All the guys would be talking about cars or sports, and I'd try to change the topic to the Civil War or butterflies or Olivia DeHaviland.

Conversations stoppers, circa 1978.

MakeeLearn, circa 2020.

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Post #: 218
RE: OT: Corona virus - 3/4/2020 5:22:03 PM   
warspite1


Posts: 41353
Joined: 2/2/2008
From: England
Status: offline
quote:

ORIGINAL: Canoerebel

That's what happened on the few occasions I was invited to a high school party. All the guys would be talking about cars or sports, and I'd try to change the topic to the Civil War or butterflies or Olivia DeHaviland.

Conversations stoppers, circa 1978.

warspite1

.. ohh I say, is that the time? I've just remembered I've got to go... whoaaah, hold on, did you say Olivia de Haviland... I've just remembered, I don't have to leave after all....


Hubba bubba!!



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Post #: 219
RE: OT: Corona virus - 3/4/2020 5:39:56 PM   
Scott_USN

 

Posts: 715
Joined: 6/2/2004
From: Eagle River, Alaska USA
Status: offline 		I work in IT and now we have this huge panic where everyone thinks they will need VPN to work from home when the apocalypse arrives from China. Even though 20% the organization has had the flu this year because it was really bad. Anyway so that his hundreds of people setup on VPN but they don't even really know what it is.

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Post #: 220
RE: OT: Corona virus - 3/4/2020 5:44:29 PM   
BBfanboy


Posts: 18046
Joined: 8/4/2010
From: Winnipeg, MB
Status: offline
quote:

ORIGINAL: Scott_USN

I work in IT and now we have this huge panic where everyone thinks they will need VPN to work from home when the apocalypse arrives from China. Even though 20% the organization has had the flu this year because it was really bad. Anyway so that his hundreds of people setup on VPN but they don't even really know what it is.

That's easy - VPN is obviously a Virus Panic Network!

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No matter how bad a situation is, you can always make it worse. - Chris Hadfield : An Astronaut's Guide To Life On Earth

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Post #: 221
RE: OT: Corona virus - 3/4/2020 5:48:14 PM   
Zorch

 

Posts: 7087
Joined: 3/7/2010
Status: offline
quote:

ORIGINAL: BBfanboy


quote:

ORIGINAL: Scott_USN

I work in IT and now we have this huge panic where everyone thinks they will need VPN to work from home when the apocalypse arrives from China. Even though 20% the organization has had the flu this year because it was really bad. Anyway so that his hundreds of people setup on VPN but they don't even really know what it is.

That's easy - VPN is obviously a Virus Panic Network!

At my company all remote work is encrypted. People don't have to understand it to use it.

(in reply to BBfanboy)
Post #: 222
RE: OT: Corona virus - 3/4/2020 6:10:05 PM   
Chickenboy


Posts: 24520
Joined: 6/29/2002
From: San Antonio, TX
Status: offline
quote:

ORIGINAL: MakeeLearn

Schematic representation of a coronavirus particle.
https://www.futuremedicine.com/doi/10.2217/fvl-2018-0144







This is the more interesting diagram of the two. Surface protein 1 (S1) is the adhesion point. Most vaccines are targeted to this spike glycoprotein because this is how the virus attaches (and subsequently invades) host cells. If you mount an IgA/IgM/IgG response against S1 that will delay / preclude viral attachment and host cell infection. The rest of the glycoproteins (S2, M, N, E) are less important regarding immunogenicity.

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Post #: 223
RE: OT: Corona virus - 3/4/2020 6:11:18 PM   
Chickenboy


Posts: 24520
Joined: 6/29/2002
From: San Antonio, TX
Status: offline
quote:

ORIGINAL: BBfanboy


quote:

ORIGINAL: Scott_USN

I work in IT and now we have this huge panic where everyone thinks they will need VPN to work from home when the apocalypse arrives from China. Even though 20% the organization has had the flu this year because it was really bad. Anyway so that his hundreds of people setup on VPN but they don't even really know what it is.

That's easy - VPN is obviously a Virus Panic Network!



_____________________________


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Post #: 224
RE: OT: Corona virus - 3/4/2020 6:18:35 PM   
Zorch

 

Posts: 7087
Joined: 3/7/2010
Status: offline
quote:

ORIGINAL: Chickenboy


quote:

ORIGINAL: BBfanboy


quote:

ORIGINAL: Scott_USN

I work in IT and now we have this huge panic where everyone thinks they will need VPN to work from home when the apocalypse arrives from China. Even though 20% the organization has had the flu this year because it was really bad. Anyway so that his hundreds of people setup on VPN but they don't even really know what it is.

That's easy - VPN is obviously a Virus Panic Network!



It spreads by contact with computer mice droppings.

(in reply to Chickenboy)
Post #: 225
RE: OT: Corona virus - 3/4/2020 6:51:31 PM   
RangerJoe


Posts: 13450
Joined: 11/16/2015
From: My Mother, although my Father had some small part.
Status: offline
quote:

ORIGINAL: Zorch


quote:

ORIGINAL: BBfanboy


quote:

ORIGINAL: Scott_USN

I work in IT and now we have this huge panic where everyone thinks they will need VPN to work from home when the apocalypse arrives from China. Even though 20% the organization has had the flu this year because it was really bad. Anyway so that his hundreds of people setup on VPN but they don't even really know what it is.

That's easy - VPN is obviously a Virus Panic Network!

At my company all remote work is encrypted. People don't have to understand it to use it.


The voice of experience here?

_____________________________

Seek peace but keep your gun handy.

I'm not a complete idiot, some parts are missing!

“Illegitemus non carborundum est (“Don’t let the bastards grind you down”).”
― Julia Child


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Post #: 226
RE: OT: Corona virus - 3/4/2020 6:51:33 PM   
Sardaukar


Posts: 9847
Joined: 11/28/2001
From: Finland/Israel
Status: offline
quote:

ORIGINAL: Kursk1943


quote:

ORIGINAL: Sardaukar

I was detained for 3 days for suspected COV-19...our legistlation is bit rude when it comes to that


Which one? Finland or THe Holy Land?


Finland.

I was cleared to just be an a-hole and not public enemy

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Post #: 227
RE: OT: Corona virus - 3/4/2020 6:57:16 PM   
Orm


Posts: 22154
Joined: 5/3/2008
From: Sweden
Status: offline
quote:

ORIGINAL: Sardaukar


quote:

ORIGINAL: Kursk1943


quote:

ORIGINAL: Sardaukar

I was detained for 3 days for suspected COV-19...our legistlation is bit rude when it comes to that


Which one? Finland or THe Holy Land?


Finland.

I was cleared to just be an a-hole and not public enemy

Did you have to pay for the pleasure?


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Post #: 228
RE: OT: Corona virus - 3/4/2020 6:58:03 PM   
RangerJoe


Posts: 13450
Joined: 11/16/2015
From: My Mother, although my Father had some small part.
Status: offline
quote:

ORIGINAL: Chickenboy

quote:

ORIGINAL: obvert


quote:

ORIGINAL: RangerJoe


quote:

ORIGINAL: JohnDillworth

The statistics are not giving a good picture of what may be going on. So the U.S. does not look so bad with 100 cases. The problem is is that only 500 people in the U.S. have been tested! 500! So, 20% of all people tested have test positive. I suspect there is a lot more than 100 cases. https://www.theatlantic.com/technology/archive/2020/03/how-many-americans-really-have-coronavirus/607348/


But who needs to be tested? As far as I know, I've had no contact with anyone who has or had it. I have not traveled. That is the problem, it takes a lot of money to test and without a good reason to do so it will not be done.


One big difference between the US and Europe (and many other places in the world) is the profit oriented healthcare industry in the States.

If containment is improved by testing and self-or-imposed quarantines of known cases, then a profit oriented medical system ends up being very ineffective. It will end up costing more in the long run of course not to splash out on the early stage efforts to test and contain (through increased hospital stays, more missed work time and general panic if numbers go way up, etc).

The large segment of the populace who don't have health insurance will also end up spreading the disease through their reluctance or inability to go in to a doctor and incur fees to be tested. It will also likely hit the poor and uninsured harder due to a higher prevalence of pre-existing conditions.


Meh.

The merits of a profit-oriented healthcare system versus that of a state-run healthcare system are too broad to start a thread about here. There is a role in a public health system / policy system that cannot be filled well by profit-oriented healthcare systems-outbreak disease investigations being a prominent difference in favor of the former.

But you can't look past the 'one size fits all' approach associated with the single-payer systems. These are more prone to rationing of care, decreased expenditures for R&D, decreased expenditures for novel treatment/interventional strategies and overstepping of state rights into individual rights than a more tailored individualistic 'for profit' healthcare system provides.



I gave a government run healthcare system three tries to detect melanoma which I did not know that I had. On the fourth time, they finally took a piece off for a biopsy. That is when they detected the melanoma. Zorch, do you remember what my right foot looks like? I had it on the bottom of my right big toe. It still took over 2 months for the surgery by which time it spread (laterally, thank HIM above) but just the right big toe would have come off if they had detected it in time. You don't want the government payer system when your life may be on the line and speed may be an issue.

< Message edited by RangerJoe -- 3/4/2020 6:59:23 PM >

_____________________________

Seek peace but keep your gun handy.

I'm not a complete idiot, some parts are missing!

“Illegitemus non carborundum est (“Don’t let the bastards grind you down”).”
― Julia Child


(in reply to Chickenboy)
Post #: 229
RE: OT: Corona virus - 3/4/2020 7:02:15 PM   
Scott_USN

 

Posts: 715
Joined: 6/2/2004
From: Eagle River, Alaska USA
Status: offline
quote:

ORIGINAL: BBfanboy


quote:

ORIGINAL: Scott_USN

I work in IT and now we have this huge panic where everyone thinks they will need VPN to work from home when the apocalypse arrives from China. Even though 20% the organization has had the flu this year because it was really bad. Anyway so that his hundreds of people setup on VPN but they don't even really know what it is.

That's easy - VPN is obviously a Virus Panic Network!



That could be it!!!

(in reply to BBfanboy)
Post #: 230
RE: OT: Corona virus - 3/4/2020 7:24:52 PM   
JohnDillworth


Posts: 3100
Joined: 3/19/2009
Status: offline 		So in New York we have a student that has tested positive and attended school on multiple days. There is nothing to be gained by testing the other students in her class?

_____________________________

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Post #: 231
RE: OT: Corona virus - 3/4/2020 7:50:23 PM   
RangerJoe


Posts: 13450
Joined: 11/16/2015
From: My Mother, although my Father had some small part.
Status: offline 		I suppose that everyone could be tested every day until they test positive. I am sure that there is enough testing supplies, equipment, and staff to do so. And people get to pay for their own tests.

But then what do you do when they finally test positive? Shoot them and cremate the bodies? It sounds like it is a bad cold or influenza that is adapting to the human host to be less deadly.

_____________________________

Seek peace but keep your gun handy.

I'm not a complete idiot, some parts are missing!

“Illegitemus non carborundum est (“Don’t let the bastards grind you down”).”
― Julia Child


(in reply to JohnDillworth)
Post #: 232
RE: OT: Corona virus - 3/4/2020 8:42:41 PM   
Chickenboy


Posts: 24520
Joined: 6/29/2002
From: San Antonio, TX
Status: offline
quote:

ORIGINAL: JohnDillworth

So in New York we have a student that has tested positive and attended school on multiple days. There is nothing to be gained by testing the other students in her class?


For those in her class, what will your decision tree look like in terms of recommendations for self-quarantine and the like? Based upon TEST POSITIVE versus TEST NEGATIVE, will outcomes or recommendations for those students be different? If so, then there is merit in testing the others in her class (and probably others in the school, bus driver, etc.).

If no difference in the lives / outcomes of others (other than curiosity or 'peace of mind'), then I don't know why there would be a rationale for testing.

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Post #: 233
RE: OT: Corona virus - 3/4/2020 8:46:23 PM   
Chickenboy


Posts: 24520
Joined: 6/29/2002
From: San Antonio, TX
Status: offline
quote:

ORIGINAL: RangerJoe
Shoot them and cremate the bodies?


[/darkhumor mode on]

RangerJoe! That's a terrible idea. Just think of all the virus you'd spread around by having bullets blow through their bodies. Better to throw them live into a flaming pit. That oughta do it.

[/darkhumor mode off]

_____________________________


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Post #: 234
RE: OT: Corona virus - 3/4/2020 8:49:28 PM   
JohnDillworth


Posts: 3100
Joined: 3/19/2009
Status: offline 		Simple. If you test positive you will be quarantined so you will not infect others. If you repeatedly test negative you will be released from quarantine. The community outcome will be significantly better if infectious people are quarantined. No point in wasting resources quarantining people who do not carry the virus. So yes, testing will offer a much better outcome for the community. There is nothing to be gained by knowingly choosing ignorance.

_____________________________

Today I come bearing an olive branch in one hand, and the freedom fighter's gun in the other. Do not let the olive branch fall from my hand. I repeat, do not let the olive branch fall from my hand. - Yasser Arafat Speech to UN General Assembly

(in reply to Chickenboy)
Post #: 235
RE: OT: Corona virus - 3/4/2020 9:08:48 PM   
Chickenboy


Posts: 24520
Joined: 6/29/2002
From: San Antonio, TX
Status: offline
quote:

ORIGINAL: JohnDillworth

Simple. If you test positive you will be quarantined so you will not infect others. If you repeatedly test negative you will be released from quarantine.


OK. If that's your rubric, then that sounds like outcomes are dictated by test results. Then, if that's your decision tree, testing is warranted.

_____________________________


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Post #: 236
RE: OT: Corona virus - 3/4/2020 9:16:07 PM   
RangerJoe


Posts: 13450
Joined: 11/16/2015
From: My Mother, although my Father had some small part.
Status: offline 		But only if they are kept separate from everyone else who may test positive. Anyone else who has contact with them should also be quarantined until it is past the date where they may test positive.

This is not like the old days where there were leper colonies. The best advice is for everyone to take sensible precautions. For those in a higher risk group, then take even more precautions such as limiting contact with other people who may be carriers of this and any other potentially deadly disease.

_____________________________

Seek peace but keep your gun handy.

I'm not a complete idiot, some parts are missing!

“Illegitemus non carborundum est (“Don’t let the bastards grind you down”).”
― Julia Child


(in reply to Chickenboy)
Post #: 237
RE: OT: Corona virus - 3/4/2020 10:08:17 PM   
Canoerebel


Posts: 21100
Joined: 12/14/2002
From: Northwestern Georgia, USA
Status: offline 		Since I posted the Johns Hopkins screengrab earlier today, the number of reported cases worldwide (including China) is up by only 650. That's over a span of about 9 hours. That's not very many, considering what we'd expect if this thing was growing exponentially (or like a culture in a petri dish, as one informed person told me yesterday).

On a drive this afternoon, a nationally broadcast radio program mentioned that the number of new cases reported in China today was something like 120. If true, that's very good news.

It's too early to make sweeping conclusions, yet, but this thing is beginning to look much less serious than expected (not to the people who are suffering from it, but compared to where it seemed like things might be headed - and were/are, according to our breathless media). Here's hoping.


(in reply to RangerJoe)
Post #: 238
RE: OT: Corona virus - 3/4/2020 10:13:01 PM   
Scott_USN

 

Posts: 715
Joined: 6/2/2004
From: Eagle River, Alaska USA
Status: offline 		I bought some RangerJoe Anti-Viral medications..

(in reply to Canoerebel)
Post #: 239
RE: OT: Corona virus - 3/4/2020 11:18:08 PM   
RangerJoe


Posts: 13450
Joined: 11/16/2015
From: My Mother, although my Father had some small part.
Status: offline
quote:

ORIGINAL: Scott_USN

I bought some RangerJoe Anti-Viral medications..


+1

_____________________________

Seek peace but keep your gun handy.

I'm not a complete idiot, some parts are missing!

“Illegitemus non carborundum est (“Don’t let the bastards grind you down”).”
― Julia Child


(in reply to Scott_USN)
Post #: 240
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