Slitherine

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ORIGINAL: Canoerebel

Numbers just posted for France at Worldometers. A huge drop in New Cases and a substantial one in Mortality. Almost certainly this report and yesterday's (and possibly others) are skewed by timing issues. I doubt there were 11k new cases yesterday and 3.8k today.

Neverthless it's good news.

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ORIGINAL: MakeeLearn

Media bias???

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ORIGINAL: JohnDillworth

Latest reports from the CDC here: (tech jargon warning) CDC

Some interesting notes on underlying conditions at time of hospital admission:

"During March 1–30, underlying medical conditions and symptoms at admission were reported through COVID-NET for approximately 180 (12.1%) hospitalized adults (Table);

89.3% had one or more underlying conditions.

The most commonly reported were:
hypertension (49.7%),
obesity (48.3%),
chronic lung disease (34.6%),
diabetes mellitus (28.3%),
and cardiovascular disease (27.8%).


Among patients aged 18–49 years, obesity was the most prevalent underlying condition, followed by chronic lung disease (primarily asthma) and diabetes mellitus.

Among patients aged 50–64 years, obesity was most prevalent, followed by hypertension and diabetes mellitus;

and

Among those aged ≥65 years, hypertension was most prevalent, followed by cardiovascular disease and diabetes mellitus"

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ORIGINAL: obvert

Everyone continues to ask what Germany is doing well to keep deaths down.

While many of the overarching strategies have been discussed, like extensive testing, case tracking and isolation early, early-on lower age case rates, keeping the vulnerable as safe as possible, and their high numbers of ICU beds (although those will likely come more into play at a later stage).

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ORIGINAL: JohnDillworth

Latest reports from the CDC here: (tech jargon warning) CDC

Some interesting notes on underlying conditions at time of hospital admission:
"During March 1–30, underlying medical conditions and symptoms at admission were reported through COVID-NET for approximately 180 (12.1%) hospitalized adults (Table); 89.3% had one or more underlying conditions. The most commonly reported were hypertension (49.7%), obesity (48.3%), chronic lung disease (34.6%), diabetes mellitus (28.3%), and cardiovascular disease (27.8%). Among patients aged 18–49 years, obesity was the most prevalent underlying condition, followed by chronic lung disease (primarily asthma) and diabetes mellitus. Among patients aged 50–64 years, obesity was most prevalent, followed by hypertension and diabetes mellitus; and among those aged ≥65 years, hypertension was most prevalent, followed by cardiovascular disease and diabetes mellitus"

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Instead of making COVID-19 symptoms worse, some antihypertensive drugs may actually reduce the severity of infections, and could therefore be used to treat the disease, both sets of doctors say. A closer look at the underlying mechanisms of the medications has also buoyed another idea for how to treat COVID-19—give patients the enzyme ACE2 as a decoy to direct SARS-CoV-2 away from their cells. A biotech company developing such an approach using recombinant ACE2 received regulatory approval today (April 2) to start clinical trials on COVID-19 patients.

“It’s a very interesting idea,” David Kass, a cardiologist at Johns Hopkins School of Medicine tells The Scientist. “Obviously, if the virus binds to this form of ACE2 that’s floating around in the bloodstream and not attached to a cell, it won’t be able to multiply and damage the cells.”
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Based on the data, Penninger’s team argued that administering a recombinant ACE2 protein could trick the virus into binding with it, rather than actual ACE2 receptors. This could then protect endogenous receptors and allow them to continue to function in counterbalancing ACE, and, ideally, protect the lung and heart from damage during a viral infection.
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Using ARBs to combat the virus is a more promising approach. As Penninger’s team showed, SARS-CoV reduced the abundance of ACE2, causing hypertension and lung failure in mice. If ARBs boost ACE2 expression, that might counteract the effects of the infection. The hypothesis is preliminary at this point, says David Gurwitz, a geneticist with a background in pharmacology at Tel Aviv University. He described the idea, which seems paradoxical, March 4 in a review article published in Drug Development Research. The main difference between ACE inhibitors and ARBs is that the former just frees up existing ACE2 receptors, while the latter leads to an increase in the number of receptors, allowing more angiotensin II to be converted to angiotensin 1-7. That would dilate blood vessels and reduce inflammation, countering any hypertensive state caused by a viral infection.

In clinical analyses designed to ensure that ARBs don’t harm COVID-19 patients, researchers in China have published preliminary data on medRxiv supporting the hypothesis. In the study, the team tracked the health outcomes of 511 patients taking medications for heart conditions who then became infected with SARS-CoV-2. The patients took either ACE inhibitors, ARBs, or other drugs that lowered their blood pressure. The results showed that patients over age 65 taking ARBs were at a lower risk of developing severe lung damage than age-matched patients not taking the medications, but there weren’t enough data to do a similar analysis for ACE inhibitors. The work reveals there was no hazard for ARBs, and there may be benefits, but as always, more data are needed, Kass says.

One way to collect those data on a larger scale, Gurwitz explains, would be to analyze many more COVID-19 patients’ health records to see if they’ve been taking ARBs prior to SARS-CoV-2 infection, then comparing the severity of infection in those patients and how well they recovered with the symptoms of COVID-19 patients not taking the medications.

Gurwitz also recommends researchers compare the percentage of people chronically medicated with different antihypertensive medications in the general population with the percentage of them among hospital admissions for COVID-19. These types of analyses could also be done with many other approved drugs, he notes, not just ARBs.

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It has been less than two weeks since New Zealand imposed a coronavirus lockdown so strict that swimming at the beach and hunting in bushland were banned. They’re not essential activities, plus we have been told not to do anything that could divert emergency services’ resources.
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It took only 10 days for signs that the approach here — “elimination” rather than the “containment” goal of the United States and other Western countries — is working.

The number of new cases has fallen for two consecutive days, despite a huge increase in testing, with 54 confirmed or probable cases reported Tuesday. That means the number of people who have recovered, 65, exceeds the number of daily infections.
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After peaking at 89 on April 2, the daily number of new cases ticked down to 67 on Monday and 54 on Tuesday. The vast majority of cases can be linked to international travel, making contact tracing relatively easy, and many are consolidated into identifiable clusters.

Because there is little evidence of community transmission, New Zealand does not have huge numbers of people overwhelming hospitals. Only one person, an elderly woman with existing health problems, has died.

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Far from the big coastal hubs of Seattle, Los Angeles and New York, this hospital in the remote southwest Georgia city of Albany — more than 35 miles from an interstate highway and 180 miles from a major international airport — is struggling to treat a community afflicted with one of the most intense coronavirus rates in the nation.

With 973 cases in Dougherty County, about one in 90 residents of this poor, predominantly black community has tested positive for COVID-19 — significantly more than the one in 1,450 residents Los Angeles County. Already, 56 people have died, about 75% of whom are African American, according to Michael Fowler, the county coroner.
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No one suspected COVID-19 when a man from the Atlanta area arrived at Phoebe Putney’s emergency room Feb. 29 complaining of shortness of breath.

The man, who was 67 years old, had chronic lung disease and had not traveled to China or the West Coast.

He had come to Albany to attend a funeral for Andrew Jerome Mitchell, a retired janitor. After more than 100 people gathered at Albany’s Martin Luther King Memorial Chapel for the service, many then crammed into Mitchell’s small three-bedroom home for a potluck meal of fried chicken, greens and cornbread.

We hugged, we talked, we cried together,” said Alice Wise Bell, the daughter of Mitchell’s longtime partner, Emell Murray. “We didn’t think anything of it.”

Before she went to bed, Murray started feeling chills. The next day, Bell rushed her mother, who is diabetic and has high blood pressure, to the hospital with a fever of 103. Staff told her they suspected a urinary tract infection.

Before long, a cascade of sick people — including Bell’s aunt and cousin — trickled in to the emergency room.

By the time hospital and local officials realized the deadly virus was in the community, it had already spread from the funeral home to churches, the county courthouse and the hospital.

Sheriff’s deputies, teachers and caregivers to the elderly were among those who tested positive for the virus, along with more than 60 hospital employees.

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ORIGINAL: RangerJoe

New Zealand isn’t just flattening the curve. It’s squashing it.

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SEOUL, April 9 (Yonhap) -- South Korea on Thursday reported its fewest additional cases of the new coronavirus since late February, as the country is implementing an extended social distancing drive to fight against the virus pandemic.

The 39 new cases, detected Wednesday and down from 53 a day ago, brought the nation's total infections to 10,423, according to the Korea Centers for Disease Control and Prevention (KCDC).

South Korea recorded around 50 or fewer daily new cases for a fourth day in a row, a sharp drop from the Feb. 29 peak of 909 new cases. But health authorities remain on high alert over cluster infections at churches and hospitals, as well as new cases coming from overseas.

The nation's death toll from the coronavirus, which emerged in China late last year, rose by four to 204, according to the KCDC. In total, 6,973 people in South Korea have recovered from the virus.

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ORIGINAL: Wuffer

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ORIGINAL: obvert

Everyone continues to ask what Germany is doing well to keep deaths down.

While many of the overarching strategies have been discussed, like extensive testing, case tracking and isolation early, early-on lower age case rates, keeping the vulnerable as safe as possible, and their high numbers of ICU beds (although those will likely come more into play at a later stage).

The more I think about the more I believe it's a cultural thing and a lot of luck.

First, there is the habit of annoying everyone with absurdly high standards, which in the end you can't meet yourself. /s

Germans distance themselves socially far more than francone or Romanic cultures, the normal distance between conversations is at least an arm's length, rather two. When talking to southern Italians, we like to take a step back, whereupon the other one takes another step forward - I have often observed how people wandered across the room during a heated dialogue. :-)

You don't find hugs or kisses in the > 50 years old generation, we were just about to introduce this into our behaviour.

Compare this with Switzerland: the number of cases in the Italian-speaking Kanton (Tessin) is significant higher than in the German-speaking world, the French part is in between.
https://de.m.wikipedia.org/wiki/Datei:Coronavirus_infected_persons_in_Switzerland_in_relation_to_population_of_canton.svg

Regarding the numbers of tests, they were not that much available in the beginning, so the more important work was tracking down e.v.e.r.y. single case and isolating all contact persons - at some point they were 3-5 or more people quarantined for every confirmed case.

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ORIGINAL: RangerJoe

The hospital went through 6 months of supplies in one week:

A small Georgia hospital battles one of the nation’s most intense coronavirus outbreaks

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Far from the big coastal hubs of Seattle, Los Angeles and New York, this hospital in the remote southwest Georgia city of Albany — more than 35 miles from an interstate highway and 180 miles from a major international airport — is struggling to treat a community afflicted with one of the most intense coronavirus rates in the nation.

With 973 cases in Dougherty County, about one in 90 residents of this poor, predominantly black community has tested positive for COVID-19 — significantly more than the one in 1,450 residents Los Angeles County. Already, 56 people have died, about 75% of whom are African American, according to Michael Fowler, the county coroner.
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No one suspected COVID-19 when a man from the Atlanta area arrived at Phoebe Putney’s emergency room Feb. 29 complaining of shortness of breath.

The man, who was 67 years old, had chronic lung disease and had not traveled to China or the West Coast.

He had come to Albany to attend a funeral for Andrew Jerome Mitchell, a retired janitor. After more than 100 people gathered at Albany’s Martin Luther King Memorial Chapel for the service, many then crammed into Mitchell’s small three-bedroom home for a potluck meal of fried chicken, greens and cornbread.

We hugged, we talked, we cried together,” said Alice Wise Bell, the daughter of Mitchell’s longtime partner, Emell Murray. “We didn’t think anything of it.”

Before she went to bed, Murray started feeling chills. The next day, Bell rushed her mother, who is diabetic and has high blood pressure, to the hospital with a fever of 103. Staff told her they suspected a urinary tract infection.

Before long, a cascade of sick people — including Bell’s aunt and cousin — trickled in to the emergency room.

By the time hospital and local officials realized the deadly virus was in the community, it had already spread from the funeral home to churches, the county courthouse and the hospital.

Sheriff’s deputies, teachers and caregivers to the elderly were among those who tested positive for the virus, along with more than 60 hospital employees.

https://www.latimes.com/world-nation/story/2020-04-08/in-southwest-georgia-a-small-hospital-battles-one-of-the-worlds-most-intense-coronavirus-outbreaks

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ORIGINAL: Sammy5IsAlive

The situation in the UK is a bit odd. Just going off the numbers today's reported deaths are higher than all but the worst single days in Italy and Spain. But we have not seen the kind of scary reports of hospitals being overwhelmed that came from Lombardy/Madrid. There is of course the possibility that the coverage is being managed to an extent by the government. But in these times of Twitter etc I'd suggest it is pretty difficult to 'gag' those on the front line. If we'd been overwhelmed I think we'd know about it.

More likely, my speculation would be two possible (not mutually exclusive) explanations. One would be that our classification of deaths is less stringent than Italy/Spain. So a similar number of 'Coronavirus deaths' would not be representing an equivalent stress on health services on the ground. The other possibility is that Italy and Spain had their cases confined to much more localised regions (Lombardy/Madrid/Barcalona) whereas the UK - which is even more densely populated than the European average (England is twice as densely populated as Italy and 4 times more densely populated than Spain and indeed the USA) has had cases and deaths - and the strain on health services these represent - spread across the country. That would tally with the FT graphs which suggest that whilst things are bad in London they are not anywhere near as bad as they were in equivalent regions in Spain/Italy.

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ORIGINAL: Encircled

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ORIGINAL: Sammy5IsAlive

The situation in the UK is a bit odd. Just going off the numbers today's reported deaths are higher than all but the worst single days in Italy and Spain. But we have not seen the kind of scary reports of hospitals being overwhelmed that came from Lombardy/Madrid. There is of course the possibility that the coverage is being managed to an extent by the government. But in these times of Twitter etc I'd suggest it is pretty difficult to 'gag' those on the front line. If we'd been overwhelmed I think we'd know about it.

More likely, my speculation would be two possible (not mutually exclusive) explanations. One would be that our classification of deaths is less stringent than Italy/Spain. So a similar number of 'Coronavirus deaths' would not be representing an equivalent stress on health services on the ground. The other possibility is that Italy and Spain had their cases confined to much more localised regions (Lombardy/Madrid/Barcalona) whereas the UK - which is even more densely populated than the European average (England is twice as densely populated as Italy and 4 times more densely populated than Spain and indeed the USA) has had cases and deaths - and the strain on health services these represent - spread across the country. That would tally with the FT graphs which suggest that whilst things are bad in London they are not anywhere near as bad as they were in equivalent regions in Spain/Italy.

They are plenty of questions for the government to answer on what it did to close down the country and whether it was fast enough, but the NHS effectively doubled its ICU capacity in that period.

Thats something that is pretty impressive, and is probably the only reason we haven't been overwhelmed.

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ORIGINAL: CaptBeefheart

OK, gents, I've got your feel good story of the day: S. Korea reports fewest virus cases since late Feb.

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SEOUL, April 9 (Yonhap) -- South Korea on Thursday reported its fewest additional cases of the new coronavirus since late February, as the country is implementing an extended social distancing drive to fight against the virus pandemic.

The 39 new cases, detected Wednesday and down from 53 a day ago, brought the nation's total infections to 10,423, according to the Korea Centers for Disease Control and Prevention (KCDC).

South Korea recorded around 50 or fewer daily new cases for a fourth day in a row, a sharp drop from the Feb. 29 peak of 909 new cases. But health authorities remain on high alert over cluster infections at churches and hospitals, as well as new cases coming from overseas.

The nation's death toll from the coronavirus, which emerged in China late last year, rose by four to 204, according to the KCDC. In total, 6,973 people in South Korea have recovered from the virus.

We still have zero deaths from this in Seoul, a city of 11 million people.

Anyway, all this without government-mandated shutdowns, except schools and the Seoul mayor recently shutting down large clubs and room salons for 10 days. [What's a "room salon?" A friend told me it's a place where you pay a gal to sing with you, whisper sweet-nothings in your ear and pour you watered-down whiskey, all in a room fitting 6-30 people.] Clearly the Korean Room Salon Association hasn't been on the ball in offering freebies to government officials.

Back to your regularly scheduled programming.

Cheers,
CB

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ORIGINAL: obvert

Midlevel bureaucrats in the city of Wuhan, where the virus originated, and elsewhere in China have been lying about infection rates, testing and death counts, fearful that if they report numbers that are too high they will be punished, lose their position or worse, current and former intelligence officials said.

England expects that every man will do his duty. Horatio Nelson October 1805

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ORIGINAL: warspite1

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ORIGINAL: obvert

Midlevel bureaucrats in the city of Wuhan, where the virus originated, and elsewhere in China have been lying about infection rates, testing and death counts, fearful that if they report numbers that are too high they will be punished, lose their position or worse, current and former intelligence officials said.

warspite1

Echoes of Chernobyl.....

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ORIGINAL: JohnDillworth

It's starting to look like Sars-Covid-19 got to NYC from Europe, not China, and was circulating for weeks before anyone knew about it. Apparently it's genetics change over time and are trackable. The paper is awaiting peer review but come form a geneticists at Mt Sinai Hospital.

https://www.nytimes.com/2020/04/08/science/new-york-coronavirus-cases-europe-genomes.html


We made mistakes for sure, but we thought we had 2 weeks only to find it has been here for a month.

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ORIGINAL: Wuffer

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ORIGINAL: warspite1

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ORIGINAL: obvert

Midlevel bureaucrats in the city of Wuhan, where the virus originated, and elsewhere in China have been lying about infection rates, testing and death counts, fearful that if they report numbers that are too high they will be punished, lose their position or worse, current and former intelligence officials said.

warspite1

Echoes of Chernobyl.....

It's the same everywhere.

England expects that every man will do his duty. Horatio Nelson October 1805