Basketbill

I do not mind them. if it is all or none option I would go with all.

This study is more of a game changer than it seems. Now we have a treatment. Further studies will use this a the control group. We are very fortunate, that this was investigated and had initial trials against ebola. Scientific research of one disease may not initially pay off, but it eventually does. It sometimes takes us on elaborate pathways. Studying HIV has led to treatments for HIV, but also led to a knowledge base that facilitated Hep B and Hep C research, then ebola and to this drug for this pandemic.

because it is a fluff piece that non scientifically discuss in vitro response of the virus to the "aptmer". They have not done any clinical trial to see if there is an effect. In vitro response does not automatically equate to human response.

So I would say that empty beds are not necessarily a sign of hospitals not being overwhelmed. What has been a surprising aspect of this epidemic, has been the patients fear of going to the hospital, rightly so at times for things that could have been managed as an outpatient, but also patients not coming in for symptoms like chest pain or abdominal pain and finding things like MI's perforated bowel late. This was a problem. There are so many elective procedure/surgery related hospital stays that when you stop elective and non-urgent procedures, whole wards are emptied out. ERs and ICU's might be filled and overwhelming but the Ortho floor is empty. Clearly though St. Louis in general has done well with hospital resources. However, I would say that after the first 2-3 weeks, elective procedures should have started back up. At this point the hospital and outpatient clinics were safe. The problem was PPE. Once the PPE is under control, the procedures and hips and knees could have and should have been started back up. I would highlight, they were not stopped because they were inherently high risk of transmission, but because they were a drain on PPE supplies that were lacking, and the anticipated surge which was a high tide and not a tsunami .

additional studies are looking good. Next study results anticipated in may hearsay fro U Chicago has patients with severe disease going home quickly.

So let me get this straight. She used science and medical professionals to guide her on the epidemic. And now she gets to open her economy. Wow it is like Science and Medicine are not actually harmful, perhaps even beneficial.....who woulda thunk.

New England Journal published the pilot study of Remdesivir for severe CV19. The follow up study is ongoing and SLU is one if the 75 centers. This data looks pretty good though a small study, so patient selection bias is a potential problem, but some pretty sick patient got better. https://www.nejm.org/doi/full/10.1056/NEJMoa2007016 hope that worked

Those are good questions that need to be answered. Epidemilogists and infectious disease experts warned us of this type of scenario in the past, it was all theoretical and consequences seemed just conjecture. Now we are seeing the possibilities were real. Today if we had reliable plentiful testing available we could get started on developing the process, but that is not available at this moment today. Dr Birx (sp?) the other day suggested university hospitals could get these tests up and running within 30 days. Of course I could not help but wonder why it was not already available, then but again a question to be answered later. What I am gathering from what I am seeing and reading, we will be in for wave of epidemic over the next six months. We will be able to watch places like Washington, SF Bay Area, and even NY to guide us. Bay Area seems to have placed restrictions on more quickly than the other two, and seems to be bending the curve there. However there are hiccups, recently a patient discharged to a NH prior to the test result, ended up testing positive days later and now the Nursing home is shut down . This is where quick reliable accessible testing is an absolute must. Make no mistake this is not just about CV19, but also about the patient about to have a heart attack or stroke that may delay coming to an ER, or have delayed response due to the hospital being overwhelmed. Quality parameters include the time from presentation to Cath lab, and in some city there are reports these are being effected. The greater the surge on ICU staff the worse that will get.

This is a discussion worth having, but it is not a black and white scenario. I see this as requiring a short term, medium term and longterm approach. The Short term is the here an now, St. Louis ICU's are filling up and the death count will be rising. We need to do these drastic restrictions because there is no reliable treatment and current knowledge is that we are all susceptible to getting and spreading the virus. Prevention and delay is the only option we have available to prevent overwhelming or hospitals. This did not change March 16th, but that is when our federal government changed its tune. That is when Fox News changed it tune. The why and how about that we can discuss later, but the here and now is what we need to deal with. CV19 sucks, but for many it is not nearly as bad as sending your sons off to World War II, Korea, Vietnam, Afghanistan, or the sudden void that 9/11 left. We have to stay home. Rebuilding the economy, healthcare, pandemic response starts with taking care of each other now. We need to acknowledge that what we do as individuals has an effect on the community around us. Now is not the time to get back to work and behave like we cannot be killed by this virus. At this time we need to stay home for the good of our neighbor with breast cancer, our neighbor who is pregnant, our neighbor with heart disease, our neighbor with an autoimmune disease now on immunosuppressive treatment, our elderly neighbor, our energetic friendly healthy friend or neighbor(who may die from a cytokine storm) and of course our family, friends and Billikens. The way to get back to work will be to get through this initial surge and then begin reliably testing everyone. Testing both for active infection and past exposure/recovery with acute and convalescent antibodies. Then quarantine strictly those with acute infection, leave some restrictions in place for those who have yet to contract this virus, more stringent for those at high risk and get those people who due to prior exposure/illness are no immune . Those who are newly immune will however need to continue aggressive hand washing etc, while they may not contract the virus they may act as a fomite and pass it along from an infected individual to a non-infected individual. There will be hardship, now and in the future, taxes will go up, the stimulus bills are a good start, but you are right we will need to pay this back, and we will need to work together to come to an agreement. We need to stop the name calling, have constructive conversation and focus on the issue at hand. Once we get back to work even at 50 % we will need to start addressing the immediate term, and longterm plan.

Try this https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/covid-19/

I cannot say for certain but I believe we would have had a better shot at having the curve look like Korea’s. Both countries had their 1st case January 20th. I am sure the populations density in Korea help them (blue font)

I understand that the assumptions are a guess, and it is reasonable to understand that in this type of rapidly changing environment the assumptions are commonly inaccurate. However, it seems to be a good a estimation of “what the hell do we need to prepare for” in a worst case scenario. I am not sure what you mean by “undocumented deaths”. Relying on the Chinese data, is problematic as there data does not appear believable, unless their ability for strict stay at home orders (which apparently was policed with electronic monitoring) is much better than our stay at home orders with loopholes for many... The updated study is just as grim. ICU availability unfortunately is not the best and timeliest trigger toggling on an off social restrictions. Below is the second Paper from NF., and their estimation data for every country with mitigation strategies. Thanks god for computers. Imperial-College-COVID19-Global-Impact-26-03-2020.pdf Imperial-College-COVID19-Global-unmitigated-mitigated-suppression-scenarios.numbers

Old Guy, can you be specific about the errors in the first Paper from the Imperial College. I have seen both and some have said that the first was filled with errors and it had to be revised. I would not describe that as such, this paper release on the 26th has just a grim an estimate, " if nothin is done or unmitigated". This second paper is more of a revision due to additional data, new considerations and an expansion of predications to cover not just the UK but also many other countries with a focus on the higher GDP countries. to say that the estimate is reduced is wrong, I see no reduction at all. Perhaps I am missing something in the data. Total Pop. cases. deaths

Over 50 percent of the high risk patients, who already have some immunity get the vaccine for Influenza. There are anti-viral treatments that have a known beneficial effect on influenza. That is why there is no panic and things do not get cancelled. Get past denial, your family needs you to.

great graphic!