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SLU & NCAA Corona Virus Discussion

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37 minutes ago, ARon said:

A lot of these conference tournaments could hardly be called “mass gatherings”.  In fact if a limit is set around 1000 people like in Santa Clara, well some of these games would have less than that anyway.


In terms of the thinking around slowing the spread of the infections, you want to talk to epidemiologists, not doctors.   Epidemiologists will use examples like this to explain why limiting mass gatherings is the preferred strategy.  https://www.biomerieuxconnection.com/2018/10/25/how-public-health-policies-saved-citizens-in-st-louis-during-the-1918-flu-pandemic/

Jeez Aron this is research based upon really up to date information. Woo!

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So to say there is a consensus among Dr’s that we cannot do something to impact this disease is wrong.  The knee jerk reaction is denial that this is happening, reassure yourself that you are not in a high risk group and deny the data before your eyes.   However once you look at that data and give it thoughtful consideration, one can see  a method and reason to the steps that are being taken,  as inconvenient as they might be. 

I am not an epidemiologist but due to work I have had to learn a little bit about it.  This all boils down to a Math problem. Those that try to compare influenza as evidence that we should not be concerned are either in denial and do not want to pull up their sleeves and get their arms dirty, pushing another agenda or just having a knee jerk reaction and passing on stuff they heard. 

Influenza yearly in the US  a relatively predictable schedule beginning in the fall and extending to April causing 12 to 60 million infections every year with up to 800,000 hospitalizations.  12,000 to 45000 deaths each year. It is a well known cause of illness.  People  ask why are we concerned about it? Why no panic about it?  Well there are a number of reasons. 1) we are familiar with it and we know it has a seasonal aspect to it.  2) we have a treatment that can shorten the duration and severity of the disease course 3) we know the high risk groups over 65 and under 16 and we vaccinate them every year  And 4th) we vaccinate health care workers so they have protection when treating  a patient with the disease.  The knowledge, the vaccine, familiarity and treatment available all provide comfort in dealing with influenza.  Despite that enough illness occurs resulting in the above statistics.  One other aspect provides benefit though it is hard to quantify and that is prior exposure to influenza.  It mutates every year and some mutations are a small shift so that a prior vaccine or infection may provide some immune memory and inherent protection from year to year.

 

So why is Covid19 scary, because we do not know the course of this disease yet.  Incubation period is about 5.5 days,  but exactly when someone becomes infectious is not certain though it does appear to spread from droplets from coughing or sneezing. We do not know if this will be seasonal, but we hope that as it gets warmer, spread will slow down, though there is no guarantee of that.   We have no treatment for it, though there are some studies going in.  We have no Vaccine and if this disease does come back in the fall we will likely not have one by that time either.

So why not just let everyone get it because “the vast majority will have mild disease”.  The answer is in the numbers. Let’s just make an assumption that the virus will infect an many people as a low Influenza season.  That is 12,000,000 and unfortunately unlike Influenza the case fatality rate is not 0.1 percent but appears to be somewhere around 2 percent in initial outbreak data.  (While some are lower some are also higher, Italy close to 6 percent) So it is reasonable to say it could be 240,000 deaths and a bad year the numbers are much worse.  We have no treatment, we likely would not have enough ventilators so what can we do?  Nothing? NO WE CAN IMPACT THE SPREAD!    I am hoping the assumption is wrong, but you do not succeed in like by planning for the best case scenario, rather you plan for the worst and hope for the best.

Every disease has varying abilities to spread, Measles is one of  the worst.   A measure of how infectious a disease is is boiled down to a simple stat called R naught.  R naught how many people,  one patient with the disease will infect.  Measles R naught is around 15.  The initial  R naught of Covid19 was 2.2 and follow up study suggest 3.0.  Seasonal influenza is 2-3 each year. Ebola 1.5 or so.  SARS. 2.58 

The good news is we can take action to lower the R naught By intervening with the disease process not within the patient but within the community.  Effective mitigation efforts exists, and were shown to slow the spread and minimize the epidemic in Wuhan and in other cities in China.   With SARS infection the initial R naught was 2.58 and was decreased to 0.4 after mitigation efforts.   IF we can do the same with Covid19, that potential 240,000 drops to less than 40,000.  So hand washing, covering your mouth, not touching your face, hand sanitizers, wiping done counters etc all will help, quarantines will be important, as well as minimizing large groupings of people in order to minimize the spread.  These efforts are important, but most important is to not blow this off as a hoax and ignore what ID and epidemiologist advise us to do.

 

 

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The R naught you refer to is the R0 number. Each epidemic strain has its own specific R0 depending on primarily the receptors and attachment sites on the particular viral strain involved. However viral strain characteristics are not the sole determinant of the R0 number. Other important factors is the level of exposure and prior experience with the virus involved. Poverty, malnourishment, excessive crowding and access to medical services of the population at large also play major roles. For example the 1918 epidemic was as devastating as it was because it was the very first time that humans had been infected with a mutated swine strain. Virgin populations (with no prior immune experience) have clinical disease which spreads more rapidly, is more severe and causes more deaths than similar diseases in populations with prior contact with the type of virus causing it. The 1918 epidemic also hit at a time when the US population was bulging at the seams with huge numbers of immigrants (many fleeing their countries draft into WWI) that lived in cities under woeful conditions of poor nutrition, poor sanitation, extreme crowding, and no access to medical care. They died like flies.

There was a second major epidemic 2009-2010 (this one started in Mexico) with real swine flu that spread in the US with an R0 of approximately half of that of the prior epidemic. This one only caused about 12,000 to 16,000 deaths in the US. In this case the population was not a virgin population as it had been in 1918, had immensely better nutritional status, less crowding, and better access to medical care than in 1918, thus the low death rate and low spread.

Covid-19 has a low spread rate, a low mortality rate, and seemingly kills primarily OLD folks. There are active reservoirs of corona viruses in the US (cats, dogs, and bats) and pets get routinely vaccinated every year or so with vaccine cocktails that include corona virus strains. As a matter of fact humans can get infected from pets, the difference with Covid-19 is that transmission between humans do not exist or has not been established. These cases are identified with a MERS qualifier after the virus name.

One factor that is important is the issue of partial immunity. Every year a lot of people in the US receives a flu vaccination. This vaccination may or may not contain the actual virus strain that is causing the epidemic that year (this is a complex cycle). You develop immunity to the strains in the vaccine and if it happens that the current strain is what was in the vaccine you do not catch the flu. The immunity is long lasting. This means that each year as you get infected or vaccinated, you develop immunity to specific antigens in the surface of the virus. Here is the clincher, there may be enough similarity between the antigens you received through vaccines or prior infection, and those of the current strain. This partial immunity does not keep you from getting sick with the virus, but makes the disease a lot milder and lowers the probabiilty of death.

So, being in contact with pets have provided the population of the US with a potential low level of partial immunity against Covid-19. This may well prove to be a factor.

If you are not totally disgusted by reading this stuff and wish more, here are 160 pages of articles on Covid-19 (in English) from the Chinese Journal of Medicine in PDF form:

Have fun boys and girls or perhaps indigestion.

Covid-19.pdf

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I am not sure what the right thing to do is as far as cancellation and isolation.  With cancellation and isolation our commerce will continue to decline but may stop the rapid spread of the virus.

I choose to continue my life as if there is no outbreak and my belief is that so should the folks like myself that want to attend events and travel.

On Monday morning I had a flight out of the East terminal at Lambert and for the first time in my life there was not one person waiting in the security line.  I asked the security if it was the corona virus scare and the security said it was. 

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This is a good observation CBFan. I completely agree, this is  not a good thing in terms of the economy. We know the economy in China took a terrible blow from this stuff, maybe we are in line for it.

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Starting to think this was all started by the xfl, the timing is no coincidence

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I can say the most frustrating thing for my family as of yet is the run on pharmacies and household items. I went to get my son baby Tylenol because of teething and the whole pharmacy looked ransacked. Completely empty shelves. 
 

I stocked up on TP before hysteria swept in - $10/roll if anyone needs it. 

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Just wondering if SLU closing up shop will affect the Billikens getting to Brooklyn.

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2 hours ago, CBFan said:

I am not sure what the right thing to do is as far as cancellation and isolation.  With cancellation and isolation our commerce will continue to decline but may stop the rapid spread of the virus.

I choose to continue my life as if there is no outbreak and my belief is that so should the folks like myself that want to attend events and travel.

On Monday morning I had a flight out of the East terminal at Lambert and for the first time in my life there was not one person waiting in the security line.  I asked the security if it was the corona virus scare and the security said it was. 

I don't get this take. You admit that cancellation and isolation "may stop the rapid spread of the virus." But then you say "I choose to continue my life as if there is no outbreak and my belief is that so should the folks like myself that want to attend events and travel." 

So yes, you understand that measures can have a benefit, but oh well? I'm not quite sure what the solution is either. But to say that your belief is that everyone should continue their life as if there is no outbreak seems...silly and irresponsible?

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2 hours ago, CBFan said:

On Monday morning I had a flight out of the East terminal at Lambert and for the first time in my life there was not one person waiting in the security line.  I asked the security if it was the corona virus scare and the security said it was. 

I'm about to head out of town for spring break tomorrow.  It will be interesting to see how crowded it is.

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I was to go on a cruise down the Rhine in April and we canceling our trip. Now as I am 71 years old, I think it is the prudent thing to do. My wife is a nurse and probably would Be put on quarantine by her hospital when we return. She does not want to lose two weeks of work/pay.

Yes, It does affect the economy,  but you need to be smart in your personal life as well. We have stockpiled nothing. We still go out to eat and shop. If we had plans to go to Brooklyn we would have gone.

mhg

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18 hours ago, cgeldmacher said:

This is all so ridiculous.  I've spoken with three friends that are doctors.  They all told me that no matter what sort of quarantining we do, the virus will continue to spread.  These sorts of efforts aren't going to stop it.  What we will do is destroy our economy all in the false hope of containing this thing when it cannot really be contained.  Then, when the world economy is crap, we won't have nearly the resources to fight it the way we should be.  Government officials should be out there telling folks and sports leagues to continue on as scheduled since canceling events won't really do anything.

Not ridiculous at all.  70 people attending a conference in Boston contracted the disease there last month.  https://www.cnn.com/2020/03/11/health/coronavirus-massachusetts-state-of-emergency/index.html

Think how many people they have spread the disease to and on and on.  By not having large events, you won't have large scale transmission of the disease all at once - it is why many  colleges are going to online classes so it doesn't spread like wildfire there.

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1 hour ago, BilliKat said:

I can say the most frustrating thing for my family as of yet is the run on pharmacies and household items. I went to get my son baby Tylenol because of teething and the whole pharmacy looked ransacked. Completely empty shelves. 
 

I stocked up on TP before hysteria swept in - $10/roll if anyone needs it. 

BilliKat, the lines in Costco last weekend were enormous and the carts were piled to the rims. I saw people with 3 packages of 18 eggs each. That is a hell of an omelet.

1 hour ago, Box and Won said:

I'm about to head out of town for spring break tomorrow.  It will be interesting to see how crowded it is.

Probably empty or sparsely  populated, I would think.

1 hour ago, Billikenbooster said:

I was to go on a cruise down the Rhine in April and we canceling our trip. Now as I am 71 years old, I think it is the prudent thing to do. My wife is a nurse and probably would Be put on quarantine by her hospital when we return. She does not want to lose two weeks of work/pay.

Yes, It does affect the economy,  but you need to be smart in your personal life as well. We have stockpiled nothing. We still go out to eat and shop. If we had plans to go to Brooklyn we would have gone.

mhg

The last thing you  want to do is to get in a cruise of any kind and have a case confirmed among passengers or crew of the boat. You may be there a LONG time.

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Just now, SluSignGuy said:

 

😕

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I agree with @Basketbill that the scary thing is that really no information on what happens after a healthy patient gets over the Coronavirus.  Is there any long term damage to your lungs? 

People like to equate it to the FLU because it gives flu-like symptoms but the unknown is still there .

All that said, I am still planning on going to Vegas for March Madness next week. 

@Wiz - prepare to send me those Vegas lines that are off :D

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4 minutes ago, disgruntledbilliken said:

Why the frown? Seems like a best case scenario for fans given the surrounding context and what others are doing.

I agree with that.  It is just disappointing that it had to happen.

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19 hours ago, cgeldmacher said:

As further back up for what I am saying, Iran is one of the hardest hit nations.  Half of their population wears garments which cover the mouth.  Despite this, its spreading like wildfire there.  If it cannot be controlled in Iran, cancelling big events here is not going to slow it down either.

One of the doctors I spoke with basically told me that everyone's going to get it within the next two years no matter what we do.  All of us carry versions of the cold and versions of influenza (the flu) with us all the time.  We also carry versions of coronavirus that isn't number 19.  We're all getting it eventually.

Then I might as well get it while cheering the Billiken's on to victory over Dayton on their way to the Big Dance. I'll be the guy in Section 9, Row 7, Seat 6, who isn't wearing a surgical mask.

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My parents said their flight from STL to NYC this morning is about 75% full, hopefully all Bills fans!

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