Coronavirus thread

[Rockey]

Not sure what happened to the link... here is the article.

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This article is the poster child of junk information. I read it before it was taken down. The author cited zero sources, gave no supporting information other than his own opinion, had no information in his bio stating any kind of legitimate credentials to make these opinions, and was posted on a website that allows anyone to post anything they want.

In addition, his theory on how the virus attacks the body is in contradiction to the evidence. Further his recommendations are not supported by the current clinical trials or standards of Medical Practice.

[YVK]

A

What do our medical people say?

I generally try to keep an open mind and perhaps some part of this theory may end up being correct. Or perhaps there is a lot of conflation going on. The explanation of lung injury and its radiographic appearance doesn't pass a scrutiny at all, in my mind.

[Maple Syrup Actual]

I don't know if this will be interesting to anyone or not:

http://www.bccdc.ca/Health-Info-Site..._8%20final.pdf

That's yesterday's daily update from my province.

Reasons I think it's kind of interesting:

We have a population of about 5.1 million on paper but there is a huge transient population of mainland chinese that don't often get factored in so in practise, we're probably closer to 5.5 million. That population had unrestricted travel to Wuhan until a couple of weeks ago; our airport has more direct flights to mainland China than just about anywhere in the western world. We never instituted testing or screening at any airports (despite government announcements saying that had been done - no steps were actually taken).

We also share a border with Washington State, with huge amounts of cross-border travel.

Our population is by and large densely packed into a couple of urban areas - Vancouver is about 1.5x as dense as Seattle, for example. And that is the location of the half-million or so transient Chinese.

It's also the location of a large Iranian population, who also had unrestricted travel until a few weeks ago.

And we have a homelessness and opioid addiction problem that makes Seattle look really clean.

We ought to be seeing some real carnage.


And yet: we're up to 48 deaths in the province now, and our case load doubling time is now 28 days. Mean age of death for the victims: 86. We have 135 people hospitalized, of whom 61 are in ICU. So far, this is really under control.

There's good detail in the PDF, they put these out every day. You can see a nice daily cases bar graph which also explains the measures enacted March 14-21:



Anyway for those of you who like this kind of thing, it's an interesting 4-page read. I do think it helps that we get releases like this every day, and the daily address by the Provincial Chief Health Officer is very widely distributed and well-attended.

[Wondering Beard]

This is interesting.

A COHORT OF CANCER PATIENTS WITH NO REPORTED CASES OF SARS-COV-2 INFECTION : THE POSSIBLE PREVENTIVE ROLE OF METHYLENE BLUE

It's a French site but the paper is in English.

[YVK]

I don't know if this will be interesting to anyone or not:

It is interesting, although I don't exactly know what to make out of it. When I see a case fatality rate of 4%, I think "not enough testing of population". I think this notion is also supported by @ 1,000 tested / day for the last week or so, and overall 1-2k tests /day on the most days of this month in a population of 5.1 mil. If population is under-tested, then the doubling time is not accurate. Methinks you guys may have a lot more overall cases than this document shows.

[Maple Syrup Actual]

It is interesting, although I don't exactly know what to make out of it. When I see a case fatality rate of 4%, I think "not enough testing of population". I think this notion is also supported by @ 1,000 tested / day for the last week or so, and overall 1-2k tests /day on the most days of this month in a population of 5.1 mil. If population is under-tested, then the doubling time is not accurate. Methinks you guys may have a lot more overall cases than this document shows.

I definitely agree with that - they have only been testing people who either show links to known cases, or need to be admitted to hospital. I would guess the actual number of infections is something like ten times the confirmed number, if not much higher, and I have been arguing from day one that we're really screwing up our denominator through insufficient testing - I think we're testing something like 0.6% of the population at the moment. The vast majority of symptomatic people are simply told, "stay home, self-quarantine, call back if you need a hospital to keep you alive."

That's why the hospitalization numbers are interesting to me: that's harder to get wrong. Same with the deaths: 48 isn't bad, all things considered. It's why I drew a bit of a parallel to WA: our fatalities are around a tenth of a state that's right next door, similar in lots of ways, slightly larger population but not the extreme density.

Anyway bearing all that in mind I would say the doubling time of total cases is not accurate in and of itself but it reflects an accuracy: we do test the people that are in serious condition. The growth of critical cases, then, is much slower than otherwise similar regions. Even within Canada, our curve is much flatter than Ontario or Quebec (and there is lots of speculation about why, but better testing isn't likely the majority of it: Ontario at least is testing less than we are).

[BN]

What is being done with the bodies of the people who die from the virus? My county has one death and they were cremated according to a local news story and no autopsy was done.

Wouldn't autopsies give guidance to help find out what the virus is doing? Are autopsies being done anywhere?

[Nephrology]

What is being done with the bodies of the people who die from the virus? My county has one death and they were cremated according to a local news story and no autopsy was done.

Wouldn't autopsies give guidance to help find out what the virus is doing? Are autopsies being done anywhere?

@Dr. Thanatos would know more, but I doubt you would learn very much from an autopsy that you would not observe in the clinic via labs/imaging/etc. Certainly nothing that would dramatically change our knowledge of the virus or how to treat it.

Autopsies also require time, personnel, PPE, etc that right now are in short supply. As far as I know the vast majority of autopsies are done for medicolegal purposes and very rarely for biomedical research purposes (not including teaching/med ed stuff), though I may be wrong.

I can tell you that of the 7 research labs I have been a member of, across 4 different teaching institutions, I have never heard of whole human cadavers being used for research purposes. Infrequently, specific whole organs are sometimes used (e.g. isolated/perfused human lungs) but that's not common for many reasons.

[Caballoflaco]

What is being done with the bodies of the people who die from the virus? My county has one death and they were cremated according to a local news story and no autopsy was done.

Wouldn't autopsies give guidance to help find out what the virus is doing? Are autopsies being done anywhere?

According to the media they’re not testing folks who died of unknown respiratory diseases in Alabama or New York anymore because they’re saving tests for the living.

I’ll try to link the story later one I saw recently said that they’re responding to 200ish deaths in the home a day above average in NYC at the moment and they just don’t have the resources to even determine cause of death.

[YVK]

Wouldn't autopsies give guidance to help find out what the virus is doing? Are autopsies being done anywhere?

They absolutely would be helpful, no doubt. From a cardiology standpoint, the mechanism of cardiac injury could be very revealing and may alter the management, and right now those mechanisms are speculative. I presume same can apply to COVID-19 renal disease. I do hope that someone somewhere does them and publishes the results.