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How many will die of Covid19 in the 2020s directly and indirectly

Less than 10,000
10 (14.7%)
10,000-100,000
9 (13.2%)
100,000-1,000,000
9 (13.2%)
One to ten million
13 (19.1%)
Ten to a hundred million
14 (20.6%)
Hundred million to one billion
9 (13.2%)
Over a billion
4 (5.9%)

Total Members Voted: 67

Voting closed: March 03, 2020, 12:39:52 AM

Author Topic: COVID-19  (Read 185749 times)

etienne

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Re: COVID-19
« Reply #4800 on: April 03, 2020, 06:59:48 PM »
BCG Studies :

I tend to believe that the correlation has nothing to do with the vaccination, but with the general context. Countries still needing the BCG vaccine are probably better prepared to handle a pandemic situation.

Does anybody knows what is the x axis in the Figures 1 and 3 ?

Shared Humanity

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Re: COVID-19
« Reply #4801 on: April 03, 2020, 07:00:16 PM »
"we estimated a crude case fatality ratio (adjusted for censoring) of 3·67%"
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext 

We all are so fucked.   

Hope, hope. hope,  we find treatment, vaccine, cure ASAP.   

Thank you for this highly informative link...this is why I have been visiting this thread...the distinction I was trying to draw between those who contribute real substance and the others could not be more stark.

The Walrus

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Re: COVID-19
« Reply #4802 on: April 03, 2020, 07:08:25 PM »
We cannot let the cure be worse than the disease.

So, you are willing to die?

Yes, if it means that my children and grandchildren have a better chance.

It doesn't mean that at all. If you die, or someone you love dies, the future that you have planned for will not happen. A few months of lower revenues?  pffft

Besides, the true answer to that question can only be known right before they intubate you, right after a week of high fever and coughing up pink foam. At that moment they will ask you, do you want to breathe or do you want to give your ventilator to somebody else, "for the economy". Only then can that question be answered truthfully.

And since you are the type of ignorant fool that would pretend the answer is yes when everything is fine and dandy, then it is almost certain that you are the type of person that would hypocritically choose life over "the economy". Almost everyone would choose life then. The type of person that would reject life to save others would not choose "the economy" over life.


But again. That is not a choice. We either attempt to stop it and save the economy along with our lives or lose both. There is no such thing as just driving through this. That's fear speaking.

Wow!  Another one of those arrogant posters, who can do nothing more than insult those with whom he disagrees.  Do you disagree with many of the experts, with whom I am basing my judgement?  This is not fear speaking, but reasonableness.  It is obvious from other posts that would not be too concerned, if the economy went to hell, preferring to sacrifice the masses to save the planet.

sigma_squared

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Re: COVID-19
« Reply #4803 on: April 03, 2020, 07:14:03 PM »
BCG Studies :

I tend to believe that the correlation has nothing to do with the vaccination, but with the general context. Countries still needing the BCG vaccine are probably better prepared to handle a pandemic situation.

Does anybody knows what is the x axis in the Figures 1 and 3 ?

x axis in figures 1 and 3:
Group on left: Lower middle income countries with universal BCG policy
Middle group: Upper middle income (UM) and high income (H) countries with universal BCG policy
Group on right: Upper middle income (UM) and high income (H) countries that never had universal BCG policy

If I understand this properly, the middle and right groups have the same socioeconomic status and the only difference is whether or not they had a universal BCG policy.

The p factor between these groups is 8.6e-04 in Figure 1 and 0.0064 in figure 3, i.e. highly statistically significant.

Also, if I understand this correctly, it's the countries who haven't received the vaccine that are suffering worst in the current pandemic.
« Last Edit: April 03, 2020, 07:19:32 PM by sigma_squared »

Archimid

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Re: COVID-19
« Reply #4804 on: April 03, 2020, 07:17:36 PM »
Bill Gates is funding new factories for 7 potential coronavirus vaccines, even though it will waste billions of dollars

https://www.businessinsider.com/bill-gates-factories-7-different-vaccines-to-fight-coronavirus-2020-4

Quote
Bill Gates is plugging money into building factories for seven promising coronavirus vaccines, despite the fact it will mean wasting billions of dollars.

In a preview clip released from Friday's episode of The Daily Show, the Microsoft billionaire told host Trevor Noah that his philanthropic organization, the Gates Foundation, can mobilize faster than governments to fight the coronavirus outbreak.

"Because our foundation has such deep expertise in infectious diseases, we've thought about the epidemic, we did fund some things to be more prepared like a vaccine effort, our early money can accelerate things," said Gates.

I am an energy reservoir seemingly intent on lowering entropy for self preservation.

etienne

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Re: COVID-19
« Reply #4805 on: April 03, 2020, 07:19:05 PM »
BCG Studies :

I tend to believe that the correlation has nothing to do with the vaccination, but with the general context. Countries still needing the BCG vaccine are probably better prepared to handle a pandemic situation.

Does anybody knows what is the x axis in the Figures 1 and 3 ?

x axis in figures 1 and 3:
Group on left: Lower middle income countries with universal BCG policy
Middle group: Upper middle income (UM) and high income (H) countries with universal BCG policy
Group on right: Upper middle income (UM) and high income (H) countries that never had universal BCG country

If I understand this properly, the middle and right groups have the same socioeconomic status and the only difference is whether or not they had a universal BCG policy.

The p factor between these groups is 8.6e-04 in Figure 1 and 0.0064 in figure 3, i.e. highly statistically significant.

Also, if I understand this correctly, it's the countries who haven't received the vaccine that are suffering worst in the current pandemic.
I agree with that, but I don't understand in figure 3 why Netherland is on the right side and Belgium on the left. I'll check what the P factor is.

Added : https://en.wikipedia.org/wiki/P-value

blumenkraft

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Re: COVID-19
« Reply #4806 on: April 03, 2020, 07:23:35 PM »
Also, if I understand this correctly, it's the countries who haven't received the vaccine that are suffering worst in the current pandemic.

This is really interesting!

Thanks for sharing Sigma2.
Unlearn things daily.

sigma_squared

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Re: COVID-19
« Reply #4807 on: April 03, 2020, 07:27:07 PM »

I agree with that, but I don't understand in figure 3 why Netherland is on the right side and Belgium on the left. I'll check what the P factor is.

Added : https://en.wikipedia.org/wiki/P-value

In figure 3, they're both in the right group, but they're marginally separated. I'm not sure why, but as I said I still need to finish reading and digesting the paper.

El Cid

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Re: COVID-19
« Reply #4808 on: April 03, 2020, 07:47:35 PM »
Bill Gates is funding new factories for 7 potential coronavirus vaccines, even though it will waste billions of dollars

That guy deserves praise for all the things his foundation did in the past few years (not for his company's product though :) :)

blumenkraft

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Re: COVID-19
« Reply #4809 on: April 03, 2020, 08:02:47 PM »
That guy deserves praise for all the things his foundation did in the past few years (not for his company's product though :) :)

Never forget, he also put billions into the education system and made things way worse. Everything had to be rolled back and the money was completely wasted.

Hoping those rich morons doing 'perhaps' the right thing is just unreliable.

The money must be put in public hands and regulated public institutions to reduce the harm people like him can do.
Unlearn things daily.

El Cid

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Re: COVID-19
« Reply #4810 on: April 03, 2020, 09:03:45 PM »
OK. Guy puts all his money into a foundation which does more to improve the lives of the poor (infectious diseases, malaria, TB, HIV, sanitation, etc) than most governments and he is a moron. Sure thing.

Alexander555

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Re: COVID-19
« Reply #4811 on: April 03, 2020, 09:04:16 PM »
The premier of Sweden is not very optimistic anymore. He thinks he will have to count the deaths by the thousands in the near future. And preventing human suffering, is the same as preventing economic suffering. And they all failed in the first. Maybe with Taiwan as the exception. https://www.hln.be/nieuws/buitenland/zweedse-premier-we-zullen-de-doden-bij-de-duizenden-tellen~a8c71fbc/

blumenkraft

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Re: COVID-19
« Reply #4812 on: April 03, 2020, 09:10:03 PM »
OK. Guy puts all his money into a foundation which does more to improve the lives of the poor (infectious diseases, malaria, TB, HIV, sanitation, etc) than most governments and he is a moron. Sure thing.

Where did i say he's a moron for his malaria research funding?

I especially told you the reason for why he is a moron. Read again, please.
Unlearn things daily.

KiwiGriff

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Re: COVID-19
« Reply #4813 on: April 03, 2020, 09:21:30 PM »
There is a hell of a lot of catastrophizing about the economy from the right wing.
This is going to take a year or more to play out.
Once it is over and you either have herd immunity or a vaccine the economy will recover. Economy is just people doing stuff after all .
The dead can never come back, tens of thousnds of survivors will always forever disabled by the effects. .

As to the commentor some are disputing with.
Please just do what I did and add the idiot to your block list .
Saves me having to read you all pointing out how stupid it is .
I don't mind those like El Cid who are optimistic but still contribute sensible content  the terminally deluded are not worth the effort

etienne

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Re: COVID-19
« Reply #4814 on: April 03, 2020, 09:34:47 PM »
The premier of Sweden is not very optimistic anymore. He thinks he will have to count the deaths by the thousands in the near future. And preventing human suffering, is the same as preventing economic suffering. And they all failed in the first. Maybe with Taiwan as the exception. https://www.hln.be/nieuws/buitenland/zweedse-premier-we-zullen-de-doden-bij-de-duizenden-tellen~a8c71fbc/
This is a sad news, I was hoping that Sweden could manage it that way because of a low density of its population. But the curve of the deaths is growing like in all the other countries, just a little bit slower.

The Walrus

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Re: COVID-19
« Reply #4815 on: April 03, 2020, 09:35:07 PM »
There is a hell of a lot of catastrophizing about the economy from the right wing.
This is going to take a year or more to play out.
Once it is over and you either have herd immunity or a vaccine the economy will recover. Economy is just people doing stuff after all .
The dead can never come back, tens of thousnds of survivors will always forever disabled by the effects. .

As to the commentor some are disputing with.
Please just do what I did and add the idiot to your block list .
Saves me having to read you all pointing out how stupid it is .
I don't mind those like El Cid who are optimistic but still contribute sensible content  the terminally deluded are not worth the effort

I prefer not to do that, unless absolutely necessary.  Some people will change once they realize their offense.

Tor Bejnar

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Re: COVID-19
« Reply #4816 on: April 03, 2020, 09:36:25 PM »
Re: BCG studies
...
Hmmm ...
I've read that Ecuador is being hit quite hard by Covid-19, and they are on the map as having a history of BCG immunizations.

e.g.: Bodies on the sidewalk: Ecuador city becomes grim coronavirus warning for region
Arctic ice is healthy for children and other living things.

SteveMDFP

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Re: COVID-19
« Reply #4817 on: April 03, 2020, 09:56:00 PM »
Re: BCG studies
...
Hmmm ...
I've read that Ecuador is being hit quite hard by Covid-19, and they are on the map as having a history of BCG immunizations.

e.g.: Bodies on the sidewalk: Ecuador city becomes grim coronavirus warning for region

If equatorial countries are having this kind of trouble, I can't fathom why anyone thinks this virus will go quiet over the summer.

etienne

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Re: COVID-19
« Reply #4818 on: April 03, 2020, 09:56:40 PM »
Lockdown seems to work in Austria (data from Worldometers)

sigma_squared

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Re: COVID-19
« Reply #4819 on: April 03, 2020, 09:57:12 PM »
Hmmm ...
I've read that Ecuador is being hit quite hard by Covid-19, and they are on the map as having a history of BCG immunizations.

e.g.: Bodies on the sidewalk: Ecuador city becomes grim coronavirus warning for region

I think Ecuador actually supports the thesis.

I've finished reading the paper, and to really understand it you also need to download the supplementary data for table 1 that shows the detailed information per country.

Ecuador is category 2, meaning they used to recommend universal vaccination, but don't any more. Compare this to its neighbors in Latin America, including Mexico, which have a current national BCG vaccination policy for all, and haven't been generating news stories such as you quoted.

Andre Koelewijn

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Re: COVID-19
« Reply #4820 on: April 03, 2020, 10:04:05 PM »
Sigma^2, I suppose Tor Bejnar meant that Covid-19 is not likely to go away once the winter ends (on the Northern Hemisphere), as some still suppose.

Alexander555

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Re: COVID-19
« Reply #4821 on: April 03, 2020, 10:09:02 PM »
It will make the testing more easy. There will be less people with the flu or the cold. Now they will probably have to use a big part of their testing capacity for people that are having a cold or the flu. That cold peak we had in Europe last week came at a bad moment.

sigma_squared

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Re: COVID-19
« Reply #4822 on: April 03, 2020, 10:14:29 PM »
Sigma^2, I suppose Tor Bejnar meant that Covid-19 is not likely to go away once the winter ends (on the Northern Hemisphere), as some still suppose.

As the Bloomberg article says, the BCG vaccine isn't a panacea:
Quote
In any case, the BCG vaccine shouldn’t be the only tool to fight Covid-19.

“No country in the world has managed to control the disease just because the population was protected by BCG,” Otazu said. Social distancing, testing and isolating cases will need to be implemented to manage the spread of the disease.

I think what he was pointing out was Ecuador is now being hit hard, as are other countries who don't have universal immunization. I'll post a simplified version of table 1 for some countries of interest, and people can judge for themselves if it's explanatory.

The paper itself is quite simple, statistically. I encourage people to read it.

gandul

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Re: COVID-19
« Reply #4823 on: April 03, 2020, 10:25:07 PM »
Hmmm ...
I've read that Ecuador is being hit quite hard by Covid-19, and they are on the map as having a history of BCG immunizations.

e.g.: Bodies on the sidewalk: Ecuador city becomes grim coronavirus warning for region

I think Ecuador actually supports the thesis.

I've finished reading the paper, and to really understand it you also need to download the supplementary data for table 1 that shows the detailed information per country.

Ecuador is category 2, meaning they used to recommend universal vaccination, but don't any more. Compare this to its neighbors in Latin America, including Mexico, which have a current national BCG vaccination policy for all, and haven't been generating news stories such as you quoted.
The Ecuador 'anomaly' can be explained, maybe, due to the lasge size of Ecuador-origin community in Spain, third immigration community by size (+400000 ppl)

sigma_squared

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Re: COVID-19
« Reply #4824 on: April 03, 2020, 10:29:05 PM »
From the paper:

Introduction

The COVID-19 pandemic originated in China and it has quickly spread over all continents affecting most countries in the world. However, there are some striking differences on how COVID-19 is behaving in different countries. For instance, in Italy there has been strong curtailing of social interactions and COVID-19 mortality is still high. In contrast, Japan had some of the earlier cases, but the mortality is low despite not having adopted some the more restrictive social isolation measurements. These puzzling differences have been adjudicated to different cultural norms as well as differences in medical care standards. Here we propose an alternative explanation: that the country-by-country difference in COVID-19 morbidity and mortality can be partially explained by national policies on Bacillus Calmette-Guérin (BCG) vaccination.

Discussion

Italy, where the COVID 19 mortality is very high, never implemented universal BCG vaccination. On the other hand, Japan had one of the early cases of COVID-19 but it has maintained a low mortality rate despite not implementing the most strict forms of social isolation[8]. Japan have been implementing BCG vaccination since 1947. Iran had also been heavily hit by COVID-19 and it started its universal BCG vaccination policy only in 1984 potentially leaving anybody over 36 years old unprotected.

Why did COVID-19 spread in China despite having a universal BCG policy since the 1950’s? During the Cultural Revolution (1966-1976), tuberculosis prevention and treatment agencies were disbanded and weakened[9]. We speculate that this could have created a pool of potential hosts that would be affected by and spread COVID-19. Currently, however, the situation in China seems to be improving.

[I believe the data in table 1 is as of March 21]

sigma_squared

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Re: COVID-19
« Reply #4825 on: April 03, 2020, 11:02:17 PM »
The Ecuador 'anomaly' can be explained, maybe, due to the lasge size of Ecuador-origin community in Spain, third immigration community by size (+400000 ppl)

It's possible. In the discussion, the paper says:
Quote
USA and other countries like Italy without a universal vaccination policy but with high fraction of immigrants from countries with different universal BCG policies and using different strains offer the possibility to perform epidemiological studies to determine vaccination schedules and strains that would optimize protection against COVID-19.

It should also be possible to do studies in countries with universal immunization and immigrant populations from non-immunized countries. If the thesis proves out, they may well do more advanced studies such as this.

Ecuador doesn't have much information in table 1, just that they had a universal immunization policy but no longer do, but without dates for starting or stopping. I also couldn't find anything on google, but Spanish speakers might have more luck.

Spain is interesting, because it seems to have had the fewest years of universal immunization of the European countries that had it, as shown in the last column below. It also appears in the top right of the right panel of figure 2, showing a r=0.54 correlation between COVID deaths per million inhabitants and the start year of vaccination (1965), with p=0.02.

Also, the news stories I've read say Guayaquil is the worst hit area in Ecuador, and I understand there are a lot of expats there, from North America and probably other European countries, so it might not be just Spain contributing to the non-immunized population.
« Last Edit: April 03, 2020, 11:08:59 PM by sigma_squared »

wehappyfew

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Re: COVID-19
« Reply #4826 on: April 03, 2020, 11:14:44 PM »
Daily testing update, beware a change in reporting methodology, previous charts showed completed plus pending tests, this chart is for completed tests only.



There is a nice increase in total tests, and a small drop in positive results percentage.

bluice

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Re: COVID-19
« Reply #4827 on: April 03, 2020, 11:21:43 PM »
I wonder if anybody has compared widespread antibiotic use and resistance to Covid mortality? It’s well known antibiotics are more widely used in Southern Europe and Italy has often been pointed out as the European hotspot.

I suppose virtually all viral pneumonia patients in ICU are treated with antibiotics and resistant bacteria could increase mortality.

https://www.ecdc.europa.eu/en/healthcare-associated-infections-acute-care-hospitals/database/microorganisms-and-antimicrobial-resistance/resistance

vox_mundi

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Re: COVID-19
« Reply #4828 on: April 03, 2020, 11:37:25 PM »
Down the Memory Hole : Description of Strategic National Stockpile On Government Website Changed After Jared Kushner Mischaracterized It's Program.
https://amp.cnn.com/cnn/2020/04/03/politics/stockpile-website-edited-kushner-claim/index.html

Kushner, President Donald Trump's senior adviser and son-in-law, said at Thursday's coronavirus briefing that states themselves have medical equipment stockpiled -- and argued that "the notion of the federal stockpile was it's supposed to be our stockpile; it's not supposed to be state stockpiles that they then use."

Reporters quickly noted the stockpile is indeed meant as a resource for the states, as noted on the department of health and human services’ website.



“When state, local, tribal, and territorial responders request federal assistance to support their response efforts, the stockpile ensures that the right medicines and supplies get to those who need them most during an emergency,” the website read.

But this morning, that language had been removed from the HHS website. “The Strategic National Stockpile’s role is to supplement state and local supplies during public health emergencies,” the website now says. “Many states have products stockpiled, as well.”



News outlets were quick to note the change, but the agency said the language revision was in the works for weeks, a claim that was met with much skepticism on Twitter.

Jeremy Konyndyk, who served under former President Barack Obama as director of the US Agency for International Development's Office of US Foreign Disaster Assistance, told CNN before the edit that the original home page "could not be a more literal refutation of Jared's claim." He called the edit "absolutely Orwellian."



Konyndyk said in an email that Kushner's Thursday remark "shows a total misunderstanding of the purpose of the SNS, but more broadly shows a misunderstanding of how federal disaster response operates."
« Last Edit: April 03, 2020, 11:52:13 PM by vox_mundi »
“There are three classes of people: those who see. Those who see when they are shown. Those who do not see.” ― Leonardo da Vinci

Insensible before the wave so soon released by callous fate. Affected most, they understand the least, and understanding, when it comes, invariably arrives too late

gandul

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Re: COVID-19
« Reply #4829 on: April 03, 2020, 11:43:14 PM »
The Ecuador 'anomaly' can be explained, maybe, due to the lasge size of Ecuador-origin community in Spain, third immigration community by size (+400000 ppl)

It's possible. In the discussion, the paper says:
Quote
USA and other countries like Italy without a universal vaccination policy but with high fraction of immigrants from countries with different universal BCG policies and using different strains offer the possibility to perform epidemiological studies to determine vaccination schedules and strains that would optimize protection against COVID-19.

It should also be possible to do studies in countries with universal immunization and immigrant populations from non-immunized countries. If the thesis proves out, they may well do more advanced studies such as this.

Ecuador doesn't have much information in table 1, just that they had a universal immunization policy but no longer do, but without dates for starting or stopping. I also couldn't find anything on google, but Spanish speakers might have more luck.

Spain is interesting, because it seems to have had the fewest years of universal immunization of the European countries that had it, as shown in the last column below. It also appears in the top right of the right panel of figure 2, showing a r=0.54 correlation between COVID deaths per million inhabitants and the start year of vaccination (1965), with p=0.02.

Also, the news stories I've read say Guayaquil is the worst hit area in Ecuador, and I understand there are a lot of expats there, from North America and probably other European countries, so it might not be just Spain contributing to the non-immunized population.
Excellent work and thanks for bringing that paper

KiwiGriff

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Re: COVID-19
« Reply #4830 on: April 04, 2020, 12:09:33 AM »
Quote
It should also be possible to do studies in countries with universal immunization and immigrant populations from non-immunized countries. If the thesis proves out, they may well do more advanced studies such as this.

1948 BCG (Tuberculosis) immunisation is introduced initially for nurses then later for all adolescents. Universal screening and vaccination of 13-year-olds stops in the South Island in 1963, is phased out in the North Island in the 1980s, and ceases in 1990.
https://healthcentral.nz/history-of-nzs-childhood-immunisation-schedule/
This may make for an interesting  data set if we get more cases here.

gandul

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Re: COVID-19
« Reply #4831 on: April 04, 2020, 12:23:53 AM »
I wonder if anybody has compared widespread antibiotic use and resistance to Covid mortality? It’s well known antibiotics are more widely used in Southern Europe and Italy has often been pointed out as the European hotspot.

I suppose virtually all viral pneumonia patients in ICU are treated with antibiotics and resistant bacteria could increase mortality.

https://www.ecdc.europa.eu/en/healthcare-associated-infections-acute-care-hospitals/database/microorganisms-and-antimicrobial-resistance/resistance
I can't say about Italy but I repeat Spain phased out the use of antibiotics 'for everything' during the 80's.
I have not been medicated with antibiotics for ages and in my parents time (50s-60s) it was mandated for a simple cold. I think this in line with the rest of Western cointries.

vox_mundi

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Re: COVID-19
« Reply #4832 on: April 04, 2020, 12:50:40 AM »
U.S. warns Americans to leave Japan amid "significant increase" in COVID-19 cases
https://www.cbsnews.com/amp/news/coronavirus-in-japan-spread-draws-warning-us-embassy-americans-get-out-2020-04-03/

Tokyo — The U.S. Embassy in Tokyo has warned Americans of a "significant increase" in the number of coronavirus infections in Japan, and urged them to leave the country now unless they plan to stay indefinitely.

"If U.S. citizens wish to return to the United States, they should make arrangements to do so now," the embassy said in a notice posted to its website, "unless they are prepared to remain abroad for an indefinite period."

... An explosive surge in infections is inevitable if Japan doesn't rapidly adopt tough restrictions like those in the U.S. and Europe, Hokkaido University Professor Hiroshi Nishiura has told Nikkei.

"Voluntary stay-home guidelines so far have only cut person-to-person contact on public transit by 20%, but contact needs to be cut by at least 80%," the forecasting expert said. Unless control measures are stepped-up, his modelling predicts new cases in Tokyo will peak at 6,000 per day.
“There are three classes of people: those who see. Those who see when they are shown. Those who do not see.” ― Leonardo da Vinci

Insensible before the wave so soon released by callous fate. Affected most, they understand the least, and understanding, when it comes, invariably arrives too late

vox_mundi

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Re: COVID-19
« Reply #4833 on: April 04, 2020, 12:55:05 AM »
Stress Disrupts Our Ability to Plan Ahead
https://medicalxpress.com/news/2020-04-stress-disrupts-ability.html

New research from Stanford University has found that stress can hinder our ability to develop informed plans by preventing us from being able to make decisions based on memory.

"We draw on memory not just to project ourselves backward into the past but to project ourselves forward, to plan," said Stanford psychologist Anthony Wagner, who is the senior author of the paper detailing this work, published April 2 in Current Biology. "Stress can rob you of the ability to draw on cognitive systems underlying memory and goal-directed behavior that enable you to solve problems more quickly, more efficiently and more effectively."

Combined with previous work from Wagner's Memory Lab and others, these findings could have broad implications for understanding how different people plan for the future—and how lack of stress may afford some people a greater neurologically-based opportunity to think ahead.

"It's a form of neurocognitive privilege that people who are not stressed can draw on their memory systems to behave more optimally," ... "And we may fail to actually appreciate that some individuals might not be behaving as effectively or efficiently because they are dealing with something, like a health or economic stressor, that reduces that privilege."
“There are three classes of people: those who see. Those who see when they are shown. Those who do not see.” ― Leonardo da Vinci

Insensible before the wave so soon released by callous fate. Affected most, they understand the least, and understanding, when it comes, invariably arrives too late

Rodius

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Re: COVID-19
« Reply #4834 on: April 04, 2020, 01:29:34 AM »
Quote
It should also be possible to do studies in countries with universal immunization and immigrant populations from non-immunized countries. If the thesis proves out, they may well do more advanced studies such as this.

1948 BCG (Tuberculosis) immunisation is introduced initially for nurses then later for all adolescents. Universal screening and vaccination of 13-year-olds stops in the South Island in 1963, is phased out in the North Island in the 1980s, and ceases in 1990.
https://healthcentral.nz/history-of-nzs-childhood-immunisation-schedule/
This may make for an interesting  data set if we get more cases here.

Damn.... I must have been one of the last ones to get that injection. I still have the scar on my shoulder from it.

Rodius

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Re: COVID-19
« Reply #4835 on: April 04, 2020, 01:32:13 AM »
U.S. warns Americans to leave Japan amid "significant increase" in COVID-19 cases
https://www.cbsnews.com/amp/news/coronavirus-in-japan-spread-draws-warning-us-embassy-americans-get-out-2020-04-03/

Tokyo — The U.S. Embassy in Tokyo has warned Americans of a "significant increase" in the number of coronavirus infections in Japan, and urged them to leave the country now unless they plan to stay indefinitely.

"If U.S. citizens wish to return to the United States, they should make arrangements to do so now," the embassy said in a notice posted to its website, "unless they are prepared to remain abroad for an indefinite period."

... An explosive surge in infections is inevitable if Japan doesn't rapidly adopt tough restrictions like those in the U.S. and Europe, Hokkaido University Professor Hiroshi Nishiura has told Nikkei.

"Voluntary stay-home guidelines so far have only cut person-to-person contact on public transit by 20%, but contact needs to be cut by at least 80%," the forecasting expert said. Unless control measures are stepped-up, his modelling predicts new cases in Tokyo will peak at 6,000 per day.

Who would leave Japan to jump into the US fire?

And the US and Europe haven't exactly had tough restrictions.

sigma_squared

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Re: COVID-19
« Reply #4836 on: April 04, 2020, 02:53:56 AM »
I updated the BCG article's simplified table 1 with COVID-19 case and death numbers for today (April 3) from worldometer.

Of course this is just a preprint. As the Bloomberg article says:
Quote
“I would read the results of the study with incredible caution,” Fish said.

Otazu, who said he’s already received comments from other experts, is working on a second version of his study that will address some of their concerns. He has also submitted the study for a formal review process with the journal Frontiers in Public Health.

At the time the preprint was published, the deaths per million people in countries with a current universal BCG vaccination policy (55 countries) was 0.78 +/- 0.40, versus 16.39 +/- 7.33 deaths per million for countries which have never had a universal BCG policy (5 countries, p=8.64e-04).

This comparison is only made using middle-high and high income countries, with annual incomes over 4,000 dollars. The countries with incomes below this level weren't used due to concerns on COVID-19 testing and other data quality issues.

Since March 21 there have been many more cases and, unfortunately, deaths, so if the effect is real there should be even more detectable difference between the two groups.

Going back to my initial questions:
  • Can the vaccine be used against COVID? Studies in Melbourne and elsewhere have started. It will take time to get results, but less than developing a new vaccine. Scaling up could also be a problem, but a good problem to have if it works.
  • Can this effect partially explain the current course of the epidemic in Japan, South Korea, and possibly China?
  • Is this a partial reason why Italy and the US are currently getting hit hard?
  • Are current epidemiological models using the data from China to extrapolate the course of the epidemic elsewhere, and is the BCG effect possibly biasing the conclusions, i.e. predicting a lower outcome than will happen in reality to populations that haven't received the vaccine?
  • Could this be partially protective in other areas of the world that have had a robust BCG vaccination program against tuberculosis?
It looks to me like the answers based on the article are:
  • Some studies have been announced, and it sounded like Robert Gallo was hinting at more.
  • It looks like yes.
  • It looks like yes.
  • I think this is the big unknown, more below.
  • Hopefully yes, but the size is unknown. Low income, high population density and poor health care systems are working against the effect, but hopefully a universal BCG immunization program will be somewhat protective.
I think the population vaccination status could have implications for the model parameters and the model itself. It seems like more jurisdictions are publicizing their models, often with code and paper references, so it would be interesting to look for this effect or ask the modelers about it, especially after the BCG article appears in peer-reviewed form.

In any event we're running the experiment in real life, and my understanding is models get updated with parameters that produce the observed results and extrapolate them forward, but I'm curious how long it will be until vaccination status is considered in them, if the effect is real.

In the US context, it looks like vaccination status is not in their favor, but immigrants from Latin America or other countries with universal BCG programs may provide some protective effects.
« Last Edit: April 04, 2020, 03:09:24 AM by sigma_squared »

vox_mundi

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Re: COVID-19
« Reply #4837 on: April 04, 2020, 03:59:27 AM »
Way Back in Early February, the U.S. Army Warned That Coronavirus Could Kill 150,000 Americans
https://www.thedailybeast.com/army-warned-in-early-february-that-coronavirus-could-kill-150000-americans



“An unclassified briefing document on the novel coronavirus prepared on Feb. 3 by U.S. Army-North projected that ‘between 80,000 and 150,000 could die.’ It framed the projection as a ‘Black Swan’ analysis, meaning an outlier event of extreme consequence but often understood as an unlikely one.”

In other words, the Army’s projections on Feb. 3 for the worst-case scenario in the coronavirus outbreak are, as of this week, the absolute best-case scenario—if not a miraculous one.

... The Army briefing on Feb. 3 also assessed that up to 80 million would be infected, with 15 to 25 million requiring care as somewhere between 300,000 and 500,000 individuals may require hospitalization.

... The death estimate wasn’t the only part of the Feb. 3 briefing that proved prescient.

The black swan estimate correctly stated that asymptomatic people can “easily” transmit the virus—a finding it presented as outside the contemporary medical consensus. Military forces might be tasked with providing logistics and medical support to overwhelmed civilians, the document warned. One potential task envisioned was “provid[ing] PPE (N-95 Face Mask, Eye Protection, and Gloves) to evacuees, staff, and DoD personnel.”

... Another assumption appeared too optimistic. A “most likely” scenario held that “HHS and CDC, state, and local Public Health departments successfully contact traced all U.S. & Canada nCOV [novel coronavirus] cases and contain the spread of the outbreak.” Fatefully, they did not, and now the U.S. is one of the epicenters of the virus.

The document made it to high levels within U.S. Northern Command (NORTHCOM), the military command responsible for operations in North America and which aided civilian agencies’ early responses to evacuating and quarantining Americans abroad. ...

A month after the Army’s briefing, on March 4, President Trump told Fox News host Sean Hannity that the World Health Organization’s coronavirus death estimate of 3.4 percent of cases was a “false number,” since it contradicted a “hunch” he had. “It’s not that severe,” the president said.
“There are three classes of people: those who see. Those who see when they are shown. Those who do not see.” ― Leonardo da Vinci

Insensible before the wave so soon released by callous fate. Affected most, they understand the least, and understanding, when it comes, invariably arrives too late

sigma_squared

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Re: COVID-19
« Reply #4838 on: April 04, 2020, 04:15:29 AM »
On a non-BCG topic, here's an interesting tweet sequence on the first emergency authorization use antibody test, explaining its pros and cons, especially in the current situation of an expected low prevalence of COVID-19 in the population:

https://twitter.com/ProfMattFox/status/1245869249383424003

Matthew Fox
@ProfMattFox
It's hard for many to grasp the relationship between sensitivity and specificty and what a person with a + test cares about: how likley is it a true +. For low prevalence events, even good tests have poor positive predictive value, even if the test is marketed as “accurate”.

https://twitter.com/zbinney_NFLinj/status/1245789672833417217

The FDA has approved the first antibody test for COVID-19, from Cellex. It theoretically tells you if you've had it & are, as far as we know, immune for some time.

Sensitivity is 93.8%, specificity 95.6%. Sounds great, right?

Well, sort of. (1/6)

If only a small % have actually had COVID-19 (our best guess now) a "positive" antibody test isn't that likely to mean you're immune.

If only 4.5% of U.S. has had COVID-19, + test only means ~50% chance you really had it. With lots of uninfected, lots of false +s. (2/6)

[see graph below]

If 10% were truly infected, a positive Cellex antibody test has a 70% chance of being right. If 30% were infected, a positive test is right 90% of the time. This happens bc when more people were sick, true positives overwhelm false positives. But that's not our situation. (3/6)

So this is test may not be that useful for saying "Zach, you are immune; Jen, you aren't." It might be wrong as often as it's right. Mistakenly telling someone they're immune & clear to return to society...you can see the problem if we do that on a large scale. (4/6)

There are simple equations to correct for this on a population level. So this test is still *very* useful for helping us figure out what % of people have been sick in different areas. And it's the best we've got; deploy it! But realize what it will & won't reliably tell us. (5/6)

Running the test 2x & only telling someone they're immune if they get 2 +s *might* help reduce false +s, depending on the error source. If it's anything systemic - say it's detecting antibodies from a similar virus that don't grant immunity to COVID-19 - no good. @KevinMalogna

Sorry, not "approved," but "granted an emergency use authorization to." I apologize for imprecise language in the interest of cutting characters.

This is starting to make the rounds so while you're here, stay at home and wash your hands so we can save a few hundred thousand lives and my favorite bar and get sports back and stuff. And give whatever you can ($$$, time) to those with less. That'd be rad. Thanks.

Bonus tweet 1: A positive test would be more likely to mean you're truly immune if you're in a high-risk group - healthcare worker, had COVID symptoms, family member had COVID - bc prevalence of infection in these subgroups is higher. So test may be more useful for these folks!

Bonus tweet 2: We might be able to reduce false +s/increase the chance a + test is right by using this test as a screener and another slightly different antibody test to confirm, if they wouldn't both show false + for the same systemic reason like antibodies to a similar virus.

kassy

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Re: COVID-19
« Reply #4839 on: April 04, 2020, 04:21:03 AM »
Re: the graph above.
In the winter of 2018 our ICU's weren't overrun.

Re: RikW
Max ICU capacity for COVID-19 patients in the Netherlands is being expanded to 2400.

Lots of early deaths were not treated in ICU so that does not factor yet.

Dutch numbers:

1324 in ICU +51

Noord Brabant and Zuid Holland are most stressed.

Random snippit other IC patients went to 300 from 500 expected.

https://www.nu.nl/coronavirus/6042360/1324-coronapatienten-op-intensive-care-51-meer-dan-donderdag.html

So for some reason they stopped mentioning the number of deaths.


1478 +148 +166 yesterday

hospitalisations:

6286 +502 + 625 the day before.

IC
1341 + 51
14 are in Germany and there is at least one case in every region.

Half of patients over 65.
Patients who die 81 years or older.
Youngest death in 35-39 age group with prior conditions.
https://nos.nl/artikel/2329279-de-coronacijfers-van-3-april-tot-nu-toe-1487-mensen-overleden-aan-het-virus.html

Þetta minnismerki er til vitnis um að við vitum hvað er að gerast og hvað þarf að gera. Aðeins þú veist hvort við gerðum eitthvað.

harpy

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Re: COVID-19
« Reply #4840 on: April 04, 2020, 04:40:23 AM »
As this virus cripples Western culture and begins to ruin our lives, let's not forget where it came from:

Wuhan, China - almost certainly from the Wuhan Institute of virology. 

This was a human error.

https://en.wikipedia.org/wiki/Wuhan_Institute_of_Virology

vox_mundi

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Re: COVID-19
« Reply #4841 on: April 04, 2020, 04:53:28 AM »
America’s COVID-19 Testing Has Stalled, and That's a Big Problem
https://arstechnica.com/tech-policy/2020/04/americas-covid-19-testing-has-stalled-and-thats-a-big-problem/

One of America's biggest fumbles in the early weeks of the coronavirus crisis was inadequate testing. Thanks to a series of poor decisions by federal officials, the United States had far too little capacity to test for COVID-19 throughout the month of February, hampering our ability to contain the spread of the virus.

In early March, things seemed to be turning around. According to data from COVID Tracking Project, daily testing grew exponentially from a few hundred tests on March 5 to 107,000 tests last Friday, March 27.

But since then, progress has stalled. The US has been testing a bit over 100,000 people a day for the last six days—including 101,000 yesterday. And that's a cause for concern because the US will need to do considerably more testing to get its coronavirus outbreak under control.



... Governors in the United States say that a shortage of testing supplies is hampering their fight against the virus. The New York Times recently obtained audio of a call between governors and President Trump:

Gov. Steve Bullock of Montana, a Democrat, said that officials in his state were trying to do "contact tracing"—tracking down people who have come into contact with those who have tested positive—but that they were struggling because "we don’t have adequate tests."

"We have a desperate need for testing kits," Washington Gov. Jay Inslee told CNN on Sunday

When testing resources are scarce, health professionals prioritize testing people with obvious COVID-19 symptoms. If testing capacity were growing faster than coronavirus infections, we would expect more testing of people with milder symptoms or no symptoms at all. That should lead to a declining rate of positive test results.

Instead, the fraction of positive test results has been steadily rising over the last two weeks. The week of March 15, around 13 percent of coronavirus tests produced positive results, according to COVID Tracking Project data. Last week it was 17 percent. So far this week, 22 percent of coronavirus tests have produced positive results. Yesterday's figure was more than 25 percent.


... It suggests that our testing capacity isn't significantly outpacing the number of infections. And a 25 percent positive testing rate also suggests that we don't currently have enough testing capacity to truly bring the virus under control, because thorough contact tracing is going to require testing a lot more than four people for every infection.

The situation in the hardest-hit states underscores the broader problem we've already discussed. Very high rates of positive test results suggest that states are focusing on testing patients with obvious COVID-19 symptoms, leaving few tests available for broader efforts to slow the spread of the virus.

New York has done 220,000 coronavirus tests. That's more than one test for every hundred New Yorkers, the highest per capita testing rate of any state. But the state's 84,000 positive results translates to a 37 percent positive rate. Similarly, New Jersey has performed 52,000 tests—well above average on a per capita basis. But its rate of positive tests was 42 percent—the second highest figure in the nation.

Michigan has the dubious distinction of the highest rate of positive coronavirus tests, at 44 percent. Michigan has more than 9,000 confirmed coronavirus cases and has had 337 coronavirus deaths—the third highest after New York and New Jersey. But unlike those states, Michigan has a below-average testing rate, with only about 0.2 tests per hundred people. Michigan desperately needs to test more.

It's not clear why the growth of testing has stalled out in the last week. On a basic level, the nation's testing laboratories probably just aren't set up to deal with sudden, massive spikes in demand. The dramatic differences in testing numbers from state to state also suggest a lack of national coordination to match health care facilities with the greatest need to labs with spare capacity.

A deeply reported piece in The Atlantic this week casts some light on America's testing predicament. It argues that private testing labs, which "now dominate the country's testing capacity" simply haven't been able to keep up with surging demand. "Testing backlogs have ballooned," Alexis Madrigal and Robinson Meyer write.

The writers report that Quest, one of the nation's two largest private testing companies along with LabCorp, has struggled to scale up its operations. Its primary testing lab is based in California, which might help explain why that state has such a backlog of pending tests.

... "The average turnaround time nationally is four to five days, from the time where we collect the specimen to when we report the results out," she said—though she admitted that some results take "several days" longer.

... Every additional week that people are forced to stay at home costs the nation's economy tens of billions of dollars. Large-scale testing is going to be an essential part of any strategy for putting the nation back to work promptly while keeping the spread of coronavirus under control.

-------------------------

... We're going to have a lot more cases than 200,000.
“There are three classes of people: those who see. Those who see when they are shown. Those who do not see.” ― Leonardo da Vinci

Insensible before the wave so soon released by callous fate. Affected most, they understand the least, and understanding, when it comes, invariably arrives too late

kassy

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Re: COVID-19
« Reply #4842 on: April 04, 2020, 04:57:02 AM »
As this virus cripples Western culture and begins to ruin our lives

1) Hysterical and 2) racist.

If you increase the amount of interaction between humans and reservoir species you will get more disease.
Þetta minnismerki er til vitnis um að við vitum hvað er að gerast og hvað þarf að gera. Aðeins þú veist hvort við gerðum eitthvað.

vox_mundi

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Re: COVID-19
« Reply #4843 on: April 04, 2020, 05:10:31 AM »
Wearing Surgical Masks In Public Could Help Slow COVID-19 Pandemic's Advance: Study
https://medicalxpress.com/news/2020-04-surgical-masks-covid-pandemic-advance.html

... In laboratory experiments, the masks significantly reduced the amounts of various airborne viruses coming from infected patients, measured using the breath-capturing "Gesundheit II machine" developed by Dr. Don Milton, a professor of applied environmental health in the University of Maryland School of Public Health and a senior author of the study published April 3 in the journal Nature Medicine.

Milton has already conferred with federal and White House health officials on the findings, which closely follow statements this week from the head of the Centers for Disease Control and Prevention saying the agency was reconsidering oft-stated advice that surgical masks aren't a useful precaution outside of medical settings.

... The study, conducted prior to the current pandemic with a student of Milton's colleagues on the Faculty of Medicine at the University of Hong Kong, does not address the question of whether surgical masks protect wearers from infection. It does suggest that masks may limit how much the infected—who in the case of the novel coronavirus often don't have symptoms—spread diseases including influenza, rhinoviruses and coronaviruses.

... The study was conducted at the University of Hong Kong as part of the dissertation research of the lead author, Dr. Nancy Leung, who, under the supervision of the co-senior authors Drs. Cowling and Milton, recruited 246 people with suspected respiratory viral infections. Milton's Gesundheit machine compared how much virus they exhaled with and without a surgical mask.

"In 111 people infected by either coronavirus, influenza virus or rhinovirus, masks reduced detectable virus in respiratory droplets and aerosols for seasonal coronaviruses, and in respiratory droplets for influenza virus," Leung said. "In contrast, masks did not reduce the emission of rhinoviruses."

Milton pointed to other measures his research has found is even more effective than masks, such as improving ventilation in public places like grocery stores, or installing UV-C lights near the ceiling that works in conjunction with ceiling fans to pull air upwards and destroy viruses and bacteria.

"Personal protective equipment like N95 masks are not our first line of defense," Milton said. "They are our last desperate thing that we do."

Open Access: Nancy H. L. Leung et al, Respiratory virus shedding in exhaled breath and efficacy of face masks, Nature Medicine (2020)
https://www.nature.com/articles/s41591-020-0843-2
“There are three classes of people: those who see. Those who see when they are shown. Those who do not see.” ― Leonardo da Vinci

Insensible before the wave so soon released by callous fate. Affected most, they understand the least, and understanding, when it comes, invariably arrives too late

Rodius

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Re: COVID-19
« Reply #4844 on: April 04, 2020, 05:17:35 AM »
As this virus cripples Western culture and begins to ruin our lives, let's not forget where it came from:

Wuhan, China - almost certainly from the Wuhan Institute of virology. 

This was a human error.

https://en.wikipedia.org/wiki/Wuhan_Institute_of_Virology

Please just fuck off with that bullshit.

Tor Bejnar

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Re: COVID-19
« Reply #4845 on: April 04, 2020, 05:54:00 AM »
Thanks, sigma_squared (Do you prefer σ2?) for your response to my musing on Ecuador earlier today.  As to other's comment about Ecuador's tropical location, much of the country is 'high up' with a delightfully pleasant year-'round climate (I'm told).
Arctic ice is healthy for children and other living things.

KiwiGriff

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Re: COVID-19
« Reply #4846 on: April 04, 2020, 06:45:38 AM »
Quote
Damn.... I must have been one of the last ones to get that injection. I still have the scar on my shoulder from it.
It was a right of passage .
Get the injection and put up with the older kids bashing your right shoulder for the next eight weeks.
Yes I have a scar .
I don't want to bet my life on the conclusions of  a pre publish paper. 

sigma_squared

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Re: COVID-19
« Reply #4847 on: April 04, 2020, 06:46:51 AM »
Thanks, sigma_squared (Do you prefer σ2?) for your response to my musing on Ecuador earlier today.  As to other's comment about Ecuador's tropical location, much of the country is 'high up' with a delightfully pleasant year-'round climate (I'm told).

You're welcome, my pleasure. I was looking at Ecuador before you asked because I noticed it was the only purple country in South America. I still don't have an answer for the person who asked why Belgium was a bit to the left of the Netherlands in figure 3, but it's not my paper, and just a preprint, so maybe they'll clean it up or explain it in the final version.

I'm still browsing around for related information. Here's the simplified table 1 information for New Zealand on April 3, which matches what KiwiGriff said, with less detail.

CountryCasesDeathsPolicyYear StartedYear StoppedYears of Vaccine
New Zealand86812 - Used to recommend, not any more1948196315

Iceland seems to have barely used the vaccine, so I hope their testing and contact tracing keeps things under control:
https://www.ncbi.nlm.nih.gov/pubmed/16155306
[Tuberculosis in Iceland. 1976].

In Canada the populations who still get it are (from the BCG World Atlas):
Quote
Infants residing among groups of persons in First Nations and Inuit communities or infants residing in populations with an annual risk of TB infection greater than 0.1%. Healthcare workers, laboratory workers, prison workers, those working in homeless shelters, etc. at high risk.

This article in Science describes more of the trials, which were planned and about to start before COVID-19 due to the other possible benefits of the vaccine, so that was good timing:

Can a century-old TB vaccine steel the immune system against the new coronavirus?
https://www.sciencemag.org/news/2020/03/can-century-old-tb-vaccine-steel-immune-system-against-new-coronavirus
Quote
Researchers in four countries will soon start a clinical trial of an unorthodox approach to the new coronavirus. They will test whether a century-old vaccine against tuberculosis (TB), a bacterial disease, can rev up the human immune system in a broad way, allowing it to better fight the virus that causes coronavirus disease 2019 and, perhaps, prevent infection with it altogether. The studies will be done in physicians and nurses, who are at higher risk of becoming infected with the respiratory disease than the general population, and in the elderly, who are at higher risk of serious illness if they become infected. ...

A team in the Netherlands will kick off the first of the trials this week. They will recruit 1000 health care workers in eight Dutch hospitals who will either receive the vaccine, called bacillus Calmette-Guérin (BCG), or a placebo. ...

Together with Evangelos Giamarellos from the University of Athens, Netea has set up a study in Greece to see whether BCG can increase resistance to infections overall in elderly people. He is planning to start a similar study in the Netherlands soon. The trial was designed before the new coronavirus emerged, but the pandemic may reveal BCG’s broad effects more clearly, Netea says. ...

A research group at the University of Melbourne is setting up a BCG study among health care workers using the exact same protocol. Another research group at the University of Exeter will do a similar study in the elderly. And a team at the Max Planck Institute for Infection Biology last week announced that—inspired by Netea’s work—it will embark on a similar trial in elderly people and health workers with VPM1002, a genetically modified version of BCG that has not yet been approved for use against TB.

Eleanor Fish, an immunologist at the of the University of Toronto, says the vaccine probably won’t eliminate infections with the new coronavirus completely, but is likely to dampen its impact on individuals. Fish says she’d take the vaccine herself if she could get a hold of it, and even wonders whether it’s ethical to withhold its potential benefits from trial subjects in the placebo arm.

But Netea says the randomized design is critical: “Otherwise we would never know if this is good for people.” The team may have answers within a few months.

I didn't devote huge thought to my user name, and of course don't care what people call me, but it's nice to learn new formatting commands, so thanks: σ2.
« Last Edit: April 04, 2020, 11:41:42 AM by sigma_squared »

blumenkraft

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Re: COVID-19
« Reply #4848 on: April 04, 2020, 07:51:15 AM »
As this virus cripples Western culture and begins to ruin our lives, let's not forget where it came from:

Wuhan, China - almost certainly from the Wuhan Institute of virology. 

This was a human error.

https://en.wikipedia.org/wiki/Wuhan_Institute_of_Virology

Please just fuck off with that bullshit.

+1

Harpy, the shit you are posting is despicable, ignorant, fake, racist, and stupid. Stop it.

This BS is proven wrong.
Unlearn things daily.

KiwiGriff

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Re: COVID-19
« Reply #4849 on: April 04, 2020, 07:57:02 AM »
+2
 Drop it.
The virus is bad enough without adding baseless conspiracy's and China bashing to the mix.
If you feel the need maybe breitbart or some other whacko right wing loon site is a better fit for you.