[Health] The Infectious Diseases Thread

[RunningMn9]

Given his history, I assumed he was suggesting that non-COVID deaths are being reported as such as part of the 'hoax.'

Then he’s an idiot.

[Kraken]

This thing feels like the reason why it is more deadly is it has so many expressions. In some it may kill lung tissue, weaken your heart, bring cytokine storms, attacks brain/nerves, and now perhaps form clots throughout the body.

Covid toes

[dbt1949]

In Arkansas one of the groups putting out lots of cases is the prisons, especially one in the SE. 900 cases so far.
They're sending some prisoners home because of it. Making a lot of people uneasy.

[gameoverman]

Our idea of social distancing is going to turn out to be not strict enough + Americans are too stubborn to change fudge factor thrown in = Worse than expected results. However the results are still magnitudes of order better than doing nothing.

If we were doing contact tracing (Spoiler: we should be doing contact tracing), my guess is we'd discover a black market that exists in NYC and parts of NJ where people are not only doing things they shouldn't be (like getting haircuts) but actively engaging in social events - private parties/dinners with small circles of friends/family they believe are safe.

Out here I know a lot more people who aren't keeping their distance than are keeping their distance. Basically, they are not going anywhere that's shut down or closed. No movie theater trips for instance. Not going in to work. Anywhere that's open, they are going there as if things were normal. Trips to the market, trips to get pizza, hanging out with family or friends, etc. Short of stationing armed guards on every street corner I think this is the best we can hope for.

I think the takeaway here is that only fear will keep people at a social distance. If the infection was so widespread that people around here knew people who were sick, they'd stay home. Not ever seeing anyone sick removes that fear and so they feel confident enough to go out. Fear of armed guards enforcing a lockdown would keep them home, not seeing any such deployment removes that fear.

[Isgrimnur]

New symptoms

The Centers for Disease Control and Prevention has added six new symptoms to its list of possible signs of the coronavirus. Previously, the CDC only noted fever, cough and shortness of breath as symptoms.

The agency has updated its list to include: chills, repeated shaking with chills, muscle pain, headache, sore throat and new loss of taste or smell. Shortness of breath has also been changed to "shortness of breath or difficulty breathing."

[Zaxxon]

Pretty soon it'll be 'if you don't feel good, it might be the Rona.'

[Max Peck]

[ImLawBoy]

You know how to treat trolls, right? The "Ignore" button. It's certainly more effective than ingesting bleach.

Who's trolling now?

Still you.

[em2nought]

You know how to treat trolls, right? The "Ignore" button. It's certainly more effective than ingesting bleach.

Who's trolling now?

Still you.

If you insist.

[LordMortis]

I'm not normally one to advertise *plonking*. I think it's verboten. But Ima come right out and say I have blocked people I know in the flesh and blood on other social media for posting that crap. My frustration for not being able to deal with intentionally and sarcastically spreading that kind of ignorance is my own and walking away is the only way I know how to deal with it.

[RunningMn9]

I'm not normally one to advertise *plonking*. I think it's verboten. But Ima come right out and say I have blocked people I know in the flesh and blood on other social media for posting that crap. My frustration for not being able to deal with intentionally and sarcastically spreading that kind of ignorance is my own and walking away is the only way I know how to deal with it.

When I returned, my first order of business was to clear my foe list, which had grown extensively towards the end due to external factors. I still have moments of regret.

However, to someone that thinks that doctors and hospitals are making this all up, and treating suicides and shark attacks as COVID-19 deaths, why? Where is there any evidence that they are over-counting? When NYC’s at-home death call rate skyrockets by 400-500% year-over-year in March, what makes someone think that this is a rash of people being run over by steamrollers?

If in the beginning of March, we discovered that suddenly cancer was killing two and a half times as many people - and you could catch cancer just by talking to someone with cancer - do people think we wouldn’t do anything about it?

[malchior]

However, to someone that thinks that doctors and hospitals are making this all up, and treating suicides and shark attacks as COVID-19 deaths, why? Where is there any evidence that they are over-counting? When NYC’s at-home death call rate skyrockets by 400-500% year-over-year in March, what makes someone think that this is a rash of people being run over by steamrollers?

If in the beginning of March, we discovered that suddenly cancer was killing two and a half times as many people - and you could catch cancer just by talking to someone with cancer - do people think we wouldn’t do anything about it?

There is no reasoning with these people. Some are deep in an information bubble and think their way of life is under attack. Some have their own nefarious goals. Many are just broken people. We just have to accept that they exist and there are a lot of them. And it sucks. Whatever it comes down to there are a lot of angry people out there and we can't win them over. They are lost. They aren't coming back. I'd say we just have to find a way past them but that'll just make them angrier. I don't know what the solution is but I'm pretty sure whatever happens it won't be pleasant or quick.

[LawBeefaroni]

I'm not normally one to advertise *plonking*. I think it's verboten. But Ima come right out and say I have blocked people I know in the flesh and blood on other social media for posting that crap. My frustration for not being able to deal with intentionally and sarcastically spreading that kind of ignorance is my own and walking away is the only way I know how to deal with it.

When I returned, my first order of business was to clear my foe list, which had grown extensively towards the end due to external factors. I still have moments of regret.

However, to someone that thinks that doctors and hospitals are making this all up, and treating suicides and shark attacks as COVID-19 deaths, why? Where is there any evidence that they are over-counting? When NYC’s at-home death call rate skyrockets by 400-500% year-over-year in March, what makes someone think that this is a rash of people being run over by steamrollers?

If in the beginning of March, we discovered that suddenly cancer was killing two and a half times as many people - and you could catch cancer just by talking to someone with cancer - do people think we wouldn’t do anything about it?

I'm not going to defend the "it's a hoax" position but there are statements like this that, taken incorrectly, feed it:

Still, the department's Director, Dr. Ngozi Ezike used part of her time during Sunday's health briefing to explain how the department determines if a death is related to Coronavirus.

Essentially, Dr. Ezike explained that anyone who passes away after testing positive for the virus is included in that category.

"If you were in hospice and had already been given a few weeks to live, and then you also were found to have COVID, that would be counted as a COVID death. It means technically even if you died of a clear alternate cause, but you had COVID at the same time, it's still listed as a COVID death. So, everyone who's listed as a COVID death doesn't mean that that was the cause of the death, but they had COVID at the time of the death." Dr. Ezike outlined.

There are a small number of what some might consider "overcounts". But they'll be sorted out by the professionals.


What do they say? Lies with some truth are the most dangerous lies?

[RunningMn9]

But even those aren’t necessarily over counts, right? Let’s say I’m in hospice with cancer, and I die from complications due to COVID-19, it doesn’t really matter that I was in hospice with cancer. I still died from COVID-19 before I died from cancer.

[malchior]

But even those aren’t necessarily over counts, right? Let’s say I’m in hospice with cancer, and I die from complications due to COVID-19, it doesn’t really matter that I was in hospice with cancer. I still died from COVID-19 before I died from cancer.

Right. Plus this seems like a pretty easy problem to fix. There is some baseline of deaths from different causes. If the baseline declines a statistically significant amount then it's probably a candidate for some investigation to see if there is a count issue.

[LawBeefaroni]

But even those aren’t necessarily over counts, right? Let’s say I’m in hospice with cancer, and I die from complications due to COVID-19, it doesn’t really matter that I was in hospice with cancer. I still died from COVID-19 before I died from cancer.

Yes, but if you died from cancer and had a COVID-19 positive test you'd also be counted as a COVID-19 death.

It means technically even if you died of a clear alternate cause, but you had COVID at the same time, it's still listed as a COVID death.

Keep you in mind, that's just Illinois. Not sure what other states are doing.

[LawBeefaroni]

But even those aren’t necessarily over counts, right? Let’s say I’m in hospice with cancer, and I die from complications due to COVID-19, it doesn’t really matter that I was in hospice with cancer. I still died from COVID-19 before I died from cancer.

Right. Plus this seems like a pretty easy problem to fix. There is some baseline of deaths from different causes. If the baseline declines a statistically significant amount then it's probably a candidate for some investigation to see if there is a count issue.

That's where the professionals get to sort it out.

Point is that while the numbers are fluid, we can only use existing data to drive the response. And existing data shouldn't be used as a political weapon.

[malchior]

But even those aren’t necessarily over counts, right? Let’s say I’m in hospice with cancer, and I die from complications due to COVID-19, it doesn’t really matter that I was in hospice with cancer. I still died from COVID-19 before I died from cancer.

Yes, but if you died from cancer and had a COVID-19 positive test you'd also be counted as a COVID-19 death.

FWIW this is nothing new from a health statistics point of view. Alcohol-related deaths have been counted this way for years. Any alcohol in your system? It is alcohol-related no matter what the level is. Is that bent to serve whatever master it needs? Sure but this isn't a huge problem and the people who'll misinterpret this are not reasonable people that we can influence in any case.

[LawBeefaroni]

Alcohol-related deaths have been counted this way for years. Any alcohol in your system? It is alcohol-related no matter what the level is.

I don't think that's the case.

[Daehawk]

Our state doesn't count people who die here. So if 101 people die of covid19 in our hospitals and 100 of them are from out of state then we have a showing of 1 death here. The rest are counted in their home state.

[malchior]

Alcohol-related deaths have been counted this way for years. Any alcohol in your system? It is alcohol-related no matter what the level is.

I don't think that's the case.

There are the Federal guidelines for this. Does everyone adhere to them? Of course not, but not everyone counts rapes and murders right either. The Uniform Crime Reporting stats and health statistics in general have all sorts of data issues. Tens of thousands of municipalities, counties, states, and a Federal government. I've been neck deep in this subject for 3 months now. Anyway, that alcohol guidance is supposed to be the standard. In the end though to get back to a point instead of nitpicking I agree that it is not of any interest in real-time for political decisions.

[Jaymon]

Alcohol-related deaths have been counted this way for years. Any alcohol in your system? It is alcohol-related no matter what the level is.

I don't think that's the case.

There are the Federal guidelines for this. Does everyone adhere to them? Of course not, but not everyone counts rapes and murders right either. The Uniform Crime Reporting stats and health statistics in general have all sorts of data issues. Tens of thousands of municipalities, counties, states, and a Federal government. I've been neck deep in this subject for 3 months now. Anyway, that alcohol guidance is supposed to be the standard. In the end though to get back to a point instead of nitpicking I agree that it is not of any interest in real-time for political decisions.

I had a relative with a history of seizures. they were on seizure meds, and being treated regularly for seizure related issues. Then one night, they had a seizure, and crashed the car, leading to eventual death. But, the tox report showed alcohol in their system, that meant the insurance company was no longer responsible, and was able to write the whole thing as an alcohol related incident.

[gameoverman]

I think the deaths from this virus are under counted if anything. So many people are dying they are sticking the bodies in morgue trucks, I find it hard to believe each one is getting a detailed autopsy. This means many people who have been dying from January/February until now weren't counted even if they should have been counted. How about our weak testing system? How do you get counted if you don't get tested? What about deaths 'caused' by the virus even if the person dying isn't infected? There are probably people who have needed medical care but didn't get it because the hospital was full OR because they were too scared to go and risk infection. So they died at home. Imo that should count as a virus caused death because if it wasn't for the existence of this virus those people would have lived.

I think it's weird to object to counting people who were infected at the time they died because you think they actually died of something else. To do it the other way means no one gets counted as a coronavirus death until it's proven that's exactly what killed them. Given how overwhelmed our system is(morgue trucks), then you would be disingenuously acting as if you want an accurate count when in fact you want the most minimized count possible.

I don't think we'll ever get an accurate, verifiable count. Too many people were cremated, and maybe the ones who were buried won't be testable if dug up later. We may also never know exactly when the first infections happened in the US. If we don't know that then we have no real idea when it was possible some deaths were virus related. You could go by stats, how many usually die in January vs how many died in January this year. That's not accurate or verifiable though.

[malchior]

Alcohol-related deaths have been counted this way for years. Any alcohol in your system? It is alcohol-related no matter what the level is.

I don't think that's the case.

There are the Federal guidelines for this. Does everyone adhere to them? Of course not, but not everyone counts rapes and murders right either. The Uniform Crime Reporting stats and health statistics in general have all sorts of data issues. Tens of thousands of municipalities, counties, states, and a Federal government. I've been neck deep in this subject for 3 months now. Anyway, that alcohol guidance is supposed to be the standard. In the end though to get back to a point instead of nitpicking I agree that it is not of any interest in real-time for political decisions.

I had a relative with a history of seizures. they were on seizure meds, and being treated regularly for seizure related issues. Then one night, they had a seizure, and crashed the car, leading to eventual death. But, the tox report showed alcohol in their system, that meant the insurance company was no longer responsible, and was able to write the whole thing as an alcohol related incident.

This is very similar and probably came from the same font (MADD lobbying) but employs a slightly different mechanism. To get Federal Highway dollars one of the 'must dos' is that states have to mandate collection of alcohol related traffic statistics. They often have a checkbox on incident reports / tickets for it. Even the mention of drinking without any toxicological markers (e.g. breathalyzer / blood tests) can get that box checked. That one is even looser than the guideline I'm talking about.

[Xmann]

Smoove_B

I'm struggling on when to decide it's ok for my teenage son to go back to work at Chic Fil A. He's been off since this has started and is bored out of his mind. Making some extra money for college next year would be nice too.

On one hand, what's the difference in letting him go back tomorrow compared to a month from now? He doesn't cashier, he works the back. I don't know if wearing a mask is required.

Our community is opening back up Friday and my thought was to wait and see what happens with people. But again, what is my deciding factor?

[Paingod]

We needed to get out and run a couple errands this weekend and discovered that the nice weather had driven everyone insane. Despite the state still being "shut down" for the most part, traffic was almost at pre-COVID levels it seemed.

I think being cooped up inside now that the weather is getting nicer is driving people closer to the brink.

[Skinypupy]

After testing positive a week before, aunt and uncle were both admitted to the hospital yesterday. They were going to try and wait it out at home, but uncle couldn't take more than 2-3 steps yesterday without collapsing. They're in isolation rooms, with him in ICU on a ventilator. No real prognosis at this point, just hoping that he'll trend upwards. He's basically living the nightmare of suffocating to death, alone, without being able to even see his family. They're both 74, with no underlying health issues other than being a bit overweight.

I'm trying really fucking hard not to lash out at the "just the flu", "let some of them die so I can get a haircut" crowd today.

[LawBeefaroni]

After testing positive a week before, aunt and uncle were both admitted to the hospital yesterday. They were going to try and wait it out at home, but uncle couldn't take more than 2-3 steps yesterday without collapsing. They're in isolation rooms, with him in ICU on a ventilator. No real prognosis at this point, just hoping that he'll trend upwards. He's basically living the nightmare of suffocating to death, alone, without being able to even see his family. They're both 74, with no underlying health issues other than being a bit overweight.

I'm trying really fucking hard not to lash out at the "just the flu", "let some of them die so I can get a haircut" crowd today.

Sorry to hear it. There's never a good time to be in an ICU but it doesn't get much worse than right now.

All the doctors I talk to who have seen it first hand say it's a nasty, nasty virus. Not 100% of the time but when it is, it's terrible. 25 or 85. Not worth rolling the dice no matter your age.

[Smoove_B]

I'm struggling on when to decide it's ok for my teenage son to go back to work at Chic Fil A. He's been off since this has started and is bored out of his mind. Making some extra money for college next year would be nice too.

On one hand, what's the difference in letting him go back tomorrow compared to a month from now? He doesn't cashier, he works the back. I don't know if wearing a mask is required.

Our community is opening back up Friday and my thought was to wait and see what happens with people. But again, what is my deciding factor?

I can completely understand your concerns. Our local supermarket is heavily staffed by teenagers and 20 somethings in front-line positions and I'm genuinely amazed at what they're willing to do in light of everything going on.

Last week the FDA released a "best practices" document that was sourced from the restaurant industry leaders. If I were being asked to come back to work in a restaurant or retail food operation, I'd want to know how they're following the recommendations here. They don't seem unreasonable, but the key would be local management and what their policies/modifications to address workflow, sick staff members and customer interactions.

In terms of risk, I am not capable of communicating that unfortunately. Depending on how it is trending in your area there very well could be greater or diminished risk sending him there today or a month from now. Whether or not it's an appreciable risk, I cannot say. Unfortunately this is going to be something that needs to be addressed regardless in the mid to long term (modified work process) for anyone working retail so above and beyond actual risk right now, having risk mitigation plans in place that are being followed would be paramount (for me).

Not sure how helpful that is, but it's nice to see the industry helping to form guidelines.

[Daehawk]

Personally I wouldn't want to go back yet. But if they are opening back up and he doesn't return they may fire him. If I was forced back Id wear a mask at the least. If they said no masks or something Id not go. But this is me.If he is really only in the back all the time and never emptying the garbage in front or anything then he should mainly just have to worry with his fellow workers. They should do a temp check for all the good that does...but its something.

[Isgrimnur]

Not sure how helpful that is, but it's nice to see the industry helping to form guidelines.

Ferengi: "Our word can be our bond."
Ferengi #2: "Until we decide to break it!"

[Smoove_B]

I was at ground zero in NJ when the tattooing and body art industry was newly regulated. It was actually really inspiring to see the regulations being crafted with the help of the industry as the public health professionals at the time had little to no knowledge of what was involved. It was the same when sushi became popular. On the flip side, being in meetings with representatives from the state's restaurant association and having them argue against lowering refrigeration temperatures was frustrating. You take the good, you take the bad, you take them both and there you have...

[em2nought]

Personally I wouldn't want to go back yet. But if they are opening back up and he doesn't return they may fire him. If I was forced back Id wear a mask at the least. If they said no masks or something Id not go. But this is me.If he is really only in the back all the time and never emptying the garbage in front or anything then he should mainly just have to worry with his fellow workers. They should do a temp check for all the good that does...but its something.

Seems like it would be a good idea to have two separate air conditioned spaces in a restaurant if you wanted to keep your employees as healthy as possible because you know people who carry the virus are going to be in your dining room once you open that back up. Something like an attic fan that runs every once in awhile to suck all the "old" air out wouldn't be a bad idea either I'd think.

[ImLawBoy]

My friend who was diagnosed was able to come out of quarantine on Saturday, so that's good. In a text I asked him how his dad was doing, but he didn't respond. I don't want to push things right now, so I'm letting it go for the moment.

[AWS260]

This is so sad.

A top emergency room doctor at a Manhattan hospital that treated coronavirus patients died by suicide on Sunday, according to her father.
***
The elder Dr. Breen said his daughter had contracted the coronavirus but had gone back to work after recuperating for about a week and a half. The hospital sent her home again, before her family intervened to bring her to Charlottesville, he said.

Dr. Breen, 49, did not have a history of mental illness, her father said. But he said that when he last spoke with her, she seemed detached, and he could tell something was wrong. She had described to him an onslaught of patients who were dying before they could even be taken out of ambulances.

“She was truly in the trenches of the front line,” he said.

He added: “Make sure she’s praised as a hero, because she was. She’s a casualty just as much as anyone else who has died.”

[Anonymous Bosch]

In this case, the lives we're trading away could be disproportionately minorities/the poor. That needs to be taken into account. While we trade policy for life in an abstract sense all the time, there is the potential for real abuse here and the ethics need to be considered carefully.

It's also worth considering that prolonged lockdowns may also be trading away and harming the lives of other vulnerable members of our society too, as observed in this op-ed from a Stanford MD:

Science says: It’s time to start easing the lockdowns

The consequences of the COVID-19 pandemic have been enormous, and New York has suffered more than anywhere else in the world. Compared as a separate country, the New York area would rank, by far, as No. 1 for deaths per capita.

The New York-New Jersey-Connecticut tri-state area accounts for approximately 60 percent of all US deaths. Theories abound, but the New York area itself is different: New York is the top port of entry for the hundreds of thousands of tourists coming to the US every month from China; Gotham has a uniquely high density of living that swells daily by millions from workers and tourists; and Manhattan sees some 1.6 million commuters daily, mostly on crowded public transit, including 320,000 from Jersey alone.

Yet the pandemic toll is falling, dramatically so in New York, including both hospitalizations and deaths per day. Few doubt that the unprecedented isolation policies had a significant impact on “flattening the curves.”

Now, we face another, even greater problem: how to sensibly re-enter normal life. This must be based on what we now know, not on worst-case projections, using facts and fundamental medical knowledge, not fear or single-vision policies.

First, we know the risk of dying from COVID-19 is far lower than initially thought, and not significant for the overwhelming majority of those infected.

Multiple recent studies from Iceland, Germany, USC, Stanford and New York City all suggest that the fatality rate if infected is likely far lower than early estimates, perhaps under 0.1 to 0.4 percent, i.e., 10 to 40 times lower than estimates that motivated extreme isolation.

In the Big Apple, with almost one-third of all US deaths, the rate of death for all people ages 18 to 45 is 0.01 percent, or 13 per 100,000 in the population, one-eightieth of the rate for people age 75 and over. For people under 18, the rate of death is zero per 100,000. Of Empire State fatalities, almost two-thirds were over 70 years of age. And regardless of age, if you don’t already have an underlying chronic condition, your chances of dying are small. Of 7,959 NYC COVID-19 deaths fully investigated for underlying conditions, 99.2 percent had an underlying illness.

Second, protecting older, at-risk people helps prevent hospital overcrowding. Of New York City’s 38,000 hospitalizations, less than 1 percent have been patients under 18 years of age. Studying 4,103 confirmed COVID-19 patients with symptoms bad enough to seek medical care, Dr. Leora Horwitz of NYU Medical Center concluded: “Age is far and away the strongest risk factor for hospitalization.”

Recent studies show a far more widespread rate of infection and lower rate of serious illness than early World Health Organization reports that noted 80 percent of all cases were mild. The vast majority of younger, otherwise healthy people don’t get hospitalized.

Third, due to fear and the single-minded focus on COVID-19 regardless of cost, other people are dying. Critical medical care isn’t being provided. Millions of Americans have missed critical health care for fear of encountering the disease, and people are dying to make room for “potential” coronavirus patients.

When states and hospitals abruptly stopped “nonessential” procedures and surgery, that didn’t mean unimportant care. Treatments for the most serious illnesses, including emergency care, were missed. Some estimate about half of cancer patients deferred chemotherapy. Approximately 80 percent of brain surgery cases were skipped. Perhaps half or more of acute stroke and heart-attack patients missed their only chances for early treatment, some dying and many now facing permanent disability. Transplants from living donors are down 85 percent from the same period last year.

And that doesn’t include the skipped cancer screenings, avoided childhood vaccinations, missed biopsies of now-undiscovered cancers numbering thousands per week — and countless other serious disorders left undiagnosed.

[Ænima]

Gee, I wonder why only right wing rags are quoting that article...

[em2nought]

Gee, I wonder why only right wing rags are quoting that article...

Because not enough damage has been done to Trump yet to beat him in November.

[YellowKing]

Ah another case where the majority of doctors and scientists in the entire world are wrong, and this one random doctor has seen through the conspiracy to bring us the truth.

[Zarathud]

This one random doctor who correlates risk to Chinese immigrants coming to New York. Stupid.