Covid positivity thread
Not about someone else getting a positive test or the metric, test positivity, but rather an opportunity to share positive developments on the the road to returning to normalcy. In the last several days there have been positive announcements on multiple fronts:
1. Therapeutics-
“British pharmaceutical company Synairge claims its new respiratory coronavirus treatment has reduced the number of hospitalized Covid-19 patients needing intensive care in a clinical trial.
The company said its nebulizer treatment produced a 79% lower risk of patients developing severe disease than those given a placebo in initial trials. It said patients who received the treatment “were more than twice as likely to recover (defined as ‘no limitation of activities’ or ‘no clinical or virological evidence of infection’) over the course of the treatment period compared to those receiving placebo.” While we will certainly want to hear what others have to say when they review the test results, my understanding is that this is a treatment that people had hope for based on other studies. https://www.cnbc.com/2020/07/20/synairgen-says-small-coronavirus-treatment-trial-could-signal-major-breakthrough.html
2. Testing - the FDA approved the first use of pooled testing for Quest. While not a panacea, it does have the ability to ramp up our testing capability which will be important as September approaches and students head for college, some schools start to open up and more return to work.
Are there other signs of potential breakthroughs in treatment, testing or vaccines? I didn’t include the Moderna results because I assumed that was a bit old news, but in general, vaccines seem to be moving along as quickly as we could realistically hope.
here's something positive on the vaccine front.
and a quote from the article:
A coronavirus vaccine the University of Oxford is developing with AstraZeneca Plc showed promising results in early human testing, a sign of progress in the high-stakes pursuit of a shot to defeat the pathogen.
The vaccine increased levels of both protective neutralizing antibodies and immune T-cells that target the virus, according to the study organizers. The results were published Monday in The Lancet medical journal.
I'll get into details about it in the Vaccine Neck Sharpies post, but the Oxford/AZ results are really promising not just on the headline level, but the way the study was performed and the often-overlooked safety data given that this is an adenovirus-vector delivery system. It's been over 20 years since adenovirus vectors became a dirty word in the world of gene therapy (Google the name "Jesse Gelsinger" if you get curious) and in some ways this is the viral vector field coming full circle.
If nothing else comes out of this whole pandemic, I hope it inspires a generation of kids to consider not just STEM careers, but devoting some serious time to pursuing research in the life sciences in particular. The history books will likely look back at global scientific response to Covid-19 as the scientific equivalent of the Normandy landings.
I may or may not be a smidge biased.
The data on the Oxford Phase 1 and 2 trials, as well as the possible prevalence of T lymphocyte reactivity among as much as 40% of the population has got to be some of the best news I've heard all year. On the latter point, a recent article by one of the bloggers on Sciencemag.com, Derek Lowe, was almost giddy. It's about time we've had some good news.
See, now this is actual positivity!
I'm not a fan of some Twitter accounts that simply take the statistics and bend them to resemble a positive trend when the overall outlook is rather grim.
I appreciate this thread a lot, blue in dc.
I think there are a lot of different perspectives on Covid right now, but one thing I am sure of is that I think all of us could use some good news and positive thoughts about all of it. Good OP.
I am encouraged that while Michigan has seen a spike in cases, the death rate has remained relatively flat. I always here that deaths are a "lagging indicator" and I am not here to argue with that, but it would appear that we are on the tail-end of a spike in cases and deaths have remained very low with only 2 yesterday. That seems positive to me.
Heard a stat today that 45% of all deaths from COVID-19 have been from people in assisted living facilities/retirement homes but that is only .6% of our total population (a quick check on that suggests it was in the ballpark based on this article https://www.nytimes.com/interactive/2020/us/coronavirus-nursing-homes.html and stats that there are roughly 2.5 m Americans in assisted living or retirement homes (2.5/330 = .7%). So the good news is that if the current wave is affecting younger folks then we MAY (it's all fluid so caveat caveat caveat) NOT see the lagging indicator of deaths follow the recent spike. And that would be good news. Of course it'd be even better news that fewer folks continue to get it.
Lower deaths is certainly a positive, but there's a counterpoint to be made: hospitalizations are increasing, and hospitals are becoming strained in many of the worst outbreak hotspots.
Deaths are due to increase at some point, just due to the law of large numbers...the number of cases we have compared to other countries is staggering.
EDIT: apologies for not being positive. Here's my positive: I trust scientists/medical experts are developing vaccines that work. This pain, even if it lasts until next Spring, is still temporary. We're already seeing better treatment regimen causing the death rate to be lower. It's amazing how quickly medical experts adapt to a new virus. Remember: this thing is brand new and we didn't see it in America until February.
Are they strained due to Covid patients or operating closer to normal capacity due to elective surgeries being started again? This was one of the misleading statistics they gave for Houston. I believe a couple weeks ago when they started talking about their strained hospital system they were looking at it in total, not just Covid-19 patients. They were saying they were near capacity because they're now operating like they would normally operate a hospital outside of a pandemic. If it did get worse they would shut down electives and convert to Covid but they are currently no where near needing to do that. It was something like 25% of patients were there for Covid-19. Going into this weekend Houston had 807 available ICU beds (1400 total and 689 occupied by Covid-19 patients) with a Covid-19 admission growth of 3% which is averaged over 7 days. Growth rate of ICU beds is 1% and Covid-19 patients using med-surge beds is at 0.1%.
Phase 2 capacity, they're only 19% into that capacity with no plans to move to Phase 3 capacity at the current admission/growth rate.
Add in the fact that the elderly and compromised are still isolating and the majority of new cases are in younger people, they are either having no symptoms or mild and if they are in the hospital, their turnaround is relatively quick so even though there may be admissions, those people aren't staying for a long time allowing numbers to start piling up. Add in better treatments if they are going in and we're getting grips on this even if the positive cases are going up. The death rate isn't following and continues to decline which is fantastic news and a number we should be focusing on more rather than positive cases.
A girl in our office tested positive a couple weeks ago. She had a sore throat and went to get tested for strep and came back positive. As a standard they're also testing for Covid-19 and that happened to come back positive. She's in her mid 20s and besides the sore throat she had a decrease in smell as her only symptom. Had she not had strep she would have never gone in. Makes you wonder how many people have had it and never knew they had it. Her co-workers and 3 roommates all got tested and came back negative. I got a test as a precaution since I was going to see a compromised family member. No real system in the drive-through testing. Super busy and workers never kept track of which of the 3 lanes should be the next to go. Add in a thunderstorm in which they worked through the worst and as it was passing all went to their cars for an hour then resumed. Finally got my test and they only stuck the swab up my nose about 1.5". Really not sure if that was a legit test or not! Definitely didn't scratch my brain.
There was a massive backlog of what were considered non essential surgeries that are now being (re)scheduled. That is a part of it, yes.
Having to stop elective surgeries (which is what Texas did) is still not a good thing that is being caused by covid infections.
"Makes you wonder how many people have had it and never knew they had it."
The best estimates are that about 10 times as many people have had it as we've confirmed via positive tests. These estimates are based on a number of seroprevalence studies that did antibody testing to determine how many people in a population may have actually had the virus (compared to those confirmed to have had it).
So yes, to your point, a lot of people have it/have had it and have mild or no symptoms and never know they had it. And the death rate based on our confirmed cases is a bit useless because of that discrepancy.
Most hospitals need to be @ 90% capacity to stay solvent. A friend had surgery in january and was there 12 days. I never saw more than 1 bed availible in recovery and zero in ICU. Elective surgeries @ that hospital Mercy south miami, are a minimum 4-6 weeks out to get a bed. My friend had a baseball sized non-cancerous mass removed from her lung. They thought it was cancer. I guess the biopsy wasnt accurate.
I worked at a hospital once that was generally maxed on beds from mid-November through April every year. Only in July and August could we drop one of our units out of service to do paint refresh's and other annual maintenance. And some years that didn't work out either.
Hospitals are real businesses too.
The pain shouldn't last till Spring. Early November, things should clear right up....but until then....MaskUpForMichigan.
I see what you did there...Maybe, maybe not, I wouldn’t be surprised by you being right or wrong with this guesstimate
Yes. All of those hospitals in those very blue states of Texas, Arizona and Florida will stop having all those pesky covid patients clog up there ICUs in the beginning of November, just like that.
hospitalizations are increasing, and hospitals are becoming strained in many of the worst outbreak hotspots.
This is true in some places, but not everywhere. I don't know hospital capacity by state, but based on these numbers, probably only a handful of states are seriously strained.
In Michigan, and other states that were hit hard in March/April, this isn't close. Michigan had nearly 4,000 Covid patients hospitalized at one point in April.
Thanks for this thread. There is a lot of gloom and doom out there, I think many of us could use some good news and positivity around this virus.
For whatever reason - and this is certainly debatable - the confirmed case fatality rate is dropping precipitously. By all rights, California, Texas and Florida should each have about 30,000 deaths like NY, but have only a combined 16,000 deaths. That’s about 75,000 deaths that didn’t happen. I don’t care if it’s better treatment, different demographics testing positive, or whatever. That’s a lot of people that could have but didn’t die. That’s great news!!!
I've heard a lot of discussion about a large factor in severe cases is Vitamin D deficiency. If that's the case, then it makes sense that CA, TX, and FL would have lower death rates than NY, especially when it hit NY in the spring before people could get out, go to parks, and get a fair amount of sun.
One the one hand, that bodes well and might encourage people to get out in the sun more.
On the other hand, that doesn't bode well as we get back into the winter months, people start staying inside more, and people start wearing more clothes.
and since this is a 'positivity thread', we won't have to read the 'vitamin D is a crazy conspiracy!' response.
I was going to but I am scouring Rite Aid for Vitamin D supplements right now.
jim harbaugh would advocate just drinking more whole milk.
I was about to say the Harbaugh knows how to correct Vitamin D levels. Drink that good cow juice!
Good thing you can take Vitamin D supplements in the winter months!
I'll give ya a supplement of D.....AMIRITE!? WOOOO
For this reason my family is spending a lot of time outside this summer. Swimming, biking, running, practicing baseball - all with the proper precautions - to make sure we are getting good vitamin D levels.
"all with the proper precautions"
Sun screen and bike helmets?
Magnus, I've worked in commercial construction over 35 years in florida.haven't had a flu shot since early 80's. Haven't had the flu since the flu from hell 2003/4. I literally didn't get out of bed for 7 days. The dry cough that came with it was awful. My whole body was sore from coughing. I recently tested negative for anti-bodies. Was hoping that flu was part of that bad sars virus outbreak in 04/05. Or from the many common colds I've had that they are saying produce similiar anti-bodies that covid-19 produce.
I spend 90% of my time in the field recently. Normally 60/40. out of respect for my colleagues i stay away which forces me to do my emails,shared calenders etc at home in the evenings. Our office is in opa-locka,north miami down the street from a huge amazon facility,we did the roof. Only half the building was up when we loaded and started. Yes big. A 22 yo cuban female in our office tested positive last week(took 9 days for results) Loss of smell,and taste and a sore throat.a follow up test was negative yesterday. Next Monday she gets another test.if a second negative she can come back. She was only sick 3 days,no headaches or muscle fatigue. Our office was sterilized over the weekend by professionals. Masks are required in our office right now. The other reason I'm staying away. Typically i only wear my mask at most 2-4 hours daily.been washing my hands constantly since that bad flu 15 years ago,and also if sick while @ home eas your hands as the cdc says it can prolong symptoms slightly. Our bodies cough to expell the unwanted visitors. Personally i think masks give limited protection. Those cheap blue ones are useless. Even a NIOSH 95 is only 95% effective. Simple test, if you can easily blow out a match with your mask on that mask cannot prevent the .3 microns a n95 will prevent 95% of the time. Imo covid-19 spreads the same as influenza. Last flu season 16 million were infected(and thats with a vaccine for 20 years) with 490,000 hospitalizations 32,000 deaths.
cdc.gov/covid
Currently 90,000 of the 140,000 are confirmed,takes 3 weeks min.most don't know it but that big number includes over 11,000 deaths from influenza and pnemonia and 9,717 probables (no lab test).positives are around 10%,90% have been testing negative.the other 26 of our employees tested negative.
We'll get through this.worst case football is delayed till October imo.
I think this is mainly due to the fact that testing is astronomically more widespread than it was. I'll spare everyone the gory details of the nerd-sheet that I have, but the basic truth is that in April the country was running about 1.2 million tests a week and for July it'll be over 5 million a week. Where once we found less than 10% of the cases that really existed, now we catch around 25%. As a result, 200,000 cases a week in April is less scary than 400,000 cases a week now. EDIT: Dammit I meant for that sentence to be the other way around. 400,000 cases a week now is less scary than 200,000 before. Dammit dammit.
Then there are improvements in treatment - we know not to just toss every ICU patient on a ventilator and we're getting better at administering the right drugs. And the 400,000+ cases we see now are more spread out among wider geographic areas than was the case in April, meaning that health care systems aren't overwhelmed in most places. We do hear about hospitals straining to cover, but not about mass shutdowns of the entire rest of the health care system to compensate, nor about hospital ships or convention-center overflow. And nobody is putting positive cases in nursing homes, either.
Long story short: raw case numbers are scary-looking compared to the ones we got used to in April and May, but a lot of factors mitigate that tremendously. A great many cases are people who would never have been tested before. Deaths lag cases by about three weeks, and the most recent week's worth of deaths divided by the cases from three weeks prior is about 2%. That'll go down again in another week, almost assuredly. It was around 6% at the beginning of May.
Here's something I don't see mentioned often: There's more space in the Sun Belt states than there is in the NYC metropolitan area. A few feet could make a difference. As well, people are more likely to be in the cars rather than public transportation. Fewer high-rise dwellings, fewer elevators, etc.
Hospital treatment has gotten a lot better. In March/April it was basically the Wild West in hospital ICUs, people were trying all kinds of tactics to find something out and the patients then, unfortunately, were guinea pigs. Initially people were quickly being put on ventilators, when we know now that many really shouldn't go on them - it may worsen their outcomes. We've also learned that putting patients on their stomach seems to help them breathe better. Remdesivir seems to be a decent treatment, although supplies remain limited. Above all, doctors/nurses at this point have seen a lot of COVID patients, they've seen the majority survive and get discharged, so the stress/fear factor is much less. Stressed-out people make more mistakes, no matter the profession. It's much more routine now.
All over the world now, you see the case fatality rate dropping (except for a few countries like Mexico which seem to be drastically under-testing). Treatment methods are being shared.
The other thing is that apparently nursing homes have better PPE/screening practices. I don't know a ton of details there, but it seems that the surge of nursing-home deaths that occurred earlier isn't happening anymore.
It's a very misleading stat. By changing the new metric to "case fatalities" it makes things look better due to the increase in testing, since we're now picking up a lot of non symptomatic infections.
I don't understand why it's a misleading stat. Can you help? Is it because we don't know the long term effects of an infection? Hypothetically speaking, if no one died from the virus and there were no long term effects, why would we care about the virus?
The virus will kill some people, so it seems to me that case fatalities is an important stat.
If there are long term effects (who knows so far?), then I can imagine other stats might be more important in the long run.
I don't see what's misleading. If anything's misleading, it's headlines about "record case numbers" without mentioning that testing capacity has quadrupled and continues to rise quickly, and positivity rates are way down from what they once were except in localized areas.
Increased testing, changing demographics, locked down retirement homes, and improved treatment have all impacted the death rate.
But one of the main factors is related to viral load. It’s statistically known that if you are exposed to a higher viral load at the start you are more likely to experience severe complications and death. That’s because while the virus replicates in the body the immune system is building up it’s defenses. Both take time. So a high initial viral load can grow exponentially before the immune system can’t mount an adequate defense.
And all the things we are doing after the first month or two, like social distancing, cloth masks, and hand sanitizer/washing hands, reduce the initial viral load. I don’t have the data in front of me but I believe the death rate has gone down in each demographic. Anecdotally, you do hear about younger people going to parties where there’s no masks and someone dies. So if you’re doing all these recommend things and you get Covid anyway, you are much more likely to have a mild disease.
A non-political COVID thread that discusses the virus as a virus and not a political issue. Refreshing.
I bet the jerks on the right side can't keep this up much longer.
Not sure if intentionally ironic or unintentionally ironic.
We all could use more positivity! Thanks for the post.
I keep waiting for him to blink, but he doesn’t.
Here's more potential good news:
https://pandemicpondering.com/2020/07/16/how-long-will-covid-19-immunity-last-how-about-17-years/
Gotta hope that oxford vaccine pans out.
I hope Synairgen is right. Their stock is up over 500%.
It was a very small study and they haven't released the data yet. As a researcher, these two things together make me say...hmmmm... But let's pray they aren't "cooking the books"...
Literally my first thought whenever a company I've never heard of releases good news related to the virus.
I do investigate a lot of financial crimes, so I'm admittedly biased.
Honest question for the board, no politics.
What does the infection fatality rate (IFR) need to be (in your mind) before COVID just becomes background noise?
My guess is that the floor would be the CDC's IFR estimate for the flu (which I think is 0.1%). And the ceiling would be below the CDC's current COVID estimate of 0.65%.
My question isn't about how or when we get there, just how low does it have to go before we can comfortably say "screw it, let's get on with our lives".
Thanks!
In my mind, this is an impossible question, as it asks us to make a moral judgment based on some arbitrary statistic. The real IFR is probably less than .65% now, if the 10-1 confirmed-to-actual infection estimate is true. It's probably about .3%, which is not much different than the flu. .3% is 990,000 Americans dead, assuming 100% infection. That's a lot of death. That would be 330,000 dead at .1% assuming 100% infection. Hell, even .05% and 165,000 dead would be tragic. On the other hand, staying "shut down" for another year would lead to far more harm, in my estimation, than "just" 990,000 dead. These questions are impossible and unanswerable, and tragic...
Agreed. You can’t compare the death rate of COVID to the flu and say everything is ok because people have the option to get a flu shot. Most elderly get flu shots. Things will go back to normal when we have a shot. And the “positivity” is that the collaboration among countries that share data and have agreed to forgo profit (US apparently hasn't signed) has dramatically accelerated the development of multiple vaccines unlike ever before.
Not sure we have enough information about long term effects other than death yet to answer that, but it's a good question to consider. Obviously a death rate of near the flu would be great, but if a bunch of people that don't die have long term complications, I'd still want to be pretty careful until it's more under control.