Airplane ownership CV19

[AH-1 Cobra Pilot]

On 4/18/2020 at 6:55 AM, Tony Starke said:

I think, though I could be wrong, that many of us are frustrated due to conflicting reports. Most of the links here come from sources that are no longer credible to many Americans. When we have been subjected to blatant propaganda over and over, how are we supposed to take anything they print seriously. It is a sad state of affairs that the public cannot get reliable data and information because the media have an agenda. 

A friend and I were discussing how to see if the COVID-19 deaths were actually from the virus or just being counted that way:  You have to compare the actual number of deaths versus the normally expected number.  The difference will be the extra deaths caused, most likely, by the virus.  He pulled up a story that stated 145 deaths/day to be the average in NYC.  I found an article that said it was 185.  An official government web site had a rate/100,000 population, and another had the population.  Multiplying gave the answer of 231 deaths/day.  One other site listed the rate as 400/day.  The old adage that figures lie and liars figure comes to mind...

Keep in mind, these were supposed to be data from a year ago or more.

Edited April 20, 2020 by Ah-1 Cobra Pilot

[Shadrach]

5 hours ago, DXB said:

 

Ah - 2-4%   That's right in the range I'd expect for an average population in the US. Considerable error in that measurement derives from variable sensitivity and specificity of that assay, and the multiple competing serologic tests in use at the moment, making it hard to compare directly to other populations (e.g. NYC, which I'm guessing should end up like 10%).  The point is the numbers are all quite small and should confer negligable population level resistance.  

Understood.  Indeed the authors of the study are trying to ramp up studies in other geographic areas. I also understand that antibodies do not guarantee long term immunity. More questions than answers right now regarding herd immunity.    With regard to my "experts" comment, I was not trying to draw you into a political discussion. I was curious about your opinion regarding experts making claims that even a layman like myself can tell are unknowable (or maybe I am mistaken).   These claims are driving policy world wide. The more invested one becomes in a particular theory the greater the temptation to justify that theory and the associated policy decisions.  The more invested a group becomes the less agile we become in our policy making. It is the nature of the situation and there is no getting away.  It's one of the reasons that I am surprised that Sweden bucked the rest of the world and came to the decision to leave their economy open and confine their focus to the most at risk population. However, I think I understand why.   It seems that if herd immunity is achievable, Sweden is taking steps to hasten that process while the rest of us are slowing it for...well a lot of guesses but we really don't know.    On the other hand, almost everyone in the US is exposing themselves to "the herd" at their community grocer/big box store. Given that exposure, I don't see how visiting a smaller business which likely, has less traffic than a grocer, has more space per human than a grocer, can more easily monitor and accomplish social distancing measures adds significantly to the transmission risk.  

To be clear, I am not expecting you to have the answers to all of these questions.  It's just nice to have a credentialed immunologist and physician in our ranks contributing to the discussion.

Edited April 20, 2020 by Shadrach

[DXB]

54 minutes ago, Shadrach said:

Understood.  Indeed the authors of the study are trying to ramp up studies in other geographic areas. I also understand that antibodies do not guarantee long term immunity. More questions than answers right now regarding herd immunity.    With regard to my "experts" comment, I was not trying to draw you into a political discussion. I was curious about your opinion regarding experts making claims that even a layman like myself can tell are unknowable (or maybe I am mistaken).   These claims are driving policy world wide. The more invested one becomes in a particular theory the greater the temptation to justify that theory and the associated policy decisions.  The more invested a group becomes the less agile we become in our policy making. It is the nature of the situation  and there is no getting away.  It's one of the reasons that I am surprised that Sweden bucked the rest of the world and came to the decision to leave their economy open and confine their focus to the most at risk population. However I think I understand why.   It seems that if herd immunity is achievable, Sweden is taking steps to hasten that process while the rest of us are slowing it for...well a lot of guesses but we really don't know.    On the other hand, almost everyone in the US is exposing themselves to "the herd" at their community grocer/big box store. Given that exposure, I don't see how visiting a smaller business which likely, has less traffic than a grocer, has more space per human than a grocer, can more easily monitor and accomplish social distancing measures adds significantly to the transmission risk.  

To be clear, I am not expecting you to have the answers to all of these questions.  It's just nice to have a credentialed immunologist and physician in our ranks contributing to the discussion.

A few apolitical comments about immunity - this is one of the most widely misunderstood concepts in the public dialogue: 

-At the individual level, immunity is never black or white - there is no such thing as total, perfect resistance to a pathogen for anyone, whether it's from a vaccine or from the natural infection. 

-Population level resistance (what we really need - the herd concept) does not require strong immunity or even durable immunity at the individual level. It merely requires enough resistance to the types of infections that produce a lot of virus shedding. The point is for there to be less pathogen in the environment.  

-That population level resistance is very likely to be achieved here with widespread enough infection, or the right vaccine, even if individual resistance to infection is fairly modest. 

-Will this virus mutate quickly as an immune escape mechanism?  Luckily it appears fairly stable so far - we know it is a rather efficient beast that is well adapted to rapid spread, and so it may not be encountering much selective pressure early on. It will certainly change over time under immune selection pressure as more people are exposed and/or a vaccine is applied.  There's a good chance those changes will also attenuate it's pathogenicity, reverting it back to being more like a common cold virus.  

I could not agree more that policy needs to be agile here as more is learned - the scientific knowledge is increasing exponentially along with the virus, though enormous uncertainty remains.  At the same time, leaders are faced with a need for clear, coherent, and consistent messaging to the general population, which is not at all easy under these circumstances. 

 

[carusoam]

Knowledge IS power...

Gents, thank you for sharing what you know.

Best regards,

-a-

[steingar]

If someone covered this I apologize for the repetition.  I couldn't read all that.

The worry with the current outbreak isn't the deaths, and it never was.  The worry is the 20% hospitalization rate.  That's held steady in every country and every setting except perhaps the Theodore Roosevelt, and I have some ideas about that.  I just saw a story saying 2/3's of the hospital beds in the US are occupied, and that's with us trying like mad to contain the disease.  When this gets out for real, and it will, it'll overwhelm our medical facilities, and fast.

They're trying to hedge this off with social distancing and closures.  It won't last, as the weather heats up folks will want to be out and there will be popular discontent.  This will roll back around in Fall, hard.  The disease will make a reappearance just as we gear up for all those big family gatherings.  By then there'll be no going back.  Not enough have overcome the illness to give us herd immunity.

Those of you who see this as unconstitutional government intrusion will get your wish.  Governments will bow to their populace, give it time, and not much as that.  But come next winter, when you need a hospital bed for your pneumonia there might not be one.  They'll be full of COVID patients.  Not only will you loose your more frail family members, you might loose those who aren't frail but who couldn't get life-saving medical treatment from an overburdened medical system.

[Hank]

13 minutes ago, steingar said:

 Not only will you loose your more frail family members, you might loose those who aren't frail but who couldn't get life-saving medical treatment from an overburdened medical system.

This is what has been given throughout at least the Western World as the reason for shutting down our economies and starting social distancing!

[PTK]

21 hours ago, steingar said:

The worry with the current outbreak isn't the deaths, and it never was.  The worry is the 20% hospitalization rate.  

I agree. We are between the proverbial rock and a hard place. And we’ll be there for as long as there’s no herd immunity. The safe way to build herd immunity is a vaccine. And with this virus we can’t begin to talk about herd immunity without a vaccine. With no vaccine we rely on natural immunity. Contract the virus and build antibodies. Problem is this is a dangerous virus with an R0 of about 6. This means one person can pass it to 6 others. That’s majorly contagious to rely on natural immunity! There will be much illness and death in a short amount of time overburdening the health care delivery system. So our only option presently is to spread it out over an extended time. Buy some time. That’s where social distancing and shutting down the country come in. We aim to flatten the curve by extending it over a longer timeline. But the area under the curve is still the same area under the curve! A vaccine is at least 12-18 months away at best and with a healthy dose of wishful thinking. Serological testing may help identify individuals who have overcome an infection in the past and have developed an immune response. We may be able to utilize such data to identify individuals who may no longer be susceptible to infection and can return to work. Key words there are “may” because there are many variables and unknowns. We are between a rock and a hard place without any good options. We will be in this tight spot for and long while.

Practice physical distancing and stay safe!

[Marauder]

4 hours ago, Shadrach said:

Understood.  Indeed the authors of the study are trying to ramp up studies in other geographic areas. I also understand that antibodies do not guarantee long term immunity. More questions than answers right now regarding herd immunity.    With regard to my "experts" comment, I was not trying to draw you into a political discussion. I was curious about your opinion regarding experts making claims that even a layman like myself can tell are unknowable (or maybe I am mistaken).   These claims are driving policy world wide. The more invested one becomes in a particular theory the greater the temptation to justify that theory and the associated policy decisions.  The more invested a group becomes the less agile we become in our policy making. It is the nature of the situation and there is no getting away.  It's one of the reasons that I am surprised that Sweden bucked the rest of the world and came to the decision to leave their economy open and confine their focus to the most at risk population. However, I think I understand why.   It seems that if herd immunity is achievable, Sweden is taking steps to hasten that process while the rest of us are slowing it for...well a lot of guesses but we really don't know.    On the other hand, almost everyone in the US is exposing themselves to "the herd" at their community grocer/big box store. Given that exposure, I don't see how visiting a smaller business which likely, has less traffic than a grocer, has more space per human than a grocer, can more easily monitor and accomplish social distancing measures adds significantly to the transmission risk.  

To be clear, I am not expecting you to have the answers to all of these questions.  It's just nice to have a credentialed immunologist and physician in our ranks contributing to the discussion.

Part of the discussion over any approach to a pandemic is an understanding of the very type of factors you mention. Sweden is a population of 10.1 million living on 158,430 sq. miles of land. New York City has a population of 8,398,748 on 306.2 sq. miles. Throw in the surrounding NY metro areas (Long Island, counties across the river) you are looking at 10 million people living on 3,450 sq. miles. By design, Sweden has some social isolationism though Stockholm has 1.56 million citizens and Gothenburg has roughly 0.5M citizens. What would Sweden's situation look like if they were all packed into Stockholm?

If you compare Austria which is under lock down with Sweden, Austria's population is a little over 9M and resides on a land mass of 32,386 sq. miles, you will see they both have roughly the same number of infected (~14,700) but Austria has only 470 deaths to Sweden's 1580. The death difference could be related to age demographics and their healthcare systems. If Austria didn't lock down, what would the results look like?

The point I am trying to make is that like you stated, there are a lot of factors that come into play (geography, population distribution, age demographics, genetic attributes, social customs (no I don't kiss Ross on the cheek when we see each other), robustness of the healthcare system, etc.) as well as a lot of unknowns about the virus itself. 

What works for one geography might not for another for a variety of reasons. I don't think there is any one expert who can say how to handle the pandemic. And that in itself is a problem. I spent a lot of time reading up on the flu epidemic of 1918 (I refuse to call it the Spanish Flu simply because if people read up on it, they would know why). One of the strangest things I learned was that media played a huge role in what happened. But not for the reasons you would think. And Seattle's experience during the Spring and Fall of 1918 is also an education. Old George has it right "Those who do not learn history are doomed to repeat it.'"

The sad part about this situation is that we walked into a fight against an adversary that was better equipped than we were. 

Edited April 20, 2020 by Marauder

[Shadrach]

1 hour ago, DXB said:

A few apolitical comments about immunity - this is one of the most widely misunderstood concepts in the public dialogue: 

-At the individual level, immunity is never black or white - there is no such thing as total, perfect resistance to a pathogen for anyone, whether it's from a vaccine or from the natural infection. 

-Population level resistance (what we really need - the herd concept) does not require strong immunity or even durable immunity at the individual level. It merely requires enough resistance to the types of infections that produce a lot of virus shedding. The point is for there to be less pathogen in the environment.  

-That population level resistance is very likely to be achieved here with widespread enough infection, or the right vaccine, even if individual resistance to infection is fairly modest. 

-Will this virus mutate quickly as an immune escape mechanism?  Luckily it appears fairly stable so far - we know it is a rather efficient beast that is well adapted to rapid spread, and so it may not be encountering much selective pressure early on. It will certainly change over time under immune selection pressure as more people are exposed and/or a vaccine is applied.  There's a good chance those changes will also attenuate it's pathogenicity, reverting it back to being more like a common cold virus.  

I could not agree more that policy needs to be agile here as more is learned - the scientific knowledge is increasing exponentially along with the virus, though enormous uncertainty remains.  At the same time, leaders are faced with a need for clear, coherent, and consistent messaging to the general population, which is not at all easy under these circumstances. 

 

Thanks for the insight Dev! 

I can see that you are not going to touch the comments on CFR and Mortality with someone else's ten foot pole  (I like to combine metaphors for effect).  So please consider my comments below to be general and not directed to you specifically.

To my reading, the bigger news in Santa Clara study is that our current denominator for determining Case Fatality Rate (CFR) is off and substantially so (by a magnitude of 50 to 100).  If we use Dev's educated WAG of 10% infection rate in New York the CFR goes from 6% to ~1%.  I am not saying either of those numbers are real.  What I am saying is that I am disheartened by manic nature of the expert narrative. 

The WHO didn't see any evidence of human to human transmission. Then the WHO didn't see a substantial risk to the US population. Politicians at the state and federal level echoed these comments. Then the face mask debacle.  There was no evidence that covering two of the main mucus membranes involved in the delivery and reception of the virus would provide any protection, besides, don't horde them as they are needed to protect medical professionals even though they don't really offer much protection.  As I write this it is a chargeable offense in some states to be in a public place without a mask.  Last week Fauci says  Covid19 10X deadlier than the flu (I'm not disrespecting Fauci, I jut don;t know how he can say such a thing with confidence). Potentially 2 MM dead...well actually it's probably under 100,000... well maybe 60,000.  These are mistakes of the past that have now been corrected (sort of) but currently, Worldometer,  IHME, etc. are all displaying numbers that suggest a 5-10% CFR without qualification even though we know that the number folks infected is far, far greater than the number that have tested positive.  To call this  $h!% show is kind of an understatement.  If you work in an industry that is still thriving, be grateful.  Much of the country has instituted hiring freezes. The service industry was hit first but it is permeating the white collar and blue collar world as well.  

[DXB]

1 minute ago, Shadrach said:

Thanks for the insight Dev! 

I can see that you are not going to touch the comments on CFR and Mortality with someone else's ten foot pole  (I like to combine metaphors for effect).  So please consider my comments below to be general and not directed to you specifically.

To my reading, the bigger news in Santa Clara study is that our current denominator for determining Case Fatality Rate (CFR) is off and substantially so (by a magnitude of 50 to 100).  If we use Dev's educated WAG of 10% infection rate in New York the CFR goes from 6% to ~1%.  I am not saying either of those numbers are real.  What I am saying is that I am disheartened by manic nature of the expert narrative. 

The WHO didn't see any evidence of human to human transmission. Then the WHO didn't see a substantial risk to the US population. Politicians at the state and federal level echoed these comments. Then the face mask debacle.  There was no evidence that covering two of the main mucus membranes involved in the delivery and reception of the virus would provide any protection, besides, don't horde them as they are needed to protect medical professionals even though they don't really offer much protection.  As I write this it is a chargeable offense in some states to be in a public place without a mask.  Last week Fauci says  Covid19 10X deadlier than the flu (I'm not disrespecting Fauci, I jut don;t know how he can say such a thing with confidence). Potentially 2 MM dead...well actually it's probably under 100,000... well maybe 60,000.  These are mistakes of the past that have now been corrected (sort of) but currently, Worldometer,  IHME, etc. are all displaying numbers that suggest a 5-10% CFR without qualification even though we know that the number folks infected is far, far greater than the number that have tested positive.  To call this  $h!% show is kind of an understatement.  If you work in an industry that is still thriving, be grateful.  Much of the country has instituted hiring freezes. The service industry was hit first but it is permeating the white collar and blue collar world as well.  

A couple things worth poking with a pole here . The actual CFR in an average population of typical age and comorbidity distribution, and access to ICU care, is 1%. I would be willing to wager that, allowing for a 50% confidence interval on either side. The calculated ones are consistently higher, and with wide range, because of variation in how many symptomatic people are tested and the innate untestability of the asymptomatic pool (the latter requires a deep dive into Bayes Theorem to explain).  Given that 1% mortality, Fauci is spot on in saying it is 10x more lethal than seasonal flu. Think of each case as having 10x more overall impact than a seasonal flu case - 10x more hospital admissions, ICU admissions, and deaths. Seasonal flu will never be a fair comparison here.  Of note, if we had zero ICU beds, mortality would go up to 1.5% to 2%.  The ICU is were people die of this disease if they come to the hospital, and optimal ICU care saves less than half if they land there.

[Shadrach]

 

 

2 hours ago, Marauder said:

Part of the discussion over any approach to a pandemic is an understanding of the very type of factors you mention. Sweden is a population of 10.1 million living on 158,430 sq. miles of land. New York City has a population of 8,398,748 on 306.2 sq. miles. Throw in the surrounding NY metro areas (Long Island, counties across the river) you are looking at 10 million people living on 3,450 sq. miles. By design, Sweden has some social isolationism though Stockholm has 1.56 million citizens and Gothenburg has roughly 0.5M citizens. What would Sweden's situation look like if they were all packed into Stockholm?

If you compare Austria which is under lock down with Sweden, Austria's population is a little over 9M and resides on a land mass of 32,386 sq. miles, you will see they both have roughly the same number of infected (~14,700) but Austria has only 470 deaths to Sweden's 1580. The death difference could be related to age demographics and their healthcare systems. If Austria didn't lock down, what would the results look like?

The point I am trying to make is that like you stated, there are a lot of factors that come into play (geography, population distribution, age demographics, genetic attributes, social customs (no I don't kiss Ross on the cheek when we see each other), robustness of the healthcare system, etc.) as well as a lot of unknowns about the virus itself. 

What works for one geography might not for another for a variety of reasons. I don't think there is any one expert who can say how to handle the pandemic. And that in itself is a problem. I spent a lot of time reading up on the flu epidemic of 1918 (I refuse to call it the Spanish Flu simply because if people read up on it, they would know why). One of the strangest things I learned was that media played a huge role in what happened. But not for the reasons you would think. And Seattle's experience during the Spring and Fall of 1918 is also an education. Old George has it right "Those who do not learn history are doomed to repeat it.'"

The sad part about this situation is that we walked into a fight against an adversary that was better equipped than we were. 

I don't disagree with anything you've said. Italy was tailor made to become a mess. Its social customs. Its garment industry importing workers direct from Wuhan. Its aged population.

RE Sweden:  consider that Dr. Fauci (sorry to keep bring him up) said earlier this month he could not understand why every state was not locking down like New York (paraphrasing).  Let's  consider Montana has had 10 deaths and 55 hospitalizations total as of today and the rate of transmission is a comparative trickle. Many other states with low population densities have similar stories.

The saddest part about this situation for me is that the Chinese government knew they had a highly contagious pathogen traveling through their population and they lied and obfuscated while persecuting whistle blowers rather than take early action that could have mitigated this a great deal.  Unfortunately the international community initially bought what they were selling (save for Taiwan which knew better).

Edited April 20, 2020 by Shadrach

[DXB]

2 hours ago, steingar said:

If someone covered this I apologize for the repetition.  I couldn't read all that.

The worry with the current outbreak isn't the deaths, and it never was.  The worry is the 20% hospitalization rate.  That's held steady in every country and every setting except perhaps the Theodore Roosevelt, and I have some ideas about that.  I just saw a story saying 2/3's of the hospital beds in the US are occupied, and that's with us trying like mad to contain the disease.  When this gets out for real, and it will, it'll overwhelm our medical facilities, and fast.

They're trying to hedge this off with social distancing and closures.  It won't last, as the weather heats up folks will want to be out and there will be popular discontent.  This will roll back around in Fall, hard.  The disease will make a reappearance just as we gear up for all those big family gatherings.  By then there'll be no going back.  Not enough have overcome the illness to give us herd immunity.

Those of you who see this as unconstitutional government intrusion will get your wish.  Governments will bow to their populace, give it time, and not much as that.  But come next winter, when you need a hospital bed for your pneumonia there might not be one.  They'll be full of COVID patients.  Not only will you loose your more frail family members, you might loose those who aren't frail but who couldn't get life-saving medical treatment from an overburdened medical system.

The worry is the ICU admissions and deaths. Of those 20% getting admitted to the hospital, only about 1/4 land in the ICU.  The other 15% are quite easy to take care of - they are mostly there for supplemental oxygen and to be physically positioned for ICU admission and intubation should they need it.  That capacity can be ramped up quickly. It's the vents, complex monitoring, clinical expertise in the ICU that are hard to expand - ICU care is an order of magnitude more resource intensive. Note death rates in the ICU if you get intubated are well over 50% even with the best care, so you are saving less than half the people who make it that far.

Also note that hospitals nationwide are far emptier than normal, except in a few hotspots like NYC.  Hospitals are like the airlines - used to running at near capacity to be profitable in an industry with very high overheads.  They don't have an economic model for cancelling all elective care and sitting there with unused capacity waiting for COVID19 patients that may never come - it is pushing them to the edge, and it will change the industry forever.

I agree with you completely about the inevitable fall spike in cases in a population with effectively no immunity. A lull in the summer is certainly possible but I am not totally confident it will happen.

[Shadrach]

On 4/20/2020 at 1:34 PM, steingar said:

If someone covered this I apologize for the repetition.  I couldn't read all that.

The worry with the current outbreak isn't the deaths, and it never was.  The worry is the 20% hospitalization rate.  That's held steady in every country and every setting except perhaps the Theodore Roosevelt, and I have some ideas about that.  I just saw a story saying 2/3's of the hospital beds in the US are occupied, and that's with us trying like mad to contain the disease.  When this gets out for real, and it will, it'll overwhelm our medical facilities, and fast.

They're trying to hedge this off with social distancing and closures.  It won't last, as the weather heats up folks will want to be out and there will be popular discontent.  This will roll back around in Fall, hard.  The disease will make a reappearance just as we gear up for all those big family gatherings.  By then there'll be no going back.  Not enough have overcome the illness to give us herd immunity.

Those of you who see this as unconstitutional government intrusion will get your wish.  Governments will bow to their populace, give it time, and not much as that.  But come next winter, when you need a hospital bed for your pneumonia there might not be one.  They'll be full of COVID patients.  Not only will you loose your more frail family members, you might loose those who aren't frail but who couldn't get life-saving medical treatment from an overburdened medical system.

I hope we're both healthy and able to weigh in on the accuracy of this prediction in the fall.

Edited April 21, 2020 by Shadrach

[DXB]

5 minutes ago, Shadrach said:

The saddest part about this situation for me is that the Chinese government knew they had a highly contagious pathogen traveling through their population and they lied and obfuscated while persecuting whistle blowers rather than take early action that could have mitigated this a great deal.  Unfortunately the international community initially bought what they were selling (save for Taiwan which knew better).

The part that makes me detest the Chinese government is their obsuring case numbers and death rates, and continuing to do so to this day.  There were epidemiologic models built upon their published data early on that were used to guide subsequent decision making worldwide. That's where they unforgivably let the world down.  Bureacratic inertia in the face of a new unfamiliar problem is almost expected (note we had plenty of our own), and I could care less if someone ate a bat (i imagine they're gonna stop doing that now).  The biology behind why bats seem to harbor so many viruses that prove much more pathogenic in other mammals is fascinating btw, but I digress...

[Shadrach]

1 hour ago, DXB said:

  Given that 1% mortality, Fauci is spot on in saying it is 10x more lethal than seasonal flu. 

He is spot on for New York if your educated guess of 10% is correct. 

For Santa Clara Co, CA?  The numbers suggest fatality rate is .15% to .4%.

The LA county/USC study that came out today suggests about the same at .18%

Department of corrections and Rehabilitation in Ohio began mass testing of inmates about 10 days ago.  Fatality rate at this time is around .25%

Certainly there are limitations with these studies. But there is a trend.

 

 

 

Edited April 20, 2020 by Shadrach

[Andy95W]

16 hours ago, DXB said:

  I would estimate 20% of Belgium's population has already been infected and has some immunity, vs. a paltry 5% for us.  

I suspect you're right, Dev, but I hope you're wrong about the 5%.  

Right now I've got a slight temperature (100.5°), get slightly more winded than normal climbing stairs or jogging, and feel kinda crappy.  Any other year I'd figure my allergies were acting up. This year, I hope I'm one of the people having a mild reaction to the virus.  And I hope it's a one-and-done sort of virus, at that.

My wife feels a little worse than me and we're staying home- except I just got back from flying my Mooney by myself.

(Thanks, by the way, for what you're doing for us all right now.)

[DXB]

29 minutes ago, Shadrach said:

He is spot on for New York if your educated guess of 10% is correct. 

For Santa Clara Co, CA?  The numbers suggest fatality rate is .15% to .4%.

The LA county/USC study that came out today suggests about the same at .18%

Department of corrections and Rehabilitation in Ohio began mass testing of inmates about 10 days ago.  Fatality rate at this time is around .25%

Certainly there are limitations with these studies. But there is a trend.

 

 

 

 I am highly skeptical of data for any virus-naive population containing a normal age distribution reporting mortality under 0.5%.  Note that aggressive testing of asymptomatic and mildly symptomatic people in a low prevalence population would falsely reduce the death rate , because most of the test positives would be false positives (that Bayes Theorem prediction).  I could see some places getting caught up early obsession over "not enough tests" and pushing hard to apply the PCR test to everyone with the sniffles. That kinda seems like a California thing to do.  

*Another possibility is a less virulent strain taking hold in that population, but that seems less likely.

[Shadrach]

21 hours ago, Andy95W said:

I suspect you're right, Dev, but I hope you're wrong about the 5%.  

Right now I've got a slight temperature (100.5°), get slightly more winded than normal climbing stairs or jogging, and feel kinda crappy.  Any other year I'd figure my allergies were acting up. This year, I hope I'm one of the people having a mild reaction to the virus.  And I hope it's a one-and-done sort of virus, at that.

My wife feels a little worse than me and we're staying home- except I just got back from flying my Mooney by myself.

(Thanks, by the way, for what you're doing for us all right now.)

In late January I was very ill.  Temp well above 102 for 3 days and peaked at 103.8. Mild pneumonia that was like sleeping next to someone eating pop rocks and rice crispies but would abate after being vertical for an hour the next morning.  It would come right back within minutes of my head hitting the pillow, cracking and popping in my breathing so loud it kept me up. Fever treated with NSAIDs,  horrible chills, unproductive cough. Flu test negative.  Never got the prescribed chest xray.  My wife lagged me behind me by 5 days with fever but no pneumonia.  Neither of us have had fevers like that since adolescence. The worst of it was only 3-4 days. Look forward to getting an antibody test.

Edited April 21, 2020 by Shadrach

[DXB]

47 minutes ago, Andy95W said:

I suspect you're right, Dev, but I hope you're wrong about the 5%.  

Right now I've got a slight temperature (100.5°), get slightly more winded than normal climbing stairs or jogging, and feel kinda crappy.  Any other year I'd figure my allergies were acting up. This year, I hope I'm one of the people having a mild reaction to the virus.  And I hope it's a one-and-done sort of virus, at that.

My wife feels a little worse than me and we're staying home- except I just got back from flying my Mooney by myself.

(Thanks, by the way, for what you're doing for us all right now.)

Thanks Andy - hope you feel better soon - the "good" news is that everyone is still getting all the other seasonal respiratory infections and allergies normally floating around, so chances are better than not that you don't have it. 

I ain't doing squat in terms of patient care right now by the way    It's not bad enough in Philly that any MDs need to get repurposed, and the hospital is rather desolate. My usual cancer patients are mostly hiding, likely too afraid to go anywhere near the hospital, and all the elective care is canceled.  There will likely be a deluge of work on the other side of this...

[Immelman]

Ross... please advise on your how antibody test goes. I hear similar stories and anecdotes around my neck of the woods. Some from folks in their 60s.

My opinion, well, my experiences:

The past month was one of shock. We are moving past the shock phase. "What's next?". We are still flying mostly blind, not even partial panel. Immunity after illness? Antibodies? Number of infected with no symptoms (making containment impossible, but mortality lower)? Swedish strategy? The Gilead drug? Small bits of data are coming out hinting at things. All while we are at the worst of this 'wave' of illness and economic shock. It may be time to step back and be patient, and let things settle. Wait another month. More will be revealed, one way or another, which will guide appropriate response, and guide what the new normal will be.

This morning I learned that the nursing home my grandmother in has 30 cases. I was told she had a fever a couple of weeks ago, was tested, and was negative. Someone's lying. As far as I know, she's okay....

I say this as an airline pilot who hasn't flown anything larger than than my Mooney since March 4. Currently on leave, caring for our daughter while my wife works from home. And I wonder if I will have a job, or if it will be a job worth going back to on Sept 30... perhaps time to refresh the old skills and get other options ready. At least there is time to prepare.

And I am allowing myself to fly my plane as an essential activity, but am not really going anywhere. I am an airline pilot. Its an essential job. Flying is a perishable skill. A320 != Mooney but the principles are the same and getting rusty sucks.

Note to self: Keep your heart healthy. Keep up the exercise. Keep the lungs strong. Keep BMI in the normal range. Avoid lifestyle decisions that promote adult-onset diabetes. All things we ought to be thinking about anyway, but now with a renewed sense of urgency. Who knows how long this will be with us?

[Andy95W]

2 hours ago, Marauder said:

no I don't kiss Ross on the cheek when we see each other),

 

20 minutes ago, Shadrach said:

In late January I was very ill.  Temp well above 102 for 3 days peaked at 103.8. Mild pneumonia that was like sleeping next to someone eating pop rocks and rice crispies but would abate after being vertical for an hour the next morning.  It would come right back within minutes of my head hitting the pillow.  cracking and popping in my breathing so loud it kept me up. 

Good thing you stopped kissing Chris.  You knew the risks with that kind of behavior...

[Shadrach]

1 hour ago, Andy95W said:

 

Good thing you stopped kissing Chris.  You knew the risks with that kind of behavior...

 The shelter in placeI diet has me feeling  like I’ve gained the COVID-19. Even with the extra chub, I’m still a little light for Chris’s taste. Probably a touch on the hairy side as well...

[Shadrach]

1 hour ago, Immelman said:

Ross... please advise on your how antibody test goes. I hear similar stories and anecdotes around my neck of the woods. Some from folks in their 60s.

My opinion, well, my experiences:

The past month was one of shock. We are moving past the shock phase. "What's next?". We are still flying mostly blind, not even partial panel. Immunity after illness? Antibodies? Number of infected with no symptoms (making containment impossible, but mortality lower)? Swedish strategy? The Gilead drug? Small bits of data are coming out hinting at things. All while we are at the worst of this 'wave' of illness and economic shock. It may be time to step back and be patient, and let things settle. Wait another month. More will be revealed, one way or another, which will guide appropriate response, and guide what the new normal will be.

This morning I learned that the nursing home my grandmother in has 30 cases. I was told she had a fever a couple of weeks ago, was tested, and was negative. Someone's lying. As far as I know, she's okay....

I say this as an airline pilot who hasn't flown anything larger than than my Mooney since March 4. Currently on leave, caring for our daughter while my wife works from home. And I wonder if I will have a job, or if it will be a job worth going back to on Sept 30... perhaps time to refresh the old skills and get other options ready. At least there is time to prepare.

And I am allowing myself to fly my plane as an essential activity, but am not really going anywhere. I am an airline pilot. Its an essential job. Flying is a perishable skill. A320 != Mooney but the principles are the same and getting rusty sucks.

Note to self: Keep your heart healthy. Keep up the exercise. Keep the lungs strong. Keep BMI in the normal range. Avoid lifestyle decisions that promote adult-onset diabetes. All things we ought to be thinking about anyway, but now with a renewed sense of urgency. Who knows how long this will be with us?

I am trying to put together a home blood serum test with the hopes that the FDA allows home testing at some point. When I have more information I will post an update.

[bonal]

All this talk about re opening being dependent on testing seems somewhat misleading. IMHO the only test that really matters is the antibody test. Unless they plan on doing a  daily test for people what good is that. Your given the green light to go to work after your test comes up negative what's to say you won't become infected that day and unless you get another test before your next day out you could be spreading the virus. We might as well just start wearing full hazmat gear if we wait for a proven vaccine the world economy is going to be beyond repair and please don't accuse me of thinking money is more important than health but the long term risk of poverty will be far worse than this stupid Chinese virus.some of you worry about our healthcare facilities being over loaded a real concern for the short term. But if we don't get people back to work and keep businesses open there isn't going to be any revenue to keep those hospitals and practices open they will be forced to close their doors permanently. State and local governments are now feeling great economic pressure because the revenue faucet has been turned off because there is very little commerce no business means no taxes.  Food supplies will begin to fail they already have. None of the political leaders are going to risk their careers by being accused of putting the economy above the possible risks associated with re opening. They are talkIng about not re opening schools even in the fall.  Our economy is the life blood of this country and if it dies there won't be any way to do anything for those that get sick. 

 

[Andy95W]

49 minutes ago, Shadrach said:

 The shelter in placeI diet has me feeling  like I’ve gained the COVID-19. Even with the extra chub, I’m still a little light for Chris’s taste. Probably a touch on the hairy side as well...

Yeah, instead of the "freshman ten" it's the "quarantine fifteen".