Coronavirus thread

[MusicTurner]

Premont, in what has has the society/businesses/life opened up so far; as in, what are they now allowing?

PD

They are hoping for a general political agreement in a few hours, besides the smaller steps that have just been implemented these days.

[Pohjolas Daughter]

Thanks MT; will be quite interested to see what they propose!

[arpeggio]

It is hard to keep up with every post because of the heavy activity here.

One of the problems we have in the United States is that there is a conservative Pro-Trump news network, Fox News.  Most of the Pro-Trump people in the United States only listen to Fox News.

Fox has been pushing forth the Trump message that he is not to blame for anything and this crises is the fault of the Chinese and the World Health Organization.

The network is also is broadcasting the idea that we need to accept people dying in order to keep the economy going.  As a result in many areas of the United States, primarily Pro-Trump areas, there have be protest over the measures that some states have taken to try to contain the virus.  One state is South Dakota.  The governor there, a Trump supporter, has refused to take any actions to contain the virus.  She claims that they have everything under control.  When one takes in account the population of Sioux Falls, South Dakota, about 180,000, their rate of infection is worse than New York City.  No matter how many people die, they have to keep the Walmart Department Store open. 

[Mandryka]

Fox has been pushing forth the Trump message that he is not to blame for anything and this crises is the fault of the Chinese and the World Health Organization.

In that he's getting some moral support from the UK and France

https://www.europe1.fr/international/coronavirus-en-chine-pour-emmanuel-macron-des-choses-se-sont-passees-quon-ne-sait-pas-3962437

Coronavirus en Chine : pour Emmanuel Macron, "des choses se sont passées qu'on ne sait pas"


https://www.dailymail.co.uk/news/article-8226967/Dominic-Raab-warns-China-faces-hard-questions-source-coronavirus-pandemic.html

It WON'T be 'business as usual' with China after coronavirus crisis is over, warns Dominc Raab as he calls for 'hard questions' for the Communist state over secrecy and spread of virus

[prémont]

Premont, in what has has the society/businesses/life opened up so far; as in, what are they now allowing?

PD

First and foremost children care and schools from first to fifth class opened yesterday. The argument is, that children stand the virus better than grown-up's (even if it is unknown if they also are less contagious). Of course lots of hygienical precautions must be taken as to distance, hand-washing and other things to prevent too much virus spreading among the children and the pedagogues. Another effect of opening in this way, which the PM has stressed is, that it allows many parents to begin working again, not having to take care of the children all day. To make this work it is presupposed, that all Danes continue the general measures (social distancing et. c.).

There is a great political pressure on our government also to allow small shops (hairdressers e.g.) to open now. This is as far as I know not decided until now, but they are negotiating about it.

I do not think more will be opened, until we know if these openings allows the virus to spread too much, or if the spread is acceptable. But it will spread the virus somewhat, more people will contract the virus, and more will die, and unfortunately it is a political question, how many more deaths are acceptable. And as Mandryka wrote above, there will be no public information or discussion of this issue.

[Mandryka]

Only the British of a certain age will understand why this is slightly funny.

[arpeggio]

In that he's getting some moral support from the UK and France

Of course he is getting some moral support from the UK and France.  I know that.  The populations of France and the UK are over 60,000,000 for each country.  I would be stunned if at least a few million in each county thought Trump walked on water.  So what? 

[JBS]

It seems to boil down to this:
Chinese regional authorities were dishonest with the national government and tried to minimize the virus's effects.  Then Chinese national authorities seem to have been dishonest with the rest of the world. And WHO  passed on that information uncritically.

The only questions are how much, at any of these three levels, was this because of bureaucratic ineptitude and how much knowing but not caring. Team Trump of course claims maximal malice from Beijing and the WHO, and that WHO willingly carries water for China. The actual facts presumably come much closer to bureaucratic ineptitude.

Being angry at WHO of course allows Trump to shift the blame for the fact that he too accepted the Chinese information uncritically and therefore took no steps to prepare for the pandemic reaching the US.

[ritter]

Yes, so it seems. But two wrongs do not make a right. China and (probably to a lesser degree) are in no way  beyond reproach—one would be naive to expect any transparency from a totalitarian regime like the Chinese—, but finger pointing and scapegoating aren't going to solve anything right now.

Some Fox News commentator I caught while zapping said it was natural to punish the WHO for doing a lousy job. That train of thought would then be applicable to the man who holds the highest office in the US, and who publicly declined to "take any responsibility" just some weeks ago.

[Que]

(Dutchnews.nl)
Half a million people may have developed coronavirus antibodies

As many as 3% of people in the Netherlands may have developed antibodies against coronavirus, indicating they have some immunity against Covid-19, the public health institute RIVM said on Thursday. Blood bank operator Sanquin arrived at the figure after studying blood and plasma samples from around 7,000 donors aged between 18 and 69 during a one-week period. If the 3% figure is reflected in the general population, as many as half a million people may have developed antibodies.

Jaap van Dissel, the RIVM's head of infectious disease control, stressed that the presence of antibodies did not guarantee that a person was immune. The research into immunity is ongoing and has not yet been published in a peer reviewed journal, he told MPs during the weekly technical briefing.

++++++++++

The figure might go up the coming weeks, but it is not as high as I expected.....

Q

[JBS]

Yes, so it seems. But two wrongs do not make a right. China and (probably to a lesser degree) are in no way  beyond reproach—one would be naive to expect any transparency from a totalitarian regime like the Chinese—, but finger pointing and scapegoating aren't going to solve anything right now.

Some Fox News commentator I caught while zapping said it was natural to punish the WHO for doing a lousy job. That train of thought would then be applicable to the man who holds the highest office in the US, and who publicly declined to "take any responsibility" just some weeks ago.

And who repeatedly claimed before then that everything was under control.  Trump is obviously scapegoating.

[BasilValentine]

It seems to boil down to this:
Chinese regional authorities were dishonest with the national government and tried to minimize the virus's effects.  Then Chinese national authorities seem to have been dishonest with the rest of the world. And WHO  passed on that information uncritically.

The only questions are how much, at any of these three levels, was this because of bureaucratic ineptitude and how much knowing but not caring. Team Trump of course claims maximal malice from Beijing and the WHO, and that WHO willingly carries water for China. The actual facts presumably come much closer to bureaucratic ineptitude.

Being angry at WHO of course allows Trump to shift the blame for the fact that he too accepted the Chinese information uncritically and therefore took no steps to prepare for the pandemic reaching the US.

The Trump administration cut the CDC staff in the Bejing office from 47 to 14, the number including epidemiologists. Sounds like a source of inside information recklessly discarded:   

https://www.reuters.com/article/us-health-coronavirus-china-cdc-exclusiv/exclusive-u-s-slashed-cdc-staff-inside-china-prior-to-coronavirus-outbreak-idUSKBN21C3N5

In any case, the warnings were multiple and loud despite Chinese misinformation.

[Karl Henning]

Early peek at data on Gilead coronavirus drug suggests patients are responding to treatment

A Chicago hospital treating severe Covid-19 patients with Gilead Sciences' antiviral medicine remdesivir in a closely watched clinical trial is seeing rapid recoveries in fever and respiratory symptoms, with nearly all patients discharged in less than a week, STAT has learned.

Remdesivir was one of the first medicines identified as having the potential to impact SARS-CoV-2, the novel coronavirus that causes Covid-19, in lab tests. The entire world has been waiting for results from Gilead's clinical trials, and positive results would likely lead to fast approvals by the Food and Drug Administration and other regulatory agencies. If safe and effective, it could become the first approved treatment against the disease.

The University of Chicago Medicine recruited 125 people with Covid-19 into Gilead's two Phase 3 clinical trials. Of those people, 113 had severe disease. All the patients have been treated with daily infusions of remdesivir.

"The best news is that most of our patients have already been discharged, which is great. We've only had two patients perish," said Kathleen Mullane, the University of Chicago infectious disease specialist overseeing the remdesivir studies for the hospital.

Her comments were made this week during a video discussion about the trial results with other University of Chicago faculty members. The discussion was recorded and STAT obtained a copy of the video.

The outcomes offer only a snapshot of remdesivir's effectiveness. The same trials are being run concurrently at other institutions, and it's impossible to determine the full study results with any certainty. Still, no other clinical data from the Gilead studies have been released to date, and excitement is high. Last month, President Donald Trump touted the potential for remdesivir — as he has for many still-unproven treatments — and said it "seems to have a very good result."

In a statement Thursday, Gilead said: "What we can say at this stage is that we look forward to data from ongoing studies becoming available."

Gilead had said to expect results for its trial involving severe cases in April. Mullane said during her presentation that data for the first 400 patients in the study would be "locked" by Gilead Thursday, meaning that results could come any day.

Mullane, while encouraged by the University of Chicago data, made clear her own hesitancy about drawing too many conclusions.

"It's always hard," she said, because the severe trial doesn't include a placebo group for comparison. "But certainly when we start [the] drug, we see fever curves falling," she said. "Fever is now not a requirement for people to go on trial, we do see when patients do come in with high fevers, they do [reduce] quite quickly. We have seen people come off ventilators a day after starting therapy. So, in that realm, overall our patients have done very well."

She added: "Most of our patients are severe and most of them are leaving at six days, so that tells us duration of therapy doesn't have to be 10 days. We have very few that went out to 10 days, maybe three," she said.

Reached by STAT, Mullane confirmed the authenticity of the footage but declined to comment further.

Asked about the data, Eric Topol, director of the Scripps Research Translational Institute, described them as "encouraging."

"The severely hit patients are at such high-risk of fatality. So if it's true that many of the 113 patients were in this category and were discharged, it's another positive signal that the drug has efficacy," he said, adding that it will be important to see more data from randomized controlled studies.

Gilead's severe Covid-19 study includes 2,400 participants from 152 different clinical trial sites all over the world. Its moderate Covid-19 study includes 1,600 patients in 169 different centers, also all over the world.

The trial is investigating five- and 10-day treatment courses of remdesivir. The primary goal is a statistical comparison of patient improvement between the two treatment arms. Improvement is measured using a seven-point numerical scale that encompasses death (at worst) and discharge from hospital (best outcome), with various degrees of supplemental oxygen and intubation in between.

The lack of a control arm in the study could make interpreting the results more challenging.

A lack of data has led to yo-yoing expectations for the drug. Two studies in China had enrollment suspended partway through because there were not enough patients available. A recent report of patients given the drug under a special program to make it available to those who are very ill generated both excitement and skepticism.

In scientific terms, all the data are anecdotal until the full trial reads out, meaning that they should not be used to draw final conclusions. But some of the anecdotes are dramatic.

Slawomir Michalak, a 57-year-old factory worker from a suburb west of Chicago, was among the participants in the Chicago study. One of his daughters started feeling ill in late March and was later diagnosed with mild Covid-19. Michalak, by contrast, came down with a high fever and reported shortness of breath and severe pain in his back.

"It felt like someone was punching me in the lungs," he told STAT.

At his wife's urging, Michalak went to the University of Chicago Medicine hospital on Friday, April 3. His fever had spiked to 104 and he was struggling to breath. At the hospital, he was given supplemental oxygen. He also agreed to participate in Gilead's severe Covid-19 clinical trial.

His first infusion of remdesivir was on Saturday, April 4. "My fever dropped almost immediately and I started to feel better," he said.

By his second dose on Sunday, Michalak said he was being weaned off oxygen. He received two more daily infusions of remdesivir and recovered enough to be discharged from the hospital on Tuesday, April 7.

"Remdesivir was a miracle," he said.

The world is waiting to find out if it is really so.

About the Authors

Adam Feuerstein
Senior Writer, Biotech

Adam is STAT's national biotech columnist, reporting on the intersection of biotech and Wall Street.


Matthew Herper
Senior Writer, Medicine

Matthew covers medical innovation — both its promise and its perils.

[Karl Henning]

R.I. "best estimate" shows COVID-19 peak on May 3, with 2,100 deaths through October

Governor Gina M. Raimondo says if social distancing rules are not followed, the peak could come April 27 with 4,000 deaths through October

[Kaga2]

Slate Star Codex https://slatestarcodex.com/2020/04/14/a-failure-but-not-of-prediction/

[Pohjolas Daughter]

First and foremost children care and schools from first to fifth class opened yesterday. The argument is, that children stand the virus better than grown-up's (even if it is unknown if they also are less contagious). Of course lots of hygienical precautions must be taken as to distance, hand-washing and other things to prevent too much virus spreading among the children and the pedagogues. Another effect of opening in this way, which the PM has stressed is, that it allows many parents to begin working again, not having to take care of the children all day. To make this work it is presupposed, that all Danes continue the general measures (social distancing et. c.).

There is a great political pressure on our government also to allow small shops (hairdressers e.g.) to open now. This is as far as I know not decided until now, but they are negotiating about it.

I do not think more will be opened, until we know if these openings allows the virus to spread too much, or if the spread is acceptable. But it will spread the virus somewhat, more people will contract the virus, and more will die, and unfortunately it is a political question, how many more deaths are acceptable. And as Mandryka wrote above, there will be no public information or discussion of this issue.

Wow!  I heard something recently on the news (I think that it was about kids being able to see their friends??) that kids (young ones anyway) will do what they would naturally do, not thinking about distancing, and go up to and hug their friends that they haven't seen in some time....which is a totally natural reaction.  I do wish you all the best and am hoping so hard that things don't 'go south' for your wonderful country and people.  It just seems way too early to me.   

So hard to watch the news these days; more job losses and pictures on the news of huge, long lines of people trying to get food help across the country....more job losses, Congress's plan to help people and businesses out has run out of money (unless they vote to fund more).  Have to check out Pres. Trump's latest plans just announced.

All the best to you and please keep us up to date,

PD

[Pohjolas Daughter]

Yes, so it seems. But two wrongs do not make a right. China and (probably to a lesser degree) are in no way  beyond reproach—one would be naive to expect any transparency from a totalitarian regime like the Chinese—, but finger pointing and scapegoating aren't going to solve anything right now.

Some Fox News commentator I caught while zapping said it was natural to punish the WHO for doing a lousy job. That train of thought would then be applicable to the man who holds the highest office in the US, and who publicly declined to "take any responsibility" just some weeks ago.

From what I recall (story this morning) re NPR story, the WHO is really an advisory part of the UN and it doesn't have the legal ability to go into a country to inspect things without their request...basically can only say that they are willing to help and give advice and offer to go in, etc., but if the said country says no, that's that.  So, it's not right to blame the WHO for doing a bad job when they can only do so much.  Am trying to find the story.  Here's the interview with Kelly Craft:  https://www.npr.org/sections/coronavirus-live-updates/2020/04/15/835485122/u-n-ambassador-says-inaction-by-who-china-would-be-unforgiveable  trying to find the response that I heard today with an interview by an authority on the WHO.

[SimonNZ]

Our PM has announced that if - if - we go down from level 4 to level 3 for a further two weeks at the end of our four week lock down it will look like this:

Covid 19 coronavirus: What alert level 3 and other levels mean for you

[...]

"BUSINESSES AND WORKPLACES

Work from home if you can, is the message from Ardern to employers.

Where that is not possible, businesses may reopen but must comply with health and safety requirements around physical distancing and contactless engagement with customers.

Businesses only accessed by the staff, and without a customer-facing function, such as building and construction or forestry can open under strict health and safety and physical distancing rules.

Businesses that are accessed by the public or customers such as retail, hardware stores and restaurants can open but only for online or phone purchases and contactless delivery or click and collect.

SOCIAL DISTANCING

Keep your bubble but you can expand it "a small amount" at level 3, Ardern said.

People must stay within their immediate household bubble, but can expand this to reconnect with close family / whānau, or bring in caregivers, or support isolated people.

This extended bubble should remain exclusive.

Sticking to existing bubbles is recommended but some expansion is allowed if, for example, you have a caregiver that you need, children in shared care, a defacto partner who is caring for others, or you're a single person who wants the company of a sibling for example. Keep it exclusive and keep it small.

Funerals and weddings will be able to go ahead, but limited to 10 people. But they can only be services. No meals, food or receptions can take place.

Public venues are closed (eg, libraries, museums, cinemas, food courts, gyms, pools, playgrounds, markets).

SCHOOLS

Early childhood education centres and schools will open for children up to and including Year 10, with appropriate public health measures in place. All young people in Years 11-13 will continue to learn at home.

Physical attendance at school is voluntary, but all children not at school should be learning by distance.

Schools will be a safe place for children to go to learn if their parents need to return to work, or the children cannot learn at a distance.

Children who are able to, should remain home and learn via distance.

Children at school would be kept in the same groups each day and it would be down to each school to work out how to do that, Ardern said.

Schools and ECEs will contact parents as they work through their plans for reopening.

Home-based early learning services can resume up to the maximum number of licensed children of four including the educator's own children, provided public health requirements are met.

Play centres and play groups will be closed.

Personal Protective Equipment (PPE) like gloves and masks are not necessary for a school environment. Children, young people and staff who are at greater risk are encouraged to stay at home. Any child, young person or staff member who is sick should remain at home.

It will take at least a week for schools and early childhood centres to get ready to open after we go to alert Level 3.

New Zealand's biggest university will run all courses remotely until Semester 2 starts in July - regardless of the Covid-19 alert level - fearing moving in and out of different alert levels will be too disruptive.

University of Auckland vice-chancellor Professor Dawn Freshwater told students last Thursday this would remain the case in alert level 3 or even in the unlikely event New Zealand moved quickly to alert level 2.

RECREATION

You can do activities that are local, which you can do safely, and which do not involve interacting with other people, or equipment touched by other people.

You should go to your nearest beach or park, not your favourite one.

Boating and jetskis are still banned because they can be prone to breakdown.

But you can swim, surf, and fish from the shore.

But don't start a new activity that you haven't done before.

If there are signs of congregation, this rule will be reconsidered so Kiwis shouldn't consider it a time to catch-up with all their swimming buddies, Ardern said.

Staying overnight at a bach or holiday home is not permitted.

Public play equipment would remain closed.

HEALTHCARE

Healthcare services should use virtual, non-contact consultations where possible.

People at high risk of severe illness (older people and those with existing medical conditions) are encouraged to stay at home where possible, and take additional precautions when leaving home. They may choose to work.

Primary care will continue to be open, Allied Health and dentists will open.

TRAVEL

Travel restrictions remain but move from local to regional.

This recognises that more people will travel to work, or to take children to school. But to avoid taking potential Covid-19 cases to other parts of the country, restricting movement to what is necessary remains the goal.

Inter-regional travel is highly limited (for example for essential workers, with limited exemptions for others).

If you were in the wrong place when the restrictions came into place, and need to get home, you can now move throughout New Zealand to do so. You can only move once, and in one direction. New Zealanders can move to or from the Cook Islands, Niue, and Tokelau once, and in one direction."[...]

[SimonNZ]

From what I recall (story this morning) re NPR story, the WHO is really an advisory part of the UN and it doesn't have the legal ability to go into a country to inspect things without their request...basically can only say that they are willing to help and give advice and offer to go in, etc., but if the said country says no, that's that.  So, it's not right to blame the WHO for doing a bad job when they can only do so much.  Am trying to find the story.  Here's the interview with Kelly Craft:  https://www.npr.org/sections/coronavirus-live-updates/2020/04/15/835485122/u-n-ambassador-says-inaction-by-who-china-would-be-unforgiveable  trying to find the response that I heard today with an interview by an authority on the WHO.

Trump could also have demanded a change of leadership at the top or the firing of those who made mistakes, rather than jumping to defunding them in the middle of a pandemic

..if, that is, they were actually guilty of what he accuses them of.

[drogulus]

     W.H.O., Now Trump's Scapegoat, Warned About Coronavirus Early and Often

      This is what should be understood about the early mistakes by the WHO and the Chinese government:

A crucial turning point in the pandemic came on Jan. 20, after China's central government sent the country's most famous epidemiologist, Zhong Nanshan, to Wuhan to investigate the new coronavirus racing through that city of 11 million people. Dr. Zhong delivered a startling message on national television: Local officials had covered up the seriousness of the outbreak, the contagion spread quickly between people, doctors were dying and everyone should avoid the city.

Dr. Zhong, an eccentric 83-year-old who led the fight against the SARS outbreak of 2002 and 2003, was one of few people in China with enough standing to effectively call Wuhan's mayor, Zhou Xianwang, a rising official in the Communist Party, a liar.

Mr. Zhou, eager to see no disruption in his plans for a local party congress from Jan. 11 to 17 and a potluck dinner for 40,000 families on Jan. 18, appears to have had his police and local health officials close the seafood market, threaten doctors and assure the public that there was little or no transmission.

Less than three days after Dr. Zhong's warning was broadcast, China locked down the city, preventing anyone from entering or leaving and imposing strict rules on movement within it — conditions it would later extend far behind Wuhan, encompassing tens of millions of people.

The national government reacted in force, punishing local officials, declaring that anyone who hid the epidemic would be "forever nailed to history's pillar of shame," and deploying tens of thousands of soldiers, medical workers and contact tracers.

It was the day of the lockdown that the W.H.O. at first declined to declare a global emergency, its officials split and expressing concern about identifying a particular country as a threat, and about the impact of such a declaration on people in China. Such caution is a standard — if often frustrating — fact of life for United Nations agencies, which operate by consensus and have usually avoided even a hint of criticizing nations directly.