The COVID-19 Discussion Thread (OTB)

[schlaugh]

Well I am shocked. Shocked I tell you! When I call the hotline for scheduling the vaccine in my county I get "all circuits are busy."

The county web site is useless as well. Once all available appointments for a week are assigned the page simply says "check back later."

Our state government at work...

ETA: In December my wife and I received an email from our primary care provider saying that they would soon offer the vaccine to first responders and health care workers, as soon as the vaccine arrived around Christmas. At that time my wife and I were in a later cohort.

Fast forward to now; Georgia moved all 65+ seniors into the first cohort effective today. Since the county health department was a washout, I called our provider and lo and behold they have created a wait list for the old fogies! Except...our provider still hasn't received the vaccine.

Drat. But some progress.

[Jens]

My Covid19 personal report goes like this. 13th day, temperature holding at 97.3F with much less need for Tylenol to reduce symptoms of slight sweat in the morning. Son has no symptoms and reports back to work tomorrow. We both have O-positive blood and were told by family members in medicine that such blood type is the best to have while going through this. Too bad mosquitoes don't sense it that way.

Just an interesting thing, but I also have O+ blood, and I don't seem particularly attractive to mosquitos (or perhaps people around me are more sensitive)?

[grant hutchison]

Just an interesting thing, but I also have O+ blood, and I don't seem particularly attractive to mosquitos (or perhaps people around me are more sensitive)?

Well, it also may depend on your secretor status. Some people (secretors) express oilgosaccharides in their sweat and other secretions which are indicative of blood group, and some (non-secretors) do not. Since mosquitoes necessarily have to make the decision to land and bite before they can sample your blood, it seems reasonable to assume that, if they can discern blood group at all, they do so using some molecules emitted by human skin. And there's some tiny evidence that secretor status influences the mosquitoes' choice. But I see others have failed to detect any influence from blood group or secretor status.

Grant Hutchison

[geonuc]

The local hospital here had a Facebook live event where a couple of the top professionals - one a senior medical doctor with responsibility over the pandemic response and the second the guy heading the distribution effort. It was useless. Beyond a doubt, both are quite knowledgeable at their respective jobs but neither was a good choice for conveying information to the public. The medical doctor, for example, committed the common Powerpoint error of just reading what was on the screen, with little added content. She also used a lot of jargon and presented some temperatures in degrees Celsius. For a presentation specifically for public consumption to allay fears and answer questions, you can't convert from C to F? The distribution guy acted like giving the presentation was an inconvenience.

Not good. If that was their best effort to calm the growing discontent concerning the vaccines and how they're being allocated, it was a fail.

[Van Rijn]

This is odd, but good news (sort of) locally: The stay at home order for my “Greater Sacramento” region (which is a fair sized chunk of California with a number of counties going to the Nevada border, and I don’t know what criteria they used to define this region) has been lifted because ICU capacity has gone up to 19%. It’s odd because not that long ago capacity was down to a few percent and people on the news were claiming the order would be continuing for some time.

LA and Southern California are still in a really bad situation though. They actually have been rationing medical oxygen supplies because it is hard to keep up with the demand.

[21st Century Schizoid Man]

because ICU capacity has gone up to 19%.

So did the percentage go up because they added capacity, because people recovered, or because people died?

[Jens]

So did the percentage go up because they added capacity, because people recovered, or because people died?

Actually, I was thinking of mentioning that as well. Clearly there will be a mixture of the second and third. The first is the question. When there is no increase, then obviously the capacity will generally be +new serious patients -recovered serious patients -deaths.

[Van Rijn]

So did the percentage go up because they added capacity, because people recovered, or because people died?

The initial report didn’t go into details, but from a local newspaper quoting the governor:

California Gov. Gavin Newsom announced Tuesday afternoon that the 13-county greater Sacramento region has been released from its month-long COVID-19 shutdown order, the result of new data that show hospitals likely will not be as crowded with COVID-19 patients in the coming weeks.

“We’re seeing stabilization in ICUs and positivity rates,” Newsom said in a social media post at 4:30 p.m. “Greater Sacramento is coming out of the regional stay-at-home and going back to purple tier effective today.

Read more here: https://www.sacbee.com/news/coronavi...#storylink=cpy

Positivity rates are better. I can’t see how it would make sense to end the stay at home order if there wasn’t improvement. And I think it would be hard to add much ICU capacity anyway. Any extra hardware or staff would go to LA. Purple tier is still the most restrictive of four tiers. Though stay at home is like a fifth tier level restriction, they aren’t calling it a tier.

Here’s hoping they won’t need to call for another stay at home period in a month or two. Hopefully vaccines will start shifting the numbers, but they are constantly balancing what is medically prudent and what the populace will accept. A lot of small companies that have survived so far are in danger of going under and there is immense pressure coming from that direction. There are a lot of others unhappy with the situation too and blaming the governor for it. There was a recent startup problem getting vaccines out, and that has caused a lot of complaints. I learned in SBA disaster assistance, you will never be fast enough and there will always be teething problems when starting the response to a disaster.

[ozduck]

A large scale trial just commenced in the UK on a treatment option that has had some very good success in small scale trials. It "involves inhaling a protein called interferon beta".

"Early findings suggested the treatment cut the odds of a Covid-19 patient in hospital developing severe disease - such as requiring ventilation - by almost 80%."

https://www.bbc.com/news/health-55639096

[Trebuchet]

Record deaths in the USA yesterday according to Worldometer. That's partly due to catching up from reduced weekend reporting but still horrible. 7-day average deaths are at an all-time high as well.

[grant hutchison]

Record deaths in the USA yesterday according to Worldometer. That's partly due to catching up from reduced weekend reporting but still horrible. 7-day average deaths are at an all-time high as well.

Per capita, the UK's doing about 60% worse than the USA. Not that it's a competition. Just a data point.

Grant Hutchison

[blueshift]

Just an interesting thing, but I also have O+ blood, and I don't seem particularly attractive to mosquitos (or perhaps people around me are more sensitive)?

It is really hard to tell. I know I have been told that O+ blood attracts mosquitoes more than other blood types but that doesn't always pan out with my astronomy club experience. I am often left alone while others are being bitten while we are observing. It just seems that the few who do move in do so at the worst time of all, during final adjustments to equipment. That is when just one or two want to buzz my ear.

I keep 3 Thermacells around my the perimeter of my scope and the back end of my car. They work pretty good but it gets expensive buying the refills. Thermacells give off a perfume scent that is similar to what geraniums give off. Mosquitoes don't like them.

[Trebuchet]

Per capita, the UK's doing about 60% worse than the USA. Not that it's a competition. Just a data point.

Grant Hutchison

Stay safe, Grant! Is Scotland doing any better than England or Wales?

[grant hutchison]

Stay safe, Grant! Is Scotland doing any better than England or Wales?

In terms of daily deaths per capita, Scotland is doing better than England and Wales at present, slightly worse than Northern Ireland. We just recently nudged ahead of the US figure, whereas England and Wales are well ahead.
The Republic of Ireland is also a worry--they've had a massive spike in case numbers in the weeks since Christmas, so there's a "baked in" wave of hospital admissions and deaths coming soon.

Grant Hutchison

[Noclevername]

My Mom got an appointment for a vaccination!!! And it's soon!

Indiana has authorized shots for over 75 high risk. We heard about it from a teacher friend of ours and immediately jumped online to make the appointment. Got one for this weekend!

[Trebuchet]

I saw "over 75" for the next batch in the local weekly as well this afternoon. What about us "over 70's"?

[schlaugh]

I saw "over 75" for the next batch in the local weekly as well this afternoon. What about us "over 70's"?

CDC is apparently recommending that states administer the vaccine to adults 65+, as well as first responders and others identified in the first cohort. YMMV based on the state where you live.

In Georgia the criteria changed this past Monday to include the 65+ population (about 1.5 million in this state). But it also means the vaccine has to be available, so good intentions mean zip if there is no medication.

[21st Century Schizoid Man]

I saw "over 75" for the next batch in the local weekly as well this afternoon. What about us "over 70's"?

Get older quickly.

Years ago, I knew someone who had the wrong birth year printed on his US state driving license, making him several years older than he actually was. He was popular, because he could buy alcohol.

I wonder if he still has the wrong date on his license. Maybe he can get social security early.

[Cougar]

CDC is apparently recommending that states administer the vaccine to adults 65+, as well as first responders and others identified in the first cohort. YMMV based on the state where you live....

I was expecting it would be March or April before I could get vaccinated. Then last week I got an email from a local medical office (that wasn't even the one I visited recently). Anyway, it said to fill out this registration form (online) and get an appointment to get the Covid-19 vaccine! (I'm not a healthcare worker or over 75.) So I filled out the 6-page form, and of course there were no appointment times left, so I just checked the box for "wait list."

The next day I got a text at about 1:00 pm saying I could likely get vaccinated if I got to this other office (in Sandpoint, Idaho) by 3:00. I got there to see two very long lines standing outside in 38 degree weather. Well, I stood in line for about an hour and was third in line when a nurse came out and said they had 9 prepared doses left. So got in and got the shot! Pfizer. I go back in 3 weeks.

Actually, the nurse said she had more doses, but they weren't "prepared" -- she'd have to take them out of their cold storage and let them warm up for half an hour, per protocol. So she counted 20 more people who wanted to wait the additional half hour.

My poor brother in SoCal probably will have to wait till March or April.

[Jens]

A large scale trial just commenced in the UK on a treatment option that has had some very good success in small scale trials. It "involves inhaling a protein called interferon beta".

"Early findings suggested the treatment cut the odds of a Covid-19 patient in hospital developing severe disease - such as requiring ventilation - by almost 80%."

https://www.bbc.com/news/health-55639096

That’s kind of cool to hear, and interesting. Interferon beta are cytokines that signal our bodies to mount anti-virus response. To me, that might mean that an early response is important for avoiding serious symptoms.


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[Noclevername]

I saw "over 75" for the next batch in the local weekly as well this afternoon. What about us "over 70's"?

Saw this morning, it's been lowered to 70 here.

[Trebuchet]

I saw "over 75" for the next batch in the local weekly as well this afternoon. What about us "over 70's"?

Saw this morning, it's been lowered to 70 here.

We got an email from the healthcare organization. It's 85, not 75!

[grant hutchison]

That’s kind of cool to hear, and interesting. Interferon beta are cytokines that signal our bodies to mount anti-virus response. To me, that might mean that an early response is important for avoiding serious symptoms.

The Phase II trial on which the current Phase III trial is based is here.
There are several interesting things going on with Interferon-β in this context. It certainly has antiviral activity, but its activity is suppressed in lung tissue infected with SARS-CoV-2, so this is to some extent a "replacement therapy"--putting stuff into the body that the body lacks.
But the overall immune-modulatory effect of the Type I interferons (which include beta) is anti-inflammatory. So we may also be seeing a damping down of the "counterproduct inflammation" that leads to Adult Respiratory Distress Syndrome and Systemic Inflammatory Response Syndrome, both of which are big killers in Covid-19.
Like so much that is perceived as "new" with this virus, the idea of IFN-β therapy for coronavirus disease actually has a fairly long history. Here's a quote from an article written in 2006, in the aftermath of the first SARS epidemic.

So, it is an interesting thought that while Type I interferons evolved to become signals for activation of intracellular antiviral mechanisms, evolutionary pressure may at the same time have moulded signals for several inflammatory mechanisms to respond negatively to interferon. Interferon's natural task during acute virus infection may therefore consist not only in inhibiting virus replication but also in mitigating inflammation. If this would indeed be the case, one would be allowed to think (perhaps a bit wishfully) that interferon is a suitable anti-inflammatory agent to be used in severe acute virus infections, superior to steroids or NSAIDs. Clinical tests done in the 1980s have shown that Type I interferons were of very little value in ‘common’ acute virus infections. However, severe acute infections caused by ‘unusual’ viruses such as the SARS coronavirus, seem to owe their life-threatening severity to excessive inflammatory reactions, as has been documented by massive production of certain cytokines and chemokines. Remarkably, this so-called cytokine storm appeared to be accompanied with only low-level production of IFN-β. Interferon therapy, thanks to a combined direct antiviral and a ‘natural’ anti-inflammatory potential, might represent a prototype approach for management of such infections.

My bold throughout. Everything old is new again.

Grant Hutchison

[Gillianren]

I will say we seem to have had less of a result from the holidays in my county than I was expecting. Bad, but nowhere near as bad as I was afraid it would be.

[publiusr]

Everything old is new again.

"Enter Quinto Tiberio Angelerio, a 50-something doctor – Protomedicus – from the upper classes. He had trained abroad, because there were no universities at the time in Sardinia. Luckily for the residents of Alghero, he was fresh from Sicily, which had endured a plague epidemic of its own in 1575....Initially, the measures were extremely unpopular, and the public wanted to lynch him. But as more people died, they came round – and he was fully entrusted with the task of containing the outbreak. Years later, he published a booklet, Ectypa Pestilentis Status Algheriae Sardiniae, detailing the 57 rules he had imposed upon the city. It turns out the 16th-Century policy may have been on the right side of science."

Et tu Fauci?

https://www.bbc.com/future/article/2...ial-distancing

[ozduck]

The Phase II trial on which the current Phase III trial is based is here.
There are several interesting things going on with Interferon-β in this context. It certainly has antiviral activity, but its activity is suppressed in lung tissue infected with SARS-CoV-2, so this is to some extent a "replacement therapy"--putting stuff into the body that the body lacks.
But the overall immune-modulatory effect of the Type I interferons (which include beta) is anti-inflammatory. So we may also be seeing a damping down of the "counterproduct inflammation" that leads to Adult Respiratory Distress Syndrome and Systemic Inflammatory Response Syndrome, both of which are big killers in Covid-19.
Like so much that is perceived as "new" with this virus, the idea of IFN-β therapy for coronavirus disease actually has a fairly long history. Here's a quote from an article written in 2006, in the aftermath of the first SARS epidemic.My bold throughout. Everything old is new again.

Grant Hutchison

Thanks for this information.

[Jens]

Thanks for this information.

I second that.

And I also wanted to post something unrelated, which bothers me a bit but I'm not sure if it should. It's about mortality statistics. The WHO lists how many people per million population have died of COVID-19, which is important. However, the problem with that statistic is that if you look at it for say a month or two months, it gives you an idea of how serious the problem is, but as the time span grows longer, is seems to lose its relevance. For example, if you look at "cumulative deaths from cancer," it might be larger than the population just because people have been dying from cancer for a long time.

So say for example that you have a disease (only one disease) that kills 5% of the population per year, but the natural population growth is 8%. That means the population will continue to grow at 3% per year, and yet within 20 years the statistics will say that everybody died of the disease...

Is this just something that is completely obvious and therefore people don't bother mentioning it?

[schlaugh]

Hot diggity, Mrs. Schlaugh and I were able to book vaccine appointments this morning through one of the big grocery chains in the southern US (Publix). The company announced last week that they would open up vaccinations at 108 of their pharmacies with appointment booking through their web site starting at 06:00 today EST.

So I got up early and waited for the site to come up, which it did about 06:10.

Reminded me of trying to get tickets to a Rolling Stones concert.

[geonuc]

And I also wanted to post something unrelated, which bothers me a bit but I'm not sure if it should. It's about mortality statistics. The WHO lists how many people per million population have died of COVID-19, which is important. However, the problem with that statistic is that if you look at it for say a month or two months, it gives you an idea of how serious the problem is, but as the time span grows longer, is seems to lose its relevance. For example, if you look at "cumulative deaths from cancer," it might be larger than the population just because people have been dying from cancer for a long time.

So say for example that you have a disease (only one disease) that kills 5% of the population per year, but the natural population growth is 8%. That means the population will continue to grow at 3% per year, and yet within 20 years the statistics will say that everybody died of the disease...

Is this just something that is completely obvious and therefore people don't bother mentioning it?

Is that not the same as when you withdraw a percentage of a retirement account per year yet you never reach zero as long as the account growth is positive? (Not intending to get off-topic from COVID - just using finances as a comparison to disease statistics.)

[geonuc]

Hot diggity, Mrs. Schlaugh and I were able to book vaccine appointments this morning through one of the big grocery chains in the south (Publix). The company announced last week that they would open up vaccinations at 108 of their pharmacies with appointment booking through their web site starting at 06:00 today EST.

So I got up early and waited for the site to come up, which it did about 06:10.

Reminded me of trying to get tickets to a Rolling Stones concert.

Very good. Hopefully the pharmacy you chose will have the vaccine when it comes time for your appointment.