Ebola round 2

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4-28-2020 We ae deep enough into the pandemic so that some strange, to me, viewpoints have become solidified on a few fronts. Unfortunately, I listen to too much TV talk. Not sure which is the worst. I guess maybe the Washington Journal call in portions have the most misinformation. However, the regular news programs are often not far behind. Seems pretty clear some folks have missed a few important points.

For one is the notion if we shut things down long enough then we can get the new infection numbers down to zero. Perhaps zero for a few days but soon infections will start again. I was talking to a friend last night about his angel fish. Some months ago I gave him some of the fry I raised from eggs. Those fry are matured and one pair have mated and laid eggs. After some discussion on what he can do with the eggs we talked about the covid19 virus.

His wife is a top nurse and she wants the shutdown to continue at least until next September or October. There are at least two and perhaps more than two problems with that. The more important, to me, is that we simply cannot tolerate such a long shutdown. The damage and loss of life just from the shutdown alone very likely will be worse than the virus. But I do not wish to get into that right now.

The next issue seems apparent. Even if we do shut down for a much longer time the virus will still be around in September or October. Those of us who successfully manage to hide for such a time will remain vulnerable to the infection when we come out at that time. Hiding does not give any form of immunity. Waiting that long can just delay the next round of infections. It will not stop the risk of infections.

The early purpose of the shutdowns was to “flatten the curve” of infections so as to not have more badly sick than there are beds and equipment. That has indeed worked. The medical side is in much better shape and has excess capacity. Those of us who get infected now have a bed to be in and equipment to be treated with. There are some medications and more understanding available to help support our immune systems while our bodies fight off the virus. There is not however any sort of cure yet. Those who get hit hardest by the infection still can only rely on our bodies ability to fight off the disease. The machines and medications can help the body fight if you can get a bed.

The “flatten the curve” deal was not supposed to mean the viral infections could be stopped. Just to spread out the rate of infections. I think Sweden may have made the better choice. It is my understanding they did not shut down the way many other countries have. They may and probably will have a slightly higher death rate early in the pandemic but will avoid the second or third waves which we are very likely to have. They have had adequate hospital space so far is my understanding. We in the USA will catch up in terms of the death rate in a next wave when we come out of hiding is the thinking. They will be well on the way to herd immunity and very likely will not have damaged their economy and food production capacity.

Of course there can be game changers if we get very lucky. Some medication or treatment might be had soon that fixes everything. So far that is many months away going by past traditional cures such as a vaccine. Yes, some vaccine trials are ongoing now but are not proven and will not be very soon. Add to that even when one is proven there will be a time for the production to be ramped up. I think the plan is to start the production earlier than normal on the vaccine types that show promise. I think that is where the 18-month hope lies. A fingers crossed hope for the best sort of thing. A more normal time frame is three to five years and sometimes a vaccine just cannot be had. So we can hope for a game changer but my guess is we have to deal with the way things are.

There continues to be a bright side from the data. There finally is some serum antibody testing going on. Not yet much in the way of significant randomized pattern testing but the early results give me some hope. Yesterday (Monday 4/27/2020) it was reported from testing in NY that up to ten times more people likely have already had and recovered from the virus than previously thought. I hope this bears out to be true. Such an outcome will be good in a couple of ways. Mostly it can mean the virus is much less deadly that thought before. A very large number of people having been infected and survived already. This may put us much closer to the needed herd immunity. This also makes opening up the cities and states much less risky for the majority of people. Yes, old guys such as myself are at higher risk and I will try to be careful. For the greater majority the disease currently is not much of a danger seems to be the case.

So many TV talking heads still are going on and on about tests for the active virus infections. I get there is some benefit for a few people. Specifically, for those showing symptoms and front line health care folks. The antibody test is the one which will make the difference. Antibody tests can give the numbers of those who have already had and survived the current strain of the virus. (I hope to be one) That test properly administered should tell us where we stand. I hope they get to this soon.
 
Here in Panama, Covid numbers are posted daily. The entire country is about the size of N Carolina, but in the poorest parts of cities people live almost on top of one another. Actions we're taken quickly to close the country off from international travel, and isolation was instituted.
As of yesterday there were just over 6000 confirmed cases
455 recovered, 167 deaths, almost 355 hospitalized.
That @ 1 death to 2 recovered does not sound like great odds to me.

I live on an island 10 miles off the coast, because of the quick action taken to isolate, we have yet detect a case here.
 
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I never thought that one thing could single handedly cause the world to stop or at least slow down on this scale and I don’t doubt many others felt the same before now.
 
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Below the type of daily briefings the Panama government provides its citizens.

*Daily Update from Official Government Press Conference April 28, 2020*

• Epidemiologist Dr. Lourdes Moreno reported the cases of COVID-19 to date:


- 179 new cases in the last 24 hours (a 3% increase over previous day’s total)


- 6,200 accumulated cases in total


- 1,590 active cases recovering in self-isolation at home


- 1,108 active cases recovering in hospital-hotels


- 270 receiving treatment in regular hospital wards


- 88 in intensive care units (ICU)


- 176 deceased (3 deaths from today and 6 suspicious deaths from earlier that were confirmed with post-mortem testing)


- 484 fully recovered from an epidemiological perspective (an increase of 29 in the last 24 hours)


- 2484 clinically recovered patients (showing no symptoms after 14 days, still pending two consecutive negative test results to be declared fully recovered)

• In terms of cases across age groups:


- Under 20: 420 cases in total with three deaths


- 20-39: 2,598 cases in total with eight deaths


- 40-59: 2,268 cases in total with 35 deaths


- 60-79: 774 cases in total with 85 deaths


- 80+: 140 cases in total with 45 deaths


- 78% of all cases are in the age groups 20-59 (working population)


- 74% of all deaths have occurred in the age groups over 60

• 961 new tests were carried out in the last 24 hours, for a cumulative total of 28,795 (6,730 tests per million population). Results to date are 76% negative and 24% positive.

• Epidemiologist Dr. Rodrigo De Antonio, special advisor to the Ministry of Health, presented various slides showing the behavior of the COVID-19 virus in Panama to date. These include the most important indicators of current public health that the government takes into consideration when making decisions regarding quarantine measures.

- At the beginning of the COVID-19 pandemic in Panama, the health authorities set a goal of 10 days for the duplication rate (defined as the number of days it takes for the number of confirmed cases of the virus to double). Last week, the country exceeded this goal with duplication rate of 16, and as of yesterday, we are closer to 17, which indicates an overall deceleration in the number of new cases. The graph for new cases is showing a “table pattern” with a distinct leveling off since April 10 and has been holding steady with an average of less than 200 new cases/day.

- The number of cases requiring hospitalization has also leveled off considerably. Since the start of the COVID-19 pandemic in Panama, we have managed to keep the number of patients in regular hospital wards under 300 on any given day, and for the last two weeks, we have not exceeded a total of 90 patients in the intensive care units. To date, COVID-19+ patients have never occupied more than 40% of the ICU beds available in the country.

- The health authorities would like Panama’s transmission rate for the virus at a given time (known as Rt) to be at 1, which indicates stable transmission. Last week, we had an average transmission rate of less than 1, which means that were on our way to suppression of the transmission of the virus in the country, but this number has unfortunately increased. The national average is now at 1.15 as of yesterday, which means that the virus is still being actively transmitted in Panama.

- The effective rate of transmission varies dramatically across the regions of the country, which indicates that the behavior of the virus is diverse in Panama. The rate of transmission is highest in the provinces of Colón (largely explained by outbreaks in clusters related to the mine in that region), Veraguas, Coclé and Darién; and lowest in the province of Chiriquí and the region of Panama Norte (both below 1 and suppressing the virus). The regions of San Miguelito, Panama City Metro, Panama Este and Panama Oeste are above slightly above 1.





- When rate of transmission is analyzed in terms of deaths from COVID-19, the average time it is taking from the initial appearance of symptoms to the recorded death of a patient is 10 days. The graph showing Rt by recorded deaths has fallen below 1, which is an important indication that the virus is starting to be effectively suppressed in the country.





- Approximately 85% of the country’s cases are able to recover at home in self-isolation or in a hospital-hotel, both with very favorable prognoses for clinical recovery (absence of symptoms) within 14 days. Panama currently has more clinically recovered cases than active cases.





- The data that Panama has collected to date is showing that the virus is most likely to be transmitted by a COVID-19+ patient two days before symptoms become visible and during the week after symptoms are first detected.





• In summary of the results presented by Dr. De Antonio, Minister of Health Rosario Turner pointed out that Panama’s health system has not collapsed; the country has maintained an optimum response time to the threat presented by the virus; and that overall, we are doing a good job based on the duplication rate for the virus. She then stated that when the government is ready to lift quarantine measures, the Ministry of Health will be carefully analyzing the data related to the rate of transmission in each region, the risks posed by opening up certain economic sectors and the state of the health care system at that time.





• Dr. Turner refrained from commenting on whether this Friday, May 1 (Labor Day holiday in Panama) would be a day of absolute quarantine and whether Saturday, May 2, would also be declared a day of absolute quarantine as it has been for the last two weekends. She stated that the authorities would make the decision and inform the public tomorrow, April 29.





• She also promised that there will be an important announcement tomorrow regarding the payment of social assistance via cédula (national identification) numbers and urges the public to be patient, as delivery of aid will be improved very soon.
 
This is the best site I have found for COVID-19 stats for the USA and the world. Clicking on USA will show what is happening in each state.

 
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Hello; A bit to early to make valid comments but some questions about how deaths due to covid19 are being counted. I did see a few days ago where the guidelines ( in the USA I think) now instruct medical personnel to count a death as from covid19 if they only suspect such to be the cause. I am not ready to contend there is something wrong with these new instructions. I am, however, curious as to why.
 
Experts are already stating that the total death count from covid could be off by 10's of thousands. It will most likely take years for all of the data to be compiled and make sense.
 
Experts are already stating that the total death count from covid could be off by 10's of thousands. It will most likely take years for all of the data to be compiled and make sense.
Hello; Yes I just finished reading an article about this. What I got from the article is they seem to expect an undercount of covid19 specific deaths. That article also suggested the covid19 may have been around much earlier that previously thought with deaths assigned to other causes. Some other reports seem to be suggesting a possible overcount. A fine mess either way.
 
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