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Old 2020-03-18, 02:28   #210
kriesel
 
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Quote:
Originally Posted by Dr Sardonicus View Post
It isn't just college towns closing the bars. In a bunch of states, all the bars -- and restaurants, too -- are forbidden to serve "sit-down" customers for the next two weeks, by order of their Governors. Take-out and delivery still allowed.
Yes. But "sleepy midwest states close their bars" just didn't seem to me as good a line. I live in Wisconsin, which has a statewide ban started 5pm tonight that's swiss-cheese riddled with exceptions. You can't serve anyone in a bar or restaurant, indefinitely, but delivery, takeout, or drivethru is ok. There are no limits on grocery stores, gas stations, etc. as long as people don't get too close to each other. The local village library closed starting yesterday. https://content.govdelivery.com/atta...er_3.17.20.pdf
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Old 2020-03-18, 02:35   #211
ewmayer
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Quote:
Originally Posted by a1call View Post
You can always count on drug companies to unnecessarily complicate things just to make sure they can turn a profit.
There are tens of thousands of recovered humans with ready to use antibodies in their blood plasma yesterday. Yet:
https://www.cnbc.com/2020/03/17/rege...ly-summer.html
Not defending the Big Pharma greedheads, but I see several potential problems with an antibody-derived treatment:

1. We're dealing with a relatively-rapidly-evolving RNA virus, so besides the fact that antibody-based passive immunity fades quite rapidly and thus leaves one still-vulnerable should the bug still be circulating months later - very likely in this case - you have the issue of the antibody sub-serotype production keeping up with the natural evolution of the various strains. AFAIK we've no idea as yet as to the partial-immunity-providing properties of one specific-strain antibody against different strains.

2. Wikipedia:
Quote:
Artificially acquired passive immunity is a short-term immunization achieved by the transfer of antibodies, which can be administered in several forms; as human or animal blood plasma or serum, as pooled human immunoglobulin for intravenous (IVIG) or intramuscular (IG) use, as high-titer human IVIG or IG from immunized donors or from donors recovering from the disease, and as monoclonal antibodies (MAb). Passive transfer is used to prevent disease or used prophylactically in the case of immunodeficiency diseases, such as hypogammaglobulinemia. It is also used in the treatment of several types of acute infection, and to treat poisoning. Immunity derived from passive immunization lasts for a few weeks to three to four months. There is also a potential risk for hypersensitivity reactions, and serum sickness, especially from gamma globulin of non-human origin. Passive immunity provides immediate protection, but the body does not develop memory, therefore the patient is at risk of being infected by the same pathogen later unless they acquire active immunity or vaccination.
OK, so regular revaccination will be required to maintain resistance to a given viral strain, until (we hope) an effective vaccine is developed. Next, the "serum sickness from gamma globulin of non-human origin" bit is important, because large-scale antibody mass-production typically requires a non-human substrate. Wikipedia sums up:
Quote:
A disadvantage to passive immunity is that producing antibodies in a laboratory is expensive and difficult to do. In order to produce antibodies for infectious diseases, there is a need for possibly thousands of human donors to donate blood or immune animals' blood would be obtained for the antibodies. Patients who are immunized with the antibodies from animals may develop serum sickness due to the proteins from the immune animal and develop serious allergic reactions. Antibody treatments can be time consuming and are given through an intravenous injection or IV, while a vaccine shot or jab is less time consuming and has less risk of complication than an antibody treatment. Passive immunity is effective, but only lasts a short amount of time.
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Old 2020-03-18, 02:43   #212
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Quote:
Originally Posted by ewmayer View Post
Not defending the Big Pharma greedheads, but I see several potential problems with an antibody-derived treatment:

1. We're dealing with a relatively-rapidly-evolving RNA virus, so besides the fact that antibody-based passive immunity fades quite rapidly and thus leaves one still-vulnerable should the bug still be circulating months later - very likely in this case - you have the issue of the antibody sub-serotype production keeping up with the natural evolution of the various strains. AFAIK we've no idea as yet as to the partial-immunity-providing properties of one specific-strain antibody against different strains.

2. Wikipedia:
OK, so regular revaccination will be required to maintain resistance to a given viral strain, until (we hope) an effective vaccine is developed. Next, the "serum sickness from gamma globulin of non-human origin" bit is important, because large-scale antibody mass-production typically requires a non-human substrate. Wikipedia sums up:
I concur with ewmayer's analysis, with a slight caveat: coronaviruses have a repair mechanism that should make their error rate lower than you'd expect for an RNA virus, though I do still expect a relatively high mutation rate. I don't know of any numbers yet on COVID-19 yet.
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Old 2020-03-18, 11:30   #213
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Quote:
Originally Posted by kriesel View Post
Yes. But "sleepy midwest states close their bars" just didn't seem to me as good a line.
<snip>
Probably just as well.

You'd have the States of Illinois, Indiana, Kentucky, Michigan, Minnesota, and Ohio on Line One complaining about being called "sleepy."

You'd have the States of California, Colorado, Louisiana, Maryland, Massachusetts, Nevada, New Hampshire, New Jersey, New York, North Carolina, Pennsylvania, Rhode Island, Vermont, and Washington on Line Two complaining about being called "midwestern."

And the District of Columbia and Puerto Rico on Line Three complaining about being called "midwestern" and "states."
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Old 2020-03-18, 15:02   #214
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Quote:
Originally Posted by yours truly View Post
Here is a sampling of our Great Leader's pronouncements:
Quote:
Jan. 22: "We have it totally under control."

Jan. 24: "It will all work out well."

Feb. 14: "We have a very small number of people in the country, right now, with it. It's like around 12. Many of them are getting better. Some are fully recovered already. So we're in very good shape."

Feb. 19: "I think it's going to work out fine. I think when we get into April, in the warmer weather, that has a very negative effect on that and that type of a virus. So let's see what happens, but I think it's going to work out fine."

Feb. 24: The Coronavirus is very much under control in the USA. We are in contact with everyone and all relevant countries. CDC & World Health have been working hard and very smart. Stock Market starting to look very good to me!
— Donald J. Trump (@realDonaldTrump) February 24, 2020

Feb. 26: "Because of all we've done, the risk to the American people remains very low. … When you have 15 people, and the 15 within a couple of days is going to be down to close to zero. That's a pretty good job we've done."

Feb. 28: "It's going to disappear. One day, it's like a miracle, it will disappear."

March 12: "It's going to go away. ... The United States, because of what I did and what the administration did with China, we have 32 deaths at this point … when you look at the kind of numbers that you're seeing coming out of other countries, it's pretty amazing when you think of it."

March 15: "This is a very contagious virus. It's incredible. But it's something that we have tremendous control over."
And, from the Gaslighter-in-Chief on Saint Patrick's day:
Quote:
I mean, I have seen that, where people actually liked it. But I didn't feel different. I've always known, this is a real -- this is a real -- this is a pandemic. I felt it was a pandemic long before it was called a pandemic. All you had to do was look at other countries...no, I've always viewed it as very serious. It was no difference yesterday from days before. I feel the tone is similar, but some people said it wasn't.
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Old 2020-03-18, 17:32   #215
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https://arstechnica.com/tech-policy/...ply-shortages/
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Old 2020-03-18, 17:45   #216
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Excellent data and graphs at the Financial Times.

A 33% growth rate per diem fits the data from sundry sources remarkably well.

There is an interesting up-tick in the US rates over the last couple of days. My view is that it may well be significant but could just be a statistical blip.
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Old 2020-03-18, 18:44   #217
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Quote:
Originally Posted by xilman View Post
There is an interesting up-tick in the US rates over the last couple of days. My view is that it may well be significant but could just be a statistical blip.
Reflects the US finally getting going with widespread testing... I hope?
If so, is that a subset of "blip"?
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Old 2020-03-18, 18:59   #218
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Quote:
10:55 am: Volunteer threatened with lawsuit after 3-D printing an $11,000 valve for $1

In Italy, a good Samaritan could be facing legal action for providing a hospital with special valves needed for breathing equipment that keeps coronavirus patients alive, according to a report from Techdirt.

Cristian Fracassi used a 3D printer to make the valves after the original manufacturer could not provide them due to overwhelming demand. Fracassi had to design the valves himself after the manufacturer refused to provide the 3D files, and he ultimately donated more than 100 valves to the hospital, each one costing him around $1 to make.

The regular listing price of the valve is about $11,000, and the manufacturer has threatened to sue Fracassi for patent infringement, leaving him fearful of sharing the 3D file with other hospitals that need the valve. —Hannah Miller

https://www.cnbc.com/2020/03/18/coro...e-updates.html
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Old 2020-03-18, 19:22   #219
ewmayer
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A view from Spain:

Welcome to Dystopia: My Life Under Lockdown in Spain | Nick Corbishley for Wolf Street
Quote:
Pressure is also mounting on the government to suspend mortgage payments, rents and utility bills for the next month, as has already happened in France. To prevent the virus crisis from “triggering a new housing crisis”, the government needs to implement broad social and economic measures, said a joint statement by the country’s two largest tenants unions, whose membership has soared in recent days

Even before this crisis hit, many tenants in cities like Barcelona, Madrid, Palma de Mallorca and Malaga were already struggling to pay their astronomical rents. Even if landlords demand full payment this month, in many cases they won’t get it. Then, what will they do? Throw out the tenants, knowing full well that the same thing is happening in buildings across the city? Who will they rent out the newly vacated apartments to? Tourists? Ha!

Finally, this crisis can also hit in another more subtle way, as my Mexican mother-in-law has learned. And that is through currency depreciation. A month and a half ago, she sold her apartment in Mexico City with a view to using the money to live in a rented apartment in Barcelona, where her only daughter lives. But since she had no bank account in Spain she could not transfer the funds (in pesos) straight away and had to wait until she got here. By the time she arrived the already weak peso had lost roughly 20% of its value against the euro.

Now, my mother-in-law is on lock down in her daughter and son-in-law’s apartment. In euro-terms, she’s 20% poorer than she was a month ago. For the moment, the three of us are living in relative harmony. We do not want for anything, apart from job security and the occasional evening stroll together. We have enough food (having stocked up in the preceding weeks), some toilet paper (but not too much), lots of books to read (and reread), films to watch (and re-watch), card games to learn, friends to speak to, the Mediterranean sun shining on the balcony and through the windows, and even the sound of birdsong, a weird but welcome element of our new reality. Most importantly, we have our health (touch wood) and each other.
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Old 2020-03-18, 22:30   #220
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Re. the a1call-linked story about the 3D "guerilla printing" of a key medical part and the resulting threatened lawsuit by the manufacturer - governments can (and I expect will do en masse in short order) simply invoke emergency powers here:

Trump invokes Defense Production Act as coronavirus response The Hill
Quote:
President Trump announced Wednesday that he will invoke the Defense Production Act (DPA), which would allow the administration to force American industry to manufacture medical supplies that are in short supply in the fight against the coronavirus pandemic.

Hospitals, health workers and state and local officials have said they are quickly running out of personal protective equipment (PPE), like masks, gowns and gloves, that are crucial to keeping doctors and nurses on the front lines of the pandemic safe.

“There’s never been an instance like this where no matter what you have it’s not enough,” Trump said at a White House briefing with reporters.

“If we need to use it, we’ll be using it at full speed ahead," he said.

Hospitals are also sounding the alarm on the lack of ventilators, or breathing machines, that are expected to be in high demand as the coronavirus spreads in the coming weeks and months.

Democrats in Congress, hearing about shortages of supplies from hospitals in their states and districts, have urged Trump to invoke the DPA to direct the domestic production of necessary medical equipment.

“This would ensure we have the materials we need at the ready, rather than wait for disruptions in the global supply chain to subside,” 57 House Democrats wrote in a letter to Trump last week.

The issue of supply shortages is likely to come up during the president's discussions with nurses and doctors Wednesday.

Supply chains are extremely strained due to tariffs on China, the main supplier of medical goods to the U.S.

While the Trump administration has recently taken some action to ease those tariffs, China and other countries are also blocking exports of those products as they seek to combat the pandemic within their borders.

Of top concern to health workers in the U.S. is the shortage of N95 respirators, which are viewed as more effective at blocking viruses than the looser-fitting surgical masks.

In a letter sent to Vice President Pence Tuesday, Dr. James Madara, the CEO and executive vice president of the American Medical Association, wrote that he is "deeply concerned" about the shortages.

"The AMA continues to hear from physicians across the country about short supplies and limited access to personal protective equipment (PPE), which is necessary to keep the health care workforce safe and to protect the health of patients," Madara wrote.

"Physicians are reaching out to their state and local health departments, but their supplies of PPE are also inadequate," he continued.

Officials in several states say they have only received a fraction of the protective equipment they requested from a national stockpile of medical supplies managed by the federal government.

A spokesperson for the Department of Health and Human Services told The Hill the role of the stockpile is to “fill the gap temporarily until states and localities working with the private sector can respond to the state and local needs.”
More on the surprisingly tricky aspect of N85 mask manufacture:

COVID-19 Has Caused A Shortage Of Face Masks. But They’re Surprisingly Hard To Make NPR
Quote:
Both the masks made for medical personnel and for consumer purchase require a once-obscure material called melt-blown fabric. It’s an extremely fine mesh of synthetic polymer fibers that forms the critical inner filtration layer of a mask, allowing the wearer to breath while reducing the inflow of possible infectious particles.

‘We’re talking about fibers where one filament has a diameter of less than one micron, so we are in the nano area,’ said Markus Müller, the sales director at German company Reicofil, a major provider of melt-blown machine lines. And there’s now a global shortage of melt-blown fabric due to the increased demand for masks — and the difficulty in producing this material.
Note that this sort of issue - everything else is easy, but there is one tricky subcomponent that is very difficult to manufacture - is ubiquitous in modern manufacturing chains. So the western world's wartime-rationing-style crash course in re-onshoring of manufacture, and refurbishment and re-use of existing gear is going to involve a lot of creative solutions. Suspending patent enforcement in this context is more or less required.

Last fiddled with by ewmayer on 2020-03-18 at 22:32
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