Manic of a panic is geopolitical

[kladner]

Originally Posted by xilman

In my view, no. The have been quite open in acknowledging that the data is incomplete.

Apply Hanlon's Razor.

My point exactly. Everyone's numbers are incomplete. UK is the case for which I had seen the update and its cause.

[ewmayer]

Re. the Stanford antibody-prevalence study and potential problems with it:

Here is a peer reviewing the Stanford study:

https://medium.com/@balajis/peer-rev...a-1f6382258c25

The above reviewer is skeptical of the conclusion because:
– test may have high false positive rate
– sample may be enriched for COVID-19
– study implies faster spread than past pandemics

The manufacturer of antibody test has a false positive rate high enough to negate the overall non adjusted test results.

They asked people if they had been feeling ill in the recruitment ad. Could this have allowed them to skew the sample towards more sick people?

If you wonder “why would they be less than honest”. Look up one of the authors, Jay Bhattacharya, on youtube and see what he has been saying since February. The study he worked on ‘proves’ the hypothesis he was sharing all along. Could he have fallen prey to the desk drawer effect and included more potentially sick people, so he didnt end up with egg on his face?

Hard to say anything for sure, the study might be correct, or it could be wrong.

It is interesting to see so many people running with the ball on the 50-85x conclusion as a proven fact, with no provisos at all.

=====================

He ran marathons and was fit. So why did Covid-19 almost kill him? - STAT: On cytokine storms, which may have been one of the reasons the 1918 flu pandemic was unusually lethal to younger adults in the prime of life and health. In the case described in the article, note the desperate resort to off-label use of anti-inflammatory drug normally used to treat rheumatoid arthritis.

Opinion | The Infection That’s Silently Killing Coronavirus Patients - The New York Times

We are just beginning to recognize that Covid pneumonia initially causes a form of oxygen deprivation we call “silent hypoxia” — “silent” because of its insidious, hard-to-detect nature.

Pneumonia is an infection of the lungs in which the air sacs fill with fluid or pus. Normally, patients develop chest discomfort, pain with breathing and other breathing problems. But when Covid pneumonia first strikes, patients don’t feel short of breath, even as their oxygen levels fall. And by the time they do, they have alarmingly low oxygen levels and moderate-to-severe pneumonia (as seen on chest X-rays). Normal oxygen saturation for most persons at sea level is 94 percent to 100 percent; Covid pneumonia patients I saw had oxygen saturations as low as 50 percent.

To my amazement, most patients I saw said they had been sick for a week or so with fever, cough, upset stomach and fatigue, but they only became short of breath the day they came to the hospital. Their pneumonia had clearly been going on for days, but by the time they felt they had to go to the hospital, they were often already in critical condition.

In emergency departments we insert breathing tubes in critically ill patients for a variety of reasons. In my 30 years of practice, however, most patients requiring emergency intubation are in shock, have altered mental status or are grunting to breathe. Patients requiring intubation because of acute hypoxia are often unconscious or using every muscle they can to take a breath. They are in extreme duress. Covid pneumonia cases are very different.

A vast majority of Covid pneumonia patients I met had remarkably low oxygen saturations at triage — seemingly incompatible with life — but they were using their cellphones as we put them on monitors. Although breathing fast, they had relatively minimal apparent distress, despite dangerously low oxygen levels and terrible pneumonia on chest X-rays.

We are only just beginning to understand why this is so. The coronavirus attacks lung cells that make surfactant. This substance helps the air sacs in the lungs stay open between breaths and is critical to normal lung function. As the inflammation from Covid pneumonia starts, it causes the air sacs to collapse, and oxygen levels fall. Yet the lungs initially remain “compliant,” not yet stiff or heavy with fluid. This means patients can still expel carbon dioxide — and without a buildup of carbon dioxide, patients do not feel short of breath.

Patients compensate for the low oxygen in their blood by breathing faster and deeper — and this happens without their realizing it. This silent hypoxia, and the patient’s physiological response to it, causes even more inflammation and more air sacs to collapse, and the pneumonia worsens until oxygen levels plummet. In effect, patients are injuring their own lungs by breathing harder and harder. Twenty percent of Covid pneumonia patients then go on to a second and deadlier phase of lung injury. Fluid builds up and the lungs become stiff, carbon dioxide rises, and patients develop acute respiratory failure.

By the time patients have noticeable trouble breathing and present to the hospital with dangerously low oxygen levels, many will ultimately require a ventilator.

Silent hypoxia progressing rapidly to respiratory failure explains cases of Covid-19 patients dying suddenly after not feeling short of breath. (It appears that most Covid-19 patients experience relatively mild symptoms and get over the illness in a week or two without treatment.)

A major reason this pandemic is straining our health system is the alarming severity of lung injury patients have when they arrive in emergency rooms. Covid-19 overwhelmingly kills through the lungs. And because so many patients are not going to the hospital until their pneumonia is already well advanced, many wind up on ventilators, causing shortages of the machines. And once on ventilators, many die.

Avoiding the use of a ventilator is a huge win for both patient and the health care system. The resources needed for patients on ventilators are staggering. Vented patients require multiple sedatives so that they don’t buck the vent or accidentally remove their breathing tubes; they need intravenous and arterial lines, IV medicines and IV pumps. In addition to a tube in the trachea, they have tubes in their stomach and bladder. Teams of people are required to move each patient, turning them on their stomach and then their back, twice a day to improve lung function.

There is a way we could identify more patients who have Covid pneumonia sooner and treat them more effectively — and it would not require waiting for a coronavirus test at a hospital or doctor’s office. It requires detecting silent hypoxia early through a common medical device that can be purchased without a prescription at most pharmacies: a pulse oximeter.

Pulse oximetry is no more complicated than using a thermometer. These small devices turn on with one button and are placed on a fingertip. In a few seconds, two numbers are displayed: oxygen saturation and pulse rate. Pulse oximeters are extremely reliable in detecting oxygenation problems and elevated heart rates.

Pulse oximeters helped save the lives of two emergency physicians I know, alerting them early on to the need for treatment. When they noticed their oxygen levels declining, both went to the hospital and recovered (though one waited longer and required more treatment). Detection of hypoxia, early treatment and close monitoring apparently also worked for Boris Johnson, the British prime minister.

Widespread pulse oximetry screening for Covid pneumonia — whether people check themselves on home devices or go to clinics or doctors’ offices — could provide an early warning system for the kinds of breathing problems associated with Covid pneumonia.

[kriesel]

WI Stats 323.10: "Declaration by governor. The governor may issue an executive order declaring a state of emergency for the state or any portion of the state if he or she determines that an emergency resulting from a disaster or the imminent threat of a disaster exists. If the governor determines that a public health emergency exists, he or she may issue an executive order declaring a state of emergency related to public health for the state or any portion of the state and may designate the department of health services as the lead state agency to respond to that emergency. If the governor determines that the emergency is related to computer or telecommunication systems, he or she may designate the department of administration as the lead agency to respond to that emergency. A state of emergency shall not exceed 60 days, unless the state of emergency is extended by joint resolution of the legislature. A copy of the executive order shall be filed with the secretary of state. The executive order may be revoked at the discretion of either the governor by executive order or the legislature by joint resolution." https://docs.legis.wisconsin.gov/statutes/statutes/323

The initial executive order declaring a public health emergency is dated March 12 2020. https://evers.wi.gov/Documents/EO/EO...cyCOVID-19.pdf It even references the above statute section. But it gives no end date, so appears to be written as indefinite or perpetual. Sixty days after March 12 is May 11. The order if enforced after that date without extension of the state emergency by joint resolution of the legislature is illegal.

Department of Health Services Secretary-designee Andrea Palm has issued emergency order 28, extending restrictions until May 26 2020. https://evers.wi.gov/Documents/COVID...aferAtHome.pdf

https://docs.legis.wisconsin.gov/mis...p2_3_24_20.pdf discusses such a proposed joint resolution permitting extension and providing funding.

April 21: "...Republican legislative leaders filed suit against Governor Tony Evers, challenging his decision to extend the state’s Safer At Home” order until May 26th." https://www.channel3000.com/vp-pence...it-to-madison/
That would imply no joint resolution permitting the extension of a state of emergency has passed.

Legislature Asks State Supreme Court to Rein In Sec.-Designee Andrea Palm https://rightwisconsin.com/2020/04/2...ee-andrea-palm

Republican state leaders sue Wisconsin governor over stay-at-home order https://www.theguardian.com/world/20...coronavirus-us

This is the same new governor who tried, via executive order, including less than 20 hours before the polls were to open, under the pretext that it was too dangerous to hold elections, to unilaterally postpone elections specified in statute to occur on a specific date, and was rebuffed by both houses of the state legislature, a federal court, the Wisconsin supreme court, and the US supreme court. Much effort was spent to identify who became infected as a result of the election occurring as scheduled. A total of seven individuals have been attributed as election related infections, in this state of over 5 million people; there have been no deaths identified to date. "It is not certain that the seven people contracted the virus at the polls. The possible connection was made because local health officials are now asking newly infected people whether they participated in the election." (see guardian link above)

It's the gubernatorial equivalent of the Keystone cops. Except that lives, businesses, and the Wisconsin economy are being outrageously lawlessly altered, to ruinous effect, by the governor and his unconfirmed appointee. Extreme measures are being applied statewide despite vastly different clinical experience county by county. The northwestern half of the state has very few Covid19 cases; 8 hospitalized, last I looked.

[kladner]

I agree with a lot he says, and I enjoy hearing him. @xilman Is his accent North England or South Scotland?
FYI: The opening salvo is about Trump and Covid19


The following are parodies of old standard songs: The Lion Sleeps Tonight, and Old Man River.

And...as long as I'm on YouTube, here's something an idled (like me) coworker sent. Don't be drinking anything when you watch!



Another from the same artist. This one is for Mitch McConnell.

[kriesel]

Calfornia beach skate park filled with many tons of sand to discourage skateboarders, increase distancing. The dirt bikers are loving it. https://www.instagram.com/p/B_LtZqnle3l

[Uncwilly]

Originally Posted by kriesel

Calfornia beach skate park filled with many tons of sand to discourage skateboarders, increase distancing. The dirt bikers are loving it. https://www.instagram.com/p/B_LtZqnle3l

[Till]

Originally Posted by kladner

I agree with a lot he says, and I enjoy hearing him. @xilman Is his accent North England or South Scotland?

Given that his (nick-)name is Galloway I'ld guess that he is scottish?


"Led by dangerous fools": I'ld see it similarly but wonder why there is still so much support for Trump or BoJo. One explanation is that governments use to get a high support in crisis times; but another one might be that the opposition parties are doing a lousy job, too?

[kladner]

Originally Posted by Till

Given that his (nick-)name is Galloway I'ld guess that he is scottish?


"Led by dangerous fools": I'ld see it similarly but wonder why there is still so much support for Trump or BoJo. One explanation is that governments use to get a high support in crisis times; but another one might be that the opposition parties are doing a lousy job, too?

His speech reminds me of my boyhood best friend's parents, who were Scottish immigrants. Their accents were much stronger.

[kladner]

https://www.theguardian.com/business...z-donald-trump
"Joseph Stiglitz attacks Donald Trump, saying US on course for second Great Depression"

Donald Trump’s botched handling of the Covid-19 crisis has left the US looking like a “third world” country and on course for a second Great Depression, one of the world’s leading economists has warned.

In a withering attack on the president, Joseph Stiglitz said millions of people were turning to food banks, turning up for work due to a lack of sick pay and dying because of health inequalities.

The Nobel prize-winning economist said: “The numbers turning to food banks are just enormous and beyond the capacity of them to supply. It is like a third world country. The public social safety net is not working.”

Stiglitz, a long-term critic of Trump, said 14% of the population was dependent on food stamps and predicted the social infrastructure could not cope with an unemployment rate that could hit 30% in the coming months.

“We have a safety net that is inadequate. The inequality in the US is so large. This disease has targeted those with the poorest health. In the advanced world, the US is one of the countries with the poorest health overall and the greatest health inequality.”

[retina]

I think that the "top economist" has not been to a third world country. Third world countries are coping much better.

The amount of spouted by the so-called "experts" ... they don't know what they are talking about.

[kladner]

Originally Posted by retina

I think that the "top economist" has not been to a third world country. Third world countries are coping much better.

The amount of spouted by the so-called "experts" ... they don't know what they are talking about.

I suspect that may have been a bit of hyperbole. Stiglitz does have credentials, and he is, at least, people-centered. He intended to shock with the metaphor.