corona virus alerts - Latest cruising Information for vessels/locations/rules

[lestersails]

Originally Posted by dannc

The only country where I have seen this published is the Netherlands. They looked at the current number of deaths compared to the last three years.

It is not believable to me that the Chinese government does not have a good idea of how many people have died because of the virus. One does not need swabs, blood tests, MRI/Cat scans or Xrays to know who had the virus and then died. In Wuhan it seems they have seven crematoriums plus the mobile units the were brought in to handle the increased number of dead. It beggers belief that they did not count how many bodies were cremated.

All one has to do is compare the current number of deaths with prior years, subtract the difference, and one has a good idea on how many people died from the virus.

Later,
Dan

Hi Dan
Appreciate your post - but it is actually extremely hard. Your idea of simply subtracting the prior year death rate would work only if absolutely nothing else was different last year compared to this. This is essentially never the case. The epidemiologists have to adjust for all sorts of things. As an example, the pandemic will probably lead to lower traffic fatalities (as those are mostly proportional to total miles driven). Also, how do you count someone who has terminal cancer, with a <50% probability of surviving 6 months, who gets COVID19 and dies? How do you attribute the cause of death in that person? A tough nut to crack. They also have to account for policy changes and human behavior, which will change every week.
There are literally hundreds of such variables in the statistical models and the epidemiologists debate them vigorously, which is why the estimates vary. Take a look at the FiveThirtyEight.com aggregation of estimates to see the effects of these variations.
These estimates are extremely useful for those who have to make policy decisions - the only rational thing to do is to use the best available evidence, even if we all know it is imperfect.

[Montanan]

Originally Posted by lestersails

It really makes me sad when I see such cynical and insulting posts. I and hundreds of my colleagues work hard to generate and freely share the highest quality health information. This is as mean spirited as it is false.

Lester, please realize the source of those comments, that be TigerPaws, which posts are typically of that content, mode and scope. They are generally mean spirited, cynical and self-centered. I am learing that the easiest thing to do is just ignore them when you see who the author is as there are lot's and lot's of them, sadly. And likely to be many more of similar messaging type. They often get called out as being inappropriate in content and demeanor, your just one of many that have remarked as such. Good on you.

Keep your chin and spirit up in these trying times.

[Waveguide]

My proposed solution to avoiding COVID mortality and reopening the economy:

• Don't smoke.
• Don't vape.
• Don't put anything in your lungs that isn't clean air.
• Put down the fork. Get your BMI down to 25. (https://www.nhlbi.nih.gov/health/edu...MI/bmicalc.htm)
• Exercise to increase lung volume and pulmonary function. (You can't exercise your way out of a bad diet, but exercise still helps with overall health.)
• Keep the schools closed till Fall because closing crowded classrooms - not the seasons - is the major reason respiratory illnesses decline in summer.
• My proposed quarantine criteria: Anyone with a BMI over 30 is prohibited from going anywhere except a gym.
• Give waiters/waitresses the same authority as bartenders to say: "I believe you've had enough."

(Even if all that fails, we'll still be much healthier.)

[Montanan]

Originally Posted by Waveguide

My proposed solution to avoiding COVID mortality and reopening the economy:

• Don't smoke.
• Don't vape.
• Don't put anything in your lungs that isn't clean air.
• Put down the fork. Get your BMI down to 25. (https://www.nhlbi.nih.gov/health/edu...MI/bmicalc.htm)
• Exercise to increase lung volume and pulmonary function. (You can't exercise your way out of a bad diet, but exercise still helps with overall health.)
• Keep the schools closed till Fall because closing crowded classrooms - not the seasons - is the major reason respiratory illnesses decline in summer.
• My proposed quarantine criteria: Anyone with a BMI over 30 is prohibited from going anywhere except a gym.
• Give waiters/waitresses the same authority as bartenders to say: "I believe you've had enough."

(Even if all that fails, we'll still be much healthier.)

I recall decades later my Physical Education teacher / Coach state when he was teaching a Health Education class in junior high school that one should always strive to keep your waist measurement less than your inseam length measurement. That is a guidance that is easy to remember and is easy to apply as for example, to shopping for clothes. Purchase a smaller waist size and then loose the weight so as to have the pants fit, or skirt / dress fit.

If one avoids "dunlap disease", one inherently tends to keep your weight in check and all the host of diseases and health issues associated with being over weight.

With but a few metabolic exceptions, maintaining proper weight is fully within the control of the individual. Just Do It!

[Waveguide]

Originally Posted by Montanan

With but a few metabolic exceptions, maintaining proper weight is fully within the control of the individual. Just Do It!

It's just arithmetic: if calories burned exceed calories consumed - you lose weight. 3,500 calories = one pound of fat. A 500 calorie-a-day deficit = one pound of fat lost per week. A very reasonable rate for most people.

One of the other mortality risk factors for COVID is diabetes. Type 2 diabetes is nearly always reversible. Lose enough weight and it resolves in nearly all cases. The connection between type 2 diabetes and obesity is so close that some doctors have (when talking amongst themselves) nicknamed it "diabesity."

[Montanan]

A situation wherein the unknown is what is known. Makes for a challenge as to best practices and policies for managing the disease.

Dr. Deborah Birx, the White House coronavirus task force coordinator, said Sunday on CBS News’ Face the Nation that it’s still unclear how long immunity lasts for those who have recovered from the coronavirus.

“In most infectious diseases, except for HIV, we know that when you get sick and you recover and you develop (an) antibody — that that antibody often confers immunity,” Birx said. “We just don’t know if it’s immunity for a month, immunity for a six months, immunity for six years” in the case of COVID-19.

Researchers are still studying whether giving plasma from recovered coronavirus patients to sick patients can allow the antibody to offer protective immunity. And questions still circulate around vaccines and whether the antibodies produced are effective, Birx said.

“These are questions that we still have scientifically,” Birx added.

Vineet Menachery, a virologist at the University of Texas Medical Branch, previously told TIME that he estimates COVID-19 antibodies will remain in a patient’s system for “two to three years,” based on what’s known about other coronaviruses, but also that it’s too early to know for certain.

Birx also spoke on ABC News’ This Week Sunday about those protesting states’ stay-at-home orders. She emphasized the importance of official social distancing guidelines.

“What is your message to these protesters out there right now?” host George Stephanopoulos asked her.

“We’ve been telling the American people all along that they need to really follow state and local guidelines,” Birx said. “We’re not only protecting ourselves but we’re protecting each other when we follow the guidelines.”

https://www.yahoo.com/news/dr-birx-u...164038756.html

[Woodland Hills]

Originally Posted by lestersails

Hi Dan
Appreciate your post - but it is actually extremely hard. Your idea of simply subtracting the prior year death rate would work only if absolutely nothing else was different last year compared to this. This is essentially never the case. The epidemiologists have to adjust for all sorts of things. As an example, the pandemic will probably lead to lower traffic fatalities (as those are mostly proportional to total miles driven). Also, how do you count someone who has terminal cancer, with a <50% probability of surviving 6 months, who gets COVID19 and dies? How do you attribute the cause of death in that person? A tough nut to crack. They also have to account for policy changes and human behavior, which will change every week.
There are literally hundreds of such variables in the statistical models and the epidemiologists debate them vigorously, which is why the estimates vary. Take a look at the FiveThirtyEight.com aggregation of estimates to see the effects of these variations.
These estimates are extremely useful for those who have to make policy decisions - the only rational thing to do is to use the best available evidence, even if we all know it is imperfect.

You can minimize the issue by using a six to ten year rolling average of deaths in the period being compared. Not perfect but still useful.

[Sand crab]

Originally Posted by Sand crab

The US has 686,991 cases with 36,721 deaths
NYC has over a third of those deaths.


The world has 2,224,426 cases with 153,177 deaths.

The stats above were 2 days ago.
Today April 20th there are 755,533 case in the US with 40,461 deaths.
The world has 2,394,278 cases with 164,937 deaths.


1 week ago the US had 21,936 deaths.
2 weeks ago the US had 9,534 deaths.
3 weeks ago the US had 2431 deaths.
4 weeks ago the US had 408 deaths.
5 weeks ago the US had 62 deaths.
6 weeks ago the US had 21 deaths
7 weeks ago the US had 2 deaths.

7 weeks and 2 days ago the US had 0 deaths

https://en.wikipedia.org/wiki/Timeli..._United_States

[Waveguide]

Originally Posted by Sand crab

The stats above were 2 days ago.
Today April 20th there are 755,533 case in the US with 40,461 deaths.
The world has 2,394,278 cases with 164,937 deaths.


1 week ago the US had 21,936 deaths.
2 weeks ago the US had 9,534 deaths.
3 weeks ago the US had 2431 deaths.
4 weeks ago the US had 408 deaths.
5 weeks ago the US had 62 deaths.
6 weeks ago the US had 21 deaths
7 weeks ago the US had 2 deaths.

7 weeks and 2 days ago the US had 0 deaths

https://en.wikipedia.org/wiki/Timeli..._United_States

And at 3:00 PM PDT, 19 April, the US just past 40,000 deaths. Source: https://news.google.com/covid19/map?...=US&ceid=US:en

The root assertion of those who are advocating ending the shutdown because: "most of us have been exposed and are already immune," should read this interview with Dr. Birx, who is on Trump's COVID task force: https://time.com/5823876/birx-immunity-coronavirus/

Quoting: “We just don’t know if it’s immunity for a month, immunity for a six months, immunity for six years” in the case of COVID-19.

By contrast to many nations, Sweden has implemented a "minimalist" approach while keeping many businesses open and not quarantining their population. Their COVID fatality rate by population is 10 times worse than the US. And it's not because of population density: Sweden is about the same size (and shape) as California, but it has only 25% the population (10 million). California, with a population of 40 million, which locked down early, has had 1,072 deaths, while Sweden has had 1,540 (both numbers as of now). I lived in Sweden for years, and I can attest that their healthcare system is every bit as good as what we have here in the US. I'm confident those higher death rates aren't a reflection of inferior care. They could however be, to some extent, a reflection of a higher usage of public transportation in the large cities, which hasn't been shut down. The hygiene of their public transportation is about as good and pristine as humanly attainable.

This epidemic has caused me to rethink my outlooks on public transportation.

As an aside, I've found this site to be a good source of general non-partisan medical news: https://www.statnews.com/

[Montanan]

Brooklyn Hospital Center is one of many hospitals testing what's called convalescent plasma. Plasma is the liquid that carries blood cells and antibodies made by the immune system to attack viruses. A recovered virus patient's plasma can be transfused into a patient who's still suffering.

http://https://www.cbsnews.com/news/...es-2020-04-19/

Dr. David Reich is president of New York's Mount Sinai Hospital, part of a national convalescent plasma program being led by the renowned Mayo Clinic in Minnesota.

"In theory, if you give a large enough dose and early enough in the disease process, the antibodies in the convalescent plasma will neutralize the viral particles in the bloodstream of that individual," Reich said. "And that could lead to a more mild course of disease. And it could lead to fewer complications."

"What is the history of this kind of plasma therapy?" Pelley asked Reich.

"It has been shown to be effective in certain epidemics and less effective in others," Reich said. "For example, there was some evidence that it was a benefit for the SARS epidemic in the early part of the 2000s. And there may have been some benefit also for the Swine Flu, also known as H1N1. But it did not seem to be effective in treatment of Ebola disease."

Recovered patient Meredith Berkman donated plasma after managing her COVID-19 symptoms at home.

"At its worst, I would say, was the tightness in the chest, but manageable," Berkman said. "Terrible, terrible headache. And just complete exhaustion."
David Berdoff also recovered and donated.
"My symptoms were gastrointestinal. I was vomiting quite a bit," Berdoff said. "Did you have respiratory symptoms?" Pelley asked.
"So I had a cough. I had a little bit of shortness of breath," Berdoff said.

When tests show a patient eliminated the virus, and has a high level of antibodies, they can volunteer to donate.

"I figure, 'Okay, I had this disease that everybody in the world is at risk for. I seem to have kicked it. My blood might be useful for whatever science experiments that they might be doing, whatever treatments they might be experimenting with,'" Berdoff said.

The donation is similar to giving blood, but only plasma is taken.

"So as you're sitting there, you watch the bag filling with what I can only describe as liquid gold," Berkman said. "I mean, literally and figuratively. The plasma is liquid gold."
The donors do not know who receives their plasma.
"I felt if you believe you can help someone else, you would," Berkman said. "Especially in a situation like this."
Dr. David Reich at Mount Sinai described how his hospital selects which patients receive the plasma.

"What we're looking for are people within the first four days of hospitalization so it's early enough that we would expect it would be effective. And for people who are showing that they're taking a turn for the worse," Reich said.

It will take weeks to know whether plasma shows promise. So far, nationwide, about 500 sick patients have received plasma, a tiny start with unknown benefits.

[Montanan]

A Covid-19 K9?

Medical detection dogs able to sniff 750 people an hour could help identify coronavirus cases, researchers say

jkossoff@businessinsider.com (Julian Kossoff)
Business Insider April 19, 2020,

http://https://www.yahoo.com/news/me...150110255.html

Specially trained medical detection dogs could be the solution to the crisis in the lack of testing that many countries are facing during the coronavirus pandemic.

The dogs are capable of sniff testing 750 people an hour, according to the head of a non-profit which trains medical dogs.

The potential for the dogs to respond to the coronavirus pandemic is being explored by the London School of Hygiene and Tropical Medicine (LSHTM), Durham University, and the Medical Detection Dogs organization.

LSHTM published a press release in late March describing the experimental project, which is seeking to establish whether the dogs can reliably detect COVID-19 in the way they can other disease.

They plan to train six dogs if the initial trials are successful, according to an April 17 report by Britain's Daily Mirror tabloid.

The training involves the dogs being given coronavirus patients' face masks to sniff to discover if COVID-19 has a unique odor that can be identified by a dog's enhanced senses of smell, the Mirror said.

It will take several weeks of experimentation before it will be known if dogs are able to identify the coronavirus.

Professor James Logan, the head of the department of disease control at LSHTM, said: "It's early days for COVID-19 odor detection. We do not know if COVID-19 has a specific odor yet, but we know that other respiratory diseases change our body odor so there is a chance that it does.

"And if it does, dogs will be able to detect it. This new diagnostic tool could revolutionize our response to COVID-19."

Medical detection dogs are already used to help screen for a range of conditions including cancer, malaria and Parkinson's.

Claire Guest, CEO of the Medical Detection Dogs charity, told the Mirror: "There have already been so many fantastic achievements in the dogs' work to detect human disease, and I believe they can be trained to sniff out COVID-19."

"When resources and testing kits are low, hundreds of people can't be tested in one go. But the dogs can screen up to 750 people really quickly. By identifying those who need to be tested and self-isolate, they can stop the spread."

[Wotname]

Originally Posted by Montanan

A Covid-19 K9?

Medical detection dogs able to sniff 750 people an hour could help identify coronavirus cases, researchers say

jkossoff@businessinsider.com (Julian Kossoff)
Business Insider April 19, 2020,

http://https://www.yahoo.com/news/me...150110255.html

Specially trained medical detection dogs could be the solution to the crisis in the lack of testing that many countries are facing during the coronavirus pandemic.

..............
"When resources and testing kits are low, hundreds of people can't be tested in one go. But the dogs can screen up to 750 people really quickly. By identifying those who need to be tested and self-isolate, they can stop the spread."

I guess this will soon answer the question "can dogs get (and transmit) Corona virus"!

[Montanan]

Originally Posted by Wotname

I guess this will soon answer the question "can dogs get (and transmit) Corona virus"!

Takes the term Service Animal to an entirely different level.

I'm thinking that one would not want to pet the dog after it has sniffed 750 person's masks, if the dog does not get infected by this specific coronavirus strain, it still could be a vector just by having it on its fur and / or exhaling the virus after having inhaled it.

Dog's do have a keen sense of smell and are highly trainable, just not sure that they could detect a specific strain of coronavirus. Dogs have long been typically vaccinated against one strain of coronavirus.

There are many varieties of coronavirus that affect animals, and up to six can affect humans.

Well they are calling is an experiment.

[Montanan]

There are 4 requirements for reopening the U.S. amid COVID-19. Americans won't tolerate all of them.
Peter Weber
The WeekApril 20, 2020,

https://www.yahoo.com/news/4-require...104148101.html

The White House has proposed a list of "preparedness responsibilities" for lifting social distancing rules enacted to slow spread the COVID-19 coronavirus. States should be able to test for the coronavirus, contact trace, and ensure hospitals have enough personal protective equipment (PPE) and ICU capacity for when the virus flares up again. Individuals should wear face masks when they can't keep six feet apart in public.

Testing, tracing and isolating, hospital readiness, and masks are the four main pillars of reopening, dozens of scientists, public health experts, and disease historians told The New York Times and ProPublica, but the White House is seriously lowballing the amount of testing needed and skimming over some difficult choices America must make. Keeping the economy locked down isn't sustainable, but "the White House's 'phased' plan for reopening will surely raise the death toll no matter how carefully it is executed," Donald McNeil Jr. writes at the Times. "The best hope is that fatalities can be held to a minimum."

A vaccine — the generally accepted prerequisite for a return toward normalcy — is realistically 18 months away at the earliest. All the experts agreed the U.S. needs to massively ramp up testing for both the virus and, separately, the antibodies that show who has already recovered — and they all agreed the U.S. is nowhere near ready for this. The U.S. also has tens of thousands too few workers trained to trace everybody who came in contact with every infected individual.

China, South Korea, and other countries Australia is one;, my Chinese clients state the tracking app has worked very well for them, aiding in the ability to reopen their massive electric vehicle component manufacturing facility, simplifies the list to a small and manageable number of individuals that need to be self-isolated. have supplemented the labor-intensive task of contact tracing with smartphone monitoring, a step the U.S. has neither the legal framework nor the civil-liberties culture to embrace. And however the positive cases are identified, the next step is even thornier. "To keep the virus in check, several experts insisted, the country also must start isolating all the ill — including mild cases," McNeil writes. China sent everyone testing positive to make-shift infirmities, while Taiwan paid infected citizens to quarantine in hotels.

"Separating people from their families for 14 days is a very tough thing to do," and "it would be massively unpopular" in America's "family-centered society," ProPublica notes. But "what we've learned in Italy, Taiwan, and now our country is sobering," and it's that when people self-isolated at home, "the disease spread to the entire family, sometimes sickening multiple generations."

[Discovery 15797]

Originally Posted by Waveguide

The root assertion of those who are advocating ending the shutdown because: "most of us have been exposed and are already immune," should read this interview with Dr. Birx, who is on Trump's COVID task force: https://time.com/5823876/birx-immunity-coronavirus/

Quoting: “We just don’t know if it’s immunity for a month, immunity for a six months, immunity for six years” in the case of COVID-19.

By contrast to many nations, Sweden has implemented a "minimalist" approach while keeping many businesses open and not quarantining their population. Their COVID fatality rate by population is 10 times worse than the US. And it's not because of population density: Sweden is about the same size (and shape) as California, but it has only 25% the population (10 million). California, with a population of 40 million, which locked down early, has had 1,072 deaths, while Sweden has had 1,540 (both numbers as of now). I lived in Sweden for years, and I can attest that their healthcare system is every bit as good as what we have here in the US. I'm confident those higher death rates aren't a reflection of inferior care. They could however be, to some extent, a reflection of a higher usage of public transportation in the large cities, which hasn't been shut down. The hygiene of their public transportation is about as good and pristine as humanly attainable.

IMHO, it is a bit disingenuous to compare what is happening in Sweden to the US. It's also not accurate to compare Sweden to California unless you also are also willing to say that New York has 10 times as many deaths compared to Sweden. (NY roughly has twice the population of Sweden). It's sort of like comparing Hawaii to New York. That's why comparing raw numbers is not an accurate representation.

A better comparison would be to other EU countries. For example, Belgium, Netherlands, and Switzerland have a higher death rate / 1 million compared to Sweden. Likewise, Norway, Denmark, and German have a lower death rate / 1 million.

Whether or not Sweden's approach to this pandemic is the right approach or not will bear out with time. I think we can all agree that South Korea nipped this thing in the butt very quickly, but also with very authoritarian measures. But, South Korea has 2 international airports. Foreigners who present with a fever are denied entry. Foreigners who violate quarantine are immediately and forcibly repatriated. Citizens who violate quarantine lose their gov't stipend, and face huge fines and jail time. There is a zero-tolerance policy.

I don't necessarily know if the "root assertion" to end the lockdown is most have been exposed and are immune. I think it is more complex than that. IMHO, it's the contradictory information. It's probably the idea that people are highlighting the devastation in New York as representative of America as a whole, and that is simply not reality. Maybe it's because the data is being presented as if everyone is equally at risk, and statistically speaking we know that is simply not true.

Or, maybe it's because governors make arbitrary decisions (e.g. they allow baristas to serve coffee, but not allow citizens to garden in their backyards). Maybe it's because some mayors are using drones to monitor it's the citizens. Maybe it's because governors are releasing prisoners and crime is increasing (burglaries up 87% in Seattle). Maybe it is because people realize the initial models were hyper-inflated and have been continuously adjusted downward.

BTW...wrt Florida opening beaches Birx said,

"If the county health directors believe that that's appropriate for their county, then I'm not going to second judge an individual's approach to this."

BTW...I do believe this crisis should have been handled very similar to the SARS virus which was contained very quickly. I also think that by March only citizens should have been allowed travel into the US, and every person arriving from overseas should have been placed in mandatory quarantine for 21 days. I also think those most at risk should have rapidly employed preventative measures including lockdowns. But, by the time many countries really clued into the reality rather than the lies...it was already too late.

Unfortunately, many countries don't seem to learn from history. Not only did the US not learn containment strategies from the SARs epidemic, we failed to prepare for mass hospitalizations even after the H1N1 epidemic in 2018 that overwhelmed hospitals. Hopefully, that will change in the future; but I won't hold my breath.