US / Canada border restrictions predictions...

[Montanan]

Originally Posted by kmacdonald

I had a biannual appointment with my cardiologist this morning. We talked about covid and he said he hasn't seen any post covid heart issues. He did say there is significant post covid fatigue and they dont know if it will go away. The long term effects are unknown and he said you really dont want to get it. At any rate, the response has financially ruined a lot of people and that will last a lifetime. You just have to make the best of the opportunities it created------- bull market. Small business is wiped out leaving larger publicly traded companies with new opportunities and growth.

I too will need to go visit my electrophysiologist / cardiologist for my annual check up so as to avail continuation of prescriptions and to discern if there are any issues. They always run an Electrocardiograms and in the past have run MRIs and echocardiograms. So far each year, they have proven contrary to popular opinion that my heart is not made of stone and that it beats, is warm and not silent or cold.

The damage to the heart arising from Covid is readily discernible from Cardiac Magnetic Resonance [CMR] and the percentage of persons with abnormalities arising from such is high. Without an CMR, it is difficult to assess Covid harm, unless the heart has really taken for the worst and then it is apparent by EKG, ECG.

https://jamanetwork.com/journals/jam...dly%20abnormal.

Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19)

Authors / Journal:

Valentina O. Puntmann, MD, PhD1; M. Ludovica Carerj, MD1,2; Imke Wieters, MD3; et alMasia Fahim3; Christophe Arendt, MD1,4; Jedrzej Hoffmann, MD1,5; Anastasia Shchendrygina, MD, PhD1,6; Felicitas Escher, MD7; Mariuca Vasa-Nicotera, MD5; Andreas M. Zeiher, MD5; Maria Vehreschild, MD3; Eike Nagel, MD1
Author Affiliations Article Information
JAMA Cardiol. Published online July 27, 2020. doi:10.1001/jamacardio.2020.3557

Abstract
Importance Coronavirus disease 2019 (COVID-19) continues to cause considerable morbidity and mortality worldwide. Case reports of hospitalized patients suggest that COVID-19 prominently affects the cardiovascular system, but the overall impact remains unknown.

Objective To evaluate the presence of myocardial injury in unselected patients recently recovered from COVID-19 illness.

Design, Setting, and Participants In this prospective observational cohort study, 100 patients recently recovered from COVID-19 illness were identified from the University Hospital Frankfurt COVID-19 Registry between April and June 2020.

Exposure Recent recovery from severe acute respiratory syndrome coronavirus 2 infection, as determined by reverse transcription–polymerase chain reaction on swab test of the upper respiratory tract.

Main Outcomes and Measures Demographic characteristics, cardiac blood markers, and cardiovascular magnetic resonance (CMR) imaging were obtained. Comparisons were made with age-matched and sex-matched control groups of healthy volunteers (n = 50) and risk factor–matched patients (n = 57).

Results Of the 100 included patients, 53 (53%) were male, and the mean (SD) age was 49 (14) years. The median (IQR) time interval between COVID-19 diagnosis and CMR was 71 (64-92) days. Of the 100 patients recently recovered from COVID-19, 67 (67%) recovered at home, while 33 (33%) required hospitalization. At the time of CMR, high-sensitivity troponin T (hsTnT) was detectable (greater than 3 pg/mL) in 71 patients recently recovered from COVID-19 (71%) and significantly elevated (greater than 13.9 pg/mL) in 5 patients (5%). Compared with healthy controls and risk factor–matched controls, patients recently recovered from COVID-19 had lower left ventricular ejection fraction, higher left ventricle volumes, and raised native T1 and T2. A total of 78 patients recently recovered from COVID-19 (78%) had abnormal CMR findings, including raised myocardial native T1 (n = 73), raised myocardial native T2 (n = 60), myocardial late gadolinium enhancement (n = 32), or pericardial enhancement (n = 22). There was a small but significant difference between patients who recovered at home vs in the hospital for native T1 mapping (median [IQR], 1119 [1092-1150] ms vs 1141 [1121-1175] ms; P = .008) and hsTnT (4.2 [3.0-5.9] pg/dL vs 6.3 [3.4-7.9] pg/dL; P = .002) but not for native T2 mapping. None of these measures were correlated with time from COVID-19 diagnosis (native T1: r = 0.07; P = .47; native T2: r = 0.14; P = .15; hsTnT: r = −0.07; P = .50). High-sensitivity troponin T was significantly correlated with native T1 mapping (r = 0.33; P < .001) and native T2 mapping (r = 0.18; P = .01). Endomyocardial biopsy in patients with severe findings revealed active lymphocytic inflammation. Native T1 and T2 were the measures with the best discriminatory ability to detect COVID-19–related myocardial pathology.

Conclusions and Relevance In this study of a cohort of German patients recently recovered from COVID-19 infection, CMR revealed cardiac involvement in 78 patients (78%) and ongoing myocardial inflammation in 60 patients (60%), independent of preexisting conditions, severity and overall course of the acute illness, and time from the original diagnosis. These findings indicate the need for ongoing investigation of the long-term cardiovascular consequences of COVID-19.

[kmacdonald]

Yep, I have to see the cardiologist to get my prescriptions refilled.

The morbidity of covid is horrendous. There is still a lot to learn about it and it's not going to be good. Several people at my wifes work have semi recovered from it but complain of fatigue. They only had minor symptoms that they described as cold like.

[pcmm]

Originally Posted by kmacdonald

I know exactly what it is. The trajectory is obvious.
Let me help you, if the total cases is a horizontal line there are no new cases, if the slope is linear the new infection rate is steady, if the slope is increasing the new infection rate is accelerating. With that basic tutorial, go back and look at it and tell me what you see.

Read the data too, not just the line. These numbers are much much lower, we're talking new cases in the low 50's for the entire province so an increase of 5 -10 has a disproportionate appearance on the graph in relation to the WA data. where the new cases was in the range of 500+ lets graph the data together and you'll see the differences If we look at the day to day new infection rates, both juristictions appear to have past "peaks" that occured in early august.

[kmacdonald]

Originally Posted by pcmm

Read the data too, not just the line. These numbers are much much lower, we're talking new cases in the low 50's for the entire province so an increase of 5 -10 has a disproportionate appearance on the graph in relation to the WA data. where the new cases was in the range of 500+ lets graph the data together and you'll see the differences If we look at the day to day new infection rates, both juristictions appear to have past "peaks" that occured in early august.

No, that's not the case. The graph is of total cases over time. It's not cases per day that would vary a lot like you say. Montanan posted a picture of it (post #271) to make it clearer for the scientifically challenged.

[Montanan]

Going back to the Heart of the Issue as to Post-Covid health difficulties.

Disconcerting news from the USA Big Ten Football Conference showing the implications to healthy college football athletes who are recovering from Covid.

“When we looked at our COVID-positive athletes, whether they were symptomatic or not, 30 to roughly 35 percent of their heart muscles (are) inflamed,” Sebastianelli said. “And we really just don’t know what to do with it right now. It’s still very early in the infection. Some of that has led to the Pac-12 and the Big Ten’s decision to sort of put a hiatus on what’s happening.”

Myocarditis was reportedly linked last month to several Big Ten athletes who contracted COVID-19. It can cause cardiomyopathy, a disease of the heart muscle.

“You could have a very high-level athlete who’s got a very superior VO2 max and cardiac output who gets infected with COVID and can drop his or her VO2 max and cardiac output just by 10 percent, and that could make them go from elite status to average status,” Sebastianelli said. “We don’t know that. We don’t know how long that’s going to last. What we have seen is when people have been studied with cardiac MRI scans — symptomatic and asymptomatic COVID infections — is a level of inflammation in cardiac muscle that just is alarming.

Data underscores Big Ten point on ‘medical uncertainty’

The Big Ten postponed its football season in early August and there were reports that the issue of myocarditis was discussed within the meetings. The only thing the conference provided on the decision at the time was that “there was too much uncertainty regarding potential medical risks to allow our student-athletes to compete this fall.”

A week later, first-year commissioner Kevin Warren penned an open letter to clarify the situation. He wrote it “was thorough and deliberative [decision], and based on sound feedback, guidance and advice from medical experts.”

He pointed to cardiomyopathy in the letter and wrote there was “simply too much we do not know about this virus.”

The data provided by Penn State’s director of athletic medicine puts numbers on those concerns and shows the seriousness of COVID-19’s impacts. The long-term effects are still being studied and discovered.

[Montanan]

Originally Posted by kmacdonald

No, that's not the case. The graph is of total cases over time. It's not cases per day that would vary a lot like you say. Montanan posted a picture of it (post #271) to make it clearer for the scientifically challenged.

As to BC, the gain in cases in the period of a bit over a month [from late July / beginning of August] going through to the beginning of September almost equals the total cases that were confirmed from mid-March to late July.

Now is that due to an increase in testing numbers or an increase in community spread, or a combination of both, I don't know but clearly B.C. number of positives is ramping up but it is still a rather small number in comparison to most places in the world.

Heck Montana which has one of the lowest levels of percentage of positives per capita in the USA has more total confirmed cases [7,889] than BC, yet we here in the 406 Country have only one fifth the population of BC.

Our number of cases increased rapidly after phasing in reopening from our lock down on June 1st and the spread has been undoubtedly been induced from the large number of tourists that flock to The Last Best Place each summer to visit Yellowstone and Glacier National Parks. There being far more tourists arrive than there is our State's native population; millions transition through in the three months of summer. The four seasons of Montana being June, July, August and Winter.

You all are doing quite well up North. Keep up the good effort and good luck.

[Mike OReilly]

The burden of cases in BC, and I believe in other rising provinces like Alberta, has shifted to the youngin's. In BC the under-40 group now makes up the majority of cases, with the the 20-29 category being the largest. This is a dramatic shift from the early case loads which were highly focused in the older categories.


https://experience.arcgis.com/experi...9e3cda29297ded


Authorities ascribe the shift to 'the kids' basically ignoring physical distancing practices. Private parties have also been identified as key spreader events.

All of this bodes poorly for all of us as schools start to reopen. Everyone is expecting a real uptick in cases. The only real question is, how big? And if it spreads beyond the kids, what will our response be?

[mitiempo]

Originally Posted by Mike OReilly

The burden of cases in BC, and I believe in other rising provinces like Alberta, has shifted to the youngin's. In BC the under-40 group now makes up the majority of cases, with the the 20-29 category being the largest. This is a dramatic shift from the early case loads which were highly focused in the older categories.


https://experience.arcgis.com/experi...9e3cda29297ded


Authorities ascribe the shift to 'the kids' basically ignoring physical distancing practices. Private parties have also been identified as key spreader events.

All of this bodes poorly for all of us as schools start to reopen. Everyone is expecting a real uptick in cases. The only real question is, how big? And if it spreads beyond the kids, what will our response be?

I agree but it does depend where you are in BC. I live on Vancouver Island - population 870,000 (2019) and we have 8 acitve cases on the island. 5 people have died on the island since March. No outbreaks in retirement homes on the island.

https://www.islandhealth.ca/sites/de...-dashboard.pdf

We definitely want to keep it this way.

[Mike OReilly]

Originally Posted by mitiempo

I agree but it does depend where you are in BC. I live on Vancouver Island - population 870,000 (2019) and we have 8 acitve cases on the island. 5 people have died on the island since March. No outbreaks in retirement homes on the island.

https://www.islandhealth.ca/sites/de...-dashboard.pdf

We definitely want to keep it this way.

Very true. BC's case load is almost completely in the Vancouver and Fraser regions. The island has virtually no active cases happening. This is great since that's where I am right now .

Even in the USA there is a huge range of infection rates from region to region. This is the problem of lumping such large geographic regions all together. Unfortunately that's how political division, and hence politics, work.

[Mike OReilly]

Mounties issue travel reminder after U.S. boater fined for ignoring COVID-19 law

[NaClyDog]

Originally Posted by Mike OReilly

Mounties issue travel reminder after U.S. boater fined for ignoring COVID-19 law

At this point, it needs to be more than warnings and reminders. They should move to a zero tolerance model.

[Mike OReilly]

Originally Posted by NaClyDog

At this point, it needs to be more than warnings and reminders. They should move to a zero tolerance model.

We're obviously only getting a small part of the story, but I am surprised that "failing to report to border agents as well as violating the Quarantine Act" equates to a mere $2,000 fine. When I failed to promptly report into CBSA one time when returning from the USA I was told in no uncertain terms that they could confiscate my boat.

[NaClyDog]

Originally Posted by Mike OReilly

We're obviously only getting a small part of the story, but I am surprised that "failing to report to border agents as well as violating the Quarantine Act" equates to a mere $2,000 fine. When I failed to promptly report into CBSA one time when returning from the USA I was told in no uncertain terms that they could confiscate my boat.

We (the Canadian we) are too nice as a whole when it comes to this kind of thing. Also, over the years, I've discovered foreigners get way more latitude with the CBSA than Canadians do. Maybe they need to direct some of the aggression against Canadians into a different direction.

[nwdiver]

Confiscate the boat and a life time ban from Canada, probably only have to do it once and the word would get around........

[NaClyDog]

Originally Posted by nwdiver

Confiscate the boat and a life time ban from Canada, probably only have to do it once and the word would get around........

Lol. I suggested that in a different thread minus the confiscate the boat part.