SARS-CoV-2 Coronavirus (COVID-19)

Governor Wolfe has announced the rest of PA will go to green phase next Friday, which essentially reopens the state - with (of course) the recommended CDC guidelines still in use. Although a part of me wants to join the likely tidal wave that will be piling into "places" that have been off limits for over three months, I will defer to better judgement. My plan is to wait at least another month to see how things go, then decide what I want to do. Many of the businesses have started sending out messages explaining their plans to address the new precautions in life as they reopen. To that end, I will wait and see whether this causes a spike in new cases, or not.

Meanwhile, I have a Monday morning "Teams" meeting, which will probably be to discuss plans on how they will schedule office employee returns after June 26th.

 

NY Governor Cuomo, arguably the most effective leader in the fight against the virus, said two days ago that he is now considering mandatory quarantines for travelers coming into NY from hot states like FL. He says this is a "full 180" from day 1.

New York Gov. Cuomo mulls quarantine Florida travelers as cases rise

Such a contrast to other "leaders", particularly the big one who insists the virus still is just going to disappear. Profit, greed and more profit as deaths pile up.

 

..odds that a primary case transmitted COVID-19 in a closed environment was 18.7 times greater compared to an open-air environment..

Closed environments facilitate secondary transmission of coronavirus disease 2019 (COVID-19) | medRxiv

 

"(95% confidence interval [CI]: 6.0, 57.9)"

That would be on the small end of the few estimates I've seen. A higher end estimate was ~300X.

 

Link?

 

From April --

New study finds few cases of outdoor transmission of coronavirus in China | TheHill

"New: Study of 318 outbreaks in China found transmission occurred out-of-doors in only one, involving just 2 cases. Most occurred in home or public transport. Raises key chance for states to move services outdoors (religious, gym classes, restaurants, etc)."

Indoor transmission of SARS-CoV-2 | medRxiv

"Three hundred and eighteen outbreaks with three or more cases were identified, involving 1245 confirmed cases in 120 prefectural cities. We divided the venues in which the outbreaks occurred into six categories: homes, transport, food, entertainment, shopping, and miscellaneous. Among the identified outbreaks, 53.8% involved three cases, 26.4% involved four cases, and only 1.6% involved ten or more cases. Home outbreaks were the dominant category (254 of 318 outbreaks; 79.9%), followed by transport (108; 34.0%; note that many outbreaks involved more than one venue category). Most home outbreaks involved three to five cases. We identified only a single outbreak in an outdoor environment, which involved two cases."

 

with average age of cases declining, i wonder if percentage of hospitalizations and deaths will also decline

 

I've heard the theory (medcram on Youtube) that one reason deaths may be dropping a bit even though cases have not is simply because doctors are getting better at knowing how to treat patients. This includes knowing what the disease can do, what to test for, and when to start certain treatments (such as testing for blood clotting and then starting anticoagulants, something they didn't even realize was an issue before).

 

State health officials concerned as cases spike among those in 20s, 30s | COVID-19 | postandcourier.com

Message is mixed on that.

It is easy to punch out new case numbers, but the hospitalization rates and morbidity numbers are slightly more nuanced.
Data data data.....

 

I am busy today but I read an interesting story from Israel talking about the various chronic conditions suffered by the virus survivors.

 

i have read a few of those as well. long term, who knows? a lot of symptoms can be caused by psychological problems as well.

 

Data is suggestive of some answers here. There is a lag, of course, between new cases and hospitalizations and deaths, but data is so far encouraging. New weekly updated CDC hospitalization rates should be released any day.





United States Coronavirus: 2,348,839 Cases and 122,204 Deaths - Worldometer


COVIDView: A Weekly Surveillance Summary of U.S. COVID-19 Activity | CDC

 

Reviewing national, state, county, and on the ground trends at my hospital there seem to be 3 main things happening that are currently working for us despite physical distancing overall worsening.

1) The elderly and otherwise vulnerable are doing a relatively much better job of sheltering in place. All of such patients I have admitted to the hospital in recent weeks endorse sheltering in place and none of them have tested +COVID-19. Many of our symptomatic teens to 40s outpatients are testing positive and not practicing appropriate physical distancing, but only with typical URI symptoms so don't need hospitalization. Measured infections are surging in our county for the last few weeks but hospitalization rates and deaths are markedly down.

2) We are finally able to test just about everyone we want to, so we are no longer capturing only the previously ~10%? of those infected; when we did, we were only testing the most ill persons so had a skewed perception of actual mortality rates.

3) Summer conditions are always very helpful to suppressing viral infection transmission; fewer folks congregate indoors where distancing is less on average and virus survivability outside the body is far greater; during the summer months, bright/hot days rapidly inactivate the virus.

This would explain why largely (detected) cases are rising, why the age distribution of those infected is getting lower, and why the dynamic fatality rate (as measured) is falling.

Now when we get back into early winter later this year and don't yet have mass vaccination (we don't anticipate mass vaccination available quite that soon), but were we to continue "phase 3" behavior, it seems things will heat up with hospitalizations and deaths.

 

i'm hoping the new normal wil include love of neighbor

 

mrs b said she heard a professor from northeastern on the radio say in an interview that his theory is that florida is going through what we went through in the winter, everyone inside because of the weather.

i don't buy it. millions of floridians are outside. not the case here in winter.

 

Something I have not heard of else. I understand the medical people here almost never test for COVID. They assume if you have the symptoms you have the virus and testing would not change their recommended treatment. This is in south central Virginia.

 

sad if true. everyone who shows up at a hospital here with symptoms gets a test. there are so many diseases that present with a variety of these symptoms, and different treatments, naturally. what a medical disaster that could be.