2019 Novel Coronavirus Covid-19 Discussion

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1691 posts

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#2464443 17-Apr-2020 20:22

Oh my things are really blowing out in Singapore as they add 728 cases today !

https://www.straitstimes.com/singapore/5-weak-links-in-singapores-covid-19-battle

It certainly shows that you have to have a great deal of vigilance , the infection rate means a steep climb when it gets a chance.

Some highlights form the article.

1. FOREIGN WORKER DORMITORIES
The high density of people living in close proximity and sharing living and sleeping spaces means that infections can spread very quickly,

2. OLD FOLKS’ HOMES

3. THOSE WHO FLOUT THE RULES
Groups of people spending hours in close contact can become “super spreader” events leading to multiple infections.
People should also avoid social gatherings in and outside of the home, such as inviting family members who do not live with them for meals, and meeting friends in the park.

4. CHILDCARE CENTRES AND PRE-SCHOOLS
While worldwide infection rates for children are generally low, many children are asymptomatic carriers of the virus and may unknowingly infect the seniors in their households.

5. WORKPLACES
The Government is looking to trim the number of companies deemed to be in essential services

Some lessons for us, from a location that has put huge resource into is contact tracing , testing , you need to be looking for the vulnerable.

Meanwhile Taiwan , has been recording zero local cases and low numbers of imported cases , discovered while people were in quarantine.
https://focustaiwan.tw/society/202004170010

Edit to replace Washington Post article that was a bit inflammatory in its language , with Taiwan article that just gives the details.

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Fred99

13684 posts

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#2464444 17-Apr-2020 20:32

Fred99

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#2464445 17-Apr-2020 20:38

ezbee:

Oh my things are really blowing out in Singapore as they add 728 cases today !

1. FOREIGN WORKER DORMITORIES
The high density of people living in close proximity and sharing living and sleeping spaces means that infections can spread very quickly,

This is a real problem in Singapore. I was looking at Singapore MOH data last night, there's approximately 500,000 foreign workers in Singapore on work visas, mainly in dormitory accommodation. Roughly 10% of the Singapore population.

This has derailed what was looking like an incredibly successful effort to contain C-19.

ezbee

1691 posts

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#2464449 17-Apr-2020 20:53

Fred99:

ezbee:

Oh my things are really blowing out in Singapore as they add 728 cases today !

1. FOREIGN WORKER DORMITORIES
The high density of people living in close proximity and sharing living and sleeping spaces means that infections can spread very quickly,

This is a real problem in Singapore. I was looking at Singapore MOH data last night, there's approximately 500,000 foreign workers in Singapore on work visas, mainly in dormitory accommodation. Roughly 10% of the Singapore population.

This has derailed what was looking like an incredibly successful effort to contain C-19.

Yes i think looking for similar vulnerable populations here, either in non ideal living conditions, or less than ideal conditions at work, and both.

Those that are normally invisible.

My suggestions of Pickers, Packers , and areas of construction industry operating at lowest income , unfortunately our Aged care workers have to a degree fitted into this minimum wage etc etc.

We can do it , and avoid if we are watchful.

vexxxboy

4089 posts

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#2464456 17-Apr-2020 21:22

Yes i think looking for similar vulnerable populations here, either in non ideal living conditions, or less than ideal conditions at work, and both.

Those that are normally invisible.

My suggestions of Pickers, Packers , and areas of construction industry operating at lowest income , unfortunately our Aged care workers have to a degree fitted into this minimum wage etc etc.

We can do it , and avoid if we are watchful.

the difference here is that they will be in quarantine for 14 days before they get anywhere to work and the ones here are in the same position as NZ workers.

Common sense is not as common as you think.

neb

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#2464522 18-Apr-2020 01:58

Fred99:
"96% accurate" is not fit for purpose for testing and for presuming (recovered) infection/immunity, especially when presumed population infection rate is a fraction of 1% and the "inaccuracy" is 4%, and that lack of specificity presumably like other of these tests being sold - gives false positives and thus false expectation of immunity.

A medical test with a sensitivity and specificity over 90% is generally regarded as pretty good, so their 96% figure isn't bad. You need to compare it with other tests for the same thing, not a hypothetical 100% perfect test which often doesn't exist. For example for things like lupus there isn't (or wasn't some years ago when I looked at it) any test at all, you tested for everything that wasn't lupus and then assumed that what was left was lupus. However, this 0% accurate test was the way people were "tested" for lupus at the time.

Sidestep

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#2464523 18-Apr-2020 02:25

Anecdotal reports of Gilead's remdesivir trials are quite positive - enough for the Dow to jump 500 points this morning, and Gilead's shares to shoot up.

It should be noted it's a small trial - and without a placebo group for comparison, though fielding a placebo group (where many die) in these cases has moral implications.
There's no doubt some of these antivirals have an effect, with so much research directed at this around the world it's likely - sooner or later - an effective treatment will show up.

Of course a treatment - once you have the disease - isn't in the same ballpark as either eradicating it from the country, or reducing the cases to small, manageable, locked down outbreaks.
Fingers crossed for NZ.

neb

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#2464525 18-Apr-2020 02:32

frankv:
This article states that WHO met with the Vietnamese Health Ministry AND US CDC on 15 January. Five days before any cases were reported in America. And Vietnam still has zero deaths, despite a common border with China.

My American denier hasn't responded to this information. :)

An update on this since several people, me included, were rather sceptical of the zero-deaths figure, there's an article that's just appeared on NPR with a quote from a US CDC person:

"Our team up in Hanoi is working very, very closely with their Ministry of Health counterparts," he says. "The communications I've had with my Vietnam team is that at this point in time, [they] don't have any indication that those numbers are false."

I'm still a bit sceptical, knowing what Vietnam's infrastructure is like, but it at least indicates that the figures are very low, if not necessarily zero.

Batman

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#2464530 18-Apr-2020 06:52

Sideface:

BBC News - Trump halts funding to WHO

breaking

"I am directing my administration to halt ...

Deny. Discredit. Deflect.

With all due respect, with 3 simple words ... this is why we have this pandemic in the first place.

Batman

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#2464531 18-Apr-2020 07:04

a NZ reporter says he tested positive after being cleared. we have these here too. "expert" view at the end of article

https://www.stuff.co.nz/national/health/coronavirus/121082065/coronavirus-false-recovery-leads-to-second-positive-covid19-test

Sidestep

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#2464534 18-Apr-2020 07:24

Batman:

a NZ reporter says he tested positive after being cleared. we have these here too. "expert" view at the end of article

https://www.stuff.co.nz/national/health/coronavirus/121082065/coronavirus-false-recovery-leads-to-second-positive-covid19-test

That's not good.

Neither is a Reuters report about testing of the entire crew of the U.S. aircraft carrier Theodore Roosevelt:

94% of the 4,800-member crew of the aircraft carrier have been tested, and the majority of the 600 positive cases so far are asymptomatic.

kingdragonfly

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#2464538 18-Apr-2020 07:43

We have to remember that Trump offered a German medical company “large sums of money” for exclusive rights to a Covid-19 vaccine.

Big pharma prepares to profit from the coronavirus

The Intercept By Sharon Lerner

Gerald Posner is the author of “Pharma: Greed, Lies, and the Poisoning of America”. He said “Pharmaceutical companies view Covid-19 as a once-in-a-lifetime business opportunity. ... They’re all in that race ... The global crisis will potentially be a blockbuster for the industry in terms of sales and profits,” adding “the worse the pandemic gets, the higher their eventual profit.”

The ability to make money off of pharmaceuticals is already uniquely large in the U.S., which lacks the basic price controls other countries have, giving drug companies more freedom over setting prices for their products than anywhere else in the world. During the current crisis, pharmaceutical makers may have even more leeway than usual because of language industry lobbyists inserted into an $8.3 billion coronavirus spending package, passed last week, to maximize their profits from the pandemic.

Initially, some lawmakers had tried to ensure that the federal government would limit how much pharmaceutical companies could reap from vaccines and treatments for the new coronavirus that they developed with the use of public funding. In February, Rep. Jan Schakowsky, D-Ill., and other House members wrote to Trump pleading that he “ensure that any vaccine or treatment developed with U.S. taxpayer dollars be accessible, available and affordable,” a goal they said couldn’t be met “if pharmaceutical corporations are given authority to set prices and determine distribution, putting profit-making interests ahead of health priorities.”

When the coronavirus funding was being negotiated, Schakowsky tried again, writing to Health and Human Services Secretary Alex Azar on March 2 that it would be “unacceptable if the rights to produce and market that vaccine were subsequently handed over to a pharmaceutical manufacturer through an exclusive license with no conditions on pricing or access, allowing the company to charge whatever it would like and essentially selling the vaccine back to the public who paid for its development.”

But many Republicans opposed adding language to the bill that would restrict the industry’s ability to profit, arguing that it would stifle research and innovation. And although Azar, who served as the top lobbyist and head of U.S. operations for the pharmaceutical giant Eli Lilly before joining the Trump administration, assured Schakowsky that he shared her concerns, the bill went on to enshrine drug companies’ ability to set potentially exorbitant prices for vaccines and drugs they develop with taxpayer dollars.

The final aid package not only omitted language that would have limited drug makers’ intellectual property rights, it also left out language that had been in an earlier draft that would have allowed the federal government to take any action if it has concerns that the treatments or vaccines developed with public funds are priced too high.

“Those lobbyists deserve a medal from their pharma clients because they killed that intellectual property provision,” said Posner, who added that the omission of language allowing the government to respond to price gouging was even worse. “To allow them to have this power during a pandemic is outrageous.”

The truth is that profiting off public investment is also business as usual for the pharmaceutical industry. Since the 1930s, the National Institutes of Health has put some $900 billion into research that drug companies then used to patent brand-name medications, according to Posner’s calculations. Every single drug approved by the Food and Drug Administration between 2010 and 2016 involved science funded with tax dollars through the NIH, according to the advocacy group Patients for Affordable Drugs. Taxpayers spent more than $100 billion on that research.

...In 2019, the pharmaceutical industry spent $295 million on lobbying, far more than any other sector in the U.S. That’s almost twice as much as the next biggest spender — the electronics, manufacturing, and equipment sector — and well more than double what oil and gas companies spent on lobbying. The industry also spends lavishly on campaign contributions to both Democratic and Republican lawmakers.

https://theintercept.com/2020/03/13/big-pharma-drug-pricing-coronavirus-profits/

Fred99

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#2464553 18-Apr-2020 08:58

neb:
Fred99:

"96% accurate" is not fit for purpose for testing and for presuming (recovered) infection/immunity, especially when presumed population infection rate is a fraction of 1% and the "inaccuracy" is 4%, and that lack of specificity presumably like other of these tests being sold - gives false positives and thus false expectation of immunity.

A medical test with a sensitivity and specificity over 90% is generally regarded as pretty good, so their 96% figure isn't bad. You need to compare it with other tests for the same thing, not a hypothetical 100% perfect test which often doesn't exist. For example for things like lupus there isn't (or wasn't some years ago when I looked at it) any test at all, you tested for everything that wasn't lupus and then assumed that what was left was lupus. However, this 0% accurate test was the way people were "tested" for lupus at the time.

As a tool to assist with diagnosis for individual patients - sure 90 or 95% is fine.
As a screening tool to survey a population where known infection rate (isolated and excluded from participating in the survey) is only 0.02% of the population, so if there was/had been one or ten or 50 more undiagnosed/unknown "infected" than known cases in the population, then even 99% specificity is completely useless and unfit for purpose.

They're doing this testing overseas and coming up with data that does not make sense. For example, a new pre-print paper from Santa Clara California concludes that 50-85 fold more people are seropositive than had been confirmed by PCR testing. They used the same type of "quick" tests (lateral flow immunoassay).

People are "believing" in a hypothesis that there are a vast swathe of undiagnosed cases, thus the case fatality rate is far far lower than what is being observed - thus on a population bases it's "not even as bad as the flu" - and we'll soon have herd immunity.

If anybody was to suggest that there had been 50,000 undiagnosed cases in the NZ population (or say 250,000 in Aus), but we'd somehow managed to trace and contain ~95% of symptomatic including mild cases - then they're completely dreaming.

frednz

1452 posts

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#2464554 18-Apr-2020 09:02

https://www.stuff.co.nz/national/health/coronavirus/121082065/coronavirus-false-recovery-leads-to-second-positive-covid19-test

From the above:

I thought I had recovered from coronavirus. I had battled it for nearly three weeks and my symptoms had finally gone.

But it wasn't to be. The virus was still in my system.

This makes me wonder – are New Zealand authorities strict enough on determining when a patient has "recovered" and is safe to come out of quarantine?

I was diagnosed with Covid-19 on March 29, five days after first developing symptoms. I officially recovered 14 days later – all I had to do was not have any symptoms for 48 hours. I could leave isolation, I was free.

... But it had, or it never went away. Within 48 hours I had another positive test result.

Now I'm in for round two. I have to be in isolation until Wednesday –10 days from when the symptoms reappeared.

Later in the article, Siouxsie Wiles, an infectious diseases expert, said that just because someone tested positive after apparently recovering, did not necessarily mean the test found infectious viable virus (which is what is required to pass it on).

Fred99

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#2464555 18-Apr-2020 09:04

Sidestep:

Anecdotal reports of Gilead's remdesivir trials are quite positive - enough for the Dow to jump 500 points this morning, and Gilead's shares to shoot up.

"Leaked" data from a small and incomplete clinical study that doesn't have a control group has the distinct odour of deliberate market manipulation.

Fortunes are being made (and lost) based on piles of bovine excrement.

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