Coronavirus

[Northern Lion]

This is what we've delved into as a country.   Instead of working together in a time of need, we politicize this epidemic.   People sicken me.  Bond together,

Agreed. This is why almost all politicians are disgusting human beings.

I second that. People are dying, there is no place for politics in a situation like this. And both sides of the isle are responsible.

[DragonAttack]

Right, and it didn't used to be like this, and it's not 'all' of the people from both sides.  Imagine how, oh any president from Teddy Roosevelt on up to Obama would have spoken to the country during this time.

My wife has been to many of the big cities in Europe.  Me, I've been to Rome, Barcelona (and various other spots along the 'shores')  We're following this because we have our second Mediterranean cruise all planned and paid for during the first two weeks of May.  Our first time to ever take a gondola ride while in Venice.

Don't think that's happenin' now.....

[MirrorMask]

Isn't the ban to travel from USA to Italy up until the end of April? maybe you can still fly in....

[Lonk]

First case in NYC confirmed.

[Northern Lion]

Right, and it didn't used to be like this, and it's not 'all' of the people from both sides.  Imagine how, oh any president from Teddy Roosevelt on up to Obama would have spoken to the country during this time.

My wife has been to many of the big cities in Europe.  Me, I've been to Rome, Barcelona (and various other spots along the 'shores')  We're following this because we have our second Mediterranean cruise all planned and paid for during the first two weeks of May.  Our first time to ever take a gondola ride while in Venice.

Don't think that's happenin' now.....

I'm sorry man, that sounds like a really fun trip.  I hope you still get to go.

[Adami]

First case in NYC confirmed.

Well, poop.

[Cool Chris]

2 deaths in WA. 10 cases in King County, 3 in Snohomish County (where I am).

[TAC]

He's already hinting at closing the southern border.

Yeah, I thought I read that the other day.

[Architeuthis]

2 deaths in WA. 10 cases in King County, 3 in Snohomish County (where I am).

Yeah I heard that on King 5 news,  and it's only gonna get worse. Ughh!   

[MirrorMask]

First case in NYC confirmed.

In what is basically one of the "capitals of the world" and most populous city of the USA? not good.

[SwedishGoose]

First case in NYC confirmed.

In what is basically one of the "capitals of the world" and most populous city of the USA? not good.

Well, at least you have a good health care sector (if you can afford to use it)

[ErHaO]

Yeah, and somehow I think SF will get the first big push, I'm pretty sure we got the biggest population of people going to and from China. I'm just waiting for it to explode here.

Each and every one of them should be carefully checked, period.

The USA are lucky, they're learning from China and Europe's mistakes, they can see what worked and what didn't. If politicians consults doctors and people expert in these fields and do what they say, they should be able to contain it.

That should absolutely happen.

Though I do wonder how feasible it is to contain this virus, as people can carry the virus and pass it without symptoms or minimal symptoms. I think we have a pretty good response here and all politicians seem to take it seriously, but still it got through the cracks and more and more cases are piling up. I work in a large medical center and we have clear protocols anticipating the virus and how to take preventative measures, yet one of the first cases was an employee here.

If people without or with minimal symptoms can pass it, so you'd need to perform a diagnostic detection test. And performing that on every person just does not seems feasible, both financially and logistically.

https://www.sciencealert.com/researchers-confirmed-patients-can-transmit-the-coronavirus-without-showing-symptoms (note: I am not familiar with sciencealert, it was the first EN source I found, but it mirrors the communication of reputable Dutch sources. And the site does link to actual published research).

[cramx3]

Though I do wonder how feasible it is to contain this virus, as people can carry the virus and pass it without symptoms or minimal symptoms.

I read somewhere at 80% of the cases are "mild" so to me, it seems a lot of people have/had the virus and because it didn't really effect them much, they aren't going to the doctor to be a "confirmed case" and therefore walking around and spreading... and then with the incubation period who knows how many people such a person would have been in contact with. 

[Grappler]

I clipped this from Facebook and sent it to my wife.  A third case popped up in the Chicago suburbs and the local news stations and social media groups are starting to share and create more fear mongering and panic.  This was in the comments section of one group and it felt like a pretty good assessment of the virus.

Good morning! We thought it would be helpful to share our thoughts on the coronavirus (COVID-19) outbreak. Although it has not hit North America yet, with it now spreading into Western Europe it is likely on its way and we want you to be as informed as possible.

Approximately 20% of the common colds we experience seasonally are coronaviruses. This viral family is nothing new, but over the years two strains have emerged that were more concerning. SARS and MERS had mortality rates of 9.5 and 34.5%, respectively. Fortunately these did not become widespread and have been contained. Unfortunately, we now have COVID-19 and it appears to be more easily spread and therefore harder to contain. Its origin is unclear and up for debate, as has been the quality of the data provided by China, but now we have numbers from outside of China (that are consistent with China's reports) and we have included them below for your review.




Current mortality statistics based on best available prelim data:
• average overall mortality rate 2.3%
• history of high blood pressure, diabetes, heart disease, chronic lung disease, or cancer is 5-10%
• no history of chronic disease <1%
• overall men 2.8%
• overall women 1.7%




By age:
• over 80 years old 15%
• 10-19 of age 0.0018%
• 0-9 years of age ~0%

On a positive note, we can breathe a sigh of relief that our children are clearly not at significant risk. Unfortunately, the same cannot be said about our older family members (being male, elderly, and especially having chronic ailments puts one at greatest risk). The biggest problem is this illness is going to look like a sniffle for many of us and so it's easy for it to go unnoticed and unknowingly spread it.

So, what can we do..




HYGIENE
• Washing our hands thoroughly (under water for more than 15 seconds) is always the best and most effective preventative measure.
• Remind your kids to keep their hands off their face! Pathogens enter our body through the eyes, nose and mouth...
• Don't send your kids to school or the park when they may be contagious. For the common cold doctors typically advise 5-7 days of avoidance, but when kids feel better after 2-3 days so many of us send them back to school. It's therefore no surprise our flu seasons are long and challenging. With COVID-19 this practice needs to STOP (and it should anyway). Although our children may not be at significant risk, our beloved friends and families are.




TRAVEL
• The CDC is advising against non essential travel to China and South Korea.
• Until we know more, we would suggest restricting any travel outside of North America.




TESTING
• Your local clinics do not have a reliable test for this yet. Commercially available testing is on the horizon, but initial batches were faulty and so there have been delays. Our practice is actively searching for testing options and will spare no expense when they become available.
• Suspected cases are currently being referred to the department of public health for testing. The CDC is only advising testing for patients with cold symptoms who have traveled to China or have a known exposure to a COVID-19 patient.




TREATMENT
• For most of us COVID-19 will just look like a common cold. Currently there are no known specific treatments for COVID-19 other than supportive care.

What we should do if we develop cold symptoms (runny nose, fever, mild cough)
• isolate
• see your doctor
• treat fever with Ibuprofen and or Acetaminophen
• address congestion with nasal saline, humidifiers, steam showers, vics, cough and cold remedies (as age appropriate)
• Hydrate




If your cold moves into your chest see your doctor to rule out pneumonia.

• COVID-19 mortality is generally due to acute respiratory distress syndrome (ARDS) and/or pneumonia
Early supportive care will improve outcomes. Options include:
• steroids to slow the immune response that can lead to ARDS
• Inhalers to improve lung function and ease breathing
• antibiotics to address and or prevent secondary bacterial complications
• inpatient care when extreme/necessary (diuretics, vents...)




Don't forget there are other illnesses out there...
• If fevers are high see your doctor to rule out influenza - Tamiflu/Xofluza work best when started early (preferably <48h)
• If you have a red sore throat with or without fever or an upset stomach see your doctor to rule out strep.




Coronaviruses are typically seasonal and so we can hope that by the time it gets here our weather warms, flu season ends, and this virus burns itself out. That said, with it so widespread worldwide there is a good chance it will become a seasonal threat, regardless. By then we hope that a safe and effective vaccine will be available. Until then we try to control spread and take care of each other.

In conclusion, please DO NOT PANIC. For the vast majority of us this is just another cold. Please let us help if you have any concerns.

Lawrence Kagan, MD, FAAP

[eric42434224]

Very informative. Thank you.

[vtgrad]

I clipped this from Facebook and sent it to my wife.  A third case popped up in the Chicago suburbs and the local news stations and social media groups are starting to share and create more fear mongering and panic.  This was in the comments section of one group and it felt like a pretty good assessment of the virus.

Good morning! We thought it would be helpful to share our thoughts on the coronavirus (COVID-19) outbreak. Although it has not hit North America yet, with it now spreading into Western Europe it is likely on its way and we want you to be as informed as possible.

Approximately 20% of the common colds we experience seasonally are coronaviruses. This viral family is nothing new, but over the years two strains have emerged that were more concerning. SARS and MERS had mortality rates of 9.5 and 34.5%, respectively. Fortunately these did not become widespread and have been contained. Unfortunately, we now have COVID-19 and it appears to be more easily spread and therefore harder to contain. Its origin is unclear and up for debate, as has been the quality of the data provided by China, but now we have numbers from outside of China (that are consistent with China's reports) and we have included them below for your review.




Current mortality statistics based on best available prelim data:
• average overall mortality rate 2.3%
• history of high blood pressure, diabetes, heart disease, chronic lung disease, or cancer is 5-10%
• no history of chronic disease <1%
• overall men 2.8%
• overall women 1.7%




By age:
• over 80 years old 15%
• 10-19 of age 0.0018%
• 0-9 years of age ~0%

On a positive note, we can breathe a sigh of relief that our children are clearly not at significant risk. Unfortunately, the same cannot be said about our older family members (being male, elderly, and especially having chronic ailments puts one at greatest risk). The biggest problem is this illness is going to look like a sniffle for many of us and so it's easy for it to go unnoticed and unknowingly spread it.

So, what can we do..




HYGIENE
• Washing our hands thoroughly (under water for more than 15 seconds) is always the best and most effective preventative measure.
• Remind your kids to keep their hands off their face! Pathogens enter our body through the eyes, nose and mouth...
• Don't send your kids to school or the park when they may be contagious. For the common cold doctors typically advise 5-7 days of avoidance, but when kids feel better after 2-3 days so many of us send them back to school. It's therefore no surprise our flu seasons are long and challenging. With COVID-19 this practice needs to STOP (and it should anyway). Although our children may not be at significant risk, our beloved friends and families are.




TRAVEL
• The CDC is advising against non essential travel to China and South Korea.
• Until we know more, we would suggest restricting any travel outside of North America.




TESTING
• Your local clinics do not have a reliable test for this yet. Commercially available testing is on the horizon, but initial batches were faulty and so there have been delays. Our practice is actively searching for testing options and will spare no expense when they become available.
• Suspected cases are currently being referred to the department of public health for testing. The CDC is only advising testing for patients with cold symptoms who have traveled to China or have a known exposure to a COVID-19 patient.




TREATMENT
• For most of us COVID-19 will just look like a common cold. Currently there are no known specific treatments for COVID-19 other than supportive care.

What we should do if we develop cold symptoms (runny nose, fever, mild cough)
• isolate
• see your doctor
• treat fever with Ibuprofen and or Acetaminophen
• address congestion with nasal saline, humidifiers, steam showers, vics, cough and cold remedies (as age appropriate)
• Hydrate




If your cold moves into your chest see your doctor to rule out pneumonia.

• COVID-19 mortality is generally due to acute respiratory distress syndrome (ARDS) and/or pneumonia
Early supportive care will improve outcomes. Options include:
• steroids to slow the immune response that can lead to ARDS
• Inhalers to improve lung function and ease breathing
• antibiotics to address and or prevent secondary bacterial complications
• inpatient care when extreme/necessary (diuretics, vents...)




Don't forget there are other illnesses out there...
• If fevers are high see your doctor to rule out influenza - Tamiflu/Xofluza work best when started early (preferably <48h)
• If you have a red sore throat with or without fever or an upset stomach see your doctor to rule out strep.




Coronaviruses are typically seasonal and so we can hope that by the time it gets here our weather warms, flu season ends, and this virus burns itself out. That said, with it so widespread worldwide there is a good chance it will become a seasonal threat, regardless. By then we hope that a safe and effective vaccine will be available. Until then we try to control spread and take care of each other.

In conclusion, please DO NOT PANIC. For the vast majority of us this is just another cold. Please let us help if you have any concerns.

Lawrence Kagan, MD, FAAP

Thanks man!  That's going out to family and friends!

The fear mongering makes me sick...

I tend to side with Chino/others regarding what's happening in the markets... most if not all of the big boys that can move percentages in the market (like we've seen over the past few trading days) are using algos to trade, taking human thought out of the decision and using pre-programmed parameters.  As we've seen just in our community here, companies of all sizes are preparing for supply-chain interruptions and as the prep-work goes forward and companies communicate that prep, investors and their algos will move with it based on their own tolerances that have already been programmed.  There is fear-mongering for certain and most of it silly, but supply-chain interruptions are real data points and the market is responding to it.  Good news is we've absorbed Friday's losses today with a little bit of creme on top (up 630~ as I write this).  Who said "buy the rumor, sell the news"?  Guess this time it's the inverse....

[Grappler]

Some of the data in that info may be outdated (as it says that no cases were in the US whenever it was written, which we know is not true as of now), but I think the general idea remains solid - this is a mild virus that is just SUPER contagious, but not super deadly. 

[MirrorMask]

Some of the data in that info may be outdated (as it says that no cases were in the US whenever it was written, which we know is not true as of now), but I think the general idea remains solid - this is a mild virus that is just SUPER contagious, but not super deadly.

Not super deadly to perfectly healthly people. The virus itself is not the problem - it's the combo of the lack of a vaccine AND the speed with which it spreads that makes it dangerous.

[cramx3]

Some of the data in that info may be outdated (as it says that no cases were in the US whenever it was written, which we know is not true as of now), but I think the general idea remains solid - this is a mild virus that is just SUPER contagious, but not super deadly.

Not super deadly to perfectly healthly people. The virus itself is not the problem - it's the combo of the lack of a vaccine AND the speed with which it spreads that makes it dangerous.

Yea, no vaccine or way to combat it plus the way it spreads is the issue, but it should really only be alarming to the old and sickly.  Even children don't seem to be dying from this.  I'm pretty confident many of us will get this virus and shake it off this year, but going forward, we will need a vaccine or something to prevent the people who are most at risk here.  In some ways, I kind of feel like quarantines should be for those at risk so they don't get it, not for everyone else as there is just no way to contain this at this point IMO.

[bosk1]

And then you have reporting like this:  https://www.yahoo.com/news/us-doctor-predicts-massive-surge-172012985.html

I mean, technically, she's not wrong.  But the tone of that "announcement" is COMPLETELY off.  So bad.

[cramx3]

And then you have reporting like this:  https://www.yahoo.com/news/us-doctor-predicts-massive-surge-172012985.html

I mean, technically, she's not wrong.  But the tone of that "announcement" is COMPLETELY off.  So bad.

I had just stumbled upon that and felt the same way.

[Dublagent66]

Handwashing is the #1 preventative measure and also the one thing that most people hardly ever do, or do properly.  Wash with soap and water thoroughly, rinse thoroughly, dry thoroughly.  I witness this probably about 5-10% of the time when I'm at work.  The majority just rinse for 5 seconds and dry after using the restroom.  If it happens that often just during the short periods of time that I actually see it every day, the number of times I don't see it must be staggering.

[bosk1]

Handwashing is the #1 preventative measure and also the one thing that most people hardly ever do, or do properly.  Wash with soap and water thoroughly, rinse thoroughly, dry thoroughly.  I witness this probably about 5-10% of the time when I'm at work.  The majority just rinse for 5 seconds and dry after using the restroom.  If it happens that often just during the short periods of time that I actually see it every day, the number of times I don't see it must be staggering.

And that doesn't include the ones I see dash from the stall to the door without so much as glancing at the wash basin.  I've never understood that.

[Podaar]

And that doesn't include the ones I see dash from the stall to the door without so much as glancing at the wash basin.  I've never understood that.

I know, right? It doesn't take that much time. I like to take it a step further, get up on my tip toes and wash my hands and my dick too!

[Dublagent66]

Handwashing is the #1 preventative measure and also the one thing that most people hardly ever do, or do properly.  Wash with soap and water thoroughly, rinse thoroughly, dry thoroughly.  I witness this probably about 5-10% of the time when I'm at work.  The majority just rinse for 5 seconds and dry after using the restroom.  If it happens that often just during the short periods of time that I actually see it every day, the number of times I don't see it must be staggering.

And that doesn't include the ones I see dash from the stall to the door without so much as glancing at the wash basin.  I've never understood that.

Yes, I see that once in a while too and am borderline mortified by it.

[cramx3]

Handwashing is the #1 preventative measure and also the one thing that most people hardly ever do, or do properly.  Wash with soap and water thoroughly, rinse thoroughly, dry thoroughly.  I witness this probably about 5-10% of the time when I'm at work.  The majority just rinse for 5 seconds and dry after using the restroom.  If it happens that often just during the short periods of time that I actually see it every day, the number of times I don't see it must be staggering.

And that doesn't include the ones I see dash from the stall to the door without so much as glancing at the wash basin.  I've never understood that.

Yes, I see that once in a while too and am borderline mortified by it.

Ever go into the penn station bathroom in NYC?  There's a lot more to be mortified than the people who dont wash their hands  (I had to stop in there over the weekend and was deeply disturbed so it's on my mind)  But yes, I do agree, who tf doesn't wash their hands in a public restroom? ew

[Northern Lion]

Some of the data in that info may be outdated (as it says that no cases were in the US whenever it was written, which we know is not true as of now), but I think the general idea remains solid - this is a mild virus that is just SUPER contagious, but not super deadly.

Not super deadly to perfectly healthly people. The virus itself is not the problem - it's the combo of the lack of a vaccine AND the speed with which it spreads that makes it dangerous.

Yea, no vaccine or way to combat it plus the way it spreads is the issue, but it should really only be alarming to the old and sickly.  Even children don't seem to be dying from this.  I'm pretty confident many of us will get this virus and shake it off this year, but going forward, we will need a vaccine or something to prevent the people who are most at risk here.  In some ways, I kind of feel like quarantines should be for those at risk so they don't get it, not for everyone else as there is just no way to contain this at this point IMO.

I agree.  And it would be relatively easy to do.  Most could just self quarantine at home and they could tell family to not come visit unless protective precautions have been taken.  And best of all, the government wouldn't have to be involved by restricting the liberties of many millions of people and spraying who-knows-what all over everyone and everything.

[Dublagent66]

Handwashing is the #1 preventative measure and also the one thing that most people hardly ever do, or do properly.  Wash with soap and water thoroughly, rinse thoroughly, dry thoroughly.  I witness this probably about 5-10% of the time when I'm at work.  The majority just rinse for 5 seconds and dry after using the restroom.  If it happens that often just during the short periods of time that I actually see it every day, the number of times I don't see it must be staggering.

And that doesn't include the ones I see dash from the stall to the door without so much as glancing at the wash basin.  I've never understood that.

Yes, I see that once in a while too and am borderline mortified by it.

Ever go into the penn station bathroom in NYC?  There's a lot more to be mortified than the people who dont wash their hands  (I had to stop in there over the weekend and was deeply disturbed so it's on my mind)  But yes, I do agree, who tf doesn't wash their hands in a public restroom? ew

What do they do out there?  Piss in the wash basins?   

[bosk1]

And best of all, the government wouldn't have to be involved by restricting the liberties of many millions of people and spraying who-knows-what all over everyone and everything.

[cramx3]

What do they do out there?  Piss in the wash basins?   

On one end was a guy passed out laying ontop of the sinks and the other end looked like a guy was cleaning his junk in the sink ala Podaar.  In the middle were people like me washing quickly trying to gtfo asap and of course plenty who just ran out without even thinking of stopping at the sinks.

That's not taking into account the people who are just sketchy and dirty af in those bathrooms lingering around

[Podaar]

Ooo, I like the idea of quarantining those who are well. "Yeah, sorry boss. I'm staying home today because I feel really good. I'm sure you understand."

[cramx3]

Ooo, I like the idea of quarantining those who are well. "Yeah, sorry boss. I'm staying home today because I feel really good. I'm sure you understand."

There's a lot of talk from people in my company and from some friend's companies about everyone working from home.

[Dublagent66]

What do they do out there?  Piss in the wash basins?   

On one end was a guy passed out laying ontop of the sinks and the other end looked like a guy was cleaning his junk in the sink ala Podaar.  In the middle were people like me washing quickly trying to gtfo asap and of course plenty who just ran out without even thinking of stopping at the sinks.

That's not taking into account the people who are just sketchy and dirty af in those bathrooms lingering around

Damn!  Break out the Geiger counter and scan for radio active waste residue within 20 feet of the door. 

[MrBoom_shack-a-lack]

I can't help getting the felling that this virus is creepin up on you no matter how careful you are. So a student told me today that his family had been sick a week after a family trip to Italy, they got worried and they did a test for the virus which luckily turned out to be negative, I hope...

Now the trip was two weeks ago and I met the kid just days after they got home so basically before they got sick... 

Kind of makes you think how easily you can obtain it without knowing about it.

[cramx3]

Yea, thats exactly the problem and why I feel the same about this creeping up on us no matter what.  I just went to a concert in Brooklyn and am going to Philly tomorrow.  If someone near me at the concert had this incubating and passed ti to me, I am about to pass it to many in another city without knowing.  I've actually been thinking about that a lot today.  Mostly because my coworker called out with flu like symptoms today.