April 28, 20205 yr 1 minute ago, Dave Moss said: Reminds me of Sesame Street....'One of these is not like the other...'
April 28, 20205 yr 1 hour ago, Abracadabra said: Those presenting with symptoms and contact tracing are only a fraction of those exposed to the virus. If you cannot grasp that fact then please, leave me to my own devices. F me in the arse with this! Yes they are a fraction with a disproportionately high infection rate.
April 28, 20205 yr https://www.nothingbutthetruthmd.com/2020/04/42820-covid-19-update.html Good evening: Jet Blue becomes the first airline to require masks. Governor Wolf of Pennsylvania has recently released the recovery plan for Pennsylvania and it includes masks for all, through all phases of the recovery. Went to see the Blue Angels this afternoon, lots of spectators, 50% without masks So.....after coming home from an absolutely scrumptious dinner and entertaining movie, I decided I just had to watch a coronavirus video, but not before I wrote my obligatory letters to leadership (less they think I moved). As I was searching through my choices, I decided ( not sure if it was before or after three fingers of Crown) that wearing masks, washing hands and physical distancing, just isn't sexy enough to attract attention. I mean, the academics aren't going to care for it, some of the data are decades old and enough studies have been done to prove efficacy, that a researcher might not even get published. And geez, it is so simple, without any cool names or letters and numbers. RT-PCR, N95, ELISA , viral titres and PPE that look like you just came back from a moonwalk. Not sure how you compete with that. From Coronavirus (Covid-19) Update What to expect Into the Summer and Fall (JAMA learning 3/31/20) Dr. Nicholas Christakis Director Human Nature Lab Yale University I have watched many videos and live streams since this began and this is the first one I have suggested you might want to watch (Click here to watch the video). Not because I agree with everything he said, because I didn't, but he has an interesting perspective on things that will be diminished in translation. Dr. Christakis has colleagues in China, so early on, he got a look at this unfolding that few others were fortunate enough to see. Did you know that the Chinese basically put close to a BILLION people under house arrest for six to eight weeks? Anybody still wondering how they got this under control? When asked why America didn't emulate what what was going on in Japan, Taiwan or South Korea, Dr. Christakis quotes Winston Churchill by saying "Americans always do the right thing after exhausting all other options." He talks about herd immunity and serology testing in this March 31 taping, especially of healthcare workers, to determine who doesn't have to be concerned with infection in the workplace. I have listened to world experts in Infectious Disease and Virology and Epidemiology in the last week, who have stated, without equivocation, that we still don't know whether the antibodies that are produced in response to the Covid-19 infection will be protective. I think it would be prudent to wait until it is determined that the antibodies are protective before we are spending billions of dollars on testing people, and certainly before sending healthcare workers into the workplace with the idea that they are now bulletproof. Herd Immunity is a wonderful concept. Most, if not all the experts that I have read or listened to in the last few months believe that if there is protective immunity, it will probably only last about 40 weeks. As we correctly have put in place mitigation procedures to flatten the curve to prevent the national implosion of our healthcare system, we are spreading out the infections. It is highly unlikely that 170,000,000 people will be infected in the next 40 weeks (the number needed to reach herd immunity with an R2 or 3 virus), so herd immunity may never be reached. Dr. Christakis expresses his outrage at the fact that healthcare workers did not have enough PPE. He accepts the fact that healthcare workers sign on and must accept risks at times, much like firefighters and police and others with risky jobs. Firefighters should not be sent into burning buildings without hoses, and water and helmets, and police should not be sent out on the streets without guns and vests and radios and he asks why did this happen? He doesn't claim to be a supply chain expert but he notes that we had about six weeks notice of what was coming and in frustration he states "it defies my understanding" I can understand his emotion. On January 24th, after I had heard about community spread I sent out my first email to some friends and family and advised them to purchase surgical masks and gloves. (there were no shortages back then) To a person I was asked why, and I assured them that they were going to need them soon. It defies my understanding that this has not been embraced with enthusiasm, especially now that we have seen what we have seen. Between April 7th and April 27th there have been 584,257 new covid infections confirmed in the United States. The overwhelming majority of these patients are symptomatic. Most experts believe that there is an asymptomatic rate of fifty to sixty percent. That means there are most likely, at least 584,257 individuals who are positive but have no symptoms, they do not know they have the disease. They are contagious, and they are out there walking among us, unknowingly spreading the disease to unprotected people. So why would anyone take such a chance and fail to adopt the simple practices of good hand hygiene, physical distancing when possible.and wearing masks? Yesterday the CEO of Tyson Meat Packing Company took out a full page ad, Ii the New York Times (and other papers), talking about plant closures, sort of suggesting that the workers needed to be allowed to go back to work. The CDC website states that these are critical infrastructure jobs so these workers are allowed to work. Yesterday, the CDC also stated that even Covid positive workers who are asymptomatic are permitted to work in these plants. In healthcare, for some time, we have been encouraged to work with Covid infection in the asymptomatic state. The ad talked about large groups of workers staying home due to illness or the fear of working. The United Food and Commercial Workers International Union on Thursday said that at least 13 workers have died and thousands more have tested positive. Why didn't the union protect its workforce? Mr. John Tyson should mandate a mask for all policy, and provide sufficient masks for his employees like the healthcare industry has,! Yesterday the CDC came out with guidelines which included face coverings for all. Why did it take so long for the CDC to make that recommendation? There are about 100,000 meat processing workers in the United States, their Covid numbers are in stark contrast to those of the healthcare workforce who work in a much more at risk environment for Covid-19 infection and who have 11,900,000 more workers. Lung Disease in Covid-19 A primer The lungs primarily function to make oxygen available intimately with the vascular system and to remove carbon dioxide, a byproduct of metabolism that depends on oxygen. Based on this description, a patient may have a problem with bringing oxygen into the body or excreting carbon dioxide out, or possibly both. Several weeks ago there were some videos and emails making the circuit claiming that we were treating the wrong disease and that we were actually harming people by putting them on mechanical ventilators. Like many diseases, there are different stages or phases of a disease and myriad presentations and severities Covid can progress incredibly rapidly in some, to a failure of the lungs to carry out the primary function of bringing oxygen in, or it may progress more slowly. At least initially, oxygenation seems to be the primary problem. Traditionally, we supply increased concentrations of oxygen in an attempt to make up for the failing of the lung to carry out its function. This can be done with nasal prongs, at low flows, 2-15 liters per minute or incredibly high flows, which sort of serve as a poor man's ventilator to help keep the airways open. There are regular oxygen masks which can deliver almost any concentration of oxygen depending on the flow of oxygen and then there are specialized masks which make possible non-invasive ventilation, (ventilation without a tube down the trachea) CPAP (continuous airway pressure) or BiPAP.(Bilevel positive airway pressure) When these non-invasive modalities do not work, that is the oxygen levels are so low as to be incompatible with life, you have little choice but to place the patient on a mechanical ventilator which can take over the mechanical function of the lung and can deliver oxygen under pressures at both the beginning, during, and the end of breath, while the patient cannot accomplish this on their own, or you accept the demise of the patient. In some rarer situations, if mechanical ventilation is not working, the patient can be placed on a machine that actually oxygenates the blood and removes the carbon dioxide outside the body. (ECMO -extracorporeal membrane oxygenation) Imaging studies, at least initially, in many patients with Covid disease that is affecting the lungs, have a "ground glass" appearance reflecting abnormal fluid accumulation in the tissue (interstitial) as opposed to fluid accumulation in the little air sacs in the lung (more commonly associated with traditional ARDS.) There is much that is not known and is being learned very rapidly, and a fair share of controversies. Are non-invasive ventilatory modalities that may generate droplets and aerosols of pulmonary secretions safe to staff and surrounding patients who are not covid positive? For certain, staff must wear special PPE and be very careful in these environments. Should patients be intubated earlier than usual to minimize the damage to the lung tissue of excessive breathing in the low oxygen state? For the cardiac patient or the frailer patient, this off loads much of the "work" of breathing and may be very beneficial. Sometimes putting the patient in the prone position seems to have a very beneficial effect. Matching the provision of oxygen to the blood flow is necessary for optimal pulmonary function. So not enough blood flow to a well oxygenated air sac is not good, and not enough oxygen to an air sac with adequate blood flow is not good either. Putting patients in the prone position often optimize this match up. For the ventilator operation, just follow the directions on the side of the machine, like following the directions for putting a bike together. There you have it, you are ready to go. (remember there is a test coming up) Numbers: 1800 from the Hopkins website Testing - 7,795,728 (202,233 new tests in the last 24 hours) USA - 1,010,717 (up 2.73%, up from 2.27% the day before) New York - data not valid New Jersey - 113,856 (up 2.39%, up from 1.97% the day before) Pennsylvania - 45,137 ( up 4.34%, up from 1.47% the day before) California - 45,497 ( up 3.74% ) Maryland - 20,113 (up 3.21% down from 4.87%, 280 fewer new cases than the day before) Texas - 26,235 (up 3.72%, up from 2.18% the day before) South Carolina - 5613 (up 2.09% down from 4.66% the day before,130 fewer new cases than the day before), World - 3,110,219 (up 2.66%, up from 2.23% the day before Projections All the States that I am tracking are past their peaks except Texas which has four day to go. Fatalities USA exceeded projections and had the projected number for 4/23 so not coming down as quickly as expected. California exceeded projections and had the number projected for 4/22 so not coming down as quickly as expected. New Jersey exceeded projections and had the number projected for 4/22, so not coming down as quickly. New York exceeded projections and had the number projected for 4/26 so slightly slower than expected. Pennsylvania exceeded projections and had the number expected for 4/21 so is not coming down as quickly as expected. Maryland exceeded projections and had the number expected for 4/15 so again slightly off. South Carolina and Texas were close. Bed Utilization California is utilizing many more beds than projected. In fact even though they are past the peak, they are utilizing more beds than ever. New Jersey is utilizing more beds than expected for this date and is matching the number expected for 4/24. New York is utilizing more beds than expected and is matching the number expected on 4/20. Pennsylvania is utilizing more beds than expected and is matching the beds expected for 4/21. Maryland and Texas are pretty much on target. What these projections generally mean is that we are recovering slower than expected. Those of you who have social media accounts, would you please post the web site onto your account. this will help spread this important message. Live Safely Be Well Thank you
April 29, 20205 yr 1 hour ago, Iggles25 said: Reminds me of Sesame Street....'One of these is not like the other...' Sweet baby Jesus is the only mask he needs.
April 29, 20205 yr JFC I didn't think this thread could possibly get any worse from the old board but miraculously here we are...
April 29, 20205 yr 13 hours ago, Dave Moss said: Yeah, the Smithfield plant in South Dakota offered a $500 bonus if you didn’t miss a shift. So people went to work sick to try to get the extra $500. Now the plant is shut down. Shame, if the company spent $500 a person on protective gear and sanitization procedures they might be able to stay open.
April 29, 20205 yr The ten states with the highest net federal funding per resident are: Virginia ($10,301) Kentucky ($9,145) New Mexico ($8,692) West Virginia ($7,283) Alaska ($7,048) Mississippi ($6,880) Alabama ($6,694) Maryland ($6,035) Maine ($5,572) Hawaii ($5,270) On the opposite end, there are some states that have negative net federal funding. These states have paid to the federal government in taxes more than they receive back in aid. New Jersey has the largest negative net federal funding of -$2,368 per resident, closely followed by Massachusetts with -$2,343 per resident. The ten states with the lowest net federal funding per resident are: New Jersey (-$2,368) Massachusetts (-$2,343) New York (-$1,792) North Dakota (-$720) Illinois (-$364) New Hampshire (-$234) Washington (-$184) Nebraska (-$164) Colorado (-$95) California ($12) __________________________________________________________________ Meanwhile, the President wants to make relief dependent on politics. Not need. "We’re not looking to recover 25 years of bad management and give them the money that they lost. That’s unfair to other states," Trump said, adding that he was open to discussions about financial assistance only if it was related to the coronavirus. "But we’d want certain things also, including sanctuary-city adjustments," he continued. "People are being protected that shouldn’t be protected. And a lot of bad things are happening with sanctuary cities... If we’re going to do something for the states, I think we probably want something having to do with sanctuary cities."
April 29, 20205 yr https://www.theguardian.com/world/2020/apr/28/coronavirus-massachusetts-veterans-outbreak-holyoke-soldiers-home 68 dead veterans. However, they are in a blue state, so the don't matter as long as you have a yellow ribbon magnet on your SUV.
April 29, 20205 yr 2 hours ago, Kz! said: looks like Elon was hitting the bottle and bong pretty hard last night.
April 29, 20205 yr Hmm, Dr. Fauci says the US may have enough tests by the end of May or beginning of June. The president says we already have enough. The best and most testing ever by anyone. The vice-President says he is tested constantly and yet, doesn't wear a mask when he visited the Mayo clinic yesterday. I wonder who's word I should take? (hmm, on April 3rd, White House mandates coronavirus test for anyone in 'close proximity' to Trump or Pence")
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