The COVID-19 pandemic

[tomh009]

One chart for today: this shows test results in Alberta by day, both positive and negative. Alberta has one of the highest growth rates of confirmed cases in Canada (around 50% at the moment) but the chart shows that the percentage of positives is actually dropping; the growth in positives is the result of more comprehensive testing.

One of the other charts shows the source of the infections; maybe 20% are suspected to be community-based.

https://covid19stats.alberta.ca/

   

[tomh009]

What could be possible is that an existing medicine (hydroxychloroquine, for example) is confirmed as effective (and side effects as acceptable) in the near term, maybe 3-6 months. This could help the treatments and reduce the healthcare system overload. But this, too, is still uncertain.

The talk of chloroquine has me remembering the time, almost 40 years ago now, when I was living abroad and required to take it for malaria prevention.  I managed to stay on it for a number of months, but the side effects were bad enough that I eventually stopped taking it an just took my chances.   I gather that the possible use against covid-19, if there turns out to be any validity to it, would be for much shorter periods so maybe not an issue.

Indeed, not pleasant, to be sure: Common side effects include vomiting, headache, changes in vision and muscle weakness.

[danbrotherston]

However, restrictions could end abruptly when a successful (or successful enough) vaccine is created - so we could be talking 4 months at the very least or 18 months at the most probably.

No way to get a vaccine in four months. If they get lucky and super-accelerate the approval process, maybe the end of the year at best, more likely next year.

What could be possible is that an existing medicine (hydroxychloroquine, for example) is confirmed as effective (and side effects as acceptable) in the near term, maybe 3-6 months. This could help the treatments and reduce the healthcare system overload. But this, too, is still uncertain.

Thank you for calling this out, I have no idea where people are getting these overly optimistic beliefs about vaccines.

For some reference, 1 year would be the fastest vaccine ever developed (the flu vaccine is a modification of existing flu vaccines, it still takes months), and it could only be achieved through a concerted efforts and risking safety by skipping steps.  This is already happening, with human trials of one possible vaccine starting a few days ago--skipping the usual animal trials which traditionally come first.  But those trials will take time, then wider trials are required to prove that it is actually effective in providing immunity.  If all of that succeeds, then the vaccine must be manufactured and distributed, and then even after receiving it, it takes time for immunity to build.

1 year to herd immunity would be a herculean effort previously only imagined by fiction writers. It's achievable but barely, sooner is a fantasy...

[panamaniac]

The talk of chloroquine has me remembering the time, almost 40 years ago now, when I was living abroad and required to take it for malaria prevention.  I managed to stay on it for a number of months, but the side effects were bad enough that I eventually stopped taking it an just took my chances.   I gather that the possible use against covid-19, if there turns out to be any validity to it, would be for much shorter periods so maybe not an issue.

Indeed, not pleasant, to be sure: Common side effects include vomiting, headache, changes in vision and muscle weakness.

Yes, I had the headaches and changes in vision.  It disturbed my sleep as well, iirc. Although, again, that was after taking the medication for months.

[plam]

Indeed, not pleasant, to be sure: Common side effects include vomiting, headache, changes in vision and muscle weakness.

Yes, I had the headaches and changes in vision.  It disturbed my sleep as well, iirc. Although, again, that was after taking the medication for months.

Definitely not pleasant. Even after taking Lariam you feel like you just ate something heavy and not good. Could be something that would get more uptake among healthcare workers.

[MidTowner]

Yes, I had the headaches and changes in vision.  It disturbed my sleep as well, iirc. Although, again, that was after taking the medication for months.

Definitely not pleasant. Even after taking Lariam you feel like you just ate something heavy and not good. Could be something that would get more uptake among healthcare workers.

I took mefloquine once (it was a generic, not Lariam, but same difference), but stopped when it seemed like I might have been suffering nightmares from it; I read that the psychiatric side effects of it have been reported to sometimes be permanent.

[tomh009]

Canada had results from 66,000 (and some) tests in total, as of yesterday. 1.46% positive.
https://www.canada.ca/en/public-health/s...c=tilelink

New York State had results from 45,000 tests -- 22.8% positive! California 10.2% positive, Illinois 12.1%, Georgia 16.5%, Michigan 27.6%!
https://coronavirus.1point3acres.com/en/test

[tomh009]

Definitely not pleasant. Even after taking Lariam you feel like you just ate something heavy and not good. Could be something that would get more uptake among healthcare workers.

I took mefloquine once (it was a generic, not Lariam, but same difference), but stopped when it seemed like I might have been suffering nightmares from it; I read that the psychiatric side effects of it have been reported to sometimes be permanent.

This might be something that is only prescribed if the COVID-19 situation is light-threatening, at which point the side effects might be considered acceptable.

[MidTowner]

No, that could not work here. It is not possible to restrict people to our homes.

If it becomes necessary, it will probably be possible.

Note that the Ezra Ave. party wasn’t just small this year — as far as I can tell from reports, it didn’t happen. My impression is the police didn’t even turn away that many people. Why? Because enough people got a clue to make a difference. Similarly, if we really got to the point where the only safe option would be for everybody to stay home unless they are specifically authorized, it would be because people were dying from the disease and almost everybody would understand that it was necessary and would trust the recommendation from the medical officer.

I don’t know what is going to happen, but if it turns out that the current state will continue for many months then I would prefer to have a short period of time during which we would ensure that everybody is stocked up, then a 3-4 week period of time during which literally nobody leaves the house except as specifically authorized by the emergency authorities (so roughly speaking emergency services, utilities, and patients going to the hospital). Theoretically, this should be a foolproof method of stopping the disease: current cases would go through whatever is going to happen, and there would be essentially no new cases. After 3-4 weeks anybody who was infected would be over it, one way or the other.

I don't think that's realistic for a lot of reasons. I think that the list of people whose roles are essential is much longer than that- there are many government services that can't be paused, and plenty of manufacturing and private sector services that needs to continue. Among them, it would be impossible to eliminate contagion entirely, and so this period would probably need to last longer than three or four weeks.

Even if we're just talking about bare necessities, how long would it take us to undertake distribution of three to four weeks (or longer) worth to every household? Who would organize that, and carry it out?

[MidTowner]

I took mefloquine once (it was a generic, not Lariam, but same difference), but stopped when it seemed like I might have been suffering nightmares from it; I read that the psychiatric side effects of it have been reported to sometimes be permanent.

This might be something that is only prescribed if the COVID-19 situation is light-threatening, at which point the side effects might be considered acceptable.

Oh, sorry, I didn't mean to suggest that I have any idea whether mefloquine or anything else would or wouldn't be a good treatment. I have no idea; I don't even know if mefloquine has anything to do with chloroquine besides the fact that they're both antimalarials. I was just reminiscing since plam brought up Lariam's side effects.

It's a good point about any potential treatment: even if a drug were no longer commonly used for its original purpose because of side effects, it might well be worth using in this case.

[ijmorlan]

If it becomes necessary, it will probably be possible.

Note that the Ezra Ave. party wasn’t just small this year — as far as I can tell from reports, it didn’t happen. My impression is the police didn’t even turn away that many people. Why? Because enough people got a clue to make a difference. Similarly, if we really got to the point where the only safe option would be for everybody to stay home unless they are specifically authorized, it would be because people were dying from the disease and almost everybody would understand that it was necessary and would trust the recommendation from the medical officer.

I don’t know what is going to happen, but if it turns out that the current state will continue for many months then I would prefer to have a short period of time during which we would ensure that everybody is stocked up, then a 3-4 week period of time during which literally nobody leaves the house except as specifically authorized by the emergency authorities (so roughly speaking emergency services, utilities, and patients going to the hospital). Theoretically, this should be a foolproof method of stopping the disease: current cases would go through whatever is going to happen, and there would be essentially no new cases. After 3-4 weeks anybody who was infected would be over it, one way or the other.

I don't think that's realistic for a lot of reasons. I think that the list of people whose roles are essential is much longer than that- there are many government services that can't be paused, and plenty of manufacturing and private sector services that needs to continue. Among them, it would be impossible to eliminate contagion entirely, and so this period would probably need to last longer than three or four weeks.

I agree it would be very difficult. Without getting into a detailed discussion it’s hard to really evaluate what the list of services needs to be, but I don’t see why we need anything other than hospitals, pharmacies, and utilities (electricity, water/sewer, gas, internet) for the short time to starve out the pandemic. Is there anything I’m missing? Note that I’m not denying the importance of other services — long term, even “frivolous” stuff like movie theatres or sporting events are important collectively — but I think most things can pause for a few weeks for something this important.

Here are a few important things that I’m pretty sure can stop for a month:

– haircuts/manicure/etc.
– restaurants
– garbage collection/street cleaning
– most any office job (although these can mostly be done from home anyway, so may not need to stop)
– manufacturing (with proper preparation)
– construction
– clothes shopping
– dentists (except for ER referrals)
– airlines (except for medevac and similar)
– real estate (both sales and transactions)

Even if we're just talking about bare necessities, how long would it take us to undertake distribution of three to four weeks (or longer) worth to every household? Who would organize that, and carry it out?

This is very difficult. People who are middle-class and above are already able to stock up; but there are a lot of people who simply cannot, and of course our stores and their distribution channels can’t really handle everybody buying a month’s supply over the course of a week. So it is a very complicated logistical problem.

You are right to point out the difficulty of this. It probably is more complicated than I think, even though I think it would be very difficult. And I am no epidemiologist, so I don’t know if it would really make enough of a difference to be worth the extreme effort. But I think there is at least a chance that it might be the right approach.

We’re already way past anything I’ve ever experienced. Just a few years ago the University of Waterloo was criticized for staying open on a WLU/Conestoga College/WRDSB snow day. Now we’ve cancelled all in-person academic activity for the rest of this term and the entire Spring term, including Spring final examinations. I sincerely hope that by the time August with its examination season rolls around, this will look like an absurd overreaction. Sadly I’m not particularly hopeful that this will actually turn out to be the case.

[KevinL]

Very troubling situation at St. Mary's Hospital. https://kitchener.ctvnews.ca/dozens-of-n...-1.4862996

[tomh009]

Very troubling situation at St. Mary's Hospital. https://kitchener.ctvnews.ca/dozens-of-n...-1.4862996

It sounds bad indeed. But would like to have some more information, preferably from another source.

I'm astounded that there were 50+ nurses caring for a single patient, though.

[ijmorlan]

Very troubling situation at St. Mary's Hospital. https://kitchener.ctvnews.ca/dozens-of-n...-1.4862996

It sounds bad indeed. But would like to have some more information, preferably from another source.

I'm astounded that there were 50+ nurses caring for a single patient, though.

I think it’s potential exposure, so probably all nurses on the floor at the time. The nurses actually caring for the patient are assumed to have possibly spread the virus to the rest of the nurses. I think.

[panamaniac]

One trusts that all hospital staff are being tested.