Coronavirus COVID-19 - Global Health Pandemic #84

[SouthAussie]

Thanks, as I believe that is one we discussed as to this link is limited to quarantines when the folks were returning at the outset and some folks were very upset.. was the limitation, which they did for flights in the beginning and put them at air force bases upon entry back in Jan/Feb.

Lock downs though is a non starter IIRC. And nothing on such as federal lockdown IIRC is even possible in the US?

I feel that they could probably 'quarantine' a whole state(s) if they wanted to use those powers. Which essentially would be closing of state borders (except to essential workers/goods, of course).

Not that I think they would do that, but I think it could hold up in Supreme Court. IMO

I think the powers are there. It clearly states 'between states'. They are just not using those powers.

 

[RANCH]

Freedom of movement under United States law

The U.S. Supreme Court also dealt with the right to travel in the case of Saenz v. Roe, 526 U.S. 489 (1999). In that case, Justice John Paul Stevens, writing for the majority, held that the United States Constitution protected three separate aspects of the right to travel among the states:

(1) the right to enter one state and leave another (an inherent right with historical support from the Articles of Confederation),

(2) the right to be treated as a welcome visitor rather than a hostile stranger (protected by the "Privileges and Immunities" clause in Article IV, § 2), and

(3) (for those who become permanent residents of a state) the right to be treated equally to native-born citizens (this is protected by the 14th Amendment's Privileges or Immunities Clause; citing the majority opinion in the Slaughter-House Cases, Justice Stevens said, "the Privileges or Immunities Clause of the Fourteenth Amendment . . . has always been common ground that this Clause protects the third component of the right to travel.").

Freedom of movement under United States law - Wikipedia

 

[weepingangel]

Oh boy. That certainly changes things doesn’t it. *sigh*
Eta- until they redefine things again next week I suppose

Not certain if this has been posted yet, I'm finding it hard to keep up with this thread.

CDC has once again redefined COVID-19 close contact, adds brief encounters.
On Wednesday, the CDC changed it to a total of 15 minutes or more — so shorter but repeated contacts that add up to 15 minutes over a 24-hour period now count.

COVID-19 in a Correctional Facility Employee Following ...

 

[SouthAussie]

<RSBM>
A new study found that the anti-inflammatory drug tocilizumab reduces the mortality rate of critically ill patients by as much as 30 percent.

“I think it’s an extremely exciting finding, 30 percent mortality reduction is a major finding,” said Dr. David Leaf, MD, from the Division of Renal Medicine at Brigham and Women’s Hospital.

The study looked at more than 14,000 patients from 68 hospitals who were given the drug within two days of going into intensive care.

This is a new one, isn't it? Tocilizumab?
Here is a bit more info about it ..... typically used for arthritis.
Perhaps they are trying it in order to prevent the dangerous cytokine storm created by the coronavirus?


Tocilizumab (brand name Actemra in Australia) belongs to a new class of medicines called biological disease modifying antirheumatic drugs (biological DMARDs or bDMARDs).

bDMARDs have now been given to over a million people worldwide since their initial use in the late 1990s.

These medicines block natural substances called cytokines, which are found in excessive amounts in the blood and joints of people with rheumatoid arthritis. The increased levels of cytokines cause inflammation, which results in symptoms of pain, joint swelling and stiffness, and can lead to joint damage.

By blocking the cytokine called interleukin-6 (IL6) tocilizumab reduces inflammation, lessens the symptoms and helps stop further joint damage. Tocilizumab is also used to treat juvenile idiopathic arthritis.

https://rheumatology.org.au/patients/documents/Tocilizumab_2016_002.pdf

 

[SouthAussie]

Don’t global pandemic conditions outweigh the need for HIPPA in this situation...isn’t it more important to be to contact tracing and trying to stem the flow at this point?

To you and I perhaps ... but I think in the US pretty much everything revolves around a person's individual rights (in people's minds). It is not about collective rights.

I think that this 'individual right' is overstated when it is a matter of national public health. The national public health - the collective rights - should come first and foremost in a pandemic, because without a healthy nation everything else (economy, for one) will simply collapse over time.

Individual rights are very important for many, many things .. and have been fought long and hard for.

But people do not have the right to infect others with a deadly virus.
They do not have the right to take their deadly virus from state to state.
They do not have the right to inadvertently put people in hospital to fight for their life, and potentially die.
They do not have the right to inadvertently make people homeless and businesses collapse.
All because they won't wear a little piece of fabric properly across their nose and mouth, or limit their movements.

All in my very frustrated opinion, of course.

 

[Rocco]

I can see that. The other thing I've been wondering about is whether the virus could carry from apartment to apartment in large complexes through the heating system. And, if so, I wonder if it would be worth it to put an additional filter over the heating vents.

Personally, I think one of the worst places to be would be in an airplane where all the air is constantly recirculated within a small space. It doesn't seem as though masks would be adequate protection in that situation.

For example, my glasses are always fogging up with my mask on and I see others with foggy glasses, so I know some of their breath is escaping the mask. When that happens on a plane, there's no way to get away from the germs because the air is designed to recirculate.

Stay off planes.

Cabin air filtration
All Boeing airplanes exchange cabin air, use high-efficiency filters, and control airflow to minimize the spread of airborne contaminants.
Cabin air filtration
All Boeing airplanes have systems already in place to help maintain a healthy cabin environment. These systems filter the air you breathe and minimize the spread of airborne contaminants.

• The volume of cabin air is exchanged every two to three minutes
• HEPA filters similar to those used in hospitals capture more than 99.9% of viruses and bacteria
• Cabin air flows primarily from ceiling to floor in a circular pattern and leaves through the floor grilles near the same seat row where it enters

ETA: Travel with Confidence

 

[Rose in SC]

This is a new one, isn't it? Tocilizumab?
Here is a bit more info about it ..... typically used for arthritis.
Perhaps they are trying it in order to prevent the dangerous cytokine storm created by the coronavirus?


Tocilizumab (brand name Actemra in Australia) belongs to a new class of medicines called biological disease modifying antirheumatic drugs (biological DMARDs or bDMARDs).

bDMARDs have now been given to over a million people worldwide since their initial use in the late 1990s.

These medicines block natural substances called cytokines, which are found in excessive amounts in the blood and joints of people with rheumatoid arthritis. The increased levels of cytokines cause inflammation, which results in symptoms of pain, joint swelling and stiffness, and can lead to joint damage.

By blocking the cytokine called interleukin-6 (IL6) tocilizumab reduces inflammation, lessens the symptoms and helps stop further joint damage. Tocilizumab is also used to treat juvenile idiopathic arthritis.

https://rheumatology.org.au/patients/documents/Tocilizumab_2016_002.pdf

For what it's worth (no judgement, please) whenever I see a pharmaceutical drug like this proposed, I always do a search for a more natural alternative, since the likelihood of me getting 'the real thing' is probably next to nil. This popped up for tocilizumab. Granted, it's from July 2020, but the abstract is interesting, especially since I already take our good old friend, Vitamin D3!

Vitamin D: A simpler alternative to tocilizumab for trial in COVID-19? - PubMed

 

[24Roses]

I had to look up the population of Iowa 3.1M. It seems as if the community spread reaches a lot of people, spread across the state. Are people concerned, worried???

For a considerable amount of time, the majority of the daily count numbers were in the 18-40 (mostly college students) range and no I don't think the college students are the least bit worried. I used to add up the numbers in the age groups everyday for a long time, but honestly tired of doing it. But I think when there are smaller amount of daily cases, that this is the age group most affected. However, now with are hospital rates going up, it is now affecting more of the 41+. I know where I live, the majority of the town is taking it seriously. I live in a rural area though with a big city 30+ minutes away. I know from what I read in news comments on Facebook that there are are large majority of people throughout the state that wanted a face mask mandate many months ago (we have never had one). So, I would say those middle age and older are very concerned and those in their 20's, 30's, and teens not so much. All IMO.

 

[10ofRods]

Unfortunately, the Governor’s attitude is to open up everything as if there’s no pandemic. He forbade counties from fining people who violated mask ordinances, and has steadily demanded, then required, the reopening of public venues and schools. As I understand it, our Governor is an advocate of “herd immunity” theory, with the idea being that if the virus spreads to much of the population, there will be enough immunity to stop the further spread. Those of us who are unwell or old are to simply stay indoors and isolate ourselves, as if this really works... He also “opened up” long term care facilities, and the disease is still running rampant through them. There are several thousand active cases in long term care facilities now. As of now some of the cases can still be tracked on the Florida DOH site: Home
As other posts have noted, the Governor is considering curtailing the release of daily cases. A former FL DOH employee, likely fired for her desire to provide accurate data, has an alternate website that may end up being the only public source of information - Florida Covid Community Action: Experience

In a state with so many retirees, the attitude simply stuns...

In another universe, long long ago, it seems to me that this would have resulted in, say, some human rights organization protesting and filing some kind of class action law suit.

This is a government run by people like my cousin (who believes that if you're afraid of getting CoVid - or dying, you should just stay home, apparently f0rever - house arrest for the elderly...)

 

[Warwick1991]

I can see that. The other thing I've been wondering about is whether the virus could carry from apartment to apartment in large complexes through the heating system. And, if so, I wonder if it would be worth it to put an additional filter over the heating vents.

Personally, I think one of the worst places to be would be in an airplane where all the air is constantly recirculated within a small space. It doesn't seem as though masks would be adequate protection in that situation.

For example, my glasses are always fogging up with my mask on and I see others with foggy glasses, so I know some of their breath is escaping the mask. When that happens on a plane, there's no way to get away from the germs because the air is designed to recirculate.

Stay off planes.

The potential to spread the virus in a building depends on the design of its HVAC system. Many apartments, assisted living facility rooms, dormitories and hotels/motels have individual systems that do not exchange air with other apartments/rooms. There would be very low to no risk in the rooms or individual units, but corridors, lobbies and public areas tend to have central systems that recirculate air. It isn’t easy - or advisable - to just retrofit high efficiency (HEPA) filters in existing buildings, because the existing equipment has to be capable of more airflow to supply adequate airflow if HEPA filters are used. Office buildings - and many others - are often sealed and use HVAC designs that depend on recirculated air. Our society needs to rethink many of the assumptions used in heating and cooling design. Building interiors with recirculated air present risk. Schools face great challenges with regard to indoor air, and most don’t have adequate budgets to retrofit or replace HVAC in their buildings.

There was also a case in China where plumbing facilitated viral spread in a high rise building. The story was mentioned in earlier threads on Covid-19, and can be found here https://nypost.com/2020/08/27/covid-19-can-waft-through-toilets-into-other-apartments-study/. In this case, contaminated air spread from the toilets to rooms below. However, the plumbing codes used in the US and Canada would likely prevent this situation by requiring traps and waste vents.

 

[dixiegirl1035]

RSBM Brigham and Women’s research finds drug improves survival in critically ill patients with COVID-19 BOSTON (WHDH) - Research led by doctors at Brigham and Women’s Hospital could bring new hope for those critically sick due to COVID-19. A new study found that the anti-inflammatory drug tocilizumab reduces the mortality rate of critically ill patients by as much as 30 percent.

“I think it’s an extremely exciting finding, 30 percent mortality reduction is a major finding,” said Dr. David Leaf, MD, from the Division of Renal Medicine at Brigham and Women’s Hospital.

The study looked at more than 14,000 patients from 68 hospitals who were given the drug within two days of going into intensive care.

On August 18th, Dr. Seheult covered this retrospective observational cohort study https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(20)30277-0/fulltext (time mark 6:45 in below) and noted that it was an observational retrospective study, and that results of ongoing randomised controlled trials are awaited.



In the same video @ 3:30 he covers another study Roche provides an update on the phase III COVACTA trial of Actemra/RoActemra in hospitalised patients with severe COVID-19 associated pneumonia which which is the gold standard (randomized, double blind, placebo-controlled phase III) study of the same drug (Actemra is the trade name for tocilizumab) that shows no reduction in mortality at week 4, yet patients would be followed for 60 days.

 

[Warwick1991]

Miami Herald article on reinstating the curfew. https://www.miamiherald.com/news/coronavirus/article246570913.html. This is part of a struggle by Miami-Dade County to restrict nightlife in crowded indoor venues.

Miami Herald articles on the coronavirus have universal access, and have interesting coverage of the situation in Florida.

 

[anneg]

RSBM for focus:

Brigham and Women’s research finds drug improves survival in critically ill patients with COVID-19
More at link
BOSTON (WHDH) - Research led by doctors at Brigham and Women’s Hospital could bring new hope for those critically sick due to COVID-19.

A new study found that the anti-inflammatory drug tocilizumab reduces the mortality rate of critically ill patients by as much as 30 percent.

“I think it’s an extremely exciting finding, 30 percent mortality reduction is a major finding,” said Dr. David Leaf, MD, from the Division of Renal Medicine at Brigham and Women’s Hospital.

The study looked at more than 14,000 patients from 68 hospitals who were given the drug within two days of going into intensive care.

I get a daily emailed Covid-19 Literature Report from the University of Washington Alliance for Pandemic Preparedness. Yesterday's email included this:

• Despite early enthusiasm for monoclonal antibodies directed against IL-6 (tocilizumab), two randomized, open-label trials did not demonstrate substantial clinical benefit, both reporting no effect on 28-day mortality. These findings, combined with two previously reported industry sponsored trials by the manufacturer of tocilizumab, indicate that tocilizumab may not be as efficacious as suggested by early observational data. More, More, More, and More

I have only glanced at the links but thought I'd put this out there for anyone interested. One of them is an editorial dated October 20 in JAMA Internal Medicine:
"Time to Reassess Tocilizumab’s Role in COVID-19 Pneumonia"

It includes a table comparing the studies to date.

 

[ilovewings]

https://www.washingtonpost.com/health/2020/10/21/coronavirus-close-contact-cdc/

Okay, I have to say I am getting weary of all this "new " info about this virus. Now it is just brief contact with people can cause the virus. It was thought you needed a certain period of time, like 15 min to contract the virus. Now it could be a minute here or a minute there with someone who has it. Frankly, I am getting pizzed---- I think I will just hide under my bed.

 

[ilovewings]

Maybe the vaccine killed this person. That sure will scare many who are already afraid of a Covid vaccine plus those who believe it's safe. JMO

Pretty scary and Astrazeneca has no plans to stop testing. Hmmmmm

 

[SoCalDavidS]

Okay, I have to say I am getting weary of all this "new " info about this virus. Now it is just brief contact with people can cause the virus. It was thought you needed a certain period of time, like 15 min to contract the virus. Now it could be a minute here or a minute there with someone who has it. Frankly, I am getting pizzed---- I think I will just hide under my bed.

I did not read the article, but it doesn't sound like anything I haven't thought already.

If you are in proximity to someone with the virus, and they release particles, then you are at risk. It seems to me that the 15 minute range is just a gauge of the point where it becomes even more risky.

But you can contract the virus in a second, given the correct circumstances. Which is why everyone wearing a mask is essential, since it decreases likelihood particles will become airborne, and then inhaled.

 

[Warwick1991]

Pretty scary and Astrazeneca has no plans to stop testing. Hmmmmm

From this link, it is said that the individual who died received a placebo, not the experimental Astra Zeneca vaccine.. COVID-19 vaccine trial will continue after subject given placebo dies in Brazil

 

[10ofRods]

Per Worldometers - Wednesday October 21, 2020

U.S. - 61,000 New Cases - 1,175 Deaths

It's simply a Fact. We've been consistently seeing New Cases of at least 50K+ for a couple of weeks now. That is translating, as it always does, into an increase in Deaths.

We're going to start seeing consistent daily death totals of 1,000+. If the case #'s begin to trend into the 70K's or 80K's, then daily deaths will soon follow at 1,500+.

And people who are 50+ and think it's NBD and are not wearing masks...are going to regret that decision.

 

[dixiegirl1035]

I did not read the article, but it doesn't sound like anything I haven't thought already.

If you are in proximity to someone with the virus, and they release particles, then you are at risk. It seems to me that the 15 minute range is just a gauge of the point where it becomes even more risky.

But you can contract the virus in a second, given the correct circumstances. Which is why everyone wearing a mask is essential, since it decreases likelihood particles will become airborne, and then inhaled.

That's my understanding also. You can get infected in less than a minute if the circumstances are right I would think. But the 15 minutes was the timing was a guideline for "close contact" for high risk contact tracing moreso than a statement of how long to get infected MOO.

The website notes that this is not an exact science
"Factors to consider when defining close contact include proximity (closer distance likely increases exposure risk), the duration of exposure (longer exposure time likely increases exposure risk), whether the infected individual has symptoms (the period around onset of symptoms is associated with the highest levels of viral shedding), if the infected person was likely to generate respiratory aerosols (e.g., was coughing, singing, shouting), and other environmental factors (crowding, adequacy of ventilation, whether exposure was indoors or outdoors)," it says.
CDC updates its guidelines for close Covid-19 contact after prison guard gets infected - CNN

ETA: I guess this means that his workmans' compensation will cover his expenses then.

 

[ilovewings]

Unfortunately, the Governor’s attitude is to open up everything as if there’s no pandemic. He forbade counties from fining people who violated mask ordinances, and has steadily demanded, then required, the reopening of public venues and schools. As I understand it, our Governor is an advocate of “herd immunity” theory, with the idea being that if the virus spreads to much of the population, there will be enough immunity to stop the further spread. Those of us who are unwell or old are to simply stay indoors and isolate ourselves, as if this really works... He also “opened up” long term care facilities, and the disease is still running rampant through them. There are several thousand active cases in long term care facilities now. As of now some of the cases can still be tracked on the Florida DOH site: Home
As other posts have noted, the Governor is considering curtailing the release of daily cases. A former FL DOH employee, likely fired for her desire to provide accurate data, has an alternate website that may end up being the only public source of information - Florida Covid Community Action: Experience

In a state with so many retirees, the attitude simply stuns...

Let's call it what it is: he has no concern for the people that will die from his misbegotten theory. Their deaths mean nothing to him.