bluefrogguy

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Everything posted by bluefrogguy

  1. Thanks. I was a week ahead of the coronavirus thread in the NBA rotoworld board. MLB fans prepare early! Looking back, in the third post on this thread I mentioned option of not playing in front of fans. Broken clock is right twice a day, as they say! (hopefully, anyway).
  2. Even if I envision the season starting, I have a hard time envisioning it not stopping again with a minor outbreak (that may or may not include players).
  3. No doubt. I'm just saying that we are going to start to see the returns this week. and it doesn't look good, especially in NYC. I think other places might show better results.
  4. Yeah I agree we *probably* haven't done a good job. But we are going to see what kind of job we have done since the messaging started this week. Trump's 15 day trial ends the 29th and then he is going to "reevaluate it". 538 reported on a poll of ID experts taken on March16-17 after the social distancing messaging started where they thought we'd be on March 29th. The median was 20,000 cases. with a range of 10K to 75K. We passed the median guess within a week. https://fivethirtyeight.com/features/infectious-disease-experts-dont-know-how-bad-the-coronavirus-is-going-to-get-either/
  5. Social distancing messaging started a week and half ago. Heck even Trump started tweeting it the morning of March 14th. That's nine days ago. I think this week will tell a lot of how effective our response has been. Doesn't look good so far.
  6. Yeah I agree, although social distancing messaging started 10 days ago and mass public closings started about a week ago, so we should start to see how well we are doing this week as that is in the 5-9 day time frame. Early returns are not so promising though, tbh.
  7. I think there are demographic differences. But the biggest difference is the timing of response (hopefully). We got to learn from their mistakes. At least hopefully we timed our response better. We'll find out this week.
  8. Definitely needs some wider randomized testing, which should be easy to do right now. If it is effective, it will definitely get a lot of press. But right now it is akin to the proverbial over-hyped, spring training "small sample size" data. Have to be careful until you get good data. I'm also hopeful for some of the antiviral options coming through. Let's go human ingenuity!
  9. Agree with the skepticism, but I also don't dismissing the data out of hand is the right thing to do either. Obviously will need to look at our own data over time to confirm before deciding on the next step to take public health wise. But if it is confirmed and the spread is mostly through close contact (family, social circles and workplace) , that opens up more (and less intrusive) options to mitigate future outbreaks.
  10. I’m more optimistic for the first time in a week that there will be baseball this year. The Chinese data shows that most transmission was between families, social circles and the workplace- I.e. adults spending extended time worth someone shedding the virus. Not as much short exposure transmission and they basically found no school transmission. Public health personnel can work with that transmission pattern in terms of contact tracing and mitigating spread should we get a new local outbreak. Second, is this report about loss of smell and taste that turns out to be pretty common. Still early but if there is a unique sentinel sign of infection to look for, that could be utilized to make people isolate or get tested. And speaking of testing, first rapid, 1 hr TAT tear was approved for emergence use authorization (EUA) by the CDC. Once testing becomes easily available, that will be helpful in surveillance and early diagnosis. Add in the hope that the virus mutates and/or shows some seasonality and we might be able to come up with a public health strategy that removes the restrictions on crowd size. We probably still recommend the at risk from being in big crowds and obviously hand washing and restricting physical contact would continue, but events with lots of attendees like sporting events could be allowed (again, once we are through this acute phase where it is everywhere). Still questions on what would happen with a local outbreak, especially if athletes involved, though. Some kind of treatment breakthrough would obviously be huge. Next two weeks are going to be rough though. Especially in NYC. We are definitely going to stress the limits of our health care system and providers. Those people can’t be appreciated enough.
  11. The best case scenario is that the virus is indeed weather or humidity variable and/or mutates along the way (a lot of viruses mutate and become less pathogenic over time- that's waht happened to some degree with MERS and SARS) and peters out this summer. We make it through this first wave with the extreme measures, maybe a drug come up that is effective too. In that scenario, late summer baseball is possible. Let's hope, anyway.
  12. Yeah influenza A mutates its N and H antigens each year and is tough to predict which combo will predominate. Sometimes the flushot is better than others. Influenza B mutates less and there is some at least partial lifelong immunity. We don't know enough about COVID-19 (aka SARS-2) to know how effective the vaccine will be. On the bummer side, they were never able to develop effective vaccines to SARS-1 and MERS, the two other "bad" coronaviruses, although we are obviously putting a lot more time and energy into this one. We'll have to see in a year.
  13. If there is no season values/salaries should be frozen, I think. Any season at all and they should advance per league rules.
  14. Definitely the worry with COVID-19 and why it has become a pandemic, whereas SARS-1, MERS and Ebola didn't. You could just tell who was sick so much easier. I couldn't find anywhere estimating the % of asymptomatic carriers with COVID-19. But like the death rate, the most important number is the total number of asymptomatic carriers, not the percentage.
  15. This is from the CDC and should answer your questions They use surrogate data and modeling but there are assumptions and limitations they outline. https://www.cdc.gov/flu/about/burden/how-cdc-estimates.htm One thing they don’t include in the denominator is asymptomatic cases. Like COVId-19 there are a lot of asymptomatic infections. https://www.clinicaladvisor.com/home/web-exclusives/most-flu-cases-asymptomatic/ So if they include asymptomatic contacts for the CoVID 19 denominator that is going to make the death rate appear lower than how they calculate the flu death rate.
  16. I don't think we can eradicate it with this effort. Horse is out of the barn. I think we will have an up and down with periods of low activity followed by outbreaks for the next 18 months until a vaccine is developed. I suspect they will try to get a season going during some window, but I could see the whole thing start over again since there are so many naive immune systems out there. What happens with an outbreak in Houston in August after starting back up in July? I just don't see how the season could continue. Hopefully human ingenuity comes up with something.
  17. I mean why not? There's a decent chance the season will be lost anyway. If I'm a professional athlete and I've been putting off surgery for one reason or another, now's the time.
  18. If it levels off like in China and S Korea.... maybe. But the thought is once social distancing lessens and people stop washing their hands so religiously, we will have outbreaks since such a large of the population has a naive immune system and we won't be able to eradicate the disease. And one outbreak could set the whole process back into motion again, especially since there is such a long asymptomatic period where people spread everywhere. I guess we wait to see if these short term public health efforts do and then reassess. But until there is a vaccine or the majority of the population is exposed and we get herd immunity, or if some sort of treatment emerges, its going to be a long year and a half. If there was ever a time for human ingenuity to come through, its now.
  19. If you are interested in helping and feeling well with no known exposures, one way to help is to give blood. There is going to be a nationwide shortage, as blood drives have been cancelled and walk in donations have plummeted. Obviously patients with COVID-19 don't need blood, but the baseline need is still there, but the supply has dried up basically overnight with social isolation. You will probably hear about this more.
  20. In regards to the testing, I think the testing availability logjam is about to get better. LabCorp just yesterday got their Phoenix lab and ready to do 6000 tests a day, and I suspect that means that other commercial labs have had the time to go through the setup and validations necessary to dramatically increase their tests/day numbers. Also the FDA has relaxed several regulations making it easier for smaller hospitals to bring on testing using existing platforms used for other tests. This will in most cases still take a few weeks to go through validation and get supplies for local labs to get the testing up though. But when that happens the TAT will become same day and not 2-4 days like it is currently. I'm most worried about the swab shortage at this point.
  21. I will still submit the death rate is a head fake in some ways. The number that matters is the to total number of critically ill patients at risk of death. If we find out that there are lots of asymptomatic patients (that decreases the death rate) that could make the situation worse as there are more people spreading the disease (increasing the prevalence) and overwhelming our system.
  22. I’ll stand by my crux of my opinion that the exact death rate is not that important right now. And I held out an olive branch by saying perhaps irrelevant was the wrong word (to which you replied “no buts” as if there was no room for nuance). It is deadly enough to put everyone at grave risk, particularly our health care workers (of whom I am one). So forgive me if I really don’t care if I have a 0.5 or 2.0 percent chance of death if I get infected. Given the potential infection rate, it’s deadly enough, IMO.
  23. Yeah obtuse. The most important factor right now is if we overwhelm the medical system. With regard to that question it is less important as to whether it is 0.5, 1.0 or 2.0 death rate. What matters is if it is 5%, 10%, 20%, 40%, 60% or even 80% infection rate. With a collectively naive immune system we could have extremely high infection rates all at once without intervention. Even at seasonal flu death rates a 60% infection rate would overwhelm our system if concentrated over 3 months. Ebola had 50-90% death rates but was relatively inconsequential on a global public health scale since it had such a low prevalence. Yes, from an individual perspective death rate is obviously the key number. But from a public health/ health system perspective, Infection rate is clearly the key number.
  24. Yeah I think like a lot of things we maybe took for granted in life, competitive sports will be appreciated even more now.
  25. Come on, don't be obtuse. You know what I mean. The exact mortality rate, whether it is 0.5, 1.0, 2.0 is not as important right now as the prevalence of disease. Plus the mortality rate will go up if we overwhelm the system. The most important variable in how we get through this is how many patients are sick at once and whether the system can handle the load.