> Guidelines are there for a reason. As much as I despise our Commander in Chief, I don't think the CDC is compromised. Fear doesn't rank over guidelines, but I understand the situation. No one wants to be the doctor that discharges patient zero.
> Personally, I'd admit you for fever of unknown origin for the time being and monitor you for any signs of sepsis. If everything looks good from an observation stand point, I'd discharge you with strict droplet precautions until the fever subsides.
> I think your doctor did the right thing given the context.
Given the above comment, most replies here are arguing against CDC regulation saying it is too stringent. Its very helpful to understand comments in this lens, rather than that the CDC is just under-testing for unknown reasons.
https://www.sciencemag.org/news/2020/02/united-states-badly-...
I was wondering about this... Very hard to justify that in my opinion.
That line is always left out of this: the CDC doesn’t want to test just anyone with cold and flu symptoms ... during flu season.
The false positives are basically guaranteed to absolutely swamp the true positives at this time, and demolish any attempt to target the sick.
I don't keep up with the news at all but recently I started reading some articles from major news outlets just for more info about this virus. It's mind boggling at how different each channel's reporting is (I'm in the US).
I was at the store this morning and they had a TV playing. One channel down played it like it's nothing and it's even "technically" less potent than the regular flu because they compared yearly flu deaths to covid-19's deaths and played it off like "we're no where near the number of deaths that the flu has killed this year!" and then all of the surrounding anchors all agreed with the spokesperson they had on, etc.
Others make it out to be 1 notch away from an apocalyptic event.
So I guess this is really what "fake news" is? I don't get it. You can get a life time of prison for ordering someone to kill someone else but somehow it's ok to potentially gamble with the entire human population by not giving accurate information about a virus that's killing people.
I would recommend to study this site https://www.worldometers.info/coronavirus/ if you want to be more informed.
To me it feels like the experts (WHO/CDC) are 'downplaying' while nonexperts (internet commenters who read a few articles) are doing the opposite.
I mean, it doesn't help when you hear stories like the one posted on Reddit too. Of course it makes you think things like "why wouldn't they test him? Is it because they want to keep the registered cases down or is it because there's not enough tests to go around or maybe it's because the tests aren't accurate?".
These are questions I have as someone who isn't working at the CDC and I'm sure other regular citizens are thinking the same. I thought the media's responsibility was to take information from experts and present that information without bias to people who are not experts in the matter.
- Wash your hands thoroughly. https://www.youtube.com/watch?v=jvcvvRp3lsY
- Cough and sneeze into a paper tissue/handerchief or the crook of your arm. https://www.youtube.com/watch?v=M3_rFPtQgKE
- If you experience shortness of breath, have a cough or fever: • Stay at home. • Contact a doctor immediately by phone or call the coronavirus infoline. • Avoid contact with those around you. • Do not go directly to the doctor or to a hospital emergency room.
[1] https://www.bag.admin.ch/bag/en/home/krankheiten/ausbrueche-...
That's not what the guidelines said. They guidelines were referring only to "hygienic masks" a.k.a. generic surgical masks:
The Federal Office of Public Health (FOPH) does not recommend that people who are well wear hygienic masks (surgical masks). If you are in good health, they do not protect you effectively against an infection with respiratory viruses (i.e. self protection). Wearing a mask therefore can give you a false sense of security.
This is a known point. But they did not mention -- nor did they advise against the use of -- properly rated and certified masks (such as N95 masks). Which do provide some protection (albeit with caveats).
Also, just think for minute around the basic logic of what you're saying. If (properly rated and certified) masks provide "no protection" (for unprotected individuals) - then why are the health care workers using them?
And N95s are heavy and uncomfortable. No one can wear them for long. But if anyone wants to, they’re welcome to it.
Looked for interventional studies testing whether face masks and eye protection work in humans to protect against airborne viral particles. A big issue with many such studies is that medical staff only use masks and/or eye protection at work, opening them to being infected outside of work.
Found a small study [1] getting around this problem by exposing subjects (n = 28, avg age 30.5 years) to monodispersed live attenuated influenza vaccine particles by placing them in front of a vibrating-orifice aerosol generator for 20 minutes, subsequently testing for infection using RT-PCR and culture in nasal washes.
RESULTS
- No precautions: 4 out of 4 infected.
- Ocular exposure only: 4 out of 4 infected.
- Surgical mask only (3M 1818): 5 out of 5 infected.
- Surgical mask with eye protection (Z87 Uvex non-vented): 5 out of 5 infected.
- N95 mask (3M 1860/1860S) only: 3 out of 5 infected.
- N95 mask with eye protection: 1 out of 5 infected.
1. Bischoff WE, Reid T, Russell GB, Peters TR. Transocular entry of seasonal influenza-attenuated virus aerosols and the efficacy of n95 respirators, surgical masks, and eye protection in humans. J Infect Dis. 2011;204(2):193–199.
Considering there are multiple papers out of china which suggest the virus is aerosolized, I think it's irresponsible for anyone to claim masks are useless PPE. Anything less than n99 or p99 might be useless, but that's a different story.
There's also one paper which claims that treating a mask with saline solution makes it substantially more effective against viruses. I'll see if I can't dig it up.
Governments the world over have already demonstrated that they cannot be trusted to properly handle this virus.
What do you think happens if the CDC says everyone needs to wear masks, you go to your local store, and there are no masks? There would be violence in the streets.
Anyhow, here in Hong Kong the virus has been, kind of, contained. Mask wearing, along with hand washing and other measures, have been adopted by the majority population.
One of the problems with the Wuhan virus is that there are quite a few asymptomatic cases, and AFAIK at least one preprint study has confirmed that these hosts can transmit the virus to others, making mask wearing for "healthy" people an even more desirable measure in preventing the virus from spreading.
This is a bizarre claim that can be countered against the reality that every front-line worker is equipped with a mask.
EDIT: Almost immediately I dropped to -2. Bizarre. Again, every health agency the world over equips health workers who deal with potential COVID-19 with N95+ masks. For some reason people desperately want to clutch onto the notion that it's useless because otherwise..uncomfortable and uncool mask, right? Another poster mentioned that the source didn't even state that about masks, but instead about surgical masks which is a tiny subset.
-Masks prevent aerosolized matter (e.g. a sneeze) from getting at mucous membranes (where it needs to get to yield an infection).
-Masks prevent you from touching your hands to the vulnerable areas of your face. It is effectively a check. So when you touch that door handle leaving the subway station it's far less likely you'll transfer to your mouth or nose, and we naturally touch our face thousands of times a day. Ideally one would have a mental process they follow where you clean thoroughly before taking it off.
Those alone seem like an absolutely enormous win for masks.
https://time.com/5785223/medical-masks-coronavirus-covid-19/
https://www.livescience.com/respirators-prevent-coronavirus-...
I'm certainly not at the point where I'm going to wear a mask in public, but the whole "Hurrr masks don't work at all" seems like either disinformation (e.g. stop buying all the masks because we want them), or people trying to comfort themselves in some bizarre way. Every bit of evidence says otherwise.
The moderation through this is absolutely cartoonish and ignorant.
In addition, the permanent rubber units provide protection when fitted with suitable filters; NIOSH calls these half masks (as distinct from full facepieces, colloquially ‘gas masks’). Where I am, these are still languishing on the shelves⁴, which means that the sort of people who are willing to spend five minutes looking up that P95 ≥ N95 are not yet panicking.
¹ https://www.cdc.gov/niosh/npptl/pdfs/UnderstandDifferenceInf...
² https://www.fda.gov/medical-devices/personal-protective-equi...
⁴ https://www.canadiantire.ca/en/pdp/3m-performance-reusable-p...
The Surgeon General, on the other hand, does understand the difference and made an appropriate comment.
This is a bizarre claim that can be countered against the reality that every front-line worker is equipped with a mask.
This is not necessarily to protect the front-line workers. Since the incubation period is so long, it makes sense for front-line workers to wear masks to prevent them infecting other people even if it has zero effect in preventing them being infected in the first place.
I downvoted you because you talked about your downvotes.
If you're keeping track of scoring, HN is perhaps not the right community for you.
Will they prevent you from getting sick? Unlikely unless it is N95 or even N100 PPE
But I'm been wondering if they are not useless in terms of the speed at which the human body experiences a high viral load.
If only one virus particle gets through that should be enough to infect if it takes root and multiplies, but going from one virus to tons in your body takes times since they have to multiply.
Compare that with an infected person coughing right in your face. In this situation, potentially thousands of virus particles will infect you. In this situation, the viral load your body experiences will climb high quickly.
The faster the viral load climbs the less time your immune system has to be able to develop antibodies and learn to fight off the infection.
I imagine this is not too dissimilar from how vaccines work.
If this is the case, that might explain why Li Wenliang died at 34 years of age. Being at the center of it all, it's likely he was exposed to many more virus particles than the typical person. I imagine this would be enough to trigger a cytokine storm if the viral load got high fast enough.
Disclaimer, IANAE (i am not an epidemiologist), I'm just reasoning from first principles here.
[1]https://www.itnonline.com/content/ct-provides-best-diagnosis...
If the CDC's current tests are flawed or too few, then the CDC should provide guidelines to health providers to quickly diagnose potential patients using CT scans.
Compared to the natural incidence of getting a fatal cancer in your lifetime (about 400 in 2000), this is a very low. And for serious conditions, a CT can literally be a life saver.
But if you apply chest CTs to screen for a disease with (let's say) a 0.1% fatality rate, the side effects of your screening increases the fatality rate by 50%.
https://www.newyorker.com/news/our-columnists/how-iran-becam...
They were pretty clear yesterday that they’re ramping up test kit production and test sites as fast as possible. They didn’t answer a direction question about how many sites there were yesterday, implying to me that the number is pretty low.
https://www.cdc.gov/media/releases/2020/t0228-COVID-19-updat...
Its unclear to me where 'managing the propaganda' came out in relation to the reddit post.
UC Davis Medical Center statement on refusal of CDC to grant permissions to test suspected patient:
https://health.ucdavis.edu/health-news/contenthub/novel-coro...
"UC Davis Health does not control the testing process."
Florida refusal to release testing data:
https://www.politico.com/states/florida/story/2020/02/27/flo...
Note that Spring Break in the US, in which about 10 million college students consume substances, exhibit poor judgement, congregate in large numbers, swap bodily fluids, and return to some 3,000+ institutions of higher education, begins today. With Florida and cruise ships as prime destinations.
https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_on_c...
I just posted my own update on COVID-19 yesterday (after watching events overtake me for 4 days -- I'd started after listening to the US CDC press conference on Feb 25):
https://joindiaspora.com/posts/bc04cb503c840138f4b8002590d8e...
On the Media's episode this week focuses strongly on COVID-19 and if anything is rather more alarmed and alarming than my own take (I very conciously strove for verified data and sober takes):
https://www.wnycstudios.org/podcasts/otm/episodes/on-the-med...
Audio: https://www.podtrac.com/pts/redirect.mp3/audio.wnyc.org/otm/...
Features Laurie Garrett, excellent content. Focuses to a large extent on both government mishandling and information suppression -- in the US having no information to report rather than China's suppressing avaiable information) -- as well as other forms of mis- and dis-information.
I find this kind of euphemism use really weird. "Substances"? Water is a "substance". A carpet is too. Why not just say what one is actually referring to?
The level of censorship around unquestionably authentic videos coming out of China has left me in a deep state of shock
Two questions:
1. Why would the hospital require permission to run a test?
2. Why would the CDC not want to test suspicious cases before severe symptoms present? From what I've read, the virus is contageous whether severe symptoms are present or not.
Nobody thinks it’s right to NOT test every potential case. It just wasn’t possible.
Good news: Just today, they released new rules that should increase testing capacity by 400x.
However the CDC has enacted emergency powers to make it illegal for hospitals to use their own testing equipment, which they have in-house, to test their own patients unless they first get CDC approval. And the CDC has ridiculously stringent requirements for approving these tests.
As a result, the only confirmed case of community-spread COVID-19 in the US is in Northern California, because the UC Davis hospital basically said "go fuck yourself" to the CDC and tested anyway.
This is not because COVID-19 is not spreading throughout the community--it is!--but rather because the CDC's stringent testing requirements prevent testing of any case that cannot be rationalized away as having been caught elsewhere. If you don't test for the virus, then you don't confirm the presence of the virus, so there is no virus, amirite?
How can new rules increase testing capacity? All you can do, is adjust the rules to the existing capacities ...
I mean, let's face it — noone's going to go get tested if it means you'll have to pay 5k+ out of pocket for the experience (even if it's a negative test and you require no further treatment), plus would have to be fired from your job for missing work and doing a self-quarantine for 2 weeks (if it's positive yet mild enough to not require hospitalisation), plus be evicted from your apartment for failing to pay rent due to the loss of the income (possibly having to cut the self-quarantine short in the first place due to any such pending evictions or the prospect thereof).
For this whole thing to work, testing has to be free, workers have to have protections, housing has to be affordable and plentiful, and Andrew Yang's UBI (Universal Basic Income) suddenly sounds like it might be a pretty good idea, after all.
We already eat healthy, me and the wife workout. But the kid? Not sure how to prepare him.
But unless your kid has an underlying health issue or vitamin deficiency, then not really. Eat well, get some sunlight if you can, wash your hands often, don't touch your face, follow the guidlines doctors are mentioning at your state/local or federal level.
You see many people speak of "boosting your immune system" but it's pure quackery. A person's immune system is many layers and types, a system, it's not a single thing that can be adjusted at will.
The way I see my immune system is a 100 liter tank of water. You can't overfill it but it can be low. At most it can only be 100 liters. Your immune system can only be as good as normal there's no turbo button to over-boost it.
https://www.worldometers.info/coronavirus/coronavirus-age-se...
Also you can read about SARS which is similar.
Seems like what kills most people is the immune system overreacting.
I am a Caltrain rider daily and I feel like it is not fair to subject other folks to this if it is a COVID-19 - but I don't also want to overload the health system unnecessary if there are folks with Acute symptoms.
I don't know what the US advice is, but the English advice is "please don't visit hospitals unless you've been told to do so".
We have people who'll come out and test you if needed, and we have "drive through" testing stations.
Telephone 111 or your GP for advice.
https://twitter.com/DrSdeG/status/1233715830170562561?s=20
https://www.gov.uk/guidance/coronavirus-covid-19-information...
Still, a bad cold isn't fair to subject others to, either.
U.S.: underdiagnozes cases.
Not sure which is worse.
As much as I criticised China's initial response, their eventual containment has proved highly effective.
The US (and numerous other countries) are point-by-point repeating China's initial failures.
This will delay control by days. Growth is presently doubling every 3 or so days, increasing by an order of magnitude every week. Delays will increase consequences directly proportionate to those rates, both infections and deaths.
As it is, if Rest-of-World (RoW) response is where China was ~22 January, we can expect to see 100x present cases (~2 orders of magnitude) and ~500x present deaths (~2.5x OOM). Very roughly.
To me the extreme measures were just an indication that they understood better than they let the rest of the world know what they are dealing with. I mean, they locked down entire cities at who knows what costs, and they were _disinfecting the streets_. Or maybe they did let everyone know via official channels. Frankly, I was surprised that WHO didn't treat this as an emergency much earlier.
I wouldn't go that far, judging from reports of death certificates with "Unknown viral pneumonia". But I agree that China seemed a little more on top of it... once the world got wind of it.
It is time to switch modes from quarantine to containment and stop pointing fingers. Openly tracking potential cases in realtime can help communities slow the spread so we don't get crushed with huge spikes of critical cases all at the same time.
Also, otherwise healthy 30-year olds need to do exactly what this person is doing: quarantine & treat it with the same meds as the flu.
From what I read, in many of the publicized cases here in Europe that started with a single person travelling there were several confirmed cases in people with close contact to the original patient.
The reports from the US are mostly about single patients with no known source of infection and about denied tests. If you don't test, you don't actually know how widespread the virus is right now. It seems plausible to me that the low number of cases in the US is mostly because of the far more limited testing, and not because there are actually that few cases.
Regardless, it sounds like a bigger budget should be set aside for for testing. If I was in charge and had the resources, EVERYONE coming back from an infected country would be tested; symptoms or not.
If it turns out you do have it, my thoughts and best wishes go out to you. (I'm sure the media coverage will explode; shame these things don't get the attention until after the fact).
The CDC counts real flu deaths and estimates infections. It doesn’t test for them. As a result you get a relatively low fatality rate.
But for COVID-19 we are using only confirmed deaths and confirmed tested infections to come up with a fatality rate that seems much higher than it actually is because most infections go unreported.
This is just a reality of the post-fact based world we now live in. Everything is bonkers.
It's worth noting that the real issue is that CFR skyrockets when the medical system saturates. With good medical care available, the CFR is still much higher than the flu but less crazy. The problem is, COVID-19 can create enough severely ill cases to saturate medical systems with uncontrolled spread.
This paper has 4000 citations: https://journals.lww.com/epidem/Abstract/1990/01000/No_Adjus...
