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Maryland schools closed starting Monday until 3-27. Think of me as I attempt to telework with a 6-year-old in the house.

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This is a sobering thread well worth reading. Here is one of the most important posts:

This is from a  few days ago and the US is still on an Italy like projection with a current lag of about 13/14 days. That means that our immediately recent growth over a few days is faster than the Italian experience. Not surprising given our lack of testing. 

Given my medical history, I will be mostly staying home for now. The spread in the DMV is starting to accelerate. Fairfax County announced 2 additional presumptive positive cases yesterday bringing the total to 6. These cases have not been tested and diagnosed by CDC yet. There is no evidence of community spread yet in Virginia and I will do my bit to help keep it that way. Only necessary trips out of the house. And for now, use delivery service and drop at the door when necessary. 

Amanda Mull of the Atlantic has an article on the ethics, and safety of delivery. In Wuhan, delivery people were considered heros and major weapons in stopping the spread. 

https://www.theatlantic.com/health/archive/2020/03/coronavirus-how-get-food-safely/608008/

 

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Gonna be interesting to watch the different approach being taken in the UK. While others are suggesting that country X is Y days <12 behind Italy, the Brits think they are four weeks behind Italy, and are tailoring their response accordingly. They are trying to match their period of peak public response, to the period of greatest danger. 
 
Scroll to 32 minutes of this vid where BoJo turns it over to the boffins. Segment runs 15 minutes.  One says two week school closures right now are a fool's errand, and that 13-16 weeks are needed for significant effect.
 
 

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Here's the chart I posted at 9pm Tuesday.............

Country,
Other
Total
Cases
New
Cases
Total
Deaths
New
Deaths
Total
Recovered
Active
Cases
Serious,
Critical
Tot Cases/
1M pop
China 80,777 +23 3,158 +22 61,481 16,138 4,794 56.1
Italy 10,149 +977 631 +168 1,004 8,514 877 167.9
Iran 8,042 +881 291 +54 2,731 5,020   95.7
S. Korea 7,513 +35 58 +5 247 7,208 54 146.5
France 1,784 +372 33 +3 12 1,739 86 27.3
Spain 1,695 +464 36 +6 135 1,524 101 36.3
Germany 1,565 +341 2   18 1,545 9 18.7
USA 975 +271 30 +4 15 930 8 2.9
Diamond Princess 696   7   245 444 32

Here's the current chart. Switzerland thru Japan all had fewer cases than Diamond Princess on Tuesday.

Country,
Other
Total
Cases
New
Cases
Total
Deaths
New
Deaths
Total
Recovered
Active
Cases
Serious,
Critical
Tot Cases/
1M pop
China 80,824 +11 3,189 +13 65,573 12,062 3,610 56.2
Italy 17,660   1,266   1,439 14,955 1,328 292.1
Iran 12,729 +1,365 611 +97 4,339 7,779   151.5
S. Korea 8,086 +107 72 +5 714 7,300 59 157.7
Spain 6,043 +811 191 +58 517 5,335 293 129.2
Germany 4,181 +506 8   46 4,127 9 49.9
France 3,661   79   12 3,570 154 56.1
USA 2,499 +252 51 +2 49 2,399 10 7.5
Switzerland 1,375 +236 13 +2 4 1,358   158.9
UK 1,140 +342 21 +10 18 1,101 20 16.8
Norway 1,052 +56 2 +1 1 1,049 27 194.1
Netherlands 959 +155 12 +2 2 945 45 56.0
Sweden 953 +139 2 +1 1 950 2 94.4
Denmark 827 +23 1 +1 1 825 2 142.8
Japan 804 +70 22 +1 122 660 35 6.4
Diamond Princess

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Given all the accounts I saw online today about how packed bars were in different parts of the country last night (including a photo of a crowded Bourbon Street), I'm really concerned that St. Patrick's Day celebrations are a very bad kind of fuel right now.

Uncertainty is difficult for people to deal with, in addition to micro and macro factors that have to be balanced when assessing risk. In order to avoid a public health catastrophe, though, extreme actions have to be taken before it's obvious to the general public that the situation is dire. By then it is too late.

Watching what's played out in other countries, especially Italy, I am very concerned. We've had the opportunity to learn from multiple countries and that knowledge looks like it might go to waste.

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From the Who situation report 52 to 54 the deaths in the us were growing at 46%. That is they double in less than 4 days.

We are at 60  today. in 4 days, it will be approximately 120 if we do not bend the curve down.

In 8 days, 240 

In 12 days 480

And in 16 days, close to 1,000

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16 minutes ago, deangold said:

From the Who situation report 52 to 54 the deaths in the us were growing at 46%. That is they double in less than 4 days.

We are at 60  today. in 4 days, it will be approximately 120 if we do not bend the curve down.

In 8 days, 240 

In 12 days 480

And in 16 days, close to 1,000

Perhaps so, but I also look at China, and theirs has slown down drastically (you could debate *why* theirs has gone down drastically, of course - has COVID-19 peaked there? Did they contain it differently? Are patterns of weather, contact, and travel different than here?)

I think it would be useful if the major news outlets interviewed people with the virus, so we could get a gauge on how sick they are - that's one piece of anecdotal knowledge I lack.

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6 hours ago, DonRocks said:

Perhaps so, but I also look at China, and theirs has slown down drastically (you could debate *why* theirs has gone down drastically, of course - has COVID-19 peaked there? Did they contain it differently?

China locked down large numbers of people. They equipped delivery people in PPE and that was how most people received food. We had full bars for St Patrick's Day yesterday.

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8 hours ago, DonRocks said:

Perhaps so, but I also look at China, and theirs has slown down drastically (you could debate *why* theirs has gone down drastically, of course - has COVID-19 peaked there? Did they contain it differently? Are patterns of weather, contact, and travel different than here?)

I think it would be useful if the major news outlets interviewed people with the virus, so we could get a gauge on how sick they are - that's one piece of anecdotal knowledge I lack.

Here's the thing -- age and risk factors shoot up the severity of the illness dramatically.  30 year olds no other issues, about the same.  70 year olds, no other issues, 2-3x worse illness.  70 year olds with issues, big problems.   Seasonal flu in the most at-risk population has a little under 2% mortality rate; Covid-19 has a little under 15% mortality rate with the numbers known about a week ago, and requires a huge amount of intervention to keep it that low (ventilators and blood oxygenation transfusion) in ICU for 21-30 days, plus on supplemental oxygen for another 3-6 weeks.  Covid-19 causes interstitial pneumonia, which basically means the aveolar sacs in the lungs cannot function and these sacs are how the oxygen we breathe in transfers into our bloodstream.   USA is expected as of 3 days to have at least 200,000 serious cases; USA has ~45,000 ICU beds.

A friend who used to run human drug trial studies has read early reports that there might be a correlation between ACE2 receptors and higher risks, which can explain why kids are less likely to get Covid-19 even if they carry the coronavirus; they're just too young to have developed arterial plaques.  Folks on ACE2 blockers have a lower incidence of Covid-19 (so far) than people with the same health issues not on blockers.  Because the blockers can cause dangerously low blood pressure, prophylactic prescription is not recommended.  However, protease inhibitors, which are antiviral drugs similar to what is used in HIV treatment, might be a line of defense.   

Naturally occurring protease inhibitors in plants include most legumes cereals, bananas, apples, raisins, pineapples, cucumbers, spinach, cabbage and potatoes.  So, time to make a big batch of lentil-spinach soup, right?  I know I will!

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7 hours ago, DonRocks said:

I think it would be useful if the major news outlets interviewed people with the virus, so we could get a gauge on how sick they are - that's one piece of anecdotal knowledge I lack.

Here is a YouTube video from Gene of Audioholics describing getting and going thru having the virus. 

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2 hours ago, deangold said:

China locked down large numbers of people. They equipped delivery people in PPE and that was how most people received food. We had full bars for St Patrick's Day yesterday.

We also had a poorly thought out and implemented travel policy revision that led to massive numbers of people being packed into major airports (ORD, DFW, JFK) like sardines for many, many hours yesterday waiting to be processed from overseas. After not checking anyone for illness regardless of where they were coming from, they suddenly were checking all the people coming from Europe but didn't have enough staff or enough space to keep people safely apart.

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might be a correlation between ACE2 receptors and higher risks,

This is presumably related to the reports yesterday that taking anti-inflammatories for fever for this might lead to worse outcomes than taking acetaminophen. That had something to do with the ACE2 factor. I think that was based on some young, previously healthy people in France, but I'm having trouble keeping all this straight. I think I saw it in a Guardian article.

 

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The number of cases outside China has just surpassed the number within. 80K v.81K
Out of 82K cases that have been closed globally, (recovered plus fatalities) there have been 6,000 fatalities 7%, plus another 6K cases 7%,  of the remaining 80K, currently considered critical.
Currently there are big differences in cases per capita by country. Italy is worst with 350 per 1M of population. S. Korea, Iran, and Spain at 165, Germany, France, at 65, UK, 20, and US at 9.  At a similar rate to current Italian, US could expect 115,000 cases, and 8,000 fatalities. Hopefully.........
 

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This is pretty comprehensive.

https://arstechnica.com/science/2020/03/dont-panic-the-comprehensive-ars-technica-guide-to-the-coronavirus/

When assessing your personal risk, remember that 80% mild cases is everything that doesn't put you in a hospital bed.  In Italy and China, this typically means you stay home or at a quarantine center until you have trouble breathing and need supplemental oxygen.  Almost 90% had fever.  Minor can still mean weeks of recovery time, especially if you are required to quarantine yourself afterwards to protect family and coworkers from infection.  Why would anyone put themselves and their family through that, or worse, for green beer?

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14 hours ago, astrid said:

Why would anyone put themselves and their family through that, or worse, for green beer?

This is a rhetorically effective, if somewhat glib, way of describing a situation where a consequence may happen anyway, regardless of whether someone goes out for green beer (which I've never done in my life - yuck). Last Saturday, I was horrified to see so many people in Arrowine, and should have left immediately, but we wanted some pantry items, so we didn't; we quickly got our comestibles and got out of there as quickly as possible, and it might (or might not) have been enough. From what I hear, many places where people go to stock up on things were extremely crowded, so the damage may (or may not) already be done - or perhaps it will be done at some unknown moment in the near future for those venturing outside to run necessary errands. I suspect many people's actions last week may not be the same as their actions this week.

I recently heard Dr. Anthony Fauci taking phone-in questions on a radio show. Someone asked what they should do when it comes to handling and opening their mail. Dr. Fauci's thoughtful, but incomplete, response was that, 'once mail is in your mailbox, enough time has probably passed so that it's safe'; what he neglected to address was the situation when your postal carrier has COVID-19, and handles or coughs on a letter, twenty-minutes before you open it. Unless we've been tested, none of us can say, today, that we don't already have COVID-19; we can only hope, and limit our chances of contracting it by using conventionally accepted protocols (which doesn't mean they work). It is possible, albeit surely less possible, that someone can barricade themselves and live like a hermit for the next month, going out only for essentials, and still come down with COVID-19 regardless.

If someone is boneheaded enough to go out and get soused in Savannah, GA where the river runs green on Saint Patrick's Day (although I doubt it will this year), they haven't been very aware recently, and are putting themselves at much greater risk, but we really don't know *how* much greater risk until specialists and historians begin analyzing what has already happened. Gas pumps, credit card transactions, going to the drug store, eating anything resembling fresh food, taking a walk down the street - any number of interactions most of us would deem "essential" in our day and age - these all increase the risk of acquiring COVID-19; we just don't know by how much.

This article you referenced last Thursday is a good one, and I suggest people take an hour out of their day and read it thoughtfully and carefully. If you're skipping the article just to get through this post, you're making a mistake. Go back and read it when you're finished reading this.

It bears mention that the 1918 flu (erroneously called the "Spanish flu" because Spain was the *one* country who honestly reported what was happening), flared in late Spring, died down in early Summer, seemingly disappeared during mid Summer, and returned with a vengeance later that year (and early in 1919) and killed the vast majority of its victims during the second and third peaks of this trimodal graph:

1918flu.png"Why the Second Wave of the 1918 Spanish [sic] Flu Was so Deadly" by Dave Roos on history.com

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Well the Virginia court's system was a real mess.  Every jurisdiction had different rules for different courts on what is going on, as of right now they finally issued an order from the Virginia Supreme Court.  Only a few jurisdictions allow online filing for certain courts, none of the Juvenile and Domestic Relations Courts up here have online filing, so this is going to be the wild west.  We have a lot of Wills, Trust and Estates matters we are working on to get done quickly 🥺

My Mom went home to her house in Garrett County last week, prepared to hunker down.  It was really hard not to hug her or touch her, but I tried to keep a safe distance and clean, clean, clean home. She isn't going to be with others or in public for a while just to be safe due to her age, so we will try to do video chats and etc. 

We went to Richmond to take food and some extra supplies we had on hand to our BIL, SIL and new baby, but we weren't out and about galavanting, we just went down to help them and came home.  I am so grateful they had friends that thought about them while they were in the hospital and picked them up packs of diapers and formula, people have been just leaving meals and texting them.  I appreciate everyone who has been so kind to them.  We ordered sushi to go as my SIL was really craving it.  I was a little shocked to hear that the restaurant was still packed when Hubby went to pick it up.  I do fear that because younger people (I say younger, there were an appalling amount of not younger people at the Starbucks we drove through to get coffee on our trip) aren't getting many symptoms, they aren't taking this very seriously.  I have been trying to take this very seriously, I saw how my co-workers and loved ones dealt with the flu strain that wasn't covered by most of the flu shots, it wasn't optimal. My poor renter, he has to travel for very important government work, and got home last Friday after the stores were pretty much empty.  I am sure we have enough, so have told him, whatever he needs, we have it and will share, not to panic if the stores were empty.  

Hubby has been ordered to work from home.  My office had to be somewhat operational because of the courts, but we are really being careful, most the attorneys are working from home, there are only a couple here at a time to make sure we function, and we are doing phone and video consults. We are very spaced out at the office, luckily, and are disinfecting like mad.  All of our staff is over 50. Thank goodness we have a spacious office, most of our attorneys already worked from home a fair amount and we're very spaced out anyway. 

I don't think it's good for people to be excessively worried or panicked, BUT I also think people need to think about the effect their actions have on the lives and safety of others, I don't think we are doing either particularly well at the moment.  All I can say is- stay safe, try to keep others safe in all that you do, and be as kind as you can in a safe way.    

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Sometimes bad stuff just happens, and can't be avoided, and sometimes it can be easily avoided.....

SoftBank Owned Patent Troll, Using Monkey Selfie Law Firm, Sues To Block Covid-19 Testing, Using Theranos Patents 

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39 minutes ago, Count Bobulescu said:
Sometimes bad stuff just happens, and can't be avoided, and sometimes it can be easily avoided.....

SoftBank Owned Patent Troll, Using Monkey Selfie Law Firm, Sues To Block Covid-19 Testing, Using Theranos Patents 

Patent trolls suck - these guys have a particular level of suck that goes beyond the norm.

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I get the sinking feeling that lock-down/self-quarantine is just delaying the inevitable but in the process it will destroy the global economy.  Some younger people are calling it boomer remover, but in reality the pandemic will screw the old and the young.  Some of the elderly will die, and the young will be saddled with repaying the stimulus package and job losses.  

ETA: When this crisis is over (whenever they come up with a vaccine), we can assess the damage done.  I'm not sure the current delay tactics truly is the best course of action.

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28 minutes ago, Ericandblueboy said:

I get the sinking feeling that lock-down/self-quarantine is just delaying the inevitable

This idea assumes that the number of deaths the virus causes is a simple function of how many people get it. This sounds reasonable but it is, counterintuitively, *not true*.  The death rate is a function of how many people get it *and* over what period of time. Without the lockdowns you get spikes in cases and spikes in cases mean sick people die because they get denied care (eg rationed ventilators) that could otherwise save them. The lockdowns will save lives over the course of the disease, they don’t just push deaths down the road. 

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