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I read that AstraZeneca was entering phase 2 of a vaccination testing (there are only 3 phases) after getting good immune responses in phase 1 with a test group of 1000+ folks. If things go well, perfect/happy-path, we are looking at something being available in October-ish timeframe. There is a $1.2bn contract for 300mm doses of a vaccination for whomever gets there first. 

Come fall/winter/early spring of 2021, there will be a drastic change. Come this time next year, all those lucky enough not to have been personally affected (death, family, jobs, wealth, etc.) will view all this as a faint memory. Oceans rise; empires fall...

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It has been a disheartening journey and it is only starting. I did not realize how there really is no definitive treatment for the illness until we got COVID patients. When they first come on our unit

He didn't get COVID.  He just ran out of immunity.

As @ChiTownDoc said, we did have capacity in March and April due to the cancellation of elective procedures, the lockdown, and people's general fear of catching the virus by coming to the hospital. Th

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I read that AstraZeneca was entering phase 2 of a vaccination testing (there are only 3 phases) after getting good immune responses in phase 1 with a test group of 1000+ folks. If things go well, perfect/happy-path, we are looking at something being available in October-ish timeframe. There is a $1.2bn contract for 300mm doses of a vaccination for whomever gets there first. 
Come fall/winter/early spring of 2021, there will be a drastic change. Come this time next year, all those lucky enough not to have been personally affected (death, family, jobs, wealth, etc.) will view all this as a faint memory. Oceans rise; empires fall...

.....and we’ll remain butt-reamingly stupid. Some things are a constant.
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1 minute ago, Brisketexan said:


.....and we’ll remain butt-reamingly stupid. Some things are a constant.

This has definitely shown me that....well, I am not sure how to characterize it. I guess I'd say that we need the deus ex machina of modern medicine/magic from the powers that be, because we are collectively too large a human, global population to be efficient and intelligent, as a whole.

In a lot of ways, globalization has made us weaker but I think coronavirus has highlighted it, too. We are much less as the sum of all the parts then we are individually and this is why tribalism and homogeneity will always prevail, it can literally be an existential issue.

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^ Astra definitely not public before 2021 according to BBC. But that would be awesome anyway.

I've posted before, won't use the term "herd immunity" but something is going on in the northeast among other places where the virus just isn't jumping around like it used to. But every time we let up a little, especially with opening bars/indoor dining, we get a reminder that it is still just as dangerous as in the spring. I agree school openings will have the same effect. Just really hope Texas is over the hump and will soon be in that category where being careful and sensible is enough to ward it off. (Except for those Brisket mentioned, and there's a bunch)

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3 minutes ago, Bartles said:

^ Astra definitely not public before 2021 according to BBC. But that would be awesome anyway.

I've posted before, won't use the term "herd immunity" but something is going on in the northeast among other places where the virus just isn't jumping around like it used to. But every time we let up a little, especially with opening bars/indoor dining, we get a reminder that it is still just as dangerous as in the spring. I agree school openings will have the same effect. Just really hope Texas is over the hump and will soon be in that category where being careful and sensible is enough to ward it off. (Except for those Brisket mentioned, and there's a bunch)

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Exciting as these developments are, it’s still early. The WHO acknowledged there’s an uphill climb through larger scale, real-world trials ahead. But if AstraZeneca keeps its grades up and makes it to production, it has a $1.2 billion deal with the U.S. for 300 million doses this fall.

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2 hours ago, BradInATX said:

On the bright side, Austin new admits headed back down with three days in a row showing a downward trend in the weekly average. Looks like (insert your choice of getting past the 4th of July, facemask mandates, or whatever) is working and starting to show up in the numbers finally.

Good work. Haircuts for everyone!

This week is looking up.  Hasbro is rolling out a retro line of the 80s G I Joe toys, and I just managed to score some Wal-Mart pre-orders for my son in time for his birthday..

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1 hour ago, Bevo said:

I think we will find a higher percentage of infected in larger and more densely packed cities. So all of Nebraska, Kansas and flyover states may only have 5% of its populations infected. Those percentages may also be low in rural areas of Texas, Illinois, and other non-fly over states. Then in cities like Chicago, NYC, Houston, Philadelphia, etc. the percentage of infected may soon get to a significant portion of the population. At that point, with a large chunk of people not susceptible, the spread will slow.

I'll give kind of a crappy comparison. 45% of America gets the flu shot. In a year where the flu vaccine is chosen properly, the flu still spreads in the US. However, if people wore masks, avoided large gatherings, and a good percentage of people worked from home, the flu may not spread much at all with an effective flu vaccine thrown into the mix. And if kids and students stayed home, I have my doubts whether it would even sustain.

Where the US and the world will screw up is when we send our kids back to school. This thing is going to blow up as soon as that happens and they will be sent back home soon after. I think at that point we will be good for the rest of the year but it is just conjecture based on the most likely vectors having immunity.

I think we’re going to have a flu season like we haven’t had in a long while unfortunately.   

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I think we’re going to have a flu season like we haven’t had in a long while unfortunately.   
Hope not. Flu+covid would be epic suckage. Don't want to speculate on what it would look like if the two both had big outbreaks regionally.
Hopefully we get this vaccine before summer ends in Texas somewhere around mid November.
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11 minutes ago, BradInATX said:

Hope not. Flu+covid would be epic suckage. Don't want to speculate on what it would look like if the two both had big outbreaks regionally.
Hopefully we get this vaccine before summer ends in Texas somewhere around mid November.

I just think the amount of avoidance we have done (handwashing/masks/sanitizer) could have a short term adverse effect on our immune system for the various seasonal viruses we are used to encountering.  

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45 minutes ago, Trey3216 said:

I just think the amount of avoidance we have done (handwashing/masks/sanitizer) could have a short term adverse effect on our immune system for the various seasonal viruses we are used to encountering.  

But if we are socially distancing, wearing masks and washing hands, won’t that suppress the flu as well? Or are you assuming schools will fuck all that up?

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3 hours ago, Newdoc said:

I agree it won’t either but every percentage tick up in infections (as long as some acquired immunity last) and with an unknown but likely  chunk of people not susceptible will get us a lower Rt and hopefully a slower spread. It’s like finding a flower in the cow patty but at least it’s something.

It’s like finding a mushroom in the cow patty... nm...

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17 minutes ago, Planet Houston said:

But if we are socially distancing, wearing masks and washing hands, won’t that suppress the flu as well? Or are you assuming schools will fuck all that up?

There, or grocery stores, liquor stores, fast food places, etc.  

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5 hours ago, B00M said:

*eye brow cocks* 1 of 60 infants that got it died? Would really like the details on.that one.

The infant in question went to the hospital for a medical condition completely unrelated to Covid. Once he was in the hospital he tested positive for Covid. Then he died. The actual cause of death - for now - is SIDS. Also, it’s 1 of 85. The 60 number is infants diagnosed with Covid in the last month only. Nueces/Corpus is explaining that by saying they are aggressively testing all family/household members of any positive test. The implication is that there are a bunch of infants out there that have it but haven’t been tested. There’s nothing nefarious going on in Corpus.

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4 hours ago, Bevo said:

I think we will find a higher percentage of infected in larger and more densely packed cities. So all of Nebraska, Kansas and flyover states may only have 5% of its populations infected. Those percentages may also be low in rural areas of Texas, Illinois, and other non-fly over states. Then in cities like Chicago, NYC, Houston, Philadelphia, etc. the percentage of infected may soon get to a significant portion of the population. At that point, with a large chunk of people not susceptible, the spread will slow.

I'll give kind of a crappy comparison. 45% of America gets the flu shot. In a year where the flu vaccine is chosen properly, the flu still spreads in the US. However, if people wore masks, avoided large gatherings, and a good percentage of people worked from home, the flu may not spread much at all with an effective flu vaccine thrown into the mix. And if kids and students stayed home, I have my doubts whether it would even sustain.

Where the US and the world will screw up is when we send our kids back to school. This thing is going to blow up as soon as that happens and they will be sent back home soon after. I think at that point we will be good for the rest of the year but it is just conjecture based on the most likely vectors having immunity.

This entire post is nonsense. Are you trying to say that 45% of the country will have been infected after school starts back up and then closes? We are likely at 12% or less right now. If your scenario happens we are totally fucked. The only part I can agree on is that school is likely a really bad idea.

as for the likely vectors we haven’t even attempted the school kids part yet. It’s spreading just fine with the idiots not wearing masks, 20-40 year olds, and the idiots not taking it seriously.

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2 hours ago, Planet Houston said:

But if we are socially distancing, wearing masks and washing hands, won’t that suppress the flu as well? Or are you assuming schools will fuck all that up?

Australia is currently in their flu season and they are having a low year, so you may be right.

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On 6/22/2020 at 5:43 PM, justhookit said:

Hospitalizations jumped from 17 to 28. ICU from 3 to 11.

I made this post about Nueces County exactly a month ago on this thread when I was starting to get concerned about a spike in new cases. Today’s hospitalization number is 408. ICU is 121.

the really, really good news is that we were under 300 cases again today, reporting 289. One week ago we reported 605. People are finally taking this seriously here. Now comes the hard part of continuing to take it seriously as cases decline. I don’t have a lot of faith.

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Starr County announces that they’ve formed a committee to determine which patients will take the few remaining hospital icu beds and the rest will be sent home. They’ve run out of space and can’t place patients in other counties.

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4 hours ago, justhookit said:

This entire post is nonsense. Are you trying to say that 45% of the country will have been infected after school starts back up and then closes? We are likely at 12% or less right now. If your scenario happens we are totally fucked. The only part I can agree on is that school is likely a really bad idea.

I don't think we know what percent have been exposed. If chitowndoc takes an antibody test today with low sensitivity does anyone have confidence to bet one way or the other. I think I was infected in late February. I haven't been tested and I have a hard time understanding why I should be tested now. A negative or a positive antibody test wouldn't change anything.

And exposure rates like I stated earlier vary dramatically by region so that 12% that you are guessing includes low percentages in some rural areas and high percentages in some urban areas. And that 12% also has a significant impact on how the virus spreads. And that number will surely grow (whatever it is) after schools reopen and people vacation and more people go back to working in the office.

As for the 45%, I was just giving an analogy when no great one exists. I don't think 45% of the population has been infected. It is much, much lower. And people probably don't remember a flu season that was particularly mild where the flu shot was highly effective. And people probably can't imagine what such a flu season would be like if people wore masks and kids stayed at home.  What I was saying is that if a decent percentage of people are immune to this coronavirus and people continue safe practices, this virus will be pretty well contained.

As for the predictions above that the flu will be particularly bad, I highly doubt it, at least through the rest of 2020. Many places around the world are doing a pretty good job with safe practices, flights are still somewhat limited. People here are generally doing okay with masks and working at home. And people here are spooked to where an outbreak of the flu will start sending people to the doctor to get tested for COVID and the flu and cause the government to intervene again and create another strong run of good practices. 

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This entire post is nonsense. Are you trying to say that 45% of the country will have been infected after school starts back up and then closes? We are likely at 12% or less right now. If your scenario happens we are totally fucked. The only part I can agree on is that school is likely a really bad idea.
as for the likely vectors we haven’t even attempted the school kids part yet. It’s spreading just fine with the idiots not wearing masks, 20-40 year olds, and the idiots not taking it seriously.
The density argument is stupid in general. You can count on your hands the amount of American cities that are actually dense, most of them being clustered in the northeast. Most cities in this country are suburban in design.
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8 hours ago, Trey3216 said:

I just think the amount of avoidance we have done (handwashing/masks/sanitizer) could have a short term adverse effect on our immune system for the various seasonal viruses we are used to encountering.  

No joke. I've got a toddler and another baby on the way and I'm pretty much planning to be sick for the first two months after we all go back into the world, day care, etc. 

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1 hour ago, Bevo said:

I don't think we know what percent have been exposed. If chitowndoc takes an antibody test today with low sensitivity does anyone have confidence to bet one way or the other. I think I was infected in late February. I haven't been tested and I have a hard time understanding why I should be tested now. A negative or a positive antibody test wouldn't change anything.

And exposure rates like I stated earlier vary dramatically by region so that 12% that you are guessing includes low percentages in some rural areas and high percentages in some urban areas. And that 12% also has a significant impact on how the virus spreads. And that number will surely grow (whatever it is) after schools reopen and people vacation and more people go back to working in the office.

As for the 45%, I was just giving an analogy when no great one exists. I don't think 45% of the population has been infected. It is much, much lower. And people probably don't remember a flu season that was particularly mild where the flu shot was highly effective. And people probably can't imagine what such a flu season would be like if people wore masks and kids stayed at home.  What I was saying is that if a decent percentage of people are immune to this coronavirus and people continue safe practices, this virus will be pretty well contained.

As for the predictions above that the flu will be particularly bad, I highly doubt it, at least through the rest of 2020. Many places around the world are doing a pretty good job with safe practices, flights are still somewhat limited. People here are generally doing okay with masks and working at home. And people here are spooked to where an outbreak of the flu will start sending people to the doctor to get tested for COVID and the flu and cause the government to intervene again and create another strong run of good practices. 

They did some antibody testing in New York and even they were nowhere near close to herd immunity.  It is a pipe dream.  There are 326 million people in this country and we are at just under 4 million confirmed cases.  That's .01%.  We would have to get between 195 and 228 million cases for herd immunity.  Our hospitals cannot handle that many people needing treatment so the death rate would go up to horrifying levels.

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At my Houston hospital we are now opening up a third COVID ICU overflow and a third medical/surgical and stepdown COVID overflow. We also now have travelers on our units as more nurses are calling off due to having COVID. I came onto shift the other day and saw an oxygen tank in our break room. I thought that was odd, and found out that one of the nurses couldn't breathe during her shift and she had to take a time out and get supplemental oxygen. A few days later she ended up testing positive for COVID. We have access to IPads now for our patients which brings about some heartbreaking conversations. A daughter was pleading for her dad to show some sign of life while he sat motionless on the ventilator. He's been off sedation for days but he is still unresponsive. One of our long stay COVID patients passed the other day. Her oxygen saturation read 1% on the ventilator. The lowest I have ever seen is in the 60s with a good oxygen saturation being between 90-100%. 

While I was watching one of my unstable COVID patients through the window yesterday an IT contractor came up to me and told me that I should try to get COVID. I laughed and then stopped once I realized he was actually being serious. He said that we need herd immunity and that he had already gotten COVID to protect himself. I told him I'll pass on that on the off chance that I myself end up where my patient currently is. 

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3 minutes ago, kevwun said:

They did some antibody testing in New York and even they were nowhere near close to herd immunity.  It is a pipe dream.  There are 326 million people in this country and we are at just under 4 million confirmed cases.  That's .01%.

And hell, even using the CDC's worst case estimate of a 10:1 ratio of unknown to known cases, that's still only 40 million confirmed cases out of 326 million people. At worst, 12% of the population has had COVID - and herd immunity starts around 60% of the population. 

I don't think ramping (at least) to 5X the number of cases and deaths is a good or desirable outcome. That's over half a million dead Americans, while our allies and neighbors are handling their pandemics with significantly fewer deaths and less economic uncertainty. 

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9 hours ago, Trey3216 said:

I just think the amount of avoidance we have done (handwashing/masks/sanitizer) could have a short term adverse effect on our immune system for the various seasonal viruses we are used to encountering.  

Did we see anything like this anywhere after sars or mers?

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14 minutes ago, Captainant said:

And hell, even using the CDC's worst case estimate of a 10:1 ratio of unknown to known cases, that's still only 40 million confirmed cases out of 326 million people. At worst, 12% of the population has had COVID - and herd immunity starts around 60% of the population. 

I don't think ramping (at least) to 5X the number of cases and deaths is a good or desirable outcome. That's over half a million dead Americans, while our allies and neighbors are handling their pandemics with significantly fewer deaths and less economic uncertainty. 

So let's pick a city - NY or Austin or Houston. I say that we will have an outbreak after Labor Day and when schools reopen and then no more peaks through 2020. What is your doom and gloom prediction? After you let me know, we can make a little bet.

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3 minutes ago, Bevo said:

So let's pick a city - NY or Austin or Houston. I say that we will have an outbreak after Labor Day and when schools reopen and then no more peaks through 2020. What is your doom and gloom prediction? After you let me know, we can make a little bet.

I don't think I'm giving doom and gloom predictions, I'm applying numerical analysis to the "let's go for herd immunity" argument. But your eagerness to literally bet on the lives of hundreds of thousands of Americans is noted

Edited by Captainant
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5 minutes ago, Captainant said:

I don't think I'm giving doom and gloom predictions, I'm applying numerical analysis to the "let's go for herd immunity" argument. But your eagerness to literally bet on the lives of hundreds of thousands of Americans is noted

If you followed what I said, you wouldn't be talking about herd immunity. It will lead you astray. As for the bet, I'm not superstitious. What I think will happen will have zero effect on what actually happens.

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They did some antibody testing in New York and even they were nowhere near close to herd immunity.  It is a pipe dream.  There are 326 million people in this country and we are at just under 4 million confirmed cases.  That's .01%.  We would have to get between 195 and 228 million cases for herd immunity.  Our hospitals cannot handle that many people needing treatment so the death rate would go up to horrifying levels.


This will probably be a dumb question, but what defines the boundaries of herd immunity? If it's defined as an entire geographical area, we're screwed because like you said that would be 228 million people, but can it be applied to small cities or towns where the percentage of infected would reach those levels?

Enviado desde mi SM-G973U mediante Tapatalk

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5 minutes ago, iodeac said:


 

 


This will probably be a dumb question, but what defines the boundaries of herd immunity? If it's defined as an entire geographical area, we're screwed because like you said that would be 228 million people, but can it be applied to small cities or towns where the percentage of infected would reach those levels?

Enviado desde mi SM-G973U mediante Tapatalk
 

 

Not a dumb question, John's Hopkins has a good information page on it

(Relevant excerpt below)

https://www.jhsph.edu/covid-19/articles/achieving-herd-immunity-with-covid19.html

What will it take to achieve herd immunity with SARS-CoV-2?

As with any other infection, there are two ways to achieve herd immunity: A large proportion of the population either gets infected or gets a protective vaccine. Based on early estimates of this virus’s infectiousness, we will likely need at least 70% of the population to be immune to have herd protection.

  • In the worst case (for example, if we do not perform physical distancing or enact other measures to slow the spread of SARS-CoV-2), the virus can infect this many people in a matter of a few months. This would overwhelm our hospitals and lead to high death rates.
  • In the best case, we maintain current levels of infection—or even reduce these levels—until a vaccine becomes available. This will take concerted effort on the part of the entire population, with some level of continued physical distancing for an extended period, likely a year or longer, before a highly effective vaccine can be developed, tested, and mass produced.
  • The most likely case is somewhere in the middle, where infection rates rise and fall over time; we may relax social distancing measures when numbers of infections fall, and then may need to re-implement these measures as numbers increase again. Prolonged effort will be required to prevent major outbreaks until a vaccine is developed. Even then, SARS-CoV-2 could still infect children before they can be vaccinated or adults after their immunity wanes. But it is unlikely in the long term to have the explosive spread that we are seeing right now because much of the population will be immune in the future.
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Just now, iodeac said:


This will probably be a dumb question, but what defines the boundaries of herd immunity? If it's defined as an entire geographical area, we're screwed because like you said that would be 228 million people, but can it be applied to small cities or towns where the percentage of infected would reach those levels?

Enviado desde mi SM-G973U mediante Tapatalk
 

It isn't a dumb question. It is very hard to answer. We live in an open system but it isn't fully open. What happens in NYC may be very different than what happens in Covelo, CA.

But most people on this board don't get herd immunity. The number isn't fixed. It was approximated based on what experts thought the R0 was and used assumptions based on no preexisting immunity, the Wuhan experience, government interventions and people's willingness to follow guidelines and people's willingness/ability to travel. Now in some places we have gone through 1 or more outbreaks and will have another one when schools reopen and after labor day. What do you think constitutes herd immunity at that point? Do you still think it will require 60% of the population to get infected? If fewer people are infected than necessary for herd immunity but there is some percentage of the population immune, do you think we will have outbreaks like in NYC or do you think they will be less severe?

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8 minutes ago, BradInATX said:

This whole schtick of just saying random words that make no sense, ignoring any factual pushback, and continuing to just randomly say words is an interesting strategy

Try addressing points that you disagree with or don't understand. It is a better approach than passive aggression. 

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17 minutes ago, Homercles said:

I agree with your point except this part.  4/326 is about 1%.  

If there's one good thing about this pandemic, it's that it exposed how absolutely terrible most of the country is at math. I've lost count of how many texts, messages, posts, etc. that I've read from people trying to minimize this by using their own hand-calculated percentages but forgetting to move over the damn decimal.

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Big fat old jump in cases yesterday in Travis county (603). Hopefully was due to some lingering weekend catchup as there were four days in a row of declining daily cases prior to yesterday.

Age Bracket 1 to 9 10 to 19 20 to 29 30 to 39 40 to 49 50 to 59 60 to 69 70 to 79 >80 Total
New Cases 7/21 vs 7/20 22 22 180 123 97 76 46 16 21 603
% of Daily Change 3.65% 3.65% 29.85% 20.40% 16.09% 12.60% 7.63% 2.65% 3.48%  
% of Total Cases 2.64% 7.53% 27.67% 21.72% 16.49% 11.65% 6.37% 3.35% 2.58% 18,307
                   
                     
                     
                     
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2 minutes ago, BradInATX said:


I did. You didn't respond. Try addressing this entire thread with actual facts and data, not just your feelings.

Go for it. Show me what you are talking about. If it requires math, I'll try to get to it between patients.

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3 minutes ago, Bevo said:

Go for it. Show me what you are talking about. If it requires math, I'll try to get to it between patients.

It's been addressed not only by me but by others countless times and you've ignored it completely.

Another winter spike might get us to 20% total infected. How do you imagine that 20% total infected is going to have us "cruising to the vaccine" after that winter spike? It doesn't make any sense.

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2 minutes ago, B00M said:

That's why I asked, so you'd support your post. Is this our thread for unfounded fears now? Lulz

No, it’s not. And I’m not at my office right now which would be easier for me to grab that info in a timely fashion.  I’ll go look.   
 

But one thing’s for certain, our bodies build immunity to certain viruses and other illnesses merely by interacting with other people.  With our interactions way down, and mass utilization of sanitizers and soaps further eliminating bodily interaction with viruses, it isn’t a stretch to hypothesize that our bodies wouldn’t be as suited as normal to fight off viruses that we’ve been able to fairly readily rid from ourselves in the past.  

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4 minutes ago, Trey3216 said:

No, it’s not. And I’m not at my office right now which would be easier for me to grab that info in a timely fashion.  I’ll go look.   
 

But one thing’s for certain, our bodies build immunity to certain viruses and other illnesses merely by interacting with other people.  With our interactions way down, and mass utilization of sanitizers and soaps further eliminating bodily interaction with viruses, it isn’t a stretch to hypothesize that our bodies wouldn’t be as suited as normal to fight off viruses that we’ve been able to fairly readily rid from ourselves in the past.  

 

The docs on the board would know better, but I wouldn't imagine we're going to lose much capability to fight off colds and little winter bugs after what looks to be less than a year of quarantine. I mean I said I expect to catch a bunch of stuff from my little germ magnet toddler, but I'm not actually worried about it being a serious problem. We're not going to see people keeling over from the cold or a sinus infection because we've been using hand sanitizer for a year. We may all just be walking around with colds the first few days. It might suck a little bit but I don't think it presents an actual serious health risk, though I'm not sure if that's what you're putting out there either.

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1 minute ago, BradInATX said:

 

The docs on the board would know better, but I wouldn't imagine we're going to lose much capability to fight off colds and little winter bugs after what looks to be less than a year of quarantine. I mean I said I expect to catch a bunch of stuff from my little germ magnet toddler, but I'm not actually worried about it being a serious problem. We're not going to see people keeling over from the cold or a sinus infection because we've been using hand sanitizer for a year. We may all just be walking around with colds the first few days. It might suck a little bit but I don't think it presents an actual serious health risk, though I'm not sure if that's what you're putting out there either.

Pretty much what I’m getting at, that we’ll see higher instance of various colds, maybe more cases of mild flu.   Not a public health crisis, just kind of a quick and noticeable uptick.    
 

but like I said, it was just me thinking about unintended consequences, which is one of the things I always think about.   

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  • immamac changed the title to COVID-19 2nd wave - Texas only - Stats and such

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