Coronavirus COVID-19

[SDHornet]

No, seriously. We use schools for storm shelters all the time. Just wondering why we aren't using them for this. I would think a gym and locker room would be easy to disinfect when done. There must be some reason, I just haven't heard it yet. It just seems like a layup to use schools without admittedly knowing all of the possible issues.

I don't know if it's the reason, but healthcare facilities (and particularly hospitals) are built so that they can't spread disease, especially when it comes to HVAC. Considering this is an airborne virus, it's even more important not to use any structure.

Yeah but if they are looking for triage space for people with severe Chinese Flu cases, what difference does it make so long they don't use that space to house non-Chinese Flu cases.

[∞∞∞]

I don't know if it's the reason, but healthcare facilities (and particularly hospitals) are built so that they can't spread disease, especially when it comes to HVAC. Considering this is an airborne virus, it's even more important not to use any structure.

Yeah but if they are looking for triage space for people with severe Chinese Flu cases, what difference does it make so long they don't use that space to house non-Chinese Flu cases.

Again I don't know if it's the reason, but healthcare workers can take proper precautions when they're around the infected.

If the virus is being spread through ductwork (literally in the air), I imagine that's a whole different scenario to deal with.

[93henfan]

I got a call from Penn Medicine this morning. Luckily I'm in the "care cannot be deferred" group. They are postponing all elective surgeries and all non lifesaving procedures for other patients. They had changed their visitor and accompanying policy to two people max a couple of weeks ago and then cut that to one for last week. Now it's zero unless medically necessary for movement of the patient into and out of the facility. They are also starting individual screening upon entry this week.

And Trip is right about the ventilation. Most hospitals have special floors for infectious patients with separate HVAC. 60 Minutes did a special on it a couple of weeks ago.

[93henfan]

Forgot to mention, driving in and out of Philly was a freaking breeze. Like.

[93henfan]

GenX FTW. My latchkey childhood certainly doesn't hurt in a situation like this.

https://parade.com/1011986/korinmiller/ ... eS9Ver3zhs

[SDHornet]

Yeah but if they are looking for triage space for people with severe Chinese Flu cases, what difference does it make so long they don't use that space to house non-Chinese Flu cases.

Again I don't know if it's the reason, but healthcare workers can take proper precautions when they're around the infected.

If the virus is being spread through ductwork (literally in the air), I imagine that's a whole different scenario to deal with.

I get the ventilation issue. If it's a HS gym, why not just turn it off?

[CAA Flagship]

Yeah but if they are looking for triage space for people with severe Chinese Flu cases, what difference does it make so long they don't use that space to house non-Chinese Flu cases.

Again I don't know if it's the reason, but healthcare workers can take proper precautions when they're around the infected.

If the virus is being spread through ductwork (literally in the air), I imagine that's a whole different scenario to deal with.

Yeah, I was thinking about that (HVAC). But it's no different than using a convention center. And I'm guessing the gym would be on a different system than other parts of the school (although maybe not the locker rooms).

[CAA Flagship]

I got a call from Penn Medicine this morning. Luckily I'm in the "care cannot be deferred" group. They are postponing all elective surgeries and all non lifesaving procedures for other patients. They had changed their visitor and accompanying policy to two people max a couple of weeks ago and then cut that to one for last week. Now it's zero unless medically necessary for movement of the patient into and out of the facility. They are also starting individual screening upon entry this week.

And Trip is right about the ventilation. Most hospitals have special floors for infectious patients with separate HVAC. 60 Minutes did a special on it a couple of weeks ago.

Are you traveling there for radiation alone? I know you couldn't for chemo.

[93henfan]

Are you traveling there for radiation alone? I know you couldn't for chemo.

Yeah. Radiation doesn't make me puke on the way back to the car or doze off while riding. Driving hasn't been an issue with radiation.

Only side effect so far is I felt like a mild hangover and a REALLY dry mouth the morning after both treatments. That could be the couple of DFH 90's I've been pounding before bed though.

[BDKJMU]

All worthless stats. Unless the level of testing is the same, comparisons based on "cases" are pointless.

This.

Yep. People are completely distracted by irrelevant case # comparisons.

[AZGrizFan]

This.

Yep. People are completely distracted by irrelevant case # comparisons.

Go read (long reads, to be sure) the two articles I posted on the previous page....it’s amazing what non-politicized info will do for clarity.

[kalm]

This.

Yep. People are completely distracted by irrelevant case # comparisons.

I’m not. Social culture, population density, timing, etc. they all play a roll. Everything should be viewed with skepticism. That doesn’t negate value of the stats we have.

[BDKJMU]

I got a call from Penn Medicine this morning. Luckily I'm in the "care cannot be deferred" group. They are postponing all elective surgeries and all non lifesaving procedures for other patients. They had changed their visitor and accompanying policy to two people max a couple of weeks ago and then cut that to one for last week. Now it's zero unless medically necessary for movement of the patient into and out of the facility. They are also starting individual screening upon entry this week.

And Trip is right about the ventilation. Most hospitals have special floors for infectious patients with separate HVAC. 60 Minutes did a special on it a couple of weeks ago.

I got the e-mails about the updated UPenn policies early last week, then was notified by them last Tues that my yearly appointment with them (Preventive Cardiovascular, usually Radnor, but this time was scheduled for the Perelman Center downtown) would be done over the phone, which I did Thur, so at least those appointments they can conduct over the phone (mine was mainly to go over lab results) they are (or were) doing that.

As far as the HVAC, I've seen stuff on the news the last week about the military possibly setting up makeshift hospitals (pop up, hotels, school dorms, gymnasiums, etc) to take the non infectious disease patients (where the isolation isn't needed), so some hospitals could be emptied of most of their non infectious disease patients, and could just focus on the Chinese Flu patients. Makes sense.

[JohnStOnge]

I decided to see if I could find assessment of the effectiveness of travel bans in fighting pandemics done before the current COVID-19 crisis was proceeding so that it would be independent of the current crisis. I found an assessment done by by some British researchers for the World Health Organization. Looks to me like it was published in 2014. You can see it at https://www.who.int/bulletin/volumes/92 ... 135590/en/.

A lot in there. But you can scroll down to the bottom and get this bottom line:

It seems likely that, for delaying the spread and reducing the magnitude of an epidemic in a given geographical area,7 a combination of interventions would be more effective than isolated interventions.16,34 Travel restrictions per se would not be sufficient to achieve containment in a given geographical area, and their contribution to any policy of rapid containment is likely to be limited.

Another statement I think is relevant to today's situation is this one:

The results of our systematic review indicate that overall travel restrictions have only limited effectiveness in the prevention of influenza spread, particularly in those high transmissibility scenarios in which Ro is at least 1.9.

R0 there is a lot of uncertainty about R0 for SARS-CoV-2. But, qualitatively, I think all agree it is highly contagious. One article at https://www.nature.com/articles/d41586-020-00154-w has an estimate of Ro in the 1.4 -2.5 range. There is also a reference to other sources estimating slightly higher values.

And, yes, I am getting around to Trump. I don't see how anyone could disagree with the contention that he did the travel ban and thought the situation was taken care of. He spent a couple of weeks downplaying the risk and bragging about how the thing had been handled early on by virtue of his travel ban. Whatever little time he gained by virtue of a travel ban, he squandered by doing nothing else and even downplaying the situation.

And, again: In this situation the case data do not suggest that travel bans were much of a factor at all. Can't say they were not a factor for several reasons including that fact that testing rates differ dramatically from country to country. But there is certainly nothing out there in the case data that even SUGGESTS that countries that were more aggressive in implementing travel bans have better situations.

[93henfan]

I decided to see...

God damn it!

[∞∞∞]

Again I don't know if it's the reason, but healthcare workers can take proper precautions when they're around the infected.

If the virus is being spread through ductwork (literally in the air), I imagine that's a whole different scenario to deal with.

I get the ventilation issue. If it's a HS gym, why not just turn it off?

So a few things, unventilated spaces are health hazards because you're not introducing new air and removing contaminated ones. That's why code requires air changes (ventilation) in nearly every type of facility, but especially so with healthcare.

However, healthcare is tricky because not only do you have to filter the air coming in, you have to filter the air going out so you're not introducing hazardous particulates and pathogens. This is done with HEPA filters which only specialized systems can safely handle.

In hospitals, ventilation also pressurizes the entire building and even within each zone, the spaces are positively pressurized (with the air leaving through dedicated returns). Since air is a fluid and wants to reach equilibrium, if the spaces aren't positively pressurized, outside (unfiltered) air with all its issues begin to enter. And equally so in the other direction if you don't give the air dedicated, filtered ways to return back outside.

And of course without air-conditioning, you introduce moisture which is a whole different issue in healthcare.

[HI54UNI]

[93henfan]

Rand Paul has tested positive.

Hopefully he stays true to his principles and lets the virus play itself out in a libertarian manner without intervention from the government or a regulated health care facility.

[UNI88]

Is Trump to thin-skinned and insecure to reach out and work together to lead this country?

Is Nancy to bitter to take his call?

[93henfan]

Rehoboth Beach on Friday



On Saturday

[93henfan]

I can't even take the Jeep out on the surf fishing beaches. Wonder if I'll get a refund on my permit?

[JohnStOnge]

For your reading enjoyment about how South Korea serves as a model for response:

https://www.sciencemag.org/news/2020/03 ... ts-success

Scroll down to "Lessons from MERS" for the good part. Anyway, they didn't wait. As soon as they saw something was going on in China they quickly developed a test and worked to be prepared to implement widespread testing to inform their efforts.

[JohnStOnge]

I decided to see...

God damn it!

Trump and his defenders are full of shit when they point to him implementing a travel ban as evidence that he was REALLY on top of the situation. He f*cked up. No doubt about it.

[93henfan]

God damn it!

Trump and his defenders are full of shit when they point to him implementing a travel ban as evidence that he was REALLY on top of the situation. He f*cked up. No doubt about it.

I haven't seen the potential President-elect stepping up to fill the leadership void. You'd think this was the time where a better qualified person would step up and guide the country as a sort of test-drive of his incredible pandemic-crushing skills.

Where's Joe? Can he still save us? Is it too late? Tune in to the next First State Files!!

[BDKJMU]

I get the ventilation issue. If it's a HS gym, why not just turn it off?

So a few things, unventilated spaces are health hazards because you're not introducing new air and removing contaminated ones. That's why code requires air changes (ventilation) in nearly every type of facility, but especially so with healthcare.

However, healthcare is tricky because not only do you have to filter the air coming in, you have to filter the air going out so you're not introducing hazardous particulates and pathogens. This is done with HEPA filters which only specialized systems can safely handle.

In hospitals, ventilation also pressurizes the entire building and even within each zone, the spaces are positively pressurized (with the air leaving through dedicated returns). Since air is a fluid and wants to reach equilibrium, if the spaces aren't positively pressurized, outside (unfiltered) air with all its issues begin to enter. And equally so in the other direction if you don't give the air dedicated, filtered ways to return back outside.

And of course without air-conditioning, you introduce moisture which is a whole different issue in healthcare.

Empty out some hospitals of most of their regular patients (can can be moved) into the makeshift hospitals, where special isolation and filtration isn't as important.

Fill those mostly emptied out hospitals (that have the proper HVAC and isolation capabilities) with the Chinese Virus patients.