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Infectious disease Doc on Rogan today

LaJolla Lion

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For those saying this is nothing or just like the flu, he seems to take a different approach. The medical community seems like it will be strained here in a few weeks. The email from the Doc in Milan is pretty telling. I’m glad they are canceling all of these events after listening to the first 20 minutes.

 
Wise words from Infectious Disease MD, Dr. Sharkawy on COVID-19:

“I'm a doctor and an Infectious Diseases Specialist. I've been at this for more than 20 years seeing sick patients on a daily basis. I have worked in inner city hospitals and in the poorest slums of Africa. HIV-AIDS, Hepatitis,TB, SARS, Measles, Shingles, Whooping cough, Diphtheria...there is little I haven't been exposed to in my profession. And with notable exception of SARS, very little has left me feeling vulnerable, overwhelmed or downright scared.

I am not scared of Covid-19. I am concerned about the implications of a novel infectious agent that has spread the world over and continues to find new footholds in different soil. I am rightly concerned for the welfare of those who are elderly, in frail health or disenfranchised who stand to suffer mostly, and disproportionately, at the hands of this new scourge. But I am not scared of Covid-19.

What I am scared about is the loss of reason and wave of fear that has induced the masses of society into a spellbinding spiral of panic, stockpiling obscene quantities of anything that could fill a bomb shelter adequately in a post-apocalyptic world. I am scared of the N95 masks that are stolen from hospitals and urgent care clinics where they are actually needed for front line healthcare providers and instead are being donned in airports, malls, and coffee lounges, perpetuating even more fear and suspicion of others. I am scared that our hospitals will be overwhelmed with anyone who thinks they " probably don't have it but may as well get checked out no matter what because you just never know..." and those with heart failure, emphysema, pneumonia and strokes will pay the price for overfilled ER waiting rooms with only so many doctors and nurses to assess.

I am scared that travel restrictions will become so far reaching that weddings will be canceled, graduations missed and family reunions will not materialize. And well, even that big party called the Olympic Games...that could be kyboshed too. Can you even
imagine?

I'm scared those same epidemic fears will limit trade, harm partnerships in multiple sectors, business and otherwise and ultimately culminate in a global recession.

But mostly, I'm scared about what message we are telling our kids when faced with a threat. Instead of reason, rationality, openmindedness and altruism, we are telling them to panic, be fearful, suspicious, reactionary and self-interested.
Covid-19 is nowhere near over. It will be coming to a city, a hospital, a friend, even a family member near you at some point. Expect it. Stop waiting to be surprised further. The fact is the virus itself will not likely do much harm when it arrives. But our own behaviors and "fight for yourself above all else" attitude could prove disastrous.

I implore you all. Temper fear with reason, panic with patience and uncertainty with education. We have an opportunity to learn a great deal about health hygiene and limiting the spread of innumerable transmissible diseases in our society. Let's meet this challenge together in the best spirit of compassion for others, patience, and above all, an unfailing effort to seek truth, facts and knowledge as opposed to conjecture, speculation and catastrophizing.

Facts not fear. Clean hands. Open hearts.
Our children will thank us for it.”
 
Wise words from Infectious Disease MD, Dr. Sharkawy on COVID-19:

“I'm a doctor and an Infectious Diseases Specialist. I've been at this for more than 20 years seeing sick patients on a daily basis. I have worked in inner city hospitals and in the poorest slums of Africa. HIV-AIDS, Hepatitis,TB, SARS, Measles, Shingles, Whooping cough, Diphtheria...there is little I haven't been exposed to in my profession. And with notable exception of SARS, very little has left me feeling vulnerable, overwhelmed or downright scared.

I am not scared of Covid-19. I am concerned about the implications of a novel infectious agent that has spread the world over and continues to find new footholds in different soil. I am rightly concerned for the welfare of those who are elderly, in frail health or disenfranchised who stand to suffer mostly, and disproportionately, at the hands of this new scourge. But I am not scared of Covid-19.

What I am scared about is the loss of reason and wave of fear that has induced the masses of society into a spellbinding spiral of panic, stockpiling obscene quantities of anything that could fill a bomb shelter adequately in a post-apocalyptic world. I am scared of the N95 masks that are stolen from hospitals and urgent care clinics where they are actually needed for front line healthcare providers and instead are being donned in airports, malls, and coffee lounges, perpetuating even more fear and suspicion of others. I am scared that our hospitals will be overwhelmed with anyone who thinks they " probably don't have it but may as well get checked out no matter what because you just never know..." and those with heart failure, emphysema, pneumonia and strokes will pay the price for overfilled ER waiting rooms with only so many doctors and nurses to assess.

I am scared that travel restrictions will become so far reaching that weddings will be canceled, graduations missed and family reunions will not materialize. And well, even that big party called the Olympic Games...that could be kyboshed too. Can you even
imagine?

I'm scared those same epidemic fears will limit trade, harm partnerships in multiple sectors, business and otherwise and ultimately culminate in a global recession.

But mostly, I'm scared about what message we are telling our kids when faced with a threat. Instead of reason, rationality, openmindedness and altruism, we are telling them to panic, be fearful, suspicious, reactionary and self-interested.
Covid-19 is nowhere near over. It will be coming to a city, a hospital, a friend, even a family member near you at some point. Expect it. Stop waiting to be surprised further. The fact is the virus itself will not likely do much harm when it arrives. But our own behaviors and "fight for yourself above all else" attitude could prove disastrous.

I implore you all. Temper fear with reason, panic with patience and uncertainty with education. We have an opportunity to learn a great deal about health hygiene and limiting the spread of innumerable transmissible diseases in our society. Let's meet this challenge together in the best spirit of compassion for others, patience, and above all, an unfailing effort to seek truth, facts and knowledge as opposed to conjecture, speculation and catastrophizing.

Facts not fear. Clean hands. Open hearts.
Our children will thank us for it.”

Could we get this pinned at the top of the board?
 
Wise words from Infectious Disease MD, Dr. Sharkawy on COVID-19:

“I'm a doctor and an Infectious Diseases Specialist. I've been at this for more than 20 years seeing sick patients on a daily basis. I have worked in inner city hospitals and in the poorest slums of Africa. HIV-AIDS, Hepatitis,TB, SARS, Measles, Shingles, Whooping cough, Diphtheria...there is little I haven't been exposed to in my profession. And with notable exception of SARS, very little has left me feeling vulnerable, overwhelmed or downright scared.

I am not scared of Covid-19. I am concerned about the implications of a novel infectious agent that has spread the world over and continues to find new footholds in different soil. I am rightly concerned for the welfare of those who are elderly, in frail health or disenfranchised who stand to suffer mostly, and disproportionately, at the hands of this new scourge. But I am not scared of Covid-19.

What I am scared about is the loss of reason and wave of fear that has induced the masses of society into a spellbinding spiral of panic, stockpiling obscene quantities of anything that could fill a bomb shelter adequately in a post-apocalyptic world. I am scared of the N95 masks that are stolen from hospitals and urgent care clinics where they are actually needed for front line healthcare providers and instead are being donned in airports, malls, and coffee lounges, perpetuating even more fear and suspicion of others. I am scared that our hospitals will be overwhelmed with anyone who thinks they " probably don't have it but may as well get checked out no matter what because you just never know..." and those with heart failure, emphysema, pneumonia and strokes will pay the price for overfilled ER waiting rooms with only so many doctors and nurses to assess.

I am scared that travel restrictions will become so far reaching that weddings will be canceled, graduations missed and family reunions will not materialize. And well, even that big party called the Olympic Games...that could be kyboshed too. Can you even
imagine?

I'm scared those same epidemic fears will limit trade, harm partnerships in multiple sectors, business and otherwise and ultimately culminate in a global recession.

But mostly, I'm scared about what message we are telling our kids when faced with a threat. Instead of reason, rationality, openmindedness and altruism, we are telling them to panic, be fearful, suspicious, reactionary and self-interested.
Covid-19 is nowhere near over. It will be coming to a city, a hospital, a friend, even a family member near you at some point. Expect it. Stop waiting to be surprised further. The fact is the virus itself will not likely do much harm when it arrives. But our own behaviors and "fight for yourself above all else" attitude could prove disastrous.

I implore you all. Temper fear with reason, panic with patience and uncertainty with education. We have an opportunity to learn a great deal about health hygiene and limiting the spread of innumerable transmissible diseases in our society. Let's meet this challenge together in the best spirit of compassion for others, patience, and above all, an unfailing effort to seek truth, facts and knowledge as opposed to conjecture, speculation and catastrophizing.

Facts not fear. Clean hands. Open hearts.
Our children will thank us for it.”

it’s worth a listen.
 
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Yes, Coronavirus Is Worse Than the Flu

By JIM GERAGHTY


Why We Fear the Coronavirus More Than the Seasonal Flu

“There have only been [insert current number here] coronavirus cases, way fewer cases and deaths than the flu!”

As mentioned a few days ago, the term “going viral” means something that “spreads rapidly through a population by being frequently shared with a number of individuals.” This means numbers don’t grow steadily and gradually. They grow quickly and exponentially.

According to the U.S. Centers for Disease Control, the coronavirus primarily spreads when someone coughs or sneezes and the droplets get on someone else. The secondary way of spreading is by touching contaminated surfaces or objects.

There is some research from Chinese epidemiologists indicating that the virus may spread much easier than originally thought:

The coronavirus that causes Covid-19 can linger in the air for at least 30 minutes and travel up to 4.5 metres – further than the “safe distance” advised by health authorities around the world, according to a study by a team of Chinese government epidemiologists.

The researchers also found that it can last for days on a surface where respiratory droplets land, raising the risk of transmission if unsuspecting people touch it and then rub their face.

The length of time it lasts on the surface depends on factors such as temperature and the type of surface, for example at around 37C (98F), it can survive for two to three days on glass, fabric, metal, plastic or paper.

This research is fascinating and ominous. On January 22, an infected passenger boarded a fully booked long-distance coach and settled down on the second row from the back. He stayed on the bus for four hours and the windows remained closed. Reviewing security camera footage, the researchers found the passenger did not interact with anyone else. The person next to him was not infected, but he did infect two people behind him, one person three rows ahead of him, four people who were six to seven rows ahead of him, and one person who got on the bus after the initial passenger disembarked.

Scientists are still getting a handle on how contagious the coronavirus is, but the current estimate of the R0 (reproduction number) is between 2 and 2.5 — meaning that the average infected person spreads it to two or two-and-a-half people. For the seasonal flu, the R0 is about 1.3 people.

Coronavirus cases in the United States and broader world are not going to stay level; they may eventually level off, but we are probably a ways away from anything resembling “herd immunity” — that is, when a significant enough portion of a population is immune to a disease, making it more difficult for a disease to spread. In the absence of dramatic steps to reduce people’s interaction with each other, the number of cases will continue to increase.

Scientists are still calculating the death rate from the coronavirus, and the death rate is probably going to continue to vary from country to country depending upon the country’s quality of medical care and preparedness. But it is already clear that the coronavirus is much more deadly than the usual seasonal flu.

The CDC’s current estimate of the death rate for the flu in the 2018–2019 flu season is 35.5 million cases, and about 34,000 deaths. That is a death rate just shy of 0.1 percent, or one out of every 1,044 people.

Many doctors and public-health officials strongly suspect that there are a lot of Americans walking around who have already caught the coronavirus and are asymptomatic — and they either will not show symptoms, or they will suffer such mild symptoms that they won’t even realize they have it. As of this writing, the United States has 729 cases and 26 deaths. That comes out to a 3.5 percent death rate. That’s 35 out of 1,000 people.

Because there are people walking around who have it and who aren’t tested, it is possible that when all is said and done, the U.S. death rate will be significantly lower. But any way you slice it, the death rate for the coronavirus is significantly higher than the death rate for the seasonal flu. And with both coronavirus and seasonal flu, those most at risk are the elderly and the immunocompromised.

There is an odd tone to some of the commentary around the virus. Ann Coulter declares, “Average age of the coronavirus dead in Italy (the country they’re using to scare Americans since it’s European): 81.

What the hell is this, Logan’s Run? I guess your perspective on the coronavirus being particularly dangerous to octogenarians depends upon how many people you know who are in their eighties or approaching it. We’ve got about 13 million Americans over age 80. About 1.5 million Floridians are in their eighties. Sure, a death toll among the elderly, who have hopefully lived full lives, is somewhat less tragic than a virus that cuts people down in their prime or children. But that doesn’t make it any less sad or worth attempting to prevent or mitigate. A virus that has even a 2 percent death toll among elderly Americans is going to mean a lot of funerals.

But wait, there’s another factor to take into account. It is surprisingly difficult to get a reliable and recent figure for the number of Americans who are immunodeficient, immunocompromised, or otherwise have immune systems that wouldn’t be able to fight off the coronavirus. A 2008 estimate puts it at ten million Americans — and that’s only counting those with HIV/AIDS (diagnosed and undiagnosed), organ transplant recipients, and cancer patients.

Secondly, the elderly and immunocompromised who are infected but survive are going to use up a lot of beds and time in intensive care units, and that will have far-reaching effects for those who are well under age 80. As Christopher Mims puts it, “If we don’t collectively slow the rate of spread of this virus, what he called suppression, it endangers everyone else because of the capacity crunch: People who need surgery. People who have accidents. Cancer patients. Everyone who would normally use our healthcare system.” Every resource put towards controlling coronavirus is a resource that can’t be used towards other health problems.

Some good news is that South Korean health officials have found that so far, “only about 10 percent of coronavirus patients required hospitalization, while the rest had strong enough immune systems to fight the virus on their own.

When people ask, “Why isn’t there this kind of panic over the seasonal flu?” the answer is, “Because the coronavirus is both more deadly and more contagious than the seasonal flu.” As noted above, the death rate for the seasonal flu is one in a thousand; the current coronavirus figure is roughly 35 in a thousand. Even if that’s elevated because we’re not testing enough, if the figure is cut in half, you’re at 17 in a thousand — or nearly one out of every fifty.

For what it’s worth, the death rate in Italy is currently at 5 percent — one in 20!

Italy is more or less in lockdown. Japan is preparing steps to instruct residents to remain indoors. Major countries do not shut down their populations because of media hype or a desire to make the American president look bad.

This is why we have to “flatten the curve.” We — ordinary citizens — have to take those basic steps of washing hands frequently and avoiding big gatherings, to reduce the rate of increase in cases, delay the peak of cases, and ensure that the hospital systems don’t get overwhelmed.

The number of people who are currently insisting that preparedness is panic is amazing. None of us want a public-health disaster, but part of being responsible is being ready for the worst-case scenarios and taking action to ensure the worst-case scenarios don’t come to pass. We have a lot of mayors of Amity and Chip Dillers among us.
 
Undoubtedly there is some hysteria out there. And the travel restrictions and canceled events seem ridiculous.

But if you consider what's happening in Italy, at least some of the public health measures to slow the spread really make sense. Because if American hospitals are overwhelmed and can't support all the people (mostly elderly) with pneumonia, lots of people will die unnecessarily.

This stuff will not stop the pandemic. The goal is simply to slow it down and flatten the peak number of cases. If 20 million people in American get severely ill, if the peak is spread out over, say, 2 years, many more will survive than if the peak is a 3 month period. That's what's important.

If you have to give up some travel, some recreation and entertainment, maybe it's not to protect YOU from the virus. What it's really about is saving the lives of other people -- increasing the survival rate of people who WILL get coronavirus so that the medical care system can get mobilized and and deal with the onslaught.

I think the best justification for these measures is they are buying time -- and if you see what's happened in Northern Italy, lockdowns may save the lives of many, many. To me that's worth it.

The Italians get it. They're an incredibly social culture, they're the last people in the world who want to be shut up in their homes cut off from their families and friends. They are also the last people in the world to respect a government order just for the sake of it. But they are complying with the lockdowns because because they get it. They get that it is saving lives and giving their hospitals, doctors and nurses a fighting chance.

Real patriotism isn't waving flags or military parades or God Bless America stuff. Real patriotism is sacrificing for the benefit of others in our country who we don't even know. We haven't had to do much of that in our lifetimes, maybe America has forgotten how to sacrifice for the benefit of the country. But maybe this is one of these times.
 
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Undoubtedly there is some hysteria out there. And the travel restrictions and canceled events seem to make no sense.

But if you consider what's happening in Italy, at least some of the public health measures to slow the spread really make sense. Because if American hospitals are overwhelmed and can't support all the people (mostly elderly) with pneumonia, lots of people will die unnecessarily.

This stuff will not stop the pandemic. The goal is simply to slow it down and flatten the peak number of cases. If 20 million people in American get severely ill, if the peak is spread out over, say, 2 years, many more will survive than if the peak is a 3 month period. That's what's important.

If you have to give up some travel, some recreation and entertainment, maybe it's not to protect YOU from the virus. What it's really about is saving the lives of other people -- increasing the survival rate of people who WILL get coronavirus so that the medical care system can get mobilized and and deal with the onslaught.

I think the best justification for these measures is they are buying time -- and if you see what's happened in Northern Italy, lockdowns may save the lives of many, many. To me that's worth it.

The Italians get it. They're an incredibly social culture, they're the last people in the world who want to be shut up in their homes cut off from their families and friends. They are also the last people in the world to respect a government order just for the sake of it. But they are complying with the lockdowns because because they get it. They get that it is saving lives and giving their hospitals, doctors and nurses a fighting chance.

Real patriotism isn't waving flags or military parades or God Bless America stuff. Real patriotism is sacrificing for the benefit of others in our country who we don't even know. We haven't had to do much of that in our lifetimes, maybe America has forgotten how to sacrifice for the benefit of the country. But maybe this is one of these times.
absolutely accurate...
 
Undoubtedly there is some hysteria out there. And the travel restrictions and canceled events seem ridiculous.

But if you consider what's happening in Italy, at least some of the public health measures to slow the spread really make sense. Because if American hospitals are overwhelmed and can't support all the people (mostly elderly) with pneumonia, lots of people will die unnecessarily.

This stuff will not stop the pandemic. The goal is simply to slow it down and flatten the peak number of cases. If 20 million people in American get severely ill, if the peak is spread out over, say, 2 years, many more will survive than if the peak is a 3 month period. That's what's important.

If you have to give up some travel, some recreation and entertainment, maybe it's not to protect YOU from the virus. What it's really about is saving the lives of other people -- increasing the survival rate of people who WILL get coronavirus so that the medical care system can get mobilized and and deal with the onslaught.

I think the best justification for these measures is they are buying time -- and if you see what's happened in Northern Italy, lockdowns may save the lives of many, many. To me that's worth it.

The Italians get it. They're an incredibly social culture, they're the last people in the world who want to be shut up in their homes cut off from their families and friends. They are also the last people in the world to respect a government order just for the sake of it. But they are complying with the lockdowns because because they get it. They get that it is saving lives and giving their hospitals, doctors and nurses a fighting chance.

Real patriotism isn't waving flags or military parades or God Bless America stuff. Real patriotism is sacrificing for the benefit of others in our country who we don't even know. We haven't had to do much of that in our lifetimes, maybe America has forgotten how to sacrifice for the benefit of the country. But maybe this is one of these times.
I lived on the gulf coast for close to 20 years. I still remember the folks that refused to leave for hurricanes because the media sensationalized so many storms. Then Katrina hit and people were wondering why or how people didn’t take the warnings seriously. I see some similarities here with some of the reactions by some people. The problem I have is you see other developed nations shutting down. I’m not saying people need to get in their bunkers but at the very least you should still be keeping an eye raised. Thankful that I work remote and I canceled my trip across the pond for next week. Good call on asking for a little sacrifice, hopefully this is overblown in the end.
 
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For those saying this is nothing or just like the flu, he seems to take a different approach. The medical community seems like it will be strained here in a few weeks. The email from the Doc in Milan is pretty telling. I’m glad they are canceling all of these events after listening to the first 20 minutes.


This is not the time to panic or despair. My wife and I listened to the interview, read the posts below it, and have educated ourselves as best we could about this virus. We find many respected experts in disagreement. We will weigh all the information, take measure of our family situation, and do the best we can to protect ourselves and our loved ones. Then, with appropriate adjustments to our daily routine, we will get on with our lives.
 
Undoubtedly there is some hysteria out there. And the travel restrictions and canceled events seem ridiculous.

But if you consider what's happening in Italy, at least some of the public health measures to slow the spread really make sense. Because if American hospitals are overwhelmed and can't support all the people (mostly elderly) with pneumonia, lots of people will die unnecessarily.

This stuff will not stop the pandemic. The goal is simply to slow it down and flatten the peak number of cases. If 20 million people in American get severely ill, if the peak is spread out over, say, 2 years, many more will survive than if the peak is a 3 month period. That's what's important.

If you have to give up some travel, some recreation and entertainment, maybe it's not to protect YOU from the virus. What it's really about is saving the lives of other people -- increasing the survival rate of people who WILL get coronavirus so that the medical care system can get mobilized and and deal with the onslaught.

I think the best justification for these measures is they are buying time -- and if you see what's happened in Northern Italy, lockdowns may save the lives of many, many. To me that's worth it.

The Italians get it. They're an incredibly social culture, they're the last people in the world who want to be shut up in their homes cut off from their families and friends. They are also the last people in the world to respect a government order just for the sake of it. But they are complying with the lockdowns because because they get it. They get that it is saving lives and giving their hospitals, doctors and nurses a fighting chance.

Real patriotism isn't waving flags or military parades or God Bless America stuff. Real patriotism is sacrificing for the benefit of others in our country who we don't even know. We haven't had to do much of that in our lifetimes, maybe America has forgotten how to sacrifice for the benefit of the country. But maybe this is one of these times.

Much to agree with and much to disagree with.

The 'patriotism' comment was a personal belief that you could have well left out.
 
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Ah, no sir.
I disagree... the seemingly over the top precautions are about flattening the curve and protecting the portion of the population that is highly susceptible. In Italy they have to determine if a patient is "savable" before admitting to ICU... meaning eff the elderly, etc... If we can collectively let this thing run its course in a less impactful manner then we will be laying to rest far fewer of our elders. My folks are in their early 80s and in assisted living. This thing comes anywhere near their facility and they are toast.
 
I think this is worth sharing here. It's a heartfelt note written by an Italian doctor in Bergamo (a beautiful city of about 120,000 at the foot of the Italian Alps). It helped put things in perspective for me at least. It may be what we are facing here in the US.

Dr Daniele Macchini's post, translated by Dr Silvia Stringhini

"After much thought about whether and what to write about what is happening to us, I felt that silence was not responsible.

"I will therefore try to convey to people far from our reality what we are living in Bergamo in these days of Covid-19 pandemic. I understand the need not to create panic, but when the message of the dangerousness of what is happening does not reach people I shudder.

"I myself watched with some amazement the reorganization of the entire hospital in the past week, when our current enemy was still in the shadows: the wards slowly 'emptied', elective activities were interrupted, intensive care were freed up to create as many beds as possible.

"All this rapid transformation brought an atmosphere of silence and surreal emptiness to the corridors of the hospital that we did not yet understand, waiting for a war that was yet to begin and that many (including me) were not so sure would ever come with such ferocity.

"I still remember my night call a week ago when I was waiting for the results of a swab. When I think about it, my anxiety over one possible case seems almost ridiculous and unjustified, now that I've seen what's happening. Well, the situation now is dramatic to say the least.

"The war has literally exploded and battles are uninterrupted day and night. But now that need for beds has arrived in all its drama. One after the other the departments that had been emptied fill up at an impressive pace.

"The boards with the names of the patients, of different colours depending on the operating unit, are now all red and instead of surgery you see the diagnosis, which is always the damned same: bilateral interstitial pneumonia.

"Now, explain to me which flu virus causes such a rapid drama. [post continues comparing Covid19 to flu, link here]. And while there are still people who boast of not being afraid by ignoring directions, protesting because their normal routine is 'temporarily' put in crisis, the epidemiological disaster is taking place. And there are no more surgeons, urologists, orthopedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us.

"Cases are multiplying, we arrive at a rate of 15-20 admissions per day all for the same reason. The results of the swabs now come one after the other: positive, positive, positive. Suddenly the E.R. is collapsing.

"Reasons for the access always the same: fever and breathing difficulties, fever and cough, respiratory failure. Radiology reports always the same: bilateral interstitial pneumonia, bilateral interstitial pneumonia, bilateral interstitial pneumonia. All to be hospitalized.

"Someone already to be intubated and go to intensive care. For others it's too late... Every ventilator becomes like gold: those in operating theatres that have now suspended their non-urgent activity become intensive care places that did not exist before.

"The staff is exhausted. I saw the tiredness on faces that didn't know what it was despite the already exhausting workloads they had. I saw a solidarity of all of us, who never failed to go to our internist colleagues to ask, 'What can I do for you now?'

"Doctors who move beds and transfer patients, who administer therapies instead of nurses. Nurses with tears in their eyes because we can't save everyone, and the vital parameters of several patients at the same time reveal an already marked destiny.

"There are no more shifts, no more hours. Social life is suspended for us. We no longer see our families for fear of infecting them. Some of us have already become infected despite the protocols.

"Some of our colleagues who are infected also have infected relatives and some of their relatives are already struggling between life and death. So be patient, you can't go to the theatre, museums or the gym. Try to have pity on the myriad of old people you could exterminate.

"We just try to make ourselves useful. You should do the same: we influence the life and death of a few dozen people. You with yours, many more. Please share this message. We must spread the word to prevent what is happening here from happening all over Italy.

"I finish by saying that I really don't understand this war on panic. The only reason I see is mask shortages, but there's no mask on sale anymore. We don't have a lot of studies, but is it panic really worse than neglect and carelessness during an epidemic of this sort?"
 
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"Reasons for the access always the same: fever and breathing difficulties, fever and cough, respiratory failure. Radiology reports always the same: bilateral interstitial pneumonia, bilateral interstitial pneumonia, bilateral interstitial pneumonia. All to be hospitalized
How may people in this thread have gotten the pneumonia vaccine? It's available at your local CVS or Walgreens.
 
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This is not the time to panic or despair. My wife and I listened to the interview, read the posts below it, and have educated ourselves as best we could about this virus. We find many respected experts in disagreement. We will weigh all the information, take measure of our family situation, and do the best we can to protect ourselves and our loved ones. Then, with appropriate adjustments to our daily routine, we will get on with our lives.
That is all we can do due to the varying reports.
 
I have listened to a few podcasts with SME’s and this was a good one. Thanks.

A chilling item he brought up is that most experts are convinced that as soon as the movement restrictions in China and Italy are removed this thing will come back immediately.

I’m glad I don’t have to make these decisions. This will be disruptive for the next 3-6 months

Well how do you get the message out to the masses when a great deal of the masses have once chosen news source. One is saying it's the end of the world....the other is saying....it just like the flu....just ignore it and continue on like nothing is happening, but wash your hands. Neither one is true, but how many times this week alone have you seen some of that posted on this same site. I mean I saw it last night with someone insisting it's just like the flu....it's as if people are willfully being ignorant because it makes them fell better I guess. It is just like the flu, except there is no medication for it, no vaccine, it's more contagious, and is a bit more deadly.....but just about the same.

There are going to be disruptions to our every day life and social gatherings. If people don't like it or care....that is on them, but it's clearly the direction we are heading in. Instead of going to London next week which we had planned for a long time, I'm taking the family camping for Spring Break. Now there will still be people at the sites, but we can hopefully limit closed crowded spaces and still have some fun and get the kids out. I'm not completely isolating myself, but I'm going to be a bit more cautious moving forward at any public place. I know where I work (I work remote, but 200 or so that don't) they are ensuring everyone is ready to work remotely. My wife's job did a trial run with everyone on Monday working from hom to work out some of the bugs.....so I think many places that can accommodate this are starting to prepare for it.

edited for Step.
 
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Gilead's coronavirus treatment is already being used in Washington state

Subscribe to Fortune’s Outbreak newsletter for a daily roundup of stories on the coronavirus outbreak and its impact on global business.

Gilead’s experimental drug remdesivir has been touted by public health officials at the Centers for Disease Control (CDC) and the World Health Organization (WHO) as one of the most—if not the most—promising antivirals to fight the new coronavirus strain.

CDC director Robert Redfield added to the buzz on Tuesday, stating that that Gilead’s pathogen-fighting COVID-19 treatment is already being deployed in Washington state, where the virus had claimed nearly two dozen lives as of Monday.

Redfield, during Congressional testimony before a House of Representatives committee regarding the CDC’s budget and spending priorities in the wake of the coronavirus outbreak, said that “remdesivir is available right now on compassionate use,” in Washington. Preliminary results for the treatment’s effectiveness will likely become clearer in mere months, according to Redfield.

Compassionate use is an analogue of the Food and Drug Administration’s expanded access program, which speeds up access to treatments that haven’t received marketing approval to patients who may direly need them—especially in emergency situations.

That could include a patient who has “a serious disease or condition, or whose life is immediately threatened by their disease or condition,” according to the FDA. It appears that coronavirus cases, at least in hard-hit regions, clear that standard.

But Gilead’s therapy has rapidly progressed through the clinical trial process in the midst of the COVID-19 crisis. It’s already being used in human clinical trials in the U.S. on top of later-stage studies in other nations that are being affected by coronavirus.

Washington’s public health department and Gilead have not yet responded to Fortune‘s multiple requests for comment about how remdesivir is being used in the state.

More coronavirus coverage from Fortune:

Coronavirus and the flu have similar symptoms. So, how are they different?
—How coronavirus is affecting the global concert industry
Politicians around the world are going into quarantine
—Some of the most extreme ways companies are combating coronavirus
—How Europe is adapting to the coronavirus outbreak
—What Xi Jinping’s visit to Wuhan says about China’s coronavirus recovery
Conferences go online amid coronavirus fears—minus the hallway schmoozing
—Coronavirus may not be all bad for tech. Consider the “stay at home” stocks

Subscribe to Fortune’s Outbreak newsletter for a daily roundup of stories on the coronavirus outbreak and its impact on global business.
 
  • Mainland China
    80,778
    3,158
  • Italy
    10,149
    631
  • Iran
    8,042
    354
  • South Korea
    7,775
    60
  • France
    1,784
    33
  • Spain
    1,622
    35
  • Germany
    1,296
    2
  • United States
    731
    29
  • Diamond Princess*
    696
    7
I've read theres an HIV drug that eases symptoms of coronavirus, that might be a huge help to those suffering the worst effects of this. So hopefully before too long this drug will available to all suffering from coronavirus, because I have a feeling this virus is just getting started.
 
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These are great posts, folks...appreciate the insight. It is still way too early to know. I appears the CDC screwed up the test kits, they call it a "glitch", and that is now fixed. Progress being made on getting these out. Regardless, I saw one official CDC official, after being pressed for a prediction, settled on a death toll of 1,000,000 in the USA if past is a predictor of future. He cautioned that treatment best practices are being learned but also thought our system would be overwhelmed by mid-April so best-practice treatments would not be available (just not enough beds and professionals to accommodate). So there is also a notion of self treatment and "drive throughs". This is interesting in terms of legal liability so the govt may end up having to wave claims against malpractice. Interesting times. I suspect, the world will be a slightly different place by next football season.
 
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What past predictor suggests a death toll of 1 million? THe 1918 flu outbreak?
 
What past predictor suggests a death toll of 1 million? THe 1918 flu outbreak?
He was discussing the metrics:
  • speed at which it is growing in the USA
  • speed at which doctors define "best practices" to mitigate
  • performance in other countries (SK, Iran, Italy, etc.)
  • Infection rate and fatality rate given ages
Of course, there is no similarity with 1918 both in terms of population climate or the virus itself
 
Listening to the podcast, if you are fat and out of shape, you need to correct that starting now.

Lot of good and interesting info in the podcast...medical industry needs to break the dependency on China for manufacturing medicine and other medical supplies.
 
How about this for policy:

If you are over the age of 60, or have an underlying medical condition (especially a pulmonary one, including heavy smokers), stay away from other people. These are the people who should be self quarantined.

Since we have no idea who has the disease, and it is probably that a large percentage of the population will get it, doesn't it make more sense to isolate those who would be most affected to reduce the chance they will get infected?

If you are healthy and under the age of 60, it is VERY unlikely that the disease will be fatal.
 
I disagree... the seemingly over the top precautions are about flattening the curve and protecting the portion of the population that is highly susceptible. In Italy they have to determine if a patient is "savable" before admitting to ICU... meaning eff the elderly, etc... If we can collectively let this thing run its course in a less impactful manner then we will be laying to rest far fewer of our elders. My folks are in their early 80s and in assisted living. This thing comes anywhere near their facility and they are toast.

On what FACTS are you basing this? If your parents are healthy and have no history of respiratory disease, they are cleanly, eat healthy, and stay away from those with compromised immune systems... they should be OK. Monitored for symptoms, but they should survive.

These are great posts, folks...appreciate the insight. It is still way too early to know. I appears the CDC screwed up the test kits, they call it a "glitch", and that is now fixed. Progress being made on getting these out. Regardless, I saw one official CDC official, after being pressed for a prediction, settled on a death toll of 1,000,000 in the USA if past is a predictor of future. He cautioned that treatment best practices are being learned but also thought our system would be overwhelmed by mid-April so best-practice treatments would not be available (just not enough beds and professionals to accommodate). So there is also a notion of self treatment and "drive throughs". This is interesting in terms of legal liability so the govt may end up having to wave claims against malpractice. Interesting times. I suspect, the world will be a slightly different place by next football season.

Holiest of all shits! Seriously?!?!? There is NOTHING, absolutely NOTHING to indicate 1,000,000 deaths from this disease.

This is insanely dangerous language to use in a situation like this.

My wife is very close to what is going on from a research stand point, and has more information at her fingertips than any of these blow-hards trying to make a name for themselves.
 
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On what FACTS are you basing this? If your parents are healthy and have no history of respiratory disease, they are cleanly, eat healthy, and stay away from those with compromised immune systems... they should be OK. Monitored for symptoms, but they should survive.



Holiest of all shits! Seriously?!?!? There is NOTHING, absolutely NOTHING to indicate 1,000,000 deaths from this disease.

This is insanely dangerous language to use in a situation like this.

My wife is very close to what is going on from a research stand point, and has more information at her fingertips than any of these blow-hards trying to make a name for themselves.
Awesome...what is her guess on total mortality numbers by this fall?
 
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Awesome...what is her guess on total mortality numbers by this fall?

They don't do this. It is irresponsible and leads to paranoia and hysteria.

Remember SARS, MEERS, Ebola? They were the 'end-of-the-world' according to the US Media... we are still here. Is this bad? Depends on your definition of 'bad'. Is it less infectious than the flu? More infectious? Current data indicates it is more infectious, but they are running off incomplete data. Extrapolating death rates from incomplete data is irresponsible.

What should you be doing?

Follow the guidelines released by CDC and NIH - specifically NIAID (National Institute of Allergy and Infectious Disease) on how to avoid and prevent it.
 
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They don't do this. It is irresponsible and leads to paranoia and hysteria.

Remember SARS, MEERS, Ebola? They were the 'end-of-the-world' according to the US Media... we are still here. Is this bad? Depends on your definition of 'bad'. Is it less infectious than the flu? More infectious? Current data indicates it is more infectious, but they are running off incomplete data. Extrapolating death rates from incomplete data is irresponsible.

What should you be doing?

Follow the guidelines released by CDC and NIH - specifically NIAID (National Institute of Allergy and Infectious Disease) on how to avoid and prevent it.
on this, I don't agree. it is natural that people will take historical data and extrapolate that to the USA. So the healthcare industry has one of two choices A) stay quiet and allow the press to run rampant in terms of setting expectation levels or B) set an expectation themselves.
 
On what FACTS are you basing this? If your parents are healthy and have no history of respiratory disease, they are cleanly, eat healthy, and stay away from those with compromised immune systems... they should be OK. Monitored for symptoms, but they should survive.



Holiest of all shits! Seriously?!?!? There is NOTHING, absolutely NOTHING to indicate 1,000,000 deaths from this disease.

This is insanely dangerous language to use in a situation like this.

My wife is very close to what is going on from a research stand point, and has more information at her fingertips than any of these blow-hards trying to make a name for themselves.
They are in assisted living... so what does that tell you? Pictures of health? This virus spreads easily through the air. It is highly courageous. Right now death rate is 10-20 times worst flu season, so that would equate to 200-500k deaths by my math. Washing hands doesn't do much actually.
 
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on this, I don't agree. it is natural that people will take historical data and extrapolate that to the USA. So the healthcare industry has one of two choices A) stay quiet and allow the press to run rampant in terms of setting expectation levels or B) set an expectation themselves.

Follow the guidelines released by CDC and NIH - specifically NIAID (National Institute of Allergy and Infectious Disease) on how to avoid and prevent it.

They aren't being quiet! The CDC and NIH aren't releasing 'death rate predictions' for a reason...
 
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Follow the guidelines released by CDC and NIH - specifically NIAID (National Institute of Allergy and Infectious Disease) on how to avoid and prevent it.

They aren't being quiet! The CDC and NIH aren't releasing 'death rate predictions' for a reason...
well, I have no problem with that. But essentially, they have selected option A (allow the press to prognosticate on their own)
 
Wise words from Infectious Disease MD, Dr. Sharkawy on COVID-19:

“I'm a doctor and an Infectious Diseases Specialist. I've been at this for more than 20 years seeing sick patients on a daily basis. I have worked in inner city hospitals and in the poorest slums of Africa. HIV-AIDS, Hepatitis,TB, SARS, Measles, Shingles, Whooping cough, Diphtheria...there is little I haven't been exposed to in my profession. And with notable exception of SARS, very little has left me feeling vulnerable, overwhelmed or downright scared.

I am not scared of Covid-19. I am concerned about the implications of a novel infectious agent that has spread the world over and continues to find new footholds in different soil. I am rightly concerned for the welfare of those who are elderly, in frail health or disenfranchised who stand to suffer mostly, and disproportionately, at the hands of this new scourge. But I am not scared of Covid-19.

What I am scared about is the loss of reason and wave of fear that has induced the masses of society into a spellbinding spiral of panic, stockpiling obscene quantities of anything that could fill a bomb shelter adequately in a post-apocalyptic world. I am scared of the N95 masks that are stolen from hospitals and urgent care clinics where they are actually needed for front line healthcare providers and instead are being donned in airports, malls, and coffee lounges, perpetuating even more fear and suspicion of others. I am scared that our hospitals will be overwhelmed with anyone who thinks they " probably don't have it but may as well get checked out no matter what because you just never know..." and those with heart failure, emphysema, pneumonia and strokes will pay the price for overfilled ER waiting rooms with only so many doctors and nurses to assess.

I am scared that travel restrictions will become so far reaching that weddings will be canceled, graduations missed and family reunions will not materialize. And well, even that big party called the Olympic Games...that could be kyboshed too. Can you even
imagine?

I'm scared those same epidemic fears will limit trade, harm partnerships in multiple sectors, business and otherwise and ultimately culminate in a global recession.

But mostly, I'm scared about what message we are telling our kids when faced with a threat. Instead of reason, rationality, openmindedness and altruism, we are telling them to panic, be fearful, suspicious, reactionary and self-interested.
Covid-19 is nowhere near over. It will be coming to a city, a hospital, a friend, even a family member near you at some point. Expect it. Stop waiting to be surprised further. The fact is the virus itself will not likely do much harm when it arrives. But our own behaviors and "fight for yourself above all else" attitude could prove disastrous.

I implore you all. Temper fear with reason, panic with patience and uncertainty with education. We have an opportunity to learn a great deal about health hygiene and limiting the spread of innumerable transmissible diseases in our society. Let's meet this challenge together in the best spirit of compassion for others, patience, and above all, an unfailing effort to seek truth, facts and knowledge as opposed to conjecture, speculation and catastrophizing.

Facts not fear. Clean hands. Open hearts.
Our children will thank us for it.”

Yes, Coronavirus Is Worse Than the Flu

By JIM GERAGHTY


Why We Fear the Coronavirus More Than the Seasonal Flu

“There have only been [insert current number here] coronavirus cases, way fewer cases and deaths than the flu!”

As mentioned a few days ago, the term “going viral” means something that “spreads rapidly through a population by being frequently shared with a number of individuals.” This means numbers don’t grow steadily and gradually. They grow quickly and exponentially.

According to the U.S. Centers for Disease Control, the coronavirus primarily spreads when someone coughs or sneezes and the droplets get on someone else. The secondary way of spreading is by touching contaminated surfaces or objects.

There is some research from Chinese epidemiologists indicating that the virus may spread much easier than originally thought:

The coronavirus that causes Covid-19 can linger in the air for at least 30 minutes and travel up to 4.5 metres – further than the “safe distance” advised by health authorities around the world, according to a study by a team of Chinese government epidemiologists.

The researchers also found that it can last for days on a surface where respiratory droplets land, raising the risk of transmission if unsuspecting people touch it and then rub their face.

The length of time it lasts on the surface depends on factors such as temperature and the type of surface, for example at around 37C (98F), it can survive for two to three days on glass, fabric, metal, plastic or paper.

This research is fascinating and ominous. On January 22, an infected passenger boarded a fully booked long-distance coach and settled down on the second row from the back. He stayed on the bus for four hours and the windows remained closed. Reviewing security camera footage, the researchers found the passenger did not interact with anyone else. The person next to him was not infected, but he did infect two people behind him, one person three rows ahead of him, four people who were six to seven rows ahead of him, and one person who got on the bus after the initial passenger disembarked.

Scientists are still getting a handle on how contagious the coronavirus is, but the current estimate of the R0 (reproduction number) is between 2 and 2.5 — meaning that the average infected person spreads it to two or two-and-a-half people. For the seasonal flu, the R0 is about 1.3 people.

Coronavirus cases in the United States and broader world are not going to stay level; they may eventually level off, but we are probably a ways away from anything resembling “herd immunity” — that is, when a significant enough portion of a population is immune to a disease, making it more difficult for a disease to spread. In the absence of dramatic steps to reduce people’s interaction with each other, the number of cases will continue to increase.

Scientists are still calculating the death rate from the coronavirus, and the death rate is probably going to continue to vary from country to country depending upon the country’s quality of medical care and preparedness. But it is already clear that the coronavirus is much more deadly than the usual seasonal flu.

The CDC’s current estimate of the death rate for the flu in the 2018–2019 flu season is 35.5 million cases, and about 34,000 deaths. That is a death rate just shy of 0.1 percent, or one out of every 1,044 people.

Many doctors and public-health officials strongly suspect that there are a lot of Americans walking around who have already caught the coronavirus and are asymptomatic — and they either will not show symptoms, or they will suffer such mild symptoms that they won’t even realize they have it. As of this writing, the United States has 729 cases and 26 deaths. That comes out to a 3.5 percent death rate. That’s 35 out of 1,000 people.

Because there are people walking around who have it and who aren’t tested, it is possible that when all is said and done, the U.S. death rate will be significantly lower. But any way you slice it, the death rate for the coronavirus is significantly higher than the death rate for the seasonal flu. And with both coronavirus and seasonal flu, those most at risk are the elderly and the immunocompromised.

There is an odd tone to some of the commentary around the virus. Ann Coulter declares, “Average age of the coronavirus dead in Italy (the country they’re using to scare Americans since it’s European): 81.

What the hell is this, Logan’s Run? I guess your perspective on the coronavirus being particularly dangerous to octogenarians depends upon how many people you know who are in their eighties or approaching it. We’ve got about 13 million Americans over age 80. About 1.5 million Floridians are in their eighties. Sure, a death toll among the elderly, who have hopefully lived full lives, is somewhat less tragic than a virus that cuts people down in their prime or children. But that doesn’t make it any less sad or worth attempting to prevent or mitigate. A virus that has even a 2 percent death toll among elderly Americans is going to mean a lot of funerals.

But wait, there’s another factor to take into account. It is surprisingly difficult to get a reliable and recent figure for the number of Americans who are immunodeficient, immunocompromised, or otherwise have immune systems that wouldn’t be able to fight off the coronavirus. A 2008 estimate puts it at ten million Americans — and that’s only counting those with HIV/AIDS (diagnosed and undiagnosed), organ transplant recipients, and cancer patients.

Secondly, the elderly and immunocompromised who are infected but survive are going to use up a lot of beds and time in intensive care units, and that will have far-reaching effects for those who are well under age 80. As Christopher Mims puts it, “If we don’t collectively slow the rate of spread of this virus, what he called suppression, it endangers everyone else because of the capacity crunch: People who need surgery. People who have accidents. Cancer patients. Everyone who would normally use our healthcare system.” Every resource put towards controlling coronavirus is a resource that can’t be used towards other health problems.

Some good news is that South Korean health officials have found that so far, “only about 10 percent of coronavirus patients required hospitalization, while the rest had strong enough immune systems to fight the virus on their own.

When people ask, “Why isn’t there this kind of panic over the seasonal flu?” the answer is, “Because the coronavirus is both more deadly and more contagious than the seasonal flu.” As noted above, the death rate for the seasonal flu is one in a thousand; the current coronavirus figure is roughly 35 in a thousand. Even if that’s elevated because we’re not testing enough, if the figure is cut in half, you’re at 17 in a thousand — or nearly one out of every fifty.

For what it’s worth, the death rate in Italy is currently at 5 percent — one in 20!

Italy is more or less in lockdown. Japan is preparing steps to instruct residents to remain indoors. Major countries do not shut down their populations because of media hype or a desire to make the American president look bad.

This is why we have to “flatten the curve.” We — ordinary citizens — have to take those basic steps of washing hands frequently and avoiding big gatherings, to reduce the rate of increase in cases, delay the peak of cases, and ensure that the hospital systems don’t get overwhelmed.

The number of people who are currently insisting that preparedness is panic is amazing. None of us want a public-health disaster, but part of being responsible is being ready for the worst-case scenarios and taking action to ensure the worst-case scenarios don’t come to pass. We have a lot of mayors of Amity and Chip Dillers among us.


I don't quote both of you because I agree or disagree with either, but as a microcosm of the bigger issue. One of these posts is from a Dr. with a demonstrated experience of fighting infectious disease....

The other is from a political correspondent...

This is the problem with the sensationalism of... pick your topic (racism, russian interference.... etc). The internet has given anyone with a thought, a platform to broadcast their thought and an alarmingly increasing number of people are taking "THE INTERNET" as gospel truth, and not checking their sourcing, or not having a healthy dose of skepticism when reading information based on the sourcing.

I would caution every one of you to take into consideration where your information is coming from


These are great posts, folks...appreciate the insight. It is still way too early to know. I appears the CDC screwed up the test kits, they call it a "glitch", and that is now fixed. Progress being made on getting these out. Regardless, I saw one official CDC official, after being pressed for a prediction, settled on a death toll of 1,000,000 in the USA if past is a predictor of future. He cautioned that treatment best practices are being learned but also thought our system would be overwhelmed by mid-April so best-practice treatments would not be available (just not enough beds and professionals to accommodate). So there is also a notion of self treatment and "drive throughs". This is interesting in terms of legal liability so the govt may end up having to wave claims against malpractice. Interesting times. I suspect, the world will be a slightly different place by next football season.


I think this point brings up another issue. In today's world that lacks patience and has a "RIGHT NOW!" mentality, why would anyone "press" an official for a number, and why would the official give one? There is absolutely nothing wrong with saying "at this point, we don't have a clear estimation of total future numbers of infected". It's like me asking my doctor how old i'm going to live to be, then pressing him when he says he doesn't know and him actually giving me an age. THEN telling everyone in my family that i'm going to die at age XX! ugh...... stupidity abounds....
 
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People are taking the data and skewing it some. USA death percentage high because most of the cases are in a low end nursing home so it lead to a high death percent. If it was not the corona but a normal strain of a bad flu bug that hit that nursing home I would be the death percentage in that nursing home would not have been much different. not saying that corona is the flu like some are saying, it is obviously much more contagious and more deadly, but you have to look at the statistics with some level of understanding. plus as been said, what percent of people have corona yet are not in the statistics because it is so mild they are not getting tested which then only makes the death percent go down.

The italian numbers are the ones that just are crazy as they have a modern day health system yet their death percent is really high.
 
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They are in assisted living... so what does that tell you? Pictures of health? This virus spreads easily through the air. It is highly courageous. Right now death rate is 10-20 times worst flu season, so that would equate to 200-500k deaths by my math. Washing hands doesn't do much actually.

I don't know why your folks are in Assisted Living, many people go into AL because it make life easier for them (they can't walk as well as they used to). If that is not the case for your parents, I am sorry.
 
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so, Angela Merkel (German PM) just stated that the infection rate could go as high as 70% in her country. With 82 million people and a mortality rate of 1% that is 820,000 people.

BBC as featured on Drudge Report right now.

Coronavirus: Up to 70% of Germany could become infected - Merkel
 
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