Was thinking/wondering the same thing (impact of high viral load, etc.).

In the coming days, more folks may begin to understand things like potential bottlenecks in testing.

That is the point may not be how many "tests" there are, but rather what our testing throughput capabilities may be.

Again, from another post I made in a different thread:

"It seems to me that the term "tests" has multiple meetings.

I see DX/screening as a workflow...


Sample collection... things like swabs, et cetera. And facilities. And properly trained personnel. And of course, proper PPE for the personnel.

Transport of samples to laboratories.

Processing of tests... materials required (like reagents). Equipment required (capital equipment), properly trained personnel, and of course once again proper PPE for the personnel. And of course laboratory work flow quality control. And process time requirements. Some types of equipment may take weeks or months to build and ship.

Clinical robustness of tests (sensitivity and specificity) is also important.

Of course the ultimate would be an unlimited supply of everything needed and a perfect point-of-care diagnostic.

Communication of results and next steps.

Similar things about Rx... not just how many HCP's and beds, but other required medical devices, disposables,PPE for HCP's, types of HCP's, and of course equipment AND related disposables... like ventilators AND disposable vent circuits.

And of folks should realize that hospitalization (in or out of ICU) has its own inherent morbidity. For example associated with HAI's. And that that morbidity might be higher in pandemic response circumstances and settings.

All of this is difficult to break down and communicate about with laypeople.

But, in my opinion, that is no excuse for any obfuscation and/or double talk by officials. "

Again, I realize that most folks/laypeople may have some trouble understanding all of this, I hope they ramp up quickly.

But we need folks that do understand (scientists and HCP's, including those in the public health arena) and others to help bridge the understanding gap.

And we need to set better and more clear expectations. We have the tools, but unfortunately those same tools can be used to share bad information.

I will say this:

Wayne's story.... 13 men go to Italy....affluent enough and healthy enough for a ski vacation. A couple of days in... one gets sick. Within a few more days, they are all sick. They all test positive.

4/13 require hospitalization. 2/13 now in the condition described by Wayne. Unfortunate. Those two 49, and 50 did not do as well as 1/13 whom is 82 years old.

The two still in hospital require HCP care and associated materials and equipment.

Wayne's story is one of the things that has gotten my attention big time.

If it goes the way you've painted, testing will quickly become mostly academic.

On that note I heard that NY came out and told everyone to assume they have been in contact with virus. Perhaps that is the best approach for most of the country? Just assume you have been exposed and plan to stay home for a couple weeks and/or limit your human contacts as much as possible and follow hygiene guidelines.

I am on the corporate hiring team and have traveled CONUS in January. Have not felt great for the last couple weeks but nothing that some ibuprofen can't help out with. All of my interviews this coming week have been converted to skype.

Like I said a few pages ago, everyone should do what I do during the flu season and act like everyone has it. Minimize contact and do the things necessary to prevent getting it or spreading it.

No clue, that's just what I heard from my wife who is communicating with my neighbor. I will post more definitive information when / if I get it. Right now, the volume and accuracy of nearly all information is spotty to say the least.

-Wayne

I am assuming exposure is unavoidable. However, I’m in day 2 of self-quarantine. I’ll know soon enough. No physical contact with anyone. Hypervigilant with my hands. Sanitizing all surfaces in my home and vehicle and not venturing forth unless absolute necessary as in emergencies only. Sounds overreactive but it’s precisely what is being pounded into us. Grocery shopping for perishables is gonna be my weak point. I figure I’ll only have to do it once.

My tiny circle of family went through a round of strange ‘colds’ and coughs about a month ago. Everyone seems OK but It would not surprise me if any one of us is positive.

I already miss the grandkids. Their parents have been ordered to work from home.

"Like I said a few pages ago, everyone should do what I do during the flu season and act like everyone has it. Minimize contact and do the things necessary to prevent getting it or spreading it."

That is likely not enough, depending on what is meant by "minimize contact," et cetera.

This novel virus appears to act differently from typical flu virus. Perhaps a heavier viral load, perhaps shedding earlier and maybe heavier and perhaps with no symptoms.

Furthermore, with more typical flu viruses, there are always quite a few people that are immune-- so we have some herd immunity.

And of course flu vaccine shots may provide protection if there is a good match.

Here humankind appears to be bare naked.

This virus is novel. Apparently no herd immunity. No vaccine. Perhaps easier to spread since that can happen before symptoms show.

And of course higher mortality and morbidity are likely to be confirmed if they haven't been already.

Acting like everyone has flu during a typical flu season may result in behavior and practices "A."

But for this novel virus, it seems clear that we are best minimizing its impact with more austere measures... let's call them behavior and practices "B."

The scientists, medical people and public health people are advising government officials that these austere measures will provide far more benefit than they "cost."

could be - I dunno the accuracy of the current tests.

What did you see about them?

Las Vegas is Closed..

Man, that could be enough to cause a recession / depression right there. Think of the overhead of that place...

-Wayne

I knew this place was gona turn into a ghost town..global tourist destination with a pandemic. Yeah right..

This place is already like a ticking time bomb..
I am surprised only 16 cases so far?

Maybe all those people took it home with them..so what happens in Vegas actually leaves Vegas.

In September the PA I saw asked if i had my flu.and pneumonia vaccine...i said i would get them..for the first time ever. So going pu a prescription at the pharmacy i got the pneumonia and about a week ago the flu.

Just an unknowning intutive whim..something just told me to get it this time? Pneumonia is the complication that kills with Corona.

I'm glad that you got those vaccines because they could save your life but unfortunately, not from this Corona virus. I get both vaccines and the pneumonia one is worthless against the viral pneumonia that is killing everyone at the moment.

Stay inside, limit contact w others and be a germaphobe for a while.

My wife already is a "Super Cleaner" type personality. She is VERY happy with everyone now pitching in to be even cleaner than normal.

I arrived at the office this morning and sprayed down all of the door knobs with sanitizing solution. Everyone is washing hands thoroughly, too many times per day.

I guess we as a society need to re-awaken the hygiene levels we should have been doing all along. First world problem.

I slightly disagree. Good hygiene is of course important to public health but the level of germaphobe that we need to be right now is completely unnecessary in normal times and even not completely desirable. IMO.

We are behind the curve in understanding this disease.

This is a good read:

https://www.justsecurity.org/69202/highlights-of-expert-panel-on-covid-19-from-harvard-mit-mass-general/

Neither of us are "germaphobes". I do like to clean my seat area on a plane, because I know they are not properly cleaned between flights.

People have become far too lax. Note the number of people using public restrooms that don't wash afterwards, even after pooping. That is GROSS! I'll admit I wasn't washing my hands "properly" all the time, but I wash everytime I go to the bathroom and use a paper towel to open the door.

Agree. I get freaked out when a restroom in a restaurant doesn't have proper hot water and real soap, (that foam stuff ain't it).