As I noted on 2/3, every new case in every new location is local "patient zero." Partial containment + mobility = spread
Click lowest "Show this thread" for latest. Please RT https://twitter.com/hussmanjp/status/1239859310588461058
Outside U.S., "observed" case fatality rate (CFR) is now above 6%, b/c reported cases are a fraction of total. Fatalities still predictable.
a) Weakly contained states, along with mobility, are propagating spread for the entire U.S.
b) Ventilators (high fatality) aren't silver bullets
c) Nor is HCQ, though it may act as DMARD
d) Asking for NIH/NIAID guidance centered on T-lymph inflamm
A friend shared this.
Cuomo's early action stopped the future rushing toward us. We're still pushing it back, but not fast enough.
I'll say it again. We need to shift focus to suppressing the cytokine storm.
The pandemic Coronavirus-disease 19 (COVID-19) is characterized by a heterogeneous clinical course. While most patients experience only mild symptoms, a relevant proportion develop severe disease...https://www.medrxiv.org/content/10.1101/2020.03.30.20048058v14
When people suggest *new cases could "peak" in next 10 days, it would look like this.
Guided by the principle of primum non nocere (first do no harm), we report a cautionary note on the potential fatal toxicity of chloroquine (CQ) or hydroxychloroquine (HCQ) in combination with...https://www.biorxiv.org/content/10.1101/2020.03.31.018556v1
Background: SARS-CoV-2 is the cause of the COVID-19 that has been declared a global pandemic by the WHO in 2020. The COVID-19 treatment guidelines vary in each country, and yet there is no approved...https://www.medrxiv.org/content/10.1101/2020.04.02.20051029v1
Aim: The new coronavirus pneumonia (COVID-19) outbreaking at the end of 2019 is highly contagious. Crude mortality rate reached 49% in critical patients. Inflammation matters on disease progression....https://www.medrxiv.org/content/10.1101/2020.04.01.20047381v1
4/9/20: A hopeful sign, a caveat, a warning, and an appeal.
The hopeful sign: thanks to containment efforts, daily growth rates have eased to 9% (cases), 12% (estimated "shadow" cases), and 15% (fatalities). Chart should bend toward logistic shortly
Next, the caveat: One way to estimate the impact of containment efforts to estimate the expected date of various outcomes using an adaptive model. It is only *continuing containment effort that prevents the future from rushing back toward us.
Next, the warning: Even with a desperately needed flattening of the curve from exponential to logistic, even a peaking of daily new cases this week would imply that most U.S. fatalities are *ahead. For that reason... https://twitter.com/hussmanjp/status/1247167822507192320
The appeal: we came to this crisis w/ a rich volume of research on prior CoV serotypes. Connecting dots of available research, ICUs need @NIH interim guidance, beyond pulmonology, addressing IL6/TNFa/Th17 inflammatory axis (w/prelim ORs from RCTs).
When we talk about "flattening the curve," this is what it might look like. Please don't assume the word "peak" means containment efforts can be relaxed.
Notes on SARS-CoV-2 (COVID-19) inflammatory pathway, and rationale for interim clinical guidance on repurposed therapeutics (possibly on the IL-6/TNF/Th17 axis).
My 4/3 memo to research colleagues and NIH/NIAID here. Please RT
My hope (if it's possible to hope for such things) is this reflects a lump-sum adjustment for non-ICU fatalities, not a shift in trajectory.
Either way, we have more cases than we thought
Critical care specialists say being on the belly seems help people seriously ill with Covid-19 because it allows oxygen to more easily get to the lungs. "It's such a simple thing to do, and we've...https://www.cnn.com/2020/04/14/health/coronavirus-prone-positioning/index.html
So much for the optimistic scenario.
We're way off book. I had hoped this was just a one-time adjustment.
Understand this: PEAK daily new cases in a containment scenario is also PEAK infectivity if containment is abandoned at that moment.
This is like throwing gasoline on an inferno the very moment firefighters begin to get the blaze under control.
See thread since Feb 2, when we had only 5 cases. https://twitter.com/realDonaldTrump/status/1251169217531056130
You don't think a Facebook ad offering serologic testing won't enrich 1.5% of your sample with actual cases?
They wisely concluded "we cannot use the rise in numbers seropositive to infer the contemporary seropositive or the growth rate of the epidemic."
Establishing how many people have already been infected by SARS-CoV-2 is an urgent priority for controlling the COVID-19 pandemic. Patchy virological testing has hampered interpretation of confirmed...https://www.medrxiv.org/content/10.1101/2020.04.15.20067066v1