All things political. Coronavirus Edition. (24 Viewers)

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    Maxp

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    I fear we are really going to be in a bad place due to the obvious cuts to the federal agencies that deal with infectious disease, but also the negative effect the Affordable Care act has had on non urban hospitals. Our front line defenses are ineffectual and our ability to treat the populous is probably at an all time low. Factor in the cost of healthcare and I can see our system crashing. What do you think about the politics of this virus?
     
    Have we seen evidence that children are in danger of this virus (catching or spreading)? I think Israel had a problem but I don't know if that has been tracked to students or teachers. The studies I have seen show little to none for kids under 10 (I will have to double check the studies on ages and don't have time right now).


    Dude really?

    The main reason children are hard to get infected is because they are short. When someone is shedding virus they are a couple feet shorter. Therefore they get less of a virus load.

    School they are all the same size. They have no advantage.

    Or did you miss a second grader the first day of school in Georgia got the whole class quarantined and the rooms that child was in shut down until cleaned?
     
    Have we seen evidence that children are in danger of this virus (catching or spreading)? I think Israel had a problem but I don't know if that has been tracked to students or teachers. The studies I have seen show little to none for kids under 10 (I will have to double check the studies on ages and don't have time right now).

    Post the links... We will check for you and save you some time.
     
    I think something we need to keep in mind when thinking about the number of cases among children is the amount of contact that they have had with other children. Since the outbreak began, there were relatively few cases in Mississippi before the lockdown started, which began as cases rose statewide. So children were isolated for the rest of the school year and when the state began to reopen, it was summer so there were few large gatherings of children. Yet, in Mississippi, the under 18 age group has had more cases than any 10-year group 70 and older and almost as many as the 60-69 group. I would guess that the majority of those under 18 have had less exposure than the working ages from 18-69. Once they return to school, I would imagine that the number of cases among school aged children will rapidly increase.

    Current Mississippi numbers:

    covid19-chart-age-08-05.png


    covid19-chart-pediatric-08-05 (1).png
     
    Have we seen evidence that children are in danger of this virus (catching or spreading)? I think Israel had a problem but I don't know if that has been tracked to students or teachers. The studies I have seen show little to none for kids under 10 (I will have to double check the studies on ages and don't have time right now).
    Yes, there is evidence, but it's a complex, emerging, picture. We definitely know children can catch it, and we know it can be severe, so we know there is some danger. But how much? The overall evidence I've seen, particularly initially, indicated that children are less likely to test positive and less likely to experience symptoms - for example, widespread testing in the Italian town of Padua detected no infections children under 10:
    https://www.nature.com/articles/s41586-020-2488-1

    "Recent studies have found that the clinical progression of infection in children is generally milder than in adults. We found that none of the children under 10 years of age who took part in the study tested positive for SARS-CoV-2 infection at either survey, despite at least 13 of them living together with infected family members. This agrees with a recent study conducted in Iceland and is particularly intriguing given the very high observed odds ratio for adults to become infected when living together with family members who are positive for SARS-CoV-2. However, this result does not mean that children cannot be infected by SARS-CoV-2, but suggests that children may be less susceptible than adults."​
    (see link for references)​

    So that sounds relatively positive.

    But then, we also have recent evidence including the CDC report of the outbreak at a Georgia YMCA camp: https://www.cdc.gov/mmwr/volumes/69/wr/mm6931e1.htm

    "A total of 597 Georgia residents attended camp A. Median camper age was 12 years (range = 6–19 years), and 53% (182 of 346) were female. The median age of staff members and trainees was 17 years (range = 14–59 years), and 59% (148 of 251) were female. Test results were available for 344 (58%) attendees; among these, 260 (76%) were positive. The overall attack rate was 44% (260 of 597), 51% among those aged 6–10 years, 44% among those aged 11–17 years, and 33% among those aged 18–21 years."​
    Which sounds quite a bit less positive. We also have recent contact tracing studies indicating children can spread it, e.g. https://wwwnc.cdc.gov/eid/article/26/10/20-1315_article which saw the highest level of household tranmission with index patients 10-19 (and lower, but not zero, rates with younger children): "We showed that household transmission of SARS-CoV-2 was high if the index patient was 10–19 years of age."

    I've seen a couple of other similar contact-tracing studies, but it's 11pm here, so I'll have to leave it there.

    I'll just add one point of speculation I've seen recently, which is that contact-tracing studies may have been missing transmission from children, due to misidentifying the index patient; I think the reasoning is that if children are more likely to be asymptomatic than adults, with responsive testing, an adult with symptoms is more likely to have been identified first and considered the index patient, with the child being tested subsequently and considered to have been infected by the adult, when it may in reality have been the other way around. There's a degree of uncertainty in a lot of these studies.

    So I think the bottom line is "we don't know much for sure." Which isn't unusual for viruses, we're still learning about ones we've known about for decades. But we do know children can catch it, and there seems to be increasing evidence that they can spread it.
     
    Have we seen evidence that children are in danger of this virus (catching or spreading)? I think Israel had a problem but I don't know if that has been tracked to students or teachers. The studies I have seen show little to none for kids under 10 (I will have to double check the studies on ages and don't have time right now).

    Two recent publications have shed new light on the role of children in the transmission of the virus.

    The first, a JAMA Pediatrics-published study by a joint team of Northwestern U Hospital and a children's hospital in Chicago found that infected children five and under have up to twice the detectable viral load in their upper respiratory tract than adults do. It certainly suggests that young children may be able to spread the virus more easily than thought, even if the severity they are experiencing is low (mild to no symptoms).

    https://jamanetwork.com/journals/ja...ium=social&utm_term=073020#.XyNyImjnx-k.email

    The second was more concerning, a CDC-published report on an outbreak at a summer (sleep-away) camp in Georgia found that nearly half of the camp tested positive (a positive rate of 76% of those who were actually tested but not all of the camp was tested). Among the younger campers, age 6 to 10, over 50% of those tested were positive. And only one-quarter (26%) were truly asymptomatic.



    The idea that children are not significant vectors for transmission, or that are somehow less disposed to get infected seems to be not only counter-intuitive, but also suspect based on new analysis. Thankfully it tends to be less severe in children, but there are certainly cases of severe infection and death in children.
     
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    It sure seems that if we open schools fully, without masks and without any social distancing, there will be a new spike of cases in the communities and in the schools. There will be relatively little severe disease and/or death in children, but it won’t be zero. What we will see in larger numbers are dead teachers, cafeteria workers, custodians and bus drivers. And also dead parents and grandparents. It’s such a mess, really. How many dead teachers and other school workers are okay? How many dead children?

    Especially if, as Trump says, we will have a vaccine by November his push to open schools fully makes zero sense.
     
    It sure seems that if we open schools fully, without masks and without any social distancing, there will be a new spike of cases in the communities and in the schools. There will be relatively little severe disease and/or death in children, but it won’t be zero. What we will see in larger numbers are dead teachers, cafeteria workers, custodians and bus drivers. And also dead parents and grandparents. It’s such a mess, really. How many dead teachers and other school workers are okay? How many dead children?

    Especially if, as Trump says, we will have a vaccine by November his push to open schools fully makes zero sense.


    Come on man!

    We did hear him say "it is what it is"

    I am more than certain that applies to children, parents, and really just anyone else.


    It is what it is!

    One thing is I am gonna be on the look out for a lightly used touring motorcycle with Sturgis happening. We are gonna have a hell of a bunch die from that. They expect a small crowd of 250k about half the normal size.

    Just wrap your head around idiots yelling at each other over stupid loud pipes spreading the virus like mad.

    The Harley crowd is not a real healthy one to begin with.
     
    Come on man!

    We did hear him say "it is what it is"

    I am more than certain that applies to children, parents, and really just anyone else.


    It is what it is!

    One thing is I am gonna be on the look out for a lightly used touring motorcycle with Sturgis happening. We are gonna have a hell of a bunch die from that. They expect a small crowd of 250k about half the normal size.

    Just wrap your head around idiots yelling at each other over stupid loud pipes spreading the virus like mad.

    The Harley crowd is not a real healthy one to begin with.
    I think it's probably going to be not that bad. Yeah, they'll be in bars, restaurants and hotels together, but most everything else is outside.
     
    I think it's probably going to be not that bad. Yeah, they'll be in bars, restaurants and hotels together, but most everything else is outside.

    That crowd is not gonna mask. I went to it in the 90s it is gonna be a shirt show that then all goes homeward to spread all the way home. It is gonna be a baby Mardi gras. When I went I camped plenty do.

    The people that would mask are not going. The age and health of the riders are exactly what coronavirus kills.

    The impact of that is gonna be pretty big. We will hear about it later.

    Hell I just hope zz top makes it out ok. If Billy, Dusty, and Frank get sick I am gonna be beyond pissed off.
     

    No underlying conditions.


    Yeah not real happy with playing with young peoples lives.

    When everything shut down schools, sports, camps, and so on we really don't know what the problems children will have. That camp in Georgia should be an eye opener. Young children got sick.

    I think it is bad enough that they are gonna have to pay for all of this financially.

    This is truly pathetic we can't look after the elderly or the youth of America.
     
    We're much better off today than we were in March, because we have a much better understanding of how to treat patients. I've heard of new convalescence plasma treatments that are working better than previous convalescence plasma. That gives patients a couple of months of immunity. If the vaccine is indeed going to be ready by the end of the year, then we would just have to give patients this convalescence treatment a couple of times. In addition, Remdesivir reduces mortality. Using new treatments and medicines should drastically reduce the mortality rate.

    I've never believed that kids were not vectors to spread. The evidence is piling up now, so we shouldn't stick our heads in the sand and pretend it isn't risky, but I think we need to get at least some of our kids back in school, because some parents can not cope without the kids being back in school. We just need to be smart about the approach to reduce the risk. I would think with the new treatment measures, continued distancing and masking, improved timeliness of tests, and some ingenuity, such as curtailed classroom attendance, eliminate recess and other contact activities, plastic separations and use of spaces like cafeterias for classes, we could allow at least some students to return to school. There are many combinations that can be used for kids to learn. Alabama is offering virtual, online, and eventually in-person attendance. Since many kids will take the virtual and online approach, the number of kids that will eventually attend in person will be reduced, therefore I think with proper precautions, the risk can be minimized for both the kids, staff, and parents. I know some kids, staff, and parents will get sick as a result, but it should be controllable if the proper precautions are taken, and this would help many challenged households to cope. If the vaccine comes through by the end of the year, then we'll be able to return to school normally next year.
     
    Asked on the Geraldo Rivera radio program when a vaccine might be ready, Trump said, "Sooner than the end of the year, could be much sooner."

    "Sooner than November 3?" he was asked.

    "I think in some cases, yes possible before, but right around that time," Trump said.

    Later at the White House, Trump said he was optimistic a vaccine would be available around that date. Asked if it would help him in the election, he said, "It wouldn't hurt. But I'm doing it, not for the election; I want to save a lot of lives."

    (well that settles it folks. Nothing to worry about)


    One thing is I am gonna be on the look out for a lightly used touring motorcycle with Sturgis happening. We are gonna have a hell of a bunch die from that. They expect a small crowd of 250k about half the normal size.

    Yeah I just read about that. It is presumed that 250,000 are going mask-less for 9 days. What could possibly go wrong? 🤔
     
    Here is my concern. Everyone is focused on the short term effects of Covid and overlooking there is potentially very dangerous long term effects that we aren't aware of yet.


    This isn’t about getting Covid and "beating it." Like, why would you ever want to risk your child getting infected in the first place? Even if the Covid symptoms are mild, what about the potential neurological effects, long term? Their brains are still developing.

    Eventually, Nia turned a corner and was able to breathe again unaided. But after several days in recovery, her condition worsened once again. This time, it was her brain rather than her lungs that was affected. Awake night after night, she began hallucinating, seeing and hearing people in the hospital who were not really there.

    During this period, Nia’s voice and behavior appeared to regress to a younger version of herself. Pediatric neurologist Dr. Ming Lim of the Evelina London Children’s Hospital diagnosed her with encephalitis, an inflammation of the brain.

    “We worry that the long-term effect would be in essentially brain growth,” he said, a particular concern among children and young adults whose brains are still developing.


    Brain growth. I'm sorry. "Going to school" isn't worth gambling with that.
     
    We're much better off today than we were in March, because we have a much better understanding of how to treat patients. I've heard of new convalescence plasma treatments that are working better than previous convalescence plasma. That gives patients a couple of months of immunity. If the vaccine is indeed going to be ready by the end of the year, then we would just have to give patients this convalescence treatment a couple of times. In addition, Remdesivir reduces mortality. Using new treatments and medicines should drastically reduce the mortality rate.

    I've never believed that kids were not vectors to spread. The evidence is piling up now, so we shouldn't stick our heads in the sand and pretend it isn't risky, but I think we need to get at least some of our kids back in school, because some parents can not cope without the kids being back in school. We just need to be smart about the approach to reduce the risk. I would think with the new treatment measures, continued distancing and masking, improved timeliness of tests, and some ingenuity, such as curtailed classroom attendance, eliminate recess and other contact activities, plastic separations and use of spaces like cafeterias for classes, we could allow at least some students to return to school. There are many combinations that can be used for kids to learn. Alabama is offering virtual, online, and eventually in-person attendance. Since many kids will take the virtual and online approach, the number of kids that will eventually attend in person will be reduced, therefore I think with proper precautions, the risk can be minimized for both the kids, staff, and parents. I know some kids, staff, and parents will get sick as a result, but it should be controllable if the proper precautions are taken, and this would help many challenged households to cope. If the vaccine comes through by the end of the year, then we'll be able to return to school normally next year.

    I don't see how it can work for kids to return to school without risking the health a futures of children, teachers, staff and administrators. Not every school district can accommodate virtual and online learning. Poor and rural districts will have large segments of their student body that do not have access to the internet, home computers or in some cases, a home support system conducive to remote learning. For motivated adults, it can be difficult to stay focused at home in order to complete online tasks for an employer or online classes. Even with consistent internet, I can't imagine how difficult it would be for a parent of four or five children to be able to get them all time to complete their daily assignments without distractions.

    From what I have seen around here, school districts are doing the best they can to come up with safe plans for in school learning. But without strict mask and social distancing mandates, all of those plans will certainly fail. Then you have the problem of a lack of support from some parents who still refuse to take precautions seriously. Administrations are trying to straddle the fence of trying to appease that type of parent by making precautions less stringent or optional, while knowing that only strict precautions are the only way this works. I fear we are about to face a massive rise in cases fed by the return of children to school.
     
    Here is my concern. Everyone is focused on the short term effects of Covid and overlooking there is potentially very dangerous long term effects that we aren't aware of yet.


    This isn’t about getting Covid and "beating it." Like, why would you ever want to risk your child getting infected in the first place? Even if the Covid symptoms are mild, what about the potential neurological effects, long term? Their brains are still developing.

    Eventually, Nia turned a corner and was able to breathe again unaided. But after several days in recovery, her condition worsened once again. This time, it was her brain rather than her lungs that was affected. Awake night after night, she began hallucinating, seeing and hearing people in the hospital who were not really there.

    During this period, Nia’s voice and behavior appeared to regress to a younger version of herself. Pediatric neurologist Dr. Ming Lim of the Evelina London Children’s Hospital diagnosed her with encephalitis, an inflammation of the brain.

    “We worry that the long-term effect would be in essentially brain growth,” he said, a particular concern among children and young adults whose brains are still developing.


    Brain growth. I'm sorry. "Going to school" isn't worth gambling with that.
    You're right that the long term affects need to get more attention, but things like this brain impact need to be kept in perspective. While it is terribly sad for that little girl, I believe that is extremely rare. I know that there are other potentially long term effects, but millions of people have recovered without seemingly any long term permanent affects. Many have taken weeks and months to get there, but I think just about everyone fully recovers within a few months after a negative diagnosis. I don't think we should make policy based on some extremely rare risks. We need to work to minimize the spread, but I think that can be done with some kids returning to school with many precautions in place. We need to be sensible about it. If a substantial percentage of kids, say over 0.1% that get infected, have permanent effects, then I would agree that it isn't worth the gamble of opening schools. There are 76M school age kids, so let's say with good precautions less than 5% of those get infected (about 1.4% of the U.S. has been infected, but opening schools will worsen this), then that's 3.8M infected kids. If less than 0.1% of those have permanent effects, then less than 3800 out of 76,000,000 kids would have permanent effects. Even then what is the long term effect? Is it permanent brain damage, or something much less severe? In the U.S., there are about 11,400,000 kids with debilitating diseases such as Spina Bifida, so this is tiny fraction of that. I realize most of these debilitating diseases are generally genetic and unpreventable, while Covid is preventable, but some of these kids will get sick even without returning to school. Returning to school is an added risk, but I'm sure many more face more risks from staying at home, so I think we should proceed with modified openings. We may find that with the precautions, much fewer than 5% of kids, staff and parents get sick due to the re-openings. If we start finding that we can't protect the kids, staff and teachers, then we can shut down the schools again, but I think we should try. The key is to wait until those precautions are in place. I think some places have them, so they should be able to try.
     
    I don't see how it can work for kids to return to school without risking the health a futures of children, teachers, staff and administrators. Not every school district can accommodate virtual and online learning. Poor and rural districts will have large segments of their student body that do not have access to the internet, home computers or in some cases, a home support system conducive to remote learning. For motivated adults, it can be difficult to stay focused at home in order to complete online tasks for an employer or online classes. Even with consistent internet, I can't imagine how difficult it would be for a parent of four or five children to be able to get them all time to complete their daily assignments without distractions.

    From what I have seen around here, school districts are doing the best they can to come up with safe plans for in school learning. But without strict mask and social distancing mandates, all of those plans will certainly fail. Then you have the problem of a lack of support from some parents who still refuse to take precautions seriously. Administrations are trying to straddle the fence of trying to appease that type of parent by making precautions less stringent or optional, while knowing that only strict precautions are the only way this works. I fear we are about to face a massive rise in cases fed by the return of children to school.
    There are places that can't open safely, but there are places that can open with limited risk. It's wrong to force everyone to remain closed due to those that can't open with limited risk. This isn't a binary situation. I know some areas that are providing computers to kids that need them, and other areas are paying for internet services. For other areas, those that don't have internet may be the subset that return to school. There will be fewer kids if it is mixed, therefore they can maintain distancing, cleansing, masking and other safety protocols. I would say for parents that don't comply with the safety protocols, then their kids must stay home. Everyone must cooperate to limit the risk, but with proper cooperation and precautions, I think the risk can be controlled. In areas with significant positivity rates (I'll randomly say higher than 5%), kids and staff must be tested regularly otherwise this won't work. We can monitor the increase of positivity, and if it exceeds say 15%, then it'll probably be time to shut down again. With proper precautions, many schools may not get there. Note, there are states with over 20% positivity rates today (Arizona is over 25%). For this positivity test to matter, a region must provide timely test (as in within 2 days) results. I'd favor the under 30 minute result antigen swab, but kids won't like that. It's not an easy proposition, but I think it can be done in some areas.
     

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