Agree with everything you said. The CDC and governments lack of preparedness to test people combined with the decisions to shut down so much of the economy has caused incredible damage.

lumberpack5 said:

---

Davie, when you get the chance maybe you could talk about viral load and titer.

https://www.sciencealert.com/does-the-amount-of-covid-19-virus-you-are-exposed-to-determine-how-sick-you-ll-get


Just as a guess, it seems the virus that came through Italy is more virulent than what came into Seattle from China but now enough time has passed that you could be getting exposed to both.

---

In answer to your question, here are my thoughts on viral load and why the virus has been so good at infecting and in many cases, killing people in this country.

1. Based on what I have read, the structure of this particular Coronavirus makes it particularly well-suited to infect people. Up until this virus, there were six Coronavirus that have been known to infect humans. Four of these have infected humans for years and they are the main cause to the common cold. Two others were the causes of the MERS and SARS outbreaks that killed lots of people during their outbreaks. This new seventh version we are dealing with now has some things going for it that make it quite effective.

The shape of the virus is a spiky ball and each of these spikes allows the virus to stick to the cell membrane by attaching to a protein known as ACE2. It is the contours of these spikes that allows it to stick more strongly to the cell walls than many other viruses. Think of it this way, the better and tighter is sticks to the cell wall, the less virus you need to infect a patient. This is one reason why the virus load for the Coronavirus does not need to be as high as for other viruses. One of the vaccines currently undergoing clinical trail is focused on inhibiting the virus' ability to attach to the cell wall, by creating an anti-body that causes the body to create a blocking protein.

Secondly, the spikes on this version of the Coronavirus consist of two connected halves. The spikes are activated when the two halves are separated and this allows the virus to penetrate the cell wall. The mechanism that causes the halves to separate is accomplished by an enzyme called furin which is made by human cells. This particular version of the Coronavirus seems to be able to be separated more easily than it can be with other viruses.

These reasons seem to point to why this version of the Coronavirus can infect people more easily than other viruses like the flu or common cold. Fewer droplets are required to cause an infection in people.

2. A patient's underlying health conditions can also greatly impact how their bodies react to the virus and explains why some people have positive outcomes and some people become very ill and die. The article you linked speaks to this issue. As we know, this version of the Coronavirus impacts people with heart disease, respiratory issues, diabetes, and hypertension more severely for various reasons. As we know, the general population in the United States has a higher proportion of these diseases (particularly diabetes and heart disease) than many other developed nations. Recent statistics indicate that 34.2 million people (10.5%) of the population of the US has diabetes. As such, these people would be at risk for more severe cases of the virus and it helps to explain why the US has different outcomes from other nations. In theory, these people would not require high viral loads to become very sick. The same is true for other underlying conditions.

3. The demographics of those affected can determine overall outcomes. We know for a fact that people over the age of 65 die at a much higher rate than those under this age. This is due in part to the fact that our immune systems become weaker as we age and is a reason why people who are older are urged to get a flu shot every year. If the virus gets into facilities such as nursing homes, it can have devastating effects on this population, due to weaker immune systems and other significant underlying conditions found with this population. Recent statistics indicated that approximately half the deaths being seen in Europe, particularly Spain, Italy, and France have come from people who were in long-term facilities. So to the degree you can keep the virus from infecting this population, you can have much better outcomes as a state and nation.

Again, these are my thoughts and opinions, based on what I have read so far about the virus. There is still a tremendous amount we do not know about this virus and the mechanisms it uses to infect people. I would also ask Mormad to weigh in on this topic, since he has much more medical training and experience than I do and can probably more easily speak to what we know about the virus and how it affects humans.

Wayland said:

---

Wayland said:

---

Wayland said:

---

Wayland said:

---

Wayland said:

---

Wayland said:

---

Wayland said:

---

Wayland said:

---

Wayland said:

---

Wayland said:

---

Wayland said:

---

Wayland said:

---

Wayland said:

---

https://www.ncdhhs.gov/covid-19-case-count-nc

3/31/2020 Morning DHHS update

NC Cases*
1,498
NC Deaths**
8
Currently Hospitalized
157

4/1/2020 Morning DHHS update

NC Cases*
1584
NC Deaths**
10
Currently Hospitalized
204


4/2/2020 Morning DHHS update (as of 11:00am)

NC Cases*
1857
NC Deaths**
16
Currently Hospitalized
184

4/3/2020 Morning DHHS update (as of 11:25am)

NC Cases*
2093
NC Deaths**
19
Currently Hospitalized
259

Guilford now shows 3 deaths and Mecklenburg 2.

15 deaths > 65 age (20% of positive cases)
2 deaths between 50-64 age (28% of positive cases)
2 deaths between 25-49 age (43% of positive cases)

2919 additional completed tests, 236 positive results for a 8.1% positive test rate day to day.

---

4/4/2020 Morning DHHS update (as of 11:00am)

NC Cases*
2402
NC Deaths**
24
Currently Hospitalized
271

Looks like DHHS is lagging in numbers today, since we should have had at least 5 more deaths in the morning count. Guilford only showing 3 deaths in this count and they are at 5 or 6. DHHS only reports lab confirmed reported deaths, so maybe the local health departments either aren't reporting or don't have lab confirmation on the media counts?

Congregate Data:
6 Nursing Homes, 4 Residential Care, 2 Correctional Facilities, and 1 Other have 2 more more lab confirmed cases. Considered Outbreak.

---

4/5/2020 Morning DHHS update (as of 11:00am)

NC Cases*
2585
NC Deaths**
31
Currently Hospitalized
261

Deaths in NC
26 > 65 years of age
3 Between 50-64 years of age
2 Between 25-49 years of age

---

4/6/2020 Morning DHHS update (as of 11:00am)

NC Cases*
2870
NC Deaths**
33
Currently Hospitalized
270

---

4/7/2020 Morning DHHS update (as of 10:15am)

NC Cases*
3221
NC Deaths**
46
Currently Hospitalized
354

Worst day. Although some of that total looks to be the lag that the media had that DHHS wasn't reported. 80% of total deaths 65+ years of age.

The highest day for positive cases by collective sample is still 3/23/2020 second highest is 4/1/2020. But positive cases still awful metric since testing is not consistent.

---

4/8/2020 Morning DHHS update (as of 11:00am)

NC Cases*
3326
NC Deaths**
53
Currently Hospitalized
386
Completed Tests
42987

---

4/9/2020 Morning DHHS update (as of 11:00am)

NC Cases*
3651
NC Deaths**
65
Currently Hospitalized
398
Completed Tests
47809

Looks like deaths now align with media totals for the morning. 82% of deaths > 65

16 Nursing Homes, 4 Residential Care Facilities, 4 Correctional Facilities, and 1 Other with outbreaks.

---

4/10/2020 Morning DHHS update (as of 11:00am)

NC Cases*
3908
NC Deaths**
74
Currently Hospitalized
423
Completed Tests
57645

A 2.5% positive test rate is insanely low.

23 Nursing Homes, 6 Residential Care Facilities, 5 Correctional Facilities, and 1 Other with outbreaks.

7 Additional nursing home since YESTERDAY (and 2 additional residential care). Just goes to show you how ineffective this has all been when we aren't actually protecting the most vulnerable. Time for a shift in strategy.

---

4/11/2020 Morning DHHS update (as of 11:38am)

NC Cases*
4312
NC Deaths**
80
Currently Hospitalized
362
Completed Tests
60393

Hospitalizations down.

Media reporting 84 deaths (so still a gap in reporting there)

2 more Nursing Homes 1 more Residential to add to outbreaks.

---

4/12/2020 Morning DHHS update (as of 10:45am)

NC Cases*
4520
NC Deaths**
81
Currently Hospitalized
331
Completed Tests
62139

---

4/13/2020 Morning DHHS update (as of 10:45am)

NC Cases*
4816
NC Deaths**
86
Currently Hospitalized
313
Completed Tests
63,388

---

4/14/2020 Morning DHHS update (as of 11:00am)

NC Cases*
5024
NC Deaths**
108
Currently Hospitalized
418
Completed Tests
65039

Now up to 30 nursing home outbreaks, 9 residential care, 6 correctional, and 1 other. Continues to explode here.

---

4/15/2020 Morning DHHS update (as of 11:00am)

NC Cases*
5123
NC Deaths**
117
Currently Hospitalized
431
Completed Tests
67827

---

4/16/2020 Morning DHHS update (as of 11:00am)

NC Cases*
5465
NC Deaths**
131
Currently Hospitalized
452 (88% hospital reporting)
Completed Tests
70917

4 Additional Congregate Outbreaks (3 nursing, 1 residential)

NandO at 138 and WRAL at 141 (-2 = 139) deaths.

Interesting the >65 death rate seems to have spiked. It was around 80% for a long time, and is now at 84%

NC has had 8 residents under the age of 50 die from corona.

Do you have a breakout of the age ranges and deaths? I know I could search for it but I assume you've got it handy

statefan91 said:

---

Do you have a breakout of the age ranges and deaths? I know I could search for it but I assume you've got it handy

---

25-49 - 8 deaths
50-64 - 13 deaths
65+ - 110 deaths

No deaths below 25.

Unfortunately NC does not break it down even further like most states where they give actual decade instead of broad sweeping like 65+ or 25-49.

65 and 85 are very different as are 25 and 49.

Another fascinating trend. I wish I had noted the numbers are the time, but it makes sense based on testing. The percentage of cases in 65+ age has spiked. I feel like when DHHS first posted the numbers it was around 15% and now it is 27%. But it makes sense since they are basically only testing the elderly or SEVERELY ill (or frontline workers and rich people)

IHME model being updated today. IHME director says the nunbers should come down as compared to the last recent update Monday. Also says the southern states should come in even lower because of social distancing measures that were taken. As wonky as this model has been, I expect the numbers to go back up after this update just to continue the narrative.

Wayland said:

---

statefan91 said:

---

Do you have a breakout of the age ranges and deaths? I know I could search for it but I assume you've got it handy

---

25-49 - 8 deaths
50-64 - 13 deaths
65+ - 110 deaths

No deaths below 25.

Unfortunately NC does not break it down even further like most states where they give actual decade instead of broad sweeping like 65+ or 25-49.

65 and 85 are very different as are 25 and 49.

Another fascinating trend. I wish I had noted the numbers are the time, but it makes sense based on testing. The percentage of cases in 65+ age has spiked. I feel like when DHHS first posted the numbers it was around 15% and now it is 27%. But it makes sense since they are basically only testing the elderly or SEVERELY ill (or frontline workers and rich people)

---

It is interesting to me that 27% of the cases are people aged 65+ and yet 84% of the deaths are in this same age range. Like you, I believe most of the new cases are coming from the 65+ age group and it is directly related to the testing being conducted now in nursing homes. I expect cases to continue to rise as they test this population and I am certain almost half the deaths in NC will eventually be from people in nursing/long-term care facilities.

For people under the age of 65, the vast majority should have positive outcomes and get over the illness. For those under the age of 40, the virus does not seem to be a significant event when it comes to mortality and is why I believe it is this population of people who should come out of lock-down first.

I know it's Fox, and that will immediately trigger some to not want to read it, but this timeline they compiled of changing opinions and flip/flops on this virus doesn't really look great for anyone on either side politically, nor for the media at large or some of the health organizations/medical experts, so I don't find it to be particularly biased. In general I find that the public has such a short attention span that they are incapable of remembering what happening yesterday, much less months ago, but it is interesting to be reminded of how things have changed. Please don't derail this into a political discussion, because that is not the intention.I think that reasonable people can see that there's no one devoid of criticism at this point.

https://www.foxnews.com/politics/from-new-york-to-canada-to-the-white-house-initial-coronavirus-responses-havent-aged-well

I have seen a couple of timeline articles.. not pretty for anyone.

Thanks Davie


A lot of whistling past the graveyard shown in the Fox story.

Fox "News" and Fox News the Opinion/Entertainment arm really are two separate things.

From the standpoint of China hiding information I don't doubt that for a minute, but lets say Duke U found something weird today - how long would it take for Duke to decide to let CDC know, then for CDC to inform Washington, and for the Administration to take a draconian action?

Put another way, how long does the "**** or go blind" phase last?


This is what airline travel from bum **** to the Big City in just a few hours creates.

Our response should be to pick out 5-6 really ****ty places in the US to build new strategic defense cities with VA hospitals, manufacturing in key equipment, etc., so that you can combine robust security with economic redevelopment of places like the KY/WVa/Va boarder, Miss/Ark/La boarder, etc. Otherwise these functions will naturally aggregate in parts of the country that are already well-off

With the protest going on around the country, I have a feeling the government officials are going to have their hands forced before they are ready to get the hell off the toilet and do something. More and more people everyday at beginning to look at this differently and feel their rights are being taken from them. Right or wrong, that seems to be what is happening right now. It's been said in this thread before but you can't take dang near everything from people but for so long before they stand up and demand to have it back.

King Leary said:

---

It's become clear that we can't treat all areas of the country the same. People in places with very little COVID spread are realizing that it makes no sense for them to stay at home for an indefinite amount of time.

NYC and other hot spots need drastic measures, but places in NC don't need those same measures.

---

Even Charlotte where I'm at shouldn't be completely locked down. I am fine with the practices of limited capacity at stores and restaurants, social distancing, etc. I have little hope that Mecklenburg will be at the front of figuring out how to open up based on how the county's leaders are acting (Health Director and County Manager)

Quite frankly a good number of people, at least here where I live, aren't staying at home, and haven't been for weeks. It was a ghost town at first, but for the last two weeks, traffic isn't much different than normal. They obviously aren't going to shops or restaurants, but they are out and about, in stores, definitely not always six feet apart. There's people on the golf courses, on the tennis courts, in the parks. But cases remain low in New Hanover county, and only one death last time I looked, despite having a fairly large population of retirees. I can't see how having a bunch of people in a park is any different than having a bunch of people at an outdoor concert, or how a bunch of people in Home Depot is different than a bunch of people in a bar, so I really don't know what is being accomplished in my area. It's different everywhere, and I don't know what it's like in other parts of the state since things got locked down. It just seems like here it's mostly business as usual.

wilmwolf80 said:

---

Quite frankly a good number of people, at least here where I live, aren't staying at home, and haven't been for weeks. It was a ghost town at first, but for the last two weeks, traffic isn't much different than normal. They obviously aren't going to shops or restaurants, but they are out and about, in stores, definitely not always sex feet apart. There's people on the golf courses, on the tennis courts, in the parks. But cases remain low in New Hanover county, and only one death last time I looked, despite having a fairly large population of retirees. I can't see how having a bunch of people in a park is any different than having a bunch of people at an outdoor concert, or how a bunch of people in Home Depot is different than a bunch of people in a bar, so I really don't know what is being accomplished in my area. It's different everywhere, and I don't know what it's like in other parts of the state since things got locked down. It just seems like here it's mostly business as usual.

---

Study from China about their outbreak (I know I know) had virtually zero traced cases to outdoor activities... a vast majority of the cases was intrafamilial or from public transit, if I recall correctly.

Found it: https://www.medrxiv.org/content/10.1101/2020.04.04.20053058v1

Take everything with a grain of salt these days but:

"Abstract

Background: By early April 2020, the COVID-19 pandemic had infected nearly one million people and had spread to nearly all countries worldwide. It is essential to understand where and how SARS-CoV-2 is transmitted. Methods: Case reports were extracted from the local Municipal Health Commissions of 320 prefectural cities (municipalities) in China, not including Hubei province, between 4 January and 11 February 2020. We identified all outbreaks involving three or more cases and reviewed the major characteristics of the enclosed spaces in which the outbreaks were reported and associated indoor environmental issues. Results: Three hundred and eighteen outbreaks with three or more cases were identified, involving 1245 confirmed cases in 120 prefectural cities. We divided the venues in which the outbreaks occurred into six categories: homes, transport, food, entertainment, shopping, and miscellaneous. Among the identified outbreaks, 53.8% involved three cases, 26.4% involved four cases, and only 1.6% involved ten or more cases. Home outbreaks were the dominant category (254 of 318 outbreaks; 79.9%), followed by transport (108; 34.0%; note that many outbreaks involved more than one venue category). Most home outbreaks involved three to five cases. We identified only a single outbreak in an outdoor environment, which involved two cases. Conclusions: All identified outbreaks of three or more cases occurred in an indoor environment, which confirms that sharing indoor space is a major SARS-CoV-2 infection risk."

Some states are starting to announce May 1 for their initial restriction rollbacks. I have seen Ohio and ND so far.

Wayland said:

---

Some states are starting to announce May 1 for their initial restriction rollbacks. I have seen Ohio and ND so far.

---

On the other hand, there are states like NY announcing a continued shutdown until mid-May. I suspect the other Northeastern states (NJ, Conn, RI, Mass) will follow their lead. I suspect Maine will open up earlier, given their low case and death numbers.

NY's announcement today affected the stock market as I expected. There was an immediate drop in the Dow Jones and I expect it will end up lower or flat for the day. What happens with it tomorrow depends on President Trump's meeting with the governors at 3pm and what he announces in the way of guidelines for reopening.

I have said that once certain parts of the country start to open up, people in other states will want to do the same. This will put pressure on the leadership of the states to answer this pressure.

So that would again make me question what the fundamental difference is from being in Costco and being in a bar. I know that they are limiting the number of people in stores and trying to keep people six feet apart, but it hasn't been my experience that people are minding that distance. We also know that six feet is basically an arbitrary number, because the virus can travel much farther than that in a cough or sneeze, or live on a surface for a period of time. I can accept an argument that the nature of a bar or concert venue entails that people will probably be in closer contact in those areas, but is the risk of transmission fundamentally different between a Home Depot and a Waffle House? Do you realistically have less of a chance of picking up the virus in a drivethru line versus your barber if both are wearing a mask and gloves and sanitizing between customers? I just don't think so. Clearly if you are never in contact with anyone else, you have almost no chance of getting it, but we've effectively allowed some types of contact and not others, and in my eyes, I don't see how that is effective at all.

I never realized how much I enjoyed going to a bar and drinking outside until this.

I might even miss the bars where your shoes stick to the floor.

wilmwolf80 said:

---

So that would again make me question what the fundamental difference is from being in Costco and being in a bar. I know that they are limiting the number of people in stores and trying to keep people six feet apart, but it hasn't been my experience that people are minding that distance. We also know that six feet is basically an arbitrary number, because the virus can travel much farther than that in a cough or sneeze, or live on a surface for a period of time. I can accept an argument that the nature of a bar or concert venue entails that people will probably be in closer contact in those areas, but is the risk of transmission fundamentally different between a Home Depot and a Waffle House? Do you realistically have less of a chance of picking up the virus in a drivethru line versus your barber if both are wearing a mask and gloves and sanitizing between customers? I just don't think so. Clearly if you are never in contact with anyone else, you have almost no chance of getting it, but we've effectively allowed some types of contact and not others, and in my eyes, I don't see how that is effective at all.

---

I think the store crap is basically false measures to give people that they scared the crap out of 'warm fuzzies' to make sure that they can still do their daily tasks.

And forget stores. You should have seen the parks this weekend. I went for a bike ride (first time basically out of the neighborhood in a month) and the greenways were packed. At one park I passed, the pickle ball courts were packed and there were about 20-30 people waiting to play. Someone had a party going on in the shelter and was cooking out (probably 10+ from an extended family). And obviously someone had called the police on these people (there were 3 police cars about about 5 officers chilling and talking to people) but no one was really being pressed.

You really need to start treating the states more like countries a la Europe.

I comply with all the directives, but I think a lot of people are done. The issue is the government and media scared the crap out of so many people they are having a hard time coping with where things are.

Wake County extended their stay at home until April 30 but added provisions:

• All Wake County businesses, even those considered "non-essential," can now reopen, as long as they limit service to curbside pick-up or delivery.
• Additionally, Wake County will allow churches to hold drive-in sermons in addition to their live-streams. Large gatherings inside or outside churches are still prohibited.

"You really need to start treating the states more like countries a la Europe."

Yup. I've said that many times in this thread. The measures need to be tailored to individual states and even metropolitan areas within states. One size fits all is stupid.

https://www.cnn.com/2020/04/16/politics/read-guidelines-for-opening-america/index.html

Coming up tonight.

Will see how states treat this. But would take 2 2-week gates to get to Phase 2, which I think most can handle. (Schools, Youth Activities, Gyms, and Bars open).

If you're referring to Wilmington, I still think there's still a 75% reduction in traffic. Ghost town.

I dunno man, I'm all over town most days, and there's a bunch of cars on the road. It's definitely not what it normally is, but I was turning left on to Market in Ogden a few days ago and had to sit forever to get an opening. Was at WB yesterday and there were a bunch of people coming and going even with the beach closed. I'm not sitting through lights for four cycles like I normally do, but traffic is definitely steadier than I would have thought, and to my eye has picked up over the last few weeks.

Traffic has picked up substantially in the triangle this week. Still lower than pre quarantine, but it has increased significantly. My one outlier and it could have just been the time of day but this week I was in wake forest, first time in a few weeks, and noticed little difference in their traffic there. Cars everywhere. Not making it through the light cycle. Wake Forest people are ready to get the show on the road, it seems.

wilmwolf80 said:

---

"You really need to start treating the states more like countries a la Europe."

Yup. I've said that many times in this thread. The measures need to be tailored to individual states and even metropolitan areas within states. One size fits all is stupid.

---

This makes sense to me on the surface. My only worry is interstate travel, inter-city travel, etc. How do we monitor?

Ohio is opening back up May 1. SC is talking about beginning to open up early May as well.

We don't. We depend on quarantines areas to follow quarantine. Like they're doing now.

packgrad said:

---

Traffic has picked up substantially in the triangle this week. Still lower than pre quarantine, but it has increased significantly. My one outlier and it could have just been the time of day but this week I was in wake forest, first time in a few weeks, and noticed little difference in their traffic there. Cars everywhere. Not making it through the light cycle. Wake Forest people are ready to get the show on the road, it seems.

---

Must have been an anomaly, because I live in WF and there's WAY less traffic. Even Capital Blvd isn't crowded anymore, which is quite nice.

is it just me or is the phrase "new normal" a bit orwellian?

Good news out of a drug trial from Chicago with remdesivir. Has Dow futures up big

Pacfanweb said:

---

packgrad said:

---

Traffic has picked up substantially in the triangle this week. Still lower than pre quarantine, but it has increased significantly. My one outlier and it could have just been the time of day but this week I was in wake forest, first time in a few weeks, and noticed little difference in their traffic there. Cars everywhere. Not making it through the light cycle. Wake Forest people are ready to get the show on the road, it seems.

---

Must have been an anomaly, because I live in WF and there's WAY less traffic. Even Capital Blvd isn't crowded anymore, which is quite nice.

---

Good to know, and kind of figured so. Was certainly an anomaly. I've enjoyed the lack of traffic in my daily triangle travels, but look forward to them again hopefully soon.