***NON-POLITICAL COVID-19 Discussion Thread***

[JakeF]

A couple of reminders...

Originally Posted by Bwana

Once again, don't come in this thread with some kind of political agenda, or you will be shown the door. If you want to go that route, there is a thread about this in DC.

Originally Posted by Dartgod

People, there is a lot of good information in this thread, let's try to keep the petty bickering to a minimum.

We all have varying opinions about the impact of this, the numbers, etc. We will all never agree with each other. But we can all keep it civil.

Thanks!

Click here for the original OP:

Spoiler!

Apparently the CoronaVirus can survive on a inanimate objects, such as door knobs, for 9 days.

California coronavirus case could be first spread within U.S. community, CDC says
By SOUMYA KARLAMANGLA, JACLYN COSGROVE
FEB. 26, 2020 8:04 PM

The Centers for Disease Control and Prevention is investigating what could be the first case of novel coronavirus in the United States involving a patient in California who neither recently traveled out of the country nor was in contact with someone who did.

“At this time, the patient’s exposure is unknown. It’s possible this could be an instance of community spread of COVID-19, which would be the first time this has happened in the United States,” the CDC said in a statement. “Community spread means spread of an illness for which the source of infection is unknown. It’s also possible, however, that the patient may have been exposed to a returned traveler who was infected.”

The individual is a resident of Solano County and is receiving medical care in Sacramento County, according to the state Department of Public Health.

The CDC said the “case was detected through the U.S. public health system — picked up by astute clinicians.”

Officials at UC Davis Medical Center expanded on what the federal agency might have meant by that in an email sent Wednesday, as reported by the Davis Enterprise newspaper.

The patient arrived at UC Davis Medical Center from another hospital Feb. 19 and “had already been intubated, was on a ventilator, and given droplet protection orders because of an undiagnosed and suspected viral condition,” according to an email sent by UC Davis officials that was obtained by the Davis Enterprise.

The staff at UC Davis requested COVID-19 testing by the CDC, but because the patient didn’t fit the CDC’s existing criteria for the virus, a test wasn’t immediately administered, according to the email. The CDC then ordered the test Sunday, and results were announced Wednesday. Hospital administrators reportedly said in the email that despite these issues, there has been minimal exposure at the hospital because of safety protocols they have in place.

A UC Davis Health spokesperson declined Wednesday evening to share the email with The Times.

Since Feb. 2, more than 8,400 returning travelers from China have entered California, according to the state health department. They have been advised to self-quarantine for 14 days and limit interactions with others as much as possible, officials said.

“This is a new virus, and while we are still learning about it, there is a lot we already know,” Dr. Sonia Angell, director of the California Department of Public Health, said in a statement. “We have been anticipating the potential for such a case in the U.S., and given our close familial, social and business relationships with China, it is not unexpected that the first case in the U.S. would be in California.”

It is not clear how the person became infected, but public health workers could not identify any contacts with people who had traveled to China or other areas where the virus is widespread. That raises concern that the virus is spreading in the United States, creating a challenge for public health officials, experts say.

“It’s the first signal that we could be having silent transmission in the community,” said Lawrence Gostin, director of the World Health Organization Collaborating Center on National and Global Health Law. “It probably means there are many more cases out there, and it probably means this individual has infected others, and now it’s a race to try to find out who that person has infected.”

On Tuesday, the CDC offered its most serious warning to date that the United States should expect and prepare for the coronavirus to become a more widespread health issue.

“Ultimately, we expect we will see coronavirus spread in this country,” said Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases. “It’s not so much a question of if, but a question of when.”

According to the CDC’s latest count Wednesday morning, 59 U.S. residents have tested positive for the new strain of coronavirus — 42 of whom are repatriated citizens from a Diamond Princess cruise. That number has grown by two since Messonnier’s last count Tuesday, although the CDC was not immediately available to offer details on the additional cases.

More than 82,000 cases of coronavirus have been reported globally, and more than 2,700 people have died, with the majority in mainland China, the epicenter of the outbreak.

But public health leaders have repeatedly reminded residents that the health risk from the novel coronavirus to the general public remains low.

“While COVID-19 has a high transmission rate, it has a low mortality rate,” the state Department of Public Health said in a statement Wednesday. “From the international data we have, of those who have tested positive for COVID-19, approximately 80% do not exhibit symptoms that would require hospitalization. There have been no confirmed deaths related to COVID-19 in the United States to date.”

CDC officials have also warned that although the virus is likely to spread in U.S. communities, the flu still poses a greater risk.

Gostin said the news of potential silent transmission does not eliminate the possibility of containing the virus in the U.S. and preventing an outbreak.

“There are few enough cases that we should at least try,” he said. “Most of us are not optimistic that that will be successful, but we’re still in the position to try.”

[Donger]

Originally Posted by MahomesMagic

Your Coronavirus Test Is Positive. Maybe It Shouldn’t Be.

In three sets of testing data that include cycle thresholds, compiled by officials in Massachusetts, New York and Nevada, up to 90 percent of people testing positive carried barely any virus, a review by The Times found..

In Massachusetts, from 85 to 90 percent of people who tested positive in July with a cycle threshold of 40 would have been deemed negative if the threshold were 30 cycles, Dr. Mina said. “I would say that none of those people should be contact-traced, not one,” he said.
Other experts informed of these numbers were stunned.

https://www.nytimes.com/2020/08/29/h...s-testing.html

Great. So, new cases are determined by testing, not that that really needed confirmation.

I don't think anyone has or is claiming that the PCR test is perfect; it's not. But it's better than nothing.

But to say that cases don't matter is asinine. It's so ridiculous that I'm surprised that anyone has the audacity to say it.

Would you like to revise this?

https://www.chiefsplanet.com/BB/show...ostcount=43822

[TLO]

Originally Posted by Donger

Great. So, new cases are determined by testing, not that that really needed confirmation.

I don't think anyone has or is claiming that the PCR test is perfect; it's not. But it's better than nothing.

But to say that cases don't matter is asinine. It's so ridiculous that I'm surprised that anyone has the audacity to say it.

Would you like to revise this?

https://www.chiefsplanet.com/BB/show...ostcount=43822

Off topic, but was going to make a point that the article already makes for me.

Instead, new data underscore the need for more widespread use of rapid tests, even if they are less sensitive.

This has nothing to do with your argument. Please continue.

[MahomesMagic]

Originally Posted by Donger

Great. So, new cases are determined by testing, not that that really needed confirmation.

I don't think anyone has or is claiming that the PCR test is perfect; it's not. But it's better than nothing.

But to say that cases don't matter is asinine. It's so ridiculous that I'm surprised that anyone has the audacity to say it.

Would you like to revise this?

https://www.chiefsplanet.com/BB/show...ostcount=43822

The PCR tests don't give a yes or no answer. They have to be calibrated and according to people who want to detect actual infections they are currently calibrated to too many cycles.

This means that many of these cases are not actual cases.

[Donger]

Originally Posted by MahomesMagic

The PCR tests don't give a yes or no answer. They have to be calibrated and according to people who want to detect actual infections they are currently calibrated to too many cycles.

This means that many of these cases are not actual cases.

Your own link above states the opposite:

The most widely used diagnostic test for the new coronavirus, called a PCR test, provides a simple yes-no answer to the question of whether a patient is infected.

[kgrund]

Originally Posted by Chief Roundup

Some of us do not live in this thread and since it is a mega thread that information gets lost.

I totally understand that, but Donger is one who does live in this thread. That was part of the point.

[MahomesMagic]

Originally Posted by Donger

Your own link above states the opposite:

The most widely used diagnostic test for the new coronavirus, called a PCR test, provides a simple yes-no answer to the question of whether a patient is infected.

Reading Comprehension isn't your strong suit, eh?

Any test with a cycle threshold above 35 is too sensitive, agreed Juliet Morrison, a virologist at the University of California, Riverside. “I’m shocked that people would think that 40 could represent a positive,” she said

From the author

Apoorva Mandavilli
@apoorva_nyc
If you adjust that down to a more reasonable CT threshold of 30, anywhere form 40%-90% of state lab results are *no longer positive.* The rest are well past the point of contagiousness.

[kgrund]

Originally Posted by MahomesMagic

Your Coronavirus Test Is Positive. Maybe It Shouldn’t Be.

In three sets of testing data that include cycle thresholds, compiled by officials in Massachusetts, New York and Nevada, up to 90 percent of people testing positive carried barely any virus, a review by The Times found..

In Massachusetts, from 85 to 90 percent of people who tested positive in July with a cycle threshold of 40 would have been deemed negative if the threshold were 30 cycles, Dr. Mina said. “I would say that none of those people should be contact-traced, not one,” he said.
Other experts informed of these numbers were stunned.

https://www.nytimes.com/2020/08/29/h...s-testing.html

A week or so, I submitted a study on the PCR test that said for it to be most effective the cycle should be set at 5.

[Donger]

Originally Posted by MahomesMagic

Reading Comprehension isn't your strong suit, eh?

Any test with a cycle threshold above 35 is too sensitive, agreed Juliet Morrison, a virologist at the University of California, Riverside. “I’m shocked that people would think that 40 could represent a positive,” she said

Mine's perfect, thanks. You claimed that the PCR test doesn't give a yes/no. The article you linked states that it does. Are you wrong, or is the article?

I have no idea why you are bringing up the cycle threshold. I'm not claiming that the PCR test is 100% accurate, or is a good indicator of how contagious a person is.

[Donger]

Originally Posted by MahomesMagic

From the author

Apoorva Mandavilli
@apoorva_nyc
If you adjust that down to a more reasonable CT threshold of 30, anywhere form 40%-90% of state lab results are *no longer positive.* The rest are well past the point of contagiousness.

I'm not talking about contagiousness. I'm talking about cases. Active and completed.

[MahomesMagic]

Originally Posted by Donger

Mine's perfect, thanks. You claimed that the PCR test doesn't give a yes/no. The article you linked states that it does. Are you wrong, or is the article?

I have no idea why you are bringing up the cycle threshold. I'm not claiming that the PCR test is 100% accurate, or is a good indicator of how contagious a person is.

If you actually read the article you would understand, its perfectly clear.

The authors point was that we get a yes or no answer but that the calibration of the test is such that we are vastly overstating cases based on too sensitive PCR tests. If we tested at 30 cycles or so many of these "cases" disappear.

[TLO]

Originally Posted by MahomesMagic

If you actually read the article you would understand, its perfectly clear.

The authors point was that we get a yes or no answer but that the calibration of the test is such that we are vastly overstating cases based on too sensitive PCR tests. If we tested at 30 cycles or so many of these "cases" disappear.

Just going to hop into the firing line here to ask a layman's question.

Would it be possible to make a test that determines if someone is infectious or not?

[Donger]

Originally Posted by MahomesMagic

If you actually read the article you would understand, its perfectly clear.

The authors point was that we get a yes or no answer but that the calibration of the test is such that we are vastly overstating cases based on too sensitive PCR tests. If we tested at 30 cycles or so many of these "cases" disappear.

I have read it, obviously, since I posted that the PCR test is yes/no, despite you claiming that it doesn't provide that. I see that you now acknowledge that it does. Glad we cleared that up.

But yes-no isn’t good enough, he added. It’s the amount of virus that should dictate the infected patient’s next steps. “It’s really irresponsible, I think, to forgo the recognition that this is a quantitative issue,” Dr. Mina said.

The PCR test amplifies genetic matter from the virus in cycles; the fewer cycles required, the greater the amount of virus, or viral load, in the sample. The greater the viral load, the more likely the patient is to be contagious.

This number of amplification cycles needed to find the virus, called the cycle threshold, is never included in the results sent to doctors and coronavirus patients, although it could tell them how infectious the patients are.

In three sets of testing data that include cycle thresholds, compiled by officials in Massachusetts, New York and Nevada, up to 90 percent of people testing positive carried barely any virus, a review by The Times found.

So, yes/no isn't good enough to determine how contagious an infected person is. I agree, and again, I'm not arguing about contagiousness. But a positive is still a case, even if the viral load is low.

[MahomesMagic]

Originally Posted by TLO

Just going to hop into the firing line here to ask a layman's question.

Would it be possible to make a test that determines if someone is infectious or not?

I can only give a layman's answer. My understanding is that you would need to reduce the cycles so that you are closer to measuring active virus AND pair that with clinical diagnosis of Covid like symptoms. If we did that we would have a better view of cases worth monitoring.

There is also the issue of how accurate these tests are..my understanding is that is a big unknown as well.

[Donger]

Originally Posted by MahomesMagic

If we did that we would have a better view of cases worth monitoring.

There you go.

[TLO]

Originally Posted by MahomesMagic

I can only give a layman's answer. My understanding is that you would need to reduce the cycles so that you are closer to measuring active virus AND pair that with clinical diagnosis of Covid like symptoms. If we did that we would have a better view of cases worth monitoring.

There is also the issue of how accurate these tests are..my understanding is that is a big unknown as well.

Well... I did post this link to an article yesterday.

Originally Posted by TLO

Diagnosing COVID-19 infection: the danger of over-reliance on positive test results

https://www.medrxiv.org/content/10.1....26.20080911v3

I'd recommend reading the whole thing, but an interesting blurb.

This is based on a widespread belief that positive results in these tests are highly reliable. However, data on PCR-based tests for similar viruses show that PCR-based testing produces enough false positive results to make positive results highly unreliable over a broad range of real-world scenarios