A report from the hospital front, from a reliable source

I visited *** Health Center in ***.  They are not a hospital, more like an urgent care clinic funded by the city and state. They act as triage for three area hospitals, take vital signs, can write prescriptions and send serious cases to Hospital ERs.  They have been overwhelmed with people worried about COVID-19…They had been testing people for the virus; they have run out of re-agent so they have stopped that….If they were provided with isolation beds and ventilators, could they take 20 patients?  No, it is not in their license and an application to change their license takes two years. When NYC reaches maximum hospital capacity, this clinic will not be part of the solution.

I visited [underfunded public health consortium] in ***, which was at the forefront of the response to H1N1 in 2009 and Sandy in 2012.  They typically see 150 ER patients a day; during H1N1 they averaged 350 at the peak; they think they will be over 1000 during COVID-19….There is no such thing as a “test kit” which tests for the virus; when people talk about those kits, such as those dropped onto that cruise ship, they are talking about a nasal swab packaged with some reagent, which is then mailed to a facility with a Polymerase Chain Reaction Machine that can look for the RNA from the virus.

You can find PCR machines on eBay for $25,000; such a machine is labor intensive and can do maybe 10 tests a day.  The hospital complex I visited, which has been designated a testing center, has been swabbing about 200 people a day and receiving multiples of that number from other hospitals. The vast majority they are sending off to a federal lab.  Two weeks ago the turnaround time was three days; now it is five to six.

There are much faster machines.  The Roche Cobas 6800 can do 3000 tests a day with very little human interaction; it costs $500k a year to rent, which is way outside a poor hospitals’s budget (while still not providing sufficient testing for the receiving area in the coming months.) Outside their budget until today, when we gave that money (I specified first year only, though they should be sure to ask in a year) as part of a larger check.  We also gave money for 10 transport ventilators with two ports, 20 isolation beds, the money to hire 14 nurses for round the clock coverage of those beds for 6 weeks, and other things that they need.  Overall it was a $1 million check, with a promise to talk to them in a week to cover anything we might have missed and to talk to them whenever they ask during the crisis.  Overall, I was pretty happy with the visit.  They were stunned, they work in a bureaucracy where everything takes 3 years.

One thing that they can’t get enough of is N-95s [face masks]. The first thing that almost every doctor I talked to mentioned was the frustration at having to re-use N-95’s, not for multiple patients, but for multiple days.

Again, here are the Emergent Ventures prizes to encourage work to support work to fight the coronavirus, and please support them if you can.

Comments

Pray for the afflicted, the dead, and the medical professionals.

Pray for yourself, for we the living.

In the Philippines, a total lockdown on Luzon island, you cannot in theory even leave your house to shop, the police and military will provide food said Trump-loving dictator Duterte today. In Greece, they just announced a ban on travel within the country unless it's to go to work, and all bars, restaurants are closed, with grocery stores and pharmacies limited to allowing no more than four (4) people inside the store at any time (there's a long line of crowded customers just outside the door).

Will the November 2020 elections be postponed? It's not impossible, as the law for Nov elections only dates to the 1790s and is a law passed by Congress, it's not in the US constitution. Stay tuned...

Me and mine are fine, in GR and PH at the moment and in self-sufficient farms (both of us). 1% always survive.

The U.S. Constitution makes it very clear: on January 20th, at noon, if there hasn't been an election and nobody has voted, Nancy Pelosi becomes President of the United States.

But, if there had been no elections, Nancy's term will also have expired. Then, wouldn't the president be the President pro tempore of the Senate?

Yes, and since a majority of the 2020 senate class is GOP, the Dems will elect the pro tem so it will be Leahy.

Not necessarily. The Presidential Succession Act doesn't have primacy here; the 12th and 20th Amendments do. On January 6, when Congress convenes to count the electoral votes, if there is no candidate that receives 270 votes then the House of Representatives chooses a President with one vote cast by each state delegation. The Constitution specifies that a quorum requires at least one Member from two-thirds of the states, and votes from a majority of the states to be elected.

Now, what happens if there *is* no House of Representatives because every single one's term expired is an interesting question, or if the House can't seat members from at least 34 states on January 3 when the new Congress begins. That's the point at which I would assume the Presidential Succession Act takes hold, and we start talking about President Leahy or President Grassley.

This also assumes, of course, that states don't take some alternate route to select Presidential electors. There's no Constitutional requirement that they do so via public vote; the Constitution only says that "Each State shall appoint, in such Manner as the Legislature thereof may direct, a Number of Electors, equal to the whole Number of Senators and Representatives to which the State may be entitled in the Congress" so in theory state legislatures could bypass popular elections and simply select electors by gubernatorial fiat, by legislative vote, by wet t-shirt contest, etc. This doesn't solve the issue of seating a House of Representatives -- which *does* have to be selected by popular vote -- but it's at least theoretically an option.

Face masks? thought that was a problem 2 weeks ago

China effectively nationalized the 3M plant in China and is blocking exports

An inevitable consequence of the outsourcing and gutting of our manufacturing capacity for the benefit of a small elite.

Hopefully, we can recover, end this experiment and it's associated opioid crisis, and rebuild our manufacturing base.

It's not that we have a lower manufacturing capacity; it's rather that we need far fewer people as part of that capacity. Manufacturing output is higher than it's ever been in the U.S., with the exception of right before the Great Recession: https://fred.stlouisfed.org/series/OUTMS.

We're still the second-biggest manufacturing economy in the world: https://www.brookings.edu/research/global-manufacturing-scorecard-how-the-us-compares-to-18-other-nations/. The difference is that it's become a comparatively smaller component of our overall economy as other sectors expand in size and importance, and the share of the workforce employed in manufacturing is lower still.

And just what fraction of that manufacturing output is value added in the US, and what fraction is the cost of components imported from China?

Blocking exports? Australia is getting some masks from China after they have built up their stocks. I don't suppose the US has said anything that might have upset China in the last four years, have they?

Regulations are killing. Here in Modena, Italy, we are fast approaching the level of Milan, where they have to choose who to try to save and who dies. The bottlenecks most mentioned are:

1) screening of patients
2) testing
3) ventilators

1) These are not differential diagnostics, you do not need a doctor, almost any person can follow a check-list. Fever, check. Cough, check, send to x-rays. X-rays show infection, check, send to testing.

2) you do not need a microbiologist to see if there are amoebas in people stool. These machine, even when labour intensive, need only a certain number of steps, that can be thought to, again, almost any person.

3) still yesterday, I found in Ali Baba Indian ventilators for 5.000$. Surely they are not as good as the Germans, and most likely have not been approved by Italian health authorities. Who cares, a cheap ventilator that needs somebody to repair it once in a while is much better than no ventilator. Allow electricians to be there and they will fix them when they have problems. Let people buy thousands of them, and rent hotels (empty anyway) transforming it in ad-hoc hospitals. Let them to set the price, competition with reputation will take care of it.

Let the private agents work without bothering them, please.

Last week, Massimo, you were saying that the quarantines were disruptive and, considering your own interests alone, were considering breaking self-isolation.

Any regrets? Any worries?

Do you think you should go to the front of the line if you violated curfew and could pay for it?

A lot of people are experiencing this whipsaw as they appreciate how wrong they were and how much harm they may have caused.

I suggest that if they come around and try to do the right thing under the circumstances, we offer them amnesty on this one.

Sure, why not? It is easy to just wash our hands, and forget the recent past.

Sure! Shake on it? Want to go grab a beer?

I still think that the forced quarantines are ethically abusive and pretty useless from a practical point of view.

I am not sure I said I was thinking of “breaking” it. From a practical point of view, I am already doing it when I go to visit my mother and other relatives. They do not stop you if you walk or cycle. They may stop you if you are driving, but I used the car a couple of times, a pretty conspicuous Ferrari, and they did not stop me. Anyway, you can write a useless “self-certification” paper saying you are doing something important. When in the car, I move with a bunch of boxes of face-masks and the paper says that I am bringing them to my brother. Of course he is doing the same and we know that if the carabinieri call we have to say that we are waiting for the other with the masks.

What are actually working are the voluntary self-quarantines. There are in the street maybe a tenth of the people that used to be. People are getting seriously scared. And that’s very fine with me. Each one decides the level of risk he is willing to take.

Re: "Each one decides the level of risk he is willing to take."

What if your choice of risk affects the risks of others?

And if we use law enforcement to control your behavior, we see this avoidance technique you so proudly mention: "When in the car, I move with a bunch of boxes of face-masks and the paper says that I am bringing them to my brother."

Will someone have to die in your family before you are ashamed?

How about someone else's family?

I cannot be ashamed, unless my ethics change.

I think I am the owner of my body, I can do whatever I want with it provided it does not infringe the liberty of others, and I am pretty sure I did not sign any social contract.

Regarding negative externalities, using the car is much more safe for others than me walking around, that is anyway effectively allowed. Moreover, I do whatever I can, inside the limits of reason, not to be a source of infection. Wear the mask, use an aseptic spray every 10 minutes, use keys instead of my finger to push buttons, and all the others reasonable precautions.

Well, at least you are consistent.
And
A loyal MR reader.

"I can do whatever I want with it provided it does not infringe the liberty of others"

It is though.

"Each one decides the level of risk he is willing to take."

The issue becomes when you are putting others at risk.

Indeed. To put it harshly, there is a line between individualist and sociopath.

Where? You said there is one. Agreed. Where in this case? As it happens I am more of a stickler for rules and laws than Massimo, but I can’t see what he’s done given his limited contact with others.

I freely admit first of all that this is hard and not easy for anyone. We should be doing the best we can, and not too harsh on ourselves or others if they're trying.

That said, we all make decisions, not only for ourselves, but also for others. I am not visiting my elderly relatives, but calling often.

Someone on the Twitter claims that their parents said "the best thing about this Coronavirus is that you call it every day."

My son in law is an ER doctor and has fitted out his parent's house (they are in Arizona while not at home) with food and medicine for when he has to self isolate from his family.

Hospitals are reporting a shortage of n-95 masks which protect healthcare workers.

Why are these masks available on Amazon, but not available to hospitals. Is this a case where Amazon should not sell a product that is in short supply to hospitals?

If they are available on Amazon, why are they not available to hospitals? Is it that the volume available on Amazon is small, so while it exists, it's not a real alternative? Is it that some rule is preventing a hospital staffer from just buying what they need? Are the prices too high even for medical procurement?

The purported facts don't seem consistent. Genuinely curious.

China seems to have enough capacity for it's domestic demand for masks right now, but is probably not exporting.

This leaves an arbitrage opportunity for private export and sale on eBay. However there is lots of fakes circulating, masks that look like N-95 masks, but have obvious defects like holes from staples and easily tears.

Good question. But, there is and will be: Here is a link: https://www.livescience.com/coronavirus-n95-mask-shortage.html

Nervous consumers.

Google "shortage or availablity of n95 masks and hospitals" if you are genuinely curious.

My guess would be the volumes on Amazon are low or represent stale pictures of inventory, not current capacity. I think the existence of a shortage would be hard to fake.

Your answer is the equivalent of :

"Cover your ears and cover your eyes"
Because you don't want to believe it.

Amazon has suspended those sales as many were fraudulent. The 3M plant in China is mass-producing but China is blocking exports. My understanding is that you can find people on the street in China wearing them, not sure if that is true. But China is blocking exports.

Thanks. I looked this morning before posting and saw them. I am glad to hear it. But, go to Amazon and look for yourself because they are being sold at the time of this post. Now, maybe if I click to buy there might be a bar but haven't checked because I don't want to buy.

But, it does raise the question on when you should use the market and when non-market directives should be implemented in a national emergency.

China is hoarding masks right now, so the market is breaking down. My understanding is that the cloth is somewhat difficult to produce so other producers can not just start production. In the longer run, American companies would fill the gap, but they can't do it in days. China doesn't care that in the long run they are seen as undependable suppliers and will not be trusted in the future. They will pay a price in the long run. They just don't care. Losing millions in sales in the future seems cheap compared to preventing disease know.

Dan,

3M has plants around the world that manufacture these mask, but they are saying that

"While 3M manufactures millions of respirators per month at production facilities in the United States and China, as well as in Latin America, Europe and Asia, we expect demand for respirators and other supplies to outpace supply for the foreseeable future." https://news.3m.com/blog/3m-stories/3m-responds-2019-novel-coronavirus

"China made half the world’s masks before the coronavirus emerged there, and it has expanded production nearly 12-fold since then. But it has claimed mask factory output for itself. Purchases and donations also brought China a big chunk of the world’s supply from elsewhere.

Now, worries about mask supplies are rising. As the virus’s global spread escalates, governments around the world are restricting exports of protective gear, which experts say could worsen the pandemic."

https://www.nytimes.com/2020/03/13/business/masks-china-coronavirus.html

Good. You did some research and showed support for the claim.
3m does have plants in the US, but that does raise the question you posed: will countries limit exports to serve their own population first.
You betcha. If you want to hear more about this subject of biosecurity and plant locations, you might want to listen to Dr. Michael Osterholm's interview on a study of this subject for DOD: https://www.youtube.com/watch?v=E3URhJx0NSw

I made a statement based on facts. You went and quoted a companies press release. I gave you more details to support my statement with a source and an explanation for why your comment was lacking. Perhaps you could have done better research when you tried to rebut me. The NY Times is just one source of such stories. BTW my freshman year in college I took a lab class so I could work with an electron microscope (a bit uncommon at the time). The professor for the class (of ten students) was a former researcher in a Bioweapons lab. His stories still make me uncomfortable in lab settings.

I did research and I posted it above.

I will post it again: https://www.livescience.com/coronavirus-n95-mask-shortage.html and request that anyone reading this comment read it for themselves.

So, you are wrong on two counts: I posted my source in the leading comment ; 2) you falsely stated that I should have researched first; 3) I linked to the page from 3m which provides the information that they claim is true..

DanC, I also read your post as 3m only has plants in China, and China is hoarding, when it has plants all over the world that make these masks. You did not offer any evidence that their normal domestic demand is not met by current capacity, nor did you provide evidence that they import from China significant amounts. Nor do you have any evidence on whether running extra shifts increases supply that is withheld from China. I don't know how you can make statements without support as to this manufacturer. Also, in the quote there was reference that production outside of China was sent to China.
Moreover, I made it clear that it is a biosecurity issue by referencing Dr. Osterholm's material where there is a problem that we have insufficient manufacturing capacity for many items.
I even complimented you on conducting some research, which, even though I am offended by your characterization, I still applaud.

I'm not sure what it is I'm supposed to be trying not to believe. Your argument is that doctors are stupid and don't know to look at amazon?

Anecdotally, local medical staff were sent around to all the home depots, targets, etc. to buy up the mask supply. It's possible nobody is attentive enough to look at amazon, but I find that hard to believe. It's really either available on amazon in quantity or there's a shortage. Both can't be true.

How many people do you think work in a hospital that are exposed to infectious agents?

Answer below.

Do you honestly believe that the stories reported in the newspapers and the reports from hospitals are false.

Answer below.

Do you think I care about "what you honestly believe" when the facts are to the contrary. I can answer for myself: I do not care what you honestly believe if it is contrary to fact.

Oh, I see you said you "hardly believe", so you can substitute hardly believe for honestly believe. There may be a difference.

I don't understand what you are trying to say. I believe there is a mask shortage. I believe there are ads on Amazon for masks. I don't believe those people advertising on Amazon are shipping more than a token number of masks. If they were shipping in volume, there would be no shortage. The medical profession is not so stupid that they never thought to look on Amazon.

You did not answer any of the questions but you admitted there is a shortage.

Progress of sorts.

I never denied there was a shortage. There is clearly a shortage. I think you may be confused.

If you are asking "Why are these masks available on Amazon, but not available to hospitals[?]", my answer is that they are not really available on Amazon.

They totally aren't actually available. If you believe otherwise, buy them and tell us all when they arrive.

This epidemic is really bringing out the best in the MR comments section.

Masks are not available on-line at Amazon or anywhere else, really.

Manufacturers wil ship first to hospitals and the government.

The real question...who in 2010 didn't replenish the National Stockpile?

And who didn't block all exports of PPE starting January 2020?

So we have people over whelming an institution due to FEAR. G what a surprise after all the hype. Meanwhile, there are only 70 deaths in the entire United States. Germany, Sweden, the UK are much less. this thing may not kill even 5% of what the regular flu does. But we wrecked the economy over it.

Extraordinary ignorance. If it doesn't kill 5% of what the flu does, that would be an enormous triumph to celebrate. If we didn't take these steps it would kill 30x what the flu does in the U.S.

@Anon, well said, and can you imagine the monster stock market rally if Covid-19 only kills what the flu normally does, and goes away with warm weather? I'm moving some money into my stock brokerage account now in anticipation of this, around late April or May. The downside of that would be Trump being re-elected. As it stands now I doubt he does.

Trump's metric will be the US versus EU response to this. Italy is looking at 400 infections per 1M people, Switzerland is 256, Norway is 231, Spain is 196, France is 83, Germany is 78, UK is 22.

The US is....11.

If we see a fraction of the pain of France and Germany, Trump can make hay.

It remains to be seen if we are just farther behind, or if the travel restrictions really have flattened the curve. FWIW, it might be better to count deaths because they're harder to miss, but it tells the same story.

I suspect a domestic air travel ban is not far behind if this gets much worse. Because of racism or something, not because limiting mobility, particularly long-distance mobility, is so helpful.

Barry! You supposed to be on my side, brah. Don’t talk about the Trumpster being re-elected!

Yrs, Joe Biden

you believe the 11? rofl

@ delenda - the '11', was that a Spinal Tap reference?

Not even I am not that sophisticated

Check the death rates.

We're far lower than EU and our growth rate is considerably lower.

The infection rates are currently garbage.

There's some reason to suspect different results in different countries, and Italy might be an outlier, not just earlier.

Germany and France appear on a similar arc, but the German death rate is a tenth of the French. Switzerland, Norway, Denmark, Sweden, Austria all have high numbers of identified infections per population but very low death rates. Spain, for example, is much worse.

Maybe it's an illusion of the timeline, but...

Conversely, it seems like a lot of people go for a gut feel analysis that this is America and not Italy, and don't think about it anymore deeply.

The danger I see is that there isn't actually that great a difference in life patterns between the two.

In our favor perhaps we have more single-family homes, and more transportation by individual car.

Anyone's guess whether that will be enough.

The US looks to be about a week behind Italy, but we started shutting things down in earnest last Thursday, only a couple days after Italy. Our trajectory should not be as bad as Italy's, even apart from any cultural or temperature or other local differences. Other Europeans may be seeing a more benign pattern too (Spain looks most worrisome).

Perhaps. After schools shut down, our kid's bro friends all went to the gym.

And as we see on TV, a lot of people think crowding a Costco is part of the plan.

The army we have.

The US's growth rate is far below that of Italy. It isn't understood why. It isn't just a matter of being "a week behind".

Trump/Fox will set a pretty low bar for "success".....maybe we will have done better than Italy or Iran

30x the Flu? What’s your basis for this? Do you know the denominator? Are you really that special?

No.

We don’t know the fatality rate. It’s likely somewhat lower than 0.6% given the data from SK.

Stop talking you horrible, horrible person.

The markets sure seem to think the morbidity rate is closer to 2.0% that 0.01% that h1n1 was. But you are probably smarter than the market...

Or the markets are bracing for the economic impacts of the various shutdowns.

The market doesn’t “think.”

It whiplashes up and down based on whatever hopes and fears and other social contagions afflict investors.

You are tremendously intelligent to know what "the market" is "thinking". And that it is one factor that you can determine! That's simply amazing. Bravo.

The market is attempting to compute the DCF of all businesses in the world given all factors.

The markets don’t know what to think. They’re gyrating every day. The mortality in Korea is 0.8% and they’re doing the most testing.

Korea might be what we get if we don't overwhelm the healthcare system, because we test enough and aggressively lock down. Europe looks like what we'll get if we do nothing. probably closer to the 5% rate seen in Wuhan.

The market is uncertain about what is going on and what the future will hold. So people resort to cash. Infrastructure is not being destroyed. Most of those dying are out of the workforce. This could see a rapid rebound in 6 - 12 months.

The Government could issue bonds at current interest rates to finance loans to major corporations who could, in turn, offer credit to their subcontractors. This is becoming a liquidity problem for many firms.

What happens after a major hurricane hits an area? If the area was vibrant before it recovers rather quickly. If the area is like Puerto Rico it struggles to recover.

I think this is a likely senario. However, I think it’s safe to say that we are witnessing an acemoglu type critical juncture. And it’s nuts, and we have a long way to go I fear before any real snap back. Months.

Regretfully I may not live to see if I am right. My wife is a physician who continues to treat patients. I am in a high-risk group. The drops in the markets make me nervous. The thought of what my wife is facing terrifies me.

But my bigger fear is that my children will live in a world where out of fear people turn to socialist governments and sacrifice freedom for the illusion of government protection. I see some of the market declines as a fear of what society becomes after this pandemic.

And the markets don't care about the virus, they care about the economic fallout from the virus. The two are not identical

The markets care about the virus because the market is made up of people who are afraid of the future beyond economic uncertainty. I think, could be wrong, that the economic fallout is overstated. Liquidity issues and temporarily lost revenue streams are causing hardships and the length of this hardship is uncertain. However, even the worst-case scenarios don't see the destruction of war or natural disasters. The world economy recovered after the Spanish Flu and the destruction of WW I. So far we don't seem to be facing that kind of destruction.

The WHO should know the numerator and the denominator, and they think the death rate is 3.4%. They have the data to observe when someone goes to the hospital and tests positive, and they trace all that person's contacts. All those people (who aren't selected from the population that showed up in the hospital) form the basis of your test of mortality. It's not perfect; really sick people might have selection bias in their contacts for example, but you could correct for stratification and put out a population estimate that's a lot better than just looking at people who run into the medical system.

Anyway, the picture from doing that is horrific. And what Italy is experiencing seems worse than that, which is what you get when COVID-19 runs into a weak healthcare system and an old population, among other problems.

We know it kills many, many multiples of the normal flu.

It kills between .5% and .95% of the people it infects. We know this, it's known.

You are a horrible person.

It worries me that the CFR seems to stay far above the 0.7 that we see from South Korea. In country after country the CFR is 2-4%. I’m starting to weigh the higher number and think SK is the anolomy.

At current rate of increase you're looking at a few thousand death in the US by about the middle of next month, and from there on out who knows.  America's decrepit federal government is going to struggle to deal with this even as effectively as somewhere like Italy.  Case fatality rate of this virus, based on current data, is about 2%, which is 10-20 times higher than the flu.  But yeah keep banging on about how everyone's needlessly panicking.

A) the growth rate, as measured by deaths is considerably slower in the US than in Italy. We’re tracking at 19% day over day. We have slightly less than a week before the death rate hits that of the flu and another 30 days after that until it hits the same rate as cardiovascular disease. These predictions assume that the actions we’ve taken have no effect and that the the fatalities follow the exponential path they have been on so far.
B) It is highly unlikely that the death rate for the disease is 2%. The denominator is very hard to judge. But best data we have is SK which places an upper bound at 0.6%. But the death rate seems influenced by demographics, and the US is lower than both SK and Italy.
C) stop talking if you don’t know anything about the disease.

I am not sure what you are trying to say with A because in there are things like this, “ We have slightly less than a week before the death rate hits that of the flu and another 30 days after that until...” So the death rate is rising over then or something? No comprendo. Maybe the measure we have taken are enough. Hopefully. Sure would be nice to have an accurate count of the number of cases now wouldn’t it.

On B... people keep saying that, that figure has been a pretty stubborn 2-3%. Some places have faired better. Let’s look at them but an exception or two does not the rule make... even if the actual is 1/4 of the current estimate (0.5%) we are still talking millions of deaths.

On C, this isn’t that complicated of a problem. The solutions are not great tho.

Time,
If you do not know that the denominator is, because there is a lack of testing, and you see community spread (that is, inability to track back), you just need to use SIR models.

Growth rates as measured by death is not the way these are tracked and analyzed, which reflects profound ignorance on your part. It is called an infection rate, buddy, and not a death rate, which you plug in a SIR model.
Get better informed before you misinform further.

You argue that the CFR is lower than reported because the ‘real’ Ro is higher than reported (I.e. lots of unreported trivial cases) but either way you have about 10 times the number of deaths as you have respirators in the US.

I think you are responding to Time and not me. Ro is the infection rate and not the death rate.

The only hard data we have is death rate.

The rate of admittance to ICU would also be a decent metric, but that data is slow to update, has quality issues and standards issues.

This makes death rate the only useful metric at this time.

What is the rationale for your assertion in b) above that the CFR is <2.0%. I’m not saying you’re wrong but can’t say you’re right from the existing data. With 7500 deaths and a CFR of O.6%, you get 1.2 million people already infected, not the 175k reported. You can’t have it both ways.

I'm using the best data we have, SK, for CFR.

And over 1M infected is more likely by that estimator.

Why is SK the best data for CFR? Because it's the lowest and fits a comforting narrative? Not saying you're wrong just don't see how you can conclude from the lethality numbers we have so far. And if the total cases is really over a million then the total numbers of deaths is going to about the same.

@Reason:
I like your use of SK's numbers. They have good testing of contacts, so we get a reasonable denominator there.

But, I think you are quoting last weeks numbers. SK's current CFR is 0.9% at a minimum--- current deaths over current cases, some of who will die. SK's upper bound is SK's deaths/(deaths+recovered) which is 6%; most will live, so the true number is closer to but probably higher than 0.9. Source:
https://www.worldometers.info/coronavirus/country/south-korea/

SK has not run out of ICUs: the numbers will be much worse anywhere that does.

There are still dip shits out there they don’t understand this yet? Wow.

There are only a few thousand cases in the us right now. But this is spreading at an exponential rate. If we don’t seriously slowdown that rate, there will be 100 million cases by May 1, 2020. That’s why things need to get drastic.

If we get to 100 million case, the 2% morbidity rate (this thing kills 1 out of 50 that get it, not 1 out of 1,000 like the seasonal flu viruses) renders 2 million dead.

If this gets to a billion cases, like h1n1 did in 2009, there could be 20 million dead.

It is jack offs like you, the stupid idiots that don’t even know how stupid they are, that require drastic state action. If people were not as stupid as you, we wouldn’t need those kind of extremes.

Stop it with the 2%. The best estimate is SK at 0.6%. It’s highly influenced by demographics.

Stop it.

So, is the U.S. more like South Korea or Italy?

Place your bets ... forget it, the horses are out of the starting gate.

So your position is really that this is over blown because it’s only going to be 5 or 10 times worse than h1n1 of 2009 (which killed 500,000 people)? So 2.5 million to 5 million deaths is not worth a recession to you?

So your position is really that this is over blown because it’s only going to be 5 or 10 times worse than h1n1 of 2009 (which killed 500,000 people)? So 2.5 million to 5 million deaths is not worth a recession to you?

A global recession? Meaning the gross world product real growth rate is negative for 2020?

No, South Korea is not the best estimate nor is just about any country other than China. And if you don't trust Chinese data, then just admit you have absolutely no idea what the death rate is.

South Korea has 75 deaths, 8236 total cases and 59 cases that are rated as serious or critical. If all of those 59 people recover, the death rate is 0.9%. If all of them pass away, the death rate is 1.6%. You don't get 0.6% from the data and it would be silly to make literally life-and-death policy decisions on the assumption that 59 people in South Korea will all get better and that none of the other people infected there do not fall into critical condition. The infection is still too new and any conclusion drawn from a "best estimate" there today will likely be wrong 5 days from now.

If you are going to use data to make life-and-death arguments, you had better make sure the numerator and denominator are relevant and up to date.

Nobody knows what the best option is so it is a good idea to be humble about any view one might have, even if you are right. Especially if you are right. Calling people "dip shits" and "jack offs" doesn't help anyone, including yourself.

Uncertain as it is the pattern seems to be that 80% of the cases have no or mild symptoms. It is the 20% of serious cases that appear to have a death rate of 3.4%. So if 100 million get infected then 20 million will get it bad and 3.4% of them will die. That is 680,000 deaths in a country that experienced 2.8 million deaths in 2017. That's a bad cold, but not the plague (even mild colds kill people).

But what if 20 million get seriously ill all at once? Mightn't the death rate be higher than 3.4%. Yup. (Again, we need to be humble about this.) But then again what if 20 million get seriously ill over the next 2 years? Can we maintain effective quarantines for that long? Would we even want to? A lot of people calling for us to "shut down" everything all seem to be assuming that we are running the 100 meter dash. But what if we've just started the marathon? I work in manufacturing. How do I make N95 masks if our workers are stuck at home?

The best news that I've seen (reported by our insurance company) was that the Case Fatality Rate in China outside of Hubei province was 0.7%. Applied to the 20 million who get seriously ill in this model, that's only 140,000 deaths. Sad. But not abnormal.

"Uncertain as it is the pattern seems to be that 80% of the cases have no or mild symptoms. It is the 20% of serious cases that appear to have a death rate of 3.4%. So if 100 million get infected then 20 million will get it bad and 3.4% of them will die."

Dude that is seriously wrong. Where did you get that idea?

Like I said, I could be wrong. But the 3.4% comes from Wuhan. One can't be certain but it appears that they were testing cases that presented to the hospital (out of necessity, not malice). This "guesstimate" is supported by the experience in South Korea where widespread testing resulted in CFR just below 1%. In any event I have shown my math so you can agree or disagree.

I am also influenced by a webinar I viewed 2 weeks ago featuring Dr Amesh Adalja. He argues that the virus is unstoppable but that the death rate will be low. He appears to be knowledgeable about this sort of thing, but that doesn't guarantee he is not wrong. Please google him and decide for yourself.

You may think me complacent. But here is my nightmare scenario: we massively quarantine everybody for 2 or 3 months severely damaging our economy in the process, then the sun comes out in the northern hemisphere and the pandemic (seems) to stop, and then in October or maybe even February the virus comes roaring back killing vastly more people than die now. In this scenario today's quarantines only serve to weaken our health care systems because the overall economic system that they are embedded in are weakened. This kind of thinking seems to be motivating the British, but nobody else. I think we need to be open to the possibility that they are right, and everyone else is wrong. Again, we all need to be humble about this.

The 3.4% is what the WHO raised the death rate to when they analyzed the data more closely to take out selection bias. It does likely reflect the pressure hospitals have been under, which was high in China, but not nearly so high as it's going to be in Europe.

Hence in Korea you have a lower death rate so far (although it's early days there so the number likely hasn't stabilized and will rise) and in Italy you have a higher death rate (although, unfortunately, it's early days there too.)

I think if you have easy access to an uncrowded western ICU you can probably expect a death rate in the 1-2% range and if crowding becomes an issue more like 5%.

Regardless of what you think of the WHO, the 3.4% rate is their best estimate of the death rate given infection. It's not their estimate of the death rate for the 20% or so who wind up in a hospital bed struggling to breath. If you're in that category, it's much worse.

Thank you for your reasoned response. I will give it some more thought.

Be well my friend, and wash your hands!

Thank you. You as well.

"But then again what if 20 million get seriously ill over the next 2 years? Can we maintain effective quarantines for that long? Would we even want to? A lot of people calling for us to "shut down" everything all seem to be assuming that we are running the 100 meter dash. But what if we've just started the marathon?"

That's the argument of the UK's GCSA Vallance. How sustainable from a social and economic perspective is a near total shut down? 2 months, 6 months, a year, 2 years?

This account says hospitals are being overwhelmed by “people worried about COVID-19,” not COVID-19 itself. But how many of these worries are legitimate and how many are not? (i.e. the person has known symptoms of COVID or has been in contact with someone known to have COVID?). I have heard from doctor friends in my area that people with no symptoms have shown up to the hospital (even the ER!) wanting to be tested merely because they were near an Asian person (most people in my area don’t encounter Asians on a regular basis).

And Bernie Sanders last night arguing that this is why we need single-payer seemed totally wrongheaded to me. Someone who shows up to the hospital for no good reason like they were near an Asian person should absolutely have to pay a co-pay (at least) to deter such conduct, otherwise the hospital system will be even more overwhelmed. Making a scarce service fee just increases scarcity. Unfortunately it seems we are headed for a situation where the right wants to legitimize racial prejudice and the left wants to make it free for people to act on said prejudice.

At this point I think the prejudice, if that's what you want to call it, has firmly transferred to Europe. Blame may still lie with China, but people are worried about folks who've been in Europe. I also detect an uptick in "prejudice" regarding folks from LA, NYC, Seattle, and Boston.

Most people expect some uptick in new cases as Americans repatriate from Europe. It'll be a few days before the benefit of the reduced volume of travel outweighs that.

At least we won't be hearing anybody talking about racism when it is Americans treating other Americans differently on precisely the same basis that Americans treated Asians differently recently due to covid-19 fears.

Might be a bit harder to dismiss the reality of that different treatment, especially as many of the people likely to soon experience it can be described as white and upper middle class.

I guarantee that if real prejudice against the coastal cities starts rising, we won’t hear the end of it from the journalist class, which is almost exclusively coastal.

They have huge platforms, hate reds, and this will make on to red vs blue. The media messaging would be inevitable.

A few weeks ago, a NYT writer wrote we should call it the Trumpvirus. Today Maureen Dowd wrote a column entitled “Plagued by the President” (which I have not read).

For a guy who pretty much got the world view of a Truman or Eisenhower and who could easily be a Dem or a Republican, Trump sure is hated.

It's an election year in the US.

He takes no responsibility for that.

I'm glad Roche has these machines. What was it about the Swiss medical diagnostics environment that led to them?

Do they have especially strong patents or high prices? At $500k, maybe price is part of it.

Should we have more public investment in this kind of medical R&D?

+1 for mentioning patents. If you read Rabinow's book on "PCR" (K. Mullis story) you'll see that lab work by competent lab technicians (not Mullis, who's an ideas guy not a details guy) was just as important as Mullis' brainstorming ideas about PCR (test tube DNA amplification, the backbone of biotech and biotech testing). In fact the 'lab rats' got named as inventors on Mullis' patent.

Roche bought out the patent rights for PCR from the Cetus Corporation, which in turn bought it off their employee (and inventor) Cary Mullis. They've had a massive headstart in developing PCR tech, and they've used it to their advantage.

By the way,

“You go to war with the army you have, not the army you might want or wish to have at a later time.” ― Donald Rumsfeld

Applicable.

Hospital workers who have school age children are faced with the problem of childcare while schools are shut down.

Wait staff are being laid off.

How about a program to link wait staff to babysitting or child care opportunities.

Customers are often like children.

"I visited *** Health Center in ***.... They have been overwhelmed with people worried about COVID-19…"

]

...unsurprisingly, people are very scared by irresponsible politicians & media -- and desperately seek medical care for normal sniffles, colds and flu.

And free medical care sparks demand.

What is the sober economic analysis of this random anecdoote?

P.S. what is the error rate on these wonderful coronavirus tests... false positives & false negatives ?

We're not scared. We're exercising caution.

Until the government is able to do widespread testing and give us better visibility into the spread or non-spread of the virus, it's better to think in terms of prevention.

Going to an ER or other public medical facility offering testing is not thinking in terms of prevention, either if one is symptom free, or if one has symptoms.

Just like the predictable response of banning travel to Europe, which turns out to be a large (and eminently avoidable) influx of people packed in a tight space, a number of them likely carrying and spreading covid-19, it seems as if the U.S. has a real problem in getting anybody to actually be aware of what prevention means.

"You can find PCR machines on eBay for $25,000; such a machine is labor intensive and can do maybe 10 tests a day."

This is bullshit. You can get a brand new 96 well Eppendorf machine for $5,5010 from Cole-Parmer (no-name machines would be less). At 2-3 hours, you could easily do more than 1,000 tests in a 24 hour day.

All the reagents are standard except for primers, which can be made by any number of suppliers for a couple hundred dollars and delivered overnight.

Agreed on the testing metrics. PCR isn't the hold-up. The most basic PCR machines use 96-well plates as the standard sample size, and are relatively cheap as far as lab equipment goes.

It’s a qPCR machine! Not just a standard PCR machine. Read the CDC protocol (I read the RUO (research use only) one).

So, yeah, they cost a lot more than a simple standard one.

The comment section here is super-low-quality on technical issues.

It is not just the comment section that is super-low-quality on technical issues.

Let me provide an example, though it a quote, and not original - "There is no such thing as a “test kit” which tests for the virus"

From a recent Post article - CureVac is not the only European company that has received interest from the United States as the coronavirus takes hold. As the administration struggled to roll out testing this month, Massachusetts-based Thermo Fisher Scientific, a government partner, acquired the Dutch diagnostic firm Qiagen in an $11.5 billion deal.

Qiagen, which has its main operations in Germany, has developed a coronavirus test kit that can process results within an hour.

You don't need a qPCR machine to do the test. There is this thing called agarose gel electrophoresis which works and has been around for ages.

>"This is bullshit. You can get a brand new 96 well Eppendorf machine for $5,5010 from Cole-Parmer..."

It's conceivable that an economist who spends years advocating for open borders and dense urban living is no the Go-To Guy for quality information on fighting disease.

That goes double when he posts a random email from an anonymous person from an undisclosed location.

Dear Published MB: Do you have suggestion for a biochemically literate person to get more accurate information? I googled qPCR and understand why the machines are more sophisticated (you need a light source/sensors to measure fluorescence in the probe, like a flow cytometer which I’ve used?). Will qPCR give you an idea of viral load? Can regular PCR be used to give a go/no-go qualitative test? Why are the rna extraction kits the bottleneck? I’m at home so it’s useful to arm myself with information. How I deal with any crisis actually.

In the meantime S Korea tests 20,000 persons a day

Basically either you test massively and quickly identify and move carriers off the streets , and your country still runs in parallel, or you have to shut down the entire country and keep the population in quarantine for weeks on end .

I agree. They managed the feat of both controlling the virus spread pretty well and not shutting down the country.
And they did it by .... gasp , being prepared.

For a North Korean attack that would likely include chemical, quite possibly nuclear, and less possibly biological weapons.

We have been better luck in our neighbors.

SK had the benefit of a single infection vector (the cult). Clamping down and tracing was comparatively easier for them.

Was it? They had a large number of infected people all at once. They could easily have been overwhelmed. And these people were the secretive type that didn’t want to reveal what they did. SK was very thorough and stayed on top of it.

> In the meantime S Korea tests 20,000 persons a day

Reuters says that S Korea has tested 220K people total, which is 440 per 100K.

Washington state, the center of this in the US, has tested 126 per 100K people. Pretty damn close to S Korea.

S Korea has a 3.6% positive rate, WA state has a 7.6% positive rate.

The US will be increasing testing an order of magnitude in the coming weeks.

Encouraging to hear

Deaths lag, but they are hard data.

Deaths in China are petering out. 9 million people a year die in China, maybe 5,000 will die from the Wuhan virus.

Italy is the canary in the coal mine. They are off the charts (30 deaths per million people, more than triple the rate of runner up Iran) and made up more than half of deaths yesterday (368 of 632), the highest daily death toll for the virus.

Italy went into lockdown before most others. Watch their death numbers over the next week or so, while we pause. This will give us a sense of our trajectory about a week later.

It's probable most countries don't achieve Chinese levels of success in stopping the spread of the virus, yet in the vast scheme of things, it turns out to not be a huge deal, precisely because the people have it in their own power to take small steps that make a big difference, rather than relying on the Wizard of Oz to get their testing shit together.

I think Italy’s new cases will peak soon , perhaps even today.

Unless "flu deaths" are tested, coronavirus deaths are not hard data. Sad, but true.

And given that in the early stages the absolute number of flu deaths dwarfs that of the new strain, it is hard to decode the signal.

"Italy went into lockdown before most others. ..."

Maybe, I see a lot of reports that Italians still aren't taking the lock down very seriously. Of course, this is all anecdotal evidence, so it may well be misleading.

My point being that it's possible for Italy to be and remain an outlier. I do think Italy will remain an upper boundary marker and that the US won't do any worst than Italy.

It's telling that the biggest problem is people "worried about the virus."

I have no idea how much a PCR or qPCR machine costs, or exactly what kind of testing "kits" are available, but anonymous information copy-pasted from "a reliable source" is what told us that doctors in Lombardy and then Seattle were allowing older people to die in order to give younger people ventilators, and that then turned out to be untrue.

I don't think that the severity of the situation is being overblown in general. But if we keep spreading alarming information that is not first-hand and later turns out to be untrue, people won't listen when the alarming things actually start to happen.

Returning from India to the US on Saturday I was stunned to find N-95s available for $3 at the Airport Pharmacy. Quantities may not have been huge but still.......

This is an anecdote. How do you scale it up to be a useful system in the current situation?

One thing that they can’t get enough of is N-95s [face masks]. The first thing that almost every doctor I talked to mentioned was the frustration at having to re-use N-95’s, not for multiple patients, but for multiple days.

My guess would be that the mask filter material (not necessarily the elastic straps) could be bathed in UV light or ozone. Take that, nasty viruses!

Here are alternative hypotheses:

1. There are people smarter than you and experts in their field and know about UV light and over time would have done this if it worked.

OR

2. You are the smartest person in the room.

Here are alternative hypotheses:

1. There are people smarter than you and experts in their field and know about UV light and over time would have done this if it worked.

OR

2. You are the smartest person in the room.

You forgot:

3) You're an ignorant twit, and there are many more hypotheses that are probably correct, including:

4) Most first-world hospitals don't even think about having to wear masks for multiple days, because masks are inexpensive and readily available 99.99+% of the time, so the issue of potentially decontaminating filter masks that have been used for more than one day basically never comes up.

"My guess would be that the mask filter material (not necessarily the elastic straps) could be bathed in UV light or ozone. "

Masks are still cheaper and more available than the time and expense to decontaminate a significant number of used ones.. Even if every hospital is limiting medical personnel to 1 mask per shift (and it's probably not that limited in most cases), it's still amounts to hundreds of masks per day. How could you decontaminate a significant fraction of that number?

Masks are still cheaper and more available than the time and expense to decontaminate a significant number of used ones.

By the definition of this problem, that is not the case in this particular case. The quote from the original post was:

The first thing that almost every doctor I talked to mentioned was the frustration at having to re-use N-95’s, not for multiple patients, but for multiple days.

...it's still amounts to hundreds of masks per day. How could you decontaminate a significant fraction of that number?

UV light robots decontaminate whole hospital rooms. I doubt a hundred masks would be a problem for them:

https://spectrum.ieee.org/automaton/robotics/medical-robots/autonomous-robots-are-helping-kill-coronavirus-in-hospitals

Similarly, masks could be placed in a filled with extremely high levels of ozone. They would not have to stay in the chamber more than minutes.

https://www.ozonetech.com/sites/default/files2/pdf/Ozone_disinfection_of_SARS_Contaminated_Areas.pdf

What about heat? Various scientific reports say that the original SARS virus and the MERS virus are killed after 30 minutes at 56° C (133° F), and SARS-CoV-2 (aka COVID-19 virus) seems to be the same.

This temperature is inachievable (too low) for most kitchen ovens, but can be done with specialized equipment, for instance with small bedbug decontamination tents (i.e., space heater + heat reflective material).

Of course, that assumes that the N95-ness property of the mask is not deteriorated by heating its fibers. Obviously there has to be a catch somewhere, otherwise there wouldn't be a need for a constant supply of new masks. Maybe the masks get contaminated by other pathogens that aren't so easily killed by moderate heat.

Hmmm, I see now that this idea is discussed a bit below in this very same comment section.

The entire issue of a lack of test kits has been overblown by the anti-Trump media.

The decision to admit or not admit a patient to the hospital has NOTHING to do with whether or not they are positive for COVID19. The decision rests upon the patient's clinical condition.

In terms of having people "self-quarantine" if they test positive for COVID19, that may be great in theory, but in practice, it doesn't work. Once someone tests positive, few care about not exposing others to disease risk, i.e. they have more to lose than to gain by isolating themselves. This isn't merely theory, it's what medical professionals are seeing in practice.

Whether you flu-like symptoms are due to a common cold or influenza or COVID19, you should (most people don't), be considerate of others and try to avoid giving them your illness. If you have no symptoms, you should behave (at least during "flu" season) the same as if COVID19 didn't exist: wash your hands, avoid crowded spaces, etc.

The shortage of test kits and the myth that this shortage has contributed to the pandemic has been created by ignorant people, the Democrats and the media (I repeat myself) and it has been used as a cudgel to attack Trump (who has also been attacked as a xenophobe and idiot by these same fools for trying to limit travel/immigration from areas where COVID19 was a problem and then later denounced for not instituting these measures sooner). The politicization of this crisis by the left is evil.

Im fairly certain that knowing that a patient has a highly contagious novel disease would be helpful for most clinicians; particularly as to WHERE to admit them and what precautions need to be taken.

The Trump cult had their chance and blew it. Time for them to close this mouths and let the experts do the talking.

China's seeming success in combating the spread didn't include testing for the virus.

They had 'fever clinics' where you show up if you show a fever, either by self detection or the many checks you receive during daily activities. They check for other symptoms, and either pass you up or on to the next.

The next is someone with other symptoms. The test is an imaging of your lungs. That shows the effects of the virus. If positive, you then go to another level, otherwise back home.

Another couple levels till the serious intensive care if needed.

The initial problems there, and seemingly Italy is where the primary care facilities get overwhelmed, and ultimately infected. Too many people showing up, no controls. Having something like the mobile test facilities will handle much of this traffic, protecting the worried and the health facilities.

https://www.nytimes.com/2020/03/04/health/coronavirus-china-aylward.html

The 'experts' sent cease and desist orders to people developing tests.

A mid-range qPCR machine will do 10 *runs* a day, that is one 96 well plate per run, a negative and positive control plus 94 patient samples. It needs a technician with a pipette to run it, but that technician's salary is much less thant 500k/yr.

We are limiting ourselves to one grocery run per week. We went today and I feel like it was a mistake. Too crowded. And checkout hygiene can never be too good. We have enough for a couple weeks, and I think we'll try not to go again until we hear that lines are short.

Checkers and baggers are heroes.

I am running down to pick up a nephew from his university. I have to help him pack up, which is a risk given all those dirty dirty students.

After that I think I can convince the family to treat this as a zombie apocalypse.

Reuse of N-95 masks and other PPE,

Having done some scientific literature search on thermal inactivation of this virus, I could find data on MERS (a close relative) that indicated thermal inactivation at about 60º C (140ºF) in about 30 minutes.

These temperatures are much lower than the inactivation temperature for bacteria spores that require high-temperature steam for inactivation. The thermal regulatory standards (about 15 psi steam) are for killing "all" pathogens of "all" types (fungal, bacterial, viral and parasites including spore stages). We only need to kill coronavirus.

I then noted that N-95 masks are designed for the massive particulate load so the particulate load on the actual mask from virus protection is insignificant relative to the capacity of the mask. If the virus particles are inactivated, long term reuse is possible.

With thermal inactivation, the part of the mask most effected by temperature will be the rubber.

I then tested "3-M" N-95 masks at 140ºF, through 180ºF (82ºC ) for 30 minutes in a toaster oven (regular oven also works fine). The rubber was OK at those temperatures and times but the virus should be effectively dead. I also tested nitrile blue gloves and they are OK and can be also reused.

I tested my home dryer (Maytag gas dryer) at the regular temperature setting on a time dry cycle and measured the temperature of the cloth, which was the required 60ºC temperature for a 30 minute kill time. The dryer has a cooling cycle, so using a 45 to 60 minute time is required.

Using the dryer on outer garments after being in contact with people can make the outer garments the equivalent of personal protective equipment (PPE). This can also be used for PPE sanitation. Our down jackets are unharmed. Shoes are better treated in the oven (bang around a lot in the dryer).

You can even run money through the oven at these temperatures.

Pass on this information about recycle of masks.

This is useless information when posted as a comment.
If you have website that allows us to verify your credentials, you should post there and link to it.
If not, we are forced to assume that your PhD is in English Literature or whatever.

Dallas,

Here is some research on the reuse of the masks and alternative methods to decontaminate which have been explored by panels of
scientists: https://www.nap.edu/read/11637/chapter/6
In fact, there is a book on this subject from the National Academies of Science: https://www.nap.edu/read/11637/chapter/1

If you do not follow the link, other readers might like to know the title of the report:
"REUSABILITY OF FACEMASKS DURING AN INFLUENZA PANDEMIC
FACING THE FLU

Committee on the Development of Reusable Facemasks for Use During an Influenza Pandemic

Board on Health Sciences Policy"

This raises two important issues:

1. We have a number of qualified persons who have different expertises, and they should be listened to for their ideas. Dallas is one. After all, Charles Darwin discovered many things, and he didn't need to be credentialed. And, there are many retired scientists in the universe who may have some good ideas.

2. But, here is another observation: If you have an idea, you must first do the literature review. Because someone else may have looked at this and run experiments. Even so, you might be able to critique that or add new information. But, do the literature review first.

Nice cites. Their bottom line is: have no way to disinfect an N95 mask, but you may reuse one if it's not visibly dirty and the alternative is a surgical mask.

Dallas's point that there maybe a useful level of heat that will deactivate cornavirus without damaging the N95 masks seems a useful contribution.

OK, consider these facts: 1) the rubber seal is important, and deformation from heat; 2) does tumble dry heat spread virus through the mask which was on the front of it; 3) these are a panel of scientists who looked at it and concluded there was no way to disinfect. Do you think they didn't think of heat as a disinfectant?

You...have no idea what an N-95 mask is. There is not rubber seal.

Its made of some kind of fibrous cloth.

Maybe you are in China, but Dallas said: "The rubber was OK at those temperatures" I also looked at the 3m Tekk mask which has a plastic outer sleeve that encloses the cloth.

But, if you are knowledgeable about the 3m n95 mask, and have one at hand, I will believe you if you post that you do.

I will follow up with looking at specs based on your response.

Here are some items from 3m's specs: Two-strap design with welded dual point attachment helps provide a secure seal
Cushioning nose foam

I assume the welding is not to metal but to plastic.

Note also I said: deformation from heat.

I also note Harun you have not responded to the challenge. Also, take apart the mask and report. Also report if there will be deformation from heat.

Waiting......

The fibers of the mask might be crimped or loosened by heat, causing it to lose its "N95-ness" (filtration efficiency), even if the mask appears superficially undamaged.

Evaluation of Five Decontamination Methods for Filtering Facepiece Respirators

https://pubmed.ncbi.nlm.nih.gov/19805391/

So, you infected your toaster oven and Maytag gas dryer in the name of science?

Or did you just run the exercise without putting covid exposed materials in the toaster oven.

I'll skip the toast if you invite me to breakfast.

That was in response to Dallas above.

I would also ask: did you clean your dryer's air filter and did the exhaust vent to the outside.

The symptoms of COVID-19 are the same as the symptoms of any other kind of pneumonia. I wonder how many people are flocking to doctors offices and hospitals with "plain old" pneumonia, believing that they have covid-19. I also wonder how many non-covid-19 pneumonia deaths will ultimately be counted as "presumptive positive."

I have something of a hypervigilance problem, myself.

The problem is this: you may have insurance, but the person you got it from did not, and therefore their problem is your problem. So, looking at the number of folks who seek review, until now, has been skewed by income or medical insurance or even awareness. As for presumptive positive, I think there is work on testing blood to determine if there was covid. Swab dead folks and save their blood. but, I would assume that if you were close to death they would have done x rays or covid screening. Hopefully.

Not all patients die of pneumonia. Covid-19 cases have a significant fatal rate from heart failure and an even higher fatality rate from lung inflammation (ie a Cytokine storm).

See https://www.oregonlive.com/coronavirus/2020/03/the-coronavirus-turns-deadly-when-it-leads-to-cytokine-storm-identifying-this-immune-response-is-key-to-patients-survival-report.html

^^^ That was useful. Thanks!

Three thousand samples a day on the Roche Cobas? As someone familiar with this area, that will only pertain to immunoassays or biochemical assays and NOT PCR used thus far for COVID 19 virus detection.

I wonder if this is widely optimistic pronouncements again. There has been no suggestion of serology tests that cause these automated platforms. It is still PCR tests that takes time.

Fake News again?

90% of CDC tests were negative. Too many nervous nellies asking for tests. this is why they were stingy. Hopefully that gets fixed.

What the f does that prove?

Go here for data so you can talk intelligently: https://ourworldindata.org/coronavirus

The US has the lowest number of tests per thousand, right next to Vietnam.

We have 100 million N95 masks in the stockpile in 2009. They were used up for H1N1 and then some special president we can't criticize decided not to replenish. Trump didn't either, though.

So in 2020 you can choose from Biden and Trump, both of whom didn't replenish the masks.

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