outbreak! (ebola, sars, coronavirus, etc)

every time this stuff gets in the news i have an anxiety attack just reading about it

do you think we're all going to die of a plague, soon?

I watched Contagion 2x in a row on a recent intercontinental flight and within 24 hours of landing I was sicker than I can ever remember being.

-Peter

that was a scary one because you know that's exactly how it's going to go down, too

my dad is of the opinion that we're all gonna drop dead from mad cow disease eventually from a lifetime of pink slime exposure

Ebola in Uganda, new flu killing East Coast seals...

Who the HECK would choose Contagion for in-flight programming???

-Peter

There is still this other side of me that wishes I'd embarked on one of my many fig tree dream careers of epidemiologist. I really get a kick form this kind of thing. Someday we will all be dead.

So how worried should we be now, anyway.

http://www.reuters.com/article/2014/07/25/us-heath-ebola-nigeria-idUSKBN0FU1LE20140725

Fanning flames, paranoia: http://www.sfgate.com/news/medical/article/New-fears-about-Ebola-spread-after-plane-scare-5651721.php

DAKAR, Senegal (AP) — No one knows for sure just how many people Patrick Sawyer came into contact with the day he boarded a flight in Liberia, had a stopover in Ghana, changed planes in Togo, and then arrived in Nigeria, where authorities say he died days later from Ebola, one of the deadliest diseases known to man.

Now health workers are scrambling to trace those who may have been exposed to Sawyer across West Africa, including flight attendants and fellow passengers.

Health experts say it is unlikely he could have infected others with the virus that can cause victims to bleed from the eyes, mouth and ears. Still, unsettling questions remain: How could a man whose sister recently died from Ebola manage to board a plane leaving the country? And worse: Could Ebola become the latest disease to be spread by international air travel?

http://www.independent.co.uk/news/world/africa/ebola-virus-top-sierra-leone-doctor-shek-umar-dies-of-disease-9636406.html

Sierra Leone's top virologist has died in the current outbreak.

http://www.nytimes.com/2014/08/05/health/patient-at-mount-sinai-has-ebola-like-symptoms-hospital-says.html

This is terrible, reports of hospitals shutting their doors, infected rotting corpses in the streets and ebola nurses downing tools after not getting paid measly $30 a week risk money pledged by the Sierra Leone gvt. Conditions described as "medieval" in parts where the health system has totally collapsed.

i heard a woman talking on the radio about it the other day and she was not holding back about how grim it was -- she was a reporter but i don't remember her name
she used the same analogy, like it was medieval in terms of what people believe about medicine as well as the degree to which people receive/shun medical care when they need it

Little did we know all the right wing survivalists had the right idea for the wrong reason. It's not Obama they should fear, but ebola.

I read an article about the stress of being an ebola nurse. Encased in completely enveloping PPE in a hot climate for 12 + hour shifts. Dealing with infectious, dying patients that constantly fall out of beds, spray blood and diarrhea all over the place. The people that deal with these patients ... I just have no idea where they get their courage from.

http://www.cbsnews.com/news/report-armed-men-attack-liberia-ebola-clinic-freeing-patients/

holy shit

Yeah,

Plague Inc is my favorite game

http://www.npr.org/blogs/goatsandsoda/2014/08/19/341412011/shadow-and-d-12-sing-an-infectious-song-about-ebola?

dr. brantly speaking now, was just discharged from emory

http://www.irishtimes.com/news/health/tests-under-way-for-ebola-following-donegal-death-1.1904073

Shit got real. school with this guys sister

Pharmeceutical industry person tries to defend the industry re charges they have not done enough re ebola because it is in poor countries

http://www.forbes.com/sites/johnlamattina/2014/08/18/washington-post-off-base-in-critiquing-pharma-efforts-in-ebola/

the incentives for the pharmaceutical industry are what they are, unfortunately

http://www.newyorker.com/magazine/2014/08/25/ebolanomics

Irish guy didn't have Ebola. Was a false alarm.

South Africa and Senegal trying to bar some folks from countries at issue from entry

First US case in Dallas. Take that NYC & LA! We're number one!

Yikes!

I wonder how many crisis of this kind will happen before countries take the WHO seriously and decide to invest in a proper international health structure to prevent this kind of outbreak. Freaking hate to see institutions like the FMI giving up to 130 millions $ but then pressure politicians in the region to go for austerity, it's a waste of money for everyone.

ebola USED to be at the top of my list of irrational fears. presbyterian hospital is about 5 miles north of where i'm sitting right now.

welp

#patientzero

The Frontline piece on this a week or so ago was eye-opening. Hospitals that are barely more than cordoned off fields, mass graves, disinfecting the back of trucks (where patients ride, near death) by tossing in buckets of bleach, doctors and other aid workers more or less forced to visit villages free of any special suits for fear of scaring the shit out of everyone, children orphaned and alone overnight. Just heartbreaking. It's both a matter of doctors struggling to keep up with a rapidly and easily spreading illness and a population almost impossible to isolate. Bodies being dumped and left by the side of the road, families taking members out of quarantine, superstitious treatments co-mingling with modern medicine ...

Here: http://www.pbs.org/wgbh/pages/frontline/ebola-outbreak/

The saddest bit may be at the end, where grave diggers, one by one, list all their families members who have succumbed.

I'm just a few miles further away, art. Drive by it almost every day as I head up to Richardson.

Your risk of dying from ebola (total confirmed 2014 ebola deaths: a few thousand worldwide) is still lower than your risk of dying due to complications related to seasonal influenza (on average, 5800-7500 a year in the US). Get a flu shot. Don't get too preoccupied by ebola.

wanna c&p that on every damn facebook post I see for the next week

be my guest

i have total confidence in the medical system to properly handle any other arising cases. that said, i am still illogically terrified

Sick Burn I saw on FB:

Don't worry about Ebola spreading in Dallas. The Cowboys have shown us that people in Dallas can't catch anything.

Ebola spreads by physical contact with bodily secretions and fluids. That makes it easier to contain in a place like the USA or Europe, where there are lots of medical facilities and a patient's recent contacts can be quickly discovered and tracked down.

Even so, if ebola strongly establishes itself in Africa, with a reservoir of infected people who keep the virus continuously viable and circulating, then not only will massive numbers of africans die, but ebola will keep leaping to other parts of the world, including the USA and Europe. It can be compared to sparks thrown out from a wildfire, which land on tinder and start other fires away from the main fire. You can put out many of these small satellite fires, but it is hard to extinguish all of them, and the more new places that start burning the harder the firestorm is to keep contained.

That's a good analogy. I really wish international focus between the Ebola outbreak and ISIL was better divided.

run for the hills imo

*not the hills of West Africa, tho*

http://i.imgur.com/LHm72Rq.png

ugh goddamned parody accounts :(

http://www.nytimes.com/2014/10/02/world/africa/ebola-spreading-in-west-africa.html

this is a very difficult article to read

apparently the problem is not money but organization and time

Oh jeez:

http://www.huffingtonpost.com/2014/10/02/texas-ebola_n_5919522.html

at what point is it ok for me to start panicking?

supposed to go to the state fair this weekend and have resolved not to touch any surfaces and to bathe myself in hand sanitizer after it is all over.

the panic is hilarious. Especially from folks who drive on the streets of Dallas. You should be much more afraid of north Texas drivers than ebola.

until there is an effective vaccine I consider ebola as a threat, but in the USA it is a long term threat, which gives the researchers plenty of time to develop that vaccine.

truly despicable imo for rand paul, a physician, to be saying things like this to score political points

http://www.cbsnews.com/news/sen-rand-paul-sounds-ebola-alarm/

http://www.nytimes.com/2014/10/02/world/africa/ebola-spreading-in-west-africa.html

this is a very difficult article to read

apparently the problem is not money but organization and time

― I dunno. (amateurist), Wednesday, October 1, 2014 7:27 PM (Yesterday

disorganization and lack of preparedness (not to mention distrust of medical authorities, belief in traditional healing, etc) are consequences of poverty, though. this was from a few weeks ago but i think it's a good primer

http://www.nejm.org/doi/full/10.1056/NEJMp1409494

First, Guinea, Sierra Leone, and Liberia are resource-poor countries already coping with major health challenges, such as malaria and other endemic diseases, some of which may be confused with EVD. Next, their borders are porous, and movement between countries is constant. Health care infrastructure is inadequate, and health workers and essential supplies including personal protective equipment are scarce. Traditional practices, such as bathing of corpses before burial, have facilitated transmission. The epidemic has spread to cities, which complicates tracing of contacts. Finally, decades of conflict have left the populations distrustful of governing officials and authority figures such as health professionals. Add to these problems a rapidly spreading virus with a high mortality rate, and the scope of the challenge becomes clear

Maybe so but I find the merest prospect of debilitation really spices up what might otherwise be a pretty normal family get together so kudos, that cousin

my bf got it beginning the end of may and had "mild" pneumonia and now has weird eczema on his face. not hospitalized and too early to tell about the long covid obv but if someone refuses to acknowledge it at all i would not stay at their house.

sorry to hear that about the bf, harbl

I'm sorry to hear as well. Everyone has to make their own risk calculations. I just meant that if you are a vaccinated, boosted, say 40yo with no health issues, the odds of a legit, severe or long-term complication from COVID are very very small based on what we know so far. That said, even the short to medium term complications can suck and I can understand wanting to avoid them as much as possible. We have a friend (some prior health issues) who had a persistent cough for a couple months. We know one young, healthy person who was previously very fit and struggled to do his exercise regimen for a couple months after COVID but ultimately fully recovered. These aren't small problems to be sure.

I’m not otherwise healthy and not youngish, for the purposes of personal risk assessment

Xposts

xp oh so me

Happy update that the amount of active patients at my hospital has notably dropped to 17. We'll see where it goes from there.

I seemed to be a week ahead on Florida's decline - it appears last week was actually just the plateau, which became evident when the numbers changed later in the week. this is somewhat the problem with very low testing, as it makes it more difficult to tell.

hospitalization admissions still going up per week but more slowly, which seems to back that up, since that trails cases by a few weeks. nowhere near our January/February hospitalization totals thankfully. but still concerning.

Here in MDC numbers and positivity rates have plateaued.

NYC % got to 9+, fell to about 8 and has been parked there for what seems like forever. Really seems like it should have fallen further by now but each wave has been its own thing kind of.

positivity rates may fall slower as less and less people get tested publicly and rely on home antigen tests.

I know the CDC also only counts PCR tests in their positivity rates and don't include antigen, even if you had it done at a facility and the results sent to your Department of Health. that seems...odd. sure, false positives abound, but seems weird to not use them in the calculation.

(this is why FL DOH's positivity rate is so much lower than what the CDC reports)

this wave has been weird and sloggish. i was hoping for cases to back off in FL *before* the Fringe Festival started (which for me was 5/18), and we're a month past that now and just seeing signs.

my state’s positivity rate is 100% because they no longer report total tests or negative results. lol?

I’m also pretty sure false negatives far outweigh false positives

my workplace, having the right equipment, had a volunteer-staffed temporary pcr covid test lab during the early pandemic and they didn’t do a binary pos/neg result, but had an inconclusive/retest result as well. not so many of them, but probably the right methodology

oops, I meant false negatives, not false positives.

I actually got an "inconclusive" result on one of my PCRs a few months ago, but it turned out to be a proper negative when I retested twice over the two days following thankfully

asking for a friend (no really, I haven't had it as far as I know). First tested positive on a rapid test 8 days ago, still showing a line on tests. Is she contagious?

In the UK she is legally allowed to go about her normal life after 5 days, but she's trying to figure out whether she should wait until the line disappears or if that's meaningless at this point.

Any insights welcome

Iirc there is a difference between infected and infectious, but solely based on my own experience I’d tell her to go easy just because I ended up very tired after because my case was mild and I didn’t really rest enough. So tl;dr she’s probably not infectious but I’d tell her to give it another couple of days and take it easy.

Our pediatrician told us you can test positive for weeks after you're actually contagious.

Yep. A good friend in January didn't get a negative PCR until three weeks after her first test, though she'd seen her doctor in the interim, who also made the distinction between infectious and infected, i.e. she was no longer contagious after about a week, give or take.

First, make sure you understand which kind of test you are taking. A PCR test is very accurate at the start of an infection because it can detect and amplify even trace amounts of virus DNA. But a PCR is not the right choice to figure out when you are no longer infectious, because of its sensitivity, Grad explains.

"There are some people who have little blips of being PCR positive for weeks, or in some cases even months, after an infection" – even though they're no longer contagious, Grad says.

A better bet is to use a rapid antigen test, because they're "positive when your viral load is high," corresponding to levels when people are likely to be infectious, says Landon. So if you're negative on a rapid test and you don't have any symptoms, consider yourself in the clear, says Chin-Hong.

What if 10 days have passed and you're still testing positive on a rapid test? "That definitely happens, and we don't have a good answer" as to why, says Landon. One thing to look at is how faint the positive line is on the rapid test, she says, because research has shown that the darker or more intense the line is and the more quickly it shows up, the more virus is present in your nose. So if you're past day 10, you feel better and you're not immunocompromised, and the rapid test line "isn't very dark or it's taking longer to turn positive each day, you're probably safe to be out in the world," she says.

https://www.npr.org/sections/health-shots/2022/02/17/1081510375/isolation-testing-omicron-infection

I’d concur with that: I spoke to a UCLH virologist when I was ill, and he said the Omicrons normally tail off after day 5 with negative LFTs a few days after that. I was testing negative on the 8th day.

thanks all, yes she isn't going to push herself but is trying to work out if a visit from her parents can go ahead-- they aren't especially vulnerable but are super nervous about getting it, so were considering cancelling a long-planned visit. It sounds like they should probably be OK, they're already on day 9 I think and the visit is later this week.

And here we are

https://www.theatlantic.com/health/archive/2022/06/pandemic-protections/661378/

And in early 2021, the sociologist Elizabeth Wrigley-Field and a small group of volunteers

also such a noted Cubs fan that they married in just to make it clear!

seriously, thanks for the link Ned!

I went to summer camp with Elizabeth!

I wonder why/how I haven't gotten it yet? I should say why/how/whether, I guess, there's no way to know for sure, really, but at no point have I had characteristic symptoms.

I guess I am in a weird state where I feel like I'm not trying very hard not to get it -- I'm traveling a lot, I'm seeing people, I'm in lots of crowded rooms. But then again, I wear an N95 on the plane and when I go in a store, which I feel like almost no one else is, and I certainly eat outside when it's convenient, which it usually is this time of year. So... I'm not trying very hard not to get COVID, but maybe I'm nonetheless trying harder than the median person? I guess by "not trying hard" I mean "I'm not taking any actions that would be annoying or difficult for me."

So... I'm not trying very hard not to get COVID, but maybe I'm nonetheless trying harder than the median person?

Ha, this.

I mask when teaching at the store, library, basically any public interior space...yet I've eaten inside restaurants and hung out in trusted homes.

I had an exposure recently where the person I hung out with indoors, unmasked tested positive the next day, and 5 days after, 10 tests (combo of PCR and antigen), all negative, no symptoms. this was after an exposure to Omicron earlier in the year 2 days before someone tested positive, same thing.

the most recent incident, nobody else has tested positive yet, so it could have been "she wasn't very contagious", but I've survived about 5 direct exposures in a 1.5 year period now. as has my brother's girlfriend.

there’s also the possibility you’ve had a very tiny infection where your immune system cleared an unnoticeable amount of virus

I've considered that too.

xpost that's definitely possible.

in either case I'm glad my more comfortable N95s arrived cos the ones I had previously left a semi-permanent indentation on my nose

Latest nyc 7-day average is about 12%

Quantity of testing is down, which lends distortion but this is the highest % in months

FL's plateau has lasted almost a month. Theory is BA.5 is pushing out BA.2 and thus prolonging the wave.

Wonder if that is the case in NYC.

Exhausting

Yeah, I don't see our national averages dropping until well into August before school starts. Everyone's traveling, and I can't blame them.

leeeeeroy jenkins

LACC and Fire Marshall is no longer letting anyone in #AX #AnimeExpo pic.twitter.com/3sLP6z3Jb6

— Anime News Network (@Anime) July 1, 2022

The vaccines in trial against all coronaviruses are exciting (if they work) - gimme that never have another cold shot right in the arm.

Cases at my hospital dropped to around 15, back up to 24, and thus weekend definitely won’t help.

xpost yeah really hoping Moderna and Pfizers excitement about their bivalent pills aren't a lot of smoke. they are really needed. i don't care how many times I have to get stabbed

https://www.youtube.com/watch?v=m2ou-WIxfLY

Just home-tested again after flying 2x and being in a few shops & restaurants in a rural area where no one was masking at all. Back in NYC now and still negative! Riding the wave (of never having had covid).

A compendium of anecdotes:

My older daughter caught covid the last week of school in May, presumably at prom. She missed her last three days of high school ever and, despite minimal symptoms for a day or so, kept testing positive for well over a week.

That makes my wife the last of us to have never tested positive for covid. But - and this is a big but - she started seriously losing her hair in January, which would have been right after her booster. Could that have sparked an autoimmune response resulting in her alopecia? She wouldn't be the first one, anecdotally; apparently serious hair loss is a relatively common side effect of covid, though dunno about the vaccine.

Somehow virtually none of our close family friends have caught covid, but the dad in one of the more cautious families finally caught a (mild) case. And the son in a family of five good friends just caught it, the first of his family to ever test positive (despite a mom that travels a ton for work); they had to cancel a trip that, ironically/sadly, was meant to be a family reunion remembering the passing of a couple people that died during (but not of) covid. Most dramatically I learned a friend of mine who finally caught covid in May ended up having something of an anxiety-induced breakdown and can no longer even drive, let alone fly. He's been on disability leave from a big tech company here because even working 4 day weeks his productivity had apparently dropped down to 60%. He can barely leave the house.

We just got back from a trip to Los Angeles, where we met up with the Aussie side of the family, for whom this was the first trip since covid hit (none of us got or are sick, so far). All four of them caught covid for the first time back in the spring, as did my sister and her family in England. It finally seems to be catching up with folks that avoided it for years. And yet the one person I know that has perpetually been most at risk, given his job is closely tied to both concerts and restaurants, has never tested positive, even when his entire family tested positive. Compare that to my kid's new piano teacher, a family of six that all had it at once. No rhyme or reason.

My parents caught it two weeks ago; Dad most likely brought it home from work. Mom suffered severe sore throat, runny nose, hacking cough, but no fever. Dad, not feeling well on Father's Day weekend, only realized he had it five days after symptom onset; that's how mild his symptoms were (both are jabbed and boosted). He tested PCR-negative last Wednesday, Mom yesterday. That's the closest it's come to me.

Can't recall if I mentioned that another person we know, their daughter tested positive the day after running a marathon. Which means she literally ran a marathon with covid.

Covid (@UCSF) Chronicles, Day 838
The die is now cast: BA.5 is destined to be our dominant virus.
In today’s 🧵I discuss the implications on the course of the pandemic, and how to think about responding.
(I use “BA.5” & not “BA.4/5” since BA.5 is poised to outrun BA.4.). (1/25)

— Bob Wachter (@Bob_Wachter) July 4, 2022

Great thread, I always love Wachter. My only quibble (and it's not just him saying this) is this part:

But since we’re missing ~80% of cases due to home tests, today’s true case-rate isn't far from Jan’s.(6/25)

Because that pre-supposes that we weren't undercounting in January, when all tests (home or lab) were difficult to obtain. But that is just a minor gripe.

The lengthy plateau he mentioned is what has me worried - we're in the midst of a month long plateau at very high levels in FL. There's been little respite. We had maybe a month of low cases after BA.1 before things started to rise again.

People keep saying "the pandemic will end, they all do", but if new scarier variants occur that cause mass reinfection, I don't see how it ends, other than "just giving up", which seems our current M.O. Endemicity seems so far away still.

Another good hot off the presses article:

Finally out after peer-review @NatureMedicine:
Emergence of SARS-CoV-2 Omicron lineages BA.4 and BA.5 in South Africa. In this publication, we describe the origins, evolution and impact of BA.4 & BA.5, which emerged in SA and now dominate most of the global COVID infections. 1/x

— Tulio de Oliveira (@Tuliodna) June 27, 2022

Wachter clearly knows what he's talking about, but honestly I've had trouble with him ever since he seriously overreacted over his (vaxxed, mild symptoms, 28-year old) son not answering the phone and essentially freaked out. Then again, anyone fully immersed in the shifting dangers of this disease is probably prone to freaking out now and then, as we've all discovered.

I’m going to start masking at my basically outdoor bar job— getting paranoid about getting it again.

At least two of my friends have had their second Cron :(

Stay safe tabes.

I ordered new N95s that fit comfortably over my big-assed nose

Well, these latest tidbits at least make me feel less like a crazy forest hermit… I reckon I’ve been applying just about the right level of restraint/caution.

But lord do I hate this