Stanford has canceled face-to-face classes. Some classes will continue online.
Abdu Sharkawy
"Iām a doctor and an Infectious Diseases Specialist. Iāve been at this for more than 20 years seeing sick patients on a daily basis. I have worked in inner city hospitals and in the poorest slums of Africa. HIV-AIDS, Hepatitis,TB, SARS, Measles, Shingles, Whooping cough, Diphtheriaā¦there is little I havenāt been exposed to in my profession. And with notable exception of SARS, very little has left me feeling vulnerable, overwhelmed or downright scared.
I am not scared of Covid-19. I am concerned about the implications of a novel infectious agent that has spread the world over and continues to find new footholds in different soil. I am rightly concerned for the welfare of those who are elderly, in frail health or disenfranchised who stand to suffer mostly, and disproportionately, at the hands of this new scourge. But I am not scared of Covid-19.
What I am scared about is the loss of reason and wave of fear that has induced the masses of society into a spellbinding spiral of panic, stockpiling obscene quantities of anything that could fill a bomb shelter adequately in a post-apocalyptic world. I am scared of the N95 masks that are stolen from hospitals and urgent care clinics where they are actually needed for front line healthcare providers and instead are being donned in airports, malls, and coffee lounges, perpetuating even more fear and suspicion of others. I am scared that our hospitals will be overwhelmed with anyone who thinks they " probably donāt have it but may as well get checked out no matter what because you just never knowā¦" and those with heart failure, emphysema, pneumonia and strokes will pay the price for overfilled ER waiting rooms with only so many doctors and nurses to assess.
I am scared that travel restrictions will become so far reaching that weddings will be canceled, graduations missed and family reunions will not materialize. And well, even that big party called the Olympic Gamesā¦that could be kyboshed too. Can you even
imagine?
Iām scared those same epidemic fears will limit trade, harm partnerships in multiple sectors, business and otherwise and ultimately culminate in a global recession.
But mostly, Iām scared about what message we are telling our kids when faced with a threat. Instead of reason, rationality, openmindedness and altruism, we are telling them to panic, be fearful, suspicious, reactionary and self-interested.
Covid-19 is nowhere near over. It will be coming to a city, a hospital, a friend, even a family member near you at some point. Expect it. Stop waiting to be surprised further. The fact is the virus itself will not likely do much harm when it arrives. But our own behaviors and āfight for yourself above all elseā attitude could prove disastrous.
I implore you all. Temper fear with reason, panic with patience and uncertainty with education. We have an opportunity to learn a great deal about health hygiene and limiting the spread of innumerable transmissible diseases in our society. Letās meet this challenge together in the best spirit of compassion for others, patience, and above all, an unfailing effort to seek truth, facts and knowledge as opposed to conjecture, speculation and catastrophizing.
Facts not fear. Clean hands. Open hearts.
Our children will thank us for it."
Isnāt Stanford on quarters? So they only changed how they are doing class for a short time to finish the quarter. If Iām wrong, let me know. Iām sure everyone is hoping this short-term change will only be in effect until after spring break.
Slovenia prohibits all large indoor events due to coronavirus
LJUBLJANA (Reuters) - Slovenian Health Minister Ales Sabeder prohibited all indoor public events for over 500 people late on Saturday due to the coronavirus, the Health Ministry said in a statement. The prohibition will be valid until the danger of the diseaseās spreading continues, the ministry said.
@MarylandJOE That was posted earlier today. You can go back and see discussion of it.
Yes, Stanford is on the quarter system. Winter quarter last day of class is 3/13, and final exams are 3/16-3-20 ( https://registrar.stanford.edu/academic-calendar ). So the last week of the quarter has been converted to online format, and presumably there will be some changes to how final exams are handled.
University of Washington, mentioned previously, is also on the quarter system. Last day of class is also 3/13, with final exams from 3/14-3/20 ( https://www.washington.edu/students/reg/1920cal.html ).
The University of Oxford has revealed its first case of a student testing positive for Covid-19. Louise Richardson, Oxfordās vice-chancellor, announced to staff on Saturday evening [UK time] that a student has tested positive for the virus but ruled out closing any university facilities or accommodation.
āI am writing to let you know that Public Health England (PHE) has confirmed that one of our students has tested positive for coronavirus (Covid-19) after returning from travel overseas,ā Richardson said.
āI am constrained in what I can say at the moment but I am glad to report that the student self-isolated as soon as they developed symptoms and did not attend any university or college events after they fell ill. As a result, PHE has advised that the risk to other students and staff is very low and that university and college activities can continue.ā
Richardson said PHE advised the university not to take āany additional public health actionsā as a result of the studentās positive test.
Last week Richardson warned that āmany of our Chinese and other Asian students and staff have felt isolated or even suspect, especially when wearing face masksā in Oxford. āThis is a time for us to come together as a community and to support not shun one another,ā she said. (Guardian)
A Marine stationed at Fort Belvoir in VA has tested positive for coronavirus and is being treated at the base hospital. This is where we see mine and my daughterās specialists, and we were at the hospital on Tuesday and Wednesday this week. Hopefully there is not much overlap between the parts of the hospital where we were and he would be.
https://www.bbc.com/news/world-middle-east-51787238
Italy to quarantine 16 million people. Milan, Venice included. Apparently they donāt have enough doctors as the government is asking doctors to come out of retirement to work the coronavirus cases.
Not signed yet. Sounds like there is some clarifying going on, pinning down details and such which is understandable given the drastic steps.
Iāve heard a lot of countries considering using retired medical workers. One problem is they are in the older demographics more likely to fall victim to severe cases themselves. In one piece I read in the UK press, the suggestion was made to use medical and nursing students who, although not as experienced, are younger and stronger. Either way, younger or retired, they could pick up the simpler work and non-infected patients freeing up medical staff.
@sdl0625 - Adding my support for you and looking forward to hearing what they tell you to do.
The luncheon I attended today included the daughter who flew in from Seattle. Everyone hugged. Her mom is celebrating a big birthday but her dad is very ill. I am sure if she happens to come down with any symptoms we will all hear about it and take precautions. She is not planing to return to Seattle at present. She works for Microsoft and will work remotely for the time being.
6 of us have great seats for a live taping of āWait, Wait Donāt Tell Meā this coming week. So far no news that its been cancelled (but with the speed this group reports, Iāll probably hear it here first!!)
From UCSD PhD Biologist, JHU ChemBE Liz Specht:
I think most people arenāt aware of the risk of systemic healthcare failure due to COVID19 because they simply havenāt run the numbers yet. Letās talk math. Letās conservatively assume that there are 2,000 current cases in the US today, March 6th. This is about 8x the number of confirmed (lab-diagnosed) cases. We know there is substantial under-Dx due to lack of test kits; Iāll address implications later of under-/over-estimate.
We can expect that weāll continue to see a doubling of cases every 6 days (this is a typical doubling time across several epidemiological studies). Here I mean actual cases. Confirmed cases may appear to rise faster in the short term due to new test kit rollouts. Weāre looking at about 1M US cases by the end of April, 2M by ~May 5, 4M by ~May 11, and so on. Exponentials are hard to grasp, but this is how they go.
As the healthcare system begins to saturate under this case load, it will become increasingly hard to detect, track, and contain new transmission chains. In absence of extreme interventions, this likely wonāt slow significantly until hitting >>1% of susceptible population. What does a case load of this size mean for healthcare system? Weāll examine just two factors ā hospital beds and masks ā among many, many other things that will be impacted.
The US has about 2.8 hospital beds per 1000 people. With a population of 330M, this is ~1M beds. At any given time, 65% of those beds are already occupied. That leaves about 330k beds available nationwide (perhaps a bit fewer this time of year with regular flu season, etc). Letās trust Italyās numbers and assume that about 10% of cases are serious enough to require hospitalization. (Keep in mind that for many patients, hospitalization lasts for weeks ā in other words, turnover will be very slow as beds fill with COVID19 patients).
By this estimate, by about May 8th, all open hospital beds in the US will be filled. (This says nothing, of course, about whether these beds are suitable for isolation of patients with a highly infectious virus.)
If weāre wrong by a factor of two regarding the fraction of severe cases, that only changes the timeline of bed saturation by 6 days in either direction. If 20% of cases require hospitalization, we run out of beds by ~May 2nd. If only 5% of cases require it, we can make it until ~May 14th. 2.5% gets us to May 20th. This, of course, assumes that there is no uptick in demand for beds from other (non-COVID19) causes, which seems like a dubious assumption.
As healthcare system becomes increasingly burdened, Rx shortages, etc, people w/ chronic conditions that are normally well-managed may find themselves slipping into severe states of medical distress requiring intensive care & hospitalization. But letās ignore that for now.
As COVID19 cases saturate virtually every state and county, which seems likely to happen any day now, it will soon be irresponsible for all HCWs to not wear a mask. These HCWs would burn through N95 stockpile in 2 days if each HCW only got ONE mask per day. HCWs are already getting infected even w/ access to full PPE. In the face of PPE limitations this severe, itās only a matter of time. HCWs will start dropping from the workforce for weeks at a time, leading to a shortage of HCWs that then further compounds both issues above.
Importantly, I cannot stress this enough: even if Iām wrong ā even VERY wrong ā about core assumptions like % of severe cases or current case #, it only changes the timeline by days or weeks. This is how exponential growth in an immunologically naĆÆve population works.
Iām an engineer. This is what my mind does all day: I run back-of-the-envelope calculations to try to estimate order-of-magnitude impacts. Iāve been on high alarm about this disease since ~Jan 19 after reading clinical indicators in the first papers emerging from Wuhan.
Undeserved panic does no one any good. But neither does ill-informed complacency. Itās wrong to assuage the public by saying āonly 2% will die.ā People arenāt adequately grasping the national and global systemic burden wrought by this swift-moving of a disease.
American Hospital Association āBest Guess Epidemiologyā over next 2 months:
96,000,000 infections
4,800,000 hospitalizations
1,900,000 ICU admissions
480,000 deaths
vs flu in 2019:
35,500,000 infections
490,600 hospitalizations
49,000 ICU admissions
34,200 deaths
Two new presumptive positive cases in Florida
Two new presumptive positive cases of the novel coronavirus have been identified in the US state of Florida, according to a tweet from the Florida Department of Health.
One new case was reported in Okaloosa County and one in Volusia County, the tweet said.
Both people have a recent history of travel and are in isolation, according to the tweet.
Florida now has 11 cases of the virus.
Hereās some optimistic news -
44 new cases in China
Health authorities in mainland China on Sunday reported 44 new confirmed cases of the Covid-19 coronavirus on Saturday, and 27 deaths (all in the Hubei province). The previous day had seen 99 new cases and 28 deaths.
China has now reported 80,695 confirmed cases, and 3,097 deaths since the start of the outbreak.
Stanford just had a faculty member test positive. There are 28 known cases here (in the Stanford area) already. I doubt anyone in a decision-making position is under the delusion that things will be better in three weeks.
@WayOutWestMom thanks, that is an amazing reference!
This is not the American Hospital Associationās best guess. They have disavowed it. In any case, it is nobodyās best guess for the next two months; that was a misreading of the underlying slide, which, again, the American Hospital Association has disavowed.
The underlying slide says the doubling rate is 7-10 days. You donāt get to 96 million cases in two months with a 7 day doubling rate unless you started with 750,000. We donāt have three quarters of a million cases right now.
Thanks @āCardinal Fangā. Can anyone else poke holes in any of this please?
Added to my previous post, Iām being told locally that the Marine is actually stationed on our base, at Quantico, rather than Belvoir. Marines arenāt generally stationed there, so it does make sense.
Iām sure a dupe wonāt hurt.
I didnāt see much in the way of actual discussion but thanks.
Seems like good information.
@milgymfam quantico was where usmc ocs was for me back in the late 80s. I remember it was really a big and incredibly forested place, at least where we were. Has it changed a lot?
I also remember it was hot, muggy and a lot of sgts yelling at me. Lol.