Coronavirus

[mikechamp]

Not good news coming out of Belgium:

Belgium facing 'tsunami' of new infections

Belgium could soon be overwhelmed by new coronavirus infections, the health minister has warned, amid soaring case numbers across the country.

Frank Vandenbroucke said new cases were close to a "tsunami" where authorities "no longer control what is happening". New measures to try to halt the spread came into force on Monday. From Monday, under new government restrictions designed to tackle the fresh outbreak, residents will only be allowed to see one other person from outside their household and should work from home if possible.

Belgium was one of the worst-hit countries during Europe's first wave of coronavirus earlier this year. Overall it has the third-highest number of Covid-related deaths per 100,000 people globally, behind only Peru and San Marino, according to Johns Hopkins University data.

According to the Belgian health institute Sciensano, Belgium has recorded an average of 7,876 new daily infections over the last seven days, a 79% rise on the previous week. Last Tuesday the country reported 12,051 cases in 24 hours, its highest daily figure since the pandemic began.

Hospitalisations have also risen, with 2,485 people in hospital with Covid-19 on Monday. Officials warn that if cases continue to rise at the same rate, Belgium will fill its capacity of 2,000 intensive care beds by mid-November. "The situation is serious," Prime Minister Alexander De Croo told RTL. "It is worse than on March 18 when the lockdown was decided."

https://www.bbc.com/news/world-europe-54602999

[AWvsCBsteeeerike3]

Yeah, all of europe, and America, is seeing a surge right now which is unfortunate.

[AWvsCBsteeeerike3]

Looking ahead for a minute, Zeus' poll in the baseball forum got me thinking....when will we, as a collective nation, accept this is over? I don't think we will ever see a day in our lifetimes again where there is not a death from Covid 19, let alone an individual case, reported in the US of A. So, I'm not optimistic in thinking a clean end, defined as the complete eradication of the virus, will ever be achieved.

Are we therefore going to continue to mask, distance, limit attendance at events like sports, weddings, funerals, avoid family gatherings in general unless covid is wiped from the face of the earth? And, if not eradication of the virus, what milestones are we going to use?

Excess deaths itself is going to be altered by the virus as we will have a years worth of data where the rolling average includes the deaths from Covid. Is getting back under that average enough for people to feel comfortable? What if we get back under that original average but do so with limited social gatherings continued meaning the deaths can jump back if the restrictions are relaxed?

What if vaccines emerge and everyone has the ability to be vaccinated though surely everyone wont? And, what if those vaccines are only 70% effective? Will that rate of protection make people congregating in public again?

Governments can relax all the guiedlines they want, even eliminate them, but unless citizens are confident it is 'safe' to go out, people will not. So, I guess the real question is, what will make people feel 'safe' and when will it truly be safe again? Because, the definition has almost assuredly been altered as there is an increased risk small as it may become, likely, forever.

[mikechamp]

Great question, AW, and great discussion topic. I'm all for looking ahead and trying to think through the next challenge to come at us. These kinds of mental exercises are valuable and necessary, at all levels of medicine, government and society. (That's why I was posting about the logistical challenge of vaccine distribution months ago.)

My hypothesis is similar to yours in that a vaccine won't be 100% effective. If I'm betting hypothetical money on when the vast majority of people would feel comfortable returning to normal, I would lay it on a combination of contact tracing & treatments.

Allow me to explain: Someday, one could get vaccinated. However, we would know it's not 100% effective, so there's still a risk (like with the flu vaccine) that you might contract COVID-19. But there is also a known course of treatment that could be administered in the first 48(?) hours of exposure. With robust contact tracing in place, should one get exposed, they would be notified quickly via an alert on their phone (SMS or app). So this hypothetical person gets a notification, and immediately heads to their local Walgreens/CVS and to acquire and start a prescribed treatment protocol.

Now, I still don't expect all that to be 100% perfect either, but I am betting the data will show that those 3 steps (vaccine, contact tracing, course of treatment in the event of exposure) will reduce cases down to a minuscule amount, and deaths in proportion to that reduction.

[AWvsCBsteeeerike3]

Mostly agree. Except I wonder if the US will ever be able to successfully contact trace. Too many people won't listen. And, good luck getting everyone to download an app to track them so they can later be told to stay home for 2 weeks.

Regarding therapeutics, that's an excellent thought. Viral infections tend to be treated early, but we're apparently content telling people that get it to go home and isolate with no medicine unless they get super sick then they should go to the hospital where they can get access to antivirals that should be given way earlier. They'll also give oxygen which helps and steroids to turn off the immune system more/less. FOAD though if its turned into pneumonia....but I digress. All that say, yes, I agree wholeheartedly we need early treatment. Not just to prevent hospitalizations, but also to prevent long-haulers as aiding the immune system early on likely prevents the cytokines from going crazy after the virus runs its course for a couple weeks. That last part about long haulers is, of course, imo.

And, I still really question not only how effective a vaccine will be but also how many people will take it. Especially amongst the younger population where risk is considerably less from covid. Will half of America even take a vaccine in the first couple years? I tend to doubt it, but I fall firmly in the 'no' camp at the moment so maybe my perception is warped.

[CardsofSTL]

https://www.reuters.com/article/us-heal ... SKBN2750KF

Pfizer Inc PFE.N and BioNTech SE announced on Tuesday the start in Japan of combined Phase I and Phase II clinical trials of their mRNA vaccine candidate against the coronavirus.

The study will recruit 160 people aged from 20 to 85, the firms said in a statement. Earlier, they had agreed to supply Japan with 120 million doses of their experimental coronavirus vaccine in the first half of 2021.

Pfizer, which is developing the vaccine with German partner BioNTech, has said it may confirm if the vaccine is effective as soon as this month, but also needs safety data from a global trial of 44,000 people that will not be available until next month.

[sighyoung]

I just found out that my mother's tested positive, which I expected because the coronavirus has torn through her nursing home over the past week. My mother's been in quarantine for four or five days because she was exposed to a staff member who tested positive. Something like 12 staff members have tested positive, and over 40 patients, but I'm not sure if that's a recent or cumulative number.

My mother's been asymptomatic so far, but she's got several days to go yet. Three patients have been hospitalized for several days. So we'll see how this goes.

[GeddyWrox]

Oh no, Sigh. She will be in my thoughts.

[Radbird]

Sorry to hear that, sigh. I hope she stays that way.

[IMADreamer]

Absolutely exploding here. There were two huge gatherings two weekends ago, and last weekend was a county wide yard sale thing. We are so screwed here. No way our tiny ass hospital can handle the onslaught coming. I think we had 66 new cases yesterday. It's nuts.

I'm starting to think we may never get past this just because people can not for one second think of anyone but themselves.