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Coronavirus (COVID-19) Thread

14 Apr 2021 05:47

Vaccines for all age groups 16+ across most of the US
Apparently, Trump did a much better job than the politicians in European countries regarding vaccines.  Here, the vaccination of the 85+ group started in January, and now three months later >85% of the 75+ group have at least one shot and vaccination of the 70-75 group is starting.  This will take some time...
Unfortunately we now have other issues.  The J&J vaccine is on pause now (it is a conventional vaccine like the AZ vaccine) and has had similar side effects in terms of serious blood clots (but only about 1 in a million).  The two mRNA vaccines are going to be it for awhile.
 
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Coronavirus (COVID-19) Thread

14 Apr 2021 05:50

The mRNA vaccine is in me. I like xkcd's explanation of how it works. Also "definitely feeling a little sore" is right. An ibuprofen helps.
► Show Spoiler
Wat, is your second dose scheduled for 28 days from now?  I have heard that's the one where the soreness really sets in.
Looks like they both still have an excellent 90% efficacy six months after the second dose though, so well worth it.

Also this is interesting- 60 Minutes did a report on vaccines of the future, 5 years from now we might have a universal vaccine against whole families of viruses!  

https://www.cbsnews.com/news/last-pande ... 021-04-11/

'ending pandemics forever' studies are already underway
 
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Coronavirus (COVID-19) Thread

14 Apr 2021 07:28

but only about 1 in a million
Far more than that for AZ in Norway.  It was stopped after about 130k doses and several cases of a combination of blood clots and low platelet counts, three of which were fatal.  Milder side effects like hemorrhages and bleeding also seem to be tenfolds higher with this vaccine than others also.  Considering that the fatality rate for covid itself has been calculated to 0.0022% by Norwegian authorities for the <40 age group, that puts the death risk for the vaccine near the death risk of the disease itself for this group.  There is of course a possibility that there have been incorrect injection procedures and this has contributed to the cases, but I think the AZ vaccine, and others showing similar issues, have become unsellable to the general public regardless.  Maybe AZ and J&J could be offered to anyone who wants it regardless of their eligibility as a way for people to get vaccinated sooner, but that has some ethical issues, and will probably be deemed unsocial anyway.

A good thing would of course be if an effective vaccine against, say, the common cold was found as a side effect of this pandemic.  I usually get a cold a couple of times a year.  Now I haven't had one since 2019, but I definitely prefer a normal society with those colds to what we've had over the past year.
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Coronavirus (COVID-19) Thread

14 Apr 2021 07:43

but only about 1 in a million
Far more than that for AZ in Norway.  It was stopped after about 130k doses and several cases of a combination of blood clots and low platelet counts, three of which were fatal.  Milder side effects like hemorrhages and bleeding also seem to be tenfolds higher with this vaccine than others also.  Considering that the fatality rate for covid itself has been calculated to 0.0022% by Norwegian authorities for the <40 age group, that puts the death risk for the vaccine near the death risk of the disease itself for this group.  There is of course a possibility that there have been incorrect injection procedures and this has contributed to the cases, but I think the AZ vaccine, and others showing similar issues, have become unsellable to the general public regardless.  Maybe AZ and J&J could be offered to anyone who wants it regardless of their eligibility as a way for people to get vaccinated sooner, but that has some ethical issues, and will probably be deemed unsocial anyway.

A good thing would of course be if an effective vaccine against, say, the common cold was found as a side effect of this pandemic.  I usually get a cold a couple of times a year.  Now I haven't had one since 2019, but I definitely prefer a normal society with those colds to what we've had over the past year.
I saw a medical mechanism posted for why this is happening with this vaccine and it's highly concerning.  The J&J vaccine works in a similar way (using an adenovirus) so it could have similar issues.  Looks like the two mRNA two dose vaccines are going to be the way to go from here on out.  Even the trials on the J&J vaccine were suspended and good results of 6 month studies with the mRNA vaccines show 90% efficacy even after 6 months after the second dose, and also in children.

Mid, have a look at the video and transcript from the link, it discusses how a universal vaccine for all viruses from the same family could be just a few years away, the studies are already underway (this includes one for common colds caused by coronaviruses.)  At Mt Sinai Hospital in NY there are also trials underway for a universal flu vaccine.
 
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Coronavirus (COVID-19) Thread

14 Apr 2021 07:52

Here's a newly published paper detailing the most serious cases in Norway, by the way.
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Coronavirus (COVID-19) Thread

18 Apr 2021 19:13

The global rate of new cases is now as high as it has ever been, at 750k per day and still increasing. Most of this increase is happening in India, which is currently doubling its rate of cases and deaths every 10 days.

Image

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Source: worldometers
 
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Coronavirus (COVID-19) Thread

19 Apr 2021 05:11

wow really bad conditions in both India and Brazil and rising rapidly again in the US.  Looks like Bolsonaro handled it badly in Brazil, basically telling people to "quit whining" hopefully he gets voted out in the elections coming up there soon.  India is another nation with an authoritarian regime.

Most of these new cases are being driven by younger people and the outcome seems to be pretty serious for them.  I also have read that there is a 50% risk of some form of brain impact, even in those who recover (like depression, mood disorders, etc.)
 
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23 Apr 2021 04:04

Parts of India are now looking like NYC at its peak, except they are even less well equipped to handle the load. Hospitals are at the breaking point, oxygen supplies are severely limited, and crematoriums are completely overwhelmed with bodies backed up for days. The rate of death is likely to be far higher than the officially reported figures.
 
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Coronavirus (COVID-19) Thread

24 Apr 2021 15:14

Parts of India are now looking like NYC at its peak, except they are even less well equipped to handle the load. Hospitals are at the breaking point, oxygen supplies are severely limited, and crematoriums are completely overwhelmed with bodies backed up for days. The rate of death is likely to be far higher than the officially reported figures.
India's officials and media are complaining because the US refuses to share the raw ingredients used to make the vaccine, I see "America First" tweets from them all over Twitter.
 
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Coronavirus (COVID-19) Thread

27 Apr 2021 14:43

And after 1.5 years, how these waves happen is little understood.  Wall Street Journal exemplifies in this 2020-12-30 article: Covid-19 Was Consuming India, Until Nearly Everyone Started Wearing Masks. One of the world’s most boisterous and diverse democracies has embraced a proven pandemic strategy with little debate.  Whilst the numbers for India seem high now, we need to remember that India's population is nearly 1.4 billion.  If we adjust for that, and even assume many unreported cases, these numbers are still pretty far from NY figures as well as several European countries.  India's current slope looks bad, though.

What if this virus' preferred way of transmission is not through big droplets, but the tiny airborne droplets?  Have even scientists been to eager to dismiss this in favour of close contacts which probably are easier to document?  Then masks will not help.  Nor 6 feet.  If you're in the same room for a while, you will inhale what others have exhaled whether 6 feet or 60 feet away, again and again, but hardly so only if outdoors.  Strict lockdowns will send people indoors, possibly making things much worse.  I have a growing suspicion that buildings are the main spreader.  If the climate allows it (as in much of the world), people could be told to keep windows and doors open as much as possible to keep a steady draft through all buildings.  But I've not heard this recommended by any authorities.  Isn't this a no-brainer?
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Coronavirus (COVID-19) Thread

28 Apr 2021 02:45

What if this virus' preferred way of transmission is not through big droplets, but the tiny airborne droplets? 
Well, this has been a matter of quite some study for quite some time. Example.

It is carried on respiratory droplets, and these droplets come with a distribution of sizes. There are more viral particles within larger droplets (the number is proportional to the volume of the droplet or radius cubed), while at the same time there are more smaller droplets which also travel further.

Cloth masks protect the wearer against larger, shorter range droplets, as well as blocking many droplets from being aerosolized in the first place. If you watch slow motion footage[sup] [/sup]or do simulations, you can see that many of the smaller droplets are formed upon fragmentation or subsequent evaporation in the air after they are expelled, so face coverings work even better than you might think.

Epidemiological studies show the effectiveness of masks under various conditions, especially in indoor spaces like restaurants and office buildings. A trip to the grocery store or doctors office is much safer where everyone is wearing masks. A trip to a gym or indoor bar is far less safe, where more people are not wearing masks. I see this over and over again with the contact tracing efforts, too.

I think the discussion about masks is polluted by oversimplified thinking, that they either they block the relevant size particles or they don't. It's more nuanced than that.
Strict lockdowns will send people indoors, possibly making things much worse.
To me it seems the opposite. We have more than a year of data from all around the world. Whenever a city or region went into lockdown, they traded exponential growth of new infections for slower growth, or even exponential decay. In other words, R was decreased. We saw this first in China, then Italy, then Seattle and NYC, the UK, Israel... and right now it is happening in India. New Delhi went into lockdown on April 19, and we are now starting to see the effect show up in the new cases curve:
► Show Spoiler
You are hitting on a piece of truth in role of indoor spread, however. Lockdown does increase the fraction of transmissions that occur indoors. In the height of NYC's lockdown, for instance, contact tracing showed that about 3 in 4 new cases were due to spread between family members in their homes. (Before the lockdown it was about 1 in 4.) At the same time, it reduced the total rate of transmissions (the effective R value), and the rate of new cases decreased exponentially.

Basically, lockdowns don't change very much the probability of transmissions indoors. It is very hard to avoid an infected person from infecting their family with our without a lockdown. But lockdown does dramatically reduce the risk of transmission throughout society. Hence, fewer people get infected, and fewer people bring it home. And given the nature of exponentials, changing the growth rate has a huge effect. Every day you don't make the decision to lock down costs exponentially more lives.

I'll take exponential decay over exponential growth of new infections any time. I'll even take a slower growth if it's the best that can be done (e.g. India last year.)

A good way to mitigate indoor transmission should be obvious. As you say,
If the climate allows it (as in much of the world), people could be told to keep windows and doors open as much as possible to keep a steady draft through all buildings.  But I've not heard this recommended by any authorities.  Isn't this a no-brainer?
I'm kind of stunned to hear that this is not being recommended there. Over here it has been the norm since last summer when things began phased reopening. Most restaurants serve outdoors, or if they are open for indoor dining, they open up the doors and windows and typically have fans going. Most businesses keep the doors wide open. When people need to go into one another's homes they open windows. Most people seem to know that crowded and poorly ventilated indoor spaces are more dangerous.

That being said, people's behavior varies a lot by region. Some places seem less aware of what's going on or how to handle it. In other counties and states more people act as if there is no virus. No surprise then that they have higher per capita rates of death, even when they have a lower population density.

Last summer my mother and many of her friends wanted to return to do volunteer work at a thrift shop up in town, which received very high traffic from a wide community, in a compact indoor space. They are elderly and highly vulnerable, and were prepared with masks, face shields, and sanitizer, and a good plan for reduced operating capacity and social distancing. I still thought they were being insane. It is too much time for them to be working in that kind of environment. I told them I did not think it would be enough, and helped them upgrade their air filtration unit to be rated for viral particles. Even then I was not crazy about the idea of them working in there, and talked my mom out of working there at all. Thankfully, though, nobody in the shop has gotten sick (even as many cases have continued to occur across my community). Apparently, they are either very lucky, or their methods are working. Now they are all fully vaccinated so the risk is even less.
 
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Coronavirus (COVID-19) Thread

28 Apr 2021 05:08

I'm not intending to oversimplify, I'd rather address ideas that things will automatically improve if you stay as much as possible at home and wear a mask if you go out.  Precisely because it's not simple.  Combating spread by being more outdoors supposes, of course, that you're not heavily socialising while outdoors.  So if you ought to wear a mask, you're too close to other people, and in that case you don't really need it.  I'm not saying that the recommendations and requirements are wrong, but it seems that the priority and effectiveness don't match so well.  I don't know how ventilation gets prioritised around the world, but I hear little about it in the media, and it should be a top priority.  Certainly, the distinction between indoor and outdoor activities is well understood and different measures have been adopted for them, but perhaps the most important thing you can do indoors, ventilation, seems to have been missed whilst focusing on disinfectants and masks.  One thing that eventually got implemented in Norwegian cities was the use face masks in public transport.  First, which fortunately was the first recommendation and the right one, was to avoid public transport if you can.  That eliminates one risk for those who can avoid it and leaves much more space for those who can't.  But at no point, I think, driving with windows open have been discussed.  That should in my opinion be second on the list, after avoid.  Then, masks if it's crowdy.  Maybe it has something to do with the comfort of the driver, but what's more important: everybody's health or the inconvenience for the driver to dress according to weather.

One simple recommendation which is somewhat misguided, as we've touched upon: If someone in your house get sick, you get quarantined and as a good citizen, you don't leave the house.  However, in most cases, the best you could do would be to stay as little at home as possible, go hiking, bring your laptop and work remotely from a favourite spot in nature, whatever.  Just don't take the bus, take the car, don't go to malls and such things.  Common sense works well.  If that could avoid 3 of 4 getting infected at home to 1 of 4 getting infected at home, the impact would be huge.  I think the trouble is that it's so much easier to enforce quarantines if people stay at home than a "roaming" quarantine.  In Norway it's perfectly fine to be outdoors if you're quarantined (for instance, if one you live together with is infected), but I think there is a fairly strong expectation that you stay much more at home than what you normally do.  But it's a bad thing, as long as you don't go to places whether other people gather.  People aren't encouraged to do this because people aren't trusted.  And we get more infections as a result.

My other point was, if we understand so well how these viruses spread, why do we have these large waves?  Most have been living with restrictions for more than a year, and we can hardly explain those waves by assuming that there were times when people simply ignored the restrictions and recommendations and other times when people were compliant.  The favourite answer seems to be mutations, but it seems to me as an oversimplification.  There must still be a lot to dig into.  Some of this might also be difficult to discuss.  For instance, in Norway some large cultural groups have about 10 times higher risk of getting infected compared to other groups, even after correcting for profession, standard of living and income.  The trouble is, how to discuss such matters without stigmatising?  Which also explains why such numbers have become public just very recently.
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Coronavirus (COVID-19) Thread

28 Apr 2021 15:22

Wat what do you think of this analysis shown in the NY Times that Covid 19 has actually been worse than the 1918 Flu Pandemic?

Also the difference between lockdown spread vs societal spread is much appreciated.  There is a difference between spreading something among one's household (all on lockdown) vs spreading it throughout an entire town.  Although both outcomes need to be avoided, the latter is much more difficult to control.

Also, some good news, the US is releasing 60 million doses of the A-Z vaccine to other nations, including India, where the pandemic worst now!

You bring up some good points, Mid, one reason that Canada has been highly criticized in its response is for restrictions against all outdoor activities..... I think they are rolling back on those now, because healthcare professionals spoke out against it.

Meanwhile mask restrictions are now being relaxed in the US for people who are fully vaccinated.

Mid do those cultural groups have different diets or are they more exposed to pollution? We have that in the US among groups that have higher rates of diabetes, obesity, hypertension and asthma for various dietary and air quality reasons.
 
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Coronavirus (COVID-19) Thread

29 Apr 2021 00:19

Mid do those cultural groups have different diets or are they more exposed to pollution? We have that in the US among groups that have higher rates of diabetes, obesity, hypertension and asthma for various dietary and air quality reasons.
To some degree, but I don't think that can explain the large difference.  These things should mainly affect the severity, which they might, but not so much the rate of infection, which is where the huge difference is.  I suspect it's more a cultural thing over socialising, maybe also the culture for compliance with official recommendation (some prefer to point to language barriers).
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Coronavirus (COVID-19) Thread

29 Apr 2021 15:54

Mid do those cultural groups have different diets or are they more exposed to pollution? We have that in the US among groups that have higher rates of diabetes, obesity, hypertension and asthma for various dietary and air quality reasons.
To some degree, but I don't think that can explain the large difference.  These things should mainly affect the severity, which they might, but not so much the rate of infection, which is where the huge difference is.  I suspect it's more a cultural thing over socialising, maybe also the culture for compliance with official recommendation (some prefer to point to language barriers).
You're right those pre-existing conditions are more likely to affect severity, not rates.  The cultural socialization issue might explain why nations like Italy and Spain have been hit so hard too.

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