Phase 3

[ricky878787]

Anyone have any update about the Phase 3?

[Puccini]

What do you mean with'Phase 3"?

[tifino]

1 minute ago, Puccini said:

What do you mean with'Phase 3"?

the next deeper draconian level...

[Davo369]

This is phase 3

[DrTuner]

Picked up a new Lancet paper on my radar, it shows a lower CFR and IFR (Infection Fatality Ratio) than previous estimates: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext#

 

It's a slow read and I'm digesting it, the data seems to be mostly from China which is natural as these studies take some time. There is one thing there that caught my eye:

Quote

It is clear from the data that have emerged from China that case fatality ratio increases substantially with age. Our results suggest a very low fatality ratio in those under the age of 20 years. As there are very few cases in this age group, it remains unclear whether this reflects a low risk of death or a difference in susceptibility, although early results indicate young people are not at lower risk of infection than adults.28 Serological testing in this age group will be crucial in the coming weeks to understand the significance of this age group in driving population transmission.

 

They are pointing out the asymptomatic cases might be mostly in the younger demographics group and they might have acted as the vector without knowing it and they then make the usual comment for more testing, in this case serological meaning testing for antibodies so they can figure out the true spread among the population.

 

It's an interesting thought, could there be an army of young, socially mobile people that have already gotten it but didn't notice? Only widespread testing will tell.

 

EDIT: Just rolling that idea in my head and thinking of all the Yais stored up in the sticks with the youngsters working in factories and the long delay in the onset of the epidemic in Thailand.. hmm.

Edited March 31, 2020 by DrTuner

[mauGR1]

5 minutes ago, DrTuner said:

It's an interesting thought, could there be an army of young, socially mobile people that have already gotten it but didn't notice? Only widespread testing will tell.

I am no scientist, but i thought it was obvious since this virus saga started.

[sezze]

9 minutes ago, DrTuner said:

Picked up a new Lancer paper on my radar, it shows a lower CFR and IFR (Infection Fatality Ratio) that previous estimates: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext#

 

It's a slow read and I'm digesting it, the data seems to be mostly from China which is natural as these studies take some time. There is one thing there that caught my eye:

 

They are pointing out the asymptomatic cases might be mostly in the younger demographics group and they might have acted as the vector without knowing it and they then make the usual comment for more testing, in this case serological meaning testing for antibodies so they can figure out the true spread among the population.

 

It's an interesting thought, could there be an army of young, socially mobile people that have already gotten it but didn't notice? Only widespread testing will tell.

Sure , younger people have more social contact . Schools , everybody close together , work also many contacts . Elderly , normally spend more times in home or with relatives then spending close contact with others . Younger people generally have no problem surviving , but it does happen ( yesterday a 12y old healthy girl and last week there was a healthy 30y old nurse , both died in Belgium of corona ) , and many times they also suffer no symptoms . But having contact everywhere does spread it around , especially if they do not know they got it . This way they bring it to the more vulnerable people ...

 

As of phase 3 , means contacts are unknown and spreading in local community . ( thats what i heard ... can be corrected if i'm wrong ) .

phase 1 contracted elsewhere

phase 2 contracted from known source which came from elsewhere

Edited March 31, 2020 by sezze

[rvaviator]

From tomorrow - I did see in 'China Daily News' - They will start publish daily numbers to show how many are reported Asymptomatic.

[DrTuner]

3 minutes ago, mauGR1 said:

I am no scientist, but i thought it was obvious since this virus saga started.

Asymptomatic transmission was debated in the early days. Maybe it's far more widespread than thought. Impossible to know without antibody testing. But it would sort of explain a few strange discrepancies in the timeline.

[DrTuner]

Ok some more about it: https://www.straitstimes.com/asia/east-asia/chinese-experts-express-concerns-over-rise-in-asymptomatic-coronavirus-carriers

 

None of the asymptomatic carriers would have been tested in Thailand, unless they were connected to known cases: https://ddc.moph.go.th/viralpneumonia/eng/file/guidelines/G_CPG_en.pdf

 

The plot thickens.

 

OP: Phase three would be exactly this, uncontrolled community transmission of unknown origin.

Edited March 31, 2020 by DrTuner

[ThailandRyan]

14 minutes ago, DrTuner said:

Ok some more about it: https://www.straitstimes.com/asia/east-asia/chinese-experts-express-concerns-over-rise-in-asymptomatic-coronavirus-carriers

 

None of the asymptomatic carriers would have been tested in Thailand, unless they were connected to known cases: https://ddc.moph.go.th/viralpneumonia/eng/file/guidelines/G_CPG_en.pdf

 

The plot thickens.

 

OP: Phase three would be exactly this, uncontrolled community transmission of unknown origin.

Ergo last weeks mass exodus from Bangkok into the provinces, and now the new cases popping up.  Could these asymptomatic folks going home have transferred the virus to others in the north, or South, or were some of those that are now positive from Bangkok, and are they now being reported as statistics on the 10th day of here being home....

Edited March 31, 2020 by ThailandRyan

[DrTuner]

1 minute ago, ThailandRyan said:

Ergo last weeks mass exodus from Bangkok into the provinces, and now the new cases popping up.  Could these asymptomatic folks transferred the virus to others in the north, or were some of those from Bangkok that have now become statistics on the 10th day of here being home....

The timeline would match. Asymptomatic younger BKK dwellers went back to Yai and she got sick. If only they had those fast test kits.

[ThailandRyan]

1 minute ago, DrTuner said:

The timeline would match. Asymptomatic younger BKK dwellers went back to Yai and she got sick. If only they had those fast test kits.

Yes, I am still trying to source some that I can get here. However, until they start to test more folks, and randomly a few younger folks as a test group, who are asymptomatic, we can not see if they have the antibodies. In essence we are still in a no mans land.  Within the next 7 days I would hope we see the bigger picture as it plays out.  This can not stay hidden and covered over for much longer.

[DrTuner]

2 minutes ago, mauGR1 said:

Perhaps our dear leaders would have better to lift all restrictions, and let us go for "herd immunity" before it's too late.

That's still a bit too hard core, the Korean model of testing, testing and more testing and isolating the infected and using big data to predict next clusters would still be possible if they acted right now. Unfortunately it looks like the incompetence of the usurpers will drive it to herd immunity uncontrolled. Comes with a higher death toll that will likely linger until there is a vaccine.

[mauGR1]

3 minutes ago, DrTuner said:

That's still a bit too hard core, the Korean model of testing, testing and more testing and isolating the infected and using big data to predict next clusters would still be possible if they acted right now. Unfortunately it looks like the incompetence of the usurpers will drive it to herd immunity uncontrolled. Comes with a higher death toll that will likely linger until there is a vaccine.

Again, perhaps it sounds cynical, but a few thousands elderly citizens dying from flu it's still peanuts if we consider the possibility of millions of people without income and food for many months to come.

Tbh, i would not want to be the one who takes the decision.

[DrTuner]

7 minutes ago, mauGR1 said:

Again, perhaps it sounds cynical, but a few thousands elderly citizens dying from flu it's still peanuts if we consider the possibility of millions of people without income and food for many months to come.

Tbh, i would not want to be the one who takes the decision.

That's basically the decision. And it's political suicide to make it explicitly, so as usual the usurpers are simply hoping the problem goes away. And in this odd case they might be right. Doesn't make them any less despicable.

 

https://www.thaienquirer.com/9948/opinion-you-would-expect-a-government-led-by-soldiers-to-be-decisive-they-cant-even-get-that-part-right/

Edited March 31, 2020 by DrTuner

[mauGR1]

16 minutes ago, ThailandRyan said:

Mexico has tried this approach, and so far its working in their favor, but they are approaching a time frame where it either explodes or they have turned the corner.  

Mexico has some charm to me, i hope it works for them.

[mauGR1]

2 minutes ago, DrTuner said:

That's basically the decision. And it's political suicide to make it explicitly, so as usual the usurpers are simply hoping the problem goes away. And in this odd case they might be right. Doesn't make them any less despicable.

 

https://www.thaienquirer.com/9948/opinion-you-would-expect-a-government-led-by-soldiers-to-be-decisive-they-cant-even-get-that-part-right/

Not wishing to discuss the Thai government here, i am discussing the choices of all world's governments.

Destroying the village to save the village is nonsensical.

[DrTuner]

2 minutes ago, mauGR1 said:

Destroying the village to save the village is nonsensical.

I've seen a few horror movies where they send to young as sacrifices to the evil monsters in the woods. Seems to be a real life one now, except it's the old being sacrificed. Makes it morally more palpatable I suppose, since they have in average less time left anyway.

 

One hard core solution would be to round up everybody over 65 and shelter them in quarantine until the vaccine is there. A state sponsored retirement home, eh?

[mauGR1]

1 minute ago, DrTuner said:

One hard core solution would be to round up everybody over 65 and shelter them in quarantine until the vaccine is there. A state sponsored retirement home, eh?

That would be inhumane, let me stay at home i'd say.

There are things which are worse than death imho.

[DrTuner]

12 minutes ago, mauGR1 said:

That would be inhumane, let me stay at home i'd say.

There are things which are worse than death imho.

The question in general is would the elderly stay home and would the younger people let them alone. Otherwise it's again useless.

 

Let's roll back a bit and assume we're already deep in phase 3. There could be a lot of young people, asymptomatic carriers, walking about. They could infect the elderly, who would then require hospital care and block the access to health care also for the younger ones. So, could the solution be simply to segregate people according to age, to keep the health care ticking until the vaccine is there? And has this actually unwittingly happened when the younger ones were working in BKK and the elderly back in the villages? Did they screw it up by closing shops? Questions, questions, not a lot of answers.

Edited March 31, 2020 by DrTuner

[mauGR1]

6 minutes ago, DrTuner said:

The question in general is would the elderly stay home and would the younger people let them alone. Otherwise it's again useless.

 

Let's roll back a bit and assume we're already deep in phase 3. There could be a lot of young people, asymptomatic carriers, walking about. They could infect the elderly, who would then require hospital care and block the access to health care also for the younger ones. So, could the solution be simply to segregate people according to age, to keep the health care ticking until the vaccine is there? And has this actually unwittingly happened when the younger ones were working in BKK and the elderly back in the villages? Did they screw it up by closing shops? Questions, questions, not a lot of answers.

Imho, the young, healthy ones have not much to worry about. By now that should be clear.

As for the elderly, many with pre-existing conditions, well, God help them.

Segregating people as if they were criminals sounds awful to my ears. Let the people live and die with dignity.

[DrTuner]

3 minutes ago, mauGR1 said:

Let the people live and die with dignity.

Well then .. a mandatory non-resuscitate order for over 65's? Somehow the load on the health system must be lowered. The highest load will come from that age group with pre-existing conditions. It's a bit unfair to put the load on doctors during triage.

Edited March 31, 2020 by DrTuner

[mauGR1]

2 minutes ago, DrTuner said:

Well then .. a mandatory non-resuscitate order for over 65's? Somehow the load on the health system must be lowered. The highest load will come from that age group with pre-existing conditions. It's a bit unfair to put the load on doctors during triage.

Doctors are humans, i would not even dare to criticise them.

Perhaps i've spent too long time in Asia, but this loss of freedom which we are just starting to experience is awful, while i can accept death as natural.

I wonder how many of the people confined in their homes are losing their mental health by now, with a grim future ahead.

[DrTuner]

10 minutes ago, mauGR1 said:

Doctors are humans, i would not even dare to criticise them.

Perhaps i've spent too long time in Asia, but this loss of freedom which we are just starting to experience is awful, while i can accept death as natural.

I wonder how many of the people confined in their homes are losing their mental health by now, with a grim future ahead.

No worries, I've always been nuts.

 

The problem with natural death is it's not natural if one is taking up a hospital bed for weeks in some ECMO machine when the lungs are already toast. That's what's going to overload the system, severe cases need treatment for quite a while and if the prospects are not good .. 

 

That's basically "phase 3" for you. Hospitals doing triage because of the growth of severe cases. Not a happy situation.

[mauGR1]

3 minutes ago, DrTuner said:

The problem with natural death is it's not natural if one is taking up a hospital bed for weeks in some ECMO machine when the lungs are already toast.

I agree with that.

I had pneumonia in India when i was 21, and i thought i could die, i healed myself and didn't even consider to go to hospital.

[White Christmas13]

1 hour ago, mauGR1 said:

That would be inhumane, let me stay at home i'd say.

There are things which are worse than death imho.

Retirement homes aka nursing homes would be the worst place to stay home stay would be safest.

[mauGR1]

2 minutes ago, White Christmas13 said:

Retirement homes aka nursing homes would be the worst place to stay home stay would be safest.

Yep, at least you can drink a beer without being pestered by doctors ????

[White Christmas13]

5 minutes ago, mauGR1 said:

Yep, at least you can drink a beer without being pestered by doctors ????

in OZ you can drink in nursing homes as well but you taking a big risk getting infected

from all sorts of diseases. Since I live by my self now I might as well put my name

down to get in, before I kick the bucket.

[mauGR1]

4 minutes ago, White Christmas13 said:

in OZ you can drink in nursing homes as well but you taking a big risk getting infected

from all sorts of diseases. Since I live by my self now I might as well put my name

down to get in, before I kick the bucket.

Home is better anyway, no hurry to kick the bucket, cheers.