Turkmenistan has no covid cases. That's official! But people are being advised to wear masks because of "high concentrations of dust" in the air. They are also advised to stay a metre apart for some completely unspecified reason. You can read about it here.

I just read but not confirmed that hospital data on COVID 19 patients will be routed first to the depart of Health and Human Services (HHS) not the CDC and the data will not be made public. The reason given is to streamline the data and give the virus task force a better way to make decisions for the allocation of supplies and other resources.

While it is probably due to the ongoing criticism the Trump administration has been getting over its response by Doctor Fauci and others is quite concerning. It seems obvious the administration wants to downplay the escalating number of cases currently in the US.

Don't know what magical test those labs are running, but in my patients the sensitivity of the antigen (PCR) test is sub 90% more in the 70% range even though the lab itself insists it is above 90%. I have diagnosed a COVID patient that clearly had all clinical signs of COVID-19 and ALSO had a CT scan that clearly showed all the signs pointing to COVID-19 (CORADS 5 score). Because of that, in the COVID team we can classify COVID-19 patients as having COVID-19 without having a positive PCR.

As cardiologists we even found high sensitive troponin T test (designed to find vulnerable patients) more sensitive for COVID than the PCR test. Others found this as well: check out this article about the relation between COVID-19 and cardiac injury: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7166030/. By the way: after running a marathon most athletes have a positive high sensitive Troponin T test as well, it is just a VERY sensitive test.

If you want to see what the CORADS classification is about, check out https://radiologyassistant.nl/chest/...classification.

By the way: the number of infected patients will never show the complete truth, only mortality rate comparisons will (eventually).

Hermani, what do you think the undiagnosed/asymtomatic rate might be?

Nobody knows for sure. However there is some data available and work is being done.

A rough estimate that 50-80% of cases will go undetected as stated here (https://www.pharmaceutical-technolog...agnosed-cases/) and I think it might be more at 90%.

Some hospitals over here have done screenings test on their personnel and 5% came out positive in three hospitals spread around the country. Tracer investigation showed most of them to have acquired the infection outside of the hospital. Last official national figures were about 50k positive tested on a population of 17M, so that is about 0,3% - while we have drive-in testing stations where everyone can get him/herself tested for free. If you extrapolate these figures you could argue that only about 6% of cases is being diagnosed, an even lower number than GlobalHealthData has come up with.

Just last week or so the news came in that antibody tests were showing diminishing antibody levels in people that have had COVID-19, raising concerns about their immunity. I might be wrong but I don't think that is a real problem, I haven't heard of patients being readmitted because of a repeated COVID-19 infection so it is probably just a theoretical problem.

The decreased immunity is from antibody tests. But I gather (as an interested but non-medically-qualified person) that antibodies are not the main line of defense against any virus. They work best against bacterial infections. Viruses are dealt with mainly by the other branch of our immune systems, the T-cell branch. Viruses don't hang about in the blood for long but go to ground in cells. The cells then display viral antigens on their walls, and T-cells carrying the corresponding antibody latch on to them and trigger them to commit suicide rather than acting as virus factories.

There is very recent evidence that T-cell immunity to covid-19 lasts a long time.

It is true that there is more to the immune system that just the antibodies. There are also acute phase and chronic phase antibodies. The antibodies can help the T-helper cells make the B-cells produce more antibodies while the cytotoxic T-cells get rid of infected cells. Then there is the inflammation reaction that helps those components reach the infected areas using swelling and hyperemia - while in a twist of fate it sometimes is this inflammation reaction that actually causes the most problems.

Anyways, it is quite complicated and I am just a cardiologist. You need me if you need a proper CPR and walk away living. On any sign of bugs I just call the microbiologist and I just got those COVID patients because they share a lot of symptoms with my heart failure patients. In the attachment you can see me in action..

Attached Thumbnails

 

No kidding, that is great to know. And you say it might be 90%. I understand that means that they are carriers and could kill someone else that is less healthy.

Another good reason to try and be lean, exercise, throw the cigarettes, drugs and alcohol away. Keep the immune system in good shape with phytonutrients, exercise and lots of water.

I heard on the radio the other day:
A little pessimistic, but also good & sobering food for thought.

Nice quote from the Spectator:
For the benefit of those who are not familiar with Welsh, the W is a vowel pronounced "oo" and the F is actually a V.

Take a look at what the Black Death did in Europe in the late Middle Ages.

And then compare the attire of the medical doctor at the time to how doctors dress today during a pandemic. I guess old habits have purpose

Attached Thumbnails

 

Frontline Covid's Hidden Toll
https://www.pbs.org/video/covids-hidden-toll-lof6d5/

Or

One thing is clear: it isn't over yet. Many people will be coming back from premature summer holidays abroad etc., there will be a second wave if there isn't one already and some countries are still in a full-on first wave.

The Orange Baby has been confronted with an undeniable truth, possibly the first time since it got elected.
Yes, face masks are good!

I wish more people would use them around here. Finns often have a sort of "this happens out there in the world, but not here, we're too small, too insignificant, on the fringe, and anyhow we're the safest of all countries" mentality, I find them just a tad complacent at the moment.

One thing that bothers me is the complete lack of responsibility of a lot of people. For instance, this week Spain has gone up in the risk scale and when e.g. people are returning to the UK from Spain they need to go into 2 weeks of quarantine. Now people are upset and angry, however it is their OWN risk.

I would have been going to Spain this weekend as well, however we canceled two weeks ago because of the appearance of a second wave in the Barcelona area. I can't and won't afford to go into quarantine after the vacation because people depend on me being there. So I accept the current situation and deal with it.

To me it seems that the more you pamper people, the more they become dependent on you. That is the backside of a welfare state.

We were warned about this 2 months ago. The medical people said that we need to hunker down the first time, as long as it takes, to get on top of it. If we stop distancing etc. a little early then it will come back again, resulting in more loss of life and business than if we did it right the first time.

I understand that the political leaders are desperate to get their economies working again. In fact you have to or face a depression. Some folks still don't understand or believe how serious this is though.

Young people, you are the least effected by this so you will probably be ok if you get it. But you will then be a carrier and give it to others, and that could kill them. Recall what happened when the Europeans came to the new world? The Europeans were fine, but after contact with the native people, the natives dropped like flies.

And then we have the stinky political side of it. If something is said by the other side, well they must be lying.

Almost a perfect storm.

We still don't know how that herd immunity is going to play out. I think a bunch more are simply going to die until this plays out.

I think that we are going to go into winter with this. In the northern hemisphere everyone is inside, and there we go again.

The teachers and admins are rebelling against opening the schools up in the fall. I thought about that. The kids going to school may be ok but, they could then bring it home to mom and dad, and kill them.

What a mess.