International Risk

Can 2020 Get Any Worse? (si)

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Until now, there had been only one confirmed case of Chapare virus, an Ebola-like illness that turned up in the rural Bolivian province of Chapare in 2004 and then disappeared. But in 2019, at least five more people caught the bug, according to research now made public. The virus spread from person to person through bodily fluids in a region near Bolivia’s capital city of La Paz, killing three people. There are no active outbreaks of Chapare in 2020, and even in the event of further outbreaks the virus would be unlikely to cause a pandemic, according to virus experts.

There are reasons to be concerned about the news, however. Three of the five confirmed patients from the 2019 outbreak were health care workers, according to a CDC statement; a “young medical resident,” an ambulance medic and a gastroenterologist all contracted Chapare after contact with bodily fluids from infected patients. Two of them died.

Deadly hemorrhagic fever in Bolivia can spread between people — https://www.livescience.com/chapare-virus-human-transmission.htm

In my next life I want to come back as an Infectious Disease specialist.

Older Adults Living with Younger People Face Increased Risk for COVID-19 Mortality (if you’re Swedish)

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Older adults who live with younger people, including those of working age, are at increased risk for COVID-19 mortality, according to a study in The Lancet Healthy Longevity.

Using Swedish population and death registries, researchers studied nearly 275,000 adults aged 70 or older in Stockholm. Roughly 3400 died between March and May 2020, 38% from COVID-19.

Those who lived with at least one person younger than 66 years had a 60% increased risk for COVID-19 death relative to those living with older people. In addition, those living in the most densely populated neighborhoods had a 70% higher risk than those in the least densely populated areas, and those living in care homes had over four times the risk of those in independent housing.

NEJM Journal Watch — https://www.jwatch.org/fw117174/2020/10/27/older-adults-living-with-younger-people-face-increased

Check out the recent Time article for an excellent overview of the Swedish Covid-19 response:

The Swedish way has yielded little but death and misery. And, this situation has not been honestly portrayed to the Swedish people or to the rest of the world.

The Swedish COVID-19 Response Is a Disaster. — https://time.com/5899432/sweden-coronovirus-disaster/

Africa’s Covid-19 Death Rate

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The most widely accepted factor is Africa’s youthful population. Only about 3 per cent of Africans are over the age of 65, the age group in which illness and death from the coronavirus are most common. (By comparison, about 18 per cent of Canada’s population is over the age of 65.)

Africa’s low COVID-19 death rate has multiple causes, WHO says — https://www.theglobeandmail.com/world/article-africas-low-covid-19-death-rate-has-multiple-causes-who-says/
  • Case fatality rate of 2.4
  • lower testing rates
  • youthful population
  • 90% of cases in people <65 years of age
  • more rural areas, more time outdoors
  • strict lock downs early
  • poor road network, limited international flights

Today’s Old are “Younger” (if you are a Finlander)

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Hundreds of Finlanders aged 75-80 were given a battery of physical and cognitive tests 30 years ago. The same tests were recently repeated, in 2017-2018, with Finlanders aged 75-80. The modern group showed substantial differences:

walking speeds .2-.4 meters per second faster

grip strengths 5%-25% stronger

knee extension strengths 20%-47% higher

better verbal fluency, reasoning, and working memory

This means that the modern group moves and thinks “younger.” “Performance measurements reflect one’s functional age,” says lead author Taina Rantanen, professor of gerontology and public health at the University of Jyväskylä.

Today’s Older People Really are Younger — https://www.fastcompany.com/90554646/todays-older-people-really-are-younger-than-in-previous-generations

You can access the study abstract here: https://academic.oup.com/biomedgerontology/advance-article-abstract/doi/10.1093/gerona/glaa224/5901594?redirectedFrom=fulltext

And if you’re Covid obsessed like I am here you go:

https://en.wikipedia.org/wiki/Template:COVID-19_pandemic_data/Finland_medical_cases_chart

I would not extrapolate the older age study findings to the general population. Clearly there are cultural, societal, dietary, climate and other differences in Finland that do not exist elsewhere. But at my age I’ll take good news about getting older anywhere I can find it.

Finland is different. They developed a real interesting rapid Covid-19 test.

Four Covid-19 sniffer dogs have begun work at Helsinki airport in a state-funded pilot scheme that Finnish researchers hope will provide a cheap, fast and effective alternative method of testing people for the virus.

‘Close to 100% accuracy’: Helsinki airport uses sniffer dogs to detect Covid — https://www.theguardian.com/world/2020/sep/24/close-to-100-accuracy-airport-enlists-sniffer-dogs-to-test-for-covid-19

Covid-19 in Uruguay

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The swift action of the government slowed the spread of the virus and bought the country vital time to prepare its hospitals and testing system, says the team of scientists advising it. It also meant they could stop the virus’s spread before it became exponential as it did in the hardest hit nations.

“By acting really fast we were able to completely identify and stop the transmission chain of the disease in every [outbreak],” says Rafael Radi, a biochemist at Montevideo’s University de la Republica leading the government’s advisory group.

Epidemiologists traced the first outbreak to a wedding, where all attendees were tested and suspected infections isolated within 24 hours. The same approach was employed at the three subsequent outbreaks: a mental health care hospital, a care home for the elderly, and the city of Rivera, bordering Brazil. The result was that most local transmission chains have been controlled at the second or third ration of contacts,4 before their spread accelerated

https://doi.org/10.1136/bmj.m3575 (Published 18 September 2020) BMJ 2020;370:m3575

Spain – a Squatter’s Paradise

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For many people, squatting is a desperate last resort, while for some it is a lifestyle choice or a political statement. Barcelona, which is ground zero of Spain’s squatting phenomenon, attracts squatters from all over Europe. In recent years, more and more young locals — including many with jobs — who have been priced out of the rental market or who simply don’t want to pay the inflated rents have also turned to squatting.

https://wolfstreet.com/2020/09/12/how-spain-became-a-squatters-paradise/

If you live in a part of the world that is blessed with a year round moderate climate this phenomenon is coming to your town.

Meanwhile in Argentina…

In Argentina, they have gone beyond just squatting. Lands with no buildings on them are being occupied, houses build on them and people moves there, sometimes in just a few weeks. Once the illegal houses are occupied getting the people out and the houses destroyed is not easy. That already was a problem before quarantine but during quarantine? It has got a lot worse. And of course there is squatting too.

Reader comment on the arttcle

COVID-19 Overwhelms Border ICUs

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COVID-19 Overwhelms Border ICUs

El Centro Regional Medical Center was so overwhelmed by COVID-19 patients it had to divert some to health care facilities in San Diego, National City and elsewhere. There have been more than 2,025 confirmed cases in Imperial County, which has the highest COVID-19 hospitalization rate in the state, said Andrea Bowers, special projects coordinator for the county health department.

“We know that our community has family on both sides of the border, so we’re relating the uptick to Mother’s Day weekend,” said Suzanne Martinez, assistant chief nursing officer at the medical center. “That means more risk as people travel back and forth over the border.”

Mothers’ Day weekend.

Hmm…then there’s Memorial Day weekend.

Followed by protests (not a political statement, just an observation of large crowds).

We are doomed.

 

House Hunters International (Pandemic Version) – Mexico

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Citation: California Border Hospitals Hit by Surge in COVID-19 Cases From Mexico – Medscape – May 20, 2020.

Here’s the link:

California Border Hospitals Hit by Surge in COVID-19 Cases From Mexico

Here’s an excerpt:

Imperial County has registered fewer than 800 known coronavirus infections and just 15 deaths to date. Baja California, by comparison, has reported 3,458 confirmed COVID-19 cases and 134 deaths.  Two main medical centers in Baja’s state capital – Mexicali Hospital General and IMSS Regional Hospital 30 – are both “saturated” by the outbreak, Mario Cervantes, head of relief services for the Red Cross of Mexicali, told Reuters.  Some arriving ambulances have had to wait hours to deliver new patients, while others were turned away altogether, he said.  Baja health department officials said neither Mexicali hospital had exhausted its bed space, but Dr. Rafael Abril, president of the Mexicali College of Surgeons, told local news in April that half the IMSS hospital’s doctors were infected with COVID-19, which could lead to staffing shortages.

COVID-19 – Oklahoma 03.19.20

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I’ve spent most of my life learning about what kills people.  Hey, it’s a job and I love it.

The numbers in Oklahoma are blessedly small.  Too small for statistical significance but there are some interesting aspects to these numbers.  The 2 out of state positives are professional basketball players.  We shouldn’t expect a huge increase from out of state since Oklahoma is not exactly a vacation tourist type destination and no one is traveling much nowadays.   The first positives were in Tulsa county.  That number hasn’t really moved much but Oklahoma county numbers have,  a clear indicator of community spread.

The most disturbing numbers are the positives ages 18-64.  This is not Wuhan.  This is not Italy.  This is not Iran.  This is not Spain.  This is Oklahoma.

Stay safe and act accordingly to your specific locale.

COVID-19 Oklahoma Test Results
Positive (In-State) 29
Positive (Out-of-State) 2
Negative 378
PUIs Pending Results 110

COVID-19 Cases by County
County COVID-19 Cases by County*
Canadian 2
Cleveland 4
Jackson 1
Kay 2
Oklahoma 14
Payne 1
Tulsa 4
Pawnee 1
Total 29

COVID-19 Cases by Age Grouping
Age Group, Years COVID-19 Cases*
00-04 1
05-17 0
18-49 13
50-64 10
65+ 5
Total 29
Age Range 0-75 yrs

COVID-19 Cases by Gender
COVID-19 Cases by Gender
Female 13
Male 16
Total 29

Data Source: Acute Disease Service, Oklahoma State Department of Health.
*As of 2020-03-18 at 07:00 AM.

A Physician’s Chilling COVID-19 Diagnostic Journey -KevinMD

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Madilyn and I waited for communication from her sister and were shocked that she landed in DFW, on a plane with 348 passengers with masks, and no one asked any questions about exposure or symptoms — there was no screening at all. She quickly realized her mask at DFW looked conspicuous, so she removed it and awaited her connecting flight home.

A physician’s chilling COVID-19 diagnostic journey

Here’s your daily dose on Covid-19.

If you are suffering from Covid-19 anxiety disorder please don’t read the full article.