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  1. - Top - End - #181
    Bugbear in the Playground
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    Default Re: The Corona Virus

    Quote Originally Posted by Tyndmyr View Post
    Yeah. I think we're going to see some long term effects even if the disease suddenly recedes. Which, yknow, it may well not. The trend so far as not been great.



    Oddly, that's...a little comforting. The US has a *lot* of ICU beds and ventilators relative to the population. If you scaled up Italy to our population size, it remains manageable. Not convenient, mind you, and still bad. I would encouage taking any steps you can to avoid putting stresses on any hospital system in the weeks to come if you can avoid it. But everyone would be getting treated, where in Italy, they sadly are just unable to keep up.
    That made me wonder about the numbers since I read another article were the US was placed relatively low in beds per capita (slightly below italy actually)
    https://www.businessinsider.com/coro...20-3?r=DE&IR=T

    So ventilators https://meduza.io/en/feature/2020/03...ilator-problem : US 18.8, Italy 8.3 per 100000 (russia is at 27.3 uk at 12.9)

    ICU beds: https://www.statista.com/chart/21105...0-inhabitants/ us at 34.7 and italy at 12.5

    I wonder why the US has a proportionally much higher percentage of ICU places among their hospital places?

  2. - Top - End - #182
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    Default Re: The Corona Virus

    Quote Originally Posted by Ibrinar View Post
    That made me wonder about the numbers since I read another article were the US was placed relatively low in beds per capita (slightly below italy actually)
    https://www.businessinsider.com/coro...20-3?r=DE&IR=T

    So ventilators https://meduza.io/en/feature/2020/03...ilator-problem : US 18.8, Italy 8.3 per 100000 (russia is at 27.3 uk at 12.9)

    ICU beds: https://www.statista.com/chart/21105...0-inhabitants/ us at 34.7 and italy at 12.5

    I wonder why the US has a proportionally much higher percentage of ICU places among their hospital places?
    You've hit on an important difference in US medical care vs the rest of the world. We have unusually few regular beds for the medical $ we spend, and a lot of everything else. Part of it is that, for a number of reasons, the US has strongly pursued outpatient, etc procedures. Reducing time spent in hospital in recovery has been a goal for quite some time. This mostly only really works for the routine stuff, though. There are a few other factors. Firearm crime rates mean our emergency rooms are unusually practiced with that sort of trauma care, and is used to dealing with a lot more of it than other countries. This can encourage a more ICU-focused outlook. Plus, we do spend an unholy amount of money on our medical care, and that money does go somewhere. Expensive medical equipment is one such cost.

    Now, how well each style works really just...depends. For many sorts of routine problems, the US method is arguably fairly inefficient, but for the particular problem of Covid-19, we're fairly well equipped.

    The open question, of course, is how bad it'll spread here. Everybody's got estimates, but there's significant uncertainty there. We may have more buffer room, but if it's enough of an additional buffer is...hopefully?

    Not being an epidemologist, but knowing a bit of math, and having attended a conference by the CDC on the topic, I did a little bit of spitballing. If you graph the US infection rate logrithmically, the infection rate thus far is a straight line. For all the talk about flattening the curve, there has been no sign of it happening yet. If it continues in this fashion, we'll cross 100k infected in the US this coming friday. However, the curve does max out at some point. If the information from China can be trusted, it already did so there, and we may see a similar inflection soon. Once we do, we'll know more about where it'll max out.

    The above doesn't mean, probably, that current countermeasures are doing nothing. It probably just means that the number of detected infections is on a delay from the number of actual infections. Largely, we're only testing people once they exhibit symptoms, so any given countermeasure won't show up in the data until after a time delay.

    Quote Originally Posted by NichG View Post
    Do you happen to know where that estimate comes from? I've seen an identical estimate quoted elsewhere, and I'm curious what it's actually based on (or even better would be to know the distribution of that coefficient across various countries).
    Yknow, now that I go looking for it, I can't find the same study I was looking at when I found it. I've found other ones with sort of similar numbers, but not that exact one. I *believe* it was a US based study, but do not recall the specific names involved.

    I would imagine that your guess that it varies by country is correct. I found a couple for Scotland and Sweden, and both of those showed an increase as well but the numbers varied. That may also represent flaws in the information gathering method. It's hard to randomly select people to be poor for the purpose of a study, so basically all the data is observational instead. It appears to be true across a wide variety of causes. Alcoholism increases, suicide rates increase, but natural causes of death also increase. Maybe stress/poorer eating, exercise, health care?
    Last edited by Tyndmyr; 2020-03-21 at 10:53 AM.
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  3. - Top - End - #183
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    Default Re: The Corona Virus

    Earlier I read a misleading comparison between the number of deaths by motor vehicles vs the virus. In Italy, the last few weeks saw over 4,000 deaths due to the virus, vs 3,300 deaths due to road accidents in the whole year of 2018.
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  4. - Top - End - #184
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    Default Re: The Corona Virus

    Quote Originally Posted by Tyndmyr View Post
    The above doesn't mean, probably, that current countermeasures are doing nothing. It probably just means that the number of detected infections is on a delay from the number of actual infections. Largely, we're only testing people once they exhibit symptoms, so any given countermeasure won't show up in the data until after a time delay.
    From the delay of getting infected to showing symptoms to becoming a confirmed case, I would expect a delay of 2-3 weeks until we see an effect of the current measures.


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  5. - Top - End - #185
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    Default Re: The Corona Virus

    Quote Originally Posted by Tyndmyr View Post
    Yknow, now that I go looking for it, I can't find the same study I was looking at when I found it. I've found other ones with sort of similar numbers, but not that exact one. I *believe* it was a US based study, but do not recall the specific names involved.

    I would imagine that your guess that it varies by country is correct. I found a couple for Scotland and Sweden, and both of those showed an increase as well but the numbers varied. That may also represent flaws in the information gathering method. It's hard to randomly select people to be poor for the purpose of a study, so basically all the data is observational instead. It appears to be true across a wide variety of causes. Alcoholism increases, suicide rates increase, but natural causes of death also increase. Maybe stress/poorer eating, exercise, health care?
    If nothing else, places where losing your job means losing access to healthcare versus places where that isn't the case should make a difference as to whether e.g. the mortality is directly caused by not having a job versus caused by accumulated side-effects of poverty, and it'd make a difference in how one would go about trying to ameliorate the effect. My instinct is that there should be more give in economic factors than in biological ones - that is to say, no matter how much money you throw at treating 80 year olds with Covid-19 you probably aren't going to get the death rate below 5%, but if economic deaths are caused by lack of funds then there's a particular amount needed to preserve that life for a given period of time.

    For example, I've read that it's about $10k per quarantined patient for the duration of treatment/quarantine in South Korea in terms of hospital operating costs, etc (the patient doesn't pay it). So if it costs less than say half of that to offset mortality from economic burden (R0 is about 2.5 people infected per case, and there's some statistics that roughly 20% of cases require hospitalization) then it'd be a reasonable trade. And if that's targeted (for example to people whose jobs mean they're likely to spread it more than average and are exposed to more economic risk if they stay home - e.g. service industry) then it could be a pretty good deal from a numbers point of view.

  6. - Top - End - #186
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    Default Re: The Corona Virus

    Quote Originally Posted by Tyndmyr View Post
    You've hit on an important difference in US medical care vs the rest of the world. We have unusually few regular beds for the medical $ we spend, and a lot of everything else. Part of it is that, for a number of reasons, the US has strongly pursued outpatient, etc procedures. Reducing time spent in hospital in recovery has been a goal for quite some time. This mostly only really works for the routine stuff, though. There are a few other factors. Firearm crime rates mean our emergency rooms are unusually practiced with that sort of trauma care, and is used to dealing with a lot more of it than other countries. This can encourage a more ICU-focused outlook. Plus, we do spend an unholy amount of money on our medical care, and that money does go somewhere. Expensive medical equipment is one such cost.

    Now, how well each style works really just...depends. For many sorts of routine problems, the US method is arguably fairly inefficient, but for the particular problem of Covid-19, we're fairly well equipped.

    The open question, of course, is how bad it'll spread here. Everybody's got estimates, but there's significant uncertainty there. We may have more buffer room, but if it's enough of an additional buffer is...hopefully?

    Not being an epidemologist, but knowing a bit of math, and having attended a conference by the CDC on the topic, I did a little bit of spitballing. If you graph the US infection rate logrithmically, the infection rate thus far is a straight line. For all the talk about flattening the curve, there has been no sign of it happening yet. If it continues in this fashion, we'll cross 100k infected in the US this coming friday. However, the curve does max out at some point. If the information from China can be trusted, it already did so there, and we may see a similar inflection soon. Once we do, we'll know more about where it'll max out.

    The above doesn't mean, probably, that current countermeasures are doing nothing. It probably just means that the number of detected infections is on a delay from the number of actual infections. Largely, we're only testing people once they exhibit symptoms, so any given countermeasure won't show up in the data until after a time delay.



    Yknow, now that I go looking for it, I can't find the same study I was looking at when I found it. I've found other ones with sort of similar numbers, but not that exact one. I *believe* it was a US based study, but do not recall the specific names involved.

    I would imagine that your guess that it varies by country is correct. I found a couple for Scotland and Sweden, and both of those showed an increase as well but the numbers varied. That may also represent flaws in the information gathering method. It's hard to randomly select people to be poor for the purpose of a study, so basically all the data is observational instead. It appears to be true across a wide variety of causes. Alcoholism increases, suicide rates increase, but natural causes of death also increase. Maybe stress/poorer eating, exercise, health care?
    A couple of notes i'd add to that.

    1. {Scrubbed}
    2. Saying china has passed the point is waaay too early. {Scrubbed}. Second we don;t know that they won't suffer another flareup once they retract the measures. In fact basic immunology theory and the current state of the world around them makes it exceedingly unlikely they won't have that happen.

    3. China was able to and did implement a level of measure far more draconian than anything europe or north america will be able to unless the situation gets a LOT worse. That means even if we take th current situation in china at face value it's far more optimistic than what the majority of countries will experiance.
    Last edited by jdizzlean; 2020-03-22 at 03:49 AM. Reason: clean up

  7. - Top - End - #187
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    Default Re: The Corona Virus

    With regards to RTA - if 500 people started dying out of no where due to a previously unknown fault in a car people would definitely want action
    If the deaths are seen as part of a personal choice itís not seen as an issue - so lower speed limits in built up areas etc
    And if icu is full then trauma victims will likely end up dying waiting for treatment
    If you want to see what selfish younger people not social distancing themselves in a highly urban country which has a lot of conspiracy theorists will cause, just look at Australia in the next few weeks.
    Last edited by mjasghar; 2020-03-22 at 06:12 AM. Reason: Spelling

  8. - Top - End - #188
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    Default Re: The Corona Virus

    2 days might be a bit soon to say but it is nice that death numbers in Italy today and yesterday haven't grown and even fallen from that 793 in a day two days ago. If measures helped and it stays sub 1000 a day that would be a relief.

  9. - Top - End - #189
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    Default Re: The Corona Virus

    Quote Originally Posted by Carl View Post
    2. Saying china has passed the point is waaay too early.
    With regards to reliability, I did include a caveat. We need some numbers to work with if we're going to make predictions, and early on, you simply don't have as much good data as you would like. All you can really do is estimate the best you can and include a note about potential error. In this instance, there is certainly a great deal that remains unknown.

    3. China was able to and did implement a level of measure far more draconian than anything europe or north america will be able to unless the situation gets a LOT worse. That means even if we take th current situation in china at face value it's far more optimistic than what the majority of countries will experiance.
    Draconian measures are not inherently more effective, just different. Punitive measures can inhibit reporting, for instance, and result in uncaught cases and a faster spread. I note that the assumption that China has done well for this reason does appear in the media, but it's rarely justified. I would hesitate to treat this as fact.

    In addition, higher availability of medical support available to some countries should provide an advantage that might reduce the impact a great deal.

    Still not seeing any bending of the curve. Here's hoping the lag time is indeed long, and we're not missing something.

    Probably my biggest concern about it so far is that, looking only at outcomes, the odds do look pretty rough. Sure, deaths often happen faster than recoveries, but we have *very* few recoveries. This isn't just a statistical thing, you usually need blood from survivors for studying for a cure. That process is far from instant, but lack of material to work with won't help, yknow?
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  10. - Top - End - #190
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    Default Re: The Corona Virus

    Quote Originally Posted by Tyndmyr View Post
    Still not seeing any bending of the curve. Here's hoping the lag time is indeed long, and we're not missing something.
    The difficult part with COVID-19 is itís relatively long incubation period. People falling ill today have very likely caught the virus at least a week ago. If Italy is now at the peak, as we have some hope may be the case if the numbers now start to decline, it happens quite precisely two weeks after Italy entered into lockdown.

  11. - Top - End - #191
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    Default Re: The Corona Virus

    Quote Originally Posted by Noldo View Post
    The difficult part with COVID-19 is itís relatively long incubation period. People falling ill today have very likely caught the virus at least a week ago. If Italy is now at the peak, as we have some hope may be the case if the numbers now start to decline, it happens quite precisely two weeks after Italy entered into lockdown.
    Also, we are already seeing a bending of the curve. It's not what I would call a definitive trend, but the usual rate of increase has been 20-30% daily, and we've spent the last 3 or 4 days significantly below that point. The first step in slowing down is to stop accelerating.
    That's all I can think of, at any rate.

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  12. - Top - End - #192
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    Default Re: The Corona Virus

    Quote Originally Posted by Strigon View Post
    Also, we are already seeing a bending of the curve. It's not what I would call a definitive trend, but the usual rate of increase has been 20-30% daily, and we've spent the last 3 or 4 days significantly below that point. The first step in slowing down is to stop accelerating.
    This is definitely not true in the US. I'm looking at it on a log chart. The acceleration is constant. It's definitely not true overall, either. That described an initial hump, followed by a leveling off, followed by a far sharper curve upward. On a log chart, that is...incredibly bad. Globally, it's actually accelerating faster than it was before.

    It looks like some other countries might be seeing improvement, though, and that's somewhat encouraging.
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  13. - Top - End - #193
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    Default Re: The Corona Virus

    Quote Originally Posted by Tyndmyr View Post
    This is definitely not true in the US. I'm looking at it on a log chart. The acceleration is constant. It's definitely not true overall, either. That described an initial hump, followed by a leveling off, followed by a far sharper curve upward. On a log chart, that is...incredibly bad. Globally, it's actually accelerating faster than it was before.

    It looks like some other countries might be seeing improvement, though, and that's somewhat encouraging.
    In the US I suspect that any initial slowing was related to people going undiagnosed because of a lack of tests. Frankly, the only country whose data I believe is South Korea, where they have actually gotten just about everyone who was exposed to the virus tested. I suspect that the US has about a 50% undiagnosed case rate (due to both the lag in tests being confirmed and the lag in tests being available).
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  14. - Top - End - #194
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    Default Re: The Corona Virus

    Sadly, I suspect you are being optimistic saying a 50% un-diagnosed case rate.
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  15. - Top - End - #195
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    Default Re: The Corona Virus

    Quote Originally Posted by Tyndmyr View Post
    This is definitely not true in the US. I'm looking at it on a log chart. The acceleration is constant.
    They didn't implement anti-virus measures there until recently, and with the incubation period of Covid-19 being anything up to a couple of weeks, you're going to have a significant delay between measures being implemented and it actually affecting the rate of increase of infections, because the people who are passing on the virus now were infected themselves a week or two ago.

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    Default Re: The Corona Virus

    Quote Originally Posted by HandofShadows View Post
    Sadly, I suspect you are being optimistic saying a 50% un-diagnosed case rate.
    Which way am I being optimistic? The higher the undiagnosed case rate, the lower the actual mortality rate. On the one hand, with about 45,000 confirmed cases (as of late yesterday), a high undiagnosed case rate means a lot more people have the virus than we think do. On the other hand, a high undiagnosed case rate means that the numbers we see about hospitalisation and fatality rates are inflated. On the gripping hand, the bulk of those cases are recent diagnoses, and the Wuhan Coronavirus takes between 2 and 8 weeks to kill.
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  17. - Top - End - #197
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    Default Re: The Corona Virus

    Since South Korea seems to have controlled it fairly successfully I suspect their numbers are the closest to correct (well for their population composition age and other risk factor wise. )


    And an uptick in italian death per day again to 743, but that is still below the high of 793 I suppose.

  18. - Top - End - #198
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    Default Re: The Corona Virus

    Quote Originally Posted by Rockphed View Post
    Which way am I being optimistic? The higher the undiagnosed case rate, the lower the actual mortality rate. On the one hand, with about 45,000 confirmed cases (as of late yesterday), a high undiagnosed case rate means a lot more people have the virus than we think do. On the other hand, a high undiagnosed case rate means that the numbers we see about hospitalisation and fatality rates are inflated. On the gripping hand, the bulk of those cases are recent diagnoses, and the Wuhan Coronavirus takes between 2 and 8 weeks to kill.
    Once again, with this sickness, it is not the raw death rate that is the issue, but the high critical rate that oversaturates the medical system and therefore leads to a *much* higher death rate and impact on the socio economic outlook

  19. - Top - End - #199
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    Quote Originally Posted by Maelstrom View Post
    Once again, with this sickness, it is not the raw death rate that is the issue, but the high critical rate that oversaturates the medical system and therefore leads to a *much* higher death rate and impact on the socio economic outlook
    My point is that if 50,000 people are infected with a 10% hospitalisation rate or 100,000 people are infected with a 5% hospitalisation rate it works out to be the same drain on medical resources (i.e. 5000 people in hospitals). More people infected means more opportunity for spread, but lower rate of complications means we should be less worried about the spread. I suspect that the US numbers are going to even out to about what South Korea has seen in terms of mortality rates, which is largely on what I am basing my estimate of 50% undiagnosed case rate. At this point, undiagnosed case rate is a wash, largely because we are still at the point of using the diagnosed cases to inform all sorts of things.

    So, I repeat, which way am I being optimistic?
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    Default Re: The Corona Virus

    One thing the media hasn't reported on is that many viruses cause permanent damage, even if we don't see it immediately. Permanently lowered lung function would be an obvious one, but also higher rates of lung cancer down the line or weakness to other diseases. Infectious disease has lots of consequences.
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    Default Re: The Corona Virus

    I wonder if the coronavirus would lead to a zombie outbreak?

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    Quote Originally Posted by Bartmanhomer View Post
    I wonder if the coronavirus would lead to a zombie outbreak?
    I believe that question was researched in I am Legend.

  23. - Top - End - #203
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    Quote Originally Posted by Bartmanhomer View Post
    I wonder if the coronavirus would lead to a zombie outbreak?
    Why exactly are you wondering that?

    So far, we've seen the virus infect people's lungs, where it causes severe inflammation. This leads to the patients being unable to breath, leaving them helpless and dying.

    To have a zombie virus the virus needs to infect the brain, cause severe hormonal and neurotransmitter imbalances leaving the patients unable to resist the all encompassing thought of eating human flesh and also giving them mild superpowers because otherwise the zombies wouldn't be dangerous.

    There's not a lot of similarity there. I'm not saying a zombie virus is absolutely impossible, but this isn't it.
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    Quote Originally Posted by Lvl 2 Expert View Post
    To have a zombie virus the virus needs to infect the brain, cause severe hormonal and neurotransmitter imbalances leaving the patients unable to resist the all encompassing thought of eating human flesh and also giving them mild superpowers because otherwise the zombies wouldn't be dangerous.
    I'm a little worried about how much thought you've put into designing a zombie virus.

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    Quote Originally Posted by Lvl 2 Expert View Post
    Why exactly are you wondering that?

    So far, we've seen the virus infect people's lungs, where it causes severe inflammation. This leads to the patients being unable to breathe, leaving them helpless and dying.

    To have a zombie virus the virus needs to infect the brain, cause severe hormonal and neurotransmitter imbalances leaving the patients unable to resist the all-encompassing thought of eating human flesh and also giving them mild superpowers because otherwise, the zombies wouldn't be dangerous.

    There's not a lot of similarities there. I'm not saying a zombie virus is absolutely impossible, but this isn't it.
    Well, it feels like it is.

  26. - Top - End - #206
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    Default Re: The Corona Virus

    Quote Originally Posted by Bartmanhomer View Post
    Well, it feels like it is.
    Have the dead begun rising? If not, then how does it feel like a zombie virus?
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    Default Re: The Corona Virus

    Quote Originally Posted by Lvl 2 Expert View Post
    Why exactly are you wondering that?

    So far, we've seen the virus infect people's lungs, where it causes severe inflammation. This leads to the patients being unable to breath, leaving them helpless and dying.

    To have a zombie virus the virus needs to infect the brain, cause severe hormonal and neurotransmitter imbalances leaving the patients unable to resist the all encompassing thought of eating human flesh and also giving them mild superpowers because otherwise the zombies wouldn't be dangerous.

    There's not a lot of similarity there. I'm not saying a zombie virus is absolutely impossible, but this isn't it.
    You called?

    Speaking of things that aren't being reported, one of the fascinating things to me locally is that the ratio of confirmed negative tests to confirmed positive tests are greater than 10:1. Until yesterday there hadn't been a confirmed positive case within 100 miles of me.

  28. - Top - End - #208
    Firbolg in the Playground
     
    DrowGuy

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    Default Re: The Corona Virus

    Quote Originally Posted by Peelee View Post
    Have the dead begun rising? If not, then how does it feel like a zombie virus?
    No, not yet........good question maybe it just a serious virus that nobody wasn't prepared for it.
    Last edited by Bartmanhomer; 2020-03-24 at 07:27 PM.

  29. - Top - End - #209
    Dragon in the Playground Moderator
     
    Peelee's Avatar

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    Default Re: The Corona Virus

    Quote Originally Posted by Imbalance View Post
    You called?

    Speaking of things that aren't being reported, one of the fascinating things to me locally is that the ratio of confirmed negative tests to confirmed positive tests are greater than 10:1. Until yesterday there hadn't been a confirmed positive case within 100 miles of me.
    How many people being tested are asymptomatic, and have little to no reason to be tested?
    The Mod on the Silver Mountain avatars by the wonderfully talented Cuthalion!

    If anyone has a crayon drawing they would like to put on the Kickstarter Reward Collection Thread, PM me.
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    Quote Originally Posted by Fyraltari View Post
    Quote Originally Posted by Peelee View Post
    Your bread looks like a rotary phone.
    This right here, is some prime quality culinary critique.

  30. - Top - End - #210
    Barbarian in the Playground
     
    Imbalance's Avatar

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    Dec 2018

    Default Re: The Corona Virus

    Quote Originally Posted by Peelee View Post
    How many people being tested are asymptomatic, and have little to no reason to be tested?
    DOH doesn't say.

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