A recent commentary in Washington Post by Bill Gates states clearly what we need to do now to improve the outcome of this pandemic. Link (may be behind paywall) : Bill Gates: Here’s how to make up for lost time on covid-19
- Nationwide stay-at-home. Given mobility in country, having some states policies lessens the effectiveness of individual state mandates. “Because people can travel freely across state lines, so can the virus. The country’s leaders need to be clear: Shutdown anywhere means shutdown everywhere. Until the case numbers start to go down across America — which could take 10 weeks or more — no one can continue business as usual or relax the shutdown. Any confusion about this point will only extend the economic pain, raise the odds that the virus will return, and cause more deaths.”
- Much more testing and quicker turnaround. This would allow more effective isolation policies and help determine if/when we are truly making progress.
- Nationwide coordination for ventilators/supplies. Competition between states is counterproductive
- Preparation for making billions of doses of vaccine (when available)
Current coronavirus tests may have a particularly high rate of missing infections. The good news is that the tests appear to be highly specific: If your test comes back positive, it is almost certain you have the infection… From a technical standpoint, under ideal conditions, these tests can detect small amounts of viral RNA. In the real world, though, the experience can be quite different, and the virus can be missed.
Thanks to Ben Gold for the following article: COVD-19 Illness in Native and Immunosuppressed States: A Clinical-Therapeutic Staging Proposal (HK Siddiqi, MR Mehra. J Heart Lung Transplantation) available at jhltonline.org
This article describes three stages of COVID-19 and associated laboratory/clinical findings.
- I -Early stage. “In patients who can keep the virus limited to this stage of COVID-19, prognosis and recovery is excellent”
- II-Pulmonary involvement (IIa) without and (IIlb) with hypoxia
- III-Systemic Hyperinflattion
And a reason to wary of hydroxychloroquine in its use for COVID-19: