Covid-19 Updates & Info

[Suliso]

BTW:
After one year of this, it seems that the Sweden experiment did not go well at all. Their death rate is huge in comparison to their three Scandinavian neighbors.

Yes, now it's quite clear. Nobody is talking about Sweden as an example in the press anymore. It's not the worst, but clearly in the bottom quarter or a third in EU.

[MJ2004]

A frightening first-hand experience from a COVID survivor (an FT writer):

Covid and me: 10 days on life support
After a month in hospital, FT critic Tim Hayward reflects on his battle with coronavirus

I’d been under the weather for four days. Back then, in mid-November, the government’s pet message was the three symptoms of Covid-19: a persistent cough, loss of smell or taste, or a raised temperature. I had none of these, just the sort of chesty flu that hits me every autumn. My wife, Al, and my daughter, Liberty, both had bouts of something flu-like, so I followed orders. Then, on November 15, things suddenly got very weird, very quickly.

I woke feeling unusually short of breath. I’d bought, on the recommendation of a medical friend, a little gadget that measures SAT, the concentration of oxygen in the blood. My score was not out of the ordinary — above 94 — but something felt wrong nonetheless. Just after lunch, I called 111. I felt “out of it” and had an overpowering feeling that life would be a lot better if I could just take one decent full breath. The ambulance was outside in 15 minutes. Two reassuring medics stuck a mask on me, checked a few vital signs and said, “Yep . . . we’re seeing a lot of this . . . looks like Covid.”

Addenbrooke’s Hospital, in Cambridge, is a centre of excellence for all kinds of medicine. Everyone here knows people who work there and we live with a sense of reassurance. Even lying woozily in the back of an ambulance, it’s good to know you’re only a five-minute drive from the best minds, hands and equipment in the country. I remember someone introducing herself as a doctor from behind a mask, a visor, apron and gloves — over the next month, I’d get used to recognising people from a single strip, the bridge of the nose, tired eyes and a muffled voice. By 4pm, I was in a comfortable bed, waiting for the results of my first Covid test and “responding well” to oxygen therapy and Dexamethasone. But I wasn’t destined to get off that lightly — at 9 o’clock that night, they called Al to tell her I was being put on a ventilator.

Most people need to be knocked out to have a tube put down their throat but somehow, I’m told, I remained conscious, though I have no recollection of this at all. I’ve managed to piece together the timeline from a flurry of cheery text messages I sent, joking about the tubing and the huge bag full of brown gunge they drained from my lungs, relaying to worried family anything positive that any masked medic said. I’ve had to collate the text trail to tell this story because it’s all a merciful blank in my mind. One horrible recollection, though, remains very clear.

I am wheeled into a side room with four medics. One introduces himself as an anaesthetist; another, directly and with no hedging, tells me they’re “worried I’ll pull out the tubes” — they need to put me to sleep. There’s no debate . . . I guess that’s the point. But, like every other news junkie and doom scroller in the country, I know what this means. People who go into intensive care, who get anaesthetised and held on life support, don’t tend to have what the news euphemises as “good outcomes”. I’m hit with awful clarity that this is probably the most significant moment in my whole life. “It will just feel like going to sleep,” says the medic. True . . . but I have no idea whether I’ll wake up.

I have no religion. In fact, I remember thinking: “Well, if I don’t wake up, I won’t know anything about it.” Then they offered me my phone. I couldn’t raise Al on voice or text so, almost automatically, I thumbed on to Twitter . ..

“So this is hapimji@g In fuve mumutre they piu nr yo sleeo fky tn gayd”

Later a nurse tells me I’d become “a legend on the unit” — as I went under, they had to prise the phone from my fingers.

An anaesthetic is a cocktail. Some ingredients keep you “asleep”, others paralyse you so that you can’t roll about, dislodging the tubes, or choke. Back in November, every ICU patient still had an individual specialist nurse watching the monitors around the clock. Nourishment comes through a thin tube up your nose and goes out a catheter at the other end. To drain the constant build-up of toxic crap and to relieve the pressure of the other organs on your damaged lungs, you will probably be “proned” on 18-hour cycles — moved to a facedown position. It takes up to nine people to do it safely, keeping all the plumbing and wiring in place.

Most of the time, intensive care is there for people who’ve had massive surgery, traumatic injury or are near to death, and there’s a reason it’s not taken on lightly. It’s hard to imagine a more invasive assault on the body than paralysing it and taking over all its functions. My friend Binks is a specialist intensive care nurse who’s had way too much experience of it for her young years. As she puts it: “People don’t realise how intense intensive care is.”

I spent 10 days unconscious in the ICU, but that’s really the wrong word. The drugs, the unfamiliar sensory input, the physical treatment of my inactive body . . . “delirium” during and after ICU is an unsurprising side effect. Those days and a considerable period after were filled with dreams.

As soon as I could, I started writing them down. Thousands of words poured out, all of them ridiculous. I recalled 15 discrete dreams, each increasingly surreal. The earliest consist only of things I know or can imagine; later ones involve being injected, restrained, paralysed or frozen. The later dreams refer back to the earlier ones, creating a rigid narrative order. Scenarios include a road that can be driven only one way, a conspiracy of hippy aristocrats, Mossad, black helicopters and being kidnapped and pharmaceutically restrained with blue washing-liquid pods by the beautiful rebel daughter of Recep Tayyip Erdogan. I am to be appointed editor of the FT by MI6 — a proper delusion of grandeur. Men with rubber faces yell: “Do you know where you are?” and stuff things down my throat to the penetrating noises I will later recognise as the pings and beeps of my own monitoring equipment. Sounds quite amusing now, I know, but what’s scary is that I doubt I’ll ever forget any detail of the dreams. I’m not sure I’ll ever recover any of the real experience that they overlaid.

On the ninth day, they start reducing my sedation. I don’t immediately recover my own breathing and it’s another day before I come round. Someone yells: “Do you know where you are?” And I try to answer, “Scotland”. I don’t know who or where I am. I’m still delusional. The ICU nurse hooks up a FaceTime call with home in which, apparently, I croak, “Laptop, laptop!” through vocal cords wrecked by the tubes. They tell Al not to worry and that it’s not really me, but she’s terrified by my insane urgency. The next day, they arrange a call with my mother. She says I was so incoherent she was convinced I’d had a stroke.

Finally, I’m considered stable enough to be moved to a small Covid-19 ward that I share with two older men with dementia. They haven’t been in the ICU but their home circumstances mean they can’t look after themselves in isolation. During the days, nurses attend to us and our weird imaginings. At night, we’re woken every few hours to have all our vital signs taken. Drugs, confusion and sleep deprivation blend and I slip back, nightly, into my world of delusions. One of the men on the ward sleeps in a deep cot that seems to calm and partially restrain him. At night, I see the walls change to something imagined by Giger. The man cries out the same name over and over again and weeps inconsolably. I’m convinced by brief flashes, which show over the sides of the cot, that he’s wearing a Victorian nightgown. I dread the nights.

A new patient is brought into an empty bed. A little older than me, wiry as hell and with a collection of what may or may not be rightwing tattoos. He won’t understand that he can’t get up and roam the wards. When the nurses can, they talk him down and back to bed. On the second night, I wake to see him standing at the bottom of my bed, staring at me. I have an overpowering feeling that I don’t want to be mad any more. A couple of hours later, they wheel me into a new ward. The first thing I do is call home and demand my passport and a lift to the airport.

Over the next four days, the dreams subside and I begin to understand where I am and what’s going on. Ever-changing shifts of nurses, fully clad in PPE, come into the room to give patients food, administer medicine, change sheets and attend to those who can’t use the lavatory unaided. They are paragons of skill, concern and grace under pressure but there is, apparently, a limit to the time they can be exposed to us. In spite of their kindness and attentiveness, it doesn’t take many hours of mental clarity to begin to feel the sense of being locked up, like prisoners or dangerous animals. The staff, meanwhile, grow more pressured as the weeks pass. One morning, a nurse announces that they’re short-staffed and covering double shifts, so they only have time for “patient safety”. We must not use our call buttons if we can possibly avoid it and it may take them a while to respond.

The doctors, on their daily rounds, stop prefacing every interaction with “Do you know where you are?” While I was unconscious, one explains, I “sustained some neurological damage” — this is apparently not uncommon. My left foot is a bit numb, tests show my right arm to be mildly affected, but I have no movement at all in my right ankle and foot. No voluntary control, just very uncomfortable “pins and needles”. I have a “drop foot” that will require a brace to aid walking, a Zimmer frame while I learn to use it and, eventually, a walking stick.

In the early hours of the next morning, a nurse notices that my heart is beating at around 200BPM. In seconds, half a dozen masked medics appear. At the bottom of the bed is a big red-wheeled cabinet, with two paddles hanging off the side and “CRASH CART” in screamingly loud caps. Once they’ve explained that they won’t be shocking me, they hook up drugs and fluids, saying it’s probably a side effect of one of the many drugs they’ve used on me. Later, I’m put into a CT scanner where they discover I have a pulmonary embolism, a bloodclot in my lung. They won’t need to operate but instead inject me with “clot-buster” drugs daily. Later, I’ll be able to take these orally . . . for many months.

On December 15, I’m discharged with a big bag of pills and an assurance that community teams will be in touch to support my recovery. I was in Addenbrooke’s for 30 days. For about half that time, I was on oxygen; for 10 days, I was fully unconscious and on life support. For 30 days, I didn’t use most of my muscles and spent only minutes out of bed. I lost just over 14kg in weight, around two stone. I’d like to say it was all fat but, sadly, a lot of it is muscle.

My legs look like two bits of grey wool, my stomach is pleasingly flat, but so is my chest. I get exhausted after about 10 minutes of anything. My voice has lost its resonance and I’m cold all the time — no muscles working to generate heat, no fat to insulate. All of this, they tell me, is likely to come back with the physiotherapy. The “clot-busters” should get rid of my embolism, though I’ll have to take drugs for it daily, and take precautions to avoid any bleeding. If I nick myself with a kitchen knife, it may well need a tourniquet not a blue plaster.

One month on, with rest and daily physiotherapy, I’m building up strength and stamina, my voice is returning and I’m even beginning to get some limited movement in the “drop foot”. It’s likely I’ll always have to wear a brace and I have to sell my beloved stick-shift sports car. The month inside was the longest I’ve gone without alcohol since I was 16 and, as most of my life is now taken up with re-learning my sense of balance, I’m disinclined to do anything that might interfere with it. I doubt I’ll ever be teetotal but I have a chance to reassess my drinking . . . C’mon, you’ve got to look for the positives.

Unlike many who go through intensive care, I haven’t displayed symptoms of PTSD. Being asked to write this and being able to express it, is one of the reasons I can hope that I won’t. For a while, I was uncomfortable watching hospital footage on the news, but that seems to have passed. All the symptoms of actual Covid-19 are gone and I’m left with the injuries and impairments sustained in the process of saving my life — but, honestly, I’m just so bloody glad to be alive that it hardly matters. 

I do struggle with survivor’s guilt. If I’d gone to sleep in ICU and not woken up, I’d have known nothing of it. My family, friends, the people the pandemic has taught us to call “loved ones”, had to confront the possibility of bereavement, unsure for days whether I was going to live or die in isolation, unable to say goodbye. Like the doctors and nurses in the hospital, I can’t speak for them, but I’m left with the feeling that they all had a worse ride than I did.

Since I was discharged, the situation in hospitals and community care has got significantly worse. I’m unbelievably lucky . . . Lucky to have lived and lucky enough to be in a position to contemplate six months “off work” to heal physically. I can’t begin to imagine how tough this is going to be for Covid-19 victims without that luck. But it’s the delirium that I still find most difficult to handle. Some people in the profession have warned that we’re unprepared for the mental health implications of the pandemic and I can’t disagree. I wasn’t expecting to spend two weeks palpably and certifiably insane. I didn’t “die” at any point in my treatment. I didn’t start drifting toward a great white light and have to be brought back by the jolt of the paddles, but — along with a stick and a brace to remind me of 2020 — I will always live with an experience of “madness”, and that is more difficult to come to terms with.

Tim Hayward is an FT contributing writer.

[Deuce]

Did you also consider thousands of lorries crossing the Canada/US border every day delivering food, factory spare parts etc? In Detroit area, for example, auto manufacturing on US side is highly integrated with just in time parts production on Canadian side. And then there is a road traffic to Alaska too. No such complications in Australia or NZ.

My theory is this. They are islands that did lock down very fast, and could do so. Other countries that have been successful have been Singapore (another island) and S. Korea, which is technically an island as their border with N. Korea is locked down. They also are affluent nations with large social security networks. What I said above: their population could afford a lock down and not have to worry about going hungry, which is what here in Colombia cannot be done.
Sure, they had proper a proper response, but that has been my gripe for quite a while. The income disparity between countries, which is reflected in that last terrible paragraph in Dry's report, makes it impossible for hundred of millions of people to really stop working. Bogota simply cannot remain locked down, as the small businesses (and Bogota is nothing more than small businesses) cannot afford more than one month or two of lock down. Their workers even less.

Granted. But comparing countries which are well off financially with those which are not financially well off is a game of apples and oranges.

When we get down to comparing apples with apples, even if the respective apples may be of slightly different varieties, I believe it is still a more valid comparison...
Canada is often viewed as being quite similar to Australia in that both countries have similar wealth, both countries possess a large land mass, both possess generously populated cities which are quite spread out from each other, and with lots of uninhabited land in between the cities. In terms of climate, Canada's winters are somewhat more harsh than are those of Australia - but that doesn't enter into this equation, because Australia was doing significantly better with the virus even before our Canadian winter set in (and we've had a comparatively mild winter thus far, at that).

Canada is not among the worst countries in terms of our management of the virus, but nor are we among the best. We're sort of somewhere in the middle. Australia is among the very best. And while some of that success can be attributed to the fact that they are an island, I believe that the majority of the discrepancy - by a significant amount - between Canada's results and those of Australia when it comes to management of the virus is due to the significantly different manners in which both countries have dealt with the virus situation.
Australia has been much more strict. I echo the words of several people on the front lines of this battle in saying that theirs is a recipe that other countries would do well to copy.

[ponchi101]

A frightening first-hand experience from a COVID survivor (an FT writer):

Covid and me: 10 days on life support
After a month in hospital, FT critic Tim Hayward reflects on his battle with coronavirus

...
Tim Hayward is an FT contributing writer.

Excellent piece.

[JazzNU]

My dad and his wife both got their first covid shots in South Carolina today. They got the Pfizer shots.

[JazzNU]

Germany recommends AstraZeneca COVID-19 shot only for under 65s

BERLIN (Reuters) - AstraZeneca’s COVID-19 vaccine should only be given to people aged between 18 and 64, Germany’s vaccine committee said in a draft recommendation, a day ahead of a decision by European regulators on whether to approve the drugmaker’s shot.

“There are currently insufficient data available to assess the vaccine efficacy from 65 years of age,” the committee, also known as Stiko, said in a draft resolution made available by the German health ministry on Thursday.

“The AstraZeneca vaccine, unlike the mRNA vaccines, should only be offered to people aged 18-64 years at each stage,” it added.

Stiko’s assessment was based on the same trial data published by medical journal The Lancet on Dec 8.

The European Union approved a vaccine developed by Pfizer and its German partner BioNTech in late December, and gave the green light to a shot made by Moderna in early January.

AstraZeneca did not immediately respond to a request for comment.

On Monday, the drugmaker denied that its COVID-19 vaccine is not very effective for people over 65, after German media reports said officials fear the vaccine may not be approved in the European Union for use in the elderly.

The German health ministry said of the 341 people vaccinated in the group aged 65 and over, only one became infected with the coronavirus, meaning the expert vaccine panel had not been able to derive a statistically significant statement.

AstraZeneca Chief Executive Pascal Soriot said the company had less data than other drugmakers on the elderly because it started vaccinating older people later.

“But we have strong data showing very strong antibody production against the virus in the elderly, similar to what we see in younger people,” he told Die Welt newspaper in an interview earlier this week.

Germany is grappling with limited vaccine doses after Pfizer and AstraZeneca announced delays to deliveries in recent weeks, and Health Minister Jens Spahn warned the shortage would last well into April.

Spahn said there were younger age groups with existing conditions who were waiting to be vaccinated, adding the final recommendation on the use of the AstraZeneca shot would only come following EU approval.

As well as those aged over 80 and people living in senior citizens’ homes, Germany is prioritising front-line medical and care staff.

In late December, Britain became the first country to approve the coronavirus vaccine developed by Oxford University and AstraZeneca.

The government said it would not recommend one vaccine over another for different cohorts of the population, even though data on the AstraZeneca/Oxford shot’s efficacy in older people is currently limited.

It began rolling out the vaccine in January in a campaign that has targeted older people and seen more than 7 million given their first dose. Britain has also been using the vaccine developed by Pfizer and BioNTech.


Reporting by Caroline Copley; Additional reporting by Emma Thomasson and Ludwig Burger; Editing by Maria Sheahan and Alexandra Hudson

https://www.reuters.com/article/us-heal ... ce=twitter

[ponchi101]

Germany recommends AstraZeneca COVID-19 shot only for under 65s

...
The German health ministry said of the 341 people vaccinated in the group aged 65 and over, only one became infected with the coronavirus, meaning the expert vaccine panel had not been able to derive a statistically significant statement.

...

Reporting by Caroline Copley; Additional reporting by Emma Thomasson and Ludwig Burger; Editing by Maria Sheahan and Alexandra Hudson

https://www.reuters.com/article/us-heal ... ce=twitter

So... what's the problem?
Sure, keep doing the statistical analysis. But I am confused.

[Suliso]

That's great for younger people. The oldies will get Pfizer instead.

[JazzNU]

So... what's the problem?
Sure, keep doing the statistical analysis. But I am confused.

Not from this article, but from previous reporting, it sounded as if there were too few participants in the over 65 group to reach a conclusion scientists were comfortable with.

I'd be super concerned with getting this one personally if you're in the upper section of the range if the full research review backs this up. So, I'm 60-64 and good to go? Am I still just as good when I turn 65 in May or ??? I don't get that.

[ti-amie]

Ask Jared.

Trump White House donated 8,700 ventilators to other nations. Officials now don’t know where many of them are, watchdog finds.

By
Yeganeh Torbati and
Lenny Bernstein
Jan. 29, 2021 at 1:42 p.m. EST

The Trump administration spent $200 million to send more than 8,700 ventilators to countries around the world last year, with no clear criteria for determining who should get them and no way to keep track of where many ended up, according to a new report from the Government Accountability Office.

The effort, driven by the Trump White House, was an unusual top-down initiative with little decision-making by experts at the U.S. Agency for International Development, which carried out the administration’s orders. Former president Donald Trump last year boasted about U.S. success in manufacturing the machines and declared the U.S. “the king of ventilators," promising donations to foreign countries.

Staff on the White House’s National Security Council communicated to the aid agency “U.S. government decisions regarding ventilator donations, including the recipient countries, quantities, and manufacturers,” the GAO found.

“These ventilators were not in State or AID’s strategic plan,” said David Gootnick, director of international affairs and trade at GAO. “They could not articulate for us the criteria they used for what ventilators went to what countries.”

The GAO was unable to identify how the Trump White House made its decisions on ventilator allocations, and White House officials did not respond to the watchdog’s questions, which came before President Biden took office last week. For instance, while Sri Lanka had just three new coronavirus cases per day when it received 200 ventilators, Bangladesh, which had 1,409 new cases, received just 100 of the machines, the report found.

Relatively wealthy recipients such as Italy and St. Kitts and Nevis also received ventilator donations, as did tiny island nations such as Nauru and Kiribati, which have yet to report a single coronavirus case.

ProPublica reported last year that the ventilator donation effort was marked by dysfunction and little clarity on how countries were chosen for the donations. The GAO’s findings largely confirmed that report and provided new details, finding that USAID ultimately spent $200 million to send 8,722 ventilators to 43 countries.

Throughout last year, USAID and White House officials frequently publicized the donations on social media, sharing pictures of large boxes plastered with USAID’s logo ready to be shipped out.

USAID and the State Department did not immediately respond to requests for comment, and a White House spokeswoman referred questions to them. The companies that manufactured the ventilators donated by USAID — Vyaire Medical, Zoll Medical and Medtronic — did not immediately respond. Chemonics, the development consulting firm that USAID paid to deliver the ventilators, confirmed its role in the ventilator deliveries and referred other questions to USAID.

“USAID-donated ventilators have equipped medical providers to deliver quality care that is saving lives around the world,” the agency said in a response to GAO’s findings, sent to the watchdog on Jan. 6.

The process revealed in the report runs counter to how foreign assistance usually works. Although officials at the White House may set priorities for foreign aid, Republican and Democratic administrations alike have generally left the details of the aid, how it is distributed, and on what basis it is allocated to experts within USAID, which has local missions around the world that work closely with their host countries to determine needs.

Ventilators are usually used in intensive care units to help the sickest pulmonary patients breathe. In the early days of the pandemic, a shortage of the devices became a symbol of how ill-prepared the United States was for this crisis, with Trump and New York Gov. Andrew Cuomo publicly arguing about the number New York hospitals would need.

Later, hospitals turned to alternatives for some patients and manufacturers churned out more of the devices, which are still widely employed for the most seriously ill covid-19 patients.

Global health experts say ventilator donations, while flashy and attention-getting, are often less useful than more basic health aid, such as simple oxygen delivery or protective personal equipment. Ventilator manuals often come in just a few major languages, and the machines require expert maintenance and operation — obstacles for stretched hospital staff in poor countries.

“I don’t think it’s at all just USAID,” said Rebecca Inglis, a physician specializing in intensive care who researches care for critically ill patients in places with few resources. “Donor organizations around the world have failed to realize that a ventilator is nothing without the people who can operate it safely and without the maintenance contracts.”

USAID said in its response to GAO that its ventilator donations included warranties, service plans, initial supplies of accessory equipment, and training.

“USAID’s investments in training are boosting the capacity of frontline workers to deliver quality care to patients in need in dozens of countries,” the agency said.

USAID also questioned whether the number of coronavirus cases is the best metric to judge the ventilator donations, given the pandemic is “not static.” The agency added that the Trump administration’s decisions on ventilator allocations were based “in part” on USAID data.

As of December, USAID and the State Department had very limited visibility into where the ventilators actually are, Gootnick said, making it difficult to know whether the aid it gave out is being used appropriately. In only 12 of 43 countries did the government have a fairly good idea where the ventilators are, he said.

USAID is now trying to figure out where the ventilators went, the report said.

While USAID rules typically require officials to monitor whether foreign aid efforts achieve their intended goals, agency officials told the GAO that it considers the ventilator donations exempt from some of those monitoring requirements.

The cost of donating the machines came out of several extra pots of money, totaling some $685 million, that Congress provided to the State Department and USAID last year to help combat the coronavirus pandemic globally, the GAO found.

In 21 of the 43 recipient countries, the cost of ventilator donations made up more than half of the extra covid-19 funding that USAID provided to those countries, the GAO found. In El Salvador, Paraguay, Egypt, and several other countries, the entire coronavirus aid budget was consumed by the ventilator donations.

“When I’m sitting there writing a budget for how a country should spend its covid money, you definitely wouldn’t dedicate that high a proportion to isolated procurement of mechanical ventilators,” Inglis said.

https://www.washingtonpost.com/national ... -watchdog/

[ponchi101]

Quick internet search says:
"A hospital-grade ventilator is a costly machine -- running between $25,000 and $50,000 each --"
8,700 x $20K each (to make is easy)= $174MM.

Yes. Ask Jared, indeed.

[JazzNU]

Testing out double masking at home today to see how I do, see which combo works best for me if any do. Anyone else double masking or planning to? I wasn't thinking much about it, feel comfortable and safe when I'm out, but there's been a lot of discussion about it this week. And the first case of the UK variant has been detected in my county, a person with no travel history, so thought it time for me to look into if I can manage it, see if it throws off my breathing too much or is workable.

[ponchi101]

I had not thought about it. N95's are readily available everywhere here (heck, there are people on modified motorcycles riding the streets selling you a full kit with everything you need) so I don't know if I will go for double masking.

[Deuce]

I've been using KN95s - with a paper towel as a filter - pretty much since the outset. I don't believe I'll change from that.

Eye protection is interesting - in that we seem to hear about it in waves. We'll hear a significant amount about it for a week or so - with recommendations to wear a plastic visor or some sort of goggles or glasses... and then we'll hear nothing about it for a couple of months...
Strange.

[ti-amie]

I'm not sure about double masking. Fresh Direct has N95's available now. I hope they still do by my delivery date.

I have a shield for my face but I haven't used it yet.