Wednesday, 8 April
If 1000 people die today and the curve is flattening off, that means that 1000 people will die tomorrow.
Wednesday, 25 Mar
The inflection point from exponential growth to "logistical" growth occurs when the change from one day to the next equals the change from the previous day to the day before that. In other words when the rate of growth is equal on successive days.
Mar 21 = 625
Mar 22 = 795
Mar 23 = 649
Mar 24 = 601
Mar 24 = 601
Mar 25 = 743
Mar 26 = 685
Mar 26 = 685
I'm not going to state any conclusions for fear of jinxing it.
Tuesday, 24 Mar
on line dichiarazione for those entering Lazio
And this is the current general autodichiarazione for travel anywhere in Italy
And this is the current general autodichiarazione for travel anywhere in Italy
Monday, 23 Mar
OMG, rate has eased in italy, everyone knocking on iron for good luck (which is what they do here).
Coronavirus Data & Statistics best data aggregator
World Health Organization world covid-19 map
JohnsHopkins interactive world covid-19 map
Coronavirus Data & Statistics best data aggregator
World Health Organization world covid-19 map
JohnsHopkins interactive world covid-19 map
Sunday, 22 Mar
Swab testing (to confirm active infection) is a start, but, in the absence of targeted therapies, only adds to statistical data. This article in Science makes a good case for antibody testing and why it might reduce the measure of morbidity rate.
Patrick Shaw Stewart contributes these tips from years of observing viral infection. From here you can also follow much of his work and contributions.
Saturday, 21 Mar
completely off the subject, but I just discovered the Red List of endangered species, but after a quick look, I wondered where the bacteria and other invisible species were given their sympathy. And then, of course, what about all the newly morphing sub-living viral particles that predictably pop up?
Exciting news from Germany, a possible compound that blocks RNA replication of SarsCoV2. Tough reading but real encouraging science as opposed to Trump's optimism.
Exciting news from Germany, a possible compound that blocks RNA replication of SarsCoV2. Tough reading but real encouraging science as opposed to Trump's optimism.
Thursday, 19 Mar
Scenes from the epicenter click for Sky News story on hospital in Bergamo
This from Jill in Rome:
And this from NPR story on why Italy is in so much trouble:
Some question why Italy was caught off guard when the virus outbreak was revealed on Feb. 21.
Remuzzi says he is now hearing information about it from general practitioners. "They remember having seen very strange pneumonia, very severe, particularly in old people in December and even November," he says. "This means that the virus was circulating, at least in [the northern region of] Lombardy and before we were aware of this outbreak occurring in China."
He says it was impossible to combat something you didn't know existed.
Wednesday, 18 Mar
This from the commune Citta della Pieve:
++ AGGIORNAMENTO COVID-19 E RACCOMANDAZIONI ++
Buon pomeriggio concittadini,
vi informo che ho ricevuto ufficiale comunicazione di altri 2 casi positivi al Covid-19 nel nostro Comune, ambedue hanno contratto il virus in ambito lavorativo fuori Regione e si trovano già in quarantena.
Come ho ribadito, nei giorni precedenti, la maggioranza dei pievesi hanno ben compreso la gravità di ciò che sta accadendo e di conseguenza hanno dimostrato, fin da subito, di essere ossequienti alle disposizioni normative emanatane ed alle regole che, come comunità, abbiamo il dovere di rispettare scrupolosamente.
Mio malgrado, devo dire che una piccola parte no, nonostante tutto continua ad approcciarsi con troppa superficialità alla battaglia che ci troviamo a combattere come Comune, come Nazione e come Pianeta!
Questo mi addolora non poco, perchè in questi giorni estremamente difficili ho bisogno di voi, di ognuno di voi, perchè è il singolo a fare la differenza nella possibilità di isolare il virus.
Vogliamo tutti uscire da questa situazione il più presto possibile, io per primo, allora aiutatemi e soprattutto aiutate la nostra comunità. State a casa!
Un solo componente del nucleo familiare va a fare la spesa, una spesa importante che duri più giorni e quando uscite dal supermercato possibilmente non gettate i guanti monouso lungo i cigli delle nostre strade!
Questo è un momento che dovrebbe portarci ad accrescere il senso di responsabilità e rispetto per la nostra comunità e per il nostro territorio e non un momento di egoismo e menefreghismo.
Le passeggiate ci sono permesse, ma devono essere effettuate e riconosciute come eccezionalità, da evitare. Piccole passeggiatine intorno casa vostra, da soli e solo quando veramente necessarie.
Questa battaglia, dal nemico invisibile e subdolo, non è uno scherzo e chiedo il vostro supporto, se vedete qualcuno che contravviene alle regole o se vedete assembramenti chiamate immediatamente i nostri vigili e le forze dell'ordine affinchè possano intervenire tempestivamente.
Grazie per la vostra preziosa collaborazione,
Fausto Risini
Rant alert: Testing in Kent, UK is effectively prohibited. This global failure has thrown away the most effective preventive weapon in controlling this threat: contact tracing. It's over. Now we are fighting a pathetic rear-guard action while we are chased in the growing rout. With no effective therapies.
Second trip to the local grocer (LIDL) revealed a abundance of stuff. Lots of fresh food on sale, presumably for lack of customers. Even free crackers. Masked police at the round-abouts checking declarations of intent.
++ AGGIORNAMENTO COVID-19 E RACCOMANDAZIONI ++
Buon pomeriggio concittadini,
vi informo che ho ricevuto ufficiale comunicazione di altri 2 casi positivi al Covid-19 nel nostro Comune, ambedue hanno contratto il virus in ambito lavorativo fuori Regione e si trovano già in quarantena.
Come ho ribadito, nei giorni precedenti, la maggioranza dei pievesi hanno ben compreso la gravità di ciò che sta accadendo e di conseguenza hanno dimostrato, fin da subito, di essere ossequienti alle disposizioni normative emanatane ed alle regole che, come comunità, abbiamo il dovere di rispettare scrupolosamente.
Mio malgrado, devo dire che una piccola parte no, nonostante tutto continua ad approcciarsi con troppa superficialità alla battaglia che ci troviamo a combattere come Comune, come Nazione e come Pianeta!
Questo mi addolora non poco, perchè in questi giorni estremamente difficili ho bisogno di voi, di ognuno di voi, perchè è il singolo a fare la differenza nella possibilità di isolare il virus.
Vogliamo tutti uscire da questa situazione il più presto possibile, io per primo, allora aiutatemi e soprattutto aiutate la nostra comunità. State a casa!
Un solo componente del nucleo familiare va a fare la spesa, una spesa importante che duri più giorni e quando uscite dal supermercato possibilmente non gettate i guanti monouso lungo i cigli delle nostre strade!
Questo è un momento che dovrebbe portarci ad accrescere il senso di responsabilità e rispetto per la nostra comunità e per il nostro territorio e non un momento di egoismo e menefreghismo.
Le passeggiate ci sono permesse, ma devono essere effettuate e riconosciute come eccezionalità, da evitare. Piccole passeggiatine intorno casa vostra, da soli e solo quando veramente necessarie.
Questa battaglia, dal nemico invisibile e subdolo, non è uno scherzo e chiedo il vostro supporto, se vedete qualcuno che contravviene alle regole o se vedete assembramenti chiamate immediatamente i nostri vigili e le forze dell'ordine affinchè possano intervenire tempestivamente.
Grazie per la vostra preziosa collaborazione,
Fausto Risini
Rant alert: Testing in Kent, UK is effectively prohibited. This global failure has thrown away the most effective preventive weapon in controlling this threat: contact tracing. It's over. Now we are fighting a pathetic rear-guard action while we are chased in the growing rout. With no effective therapies.
Second trip to the local grocer (LIDL) revealed a abundance of stuff. Lots of fresh food on sale, presumably for lack of customers. Even free crackers. Masked police at the round-abouts checking declarations of intent.
Tuesday, 17 Mar
It's hitting closer to home now. Britain has taken an unusual, less "draconian" approach; allowing the schools to stay open and many businesses to continue. The subsequent data is beginning to climb up the exponential curve. Confirmations and deaths are piling up.
Meanwhile, what do you know? Trump is going to initiate Andrew Yang's guaranteed basic income to keep the country from bankruptcy. Funny how it takes a hard slap to the head. Let's hope the slap is hard enough to knock some talent into office.
Sunday, 15 Mar
Quaranta Giorni. "40 days" hence the term Quarantine. Thank you LaVerzura. Please click for a well written, first person impression of life in our town during this crisis.
Saturday, 14 Mar
The bright heart of Italy
In the meantime, UK seems to be on a program to harden off the population through slow infection. This is supposed to lessen the impact on hospitals and the economy, but, seems to me, puts old folk at risk. If high infections rates hide behind a terribly inadequate testing regime, UK could be betting on lower than calculated morbidity rate. Trial and error pandemic policy.
Yesterday Italy imposed a nationwide shutdown of all non-essential business. I drove to the store armed with a signed declaration (as required, downloaded and printed) stating who I was and where I was going. No police, little traffic, store loaded with everything except people, plenty of loo paper, employees cheerfully wearing masks, and disposable plastic gloves supplied outside with the shopping carts. It was all quite pleasant except for the impatient tailgater chasing me home.
Friday 13th March. days of warm sun and isolation
Here's a recent study from Germany indicating an RNA particle shed early in the infection. Here's a pretty good press interpretation. The study seems to indicate fairly rigorous immunity and very low infection potential from recovered individuals.In the meantime, UK seems to be on a program to harden off the population through slow infection. This is supposed to lessen the impact on hospitals and the economy, but, seems to me, puts old folk at risk. If high infections rates hide behind a terribly inadequate testing regime, UK could be betting on lower than calculated morbidity rate. Trial and error pandemic policy.
Yesterday Italy imposed a nationwide shutdown of all non-essential business. I drove to the store armed with a signed declaration (as required, downloaded and printed) stating who I was and where I was going. No police, little traffic, store loaded with everything except people, plenty of loo paper, employees cheerfully wearing masks, and disposable plastic gloves supplied outside with the shopping carts. It was all quite pleasant except for the impatient tailgater chasing me home.
We spend our days enjoying the peace and quiet, reading and writing. So far the wine cellar is holding.
There has been some criticism of EU authorities not following the Chinese/Korean model of active testing and control. Here we are simply told to stay home while hospitals overflow and no public testing is conducted. Reported cases here in Italy continue to grow exponentially while in China/Korea all indicators are falling.
Tuesday 10 March
National lockdown takes effect
Monday 9 March, pensieri inutili
Italy officially imposes a national lockdown, extending the travel restrictions to all of italy.
I'm concerned about the veracity of the data. Poor data due to the lack of universally qualified testing procedures and a general lack of experience with this pathogen only opens the door to conjecture and hysteria.
Evidently, this new virus is capable of leading to fatal illness. And it seems to effect weaker individuals. Rates of contagion can't be accurate due to the lack of testing among the general population. The rate is being characterized as typical exponential growth. It seems likely the rates of contagion are much higher, or at least further along the exponential curve than suspected. The rates of morbidity have no basis in fact at all until adequate data is achieved. The only data reported is the number of deaths vs. verified cases; but verified cases rely on positively tested individuals. It is highly likely that many individuals who have contracted the illness are not demonstrating severe symptoms and therefore not submitting themselves for diagnosis. Tests for these individuals just isn't available. I am personally aware of family members who seem to suffer from the symptoms but are reluctant to submit to testing and are happy to quarantine themselves. I returned home from Egypt with a fever and was told to stay home.
We have calculated, based on wild estimates, that this virus resembles known flu viruses with similar morbidity. Current contagion estimates are simply not reliable.
This is not to be mistaken for an attitude of denial of the seriousness of the pandemic. The rates of increase are classical exponential growth which is alarmingly steep in the latter part of the curve. Caution is the best policy and we support the draconian measures the Italian government has put in place and we encourage every political entity to exercise the same degree of caution until adequate date is available.
Luckily, this crisis comes at the perfect time of year. Early Spring in Italy can encourage a love of life in the darkest heart. As the season opens up, so will our understanding of Sars-CoV-2 and Covid 19.
Looking across the fields we see the occasional car or truck but very little activity. Trains run infrequently. Our neighbor stops by daily on her walk with her daughter, and, in fact, we see them more now than ever before. In the meantime we wash our hands and prepare ourselves for our flu jab in two years.
And here's your primer on exponential and logistic growth of Covid-19 by Animated Math.
Dear Colleagues,
As some of you may recall, when I was a professor of pathology at the University of California San Diego, I was one of the first molecular virologists in the world to work on coronaviruses (the 1970s). I was the first to demonstrate the number of genes the virus contained. Since then, I have kept up with the coronavirus field and its multiple clinical transfers into the human population (e.g., SARS, MERS), from different animal sources.
The current projections for its expansion in the US are only probable, due to continued insufficient worldwide data, but it is most likely to be widespread in the US by mid to late March and April.
Here is what I have done and the precautions that I take and will take. These are the same precautions I currently use during our influenza seasons, except for the mask and gloves.:
1) NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc.
2) Use ONLY your knuckle to touch light switches. elevator buttons, etc.. Lift the gasoline dispenser with a paper towel or use a disposable glove.
3) Open doors with your closed fist or hip - do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.
4) Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.
5) Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been.
6) Keep a bottle of sanitizer available at each of your home's entrances. AND in your car for use after getting gas or touching other contaminated objects when you can't immediately wash your hands.
7) If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!
What I have stocked in preparation for the pandemic spread to the US:
1) Latex or nitrile latex disposable gloves for use when going shopping, using the gasoline pump, and all other outside activity when you come in contact with contaminated areas.
Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average - everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon. This virus only has cell receptors for lung cells (it only infects your lungs) The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.
2) Stock up now with disposable surgical masks and use them to prevent you from touching your nose and/or mouth (We touch our nose/mouth 90X/day without knowing it!). This is the only way this virus can infect you - it is lung-specific. The mask will not prevent the virus in a direct sneeze from getting into your nose or mouth - it is only to keep you from touching your nose or mouth.
3) Stock up now with hand sanitizers and latex/nitrile gloves (get the appropriate sizes for your family). The hand sanitizers must be alcohol-based and greater than 60% alcohol to be effective.
4) Stock up now with zinc lozenges. These lozenges have been proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx. Use as directed several times each day when you begin to feel ANY "cold-like" symptoms beginning. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx. Cold-Eeze lozenges is one brand available, but there are other brands available.
I, as many others do, hope that this pandemic will be reasonably contained, BUT I personally do not think it will be. Humans have never seen this snake-associated virus before and have no internal defense against it. Tremendous worldwide efforts are being made to understand the molecular and clinical virology of this virus. Unbelievable molecular knowledge about the genomics, structure, and virulence of this virus has already been achieved. BUT, there will be NO drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available.
I hope these personal thoughts will be helpful during this potentially catastrophic pandemic. You are welcome to share this email. Good luck to all of us! Jim
James Robb, MD
Luckily, this crisis comes at the perfect time of year. Early Spring in Italy can encourage a love of life in the darkest heart. As the season opens up, so will our understanding of Sars-CoV-2 and Covid 19.
Looking across the fields we see the occasional car or truck but very little activity. Trains run infrequently. Our neighbor stops by daily on her walk with her daughter, and, in fact, we see them more now than ever before. In the meantime we wash our hands and prepare ourselves for our flu jab in two years.
And here's your primer on exponential and logistic growth of Covid-19 by Animated Math.
Tuesday, 3 Mar What to do
I received an attachment from a friend with advice from a lifetime researcher on coronal virus. Here's what to do:Dear Colleagues,
As some of you may recall, when I was a professor of pathology at the University of California San Diego, I was one of the first molecular virologists in the world to work on coronaviruses (the 1970s). I was the first to demonstrate the number of genes the virus contained. Since then, I have kept up with the coronavirus field and its multiple clinical transfers into the human population (e.g., SARS, MERS), from different animal sources.
The current projections for its expansion in the US are only probable, due to continued insufficient worldwide data, but it is most likely to be widespread in the US by mid to late March and April.
Here is what I have done and the precautions that I take and will take. These are the same precautions I currently use during our influenza seasons, except for the mask and gloves.:
1) NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc.
2) Use ONLY your knuckle to touch light switches. elevator buttons, etc.. Lift the gasoline dispenser with a paper towel or use a disposable glove.
3) Open doors with your closed fist or hip - do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.
4) Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.
5) Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been.
6) Keep a bottle of sanitizer available at each of your home's entrances. AND in your car for use after getting gas or touching other contaminated objects when you can't immediately wash your hands.
7) If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!
What I have stocked in preparation for the pandemic spread to the US:
1) Latex or nitrile latex disposable gloves for use when going shopping, using the gasoline pump, and all other outside activity when you come in contact with contaminated areas.
Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average - everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon. This virus only has cell receptors for lung cells (it only infects your lungs) The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.
2) Stock up now with disposable surgical masks and use them to prevent you from touching your nose and/or mouth (We touch our nose/mouth 90X/day without knowing it!). This is the only way this virus can infect you - it is lung-specific. The mask will not prevent the virus in a direct sneeze from getting into your nose or mouth - it is only to keep you from touching your nose or mouth.
3) Stock up now with hand sanitizers and latex/nitrile gloves (get the appropriate sizes for your family). The hand sanitizers must be alcohol-based and greater than 60% alcohol to be effective.
4) Stock up now with zinc lozenges. These lozenges have been proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx. Use as directed several times each day when you begin to feel ANY "cold-like" symptoms beginning. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx. Cold-Eeze lozenges is one brand available, but there are other brands available.
I, as many others do, hope that this pandemic will be reasonably contained, BUT I personally do not think it will be. Humans have never seen this snake-associated virus before and have no internal defense against it. Tremendous worldwide efforts are being made to understand the molecular and clinical virology of this virus. Unbelievable molecular knowledge about the genomics, structure, and virulence of this virus has already been achieved. BUT, there will be NO drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available.
I hope these personal thoughts will be helpful during this potentially catastrophic pandemic. You are welcome to share this email. Good luck to all of us! Jim
James Robb, MD
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