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  1. #1
    Registered User Heisman2's Avatar
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    COVID-19, let's put updates here

    Hey all,

    Been reading/following a lot about this in recent days. Happy to take any questions. Some current thoughts for us in the USA (which is where I am) from various people in the medical community (I'm not gonna provide sources as a lot of this is from various physician groups on facebook and it would be challenging to source well, but if anyone needs a specific reference I can try to provide):

    - We are well past the containment phase. Now we're trying to slow the rapid spread of the disease and care for those who need it
    - Expected that 40-70% of Americans may get this over the next 12-18 months
    - Fatality rate seems to be 10x that of influenza, age 80+ may have fatality rate 10-15%, in Italy with recent numbers fatality rate was 0.1% <40yo, 0.6% age 50-60, 2.7% age 60-70, higher above that
    - No data yet to suggest this will die down in the summer but if it does it will almost certainly come back next fall
    - People may be infectious 2 days prior to symptom onset up to 14 days post onset. There will be some outliers
    - Unclear how long this virus will last on surfaces but it is very easy to kill with standard microbial sanitation methods
    - If you get sick from this or something else and have cold-like symptoms and you are not high risk (ie, elderly or other cardiopulmonary or immunocompromising condition), STAY HOME unless you start to have trouble breathing. There is no treatment we can give for this. If you are elderly or have a high risk condition, consult your doctor and ask if you are eligible for compassionate use of Remdesivir as this seems to be helping the critically ill patients
    - When people get really sick it seems to occur 7-10 days into illness and then there is a rapid decline into respiratory failure (over 1-2 days)

    The situation and guidance is changing very rapidly. Biggest take away is if you think you are sick call your doctor for guidance rather than go to the doctor's office in person (unless you have trouble breathing) as the biggest goal at this time should be to slow the spread of the disease as much as possible so the healthcare system does not get completely overrun.
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    Registered Lifter boo99's Avatar
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    Thank you for posting

    I guess I’m a little more concerned because I’m an older lifter

    Would having more mass, etc because we go to the gym and bodybuild be more protective and preventative against it’s life threatening effects than someone whos a DYEL?
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  3. #3
    Common sense/moderation. gbullock32's Avatar
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    2020 off to an interesting start with this. Good basic info in here though.
    Short cuts to success are often paved with lies.
    1/13/16: Massive hernia.
    5/10/16: Finally back to lifting, light but improving.

    Why Teens shouldn't cut/Lack of progress thread- http://forum.bodybuilding.com/showthread.php?t=169272763&p=1397509823#post1397509823
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  4. #4
    feminine and fast-twitch etet1919's Avatar
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    Heisman, do you recommend the WHO (World Health Organization) for the very latest, conscientious and most thorough info on this subject? Any additional sites you'd rely on? Thanks again!
    Fact: My first-generation uncle was a boxer who fought Sugar Ray Robinson! He also fought in the war, sacrificing the career he deeply loved, so people could have the right to freedom.

    Let's show RESPECT for the POLICE and ALL FIRST RESPONDERS by helping to keep THEM SAFE AND SOUND, and thereby able to PROTECT US!
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    Registered User Heisman2's Avatar
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    boo99, I don't think that lifting a lot will be significantly impactful, though being generally healthy without comorbidities likely would significantly improve risk. No reason in my mind to think that extra muscle mass would in any way impact the ability of the virus to hit the lungs or heart hard.

    etet1919, see below for several links. I do believe WHO has good information.

    Other "updates":
    - there is being an increasingly large push to move to telemedicine at this time. Meaning if anyone thinks they need to go to the doctor for any reason, I recommend calling in first and ask if this is something you should come in for or if it could be handled over the phone to minimize exposure risk to COVID-19
    - it'll take time for all this to shake out but a large number of medical people are not happy with the national response thus far. The collective "we" (being healthcare workers) will likely be making it known at some point what things should have been done (hindsight being 20/20 will help) and then I am really hopeful changes will be made so that when another potential pandemic strike we are better prepared. In the shorter time period there may be a push to change things regarding primaries and other things to further stem this.
    - if you have an upcoming elective surgery this very well may be cancelled as a lot of hospitals are trying to make as much space as possible for a potential surge in COVID-19 patients

    Here is a nice paper detailing the clinical course of some patients; look at figure 1 for the time course of symptoms (of note, fever & cough start day 1 but shortness of breath doesn't start until day 7 with sepsis following day 9-10 and ARDS shortly after for people hit hard): https://www.thelancet.com/journals/l...Fp3AKy9Yq-o89A

    Nice pictures/graphs being updated regularly: https://informationisbeautiful.net/v...QoNIbZfNCxnSCs

    For the parents, a comic/graphic for children (I had a 5 year old in clinic who said he is scared to go to sleep because he is worried the coronavirus is going to get him): https://www.npr.org/sections/goatsan...UyZOGpf7khT3FA and other cartoon things: https://www.comicsforgood.com/weiman...Xi6Vh3ZyMnApUo

    A CDC COVID-19 page being updated regularly (more info in the links on the left side): https://www.cdc.gov/coronavirus/2019...ses-in-us.html

    A link with world COVID-19 counts being updated regularly: https://www.worldometers.info/corona...9jpkP1TIdHx8aI

    WHO link for general info: https://www.who.int/emergencies/dise...ronavirus-2019 and specifically with myths: https://www.who.int/emergencies/dise...c/myth-busters and specifically with FAQ: https://www.who.int/news-room/q-a-de...-coronaviruses
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  6. #6
    Registered Lifter boo99's Avatar
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    Originally Posted by Heisman2 View Post
    boo99, I don't think that lifting a lot will be significantly impactful, though being generally healthy without comorbidities likely would significantly improve risk. No reason in my mind to think that extra muscle mass would in any way impact the ability of the virus to hit the lungs or heart hard.
    Thanks much for the reply and todays post of awesome info!


    Other question........

    Have you seen chat online showing that ACE/ARB meds for HTN need further investigation to if they could worsen symptoms of COVID-19?

    Im sure its too soon to come to a conclusion but I am on an ARB so I ask


    https://www.thelancet.com/pdfs/journ...20)30116-8.pdf

    Thanks for this thread and your contribution
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    Registered User Heisman2's Avatar
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    I have seen that. I don't have great guidance. Per this: https://www.ncbi.nlm.nih.gov/m/pubme...Okzqj8af0Y#fft there was no difference in outcomes, but definitely need more data to know more confidently. Consider calling your physician and asking if you should temporarily switch from an ARB to a CCB (calcium channel blocker).
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    Registered Lifter boo99's Avatar
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    Originally Posted by Heisman2 View Post
    I have seen that. I don't have great guidance. Per this: https://www.ncbi.nlm.nih.gov/m/pubme...Okzqj8af0Y#fft there was no difference in outcomes, but definitely need more data to know more confidently. Consider calling your physician and asking if you should temporarily switch from an ARB to a CCB (calcium channel blocker).

    Yes too soon to know

    Thanks much
    Will do

    I think I was on beta blockers in past but that’s not calcium channel blocker
    Last edited by boo99; 03-14-2020 at 07:18 PM.
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    Registered User Heisman2's Avatar
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    Originally Posted by boo99 View Post
    Yes too soon to know

    Thanks much
    Will do

    I think I was on *** in past but that’s not calcium channel blocker
    Try not to name specific meds as that is against the rules.

    Haven't looked through this link in detail yet but it's being shared around as legit information: https://fas.org/ncov/?fbclid=IwAR3IN...-f3d8fd88-28ad
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    Registered Lifter boo99's Avatar
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    Originally Posted by Heisman2 View Post
    Try not to name specific meds as that is against the rules.

    Haven't looked through this link in detail yet but it's being shared around as legit information: https://fas.org/ncov/?fbclid=IwAR3IN...-f3d8fd88-28ad

    Oops. You are right. My bad. Fixed.

    Thanks for the link

    Will study it tonite
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    Registered User Heisman2's Avatar
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    Originally Posted by boo99 View Post
    Oops. You are right. My bad. Fixed.

    Thanks for the link

    Will study it tonite
    So I did just see this; new guidance from 2 days ago suggesting NOT to stop ARBs/ACE-I: https://www.escardio.org/Councils/Co...NPXQV5JqcmIJjw (this can still change with more data).

    More links:

    Guidance for hospital care for those who find this interesting: https://emcrit.org/ibcc/COVID19/?fbc...9-XSErScVVgkPk

    Analysis in the Lancet showing that had we tested people promptly and been on top of this from the start there is a chance this could have been contained much better (though not a guarantee by any means): https://www.thelancet.com/journals/l...seccestitle140

    Recent panel on COVID-19, including Dr. Wu (chief epidemiologist in China): https://www.youtube.com/watch?v=L-Cv...3Gh_Wwtdfp81HY

    Physician blog post on COVID-19 written 3/14: https://www.kevinmd.com/blog/2020/03...TcDdsK4PeDsD04



    I'm gonna keep this to 1 post daily so it doesn't become too difficult to follow (unless I'm addressing specific questions). I've put a bunch of links here now covering various aspects of information and will continue to do so as I find new good sources. Anyone can post whatever questions/observations they have.
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    Registered Lifter boo99's Avatar
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    Originally Posted by Heisman2 View Post
    So I did just see this; new guidance from 2 days ago suggesting NOT to stop ARBs/ACE-I: https://www.escardio.org/Councils/Co...NPXQV5JqcmIJjw (this can still change with more data).
    Thank you for that!

    Just what I needed to hear and it was written very clearly and made me understand some additional questions I had which are now answered
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    Is it possible for someone to be infected, but show zero symptoms for the entire duration of infection?

    I saw a video where they interviewed a positive-test case patient from that cruise ship, and she essentially said she felt 100% normal except some mild tiredness beyond usual... no fever, sore throat, no cough... nothing.
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    Originally Posted by AdamWW View Post
    Is it possible for someone to be infected, but show zero symptoms for the entire duration of infection?
    Yes. The likelihood that this is the case appears to be tied to age (lower is better) and absence of pre-existing chronic conditions.
    I can tell time. Time cannot tell me.

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    Registered User Heisman2's Avatar
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    Great link!

    Originally Posted by AdamWW View Post
    Is it possible for someone to be infected, but show zero symptoms for the entire duration of infection?

    I saw a video where they interviewed a positive-test case patient from that cruise ship, and she essentially said she felt 100% normal except some mild tiredness beyond usual... no fever, sore throat, no cough... nothing.
    Definitely possible, though I would wager not overly likely. I expect most young healthy people to have some cold-like symptoms.

    No major updates today relative to yesterday. One thing that is being discussed in medical circles is if nebulizers are safe (anyone here with asthma/COPD may have one); if you're using it for yourself that's fine but it may aerosolize the virus and thus in clinical settings a lot of people are going away from them temporarily and using inhalers instead. There was one mention of NSAIDs worsening the clinical course but I have not see any strong evidence of this anywhere. If that changes I will post to indicate this.

    Nice simulations here for people wanting a better description of how quarantining may be effective: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4703655/

    Another link with US updates in graphical format: https://coronavirus.1point3acres.com...30XHaRCJidN9o4
    Last edited by Heisman2; 03-16-2020 at 06:12 AM.
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    Originally Posted by AdamWW View Post
    Is it possible for someone to be infected, but show zero symptoms for the entire duration of infection?

    I saw a video where they interviewed a positive-test case patient from that cruise ship, and she essentially said she felt 100% normal except some mild tiredness beyond usual... no fever, sore throat, no cough... nothing.
    Seen some suggestion of it according to a study conducted on the Diamond Princess cruise ship (probably the ship you are talking about)

    https://www.eurosurveillance.org/con....25.10.2000180

    If they were truly fully symptom free I have no-idea of course but I assume the possible is likely based on population numbers and the infection rate COVID-19 has on populations especially with the drive of media I would have thought any signs people would go and get tested depending on testing rates in each country.
    Last edited by hardyboysare; 03-16-2020 at 04:59 PM.
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    ^ Here in USA, test kits have yet to be deployed well enough for people to be ABLE to test. There are some promises that kits will become substantially easier to come by during the course of this week.

    That said, expect an EXTREME spike in the number of cases! Globally, the pathology of downward-pyramiding is helping to spike the numbers, but in the United States there will also be a lot of new positives for people who wanted to get tested like on the 4th or 11th but couldn't find any way to get tested, so that will spike the numbers even more.

    So, a good part of the spiking of numbers will be REAL, but part of it will also be an illusion because of the portion that is merely catching up from formerly not being able to get tests.

    I am following some protocols which I HAVE NOT HEARD/READ ABOUT in any advice that's been given. I came up with these on my own. I have a home office so I don't need to go out often, and it would be rather onerous for somebody to have to do this many times every day, but I can get away with it. It's actually fairly easy for me to self-quarantime for two weeks at a time.

    1. I wear disposable nitrile gloves (latex preferred, much easier to put on and take off, but couldn't find any). But today I remembered I have some elbow-length latex surgical gloves in storage, so I'll go and get those, and they're not disposable, but gloves can be reused four or five days later.

    2. When I get home, I spray the gloves with disinfectant immediately. Then, I take my coat and all my clothes off, and I spray them all with disinfectant (whether or not I plan to wear those clothes later).

    3. Then, I take my gloves off "hospital style" - grabbing the cuff on one (with a piece of paper towel) and pulling the glove so it comes off inside-out. Then I grab the other glove cuff, using the inside-out glove like a potholder, and pull the other glove off. Then, I wash.

    Other precautions I'll start taking:
    4. (with my gloves on, of course - which also protects against CHEMICALS) spraying anything that is possible to spray, that I'm going to touch, such as the handle-and-nozzle at a gas station, door handles, stylus pens, keypads, etc. (Probably not cool to spray a keypad on the chip reader at the store, or an ATM inside a store, but surely the keypad at, say, a gas pump is OK.) This may actually be a public service for the NEXT person to use that device. I wipe it off before I leave, with a piece of paper towel, so the next person doesn't get nasty chemicals on their hands.

    5. Making sure I have enough washrags and towels so that I can "cycle through" without using any individual one again for five days.

    POSTING THIS IN THE "UPDATE" THREAD, because it's some advice I've come up with on my own, and you might not hear anywhere else. Again, this might not work for everybody, but it works for me because I go out rarely enough that the "burden" of doing this is only moderate at worst.
    Last edited by frankfrank3630; 03-16-2020 at 05:47 PM.
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    I hope this is a wake-up call for all the Trump-supporters that his lack of empathy, direction, and intelligence know no bounds.

    I know it's off topic, but it truly sickens me.
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    frankfrank3630, I appreciate your thoroughness!

    AdamWW, I'm going to leave the politics out of it so the thread doesn't get derailed. Just hoping collectively we learn from this.

    Link to find a health center near you to inquire about testing: https://findahealthcenter.hrsa.gov/?...iwbxI7tTH9hFWc

    Scroll down to Figure S3 here: per the test in Italy Lodi had the first case and started practicing social distancing 2/23 while Bergamo did not start until 3/8 and you can see the impact: https://osf.io/fd4rh/?view_only=c2f0...421fc2ea38e295


    No big changes in clinical information today relative to yesterday. Nationwide more and more restrictions are being placed on public gatherings, places that are open, curfews, etc. This should all help a lot to slow the spread of the disease. Keep in mind that with a median incubation period of 5 days any increase in cases we see any given day reflects what occurred 5 days prior, so even with a big increase in social distancing we won't see an impact on numbers until 5 days later. One big difference now is that testing is ramping up big time so we will finally have more realistic numbers of everything shortly. This testing will be HUGELY important for healthcare workers as a lot of people who test negative would no longer need to be quarantined for a full 2 weeks and can get back to work helping patients. Again, if you are ill, DO NOT go to your doctor without calling first and asking if you need to be seen.

    Updated US map of cases: https://www.cdc.gov/coronavirus/2019...ses-in-us.html
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    What I would like to know is whether children can and are likely to get it. I know that a few children have been diagnosed, but I'm not aware of how many. It also seems as though they don't yet know whether children can catch it in large numbers, and spread it. The reason I am curious, is because at this time the UK government haven't closed the schools. However, Ireland have closed them (for up to 16 weeks I think).

    I wonder if it's possible that children do contract it, but aren't highly contagious due to not having symptoms. I think with any illness, you're most contagious at the point of exhibiting symptoms.

    If children can catch and spread it, then there is no hope for me whilst my kids are at school because illnesses spread like wildfire within schools and basically parents end up catching everything that their kids do.
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    MrCarrot, children can definitely get it and no reason to think they won't be contagious. See below:

    Brand new study of COVID-19 with children. I am going to copy/paste the abstract as it should be publicly available soon.

    - https://pediatrics.aappublications.o...peds.2020-0702

    Abstract:
    OBJECTIVES: To identify the epidemiological characteristics and transmission patterns of
    pediatric patients with COVID-19 in China.

    METHODS: Nationwide case series of 2143 pediatric patients with COVID-19 reported to the
    Chinese Center for Disease Control and Prevention from January 16 to February 8, 2020 were
    included. The epidemic curves were constructed by key dates of disease onset and case diagnosis.
    Onset-to-diagnosis curves were constructed by fitting a log-normal distribution to data on both
    onset and diagnosis dates.

    RESULTS: There were 731 (34.1%) laboratory-confirmed cases and 1412 (65.9%) suspected
    cases. The median age of all patients was 7 years (interquartile range: 2-13), and 1213 cases
    (56.6%) were boys. Over 90% of all patients were asymptomatic, mild, or moderate cases. The
    median time from illness onset to diagnoses was 2 days (range: 0 to 42 days). There was a rapid
    increase of disease at the early stage of the epidemic and then there was a gradual and steady
    decrease. Disease rapidly spread from Hubei Province to surrounding provinces over time. More
    children were infected in Hubei province than any other province.

    CONCLUSIONS: Children at all ages appeared susceptible to COVID-19, and there was no
    significant gender difference. Although clinical manifestations of children’s COVID-19 cases
    were generally less severe than those of adults’ patients, young children, particularly infants, were
    vulnerable to infection. The distribution of children’s COVID-19 cases varied with time and space,
    and most of the cases concentrated in Hubei province and surrounding areas. Furthermore, this
    study provides strong evidence for human-to-human transmission.
    Commentary on that study:
    -https://pediatrics.aappublications.org/content/early/2020/03/16/peds.2020-0834

    Relevant paragraph:
    Third, children may play a major role in community-based viral transmission. Available data
    suggest that children may have more upper respiratory tract (including nasopharyngeal carriage),
    rather than lower respiratory tract involvement.4 There is also evidence of fecal shedding in the
    stool for several weeks after diagnosis,8 leading to concern about fecal-oral transmission of the
    virus, particularly for infants and children who are not toilet-trained, and for viral replication in
    the gastrointestinal tract.9 Prolonged shedding in nasal secretions and stool has substantial
    implications for community spread in daycare centers, schools, and in the home. Additionally,
    non-COVID-19 coronaviruses are detectable in respiratory secretions in a large percentage of
    healthy children,6 and the extent to which this is also seen in COVID-19 is unclear. Prolonged
    viral shedding in symptomatic individuals, combined with shedding in asymptomatic persons,
    would render contact tracing and other public health measures to mitigate spread less effective.
    Last edited by Heisman2; 03-17-2020 at 04:01 AM.
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    Originally Posted by MrCarrot View Post
    What I would like to know is whether children can and are likely to get it. I know that a few children have been diagnosed, but I'm not aware of how many. It also seems as though they don't yet know whether children can catch it in large numbers, and spread it. The reason I am curious, is because at this time the UK government haven't closed the schools. However, Ireland have closed them (for up to 16 weeks I think).

    I wonder if it's possible that children do contract it, but aren't highly contagious due to not having symptoms. I think with any illness, you're most contagious at the point of exhibiting symptoms.

    If children can catch and spread it, then there is no hope for me whilst my kids are at school because illnesses spread like wildfire within schools and basically parents end up catching everything that their kids do.
    They can, which is why every country has shut schools.

    unfortunately we have Boris and his "we need to take measures" but won't do anything for fear of losing money
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    Originally Posted by WolfRose7 View Post
    They can, which is why every country has shut schools.

    unfortunately we have Boris and his "we need to take measures" but won't do anything for fear of losing money
    Please refer to Heisman2 below:-

    Originally Posted by Heisman2 View Post
    AdamWW, I'm going to leave the politics out of it so the thread doesn't get derailed. Just hoping collectively we learn from this.
    So please can you restrain from your political standpoint even if its not American politics. This information provided will hopefully offer some insight into different strategies and scientific evidence into the virus and its overall effects.
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    Originally Posted by hardyboysare View Post
    Please refer to Heisman2 below:-



    So please can you restrain from your political standpoint even if its not American politics. This information provided will hopefully offer some insight into different strategies and scientific evidence into the virus and its overall effects.
    it wasn't a political standpoint tbf, it's matter of fact for what the U.K is doing right now.

    We will be the case study of what happens when you force everything to stay open I suppose.
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    Originally Posted by WolfRose7 View Post
    it wasn't a political standpoint tbf, it's matter of fact for what the U.K is doing right now.

    We will be the case study of what happens when you force everything to stay open I suppose.
    Fair enough I am just hoping we can maintain a high standard of leaving all politics away from this open scientific studies and viewpoints as asked by the OP, be that from any country. As we all know politics and science go together about as well as religion and science.

    Got to start somewhere I guess with case studies :-) At least in a generation time we will have something to tell our kids or grand-kids.

    Anyway keep safe all and lets see what is in front of us.

    Saw an article related to death rates prediction which suggests a possible reduction in fatality rates then first suggested:-

    https://www.statnews.com/2020/03/16/...ate-estimates/

    https://www.researchsquare.com/article/rs-17453/v1 - The study in Wuhan therefore may not be applicable for world analysis of course.
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    Here in Seattle, the Bill & Melinda Gates Foundation as well as Amazon are pairing up to hopefully deliver at-home testing kits to Seattle residents.

    https://www.geekwire.com/2020/report...s-coronavirus/



    Looking forward to seeing this progresses.
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    Thought I would post current advice from the Royal College of Obstetricians and Gynaecologists for newborns/ pregnant women in light of COVID-19 if anyone happens to have young infants/ prenatal they are concerned about (it contains the healthcare paper in the description with references at the bottom):-

    https://www.rcog.org.uk/en/guideline...and-pregnancy/

    This information does not precede any info given by your own medical specialist within your own country this is just guidance based on a a UK based organisation for guidance for maternal nursing.
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    Looks like they’re already starting human tests on a vaccine:

    https://www.forbes.com/sites/victori...ne-in-seattle/
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