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Gordo

Just curious, anyone have a plan, or preps for global pandemic?

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Here is a preprint of a study [1] out of China. It looked at the blood types of ~2200 covid-19 patient from three hospitals in Wuhan. It found that A blood type folks were 20% more likely than non-A's and O blood type folks were 33% less likely than non-O's to come down with covid-19. This relationship was largely independent of age and gender.

I wonder why blood type would impact susceptibility to covid-19.

--Dean

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[1] Relationship between the ABO Blood Group and the COVID-19 Susceptibility


Jiao Zhao, Yan Yang, Han-Ping Huang, Dong Li, Dong-Feng Gu, Xiang-Feng Lu, Zheng Zhang, Lei Liu, Ting Liu, Yu-Kun Liu, Yun-Jiao He, Bin Sun, Mei-Lan Wei, Guang-Yu Yang,  View ORCID ProfileXinghuan Wang, Li Zhang, Xiao-Yang Zhou, Ming-Zhao Xing,  View ORCID ProfilePeng George Wang


doi: https://doi.org/10.1101/2020.03.11.20031096


This article is a preprint and has not been certified by peer review [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.

Abstract
OBJECTIVE To investigate the relationship between the ABO blood group and the COVID-19 susceptibility. DESIGN The study was conducted by comparing the blood group distribution in 2,173 patients with COVID-19 confirmed by SARS-CoV-2 test from three hospitals in Wuhan and Shenzhen, China with that in normal people from the corresponding regions. Data were analyzed using one-way ANOVA and 2-tailed χ2 and a meta-analysis was performed by random effects models. SETTING Three tertiary hospitals in Wuhan and Shenzhen, China. PARTICIPANTS A total of 1,775 patients with COVID-19, including 206 dead cases, from Wuhan Jinyintan Hospital, Wuhan, China were recruited. Another 113 and 285 patients with COVID-19 were respectively recruited from Renmin Hospital of Wuhan University, Wuhan and Shenzhen Third People's Hospital, Shenzhen, China. MAIN OUTCOME MEASURES Detection of ABO blood groups, infection occurrence of SARS-CoV-2, and patient death RESULTS The ABO group in 3694 normal people in Wuhan showed a distribution of 32.16%, 24.90%, 9.10% and 33.84% for A, B, AB and O, respectively, versus the distribution of 37.75%, 26.42%, 10.03% and 25.80% for A, B, AB and O, respectively, in 1775 COVID-19 patients from Wuhan Jinyintan Hospital. The proportion of blood group A and O in COVID-19 patients were significantly higher and lower, respectively, than that in normal people (both P < 0.001). Similar ABO distribution pattern was observed in 398 patients from another two hospitals in Wuhan and Shenzhen. Meta-analyses on the pooled data showed that blood group A had a significantly higher risk for COVID-19 (odds ratio-OR, 1.20; 95% confidence interval-CI 1.02~1.43, P = 0.02) compared with non-A blood groups, whereas blood group O had a significantly lower risk for the infectious disease (OR, 0.67; 95% CI 0.60~0.75, P < 0.001) compared with non-O blood groups.In addition, the influence of age and gender on the ABO blood group distribution in patients with COVID-19 from two Wuhan hospitals (1,888 patients) were analyzed and found that age and gender do not have much effect on the distribution. CONCLUSION People with blood group A have a significantly higher risk for acquiring COVID-19 compared with non-A blood groups, whereas blood group O has a significantly lower risk for the infection compared with non-O blood groups.

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32 minutes ago, Dean Pomerleau said:

Here is a preprint of a study [1] out of China. It looked at the blood types of ~2200 covid-19 patient from three hospitals in Wuhan. It found that A blood type folks were 20% more likely than non-A's and O blood type folks were 33% less likely than non-O's to come down with covid-19. This relationship was largely independent of age and gender....

Thanks. This is really fuzzy however, as blood groups are significantly more complex than this.

I would take it with a large salt shaker.

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1 hour ago, Ron Put said:

Thanks. This is really fuzzy however, as blood groups are significantly more complex than this.

I would take it with a large salt shaker.

Ron,

Can you elaborate on why/how the complexity of blood groups would undermine the credibility of this finding on blood type association with covid-19 risk? Because to me it sounds analogous to the specious argument that high LDL shouldn't be interpreted as a risk factor for heart disease because you might have "large fluffy" LDL particles.  While having large fluffy LDL particles may indeed be harmless (or less harmful than small dense particles), the fact remains that overall, high LDL cholesterol is associated with greater CVD risk.

In the present case, the study may have other faults (esp. since it hasn't been peer reviewed yet), but simply saying "blood groups are significantly more complex than this" does not seem to me to undermine in any way the high level association between covid-19 susceptibility and certain blood groups (i.e. O-type being beneficial, A-type being detrimental).

--Dean

 

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59 minutes ago, Dean Pomerleau said:

... Can you elaborate on why/how the complexity of blood groups would undermine the credibility of this finding on blood type association with covid-19 risk? ...

I am generally leery of simple ABO studies, because often the conclusions reached are not well replicated, or when more granular examination of the 300 or so variations is done. The ABO Diet is a good example, but there are also overall mortality studies, longevity studies, etc. -- for instance, I've seen studies which say that O's are healthier and live longer than non-Os, which are then contradicted by other studies.

Now, if the claim above was true, one would expect a much higher mortality rate in Europe and the the US than in China, since there is higher prevalence of A in caucasians. But I doubt this is the case -- my guess is if someone does a study in Italy or the US, a different mix will be found.

 

Edited by Ron Put

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19 hours ago, Gordo said:

Based on China I’d say new infections peak within a month:

I'd agree with you if we were handling it like China but it looks to me like we are handling it more like Italy,  perhaps worse as we lack a national health care system.  Italy is less than 2 weeks ahead of us on the exponential growth curve of daily Covid-19 deaths with a reported 627 deaths today and no indication of a peak yet in sight.

China aggressively tests people for the virus.  When someone tests positive they are interviewed to determine who they potentially exposed to the virus and they are also tested.  People testing positive are placed in quarantine facilities.  Cities with large numbers of infected are quarantined drastically limiting travel in and out of the city.  China has tried to target restrictions towards those most likely to spread the disease.

By contrast here in the US very few people have been tested for the virus and mostly only the acutely ill.  We have made no effort to determine who is spreading this and instead encourage weak "social distancing" of everyone.  Even in our tightest "lockdowns" we keep essential businesses open such as grocers, gas stations, etc. which are largely staffed by low wage workers often without paid sick leave or health insurance.  Many of these workers especially the younger ones who are unlikely to get very sick from Covid-19 are compelled to tough it out and keep working if they get a little bit sick.  Without insurance testing can be expensive and most are not getting tested and even the few that do when tested positive will not be isolated from their families, roommates and friends.  They might skip a few days work but are unlikely to sit it out sufficiently long unpaid.  They may still need to use essential services while sick and go shopping, buy gas, use the post office, etc.   There are no additional restrictions on the sick who are free to travel anywhere in the country.  It remains to be seen how effective this strategy is but I'll be very surprised if we see a peak in infections or death rates in a month.  I expect this approach will slow the growth over doing nothing.  Italy's growth rate is still disturbingly high with daily deaths doubling in the last 5 or 6 days. We are unlikey to see much relief until a vaccine or drugs are available to curb this virus.  My city, county, state and the federal government all have poor balance sheets and I hope the economy isn't grievously wounded.

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image.png.16cff83360fb62d3c14431fe05587736.png

Bondi Beach, Australia   Friday, March 20

The Beach is set to be closed down  today after outrage was expressed at images showing large numbers of youthful, carefree beachgoers ignoring public health advice .

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Sunshine and fresh air (= outdoors) seems to have been an effective strategy  in 1918 for a variety of reasons:

Coronavirus and the Sun: a Lesson from the 1918 Influenza Pandemic

Other than diet and proper sleep, REGULARLY being outdoors (especially when coupled with exercise) is IDEAL for emotional and physical health (= robust immune system) .

The news media and govt. agencies rarely menion these important variables. 

Edited by KHashmi317

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2 hours ago, KHashmi317 said:

Sunshine and fresh air (= outdoors) seems to have been an effective strategy  in 1918 for a variety of reasons:

Coronavirus and the Sun: a Lesson from the 1918 Influenza Pandemic

Other than diet and proper sleep, REGULARLY being outdoors (especially when coupled with exercise) is IDEAL for emotional and physical health (= robust immune system) .

The news media and govt. agencies rarely menion these important variables. 

In Italy, the transmission issue seems to prevail on the issue of physical and psychological benefits of outdoor exercise. Police patrols are discouraging people running and jogging (even walking outside) and all parks and green areas have been closed as today. You can only walk within a limited distance from home. Fines and more serious means are being applied. I do not agree with that much but it is clear that, considering the steep curve of new cases and new deaths in Italy, the authorities are insisting on the lockdown strategy, which appears to have been effective in Wuhan.

Spain is another country that is enforcing the lockdown pretty seriously. There the situation is possibly even more serious than in Italy, considering that only serious cases have been tested.

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Coronavirus quickie just-the-numbers sites and/or "apps"

This one is live and updates 1/min. Probabaly best for phones. Very well-designed:

https://ncov2019.live/

Here is another:

https://coronavirus.app/map

Here is another:

https://www.worldometers.info/coronavirus/

Finally, Wikipedia page (not sure about update freq.):

https://en.wikipedia.org/wiki/2019–20_coronavirus_pandemic

 

 

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About "at-home" lockdowns...

By all mean, and as necessary, close airports, train stations, etc.

BUT, folks need to get groceries, visit pharmacy, go to hospital and walk their dogs.

The news media and govt. authorities need to do a BETTER job communicating PHYSICAL DISTANCING and hygiene. So ...  robo-calls, emergency phone "alert" messages, tv ads, etc.

If AFTER communicative efforts, some break the law ... chalk up the losses to Darwinism. 

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4 hours ago, Dean Pomerleau said:

Nice article arguing with numbers that the best way to proceed is a tight lock down for a few weeks (like Hubei and current Italy) followed by relaxation of restrictions just enough to keep the R value below 1.

Great find Dean, the article exceeded my expectations.  I think you are mistaken in lumping Hubei and Italy together.  Italy may be strict on their lockdown tactics but I don't believe their testing, tracing and quarantining match Hubei.  As the article clearly explained it is desirable to crush R to a very low value far below 1.0 for a few weeks.  There is no sign that anyone outside of China and South Korea have done this yet.

Edited by Todd Allen

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I think all survivors of COVID19 should be scientifically tracked and followed for the rest of their lives. One reason ... to gauge their resistance to cancers, as somewhat document by Coley. In fewest words: when you get sick, so do your "disguised " cancer cells ... but the fever/infection causes cancer-cell "metabolism exhaust" to burn dirtier, alerting the body's immune system of their presence. 

 

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3 hours ago, KHashmi317 said:

BUT, folks need to get groceries, visit pharmacy, go to hospital and walk their dogs.

These are considered legitimate outings, but in Italy you need to prove it with documents. For example, some guy has been found to declare he was out for groceries 20 km away from his residence.

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9 hours ago, Dean Pomerleau said:

Nice article arguing with numbers that the best way to proceed is a tight lock down for a few weeks (like Hubei and current Italy) followed by relaxation of restrictions just enough to keep the R value below 1.

https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56

--Dean

Thanks, Dean. It seems persuasive at first glance, but after a brief perusal, it turns out to be using inaccurate data and assumptions in order to promote its apocalyptic scenario and condemn anyone who does not agree with its conclusions.

There is a reason for Medium's disclaimer on top of the page: "Anyone can publish on Medium per our Policies, but we don’t fact-check every story."

There are a number of inaccuracies which jump out right away, such as the number of ventilators available in the US -- the author claims that there are 100,000, but the real number is about 160,000 and possibly as high as 200,000 according to an NPR report from yesterday, and production is ramping up, with a lot more coming on line over the next three months (some are not full featured, but are adequate for treating the respiratory effects of COVID-19).

Similarly with ICU beds -- he claims that there are 50,000 in the US, when in fact there are are between 100,000 and 116,000, depending on the source.

His potential infections/hospital admission predictions are off, as well as his 4% mortality rate.

This should again remind us that social media is often a poor source of accurate information.

Edited by Ron Put

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12 minutes ago, Ron Put said:

His potential infections/hospital admission predictions are off, as well as his 4% mortality rate.

What are the best estimates for those,  according to your sources?

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8 minutes ago, Sibiriak said:

What are the best estimates for those,  according to your sources?

LOL, so this is the part you chose to focus on? Because...?

Well, read the worst case scenario in the second reference I posted above. It states:

"Estimates of hospitalized patients requiring critical care and mechanical ventilation: The U.S. Department of Health and Human Services estimated in 2005 that 865,000 U.S. residents would be hospitalized during a moderate pandemic (as in the 1957 and 1968 influenza pandemics) and 9.9 million during a severe pandemic (as in the 1918 influenza pandemic).16 A recent AHA webinar on COVID-19 projected that 30% (96 million) of the U.S. population will test positive, with 5% (4.8 million) being hospitalized. Of the hospitalized patients, 40% (1.9 million) would be admitted to the ICU, and 50% of the ICU admissions (960,000) would require ventilatory support...." 

So, in the worst case scenario, we have 1.9 million hospitalizations, not 3 million as this "marketing guru" claims. Add to this the other inaccuracies and you'll see that the total adds up to scaremongering.

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14 minutes ago, Ron Put said:

Because...?

Because critical to all the predictions regarding  the number of infections and deaths under various policies ("suppression",  "mitigation" etc.), and on other  questions, for example ventilators, you stated what you thought the real numbers were.

Just a question.  I'm not defending that analysis.

Edited by Sibiriak

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3 minutes ago, Sibiriak said:

Because critical to all the predictions regarding  the number of infections and deaths under various policies ("suppression",  "mitigation" etc.). 

Just a question.  I'm not defending that analysis.

I see, thanks. I get combative in isolation, I guess :)

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39 minutes ago, Ron Put said:

There are a number of inaccuracies which jump out right away, such as the number of ventilators available in the US -- the author claims that there are 100,000, but the real number is about 160,000 and possibly as high as 200,000 according to an NPR report from yesterday

Exponential growth laughs at trivial numeric differences.   Instead of running out of ventilators today we run out tomorrow.  Fast forward a couple weeks into the future and those numbers scarcely mattered at all.   

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21 minutes ago, Todd Allen said:

Exponential growth laughs at trivial numeric differences.   Instead of running out of ventilators today we run out tomorrow.  Fast forward a couple weeks into the future and those numbers scarcely mattered at all.   

First, these are not "trivial numeric differences," this is outright alarmist disinformation.

Second, what is your basis for assuming unmitigated exponential growth? The experience with other viruses and the experience of countries, like Korea, do not support this assumption. And here is the CDC page tracking infections: 

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html?CDC_AA_refVal=https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html

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38 minutes ago, Ron Put said:

... in fact there are are between 100,000 and 116,000 [ICU beds in the US] , depending on the source... 

A recent AHA webinar on COVID-19 projected that 30% (96 million) of the U.S. population will test positive, with 5% (4.8 million) being hospitalized. Of the hospitalized patients, 40% (1.9 million) would be admitted to the ICU, and 50% of the ICU admissions (960,000) would require ventilatory support...." 

... scaremongering... 

Ron, 

You quote credible sources projecting we'll need nearly 20x more ICU beds than the total number we have in this country, to say nothing of the fact that the vast majority of those existing beds are already occupied by very sick (non-coronavirus) patients and the geographic distribution of those beds is very unlikely to match up with the location where they are needed. 

And yet you keep calling out people for scaremongering.

I agree panic is to be avoided, but I don't get why you seem to be continually downplay the seriousness of the situation when the evidence strongly suggests that US hospitals are on track to become overwhelmed with gravely ill patients like they were in Wuhan and are now in parts of Italy and Spain. 

--Dean 

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