Coronavirus Sars-CoV-2/Covid-19 Megathread

[Sheilbh]

So this is a little bit of good news:

Steroid found to help prevent deaths of sickest coronavirus patients
Trial shows dexamethasone responsible for survival of one in eight patients on ventilators
Sarah Boseley Health editor
Tue 16 Jun 2020 13.20 BST
Last modified on Tue 16 Jun 2020 14.02 BST

A cheap steroid has become the first life-saving treatment in the Covid-19 pandemic, described by scientists as a major breakthrough and raising hopes for the survival of thousands of the most seriously ill.

Dexamethasone is cheap, available from any pharmacy, and easily obtainable anywhere in the world. Investigators said the drug was responsible for the survival of one in eight of the sickest patients – those who were on ventilators – in the Recovery trial, the biggest randomised, controlled trial of coronavirus treatments in the world.

"It is the only drug so far shown to reduce mortality and it reduces it significantly," said Peter Horby, a professor of emerging infectious diseases in the Nuffield department of medicine, at the University of Oxford, and one of the chief investigators of the trial. "It is a major breakthrough, I think."

Prof Martin Landray, his co-chief investigator said the sickest patients could begin to be treated with the drug immediately. "The search has been on for a treatment that actually reduces the risk of dying. There hasn't been one until today.

"This is a drug that is globally available. This is not an expensive drug. That is immensely important."

A total of 2,104 patients were chosen at random to receive 6mg of dexamethasone once a day (either by mouth or by intravenous injection) for 10 days, and were compared with 4,321 patients chosen at random to continue with normal care alone. Among the latter group of patients, 28-day mortality was highest in those who required ventilation (41%), intermediate in those who required oxygen only (25%), and lowest among those who did not require any respiratory intervention (13%).

Dexamethasone reduced deaths by one-third in ventilated patients (rate ratio 0.65 [95% confidence interval 0.48 to 0.88]; p=0.0003) and by one fifth in other patients receiving oxygen only (0.80 [0.67 to 0.96]; p=0.0021). There was no benefit among those patients who did not require respiratory support (1.22 [0.86 to 1.75; p=0.14).

Based on these results, the use of dexamethasone would prevent one death of around eight ventilated patients, or one of about 25 patients requiring oxygen alone.

Last week, the Recovery team, who have been trialling seven drugs and will add more, concluded that hydroxychloroquine did not benefit patients in hospital with Covid-19.

Sir Patrick Vallance, the government's chief scientific adviser, said: "This is tremendous news today from the Recovery trial showing that dexamethasone is the first drug to reduce mortality from COVID-19. It is particularly exciting as this is an inexpensive widely available medicine.

"This is a ground-breaking development in our fight against the disease, and the speed at which researchers have progressed finding an effective treatment is truly remarkable. It shows the importance of doing high quality clinical trials and basing decisions on the results of those trials."/quote]

[Zanza]

Silliest flight I've taken was Porto - Lisbon. Barely 45 minutes, the plane doesn't even climb very high in the sky at all.

When I still did business trips, I regularly flew Stuttgart - Frankfurt, which has about 20-25 minutes in the air. I flew business class of course. But it was always to start or come back from an intercontinental trip in Frankfurt and I preferred going by train, although that wasn't always possible.

[Barrister]

Silliest flight I've taken was Porto - Lisbon. Barely 45 minutes, the plane doesn't even climb very high in the sky at all.

When I still did business trips, I regularly flew Stuttgart - Frankfurt, which has about 20-25 minutes in the air. I flew business class of course. But it was always to start or come back from an intercontinental trip in Frankfurt and I preferred going by train, although that wasn't always possible.

I've flown Calgary-Edmonton, which is only about 30 minutes in the air.  It's kind of funny - there's no level flight - you just go up, then you go down.

If you factor in the time it takes to go to the airport, park, get to the terminal, check in, go through security, and board it doesn't make any sense as a solo flight, but can make sense if it's just a connection to a then-longer flight.  But even then a couple of times I've driven to Calgary to then jump on a flight to somewhere else.

[Duque de Bragança]

Silliest flight I've taken was Porto - Lisbon. Barely 45 minutes, the plane doesn't even climb very high in the sky at all.
In Spain back in the day the busiest air route by far was Madrid - Barcelona. Now that there's high speed train between both cities the number of those flights has plumetted.

Many connections between Porto and Lisbon, no excuse.
2h50 with the fastest Pendolino. Not that great but still way more practical than boarding a plane.
Problem is, instead of building 3 motorways, one and a new high-speed line would have been enough.

I took the plane between Bragança and Lisbon, actually Cascais/Tires is great though (500 km), line ends in Portimão. There are stops in Vila Real (!) and Viseu but I don't think anyone takes the plane just for such a short distance (20 to 30 min flights). Vila Real airport is closed for the time being anyways.

[The Larch]

Silliest flight I've taken was Porto - Lisbon. Barely 45 minutes, the plane doesn't even climb very high in the sky at all.
In Spain back in the day the busiest air route by far was Madrid - Barcelona. Now that there's high speed train between both cities the number of those flights has plumetted.

Many connections between Porto and Lisbon, no excuse.
2h50 with the fastest Pendolino. Not that great but still way more practical than boarding a plane.
Problem is, instead of building 3 motorways, one and a new high-speed line would have been enough.

I took the plane between Bragança and Lisbon, actually Cascais/Tires is great though (500 km), line ends in Portimão. There are stops in Vila Real (!) and Viseu but I don't think anyone takes the plane just for such a short distance (20 to 30 min flights). Vila Real airport is closed for the time being anyways.

As with the other silly short plane routes, it was part of a longer trip. I've done Vigo - Porto - Lisbon by train several times, the only bother is having to change train station in Porto. There used to be a Vigo - Lisbon route that was moderately useful, but that was cancelled a couple of years ago.

[Maladict]

That's the Monopoly square nearest me

Monopoly: London version.

You correct people who call the NYT The Times, so you gotta play by the same rules.

No, it's the nearest Monopoly square to me in all versions of Monopoly

I use three locations on my commute

[garbon]

https://www.theguardian.com/commentisfree/2020/jun/17/coronavirus-england-lockdown-shops-parks-social-distancing

Coronavirus hasn't gone away. So why are people acting as if it has?

I have a weird feeling of disorientation when I go outside these days. It's like waking from a very long sleep to find the world irrevocably changed; a trope in science fiction – from Bill Masen in The Day of the Triffids missing the blinding meteor shower and going out into a London transformed, to 28 Days Later.

Except what's weird is not the London of a few weeks ago, the eerie, empty stage that my husband and I walked onto, with Piccadilly Circus vacant but for the masked queue outside Boots, the famous advertisements all Covid-19-related messages of comfort and strength. No, what's weird now is that things feel almost back to normal. Shops have opened, the traffic has resumed its flow, people blast music from cars, groups of people sit in parks, sharing crisps. Am I mad, I wonder, to still feel nervous?

The people a few houses down have been having parties in their garden. Meanwhile my dad, in north-west Wales, remains in almost total lockdown. There are the geographical discrepancies, but the other disconnect is psychological. People no longer bother with the 2-metre distance rule. Many aren't wearing masks in shops. People no longer politely step aside to give one another space on park paths.

There were always people who didn't observe lockdown, whose way of coping seemed to be denial, or whose perception of risk was different to my own. The strange, Crucible-esque shaming streak that hit the country at one stage seems to have dissipated, thankfully. I made the decision early on not to get het up about other people breaking the rules. Better, I thought, to be able to look back on this, maybe in a few decades' time, and be able to say that I did my best to protect other people. Better to just privately lose respect for someone, rather than to get on your high horse about it, or try to humiliate them. And anyway, Dominic Cummings put paid to all that. He's part of the reason why the lockdown has unravelled so dramatically.

What we are left with are people living in two parallel universes. In one, there are people who – knowing that the virus has not gone away – feel gaslit by the fact that things are opening up when there is absolutely no scientific reason for that to be happening.

Because of this, it feels almost as though we are going mad. In fact, the last time I felt this sense of dislocation was because I actually was going mad: I had agoraphobia. At the time, I couldn't understand how people were still going about their daily lives when the world was such a threatening place. A relative told me that their experience of grief was similarly jarring. They couldn't process why the world kept on turning when their mother was dead. I suspect it is the people who have lost relatives in this pandemic, and have not been able to grieve them in the usual way, who feel the most gaslit of all.

And then there is the other universe. In that universe, the sun is shining, and the worst is over. It looks nice, this universe. I don't begrudge these people at all. Maybe they think that the worst really is over, or maybe it is just their way of coping. Maybe they feel less at risk. There have always been those sorts of people who feel like things ultimately will always be OK, as opposed to the catastrophisers among us.

Maybe, like all of us, they are just so sick of it now that they have made a conscious decision to just exhale and shake it off, and try to live. Maybe they have spent this entire time working on the frontline, and have not had the luxury of being able to cocoon themselves away with their families and control their interactions with other people to the same level that some other, more privileged people have, with their takeaways and their internet shopping.

I don't know how, or when, these two realities will merge. I suspect that the more cautious among us will gradually loosen up in time for a second wave of infection, but even then, I don't think we will ever return to a full lockdown in England, now that the government has proved itself incapable – and unwilling – to maintain one. I simply felt the need to put in writing that feeling of dislocation that many of us feel, so that if there comes a point in the future when I am asked why we didn't try to do more to protect people from deaths that were far from inevitable, I can point them to this and say, well, it was a complicated time, and although there were parties, there was also great unease.

[Tamas]

All good points.

It does absolutely feel like only people who (and whose employers) choose to are still maintaining a semblance of distancing/lockdown measures.

[Tamas]

Did I read it right that it was two Brits who brought the virus back to New Zealand? I think we are on track for the world to put the island under quarantine, and I don't mean NZ.

[Josquius]

Did I read it right that it was two Brits who brought the virus back to New Zealand? I think we are on track for the world to put the island under quarantine, and I don't mean NZ.

Yeah. There's a weird disconnect in the discourse in the UK too. People speaking about establishing air bridges et al as if it is the other countries that are the problem.
We should really scrap the 2 weeks quarantine for new arrivals and beg other countries to let us out.

[Sheilbh]

Did I read it right that it was two Brits who brought the virus back to New Zealand? I think we are on track for the world to put the island under quarantine, and I don't mean NZ.

I'm not keen on the way that story's been picked up. They were sisters who'd gone to New Zealand to visit a dying parent. They were in mandatory quarantine when they arrived, but their parent took a bad turn, so they were given an approved exemption to leave quarantine. They logged travel plans with the officials to avoid contact with other people and followed the rules.

The New Zealand public health director has said they did everything right and didn't put others at risk.

[Tamas]

Did I read it right that it was two Brits who brought the virus back to New Zealand? I think we are on track for the world to put the island under quarantine, and I don't mean NZ.

I'm not keen on the way that story's been picked up. They were sisters who'd gone to New Zealand to visit a dying parent. They were in mandatory quarantine when they arrived, but their parent took a bad turn, so they were given an approved exemption to leave quarantine. They logged travel plans with the officials to avoid contact with other people and followed the rules.

The New Zealand public health director has said they did everything right and didn't put others at risk.

Still though that could not have happened to a lot of people arriving there, just how many infected must be on this island if the special case let-outs end up being infected, what are the odds?

And yeah as Tyr said there's talk of air bridges when we are producing the worst numbers in Europe. If there will be any airbridge it will be to exclude us.

[garbon]

Did I read it right that it was two Brits who brought the virus back to New Zealand? I think we are on track for the world to put the island under quarantine, and I don't mean NZ.

I'm not keen on the way that story's been picked up. They were sisters who'd gone to New Zealand to visit a dying parent. They were in mandatory quarantine when they arrived, but their parent took a bad turn, so they were given an approved exemption to leave quarantine. They logged travel plans with the officials to avoid contact with other people and followed the rules.

The New Zealand public health director has said they did everything right and didn't put others at risk.

Still though that could not have happened to a lot of people arriving there, just how many infected must be on this island if the special case let-outs end up being infected, what are the odds?

And yeah as Tyr said there's talk of air bridges when we are producing the worst numbers in Europe. If there will be any airbridge it will be to exclude us.

Maybe we can bond with Sweden.

[Sheilbh]

Still though that could not have happened to a lot of people arriving there, just how many infected must be on this island if the special case let-outs end up being infected, what are the odds?

And yeah as Tyr said there's talk of air bridges when we are producing the worst numbers in Europe. If there will be any airbridge it will be to exclude us.

But the others are in quarantine - that's the point of quarantine. And I don't think many people have been arriving in New Zealand.

In terms of the air bridge stuff - I think the UK absolutely should lift quarantine for most European countries.

But for going to places it's just really mixed. So the UK, Spain, Sweden and Portugal (weirdly) all have to quarantine if we went to Austria, but we could all go to Belgium with no restrictions, or Italy. But then Greece has mandatory tests (and quarantines until the results) for people from France, the UK, Belgium and the US.

Of course none of this matters because the UK rules are still that travelling to an airport for a holiday is non-essential travel so you shouldn't do it. (Not that I've spent an alarming amount of time in recent days trying to work out how and where to go on holiday  ).

[Sheilbh]

Mildly obsessed with the FT's piece on luxury lockdown in South Kensington:
https://www.ft.com/content/8ea1c992-89f8-11ea-a109-483c62d17528

The awkward lessons of my luxury lockdown in Kensington
Pandemic shows us we owe the most to the people who surround and support us
Shruti Advani 10 hours ago

All of us have had to put up with restrictions "of a kind that we have never seen before in peace or war", as UK prime minister Boris Johnson put it.

We have had to re-evaluate many things, big and small, from how we connect with loved ones to how we approach door handles. Many of us have had to redefine what our homes mean to us as they stretch to accommodate activities we could previously undertake in schools, offices, gyms and cafés.

Some of us have even had to redefine our households. My India-based mother, for one. In the hours before lockdown, as people took stock of their larders and medicine cabinets, she persuaded a widowed niece and her own veteran masseuse to move into her New Delhi home where the terraces offer an intermittent breeze and an uninterrupted view of an elaborate 16th-century mausoleum.

Living in the middle of London with two young children, I needed to be more pragmatic. I gave up one spare room to bring our nanny into our South Kensington home and prepared the other for a friend who needed to move to be isolated from her husband, a surgeon. Several other married friends subsequently pointed out they too would like to be isolated from their husbands. But by then my household was full.

Conscious of my responsibility towards the additional souls on board, I took stock of what resources I could call on. Trebling our usual order from the Freddie's Flowers delivery service was the obvious place to start. It escapes me now why this particular luxury had struck me as essential at the time. Regardless, I take comfort in knowing that over the past few months, staff, house guests and my children's online teachers may have seen or heard some bizarre things, but it has always been against the backdrop of a tidy room with fresh flowers.

As Ocado's grocery deliveries were whittled down to one a week and the food halls at Harrods, which had served customers throughout the second world war, shuttered early in the current crisis, we had to find our sustenance elsewhere. Fortuitously, the Chelsea gym that was my regular haunt BC (before Covid) was loath to leave its members vulnerable to the dangers of what has since been identified as "coronacarbs". We can have little extras such as protein shakes, artisanal coffees and snacks delivered to our doorsteps.

Once the lockdown eased a little, the many bijou boulangeries and épiceries that dot our neighbourhood reopened. Life began to look a bit more normal. Only it was not, marked by the twin terrors of home schooling and working from home. Fairly early, I felt justified in bringing in reinforcements. Despite my two degrees in finance, I have been called out on more than one occasion by my seven-year-old son for getting Year Two maths wrong. This is not good for my self-esteem, nor does it bode well for the boy's continued wellbeing.

After much shouting, we found relief in online tutoring. At £65-95 an hour depending on whether it is for chess or maths, a tutor costs half as much as the psychiatrist we may have needed otherwise.

As a freelance journalist blessed with an inheritance as well as a venture-capitalist husband, my work wardrobe is split in a rather self-contradictory manner between Chanel tweed blazers that I wear to interviews and athleisure for when I toil in front of a computer. Neither fit the brief for Working From Home While Under Constant Electronic Surveillance. "Casual but groomed," advised a personal shopper who encouraged me to look at boiler suits in linen or denim. Not one to veer too far from the familiar, I turned instead to Olivia von Halle for silk pyjamas in colours guaranteed to make the dullest Zoom meeting come alive.

Armed thus, with the advantages of wealth, I was insulated from many of the pandemic's challenges. But the reality of life and death remains a great leveller.

Seeing the Covid news reports made me think hard. I listed the things I should talk about with my widowed mother in case the virus denied us a future. We debated the need for a revised will, tried to untangle past misunderstandings and made our peace while leaving some differences unresolved. Neither of us has acknowledged the possibility that my trip to India last year for a friend's wedding may be our final memory together as mother and daughter.

We each carry on in opposite corners of the world. My mother grieves for a friend of half a century who succumbs to a Covid-like infection, I stand at my doorstep to pay my last respects to an elderly neighbour as his body is carried into an ambulance. Wealth may offer some protection against the virus, but it is not a talisman.

Instead, it is the people who surround and support us that keep us afloat. Sanjay, a 30-year old father of two who chooses to stay on in Delhi to cook and clean for my mother rather than return to his village; Peter the postman who drops off my mail with a smile and a promise he will be back the next day; the police officers in Hyde Park who turn on the lights of their patrol car to amuse my children.

And even my old friend could not have been transported to the mortuary if the ambulance crew had not been ready to take the risk and bear him away.

Shruti Advani is a freelance writer on private banking