COVID-19 Boots on the ground reports, what is happening in your town?
- Thread starter shaggyballs
- Start date
Hempy McNoodle
Well-known member
Scamdemic
Hempy McNoodle
Well-known member
Pan-dem-ic = PAN(icking)DEM(ocrats on)IC(mag)
Hempy McNoodle
Well-known member
I posted this on the wrong thread earlier. Sorry for the double post.
Here is the updated "Case Definition" from August...
https://wwwn.cdc.gov/nndss/condition...on/2020/08/05/
Coronavirus Disease 2019 (COVID-19)
2020 Interim Case Definition, Approved August 5, 2020
NOTE: A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. Surveillance case definitions are not intended to be used by healthcare providers for making a clinical diagnosis or determining how to meet an individual patient’s health needs.
CSTE Position Statement(s)
Interim-20-ID-02
Background
In late December 2019, investigation of a cluster of pneumonia cases of unknown origin in Wuhan, China resulted in identification of a novel coronavirus. The virus is distinct from both severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), although closely related. Early epidemiologic findings indicate COVID-19 may be less severe1 than SARS or MERS, but evidence suggests that the virus is more contagious than its predecessors. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a newly identified pathogen and it is assumed there is no pre-existing human immunity to the virus. Initial seroconversion, including neutralizing antibodies, has been documented and there is some evidence that immunity to SARS-CoV-2 re-challenge during early convalescence is likely. The extent of long-term immunity from anamnestic responses is unknown currently. At the beginning of the pandemic, everyone was assumed to be susceptible; it is now known that there are risk factors that increase an individual’s illness severity.
Those at highest risk for severe disease and death include people aged over 60 years (especially those 85 years and older) and those with underlying conditions such as obesity, hypertension, diabetes, cardiovascular disease, chronic respiratory or kidney disease, immunosuppression from solid organ transplant, and sickle cell disease. Disease in children mostly appears to be relatively mild, and there is growing evidence that a significant proportion of infections across all age groups are asymptomatic.
Cases of COVID-19 in China and the initial U.S. cases in early March 2020 were clustered. Most cases in China occurred in households and in Washington, for example, a significant cluster was associated with a long-term care facility. By mid-March, multiple areas in the United States reported cases with no direct epidemiologic link to confirmed cases. As of July 2020, widespread community transmission of SARS-CoV-2 has been documented in geographically dispersed regions. Ongoing surveillance of illness, risk factors, and epidemiologic linkage is needed to characterize the disease transmission in the United States, to inform intervention and mitigation strategies, and to monitor and assess their impacts.
Epidemiological reports from the field are demonstrating a growing importance of presymptomatic and asymptomatic infections from two lines of evidence: the serial interval of COVID-19 appears to be close to or shorter than its median incubation period and clusters linked to presymptomatic and asymptomatic index cases2, 3. The Council of State and Territorial Epidemiologists (CSTE) realizes that field investigations will involve evaluations of persons with no symptoms and these individuals will need to be counted as cases.
Because of the rapid advancement in the science of COVID-19 disease and SARS-CoV-2 infection, CSTE is updating the COVID-19 position statement within four months of its first interim approval by the Executive Board on April 5, 2020. In these four months, CSTE has received feedback from members on implementation, and in addition, antigen detection tests and serologic tests have been developed and authorized for use by the U.S. Food and Drug Administration (FDA). This update clarifies interpretation of antigen detection tests and serologic test results within the case classification. CSTE acknowledges the dual utility of these tests for public health surveillance of COVID-19 and clinical diagnosis of COVID-19. Classifying a test as confirmatory, presumptive, or supportive laboratory evidence is intended solely to assist a public health agency with case investigation and case counting, in the context of population health, that will lead to public health action. A provider may order a test under a variety of circumstances ranging from a drive-through testing site in a minimally symptomatic or asymptomatic person where very little clinical or epidemiologic data will be collected, to an acutely ill person presenting in an emergency department for hospital admission. The provider will use the testing platform that best fits the clinical situation, testing availability, and diagnostic capability, which should not be influenced by CSTE position statement Interim-20-ID-02.
Clinical Criteria
In the absence of a more likely diagnosis:
At least two of the following symptoms:
fever (measured or subjective),
chills,
rigors,
myalgia,
headache,
sore throat,
nausea or vomiting,
diarrhea,
fatigue,
congestion or runny nose
OR
Any one of the following symptoms:
cough,
shortness of breath,
difficulty breathing,
new olfactory disorder,
new taste disorder
OR
Severe respiratory illness with at least one of the following:
Clinical or radiographic evidence of pneumonia,
Acute respiratory distress syndrome (ARDS).
Laboratory Criteria
Laboratory evidence using a method approved or authorized by the FDA4 or designated authority:
Confirmatory* laboratory evidence:
Detection of severe acute respiratory syndrome coronavirus 2 ribonucleic acid (SARS-CoV-2 RNA) in a clinical or autopsy specimen using a molecular amplification test
Presumptive* laboratory evidence:
Detection of SARS-CoV-2 by antigen test in a respiratory specimen
Supportive* laboratory evidence:
Detection of specific antibody in serum, plasma, or whole blood
Detection of specific antigen by immunocytochemistry in an autopsy specimen
*The terms confirmatory, presumptive, and supportive are categorical labels used here to standardize case classifications for public health surveillance. The terms should not be used to interpret the utility or validity of any laboratory test methodology.
Epidemiologic Linkage
One or more of the following exposures in the prior 14 days:
Close contact** with a confirmed or probable case of COVID-19 disease;
Member of a risk cohort as defined by public health authorities during an outbreak.
**Close contact is generally defined as being within 6 feet for at least 15 minutes. However, it depends on the exposure level and setting; for example, in the setting of an aerosol-generating procedure in healthcare settings without proper personal protective equipment (PPE), this may be defined as any duration. Data are insufficient to precisely define the duration of exposure that constitutes prolonged exposure and thus a close contact.
Criteria to Distinguish a New Case from an Existing Case
A repeat positive test for SARS-CoV-2 RNA using a molecular amplification detection test within 3 months of the initial report should not be enumerated as a new case for surveillance purposes. To date, there has been minimal evidence of re-infection among persons with a prior confirmed COVID-19 infection and growing evidence that repeat positive RNA tests do not correlate with active infection when viral culture is performed. Similarly the experience with other coronaviruses is that reinfection is rare within the first year.5,6 NOTE: The time period of 3 months will be extended further when more data becomes available to show risk of reinfection remains low within one year of the initial report.
Case Classification
Suspect
Meets supportive laboratory evidence*** with no prior history of being a confirmed or probable case.
*** For suspect cases (positive serology only), jurisdictions may opt to place them in a registry for other epidemiological analyses or investigate to determine probable or confirmed status.
Probable
Meets clinical criteria AND epidemiologic linkage with no confirmatory laboratory testing performed for SARS-CoV-2.
Meets presumptive laboratory evidence.
Meets vital records criteria with no confirmatory laboratory evidence for SARS-CoV-2.
Confirmed
Meets confirmatory laboratory evidence.
Other Criteria
Vital Records Criteria
A death certificate that lists COVID-19 disease or SARS-CoV-2 as an underlying cause of death or a significant condition contributing to death.
Comments
CSTE approved interim position statement Interim-20-ID-02 on August 5, 2020. Interim-20-ID-02 supersedes the first CSTE COVID-19 interim position statement, Interim 20-ID-01, which was approved on April 5, 2020.
This position statement, Interim-20-ID-02, updates the standardized case definition for COVID-19, including asymptomatic infections caused by SARS-CoV-2, and retains COVID-19 as a nationally notifiable condition. The updates clarify clinical, laboratory, epidemiologic linkage, and vital records criteria for case ascertainment and case classification based on the continued evolution of the COVID-19 pandemic. In addition, the probable case classification is updated, and a suspected case classification is added.
Reference(s)
The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) in China. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(2):145–151. DOI:10.3760/cma.j.issn.0254-6450.2020.02.003.
Hiroshi Nishiura, Natalie M. Linton, Andrei R. Akhmetzhanov. Serial interval of novel coronavirus (COVID-19) infections. PII: S1201-9712(20)30119-3 DOI: https://doi.org/10.1016/j.ijid.2020.02.060 Reference: IJID 4006 To appear in: International Journal of Infectious Diseases, Accepted Date: 27 February 2020.
Wei WE, Li Z, Chiew CJ, Yong SE, Toh MP, Lee VJ. Presymptomatic Transmission of SARS-CoV-2 — Singapore, January 23–March 16, 2020. MMWR Morb Mortal Wkly Rep 2020;69:411–415. DOI: https://dx.doi.org/10.15585/mmwr.mm6914e1.
FDA Emergency Use Authorizations https://www.fda.gov/medical-devices/...authorizations and https://www.fda.gov/medical-devices/...cov-2#nolonger.
Korean “Re-Positives” Assessed as Not Infectious. https://www.cdc.go.kr/board/board.es...367267&nPage=1 accessed July 10, 2020.
COVID-19: Ongoing viral detection and repeat positives. https://www.publichealthontario.ca/-...ives.pdf?la=en accessed July 13, 2020.
Related Case Definition(s)
Coronavirus Disease 2019 (COVID-19) | 2020 Interim Case Definition, Approved April 5, 2020
Content source: Centers for Disease Control and Prevention
Office of Public Health Scientific Services (OPHSS)
Center for Surveillance, Epidemiology, and Laboratory Services (CSELS)
Division of Health Informatics and Surveillance (DHIS)
Here is the updated "Case Definition" from August...
https://wwwn.cdc.gov/nndss/condition...on/2020/08/05/
Coronavirus Disease 2019 (COVID-19)
2020 Interim Case Definition, Approved August 5, 2020
NOTE: A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. Surveillance case definitions are not intended to be used by healthcare providers for making a clinical diagnosis or determining how to meet an individual patient’s health needs.
CSTE Position Statement(s)
Interim-20-ID-02
Background
In late December 2019, investigation of a cluster of pneumonia cases of unknown origin in Wuhan, China resulted in identification of a novel coronavirus. The virus is distinct from both severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), although closely related. Early epidemiologic findings indicate COVID-19 may be less severe1 than SARS or MERS, but evidence suggests that the virus is more contagious than its predecessors. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a newly identified pathogen and it is assumed there is no pre-existing human immunity to the virus. Initial seroconversion, including neutralizing antibodies, has been documented and there is some evidence that immunity to SARS-CoV-2 re-challenge during early convalescence is likely. The extent of long-term immunity from anamnestic responses is unknown currently. At the beginning of the pandemic, everyone was assumed to be susceptible; it is now known that there are risk factors that increase an individual’s illness severity.
Those at highest risk for severe disease and death include people aged over 60 years (especially those 85 years and older) and those with underlying conditions such as obesity, hypertension, diabetes, cardiovascular disease, chronic respiratory or kidney disease, immunosuppression from solid organ transplant, and sickle cell disease. Disease in children mostly appears to be relatively mild, and there is growing evidence that a significant proportion of infections across all age groups are asymptomatic.
Cases of COVID-19 in China and the initial U.S. cases in early March 2020 were clustered. Most cases in China occurred in households and in Washington, for example, a significant cluster was associated with a long-term care facility. By mid-March, multiple areas in the United States reported cases with no direct epidemiologic link to confirmed cases. As of July 2020, widespread community transmission of SARS-CoV-2 has been documented in geographically dispersed regions. Ongoing surveillance of illness, risk factors, and epidemiologic linkage is needed to characterize the disease transmission in the United States, to inform intervention and mitigation strategies, and to monitor and assess their impacts.
Epidemiological reports from the field are demonstrating a growing importance of presymptomatic and asymptomatic infections from two lines of evidence: the serial interval of COVID-19 appears to be close to or shorter than its median incubation period and clusters linked to presymptomatic and asymptomatic index cases2, 3. The Council of State and Territorial Epidemiologists (CSTE) realizes that field investigations will involve evaluations of persons with no symptoms and these individuals will need to be counted as cases.
Because of the rapid advancement in the science of COVID-19 disease and SARS-CoV-2 infection, CSTE is updating the COVID-19 position statement within four months of its first interim approval by the Executive Board on April 5, 2020. In these four months, CSTE has received feedback from members on implementation, and in addition, antigen detection tests and serologic tests have been developed and authorized for use by the U.S. Food and Drug Administration (FDA). This update clarifies interpretation of antigen detection tests and serologic test results within the case classification. CSTE acknowledges the dual utility of these tests for public health surveillance of COVID-19 and clinical diagnosis of COVID-19. Classifying a test as confirmatory, presumptive, or supportive laboratory evidence is intended solely to assist a public health agency with case investigation and case counting, in the context of population health, that will lead to public health action. A provider may order a test under a variety of circumstances ranging from a drive-through testing site in a minimally symptomatic or asymptomatic person where very little clinical or epidemiologic data will be collected, to an acutely ill person presenting in an emergency department for hospital admission. The provider will use the testing platform that best fits the clinical situation, testing availability, and diagnostic capability, which should not be influenced by CSTE position statement Interim-20-ID-02.
Clinical Criteria
In the absence of a more likely diagnosis:
At least two of the following symptoms:
fever (measured or subjective),
chills,
rigors,
myalgia,
headache,
sore throat,
nausea or vomiting,
diarrhea,
fatigue,
congestion or runny nose
OR
Any one of the following symptoms:
cough,
shortness of breath,
difficulty breathing,
new olfactory disorder,
new taste disorder
OR
Severe respiratory illness with at least one of the following:
Clinical or radiographic evidence of pneumonia,
Acute respiratory distress syndrome (ARDS).
Laboratory Criteria
Laboratory evidence using a method approved or authorized by the FDA4 or designated authority:
Confirmatory* laboratory evidence:
Detection of severe acute respiratory syndrome coronavirus 2 ribonucleic acid (SARS-CoV-2 RNA) in a clinical or autopsy specimen using a molecular amplification test
Presumptive* laboratory evidence:
Detection of SARS-CoV-2 by antigen test in a respiratory specimen
Supportive* laboratory evidence:
Detection of specific antibody in serum, plasma, or whole blood
Detection of specific antigen by immunocytochemistry in an autopsy specimen
*The terms confirmatory, presumptive, and supportive are categorical labels used here to standardize case classifications for public health surveillance. The terms should not be used to interpret the utility or validity of any laboratory test methodology.
Epidemiologic Linkage
One or more of the following exposures in the prior 14 days:
Close contact** with a confirmed or probable case of COVID-19 disease;
Member of a risk cohort as defined by public health authorities during an outbreak.
**Close contact is generally defined as being within 6 feet for at least 15 minutes. However, it depends on the exposure level and setting; for example, in the setting of an aerosol-generating procedure in healthcare settings without proper personal protective equipment (PPE), this may be defined as any duration. Data are insufficient to precisely define the duration of exposure that constitutes prolonged exposure and thus a close contact.
Criteria to Distinguish a New Case from an Existing Case
A repeat positive test for SARS-CoV-2 RNA using a molecular amplification detection test within 3 months of the initial report should not be enumerated as a new case for surveillance purposes. To date, there has been minimal evidence of re-infection among persons with a prior confirmed COVID-19 infection and growing evidence that repeat positive RNA tests do not correlate with active infection when viral culture is performed. Similarly the experience with other coronaviruses is that reinfection is rare within the first year.5,6 NOTE: The time period of 3 months will be extended further when more data becomes available to show risk of reinfection remains low within one year of the initial report.
Case Classification
Suspect
Meets supportive laboratory evidence*** with no prior history of being a confirmed or probable case.
*** For suspect cases (positive serology only), jurisdictions may opt to place them in a registry for other epidemiological analyses or investigate to determine probable or confirmed status.
Probable
Meets clinical criteria AND epidemiologic linkage with no confirmatory laboratory testing performed for SARS-CoV-2.
Meets presumptive laboratory evidence.
Meets vital records criteria with no confirmatory laboratory evidence for SARS-CoV-2.
Confirmed
Meets confirmatory laboratory evidence.
Other Criteria
Vital Records Criteria
A death certificate that lists COVID-19 disease or SARS-CoV-2 as an underlying cause of death or a significant condition contributing to death.
Comments
CSTE approved interim position statement Interim-20-ID-02 on August 5, 2020. Interim-20-ID-02 supersedes the first CSTE COVID-19 interim position statement, Interim 20-ID-01, which was approved on April 5, 2020.
This position statement, Interim-20-ID-02, updates the standardized case definition for COVID-19, including asymptomatic infections caused by SARS-CoV-2, and retains COVID-19 as a nationally notifiable condition. The updates clarify clinical, laboratory, epidemiologic linkage, and vital records criteria for case ascertainment and case classification based on the continued evolution of the COVID-19 pandemic. In addition, the probable case classification is updated, and a suspected case classification is added.
Reference(s)
The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) in China. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(2):145–151. DOI:10.3760/cma.j.issn.0254-6450.2020.02.003.
Hiroshi Nishiura, Natalie M. Linton, Andrei R. Akhmetzhanov. Serial interval of novel coronavirus (COVID-19) infections. PII: S1201-9712(20)30119-3 DOI: https://doi.org/10.1016/j.ijid.2020.02.060 Reference: IJID 4006 To appear in: International Journal of Infectious Diseases, Accepted Date: 27 February 2020.
Wei WE, Li Z, Chiew CJ, Yong SE, Toh MP, Lee VJ. Presymptomatic Transmission of SARS-CoV-2 — Singapore, January 23–March 16, 2020. MMWR Morb Mortal Wkly Rep 2020;69:411–415. DOI: https://dx.doi.org/10.15585/mmwr.mm6914e1.
FDA Emergency Use Authorizations https://www.fda.gov/medical-devices/...authorizations and https://www.fda.gov/medical-devices/...cov-2#nolonger.
Korean “Re-Positives” Assessed as Not Infectious. https://www.cdc.go.kr/board/board.es...367267&nPage=1 accessed July 10, 2020.
COVID-19: Ongoing viral detection and repeat positives. https://www.publichealthontario.ca/-...ives.pdf?la=en accessed July 13, 2020.
Related Case Definition(s)
Coronavirus Disease 2019 (COVID-19) | 2020 Interim Case Definition, Approved April 5, 2020
Content source: Centers for Disease Control and Prevention
Office of Public Health Scientific Services (OPHSS)
Center for Surveillance, Epidemiology, and Laboratory Services (CSELS)
Division of Health Informatics and Surveillance (DHIS)
Hempy McNoodle
Well-known member
From CDC's August 5th "Case Definition Update:
"*The terms confirmatory, presumptive, and supportive are categorical labels used here to standardize case classifications for public health surveillance. The terms should not be used to interpret the utility or validity of any laboratory test methodology."
So, according to CDC, a 'confirmed' case should not be regarded as a statement of validity, because of a general lack of (scientific) methodology.
"*The terms confirmatory, presumptive, and supportive are categorical labels used here to standardize case classifications for public health surveillance. The terms should not be used to interpret the utility or validity of any laboratory test methodology."
So, according to CDC, a 'confirmed' case should not be regarded as a statement of validity, because of a general lack of (scientific) methodology.
H G Griffin
Well-known member
FINALLY, some concrete action.
Now we just need compliance and/or enforcement if we are going to get ahead of this fucking virus.
https://www.cbc.ca/news/canada/edmonton/covid-alberta-briefing-hinshaw-kenney-1.5832682
Now we just need compliance and/or enforcement if we are going to get ahead of this fucking virus.
https://www.cbc.ca/news/canada/edmonton/covid-alberta-briefing-hinshaw-kenney-1.5832682
Hempy McNoodle
Well-known member
A victim of COVID-19
https://www.youtube.com/watch?v=4x0fUIvBmV0
https://www.youtube.com/watch?v=4x0fUIvBmV0
Hempy McNoodle
Well-known member
Boots on the ground
https://www.youtube.com/watch?v=cuizbP5inQM
I particularly like the comments made about SNL.
https://www.youtube.com/watch?v=cuizbP5inQM
I particularly like the comments made about SNL.
The woman has a pair, and believes in doing the right thing.They took her computers, server and all her technology, her lawyers will not be happy with this!
Do believe she is worth keeping an eye on.
CDC indicates excess deaths in 2020 to be between 250,000 and 350,000.
How do you explain those.
https://ourworldindata.org/excess-mortality-covid
ahahahahaAHAHAHAHAHAHAHAHA
WOW HEMPY so klever
nvm all the millions that AREN'T on icmag that might die...
this musta been what it feels like to live in germany in the late thirties. not to undermine the millions dead from genocide.
Hempy McNoodle
Well-known member
I can't really dive into this right now. But I see some potential issues. For now, here is the actual CDC coverage of the data (see below). I very briefly looked over it and noticed a lot of interesting stuff which I'd like to study more in depth later.
https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
Keep two eyes on this story.
https://www.yahoo.com/entertainment/florida-gop-official-resigns-protest-raid-covid-data-scientist-i-couldnt-believe-it-075650054.html
https://www.miamiherald.com/news/coronavirus/article247680010.html
https://www.miamiherald.com/news/politics-government/state-politics/article247700170.html
St. Phatty
Active member
Why are we paying money to state & federal governments ?
They add no value.
They add no value.
H G Griffin
Well-known member
most middle management will NEVER justify its expense.
The endless, unsolvable(so far) problem: other than bureaucracy, no other structure has been found to be functional once an organization reaches a certain size, yet bureaucracies themselves are inherently inefficient.
Ron Filipkowski, a Marine veteran, former state and federal prosecutor, and a lifelong Republican who was appointed to the 12th Circuit Judicial Nominating Commission by DeSantis, resigned Tuesday morning after reviewing the search warrant affidavit the state used to seize computers and phones from Rebekah Jones, the former Department of Health data analyst who has been running an alternative website to the state’s COVID dashboard.
I salute this gentleman for his position on the subject.
I salute this gentleman for his position on the subject.
if you truly love america, for god's sake wear a mask
