The above comes from the Asthma and Allergy Foundation of America, and is sourced to WHO.

Update: On March 12th, the CDC – finally – updated its health conditions list with more detail, albeit, buried in an item about the situation in Santa Clara County, California.

https://www.cdc.gov/coronavirus/2019-ncov/downloads/Santa-Clara_Community_Mitigation.pdf

Appendix A: Underlying medical conditions that may increase the risk of serious COVID-19 for individuals of any age.

•Blood disorders (e.g., sickle cell disease or on blood thinners)

•Chronic kidney disease as defined by your doctor. Patient has been told to avoid or reduce the dose of medications because kidney disease, or is under treatment for kidney disease, including receiving dialysis

•Chronic liver disease as defined by your doctor. (e.g., cirrhosis, chronic hepatitis) Patient has been told to avoid or reduce the dose of medications because liver disease or is under treatment for liver disease.

Compromised immune system (immunosuppression) (e.g., seeing a doctor for cancer and treatment such as chemotherapy or radiation, received an organ or bone marrow transplant, taking high doses of corticosteroids or other immunosuppressant medications, HIV or AIDS)

•Current or recent pregnancy in the last two weeks

•Endocrine disorders (e.g., diabetes mellitus)

•Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)

•Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)

•Lung disease including asthma or chronic obstructive pulmonary disease (chronic bronchitis or emphysema) or other chronic conditions associated with impaired lung function or that require home oxygen

•Neurological and neurologic and neurodevelopment conditions [including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy (seizure disorders),stroke, intellectual disability, moderate to severe developmental delay, muscular dystrophy, or spinal cord injury].

CDC has, on various pages, defined older as “60+” based on the sharp increase in mortality of SARS-CoV-2 infections that occur at age 60 and up. For those age 50 and up, the curve is also several times higher than below 40,

Unfortunately, there is no clarity on what is meant by officials when they warn us about risks to “older” people or the “elderly”.

CDC seems to imply that with regards to novel coronavirus, “older” is age 60 while some public health districts in California use age 50. Although regarding the warning against traveling on cruise ships, the LA Times says this applies those age 70 or older.

Similarly, there are references to “the elderly” – what does that mean?

• Social Security says age 65.
• The U.S. Housing and Urban Development Administration says age 62.
• This page says the term “senior citizen” applies to those at age 60 or 65.
• Officially, if you are past “middle age”, you may be considered “older” or “elderly”.
• Interesting items here suggest it has become associated with “feeble” but the root word is actually “elder”, which describes someone to be respected.

There does not seem to be a precise definition – but it seems to fall somewhere in the 60-65 age range and occasionally in the 65-70 range.

The lack of any definition does not help the CDC’s communication. How do individuals know if they are the target audience for the recommendation when vague terms like “older” or “elderly” are given, but not defined?

Source: Swiss government bans all events over 1,000 people – MarketWatch

Numerous tech industry conferences have been canceled in the U.S. already. Flights to and from Asia have been slashed or eliminated.

The modern world has no effective way to deal with a spreading virus except to shut down the entire economy – potentially destroying entire economic systems and causing additional harm to populations.

Although many consumers pay nothing out of pocket for flu shots, insurers foot the bill. And those prices vary dramatically.

Source: The Startlingly High Cost Of The ‘Free’ Flu Shot | Kaiser Health News

Insurance has made possible random pricing for what should be fixed price goods and services. Contrary to widespread misunderstanding, insurance does not make health care cheaper, it merely makes someone else pay for it. Kaiser found that 3rd parties pay $15 to $85 for the same flu shot.

I paid $19.99, cash, at Costco, because we no longer have 3rd party paymet for prescriptions or vaccinations. Fred Meyer wanted $60 – it was hard to get a price quote from them as they were flustered when I asked for a cash price, as if they didn’t know what to do. Several minutes later they got back to me with a price.

Since I have skin in the game, I shop around. There is no reason for anyone or any insurer to pay exorbitant (and secret) prices for a fixed service like a flu shot. But they do it anyway.

All proposals for addressing health care issues in the United States are of the form “health care costs too much so let’s find someone else to pay for it“. This strategy will only work as long as you can find someone else to pay for it, and then it collapses.

The reality – as shown by prices paid, time after time – is that 3rd party payers enable high prices and do not control them, as they claim.

Off our usual topics here but … Having experienced six traumatic brain injuries in life, this study is of great interest to me:

The authors point out that there is growing evidence of persistent changes in the brain that last well beyond clinical recovery and clearance to return to play. This study confirmed those findings showing clear brain changes in both structure and function that persisted six-months after injury. They also showed that these persistent brain changes related to concussion history, even in healthy athletes.

“We were able to show evidence of prior concussion history through this method,” said Menon who is also a scientist at Robarts Research Institute and the director of the Western Centre for Functional and Metabolic Mapping. “This component correlates directly with the number of previous concussions that an athlete has had. This hasn’t been shown before.”

Source: MRI technique shows unique signatures of concussion in rugby players – Media Relations

Very interesting!

I have had six traumatic brain injuries (TBIs) ranging from about age 5 or 6 up through about age 50. One included a skull fracture (and unconsciousness) and 3 others involved knock out blows. Two did not knock me out but left me disoriented or with other affects such as “slow brain” and (oddly enough) arrhythmia for a couple of weeks.

In the past, these were called “head injuries” not “brain injuries” and were mostly ignored by doctors. Associated broken bones got attention! This is why TBI has been called an “invisible injury”.[1]

Incredibly, I did not know what a “TBI” was until 2018! I had, at various times, and in some cases still, experienced a variety of common TBI symptoms including “word finding” (knew what word I wanted to say but was physically incapable of saying the word), “stabbing” headaches, “throbbing” headaches, tinnitus, visual migraines, “slow brain”, emotional lability (since my third TBI, I found myself breaking into tears at emotional movie scenes or news stories), irritability, anxiety, “negatavistic thinking” including rumination and perseveration, sensitivity to low frequency sounds and noise and very short term memory issues (but not long term). For example, I tend to misplace tools I am working with and then spend 10 minutes looking for them, misplace my reading glasses, leave a stove burner on, etc. I developed coping strategies to avoid this now and it no longer happens as often as it once did!

I had no idea my brain was not behaving as it should. I learned just this year that this was not normal brain functioning and these were common after TBI (and sometimes long term after TBI). Merely learning this has left me with a wonderful feeling – finally – a coherent explanation and treatment options for a few things that linger on from long ago TBIs.

I learned that some people had very mild head injuries – but very debilitating brain injuries. There are some who have severe head injuries – but have made fantastic recoveries. There are also those who have had injuries and have had very difficult recoveries. Personally, I feel incredibly grateful that I came through a staggering six TBIs quite well and without diagnosis or appropriate treatment – not everyone has been so fortunate.

The above study has found a method for doctors to finally see evidence of physical changes, which they were previously unable to see. Lacking physical evidence, many patients with brain issues were ignored. More recently neuropsychologists have been brought in to evaluate cognitive functions and diagnose brain disorders that show no physical evidence.

Help for TBI patients is available.

Notes

[1] When I was 11 1/2 and recovering from a skull fracture, I remember I felt odd being so affected but nothing to show for it. Back in those days, kids with broken arms and legs got sympathy – but most didn’t know I too had a significant bone fracture and brain injury. TBI is mostly invisible. Yet my skull was fractured from my left temple to behind my left ear due to my bicycle striking a small pot hole, turning the front wheel into the curb, and throwing me over the handle bars, landing on the back of my head (per witnesses and evidence – obviously I have no memory of it). This was back in 1971 before bike helmets existed.