COVID-19

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Jin+Guice
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Joined: Sat Jun 30, 2018 8:15 am

Re: COVID-19

Post by Jin+Guice »

An ER doc I know here in New Orleans got called in today. He said the situation is deteriorating quickly and he estimates the hospital he works at will be at capacity in 7 days if the coronavirus admission rate stays constant (obviously, it's likely to increase).

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Ego
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Joined: Wed Nov 23, 2011 12:42 am

Re: COVID-19

Post by Ego »

I've been receiving Moroccan updates from the State Department since registering with them a few years ago while traveling there. Today I received this message.
The Department of State and the U.S. Mission to Morocco have arranged special chartered flights for U.S. citizens and U.S. Lawful Permanent Residents departing Marrakech International Airport on Friday, March 20, 2020, beginning at 11:30 am. These flights will include a Marrakech to London Heathrow leg and an onward connecting flight to one of 10 cities in the USA served by British Airways. The $1485 cost of these one-way tickets will include the flight to London AND to one of the 10 U.S. destinations below:

Miami (MIA), Los Angeles (LAX), Newark (EWR), Boston (BOS), Washington, DC Dulles (IAD), Chicago (ORD), New York City (JFK), Seattle (SEA), San Francisco (SFO), and Dallas-Fort Worth (DFW)

All passengers will need to reimburse the U.S. Government for the flight, and a promissory note for approximately $1485 which must be signed before boarding. No cash or credit card payments will be accepted. You will be responsible for any arrangements or costs (lodging, onward destination or local transportation, etc.) beyond your initial destination in the USA. Exact departure time and routing are subject to change.

IlliniDave
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Joined: Wed Apr 02, 2014 7:46 pm

Re: COVID-19

Post by IlliniDave »

jacob, I agree the horse is out of the barn and hunkering down and hiding out is the only hope to minimize how overwhelmed the system gets. Enough people aren't on board that it may be too late for that. Random testing would be useful for several reasons, but won't directly drive a solution. Optimally it would have started immediately. The point he made that I most agree with is that the numbers are imprecise and it puts the people who had/have to make decisions in a bind.

I think S. Korea cast a wide net around positives in their testing, and I suspect people there go home when sent home to self quarantine instead of to the beach for spring break parties. My boss left work on self-quarantine. Her college-age daughter went on a cruise last week (because cheap) and they interacted right before the word came down that any cruise anywhere required quarantine.

sky
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Re: COVID-19

Post by sky »


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Ego
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Joined: Wed Nov 23, 2011 12:42 am

Re: COVID-19

Post by Ego »

The contrarian opinion from Stanford epidemiologist John P.A. Ioannidis

https://www.statnews.com/2020/03/17/a-f ... able-data/
This evidence fiasco creates tremendous uncertainty about the risk of dying from Covid-19. Reported case fatality rates, like the official 3.4% rate from the World Health Organization, cause horror — and are meaningless. Patients who have been tested for SARS-CoV-2 are disproportionately those with severe symptoms and bad outcomes. As most health systems have limited testing capacity, selection bias may even worsen in the near future.

The one situation where an entire, closed population was tested was the Diamond Princess cruise ship and its quarantine passengers. The case fatality rate there was 1.0%, but this was a largely elderly population, in which the death rate from Covid-19 is much higher.

Projecting the Diamond Princess mortality rate onto the age structure of the U.S. population, the death rate among people infected with Covid-19 would be 0.125%.

This has been out for two days now. I've seen some criticisms of it but they all seem to fall back on the same phrase they have been using for any opinion they don't like... "there is no evidence to believe..."

Has anyone seen a good rebuttal?

black_son_of_gray
Posts: 452
Joined: Fri Jan 02, 2015 7:39 pm

Re: COVID-19

Post by black_son_of_gray »

@Ego

https://www.researchers.one/article/2020-03-10

ETA: From N.N. Taleb
My own review is "Ioannidis mistakes absence of evidence for evidence of absence /recommends to buy insurance AFTER the harm when we now have evidence".

George the original one
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Joined: Wed Jul 28, 2010 3:28 am
Location: Wettest corner of Orygun

Re: COVID-19

Post by George the original one »


CajunQueen
Posts: 12
Joined: Tue Mar 10, 2020 2:17 pm

Re: COVID-19

Post by CajunQueen »

"A breakdown of known coronavirus cases at the county level appears to show Orleans Parish — home to New Orleans — far outpacing other jurisdictions in COVID-19 rate per capita in the U.S."

Mardi Gras is a season, not just a single day event. I can't think of a better way to seed a city.

https://www.wwno.org/post/new-orleans-o ... ses-capita

Jin+Guice
Posts: 688
Joined: Sat Jun 30, 2018 8:15 am

Re: COVID-19

Post by Jin+Guice »

I keep seeing this simplistic argument about the death rate, but that's not really telling the story.

The death rate is scary but without the likely infection rate it doesn't tell us much. How many are likely to be infected? If we make the, somewhat fucking wild, assumption that the true death rate is 0.125% and then make the equally wild assumption that everyone in the world is exposed and susceptible to the disease then 8,750,000 die.

The abstract death rate isn't even the real fucking problem though, despite the fact that everyone keeps pretending like it is. The problem is hospital overwhelm, which, as far as I know, has happened in Italy and Wuhan. When hospitals are overwhelmed we have to consider the "regular" death rate, the additional deaths due to overwhelm and the additional deaths due to non-corona patients who don't get hospital beds.

The 20% hospitalization rate is scarier than the death rate.

Now add in that the disease is ageist and targets old people disproportionately. I'll go ahead and make the shitty judgement call that this is better than a disease targeting young people, but don't try to pretend like it isn't part of the story and part of the calculations. If the CFR was 0.125%, but 7% of those who made outrageous calculations died, you can be these motherfuckers would be massaging the numbers different direction.

Let's not forget that this has largely been a disease of rich countries...so far. Countries that can afford to pay for the food and rent of people who are out of work for a few months. Countries that have expensive medical equipment. Countries with educated populations where the government is trusted enough to shut shit down and the reopen it again.


@CajunQueen: I have every reason to believe that things are going to go very badly here. Today I noticed that people are starting to take this seriously. FQ still had enough people that I didn't walk through it though.

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fiby41
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Joined: Tue Jan 13, 2015 8:09 am
Location: India

Re: COVID-19

Post by fiby41 »

26000 Indians might be returning from Gulf countries. They'll be quarantined and even if negative will be barred from public transport.
International flights being cancelled.
Prime minister addressed the nation yesterday. Old people should refrain from leaving the home, don't cut wages or fire absentees, practice self isolation on Sunday, temples and congregational gatherings closed, practice social distancing, cross country trains being cancelled due to disuse and as a precautionary measure, work from home encouraged, government offices in my state working on alternate days in 50% capacity shifts.
Spitting being fined at ~$20/ instance.
About 27% of 163 cases in the nation is in my state (44.) Chief minister declares 'war on the virus'. Isolation chambers are being created and rented from private hospitals.

Clarice
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Joined: Sat Dec 02, 2017 4:45 pm
Location: California

Re: COVID-19

Post by Clarice »

I am under the shelter-in-place order in the San Francisco Bay Area. I am actually going to work every day as I am a healthcare worker. The atmosphere is of complete fear. The pulmonologist in the YouTube video below offers an alternative perspective. It resonates with me. It used to be that 50% of the patients I am dealing with used to have a diagnose of Pneumonia, unspecified organism. Nobody tested them. Ever. Now they all started to get tested for COVID-19. What does it mean though? The interview is in German with English subtitles.


https://www.youtube.com/watch?v=p_AyuhbnPOI

horsewoman
Posts: 378
Joined: Fri Jun 07, 2019 4:11 am

Re: COVID-19

Post by horsewoman »

OMG now this stupid video is leaving the German language area... This guy is an anti-vaxer and a conspiracy theorist. There are several rebuttals by people who know a lot more about viruses than him (my links are in German, so they will not be of much use here).

If we get a curfew this idiot is the culprit, since people share this video and organise Corona Partys, treating the whole thing as a joke! It's unbelievable. Stay the fuck home and take this seriously! Of course, our politicians will drive Europe's economy against the wall because the pharma industry as not enough revenue this year. Tin foil hats anyone?

Sorry, rant over. This video triggers sensible Germans by now.
Last edited by horsewoman on Fri Mar 20, 2020 1:57 am, edited 1 time in total.

classical_Liberal
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Joined: Sun Mar 20, 2016 6:05 am

Re: COVID-19

Post by classical_Liberal »

Some rural US updates. In N.D. we now have 19 confirmed cases. The state population is only 700k. So that's about 27 per 1m, less than the total US numbers. We are testing more liberally now, with drive though centers opening up in the only three large population centers of 100k or more. Not as liberally as our neighboring state MN, who has apparently burnt through most of their testing ability and may have to change tactics.

All restaurants, bars, movie theaters, etc are ordered close at of noon tomorrow. They can still offer take out services if so desired. The malls have been closed since last week. No sporting events or the like for at least the past week already, when we had only 3 cases. Schools never came back from spring break and most districts are now setting up online education for the remainder of the school year. I'm still going to work (obviously), and I would say traffic levels are at about 50% normal, which is a pretty good indication because pretty much everyone drives around here. No regulations about leaving home though, and the retail chains like walmart and costco are still open, but with reduced hours.

_____

@Jin+Guice or anyone else who has close friends dependant on service/entertainment/retail industry jobs.

Given all the dire economic statistics about people living paycheck-to-paycheck and not having even $300 for an emergency. Plus the fact that these folks tend to be the most vulnerable to such economic circumstance, what are their plans for interrupted work? It seems to me any economic stimulus getting to them would be too late. Even unemployment takes awhile. When someone's entire social network in is the same situation, I would imagine it exacerbates the problems as those who may have helped out, no longer can.

ertyu
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Joined: Sun Nov 13, 2016 2:31 am

Re: COVID-19

Post by ertyu »

From a Bergamo hospital: https://vimeo.com/398334975

At least in addition to this there aren't crowds sitting against the wall amongst dead bodies, as there were on the Wuhan video posted earlier. In fact, even though this is comparatively crowded, it seems to me leaps and bounds beyond what most countries and hospitals are likely to manage in a state of similar overwhelm.

Zanka
Posts: 91
Joined: Tue Aug 01, 2017 2:33 am

Re: COVID-19

Post by Zanka »

Regarding the numbers of infected people. Most countries (in europe at least) are only testing the cases that need hospitalization. And if the number of hospitalizations is 20% you can just make your own calculations.

But, if you also factor in that most people do not go to the hospital on day 1, but rather on something like day 7 from starting feeling symptom, you can adjust your number even more. And then you can add the incubation period of average 5 days or whatever and you understand that any official number is just so uncertain and not a representation at all about how Spread the disease is.

When a country like Italy has 3000 cases confirmed one day it is actually saying that 15 000 got infected around 12 days ago.

IlliniDave
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Joined: Wed Apr 02, 2014 7:46 pm

Re: COVID-19

Post by IlliniDave »

Ego wrote:
Thu Mar 19, 2020 8:38 pm
The contrarian opinion from Stanford epidemiologist John P.A. Ioannidis

https://www.statnews.com/2020/03/17/a-f ... able-data/

Has anyone seen a good rebuttal?
I posted the same link a little while back. I'd guess the author is pretty solid in his "science", at Stanford they usually are. jacob commented a few posts back although not a rebuttal per se. My take is sort of similar. Sharpened pencils on the statistics would have helped a month or six weeks ago maybe and would be useful down the road when people try to figure out what really happened. But the time for elegant solutions seems to be past.

A sister facility of the megacorp whose facility I work in (not my employer) is located in the Bay area. When the shelter in place came down they managed to convince the powers that be that they were a "critical industry" or something like that, and got an exemption after one day and were back to work*. I suspect most of the big corps that make all the right contributions could play that card if they wanted. Half measures like that will probably tip the balance towards a bad overall outcome. Here in Alabama the only curbing of business activity has been voluntary on the part of business with the exception of some of the federal gov't presence.

Since we can only guess at the true extent of the situation and trajectory, I, being conservative by nature (conservative in the personality sense rather than political), would say shut it all down now and eat the economic consequences. Instead a significant subset of our leaders are more interested in pointing their political fingers at each other. I suspect we'll see a lot of toothless pronouncements. We might luck out and get a summertime reprieve, or we might not.

I did see a segment on youtube taken from a verboten news source that reported on some doctors in France that had success treating serious covid-19 cases with a common anti-malaria drug. US officials are supposedly aware of it. Some trial anti-viral drugs have been anecdotally attributed to recoveries here (deployed due to the new "compassionate use" policies presumably). I just don't know that we'll have the time to sort through all of that.

ETA, in their defense, a small minority of their workforce could probably be justifiably deemed critical.

J_
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Location: Netherlands/Austria

Re: COVID-19

Post by J_ »

Jacob made a clear way to calculate what the number of casualties will be, see above. It is not the number of official infected people what gives insight but the number of deaths. You can vary with Lombardian numbers (death rate very high) or Korean numbers (death rate low) and with the days of doubling time in Germany at the moment <3!

Jason
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Joined: Mon Jan 30, 2017 8:37 am

Re: COVID-19

Post by Jason »

A family in NJ has lost four members in a week after having dinner with someone who was associated with the state's first Corona death. No one had underlying health issues. One was old. They are tied to Yonkers Race Track. Being that there is a doctor in the e-house, I will ask if there is genetic susceptibility factor. I mean, damn, three siblings and their mother taken out?

https://www.nytimes.com/2020/03/18/nyre ... virus.html#

CS
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Joined: Sat Dec 29, 2012 10:24 pm

Re: COVID-19

Post by CS »

High BMI is a health issue. That picture says everything about that. There could be underlying high blood pressure and undiagnosed diabetes (not uncommon).

There was a slight difference in outcomes by blood type according to some Chinese study... it wasn't huge, a few(7? percent). Not hugely strong results. (great language there, eh?)
“People of blood group A might need particularly strengthened personal protection to reduce the chance of infection,” wrote the researchers led by Wang Xinghuan with the Centre for Evidence-Based and Translational Medicine at Zhongnan Hospital of Wuhan University."
https://www.scmp.com/news/china/society ... hina-study

They could also share habits, like taking Ibuprofen, which is associated with poorer outcomes.

CS
Posts: 549
Joined: Sat Dec 29, 2012 10:24 pm

Re: COVID-19

Post by CS »

"While it is too soon to know who is more susceptible to the new coronavirus strain, there are many well-studied genetic variants that impacted SARS susceptibility – as well as with other viruses."
https://www.geneticlifehacks.com/viral- ... -and-more/

That said, my family lost three people quick to the 1918 pandemic (Father, Mother and Son - the father being my great-grandfather, the son my grandfather's brother)
Last edited by CS on Fri Mar 20, 2020 9:48 am, edited 1 time in total.

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