COVID-19

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Ego
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Re: COVID-19

Post by Ego »

Hungarian Parliament passes bill that gives PM Orbán unlimited power & proclaims:

- State of emergency w/o time limit
- Rule by decree
- Parliament suspended
- No elections
- Spreading fake news + rumors: up to 5 yrs in prison
- Leaving quarantine: up to 8 yrs in prison

Jin+Guice
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Re: COVID-19

Post by Jin+Guice »

https://www.imperial.ac.uk/media/imperi ... 3-2020.pdf

Here's the link for all of their reports: https://www.imperial.ac.uk/mrc-global-i ... /covid-19/

The top link contains both the 500,000 U.K. and 2.2 million death numbers I keep seeing being called the "worst case estimates." This is the right report?

If so:
Imperial College wrote: The age-stratified proportion of
infections that require hospitalisation and the infection fatality ratio (IFR) were obtained from an
analysis of a subset of cases from China. These estimates were corrected for non-uniform attack
rates by age and when applied to the GB population result in an IFR of 0.9% with 4.4% of infections
hospitalised.

...


In the (unlikely) absence of any control measures or spontaneous changes in individual behaviour, we
would expect a peak in mortality (daily deaths) to occur after approximately 3 months. In
such scenarios, given an estimated R0 of 2.4, we predict 81% of the GB and US populations would be
infected over the course of the epidemic. Epidemic timings are approximate given the limitations of
surveillance data in both countries: The epidemic is predicted to be broader in the US than in GB and
to peak slightly later. This is due to the larger geographic scale of the US, resulting in more distinct
localised epidemics across states than seen across GB. The higher peak in mortality in GB
is due to the smaller size of the country and its older population compared with the US. In total, in an
unmitigated epidemic, we would predict approximately 510,000 deaths in GB and 2.2 million in the
US, not accounting for the potential negative effects of health systems being overwhelmed on
mortality.
@Bankai: I keep attacking your sources, but I do appreciate your dissenting voice. I am of the opinion that a strict quarantine would be the best course of action, but I am very worried about the economic and political (police state anyone?) ramifications of this. I only began delving into the numbers used to come up with the "worst case scenario" because they didn't make sense to me. I'm not confident in my opinion or the current course of action taken by most countries, it's just the best thing I can think of with the current available information.

bostonimproper
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Re: COVID-19

Post by bostonimproper »


Jin+Guice
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Re: COVID-19

Post by Jin+Guice »

Ego wrote:
Mon Mar 30, 2020 4:13 pm
Hungarian Parliament passes bill that gives PM Orbán unlimited power & proclaims:

- State of emergency w/o time limit
- Rule by decree
- Parliament suspended
- No elections
- Spreading fake news + rumors: up to 5 yrs in prison
- Leaving quarantine: up to 8 yrs in prison
O.k., this is what I am most afraid of on the human reaction side of the equation.

black_son_of_gray
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Re: COVID-19

Post by black_son_of_gray »

@bostonimproper

Same thing is happening in Bay Area/SF, except we're seeing lots of coyotes out in the empty streets.

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Bankai
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Re: COVID-19

Post by Bankai »

Hungary was flirting with authoritarianism for a number of years now so this doesn't come as a surprise to me. If they push it too far, they'll be kicked out of the EU so...

Re:
not accounting for the potential negative effects of health systems being overwhelmed on
mortality


I think we're already experiencing this. Once all the resources are focused on the virus, there's nothing left for BAU emergencies & procedures anyway, no matter how overwhelmed the system is, ie. anyone who dies at 3000% over capacity still dies at 110%. This is already happening in the UK where people write to the BBC because their cancer op was postponed indefinitely. In the 'do nothing' scenario you can go back to treating BAU patients after 3 months while 'close the world' scenario is 6 months best and more likely 12-18 so it's possible that 'do nothing' scenario might actually result in fewer, not more, non-virus deaths.

Current UK strategy costs £97,000 per 1 year of life saved (for bailouts alone) assuming realistic 'worst case' scenario of 500,000 deaths. Any other treatment has a cut-off of £30,000 per year saved or it doesn't get approved. So we're already paying 3.25x more for covid than saving life-years when fighting any other disease and that's before gargantuan cost to society.

Having said that I'm still not sure what the right course of action is in the current situation. What's obvious now in 20/20 hindsight is that borders should've been closed as soon as or before China announced their lockdown.

thrifty++
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Re: COVID-19

Post by thrifty++ »

Im wondering how healthcare is going to be triaged when health care systems are getting overwhelmed.

Its not nice to discuss but I am really hoping that there is priority focus on younger people with serious covid19 or other medical problems. Older people have enjoyed life much longer and have less to contribute and cost a lot more to society. Younger people will need to rebuild and contribute after all this carnage. Tough decisions need to be made.

Seppia - have you noticed anything about triaging in Italy on an age and symptoms basis?

IlliniDave
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Re: COVID-19

Post by IlliniDave »

thrifty++ wrote:
Mon Mar 30, 2020 5:29 pm
Im wondering how healthcare is going to be triaged when health care systems are getting overwhelmed.

Its not nice to discuss but I am really hoping that there is priority focus on younger people with serious covid19 or other medical problems. Older people have enjoyed life much longer and have less to contribute and cost a lot more to society. Younger people will need to rebuild and contribute after all this carnage. Tough decisions need to be made.

Seppia - have you noticed anything about triaging in Italy on an age and symptoms basis?
Be interesting to hear Seppia's experience. For what it's worth, I thought it was pretty widely reported that the oldest people often did not get treated for the sake of the younger, based primarily on survival odds of their respective age cohorts.

classical_Liberal
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Re: COVID-19

Post by classical_Liberal »

jennypenny wrote:
Mon Mar 30, 2020 11:41 am
This time, everyone is being asked to do their part — everyone’s participation matters.
The difference being that the blue/pink collar worker's "part" is going to work and risking their and their families lives to exposure, while the white collar folks are asked to take care of their own kids for once and work from home. There is a huge disparity in what is "being asked" of people. This is not only in healthcare, but in the essential retail and service sectors, manufacturing, etc.

I mentioned this in the other thread and @ego has mentioned this as well. A prolonged situation like this is going to create some serious class related social blowback. Anecdotally, I already see it happening in my pink collar work, and blue collar friends and neighbors (ie not suburbia). Cannon fodder rarely continue their roles for long without threat of force.

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jennypenny
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Re: COVID-19

Post by jennypenny »

Sorry, I didn't see it mentioned in another thread. I wish I had since that is not my experience. In my sphere, outside of healthcare and food service, the people I know being forced to go into work are in pharma, biotech, aviation, DoD/military, and IT work with tight security that can't be accessed from home. Just because you don't see them working doesn't mean they aren't. Many are choosing to live at work to avoid putting their families at risk.

Not trying to be argumentative, just sharing what I've seen personally.

jacob
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Re: COVID-19

Post by jacob »

thrifty++ wrote:
Mon Mar 30, 2020 5:29 pm
Im wondering how healthcare is going to be triaged when health care systems are getting overwhelmed.
Medical ethics boards are already writing out guidelines. From what I've seen from the overloaded countries, the priority is according to immediate survival odds rather than expected remaining life expectancy, but maybe the guidelines go into more detail. It's probably more complicated than that.

The comorbidities (*) and age/gender distributions are already known. For example, I saw a tweet stream (since deleted) out of Seattle than if you were >40yo, obese, diabetic, (<= this describes a disturbingly large fraction of Americans), and had one or more organs failing, you'd be out of luck in terms of getting one of their IIRC 13 ventilators.

(*) Published numbers, listed upthread. Some are significant---according to the report 98%+ of those who died had one or more of the comorbitidies. IOW, if you're healthy, you'll almost surely survive

thrifty++
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Re: COVID-19

Post by thrifty++ »

58 news cases in NZ bringing total confirmed or probable to 657.

74 people have recovered.

1 person has died - a 74 year old woman

14 people in hospital - 2 people are in a stable condition in intensive care units.

So far a mortality rate of only 0.15%. And a combined serious/critical condition and mortality rate of 0.46%.

Apparently there are only 533 ventilators in NZ which is worrying. Apparently more being ordered from overseas, but don't know from where.

Noting comments about Germany and Iceland above, there are some countries with low mortality rates. Although noting what Jacob said, I would have thought that there would be more fatalities in Iceland by this point. Im hoping NZ just stays on the same trajectory as Iceland. I do have the feeling that the high death rates in some countries is linked more to a lack of reporting and recording of all the mild cases.

The govt has finally published its worst case scenario projections in conjunction with the University of Otago and academics in Germany. 3.32 million expected to get symptomatic illness (69%) 146,000 would be sick enough to require hospital admission (3.03%) 36,600 would be in intensive care (0.76%); and 27,600 would be expected to die (0.57%). That is worst case scenario. https://www.health.govt.nz/publication/ ... ng-reports
Last edited by thrifty++ on Mon Mar 30, 2020 8:42 pm, edited 2 times in total.

classical_Liberal
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Re: COVID-19

Post by classical_Liberal »

jennypenny wrote:
Mon Mar 30, 2020 8:09 pm
Not trying to be argumentative, just sharing what I've seen personally.
Don't be sorry! I wasn't trying to be argumentative either. Just making the point of what I am hearing and seeing from my anecdotal experience. Most of the walmart shelver's and clerks don't have the option of segrating from their families after work. Nor do many others, it's cost prohibitive and they are not being extended the benefits their white collar cousins are getting if being considered essential. I think it's an important point to consider if some of these conditions last longer than a month or two. No doubt their limited economic situation means they're less likely to just walk out under these circumstances, as more of the white collar world would. I certainly considered it just a week ago, and under certain perfect storm bad circumstances, likely still would walk away.

Edit: It is already beginning.
https://www.cnn.com/2020/03/29/tech/ins ... gfooterold

https://medium.com/@GigWorkersCollectiv ... df11b6995a
Shoppers have had enough. Instacart has refused to act proactively in the interests of its Shoppers, customers, and public health, so we are forced to take matters into our own hands. We will not continue to work under these conditions. We will not risk our safety, our health, or our lives for a company that fails to adequately protect us, fails to adequately pay us, and fails to provide us with accessible benefits should we become sick.
I think this type of thing will be a snowball effect. As more, lower paid, service sector employees make demands, more will follow.

George the original one
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Re: COVID-19

Post by George the original one »

One of the most mis-used phrases I've heard lately, usually by a leader who was late to lockdown, is "things were going fine until the cases went exponential". Total misunderstanding that they were exponential already and the leader was oblivious.

Jin+Guice
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Re: COVID-19

Post by Jin+Guice »

@c_L: Interesting, most people I know who still have jobs still feel lucky to have them (I haven't talked to any healthcare people, I'm talking mostly about grocery store workers and to-go service industry people). I'm not sure this sentiment will hold once (if) most people know multiple people who've become gravely ill and/ or multiple people who've died.

@Bankai: From what I've read and what's been discussed here, hospital overrun appears to significantly increase the deaths from the disease by a factor of at least 3x. This knocks the cost of a quality year down to around what is apparently normal to spend in England. Of course this means precisely nothing because more money will be spent and there's so much uncertainty around what the unchecked death rate for the virus is that I could construct it to be almost anything I want it to be. What's the best solution given that the death rate may be 0.1% (many undetected mild cases) or 10% (this is close to the death rate based on diagnosed cases in Italy and Spain)?

I don't think the path we're currently on is very wise. It seems like we're collectively doing our best to incur significant economic costs and ensure as few lives are saved as possible. Personally I favor a total shutdown for 3 months with contact tracing and quarantining of those who've been exposed. I acknowledge that this will neither be pretty nor pleasant, but rich countries can afford it and the track record in China, and to a certain extent SK is there. I am worried about what the increased surveillance necessary for this would imply for the future. Mostly we have to do the thing which our society is least equipped to do, make a tough decision about the future in the face of uncertainty.

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fiby41
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Re: COVID-19

Post by fiby41 »

We've 1 ventilator for every 25,000 citizens. Defence Research and Development Organization has developed ventilator than can hookup multiple patients. Bharat Heavy Electricals Limited (ticker BHEL) will be manufacturing 5,000 of these.

CS
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Re: COVID-19

Post by CS »

Dr. John Campbell (You tube, mentioned earlier up thread) mentioned that someone adapted using oxygen with a cpap machine and it worked pretty well to assist breathing - with much fewer drugs and personal needed as compared to intubation and ventilation. I can't remember who did it, but it was a prototype. He hopes they make the prints available to others who can ramp up production as well.

I know there are a few people here who snagged some cpap machines. If you're interested in what he says (it was just a blip basically, but I do think he mentioned who it was) it was about midway through the March 30th update.
Last edited by CS on Tue Mar 31, 2020 10:27 am, edited 1 time in total.

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jennypenny
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Re: COVID-19

Post by jennypenny »

@c_l -- I guess some of it will also depend on whether people in those jobs compare themselves to others in their peer group who are hurting because they don't have jobs or people who have been able to arrange better working conditions.

Thinking about it some more, given the potentially generous unemployment benefits, if that were me I might be happier being laid off. I hadn't considered that. It probably also depends on your employer. DD is working that level of job but her employer is providing lunch every day and giving all the employees hazard pay so everyone feels compensated for the additional risk.

----

I heard someone call the weight gain the 'COVID 19' like the 'freshmen 15'. I also saw several similar memes to this ... 'how I thought I'd dress during SHTF' with someone in head-to-toe tacticool gear, and then 'how I'm actually dressing during SHTF' with a person in sweatpants on a sofa. I'm enjoying the dark humor. I hope it lasts.

Toska2
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Re: COVID-19

Post by Toska2 »

I feel sorry for the part timers who got their hours cut and can't collect unemployment. I know a few that are scheduled for 8 hrs a week.

ertyu
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Re: COVID-19

Post by ertyu »

friend from the states has gallstones/gallbladder inflammation. apparently prices are jacked up 3x, because if you're at the hospital now, clearly you must be desperate, dying, and willing to pay. gotta make up of all these low-margin covid patients somehow, ey

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