I have to say that I believe you may have some problems decoding my text - which may mean I have to write more clearly. Or at least you have problems seeing the bigger frame I'm trying to draw instead of whatever sketching I'm doing of the smaller details. I've only been talking about the dangerousness of this pandemic for two months on this forum. So somehow to see my comment from the standpoint of it being some kind of potential minimization it is just amazing to me. I agree that minimizing and under responding to a pandemic is far worse than overestimating it.
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Coronavirus
- Thread starter Wenche
- Start date
I have to say that I believe you may have some problems decoding my text - which may mean I have to write more clearly. Or at least you have problems seeing the bigger frame I'm trying to draw instead of whatever sketching I'm doing of the smaller details. I've only been talking about the dangerousness of this pandemic for two months on this forum. So somehow to see my comment from the standpoint of it being some kind of potential minimization it is just amazing to me. I agree that minimizing and under responding to a pandemic is far worse than overestimating it.
Norbert
TSLA will win
As I mentioned, I had a specific reason to think so, but I am glad if that is not the case.
SageBrush
REJECT Fascism
ECDC Data through Apr 4
Commentary: Countries can be compared by mentally shifting a curve so that the start points of 1death/10M are the same. The US looks very much like Italy with a 3 week delay, and all these countries are similar. Uncertain though is whether the countries with later starts will have earlier (or later) bends.
Commentary: Countries can be compared by mentally shifting a curve so that the start points of 1death/10M are the same. The US looks very much like Italy with a 3 week delay, and all these countries are similar. Uncertain though is whether the countries with later starts will have earlier (or later) bends.
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https://www.imperial.ac.uk/media/im...urope-estimates-and-NPI-impact-30-03-2020.pdf
A potential pickle ... this study which used data up to March 28 estimates that R0 (how many infections spread by 1 person on average) in European countries is likely still just above 1, with all control measures in place. It’s exactly the sort of modeling you’d do if you wanted to guess at the effect of control measures given the limitations of the dataset. Definitely worth a scroll for the country specific figures.
Btw, this model does not match the falloff the IMHE healthcare peak model assumes.
This model suggests that lifting the non-essential shutdown sends the disease back to exponential growth (R0 to ~2). But continuing in the status quo the disease active cases plateau indefinitely. This suggests to me that we still need to add new measures to our covid-19 response. R0 needs to be brought below 1. The healthcare environment is probably the best place to look to make major changes. Maybe procedure changes could help. Or even more drastic measures such as big changes to who is kept in the hospital vs. at home (potentially with oxygen).
I don’t like this result. Our collective response has already come at great cost and effort. I was hoping for greater effect.
A potential pickle ... this study which used data up to March 28 estimates that R0 (how many infections spread by 1 person on average) in European countries is likely still just above 1, with all control measures in place. It’s exactly the sort of modeling you’d do if you wanted to guess at the effect of control measures given the limitations of the dataset. Definitely worth a scroll for the country specific figures.
Btw, this model does not match the falloff the IMHE healthcare peak model assumes.
This model suggests that lifting the non-essential shutdown sends the disease back to exponential growth (R0 to ~2). But continuing in the status quo the disease active cases plateau indefinitely. This suggests to me that we still need to add new measures to our covid-19 response. R0 needs to be brought below 1. The healthcare environment is probably the best place to look to make major changes. Maybe procedure changes could help. Or even more drastic measures such as big changes to who is kept in the hospital vs. at home (potentially with oxygen).
I don’t like this result. Our collective response has already come at great cost and effort. I was hoping for greater effect.
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Thanks for sending that. It's a technically impressive publication. But those numbers are frankly terrifying with very few countries anywhere near R0 equal to or less than 1, and this despite an economically or for that matter psychologically unsustainable level of lockdown. I hope they are at least a little bit off because otherwise we're in deep s***. And the initial R0 being almost 4 is also very very bad. About the only encouraging thing is where the authors state that there's a high level of uncertainty in their estimates. Let's hope so. And let's hope the uncertainty is in our favor because otherwise this is as you surmise very bad news
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SageBrush
REJECT Fascism
Compare with German response:
coronavirus-why-does-germany-have-so-few-covid-19-deaths
The US had all the information and capability to have done the same. The primary deficiencies have been Federal, to be sure, but States and cities played their own roles too. Overall Gross Contributory negligence from the Trump Administration, which years earlier had its own warning of lack of preparation from both a previous administration study and their own. Driven by callous federal health care policies and ill-prepared States, hospitals all over the US were closed and reserves of ICU beds were reduced, together with PPE, etc. When this finally dies down, the world needs to learn from Germany and South Korea, after which improve from their base. Both are already learning from their own errors. The Trump Administration is learning nothing, just blaming every messenger and silencing all critics. The last straw is relieving Captain Brett Crozier, who's missive reflects dedication to his mission. he was relieved for not keeping his letter sufficiently classified. True enough, but had he not done so this entire affair would have been covered up just as have been other crimes.
All this should be considered Criminal Negligence or worse. Sadly many countries have been just as badly prepared as the US. Spain, Italy and France are the obvious ones now. Others are joining this infamous group. Israel has run out of critical items, Israeli papers report. Brazil is running short of testing ability and equipment in Sampa and Rio.
If this teaches us all anything it is that we desperately need well-supported WHO and global coordination. The entire world needs to be better prepared for widespread ICE and emergency care.
I hope this is not considered Off-Topic.
Norbert
TSLA will win
Hmm, Germany has 22% more (known) total cases than the US per capita, but only 68% the number of deaths per capita.
Due to higher testing? Or lower death rate?
SageBrush
REJECT Fascism
Quite frankly, the epidemic is being approached ass backwards.
We do not need more funeral homes, we need less deaths.
We would not have to wonder where to get vents if there were less patients.
We would not run out of N95 masks for physicians if there were less patients.
Simple, DIY masks used by the entire population is the missing link. Until that changes we are pissing into the wind.
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Aren’t DIY cloth masks more theater than function? Like barely better than nothing. Surgical masks for everyone and n95 masks for healthcare settings would be a much different effect than diy masks I think.
SageBrush
REJECT Fascism
The Republican politicos have a playbook called "How to be an abject MORON."
Here Are The 9 State Governors Who Have Refused To Issue Stay-At-Home Orders
It goes like this:
The White House Moron says "I leave decisions up to the Governors. They know what they are doing."
The Governors say "I leave decisions up to the Mayors. They know what they are doing."
The Mayors say "We need backing from our Governors and President."
Until eventually we get this pearl from the likes of the Florida governor:
Here Are The 9 State Governors Who Have Refused To Issue Stay-At-Home Orders
It goes like this:
The White House Moron says "I leave decisions up to the Governors. They know what they are doing."
The Governors say "I leave decisions up to the Mayors. They know what they are doing."
The Mayors say "We need backing from our Governors and President."
Until eventually we get this pearl from the likes of the Florida governor:
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SageBrush
REJECT Fascism
No.
Cloth masks are not an effective way to not get infected but they are effective in reducing the effective R value --- and that is the all important detail.
See my (and @SMAlset ) earlier posts of DIY masks using polypropelene 'blue shop towels' which have effective 0.3 micron filtration if you want a solution to avoid getting infected by your neighbors too dumb and uncaring to mask themselves.
OK, another visual from r/dataisbeautiful The State of COVID-19 in US by State
warning: The colors on the map are continuous interpolations of a single-hue color. However, the colors of the legend (bars) is discrete schemes of the same color. So bounding the bars with the numbers wouldn't make much sense (the start and end of the bar has exactly same color). But one can use a continuous interpolation for the legend and put the numbers as you described.
So reading it might be counter intuitive if you expect the color of the state fill and the bar section to match exactly.
Little tidbit to add on testing for Michigan. Looks like we have the darkest shading at 54% positive testing.
My wife's doctor, family ER doc friend, NIH friend have all been on a private text thread for the last 13 days regarding her condition.
I would share, but the redaction would make it a pain. We are also good friends. So there is no egos within the professional text...
All three considered her conditions reported three times a day by me including temperature, respirations per minute, heart rate, BP, general description of feeling. There was no hesitation by all 3 that she would test positive, but absent the breathing issue of severe distress she should/could not be admitted. Which also meant she would not be tested.
Criteria for testing in Michigan. Not in order, but the things she was read from testing center which is also her medical system.
1. Over 65
2. Your chart history. Nothing underlying. They could see all of it. (University system also doing testing)
3. Family member or yourself are not a medical first responder defined for this event.
4. Severe respiratory distress while under care in either office, or a respiratory clinic.
I am not saying she needed a test. We are treating her as positive, and our entire family is in lockdown. Will remain until we can get testing. That way we don't put people at risk. Not a feel better, but a test.
How can we ever get back to work if I never get tested? I had a crappy two nights a bit of sweats, and a cough. Yet it is gone, and I could potentially infect hundreds if I did not self quarantine. I have always been that way. My wife gets a flu or cough. I get it a bit later with a 1/10th of symptoms.
Sorry for the TLDR, but I would say the criteria to get tested in Michigan makes it so you pretty much have to be pretty bad off. For the experts. How is this going to work long term? Don't you have to have some larger testing pool to see how things are going?
@ohmman want to see some baking pics. Some flour magic I don't have.
Edit add: She is doing just fine, but worried about what she doesn't know.
Also university system said 3 layers of review go through each set of notes. So the person she spoke to would not be the only person deciding on whether to test. The news headlines of people passing denied testing is starting here.
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Please be serious. That is crucial, to be sure, but it is NOT all. Widespread testing, exhaustive clustering (tracking of case contacts, concentration on early diagnosis and treatment are all needed. Were masks and personal hygiene practiced carefully and universally we'd have much less need for those others things.No single thing can resolve all the issues.
That said, in my household and extended family we all use masks and have plenty in reserve. Our supply are old, but perfectly functional. Some used to call us paranoid.
SageBrush
REJECT Fascism
To clarify, I was not saying that masks are the only ingredient, I was saying they are the only missing key ingredient.
bkp_duke
Well-Known Member
I don't know for certain, but this could explain why we are seeing such bad outcomes in some patients and not others. Further research required:
COVID-19 patients often infected with other respiratory viruses, preliminary study reports
Higher co-infection rates in COVID19
When I was practicing in pediatrics, often the sickest kids in the ICU were those with more than one respiratory virus at a time.
I would love to see more testing, especially of the hospitalized patients, for additional viruses.
COVID-19 patients often infected with other respiratory viruses, preliminary study reports
Higher co-infection rates in COVID19
When I was practicing in pediatrics, often the sickest kids in the ICU were those with more than one respiratory virus at a time.
I would love to see more testing, especially of the hospitalized patients, for additional viruses.
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To get back to work, we probably will have to test anyone with even the remote suspected chance of symptoms. Then aggressive backtracing before you start seeing too many cases.
Do they set up specialized places in each town for testing plus home testing kits? We may need to build small testing facilities for a long term national pandemic response. Rapidly Deployable Mobile Testing Trailers? As I don't see how you would want these patients going to primary care doctors to get checked due to ease of transmission with other people. We may have to assume a different strain of this virus could come back even after we get a vaccine (even if it is not likely).
Just some thoughts off the top of my head (from someone with no expertise in these fields).
(Edit: Assuming aggressive use of masks by general public for at least a year. Dependent on vaccine progress.)
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Dr. J
Active Member
Quotes from the article:
South Dakota Governor Kristi Noem, for instance, told reporters earlier this week that “the people themselves are primarily responsible for their safety”
Governor Kim Reynolds, of Iowa, rejected Fauci’s recent calls to implement a nationwide stay at home order: “I would say that maybe he doesn't have all the information," she told reporters this week. “I can’t lock the state down… people also have to be responsible for themselves,” she said.
The ideology of every person being responsible for himself/herself (which is what they are saying despite the use of plural pronouns) is ineffective against a contagion. Sure, individuals need to behave responsibly, but the only way transmission slows or stops is with an intelligent group effort and coordinated action. This is likely to hurt the US relative to other countries. It's a great, unfortunate experiment from which we will probably learn the wrong lessons.
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