Coronavirus

[jerry33]

I remember when Northwest Airlines was the first to offer smoke-free flights. Other airlines figured Northwest would lose too many passengers and have to add the smoking sections back in. As it turned out, passengers who preferred safe and smoke-free outnumbered the smokers and Northwest's loads grew. Before long, virtually all airlines in the U.S. dropped their smoking sections in order to complete.

If you were given a choice of an airline with an "all passengers and flight attendants wear masks" rule and a traditional airline for a trip this week, which one would you choose?

I recall when the flight attendant announced that Canadian Pacific Airlines was now non-smoking. It sounded as if every passenger cheered.

 

[jerry33]

Yeah, CNN is unfortunately a complete and total joke. Is like flip side of FOX. Both are pretty useless. I wish I could say they were laughable but significant portions of the population have tied themselves to the daily idiocies they spout.

It's what you get when the media is controlled by six corporations, and news is judged by the amount of advertising dollars it generates.

 

[jerry33]

If it works in Sweden, it can work here, right?

Well, if we could get it to work in Washington (DC), I'd be all for it.

 

[Ocelot]

They are uncommon and just the use of one has VERY HIGH rates of complication.

I'm sure some facilities will use them, because:
1) they are available to them
2) they can drive revenue for the hospital in a time when elective procedures don't exist

But honestly, as a physician, I would have to think twice about being put on one of these. I might just tell them to pull the plug and let me die first.

It is hard to drive home what exactly is ECMO. In theory , oh lets bypass the lungs, let patient heal, turn off machine, done. I am no expert in ECMO, but have seen patients on them, and well would would have to think way more than twice about being put on one.

 

[dfwatt]

It's a moot point. Even the highest level trauma centers and tertiary care facilities only have 1-4 of these machines. And they require a specially trained team with someone being IN ROOM 24/7 to take care of the machines and watch the patient. One week on one of these is like 150-200k in hospital charges

At our Medical Center where I was for 25 years it was forty thousand bucks a day when I left practice there.

 

[bkp_duke]

At our Medical Center where I was for 25 years it was forty thousand bucks a day when I left practice there.

I was just quoting google numbers, since adult pricing could be different. IIRC at the children's hospital where I worked the ICU bed + staff + ECMO + other related items was about 400,000 per week. We all cringed when we heard someone was going on ECMO that we were caring for, because we knew the odds of them coming off it and going home were not good.

 

[NikolaACDC]

Your link says

"...the prime offender was Camel, which cited an incredible study that found “more doctors smoke Camels than any other cigarette.” Turns out, this “independent research” was the work of the William Esty Co., R.J. Reynolds' ad agency. Participating doctors were paid, too—with cartons of Camels."

 

[dfwatt]

I was just quoting google numbers, since adult pricing could be different. IIRC at the children's hospital where I worked the ICU bed + staff + ECMO + other related items was about 400,000 per week. We all cringed when we heard someone was going on ECMO that we were caring for, because we knew the odds of them coming off it and going home were not good.

Sure I wasn't trying to contradict what you were saying I'm just saying it's a very expensive . . . . and dangerous and occasionally life-saving machine. Even for folks who don't need this level of invasive hi tech intervention have to wonder how many people are going to be virtually bankrupted by their stay in the hospital with covid-19. Especially those who've lost their insurance. It's really a scary intersection to contemplate.

 

[AlanSubie4Life]

Some new additions to the previously linked estimates of effective reproductive number nationwide (and worldwide). Obviously there is a lot of uncertainty on their estimates (included in the figures, but the map below loses that subtlety).

Covid-19: National and Subnational estimates for the United States of America

Looks like we're out of the woods, eh?

Georgia looks "golden" (not to be confused with orange in this context...). Guess that's the data the governor saw that caused him to want to open 'er up. Gotta get back in the growth club.

 

[dfwatt]

Some new additions to the previously linked estimates of effective reproductive number nationwide (and worldwide). Obviously there is a lot of uncertainty on their estimates (included in the figures, but the map below loses that subtlety).

Covid-19: National and Subnational estimates for the United States of America

Looks like we're out of the woods, eh?

Georgia looks golden. Guess that's the data the governor saw that caused him to want to open 'er up. Gotta get back in the growth club.

View attachment 536810

Georgia is blue South Carolina above it is golden

 

[AlanSubie4Life]

Georgia is blue South Carolina above it is golden

Ha. I assume you were kidding...but to be clear, I mean "golden" in the sense that their effective R is/was less than 1, so Georgia is "blue" and has a reduction in case growth, and hence is "golden" to open. (Maybe...I guess it's all going to be a great experiment to find out how this goes. Looks like we should have results in a couple weeks in time for phased reopening of California. Someone has to go first and be the guinea pig I guess.)

 

[FoverM]

Actually there is error in the data presentation.
New York County= Manhattan (slight discrepancy being a tiny park of The Bronx)
Kings County= Brooklyn
Queens County=Queens
Richmond County=Staten Island
All four of those counties would be on the list.
FWIW, Boroughs of NYC roughly equate to Counties but there are elected officials for all three entities.
One can look this up on the NYS or NYC website.

It looks like an error but it isn't. JHU piles the cases and deaths of those counties (FIPS: 36005, 36047, 36081, and 36085) into New York County (FIPS: 36061). I don't know why. More strange is that they include those counties in their CSV files with zeroes for everything.

Anyway, I account for that in my code when it comes to calculating county populations, rates, population densities, etc.

 

[AlanSubie4Life]

Oh no! The pug was licking the plates! Poor pug.

“(The dog) licks all of our dinner plates and sleeps in my mom’s bed, and we’re the ones who put our faces into his face. So, it makes sense that he got (coronavirus),” said McLean's son, Ben.

They always say, dog mouths are cleaner than human mouths. Proves true once again. He's apparently no fan of the nasopharyngeal swab either.

Chapel Hill pug tests positive for virus that causes COVID-19; first known case in a dog in the US :: WRAL.com

 

[dfwatt]

Ha. I assume you were kidding...but to be clear, I mean "golden" in the sense that their effective R is/was less than 1, so Georgia is "blue" and has a reduction in case growth, and hence is "golden" to open. (Maybe...I guess it's all going to be a great experiment to find out how this goes. Looks like we should have results in a couple weeks in time for phased reopening of California. Someone has to go first and be the guinea pig I guess.)

Gotcha now. I assumed you were talking literally about Golden color rather than opportunity golden! But I suspect I was not the only person who didn't quite track what you were trying to say. Or perhaps I was in which case I will obviously have to use a quick shot of Moron Spray.

 

[hcdavis3]

Gotcha now. I assumed you were talking literally about Golden color rather than opportunity golden! But I suspect I was not the only person who didn't quite track what you were trying to say. Or perhaps I was in which case I will obviously have to use a quick shot of Moron Spray.

Thanks Doug. My local Walgreens is out of Clorox Chewables. In the interim where can I get moron spray?

 

[winfield100]

Not even close.
The general relationship of mortality with length of invasive care reflects nosocomial complications.

Foreign bodies get infected
Blood run through tubes clots

@SageBrush
Back in the mid 1970’s we had a patient come through the lab that was on home dialysis, his dialysis technician “forgot” something (the concentrate perhaps) causing the RBC’s to “pop” as they went through.
Dialysis was discontinued rapidly before he expired, raced to the VA, I vaguely recall he may have gotten some packed RBC’s, but when we spun down a few tubes of blood, there wasn’t a lot at the bottoms of the tubes and it was very pink (I’m color weak).
HCT maybe 20 or less
Plasma doesn’t oxygenate very well by itself.
You do remember outlier incidents
There were, however, “no clots”

 

[AZRI11]

If it works in Sweden, it can work here, right?

Sweden's deaths per million are the same as Rhode Island. It'll be interesting to see if it keeps following each other.

 

[Daniel in SD]

Sweden's deaths per million are the same as Rhode Island. It'll be interesting to see if it keeps following each other.

Seems like Minnesota would be a better comparison, much less dense and way more people of Swedish descent.

 

[Doggydogworld]

Actually there is error in the data presentation.
New York County= Manhattan (slight discrepancy being a tiny park of The Bronx)
Kings County= Brooklyn
Queens County=Queens
Richmond County=Staten Island
All four of those counties would be on the list.
FWIW, Boroughs of NYC roughly equate to Counties but there are elected officials for all three entities.
One can look this up on the NYS or NYC website.

Correct, but many sites combine the 5 NYC counties into 1 for reporting purposes. 8.4 million population is all 5 counties combined.

Note Trevor thinks we're generating about 300k-600k new cases daily in the United States. So presumably that means we need at least that many tests per day, for starters.... Ideally something like 1-2 million per day.

600k sounds way too high. Even 300k sounds a little high. NY is one of the most under-tested states at 10:1. Most states have much lower positivity ratios. Or consider tests per death - NY and NJ are under 40 while large population states CA and FL are near 300 and TX is over 400 (and Utah wins again at >2000). Anyway, I still say the ratio is ~5:1 outside of the hotspots.

I'm fascinated by Sweden. Here's what the chief epidemiologist recently said:

It sounds like they're looking at the change in new cases and fitting it to a model? I don't think that's going work very well, it would be very sensitive to the changing R0 over time. You might think that the rate of spread is slowing due to herd immunity when it could just be changing because people are changing their behavior. I'm a little bit skeptical that the staff of a hospital in Stockholm is a representative sample to say the least. I can't find any information on that study.
Coronavirus: Sweden's Anders Tegnell stands by unorthodox strategy

It's hard to see trends in Sweden because their daily numbers bounce around so much, especially on weekends. But trailing 7 day numbers are encouraging, especially deaths which are 590 the past 7 days vs. 732 the 7 days before that.

That said, I don't believe they are anywhere near herd immunity, even in Stockholm.

People act as if Sweden did zero mitigation. But they implemented work from home, outlawed gatherings of 50+, closed bars and high school and college campuses. Their numbers are worse than Norway and Finland, but still manageable. When all is said and done their approach may prove to be superior.

 

[AZRI11]

Seems like Minnesota would be a better comparison, much less dense and way more people of Swedish descent.

Ya. More than 80% of the deaths from covid-19 in R.I. are from nursing home residents. Very old population in my state, with nursing homes packed to the hilt.