Coronavirus

[AlanSubie4Life]

I'm talking specifically about places like NYC and other cities where large portions of the population have contracted it and the excess deaths (compared to normal) are very large.

Go back and look at the original post.

Fair enough. I thought we were talking about explaining Wisconsin (and I think it's understandable why I would think that)? They're probably at about 2% infected overall, so I'd expect no significant impact on mortality going forward. Even if a large portion of the deaths are from long term care facilities, that doesn't necessarily mean a large portion of the long term care facilities have been affected (I would certainly hope not!).

In NYC we will certainly see a more noticeable effect, but still not sure how readily it will be seen, given the large number of people who died who were going to live a lot longer.

 

[golfcart]

Fair enough. I thought we were talking about explaining Wisconsin (and I think it's understandable why I would think that)? .

I guess the words "I can't speak to Wisconsin specifically" were not clear enough... I apologize.

I'm just pulling your chain, I get it.

 

[madodel]

Assisted living facilities are different from nursing homes. Anecdotally my grandparents lived in an assisted living facility for about 10 years and the nursing home on the ground floor of the same building for about a year.

Maybe different where you are, but here in Pennsylvania the same lockdown for nursing homes was applied to assisted living facilities.

 

[Daniel in SD]

Maybe different where you are, but here in Pennsylvania the same lockdown for nursing homes was applied to assisted living facilities.

Of course, I was merely pointing out that the high death figures cited were for nursing homes and assisted living facilities (where ones life expectancy is much longer).

went back and uncovered it. And the search feature is great. I guess I should have caveated my "would be a bit surprised" statement earlier. I'm not surprised this came from @SageBrush - I got the same treatment as you for "playing doctor." It's actually impossible for @SageBrush to follow along in this thread now, since he has most people on ignore. It's kind of comical.

I would hardly call that evidence of groupthink. Also, that was in response to a post from another doctor though, not @N5329K. It seems like people want a thread where no one ever disagrees with them whereas I like arguing with people.
I am happy I didn't make any predictions about the stock market on this thread.

 

[AlanSubie4Life]

Also, that was in response to a post from another doctor though, not @N5329K.

It was a response to this post, although somehow it just reads as "caution:" Post

There's a bunch of back and forth before this, but certainly it happened. I haven't read the details to figure out what it was about, but seems like as usual there is some uncertainty about presymptomatic vs. asymptomatic. Both forms of transmission do exist, of course.

Here's another relevant post.

Anyway, we don't need to re-litigate it. I think at this point we can agree that there's definitely transmission that occurs without symptoms, and anyone who thought otherwise was wrong.

am happy I didn't make any predictions about the stock market on this thread

Stonks.

 

[Daniel in SD]

It was a response to this post, although somehow it just reads as "caution:" Post

Oops clicked on the wrong quote.
My objection is really about the accusation of groupthink. If you look back there is talk of asymptomatic transmission on this thread in January. I don't disagree that the tone of some users is a little bit over the top.

 

[bkp_duke]

Smaller RCT, but adding the the body of evidence:

https://www.nejm.org/doi/full/10.1056/NEJMoa2016638?query=TOC

"After high-risk or moderate-risk exposure to Covid-19, hydroxychloroquine did not prevent illness compatible with Covid-19 or confirmed infection when used as postexposure prophylaxis within 4 days after exposure."


And no, they didn't evaluate Zinc or concomitant antibiotic usage.

 

[JRP3]

And no, they didn't evaluate Zinc or concomitant antibiotic usage.

Aha!

 

[SVMike]

The main thing I took away from it is that it is very common to live 5-30 years with co-morbidities.

I think that Norman Bates lived with his mother for at least that long.
Does that count?

 

[Norbert]

Although we did have discussions about the amount of asymptomatic and pre-symptomatic cases, the existence and effect as such was agreed upon. They were also part of our understanding of the South Korea situation.

I think we did respond to some claims that they would be a larger multiple of the symptomatic cases by rejecting these claims as unfounded. Or something like that. However compared to numbers we hear about from recent serological studies (around 30%-40%), if anything we overestimated them (for example as 50%-75%), although the CDC estimate of 25% (or so) was also mentioned.

EDIT: Not to be confused with the large amount of untested cases, which was also acknowledged on this thread. I remember discussing those with Alan and Daniel very early compared to much of the discussion in the media.

 

[SVMike]

There's probably less stress overall with people receiving large unemployment benefits, which will result in fewer cardiovascular disease deaths (650k per year!!!). If you don't have to work and get outside the house, I imagine the risk of a cardiac event goes down a fair amount. Also less McDonald's/fast food/unhealthy meals, probably (I believe, though I am not sure, that recent meals have an impact on likelihood of a cardiac event - not a doctor, so someone would have to confirm that).
.

I think the idea of a pandemic can be overwhelming for some even if they are getting paid to stay at home.
Here is one data point

Suicides on the rise amid stay-at-home order, Bay Area medical professionals say

WALNUT CREEK, Calif. (KGO) -- Doctors at John Muir Medical Center in Walnut Creek say they have seen more deaths by suicide during this quarantine period than deaths from the COVID-19 virus.

 

[Norbert]

I think the idea of a pandemic can be overwhelming for some even if they are getting paid to stay at home.
Here is one data point

Suicides on the rise amid stay-at-home order, Bay Area medical professionals say

WALNUT CREEK, Calif. (KGO) -- Doctors at John Muir Medical Center in Walnut Creek say they have seen more deaths by suicide during this quarantine period than deaths from the COVID-19 virus.

Perhaps not unrelated to the sale of firearms going up a lot (at least at the outset of the outbreak).

Note that in SF (with early mitigation), the number of Covid-19 deaths is far below even the normal suicide rate, which in turn is lower than the national average.

 

[madodel]

Although we did have discussions about the amount of asymptomatic and pre-symptomatic cases, the existence and effect as such was agreed upon. They were also part of our understanding of the South Korea situation.

I think we did respond to some claims that they would be a larger multiple of the symptomatic cases by rejecting these claims as unfounded. Or something like that. However compared to numbers we hear about from recent serological studies (around 30%-40%), if anything we overestimated them (for example as 50%-75%), although the CDC estimate of 25% (or so) was also mentioned.

EDIT: Not to be confused with the large amount of untested cases, which was also acknowledged on this thread. I remember discussing those with Alan and Daniel very early compared to much of the discussion in the media.

Wasn't it the Governor of Georgia who was amazed that people could show no symptoms and be contagious? That was in April, by which time pretty much everyone who wasn't in complete denial like said Governor knew that people could have COVID-19 and have few or no symptoms.

 

[Dr. J]

That was in April, by which time pretty much everyone who wasn't in complete denial like said Governor knew that people could have COVID-19 and have few or no symptoms.

First I've heard of it.

 

[AlanSubie4Life]

I think the idea of a pandemic can be overwhelming for some even if they are getting paid to stay at home.
Here is one data point

Suicides on the rise amid stay-at-home order, Bay Area medical professionals say

WALNUT CREEK, Calif. (KGO) -- Doctors at John Muir Medical Center in Walnut Creek say they have seen more deaths by suicide during this quarantine period than deaths from the COVID-19 virus.

Oh for sure, life can be less stressful for a lot of people and possibly result in fewer cardiac events, while also being more stressful for a lot of other people, and thus result in more suicides. Definitely not contradictory. For sure, the social distancing is super hard for a lot of people! Since there are more than 10 times as many cardiac deaths as compared to suicides, if there is a fairly even distribution of both positive and negative stress effects, that would result in a bias towards fewer deaths. It sounds like they're mostly seeing young people die by suicide, so that is a distinct group.

And it certainly wouldn't be surprising for there to be more suicides than COVID deaths in areas that are less seriously impacted by COVID - the nonuniformity of impacts mean quite low per capita COVID death rates in some locations.

I think it's important for providers to put every effort into continuing to provide resources & services for people, and maybe even do in-person meetings. Just have to make sure mitigation measures are robust. More testing would be good.

 

[Norbert]

Wasn't it the Governor of Georgia who was amazed that people could show no symptoms and be contagious? That was in April, by which time pretty much everyone who wasn't in complete denial like said Governor knew that people could have COVID-19 and have few or no symptoms.

On this thread, asymptomatic transmission was discussed before I joined it. Early example from January 31:

The few German cases suggest asymptomatic transimission is 1 to 3.

There seem to be a large variability on how transmissible and how deadly it can be. And south korea seems to be the country to observe as its H2H transmission seems more mature.
[...]

 

[byeLT4]

Oooh my county blew up today. After a period of averaging about 2-3 a week, today alone we had 6 new cases. No info on whether they were related or anything...... Weird conflicting data on tests. County says its over 2k but worldometers shows only 1/10th of that @249. I know we have been tight on tests but I don't think we have done that few.....

 

[eevee-fan]

"Pneumonia Deaths" & "Flu Deaths" Jump Enormously In USA | CleanTechnica


... because they say it's "just the flu"

 

[TheTalkingMule]

"Pneumonia Deaths" & "Flu Deaths" Jump Enormously In USA | CleanTechnica


... because they say it's "just the flu"

These are the cases I was referring to. Certain states are padding their covid stats, others are clearly pushing them to pneumonia. This country is a mess.

Philadelphia goes to "code yellow" Friday, can we just light this thread on fire and go on vacation?

 

[dhanson865]

Brazil looks to pass Italy tomorrow (Thursday that is). With only UK and the US ahead of them then.