Coronavirus

[ggr]

House passes the CARES act, sends to Trump for signing:
House passes historic $2 trillion stimulus despite objections from GOP lawmaker - CNNPolitics

 

[rallybob]

A couple of hundred posts ago, I mentioned that my brother-in-law is a nurse in Seattle. It happens that he works at the VA hospital.

Almost two weeks ago he had mild, generic flu symptoms. His tests for influenza and COVID both came back negative (although he was told there was a 5% rate of false negatives). He was asked to return to work, since the tests were negative and the need for workers was dire.

A few days ago, his symptoms (including fever) got MUCH worse. His wife (who had similar symptoms, but much milder) wasn't sure he was going to make it through yesterday. But he seemed to turn a corner last night, and was able to speak to my wife today. He noted that it felt worse than anything he had experienced in his life.

He didn't get a second test. He's worked with patients with COVID, and his symptoms seemed to match exactly...but without the test, we aren't sure. Maybe he doesn't have COVID? Regardless, he's not counted in the stats.

I agree with major concerns for our health care workers. I have a friend who is an ER dr., my nice is a Ped Dr. and many nurses in the family. U.S. seems to be way behind in testing. In Canada, we have tested more than the U.S. and we need to do more. Scary what the real numbers are. How many may be listed as other causes, since they were not tested before they died. Good time to be on the space station. So many people still out not heeding the call. I have cabin fever but still healthy. Fear what the world will look like when the smoke clears. Trump wants to put troops on the Canadian border! Is that to stop Canadians from sneaking across to get cheap milk or Americans from sneaking into Canada to get Canadian beer? Is this an issue? So, do your best to stay healthy and keep other the same. We aren't doing too bad as this is the first pandemic in 100 years. Let's hope the health care folks can keep us healthier than they could back in 1917.

 

[Dr. J]

So, I'm wondering whether one approach would be for us to undergo a controlled exposure to a very small number of the virus particles and endure a mild illness. Might beat waiting at home more than a year for a vaccine to show up -- if one does prove safe and effective.

You first!

 

[Daniel in SD]

I have been computing the death rate of every report and it has consistently been 2.2%, NOT .2%. Your decimal is in the wrong place. In Italy right now, it has spiked to 10%. The guy in another post here said if 1/3 of the US population got the virus, 2.2 million Americans would die. That is correct, mathematically. That is why he was arguing to shelter in place NOW. We cannot allow 100,000,000 people to catch the illness.

Yes he is wrong but you are also wrong. You can't calculate fatality rate by looking at current positive test results and current number of deaths. Current number of positive tests results does not come close to counting the number of actual cases. Current deaths does not count the people who are currently infected who will die. Garbage in = garbage out. There are actual epidemiologists working to compute the true infection fatality rate. It's probably around 1% (assuming good medical care!).

 

[MXLRplus]

The US is an 'undeveloping' country 'Glad' I wasted 8 years of my life protecting their freedom in the Navy so ~half of them can slowly rot the nation I served with ignorance........ truly pathetic.

Coronavirus: Teenage boy whose death was linked to COVID-19 turned away from urgent care for not having insurance

You need to make the font larger for the boomers. TIA.

From the article - "However, Los Angeles’ County Department of Public Health later said the teen’s death was taken off a list of deaths associated with Covid-19 in the area. The department said the CDC would complete an investigation into the teen’s death."

Urgent Care is not a hospital, anymore than a bodega is a department store. This is not the first death of somebody who Urgent Care sent to a hospital, and it won't be the last. People like Urgent Care because public hospital ER's are packed with people with minor complaints. Public ER's are free and people know it, so it's overloaded. But an Urgent Care not a trauma center, nor an emergency room. Normally you are treated by PA's instead of MD's. There is no surgeon that I've heard of working at an Urgent Care.

You always seem to have a thorn in your paw. Perhaps having a mouse as a pet would be therapeutic?

 

[nwdiver]

You always seem to have a thorn in your paw.

I've grown exponentially exasperated with morons choosing to ignore problems instead of addressing and solving them.....

If someone shows up to a health clinic you don't turn them away... you isolate them (if there's an infection concern) or begin treating them until an Ambulance arrives to take them to a hospital.

 

[jerry33]

My reply is not to advocate for insurance companies. And I am sure your experience was a miserable one.

I have literally wasted years of my life on the phone arguing the medical necessity of a procedure or test for a patient . . . with a bean counter with no medical training on the other end reading from a script. I am no fan of insurance companies, nor the owners of hospital systems. I think the US healthcare system can be FAR better. But I am a HUGE skeptic of putting that kind of power in the government's hands to determine for us (i.e. socialized medicine). Just look how far the current pandemic here has been screwed up by our government (Trump aside, there are multiple layers of screw-ups, from the CDC on down).

I fully expect to get disagreed on this post, but those that have read my posts in the market politics thread know that I am an advocate for removing the small, individual, regional monopolies that plague the US healthcare system. Specifically, stop letting one or a few insurance providers sell in just a single state (i.e. allow anyone in the US to buy any policy, from any company, in any state). Additionally, hospitals, providers, etc. should be FORCED to publish their prices. Right now, there is nearly ZERO price transparency for anything in the healthcare system here. That lack of transparency lets prices run amok and increase with no counterbalance (i.e. competition). If prices were published, and hospitals had to compete for services, not only would prices decrease, but the quality of care would increase.

It's only when companies and systems are allowed to become monopolies that we have serious issues with cost and quality.

My 0.02. Feel free to disagree.

The fly in the ointment is mergers. Because mergers are relatively easy to do, what happens is that you start with some number (say thirty) and end up with three. If mergers were almost impossible to do, then we'd be much better off in a lot of areas. So using your plan works only until the mergers occur and then it's back to where we are now. At least with the government there is a slim chance of getting decent politicians in. (Okay, it's not a good chance. In my lifetime there have been three decent presidents: Eisenhower, Kennedy, and Carter. All the others have been corporations and military over people).

 

[Spry]

Most of what we've heard so far has been from medical science. The medical community has two biases: financial (keep the beds filled) and the Hippocratic Oath (treat the sick to the best of one's ability). One result is a drive to obtain as many ventilators as possible, without regard to cost. What is the cost to the economy for this heroic effort? How many folks would die if there are no ventilators. How many years of life get saved? Another element to the Hippocratic Oath is to teach the secrets of medicine to the next generation. There ain't gonna be a next generation if we don't get our arms wrapped about the economic consequences. We are going to need more input from the dismal science -- economists. In the extreme, if everyone stays home, no one will produce and deliver food, and everyone will die. We may be heading to a real war between generations when the youngsters realize how significantly their future is being jeopardized by the cost of keeping the economy closed--primarily to enable elderly virus patients to live a few more years. Us baby boomers might want to consider making a sacrifice to save our kids.

 

[MXLRplus]

I've grown exponentially exasperated with morons choosing to ignore problems instead of addressing and solving them.....

If someone shows up to a health clinic you don't turn them away... you isolate them (if there's an infection concern) or begin treating them until an Ambulance arrives to take them to a hospital.

If I was in cardiac or respiratory distress, I would not go to an Urgent Care, nor should you. It might not be open, and it will send you to a hospital anyways.

Did the 17 year old have a gunshot wound or drug overdose? Those are big killers in Lancaster. It's not Malibu.

 

[Causalien]

So, I'm wondering whether one approach would be for us to undergo a controlled exposure to a very small number of the virus particles and endure a mild illness. Might beat waiting at home more than a year for a vaccine to show up -- if one does prove safe and effective.

That seem to be the best course right now. But maybe legally unfeasible in america since the patient can probably sue for damages.

Either way you'll still need tests to determine if a person is cured or not afterward.

It is starting to look like a socialist medicare to all are able to mount a more effective response faster because there is a central command. It is also easier to allocate resources between regions.

If you look at usa's response as a military reaction to an invasion. It's like you guys are fighting a guerilla war without a Pentagon whilst each local cell is arguing abougt the P&L of firing a RPG against a tank.

 

[jerry33]

No doc I know of likes dealing with medicare now, forget if it is forced upon them.

Which basically means that if you are retired, there's really no such thing as medical care that's affordable by most.

 

[Causalien]

We have a very utopian society here - the plan is for everyone to get infected regardless of race, religion or political persuasion.

Lovely.

It's very egalitarian indeed and your PM leads by example.

 

[Daniel in SD]

Most of what we've heard so far has been from medical science. The medical community has two biases: financial (keep the beds filled) and the Hippocratic Oath (treat the sick to the best of one's ability). One result is a drive to obtain as many ventilators as possible, without regard to cost. What is the cost to the economy for this heroic effort? How many folks would die if there are no ventilators. How many years of life get saved? Another element to the Hippocratic Oath is to teach the secrets of medicine to the next generation. There ain't gonna be a next generation if we don't get our arms wrapped about the economic consequences. We are going to need more input from the dismal science -- economists. In the extreme, if everyone stays home, no one will produce and deliver food, and everyone will die. We may be heading to a real war between generations when the youngsters realize how significantly their future is being jeopardized by the cost of keeping the economy closed--primarily to enable elderly virus patients to live a few more years. Us baby boomers might want to consider making a sacrifice to save our kids.

This keeps getting brought up. People really want to believe that there is solution to this problem where a couple percent of the population dies and the economy keeps booming. The only way for this to possibly work would be to simply deny medical care to the vast majority of people who fall ill. There are many middle aged people who require hospitalization when infected with COVID-19. I'm 41 years old in good health but the hospitalization rate for my age bracket is 4.3% (https://www.medrxiv.org/content/10.1101/2020.03.09.20033357v1.full.pdf). If there are no hospitals I will not be going about life as usual, I can tell you that. There are enough people like me that the economic devastation would be enormous anyway.

 

[EVNow]

Sigh...how do you know they are not consulting with such?

Yes they are - and ignoring their advice and trashing their models.

I ran companies at the back end of my career.

I made decisions and had a varied set of inputs/expertise on my team (and although I held a number of discipline positions in my career prior to my roles as CEO/Chairman, please note that in my most Senior Roles, I relied on the expertise of others to round out my decision making).

If you were Covid Czar would you have an epidemiologist on the task force or not ? If not, why not ?

Would you have a self-driving team without an expert on NN ?

 

[bkp_duke]

The fly in the ointment is mergers. Because mergers are relatively easy to do, what happens is that you start with some number (say thirty) and end up with three. If mergers were almost impossible to do, then we'd be much better off in a lot of areas. So using your plan works only until the mergers occur and then it's back to where we are now. At least with the government there is a slim chance of getting decent politicians in. (Okay, it's not a good chance. In my lifetime there have been three decent presidents: Eisenhower, Kennedy, and Carter. All the others have been corporations and military over people).

I agree. I think, and have thought for a long time, that the Sherman Antitrust Act should be enforced. It seems we just gloss of that these days.

THAT should be the sole job of government - to ensure and enforce that competition exists and the playing field is level.

 

[gaspode]

And that's the danger of basing policy on one study. That report from the Imperial College pegged the overall mortality rate above 2%, which is around 10-20x greater than what we've seen out in the real world. Yes, 80M+ Americans are going to be infected with this coronavirus, but only about .2% or likely less will die.

The guy who published that report is a genius, and likely in the top handful of people qualified to write such a report, but he was wrong.

Staying locked down will probably help us flatten the curve, but this thing is spreading. There's not much we can do now since we decided not to test people, so that 80k(or I think more like 40k) are going to die eventually regardless of staying home. If the hospital crunch happens, it'll be worse.

"The guy who published that report is a genius, and likely in the top handful of people qualified to write such a report, but he was wrong.'
Are you a genius with any kind of qualification to spout your ill-informed plain stupid ideas?

 

[jerry33]

I once considered going 100% concierge, and not even having an office but going to my patients. I would have had no nurse, no staff, no insurance to deal with, and could have spent a lot more time with my patients. It would have also likely been cheaper for the patients. About the same time I considered this, my side business became my main job, so I never pursued it further.

I remember when doctor home visits were common. If they had an office, the only person there was the person that answered the phone and took messages. And you actually saw the doctor. The past twenty years I saw the doctor twice, and the rest of the time is was just an assistant. Now I can't see that doctor anymore because Medicare isn't taken. I have no underlying health problems, and don't even need to take any medicine. (The eye doctor is always surprised at this).

 

[Causalien]

Yet somehow many other countries are able to provide it.

I agree. I don't know where the "communist healthcare will bankrupt the country" research comes from.

Canada is paying dearly for healthcare, but we provide free drugs for homeless drug addicts on top of their food, lodging and needles. We also provide for foreigners who abuse the system and then don't pay. If you just limit it to tax payung residents, the math is actually ok.

Another argument is, S. Korea, Singapore, Taiwan and Vietnam. Much poorer than usa with medicare for all. But they can afford it. Maybe study tgeir model and see how you can improve?

 

[Daniel in SD]

A. Their explanation for cutting the number in half in the German studies is: "Early IFR rates are subject to selection bias as more severe cases are tested – generally those in the hospital settings or those with more severe symptoms. Mortality in children seems to be near zero (unlike flu) which will drive down the IFR significantly. In Swine flu, the IFR was fivefold less than the lowest estimate in the 1st ten weeks (0.1%). Therefore, to estimate the IFR, we used the estimate from Germany’s current data 22nd March (93 deaths 23129) cases); CFR 0.57% (95% CI, 0.50% to 0.65%) and halved this for the IFR of 0.29% (95% CI, 0.25% to 0.33%) based on the assumption that half the cases go undetected by testing and none of this group dies."

This makes absolutely zero sense. How are they accounting for the people who are currently in the hospital who WILL die? I can 100% guarantee that if they use this same methodology in 1 week in Germany they will be outside their CI!

I was wrong, it didn't take a week. Using their (idiotic) methodology the CFR is now 0.67% (338 deaths 50,178. cases). I'm a modern day Nostradamus

At least they have disclaimer!

 

[Lessmog]

The US is an 'undeveloping' country 'Glad' I wasted 8 years of my life protecting their freedom in the Navy so ~half of them can slowly rot the nation I served with ignorance........ truly pathetic.

Coronavirus: Teenage boy whose death was linked to COVID-19 turned away from urgent care for not having insurance

Hey, springtime for ambulance chasers!
Class action galore!
Mega big moneybags to loot in the health insurance biz!
Would be more fun than pro wrestling.

I only wish that wasn't a joke ...