OT: Corona virus

[BBfanboy]

ORIGINAL: Canoerebel

Watching data come in hour by hour is pretty brutal because usually it will take at least three days of consistency to establish a trend with any degree of confidence.

Nevertheless, the data coming from Italy remains a key to understanding progression and containment. So I'll be looking at that today (yesterday it came in about 1 p.m. eastern (USA) time).

In the meantime, new cases in Spain, France, Germany, USA and lots of other counties are on the rising (discouraging) side of the bell-shaped-curve. Knowing when Italy tops out and then begins to decline (as South Korea did about 10 days back) is meaningful info.

Very late last night there was news that Italy's daily rate of new infections came down for the first time in about three weeks. That means flattening the curve may be starting. We won't know if it is an anomaly or a trend until a few more days of this data point come in.

[Zorch]

ORIGINAL: MakeeLearn

The virus has now been reported in every state except for West Virginia, according to the CDC."

Country roads, take me home
To the place I belong
West Virginia, mountain mama
Take me home, country roads…
John Denver

[BBfanboy]

ORIGINAL: MakeeLearn

CORONA CHAOS Coronavirus LIVE news: UK airports could shut ‘within weeks’ – latest updates
https://www.thesun.co.uk/news/11176662/ ... tes-cases/
17 Mar 2020, 13:44



"LONDON's transport network could come to a near halt as Britain is gripped by the coronavirus lockdown with the English capital at the centre of the outbreak.

Britain has entered lockdown with millions of Brits staying at home and over-70s being urged to shield themselves from the outside world.

Medical advisers have warned that Britain's coronavirus death toll, currently at 55, will soar to 260,000 unless the lockdown is made stricter."

Apparently (according to someone interviewed on BBC news this morning) the UK Health Minister stated that their target is to hold deaths to 20,000 or less. That sounds high too - very pessimistic. That might mean they are planning fewer isolation measures than other countries.

[BBfanboy]

ORIGINAL: Q-Ball

ORIGINAL: Canoerebel

The USA benefitted from being a bit later in virus onset (in most places) and getting to see what was going on in Europe and how things were being handled. As a result, federal, state and local governments began taken strong action comparatively early and in some ways we've caught up to Western Europe (and perhaps surpassed some, in some ways).

That may not be the case with all states, like Washington State which saw an early outbreak back in February and dealt with far more uncertainty in what to do.

We do have that advantage, but IMO, we have squandered some of that through mis-management of testing. Truth is we have no way of knowing right now how widespread it is.

We are also behind in respirators; the US has a Strategic Reserve of Medical devices that includes respirators. We need to not only be deploying those right now, but also training additional staff in their use. In fact, we should be training additional medical help staff right now. We can't train up more nurses and doctors, but we can provide some basic training to Guardsmen and others to help in an emergency.

It's almost a certainty that as the hospitals admit more patients, there will be fewer nurses, because a) some will get sick, and b) 38% of the Nurses in this country have school-age children; some of those need to watch their kids!!!!

There is probably a large pool of recently retired nurses who could be used if they volunteer and the usual requirements for Registration are suspended for this crisis. The ones with time-expired credentials (has not worked at nursing for X weeks) could be used in the simpler but necessary tasks while the freed-up nurses do the more complex work. Funding for the virus fight should be used to pay the volunteer nurses (as an incentive for volunteers to come forward).

[Canoerebel]

I saw that too, BBfanboy.

It prompted my post (above) about really needing three days of info to reliably detect a trend. There are daily fluctuations that are alternately discouraging or encouraging.

But since Italy is 2.5 weeks into this, there is a chance its case rate will level out sooner rather than later.

I'm anxious to see today's info.

[BBfanboy]

ORIGINAL: Kull

I'll spare you the links since it's happening everywhere, but jury duty and trials are being suspended all across the country. Apparently the "right to a speedy trial" isn't such an important right after all. Which other rights aren't so important? It shouldn't matter whether you are liberal or conservative, dangerous precedents are being set.

A jury is only 12 people clustered together and surely they could be tested before a trial begins and sequestered as necessary in the community they are in?
Limits on courtroom spectators could ensure social space of at least six feet. Lawyers could be forbidden from picking their noses ...[:-]

[Canoerebel]

Information for Italy just added to the Worldometer website.

The number of deaths (the number I've been focusing on) is 345, which is essentially the same as the past two days.

Aberration of true leveling out? Darn it, we can't know for certain for days. But its certainly better than exponential growth.

[BBfanboy]

Surprising the Switzerland, Norway and Iran have such high infection rates per million population.
Too much heavy breathing from climbing mountains or just heavy testing?

[alanschu]

I'm concerned about the 10-12% jump in new cases in a day, though.

[Canoerebel]

Yeah, and why the huge concentration and outbreak of cases in the Lombardy province of Italy?

I've seen some reports attributing mortality in Italy to the comparatively large number of elderly folks. I don't think that can be the case, as surely Lombardy isn't that much different than other provinces in the country. Something else had to happen there.

In China it was the Wuhan province disproportionately affected. In South Korea, it was the are where that church was located. In the USA, that Washington State nursing home was a ground zero for awhile.

[Canoerebel]

The good news, Alanschu, is that number of new cases has been basically level for four days now! Truly, that might be the leveling out of the bell-shaped-curve.

ORIGINAL: alanschu

I'm concerned about the 10-12% jump in new cases in a day, though.

[BBfanboy]

ORIGINAL: alanschu

I'm concerned about the 10-12% jump in new cases in a day, though.

That rate is down from something like 18% a few days ago. That is the flattening of the rate curve we are monitoring. Once the country has had 14 days or more of the lockdown, the number of new cases should fall dramatically. There may be a slight delay in that where infected persons have been locked down with uninfected family members or same building neighbours who didn't follow the rules about no visiting.

[Lokasenna]

ORIGINAL: Kull

ORIGINAL: Lokasenna

Coming back to this.

This is just critical care beds of all types, yes? What's important is the number of critical care devices that can assist patients with symptoms of severe respiratory infections - so respirators/ventilators and any other devices that can assist in breathing for a patient. It's notable because what's going on in Italy is they are having to decide which patients get the ventilator when it's available and which don't.

In general, we aren't talking about just the bed, but the unit and it's support capabilities for "X" number of CCBs. I haven't been able to find any stats relative to "ventilators per CCB", but it's got to be very high, although it may vary from country to country. There are interesting stats at the American Association for the Surgery of Trauma, in particular:

Mechanical ventilation is one of the most common interventions implemented in the intensive care unit. More than half of the patients in the ICU are ventilated the first 24 hours after ICU admission; comprised of individuals who have acute respiratory failure, compromised lung function, difficulty in breathing, or failure to protect their airway.

And this:

790,257 hospitalizations involving mechanical ventilation in 2005, representing 2.7 episodes of mechanical ventilation per 1000 population; estimated national costs were 27 billion representing 12% of all hospital costs.

That means there have to be a lot and given the regulatory environment, it wouldn't surprise me if a high ratio was mandated (possibly even 1-to-1).

Here's some information on ventilators from the American Thoracic Society. What they do, how they work, and more.

I'd be surprised if it was 1:1, but you raise a good point - I forgot that ventilation was so common. Still, we need many more ventilator-capable beds.

The Imperial College study that came out yesterday is sobering: https://www.imperial.ac.uk/media/imperi ... 3-2020.pdf

20 pages. Go to page 8 for the critical care beds capacity vs. needs - it's for what they call Great Britain, I don't know why they don't say UK... but just move that tiny red line up to the US per capita CCB of 30-something and it doesn't make a whole lot of difference when you need 150 to 200 per capita. The measures we are taking now are somewhere between the blue and orange bull curves. I saw in another post that the orange bell curve is a peak of roughly 50,000 deaths per day in late May/early June. Think about that for a minute.

It estimates somewhere around 1.1M to 1.2M deaths in the US, most of them occurring before mid-summer.

Maybe they're wrong, but how likely are they to be wrong by that many orders of magnitude?

[Lokasenna]

ORIGINAL: Canoerebel

The good news, Alanschu, is that number of new cases has been basically level for four days now! Truly, that might be the leveling out of the bell-shaped-curve.

ORIGINAL: alanschu

I'm concerned about the 10-12% jump in new cases in a day, though.

I'm extremely skeptical that it is sustainable. I think it is far more likely that the perceived flattening is the result of one of two things: (1) testing is still not being done widely enough to accurately capture the actual spread; or (2) the relatively draconian (compared to normal times) measures that are already in place in the US's major population centers may actually be working, but would need to be maintained for over a year and possibly as long as 18 months for this rate of spread to be sustainable without the rate of spread exploding upwards again.

[Canoerebel]

A very high likelihood, I think. Almost as high as that Australian group that estimated 15,000,000 deaths under the best case of seven scenarios.

[Canoerebel]

I agree that testing is questionable, Loka. That's why I prefer using mortality numbers.

(Note that the discussion you commented actually wasn't about the USA. It was about Italy.)

ORIGINAL: Lokasenna

ORIGINAL: Canoerebel

The good news, Alanschu, is that number of new cases has been basically level for four days now! Truly, that might be the leveling out of the bell-shaped-curve.

ORIGINAL: alanschu

I'm concerned about the 10-12% jump in new cases in a day, though.

I'm extremely skeptical that it is sustainable. I think it is far more likely that the perceived flattening is the result of one of two things: (1) testing is still not being done widely enough to accurately capture the actual spread; or (2) the relatively draconian (compared to normal times) measures that are already in place in the US's major population centers may actually be working, but would need to be maintained for over a year and possibly as long as 18 months for this rate of spread to be sustainable without the rate of spread exploding upwards again.

[Lokasenna]

ORIGINAL: Kull

ORIGINAL: Canoerebel

Ten days after passing the peak of the bell-shaped-curve, recoveries in South Korea are rapidly increasing. That country has had 84 deaths and 1401 recoveries, which is 33 more deaths and nearly 1300 more recoveries than a week ago.

In western democracies, a lockdown is only going to work for a short period, and it's really imperative that we use that time to lay the groundwork for opening society back up along the lines of the South Korean model. People who are talking about lockdowns lasting for months and months are insane.

The healthcare system isn't the only one that has a finite capacity, the same is true of the criminal justice system. What WILL millions of young people do when they can't work or socialize for months and months? I'd rather not find out.

Young people aren't more likely to commit crimes - crime rates among people born after lead was (mostly) removed from the environment have been dropping like a watermelon and an apple from the top of the tower of Pisa.

https://www.bop.gov/about/statistics/st ... te_age.jsp

"Youth crime continues to plummet across the country, with arrests of people under age 18 falling for the 13th straight year and reaching lows not seen in at least six decades, new FBI figures show." (October 3, 2019)
https://www.sfchronicle.com/crime/artic ... 487543.php

Kids these days are more likely to play more video games than engage in risky, possibly criminal behaviors.

[Lokasenna]

ORIGINAL: Canoerebel

I agree that testing is questionable, Loka. That's why I prefer using mortality numbers.

(Note that the discussion you commented actually wasn't about the USA. It was about Italy.)

It's impossible to keep track of this War and Peace thread because not everyone quotes the context for their comment.

[Canoerebel]

Yeah, I know.

[Lokasenna]

ORIGINAL: Canoerebel

A very high likelihood, I think. Almost as high as that Australian group that estimated 15,000,000 deaths under the best case of seven scenarios.

Even "just" 200K dead by mid-summer (as opposed to 1.1-1.2M) is a whole lot of extra dead people. If 1.1-1.2M is 50K deaths per day at peak, 200K would be ~10K deaths per day at peak?

That's more than doubling the typical daily mortality rate of 7K-something.