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Sammy, given the level of scrutiny in place in the US, anyone who dies under any circumstances is likely being tested and counted. That is true whether they die in a hospital or at home or in a hotel. Coroners and other officials strive to assign an accurate cause of death in the US. I don't think that's changed. In fact, it's probably more likely given the spotlight on the coronavirus.

As for healthcare, Cap Mandrake has already confirmed that anybody in the US who presents at a hospital for treatment will receive it. I think Cap used the phrase "this is indisputably true." Most Americans know this. Not all of them will seek medical services, for any number of reasons, but if they do they'll receive it.

As far as the coronavirus is concerned the US offers/provides universal healthcare.

There have been reports of people calling 911 (emergency services) when they run out of toilet paper. Most people who are really sick will go to the emergency room or, if unable to get there, will call 911.

The level of crisis in NYC and immediate vicinity is without question overwhelming all kinds of emergency services right now. So how they manage things, from intakes to disposal of bodies to testing for cause of mortality, may be set aside temporarily until things are under control. And they're slowly improving already. But when all is said an done, science and medicine will do their best to present accurate totals.

ORIGINAL: Canoerebel

Sammy, given the level of scrutiny in place in the US, anyone who dies under any circumstances is likely being tested and counted. That is true whether they die in a hospital or at home or in a hotel. Coroners and other officials strive to assign an accurate cause of death in the US. I don't think that's changed. In fact, it's probably more likely given the spotlight on the coronavirus.

As for healthcare, Cap Mandrake has already confirmed that anybody in the US who presents at a hospital for treatment will receive it. I think Cap used the phrase "this is indisputably true." Most Americans know this. Not all of them will seek medical services, for any number of reasons, but if they do they'll receive it.

As far as the coronavirus is concerned the US offers/provides universal healthcare.

To what extent are people getting tested post-mortem though? Genuine question - I don't know the answer in the US or the UK.

Re. healthcare - this is a horse that has been whipped into exhaustion already and I don't want to derail things again. All I will say is that the issue is not whether people will get treatment if they go to hospital without insurance (on that question I agree with you, both from my own understanding and more importantly from what you and Cpt Mandrake etc are feeding back) but whether they access healthcare in the first place. Put bluntly - if they don't go to hospital then they don't get refused.

Right, but most people do go. They go if they have a broken toe or a high fever or gunshot wound or a laceration. I see no reason the great majority wouldn't go if having serious coronavirus symptoms. Cap Mandrake and others are more likely to know for certain, but that's my experience here in Georgia and vicinity and anecdotally around the country.

Regarding post-mortem testing there has been one case that I know of. More importantly, as noted above coroners and others have a duty to assign an accurate cause of death. If in NYC emergency conditions prevail so that testing can't be done yet it will be done later - from the bodies or preserved specimens, I'd guess. Most places are not that overwhelmed, however, so likely have the capacity to handle things as they occur. It wouldn't be surprising if they're temporarily having to let standards slide in NYC but it would be a surprise in most other places - North Carolina, for instance.

I knew someone who had good insurance but did not go until it was too late. The cancer spread too much, even though he was having problems.

There you go. Some folks just aren't going to go, no matter what.

Thanks, Nomad. I read the article. Before reading it I wasn't really familiar with the Swedish approach. The article writer is an unabashed fan, so I don't know if there are contrary views he mightn't have explored in detail. But the approach makes sense (especially the "protect the most vulnerable but don't lock down those who aren't" approach. That makes sense, though I think it would take both strong leadership and a community (very much including the press) to support it - the "Hey, this isn't perfect but it's probably the best way" approach.

Interestingly, I think JohnDillworth touched on this kind of approach in his comments in mid-week. No easy answer and herd immunity may turn out to be the only real way to handle this long-term (though IMO flattening the curve was a sensible approach to buy time to come up with counters and countermeasures).

ORIGINAL: Nomad

An interesting article, I have no idea how correct it is, I have no medical training.

https://timesofindia.indiatimes.com/blo ... -approach/

ORIGINAL: Canoerebel

The level of crisis in NYC and immediate vicinity is without question overwhelming all kinds of emergency services right now. So how they manage things, from intakes to disposal of bodies to testing for cause of mortality, may be set aside temporarily until things are under control. And they're slowly improving already. But when all is said an done, science and medicine will do their best to present accurate totals.

Agreed. Hopefully things like the results they've had from Iceland https://www.dailymail.co.uk/news/articl ... id-19.html will extrapolate internationally. If that is the case then we may already have got close to 'herd immunity' without realising it.

My suspicion would be that the bigger the geographical and population spread the less informative those Icelandic numbers are. I think that the US may have a different problem to deal with compared to Europe in that by and large you have dense population centres separated by large expanses of space comparative to Europe. Until we have more data about how many people have actually been infected I would be working off the assumption that without significant ongoing restrictions each of your other top 10 cities could end up like NY in a second or third wave of the virus before we get a vaccine.

That's almost certainly not going to be the case, Sammy.

The pandemic, as we understand it today, reached many of our biggest cities at the same time or even before it was reported in NYC. Many other cities - LA, San Francisco, Chicago, Seattle and even New Orleans - have had very different results. For whatever reason, the virus hasn't affected the populations outside NYC in the same way.

And here's the kicker. They aren't projected to. The Univ. of Washington models, which have performed so consistently well for nearly two weeks, project that the pandemic is past peak in many states and nearing peak in many others. No state is projected to have anything close to what NYC and immediate vicinity has experienced.

Illinois (Chicago), for example, is projected to have a total of 777 deaths. Statistically speaking, that's next to nothing. Texas, with Dallas, Houston and San Antonio, is projected to have 2,350 deaths. California, with 40 million people, has had 674 deaths and is projected to end up with 1616 (the margin of error is 1k to 3.5k).

Folks are focused on NYC (understandably - it's the nerve center of the US and where the media is concentrated). The media gives, and people receive, a misperception about what's going on elsewhere, where the actual bulk of the population resides. NYC is density beyond measure but most of the country is doing pretty darned well.

ORIGINAL: Canoerebel

Right, but most people do go. They go if they have a broken toe or a high fever or gunshot wound or a laceration. I see no reason the great majority wouldn't go if having serious coronavirus symptoms. Cap Mandrake and others are more likely to know for certain, but that's my experience here in Georgia and vicinity and anecdotally around the country.

That's the thing though - I'd suggest that your local experiences and the wider experiences via anecdote (given that my understanding is that you avoid the media I assume that this anecdotal evidence comes from your own acquaintances elsewhere in the US) do not equate to the experiences of (leaving race aside for the time being) impoverished inner city communities in New York - or indeed in the other big US cities that are potentially at risk of big outbreaks moving forward.

Read my previous post at the end of the last page. Projections don't call for big outbreaks elsewhere, moving forward.

I have a grave mistrust of the media, though I'm plugged in a lot due to my business. I have my finger on the pulse of Georgia, the 8th largest state in the US, due to my business and my interests. To an extent that bleeds over to adjacent regions, which are geographically near and where I have family and have lived. And I have many professional ties to the medical community, due to my legal background and friendships. I live in the medical center of northwest Georgia. That's not to say I'm an expert; but rather that I'm probably considerably more knowledgeable that the average citizen. But Cap Mandrake and others can provide far more insight than I can.

Reading the carefully articulated thoughts contributed by folks here gives a distinct impression that some are relying on the media for a sense of what's going on in the US. That's understandable but it's leading to grave misperceptions. The raw data and the projections by apparently reputable organizations seem to paint a much different picture. As noted a few days back, I'm thankful this forum worked to create a picture of what's going on. We got it righter sooner than the media. Sometimes dramatically so.

ORIGINAL: Cap Mandrake

The "Theory of Everything" will have to explain why I put the lint trap in backwards EVERY time when I should get it right half the time. And what happens to the missing socks? I am suspicious there is an undiscovered particle called the "anti-sock"

In alternate universe somewhere far, far away... you are married to Frau Blucher.

This may be an unpopular viewpoint, but I think states, cities and counties around the U.S. (and probably other countries) seriously need to look at easing business closures and travel restrictions. I've been in touch with a number of friends and relatives in the U.S. and the governments of certain jurisdictions are doing some very arbitrary and counterproductive things. The leaders look like petty tyrants.

The question should be: "Is the local medical establishment handling new cases, is there a surplus of ICU capacity?" If the answer is "yes," then time to ease off. Civil disobedience is going to get more and more prevalent and respect for government will likewise continue to decline.

More good news in Korea: New cases at 25 yesterday. People are very much out and about. People are no longer working from home. Schools are still closed, but as I mentioned private institutes are back in action. My daughter started a ballet class on Saturday. I took the family to two great restaurants over the weekend. There is no second wave.

Cheers,
CB

Capt. Beefheart, that's probably where we're headed. That approach was discussed here, at length, two days ago. Half the country will be in favor, half will oppose. So it'll probably come down to leadership.

ORIGINAL: Canoerebel

Read my previous post at the end of the last page. Projections don't call for big outbreaks elsewhere, moving forward.

I have a grave mistrust of the media, though I'm plugged in a lot due to my business. I have my finger on the pulse of Georgia, the 8th largest state in the US, due to my business and my interests. To an extent that bleeds over to adjacent regions, which are geographically near and where I have family and have lived. And I have many professional ties to the medical community, due to my legal background and friendships. I live in the medical center of northwest Georgia. That's not to say I'm an expert; but rather that I'm probably considerably more knowledgeable that the average citizen. But Cap Mandrake and others can provide far more insight than I can.

I think the important thing to keep in mind with the Washington projections is that (as far as I understand) they are single curve projections running to August based on the imposition of extreme lockdown measures.

What they don't predict in any way is what happens once those lockdown measures are lifted.

Right. That's where we have to use our best judgment, as discussed at length here, two days ago.

Thus far, the U. Wash. projections have been very good. When they've missed it's nearly always been by being too pessimistic, resulting in several recalculations that reduced mortality projections.

Most of the earliest projections by other sources that got it so very wrong assumed social distancing and countermeasures. The U. Wash. site has been consistently more accurate and relied upon widely, as best I can tell, including Dr. Fauci and the media.

ORIGINAL: Canoerebel

Right. That's where we have to use our best judgment, as discussed at length here, two days ago.

Thus far, the U. Wash. projections have been very good. When they've missed it's nearly always been by being too pessimistic, resulting in regular recalculations.

Most of the earliest projections by other sources that got it so very wrong assumed social distancing and countermeasures. The U. Washington site has been consistently more accurate and relied upon nearly universally, as best I can tell, including Dr. Fauci and the media.

I guess the thing with any projection of this nature is where you put the end point.

My endpoint is January 2022. Once we're there I'll look back and see how things have stacked up. Where do you see your own endpoint being?

I'm not sure what you mean, but hindsight is always better than foresight of course.

If you mean, "What do we do next?" That was discussed in here at length a few days back, with lots of different viewpoints. It was an interesting discussion. Capt. Beefheart's post just above kind of encapsulizes the train of thought that you have to move forward at some point. As I posted in here about a week ago, to me that comes when mortality drops to about 0 per day and the medical communities have the capacity to handle flair ups. Ease restrictions, protect the most vulnerable, and move forward.