OT: Corona virus

[BBfanboy]

ORIGINAL: Kull

I posted this graph earlier as part of a different topic, but let's look at it again in a different context.

Let's assume for a second that a country gains control of the infection growth rate, perhaps even reverses it. New cases are dropping, and after a month the population of that country looks at their Covid-19 numbers and no longer sees the uncontrolled growth. Pressure on governments to loosen restrictions will rise. Are schools going to stay closed? Do the bans on social events and entire industries remain in effect?

Because the reality is that absent a vaccine, all of this has but a single goal - trying to ensure that healthcare systems can handle the caseloads. However, the reality of a "flatter curve" is a MUCH longer duration for the Covid-19 outbreak. Once you open the doors to "normal actvity, the curves will resume their exponential characteristics. Nobody is saying it, but the underlying assumption for the flatter curve is that it takes longer for Covid-19 to run it's course through the entire population. And if that takes 9-12 months, are people really prepared for that?

9-12 month shutdowns are not something that ANY business can sustain. I can't see any bar or restaurant businesses surviving, the cruise industry is gone, for-profit airlines will be a thing of the past, brick-and-mortar schools will be relics, the list goes on and on. What are all those workers going to do in the interim? How does society handle the long-term loss of a system which uses schools largely as daycare centers for kids so that parents can leave the house and hold jobs? The "law of unintended consequences" is going to play out in a big way here, and many of them are going to major and devastating.

More than a few people in this thread have noted that "the cure may be worse than the disease", and I think they are right.

There are mixed indications that summer may reduce the rate of transmission by deactivating most of the viruses more quickly. There was also some info during discussion of how the virus works that it will change to a less potent form - either to persist longer or just because it is designed to evolve rapidly and is bound to dilute the current form with whatever new RNA it creates. People are also likely to have more respect for hygiene measures in future when the bans are lifted.

For these reasons I am hopeful that by June we can relax some of the containment measures without exponential growth in cases. At some point we will have to brave the virus and resume economic activity to restock shelves and live life.

[RangerJoe]

My understanding of the blindness with measles is that you have to keep the person in a dark room. Then no blindness occurs. Simple precaution for a highly contagious disease.

[witpqs]

Kull,

We are being told appropriate masks (N-95, surgical masks don't work for this) are not available here as they are in shortage for health care practitioners on the job, right?

[Canoerebel]

Yeah, South Korea gives a lot of important information. And it seems that SK is on the far side of things, as we noted in here yesterday or the day before.

The information from Singapore (anomalous, if accurate) and Japan is also interesting They also are about four weeks into this with non-apocalyptic numbers.

[witpqs]

ORIGINAL: RangerJoe

Well George, I won't include that long quote but I did post where they are trying rheumatoid artheritis drugs for COViD-19 when the body develops what is called a cytokine storm. From what I read in the quote, that is what is needed. I am not a MD and those on the line like that doctor probably don't have time to read it, but someone should be collating that information and getting it out to the people who need it. Then again, those drugs may be too expensive and there may not be enough of them for those who urgently need it at this time.

I hope that or something(s) else they are exploring turn out to work, and the effective drugs are available in needed quantity. The way we manage inventory in this country (and most countries?) there are shortages of various drugs on a routine basis.

Just to clarify, I was only forwarding that physicians comments, not meaning to suggest one or another treatment, etc.

[Kull]

ORIGINAL: witpqs

Kull,

We are being told appropriate masks (N-95, surgical masks don't work for this) are not available here as they are in shortage for health care practitioners on the job, right?

True, only masks of a certain type, properly worn, can keep the wearer "safe" The REAL benefit is to prevent cough-spreaders from leaving clouds of virus in their wake.

[RangerJoe]

I understand and I agree with what you did. Thank you.

I would also like to point out that the Corona virus 19 appears to latch onto something on the human cell called ACE. Another treatment that is being tried is to flood the body with extra ACE so the virus latches onto that and then can't infect a cell. Whether or not this is the same ACE where some people with heart disease takes ACE inhibitors, I don't know.

As far as the lack/shortage of medical supplies go, there may be a reason for that:

https://www.nytimes.com/2020/02/18/busi ... plies.html

I won't post quotes, but if you read it the the lack of certain supplies may become evident.

[witpqs]

ORIGINAL: Kull

ORIGINAL: witpqs

Kull,

We are being told appropriate masks (N-95, surgical masks don't work for this) are not available here as they are in shortage for health care practitioners on the job, right?

True, only masks of a certain type, properly worn, can keep the wearer "safe" The REAL benefit is to prevent cough-spreaders from leaving clouds of virus in their wake.

And for that the disease specialist said surgical masks do work.

[BBfanboy]

ORIGINAL: Canoerebel

Yeah, South Korea gives a lot of important information. And it seems that SK is on the far side of things, as we noted in here yesterday or the day before.

The information from Singapore (anomalous, if accurate) and Japan is also interesting They also are about four weeks into this with non-apocalyptic numbers.

The NYT article about effective steps to deal with the outbreak mentioned that Singapore, an island state, put mandatory screening for all arriving persons in place very early. By checking temperature and other visible indicators they could triage the travelers for further testing and if there was any doubt, put them in 14 day quarantine. Small nations with very small areas can monitor more easily than big diverse countries with people moving long distances within its boundaries daily.
Israel has instituted its very strict access control because it is also a small nation which could easily be overwhelmed from border to border if too many cases come in.

[witpqs]

ORIGINAL: RangerJoe

I understand and I agree with what you did. Thank you.

I would also like to point out that the Corona virus 19 appears to latch onto something on the human cell called ACE. Another treatment that is being tried is to flood the body with extra ACE so the virus latches onto that and then can't infect a cell. Whether or not this is the same ACE where some people with heart disease takes ACE inhibitors, I don't know.

As far as the lack/shortage of medical supplies go, there may be a reason for that:

https://www.nytimes.com/2020/02/18/busi ... plies.html

I won't post quotes, but if you read it the the lack of certain supplies may become evident.

Quotation:

Individuals who try to organize relief supplies face violating the country’s strict charity law.

Crikey!

An aside, the article mentions China says 3,000 healthcare workers have become infected. While this is only a suspicion rather than based on hard numbers/research, that figure versus 80,824 total cases in China feels to me like additional reason to be very suspicious of that 80 thousand official number from the Chinese government.

[mind_messing]

Let me go for the trifecta and be open-minded, optimistic, and neutral.

The outbreak in the USA didn't really start the big upward curve until the first of March. From late January until then it was mostly confined to Washington State and a few pockets in California. Little testing was done, but people weren't getting sick nor were there hospitalizations.

Testing limitations throw the US numbers off by quite a margin.

China had it for two months before they began to experience exponential growth. Then it took drastic measures that have apparently worked.

There's comments earlier on the thread on the validity of the Chinese numbers, so I'd consider that statement in light of them.

Agreed that the drastic measures have the appearance of working, but they are indeed drastic.

I am indeed optimistic about the quality of healthcare in the USA. There's no place I'd rather be in a pandemic.

In light of the evidence, I wouldn't be.

- You've a large proportion of the US population without any form of health cover. What's worse is that this group is going to be in socio-economic clusters that are geographically concentrated.

- It costs $300 for testing. That's a substantial amount for the group above, so limited chances of proactive seeking of tests.

- What's the cost of a 14 day stay in a US hospital? As a ballpark, let's say $20k. The above-mentioned groups are not in the position to make that affordable (and lets not get to treatment variation based on being insured or not).

The sum result is that irrespective of how good the health system is, there's a financial incentive for a large section of the population to avoid interacting with it. In a public health situation like this one, that's a massive, massive issue.

It was growing fast in other parts of the world a week or ten days before it began exponential growth in the US. Europe is currently well ahead of the USA - a week or two. We learned and have taken action fairly quickly now. Maybe not enough, but things are beginning to roll fast now.

I see all kinds of information in numbers and trends. This is a medical problem with quantifiable trends. So it's interesting to search for those trends

To be perfectly blunt, neither you, I or anyone else on the forum is capable of a worthwhile analysis on the data to hand on this.

There's a reason why public health is a rich soup of disciplines and professions - there's a limitless list of caveats and quirks within the data and reporting of it that it's a massive effort to pull it together nationally, let alone internationally.

I remain optimistic. This seems to grate against those who are relentlessly pessimistic. It is a subset of that group whose conduct has been questionable in here, ranging from vicious to unthoughtful to contemptuous. Why is there a subset of people who will not tolerate different viewpoints? Why does the expression of contrary views agitate so much? Would yo uprefer that I keep my opinions to myself? Should I surrender them to the wisdom of those who see this otherwise? Is it better that I withdraw from the thread I started among a community I've been part of 18 years? Can we all march in lock-step?

That's good that you're optimistic. Optimism is a good thing in most areas of life.

Not so in terms of public health. There is a reason that actions are planned on the basis of a reasonable worst case scenario, rather than the reasonable optimistic scenario.

That's worth keeping in mind.

[Kull]

ORIGINAL: witpqs

ORIGINAL: Kull

ORIGINAL: witpqs

Kull,

We are being told appropriate masks (N-95, surgical masks don't work for this) are not available here as they are in shortage for health care practitioners on the job, right?

True, only masks of a certain type, properly worn, can keep the wearer "safe" The REAL benefit is to prevent cough-spreaders from leaving clouds of virus in their wake.

And for that the disease specialist said surgical masks do work.

We touched upon this in a light-hearted way when looking at the toilet paper shortage idiocy, but the lesson also applies to masks intended ONLY to contain explosive clouds of germs. Are there shortages of masks of every type? Of course. Does that mean nothing can be done? Absolutely not.

There are MANY options for something that could be wrapped around the mouth region in order to prevent the wearer from expelling clouds of germs. In addition to those perfectly adapted to the purpose (such as a bandanna), almost any type of cloth could be easily modified or tailored. And cheap too. They also have the benefit of being washable, so re-use is a snap. The entire population of pretty much ANYWHERE could quickly adopt this system (would have to be mandated, of course) and I'll bet infection rates would plunge.

[Canoerebel]

Your opinions are colored by your political viewpoints. Mine are too.

You have a jaundiced perception of the US healthcare system that doesn't match what actually takes place here. We discussed this two or three days ago in here - you and me. With a few exceptions, nobody in this country is denied healthcare, at least at the level of being seen and admitted. (You acknowledged that two days ago, moving from that to stating something about "hence the high cost of health care in the US.)

[mind_messing]

ORIGINAL: Canoerebel

Your opinions are colored by your political viewpoints. Mine are too.

The numbers have no political viewpoints.

https://www.census.gov/library/publicat ... 0-267.html

In 2018, 8.5 percent of people, or 27.5 million, did not have health insurance at any point during the year. The uninsured rate and number of uninsured increased from 2017 (7.9 percent or 25.6 million).

You have a jaundiced perception of the US healthcare system that doesn't match what actually takes place here. We discussed this two or three days ago in here - you and me. With a few exceptions, nobody in this country is denied healthcare, at least at the level of being seen and admitted. (You acknowledged that two days ago, moving from that to stating something about "hence the high cost of health care in the US.)

The "at least at the level of being seen and admitted" is a very big caveat on your statement.

[mind_messing]

The data really does have no political viewpoints.

https://www.cdc.gov/nchs/fastats/access ... h-care.htm

Percent of persons who failed to obtain needed medical care due to cost: 4.8%

[Canoerebel]

To offer some perspective about my views on US healthcare and costs, I am self-employed. My company does not provide for healthcare. I've been responsible for my own health care since graduating from college in 1986. From then until 2013, I bought a family-coverage policy from Blue Cross/Blue Shield. Since 2013, my family has participated in a Christian healthcare sharing program - in our case, it's Samaritan Ministries. There are about four of these in the USA, the oldest of which has been around since the '80s (and that one had some problems back about 25 years ago). Under this plan, we handle our own medical expenses - everything from doctor's visits to medicines to eyecare. But if we run into a major issue, the members of the group cover the cost, less a $300 deductible. We didn't have to use that until March of this year, when my youngest child was hospitalized.

Since we handle our own costs, we negotiate with doctors. When we have an issue, we talk to them. They work with us. They appreciate being paid in cash (avoiding the cumbersome insurance market) and always give us good discounts. A friend of ours was quoted a price of $40,000 for a knee replacement. When he said he'd pay cash, the price dropped to $6,000.

My daughter had a serious (and ongoing, chronic) kidney issue when she was 12 years old in 2005. This made things very difficult for us financially for the rest of her childhood, partly because it's then we bought the business - carrying sizeable debt - two weeks before she got sick. But we've made it.

It's been a struggle for us in some ways but in most ways we're very blessed. We live in a mostly free, extraordinarily wealthy country. I had the freedom to choose what I wanted to do and how I wanted to do it. I made many missteps. As a result, I drive a dented '99 Ford pickup truck that I bought in '99. I'm glad it's still running.

My parents lived through the Depression and my dad served in WWII. He never complained about freedom or health care or costs. He certainly didn't feel oppressed to live in a free country or that the health care system was unfair, draconian, for the 1%. I agree with him. I can't believe the level of belly aching that comes from a population blessed to live (mostly) in a time of peace and plenty.

Yeah, I'm optimistic. I'm glad to be right where I am, no matter what missteps I made and no matter what inefficiencies and issues there are.

[Kull]

ORIGINAL: Canoerebel

Your opinions are colored by your political viewpoints. Mine are too.

You have a jaundiced perception of the US healthcare system that doesn't match what actually takes place here. We discussed this two or three days ago in here - you and me. With a few exceptions, nobody in this country is denied healthcare, at least at the level of being seen and admitted. (You acknowledged that two days ago, moving from that to stating something about "hence the high cost of health care in the US.)

The reality is that under "normal conditions", 100% of people that show up at the ER will be seen and if they have a life-threatening emergency, they will be admitted. 100%. That's how it is and how it has been. Nobody is turned away because they don't have insurance. This isn't a discussion on the pros and cons of for-profit healthcare, it's a single issue - will the extreme Covid cases be admitted? And the answer is yes.

However, if the healthcare system is overwhelmed by cases (as it apparently is in Italy), then that poses a different problem, but one that is not affected in any way by the "cost of the healthcare system". Even if were universal and free, you would still be dealing with triage.

[mind_messing]

But let's actually get down in to the data shall we?

https://public.tableau.com/profile/nhis ... shboard3_2

Largest groups are the 18-64 age group, the group that should be the most economically active.

Again no political viewpoints here.

[mind_messing]

ORIGINAL: Kull

ORIGINAL: Canoerebel

Your opinions are colored by your political viewpoints. Mine are too.

You have a jaundiced perception of the US healthcare system that doesn't match what actually takes place here. We discussed this two or three days ago in here - you and me. With a few exceptions, nobody in this country is denied healthcare, at least at the level of being seen and admitted. (You acknowledged that two days ago, moving from that to stating something about "hence the high cost of health care in the US.)

The reality is that under "normal conditions", 100% of people that show up at the ER will be seen and if they have a life-threatening emergency, they will be admitted. 100%. That's how it is and how it has been. Nobody is turned away because they don't have insurance. This isn't a discussion on the pros and cons of for-profit healthcare, it's a single issue - will the extreme Covid cases be admitted? And the answer is yes.

However, if the healthcare system is overwhelmed by cases (as it apparently is in Italy), then that poses a different problem, but one that is not affected in any way by the "cost of the healthcare system". Even if were universal and free, you would still be dealing with triage.

Sorry my point must not have been explicit.

The point is not about people being turned away, it's about people being adverse to going because of potential financial cost. In a public health context, that's massive.

As stated, testing is $300. For a large proportion of the US population, that's not a trivial sum.

[Canoerebel]

Expense is not an issue in the USA. It might be for a very few, especially those who are too far away or are afraid of going for legal reasons, but everybody who gets sick simply goes to the emergency room and gets treated. If you lived here, you'd know that instead of arguing with those of us who live here.