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On April 25 2020 15:30 Danglars wrote: The overwhelming stress was pretty much NYC-localized, and practically everyone that needs hospital treatment can get hospital treatment. As we saw from case mortality that I quoted earlier, there isn't a nation in the west doing better besides Germany (and bravo for that).
Like, I know it's easy to spot the errors and terrible statements and lack of preparation. It's undeniable and pretty ridiculous in it's own right, and very open to criticism. And I have to say it because I know some people will deny that to get to some kind of prefab conclusion.
So I'd advise a little more circumspect look besides standing, jaw dropped, at total number infected and bulk records broken in densely populated areas. I'd say this similar to the way we put qualifications on why Switzerland has ~20% higher deaths/100k compared to the US, and China has (officially) 95% less than Germany. It makes little sense to me to only cover-up the nuance (Big Numbers!!!) in one case and extend great considered weight in others.
California has mostly flattened the growth curve. Most counties are in the linear increase range. Gov Newsom is allowing elective surgeries to resume in hospitals, thank god. Hopefully he'll steer things towards extensive random sampling to give a better idea of asymptomatic case spread and closer approximations of fatality rate. The testing capacity has been increasing very quickly.
I'd like you to stop comparing mortality rate at that point, since the US isn't reporting any nursing home fatalities, and there had to be lawsuits to even reveal the names of nursing homes where deaths happened (not even mentioning the amount of casualties in them) in some states (Florida comes to mind), because they are "privately owned and have a right to privacy".
- Belgium is reporting nursing home deaths, even including suspected cases in their toll (they say that for comparison purposes, one should divide the number by 2 as nursing homes deaths are > 50% of their death toll). - France has been reporting them for the last 4 weeks and is now caught up with the backlog (they account for nearly 40% of deaths). - Spain and Italy are doing it too, though I'm not sure to what extent. - The UK still has discrepancies in their reporting of nursing homes fatalities.
So if you do the same math, you need to nearly double the casualties in the US, and suddenly numbers look more in line with the rest. The NYT made a tally last week, going up to 7k, a lot more than officially reported (and it's not complete of course) https://www.nytimes.com/2020/04/17/us/coronavirus-nursing-homes.html
Add to that the epidemic was a few weeks late to really take off compared to Europe, which means the deaths are delayed, too. The US is NOT doing better on any metric than "most countries in the west barring Germany". The new cases (30k a day) and fatality (2k a day) numbers have not even peaked yet and look plateaued but not decreasing.
I can hold off on that in future since it’s uncertain how many deaths in nursing home facilities are being specifically noted separate from coronavirus deaths, or just underreporting in general.
A closer reading of your NYT article will show that these deaths were being tallied, but the study was able to trace their specific locations to nursing homes. Doubling the “true deaths” from coronavirus using nursing homes is way unsupported and not believable.
Agreed. It's a little hard to follow, you kff link is an excellent source of detailed information.
The news these past few days coming from CDC, where they said there were going to *start* tracking deaths in nursing homes was a little confusing (they are going to track them directly and required nursing homes to directly report numbers to them). Especially as these homes were not even required to communicate to their residents and families if there were cases or deaths (depending on states), it's hard to be sure if they had to give tallies to the authorities. Private sector homes (and even hospitals) and rules being different between states complicate things.
More simple here, as most hospitals are public.
Doubling deaths would be believable if most of the reporting was not available (seems it is, then), as it happens in several countries, sometimes despite underreporting, and your own link mentions reported nursing homes deaths vary between currently reporting states between 8% and 60% of the total with an average at 27%. I believe NY has more than 10k deaths in homes versus 22k in total.
There is also another issue for the US : due to the status of health care coverage, there may be more deaths at home than in european countries, as patients can be refused by hospitals, and some may not even try to. It is going to be hard to get exact figures before a while, if ever.
That's why overall, I think it's best not to compare death rates while everything is ongoing, as all countries are functioning (and counting, and testing) differently. It makes little sense. I'd rather see comparisons between the increasing/decreasing amount of fatalities in each country (graphs), as they can show the evolution and result of the policies taken.
Just to clarify, hospitals in the US can't refuse patients. Doing so would be a violation of EMTALA (which virtually all hospitals comply with) which dictates that any patient that presents to a hospital has to be evaluted and may not be discharged until they are stable, regardless of their ability to pay.
I think all countries are doing quite well. When you look at the logarithmic graphs instead of the linear graphs, USA, Spain, Italy, France, etc. are all flattening out.
"There is currently no evidence that people who have recovered from Covid-19 and have antibodies are protected from a second infection," the WHO said in a briefing note.
Virus be weird, yo.
This is one of the most fascinating things about this story and it appears to continually change our thoughts on it. At first people who got it a second time were thought to be false positive, but if they are not getting antibodies than this means you can been infected again and again? Is social distancing the new norm for a long time?
The way to interpret the studies so far is that antibodies might be irrelevant, or less relevant than expected, in fighting the infection.
They key takeaway here is that the humoral immune system (think antiboidies) might not be as important as expected.
On April 26 2020 01:33 Antisocialmunky wrote: Its weird because anti-bodies from donated blood seem to work. If they had said something along the lines of: "We don't know how long immunity will last." or "We don't know if there are multiple strains that you can get infected with." it would make more sense. But this is quite a curious statement.
It's not a curious statement. BBC just did a bad job explaining the studies.
WHO is saying that there is no evidence that the humoral immune system response, by itself, is a good indicator for future infection.
The studies WHO is going off of show that previously infected patients have recovered with undetectable amounts of antiboides; and that there is evidence of a negative correlation between humoral immune response and cellular immune response.
here is the source of the WHO statement and all the studies they referenced
Relevant quote that summarizes
"However, some of these people have very low levels of neutralizing antibodies in their blood,4 suggesting that cellular immunity may also be critical for recovery. As of 24 April 2020, no study has evaluated whether the presence of antibodies to SARS-CoV-2 confers immunity to subsequent infection by this virus in humans. "
"There is currently no evidence that people who have recovered from Covid-19 and have antibodies are protected from a second infection," the WHO said in a briefing note.
Virus be weird, yo.
This is one of the most fascinating things about this story and it appears to continually change our thoughts on it. At first people who got it a second time were thought to be false positive, but if they are not getting antibodies than this means you can been infected again and again? Is social distancing the new norm for a long time?
The way to interpret the studies so far is that antibodies might be irrelevant, or less relevant than expected, in fighting the infection.
They key takeaway here is that the humoral immune system (think antiboidies) might not be as important as expected.
On April 26 2020 01:33 Antisocialmunky wrote: Its weird because anti-bodies from donated blood seem to work. If they had said something along the lines of: "We don't know how long immunity will last." or "We don't know if there are multiple strains that you can get infected with." it would make more sense. But this is quite a curious statement.
It's not a curious statement. BBC just did a bad job explaining the studies.
WHO is saying that there is no evidence that the humoral immune system response, by itself, is a good indicator for future infection.
The studies WHO is going off of show that previously infected patients have recovered with undetectable amounts of antiboides; and that there is evidence of a negative correlation between humoral immune response and cellular immune response.
here is the source of the WHO statement and all the studies they referenced
Relevant quote that summarizes
"However, some of these people have very low levels of neutralizing antibodies in their blood,4 suggesting that cellular immunity may also be critical for recovery. As of 24 April 2020, no study has evaluated whether the presence of antibodies to SARS-CoV-2 confers immunity to subsequent infection by this virus in humans. "
This is what doesn't make sense to me. It's said that memory cells remember when a virus is defeated, so you can't get infected a second time. Are there no alive memory cells after COVID-19? How is this possible?
"There is currently no evidence that people who have recovered from Covid-19 and have antibodies are protected from a second infection," the WHO said in a briefing note.
Virus be weird, yo.
This is one of the most fascinating things about this story and it appears to continually change our thoughts on it. At first people who got it a second time were thought to be false positive, but if they are not getting antibodies than this means you can been infected again and again? Is social distancing the new norm for a long time?
The way to interpret the studies so far is that antibodies might be irrelevant, or less relevant than expected, in fighting the infection.
They key takeaway here is that the humoral immune system (think antiboidies) might not be as important as expected.
On April 26 2020 01:33 Antisocialmunky wrote: Its weird because anti-bodies from donated blood seem to work. If they had said something along the lines of: "We don't know how long immunity will last." or "We don't know if there are multiple strains that you can get infected with." it would make more sense. But this is quite a curious statement.
It's not a curious statement. BBC just did a bad job explaining the studies.
WHO is saying that there is no evidence that the humoral immune system response, by itself, is a good indicator for future infection.
The studies WHO is going off of show that previously infected patients have recovered with undetectable amounts of antiboides; and that there is evidence of a negative correlation between humoral immune response and cellular immune response.
here is the source of the WHO statement and all the studies they referenced
Relevant quote that summarizes
"However, some of these people have very low levels of neutralizing antibodies in their blood,4 suggesting that cellular immunity may also be critical for recovery. As of 24 April 2020, no study has evaluated whether the presence of antibodies to SARS-CoV-2 confers immunity to subsequent infection by this virus in humans. "
This is what doesn't make sense to me. It's said that memory cells remember when a virus is defeated, so you can't get infected a second time. Are there no alive memory cells after COVID-19? How is this possible?
I’m sure there is someone around here with a better understanding of genetics than I, but from what I know, the problem is just that the process is somewhat less deliberate than commonly assumed. Antibodies are made in a very “trial and error” fashion, and the way you know that they worked is... the virus didn’t kill you.
I’m sure some studies will eventually show the true cause of this now fairly common report of reinfection, but based on the little we know, my inference is that making antibodies that permanently stop the disease is difficult. They significantly reduce the spread of the virus, but not enough to completely stop it.
Good video highlighting what I have been saying for a few weeks now. The curve has been flattened so severely that thousands of healthcare workers are being laid off or furloughed across the country.
Good video highlighting what I have been saying for a few weeks now. The curve has been flattened so severely that thousands of healthcare workers are being laid off or furloughed across the country.
I don't see anything there about the curve flattening being to blame. Rather that hospitals make money off elective surgery, not off ER care (or maybe they do off the latter, but less of a margin). So even if the hospital is full of Covid patients they don't make enough. Given how the Covid crisis is localized and the ban on elective surgery is country-wide (or at least state-wide in the case of those Washington hospitals highlighted there), it is even worse for rural areas where Covid has not hit badly, but they still can't do any of the money-making surgery.
It isn't an example of flattening the curve too much. It's an example of how things can go completely down the shutter if you only rely on private healthcare.
E: I'm not saying a publicly run hospital would be making money in Tonetskwa county. I'm saying that the hospital running at a loss wouldn't matter because it'd continue to serve the greater good of providing health care to the community.
Flattening the curve in this context might mean, that we forfeit all other activities. Including the revenue generating hospital treatments. Though I'd blame other things than the pandemic for that.
The following is second hand from an MD I just recently spoke to about this: "Fee for service" medicine is a huge part of the hit to hospitals, meaning in addition to the straight reduction in elective and non-serious procedures, providers are no longer able to willy nilly screen patients without doing the hard work of initial hands-on work ups. In other words, it's no longer feasible to order out CT scans left and right when sterilizing the CT machine takes 30-40 minutes every use. So yeah, although there's no doubt problems with the scope of many of the restrictions on providers, I'd wager that the notion that we should lift 'rona restrictions and allow hospitals/medical systems to try to go back to where we were is a bad one.
This problem matches up relatively well with our similarly flawed approach to unemployment insurance imo.
Pretty strange title of hospital in critical condition / are failing is that it cannot make as much profit as it used to do. I would associate those phrases to be a hospital where patients and medical staff are dying.
Such a contrast to here where people got trained to work in healthcare since they expected a peak and several industries had minimal use of their trained personnel. Especially when air plane cabin crew (flight attendants) has a lot of relevant courses as part of their job along with the training required for a specific disease being less than for general healthcare.
"There is currently no evidence that people who have recovered from Covid-19 and have antibodies are protected from a second infection," the WHO said in a briefing note.
Virus be weird, yo.
This is one of the most fascinating things about this story and it appears to continually change our thoughts on it. At first people who got it a second time were thought to be false positive, but if they are not getting antibodies than this means you can been infected again and again? Is social distancing the new norm for a long time?
The way to interpret the studies so far is that antibodies might be irrelevant, or less relevant than expected, in fighting the infection.
They key takeaway here is that the humoral immune system (think antiboidies) might not be as important as expected.
On April 26 2020 01:33 Antisocialmunky wrote: Its weird because anti-bodies from donated blood seem to work. If they had said something along the lines of: "We don't know how long immunity will last." or "We don't know if there are multiple strains that you can get infected with." it would make more sense. But this is quite a curious statement.
It's not a curious statement. BBC just did a bad job explaining the studies.
WHO is saying that there is no evidence that the humoral immune system response, by itself, is a good indicator for future infection.
The studies WHO is going off of show that previously infected patients have recovered with undetectable amounts of antiboides; and that there is evidence of a negative correlation between humoral immune response and cellular immune response.
here is the source of the WHO statement and all the studies they referenced
Relevant quote that summarizes
"However, some of these people have very low levels of neutralizing antibodies in their blood,4 suggesting that cellular immunity may also be critical for recovery. As of 24 April 2020, no study has evaluated whether the presence of antibodies to SARS-CoV-2 confers immunity to subsequent infection by this virus in humans. "
This is what doesn't make sense to me. It's said that memory cells remember when a virus is defeated, so you can't get infected a second time. Are there no alive memory cells after COVID-19? How is this possible?
I’m sure there is someone around here with a better understanding of genetics than I, but from what I know, the problem is just that the process is somewhat less deliberate than commonly assumed. Antibodies are made in a very “trial and error” fashion, and the way you know that they worked is... the virus didn’t kill you.
I’m sure some studies will eventually show the true cause of this now fairly common report of reinfection, but based on the little we know, my inference is that making antibodies that permanently stop the disease is difficult. They significantly reduce the spread of the virus, but not enough to completely stop it.
To add to this, the virus is simply too new. As an example, we are only now starting to realize the whole clotting component of the infection.
An estimated 40,000 packed onto Newport Beach on Friday and similar crowds were expected Saturday according to the Associated Press
This is bad but it was expected. We've been on lockdown for over a month and the temperature has shot up in the last week. Orange County doesn't have a citywide stay at home order like LA county does (there's still a statewide order in place) and their per capita cases of COVID are much lower than in LA county but if shit like this continues that's gonna change.
Damn it, we were doing so well here in keeping our numbers low. I'm worried this heat is gonna drive people outside until the cases start spiking and by then it's gonna be too late.
Good video highlighting what I have been saying for a few weeks now. The curve has been flattened so severely that thousands of healthcare workers are being laid off or furloughed across the country.
I don't see anything there about the curve flattening being to blame. Rather that hospitals make money off elective surgery, not off ER care (or maybe they do off the latter, but less of a margin). So even if the hospital is full of Covid patients they don't make enough. Given how the Covid crisis is localized and the ban on elective surgery is country-wide (or at least state-wide in the case of those Washington hospitals highlighted there), it is even worse for rural areas where Covid has not hit badly, but they still can't do any of the money-making surgery.
It isn't an example of flattening the curve too much. It's an example of how things can go completely down the shutter if you only rely on private healthcare.
E: I'm not saying a publicly run hospital would be making money in Tonetskwa county. I'm saying that the hospital running at a loss wouldn't matter because it'd continue to serve the greater good of providing health care to the community.
The reason healthcare workers are being laid off is precisely because of flattening the curve. You can see at 4:20 in the video where the guy says they are seeing 50% of the typical patient volume they normally see around this time of year. If the hospitals weren't empty then there would be no furloughs or lay-offs. You can't have a hospital full of patients with nobody to take care of them regardless if you're making money off elective surgeries.
An estimated 40,000 packed onto Newport Beach on Friday and similar crowds were expected Saturday according to the Associated Press
This is bad but it was expected. We've been on lockdown for over a month and the temperature has shot up in the last week. Orange County doesn't have a citywide stay at home order like LA county does (there's still a statewide order in place) and their per capita cases of COVID are much lower than in LA county but if shit like this continues that's gonna change.
Damn it, we were doing so well here in keeping our numbers low. I'm worried this heat is gonna drive people outside until the cases start spiking and by then it's gonna be too late.
Feels like lockdown has run out of steam in the US. It's just so contrary to the way that Americans are as a culture as to be untenable. As premature as it seems, it's looking very much like early May is going to be when we see only partial lockdowns at best. Yes, it is certain that more death will come from that.
An estimated 40,000 packed onto Newport Beach on Friday and similar crowds were expected Saturday according to the Associated Press
This is bad but it was expected. We've been on lockdown for over a month and the temperature has shot up in the last week. Orange County doesn't have a citywide stay at home order like LA county does (there's still a statewide order in place) and their per capita cases of COVID are much lower than in LA county but if shit like this continues that's gonna change.
Damn it, we were doing so well here in keeping our numbers low. I'm worried this heat is gonna drive people outside until the cases start spiking and by then it's gonna be too late.
Feels like lockdown has run out of steam in the US. It's just so contrary to the way that Americans are as a culture as to be untenable. As premature as it seems, it's looking very much like early May is going to be when we see only partial lockdowns at best. Yes, it is certain that more death will come from that.
So the pattern is gonna be "lockdown is working but I'm bored let's go out!" to "we went out so the case rate spiked, let's stay home" rinse repeat.
The important question is how are regional hospitals handling it, if there is a lot of spare capacity and new cases are not on a sharp rise then partially lifting measures can be considered.
An estimated 40,000 packed onto Newport Beach on Friday and similar crowds were expected Saturday according to the Associated Press
This is bad but it was expected. We've been on lockdown for over a month and the temperature has shot up in the last week. Orange County doesn't have a citywide stay at home order like LA county does (there's still a statewide order in place) and their per capita cases of COVID are much lower than in LA county but if shit like this continues that's gonna change.
Damn it, we were doing so well here in keeping our numbers low. I'm worried this heat is gonna drive people outside until the cases start spiking and by then it's gonna be too late.
Feels like lockdown has run out of steam in the US. It's just so contrary to the way that Americans are as a culture as to be untenable. As premature as it seems, it's looking very much like early May is going to be when we see only partial lockdowns at best. Yes, it is certain that more death will come from that.
So the pattern is gonna be "lockdown is working but I'm bored let's go out!" to "we went out so the case rate spiked, let's stay home" rinse repeat.
God people are stupid.
"because bored" is a bad reason to open up but the general wave pattern of lockdown to reduce spread, into increased spread as measures are eased up until they need to be reinstated is kind of what every country is planning simple because staying in lockdown for over a year isn't really possible.
On April 27 2020 04:49 Gorsameth wrote: The important question is how are regional hospitals handling it, if there is a lot of spare capacity and new cases are not on a sharp rise then partially lifting measures can be considered.
Is California still trending up with new cases?
Slowly yea. I was reading an article the other day that showed that LA County only got to 100 cases per 100,000 people as of last week, yet we've been on lockdown since mid March.
So the cases are at the highest they've been but we've managed to get there much more slowly than many other states or counties because of our social distancing policies.
If people start violating them now especially in large crowded areas like the beach, the cases are guaranteed to spike. What our hospital capacity is like, I have no idea, I haven't seen any data or read anything on it. So far everything has been from what I understand mostly manageable that's why our death rate has been lower too. I just don't want to see us turning into New York because of these dumbasses.
An estimated 40,000 packed onto Newport Beach on Friday and similar crowds were expected Saturday according to the Associated Press
This is bad but it was expected. We've been on lockdown for over a month and the temperature has shot up in the last week. Orange County doesn't have a citywide stay at home order like LA county does (there's still a statewide order in place) and their per capita cases of COVID are much lower than in LA county but if shit like this continues that's gonna change.
Damn it, we were doing so well here in keeping our numbers low. I'm worried this heat is gonna drive people outside until the cases start spiking and by then it's gonna be too late.
The beaches are a good test case as opposed to enclosed restaurants and indoor stadiums for transmission. 100,000+ in Orange County beaches should register on them if outdoor open-air transmission is really high.
Is France slow on testing? 124k cases seem a bit low compared to other big European countries. Also, Italy and Spain seem to be stabilising in terms of new infections, so that's good. I think the end of coronavirus is near (or 1st wave at least).
EPT![[image loading]](https://i.imgur.com/luKcKOG.png)
