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Thought For the Day

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DJH
DJH
Monday, March 16, AD 2020 6:08pm

It occurred to me all these restrictions are hitting our young and economically vulnerable more of all, destroying certain sectors of the economy. A plan for spreading more government dependency, perhaps?

David WS
David WS
Monday, March 16, AD 2020 6:58pm

1920 Spanish influenza

Hank
Monday, March 16, AD 2020 8:22pm

Don

On the good side getting to Mass on Sunday was easy. Woke up, went down stairs and turned on the computer. But no real communion. Bummer!

Two weeks ago I figured out that no matter what the virus did, the politicians had boxed themselves into declaring a hard quarantine. Been gradually picking stuff up. I guess this means I’ll I have more time to pray for those who couldn’t .

Bob S. in PI
Bob S. in PI
Tuesday, March 17, AD 2020 2:02am

The “facts” are wrong. 1) The R0 number is somewhere between 2 and 6. Needs to be 1 or lower to stop spreading. 2) The virus spread is accelerating in most countries; it does seem to be leveling off in some countries (Singapore, etc.) where drastic social distancing, testing, quarantine measures were enacted. 3) Baloney. It certainly is being used for political theater but it didn’t come from an attempt to create a political smear job. The mass graves in Iran, the still hot crematoria in China, and the dead piling up in the hospital hallways of Italy tell the true story. Facts, to be useful, need to be true. Bogus facts in a crisis are dangerous.

Michael Dowd
Michael Dowd
Tuesday, March 17, AD 2020 3:04am

This is from Goldman Sachs on Sunday–

50% of Americans will contract the virus (150m people) as it's very communicable. This is on a par with the common cold (Rhinovirus) of which there are about 200 strains and which the majority of Americans will get 2-4 per year.
70% of Germany will contract it (58M people). This is the next most relevant industrial economy to be effected.
Peak-virus is expected over the next eight weeks, declining thereafter.
The virus appears to be concentrated in a band between 30-50 degrees north latitude, meaning that like the common cold and flu, it prefers cold weather. The coming summer in the northern hemisphere should help. This is to say that the virus is likely seasonal.
Of those impacted 80% will be early-stage, 15% mid-stage and 5% critical-stage. Early-stage symptoms are like the common cold and mid-stage symptoms are like the flu; these are stay at home for two weeks and rest. 5% will be critical and highly weighted towards the elderly.
Mortality rate on average of up to 2%, heavily weight towards the elderly and immunocompromised; meaning up to 3m people (150m*.02). In the US about 3m/yr die mostly due to old age and disease, those two being highly correlated (as a percent very few from accidents). There will be significant overlap, so this does not mean 3m new deaths from the virus, it means elderly people dying sooner due to respiratory issues. This may however stress the healthcare system.
There is a debate as to how to address the virus pre-vaccine. The US is tending towards quarantine. The UK is tending towards allowing it to spread so that the population can develop a natural immunity. Quarantine is likely to be ineffective and result in significant economic damage but will slow the rate of transmission giving the healthcare system more time to deal with the case load.

Bob Kurland, Ph.D.
Admin
Tuesday, March 17, AD 2020 4:09am

Goldman Sachs also predicts, I heard over TV, a quick economic (stock market) recovery.

ken
ken
Tuesday, March 17, AD 2020 8:11am

It is amazing in this age how poorly information is getting transmitted, adding to the hysteria. Infection rates are at best guesses due to limited testing supplies. Up to date age, sex, co-morbidity numbers of the deceased are extremely limited. I’m guessing they don’t want to show us the rapid recovery of the NBA players or their mild symptoms as it would further embolden the young.
Maybe I’m crazy, but no one in my brood is over fifty, we are all in good to excellent health. I’d prefer to get sick right now and just deal with it, i.e. not rush my child to the hospital when they get a fever.

Foxfier
Admin
Tuesday, March 17, AD 2020 8:33am

Bob in PI-
I recognize the numbers they’re using; they’re based off of those places where there are actual numbers, like Japan, and the Diamond Princess, and it even gives wiggle-room for those places that are openly not treating the elderly or infirm.

The virus’ diagnosis rate is going high and hard in a lot of countries.
That happens when you start at zero, and especially when you then go backwards and diagnose people who died when the country was at “zero cases.”

If this was actually as insanely contagious and deadly as is pushed, there would be piles of dead in the streets of Seattle, Portland and LA, in the homeless camps.

Instead, we have double-digits dead… in a single elder care center, which didn’t even notice something was seriously wrong until they had three dead people in less than a week.

Foxfier
Admin
Tuesday, March 17, AD 2020 8:39am

I sometimes think folks have no idea how interconnected the world is….
China has admitted to cases from early November.

It is not uncommon for people to go back to China to visit, in both California and Washington. (A lot of the Chinese ladies when we lived in the Seattle Blob would chit-chat with me, I still think they’re crazy for setting foot back in that hell-hole, but they did it at least twice a year, or brought family over here.)

Even if you assume a three week incubation period, we’d be on the fifth wave of spreading by now.

grim smile I can’t wait until they start testing all the flu swabs that came back negative for the flu this year, since they’ve been yelling about it being a “bad flu season” and there’s already been a few indications that the kung flu is really to blame.

Looks like the bad outcomes are a result of horrible healthcare, already vulnerable lungs, and people who are already ill getting sick.

Patrick
Patrick
Tuesday, March 17, AD 2020 8:49am

A viruses mutating into a less virulent strain may be more common because it allows for a greater penetration, since it can spread further when the host survives longer (at least long enough to infect many others). There is however the risk that the virus could mutate into a more virulent strain. Although this more virulent strain would burn out sooner, it could be more devastating in an environment that favors rapid transmission before the host dies. Perhaps the perfect storm with the 1918 pandemic was the concentration of soldiers so that an extremely virulent virus could infect many before the virus’s lethality forced it to burn out. Urban concentration as well as globalization with the ability to rapidly travel between countries and continents seems make the spread of a high virulence pathogen more likely.
There is also the concern about the risk of eating wild animals that may harbor viruses that are of low virulence for the common host, but are more virulent when the cross over to another species that is without natural immunity.
I recently ordered a book titled “ Three seconds to midnight” it was written by a virologist who worked at the US Army research institute of infectious disease where he studied African Hemorrhagic fevers. He predicts that recurring pandemics will continue and eventually we will see a strain as deadly as the 1918 Influenza.
Our population is more dense now and the virus would likely spread before vaccines could be developed. The author of this book believes that preparation is inadequate and measures need to be taken to reduce the effects of a severe pandemic.
Perhaps this Corona Pandemic will focus attention on strategies to limit the effects of these events. Our goal each year should be to reduce the morbidity and mortality of the annual influenza, while developing the knowledge and skills needed to limit the effects of a pandemic with the virulence of the 1918 Pandemic.

TomD
TomD
Tuesday, March 17, AD 2020 9:19am

The “Every election year has a disease” meme is similar to the “Emergency rooms fill up during the full moon” meme.

Fact is, the moon appears to most people to be full for 4 to 6 days, depending on the individual’s judgement. This means that for many people a full moon will almost always be seen as occurring on a weekend. It is weekend activities that drives up ER usage.

Of course, there is selective reporting in that list. SARS ran from between November 2002 [after the election] and July 2003, NOT 2004. The Ebola outbreak in ‘2014’ actually lasted from December 2013 to January 2016 – TWO election years, but was off most people’s radar by November 2016. We have another Ebola epidemic that is ongoing right now that has killed almost 2,300 people.

Ernst Schreiber
Ernst Schreiber
Tuesday, March 17, AD 2020 9:24am

You want to talk about facts Bob S.? There are 827 dead in Italy.

So if the bodies are piling up, it’s because the Italians are as casual about their dead as they are about everything else, and nor because they’re overwhelmed.

TomD
TomD
Tuesday, March 17, AD 2020 10:04am

As of today there are 2,158 dead in Italy, Ernst. That’s a 7.7% mortality rate, which is higher that China’s reporting (yes, I know the problem there) and the 2003 SARS outbreak.

https://www.theguardian.com/world/2020/mar/17/this-is-like-a-war-view-from-italys-coronavirus-frontline

Foxfier
Admin
Tuesday, March 17, AD 2020 10:20am

TomD, did you read the article you linked?

It might, just possibly, point to why they’re having a high death rate– that kind of tends to happen when you refuse to treat someone who has a serious medical condition when they get a disease that can cause breathing problems.

Also note that in spite of being the only care the poor 47 year old gal had, four of the seven other people in the house did not get sick.

And then, even with refusing to so much as see the younger folks with the disease, the average age for those dying is still over 80.

Further on the numbers:
note that the woman was not a confirmed case until after she was dead. If that is a standard practice, that will seriously skew the reported death rate– especially since the best controlled environment we have, the cruise liner, had a full half of those who tested positive showing no symptoms.

TomD
TomD
Tuesday, March 17, AD 2020 10:40am

Foxlier, did you understand the article? People are being refused treatment because there are not enough resources available to treat everyone</>.

And in any case my main purpose was to dispute Ernst’s stat of 827 dead, which is just a few days old. Exponential math is like that. Fortunately the Italian infection rate is slowing down, so the death rate should follow soon, but it’s not going to drop to zero immediately.

BTW, I did make one mistake: I mentally transposed the 2003 SARS fatality rate. It was 9.6%, not 6.9%, so my comment regarding the 7.7% death rate should be reversed.

note that the woman was not a confirmed case until after she was dead. If that is a standard practice, that will seriously skew the reported death rate

That’s ridiculous. One person out of 2,158 is half of a tenth of a percent, and half of a hundredth of a percent of total cases. Sure, there will be more like her, but the overall picture is not going to change due to such statistical anomalies.

Ernst Schreiber
Ernst Schreiber
Tuesday, March 17, AD 2020 11:42am

Yeah, I was quick to take the numbers from the “From China With Love” post to contest Bob S.’s assertion about bodies piling up in hospital hallways. Knew it as soon as I hit “post.”

The numbers I’m most interested in are in Michael Dowd’s comment. 80% early stage 15% mid stage 5% critical. That more or less corresponds with what’s been reported in my state. But our sample of 10 cases is too small to draw conclusions from.
Personally, I think we would have done better to do as the Brits have done: ask the elderly and immunocompromised to take appropriate precautions, and tell everyone else to carry on like they would in a bad flu season.

Foxfier
Admin
Tuesday, March 17, AD 2020 11:51am

Ah, I see I must be making a very effective point again, you got all “subtle” with the fox liar thing again. It really is a very useful tell, you know– very pound-the-table.

Yes, I understood the article, which is why I asked if you had even read it. Your response makes it clear that no, you did not pay attention to the article’s content.

The woman became sick a week before she died; that would be one week after the first caught-in-country positive test in Italy.
That is not “not enough resources to treat everyone.” That is “hey, you are already sick, we’re going to refuse to treat you.”

Which is not really a shock when each patient is a burden, not a customer, but there you go.


note that the woman was not a confirmed case until after she was dead. If that is a standard practice, that will seriously skew the reported death rate

That’s ridiculous. One person out of 2,158 is half of a tenth of a percent, and half of a hundredth of a percent of total cases.

On what basis do you assume that she is the only case where they did not test until after death?

Especially when you are also arguing that they were out of resources to even look at the relatively young one week after the first native case? (I spent a whole maybe 30 seconds looking– there are other mentions of cases only being identified post-mortem. And I’m not even looking in Italian.)

In addition, you rather ignored that the refusing to treat those who are elderly or have another condition is going to seriously impact the survival rate; that alone might explain why in the case where they were using an even older-skewed demographic, with perfect conditions for transmission, there was only 17% infected, 8% had any symptoms at all, and about 2% of those with symptoms in that highly at-risk group died. 6.5% needed serious medical care before recovering. In a group that was 1/3 the most at risk demographic.

Ernst Schreiber
Ernst Schreiber
Tuesday, March 17, AD 2020 12:10pm

Is their a “death panel” care rationing thing going on in Italy?
Doctor, I’m sick with I don’t know what!
Lady, you’re 80 years old. You’ve already used up your fair share of social medicine. Go home.
But I might die!
Exactly.

Bob Kurland, Ph.D.
Admin
Tuesday, March 17, AD 2020 2:49pm

Keep it going guys (and gals). I find the different statistics and analyses useful and informative, even though I’m not sure how to act on them (or for my Good Lady, who’s not only > 80 but has health issues increasing the risk.)

TomD
TomD
Tuesday, March 17, AD 2020 2:50pm

Ernst, what do we do under such circumstances? If we really can’t treat everyone then someone is not going to get treated. Who? I don’t like this, but that’s the way it is. And, seriously, how is it possible to decry such rationing and then advocate British and Dutch ‘herd immunity’ which denies treatment to all but the well connected, the REAL socialistic way to ration.

TomD
TomD
Tuesday, March 17, AD 2020 4:14pm

Bob Kurland, look at this from CNN. Georgia currently has 121 confirmed cases:

One Georgia hospital ripped through months’ worth of supplies while tending to coronavirus patients, its president has told CNN.

Scott Steiner, president and CEO of Phoebe Putney Health Systems, told CNN that despite being well prepared in terms of protective gear — with six months’ worth of inventory stockpiled — the system has gone through five months’ worth of that inventory in just six days.

Ernst Schreiber
Ernst Schreiber
Tuesday, March 17, AD 2020 4:19pm

You’re making a triage point. I’m following a suggestion from foxfier and making a rationing point.

CAM
CAM
Wednesday, March 18, AD 2020 12:26am

Triage in Italy: they are not treating 80 y.o. and up patients with Corona virus since supplies are dear. The news story did not specify if this was all over Italy or a specific province.
As my then 94 y.o. mother told her doctor when queried as to why she had cancelled her doctor appts, “I don’t want to be selected by one of Rahm Emmanuel’s death panels.”

Bob S. in PI
Bob S. in PI
Wednesday, March 18, AD 2020 5:22am

Sorry for not putting numbers on my “Baloney” comment. It is a futile effort to chase them when things go exponential. Italy reports its COVID -19 death toll is now 2,158 (17 March). And the bodies aren’t just in the hospital hallways anymore; they are in the empty churches as they can’t bury them fast enough.

Don: the virus mutates regularly, sometimes becoming less virulent but sometimes becoming worse. Hard to tell which country has which when things are changing so quickly. There is some speculation that the strain in Italy is different somehow but the analysis is slow coming under the crush of the crisis there. As I’ve written before, it seems 80-85% get virus and recover. But that leaves 15-20% who get sick enough to be hospitalized. With a large outbreak, that is a real concern. Italy, and now France and Spain, struggle to cope with this outbreak which is on top of an already worse than normal flu season. The overwhelmed medical systems in Italy are, in their own words, collapsing. They took a casual approach to the virus and now beg us not to do the same. I hope and pray that doesn’t happen in the US (or here in the Philippines where the entire main island of Luzon is on expanded quarantine) as cases and deaths accelerate. But enough medical experts have said this virus has an unusual combination of infectiousness and lethality that they haven’t seen in many generations. Just saying that an overabundance of caution in the face of something we haven’t seen before is prudent. It is the dilemma St. Louis and Philadelphia faced in different ways in the 1918-1920 flu pandemic. The cases of infected were about the same but the death rate was much higher in Philly. We can avoid that, I think, by being extra cautious. And the latest worrisome reports out of both Italy and France is that about half of their ICU patients are under 65 years old – an unwelcome development if confirmed.

TomD
TomD
Wednesday, March 18, AD 2020 12:10pm

I don’t understand the point, Ernst. Just don’t ration? Is that the point?

Ernst Schreiber
Ernst Schreiber
Wednesday, March 18, AD 2020 12:16pm

All right, let me try it this way: Triage is easy when you never had any intention of treating one group in the first place.

TomD
TomD
Wednesday, March 18, AD 2020 12:29pm

That’s a valid point, Ernst. Just not right now. Stating it still doesn’t help medical people to decided what to do if or when our resources are dry.

Ernst Schreiber
Ernst Schreiber
Wednesday, March 18, AD 2020 12:35pm

Of course it’s valid right now because there’s no basis for meaningful comparison. You can’t go around waiving your hands shrieking “oh my God! It’s so bad they’re sending the elderly home to die!” When they always send the elderly home to die.

TomD
TomD
Wednesday, March 18, AD 2020 12:55pm

Not always. I have very elderly relatives and the only reason up to now for any denial of services is because they wouldn’t survive some of them.
And yes, people do eventually die.
No basis for a meaningful comparison? I thought that was my point. We can’t compare what they always do with what they likely will have to do. The criteria is likely to be vastly different. I know a doctor at Mass General who called his parents and told them to not go to work, because they plan to deny services to those aged 65 and older if they get swamped (the parents are just under that limit). He’s saying that the lung xrays look like nothing they have ever seen.

Ernst Schreiber
Ernst Schreiber
Wednesday, March 18, AD 2020 1:28pm

If you’re very elderly relatives aren’t living in Italy, they are completely, entirely and wholly irrelevant to this conversation, which I am now ending because it’s turning into an argument for argument’s sake, and I’ve already broken my rule about charity in the comboxes more than enough times in the last couple of days.

Like Bill O’Reilly, I’ll let you have the last word. Not because I want to appear generous, but because I don’t care what you have to say on this topic anymore.

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