All things political. Coronavirus Edition. (21 Viewers)

[Maxp]

I fear we are really going to be in a bad place due to the obvious cuts to the federal agencies that deal with infectious disease, but also the negative effect the Affordable Care act has had on non urban hospitals. Our front line defenses are ineffectual and our ability to treat the populous is probably at an all time low. Factor in the cost of healthcare and I can see our system crashing. What do you think about the politics of this virus?

 

[Taurus]

Here is a very cool article about how the virus seems to have plateaued in China as a result of some crazy aggressive plan they did whoich included quarantining an entire city (Wuhan) of 8 million people (Los Angeles has 4 million by comparison). And they built two hospitals in a week.

The article questions whether these procedures could ever happen in a non authoritarian society. Can you imagine trying to quarantine Los Angeles and keep people from leaving or going there?

Maybe they just slowed it down, who knows yet. They certainly have mounted a much more aggressive response than the US. And this is not me being critical of Trump, although I think his response has been weak. Its hard to know exactly how aggressive we should be.


To get at this question, the report notes that so-called fever clinics in Guangdong province screened approximately 320,000 people for COVID-19 and only found 0.14% of them to be positive. “That was really interesting, because we were hoping and maybe expecting to see a large burden of mild and asymptomatic cases,” says Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security. “That piece of data suggests that’s not happening, which would imply that the case fatality risk might be more or less as we currently have.” But Guangdong province was not a heavily affected area, so it is not clear whether the same holds in Hubei province, which was the hardest hit, Rivers cautions.
Much of the report focuses on understanding how China achieved what many public health experts thought was impossible: containing the spread of a widely circulating respiratory virus. “China has rolled out perhaps the most ambitious, agile, and aggressive disease containment effort in history,” the report notes.
The most dramatic—and controversial—measure was the lockdown of Wuhan and nearby cities in Hubei province, which has put at least 50 million people under a mandatory quarantine since 23 January. That has “effectively prevented further exportation of infected individuals to the rest of the country,” the report concludes. In other regions of mainland China, people voluntarily quarantined and were monitored by appointed leaders in neighborhoods.
Chinese authorities also built two dedicated hospitals in Wuhan in just over 1 week.

Science | AAAS

www.sciencemag.org

I'm very curious as to how those 50 million have been getting supplies all this time. That's a massive amount of food to be moving around in hazmat gear.

 

[Beach Friends]

Exacto-freaking-ly. (Except for the lethality part)

We're finding people who died a week ago and went undetected until we tested the corpse.
When Covid19 gets bad it gives you pneumonia. When you show up in the ER, that's what they see..pneumonia. If you die, that's what goes down as cause of death: Pneumonia.
[/QUOTE]

I am sure the folks who analyze the stats factor in for this and it's probably just admitted ignorance on my part - but how do we come up with an accurate morality (tacoes) rate when we know that the infection rate is under reported/diagnosed?

That's an inarticulate question I know.

I am sure it's a percentage of known cases, but from what I understand many people who have the virus are actually asymptomatic. Certainly there are many cases where people are symptomatic, but they are never diagnosed.

I am just not sure how we can make comparisons with the mortality rate of the flu with such little information.

One thing I heard this morning is that complications with this virus tend to be lower respiratory as opposed to upper with the cold and flu, and that's one reason it may be more fatal.

 

[zztop]

meanwhile:
In 2014, Trump relentlessly attacked Obama’s handling of the Ebola epidemic in Africa, savaging him in nearly 100 Twitter posts over a three-month period.

“The United States must immediately institute strong travel restrictions or Ebola will be all over the United States-a plague like no other!” Trump wrote on Sept. 30, 2014.

“Obama just appointed an Ebola Czar with zero experience in the medical area and zero experience in infectious disease control. A TOTAL JOKE!” he wrote two weeks later. (Wednesday, Trump defended his choice of Pence, who is also not a doctor or scientist, because he had been a governor.)

(Oh and Trump also dismantled the pandemic response team Obama left him) https://www.snopes.com/fact-check/trump-fire-pandemic-team/

 

[superchuck500]

Exacto-freaking-ly. (Except for the lethality part)

We're finding people who died a week ago and went undetected until we tested the corpse.
When Covid19 gets bad it gives you pneumonia. When you show up in the ER, that's what they see..pneumonia. If you die, that's what goes down as cause of death: Pneumonia.
I am sure the folks who analyze the stats factor in for this and it's probably just admitted ignorance on my part - but how do we come up with an accurate morality (tacoes) rate when we know that the infection rate is under reported/diagnosed?

That's an inarticulate question I know.

I am sure it's a percentage of known cases, but from what I understand many people who have the virus are actually asymptomatic. Certainly there are many cases where people are symptomatic, but they are never diagnosed.

I am just not sure how we can make comparisons with the mortality rate of the flu with such little information.

One thing I heard this morning is that complications with this virus tend to be lower respiratory as opposed to upper with the cold and flu, and that's one reason it may be more fatal.

There are different methods that are used (population based analysis) for data from epidemics - it’s not purely a deaths/cases ratio. Right now the estimated (observed) mortality for Covid-19 is 3.4% by WHO - which is less than the >6% figure you get if you divide reported deaths by total cases. I heard an expert explain it last week but I didn’t fully get it - but it draws on extrapolations about medical presentation against the total population in an area. There’s a lot of developed science here, there’s some complex statistical analysis deployed to answer some of these questions.

Note that he also said that he doesn’t think there are meaningful numbers of asymptomatic cases of this virus. Most people are going to get sick, even if it’s “mild” they will have fever and even some mild respiratory discomfort. How many of those will get tested remains to be seen.

 

[MT15]

The lack of testing is the huge, huge, huge reason. While other countries were emphasizing testing, and getting that all ramped up, we were saying we had to keep it from getting here. Well, guess what, it was probably already here while they were saying that. The CDC refused to test anyone who hadn’t traveled to China for a couple of months, and we squandered that time by not knowing it was already here. People who presented with symptoms were not tested, which denied us the valuable information that was really desperately needed to set priorities.

Without viable testing that’s available to all the hospitals and all the urgent care centers, we aren’t going to even know what the infection rate is here. We aren’t going to know how lethal it is, either. And we still don’t have enough test kits, which is just unconscionable. It was bad enough that the CDC went with a faulty test kit, rather than use the kit developed by WHO, but that was a couple of weeks ago, and we still don’t have wide access. This is going to lead to huge numbers of cases going undetected, which means that huge numbers of people are going to infect more people than they should, because they don’t know they have the virus.

A lot of people will die, who didn’t need to die, if we had done half as good a job as we did with the H1N1 or Ebola crises.

 

[SaintForLife]

I’m going to screenshot highlights of this twitter thread, because I think it’s spot on about why our response has been so inadequate.

it’s a long thread, but well worth the read.

That guy has a definite POV. I see you've come around on the Twitter posts after scolding me about it.

 

[MT15]

Oh, I’m not against Twitter, but I think you have to be careful about who you lend credence to. This guy seems to be pretty impartial and knowledgeable about crisis management. He’s not someone I follow or anything, but he worked on Ebola, which was handled to perfection, so I would give him a listen.

I thought he had a great point about how the attitude from the very top of an organization can bleed down and disrupt decision making. It’s a huge error in management. It’s like refusing to follow the scientific data wherever it leads, but rather trying to bend it to fit your predetermined conclusion.

Presumably there are still a lot of people at the CDC who were there for Ebola and/or H1N1, but they ignored what they should have been doing because the president made it obvious the way he leaned. He didn’t let the experts do their jobs, but he rather tried to control the situation himself, and let them know the angles he wanted them to take. So we had a lack of testing, except for people who had been in China, and an emphasis on downplaying the risks, and meanwhile the virus was already here and being circulated in the Northwest, undetected. And I still hear about travel bans, even now. We should be testing everyone who has pneumonia of unknown origin. We should have been doing that weeks ago. We lost our opportunity to get in front of this, slim as it was.

 

[superchuck500]

Always look on the bright side of life . . .

 

[wardorican]

Morality isn’t going to be 3.4% in the US - but it’s substantially worse than the flu. Right now, I think one of the biggest errors we could make would be to disregard it as relatively benign. A significant percentage of infected require hospitalization - and if those numbers get too big in a given region, it can get ugly quickly, not only for Covid-19 patients but for the whole healthcare system.

If you’re too cavalier about it early on, it makes it much harder to pivot if you realize you under-appreciated the threat. The US lost valuable time by mismanaging the early response but we can keep it manageable if effective tracking, isolation, and social mitigation (where needed) are deployed.

The problem with this “it’s all the alarmist media” and insisting it’s not a big deal is that it puts people in the wrong mindset to succeed if their locality suffers a significant outbreak. You don’t have to believe it’s a big deal but at least be ready to do your part if health and emergency authorities ask you to.

I look at it differently. I do think there is a good reason to be more cautious with this strand of coronavirus. I also think it's a little over blown.

However, at the same time, this illustrates how terrible we are at just doing basic normal stuff to keep pathogens at bay. Wash your hands, keep your distance, if you're sick, stay away, don't lick your freaking hands if you're sick, don't lick your hands and touch a bunch of shared things, even if you're healthy.. c'mon man.. We really should take the Flu more seriously.

We don't have to be germaphobes, but we need to be less dirty. It always annoys me when I hear guys say "Well, I don't need to worry about all that, I have a strong immune system, unlike you weaklings". This whole alpha pride at having well beyond substandard hygiene habits is just stupid.

 

[Goatman saint]

Oh, I’m not against Twitter, but I think you have to be careful about who you lend credence to. This guy seems to be pretty impartial and knowledgeable about crisis management. He’s not someone I follow or anything, but he worked on Ebola, which was handled to perfection, so I would give him a listen.

I thought he had a great point about how the attitude from the very top of an organization can bleed down and disrupt decision making. It’s a huge error in management. It’s like refusing to follow the scientific data wherever it leads, but rather trying to bend it to fit your predetermined conclusion.

Presumably there are still a lot of people at the CDC who were there for Ebola and/or H1N1, but they ignored what they should have been doing because the president made it obvious the way he leaned. He didn’t let the experts do their jobs, but he rather tried to control the situation himself, and let them know the angles he wanted them to take. So we had a lack of testing, except for people who had been in China, and an emphasis on downplaying the risks, and meanwhile the virus was already here and being circulated in the Northwest, undetected. And I still hear about travel bans, even now. We should be testing everyone who has pneumonia of unknown origin. We should have been doing that weeks ago. We lost our opportunity to get in front of this, slim as it was.

Dr. Fauci was there when the HIV virus made its appearance, and was one of the people involved in setting policy and the management of it while running into issues with Reagan and the gay plague that was going around. He’s also contributed to the Ebola outbreak and such. Yet, he is on record this last week how you can’t go against the president. So once again an expert who has been there, done that is being muzzled and interferes with by a clueless elected official who doesn’t have the depth of knowledge or experience of a career professional. I mean the two people leading the show, one tried to pray away an HIV epidemic and the other is the guy who thinks..... well doesn’t

 

[reubenray]

What is the mortality rate in the US?

 

[Goatman saint]

What is the mortality rate in the US?

Right now very artificially high. The first cases that are passing are the older, unhealthy people on the ships, or the nursing home in Washington where there are 60+ positive cases in an age bracket and health category where I assume most will end up dying. Also, with the lack of testing, who knows how many are having it and simply just going through the day? It’s been in Washington 6 weeks and I would guess the way it’s popping up in SF for just as long. So, our rates are probably as accurate as China’s first set of numbers. High death rate with lots of more minor cases slipping through undetected.

 

[wardorican]

This older guy on CNBC said, follow the data and dont panic. If under 60 mortality is almost 0 (or is?). 60-80 it is in single digits. Above 80, it is like a 20% and up mortality rate...

Not sure if he was accurate or not.

 

[JimEverett]

Just saw the Governor said a case was confirmed in my county. Williamson County, Tennessee

 

[efil4]

Just saw the Governor said a case was confirmed in my county. Williamson County, Tennessee

and traveled from within US

( not Italy, China or another affected area )

 

[MT15]

So I thought Trump was going to let Pence control the flow of information? And he just. keeps. talking. He should clam up about it, he’s not helping.

 

[SaintForLife]

Oh, I’m not against Twitter, but I think you have to be careful about who you lend credence to. This guy seems to be pretty impartial and knowledgeable about crisis management. He’s not someone I follow or anything, but he worked on Ebola, which was handled to perfection, so I would give him a listen.

I thought he had a great point about how the attitude from the very top of an organization can bleed down and disrupt decision making. It’s a huge error in management. It’s like refusing to follow the scientific data wherever it leads, but rather trying to bend it to fit your predetermined conclusion.

Presumably there are still a lot of people at the CDC who were there for Ebola and/or H1N1, but they ignored what they should have been doing because the president made it obvious the way he leaned. He didn’t let the experts do their jobs, but he rather tried to control the situation himself, and let them know the angles he wanted them to take. So we had a lack of testing, except for people who had been in China, and an emphasis on downplaying the risks, and meanwhile the virus was already here and being circulated in the Northwest, undetected. And I still hear about travel bans, even now. We should be testing everyone who has pneumonia of unknown origin. We should have been doing that weeks ago. We lost our opportunity to get in front of this, slim as it was.

That might be true about him being impartial, but he has been retweeting MSNBC's Chris Hayes so maybe not . Joking aside I think your post shows it's good to ascertain the credibility of someone's work by reading it, looking for other sources that confirm the accuracy, etc instead of just dismissing everything because you don't like what they are saying like you did in the Russia thread.

 

[MT15]

That might be true about him being impartial, but he has been retweeting MSNBC's Chris Hayes so maybe not . Joking aside I think your post shows it's good to ascertain the credibility of someone's work by reading it, looking for other sources that confirm the accuracy, etc instead of just dismissing everything because you don't like what they are saying like you did in the Russia thread.

So that’s a gross misrepresentation of what happened.

You were the one asserting your fave the yellow highlighter lady is an unbiased, I think you used the word “straight”, news reporter. What I pointed out to you is that she is totally in the conservative camp, and her work is completely one sided. You can still like her or whatever, but she’s definitely coming at everything from one side. Just like Maddow, who you totally dismiss, she’s the right’s version of Maddow. She was one of the reporters who worked for Fox when they started it up. Neither one just makes stuff up, but both are only going to give you one side of the story.

It’s fine to consume biased sources, but you need to at least recognize that you are doing so.