All things political. Coronavirus Edition. (1 Viewer)

[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?

 

[superchuck500]

I didn't realize until I looked it up after you posted this that Ireland, like the U.K., is exempted from the European travel ban despite being a member of the E.U. But I guess it makes sense since he owns golf courses in both places.

Supposedly it's because the ban only relates to nations in the Schengen Area - and UK isn't a part of that.

 

[superchuck500]

Trevor Bedford calculates that the Europe travel ban will prevent 1 new case for every 18 new cases resulting from domestic US spread.

 

[SystemShock]

I've been seeing your post on Covid-19 for a while now on here and on SR. It seems like you continue to miss the point over and over with this virus. It's not just the illness itself that is the issue (well, it is for older people, but not as much for the rest of the general population). It's multiple issues around the virus that when combined create the problem we're facing. Those issues are:

1.) How easily the virus is transmitted.
2.) The incubation period of the virus and that people can spread it easily before they show symptoms.
3.) The percentage of people that develop serious respiratory illness requiring hospitalization and ventilators.
4.) The fact that we have a limited number of ICU hospital beds and ventilators (and no where close enough to provide for the estimated number of pople that will require them.
5.) The fact that there are no vaccines or viral treatments for this virus since it's new and that it will take at least a year to develop effective vaccines and treatments.
6.) The fact that we have limited testing to date on the number of people infected and clear vision on community spread and are still having problems getting test.
7.) Due to the shot lifespan, we still don't know if this is seasonal, like the flu (although indication are that it's not seasonal since it's spreading currently in warm weather climates), and what will happen long term.

If it where just any one or two of those factors, we'd probably be fine. But when you combine that with the seasonal flu and current hospital load/health care treatment, it overloads our health care system and creates a cascading list of critical problems that we'll have to face.

You're a logical person, so just on a numbers and logic basis, you should be able to make since why we should all be taking this seriously. Yet it seems like you're very dismissive of it all. Maybe you as an individual will be fine even if you do get sick. If that's all you care about, then fine. But we all have parents, grandparents, other family, friends, co-workers, etc, that may not be in that same position due to other reasons. And even if you don't get coronovirus, you better hope you don't have some other medical emergency while the health care system is overloaded, because you'll be up shirt creek.

Again, I was told the healthcare system was fine if all of the sudden millions of extra people... anyway..

But I am not missing the point. And I never said we should not take things seriously. What I am saying is, we should not be panicking and contributing to the frenzy.

Numbers wise, if you want to project 10 million people are going to have to be rushed to the hospital at the same time and all will need respirators for months on end, ok... but so far, the actual numbers don't support that.

Speaking of the flu, don't believe the cold weather hype. Temperatures in my hometown rarely go below 60 at night during the coldest month, and people get the flu.

 

[coldseat]

Again, I was told the healthcare system was fine if all of the sudden millions of extra people... anyway..

By whom?

 

[SaintForLife]

How worried should we be about coronavirus?

So are we all going to die or is it going to fizzle out? In Naples the police drive along streets with loudhailers, warning everyone to keep indoors; in Britain the government declines to close schools, call off sporting fixtures and persuade people out of the pub. Something feels not quite...

www.spectator.co.uk

 

[superchuck500]

How worried should we be about coronavirus?

So are we all going to die or is it going to fizzle out? In Naples the police drive along streets with loudhailers, warning everyone to keep indoors; in Britain the government declines to close schools, call off sporting fixtures and persuade people out of the pub. Something feels not quite...

www.spectator.co.uk

It's fair analysis to be sure - I think the 1% case fatality rate is probably a best figure, all things considered (though 1% is 5x the CFR for H1N1 and something like 10x seasonal flu). The contagiousness analysis is based on a lot of extrapolation, it's hard to really be that confident about it. It's clear that the virus is substantially contagious, but only during the symptomatic phase - which makes it much easier to mitigate.

I think it's important for the response to remain factual - and I don't think that appropriate efforts to mitigate the spread should be seen as "panic." But I think that saying "don't be worried because you're not likely to die" results in an under-appreciation of the risks that are there, and the need for people to embrace the mitigation effort.

And for that, I think there are two items in particular that are under-appreciated in that article::
(1) The case fatality rate for people over 70 is significantly higher (believed to be approx. 5%) and for over 80 it is substantially higher (perhaps north of 15%). . . and when you add underlying medical conditions (which can by anything from diabetes to respiratory conditions like asthma) the at-risk age gets younger. We can't just tell the 70+ to stay in their homes for a year while the rest of us suffer mild illness and get on with it. Either it's mitigated or it isn't.

(2) The article fails to mention, at all, the rates of hospitalization and the burden it has on the healthcare system in any given community where case-load exceeds hospital capacity. As we learn more about how the western countries are handling it, we are seeing more and more focus from the medical and infectious disease experts that rates of hospitalization (and ICU needs) are much higher than other respiratory illness and when a given hospital or hospital runs out of ICU space or out of ventilators, it becomes really problematic. And the quality of outcomes goes down.

Taking this seriously isn't panic. But treating it as mostly benign enhances risk.

 

[Joe Okc]

Pelosi ignores Trump taunts as she steers through another crisis

The speaker has taken charge of the economic rescue plan as the coronavirus spreads.

www.politico.com

Wow... that website is neutral for sure..lol... If it threw anymore Sugar on Pelosi she'd turn into a marshmellow... shheeezzzzzz... I bet that website is not biased... nope... not at all...

Two things...

If this virus is helping any candidate in particular it has to be Sanders with his free healthcare...

 

[SaintForLife]

It's fair analysis to be sure - I think the 1% case fatality rate is probably a best figure, all things considered (though 1% is 5x the CFR for H1N1 and something like 10x seasonal flu). The contagiousness analysis is based on a lot of extrapolation, it's hard to really be that confident about it. It's clear that the virus is substantially contagious, but only during the symptomatic phase - which makes it much easier to mitigate.

I think it's important for the response to remain factual - and I don't think that appropriate efforts to mitigate the spread should be seen as "panic." But I think that saying "don't be worried because you're not likely to die" results in an under-appreciation of the risks that are there, and the need for people to embrace the mitigation effort.

And for that, I think there are two items in particular that are under-appreciated in that article::
(1) The case fatality rate for people over 70 is significantly higher (believed to be approx. 5%) and for over 80 it is substantially higher (perhaps north of 15%). . . and when you add underlying medical conditions (which can by anything from diabetes to respiratory conditions like asthma) the at-risk age gets younger. We can't just tell the 70+ to stay in their homes for a year while the rest of us suffer mild illness and get on with it. Either it's mitigated or it isn't.

(2) The article fails to mention, at all, the rates of hospitalization and the burden it has on the healthcare system in any given community where case-load exceeds hospital capacity. As we learn more about how the western countries are handling it, we are seeing more and more focus from the medical and infectious disease experts that rates of hospitalization (and ICU needs) are much higher than other respiratory illness and when a given hospital or hospital runs out of ICU space or out of ventilators, it becomes really problematic. And the quality of outcomes goes down.

Taking this seriously isn't panic. But treating it as mostly benign enhances risk.

We should definitely take it seriously and be extra careful. I think the media is to blame for making it seem like it's much worse than it is. I was talking to a doctor today that I work with and he said when you remove the Chinese deaths then the mortality rate is much closer to the flu. He also thinks the media reaction is over the top and scaring people.

 

[UncleTrvlingJim]

By whom?

I think he means me when I said insuring everyone would not overly strain our current system. I'm not sure why he thinks a large increase in people getting sick is the same thing as a large number of people getting insured though. Should be obvious they aren't the same scenario.

 

[superchuck500]

We should definitely take it seriously and be extra careful. I think the media is to blame for making it seem like it's much worse than it is. I was talking to a doctor today that I work with and he said when you remove the Chinese deaths then the mortality rate is much closer to the flu. He also thinks the media reaction is over the top and scaring people.

I don't think that's accurate - I think the case fatality rate outside of China has been higher so far. Part of that is due to Italy's population being quite old.

 

[SaintForLife]

I don't think that's accurate - I think the case fatality rate outside of China has been higher so far. Part of that is due to Italy's population being quite old.

He is also factoring in that most of the deaths have been the elderly. Also since we have limited amounts of tests then we have to assume that there are many more people out there that have the Coronavirus that haven't been tested which would also lower the mortality rate for all age groups except the elderly.

 

[Nebaghead]

We should definitely take it seriously and be extra careful. I think the media is to blame for making it seem like it's much worse than it is. I was talking to a doctor today that I work with and he said when you remove the Chinese deaths then the mortality rate is much closer to the flu. He also thinks the media reaction is over the top and scaring people.

The spread grows exponentially until restrictions are implemented. Will the US be able to tell people stay home. Even if people do stay home till the peak goes away, how bad will the financial impact be. People who live paycheck to paycheck or don't have sick time or PTO will be crushed. Businesses that don't have reserves will go out of business. Small Businesses will be destroyed.

 

[UncleTrvlingJim]

This is an interesting case study on how people perceive risk, and how to mitigate it.

If COVID-19 follows a worst case scenario - which means something like half the world's population catches it with a 10% ending up in ICU and 1% fatality - that's 350 million people in the ICU worldwide and 35 million dying. Obviously, that seems like something to get worked up over right?

If COVID-19 follows a best (realistic) case scenario - that would be something like 30% of the world's population getting it with 3% ICU and .1% fatality. That would be 63 million in ICU and 2.1 million fatalities. What sort of reaction would that be worth?

Now, how do you assess the probability of the various scenarios? What are the ramifications and costs of each scenario? How much are you willing to spend to lower the probability of a particular scenario?

In general, people don't need to panic, in terms of believing they are going to die or become seriously ill from COVID-19. But they should understand that this could be a serious issue for the the public health system and they have a responsibility to act in a reasonable manner to slow the spread of the disease, and government officials absolutely should not be downplaying the risks.

 

[superchuck500]

He is also factoring in that most of the deaths have been the elderly. Also since we have limited amounts of tests then we have to assume that there are many more people out there that have the Coronavirus that haven't been tested which would also lower the mortality rate for all age groups.

Yeah, maybe. The WHO's report in China concluded that truly asymptomatic cases are very unlikely - 99% of people are going to at least experience some kind of symptoms including fever, fatigue, and coughing. In other words, you know you've got something - but for most healthy people those kinds of symptoms probably don't prompt you to go to the doctor. That's actually part of the point of widespread testing is that people with mild testing can go get tested (under responsible arrangements such as drive-through testing) to help the public health experts understand the scope of the outbreak.

Given that the rate of hospitalization has been so high among the 70+ age group (I saw it was north of 40% in Italy), I don't it's that reasonable to presume that there are truly meaningful numbers of older people that go through it with such mild symptoms that they don't go see a doctor. My mother (71) is just getting over a cold - and she felt so bad she went to the doctor about it. And she's not the kind of person that rushes off to the doctor about everything . . . I just think older people are more disposed to go to the doctor when something is wrong. They have to if they're going to keep ahead of possible problems at their age.

I dont' know, we'll see how it plays out. But the only way to really know what we're dealing with is to have robust testing and good Lord we've done so poorly on that. The African nation of Senegal has a better test program than the United States.

 

[Nebaghead]

https://www.haaretz.com/us-news/bra...week-tests-positive-for-coronavirus-1.8669245

I guess all those rich people that go to Mar-a-largo will get quarantined.

 

[GMRfellowtraveller]

We should definitely take it seriously and be extra careful. I think the media is to blame for making it seem like it's much worse than it is. I was talking to a doctor today that I work with and he said when you remove the Chinese deaths then the mortality rate is much closer to the flu. He also thinks the media reaction is over the top and scaring people.

'the media' takes are always too facile
1st there isn't a THE MEDIA - sure it can sometimes be some unfortunate aggregate of our collective id, ego and corporate interests
but be that as it may - what should 'the media' do? - assume that not everyone stays glued to news cycles 24/7 the way we do. we would want some sort of amplification to make sure the message reaches as many as possible (rhetorical, yes, we would want that) - a degree of exaggeration is to be expected

 

[SystemShock]

By whom?

By people here when I wondered about Bernie Sanders' healthcare plan not mentioning any plans for a health care system infrastructure that all of the sudden would take on millions of extra patients for every illness (imagined or otherwise) there is... and people assured me that it was going to be all honky dory the way it is now, as people were going to be orderly and get preventive care (as if that doesn't take up resources) and for the most part no one is going to get sick because of the preventive care...

 

[coldseat]

By people here when I wondered about Bernie Sanders' healthcare plan not mentioning any plans for a health care system infrastructure that all of the sudden would take on millions of extra patients for every illness (imagined or otherwise) there is... and people assured me that it was going to be all honky dory the way it is now, as people were going to be orderly and get preventive care (as if that doesn't take up resources) and for the most part no one is going to get sick because of the preventive care...

Ok. That's not really what we're talking about and not really the same thing. You're kind of being a little obtuse here, I guess to make a point about medicare-for-all or something.