Coronavirus testing (1 Viewer)

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    dtc

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    What is the deal with the tests?

    Seems like I'm reading we are processing 30% fewer tests this week than last and we've never been testing anywhere near what we should have been.

    What happened to the drive-thru testing and all that and why in this nation are we having a hard time putting our hands on freaking cotton swabs?

    I find it terribly unnerving to know we haven't been able to test as well as Korea or really anywhere yet.

    What gives?
     
    Glad you got tested.

    Not this winter but the one before last I got walking pneumonia and have had it a few times in my life not fun in the least and really takes a good bit of time until you are really back to where you were beforehand.

    We all are gonna have to get tested eventually. I could see a point where you can't get on a plane or your employer makes it mandatory because they don't want the potential law suits.

    What if I you are retired and don't fly? I am retired and I take my trips in my motorhome. There are a lot of RV'rs out there that are retired and don't fly.
     
    What if I you are retired and don't fly? I am retired and I take my trips in my motorhome. There are a lot of RV'rs out there that are retired and don't fly.


    I don't have anything to say to that except good for you! Your fuel costs are probably more than my whole vacation.

    I don't fly much either most of my travels are on two wheels but sleeping on the ground every now and again because I am kinda cheap.

    I am more than certain you will have to get tested to ever have any operation or real dental work done in the future.

    Don't you worry you are gonna have to take one eventually.
     
    I don't have anything to say to that except good for you! Your fuel costs are probably more than my whole vacation.

    I don't fly much either most of my travels are on two wheels but sleeping on the ground every now and again because I am kinda cheap.

    I am more than certain you will have to get tested to ever have any operation or real dental work done in the future.

    Don't you worry you are gonna have to take one eventually.

    Not to get off topic, but traveling in my motorhome is not as expensive as you think (minus the motorhome cost). I can spend $400 in fuel and be 2000 miles away. I always spend a few nights or more around the 250 mile point. A 7,000 mile trip that would cost me between $1,500 to $2,000 in fuel would last 3 months.

    Back to the subject my brother had to get tested being he had surgery. If I don't need surgery a year or two down the road they may not still be testing. My point is I would not get tested until I had to.
     
    Not to get off topic, but traveling in my motorhome is not as expensive as you think (minus the motorhome cost). I can spend $400 in fuel and be 2000 miles away. I always spend a few nights or more around the 250 mile point. A 7,000 mile trip that would cost me between $1,500 to $2,000 in fuel would last 3 months.

    Back to the subject my brother had to get tested being he had surgery. If I don't need surgery a year or two down the road they may not still be testing. My point is I would not get tested until I had to.

    I hear you on if you don't need to but if this is around a couple of years I am sure everyone will have to eventually.

    On the side I like the RV thing just not in the budget. But I ride a smaller cc motorcycle. I get exceptionally good mileage. 50s normally. Nowhere near as comfortable as you but the last real trip I took across South Texas and into Mexico I probably spent 350 to 400 total.

    Don't get me wrong would rv if I could but would at least have a scooter on the back.
     
    I'm also getting tested tomorrow. I don't know when they'll give me the results.
    I tested negative for antibodies.

    On another matter, the world-wide disparity in mortality data by country is crazy! How can several countries have less than a 1% mortality rate while other countries are more than 100 times higher? Here is a sampling:

    Bahrain 0.1%
    Singapore 0.13%
    Qatar 0.22%
    Kuwait 2.2%
    Russia 2.7%
    Luxembourg 2.8%
    Norway 3.0%
    Germany 5.0%
    Denmark 5.3%
    China 5.6%
    Spain 12.1%
    Brazil 13.4%
    USA 17.4%
    Italy 18.4%
    Sudan 23.8%
    France 30.0%
    Belgium 37.7%
    Sweden 45.9%
    Haiti 60.0% (but this is only out of 55 people whose cases are closed)

    I wonder how much of this is a function of different reporting standards, different test levels, deception, different treatments, different health systems, different population susceptibilities and/or different bugs? Some can be explained by different approaches to handling the bug, but it is an extraordinary difference. Does anyone know whether this occurred during the 1918 flu or more recent mini-breakouts?
     
    I tested negative for antibodies.

    On another matter, the world-wide disparity in mortality data by country is crazy! How can several countries have less than a 1% mortality rate while other countries are more than 100 times higher? Here is a sampling:

    Bahrain 0.1%
    Singapore 0.13%
    Qatar 0.22%
    Kuwait 2.2%
    Russia 2.7%
    Luxembourg 2.8%
    Norway 3.0%
    Germany 5.0%
    Denmark 5.3%
    China 5.6%
    Spain 12.1%
    Brazil 13.4%
    USA 17.4%
    Italy 18.4%
    Sudan 23.8%
    France 30.0%
    Belgium 37.7%
    Sweden 45.9%
    Haiti 60.0% (but this is only out of 55 people whose cases are closed)

    I wonder how much of this is a function of different reporting standards, different test levels, deception, different treatments, different health systems, different population susceptibilities and/or different bugs? Some can be explained by different approaches to handling the bug, but it is an extraordinary difference. Does anyone know whether this occurred during the 1918 flu or more recent mini-breakouts?


    It all comes down to several factors

    How quickly the countries implemented lock downs and restrictive measures
    How well developed the medical systems are in the countries
    The population density
    Number of people tested.

    My experience is mostly with Scandinavia so lets look at Norway, Sweden and Denmark.

    At the beginning Denmark set up special screening when planes arrived from China but to no avail because the virus did not arrive from China but from Austria and Italy. The week before everything started to go haywire in Italy, was our wintervacation week so people went skiing in Austria and Northern Italy. The outbreak there only just started when people were returning from their vacation so it took a few days before the authorities became aware of the risk associated by those returning from their vacation there. So we began with around +50 infected who all had been going about their business for a few days before becoming symptomatic - and all tracing the infection to two small towns in Italy and Austria. Denmark was the first to lock down everything and are only just beginning to open up. Denmark also have the highest population density of all three at 129. Since Denmark also have been testing the most of all 3 that helped to keep the mortality rate down (82/1000)

    Norway also shut down quickly, and with its low population density, and without the initial "imported cases" they have fared best of all the scandinavian Countries. They had also been testing a lot of people (44/1000)

    Sweden went the other way. They did not believe in lock downs and kept everything open - going for "herd immunity" which the number of deaths also clearly shows. They also only test far less people than Norway and Denmark (22/1000) . So less people tested positive + many more deaths = High mortality rate.
     
    It all comes down to several factors

    How quickly the countries implemented lock downs and restrictive measures
    How well developed the medical systems are in the countries
    The population density
    Number of people tested.

    My experience is mostly with Scandinavia so lets look at Norway, Sweden and Denmark.

    At the beginning Denmark set up special screening when planes arrived from China but to no avail because the virus did not arrive from China but from Austria and Italy. The week before everything started to go haywire in Italy, was our wintervacation week so people went skiing in Austria and Northern Italy. The outbreak there only just started when people were returning from their vacation so it took a few days before the authorities became aware of the risk associated by those returning from their vacation there. So we began with around +50 infected who all had been going about their business for a few days before becoming symptomatic - and all tracing the infection to two small towns in Italy and Austria. Denmark was the first to lock down everything and are only just beginning to open up. Denmark also have the highest population density of all three at 129. Since Denmark also have been testing the most of all 3 that helped to keep the mortality rate down (82/1000)

    Norway also shut down quickly, and with its low population density, and without the initial "imported cases" they have fared best of all the scandinavian Countries. They had also been testing a lot of people (44/1000)

    Sweden went the other way. They did not believe in lock downs and kept everything open - going for "herd immunity" which the number of deaths also clearly shows. They also only test far less people than Norway and Denmark (22/1000) . So less people tested positive + many more deaths = High mortality rate.
    That does not seem to explain it. Austria, for example, has a testing rate less than half that of Denmark - yet their death rate is almost a third less than Denmark's.
    In fact, there are a lot of nations with a lower death rate than Denmark's and also a lower testing rate - including the fellow Noric country of Finland, whose testing rate is less than a third of Denmark's and whose death rate is close to half of Denmark's.
     
    That does not seem to explain it. Austria, for example, has a testing rate less than half that of Denmark - yet their death rate is almost a third less than Denmark's.
    In fact, there are a lot of nations with a lower death rate than Denmark's and also a lower testing rate - including the fellow Noric country of Finland, whose testing rate is less than a third of Denmark's and whose death rate is close to half of Denmark's.


    Finland has the lowest population density of all the scandinavian Countries. Population density matters as is obvious when you compare New york and Wyoming. Austria was among those countries hit hard and very early in Europe so they also locked down everything very quickly. The initial outbreak in Austria was contained to one region with a low local population density but with a huge amount of tourists coming in for skiing. Austria along with northern Italy was the hot spots from which most of Europe got infected.

    Bottom line is this. Most of the countries which took early preventive measures and locked down quickly, were hit a lot less than those which locked down later down the road (or like Sweden did not lock down at all)

    Austria had its first confirmed case on 25th of February 2020 and locked down on March 15th/16th (18 days)

    Italy had its first confirmed case in january and suddenly by 21th of February they had a lot of cases within a few days and the first death on the 22nd so they were slow to detect the initial outbreak in Lombardy. Yet they did not shut everything down until March 21st, although they did start a gradual shut down on march 9th and gradually expanded it until March 21st.
     
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    Finland has the lowest population density of all the scandinavian Countries. Population density matters as is obvious when you compare New york and Wyoming. Austria was among those countries hit hard and very early in Europe so they also locked down everything very quickly. The initial outbreak in Austria was contained to one region with a low local population density but with a huge amount of tourists coming in for skiing. Austria along with northern Italy was the hot spots from which most of Europe got infected.
    Germany is more dense than Italy, has tested 20% less than Italy, and yet their death rate is well south of a quarter of Italy's.
    I think Lapaz's question is a good one, and you are going to be able to find stats that discount explanations based on things like testing rate and density.
    Although, I do think those are factors
     
    Germany is more dense than Italy, has tested 20% less than Italy, and yet their death rate is well south of a quarter of Italy's.
    I think Lapaz's question is a good one, and you are going to be able to find stats that discount explanations based on things like testing rate and density.
    Although, I do think those are factors


    As I just wrote in my edited answer - how speedy the countries locked down after the initial infections were discovered mattered a lot.
     
    As I just wrote in my edited answer - how speedy the countries locked down after the initial infections were discovered mattered a lot.
    Why do you think that matters in terms of a death rate? I get that a speedy lockdown could slow the spread, but the death rate?
    Poland - a country with a population density just slightly less than Denmark did not start aggressive lockdowns until late March, has tested basically a fifth of the rate of Denmark, yet has a death rate less than a third of Denmark.
     
    I haven't checked the numbers for Poland.

    One of the issues in DK was that we got a lot of cases at once. We did not have a patient 0

    People got back from Skiing in Austria and we had +50 infected running around for almost a week before anyone knew they were infected or even been exposed. To show just how much just one person matters.. 45 of those all went to the same afterskiing bar i Austria, where one of the bartenders were infected. That ONE person started outbreaks in at least 7 countries...

    To make matter worse, the local authorities KNEW he was infected long before people started getting sick around Europe but chose to stay silent to protect their tourist industry. If they had notified the WHO and the other European countries, many outbreaks around Europe could have been more effectedly contained
     
    I haven't checked the numbers for Poland.

    One of the issues in DK was that we got a lot of cases at once. We did not have a patient 0

    People got back from Skiing in Austria and we had +50 infected running around for almost a week before anyone knew they were infected or even been exposed. To show just how much just one person matters.. 45 of those all went to the same afterskiing bar i Austria, where one of the bartenders were infected. That ONE person started outbreaks in at least 7 countries...
    I think you make some good points. I mean it is clear that the less you test you are going to have a higher death rate - assuming deaths are reported with some degree of consistency. not sure denser areas will have a higher death rate - higher case rate I can see. Although if there is evidence of a location's health infrastructure being overwhelmed I could see density being a factor in higher death rates.
    But there seems to be more than a few exceptions to any sort of reason given for such wide variation in death rates. It will be interesting to see how such variations are ultimately explained.
     
    I think it matters a lot if a country have a patient 0 or not - and also how honestly authorities are sharing informations about outbreaks.

    Most European contries took agressive and early actions regarding people arriving from China but since the Austrians did not share the information about Ischgl no one took any particular actions regarding those who arrived from there

    https://www.insider.com/austria-isc...ty-culture-coronavirus-outbreak-linked-2020-4

    https://www.washingtonpost.com/worl...4fa5fa-93bf-11ea-87a3-22d324235636_story.html
     
    not sure denser areas will have a higher death rate - higher case rate I can see.
    There's some speculation that viral load, particularly in terms of the infectious dose, correlates to severity of the illness. And it's possible that in densely populated areas with higher case rates, some people will typically be exposed to more potentially infected people and higher environmental contamination and hence higher viral loads than people in less densely populated areas with lower case rates. If so, this could result in not just more cases, but a higher likelihood of those cases being severe, and hence likely higher death rates.

    For example, here's one article discussing this in terms of the role of viral load in coronavirus transmission in the home environment: https://www.bmj.com/content/369/bmj.m1728

    To be absolutely clear, as far as I'm aware this isn't a confirmed factor for SARS-CoV-2 at this point, but it is a possibility, and would offer one reason for why denser areas could see a higher death rate. Other factors would still apply of course (e.g. testing in terms of metrics, differing PPE, distancing, hygiene, etc., in terms of how significant this factor is, if at all).
     
    I think Jim is right that many of the things y'all are saying would only affect the spread, not the death rate. Rob's point about the environmental factors in dense areas is certainly a viable factor, but I find it hard to believe that it would result in the vast differences in mortality between countries. One thing I've read is that Germany doesn't do post mortems, therefore they may have had many more deaths by Covid than is being reported, even though their rate of 5% is still much higher than some countries, but I think many of the countries that are reporting below 0.5% may have similar factors at play. I'm suspicious of countries that are reporting such low mortalities. It doesn't make sense that Singapore has only 23 deaths with over 33k cases and over 18k of those resolved! We had almost that many deaths in the Princess Cruise line!
     
    Death rates between countries that are being reported at this point in time are not worth much, imo. And not because the US is overstating them, we almost certainly are not, but because there is so much variation between countries on how deaths are reported. Death rate is one of those things that can only be estimated right now, and it will take a lot of research to pin it down after we get through the pandemic.

    For example, I read that even now Florida seems to be reporting “pneumonia” as a cause of death at a rate that is about 3-4 times (IIRC) the historical rate for pneumonia at this time of year. It’s a pretty good bet a fair number of those are undiagnosed Covid cases. Things like pneumonia and cardiac arrest as causes of death have a pretty good baseline figure for mortality. So any deviation makes one wonder if something else is at play.

    I’ve seen hospitalizations proposed as a better indicator for current level of community spread, but even that isn’t perfect I don’t think. It depends on what the admitting doctor puts on the record. So, it’s a pretty fluid situation.

    I can say that the ages of our hospitalized patients have surprised me somewhat. I expected a much older demographic to be in the hospital. We see mostly 50s and 60s, with a few seventies and a few forties. And age doesn’t seem to correlate exactly with severity, anecdotally, for our hospital. Some of the most severe cases have been in that 55-68 range. We just admitted a lady Friday directly to ICU that is 62.

    Also, lab results are crazy. A really weird mix of abnormal labs that you usually don’t see together. Sky high inflammation markers, which makes a certain amount of sense. But also iron metabolism is out of whack, and fibrinogens that are high as well. Most of them have high cardiac markers too. I can see why they are at risk of stroke. Our vendors have had to up their manufacture of certain reagents because we are doing a lot more of some tests that we normally don’t use that often. I’ve never seen anything quite like this.
     
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