Coronavirus (way, way, off topic)
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@NeverDie depends on who's old. Here in FR, yesterday, 38% of people in reanimation are <60years old. Being in reanimation, means people may also have future health consequences=money cost too.
Sadly, there are also doctors who died, infected nurses and firemen.. each day seems worse. with confinement, peak is coming very soon here I think.
Citing a french doctor: "when there is fire, you shouldn't look at the water bill" -
@NeverDie depends on who's old. Here in FR, yesterday, 38% of people in reanimation are <60years old. Being in reanimation, means people may also have future health consequences=money cost too.
Sadly, there are also doctors who died, infected nurses and firemen.. each day seems worse. with confinement, peak is coming very soon here I think.
Citing a french doctor: "when there is fire, you shouldn't look at the water bill"@scalz said in Coronavirus (way, way, off topic):
38% of people in reanimation are <60years old
They may be in re-animation, but are they dying? So far, US death rate seems governed by age:
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@scalz said in Coronavirus (way, way, off topic):
38% of people in reanimation are <60years old
They may be in re-animation, but are they dying? So far, US death rate seems governed by age:
@NeverDie As @scalz aptly quoted, "when there is fire, you shouldn't look at the water bill", unfortunately many of our politicians obsess over little else.
Frequently ignored on stats relating to age range of fatalities is the realities faced where COVID overwhelms, such as Italy. Those >60 are more likely to have medical complications which increase chances of pneumonia. When numbers attending hospital exceed resources, prioritising WHO gets ventilation kicks in. Over 60s are not priority but are given "assistance" to suffer less, hence inflating fatalities in that age range. A dreadful but necessary choice for doctors typical of a war zone.
China went on a war footing rapidly, field hospitals, roving screening, contact tracing, they wrote the book. Korea and Singapore refined the techniques successfully, look at their numbers and condition now...It is too early to assess the long term damage to health for survivors, but lung damage is fully expected, hence the desperate search for drugs which can have beneficial effect BEFORE infection becomes destructive.
Finally, the front line as @scalz highlighted. It is crucial medics etc are given all the PPE and kit they need, without it their numbers will deplete, and fatalities will increase... No healthcare system can handle this, again highlighting the importance of strategy deployed by Singapore/Korea etc, screen, test, trace, isolate.
Watch London in the next 10 days for a textbook example of bean-counter mentality on the health of a populace, it will eclipse Lombardy...
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@NeverDie As @scalz aptly quoted, "when there is fire, you shouldn't look at the water bill", unfortunately many of our politicians obsess over little else.
Frequently ignored on stats relating to age range of fatalities is the realities faced where COVID overwhelms, such as Italy. Those >60 are more likely to have medical complications which increase chances of pneumonia. When numbers attending hospital exceed resources, prioritising WHO gets ventilation kicks in. Over 60s are not priority but are given "assistance" to suffer less, hence inflating fatalities in that age range. A dreadful but necessary choice for doctors typical of a war zone.
China went on a war footing rapidly, field hospitals, roving screening, contact tracing, they wrote the book. Korea and Singapore refined the techniques successfully, look at their numbers and condition now...It is too early to assess the long term damage to health for survivors, but lung damage is fully expected, hence the desperate search for drugs which can have beneficial effect BEFORE infection becomes destructive.
Finally, the front line as @scalz highlighted. It is crucial medics etc are given all the PPE and kit they need, without it their numbers will deplete, and fatalities will increase... No healthcare system can handle this, again highlighting the importance of strategy deployed by Singapore/Korea etc, screen, test, trace, isolate.
Watch London in the next 10 days for a textbook example of bean-counter mentality on the health of a populace, it will eclipse Lombardy...
@zboblamont Yes, in an ideal world, I'm all for that. But realistically, for how long can it be maintained? At the moment, we're teetering on recession/depression. As you may have heard, in the US the politicians just recently authorized $2 Trillion direct cash injection to individuals and businesses, and supposedly that means most people will get a roughly $2,000 check. Wonderful. Just how long will that $2,000 last you before it runs out? A week? Two weeks? And then what? Another $2 Trillion? For argument's sake, let's say $4 Trillion/month. Times what? 12 months? 24 months? That would be a range of $48 Trillion to $96 Trillion dollars. Who's going to lend the US that kind of money, especially in an environment where other countries will be needing to borrow similar amounts? Even if everyone got behind that, is it even possible? I just don't see how. In the near term the treasury could print money, but there are limits to even that before dollars lose much of their value to inflation, and if that's the only plan then dollars will become devalued even sooner. US GDP is roughly $20 Trillion. Total existing national debt is $22 Trillion. If there's some way it's possible, I'm just wondering how.
And I don't mean this to be about the US. The same thing in will probably happen in many if not most other countries.
My earlier point was simply this: in the US the average life expectancy is 78.6 years. For simplicity, let's set aside the nuances of what that means and take that number at face value. Suppose that by whatever means and at whatever cost you could save a large chunk of the 85+ year olds. Just how much longer do you suppose they would live, even before coronavirus? Maybe a couple more years, on average? And yet, because I doubt the US will triage like the Italians are doing, they'll probably be occupying most of the hospital beds and respirators, because they'll become the sickest in the biggest numbers.
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Hi guys from Italy. I live in one of the most interested areas by the Virus and I can say that the situation is very bad. I read some of you refer to older people as the main group touched by the virus. That's obviously true but our doctors start to say that the last days people around 50 years old are now increasing in the intensive care units. So, since you all have more time than us, please stay at home and avoid any possible contact with others because this virus is very aggressive. Take care!
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Hi guys from Italy. I live in one of the most interested areas by the Virus and I can say that the situation is very bad. I read some of you refer to older people as the main group touched by the virus. That's obviously true but our doctors start to say that the last days people around 50 years old are now increasing in the intensive care units. So, since you all have more time than us, please stay at home and avoid any possible contact with others because this virus is very aggressive. Take care!
@giangired said in Coronavirus (way, way, off topic):
but our doctors start to say that the last days people around 50 years old are now increasing in the intensive care units
And yesterday a 16 y.o. girl died in France...
Edit: no pre-existing condition known and no saturation of hospital/missing equipment involved...
http://www.leparisien.fr/essonne-91/morsang-sur-orge-91390/julie-16-ans-decedee-du-coronavirus-personne-n-est-invincible-se-desole-sa-soeur-27-03-2020-8288850.php -
@zboblamont Yes, in an ideal world, I'm all for that. But realistically, for how long can it be maintained? At the moment, we're teetering on recession/depression. As you may have heard, in the US the politicians just recently authorized $2 Trillion direct cash injection to individuals and businesses, and supposedly that means most people will get a roughly $2,000 check. Wonderful. Just how long will that $2,000 last you before it runs out? A week? Two weeks? And then what? Another $2 Trillion? For argument's sake, let's say $4 Trillion/month. Times what? 12 months? 24 months? That would be a range of $48 Trillion to $96 Trillion dollars. Who's going to lend the US that kind of money, especially in an environment where other countries will be needing to borrow similar amounts? Even if everyone got behind that, is it even possible? I just don't see how. In the near term the treasury could print money, but there are limits to even that before dollars lose much of their value to inflation, and if that's the only plan then dollars will become devalued even sooner. US GDP is roughly $20 Trillion. Total existing national debt is $22 Trillion. If there's some way it's possible, I'm just wondering how.
And I don't mean this to be about the US. The same thing in will probably happen in many if not most other countries.
My earlier point was simply this: in the US the average life expectancy is 78.6 years. For simplicity, let's set aside the nuances of what that means and take that number at face value. Suppose that by whatever means and at whatever cost you could save a large chunk of the 85+ year olds. Just how much longer do you suppose they would live, even before coronavirus? Maybe a couple more years, on average? And yet, because I doubt the US will triage like the Italians are doing, they'll probably be occupying most of the hospital beds and respirators, because they'll become the sickest in the biggest numbers.
@NeverDie We have been teetering on global recession/depression since 2008 because the underlying problem was never addressed, we just stuck a band-aid on it and carried on with the same "religion". The MMT model is now peeking out amid the UK crisis, and the finance circus are up in arms seeing their QE milk-cow taken away. For the US there are multiple times that resistance and greater lobbying power but that's a whole other issue..
The problem with your earlier point is what value is placed on a human life, and as both preceding posts made clear the statistical prevalence of older sicker people masks the fact that this virus takes out the young and fit also.
Without mitigation and ultimately intervention those numbers will escalate dramatically, and you're going to need multiple field hospitals built by the army in record time to cope. It is THAT serious.As of this morning the US exceeded China's infections (who tested rigorously and universally v the US scenario) the wider the spread of the virus the greater the number of young and middle-aged who will die, it really is THAT simple.
As an aside, a 4,000 bed field ICU is almost completed in London just as ALL hospitals are at breaking point, but with it's high population it will still be too little for the tsunami which hits over the next 10 days.
Time was up 6 weeks ago.... -
@NeverDie We have been teetering on global recession/depression since 2008 because the underlying problem was never addressed, we just stuck a band-aid on it and carried on with the same "religion". The MMT model is now peeking out amid the UK crisis, and the finance circus are up in arms seeing their QE milk-cow taken away. For the US there are multiple times that resistance and greater lobbying power but that's a whole other issue..
The problem with your earlier point is what value is placed on a human life, and as both preceding posts made clear the statistical prevalence of older sicker people masks the fact that this virus takes out the young and fit also.
Without mitigation and ultimately intervention those numbers will escalate dramatically, and you're going to need multiple field hospitals built by the army in record time to cope. It is THAT serious.As of this morning the US exceeded China's infections (who tested rigorously and universally v the US scenario) the wider the spread of the virus the greater the number of young and middle-aged who will die, it really is THAT simple.
As an aside, a 4,000 bed field ICU is almost completed in London just as ALL hospitals are at breaking point, but with it's high population it will still be too little for the tsunami which hits over the next 10 days.
Time was up 6 weeks ago....@zboblamont Sounds apocalyptic. Here we've barely left the house since January. Take care, and even more so if you have one or more of the known co-morbidities that puts you at higher risk of death. Plan ahead and identify your source of nearest available supplemental oxygen in case it comes to that.
The Italians have started to say that hospitals are a major source of caronavirus infection, so I intend to stay away unless it's truly unavoidable.
In the US there's a push toward hospitals not attempting to resuscitate anyone (aka as "universal DNR") with caronavirus, because healthcare workers don't want to expose themselves to greater risks than they're already taking (which is the stated reason), but probably also legally absolve themselves from taking action when, for example, there simply aren't enough ventilators or other resources to meet demand. Otherwise, they'd be in a constant thrash mode trying to revive someone who has no ventilator access only to be in the same position a moment later, because there's still no spare ventilator to put them on. The only prior precedent for it would be people who officially ask in advance for DNR, with notarized paperwork and instructions to that effect, but this would encompass everyone, even if you've made it clear that's not what you want. I'm guessing it will be approved, but even if it isn't, I can imagine they may adopt that policy unofficially anyway out of either self survival or absurdity avoidance, in which case the public at large may not find out until after the dust has settled, if ever. At least if it were official, people would know what they may be in for if they're unable to breathe on their own, or worse, which is probably the only reason you'd want to be in a hospital in the first place. A brand new catch-22.
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@zboblamont Sounds apocalyptic. Here we've barely left the house since January. Take care, and even more so if you have one or more of the known co-morbidities that puts you at higher risk of death. Plan ahead and identify your source of nearest available supplemental oxygen in case it comes to that.
The Italians have started to say that hospitals are a major source of caronavirus infection, so I intend to stay away unless it's truly unavoidable.
In the US there's a push toward hospitals not attempting to resuscitate anyone (aka as "universal DNR") with caronavirus, because healthcare workers don't want to expose themselves to greater risks than they're already taking (which is the stated reason), but probably also legally absolve themselves from taking action when, for example, there simply aren't enough ventilators or other resources to meet demand. Otherwise, they'd be in a constant thrash mode trying to revive someone who has no ventilator access only to be in the same position a moment later, because there's still no spare ventilator to put them on. The only prior precedent for it would be people who officially ask in advance for DNR, with notarized paperwork and instructions to that effect, but this would encompass everyone, even if you've made it clear that's not what you want. I'm guessing it will be approved, but even if it isn't, I can imagine they may adopt that policy unofficially anyway out of either self survival or absurdity avoidance, in which case the public at large may not find out until after the dust has settled, if ever. At least if it were official, people would know what they may be in for if they're unable to breathe on their own, or worse, which is probably the only reason you'd want to be in a hospital in the first place. A brand new catch-22.
@NeverDie It's only apocalyptic because politicians made it so or played it down, the nuts claiming it's no worse than flu, or a scam by money manipulators, or Chinese conspiracy, or would damage the economy, only helped obscure the danger to human life by confused messaging.
Odds of dying in ICU is averaging 17% from the figures I've seen, 27,000 dead so far, no plans to join that number but acutely aware I'm high risk, hence isolated...
DNR is normal once ICUs are overloaded, a shot of morphine is all they can do to ease the passing.For now hunker down and take reasonable precautions, even from our own family members if symptoms show. Until governments are forced to take this seriously and adopt the WHO measures, there is very little upside until you survive it...
Best of luck over there. ;) -
@zboblamont said in Coronavirus (way, way, off topic):
Odds of dying in ICU is averaging 17%
If you don't already own one, you may want to buy an oximeter, just to have some objective measure of your condition or a family member's. They're cheap and even now probably pretty widely available. And if you do end up in a hospital, it sounds like you may want to take it there with you. Otherwise, you may be turning blue before anyone notices.
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There's growing consensus that the Italian data (not the Chinese data) provides the best model for infection rates and death rates in western countries. Because no one has any natural immunity to this virus, anyone who is exposed will get sick to one degree or another, though some may only be unwitting carriers. That much is a given. Current estimates are that 10% of those exposed will require hospitalization. About half of those "lucky" enough to be on ventilators will die anyway. Cause of death is pneumonia, which in turn is caused a body's excessive inflammatory response. The current average death rate is about 3%. So, when the supply of ventilators and hospital support run out, expect a higher death rate. In the US, the "peak" (i.e. number of new cases per day) is estimated to be sometime in May, with the number of new cases doubling about every 3.5 days up to that peak point. Due to lag, peak death will be sometime in July. It's likely we'll all continue in lockdown until at least August. So, answering my own question from earlier, I'm guessing that yes, the US can self-finance through August. If there is a second wave of infection that comes after, as some predict, then...
This took some work to dig up and distill, but there it is. Sorry to be the messenger.
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Here in DK, we started with closing down all public schools, and educational institutions 2 weeks ago. For my part, I have been working at my home office for the last 2½ weeks.
The government is taking a more and more strict approach to the current situation, limiting the freedom of movement, the latest is that (unless you'r a family living together) you are only allowed to be 2 persons in the same area (taking a walk etc.). And the schools etc. are closed at least until 14th of april (after the Easter holidays in denmark)
Luckily I live in the countryside, so we have lot's of space around us, with forrests etc. So we can get out in the fresh spring air, almost without meeting other people, or if we do meet other people, we can keep a safety distance of 2m. This also means that our local grocery store is not overly crowded with people, when we do shopping, as opposed to the shops in bigger cities.
As a kind of bonus, I get the opportunity to order some gadgets for my home office, now that I work full time here. "But honey, this thing will unclutter my desktop / make it easier for me to switch between work and hobby".." :smirk:
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If you have a weak temperament or are easily upset, you may want to stop reading now.....
OK, then, for those who are still reading... I think we all have a shared interest in vetting out what is real vs propaganda. Therefore, how is it that as of this morning the news media is projecting "only" 20,000 dead in the UK and maybe "only" 200,000 dead in the US? Those sound like linear extrapolations to me, not exponential ones. If instead covid-19 really is doubling every 3.5 days, as I've heard from MD's, then in 5 weeks time it's going to be 2^10, i.e. 1000x, worse. Right? So, by that rekoning, in the UK it's going to be a million dead or dying and in the US about 2.5 million. In just 5 weeks from now. Even if social distancing has slowed the rate, the media numbers for the total cost (not just 5 weeks from now) sound way, way off. Or am I missing something? Even if we manage to "flatten the curve," then short of a miracle, that only means it will take longer for the 1000x damage to occur, not that it's going to be avoided. Right? Meanwhile, due to shortages that haven't yet occurred and so aren't yet reflected in the early numbers, I'd wager the outcomes will be even worse than 1000x worse. Does anyone here have a different viewpoint? It seems to me that the official projections are incredibly low-balled, and so they are actually contributing to the problem! The best way to flatten the curve would be for people to have accurate projections, because then they'd be shocked out of their complacency and not be taking unwise risks.
If you can possibly stay at home and not go out at all for anything for the next two months, I think you'd be wise to do that. Why? Because within that timeframe the actual trendlines should become a lot more apparent to everyone, and so by then people will have dialed in more closely to whatever the actual risks are and adjusted their behavior accordingly. To draw an anology, right now it's like Chernobyl just happened, and yet people are still attending parades outdoors the following day (which is what actually happened) because they were not made aware of the true risks.
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Here the federal government has revised upwards its projections regarding # of infections, # of deaths, and the date of the "peak". They didn't have much choice, given that their prior projections would have soon been invalidated after-the-fact. Their new projections, especially regarding the "peak" date still seems far too conservative. I can only assume they are simply trying to avoid mass panic. Locally the governor has ordered that everyone not involved in giving or receiving essential services stay at home. Finally!
At least so far no one has talked about whether the food delivery infrastructure will be critically damaged. Because it is a high priority, though, I presume that to one degree or another it will continue to function. Some food items are being rationed, and a few categories, like dried beans, have been wiped out, but overall getting enough food to survive doesn't appear to be a problem if you have the money to pay for it. However, with large segments of the economy effectively "turned off," it seems likely that large numbers of people will be running out of money soon, and with the government here being slow to react...
Anyone have an updates for their country? I'm interested to hear more about Viet Nam, since it sounded as though it was doing well and there's so little coverage in the press here about it. Unfortunately, the case of China, there's a lot of suspicion that China under-reported how badly they were affected, which would surely have contributed to the under-reaction in the West. The data from Italy seems solid though. It it weren't for the Italians generously sharing their experience, I'm sure things would be even worse throughout the world.
I'm not sure how much the hospitals can actually do that makes a difference. I had previously read a WHO article that had said that oxygen, which is the first line treatment, didn't actually appear to change the outcomes, though it can keep you alive a bit longer than without it. I'm hearing that 70-80% of those who do advance to ventilation and intubation end up dying even with the added support. I mean, I'm not saying we shouldn't try to do all that we can, just that even our best efforts may only occasionally help--which is suprising. I had thought modern medicine, when properly administered, would make more of a difference.
:sneezing_face:
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I don't know if any of you have seen this before:
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
@tbowmo said in Coronavirus (way, way, off topic):
I don't know if any of you have seen this before:
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
Yes it's famous, I used to watch it daily when there was mainly a big red dot over China, and a few tiny dots elsewhere. Now they had to reduce the size of dots, and it's red everywhere :(
I find the table here https://www.worldometers.info/coronavirus/ easier to see the trends, as the main info to know the progress of the epidemic in a place is the number of new cases / total cases and you can see it right away without clicking on each country. -
Here the federal government has revised upwards its projections regarding # of infections, # of deaths, and the date of the "peak". They didn't have much choice, given that their prior projections would have soon been invalidated after-the-fact. Their new projections, especially regarding the "peak" date still seems far too conservative. I can only assume they are simply trying to avoid mass panic. Locally the governor has ordered that everyone not involved in giving or receiving essential services stay at home. Finally!
At least so far no one has talked about whether the food delivery infrastructure will be critically damaged. Because it is a high priority, though, I presume that to one degree or another it will continue to function. Some food items are being rationed, and a few categories, like dried beans, have been wiped out, but overall getting enough food to survive doesn't appear to be a problem if you have the money to pay for it. However, with large segments of the economy effectively "turned off," it seems likely that large numbers of people will be running out of money soon, and with the government here being slow to react...
Anyone have an updates for their country? I'm interested to hear more about Viet Nam, since it sounded as though it was doing well and there's so little coverage in the press here about it. Unfortunately, the case of China, there's a lot of suspicion that China under-reported how badly they were affected, which would surely have contributed to the under-reaction in the West. The data from Italy seems solid though. It it weren't for the Italians generously sharing their experience, I'm sure things would be even worse throughout the world.
I'm not sure how much the hospitals can actually do that makes a difference. I had previously read a WHO article that had said that oxygen, which is the first line treatment, didn't actually appear to change the outcomes, though it can keep you alive a bit longer than without it. I'm hearing that 70-80% of those who do advance to ventilation and intubation end up dying even with the added support. I mean, I'm not saying we shouldn't try to do all that we can, just that even our best efforts may only occasionally help--which is suprising. I had thought modern medicine, when properly administered, would make more of a difference.
:sneezing_face:
@NeverDie said in Coronavirus (way, way, off topic):
I'm not sure how much the hospitals can actually do that makes a difference.
Specialist ICUs can save some of those who are develop viral pneumonia, the reality is that some will die but there is no telling which is which until they succumb. The dilemma is that once ICUs are overloaded the fatality rate climbs due to prioritisation, so the trick is to avoid overwhelming the facilities or accept a higher death rate than may otherwise be the case.
The easiest way to look at this much is as a flu outbreak, but with the added feature of 10 times the infectivity. For flu there are shots which can provide greater but not complete protection for the more prone, an annual mutation which the manufacturers refine on each cycle.
In the COVID case there is as yet no vaccine nor natural immunity, but crucially it is infectivity which is the danger as it presents a deluge of critical cases rather than spread over say many months.
Social distancing and isolation measures can slow the rapid spread, testing vigorously and isolating as in the Singapore and Korean etc models is another successful technique.The rest is a political decision...
This post I thought entirely apt...
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A quick update regarding how long the virus can live on surfaces. Now it's up to 5 days.
Here’s how long the virus typically lasts on common surfaces:
Glass – 5 days.
Wood – 4 days.
Plastic & stainless-steel – 3 days.
Cardboard – 24 hours.
Copper surfaces – 4 hours.
https://health.clevelandclinic.org/how-long-will-coronavirus-survive-on-surfaces/I'm a bit annoyed by the use of the word "typically." I mean, to be useful, we need to know the high end of the range, not the median.
If anyone else here has found any other useful tidbits, please post an update.
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A quick update regarding how long the virus can live on surfaces. Now it's up to 5 days.
Here’s how long the virus typically lasts on common surfaces:
Glass – 5 days.
Wood – 4 days.
Plastic & stainless-steel – 3 days.
Cardboard – 24 hours.
Copper surfaces – 4 hours.
https://health.clevelandclinic.org/how-long-will-coronavirus-survive-on-surfaces/I'm a bit annoyed by the use of the word "typically." I mean, to be useful, we need to know the high end of the range, not the median.
If anyone else here has found any other useful tidbits, please post an update.
