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Posted

Sure, but once we find a method that is precise enough, it will give us very strong confidence in the most important data -- lethality rate & infection rate.

 

That's an important "but" that can't be hand-waved away.

 

A lot of antibody tests had false positives in the 50% range, depending the population being sampled (it'll be higher outside of the major outbreak zones). That's way too high to be very useful.

 

Stanford Dr. Bhattacharya says he had 0.5% false positive in his test.

The 0.5% may be important for Santa Carla study that found 3% infection rate.  But still you can take 2.5% and calculate IFR.

 

0.5% false positive is not important for NYC with 20% infection rate.  Or Boston Chelsea with 30% infection rate.

 

The different studies gave infection fatality rate between 0.1% to 0.5%. NY had higher rate at 0.5%. 

 

For example Miami Dade study gave 6% and 0.5% is not very important. https://www.miamiherald.com/news/coronavirus/article242260406.html

They say 165000 infected.  Presently about 500 dead (I dont know numbers as of mid April).  So a conservative number of using todays 500 deaths/165000 gives 0.3% IFR.

 

Below is a study by Denmark:

 

Using available data on fatalities and population numbers a combined IFR in patients younger than 70 is estimated at 82 per 100,000 (CI: 59-154) infections.  Thats 0.082% for patients younger than 70.

The seroprevalence was adjusted for assay sensitivity and specificity taking the uncertainties of the test validation into account when reporting the 95% confidence intervals (CI).

 

New tests are even better. See below:

 

Researchers at the University of Washington School of Medicine found Abbott’s test had a specificity rate of 99.9% and a sensitivity rate of 100%, suggesting very few chances of incorrectly diagnosing a healthy person with the infection and no false negatives.

https://www.cnbc.com/2020/05/08/study-suggests-abbott-covid-19-antibody-test-highly-likely-to-give-correct-results.html

 

Some people dont like the result of 0.1% to 0.5% IFR but it is now done by Denmark, Germany, Santa Carla, LA, Miami Dade, NYC, Boston by different well known professors and hospitals.  The IFR is much lower if you take less than 70 population.

 

At one point people need to agree with the data.

 

+1

 

It's puzzling how some people overlook at observed DATA because of the uncertainties while they trust a predictive MODEL with even more uncertainties due to its nature. Much of that has to do with their original (political) bias.

Posted

https://www.foreignaffairs.com/articles/sweden/2020-05-12/swedens-coronavirus-strategy-will-soon-be-worlds

 

Tend to agree.  The ability to effectively lockdown like China is unrealistic for a long period of time.  No matter how much sense it makes it simply won't happen.

 

And this will be more painstakingly clear as countries deal with second waves as soon as they lift lockdown measures... see what's happening in Singapore, S Korea, Wuhan as we speak...

Posted

Sure, but once we find a method that is precise enough, it will give us very strong confidence in the most important data -- lethality rate & infection rate.

 

That's an important "but" that can't be hand-waved away.

 

A lot of antibody tests had false positives in the 50% range, depending the population being sampled (it'll be higher outside of the major outbreak zones). That's way too high to be very useful.

 

Stanford Dr. Bhattacharya says he had 0.5% false positive in his test.

The 0.5% may be important for Santa Carla study that found 3% infection rate.  But still you can take 2.5% and calculate IFR.

 

0.5% false positive is not important for NYC with 20% infection rate.  Or Boston Chelsea with 30% infection rate.

 

The different studies gave infection fatality rate between 0.1% to 0.5%. NY had higher rate at 0.5%. 

 

For example Miami Dade study gave 6% and 0.5% is not very important. https://www.miamiherald.com/news/coronavirus/article242260406.html

They say 165000 infected.  Presently about 500 dead (I dont know numbers as of mid April).  So a conservative number of using todays 500 deaths/165000 gives 0.3% IFR.

 

Below is a study by Denmark:

 

Using available data on fatalities and population numbers a combined IFR in patients younger than 70 is estimated at 82 per 100,000 (CI: 59-154) infections.  Thats 0.082% for patients younger than 70.

The seroprevalence was adjusted for assay sensitivity and specificity taking the uncertainties of the test validation into account when reporting the 95% confidence intervals (CI).

 

New tests are even better. See below:

 

Researchers at the University of Washington School of Medicine found Abbott’s test had a specificity rate of 99.9% and a sensitivity rate of 100%, suggesting very few chances of incorrectly diagnosing a healthy person with the infection and no false negatives.

https://www.cnbc.com/2020/05/08/study-suggests-abbott-covid-19-antibody-test-highly-likely-to-give-correct-results.html

 

Some people dont like the result of 0.1% to 0.5% IFR but it is now done by Denmark, Germany, Santa Carla, LA, Miami Dade, NYC, Boston by different well known professors and hospitals.  The IFR is much lower if you take less than 70 population.

 

At one point people need to agree with the data.

 

I agree that some areas (NYC, Chelsea MA) are reaching numbers that imply that we are well on way of herd immunity.  It that a true only in those heavily hit areas,  not true in the rest of NY or MA and much less the rest of the country.

 

It not true in Sweden either, Stockholm, Sweden represents only 10% of the Swedish population and that’s where the majority of the infection are for now.

 

I am routing for the Swedes, they have a clear plan and are following it, so far within a fairly acceptable cost. Germany and other Skandinavien countries have pushed the curve far far down, so they have a chance squash the second waves ( the extend of which is a function of how far down the first wave have been pushed ) with aggressive test and track.

 

What is our strategy? It depends on the state you are in and we just have to wing it. Sad.

Posted

(thread)

 

We tested 3600 samples collected in Jan 2020 for COVID-19 status and found zero positives. We tested 3308 samples collected in Feb 2020 and found a first positive on Feb 21 with a total of 10 samples testing positive in Feb. 5/18
Posted

(thread)

 

We tested 3600 samples collected in Jan 2020 for COVID-19 status and found zero positives. We tested 3308 samples collected in Feb 2020 and found a first positive on Feb 21 with a total of 10 samples testing positive in Feb. 5/18

 

Interesting thread, thanks again for posting.

Posted

Sure, but once we find a method that is precise enough, it will give us very strong confidence in the most important data -- lethality rate & infection rate.

 

That's an important "but" that can't be hand-waved away.

 

A lot of antibody tests had false positives in the 50% range, depending the population being sampled (it'll be higher outside of the major outbreak zones). That's way too high to be very useful.

 

Stanford Dr. Bhattacharya says he had 0.5% false positive in his test.

The 0.5% may be important for Santa Carla study that found 3% infection rate.  But still you can take 2.5% and calculate IFR.

 

0.5% false positive is not important for NYC with 20% infection rate.  Or Boston Chelsea with 30% infection rate.

 

The different studies gave infection fatality rate between 0.1% to 0.5%. NY had higher rate at 0.5%. 

 

For example Miami Dade study gave 6% and 0.5% is not very important. https://www.miamiherald.com/news/coronavirus/article242260406.html

They say 165000 infected.  Presently about 500 dead (I dont know numbers as of mid April).  So a conservative number of using todays 500 deaths/165000 gives 0.3% IFR.

 

Below is a study by Denmark:

 

Using available data on fatalities and population numbers a combined IFR in patients younger than 70 is estimated at 82 per 100,000 (CI: 59-154) infections.  Thats 0.082% for patients younger than 70.

The seroprevalence was adjusted for assay sensitivity and specificity taking the uncertainties of the test validation into account when reporting the 95% confidence intervals (CI).

 

New tests are even better. See below:

 

Researchers at the University of Washington School of Medicine found Abbott’s test had a specificity rate of 99.9% and a sensitivity rate of 100%, suggesting very few chances of incorrectly diagnosing a healthy person with the infection and no false negatives.

https://www.cnbc.com/2020/05/08/study-suggests-abbott-covid-19-antibody-test-highly-likely-to-give-correct-results.html

 

Some people dont like the result of 0.1% to 0.5% IFR but it is now done by Denmark, Germany, Santa Carla, LA, Miami Dade, NYC, Boston by different well known professors and hospitals.  The IFR is much lower if you take less than 70 population.

 

At one point people need to agree with the data.

 

I agree that some areas (NYC, Chelsea MA) are reaching numbers that imply that we are well on way of herd immunity.  It that a true only in those heavily hit areas,  not true in the rest of NY or MA and much less the rest of the country.

 

It not true in Sweden either, Stockholm, Sweden represents only 10% of the Swedish population and that’s where the majority of the infection are for now.

 

I am routing for the Swedes, they have a clear plan and are following it, so far within a fairly acceptable cost. Germany and other Skandinavien countries have pushed the curve far far down, so they have a chance squash the second waves ( the extend of which is a function of how far down the first wave have been pushed ) with aggressive test and track.

 

What is our strategy? It depends on the state you are in and we just have to wing it. Sad.

 

The strategy will depend on the data and scientists doing their studies and discussing their data and opinions openly without being attacked.

 

Below is an interview with Dr. John Ioannidis.  Initially Stanford team was criticized for their study conclusion of lower IFR and was told their experiment has serious short comings.  Then as more and more teams got similar result across the world, he is being told everyone always meant much lower IFR than 1%, there is nothing new here........well read it

 

https://undark.org/2020/05/09/john-ioannidis-responds/

 

UD: Who thought that? The WHO said that 3.4 percent was the case fatality rate. Epidemiologists I’ve talked to said that it was clear the true infection fatality rate would likely end up being much lower. One scientist described the argument you’re making right now as “a straw man.”

 

JI: Well, let’s go back and check the exact announcement. [Note: The WHO announcement in question, from early March, specifies that “3.4 percent of reported cases have died.”] That was at the time when WHO had sent an envoy to China. And [the WHO envoy] came back and he said there’s no asymptomatic cases. Just go back and see what the statement was. He said there’s hardly any asymptomatic cases, it’s very serious and has a case fatality of 3.4 percemt.

 

Of course, that [fatality rate] was gradually dialed back to 1 percent or 0.9 percent. And these are the numbers that went into calculations, and these are the numbers that are still in many of the calculations, you know, until very recently.

 

You know, 1 percent is, is probably like the disaster case, maybe in some places in Queens, for example, it may be 1 percent, because you have all that perfect storm of nursing homes, and nosocomial infection [an infection that originates in a hospital], and no hospital system functioning. In many other places, it’s much, much lower.

...............

Posted

Germany and other Skandinavien countries have pushed the curve far far down, so they have a chance squash the second waves ( the extend of which is a function of how far down the first wave have been pushed ) with aggressive test and track.

 

 

I haven't been able to envisage the end state here. So imagine you are super-successful like Oz, NZ, Singapore and your cases go to zero. The rest of the world (ROW) screws up and muddles its way to group immunity, perhaps at horrific cost. So ROW have 70-80% people with immunity, and  the virus is still circulating. Now you have three ways out.

1. Vaccine is developed and you get immunity without the horrific costs.

2. The virus is totally eradicated.

3. You live in your bubble, separate from the rest of the world until either 1 or 2 happen. This doesn't seem like a viable option if its a long time.

 

So whats the end state these guys are thinking of or hoping for?

 

Posted

Germany and other Skandinavien countries have pushed the curve far far down, so they have a chance squash the second waves ( the extend of which is a function of how far down the first wave have been pushed ) with aggressive test and track.

 

 

I haven't been able to envisage the end state here. So imagine you are super-successful like Oz, NZ, Singapore and your cases go to zero. The rest of the world (ROW) screws up and muddles its way to group immunity, perhaps at horrific cost. So ROW have 70-80% people with immunity, and  the virus is still circulating. Now you have three ways out.

1. Vaccine is developed and you get immunity without the horrific costs.

2. The virus is totally eradicated.

3. You live in your bubble, separate from the rest of the world until either 1 or 2 happen. This doesn't seem like a viable option if its a long time.

 

So whats the end state these guys are thinking of or hoping for?

 

You might be misunderstanding the situation with "ROW have 70-80% people with immunity, and  the virus is still circulating".

This does not mean that virus is actively shedding from 70-80% of ROW. So, yeah Oz, NZ can live in their bubble by testing everyone who comes into the country. It's not that high load on testing. Admit people who test negative, kick out the ones who test positive, and track or quarantine everyone who enters for incubation period. Is that impossible for them to do long term (3+ years)?

 

Edit: I guess tourism would be mostly screwed though.

Posted

Germany and other Skandinavien countries have pushed the curve far far down, so they have a chance squash the second waves ( the extend of which is a function of how far down the first wave have been pushed ) with aggressive test and track.

 

 

I haven't been able to envisage the end state here. So imagine you are super-successful like Oz, NZ, Singapore and your cases go to zero. The rest of the world (ROW) screws up and muddles its way to group immunity, perhaps at horrific cost. So ROW have 70-80% people with immunity, and  the virus is still circulating. Now you have three ways out.

1. Vaccine is developed and you get immunity without the horrific costs.

2. The virus is totally eradicated.

3. You live in your bubble, separate from the rest of the world until either 1 or 2 happen. This doesn't seem like a viable option if its a long time.

 

So whats the end state these guys are thinking of or hoping for?

 

I wouldn’t necessarily discount the possibility that bilateral travel bubbles form between countries with a low enough prevalence of COVID-19. In fact both New Zealand and Australia are thinking about this and this would help out the New Zealand tours industry as most tourist come from Australia. I can see other bubbles forming in other regions like Northern Europe and later southern there Europe if the number go down far enough.

 

You only need to do this for 18 month hopefully until a vaccine is there and / or you can reduce the risk of adverse outcomes with better medication. So they would be the end state since you ask for it.

 

Since I am basically located in a COVID-19 leper colony here in MA, I am not counting of going anywhere far this year, certainly not Europe as I planned. It’s probably going to be a camping trip north, if those folks from VT, NH or ME will have us.

 

https://www.theguardian.com/world/2020/may/05/trans-tasman-travel-bubble-to-allow-flights-as-soon-as-lockdowns-ease-morrison-and-ardern-agree

Posted

Germany and other Skandinavien countries have pushed the curve far far down, so they have a chance squash the second waves ( the extend of which is a function of how far down the first wave have been pushed ) with aggressive test and track.

 

 

I haven't been able to envisage the end state here. So imagine you are super-successful like Oz, NZ, Singapore and your cases go to zero. The rest of the world (ROW) screws up and muddles its way to group immunity, perhaps at horrific cost. So ROW have 70-80% people with immunity, and  the virus is still circulating. Now you have three ways out.

1. Vaccine is developed and you get immunity without the horrific costs.

2. The virus is totally eradicated.

3. You live in your bubble, separate from the rest of the world until either 1 or 2 happen. This doesn't seem like a viable option if its a long time.

 

So whats the end state these guys are thinking of or hoping for?

 

I wouldn’t necessarily discount the possibility that bilateral travel bubbles form between countries with a low enough prevalence of COVID-19. In fact both New Zealand and Australia are thinking about this and this would help out the New Zealand tours industry as most tourist come from Australia. I can see other bubbles forming in other regions like Northern Europe and later southern there Europe if the number go down far enough.

 

You only need to do this for 18 month hopefully until a vaccine is there and / or you can reduce the risk of adverse outcomes with better medication. So they would be the end state since you ask for it.

 

Since I am basically located in a COVID-19 leper colony here in MA, I am not counting of going anywhere far this year, certainly not Europe as I planned. It’s probably going to be a camping trip north, if those folks from VT, NH or ME will have us.

 

https://www.theguardian.com/world/2020/may/05/trans-tasman-travel-bubble-to-allow-flights-as-soon-as-lockdowns-ease-morrison-and-ardern-agree

 

Who is going to want to allow travellers in from the US given the large number of continuing cases? I think Canada and US will need to decide soon what to do about the border for June... my guess is Trudeau is going to want to continue with current restrictions while the ‘stable genius‘ is going to want to get back to normal...

 

International travel is going to be severely restricted. Imagine being that person from China who travels to the US and is involved with a positive test? Or an American going to China and same? Just think about the political points to be scored by Trump or the Chinese state. Crazy times.

Posted

Trump knows better than everyone about everything:

 

https://www.cnbc.com/2020/05/13/coronavirus-trump-says-faucis-warnings-about-reopening-are-not-acceptable.html

 

Top coronavirus health expert Dr. Anthony Fauci’s recent warning about the potentially dire consequences of reopening states and schools too soon was “not an acceptable answer,” President Donald Trump said Wednesday.

 

First of all its not a doctors call. Dr. Fauci himself said he only advises on health matters, not on economy.  But economy has lot of health effects.

 

https://www.cbsnews.com/news/coronavirus-deaths-suicides-drugs-alcohol-pandemic-75000/

Coronavirus pandemic may lead to 75,000 "deaths of despair" from suicide, drug and alcohol abuse, study says

 

And main logic presented for Children not going to school is they pass the infection back home.  Except that:

 

https://www.nationalreview.com/corner/icelandic-study-we-have-not-found-a-single-instance-of-a-child-infecting-parents/

Children under 10 are less likely to get infected than adults and if they get infected, they are less likely to get seriously ill. What is interesting is that even if children do get infected, they are less likely to transmit the disease to others than adults. We have not found a single instance of a child infecting parents.

Posted

New York City area antibody test results show that crucial frontline workers, such as first responders and health care employees, have lower rates of exposure to the coronavirus than the general population, Gov. Andrew Cuomo said Wednesday.

 

https://www.nbcnews.com/health/health-news/live-blog/2020-05-13-coronavirus-news-n1205916/ncrd1206251#liveBlogHeader

 

Last week NYC study showed overwhelming hospitalizations for Covid are from people staying home.

Also Cuomo said:

 

https://news.yahoo.com/cuomo-frontline-workers-tested-antibodies-162530547.html

During a press conference, New York Gov. Andrew Cuomo shared antibody testing results for essential workers and says the reason frontline workers' infection rate is lower is due to them consistently wearing masks.

 

Thats why IMO, it worked in Japan.  They had people go out wearing masks without lockdown.  Which is better IMO than lockdown without masks which western world did.

Posted

Get ready for alot more actions like this. Commercial landlords are in a very tough spot...

 

Starbucks asks landlords for a year’s worth of rent concessions

- https://www.washingtonpost.com/nation/2020/05/13/coronavirus-update-us/#link-IRDOQGL7NBFNFOTF2E5VL4U3XE

 

In a letter to corporate landlords, Starbucks said it “will require” rent breaks for at least a year in the wake of its stores’ closures from the coronavirus pandemic.

 

The Seattle-based coffee giant is asking for adjustments to lease terms and base rent for 12 months effective June 1, the company’s chief operating officer, Roz Brewer, wrote in a form letter, which was obtained by the Greater Baton Rouge Business Report and several news outlets.

 

“Starbucks will require concessions to support modified operations and structure, so we can withstand this uncertainty together,” Brewer wrote. The letter is dated May 5, a day after Starbucks announced that 85 percent of its 8,000 company-owned U.S. stores would reopen by the end of that week. The company temporarily shuttered half of its stores in late March.

 

“None of us know the full extent of the challenges ahead, but it’s clear the value of commercial real estate has changed,” Brewer wrote. “We understand what we ask of you may not be easy, and our commitment is to be fair in our discussions.”

 

“We look toward the future with realistic optimism and expect, as you have in the past, your support in the enduring success of the Starbucks brand,” she added.

 

Given the scale of the company, the ask will have ripple effects, especially as landlords negotiate with other tenants and may have bankers to pay.

 

 

Posted

Get ready for alot more actions like this. Commercial landlords are in a very tough spot...

 

Starbucks asks landlords for a year’s worth of rent concessions

- https://www.washingtonpost.com/nation/2020/05/13/coronavirus-update-us/#link-IRDOQGL7NBFNFOTF2E5VL4U3XE

 

In a letter to corporate landlords, Starbucks said it “will require” rent breaks for at least a year in the wake of its stores’ closures from the coronavirus pandemic.

 

The Seattle-based coffee giant is asking for adjustments to lease terms and base rent for 12 months effective June 1, the company’s chief operating officer, Roz Brewer, wrote in a form letter, which was obtained by the Greater Baton Rouge Business Report and several news outlets.

 

“Starbucks will require concessions to support modified operations and structure, so we can withstand this uncertainty together,” Brewer wrote. The letter is dated May 5, a day after Starbucks announced that 85 percent of its 8,000 company-owned U.S. stores would reopen by the end of that week. The company temporarily shuttered half of its stores in late March.

 

“None of us know the full extent of the challenges ahead, but it’s clear the value of commercial real estate has changed,” Brewer wrote. “We understand what we ask of you may not be easy, and our commitment is to be fair in our discussions.”

 

“We look toward the future with realistic optimism and expect, as you have in the past, your support in the enduring success of the Starbucks brand,” she added.

 

Given the scale of the company, the ask will have ripple effects, especially as landlords negotiate with other tenants and may have bankers to pay.

 

Every commercial property lessee is going to ask for rent reduction /participation in cost due to COVID-@9 impairments. Have some office space where you can’t fit all the people in the elevator at the same time, or can’t occupy your office space with the same density - well you are going to ask for a rent reduction. Same for pretty much any B&M store which are getting whacked by online retailing anyways.

 

That’s going to have quite a bit of impact for the real estate asset and CMBS loan valuations. Ouch!

Posted

Get ready for alot more actions like this. Commercial landlords are in a very tough spot...

 

Starbucks asks landlords for a year’s worth of rent concessions

- https://www.washingtonpost.com/nation/2020/05/13/coronavirus-update-us/#link-IRDOQGL7NBFNFOTF2E5VL4U3XE

 

In a letter to corporate landlords, Starbucks said it “will require” rent breaks for at least a year in the wake of its stores’ closures from the coronavirus pandemic.

 

The Seattle-based coffee giant is asking for adjustments to lease terms and base rent for 12 months effective June 1, the company’s chief operating officer, Roz Brewer, wrote in a form letter, which was obtained by the Greater Baton Rouge Business Report and several news outlets.

 

“Starbucks will require concessions to support modified operations and structure, so we can withstand this uncertainty together,” Brewer wrote. The letter is dated May 5, a day after Starbucks announced that 85 percent of its 8,000 company-owned U.S. stores would reopen by the end of that week. The company temporarily shuttered half of its stores in late March.

 

“None of us know the full extent of the challenges ahead, but it’s clear the value of commercial real estate has changed,” Brewer wrote. “We understand what we ask of you may not be easy, and our commitment is to be fair in our discussions.”

 

“We look toward the future with realistic optimism and expect, as you have in the past, your support in the enduring success of the Starbucks brand,” she added.

 

Given the scale of the company, the ask will have ripple effects, especially as landlords negotiate with other tenants and may have bankers to pay.

 

Every commercial property lessee is going to ask for rent reduction /participation in cost due to COVID-@9 impairments. Have some office space where you can’t fit all the people in the elevator at the same time, or can’t occupy your office space with the same density - well you are going to ask for a rent reduction. Same for pretty much any B&M store which are getting whacked by online retailing anyways.

 

That’s going to have quite a bit of impact for the real estate asset and CMBS loan valuations. Ouch!

 

The virus is causing value destruction all the way down the chain:

- retail establishment or restaurant is impaired

- lower employment

- commercial real estate is impaired (depends on scale)

- suppliers to retail / restaurant are impaired; bad debts?

- advertising budget cut etc

- everyone earns less so they pay less in taxes

 

Its like a recession that is hitting the globe at pretty much the exact same time. No wonder most people have no idea where this crazy train is taking the global economy :-)

Posted

Leadership: UK vs New Zealand:

 

 

BJ’s contribution to herd immunity wasn’t particular impressing, emergency room visit and all. I also don’t know what came into his mind we he told his nation on Sunday that’s whoever can should go back to work on Monday basically. That’s kind of a short notice.

 

What is sort of ironic is that the UK had tougher restrictions for citizens during the shutdown than most of the rest or Europe (Germany, France, Scandinavia, France) and yet their results are on par with Italy and Spain’s despite having more time to prepare. Germany and Denmark have already eased their restrictions before the UK could.

Posted

Two-part post

 

1-a study which will satisfy the beliefs of both tribes

https://english.elpais.com/society/2020-05-14/antibody-study-shows-just-5-of-spaniards-have-contracted-the-coronavirus.html

It's from Spain and many features point to solid work. Some will conclude that 90% of cases have not been detected by tests, implying a wider spread while others will conclude that 5% is still far from 60% (if 60% is the 'right' number for herd immunity).

 

Countries with relatively (still) steady state of new cases: US, UK, Sweden, Philippines, my area...

Countries with rising cases: Brazil, Nigeria, Egypt, India, Russia, Mexico, Ethiopia, Pakistan, Indonesia, South Africa...

 

So, one should at least consider the possibility that the rough patch may not be transient and there may be a few Vs in the "recovery".

 

2-an interesting parallel which shows how clusters can feed in the community and vice-versa

https://www.msn.com/en-ca/news/canada/analysis-how-montreals-chslds-mirrored-the-diamond-princess-outbreak/ar-BB144o2Z?ocid=spartanntp

My area has reported a very high number of deaths, adjusted for population, and most (more than 80%) deaths happened in people living in chronic care institutions. The author submits that chronic care centers acted as many Diamond Princess cruise ships floating right in the middle of urban centers. Retrospective analysis shows that acute policy mistakes were made on top of consequences of decisions made years ago by the host. The urban community neighborhoods most affected are populated by people working in chronic care homes..

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