Coronavirus

[meiroy]

This is a really interesting data point. I am not saying all of these users are dead. There are just two mobile providers in China. I don't think all of a sudden these 8M users decided to switch to the other one right in Jan and Feb.

 

There are three providers, not two and there are plenty of technical reasons for such a drop, such as indeed a switch of provider due to 5G or new regulations or store closing/not selling services, or businesses not renewing/buying numbers for spam purposes etc.

[pterhx]

https://fivethirtyeight.com/features/infectious-disease-experts-dont-know-how-bad-the-coronavirus-is-going-to-get-either/

 

Just as flu season can have two peaks, the surveyed experts think there’s a good chance there will be a second wave of coronavirus-related hospitalizations sometime between August and December. Individual estimates for the likelihood of that second round of cases ranged from 40 percent to 96 percent, with an expert consensus of a 73 percent chance.

[Liberty]

https://www.propublica.org/article/a-medical-worker-describes--terrifying-lung-failure-from-covid19-even-in-his-young-patients

 

“ A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients”

[orthopa]

https://medium.com/@Jason_Scott_Warner/the-sober-math-everyone-must-understand-about-the-pandemic-2b0145881993

 

If he is right that 50 people have it for every 1 we know about, then 22 people have died out of 180,000 infected in NYC.

 

You have to take into account time it takes for the virus to run its course, though. Daily exponential growth means the vast majority of infections are early stage and haven’t had time to create complications.

 

Do we also upwardly adjust the 180,000 number to add back the number of people who were once infected but no longer are?

 

Exactly, as I posted way, way back in the thread the death count is severely over estimated. Just like in finance this maybe just the first estimate down.

 

https://www.newsweek.com/wuhan-coronavirus-death-rate-china-mortality-covid-19-1493201

[Dalal.Holdings]

https://www.nytimes.com/2020/03/20/nyregion/ny-coronavirus-hospitals.html

 

“The most striking part is the speed with which it has ramped up,” said Ben McVane, an emergency room doctor at Elmhurst Hospital Center in Queens. “It went from a small trickle of patients to a deluge of patients in our departments.”

 

Dr. Mitchell Katz, the head of the Health and Hospitals Corporation, which runs New York City’s public hospitals, said there were 230 patients in the Elmhurst emergency room on Thursday, about 50 more than any recent peak. Most were patients with the symptoms of Covid-19, the illness caused by the virus, he said.

[orthopa]

I dont practice in NYC, King County, LA etc but to just give some perspective whats happening here medically.

 

1. The urgent cares in our network have closed down centers within close proximity on weekends. 15% of centers now closed on weekends. Next step is closing at 6pm instead of 8pm. Volumes are down 80% across the board.

2. ER wait times online averaging 0-10 minutes. There are 5 hospitals in this IDN with these ERs. ~2400 beds total, not sure of bed count.

3. All elective surgery has been cancelled at local hospitals. Nurses are being told to take vacation time/furloughed as there are little no patients on the orthopedic/general surgery floors. OB/GYN still at normal volumes of course. No pre op/post op recovery being done.

4. Im still in contact with many in the orthopedic community and the largest non academic orthopedic group has asked all non provider staff to take 50% pay cuts going forward if salaried. Use vacation/sick time first. All PAs have been furloughed until further notice as its mainly a non trauma/orthopedic group. Ortho surgeons who do sports medicine better have a nice emergency fund saved up.

5. Local surgical centers have shut down. ENT, plastics, ophthalmology, GI docs/PAs, nursing staff same as above.

 

The hospitals are all emptied, waiting, and ready to go.

 

Maybe cobfadec and others/relatives/family working in the hospitals can give some color on what they are seeing.

[Dalal.Holdings]

I dont practice in NYC, King County, LA etc but to just give some perspective whats happening here medically.

 

1. The urgent cares in our network have closed down centers within close proximity on weekends. 15% of centers now closed on weekends. Next step is closing at 6pm instead of 8pm. Volumes are down 80% across the board.

2. ER wait times online averaging 0-10 minutes. There are 5 hospitals in this IDN with these ERs. ~2400 beds total, not sure of bed count.

3. All elective surgery has been cancelled at local hospitals. Nurses are being told to take vacation time/furloughed as there are little no patients on the orthopedic/general surgery floors. OB/GYN still at normal volumes of course. No pre op/post op recovery being done.

4. Im still in contact with many in the orthopedic community and the largest non academic orthopedic group has asked all non provider staff to take 50% pay cuts going forward if salaried. Use vacation/sick time first. All PAs have been furloughed until further notice as its mainly a non trauma/orthopedic group. Ortho surgeons who do sports medicine better have a nice emergency fund saved up.

5. Local surgical centers have shut down. ENT, plastics, ophthalmology, GI docs/PAs, nursing staff same as above.

 

The hospitals are all emptied, waiting, and ready to go.

 

Maybe cobfadec and others/relatives/family working in the hospitals can give some color on what they are seeing.

 

NY and WA are early in this course and predictors of what every other place will look like. The rest of the country is our France/Spain/Germany to the Italy (NY and WA). So what is going on in other places is irrelevant. Exponential growth blah blah

[Liberty]

Newest interview by Peter Attia on the latest we know about the virus:

 

https://peterattiamd.com/peterhotez2/

[no_free_lunch]

It follows an exponential growth trajectory if no measures are in place. There is a lot of ignorance here, if you look at South Korea or Taiwan cases are not growing exponentially.  This is a solvable problem.

[muscleman]

This is a really interesting data point. I am not saying all of these users are dead. There are just two mobile providers in China. I don't think all of a sudden these 8M users decided to switch to the other one right in Jan and Feb.

 

There are three providers, not two and there are plenty of technical reasons for such a drop, such as indeed a switch of provider due to 5G or new regulations or store closing/not selling services, or businesses not renewing/buying numbers for spam purposes etc.

 

all three lost 18M combined. I do agree that they could be closing the account for some economic reasons though.

[Kaegi2011]

https://medium.com/@Jason_Scott_Warner/the-sober-math-everyone-must-understand-about-the-pandemic-2b0145881993

 

If he is right that 50 people have it for every 1 we know about, then 22 people have died out of 180,000 infected in NYC.

 

You have to take into account time it takes for the virus to run its course, though. Daily exponential growth means the vast majority of infections are early stage and haven’t had time to create complications.

 

Do we also upwardly adjust the 180,000 number to add back the number of people who were once infected but no longer are?

 

Really we need to look at this data at a cohort level, which as far as I know does not exist publicly.  Without it we need to look at places like China where it's mostly run its course - otherwise we'll be comparing apples and oranges.

[Liberty]

 

Invisible Hands volunteers

[cubsfan]

And what a fool he has been to voice the opinion that it's NOT China's destiny to surpass the USA in GDP - that our

country and citizens were worth fighting for against a Chinese juggernaut.

 

So, I'm curious how you resolved the cognitive dissonance between being a passionate Trump supporter on China with the belief that the government should try to keep away from business. It feels like, if America wants to go this path of eliminating China from supply chains, it requires either massive tariffs or extreme regulations--basically the government completely destroying the supply chain of many businesses.

 

(FWIW, I agree with you that Western countries ought to disassociate from China for all the reasons you say, but I can say that because I'm fine with government interfering with business for the greater good.  But I don't see how one solves this problem if one believes the non-interference of government in business is the greater good.  Can you enlighten me?)

 

Richard - no simple answer because I am a free trade believer as well.

 

But like our energy situation of 20 years ago - was it really wise to be reliant on Iran, Iraq, Venezalua, etc for our energy needs?

Isn't this country in a vastly better situation now being energy self sufficient?

Of course we are - and perhaps a combination of government policy on drilling and American ingenuity made the difference.

 

That's what I'm saying about China - and our key industries like drugs, medical and tech.

Clearly we don't want to be dependent on them for ALL or a MAJORITY of this anymore.

Like players in the Middle East - why be overly dependent on people that hate us and we can't trust?

 

Certainly we wouldn't do it for defense products - as a country we need to prioritize those key businesses.

 

So how government moves us in that direction - trade wars, tariffs, tax holidays to bring cash home, etc - we ought to get there.

 

And if Trump makes us see the benefits to employment opportunities for our citizens - it's just another bonus for the country.

After this disaster, we are really going to needs those jobs.

 

Like many things in life - you make these tradeoffs for the national interest and our citizens.

 

Too extreme?  Perhaps, but headed in the right direction:

 

https://www.amgreatness.com/2020/03/20/sen-cotton-and-rep-gallagher-introduce-bill-to-eliminate-american-dependence-on-chinese-pharmaceuticals/

 

" Senator Cotton pointed out that “the Chinese Communist Party has threatened to cut off America’s access to vital drugs in the midst of a pandemic caused by its own failures,” and that “it’s time to pull America’s supply chains for life-saving medicine out of China"

 

Medical equipment and technology should be under consideration as well...

[Guest cherzeca]

 

Invisible Hands volunteers

 

thanks for posting.  this is exactly the kind of focused activity the govt should be doing, allocating all resources to those most at risk to mortality, and letting the rest of us and the economy go about its business.

[orthopa]

I dont practice in NYC, King County, LA etc but to just give some perspective whats happening here medically.

 

1. The urgent cares in our network have closed down centers within close proximity on weekends. 15% of centers now closed on weekends. Next step is closing at 6pm instead of 8pm. Volumes are down 80% across the board.

2. ER wait times online averaging 0-10 minutes. There are 5 hospitals in this IDN with these ERs. ~2400 beds total, not sure of bed count.

3. All elective surgery has been cancelled at local hospitals. Nurses are being told to take vacation time/furloughed as there are little no patients on the orthopedic/general surgery floors. OB/GYN still at normal volumes of course. No pre op/post op recovery being done.

4. Im still in contact with many in the orthopedic community and the largest non academic orthopedic group has asked all non provider staff to take 50% pay cuts going forward if salaried. Use vacation/sick time first. All PAs have been furloughed until further notice as its mainly a non trauma/orthopedic group. Ortho surgeons who do sports medicine better have a nice emergency fund saved up.

5. Local surgical centers have shut down. ENT, plastics, ophthalmology, GI docs/PAs, nursing staff same as above.

 

The hospitals are all emptied, waiting, and ready to go.

 

Maybe cobfadec and others/relatives/family working in the hospitals can give some color on what they are seeing.

 

NY and WA are early in this course and predictors of what every other place will look like. The rest of the country is our France/Spain/Germany to the Italy (NY and WA). So what is going on in other places is irrelevant. Exponential growth blah blah

 

I am in New York. I assume NYC is what you mean. The closest Urgent care in our network to NYC is Poughkeepsie. Ill call them and let them know what you said!

[samwise]

Agree with posters who say that a death is a death, regardless of cause. Instead of measuring deaths from COVID19, the relevant statistic is excess deaths. That is how mortality from 1918 influenza is commonly measured, since there were no tests for influenza at that time.

 

This is the first statistic on excess death which I have seen. In the town of Bergamo in North Italy, deaths in the first two weeks of March went from  56 last year to 164 this year. Not all are attributed to COVID19, since many were not even tested. This is not a scientific study, just the mayors anecdotes. But it’s scary, and accounts for heart attacks, traffic accidents and all other causes of deaths in that town. Maybe they had more heart attacks from anxiety, or distracted driving, or undetected COVID19. Every one is free to form their hypothesis, I know what I would pick.

 

https://www.reuters.com/article/us-health-coronavirus-italy-homes-insigh/uncounted-among-coronavirus-victims-deaths-sweep-through-italys-nursing-homes-idUSKBN2152V0

 

A few more towns that react late and we will gather enough data for a more solid conclusion which can help resolve the debate. Of course, their may be ethical considerations which might override the need for better clean data. People are on either side of that debate depending on their view of the ultimate excess death and life years lost.

[Guest Schwab711]

https://medium.com/@Jason_Scott_Warner/the-sober-math-everyone-must-understand-about-the-pandemic-2b0145881993

 

If he is right that 50 people have it for every 1 we know about, then 22 people have died out of 180,000 infected in NYC.

 

You have to take into account time it takes for the virus to run its course, though. Daily exponential growth means the vast majority of infections are early stage and haven’t had time to create complications.

 

Do we also upwardly adjust the 180,000 number to add back the number of people who were once infected but no longer are?

 

Exactly, as I posted way, way back in the thread the death count is severely over estimated. Just like in finance this maybe just the first estimate down.

 

https://www.newsweek.com/wuhan-coronavirus-death-rate-china-mortality-covid-19-1493201

 

https://www.cornerofberkshireandfairfax.ca/forum/general-discussion/coronavirus/msg400262/#msg400262

 

This has been my issue with your posts so far. You claim you are right despite the article saying an adjusted CFR of >1%. It's in complete contradiction to your above post that implies CFR will be lower than the seasonal flu in your above post.

[Dalal.Holdings]

I dont practice in NYC, King County, LA etc but to just give some perspective whats happening here medically.

 

1. The urgent cares in our network have closed down centers within close proximity on weekends. 15% of centers now closed on weekends. Next step is closing at 6pm instead of 8pm. Volumes are down 80% across the board.

2. ER wait times online averaging 0-10 minutes. There are 5 hospitals in this IDN with these ERs. ~2400 beds total, not sure of bed count.

3. All elective surgery has been cancelled at local hospitals. Nurses are being told to take vacation time/furloughed as there are little no patients on the orthopedic/general surgery floors. OB/GYN still at normal volumes of course. No pre op/post op recovery being done.

4. Im still in contact with many in the orthopedic community and the largest non academic orthopedic group has asked all non provider staff to take 50% pay cuts going forward if salaried. Use vacation/sick time first. All PAs have been furloughed until further notice as its mainly a non trauma/orthopedic group. Ortho surgeons who do sports medicine better have a nice emergency fund saved up.

5. Local surgical centers have shut down. ENT, plastics, ophthalmology, GI docs/PAs, nursing staff same as above.

 

The hospitals are all emptied, waiting, and ready to go.

 

Maybe cobfadec and others/relatives/family working in the hospitals can give some color on what they are seeing.

 

NY and WA are early in this course and predictors of what every other place will look like. The rest of the country is our France/Spain/Germany to the Italy (NY and WA). So what is going on in other places is irrelevant. Exponential growth blah blah

 

I am in New York. I assume NYC is what you mean. The closest Urgent care in our network to NYC is Poughkeepsie. Ill call them and let them know what you said!

 

You don't need to call anyone, you can just look at what this ER doc in Queens has to say:

 

“The most striking part is the speed with which it has ramped up,” said Ben McVane, an emergency room doctor at Elmhurst Hospital Center in Queens. “It went from a small trickle of patients to a deluge of patients in our departments.”

 

A trickle to a deluge. Wonder if that ever happens with cancer or heart disease...

[Spekulatius]

I dont practice in NYC, King County, LA etc but to just give some perspective whats happening here medically.

 

1. The urgent cares in our network have closed down centers within close proximity on weekends. 15% of centers now closed on weekends. Next step is closing at 6pm instead of 8pm. Volumes are down 80% across the board.

2. ER wait times online averaging 0-10 minutes. There are 5 hospitals in this IDN with these ERs. ~2400 beds total, not sure of bed count.

3. All elective surgery has been cancelled at local hospitals. Nurses are being told to take vacation time/furloughed as there are little no patients on the orthopedic/general surgery floors. OB/GYN still at normal volumes of course. No pre op/post op recovery being done.

4. Im still in contact with many in the orthopedic community and the largest non academic orthopedic group has asked all non provider staff to take 50% pay cuts going forward if salaried. Use vacation/sick time first. All PAs have been furloughed until further notice as its mainly a non trauma/orthopedic group. Ortho surgeons who do sports medicine better have a nice emergency fund saved up.

5. Local surgical centers have shut down. ENT, plastics, ophthalmology, GI docs/PAs, nursing staff same as above.

 

The hospitals are all emptied, waiting, and ready to go.

 

Maybe cobfadec and others/relatives/family working in the hospitals can give some color on what they are seeing.

 

Same here at the MA/ NH border. My wife works as a specialty nurse (dialysis) in several hospitals and they are all,pretty much empty and preparing for a flood of new patient by rearranging the hospital rooms and opening “droplet control?” areas. So far only one COVID-19 Patient that my wife knows about (but not in her care).

[Guest cherzeca]

my daughter's father in law is a pulmonologist/ER physician in Jax, working extra shifts.  he reports hospital is humming along just fine with everyone working hard and in good spirits.  all admitted cases doing well and not in ICU.  he notes that good news like his wont be reported by media.

[Guest Schwab711]

I appreciate the anecdotal cases from everyone. Please keep posting them. It's helpful for getting an idea of what's going on.

[LC]

Agree with posters who say that a death is a death, regardless of cause. Instead of measuring deaths from COVID19, the relevant statistic is excess deaths. That is how mortality from 1918 influenza is commonly measured, since there were no tests for influenza at that time.

 

Given how sporadic COVID testing has been implemented globally, this will probably be the measure-of-choice in 2020 as well, now almost 100 years later. Look how far we've come...  :-\

[EliG]

A thread by an American living in Japan.

 

 

[Liberty]

Scott Gottlieb thread on next steps:

 

[ERICOPOLY]

https://medium.com/@Jason_Scott_Warner/the-sober-math-everyone-must-understand-about-the-pandemic-2b0145881993

 

If he is right that 50 people have it for every 1 we know about, then 22 people have died out of 180,000 infected in NYC.

 

You have to take into account time it takes for the virus to run its course, though. Daily exponential growth means the vast majority of infections are early stage and haven’t had time to create complications.

 

Do we also upwardly adjust the 180,000 number to add back the number of people who were once infected but no longer are?

 

Really we need to look at this data at a cohort level, which as far as I know does not exist publicly.  Without it we need to look at places like China where it's mostly run its course - otherwise we'll be comparing apples and oranges.

 

The Chinese data tells us that 3.4% of the cases they identified died.  But it doesn't tell us the % of infected that were identified.

 

The Diamond Princess is the best population that I've heard of yet.  1% of infected died -- relatively old people go on cruises.

 

So if we were to take the number of people who died in NYC yesterday, and if we can estimate when they contracted it, then perhaps we could estimate the number of infected people in NYC at that time.  If we then estimate the rate of spread, we can take a stab at how many are infected in NYC today.