More interesting data regarding Covid

[Guest]

...

Except, there is no evidence that suggests even a substantial minority of Swedes has been infected. Or that prior infection confers future immunity for any known period of time....

 

Oops. Didn't take a long time to prove that wrong:

https://www.sciencenews.org/article/coronavirus-covid19-reinfection-immune-response

"In the study, researchers tried to isolate infectious coronaviruses from samples taken from 108 people who retested positive. All of those samples tested negative. When the scientists examined 23 of those patients for antibodies against the coronavirus, almost all had neutralizing antibodies that can stop the virus from getting into cells ." (Of course, I would argue that the fact that not a single person has ever been ill from Covid-19 twice was evidence suggesting at least temporary immunity, before we had this hard scientific evidence)

Note: I have never been a proponent of the Swedish model. What I have argued for is gradual re-opening, with special protections given to senior citizens (which the Swedes, to their shame, didn't do).

Edited May 20, 2020 by Unicorn

[+ stevenkesslar]

And I think this seals the deal that the numbers do not look very good for herd immunity. Unless you fancy 2 million dead Americans, who are mostly senior citizens.

 

 

From the article I found this chart in:

 

What is the true infection fatality rate of COVID-19, broken down by age and health status? This is a simple question for which the CDC should have a clear answer by now, accompanied by a readable chart – a chart showing everyone’s demographic risk assessment so that we can better target our infection mitigation efforts. Yet it’s the one thing our government hasn’t done. Wonder why?

 

Take a look at this chart (which I translated into English using Google Translate) prepared by the Economisch Statistische Berichten (ESB), a Dutch economics magazine, quantifying the infection fatality rate for the Dutch population based on age bracket. The data were calculated from an antibody test of 4,000 blood donors conducted by Dutch blood bank Sanquin to see how many have been infected for the purpose of donating blood plasma to those currently suffering from the virus. The data were presented to the Dutch House of Representatives in mid-April by the National Institute for Public Health and the Environment (RIVM).

 

So this is a "give me the facts, the facts, and only the facts" post. What I found very interesting about this particular article is that it is written by an author in a journal that has exactly the opposite view point as mine. the author argues forcefully that the data is accurate, and relevant.

 

So the math and science question is: can we agree on certain basic facts that will keep senior citizens alive? And based on this chart, I think the answer is yes. The data comes from a country which has had a roughly equivalent number of deaths from COVID-19 as the US. (334 deaths per million in The Netherlands versus 283 deaths per million in the US.)

 

So I agree with the author's points about data. This is the kind of information the government should be telling us. And what it says about the impact of COVID-19 on different age cohorts may be quite relevant to the US.

 

This is also an interesting lesson in the usefulness and uselessness of statistics. Here is the author's take:

 

As you can see, the death rate doesn’t even climb above 1% until you reach over 70, with a steep and dangerous growth of risk over 75 and 80.

 

As a statistical point, that's a true statement. The intent of the author is to say what a lot of people are saying: What'sthebigdeal? It'sonlyonepercent! Theseareseniors! They'regonnadieanywaysoon! Sorry, but I've now heard these sound bites enough that the words just all kind of bunch together and roll off the lips.

 

The big deal is that based on this data, 2 million Americans are going to die. Just do the math. That's what the numbers tell us, Even though the author doesn't spell that part out.

 

My sense from everyone I know is that 100,000 or so COVID-19 deaths has already been quite exhausting. Particularly for those who live in the relatively few hot spots, like New York City or Boston. If we turn the entire US into similarly intense or more intense hot spots, 2 million dead is probably in the ballpark of what we should expect.

 

So, yes, this is quite useful information to know.

 

The number of deaths in the The Netherlands is 5,715 right now. Relative to the US, that's actually a slightly higher number of deaths per million residents, as I said above. And in both The Netherlands and the US, in a few months of pandemic the total numbers of deaths from COVID-10 are already more than double the annual number of deaths from the flu. So the question now is: are we going for 5 times as many deaths as the flu? 10 times as many deaths? The sky's the limit? The experience in The Netherlands does suggest the upper limit in the US is about 2 million - which is what Dr. Fauci and Dr. Birx have been saying all along.

 

To do the math, you can see the number of total Americans by the same age cohorts here. And you can see the number of Americans that die of the flu in any of the last ten years by ago cohort here. I picked the 2016-2017 flu season for a reason. If you average the last ten years, the average number of flu deaths was about 38,000 a year. So I picked the year in the last decade that came closest to the average. There were 38,320 flu deaths in 2016-2017. Of those deaths, 32, 833 were among seniors aged over 65. So that is the nature of the beast. Respiratory diseases mostly kill seniors. That is the way it works.

 

Right out of the gate, this herd immunity is not looking like a very good idea. We're already at 93,533 dead Americans, in a few months - compared to 38,000 US flu deaths annually. We don't know how much of the US population has been infected. But even in New York City, the high end estimate was maybe 1 in 5 people - if these antibody tests are in the ballpark of correct. So herd immunity basically means mass disease, mass illness, mass hospitalization, and mass death. Again, pretty much what the scientists have been saying all along.

 

So if you take 5 minutes to do the math, here are the number of Americans that will die of COVID-19 based on age cohort, using the death rates by age cohort from The Netherlands:

 

0 -19 years: 2,459 deaths

20-29 years: 1,362 deaths

30-39 years: 3,495 deaths

40-49 years: 6,878 deaths

50-54 years: 12,104 deaths

55-59 years: 31,813 deaths

60-64 years: 58,957 deaths

65-69 years: 129,295 deaths

70-75 years: 223,530 deaths

75-79 years: 410,496 deaths

80+ years: 993,604 deaths

 

So how is herd immunity looking to everyone so far?

 

This all adds up to a grand total of 1,873,993 deaths. Again, this is using data of actual deaths from The Netherlands that people who think this isn't just that a big deal are saying are the kinds of numbers the government should be telling us.

 

the data also syncs with what the smartest scientists all over the world has been saying. Dr. Fauci has been saying the actual death rate is probably about 1 % of all those infected. A very detailed study in The Lancet in March produced what now looks like a very accurate scientific best guess:

 

Our estimated overall infection fatality ratio for China was 0·66% (0·39–1·33), with an increasing profile with age. Similarly, estimates of the proportion of infected individuals likely to be hospitalized increased with age up to a maximum of 18·4% (11·0–37·6) in those aged 80 years or older.

 

the Netherlands data is actually slightly low ball compared to Fauci and The Lancet. But the range is the same. And since The Netherlands data is based on the actual experience of death, not just theory, I would tend to overweight it as what is likely in The United States.

 

So what the numbers are telling us is that 2 million Americans will die if we embrace this approach. So we need 20 times more death than we've had so far. Would I be wrong to guess this just doesn't sound like a very good idea?

 

Of course, part of the reason this is so much more deadly than the flu - 38,000 flu deaths in a typical year, as opposed to up to 2 million from COVID-19 - is that way more people will get infected. In 2016-2017, the CDC estimates that 30 million Americans got the flu. 2 million deaths is based on the idea that 100 % of the herd gets sick.

 

That obviously won't happen. But the basic idea of herd immunity is that most of the herd actually does have to get sick.

 

And as much as it is sexy and fun and exciting and incredibly orgasm-inducing to say that OF COURSE we will bubble wrap seniors and OF COURSE that will be very easy and OF COURSE not even one senior will die ................ well, it turns out that is totally bullshit. It didn't work out that way in Italy or France or Spain or New York. Or even in Sweden, where it was the specific intent of government policy. Whatever the plan may be, the reality is quite clear: letting COVID-19 run amok leads to the mass death of seniors. Every time. That is what The Netherlands learned. Again, every time.

 

Even if you assume "herd immunity" only requires 50 % of Americans to get infected, it still means mass illness, mass hospitalization of the US work force, and most death ........... mostly of seniors. Instead of up to 2 million dead Americans, letting the virus infect half the US population cuts the number of deaths top "only" 1 million. Woo hoo!

 

So I completely agree with the author's point. Facts are facts. And when you look at these facts, it is very hard to see why anybody would support this approach. The data and the numbers are simply awful. It has nothing to do with politics, or ideology. The virus doesn't understand politics, or have an ideology. This is just basic science, and basic math.

[+ stevenkesslar]

The "let's try herd immunity" approach actually induced the mass death of seniors in Sweden, by allowing the virus to run amok. I suspect he is also wrong about "herd immunity". He says that Sweden will achieve it relatively soon. Except, there is no evidence that suggests even a substantial minority of Swedes has been infected. Or that prior infection confers future immunity for any known period of time.

 

Oops. Didn't take a long time to prove that wrong:

 

Seriously? You think that study you posted proves anything about the validity of herd immunity?

 

If I recall right, you're a doctor, right?

 

I have a few simple biases about this whole thing: 1) Doctors, nurses, scientists, and first responders are the biggest heroes in this movie; 2) They know shit that is above my pay grade.

 

So when you post charts about ventilator protocols, I simply assume that is above my pay grade. I have nothing but empathy for doctors like @purplekow and nurses that have to make really difficult decisions about whether somebody goes on a ventilator. Speaking as a non-professional, the simple idea that makes the most sense to me, and I think the overwhelming majority of Americans, is that the best way to treat COVID-19 is to simply not get infected by it at all.

 

So the idea that getting sick once from COVID-19 prevents you from getting sick twice is a theory, not a fact. We just don't know.

 

I can't imagine how we could know. The US CDC was informed about this virus on January 3, 2020, when Dr. Redfield got the call from the Chinese CDC. Him and Azar agreed immediately this was a "very big deal". We are about four and one half months from that point. So the idea that anybody knows at this point whether herd immunity works - or how long it works for - is anybody's guess. And that is not above my pay grade. We just don't know.

 

I've read various interesting theories about it. One was posted by @bigjoey from some place up in Minnesota. They theorized that maybe COVID-19 confers immunity for six months, or maybe a year. Which is one sensible enough theory. That would put COVID-19 somewhere in the ballpark of influenza, which does not provide total or permanent immunity.

 

It's actually very depressing to think about. I don't think anyone wants to really contemplate the idea that COVID-19 could turn into the gift that mutates and keeps giving year after year. Again, Rule Number One: scientists are the heroes in this action movie. Everybody in America (and the world) is rooting for Captain Marvel to discover the vaccine, maybe even this year. And, sorry, the Marvel action script calls for the vaccine to work permanently. Check with Steven Spielberg for the script notes on that one.

 

The study you posted, and several other ones, probably say a lot more about test efficacy than about herd immunity. Nobody knows exactly why some people who were infected and recovered and tested negative then test positive a week or two later. One educated guess is that if you have something like 95 % test efficacy, it means that you are going to get some false positives. So if you test 100 recovered people who tested negative once, some small number of them are going to test positive if you test them again. It probably does not mean they were reinfected. Let alone that they can infect anyone else.

 

I think we do know that antibodies to COVID-19 exist, which is why we can fortunately have antibody testing and plasma donations. I assume, or at least hope, that the antibody tests being used in places like New York are relatively accurate. Like I said above, even if you assume the testing shows that 20 % of New York City residents were infected, it still means you need 2 or 3 or 4 times as much mass death to achieve herd immunity. Does anyone hear anyone in New York City who wants double or triple or quadruple the horror show they just went through? Or anyone else who wants that shit show in their local movieplex, and intensive care center?

 

And, again, I'm all for clicking my heels and wishing and hoping for permanent herd immunity - ideally through a vaccine. But wishing doesn't make it so. If there is any evidence anywhere that COVID-19 antibodies protect anyone for at least a year or two, please let us know. I simply don't think anyone knows anything about that yet.

[+ purplekow]

I guess in a country that constitutionally allows 40000 deaths a year by gun violence so the big guns and the NRA can have lavish lifestyles, 365000 a year (yes 1/10 of 1 per cent is still 365000 deaths a year no matter how you try to minimize it) is acceptable for big businesses which can withstand an absentee rate for 7% for weeks at a time. Small business probably would sink under such a burden, Well it is acceptable as long as the people who are dying are old, poor and chronically ill. I this was a disease striking corporate board rooms, there may be a different feeling about it. Statistics are impersonal, even death and dying statistic. Death and dying however, are very personal and if you are personally affected, your thoughts about this are probably colored by it.

Ultimately to some of the people here, this is all about money and dollars and to others it is about lives and death. As a result this will continue to be debated because it is clearly a case of comparing apples a day to orange man in the White House.

[+ stevenkesslar]

Note: I have never been a proponent of the Swedish model. What I have argued for is gradual re-opening, with special protections given to senior citizens (which the Swedes, to their shame, didn't do).

 

The context of my comment about Sweden is that Anders Tegnell is much better at stating theories than facts. And his theories don't hold up so well in practice, we are learning.

 

We can only speculate about his theories about herd immunity. But I think we know for a fact that his theories about "special protections" for senior citizens just don't work.

 

In theory, I think senior citizens should be able to live forever. That sounds very nice in theory, doesn't it? And it sounds very nice when Tom Freidman, the US version of Anders Tegnell, pushes the idea of bubble wrapping seniors for a year or so. He calls it "harmonious balance". Sounds wonderful in theory, right? Who could be against harmony, and balance?

 

The problem is that senior citizens don't actually live forever in practice. So as much as my theory that seniors should live forever sounds nice, it just never works.

 

And other than sounding nice, "special protections" for seniors does not work in practice, either. Again, it didn't work in France, or Italy, or Spain, or New York City, or anywhere. I think it is fair to single out Anders Tegnell and Sweden. Unlike those other places, which were suddenly hit by a tidal wave of death they did not anticipate or plan for, this was actually planned for in Sweden.

 

I could post many endless walls of text about how this worked in practice with my Mom and Dad in nursing homes. It just makes no sense. It is bat shit crazy. If these people ever spent serious time with a loved one in a nursing home, it sure doesn't show in their theories. Who puts the plate of food in front of Mom? The minimum wage college student? How do we know they are not asymptomatic? Who hands Dad his meds? The nurse with two kids at home? She tested negative two weeks ago, but how do we know her kids didn't bring COVID-19 home from school two days ago? And, sorry, you have to have lots of people that put the fork in Mom's mouth, and dress her, and lift her on to the toilet seat or change her adult diaper.

 

I don't even think it's fair to blame these deaths on the nursing homes. I have a huge amount of respect for the people who work in those homes. What does "special protections" even mean? These are mostly skilled women with good hearts who work hard and don't get paid all that well. If Tom Friedman wants to talk about "special protections", he should go feed seniors and clean up their shit in a nursing home for a few months. Then I'd like him to explain, in detail, what "special protections" actually means to him.

 

If we are going to be honest about herd immunity, I think we need honest vocabulary. So we should not be talking about "special protections". We should be honestly talking about the "special deaths" and "special pain" seniors get from COVID-19.

 

Here is what "special death" looks like in the UK:

 

 

This is happening all over the world, wherever there is a COVID-19 hot spot. Even when you factor in the huge spike in deaths from COVID-19, there is still a gap between COVID-19 deaths and the total increase above average deaths. In the UK, that worked out to be slightly less than 15,000 "extra" deaths not diagnosed as COVID-19 in one month in the chart above. In New York City, the estimate is that about 5,000 additional people, mostly seniors, experienced "special deaths" from undiagnosed COVID-19 in their home, probably alone. In some cases in New York City, people figured it out when the body started to stink. That's what COVID-19 "special deaths" are like.

 

So people can talk about "special protections" all they want. It sounds like a wonderful theory. But in reality, what sounds far more real and much less fun is "special death" for senior citizens at home.

 

And Anders Tegnell and Tom Friedman need to think about "special pain" for seniors a lot more before they cart out their "special protections" nonsense.

 

In theory, the idea that we are going to shower care on seniors in their home to make sure they are safe and well fed sounds wonderful. But, in reality, seniors are telling house cleaners and care providers to stay out. They don't want to take the risk that someone asymptomatic or suffering from "allergies" is going to unintentionally leave the virus behind when they leave. And the more we let the virus run amok, the greater the chance that someone asymptomatic is going to unknowingly give you the "special pain" you don't really want or need.

 

This is the single best article I've read about the massive challenges COVID-19 has created for in home care. This line sums the challenge up:

Last week, American Health Care Association (AHCA) President and CEO Mark Parkinson called coronavirus “an almost perfect killing machine” for the elderly.

 

Because Parkinson is right, allowing COVID-19 to spread deeply and broadly into any community is always going to be a disaster for seniors. Forget about the fact that grocery store workers and factory workers and cops are going to die. Seniors don't need those people coming into their homes, if they still live independently. What about the care workers? Who is going to make sure they are tested, and safe? And if we let the virus spread as far and wide as it wishes, doesn't that just make it much more likely that the people coming into your home are unknowingly bringing the virus with them?

 

This one is a special sore spot for me. There were two times my Dad got regular in-home care after my Mom had to go into a nursing home. Both times I interviewed and hired the agency. The staff members were all good caring people who my Dad really liked. But the first time we hired, he gradually undermined the idea because he thought they were too expensive. So then I organized two of my brothers to help me pay for the care, since my Dad needed it but didn't want to pay for it himself. Penny wise, pound foolish. Then my brothers gradually undermined that idea, because they pandered to my Dad's desire to not have to be taken care of by anybody other than my Mom, who by that point was in a nursing home.

 

So I lost that battle to Dad. His life, his choice. But then the predictable happened. A few months after the in-home care people stopped coming, my sister went over to my Dad's house and found him naked and unconscious by the toilet. There was a trail of feces all through the house, from his bedroom to the guest bathroom where my sister found him, still alive. We worked out that he probably fell asleep sitting on a kitchen stool, banged his head on the floor, and spent two days in some altered state he never remembered a thing about, trying to stay alive. The emergency alarm system one of my brothers insisted was a decent alternative to daily in-home care never worked, for whatever reason. That was the beginning of the end for Dad. He went straight to the nursing home from the hospital after that unfortunate brush with death, and never went back home.

 

So I think if we are being honest, this is the kind of "special pain" Anders Tegnell and Tom Friedman are promoting. Even though they don't have a clue that that is how their theories work out in practice.

 

I told the story about my Dad because what I'm reading suggests, at least anecdotally, that seniors don't want cleaners or even caregivers coming into their homes. So their kids show up, and find Mom or Dad in bed or sitting in a chair in their own feces.

 

COVID-19 is not creating any "special protections" for seniors who don't want to live in nursing homes, like my Dad. It is only creating many more opportunities for "special pain". Knowing how my Dad felt about independence and in-home care, even before COVID-19, I can't blame them. But anyone who doesn't realize that the consequences of this are going to be very bad for many seniors living at home is just engaged in wishful thinking.

 

If we want them to live safely at home, we have to keep the virus out of the community. Period. Once it is allowed in, in every country in the world COVID-19 has been very effective at finding seniors, and killing them.

 

If Tom Friedman or anyone has a serious national plan for safely bubble wrapping seniors living at home or in nursing homes for a year or two, while a lethal virus runs amok, I'd like to hear it. All I hear is hollow rhetoric about "harmonious balance" and "special protections". Translated to the real world, that basically means "special death" and "special pain", I think.

Edited May 20, 2020 by stevenkesslar

[Guest]

Fox News has Sean Hannity, Tucker Carlson and several part-time loonies. Enough said.

I said nothing in support of Fox. Cuomo and Lemon are full time loonies. Enough said.

[Guest]

The term “Excess Deaths” in your chart is ridiculous. And they know what they’re doing when they reference “Covid RELATED deaths”

 

it’s just an emotional label given to something that’s inevitable. It does NOTHING to indicate the qualitative factors contributing to death. Remember, death WITH covid now defaults to death FROM covid.

 

That chart And entire line of thinking means nothing when the incremental rate is 0.0007575758

[+ Pensant]

I'm not sure "hysterical" is the right word, but the press sure has been inflammatory often. Just yesterday on the local news, the reporters were saying that "deaths are increasing," even though the number of daily deaths was decreasing. Yes, technically, as long as there is at least one death, the total number of deaths has increased. The total number of deaths cannot decrease. But to say that "deaths are increasing" when the total number of deaths per day has been decreasing steadily is misleading at best. So far, I'm not hearing the press say things such as "hospitals have been mostly empty, ICU beds are as empty as they've been in years, and serious Covid cases have been falling," although this is often the case. Keeping the public on edge and glued to their TV sets seems to be the priority, rather than putting things into perspective.

This is why I’m glad I pulled the plug on cable 3 years ago at my main place. Endless shrieking and blaming and hyperbole, interspersed with ads for incontinence and ED aids. Even a snowstorm prediction is filled with alarming chyrons.

[+ bigjoey]

If done properly, seniors living in senior living facilities can be protected. As Anders Tegnall in Sweden admitted, it is in the execution of actions that Sweden made its mistake concerning senior facilities. Actions taken tells much of the tale in the difference in the statistics. For example, part of the huge difference in deaths in nursing facilities between NY and Florida can be attributed to NY mandating that nursing homes take residents with Covid19 while Florida did not.

 

I live in Johnson County, Kansas. In 2019, the population was 602,401. There are about 150 senior living facilities housing about 20,000 residents. Here is how they are doing with deaths in this pandemic:

https://public.tableau.com/profile/mapper.of.the.day.mod.#!/vizhome/shared/558GFDZKM

There are 28 deaths in 7 facilities; a closer look shows 14 deaths at one facility! Half of the Covid19 deaths from one facility tells the tale: bad management and bad practices can kill.

 

This means that the other facilities are doing things right so that deaths are none or minimal. If best practices are followed, there does not need to be mass deaths of seniors. We know what to do, it is just a matter of following through.

 

Like everything else, there are badly run places and well run places be it restaurants or senior facilities; strict government licensing and inspections need to weed out the bad providers (most places publish the restaurant inspection reports and which ones get closed down). Over the years, local senior facilities have been closed down for poor inspections.

 

 

 

FULL DISCLOSURE: the Brighton Gardens facility with the 14 deaths is 8 blocks down the street from my home! When my next door neighbor broke her hip and needed a temporary nursing facility during rehab, her husband and son looked at Brighton Gardens because it was so close. When they saw poorly trained staff, they chose the facility where I volunteer and loved the place because of the caring staff. Bottom line: at Brighton Gardens, the staff and management was poor years ago and from the deaths there, it is still poor.

 

Just because excellence in providing quality care for seniors is hard work, that does not mean it can’t be done. There are wonderful, caring staff in nursing homes that can and do provide great care. Staff can provide protection during this pandemic.

[+ bigjoey]

Snarky alternative hypothesis: election is over in November, regardless of outcome, and it’s all over.

 

It’s also interesting to see folks who normally lambast Sweden as a socialist dystopia hold it up now as a paradigm for the world.

 

Hypocrisy- n.the practice of claiming to have moral standards or beliefs to which one's own behavior does not conform; pretense.

Not sure where you get the idea that today’s Sweden is held up as a “socialist dystopia.” Sweden long ago dumped much of its socialist dystopian ideas: they ended their wealth tax, the ended their estate tax, they lowered their corporate tax rate (to about where Trump lowered ours), they privatized some nationalized businesses and they even moved away from a total government run healthcare system and now have some private healthcare. Sweden was pragmatic and when the socialist ideas didn’t work, they moved back towards a more balanced tax structure and economy.

[xyz48B]

Not sure where you get the idea that today’s Sweden is held up as a “socialist dystopia.” Sweden long ago dumped much of its socialist dystopian ideas: they ended their wealth tax, the ended their estate tax, they lowered their corporate tax rate (to about where Trump lowered ours), they privatized some nationalized businesses and they even moved away from a total government run healthcare system and now have some private healthcare. Sweden was pragmatic and when the socialist ideas didn’t work, they moved back towards a more balanced tax structure and economy.

I didn’t say I said it’s a socialist dystopia. I spoke of those who lambast it that way...Now they love it. And lest I’m accused of saying anyone who agrees with Sweden’s approach also has called it socialist – no. My comment was pretty clear. It’s interesting to see those who have done that now holding it it. Nothing more. Nothing less.

[Populist Fury]

IDK how anyone can still consider CNN (or any of those other corporate "news" outlets) actual news these days.

 

It's time for all these authoritarian fear-based lockdowns orders to be lifted, especially here in Cali where the virus has a hard time spreading in our hot spring/summer weather. Young & healthy people should be out working & enjoying life ?‍♂️?‍♂️ Those still fearing the virus, the elderly, & the physically vulnerable, can remain on voluntary lockdown if they want... their choice, their right.

 

I #CovExited on May 1st, threw a small bday party for my BF on May 2, & been doing everything I want since then. We don't actually have to wait for permission from our self-serving government officials to live life! People are safer from SARS-CoV-2 out in the warm spring/summer weather than locked up inside anyway.

[+ WilliamM]

IDK how anyone can still consider CNN (or any of those other corporate "news" outlets) actual news these days.

 

It's time for all these authoritarian fear-based lockdowns orders to be lifted, especially here in Cali where the virus has a hard time spreading in our hot spring/summer weather. Young & healthy people should be out working & enjoying life ?‍♂️?‍♂️ Those still fearing the virus, the elderly, & the physically vulnerable, can remain on voluntary lockdown if they want... their choice, their right.

 

I #CovExited on May 1st, threw a small bday party for my BF on May 2, & been doing everything I want since then. We don't actually have to wait for permission from our self-serving government officials to live life! People are safer from SARS-CoV-2 out in the warm spring/summer weather than locked up inside anyway.

 

Doctor Sulkin was the Veterans Administration Director until recently. He just appeared on CNN discussing the risk of veterans during this novel coronavirus pandemic. That is one of many reasons to watch CNN, especially for vets and those who are concerned about vets.

[+ bigjoey]

Doctor Sulkin was the Veterans Administration Director until recently. He just appeared on CNN discussing the risk of veterans during this novel coronavirus pandemic. That is one of many reasons to watch CNN, especially for vets and those who are concerned about vets.

Yes, vets have problems that differ from the population at large and solutions to help require unique responses. While we talk in universal terms and the statistics give are macro ones covering the entire population, solutions are often at the micro level.

[+ bigjoey]

Today’s Wall Street Journal has a story focused on nursing homes and how to prepare them for the second and third Covid19 waves that are expected:

https://www.wsj.com/amp/articles/prepare-nursing-homes-for-the-next-coronavirus-wave-11589927449

 

This is behind a firewall and for those who do not have access some key points:

1-while nursing home residents make up less than 1% of the US population, they count for about half the Covid19 deaths (some states are more like Minnesota 81%, Pennsylvania 77%).

 

2-shutting down the economy did not prevent these deaths as nursing home residents were already pretty much staying “home”.

 

3-while the focus on the pandemic was hospital/ICU centered, states and the federal governments (like they did in Sweden),pretty much ignored nursing homes (the article gives examples) until it was too late.

 

4-even in normal times, the CDC says 380,000 residents of long term care facilities die each year from infections. Lax standards are all too normal (the article gives examples). That 1% of the population has 380,000 deaths from preventable infections puts the Covid19 pandemic in perspective when shutting down the entire economy.

 

5-in total, it seems that about 51-53% of Covid19 deaths are nursing home residents.

 

It becomes clear that the complete shutdown which has physical, emotional, educational and economic collateral damage was not necessary. A common sense approach closing crowded venues, emphasizing hand washing, physical distancing, etc while more rigorous infection control at long term care facilities would have cut the death toll substantially.

 

Think about it a moment: the CDC gives the statistic that infections in long term care facilities due to lax standards kill 380,000 residents each year. Where is the outcry and hysteria over this yearly total? This is a huge scandal but the media which is creating a pandemic of fear ignores these 380,000 preventable deaths.

[xyz48B]

@bigjoey- I theorize a lot has to do with generational politics. Many of those in positions of authority – governors, Congress, CDC head honchos, etc. – are looking at this disease ravaging their parents and for the first time ever they’re really being confronted with the truth of mortality. Until now, death has been an abstract thing for them, on the whole. But now all of a sudden those people who didn’t used to seem old are literally dying in droves. And it’s mom. It’s dad. And that means these leaders (some are boomers, some older) are the next generation in line to face mortality. Our medicine industrial complex has largely inoculated us from death and made it so we don’t have to admit we’re going to die – at least not for a long time. When we have the horror of our mortality unveiled to us, we drive the metaphoric dagger into the painting to rid ourselves of the pain. But this time, instead of just stabbing themselves after they’ve realized they’re not immortal, our leaders have said we’re going to all suffer with them. If they’re not going to live, neither are we. We’re in this together, after all!

[+ bigjoey]

@bigjoey- I theorize a lot has to do with generational politics. Many of those in positions of authority – governors, Congress, CDC head honchos, etc. – are looking at this disease ravaging their parents and for the first time ever they’re really being confronted with the truth of mortality. Until now, death has been an abstract thing for them, on the whole. But now all of a sudden those people who didn’t used to seem old are literally dying in droves. And it’s mom. It’s dad. And that means these leaders (some are boomers, some older) are the next generation in line to face mortality. Our medicine industrial complex has largely inoculated us from death and made it so we don’t have to admit we’re going to die – at least not for a long time. When we have the horror of our mortality unveiled to us, we drive the metaphoric dagger into the painting to rid ourselves of the pain. But this time, instead of just stabbing themselves after they’ve realized they’re not immortal, our leaders have said we’re going to all suffer with them. If they’re not going to live, neither are we. We’re in this together, after all!

I think there is much to that: the Boomer’s fear of death is driving their responses. After thinking about that, another factor may be that Boomers (and younger people) are more secular than previous generations. Just my general observation (but I welcome someone posting research) is that deeply religious people are more accepting of death and human mortality than non-believers.

[xyz48B]

I think there is much to that: the Boomer’s fear of death is driving their responses. After thinking about that, another factor may be that Boomers (and younger people) are more secular than previous generations. Just my general observation (but I welcome someone posting research) is that deeply religious people are more accepting of death and human mortality than non-believers.

A *true* Christian accepts that death isn’t the worst possible thing to happen to them. That doesn’t mean you go out and start being irresponsible, but you also don’t live your life in fear of dying.

[+ WilliamM]

A *true* Christian accepts that death isn’t the worst possible thing to happen to them. That doesn’t mean you go out and start being irresponsible, but you also don’t live your life in fear of dying.

 

People who die Young, especially in war, often leave parents and girlfriends behind. I am not sure they are thinking of the great beyond when near death.

[RealAvalon]

I don't see how anyone could look at these graphs and be horrified at the thought of a gradual re-opening

There isn't anyone that is 'horrified' about a gradual re-opening. The argument is whether to base it on science or on politics.

[Guest]

If done properly, seniors living in senior living facilities can be protected. As Anders Tegnall in Sweden admitted, it is in the execution of actions that Sweden made its mistake concerning senior facilities. Actions taken tells much of the tale in the difference in the statistics. For example, part of the huge difference in deaths in nursing facilities between NY and Florida can be attributed to NY mandating that nursing homes take residents with Covid19 while Florida did not.

 

I live in Johnson County, Kansas. In 2019, the population was 602,401. There are about 150 senior living facilities housing about 20,000 residents. Here is how they are doing with deaths in this pandemic:

https://public.tableau.com/profile/mapper.of.the.day.mod.#!/vizhome/shared/558GFDZKM

There are 28 deaths in 7 facilities; a closer look shows 14 deaths at one facility! Half of the Covid19 deaths from one facility tells the tale: bad management and bad practices can kill.

 

This means that the other facilities are doing things right so that deaths are none or minimal. If best practices are followed, there does not need to be mass deaths of seniors. We know what to do, it is just a matter of following through.

 

Like everything else, there are badly run places and well run places be it restaurants or senior facilities; strict government licensing and inspections need to weed out the bad providers (most places publish the restaurant inspection reports and which ones get closed down). Over the years, local senior facilities have been closed down for poor inspections.

 

 

 

FULL DISCLOSURE: the Brighton Gardens facility with the 14 deaths is 8 blocks down the street from my home! When my next door neighbor broke her hip and needed a temporary nursing facility during rehab, her husband and son looked at Brighton Gardens because it was so close. When they saw poorly trained staff, they chose the facility where I volunteer and loved the place because of the caring staff. Bottom line: at Brighton Gardens, the staff and management was poor years ago and from the deaths there, it is still poor.

 

Just because excellence in providing quality care for seniors is hard work, that does not mean it can’t be done. There are wonderful, caring staff in nursing homes that can and do provide great care. Staff can provide protection during this pandemic.

I have friends that own senior living facilities. Because I have minority investments in some of them, we talk frequently. Collectively, they own 20 properties...both SNF and ALF...not a single case among residents or staff. That’s not taken for granted...it requires constant vigilance and caring awareness of the life challenges faced by staff and attention to details.

[Guest]

People who die Young, especially in war, often leave parents and girlfriends behind. I am not sure they are thinking of the great beyond when near death.

That has nothing to do with @xyz48B ’s comment...

[+ stevenkesslar]

A very handy summary of what has happened so far in Europe.

 

The Results of Europe’s Lockdown Experiment Are In

 

The article raises a bunch of interesting questions about why individual countries had the outcomes they did. I strongly agree with the main conclusion the author reaches:

The economic data for the lockdown period are only just appearing, and they may be revised substantially in the future given the obvious difficulties of collecting data during a pandemic. Regardless, what the past few months suggest is that the economic cost is not the only downside to a draconian lockdown. The Covid-19 experience has taught us that it’s far better to respond quickly and smartly, with the right technology and mass testing and tracing, rather than only relying on the crudest of shutdowns. If there are second waves of the virus, we shouldn’t repeat the mistakes of the first.

 

I've viewed this "health v. wealth" debate as bullshit from the beginning. Most scientists and economists seem to agree: the economic problem is being driven by a public health problem - a lethal virus. So if you want to deal with the economic problem, you have to deal with the public health problem. You have to control the virus. Period. So the real question is: how do we best control the virus? Lock downs are supposed to be a crude and almost desperate step. The best play is to move quickly and smartly.

 

Most citizens of every country I've seen surveys in strongly agree that this is the right way to look at the problem. In the US poll after poll after poll shows that the public places safety and health first. People are more worried about ending lock downs too early than rushing to reopen things and allowing the virus to come back stronger than ever.

 

That said, what is absolutely clear is the the countries that got their shit together the quickest had the best outcomes. Meaning that lock downs were shorter and/or less severe. Iceland and South Korea are not on that list, but I don't think they even had a full lock down. They are two of the poster children for how to test, trace, and treat the virus into control.

 

This article also confirms the impression I've had that Germany and Austria also did better than most countries. My sense is that both countries were very good at messaging and getting the public on board. Austria in particular was very stringent, from some of the anecdotes I read. But I think that the idea they got across effectively is that this has a beginning, a middle, and an end. It will not last forever. And the more everybody cooperates and does what they need to do the quicker and safer we will be able to leave our homes again. I think it worked.

 

Implicit is all of this is the idea that none of these countries, except possibly Sweden, are going for herd immunity. They are obviously going for containing or suppressing the virus until a vaccine confers artificial immunity, and then (hopefully) things can really start to get back to normal. The chart shows death trends, not cases. But in all the big countries cases loads are now down by 90 % or more. So all of them are showing that even when the virus was completely out of control, like in Italy and Spain and France, it can seemingly be put back in the bottle. That said, the article is exactly right that the smartest move was to never let the genie fully out of the bottle in the first place.

 

One thing this article doesn't speak to is the intensity of how quickly the pandemic seemed to hit in some of these places. My impression is that Italy had to lock down quickly, because within a matter of days they were literally in a horror movie. They actually started the lock down in one part of the country, and then quickly expanded it. It at least felt while it was happening like "desperate people do desperate things." They were the first Western country that got hit really hard without knowing what was coming. Meanwhile, my impression is that Germany had the advantage of having at least a few weeks before their first big wave hit. They seem to have used the extra time they had very wisely. The chart in this article does not reflect this, in that it shows Germany having its first case slightly before Italy did. But as it was happening there was no question that it seemed like Italy was where all hell was breaking loose all of a sudden.

 

This article makes me want to learn more about what both Germany and Austria did. Meanwhile, it's no surprise that the UK (and the US, which is not on the chart) fared the worst in terms of deaths. Both countries lagged in getting their shit together.

 

The comparison between the Nordic countries raises lots of questions, too. The data shows, no surprise, that Sweden fared worse than its immediate neighbors in terms of deaths. None of the Nordic countries fared all that poorly economically, compared to Spain or France or Italy. What is also interesting about the charts in the article is it appears that even though Norway and Finland had more stringent lock downs and therefore far fewer deaths, they actually took no economic hit. They appear to have done slightly better economically than Sweden.

 

This data reinforces what appears to be a growing wall of data that the sweet spot, which is found in places like Germany or South Korea or Australia, involves acting quick and smart to get the virus under control, and then using a very aggressive testing and tracing program to keep it under control.

 

As far as the economy goes, it is very clear that if you get to the point of New York City, you are fucked. Nobody is going to go to Starbucks, even if it is open, if they know that outside every hospital is a refrigerated truck with dead bodies in it. But the flip side is that the people arguing that they should just be able to ignore everything because I live in Bumblefuck and we don't have that virus here are just wrong. Sioux Falls didn't have the virus, either, until a few meat packers started to feel sick. Before they knew it the meat packing plant was closed, 3000 people had COVID-19, workers were dying, and the ICUs in the local hospitals were completely full. So any Bumblefuck in America or the world can have the misfortune of finding themselves in a big fucking mess of death and disease in a matter of weeks, if they want to try flying blind. That is also part of the clear lesson.

 

This is encouraging. As the author notes, we ought to be able to get smarter and smarter at beating the virus as we go.

Edited May 21, 2020 by stevenkesslar

[Guest]

More evidence that easing restrictions doesn't necessarily imply death and doom. And I heard on the news yesterday that deaths from strokes and heart attacks in NYC more than doubled because people were afraid to go to the hospital...

https://news.yahoo.com/as-more-states-reopen-georgia-defies-predictions-of-coronavirus-resurgence-whats-the-lesson-for-the-rest-of-the-country-164734815.html

"For the seven-day period ending on May 4, Georgia’s daily average stood at 746 cases.

 

By May 11, the average had fallen 12.6 percent to 652 daily cases.

 

By May 18, it had dropped to 612 cases, a further decline of 6.1 percent.

 

At the same time, Georgia’s seven-day average of COVID-19 hospitalizations fell from 1,432 on May 4, to 1,239 on May 11, to 1,049 on May 18 — a three-week decline of 26.7 percent."

[+ stevenkesslar]

More evidence that easing restrictions doesn't necessarily imply death and doom. And I heard on the news yesterday that deaths from strokes and heart attacks in NYC more than doubled because people were afraid to go to the hospital...

 

How many people was that?

 

New York City is estimating about 5,000 people died from COVID-19 at home, who are not accounted for in the state's hospital death totals. Whether they were too sick to go to the hospitals, which were basically crushed by demand, or too afraid to go, who knows? The TV images showed long lines of people waiting to get into hospitals because they were sick. The death totals from New York (and many other hot spots) show a huge spike in deaths above long term averages, even after accounting for all the diagnosed COVID-19 deaths. Meaning, the COVID-19 death totals in these hot spots are very likely low ball figures. It was even worse than we thought.

 

Obviously having a stroke (which could be related to COVID-19, actually) or getting shot or being in a car crash in the middle of this mess in New York City is part of the reason that the lock downs occurred. The hospitals knew they were going to be crushed. And they were. It could happen anywhere. It completely filled the ICU's in Sioux Falls, SD, of all places. Who'd have thought? Wasn't this ONLY supposed to happen in big cities? What were people who had heart attacks and strokes in Sioux Falls supposed to do?

 

I'm not completely sure I understand your point. Are you saying instead of a lock down in NYC, it would have been better if 50,000 or 100,000 New Yorkers fell ill and died? Would it have have made it easier for people with gun shot wounds or car crash injuries to get treatment if the hospitals were so crowded that people were dying in hospital hallways? Is that your point?

 

If it's not, what is your point? If your point is that people with normal reasons to urgently need an ER - like a heart attack or a gun shot wound - are going to have a huge problem all through 2020, at a minimum, if we let this virus run amok, you are correct. That is an excellent reason to control the virus, like most European countries now have.

 

Italy is generally thought of as a country with first rate hospital care. That wasn't how the people who worked in those hospitals felt a few months ago, though. In fact, some of the doctors and nurses got sick and died of COVID-19 themselves. Now, hopefully, with the virus controlled through testing and tracing, they can get back to providing first rate care for the people who need it for the "normal" reasons.

 

I hope you are right that Georgia is going to open in a way that does not bump up the infection rates much. As @bigjoey said already, it is too early to tell. That said, I think one of the biggest indicators that "it can and will happen here" is if people are thinking "it can't happen here". Conversely, the single most important lesson from Europe in that article I posted above seems to be that we don't need to fly blind, and we shouldn't fly blind. Iceland and South Korea are perfect examples, among many, of countries that very wisely used testing and tracing precisely so they could avoid lock downs.

 

There's no question that complete lock downs are more blunt object than surgical intervention. It is the equivalent of amputating a leg rather than healing it. At this point in the game, we should be smart enough and prepared enough to be using these more surgical tools to control the virus, like other countries all over the world are doing. As Dr. Fauci and Dr. Birx and Dr. Frieden and many others keep saying, that is actually the point of the lock downs: to get prepared to fight the virus smarter and faster.