Taking it to the Streets - Covid-19 #12

[Jeor]

There are obviously a myriad of things going on but I'm still going with density as one of the major factors.

The places where major outbreaks have occurred - New York City, Singapore's domestic workers, Wuhan - all have major population density issues with lots of people living closely together. I'm less certain of the situation in northern Italy or Spain.

Some of the places that are going relatively fine - Australia, New Zealand sort of Sweden (debatable) - are quite sparsely populated or at least do not have major concentrations of people in the same way that the places above do.

Of course the major outliers here are Hong Kong (incredibly dense, yet outcomes good), South Korea and Taiwan, but I'm willing to bet that all of these countries have a more "conscientious" population and more experience given SARS etc. I'm a believer in the mask effect as well given the potential for asymptomatic or presymptomatic cases and in HK and Taiwan there are certainly a very high percentage of mask wearers.

[Loge]

5 hours ago, Isabel said:

Huh, why do people think its that  bad in the netherlands?  We have it pretty much under control and or ic's can handle it.

The reason that the outbreak was so high in the beginning is that the government and health organisation made big mistakes.

A lot of dutch people went skiing in Austria and Italy. The european countries should have worked together and stopped that from happening from the beginning or half februari.

In the south of the netherlands they also celebrated carnaval (guess some kind of mardi grass) , so that spread it a lot.

Plus not enough testing of people. For example not testing people who were in the hospital with respiatory complains, but not testing them because they didnt go to italy or china.

And no quarantaine from people who traveled to italy or austria or even other hotspots.

 

The Netherlands was mentioned together with Belgium, which is second only to San Marino in the number of deaths per million population. The Netherlands isn't quite as bad but still top 10, ahead of Sweden. There is a region from the north-east of France through Belgium, and the extreme West of Germany (Heinsberg) where case numbers have been very high. I guess the same is true for the south of the Netherlands because the virus doesn't stop at the border. If somebody did the statistics for that region it probably would be as bad as Lombardy.

[Isabel]

1 hour ago, Loge said:

The Netherlands was mentioned together with Belgium, which is second only to San Marino in the number of deaths per million population. The Netherlands isn't quite as bad but still top 10, ahead of Sweden. There is a region from the north-east of France through Belgium, and the extreme West of Germany (Heinsberg) where case numbers have been very high. I guess the same is true for the south of the Netherlands because the virus doesn't stop at the border. If somebody did the statistics for that region it probably would be as bad as Lombardy.

The question is: which numbers are counted in the official numbers? I heard belgium also counted the care homes.

Not so sure about our numbers?

[Loge]

27 minutes ago, Isabel said:

The question is: which numbers are counted in the official numbers? I heard belgium also counted the care homes.

Not so sure about our numbers?

 

I think it's standard by now to count all deaths ascribed to Covid 19, not just those who die in hospitals. I don't know about the figures published by the Dutch government, but I'm fairly sure Worldometer and the Johns-Hopkins University do.

[Ser Scot A Ellison]

13 hours ago, Fragile Bird said:

This interview with the mayor of Las Vegas has to be seen to be believed.

https://www.thedailybeast.com/las-vegas-mayor-carolyn-goodman-embarrasses-herself-during-batshit-coronavirus-interview-with-anderson-cooper

Is the mayor of Las Vegas a position with actual power or is Vegas a city run by a City Manager with the Mayor as a figurehead?

[A wilding]

12 minutes ago, Loge said:

I think it's standard by now to count all deaths ascribed to Covid 19, not just those who die in hospitals. I don't know about the figures published by the Dutch government, but I'm fairly sure Worldometer and the Johns-Hopkins University do.

The key word there is "ascribed" though. Those sites can only quote the numbers they are given. For example the UK figures do still only count Covid-19 deaths in hospitals, which are in any case sometimes only reported days later. In particular they still don't include deaths in care homes, the number of which is unclear but is certainly many thousands. They are downplaying the numbers for political reasons of course.

[Fez]

58 minutes ago, Ser Scot A Ellison said:

Is the mayor of Las Vegas a position with actual power or is Vegas a city run by a City Manager with the Mayor as a figurehead?

There is a city manager and a city council, I've no idea of the relative power of each.

However, I do know that Las Vegas is actually much smaller than "Las Vegas." The entire Strip is actually outside of the city limits in unincorporated land that's run by the Clark County Commission. The Mayor has literally zero authority over the casinos or other businesses that are there.

Places like Fremont Street are part of the city, but so long as the Strip itself stays closed, I imagine very little of the city will reopen or see visitors.

[Fragile Bird]

Canada counts all Covid-19 deaths, and is testing all people in care facilities. The province of Quebec, for example, has about 1200 deaths, a shocking 75% in long term care institutions. 

[Loge]

1 hour ago, A wilding said:

The key word there is "ascribed" though. Those sites can only quote the numbers they are given. For example the UK figures do still only count Covid-19 deaths in hospitals, which are in any case sometimes only reported days later. In particular they still don't include deaths in care homes, the number of which is unclear but is certainly many thousands. They are downplaying the numbers for political reasons of course.

Looks like things are bit more complicated. NHS reports deaths in hospitals only. The ONS publishes the full count, but only once a week:

https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/causesofdeath/articles/comparisonofweeklydeathoccurrencesinenglandandwales/uptoweekending10april2020

Figures for Scotland and Northern Ireland include non-hospital deaths, too. Worldometer seems to use the NHS figures, though. 

[Jeor]

12 minutes ago, Fez said:

However, I do know that Las Vegas is actually much smaller than "Las Vegas." The entire Strip is actually outside of the city limits in unincorporated land that's run by the Clark County Commission. The Mayor has literally zero authority over the casinos or other businesses that are there.

Reopening Las Vegas would be a complete disaster.

If they're allowed, some casinos will probably dip their toe in the water to try it - after all, hardcore gamblers have somewhat inelastic demand, they will want to get their fix and head out to Vegas. Between all the cards and chips changing hands, and then all the people flying in and out of Vegas to other parts of the US, it would be sheer lunacy to have that as the first place open.

[rotting sea cow]

33 minutes ago, Fragile Bird said:

Canada counts all Covid-19 deaths, and is testing all people in care facilities. The province of Quebec, for example, has about 1200 deaths, a shocking 75% in long term care institutions. 

In Europe they estimate that half of the deaths comes from nursery homes

https://www.dw.com/en/coronavirus-latest-half-of-european-deaths-were-in-nursing-homes/a-53213299

Of course, they are probably still undercounting.

 

[rotting sea cow]

Ventilators do not help much, it seems

https://thehill.com/homenews/state-watch/494260-almost-all-covid-19-patients-on-ventilators-in-new-york-health-system

[Ser Scot A Ellison]

52 minutes ago, Fez said:

There is a city manager and a city council, I've no idea of the relative power of each.

However, I do know that Las Vegas is actually much smaller than "Las Vegas." The entire Strip is actually outside of the city limits in unincorporated land that's run by the Clark County Commission. The Mayor has literally zero authority over the casinos or other businesses that are there.

Places like Fremont Street are part of the city, but so long as the Strip itself stays closed, I imagine very little of the city will reopen or see visitors.

So, she’s an idiot who has little or no power.  Why bother interviewing her in that case?

[Loge]

38 minutes ago, rotting sea cow said:

Ventilators do not help much, it seems

https://thehill.com/homenews/state-watch/494260-almost-all-covid-19-patients-on-ventilators-in-new-york-health-system

Here is a rather interesting interview on the subject (in German) with physician who works in palliative care:

https://www.deutschlandfunk.de/palliativmediziner-zu-covid-19-behandlungen-sehr-falsche.694.de.html?dram:article_id=474488

 

Quote

I can see that these are very wrong priorities and all the ethical principles we know are being violated. So we as doctors should do more good than harm. Of course, if the disease is severe, i.e. leads to respiratory failure, then according to a Chinese study we can only save three percent of the patients, 97 percent die despite maximum therapy.

Quote

Well, the benefit is that you only save a very small number of patients, only a few of them return to their old life, a large number of those you save, after two to three weeks of ventilation, remain severely disabled. And these are conditions that most elderly people reject for themselves. In other words, the elderly are actually against operations that are associated with a high risk of permanent severe disability. Therefore, therapy goals for these patients are not actually achieved, which means that the indication is questionable.

He implies that putting Covid patients into intensive care is mostly financially motivated.

[Ran]

The paper modelling Stockholm's outbreak has been revised and is available here. As suspected, the "Scenario 1" was the more correct one. Per the model ,that means April 18th was peak of infections in Stockholm, and that by May 1st 26% (rather than 33%) of Stockholm will be infected. Antibody tests, PCR studies, etc. will continue, of course. They emphasize it's just a mathematical model and they're constantly getting more data and information, both in Sweden and from elsewhere, that they are using actively. The plateau still seems to be case in Stockholm, and in fact hospitalization rates seem to be going down there, which tends to support the hypothesis of a wide spread starting to slow things down. 

 

@Loge

Very interesting, forthright interview with Dr. Thöns. Much hay is being made of the fact that Stockholm's region reduced the amount of people 70+ getting intensive care after March, but as a doctor there says, part of it is that you learn more about the outcomes and you realize that under similar circumstances in a non-crisis time you'd still hesitate to do it given how much trauma is caused by ventialation.

 

[mcbigski]

11 hours ago, Tywin et al. said:

I do not want to alarm anyone, but there are several hospital networks that are effectively going broke. Or at least they are projecting they will be without more heavy subsidization. I am sure this is true all over the world. Governments are going to have to spend unheard of sums of money to contain this while trying to stabilize their economies, and that's just for this wave, however it looks. And there will more likely than not be more, in the plural sense, without us knowing exactly what they'll look like right now.

Are these hospital networks in NYC, New Orleans, and others of the hardest hit spots?  Or in places where non-emergency medicine is shut down and the Covid case loads aren't utilizing full capacity?  You can see on you tube nurses claiming to be furloughed because there's no work in their area.  But I'm skeptical of all self dramatized anecdotes by default.  (Unvarnished truth has rather lower virality, alas.)

Supposedly, hospitals are getting reimbursed more money, more quickly, for Covid patients than for other patients.  If that's the case, then trusting the US case numbers becomes rather more difficult for me as well.  (And as Ty also mentioned upthread about greedy non-profits, non-profit is merely a tax classification. It doesn't cause an organization to behave ethically and in society's wider interest necessarily.  And while I'd rank the ethics of hospital billing above some industries, I suspect the lack of transparency incentivizes chicanery)  So that would make me think that hospital systems in NYC and its suburbs aren't the ones you're talking about.  Could you clarify?

[A Horse Named Stranger]

On 4/21/2020 at 6:50 PM, A Horse Named Stranger said:

So I got a call from my dad's nursery:

Hello, it's about the spread of Covid.

*gulp* Ok...

Yes, two of our staffers have tested positive. They are of course sent home for now. However, we'd like to get your permission to have your father tested.

So you are just asking for my consent for a test, that's all? *sigh of relief* Ok, considered it hereby given.

[I am my dad's legal guardian, so they presumably had to call me, even if this is a non-invasive procedure].

 

Thought I'd give an update.

Test results came back. The patients/inhabitants (no, idea what the right word is in English) have all tested negative for COVID. They are still waiting for a few (17 or so) results, however my dad's test result was among the confirmed negatives.

[Ran]

2 minutes ago, A Horse Named Stranger said:

Thought I'd give an update.

Test results came back. The patients/inhabitants (no, idea what the right word is in English) have all tested negative for COVID. They are still waiting for a few (17 or so) results, however my dad's test result was among the confirmed negatives.

Glad to hear it. Fingers crossed.

[Fragile Bird]

40 minutes ago, Ser Scot A Ellison said:

So, she’s an idiot who has little or no power.  Why bother interviewing her in that case?

Lol, probably because they saw news reports that Las Vegas wants to open, and how were they supposed to know she's an idiot?

[HexMachina]

55 minutes ago, rotting sea cow said:

Ventilators do not help much, it seems

https://thehill.com/homenews/state-watch/494260-almost-all-covid-19-patients-on-ventilators-in-new-york-health-system

Hmm, seems a strange conclusion to draw. Those on ventilators are presumably the most seriously ill so it seems natural that there would be a higher number of deaths among these patients, unless i’m just missing something