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Statesman
 
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Post 22 Mar 2020, 9:28 am

freeman3
And the only way to do that (I think) is to have real-time knowledge of who has (or who may have) the disease.

That would be ideal public health management. Its not possible in the USA right now. Your health care and health insurance system make it impossible.

In the US the average test for corona virus; including a visit to emergency, is over $1300. For a family of 4 ...thats $5200.
Insurance may cover part of it....(Directives to "cover the cost of the test" by the President don';t stipulate that the entire cost be covered...")
But if you have inadequate insurance or none ..... the cost will force people to avoid getting tested.

Last week Katie Porter got the CDC Director to make testing free for all. She thought. Since then the CDC director hasn't been seen in public. Hmmm?

https://www.realclearpolitics.com/video ... _free.html

https://thehill.com/policy/healthcare/p ... e-covid-19
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Post 22 Mar 2020, 10:52 am

I know. It's absolutely ridiculous. And embarrassing. Our country has reached an unsightly level of selfishness where it's like "oh my God what would happen to my health insurance if there is Medicare For All, I like my health insurance" and no worries about the 30 million who are uninsured. And with regard to the homeless it's like they are all either crazy or druggies (granted a large percentage are--but a good many arent--and in any case they are all still human beings who deserve compassion) and so just get them away from here instead of trying to change policies that create the problem.

We will be a better country after this, I think. I hope.
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Post 22 Mar 2020, 11:45 am

We're in pretty much full lockdown here in NYC. I read an article and thought there is a lot of sense here:

https://www.nytimes.com/2020/03/20/opinion/coronavirus-pandemic-social-distancing.html

Likely too late now, at least in NYC, but being targeted migh be more impactful on the disease, but less impactful on the lives of people at low risk.
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Post 22 Mar 2020, 12:02 pm

We should be looking at alternative ideas like this one but I wonder about its' feasibility. For one thing, he says 99% of cases are mild but the figures I have seen are 15-20% hospitalized and 40% getting moderate pneumonia. Now those figures are significantly overstated because we are not picking up mild cases but I can't believe they are that overstated. And while not that many young people die, a lot of people under 50 are being hospitalized. What's happening in Italy just seems difficult to ride out. But I agree with him that this total lockdown idea has to be temporary, no more than a month or two, and then we got to get people back to work otherwise the response to the virus could be more damaging than the virus itself.
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Post 22 Mar 2020, 12:38 pm

I've been focusing on new cases and new fatalities in Italy as a leading indicator. There is actually good news today in that total deaths and total new infections both decreases vis-à-vis yesterday. NY, CA, etc. are about 10 days behind Italy in the curve, so I think we have to hang on for another week before this feels more manageable.
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Post 22 Mar 2020, 2:05 pm

That is good news. Once we have slowed down the infection rate here enough...then we need a path forward to a less restrictive phase so our economy can rebound without the virus surging again.

Here is a good article on the necessary shut-down phase--and what needs to be done to get out if it.

https://www.cnn.com/2020/03/22/opinions ... frey-sachs
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Post 22 Mar 2020, 10:45 pm

A Nobel prize winner did a similar analysis with regard to 78 countries and he thinks things will be better in a couple of weeks. But those are with somewhat draconian measures that kill the economy. Restarting the economy without bringing the virus back is a question his analysis does not answer.

https://www.google.com/amp/s/www.latime ... f_amp=true
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Post 24 Mar 2020, 8:03 am

https://www.visualcapitalist.com/infect ... d19-curve/

Great visualization of the epidemiology around the world.
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Post 25 Mar 2020, 5:39 am

rickyp wrote:https://www.visualcapitalist.com/infection-trajectory-flattening-the-covid19-curve/

Great visualization of the epidemiology around the world.


Ricky, thanks it is a very interesting graph. The US is certainly not handling this correctly.

You can also see smaller countries that haven't been in the news but will be hit even harder in a couple of weeks. For example, take a look at Ecuador's curve. Their medical facilities will be under assault in April.

Turkey is also interesting. They have the worst curve for any large country so we will hear about them in April.

Of course these curves are incomplete because people testing positive for Corona are a fraction of actual people with the virus. In the US the rule of thumb is 10X more people have it than is being reported. Each country will have a different factor so no way to really know what's going on without more testing everywhere.

This does tell you that Asian countries (both democratic and totalitarian) are much better at handling this than western countries. A lot of my work has been in the developing world where this will become a true tragedy. It's more crowded; there's less social distancing; people don't believe their governments (for good reason); they don't have adequate sanitation or health services. It's going to be bad here for a couple of months. It's going to be bad there for years.
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Post 25 Mar 2020, 8:32 am

rayjay
Of course these curves are incomplete because people testing positive for Corona are a fraction of actual people with the virus


Where early quarantining and enforced social distancing didn't happen. Only South Korea and china have "planked" the curve do far. Perhaps Japan.

There are other places that may have acted quick enough with a large enough impact. . New Zealand is one example.(And I'm hoping Canada, though we took for ever to shut the US border...)

So I don't think its just Asian countries. Its countries that had a plan, and enacted it with general cooperation from the populace and perhaps had geographic advantages like New Zealand.
I recently saw a study from 2017 that had the US ranked #1 in the world for preparedness at that time, for a pandemic. Since then there has been some unraveling of the organizations that were involved. (Probably not as much as Democrats say...)
But I think one thing the study didn't take into account was how ideology might affect a governments reaction.
When the Lt. Gov of Texas is all for older folks dying to preserve the economy.... And apparently Glenn Beck is willing to take one for the team too....
And they find significant support .....

In 4 years Its come a long way from conservatives saying that Obama Care death panels will kill your grand parents to, the old folks gotta take their chances so the economy keeps ticking...
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Post 25 Mar 2020, 9:10 am

Asian countries have an advantage in being more communal oriented, less concerned with impinging on individual privacy rights and easier to get cooperation from its populace. That makes it easier to clamp down on the virus. But the US has advantages too and it may come up with innovations in fighting the virus. Every culture has its strengths and weaknesses.
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Post 25 Mar 2020, 1:38 pm

https://www.statista.com/chart/20629/ab ... -pandemic/

https://www.ghsindex.org/news/inaugural ... pandemics/

https://www.weforum.org/agenda/2020/02/ ... ergencies/

Here's the study and charts I was referring to .... Its interesting that China is ranked 53 and the US is number one.And quoting from the article written on Feb 28 Even though Chinese authorities have said that they have observed evidence of person-to-person transmission, health officials in Orange and LA countries in the United States have said that the precautions in place should stop any spread of the coronavirus.


What we may learn from corona virus and each nations reactions is that strong governance and compliance by an informed populace are more important to the success of battling a pandemic than any other factor.
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Post 27 Mar 2020, 6:52 pm

Maybe a potential strategy that could work.

"As Vo’ fell under quarantine, Andrea Crisanti, a microbiology professor and infectious diseases expert at the nearby University of Padua, saw an opportunity. Dr. Crisanti had developed a test for the coronavirus by mid-January using information about the virus made public by Chinese doctors.

Dr. Crisanti oversaw the testing of 95% of the residents of Vo’ in the days after the first infection was reported. He found 3% of the population had been infected and that just under half of those who tested positive were asymptomatic.

When everybody was tested two weeks later, the rate of infection had fallen to 0.1% with only eight new infections, all of whom lived with previously infected people.

“The main lesson from Vo’ is that when you have a cluster of infected people, you should do a very aggressive lockdown and then test as many people as possible,” Dr. Crisanti said."

https://www.google.com/amp/s/www.wsj.co ... 1585314541
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Post 28 Mar 2020, 12:50 am

There is a 15 minute test now. That's getting pretty close to real-time.

https://www.cnn.com/2020/03/27/us/15-mi ... index.html
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Post 28 Mar 2020, 7:33 am

BioConcept's test is fast, but it's not as good at detecting positive cases of COVID-19 as the PCR tests used today. Specifically, the test's "sensitivity" -- a measure of its ability to detect true positives -- is only 60%.

“It is not very sensitive for detecting the virus in patient specimens," Pritt said. “A sensitivity of 60% means that only 6 out of every 10 cases of COVID-19 will be detected by this test, and 4 will be missed.

https://abcnews.go.com/Health/promising ... d=69799168

I don't know that a test that misses 40% of the time will be a saviour. It may screen out some early stage or asymptomatic people but the problem is that there are far too many places still not on lock down. In a about a week New Orleans is sure to go nuts... for instance.
Mardi Gras was packed...