Statistical data vs emotion -

[Magox]

We were somewhat discussing this topic earlier in another area but I think it deserves its own thread.  This is going to be a long thread, so I apologize and I don't expect most to read it.

 

If policy makers are going to make huge impacting decisions then I think it's important that the overall picture is considered with as much reliable data so that decisions based off of science-based statistical analysis are considered with more weight as opposed to allowing fear drive eventual outcomes.  Right now, I don't think there is a clear message that is being communicated from Federal, State and local governments on what is driving policy regarding CoVid.

 

It seemed to me that what was dictating policy was "flattening the curve".  The whole hypothesis behind this was that the government wanted to flatten the curve so that it wouldn't apply so much stress on our hospital systems so that virtually every potential patient could get the adequate care needed.   I think that is a fair and reasonable standard.   It is becoming apparently clear that the Hospital systems are in a position to do what is necessary to help out their citizenry when it comes to CoVid.

 

But the debate and some policy makers stated positions seem to be shifting.  I don't hear that flattening the curve is the priority when it comes to opening things up as much as what I'm hearing in that "we need to protect our citizens".   I want citizens to be protected as well.  But what does that mean exactly?  It would be helpful if they could properly define this.  Flattening the curve is a stated goal that is definable.  "Protecting our citizens", is not being defined.

 

For me, the standard should first be about flattening the curve.   But even then, once the curve is flattened, that doesn't mean that everything is all hunky-dory and we can back to business as usual.  The Virus doesn't just disappear.

 

I think the key to restoring confidence among the citizenry is data.   As much good statistical data as possible.   Which means, not just CoVID related data, but also data based off of studies on the impacts of mental health, impacts on stress to immune systems, isolation, increased poverty and how that relates to worse health outcomes etc etc.

 

If you are going to do this in a logical manner and the true stated goal is to have a better overall health outcome, then you can't just view CoVid in a vacuum. 

 

It appears to me that many policy decision makers are viewing this purely on a CoVid health spectrum and not nearly enough on the impacts to people's health due to the economic decisions that are being self-imposed by governments throughout the world. 

 

Suicide rates are going up and it is a proven fact that when economies go south, suicide rates are increased.  The projections vary, but some projections have the numbers could end up being as high as the Virus itself.

 

Quote

 

If unemployment hits 32%, some 77,000 Americans are likely to die from suicide and drug overdoses as a result of layoffs. Scientists call these fatalities deaths of despair.

Then add the predictable deaths from alcohol abuse caused by unemployment. Health economist Michael French from the University of Miami and a co-author found a "significant association between job loss" and binge drinking and alcoholism.

 

The impact of layoffs goes beyond suicide, drug overdosing and drinking. Overall, the death rate for an unemployed person is 63% higher than for someone with a job, according to findings in Social Science & Medicine.

 

  

Suicide hotlines are already seeing an astonishingly 800% increase in calls over normal times.

 

This is a perfect storm of events for suicides because not only is unemployment a leading cause but isolation as well.  This is like a double whammy, not to mention the sensationalism of the media that amplifies those fears.

 

Then we have to take into consideration what stress does to people's auto immune systems and how that affects peoples health outcomes.

 

Quote

The morbidity and mortality due to stress-related illness is alarming. Emotional stress is a major contributing factor to the six leading causes of death in the United States: cancer, coronary heart disease, accidental injuries, respiratory disorders, cirrhosis of the liver and suicide. According to statistics from Meridian Stress Management Consultancy in the U.K, almost 180,000 people in the U.K die each year from some form of stress-related illness (7). The Centre for Disease Control and Prevention of the United States estimates that stress account about 75% of all doctors visit (7). This involves an extremely wide span of physical complaints including, but not limited to headache, back pain, heart problems, upset stomach, stomach ulcer, sleep problems, tiredness and accidents. According to Occupational Health and Safety news and the National Council on compensation of insurance, up to 90% of all visits to primary care physicians are for stress-related complaints.

 

There was a Harvard study that linked over 260,000 EXCESS Cancer due to the 2008 downturn.

 

Quote

 

Boston, MA ─ The economic crisis of 2008-10, and the rise in unemployment that accompanied it, was associated with more than 260,000 excess cancer-related deaths—including many considered treatable—within the Organization for Economic Development (OECD), according to a study from Harvard T.H. Chan School of Public Health, Imperial College London, and Oxford University. The researchers found that excess cancer burden was mitigated in countries that had universal health coverage (UHC) and in those that increased public spending on health care during the study period.

The study will be published May 25, 2016 in The Lancet.

“Higher unemployment due to economic crisis and austerity measures is associated with higher number of cancer deaths. Universal health coverage protects against these deaths. That there are needless deaths is a major societal concern,” said Rifat Atun, professor of global health systems at Harvard Chan School and senior author of the study. He added that increased joblessness during the economic crisis may have limited people’s access to health care, leading to late-stage diagnoses and poor or delayed treatment.

 

 

That's just cancer related, that doesn't take into account heart disease and how stress affects those outcomes.

 

Then there are anecdotal reports of around 40% to 60% less reported heart attacks and strokes over the past 45 days or so. 

 

Quote

What is striking is that many of the emergencies have disappeared. Heart attack and stroke teams, always poised to rush in and save lives, are mostly idle. This is not just at my hospital. My fellow cardiologists have shared with me that their cardiology consultations have shrunk, except those related to Covid-19. In an informal Twitter poll by @angioplastyorg, an online community of cardiologists, almost half of the respondents reported that they are seeing a 40 percent to 60 percent reduction in admissions for heart attacks; about 20 percent reported more than a 60 percent reduction.

 

 

That is almost an unbelievable number.  Obviously there aren't 40-60% less people suffering from heart attacks and strokes, common sense dictates that people are afraid to leave their homes and are suffering with this without proper medical care.

 

The economic carnage is going to be devastating, there are studies out there that indicate we could end up seeing Half a billion people move into poverty.   HALF A BILLION PEOPLE.

 

Quote

Oxfam’s new report ‘Dignity Not Destitution’ presents fresh analysis which suggests between six and eight percent of the global population could be forced into poverty as governments shut down entire economies to manage the spread of the virus. This could set back the fight against poverty by a decade, and as much as 30 years in some regions such as sub-Saharan Africa and the Middle East and North Africa. Over half the global population could be living in poverty in the aftermath of the pandemic.

 

They do preface it that if "urgent action" isn't taken, which there will be.  But not all countries are lucky enough to be able to accumulate so much debt and have the power of the federal reserve to bail them out.  Plus, even here in the U.S, there will be a lot of people who slip through the cracks and will fall into poverty.   The more people who fall into poverty, the more people who will have worse health outcomes.  That is a sad and undeniable fact.

 

So these things need to be considered as well and need to be considered heavily when policy makers are making huge impacting decisions.  

 

So how can policy makers restore confidence?

 

Data data data.   

 

We need to know what the actual mortality rate.  And not just the overall mortality rate but broken down by age, by comorbidities, genetics, etc etc.   

 

In order to know this we need to have a clearer picture of both the divisor and the denominator. The death count is a bit more clear but is still a bit murky.  The infection count is truly the unknown.  

 

In regards to the death count, there needs to be more clarity and some critical thinking analysis that is applied here.   Right now, the common accepted COVID related death that is being used is if the patient tested positive and he/she parishes then no matter what other underlying condition they have, it counts as a COVID death.  No questions asked.

 

Then the other one that is beginning to be used is if a doctor/coroner suspects that if the person who passed away never tested positive but they were suspected to have contracted COVID based off symptoms and other evidence that is gathered, then they will consider that a COVID death.   

 

I think a deeper statistical analysis needs to be applied.  I think those in the CDC or whatever decision making board should do is to view outside data as well.   How many people normally die from the flu during these months?  How many were reported to have died during these months?  How many heart, cancer and other health afflicted related deaths normally occur during these months and how many were reported?  From there extrapolate the normally reported deaths due to these underlying conditions vs the reported deaths and TAKE THAT INTO CONSIDERATION.  Not just the supposed COVID deaths but even the positive tested ones as well.

 

That is only logical.  Policy makers have to get this right.  And in order to get it right, they need to get the true COVID related death count.  You have to have the divisor and the denominator to get a true count and in order for the analysis to be correct it has to be as accurate as possible.   

 

And in regards to the infection rate.  I think mass randomized antibody testing throughout the country administered by each state and reviewed by the Federal government will give us a true idea.  This will give you an idea of the infection rate.   

 

And if you can do both of these, then you can get an idea of what the infection rate, more accurate COVID death rate will be meaning you will get the coveted COVID mortality rate.

 

And from there, you can make truly responsible decisions.

 

With that said, this will take some time, several months at a minimum.

 

That doesn't mean that everything should be shut down until then.  Policy makers in the meantime could begin making decisions to lax some of the social distancing measures that they believe is appropriate.  But they should be cautious until more data comes out.  It doesn't have to be black or white.  But as more data comes in, and if it turns out to be favorable for more economic conditions then they can loosen things up as the data comes in.

 

Sorry for the long post.

[Foxx]

14 minutes ago, Magox said:

We were somewhat discussing this topic earlier in another area but I think it deserves its own thread.  This is going to be a long thread, so I apologize and I don't expect most to read it....

 

...Sorry for the long post.

is there a tl dr; version?

 

TYIA

Edited April 16, 2020 by Foxx

[RochesterRob]

14 minutes ago, Magox said:

We were somewhat discussing this topic earlier in another area but I think it deserves its own thread.  This is going to be a long thread, so I apologize and I don't expect most to read it.

 

If policy makers are going to make huge impacting decisions then I think it's important that the overall picture is considered with as much reliable data so that decisions based off of science-based statistical analysis are considered with more weight as opposed to allowing fear drive eventual outcomes.  Right now, I don't think there is a clear message that is being communicated from Federal, State and local governments on what is driving policy regarding CoVid.

 

It seemed to me that what was dictating policy was "flattening the curve".  The whole hypothesis behind this was that the government wanted to flatten the curve so that it wouldn't apply so much stress on our hospital systems so that virtually every potential patient could get the adequate care needed.   I think that is a fair and reasonable standard.   It is becoming apparently clear that the Hospital systems are in a position to do what is necessary to help out their citizenry when it comes to CoVid.

 

But the debate and some policy makers stated positions seem to be shifting.  I don't hear that flattening the curve is the priority when it comes to opening things up as much as what I'm hearing in that "we need to protect our citizens".   I want citizens to be protected as well.  But what does that mean exactly?  It would be helpful if they could properly define this.  Flattening the curve is a stated goal that is definable.  "Protecting our citizens", is not being defined.

 

For me, the standard should first be about flattening the curve.   But even then, once the curve is flattened, that doesn't mean that everything is all hunky-dory and we can back to business as usual.  The Virus doesn't just disappear.

 

I think the key to restoring confidence among the citizenry is data.   As much good statistical data as possible.   Which means, not just CoVID related data, but also data based off of studies on the impacts of mental health, impacts on stress to immune systems, isolation, increased poverty and how that relates to worse health outcomes etc etc.

 

If you are going to do this in a logical manner and the true stated goal is to have a better overall health outcome, then you can't just view CoVid in a vacuum. 

 

It appears to me that many policy decision makers are viewing this purely on a CoVid health spectrum and not nearly enough on the impacts to people's health due to the economic decisions that are being self-imposed by governments throughout the world. 

 

Suicide rates are going up and it is a proven fact that when economies go south, suicide rates are increased.  The projections vary, but some projections have the numbers could end up being as high as the Virus itself.

 

  

Suicide hotlines are already seeing an astonishingly 800% increase in calls over normal times.

 

This is a perfect storm of events for suicides because not only is unemployment a leading cause but isolation as well.  This is like a double whammy, not to mention the sensationalism of the media that amplifies those fears.

 

Then we have to take into consideration what stress does to people's auto immune systems and how that affects peoples health outcomes.

 

 

There was a Harvard study that linked over 260,000 EXCESS Cancer due to the 2008 downturn.

 

 

That's just cancer related, that doesn't take into account heart disease and how stress affects those outcomes.

 

Then there are anecdotal reports of around 40% to 60% less reported heart attacks and strokes over the past 45 days or so. 

 

 

 

That is almost an unbelievable number.  Obviously there aren't 40-60% less people suffering from heart attacks and strokes, common sense dictates that people are afraid to leave their homes and are suffering with this without proper medical care.

 

The economic carnage is going to be devastating, there are studies out there that indicate we could end up seeing Half a billion people move into poverty.   HALF A BILLION PEOPLE.

 

 

They do preface it that if "urgent action" isn't taken, which there will be.  But not all countries are lucky enough to be able to accumulate so much debt and have the power of the federal reserve to bail them out.  Plus, even here in the U.S, there will be a lot of people who slip through the cracks and will fall into poverty.   The more people who fall into poverty, the more people who will have worse health outcomes.  That is a sad and undeniable fact.

 

So these things need to be considered as well and need to be considered heavily when policy makers are making huge impacting decisions.  

 

So how can policy makers restore confidence?

 

Data data data.   

 

We need to know what the actual mortality rate.  And not just the overall mortality rate but broken down by age, by comorbidities, genetics, etc etc.   

 

In order to know this we need to have a clearer picture of both the divisor and the denominator. The death count is a bit more clear but is still a bit murky.  The infection count is truly the unknown.  

 

In regards to the death count, there needs to be more clarity and some critical thinking analysis that is applied here.   Right now, the common accepted COVID related death that is being used is if the patient tested positive and he/she parishes then no matter what other underlying condition they have, it counts as a COVID death.  No questions asked.

 

Then the other one that is beginning to be used is if a doctor/coroner suspects that if the person who passed away never tested positive but they were suspected to have contracted COVID based off symptoms and other evidence that is gathered, then they will consider that a COVID death.   

 

I think a deeper statistical analysis needs to be applied.  I think those in the CDC or whatever decision making board should do is to view outside data as well.   How many people normally die from the flu during these months?  How many were reported to have died during these months?  How many heart, cancer and other health afflicted related deaths normally occur during these months and how many were reported?  From there extrapolate the normally reported deaths due to these underlying conditions vs the reported deaths and TAKE THAT INTO CONSIDERATION.  Not just the supposed COVID deaths but even the positive tested ones as well.

 

That is only logical.  Policy makers have to get this right.  And in order to get it right, they need to get the true COVID related death count.  You have to have the divisor and the denominator to get a true count and in order for the analysis to be correct it has to be as accurate as possible.   

 

And in regards to the infection rate.  I think mass randomized antibody testing throughout the country administered by each state and reviewed by the Federal government will give us a true idea.  This will give you an idea of the infection rate.   

 

And if you can do both of these, then you can get an idea of what the infection rate, more accurate COVID death rate will be meaning you will get the coveted COVID mortality rate.

 

And from there, you can make truly responsible decisions.

 

With that said, this will take some time, several months at a minimum.

 

That doesn't mean that everything should be shut down until then.  Policy makers in the meantime could begin making decisions to lax some of the social distancing measures that they believe is appropriate.  But they should be cautious until more data comes out.  It doesn't have to be black or white.  But as more data comes in, and if it turns out to be favorable for more economic conditions then they can loosen things up as the data comes in.

 

Sorry for the long post.

  Human nature does not allow for true equality economically or otherwise.  An observation that dates back to Biblical times.  As long as humans roam the Earth some will have more than others.

[mead107]

Before c19 150-200 people died in NYC everyday 

are those now be counted as C19 deaths? 

 

[Magox]

2 minutes ago, RochesterRob said:

  Human nature does not allow for true equality economically or otherwise.  An observation that dates back to Biblical times.  As long as humans roam the Earth some will have more than others.

 

Right, but that doesn't mean there should be reckless abandonment as well.   You can do both.

[Buffalo_Gal]

As evidenced by the COVID-19 thread, you are not going to get a non-emotional response from some people.

I fall on the side of honest data. That is how models can more accurately be built. It is how people can be informed who is most at risk.   I laid out my opinion in that thread pretty well - honest data is necessary to make informed decisions.

 

[BuffaloHokie13]

9 minutes ago, Foxx said:

is there a tl dr; version?

 

TYIA

People are going to die, and we need to decide how and back our decisions up with data. I think. Basically. 

[RochesterRob]

7 minutes ago, Magox said:

 

Right, but that doesn't mean there should be reckless abandonment as well.   You can do both.

  The tone of your statement suggests that poverty can be addressed world wide.  How do you address it in nations such as Russia?  How do you address it in China?  How do you address it in Somalia?  

Edited April 16, 2020 by RochesterRob

[Magox]

Just now, RochesterRob said:

  The tone of your segment suggests that poverty can be addressed world wide.  How do you address it in nations such as Russia?  How do you address it in China?  How do you address it in Somalia?  

 

That's not what I was suggesting.   

 

What I was saying was that due to governments world wide applying self-imposed lock downs and/or heavy social distancing measures that people are becoming unemployed, businesses are getting destroyed and therefore more people are moving into poverty.  

[ALF]

The main thing is not to overwhelm the hospitals in a hot spot.

[Magox]

9 minutes ago, ALF said:

The main thing is not to overwhelm the hospitals in a hot spot.

 

To me that should be the standard.  The question is based off of the data at hand, what is the best way to maximize the economy without overwhelming the hospitals.

[Orlando Tim]

The data is hard to build quickly because we were lied to by the Chinese. The data we started with- up until about mid February- was bogus and we had to start all over again. People that want a solid database immediately are unable to understand how the world works.

[Taro T]

@Magox, you're right in that we need better data but not sure how best to go about gathering the better data, which absolutely is necessary at present.  (As you point out both to figure out how best to come out of this crisis and to prepare for a future event.)  Because that all or nothing counting of cases and outcomes leaves us with very poor data.

 

It is perfectly logical to assume a large percentage of increased death rates in places like NYC is due to COVID-19 and even some percentage of deaths from treatable / curable causes such as heart attacks that weren't treated because the hospital was too tied up with COVID-19 cases to have the resources that would normally be available to keep a particular patient alive but wasn't when the resources were needed.

 

But that's only part of it, and like you say, they really need to be able to figure out with reasonable accuracy how many additional heart attacks happened, not because the patient had the virus but because the patient's blood pressure and heart rate climbed due to the stress induced simply by the fear of getting it?  Right now, we seem to be seeing official #'s for strokes and heart attacks decreasing which can't be the case in reality.  If we're undercounting those and overcounting virus induced deaths, there's no way they'll be able to minimize the TOTAL death count.  Because somewhere the total combined deaths reaches a minimum as stress related deaths increase and virus related deaths decrease and vice versa.  But if we're actually seeing stress related deaths go down by enacting measures that increase stress to reduce the spread of the virus and thus virus related deaths, we'll absolutely keep things shut down longer than necessary because the data us faulty.

 

And reducing total deaths (through virus, stress, and other means such as starvation and related maladies or crimes induced by desperation) should be the major focus and a secondary and yet still very important focus is not forcing large portions of our nor the world's population into abject poverty which won't kill as many today as the virus might but could kill far more via war and famine down the line.

 

 The politicians have to be cursing their own fates at present because this ain't what they signed up for and there are no obviously good choices.  People are going to die regardless, people's lives are going to be dramatically effected regardless and not in a good way.  But there are right answers out there.  But to get to them, they need accurate data.  (And not going into at all how not all politicians want to see our society return to a semblance of "normal;" there are those that want society "tranformed." What they might consider the "right" decision won't be considered right by those that wants return to normalcy.  That's a discussion for so many other threads we have.)

 

If the decision makers have accurate data (and let's face it, the decision makers are politicians; their advisors are the ones interpreting the data and making recommendations and those are only as good as the data), we'll be lot better off than if they don't have it.

[Magox]

1 minute ago, Taro T said:

@Magox, you're right in that we need better data but not sure how best to go about gathering the better data, which absolutely is necessary at present.  (As you point out both to figure out how best to come out of this crisis and to prepare for a future event.)  Because that all or nothing counting of cases and outcomes leaves us with very poor data.

 

It is perfectly logical to assume a large percentage of increased death rates in places like NYC is due to COVID-19 and even some percentage of deaths from treatable / curable causes such as heart attacks that weren't treated because the hospital was too tied up with COVID-19 cases to have the resources that would normally be available to keep a particular patient alive but wasn't when the resources were needed.

 

But that's only part of it, and like you say, they really need to be able to figure out with reasonable accuracy how many additional heart attacks happened, not because the patient had the virus but because the patient's blood pressure and heart rate climbed due to the stress induced simply by the fear of getting it?  Right now, we seem to be seeing official #'s for strokes and heart attacks decreasing which can't be the case in reality.  If we're undercounting those and overcounting virus induced deaths, there's no way they'll be able to minimize the TOTAL death count.  Because somewhere the total combined deaths reaches a minimum as stress related deaths increase and virus related deaths decrease and vice versa.  But if we're actually seeing stress related deaths go down by enacting measures that increase stress to reduce the spread of the virus and thus virus related deaths, we'll absolutely keep things shut down longer than necessary because the data us faulty.

 

And reducing total deaths (through virus, stress, and other means such as starvation and related maladies or crimes induced by desperation) should be the major focus and a secondary and yet still very important focus is not forcing large portions of our nor the world's population into abject poverty which won't kill as many today as the virus might but could kill far more via war and famine down the line.

 

 The politicians have to be cursing their own fates at present because this ain't what they signed up for and there are no obviously good choices.  People are going to die regardless, people's lives are going to be dramatically effected regardless and not in a good way.  But there are right answers out there.  But to get to them, they need accurate data.  (And not going into at all how not all politicians want to see our society return to a semblance of "normal;" there are those that want society "tranformed." What they might consider the "right" decision won't be considered right by those that wants return to normalcy.  That's a discussion for so many other threads we have.)

 

If the decision makers have accurate data (and let's face it, the decision makers are politicians; their advisors are the ones interpreting the data and making recommendations and those are only as good as the data), we'll be lot better off than if they don't have it.

 

I appreciate the thoughtful response.  I think we are pretty much on the same page on a number of things.  

 

I think what is lacking here from many of the policy makers (politicians in charge) is an overall criteria on when to reopen up their economies.  The focus is being viewed I think too much in a COVID vacuum.  The residual effects which arguably are even larger than the virus itself are not taken into consideration enough.

 

Evers, the governor of Wisconsin stated this as his reasoning for extending the stay-at-home until the 26th.

 

Quote

“A few weeks ago, we had a pretty grim outlook for what COVID-19 could mean for our state, but because of the efforts of all of you, Safer at Home is working. That said, we aren't out of the woods just yet,” said Gov. Evers. “As I've said all along, we are going to rely on the science and public health experts to guide us through this challenge. So, as we extend Safer at Home, I need all of you to continue doing the good work you've been doing so we can keep our families, our neighbors, and our communities safe, and get through this storm together.”

“Before we lift Safer at Home, the steps of testing and more robust public health measures must be in place,” explained Secretary-designee Palm. “These steps will help us reduce the risk of a second wave of the virus. If we open up too soon, we risk overwhelming our hospitals and requiring more drastic physical distancing measures again.”

 

 

I see this as the governor abdicating his role to the public health officials.  If you only listen to the public health officials then they will ALWAYS err on the side of caution. It's up to the executive branch to consider all the factors.

 

Wisconsin supposedly already hit their peak.  Now they are talking about closing it down for an additional 40 days????  WTF!

 

On the other hand, Ohio is now announcing that they are planning on reopening on the 1st of May.  There have been more than twice as many deaths in Ohio than Wisconsin and their peak supposedly was about 1 week after Wisconsin's.    

 

There is a clear schism that is beginning to unfold between Democratic and Republican Governors.  If you closely listen to the Democrats they are all basically repeating the same thing from Biden all the way down which is that "we are going to rely on the science and health experts".   I could be wrong, but I do not think this will be politically advantageous for them and I think people are going to get tired of this.

 

If you are from Michigan, Pennsylvania and Wisconsin which are all led by Democrats and all of these states are extending their stay-at-home orders and you see your Midwest neighbor Ohio, deciding to open things up in a responsible manner, how are you going to feel?  I would suspect there will be a lot of people from these states (which Trump won) that will be pretty pissed seeing Ohio beginning to normalize while they still stuck in their homes.

[Taro T]

48 minutes ago, Magox said:

 

I appreciate the thoughtful response.  I think we are pretty much on the same page on a number of things.  

 

I think what is lacking here from many of the policy makers (politicians in charge) is an overall criteria on when to reopen up their economies.  The focus is being viewed I think too much in a COVID vacuum.  The residual effects which arguably are even larger than the virus itself are not taken into consideration enough.

 

Evers, the governor of Wisconsin stated this as his reasoning for extending the stay-at-home until the 26th.

 

 

 

I see this as the governor abdicating his role to the public health officials.  If you only listen to the public health officials then they will ALWAYS err on the side of caution. It's up to the executive branch to consider all the factors.

 

Wisconsin supposedly already hit their peak.  Now they are talking about closing it down for an additional 40 days????  WTF!

 

On the other hand, Ohio is now announcing that they are planning on reopening on the 1st of May.  There have been more than twice as many deaths in Ohio than Wisconsin and their peak supposedly was about 1 week after Wisconsin's.    

 

There is a clear schism that is beginning to unfold between Democratic and Republican Governors.  If you closely listen to the Democrats they are all basically repeating the same thing from Biden all the way down which is that "we are going to rely on the science and health experts".   I could be wrong, but I do not think this will be politically advantageous for them and I think people are going to get tired of this.

 

If you are from Michigan, Pennsylvania and Wisconsin which are all led by Democrats and all of these states are extending their stay-at-home orders and you see your Midwest neighbor Ohio, deciding to open things up in a responsible manner, how are you going to feel?  I would suspect there will be a lot of people from these states (which Trump won) that will be pretty pissed seeing Ohio beginning to normalize while they still stuck in their homes.

 

Really wonder whether the governors of those states that are planning to stay on indefinite lockdown aren't hoping that places like Ohio that plan to open soon end up with a rebound in cases so they can have a "see, we told you so" moment.

 

Hoping that's not the case.

[Magox]

16 minutes ago, Taro T said:

 

Really wonder whether the governors of those states that are planning to stay on indefinite lockdown aren't hoping that places like Ohio that plan to open soon end up with a rebound in cases so they can have a "see, we told you so" moment.

 

Hoping that's not the case.

 

That's the risk...And the standard shouldn't be if there is an outbreak.  For me, the standard should be can the curve stay flattened down enough so that the hospitals can keep up with the patients.  That should be the standard and criteria.

[OldTimeAFLGuy]

6 hours ago, mead107 said:

Before c19 150-200 people died in NYC everyday 

are those now be counted as C19 deaths? 

 

 

....thought I read hospitals get more money if deaths are termed "Covid-19 related"......perhaps from Medicare?.....anybody?...........

[Buffalo_Gal]

1 minute ago, OldTimeAFLGuy said:

 

....thought I read hospitals get more money if deaths are termed "Covid-19 related"......perhaps from Medicare?.....anybody?...........

I asked that question in the COVID-19 thread and was eviscerated. I would also like to know the answer.

 

Edited April 16, 2020 by Buffalo_Gal

[OldTimeAFLGuy]

3 minutes ago, Buffalo_Gal said:

I asked that question in the COVID-19  and was eviscerated. I would also like to know the answer.

 

 

...appears to be a component in the CARES Act relief directed towards hospitals.....so declare everything Covid-19 related gets you a bigger check............

US hospitals getting paid to list patients as Covid-19

By

Curated Content-ACCOUNTING WEEKLY

-

Apr 11, 2020

 

Hospitals are getting paid more to list patients as Covid-19 and three times as much if the patient goes on a ventilator, according to The Spectator.

 

Last night Senator Dr. Scott Jensen from Minnesota went on The Ingraham Angle to discuss how the Centers for Disease Control and Prevention (CDC) is encouraging American doctors to overcount coronavirus deaths across the US.

 

This was after Dr. Scott Jensen, a Minnesota physician and Republican state senator, told a local station he received a 7-page document coaching him to fill out death certificates with a Covid-19 diagnosis without a lab test to confirm the patient actually had the virus.

 

Dr. Jensen also disclosed that hospitals are paid more if they list patients with a Covid-19 diagnosis.

 

And hospitals get paid THREE TIMES AS MUCH if the patient then goes on a ventilator.

 

Senator Dr. Scott Jensen: Right now Medicare is determining that if you have a Covid-19 admission to the hospital you get $13,000. If that Covid-19 patient goes on a ventilator you get $39,000, three times as much. Nobody can tell me after 35 years in the world of medicine that sometimes those kinds of things impact on what we do.

 

https://accountingweekly.com/us-hospitals-getting-paid-to-list-patients-as-covid-19/

 

Here comes the cash: North Texas hospitals start getting millions from the feds to offset COVID costs

About $2 billion will go to over 24,000 providers in Texas, including doctor’s offices. More money will follow.By Mitchell Schnurman 7:01 AM on Apr 14, 2020
 

Federal dollars are starting to flow to Dallas-Fort Worth hospitals and medical practices after the government began releasing $30 billion from the giant relief package passed by Congress last month.

Baylor Scott & White Health, whose business stretches from Sherman to San Marcos, already has received $100 million and more may be coming, the Dallas-based company said.

Texas Health Resources in Arlington said it would get about $50 million. UT Southwestern in Dallas, the region’s leading academic medical center, will get about $25 million.

Parkland Health & Hospital System, which cares for many uninsured in Dallas and the broader region, said it will get $12.4 million.

The payments are just the start of the federal coronavirus bailout — $70 billion more will come later from this particular source — and local hospitals badly need the infusion.

 

“These relief funds are just a fraction of the total COVID-19-related losses we are experiencing,” wrote Baylor spokeswoman Julie Smith in an email.

In all, over 24,000 providers in the state are expected to share $2.09 billion. Only California and Florida have higher total payments than Texas, and the awards are especially attractive.

https://www.dallasnews.com/business/health-care/2020/04/14/here-comes-the-cash-north-texas-hospitals-start-getting-millions-from-the-feds-to-offset-covid-costs/

 

 

[Taro T]

1 hour ago, Magox said:

 

That's the risk...And the standard shouldn't be if there is an outbreak.  For me, the standard should be can the curve stay flattened down enough so that the hospitals can keep up with the patients.  That should be the standard and criteria.

 

Once again, you and I differ on the details, but in general are on the same page.

 

When things open back up, there will be additional cases but if done right, this won't exceed capacity.  And if they've found effective treatments, whether it be hydroxychloroquine & zinc, or erythromycin, that new drug that they're testing, or something else, then we absolutely won't exceed capacity.

 

Keep up social distancing protocols if necessary, but open businesses and society back up when this wave is past.  Waiting for full herd immunity or a significant portion of the population to be vaccinated will likely be significant overkill.

 

(Oh, and just because it hasn't been said in a while - #### the CCP and the bat they flew in on.)

[Taro T]

1 hour ago, Buffalo_Gal said:

I asked that question in the COVID-19 thread and was eviscerated. I would also like to know the answer.

 

 

Can't even put any blame on hospitals for wanting the higher reimbursement rates.  But if we're getting faulty data because of that, then we won't come out of this crisis as smoothly as we could with good data.

 

BUT, IF patients that don't need to be going on ventilators are going on them, then somebody needs to go to jail for blatant malpractice.  They cause issues of their own for patients, but if you need to be on 1, the issue they solve is more acutely deadly than the issues they cause; so they are beneficial for some.

[Tiberius]

4,500 deaths in one day. That's about 1/10 the number of suicides per year. 

[Buffalo_Gal]

 

[SoCal Deek]

1 hour ago, Buffalo_Gal said:

 

We lose 240,000 Americans per month in a typical year. That means 720,000 die over the three months since this all started....that’s in a TYPICAL year!  This virus has taken 45,000 over that same period. You can judge whether that’s a lot or a little. I’ve said it before....it doesn’t sound like all that many to me. This has gone on long enough.

[CarpetCrawler]

On 4/16/2020 at 10:02 AM, Foxx said:

is there a tl dr; version?

 

TYIA

We're all going to die, nobody ever died of nothing.

[CarpetCrawler]

On 4/16/2020 at 6:23 PM, Taro T said:

 

Can't even put any blame on hospitals for wanting the higher reimbursement rates.  But if we're getting faulty data because of that, then we won't come out of this crisis as smoothly as we could with good data.

 

BUT, IF patients that don't need to be going on ventilators are going on them, then somebody needs to go to jail for blatant malpractice.  They cause issues of their own for patients, but if you need to be on 1, the issue they solve is more acutely deadly than the issues they cause; so they are beneficial for some.

Let's just say that anyone that comes into the ER showing any sign of needing a ventilator is intubated because it's easier to to it then as opposed to when the patient is in full respiratory distress.....and there is less chance of transmission of the disease too.  ?

[Buffalo_Gal]

Pa. removes 200 deaths from state coronavirus count as questions mount about reporting process, accuracy
 

Pennsylvania has corrected its coronavirus data multiple times over the past week to account for irregularities, according to new reports.
 

Earlier this week, Pennsylvania started to include “probable deaths” in its fatalities. As a result, the total number of coronavirus deaths grew by 276, then 360, in successive nights, almost doubling the number of deaths in the state in two days. The Pennsylvania Department of Health (DOH) subsequently removed 200 deaths from its count after facing mounting questions about the accuracy of the count.
 

</snip>
 

“There’s a discrepancy in the numbers,” Charles E. Kiessling Jr., president of the Pennsylvania Coroners Association and coroner in Lycoming County, told the Inquirer. “I’m not saying there’s something going on... I’m not a conspiracy theory guy. But accuracy is important.”
 

“This is why I’m so upset,” Kiessling added. “Our job is to investigate... We do this every day.”

Kiessling said it was a matter of public safety that the DOH clarify the discrepancy. Coroners have complained over the past month regarding discrepancies in the death figures.
 

</snip>

[SoCal Deek]

The NY death count is down to HALF of what it was at the peak....just as it had to be when the admittance figures dropped like a stone. This story has been played out to the point of sheer boredom!

[Magox]

This is pretty important.

 

—————

Emergency rooms have about half the normal number of patients, and heart and stroke units are nearly empty, according to doctors at many urban medical centers. Some medical experts fear more people are dying from untreated emergencies than from the coronavirus.

A recent paper by cardiologists at nine large medical centers estimated a 38 percent reduction since March 1 in the number patients with serious heart attacks coming in to have urgently needed procedures to open their arteries.

——

Researchers in Austria estimated that in March 110 citizens died from untreated heart attacks, compared with 86 who died of Covid-19. They based their calculations on a precipitous decline in patients going to hospitals, the expected number of heart attacks in Austria, and the mortality rates of untreated heart attacks.

“I am very very worried that we are creating a problem that will have long-term consequences for the health of the community,” said Dr. Richard A. Chazal, medical director of the Heart and Vascular Institute at Lee Health in Fort Myers, Fla., and a past president of the American College of Cardiology.

——

 

 

 

[oldmanfan]

OP makes a good point.   Data is needed on all fronts and then should be used to guide responsible decision making.  That should be the role of each state health department which should then be collated by the CDC.  Having good reliable numbers in not only medical but economic issues is critical. 

 

Accurate and more complete testing data is required right now both to determine the extent of the disease and through antibody testing knowing who has developed immunity.  One of my fears is that the presence of antibodies may not equate to immunity, such as what is seen with HIV.  If that is the case I’m concerned that could influence production of an effective vaccine.

[Magox]

43 minutes ago, oldmanfan said:

OP makes a good point.   Data is needed on all fronts and then should be used to guide responsible decision making.  That should be the role of each state health department which should then be collated by the CDC.  Having good reliable numbers in not only medical but economic issues is critical. 

 

Accurate and more complete testing data is required right now both to determine the extent of the disease and through antibody testing knowing who has developed immunity.  One of my fears is that the presence of antibodies may not equate to immunity, such as what is seen with HIV.  If that is the case I’m concerned that could influence production of an effective vaccine.

 

From what I am reading is that there are different levels of antibodies and that the research that has been conducted indicates that in most cases it would protect you but in others that the antibodies may not.  The way I read it is that antibodies don’t appear and turn on like a light switch.   There is a process in the development of it and depending where in the process that it lies also helps determine the effectiveness of it.  
 

*Disclaimer*.  Don’t take what I say as fact.  That was my interpretation of it *

[oldmanfan]

9 minutes ago, Magox said:

 

From what I am reading is that there are different levels of antibodies and that the research that has been conducted indicates that in most cases it would protect you but in others that the antibodies may not.  The way I read it is that antibodies don’t appear and turn on like a light switch.   There is a process in the development of it and depending where in the process that it lies also helps determine the effectiveness of it.  
 

*Disclaimer*.  Don’t take what I say as fact.  That was my interpretation of it *

Hope you’re right.   There is some progress with convalescent serum from infected individuals but also some data on reinfection.  So it’s kind of murky right now.

[Magox]

10 minutes ago, oldmanfan said:

Hope you’re right.   There is some progress with convalescent serum from infected individuals but also some data on reinfection.  So it’s kind of murky right now.

 

Here is a good article.  Have a look:

 

 

—————-

 

Detecting antibodies is the first step. Interpreting what they mean is harder.

Typically, a virus that causes an acute infection will prompt the body’s immune system to start churning out specific antibodies. Even after the virus is cleared, these “neutralizing” antibodies float around, ready to rally a response should that virus try to infect again. The virus might infect a few cells, but it can’t really gain a toehold before the immune system banishes it. (This is not the case for viruses that cause chronic infections, like HIV and, in many cases, hepatitis C.)

“The infection is basically stopped in its tracks before it can go anywhere,” said Stephen Goldstein, a University of Utah virologist. But, Goldstein added, “the durability of that protection varies depending on the virus.”

Scientists who have looked at antibodies to other coronaviruses — both the common-cold causing foursome and SARS and MERS — found they persisted for at least a few years, indicating people were protected from reinfection for at least that long. From then, protection might start to wane, not drop off completely.

The experience with other viruses, including the other coronaviruses, has encouraged what Harvard epidemiologist Marc Lipsitch summed up as the “educated guess” in a recent column in the New York Times: “After being infected with SARS-CoV-2, most individuals will have an immune response, some better than others. That response, it may be assumed, will offer some protection over the medium term — at least a year — and then its effectiveness might decline.”

But many serological tests aren’t like pregnancy tests, with a yes or no result. They will reveal the levels (or titer) of antibodies in a person’s blood. And that’s where things can get a bit trickier. At this point, scientists can’t say for sure what level of antibodies might be required for a person to be protected from a second Covid-19 case. They also can’t say how long people are safeguarded, though it’s thought that a higher initial titer will take longer to wane than low levels.

“Further investigation is needed to understand the duration of protective immunity for SARS-CoV-2,” a committee from the National Academies of Sciences, Engineering, and Medicine wrote in a reportthis month.

[oldmanfan]

3 minutes ago, Magox said:

 

Here is a good article.  Have a look:

 

 

—————-

 

Detecting antibodies is the first step. Interpreting what they mean is harder.

Typically, a virus that causes an acute infection will prompt the body’s immune system to start churning out specific antibodies. Even after the virus is cleared, these “neutralizing” antibodies float around, ready to rally a response should that virus try to infect again. The virus might infect a few cells, but it can’t really gain a toehold before the immune system banishes it. (This is not the case for viruses that cause chronic infections, like HIV and, in many cases, hepatitis C.)

“The infection is basically stopped in its tracks before it can go anywhere,” said Stephen Goldstein, a University of Utah virologist. But, Goldstein added, “the durability of that protection varies depending on the virus.”

Scientists who have looked at antibodies to other coronaviruses — both the common-cold causing foursome and SARS and MERS — found they persisted for at least a few years, indicating people were protected from reinfection for at least that long. From then, protection might start to wane, not drop off completely.

The experience with other viruses, including the other coronaviruses, has encouraged what Harvard epidemiologist Marc Lipsitch summed up as the “educated guess” in a recent column in the New York Times: “After being infected with SARS-CoV-2, most individuals will have an immune response, some better than others. That response, it may be assumed, will offer some protection over the medium term — at least a year — and then its effectiveness might decline.”

But many serological tests aren’t like pregnancy tests, with a yes or no result. They will reveal the levels (or titer) of antibodies in a person’s blood. And that’s where things can get a bit trickier. At this point, scientists can’t say for sure what level of antibodies might be required for a person to be protected from a second Covid-19 case. They also can’t say how long people are safeguarded, though it’s thought that a higher initial titer will take longer to wane than low levels.

“Further investigation is needed to understand the duration of protective immunity for SARS-CoV-2,” a committee from the National Academies of Sciences, Engineering, and Medicine wrote in a reportthis month.

Thanks.  I teach physiology and anatomy but I’m far from an expert in immunology.  This helps.

[SoCal Deek]

You want facts and statistics: 

 

As of one week ago since the Covid 19 story exploded there have been 600,000 American deaths in the age group of 55 and over. Of those 600,000 deaths...roughly 25,000 had been from Covid 19.
 

In that same period there have been less than 1,000 deaths of anyone under 45 years old....out of over 50,000 nation wide deaths due to all causes.

 

Can we go back to our semi-normal lives now, and be more acutely aware of our senior population? (PS: I’m a young senior!)

[plenzmd1]

I don't know where to post this, but will do it here and maybe someone like @Hapless Bills Fan can help me interpret. Did not want to put on main board as some may think it political.

 

https://www.vdh.virginia.gov/content/uploads/sites/3/2019/12/Weekly-Influenza-Activity-Report.pdf

 

Here is a report from VA on influenza and pneumonia deaths in 2019-2020 flu season for Virginia. As seen on page 6 of the report, 2695 deaths so far. Of that, 6 pediatric deaths . 

 

 

 

Interesting that that number was climbing from 100 in week 10, to 150 in week 13..to almost zero in week 16. Week 13 BTW was March 23rd. 

 

As of today, VA has 436 deaths from Covid, so about 1/5th. Certainly understand different time frame..but could some of those flu deaths now be included in the Covid deaths?

 

As well, just about 13K confirmed cases for both infections, and it seems readily apparent that many many more people are asymptomatic with Covid that regular influenza. Would that not indicate morbidity rates are way BELOW flu? What am i missing here? 

 

Also, have the news on in the background...VA has over 6K hospital beds available, and only 20% of available entilaters are being used.

 

BTW, i am not one who thinks the social distancing was wrong, just wondering when these types of numbers start to get factored into decsion making.

[B-Man]

Former Neuroradiology Chief at Stanford Medical Center Gives Us the Facts

On Monday morning, most of the country will begin the seventh week of the COVID-19 quarantine. Following advice from the experts, President Trump made the decision to shut down the U.S. economy for 15 days, at which time, he and his advisors would reassess. The strategy made sense at the time. A pandemic, made in China, was spreading across the world and the death toll was mounting by the day. All over the world, people were frightened. This was virgin territory for all of us.

 

Six weeks later, much has changed. Most importantly, the COVID curve is at or beyond its peak in every state, well beyond in some cases, which had been the goal of the shutdown. We’ve learned that the virus arrived in the U.S. much earlier than thought and that up to 33 percent of Americans have antibodies present in their blood, meaning they had the disease although some may not have realized it.

 

Dr. Scott Atlas, the former neuroradiology chief at Stanford University Medical Center, wrote an op-ed at The Hill on Friday that every American should read. He lays out five key facts that no one is paying attention to. He calls on policymakers “to ignore the panic and rely on facts. Leaders must examine accumulated data to see what has actually happened, rather than keep emphasizing hypothetical projections; combine that empirical evidence with fundamental principles of biology established for decades; and then thoughtfully restore the country to function.” The bottom line is that the mortality rate for COVID is equivalent to the annual flu.

 

Atlas makes the case that total isolation no longer makes sense and that it’s time for Americans to go back to work.

 

Fact 1:

The recent Stanford University antibody study concluded the death rate to be between 0.1 to 0.2 percent, in other words, right in line with the seasonal flu.

 

(Edited: much more under each FACT given)

 

Fact 2:

Hospitalizations in New York City as of Friday, April 24: 34,600

Under 18 years old:  0.01 percent

18-44 years old:  0.10 percent

65 to 74 years old:  1.7 percent

 

 

Fact 3:

The quarantines have prevented us from achieving herd immunity. This, Dr. Atlas points out is just “prolonging the problem.” In the last week or so, we’ve seen several studies showing that 30 percent or more of groups tested are found to have developed antibodies.

 

Fact 4:

“People are dying because other medical care is not getting done due to hypothetical projections.”

This is something that we’re starting to hear about more and more.

 

 

Fact 5:

We know that the elderly and those with underlying health issues are the most vulnerable members of the population. And those who fall into this category should absolutely remain in quarantine.

“Knowing that,” says Dr. Atlas, “it is a commonsense, achievable goal to target isolation policy to that group, including strictly monitoring those who interact with them. Nursing home residents, the highest risk, should be the most straightforward to systematically protect from infected people, given that they already live in confined places with highly restricted entry.”

 

President Trump was right to call for a quarantine. With the information that was available at the time, he really had no other choice. If he had done nothing, and the coronavirus had turned out to be far more lethal than what had been expected by the experts, or even as lethal as they’d warned, inaction could have been catastrophic.

Knowing what we know now, however, it’s time for us to go back to work. Because America has another problem to deal with – its economy.

 

https://www.redstate.com/elizabeth-vaughn/2020/04/26/stanford-medical-center-neuroradiology-chief-gives-us-the-stats-tells-americans-to-go-back-to-work/.

Edited April 26, 2020 by B-Man

[GG]

3 hours ago, Magox said:

This is pretty important.

 

—————

Emergency rooms have about half the normal number of patients, and heart and stroke units are nearly empty, according to doctors at many urban medical centers. Some medical experts fear more people are dying from untreated emergencies than from the coronavirus.

A recent paper by cardiologists at nine large medical centers estimated a 38 percent reduction since March 1 in the number patients with serious heart attacks coming in to have urgently needed procedures to open their arteries.

——

Researchers in Austria estimated that in March 110 citizens died from untreated heart attacks, compared with 86 who died of Covid-19. They based their calculations on a precipitous decline in patients going to hospitals, the expected number of heart attacks in Austria, and the mortality rates of untreated heart attacks.

“I am very very worried that we are creating a problem that will have long-term consequences for the health of the community,” said Dr. Richard A. Chazal, medical director of the Heart and Vascular Institute at Lee Health in Fort Myers, Fla., and a past president of the American College of Cardiology.

——

 

 

 

The NYT being NYT.   Nowhere in the article do they mention that NY EMT were told not to bring in patients who can't be revived in the field.  That's the main reason why the cases are down in NYC. 

 

In other areas, people were scared off to go to the ER.  

 

There really needs to be a bifurcated approach between NYC metro and the rest of the country.  

[SoCal Deek]

2 hours ago, SoCal Deek said:

You want facts and statistics: 

 

As of one week ago since the Covid 19 story exploded there have been 600,000 American deaths in the age group of 55 and over. Of those 600,000 deaths...roughly 25,000 had been from Covid 19.
 

In that same period there have been less than 1,000 deaths of anyone under 45 years old....out of over 50,000 nation wide deaths due to all causes.

 

Can we go back to our semi-normal lives now, and be more acutely aware of our senior population? (PS: I’m a young senior!)

Nobody wants to comment? You all just want to blather in about nonsense?

[Boatdrinks]

2 hours ago, SoCal Deek said:

You want facts and statistics: 

 

As of one week ago since the Covid 19 story exploded there have been 600,000 American deaths in the age group of 55 and over. Of those 600,000 deaths...roughly 25,000 had been from Covid 19.
 

In that same period there have been less than 1,000 deaths of anyone under 45 years old....out of over 50,000 nation wide deaths due to all causes.

 

Can we go back to our semi-normal lives now, and be more acutely aware of our senior population? (PS: I’m a young senior!)

Makes sense to me. The shutdowns are far too extreme for the actual problem, creating a larger problem that is much worse. Some precautions and guidelines for those who will be around the most vulnerable should be the focus. Those who are somewhat more vulnerable than the healthy population should take personal precautions when indoors around larger groups of people. Flattening the curve appears to have been a success. It’s time to end the insanity ; the ridiculous notion that the government should trample individual rights to prevent anyone from contracting a virus.