China quarantines city of 18 million to try to contain virus

[Blankpage]

South Korea has drive through testing. There's not a lot of negative exposure if you don't even get out of your car.
Knowing the numbers can't be a bad thing.

 

[Climber]

I believe South Korea had something like a 6% positive rate on their testing. That’s a lot of resources used for modest return, when the best you can do with the information is tell people to go home and self quarantine, go to the ER if you can’t breathe. Testing diverts healthcare workers from other roles and puts them at risk for infection. As the cases propagate exponentionally, the value of testing for quarantine purposes diminishes rapidly. A handful of cases in my county will completely exhaust all public health personnel resources.

Travel restrictions are much more efficient in slowing the rate of epidemic progression when you’re trying to protect a population.

The US is a Pacific Rim nation, yet we have not YET seen the numbers elsewhere.


Testing is a Dem talking point, at least to an extent, because they are not going to miss a chance to politicize this thing and maybe avoid catastrophe in November.

When the story gets written, testing will be put in perspective, by experts anyway. More testing may have slowed things somewhat, though travel restrictions were also very important. Going forward, self quarantine and travel avoidance, voluntary or not, will be our best weapon. Our extra 125,000 vents will save as many lives, or a lot anyway.

Earlier testing would have given officials and health experts a better picture of what the situation was, instead they were making decisions with little to no data.

I'm not a healthcare expert, but the above statement is valid regardless. Decisions without sufficient data is always a very inefficient proposition.

 

[KnifeySpoony]

. Mechanical ventilation may save three fourths of the people placed on it.

.

One of the chinese studies in the lancet a few days ago showed pretty poor outcomes for those that got intubated. Out of 191 pts at one hospital, 32 pts ended up on the vent. 31 of those died. Too many variables to know why such a poor outcome, but concerning nonetheless.

 

[Climber]

One of the chinese studies in the lancet a few days ago showed pretty poor outcomes for those that got intubated. Out of 191 pts at one hospital, 32 pts ended up on the vent. 31 of those died. Too many variables to know why such a poor outcome, but concerning nonetheless.

Could it be that they didn't have the vent resources, so they were putting the very worst cases on the vents and by then it was already too late for them?

 

[KnifeySpoony]

South Korea has drive through testing. There's not a lot of negative exposure if you don't even get out of your car.
Knowing the numbers can't be a bad thing.

Kaiser is drive through testing as well.

 

[KnifeySpoony]

Could it be that they didn't have the vent resources, so they were putting the very worst cases on the vents and by then it was already too late for them?

Yes, that is absolutely possible.

 

[UDRider]

Huh! Imagine that.

Too simple of an analysis. For example this study shows that US has 20-31 ICU beds per 100k. Versus for example Canada which has 13.5. Certainly one can have same reaction as this discussion, but going a little deeper:

However, we must be cognizant of the fact that the relative provision of (and therefore need for) intensive care may be driven by many factors. First are distinct differences in patient populations. Data comparing middle-aged Americans with a similar population in the United Kingdom demonstrated a higher burden of chronic illnesses among the American cohort –double the rate of diabetes and a third higher rate of hypertension [33]. Such comparisons are essential to understanding the relative healthcare needs of populations. Frequency of interventions and surgical procedures may also impact the need for intensive care. For example, patients who receive a liver transplant will require a stay in an ICU. This need for intensive care is, therefore, driven not solely by disease, but also by management choices [34]. An older study comparing admissions to intensive care in Alberta (Canada) and western Massachusetts (US) found that ICU days per million population were two to three times higher in western Massachusetts, primarily due to a higher ICU incidence (i.e. percent of hospitalized patients treated in the ICU). This discrepancy was driven by all of the factors described above [35].

So maybe there are more mechanical ventilators in US, not because of our awesome capitalist system, but because US population needs them more.

 

[Snaggy]

South Korea has drive through testing. There's not a lot of negative exposure if you don't even get out of your car.
Knowing the numbers can't be a bad thing.

New York started drive through testing. They can do 200 cars a day. How many people live in New York? Testing is good. From here on, if you need a test to tell you to quarantine yourself if you’re sick, avoid contact with people as much as possible if you’re well, and go to the hospital if, and only if, you can’t breathe, God help you, and God help us all.

Weather forecasters are very helpful when a hurricane is coming, not so much after it strikes land.

We’d all like to think we have some control of the situation here. Testing doesn’t give us that much control, but hopelessness is a bad thing. So let’s test, if it makes you feel better. Of about 60,000 cases from Wuhan in a report I read a week or so ago, about a third were never tested, simply included as presumptive infection on clinical grounds.

This ain’t strep or flu, testing shouldn’t be a prerequisite for appropriate action.

 

[Snaggy]

Earlier testing would have given officials and health experts a better picture of what the situation was, instead they were making decisions with little to no data.

I'm not a healthcare expert, but the above statement is valid regardless. Decisions without sufficient data is always a very inefficient proposition.

The most important decision was travel restriction. The index Seattle case was apparently a Chinese National who arrived in Mid January, only 2 weeks after the world heard of the virus. Data gathering is certainly important, but I think there was enough data from China to work with initially.

I think that when the history of this is written, the countries that clamped down harshly on travel and quarantine are going to have the best outcomes.

Testing will have little effect once 50% of the population is infected.

 

[bojangle]

Too simple of an analysis. For example this study shows that US has 20-31 ICU beds per 100k. Versus for example Canada which has 13.5. Certainly one can have same reaction as this discussion, but going a little deeper:


So maybe there are more mechanical ventilators in US, not because of our awesome capitalist system, but because US population needs them more.

That very well may be true. Healthcare is complex and insurance skews prices in supply and demand because consumers aren't directly paying the costs. But one thing I believe capitalist systems are fairly good at is responding to increased demand with more supply. I don't have the same faith in a socialist medical system. My belief is that Americans, for a variety of reasons, are less healthy than those in other countries, driving a need for additional ventilators or whatever. But I don't believe a socialist system would respond appropriately to the demand, making things even worse.

 

[Snaggy]

Too simple of an analysis. For example this study shows that US has 20-31 ICU beds per 100k. Versus for example Canada which has 13.5. Certainly one can have same reaction as this discussion, but going a little deeper:


So maybe there are more mechanical ventilators in US, not because of our awesome capitalist system, but because US population needs them more.

Or maybe it’s because Americans have been offered, and eagerly accepted, a healthcare system which is excellent at providing expensive care to the oldest and sickest and not so good at prenatal care.

I don’t argue that Americans are fatter, and less healthy, but we smoke less than many places. I don’t think we have 2-3 times more vents just because we’re sicker. I think it’s mostly because we treat more aggressively. You’re a doc too, you know how this stuff works. The argument likely won’t be closed completely despite various studies favoring one theory or the other.

 

[Abacinator]

There is no vaccine for the coronavirus, so free medicine wouldn't make any difference. The test is already free. Now, the U.S. is going to cover all the other costs. The vaccine is being developed by capitalists, by the way.

The majority of people do not get very sick and don't need to even see a doctor. Isolate and get better, just like a flu. More government control of medicine wouldn't do anything. Has government medicine made a difference in any country? Isn't China about as socialist as it gets?

Those capitalists as University of Saskatchewan?

We have no fucking idea how many people might be infected because we're not fucking testing people. An expert from Johns Hopkins estimated that anywhere between 50,000 and 500,000 Americans have been infected. What good are "free" tests if nobody can get one? The powers that be are deliberately shirking their responsibility to deal with this crisis and the rest of us are going to pay the price.

 

[UDRider]

Or maybe it’s because Americans have been offered, and eagerly accepted, a healthcare system which is excellent at providing expensive care to the oldest and sickest and not so good at prenatal care.

Could be that too. :laughing

I don’t argue that Americans are fatter, and less healthy, but we smoke less than many places. I don’t think we have 2-3 times more vents just because we’re sicker. I think it’s mostly because we treat more aggressively. You’re a doc too, you know how this stuff works. The argument likely won’t be closed completely despite various studies favoring one theory or the other.

Not a doc, just an idiot with an opinion. :laughing
I do find your posts valuable. :thumbup

 

[Beanzy]

...
I do find your posts valuable. :thumbup

Yeppers.

 

[Killroy1999]

The funny thing about China is that all of my Chinese friends are asking me "How are you doing" and "Are you safe?".

At the Chinese factories that make my widgets, it's business as usual and not a hit of spreading Corona Virus. Yet, there are some rumors of still some issues and I'm sure someone will post an article to them right after this.

 

[Beanzy]

Yeah... :rofl

Think burning man hospital in the desert. All patients and no staff.

Am re-reading this thread and have to say that Burning Man's medical staff are all professional doctors and nurses who volunteer their time on the Playa.

And I bet many of them are now working in NYC and other city hospitals dealing with Covid-19 patients.

Burning Man is a giving community and the all-volunteer medical staff truly exemplify that philosophy.

 

[Sharky]

Am re-reading this thread and have to say that Burning Man's medical staff are all professional doctors and nurses who volunteer their time on the Playa.

And I bet many of them are now working in NYC and other city hospitals dealing with Covid-19 patients.

Burning Man is a giving community and the all-volunteer medical staff truly exemplify that philosophy.

Well they won't have to take time out for planning because BM is cancelled this year.

 

[phil turdwater]

I might get a day of

haha yeah i know right?!!?

 

[NeilInPacifica]

youtu.be/Le_rfTdayLs

Came across this tonight. IMO Occam's razor applies.

 

[Climber]

youtu.be/Le_rfTdayLs

Came across this tonight. IMO Occam's razor applies.

You do realize that the Epoch Times are rated as Far Right in Media Bias?