Rate of infection 50 times higher?

[tuxumino]

Article about the under reporting of corona virus deaths.


https://www.ft.com/content/6bd88b7d-3386-4543-b2e9-0d5c6fac846c

 

[Archimedes]

Speaking for myself, but I think most doctors would do the same, but in your example I absolutely would sign that off with Covid as a "Due to". No hesitation. I'm not sure I can explain it, maybe we just think differently about it, but what tipped the boat is important. If metastatic colon cancer were also present, I would list it further down, with "other conditions contributing". I think that's the standard, though I've posted before that death certificate entries are subjective.

I can understand that, from a technical perspective, what tipped the boat over might be considered the direct cause of death on that day, however, then one has to be very careful how they use that data and extrapolate it to the general population and make decisions. Taken to the extreme, if every death was occurring in a nursing home setting to people with serious underlying conditions, it would make sense to shift resources to locking them down and protecting them directly rather than doing it by locking down the whole country and hoping that it indirectly protects that vulnerable population. Also, the general public has the right to know how prevalent mortality from this disease is to various demographics such as age and health condition. The limited data out there does suggest that it dramatically disproportionaly impacts seniors and people with underlying health conditions. IIRC, some data showed something like 26 percent of the deaths had diabetes and in LA County deaths of the elderly in nursing homes was a very significant percentage of the total.

 

[Snaggy]

Taken to the extreme, if every death was occurring in a nursing home setting to people with serious underlying conditions, it would make sense to shift resources to locking them down and protecting them directly rather than doing it by locking down the whole country and hoping that it indirectly protects that vulnerable population.

Not every country wanted to SIP. The UK initially wanted to let the chips fall where they may until only the fleetest gazelles were left.

They didn't, and good thing. Reports from UK already show more deaths per capita and a reeling medical system, with hospitals running out of troops and even oxygen generation capacity.

You couldn't let our medical system be completely overwhelmed, with people dying in tents, and a doctor or nurse gasping for air the next cot over. You couldn't have nursing homes deserted except for old people dying in shit because the nurses aids were sick or too afraid to bring the disease home to their families. It's happened before, Katrina and even Seattle. You couldn't have essential services shut down, you had to keep those workers healthy and on the job.

We all know the dying will continue until we have a vaccine, a good treatment or 60-70% with acquired immunity. The percentage might be lower than we thought or maybe seniors, like myself, are the most affected, but we have to spread the process out to preserve our ability to provide healthcare and avoid the horror and the scars to our national psyche.

We had to prevent chaos, it would have been just as hard, or worse, on the economy. Sure we need to open up, but we have to avoid that. Maybe we overshot, I don't know when it will be safe so I won't speculate.

 

[budman]

Good take Snaggy.

Chaos would shake the Nation more than the SIP in my mind.

I try to remember there are questions in the minds of the smartest people dealing with this shit, so my little brain is OK to wonder WTF? :laughing

I like most, have my thoughts on this or that. This isn't a case where a math formula applies so I just keep chiseling away at gleaming good information and putting together my own little puzzle. Problem is that the puzzle pieces being offered at times are not part of the damn puzzle. :rant

 

[Yakoo752]

[...]This isn't a case where a math formula applies [...]

It absolutely is a case. We just have to accept the decision variables.

How many deaths are ok?
How much harm do we do to the economy?
Which hurts the economy more?

 

[bojangle]

It absolutely is a case. We just have to accept the decision variables.

How many deaths are ok?
How much harm do we do to the economy?
Which hurts the economy more?

It's gonna kinda be like worker safety measures. Often, a low cost measure will make a big difference in reducing illness or injury. But as we attempt to approach 0, the costs will skyrocket for increasingly diminishing returns.

We need to figure out the right balance between cost effectiveness that that give the greatest impact in reducing virus transmissions. Once we hit a certain level of diminishing returns, it is time to come to terms with the "acceptable" losses.

 

[Archimedes]

Not every country wanted to SIP. The UK initially wanted to let the chips fall where they may until only the fleetest gazelles were left.

They didn't, and good thing. Reports from UK already show more deaths per capita and a reeling medical system, with hospitals running out of troops and even oxygen generation capacity.

You couldn't let our medical system be completely overwhelmed, with people dying in tents, and a doctor or nurse gasping for air the next cot over. You couldn't have nursing homes deserted except for old people dying in shit because the nurses aids were sick or too afraid to bring the disease home to their families. It's happened before, Katrina and even Seattle. You couldn't have essential services shut down, you had to keep those workers healthy and on the job.

We all know the dying will continue until we have a vaccine, a good treatment or 60-70% with acquired immunity. The percentage might be lower than we thought or maybe seniors, like myself, are the most affected, but we have to spread the process out to preserve our ability to provide healthcare and avoid the horror and the scars to our national psyche.

We had to prevent chaos, it would have been just as hard, or worse, on the economy. Sure we need to open up, but we have to avoid that. Maybe we overshot, I don't know when it will be safe so I won't speculate.

Geez, tangent. I don't disagree with anything you're saying. But to assume that what we've done so far was perfect or even relevant to our future decisions without actually studying and SHARING the underlying demographic data is ridiculous. There may be a better way forward in terms of our approach. We have no idea exactly how 'successful' we've been because we have no real control group. Further, now that we have more information, we might be able to design a much better strategy go forward. To simply ignore significant insights we've gained and just keep doing what we're doing, particularly without being transparent about the data with the public, makes no sense.

Again, in my extreme example, you would devise a strategy to isolate and care for those in nursing homes, and a different strategy for everyone else. The reality is somewhere in between that extreme and what we have now, which is simply assuming everyone has the same risk of infection and mortality, which is clearly not true.

Current statistics show that 51 percent of the deaths in LA county, the worst hit location in California with over half the state's total deaths, 51 percent of their deaths were in an institutional setting (nursing home, residential facility). You don't think that information might be relevant and suggest a different strategy might be warranted? Also, don't you think that has implications as to how we view the risk to the general population in California?

 

[budman]

It absolutely is a case. We just have to accept the decision variables.

How many deaths are ok?
How much harm do we do to the economy?
Which hurts the economy more?

Well.. I agree, but that is not a known formula to be able to apply.

A x B = C calculation deal.

Ultimately yeah.. but who knows it??

 

[Archimedes]

Well.. I agree, but that is not a known formula to be able to apply.

A x B = C calculation deal.

Ultimately yeah.. but who knows it??

How about simply letting people decide for themselves how much risk they want to take at this point?

At this point, we're destroying the very fabric of our lives. Is it worth it? The sacrifices being made right now by our population are enormous, far greater than just having to sit at home for eight weeks. Lives are being changed forever. Our society is being altered, potentially permanently.

Why not let people have a say in this and make their own decisions?

 

[bojangle]

Geez, tangent. I don't disagree with anything you're saying. But to assume that what we've done so far was perfect or even relevant to our future decisions without actually studying and SHARING the underlying demographic data is ridiculous. There may be a better way forward in terms of our approach. We have no idea exactly how 'successful' we've been because we have no real control group. Further, now that we have more information, we might be able to design a much better strategy go forward. To simply ignore significant insights we've gained and just keep doing what we're doing, particularly without being transparent about the data with the public, makes no sense.

Again, in my extreme example, you would devise a strategy to isolate and care for those in nursing homes, and a different strategy for everyone else. The reality is somewhere in between that extreme and what we have now, which is simply assuming everyone has the same risk of infection and mortality, which is clearly not true.

Current statistics show that 51 percent of the deaths in LA county, the worst hit location in California with over half the state's total deaths, 51 percent of their deaths were in an institutional setting (nursing home, residential facility). You don't think that information might be relevant and suggest a different strategy might be warranted? Also, don't you think that has implications as to how we view the risk to the general population in California?

Yeah, I agree. As long as we can trust the data and be assured certain states aren't manipulating things, then we should use it to find better approaches. We should find the balance that does the most to protect people without overburdened the economy with ever diminishing returns on safety. It will take a bit to find that acceptable balance, and not everyone will agree what that will look like.

How about simply letting people decide for themselves how much risk they want to take at this point?

At this point, we're destroying the very fabric of our lives. Is it worth it?

The problem there is that it's not as simple as an individual choice = an individual risk. That model describes the choices we make when deciding to ride a motorcycle. With SARSCoV2, an individual can make decisions that effect the risk of others. And without a coordinated effort, like everyone wearing masks, if only at risk people chose to wear cloth masks, that's not really helping, whereas if everyone were mandated to wear them in public around others, that will have a public benefit. Those are the reasons that the individual risk assessment model does not work in the realm of community acquired infections.

 

[Archimedes]

The problem there is that it's not as simple as an individual choice = an individual risk. That model describes the choices we make when deciding to ride a motorcycle. With SARSCoV2, an individual can make decisions that effect the risk of others. And without a coordinated effort, like everyone wearing masks, if only at risk people chose to wear cloth masks, that's not really helping, whereas if everyone were mandated to wear them in public around others, that will have a public benefit. Those are the reasons that the individual risk assessment model does not work in the realm of community acquired infections.

How is that any different than driving a car? Every time I got out on the road, I'm at risk from someone driving drunk or some idiot street racing. I just have to manage that risk to the best of my ability. You can never reduce your risk of injury or death from the actions of other people to zero. And the data and CDC guidance would indicate that this should be fairly easy for most people to mitigate if they are careful.

The public benefit argument falls flat at this point in my opinion. It's simply government telling people how to live their lives.

 

[GAJ]

How is that any different than driving a car? Every time I got out on the road, I'm at risk from someone driving drunk or some idiot street racing. I just have to manage that risk to the best of my ability. You can never reduce your risk of injury or death from the actions of other people to zero. And the data and CDC guidance would indicate that this should be fairly easy for most people to mitigate if they are careful.

The public benefit argument falls flat at this point in my opinion. It's simply government telling people how to live their lives.

The State is opening up and yet your hysteria seems to be ramping up.

In your perfect world what would YOU be able to do tomorrow and what, if any, precautions would you deem appropriate?

 

[mikev]

anything he wants. Fuck other people who might get sick and die.


That's the mentality.

 

[Snaggy]

Current statistics show that 51 percent of the deaths in LA county, the worst hit location in California with over half the state's total deaths, 51 percent of their deaths were in an institutional setting (nursing home, residential facility). You don't think that information might be relevant and suggest a different strategy might be warranted? Also, don't you think that has implications as to how we view the risk to the general population in California?

Yeah, sorry I went full drama on ya. I think my concern is you can’t protect nursing home residents unless you protect the people that work there, or anyone that’s in contact with seniors and other most-vulnerable people. That means you have to protect the families of caregivers

A nurse or an aide at at facility can’t work if her kids are sick, or if she gets sick from them. We had to close schools to eliminate that hotspot. Churches are full of old people, they should be closed. People with elder family members need protection. I think you would still have these nursing home horror shows, if a lot of the staff were ill. I haven’t worked in nursing homes for years, but I would think they’re at the low end of the pecking order for PPE, the facilities aren’t set up for isolation, they’re thinly staffed and you can’t get a demented person to wear a mask.

FWIW, I think we could open up dramatically tomorrow, if we had a billion face masks a day and everybody wore them. Report from China, putting masks over hamster cages, shit you not, reduced COVID spread between hamsters by 75%.

CDC is walking back contact transmission some and data is accumulating that masks work. I don’t think the paradigm that they don’t work for aerosols is so valid anymore. That PNAS article pointed out that small droplets are produced when large droplets shrink through evaporation, and face masks do collect large droplets when you exhale.

 

[budman]

How about simply letting people decide for themselves how much risk they want to take at this point?

At this point, we're destroying the very fabric of our lives. Is it worth it? The sacrifices being made right now by our population are enormous, far greater than just having to sit at home for eight weeks. Lives are being changed forever. Our society is being altered, potentially permanently.

Why not let people have a say in this and make their own decisions?

People are all ready doing that and have been since the SIP started.
Any of the medical, police or any other essential worker had to make a choice to continue to work. Sure for some it was financial over fear. Service over fear or.. they simply were not concerned.

I get the freedom angle to do as you wish, but I don't have a lot of confidence in the population that they would do things right.. and because that affects so many others I am choosing to listen to the Health orders.

Simple as that for me really, however the economic impact is huge and I get the desire to work. I like that counties are doing their thing based on their situations.

I am just not on board with open the gates and let it happen as it comes.

 

[Abacinator]

anything he wants. Fuck other people who might get sick and die.


That's the mentality.

No, no. He has a family member who is high risk, so he won't be putting himself out there to possibly get infected. But it's ok for everyone else

 

[nbean16]

anything he wants. Fuck other people who might get sick and die.


That's the mentality.

I think his mentality is more that this crisis may be not as severe as it was made to be and there should probably be some risk vs reward to destroying how the country functions.

Your bullshit words you put in his mouth are just obnoxious. At this point it seems like you would gladly have people die just so you could say "I told you so."

 

[Yakoo752]

I think his mentality is more that this crisis may be not as severe as it was made to be and there should probably be some risk vs reward to destroying how the country functions.

Your bullshit words you put in his mouth are just obnoxious. At this point it seems like you would gladly have people die just so you could say "I told you so."

but it's severe enough to him to limit his exposure so his high risk family member doesn't get it

I think for him, he doesn't like the government overreach.

He speaks out both sides of his mouth

Shelter in place works : shelter in place is too much

 

[nbean16]

but it's sever enough to him to limit his exposure so his high risk family member doesn't get it

I think for him, he doesn't like the government overreach.

Yeah, a lot of people don't. I dont think he is saying the disease is fake, but people may he able to decide to limit their own risk as he will do. I don't think it justifies the outlandish attacks for suggesting that.

That isn't speaking out of both sides of his mouth. Something can work without agreeing the government should do it. Unlawful searches could reduce crime. Doesn't mean we should all agree its a good idea.

 

[Yakoo752]

I see what you're saying