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comment by mk
mk  ·  1467 days ago  ·  link  ·    ·  parent  ·  post: A fiasco in the making?

One issue I take with this article is that it doesn't address the hospital saturation issue appropriately:

    Yet if the health system does become overwhelmed, the majority of the extra deaths may not be due to coronavirus but to other common diseases and conditions such as heart attacks, strokes, trauma, bleeding, and the like that are not adequately treated.

Italy is nearing a 10% death rate atm, and as far as I know, heart attacks, strokes, and the like aren't the issue. COVID-19 seems to result in a large number of people that need intensive care for several days, and not a small number that need to be on a ventilator. Even if COVID-19 has a flu-like death rate, all signs point to it being far more infectious. Overwhelmed systems seem to result in significant numbers dying from COVID-19.

I agree that we need more data, but what is going on in Italy doesn't look anything like a flu season.





b_b  ·  1467 days ago  ·  link  ·  

I agree that it seems completely abnormal to the point it's hard to make a flu comparison. But I guess we have to wait for the numbers to catch up. Part of me also wonders what part bad government plays in this saga. Neither Italy nor Spain have had a stable government since the financial collapse of 2008. You can see what damage 3 years of terrible leadership has wrought here. What does 12 years (or way, way longer if we're not being generous) do? I could be totally off base, but places with a swift, sensible government response seem to have faired the best so far (e.g. Taiwan, Singapore).

mk  ·  1466 days ago  ·  link  ·  

This seems a reasonable comparison based on current data:

It looks like we might be trying the “let it run its course” approach, however:

https://www.cnn.com/2020/03/24/politics/donald-trump-coronavirus-strategy/index.html

b_b  ·  1466 days ago  ·  link  ·  

I would caution against reading too much into the hospitalization and case fatality rates, because we don't know the infection rate, without which those numbers are close to meaningless. It is reckless to say we have a 3% CFR without knowing the IFR (infection fatality rate). The flu has been around long enough, and testing for it is routine enough, that we pretty much can make a really good guess about the CFR/IFR. Since we're sailing in uncharted waters wrt covid, I think we're in danger of making some wildly inaccurate speculations (like the WHO's reckless and irresponsible pronouncement about a 3.4% CFR).

I despise the president as much as the next guy, but I hope our collective hate for him isn't going to make us knee-jerk react against anything he suggests (even the proverbial blind squirrel can find a nut from time to time). I think reopening for business is very premature, but I also think that he's correct about his statement that if it were up to "the doctors" (probably meaning Fauci) we'd be closed for business for a year. We've got to balance somehow. I don't know enough to know what the right balance is, but I do know that a major depression is going to cause way more deaths and diseases to the most innocent among us (poor children) than covid ever could. We have enough history behind us to be very certain of that.

mk  ·  1465 days ago  ·  link  ·  

We don't have the infection rate pinned down, but signs suggest the R0 range is higher than flu. We also have some confidence that the hospitalization rate is greater. We aren't flying blind in terms of genomic epidemiology, which does provide clues of the infection rate and the physical spread.

https://nextstrain.org/ncov?c=country

No doubt, doctors shouldn't decide when the economy is reopened. But I don't expect Trump to make a data-driven call. My guess is the sweet spot is somewhere between 15 days and one year.

Just giving enough time so that everyone has a supply of surgical masks could get us closer to striking a rational balance. In China, you need to wear a mask if you are out in public, not so much to protect yourself, but to reduce your chance of infecting others. We know that works. If everyone in the US returned to work with ample supply of surgical masks, that could increase economic activity while minimizing the burden on hospital systems.

b_b  ·  1465 days ago  ·  link  ·  

Totally agree on all counts. Now if we could only get the NY Times to stop making body counts their lead story everyday!

mk  ·  1465 days ago  ·  link  ·  

South Korea seems a good example for what COVID-19 looks like when managed in a reasonable way. They had a flare up, tested like crazy, and have managed to keep the death rate around 1% while staying open for business.

https://www.msn.com/en-us/news/world/how-south-korea-flattened-the-coronavirus-curve/ar-BB11AJwA

https://abcnews.go.com/International/south-korea-takes-measures-face-masks-domestically-amid/story

kleinbl00  ·  1466 days ago  ·  link  ·  

We're getting our guidance from Facebook groups.

Facebook groups.