2019-nCoV / Corona virus Pt 2

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Thanks.


Those outside the US may not fully appreciate how, um, decentralized healthcare is here.

In addition to States, some cities (etc) have their own health departments (yes, with their own rules).

Hospitals may have a lot of latitude, especially if they’re privately owned.

And availability of testing may vary, within a state, across a hospital system (still common but hopefully becoming less so).
Three more ways in which the US is an outlier (at least partially so):

- high relative % of population incarcerated -> lots of unintended death sentences?

- opioid epidemic, considerable geographic variation, and as yet few covid-19 cases where it's worst (e.g. West Virginia) -> spike in deaths of mostly younger addicts?

- homelessness: the US is not really an outlier in the relative % of people homeless, but perhaps it is in how it addresses this group's health? -> spike in deaths of mostly younger folk?

OK, four:

- lots of uninsured and underinsured people (tens of millions) -> won't show up until needing ER care, all but ensuring some brutal triage decisions.
 
I was right regardless of people getting upset because I described it as 'let the disease run it's course'. This is hardly different and is a very, very bad idea as well. Whether or not this is the 'not crack pot' plan, it is one being bandied about.

The Guardian: Quarantine everyone over 70 is a policy being announced in the UK. Let the young and middle-aged people go out and do their thing to get the virus and build herd immunity.

That's naive. What about the older folks who live in multi-generational households? And what about the fact that every single age bracket dies of this disease? Kill off a small percent, better than closing the bars. :rolleyes:

The Guardian: I’m an epidemiologist. When I heard about Britain’s ‘herd immunity’ coronavirus plan, I thought it was satire
 
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I think the `mitigation' (spread the peak and bank on herd immunity) plan was the UK plan a few days ago, and won't be in a few days. Not sure now. The Imperial group seems to be advising the government, and they say:

We therefore conclude that epidemic suppression is the only viable strategy at the current time. The social and economic effects of the measures which are needed to achieve this policy goal will be profound. Many countries have adopted such measures already, but even those countries at an earlier stage of their epidemic (such as the UK) will need to do so imminently.
Our analysis informs the evaluation of both the nature of the measures required to suppress COVID-19 and the likely duration that these measures will need to be in place. Results in this paper have informed policymaking in the UK and other countries in the last weeks. However, we emphasise that is not at all certain that suppression will succeed long term; no public health intervention with such disruptive effects on society has been previously attempted for such a long duration of time. How populations and societies will respond remains unclear.
 
Caveat first: I have not yet carefully read the key primary documents.

The UK's government's approach seems to be consistent with this, right?

It's too late to do what Singapore has done (and continues to do).
We cannot do what China did.
We have very low confidence that we could do what S Korea did (and continues to do).
So the best thing we can do is kill off a few hundred thousand people (they're mostly old and/or sick anyway).
 
As others have posted, this is a good link to watch IMO: https://www.worldometers.info/coronavirus/#countries

But I wish there was a column for number of deaths per 1mil population. I feel that would give a real number of the risk going up or down.

It has a column for # of cases per 1mil population, but the number of cases is not a reliable number since the number of people tested is all over the place (high in some areas - like S. Korea - and very low in others).
 
Malaysia just announced a soft shut down from tomorrow night. The vast majority of businesses (except essential services), all places of worship, schools and universities will close until 31st March.

Not requiring people to stay in their homes (but prohibiting mass gatherings); just making sure all the fun stuff they would do will be closed. Supermarkets, public markets (I assume including wet markets), and local 'runcit' shops will stay open to provide essentials.

The curious thing for us is that the essential industries includes my wife's (though she is not front line), while I work on diplomatic premises so protected under the Vienna conventions. Academic in a way, as our daughter's nursery will shut, so we'll have to work out someone staying at home.

Bad form to quote oneself, but my form is rarely described as good. Malaysian Govt clarified today the Movement Control Order coming into effect in, oh, 16 minutes would generally require people to stay at home. So I am now locked down, it seems.

The police also brought in a rule at 20.00 that travel between states would only be allowed if you informed your local police station.

At 22.30 they amended that so that people could travel from the state which surrounds the capital to the capital, because a lot of people commute to do essential work.

At 23.08 they got rid of the ban altogether, as they were getting big crowds of people lining up outside police stations. Good stuff.
 
Why aren't we trying to use mobile phones to do contact tracing (semi-)automatically?

Easy.

There are still lots of people - including a large cohort of seniors - who don't have a mobile phone.

It's a bit 1984, but it's probably what saved China.

There is going to be leakage, at grocery stores or such. Or via delivery drivers. In a few weeks we will ALL have been exposed. No more need for quarantines. How long will that take?

South Korea & China are showing that's not necessarily the case. In both countries, the main pain will last three months and China's already talking about growth in Q3.

Well at least it's not Black Death numbers.

Funnily enough, it is. Obviously nothing like the percentage, but the final number could well be very similar - 50,000,000 dead.

The use of face masks has been debated a lot, and here is an interesting opinion piece about how telling people not to wear face masks has been a poor message.

The only problem with that is there aren't anywhere near enough to go around.
 
The only problem with that is there aren't anywhere near enough to go around.


But even a simple, not so perfect, home made mask would be better than nothing. I saw a youtube video from Hong Kong about how to make your own facemask. You need rubber bands, toilet p...……..never mind.
 
In all seriousness, we ought to all be wearing masks when we're out, even if they aren't high quality, hospital grade, masks. After reading, I'm convinced they protect the wearer a little bit, and the people near the wearer a lot.
 
There is going to be leakage, at grocery stores or such. Or via delivery drivers. In a few weeks we will ALL have been exposed. No more need for quarantines. How long will that take?

Denial is truly not just a river in Egypt.
 
There is going to be leakage, at grocery stores or such. Or via delivery drivers. In a few weeks we will ALL have been exposed. No more need for quarantines. How long will that take?

I doubt many delivery drivers will be encouraged to (or wish to) get within transmission distance of the people to whom they are delivering. I can go to a grocery now and if I pick a less than crowded time I have no trouble staying away from other shoppers; if I am careful what I touch and wash my hands I have virtually zero chance of transmission.

Sure there will be some "leakage." That's why people are hoarding toilet paper.:) But the dynamics of epidemics are such that very low rates of transmission can be identified, controlled and stanched once appropriate systems are in place, whereas high rates of transmission (e.g. without quarantines) overwhelm these controls and cannot.
 
Glimmer of hope, or false dawn?

New cases have stayed static for three days in a row.

Of course, that's tested cases, and since India is probably unaware of 99% of cases it currently has, I'm going with false dawn.
 
In all seriousness, we ought to all be wearing masks when we're out, even if they aren't high quality, hospital grade, masks. After reading, I'm convinced they protect the wearer a little bit, and the people near the wearer a lot.

Not recommended by the FDA.

I did just find a couple of N95 respirator masks in the old garage and brought them up to the house. Not going to get into them unless there's a good reason.
 
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