OT: Article on why testing for COVID19 in the US has been a debacle (and other notes)
https://thedispatch.com/p/timeline-the-regulationsand-regulatorsthat
Here's a good article that explains why the US has tested so few (although that seems to be getting up to speed finally).
The FDA made it near impossible for labs to make testing kits BECAUSE of their emergency declaration. Then, they put all their eggs into one basket with a CDC test, which had a bunch of problems and was essentially unusable. And there's no good reason why they didn't just use the WHO tests.
Here's an update on the COVID19 mortality rate in Korea, which is likely the country closest to the true mortality rate because they've done the most testing.
https://twitter.com/iampaulkerry/status/1240811385660903431?s=20
After jumping up and down a bit in the beginning, it settled low but has been rising consistently and hasn't tapered off yet. It's at 1.1% as of now. The initial infected in Korea were largely young, so this is likely due to more elderly people getting infected and/or the disease running its course more fully. Reminder that the seasonal flu's mortality rate is about 0.1%.
And I'll just make a couple other remarks since I have the OP mic and you can't stop me, which you can TL;DR. It's still really early to tell how bad it can be and which countries have had the best response, besides obvious comparisons like Korea did a much better job than Italy (tracking is at least as important as testing). Italy probably got hammered with a mix of indifference until it was too late, the oldest median age population in the world, a lot of smokers, and pretty bad air pollution in northern Italy. Having said that, Japan is the 2nd oldest population and also has lots of smokers (you can still smoke in bars there! even some spots in restaurants), and also doesn't have the cleanest air in the world. While cases ramped up in Korea, testing languished in Japan and many Japanese were worried there was a coming disaster, but it hasn't materialized. Things are certainly going to get worse in the US, but urban sprawl, car ownership, and low smoking rates may help. I wonder how much is just plain luck as well. It's not entirely accurate to say China had a ton of cases. Wuhan and the surrounding provinces had a lot, but there are many provinces in China with tens of millions of people each that barely had any cases. As of a couple days ago, about 75% of all cases in Korea were in Daegu. This is largely because of a cult that had some super spreaders who had just come back from meetings in Wuhan and were very much uncooperative with authorities (avoiding testing, not telling about their contacts). New cases have dropped off dramatically since about a week ago.
That people just want someone to blame, and seem to not realize that we’re not in this boat because of one side or the other.
Trump is a moron of epic proportions. But as soon as social distancing got thrown out, way too many people were not following it to be successful, and way too many still aren’t today...and pretty sure they’re not all from just 1 side of the aisle...
Its impossible to "politicize" a political subject. We are talking about choices made at the political level that made tests inadequate/unavailable, therefore it would be inappropriate to not "politicize" the subject as it wouldn't be germane. Whats wrong with identifying the heart of the issue regardless if its political or not?
Most of the people ignoring the advice are indeed from one side of the aisle; not surprisingly, the side that support the president and gets its news from the outlet that pushed the false narrative that the reports of a virus much, much worse than the seasonal flu were a "hoax."
March 21st, 2020 at 12:07 PM ^
I will say in all honesty that other than Germany, pretty much all Western countries screwed up their initial response to this pandemic - almost none took this as seriously as they should have. The main variable has been when they finally woke up and started acting.
Germany seems to have been on top of things right away and was aggressively testing. They've kept their CFR super low. (It helps that they also have a high ratio of hospital beds per capita.)
March 21st, 2020 at 10:23 AM ^
You made me think about something that didn’t occur to me until now. With the number of people vaping and now showing lung damage I wonder how many of these relatively young people that would’ve had a minor case of Coronavirus now get severe respiratory cases due to that damage.
I’ve seen the Xrays of the Grosse pointe 17 year old that got the double lung xplant and he was about to die from vaping.
March 21st, 2020 at 10:28 AM ^
US death rate is at 1.3% right now and steadily dropping. Government bureaucrats are always gonna bureaucrat. That's all they know. That's why Italy is a disaster with their government healthcare deciding who lives and who dies.
March 21st, 2020 at 10:37 AM ^
Here is a widely suspected reason it is dropping.. because we are testing more. We are finding out the the Ohio health secretary was right. Hundreds of thousands or millions of americans have already been exposed to the virus and contracted it. Of course 85% of people have almost no symptoms and it is clearly in every corner of our country. and it has been here FOR MONTHS.
The health care system has not cratered under it... and it will not crater under it now that we are testing and isolating the vulnerable.
In the end, the fight will be this: those who claim it was never that bad to begin with vs. those who say the government saved us with forced social distancing.
In a month or two, when the hospitals are not maxed out of ICU beds we should be able to return to normal. UNLESS, the fear mongering is too ingrained in all of us by then....
March 21st, 2020 at 10:58 AM ^
"The health care system has not cratered under it... and it will not crater under it now that we are testing and isolating the vulnerable."
Holy shit, dude. Do you even realize what is happening in NY, Louisiana and Seattle?
March 21st, 2020 at 11:08 AM ^
Dear God. Please enlighten me. The only thing I have seen are anecdotes about treating patients in those areas. Being sick is no joke and should not be taken lightly. But that doesn't mean the hospitals are overrun.
I just read an article that Washington state hospitals are sitting down to plan what to do if there is an onslaught of cases in the coming weeks. That was yesterday.
There may and will be stress on a hospital system that is already facing flu season and doesn't have many beds.
But, those health systems are not overrun treating these patients. The are, however, overrun with people concerned they have the disease.
(Of course they are preparing with supplies for the worst case scenario. As they definitely should.)
Please stop fear mongering.
March 21st, 2020 at 11:11 AM ^
One in five confirmed cases has resulted in hospitalization so far. The number of confirmed cases is soaring.
I don’t say this to scare you or anyone but this is serious ... practice social distancing as much as you can.
March 21st, 2020 at 11:24 AM ^
Umm. This is why stats suck for most people. The idea that one in five confirmed cases require hospitalization is based on the low number of confirmed cases. Only the most severe had been getting the test in the past. as testing ramps up that one in five number will shoot down. So don't project it to continue on into the future at the same rate.
The worldwide stats show 5% of people are in serious condition. In light of the epidemic, hospitals are admitting anyone who is positive and is in a high risk group. They would not normally be hospitalized. An example was Tom Hanks. Mild symptoms but monitored in the hospital because of his age and diabetes.
I agree. Practice social distancing. Just know it's not that bad.
March 21st, 2020 at 12:46 PM ^
You've made your (same) point here like 20-30 times. Do you think you will persuade people by exhausting them? Move on.
March 21st, 2020 at 11:08 AM ^
The CFR is very strongly correlated with the amount of available hospital resources. If your local hospital has enough ventilators and ICU beds, most patients will make it through. If not, it gets bad.
March 21st, 2020 at 11:26 AM ^
It's good that America has the most ICU beds per person in the world. Germany is a close second. It really falls off after that.
We are very prepared for this and we are marshalling additional resources.
Our health care system will shine. It will not be overrun.
That is great to see. Our health care system is so prepared. Even if there is a 10% chance you need those beds, get them ready! People are going to be seriously praising the much maligned US healthcare system after this whole thing is over.
March 21st, 2020 at 11:20 AM ^
Lots of hindsight bias on this blog. If you over-prepare people ask why and accuse you of panicking and creating hysteria. If you aren’t ready for something, you get accused of having an inadequate response.
No country was or is prepared for this. Judge the corrections and responses to it. The US overcame the Spanish Flu while in the midst of a war. This will pass also.
March 21st, 2020 at 12:15 PM ^
Most weren't prepared. South Korea and Taiwan were prepared, and it shows. In the West it was basically only Germany that figured it out from the start.
South Korea has many more cases per million population than many other countries including the US. They have only tested .6% of their population. You can’t go authoritarian on your population in the US like you can in Asian countries.
Unless they let you out of fear.
March 21st, 2020 at 11:22 AM ^
perhaps this pandemic and insanity will yield a silver lining when it all settles out. This is a quick video that makes a lot of sense and relates to everything going on in the here and now
March 21st, 2020 at 11:31 AM ^
First, It’s important to look at who is making decisions at the FDA
Alex Azar
Former lobbyist for Eli Lily
Former president of Eli Lily under who they dramatically increased drug prices
Former lawyer for Ken Starr during the Whitewater investigations. And more.
Clearly a swamp creature.
https://en.m.wikipedia.org/wiki/Alex_Azar
Second, Comparing the United States to Korea is complete ignorance. Korea was extremely well prepared and there is plenty of information out there about all the things they did and are doing that United States it’s not.
Most of SE Asia countries were better prepared because of SARS. It shows in their approaches and their numbers. The West was not prepared.
Third, based on this chart the United States is on Italy’s path or worse.
https://www.vox.com/future-perfect/2020/3/20/21179040/coronavirus-us-italy-not-overreacting
Fourth, it could be that the death rate is 1%. That would be true if there are a lot of people that are asymptotic that never got tested and if everyone gets access to a hospital bed and ventilator that needs it. Both of those things occurred on the diamond princess and in Korea. But they will not occur under the current trajectory in New York and they certainly are not occurring in Italy.
Finally, for those of you that think this is just like the flu and it should run its course, even at 1% that 50 million dead worldwide. That 50 million dead accounts for the 70% infection rate needed to get to an R0 of less than one. The reality however is if you were to let the virus run its course, healthcare would be overwhelmed and the death rate would be about 10 times that
March 21st, 2020 at 12:26 PM ^
Here is a chart to say we are definitely NOT on "Italy's path or worse."
This is a few days old; mentally place our little pink dot just over the 200 mark on the Y-axis and at 16 on the X-axis for the latest.
Notice that the scale is not linear. Then notice how far we still are below Italy. If it were linear, we'd need a far, far taller graph to show the difference between us and Italy.
We are not going to catch up to Italy any time soon, if ever. Worse than South Korea.....but saying we are headed for a worse place than Italy is fearmongering.
March 21st, 2020 at 12:45 PM ^
The biggest thing we have going for us is the horrific example of Italy to scare us into action. It might work - we'll see.
Italy, a country where approximately 25% of the people still smoke (how does that happen) and a country that did not take the disease serious enough early on. If some good can possibly come out of the other side of this disease is that the world will change in regards to living a healthier lifestyle.
Italy took the disease on earlier than NY did.
We may exceed Italy in total number of deaths. And if (when) we do that is the ONLY number the media will be reporting. No (or little) mention of the fact that the USA has 5.5 times more people than Italy.
My disappointment is the lack of perspective and general panic it induces. The media is horrible and social media is worse.
Looking forward to this being “over”.
PS - Happy to see the testing increasing and mortality rate dropping on a daily basis.
If it bleeds, it leads.
You are looking at an old chart of deaths. You need to compare growth rates in cases. Death rates go up when you reach capacity in health care.
Here is the recent chart you need.
I saw that chart the first time you linked it, and I'm arguing specifically against using it to say we are on, as you put it, "Italy's path or worse."
First off, that chart shows total cases, not cases per capita. We have over six times the population of Italy. We're going to have more cases. But probably not more cases per capita.
Second, and more importantly, people dying is the problem, not people getting sick. For a multitude of reasons, we have a lower death rate than Italy - much lower. If you want a newer chart, see below. Same source, five days later. It doesn't change the story. At the same point in the chart we have about a quarter of the deaths. Italy's path is one with a high death rate that we are not experiencing now and almost certainly will not in the future.
The last 4 days in the US on the graph are not encouraging. And yes, I know that the steps of closing school and restaurants are still too recent to be reflected in the number of deaths. It looks like we're on pace to pass Iran and perhaps approach Italy.
Don't be fooled by the non-linear scale of that graph. We may yet pass Iran, since we've passed them in terms of number of cases. (A freer, more mobile society will do that.) Italy appears to be flattening out on that graph partly because the scale squeezes together.
Maybe he shorted the market.
March 21st, 2020 at 12:03 PM ^
I still don't get why we are killing our economy for a mortality rate of 1.1%. Granted, if all this social distancing is over by May it's meh, but if this continues until next fall as Trump suggested I am going to be one unhappy camper.
March 21st, 2020 at 12:25 PM ^
The mortality rate isn't set in stone, it depends on whether we'll have sufficient hospital resources to deal with all the severe cases. If you have five patients in desperate need of a ventilator and only three ventilators, two will most likely die. That's what's happening in Italy where the rate has shot up to 8.6%.
Ask any health professional about this - it's the biggest challenge to our health system in a long time. If we are responsible in the coming weeks and follow the recommendations to social distance, wash hands regularly, etc., it doesn't have to get too bad. It comes down to our own decisions.
As for the economy, you're not realistically going to have a functional economy during a pandemic. This needs to get fixed first.
March 21st, 2020 at 12:50 PM ^
We'll all be unhappy, but better unhappy than dead.
Corona is just a common cold. It's been around forever. I don't trust the testing one bit. A lot of people are saying this is a false flag to push tyranny. Based on the reaction of authorities they might be on to something.
So says the guy who believes in Agenda 2030.
Have any more inside information to share with us, Thumper?
People not trying to look outside the box and consider other possibilities are truly lying to themselves and are most likely experiencing cognitive dissonance.
The only reason you laugh and mock anything that sounds like a conspiracy theory is because you most likely have never actually taken the time to sit down and look through the mountains of research people have been doing for over 50 years
You can’t save the economy in a Pandemic but you can save millions of lives
Easily one of the most dumbfuck statements ever posted on this board. And that's saying something.
I’d focus on the first part of your statement - that is, your lack of understanding. Is this your area of expertise? No. But don’t let that stop you from weighing in as if you were.
March 21st, 2020 at 12:49 PM ^
One potential positive amidst all the bad news: New York City has ramped up its testing capacity to a higher level per capita than any other country in the world. So, their denominator is probably getting closer to the true denominator than most places.
The case fatality rate in New York State is about 0.5% now.
There isn't one "true" mortality rate, it's going to vary. In Italy it's far worse in Lombardy than in any other region as its health systems are massively overstretched.
It's all about the number of critically-ill patients vs. the amount of resources we have for them.
EDIT: Italy just updated. 793 deaths today. Worst day by far.
There are modelers who say an attempted quarantine is worse than strong social distancing. Is it possible that Italy is showing us that right now? They shut down travel to China first and sprung into action with a lockdown. It has not lifted their numbers yet (as they should have expected today).
Italy isn't literally quarantining the entire population. You're allowed to leave your home for certain specific reasons - to go to work, to buy food, to get exercise - but you can't be in any sort of crowd, and can't just loiter around. Basically it's enforced social distancing. California, Illinois and New York are now doing likewise.
I'm sure this approach limits the new infection rate, but enough people were already infected that the curve will go on for some time. Also, there is still some degree of social contact, probably people infecting their families, and health professionals getting infected. The rate of infections is slowly flattening but this is a long process. In the meantime the health system has to slowly work its way through the massive load of patients. In Lombardy they are stretched beyond their capacity, which explains the continuing high fatality rate.
In fact, when it's all said and done, there definitely will be a statistical CFR, so not sure what your first comment means. Each locality will cetainly see variation in the CFR.
The difference in a national CFR of 0.5% versus 2% is a difference of over a million lives saved once half the population gets this.
If you look in a medical textbook coronavirus is a common cold. It will spread and some people will die like the common cold and the flu. You can't stop it. A heavy handed reaction is much more dangerous.
There are a lot of different coronaviruses. Sort of like how there are lots of types of fish.
This is not the coronavirus that causes the common cold, it is the one that causes COVID-19. It is much more shark than goldfish.