COVID19 Factors We Should Consider/Current Events

[Gerald Boggs]

It is simply amazing that you quoted a story about your friends wife having passed away from a "hospital acquired infection", yet don't seem to understand the probability of hospital acquired infections will increase given a novel, extremely contagious pathogen being introduced into the hospital that is inadequately prepared to handle. Your disconnect here is simply incomprehensible.

You can add my mother to the list of people killed by visits to the hospital. She went into the hospital for a knee operation. Should have been an in/out after a few days, it turned into a several years long horror story. It included a long list of errors by the doctors and hospital, but by God, they still got paid. And is this a good time to point out the third highest cause of death is a visit to the hospital.

[Joe Cavazos]

As it so happens, The Times also wrote about this subject today. They link to this paper by Eichenbaum et al that is reasonably understandable to a layman like me. It uses a Value of Statistical Life as a variable. Based on a VSL of $9.3m and a high-end estimate of ~2.2m deaths given no government intervention, the authors would predict a -5.5% hit to GDP.

2.2 million deaths is a nonsense prediction. I can't believe anyone still takes it seriously.

[Rob Waskis]

What do you think the model will predict for May 15?

It will all be over. According to the model, every person in the US will have it by about April 29th (assuming the CDC case number is perfectly accurate, 100% of citizens will get it, doubles every 2.8 days). Add another two weeks for those who have it to die, and we'll be done with COVID-19.

Of course, if not everyone gets it and we're drastically undercounting the number of cases out there (as has been widely "reported"), we should be done much sooner. Unless that 2.8 changes, then we could be done much later. Or even sooner-er.

Time to make more substantive policy decisions based on the mathematical equivalent of a giant shrug.

I can assure you the morality rate will increase once we get closer to being in the thick of this, we are at the beginning.

I keep hearing things like this tossed around. How will we know when "the beginning" is over and "the thick" has started? It's been three months. When will then become now?

Another thing I keep hearing is that we're "two weeks behind Italy". If you look at the WHO data, two weeks ago Italy had 463 deaths and now we have 471. So that actually does make it look like we're two weeks behind Italy. Of course, two weeks ago they had 9172 cases and now we have 42164, so are we actually two weeks ahead of Italy?

[Jeff Brophy]

Wonder why H1N1 in February didn't require a country wide shutdown?

H1N1 Scare: India Records 884 New Cases and 14 Deaths Since January | The Weather Channel

[Rob Waskis]

Actually, Cuomo provided concrete numbers for the number of additional hospital beds, N95 masks, and ventilators that are needed. You can evaluate whether his requests were legitimate within 2-3 weeks.

Coumo said he needed 30,000 ventilators. In a state that has had 21,689 TOTAL CASES.

What am I going to do with 400 ventilators when I need 30,000?” he said later. “You pick the 26,000 people who are going to die because you only sent 400 ventilators.”

[Gerald Boggs]

Had a thought and did a search. How many days of supplies do hospitals keep on hand? 3-4 days, not based on possible emergencies, but BASED on current usage. I have never worked anywhere that so little supplies were kept on hand. As a Commo Chief in the army, I kept a 30 day supply of radio batteries and that wasn't war stock, just routine training usage.
What's that saying? Poor planning on your part does not necessitate an emergency on mine." Unfortunately, in the hospital's case, it means "you die because of my poor planning"

[lazygun37]

That only answers the first part of his question, and only if you assume that every person that goes to the ICU is placed on a ventilator. I have no idea if that is a good assumption or not. The paper makes no mention of ventilators. Of the reported COVID-19 cases, 4.9% were admitted to the ICU, and 1.8% died. It doesn't break out what percentage of the ICU patients vs. the hospitalized patients died.

Your article contained none of that information. Good work.

Mark's question was:

[W]hat percentage of people are placed on ventilators for COVID19, and how many of them die anyway?

The article I linked shows that, among the 2449 US cases with known ages studied

1. the percentage of cases requiring hospitalization was between 20.7% and 31.4%
2. the percentage of cases requiring ICU care was between 4.9% and 11.5%
3. the percentage of cases who ended up dying was was between 1.8% and 3.4%

As I explicitly acknowledged, this only answers Rip's question if most patients on ventilators are in the ICU, and most ICU patients are on ventilators. This is almost certainly true -- these are patients suffering from severe respiratory problems. The need for a ventilator will usually be what necessitates a move to the ICU. Nevertheless, I did try to look this up, but I haven't been able to find the exact numbers. I think I found one very small study from China in which this percentage of ICU patients on ventilation was ~70%, and I also recall another Chinese study in which there were more patients on ventilation than were in the ICU, which presumably means some hospitals had some extra capacity they could deploy outside the ICU. But both of these suggest that "ICU ~ ventilator" is a reasonable first approximation.

Putting (2) and (3) together then, [B] the percentage of patients who needed critical (ICU) care who survived was between 63% and 70%. Two out of every three critical patients survived.

This doesn't exactly support the idea that all this critical care and ventilation is a waste of time and just makes these patients suffer needlessly. Most of them survive. They would probably prefer to receive ventilator treatment, if they are given a choice...

It's really frustrating, by the way, that none of you ever actually engage with the numbers. I mean you ask for them (and then ignore the answers if you don't like them), you cite random ones from unrefereed Medium articles that you think support your view (but don't), and you feel justified in ignoring any number that does not agree with your view, based on the assumption that nobody knows how to account for biases or uncertainties. But none of you seem to actually want to do even the slightest amount of home work to actually show that your views are backed up by actual data.

At least Itomo made it pretty clear (if I understood him correctly) that there is no number -- no number of cases, deaths, ICU patients, businesses destroyed forever or anything else -- that would justify the government demanding that people should self-quarantine. That's an irrational position, but at least it's a consistent one.

[DaveJF]

Mentioned yesterday: COVID19 Factors We Should Consider.

But the FT article is behind a paywall for me, so here's another story on that Oxford modeling: Oxford Epidemiologist: Here’s Why That Doomsday Model Is Likely WAY Off | The Daily Wire.

Might be a bit late but I didn't see that article on here yet. I have a few personal anecdotes based on symptoms that lead me to consider that this thing might have started to spread quite a while before what we are mostly being told right now. Plus if you search there are articles out there claiming Chinese Dr's may have been alerted to some form of upper respiratory illness spreading quickly by early November of last year.

I thought weeks ago the CDC should start large-scale antibody testing to help figure out what we're really up against here, but dismissed it as either not available or they didn't want to announce it fearing a run on clinics and such.

[MashedTaters]

Stop the Economic Suicide

Below is a link to Part 1 of 3 of an interesting exchange between Kevin Roche, former General Counsel of UnitedHealth Group in Minneapolis and the Star Tribune. Links to Parts 2 and 3 are embedded at the end of Part 1. These are quick, easy, and INFURIATING, reads. One illustration the ruination of journalism as a profession.

Kevin Roche: My struggle with the Star Tribune | Power Line

[bearalift]

These predictions will undoubtedly come true.

Why are the homeless people not dying?

From the Times Article:

The only case in which the benefits of lifting restrictions outweigh the costs in lost lives, Mr. Wolfers said, would be if “the epidemiologists are lying to us about people dying.”

I know we’ve debated whether the CDC etc. are inaccurate about the lethality or R-naught of Coronavirus. I don’t think it’s controversial to say that if Corona is “just the flu,” then the economic cost is too high and the government has overreacted.

But if the CDC is right, which we’ll know soon, then I think it’s important to acknowledge that there’s no scenario in which we avoid a major recession (according to the cited economists). So it’s not a fair characterization to say the government has a choice between “business as usual” and “stopping the spread”, because there is no business as usual — as soon as the virus got out, the jobs were already lost.