Forum: Author Hangout

The main objectives of the government efforts is to slow down the transmission so that the medical services aren't overwhelmed and they have more time to develop a treatment etc. before the entire population is infected, thus lowering the overall death rate further.

And allow the supply chain to catch up to unprecedented levels of demand for goods. As well as allow the medical personnel themselves to start to develop a cadre of people who are resistant to the illness while contending with said supply shortages. Having up to half of your care providers out of action because they're sick with the illness they're treating doesn't help.

@Darian Wolfe

I need a little help. As I watch the news about Corona I don't understand what the fuss is about. Maybe my maths are wrong, but it seems like the fatality rate runs about 3% out of 100.

The real fatality rate is likely to be lower than 1% after all is said and done. It's tracking in the 1 to 2% range among known cases in the areas where the medical system isn't swamped. Once the hospitals have more cases than they can handle, that's when people start to die, and the death rate goes up a lot.

The real fatality rate is likely to be lower than 1% after all is said and done.

One factor is that we don't know the denominator.

We do know from some of the Asian countries that started population wide testing early on that a sizeable percentage of cases are asymptomatic or have symptoms so mild they don't seek medical care.

I've seen estimates that that group is as much as 80% of cases. Once that's known and accounted for the case fatality rate could drop as low as 0.1%, inline with the seasonal flu.

I've seen estimates that that group is as much as 80% of cases. Once that's known and accounted for the case fatality rate could drop as low as 0.1%, inline with the seasonal flu.

Keep in mind that a .1% mortality rate for the flu is NOT directly comparable with a possible .1% mortality rate for coronavirus.

You're forgetting there is a substantial (partial) immunity base for the flu. Vaccines also help reduce mortality rates, a very notable example incidentally happens to be US mortality rate vs Italy for the flu. Only the 65 and over demographic in Italy vaccinates at the same level as the US. For 65 and under, the vaccination rate in the US is much higher. And the mortality rates bear that out.

Italy's much vaunted healthcare system typically sees 4 to 5 times the fatalities per unit of population compared to the US when it comes to the flu. So with that as a base line, your "let it run" scenario going with a fairly mild flu season(30,000 dead) as the baseline and a 4x multiplier in play nets you about 120 thousand dead. If it's a 5x multiplier and a more severe year with a 60K dead baseline, we're talking about 300 thousand dead.

So with that as a base line, your "let it run" scenario

I never said let it run. The position that there is no middle ground between total global population quarantine and do nothing is insanity.

going with a fairly mild flu season(30,000 dead) as the baseline and a 4x multiplier in play nets you about 120 thousand dead. If it's a 5x multiplier and a more severe year with a 60K dead baseline, we're talking about 300 thousand dead.

Assuming you mean 300k just for the US, not globally, even 300K dead still isn't enough to justify wiping out our economy.

Assuming you mean 300k just for the US, not globally, even 300K dead still isn't enough to justify wiping out our economy.

That would be for the United States only, and that is an absolute best case. Because even without vaccination rates anywhere near the US for those under 65 in Italy, some of them do get vaccinated, and the Italian population has at least partial resistance to the flu due to prior exposure to related strains. Something which won't exist for Covid19, so it is likely to be some unknown multiple of that 300K number.

I agree there ultimately is a cost/benefit calculation that needs to be made in regards to how long the lockdown, or more aggressive social distancing practices remain post-lockdown(IE: no gatherings greater than 50 people). But at least until the medical supply situation is more sorted out, keeping things locked down is very prudent.

But at least until the medical supply situation is more sorted out, keeping things locked down is very prudent.

Everything in the economy is connected. The damage they have already done will only make sorting out the medical supply situation that much harder.

It may already too late for a lot of smaller businesses to survive. The restaurant and bar association is out looking for donations to keep restaurants afloat.

people will still get into accidents,

Currently there are a lot less accidents. No traffic jams, not even the usual congestions, empty streets. Of course the number of heart attacks and strokes remain.

Currently there are a lot less accidents.

Yes, but as you know the number is not zero. We transported one tonight; the cases my agency transports are often the serious ones which wind up in ICUs. At the moment it's not an issue but, if my countrymen (and -women) don't stay home...

Yes, but as you know the number is not zero. We transported one tonight; the cases my agency transports are often the serious ones which wind up in ICUs. At the moment it's not an issue but, if my countrymen (and -women) don't stay home...

True. Around here there are a lot less transports. I live less than a mile from a large hospital. Normally I hear at least 6-7 times a day sirens pass by from police and ambulances. At least once a week an emergency chopper too. Now, days pass without a single siren. I'm not sure if that's a good thing or not...

At the John Hopkins site Italy is shown as 124,632 confirmed cases and 15,362 deaths. That is about 12%.
US is shown as 312,237 cases and 8,502 deaths so about 3% but the US is earlier in the cycle than Italy.

There are multiple factors in play here that are likely to play with the US numbers further.

Reporting criteria differ between nations, and even states within the US.

Italy is classifying any Covid19 related death as a Covid19 death. Other nations(in particular Germany) seem to attributing cause of death to whatever it is they determine killed the patient, which may not be Covid19, so it would be a death with covid19, rather than death by covid19. (Never mind, both methodologies are flawed IMO, co-morbities are co-morbidities, and one can trigger the other--organ failure seems to be a common issue for Covid19 patients to contend with) There are reports one case where a young patient died in the Unites States who had a covid19 infection, but cause of death appears to have been a heart attack rather than Covid19. (Although it's entirely possible the infection stressed his system enough to trigger the heart attack, still reasonable enough to conclude the patient very probably had an undiagnosed pre-existing condition prior to covid19 infection)

But going back to the Italy death numbers for a bit. They're not testing the dead for Covid19, as test kits are in short supply and better used on the living. Also from what I'm hearing from "a random guy on an internet forum claiming to be living in Italy," all indications is that the Italian death rate for the month of March is 5 times above the normal death rate they've experienced over the 5 years previous to this past month(although he might have meant for that province, not the entire country). So the real impact of Covid19 may have been even worse for Italy than what the tracker currently reports, and by a multiple.

Italy does have a few other things going on that aren't as common in the US. Their population is old, only Japan's Population is older on average. I think it's safe to say the average American is probably more than a decade younger than the "average Italian." Also, multi-generational household are exceedingly common in Italy, they're not very common in the US by comparison.

But going back to Italy's possible death rate, from:
https://knoema.com/atlas/Italy/Death-rate
Their 2019 "crude death rate"(annual) is reported as 10.6 per 1,000 or 0.883 per month per 1,000. 5 times that is 4.416 per month per 1,000. At 60.55 Million citizens estimated for 2019, that indicates as many as 267,388 deaths in a month compared to a more typical 53,465 deaths they would have experienced. Or 213,923 deaths above what they would have otherwise expected, which is an entire order of magnitude beyond what Johns Hopkins is tracking. Assuming he meant the death rate for Lombardy Province alone, it has a population of about 10 million, so assuming the national average death rate is applicable, you're still talking 44,160 dead vs the more typical(according to my assumptions, which are not based on hard data) 8,830 dead in Lombardy Province alone, or a difference of 35,330 additional dead over what would normally be expected. More than double the number from John's Hopkins.

The problem at present is we don't have good data and a lot of misinformation floating around right now. the data analytics on this will be interesting once the right people get a chance to crunch the numbers, but by then most of society will no longer care.

At the John Hopkins site Italy is shown as 124,632 confirmed cases and 15,362 deaths. That is about 12%.

The problem with all those numbers, they relate to confirmed cases.
If like in Italy they test only medium or severe cases (not enough capacity to to test all suspected cases), nobody knows how many with light symptoms are really Corvid-19, flu, common cold or hay fever, just to name some possibilities. The death rate is significant higher if the lighter cases aren't taken into consideration.
More sound would be the death rate related to total population on a time axis starting with the first death.
So how is the death rate in the US compared to Italy 4, 6, 8, 10 weeks after the first dead? (sum of Corvid-19 deaths to total population).
This will tell you if you do better than Italy in fighting the pandemic.

HM.

US is shown as 312,237 cases and 8,502 deaths so about 3% but the US is earlier in the cycle than Italy.

The Italian population is older on average than the US population, and the US has significantly more ICU beds per capita.

I heard that Italy has more beds and doctors PER CAPITA than the U.S.

General hospital beds or intensive care beds?

The numbers I saw had the US at around 20-30 ICU beds per 100K pop vs around 12.5 for Italy.

It's worth-while pointing out that the USA by average, is more overweight than most other nations.

Italy has far more heavy smokers. Which is a much bigger risk factor for corona than weight.

.if it mutates again (and it will), who's to say, what it will do next.

The next mutation is just as likely to make it less deadly as it is to make it more deadly. But the fear mongers want you to believe that it only goes one way.

There is no bad outcome to being paranoid and extra cautious if the virus mutation turns it less harmful. But there is a high price to pay for being careless

This is foolish. Yes, there is a high price for being careless, but there is also a high price for being too cautious. The damage the lock downs are doing to the economy will not be so easily reversed.

ETA: It is utter insanity to act as if:
1. Inaction has infinite cost.
2. Infinite caution has zero cost.
3. There is no middle ground between 1 & 2.

if it mutates again (and it will), who's to say, what it will do next.

The next mutation is just as likely to make it less deadly as it is to make it more deadly. But the fear mongers want you to believe that it only goes one way.

Well the "cheery thought" to borrow from the Brits is that by resorting to isolation tactics, we're helping to ensure that either the most contagious, or the longest lived(if not both) versions of the virus survive to continue to propagate going forward.

Well the "cheery thought" to borrow from the Brits is that by resorting to isolation tactics, we're helping to ensure that either the most contagious, or the longest lived(if not both) versions of the virus survive to continue to propagate going forward.

I'd like to note that in general, over the long term, diseases that don't kill their hosts are generally more successful. So in evolutionary terms, the general pressure is towards diseases becoming less deadly over time.

if it mutates again (and it will), who's to say, what it will do next.

Maybe 'they' already know...

Why else would the US consider gun shops staying open "essential"..?

Odds on the next mutation being Zombies..??

:)

You'd never tell which had the virus and which didn't with the way some people are already Zombies in all but name in some parts of the USA.

Idiots know no national boundaries.

Madi Gras and Spring Break. Both Florida and Louisiana should have shut them down.

308,800 thousand confirmed cases, and 8,400 deaths from the same. That's a 2.72% death rate.

330,231 confirmed, 9443 deaths as of 2:27 pm CST, 04/05/2020

Not sure where you got those numbers or when. It doesn't change much though. By your numbers it's ~2.86% mortality verses 2.72%. For the population size, that's well within a margin of error.

Oh, and I think everyone can agree that China is lying about the number of cases they have, same as North Korea.

Sadly, that's not true. There are still idiots holding out that China has been honest about it.

Many/most Chinese people in China believe what their government says. That's what happens when your government controls your internet :(

There are many in China who don't believe their government either. They will not speak up as that tends to be unhealthy for them. Instead, they've worked out various codes to communicate with each other. That has been happening long before this more recent mess.

It's also a mistake to take the western governments for their word.
In saying that, I wished the speeches given by the world's government leaders were more in line with that of the Queen of England given today. Whatever someone's political bent, a message of unity like that wouldn't go amiss elsewhere in the world.

But I was an NBC warfare specialist.

radio or television?

Tongue in cheek? If not, it means Nuclear, Biological, Chemical (NBC).

They added Radiological because of the potential for dirty bombs; conventional explosives, in the middle of a nice pile of radioactive waste.

The back story for that was a stolen industrial radiography source. Or at least it was thought to be stolen, among several others.

The idea of a 20Ci/740GBq Co60 source running loose scared the hell out of a lot of people, though as it turned out, the company was trying to pull a fast one to dodge responsibility for maintaining it. Within a year of that incident, another source was literally dropped off the back of a radiography companies truck bed as the truck accelerated out of a Chicago toll booth. None of those incidences caused an exposure, but they did leave the source uncontrolled.

Then there were the incidents of exposure.

https://listverse.com/2011/08/07/10-more-cases-of-deadly-radioactive-exposure/

The last one on the list was the final straw though the writer got some details wrong.

Imagine the chaos caused if one of those source pigtails was discovered tapped up under a table at starbucks. Or simply ground up and added to some C4 and detonated on a bus.

Every regulatory agency on the planet came down on radiography companies and industrial users like a ton of bricks after 9-11. They were already on very thin ice before, but after, the regulations changed to require background checks etc on both the companies and the employees that had access to them.

"So that means C19 likes felines, ..."
Perhaps it likes preditors?

preditors

Public Relations editors?

It is important to remember that once we start running out of respirators, death rate will go up drastically.

There is something more critical than the number of respirators. The number of people trained to use them is finite. A few million respirators will help only a hundred thousand people if that is all the trained personnel available.

Absolutely true.

The point is a lot of people do not realise how high the death percentage can go if we can not threat the ones with severe symptoms. How high nobody knows, but a lot more than 3%.

The point is a lot of people do not realise how high the death percentage can go if we can not threat the ones with severe symptoms. How high nobody knows, but a lot more than 3%.

Well on the other end of that, there is the issue that it is known at this point that a significant percentage of those infected are either asymptomatic or very mild symptoms typical of a normal cold. How high that percentage is represents another unknown that is likely to push the finale case fatality rate much lower.

You are however likely right that the fatality rate on the serious cases requiring hospitalization is likely to increase.

The point is a lot of people do not realise how high the death percentage can go if we can not threat the ones with severe symptoms. How high nobody knows, but a lot more than 3%.

Before we sold the company, we employed a doctor for the purposes of screening, and primarily, keeping track of what country had what immunization and disease requirements/risk as we had a lot of work overseas. She carried on with the new owners, but we still stay in contact. What I stated was her point to me, but while not originally my idea, it is a good point to share.

The point is especially true of countries where medical services have broken down into extreme specialization. The U.S. is a good example of that. Politicians have a nasty habit of pointing to inanimate objects they can blame. Examples being, plastic straws, lack of respirators, certain safety devices for cars, the old lawn darts, ad nauseam. All examples of inanimate objects that require human action to become a positive, or conversely, a negative form of impact on human life and or quality of the same.

In this case, the respirator situation is already killing people. Not so much because they are not there, but due a lack of people trained to use them. The politicians and talking heads, point to the inanimate objects (respirators) and scream foul, while the reality is, the policies and legal ramifications ran wild are the causes. No one gets a ventilator until someone is signed off to operate it. Therefore more people are going to die if this pandemic continues its current course.

The same can be said about the peace time practice of long drawn out studies to get FDA approval of various potential therapies/drugs. More people are going to die while they drag their feet.

The bottom line is, the death rate will rise significantly in the coming months short of a massive breakthrough. The cause of that, has already happened in the preceding months and years prior to Covid19.

The bottom line is, the death rate will rise significantly in the coming months short of a massive breakthrough. The cause of that, has already happened in the preceding months and years prior to Covid19.

I agree and if whoever is in charge after this is over does not do a thorough root cause analysis, focusing on what failed rather than who failed, we can look forward to a repeat of this bit of history.

I agree and if whoever is in charge after this is over does not do a thorough root cause analysis, focusing on what failed rather than who failed, we can look forward to a repeat of this bit of history.

It will never happen, because a thorough and honest root cause analysis would require the politicians and bureaucrats that run the government to lay the blame squarely at their own feet.

Sad but true.

Up here in the great white north it seems someone is thinking fast. We have an army qualification called TCCC (Tactical Combat Casualty Care), open to any combat arms trade. Think combat medic light, very light (patch the leaks and go!) Only trained to do nasal airway (NAP). Word is that they are running a crash course to do oropharyngeal airway to help out on the civilian side.

The Military, when they want to, can cut through the BS much faster than the civilian side can. Too bad we wouldn't see it short of martial law being declared.

...wife canceled her annual physical...

My wife has 2 appointments this week. Unfortunately her condition doesn't allow her to miss these medical treatments.
If not for that, we are remote enough and have sufficient provisions we wouldn't have to interact with other people for a month or more.
I can only imagine what it is like for those who have no choice but to interact with large numbers of people daily.

I can only imagine what it is like for those who have no choice but to interact with large numbers of people daily.

It's a truly horrible experience... LOL ;)

And that was before the pandemic. :)

You can't fix stupid, nor government logic either.

You can't fix stupid

No, you can't, but with enough duct tape you can shut it up. :)

For estimated taxes I am just going to file when due to avoid a screw up and possible balloon payment down the road or a penalty for underpaying.

I run service as a self employed one-man small business as an LLC. I have irregular but predictable income, and do my own taxes (USA) at a savings of $400+/year. Form 2210AI takes more time than the other 15 federal forms combined. We are sending Q1 now and may not owe anything additional in Q2.

So bats pass bat flu to humans who then pass it to cats whereupon it becomes cat flu.

If we pass it to an oversized gorilla, does it become Kong flu?

"Does that mean if Batman has coitus with a human he'll become Catwoman?"

What do you get if you cross Batman with an elephant?
.
.
.
.
Flatman.

The staff to provide ventilator support is/will be there, the big issue is still the lack of equipment (ventilators, protective personal equipment like gloves and masks) rather than those to work it.

I can't speak for the UK, but in the USA, the ventilator issue is the opposite. The nitrile gloves and N95/+ grade mask are the same most likely.

The ventilator production can and is being ramped up. Some people are confused when they hear of car manufacturers doing that, but the equipment for certain car parts, injection molding for instance, isn't far off from that required for ventilators. From a cold start, I'd estimate three months to ramp up.

Acrylonitrile butadiene rubber, aka the synthetic rubber nitrile gloves are made from, is the choke point for the gloves. Butadiene monomers specifically. The US manufacturers ~17 tons a year on average. That's for all uses. The majority of the world's supply is manufactured in India, and you guessed it, China.

Ramping up a plant to manufacture more, is much more complicated than ramping up to manufacture ventilators. The vessels, crackers, piping systems, controls, etc for a single plant would take six months minimum, short of a war time draconian environmental red tape hammer.
"Not in my back yard" has been the call to arms for environmentalist on that. China, India, third world nation? No problems, just not in my backyard.

Bottom line there is, it's left us in the so called first world nations with a bowl in our hand asking "Please, sir, I want some more."

The N95 or higher rated mask can be ramped up fast if we kick the environmentalist in the head. Their biggest issue is the activated charcoal/carbon used in them. Pyrolysis of the organic materials necessary being at issue. Pyrolysis is simply cooking organic material (hard woods without sap, coconut shells, etc) in an oxygen restricted environment. What's left is charcoal/carbon once the organic volatiles are cooked off. It's the gases that process creates they get up and arms about.

The second half of that is the chemical calcium chloride. It is where the "activated" part of activated carbon comes from. The chlorine itself not a greenhouse gas itself, but it's damned difficult to keep the gas from combining with free organics which are green house gases. Build out of a facility becomes very hard due to that, and once again we are into Olivers bowl as a result.

I find it a touch ironic that the mask and gloves the environmentalist are now screaming for are in shortage due to many of the policies they themselves rammed through.