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COVID-19 Check-in

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Comments

  • texdawgtexdawg Posts: 11,002 ✭✭✭✭✭ Graduate
  • YaleDawgYaleDawg Posts: 5,313 ✭✭✭✭✭ Graduate
    edited March 2020

    Spain is also pretty bad. From what I've read it's from the hospitals being overwhelmed. Not enough ventilators to go around so medical ethicists having to decide who gets to live and die. New York seems to be close to this point.

    Edit: @razorachilles makes good points to why Italy specifically has such high death rates. Spain has a high median age as well which may be contributing to high amounts of hospitalizations.

  • pgjacksonpgjackson Posts: 13,289 ✭✭✭✭✭ Graduate

    One of the things that is kind of terrifying is that back when all of this was first starting millions of people fled Wuhan. Where they went...??? I wonder how many went to NYC? Might explain why NY has about 20Xs the confirmed cases as any other state.

    https://www.businessinsider.com/5-million-left-wuhan-before-coronavirus-quarantine-2020-1

  • KaseyKasey Posts: 23,541 mod

    Cuomo and DeBlasio also both kept harping on testing rather than prepping the hospitals. Now everyone went in for a test when they should’ve stayed home. More testing will reveal more cases.

    I think nyc would have higher count regardless, but the testing push is what drove this high number imo

  • YaleDawgYaleDawg Posts: 5,313 ✭✭✭✭✭ Graduate

    "Escaping the outbreak may have been the cause for some people fleeing the city. But it also coincided with the Lunar New Year, China's most important holiday in which city workers return to their hometowns.

    Lunar New Year is the largest annual human migration, with Chinese citizens making a combined 3 billion trips during the season.

    Chinese workers get a week off work, from January 24-30. For many, it's the only time they get to go home during the year, which may explain the desperation to leave Wuhan in the face of an impending quarantine."

  • YaleDawgYaleDawg Posts: 5,313 ✭✭✭✭✭ Graduate
    edited March 2020

    Yeah testing needs to be done in a smart way. Either at home or drive thru testing. The greater Seattle area is trying an at home testing kit, so we'll see if that works. My only concern is people doing the swab wrong, or messing up some other part of the test. It's hard to make anything idiot proof.

  • BadDawgBadDawg Posts: 125 ✭✭✭ Junior

    Also, I dont disagree. I work at a job that was deemed essential. Just this morning I was in a serious discussion with the head of my center about our safety protocols.

    They want us to take every precaution we can, while at the same time, expecting 100 people to get our scanners for work from a room no bigger than most people's bathroom.

  • DvilleDawgDvilleDawg Posts: 2,337 ✭✭✭✭✭ Graduate

    We have people from France in our offices all the time, and now we get a lot from Germany. Those people love to smoke. Our site made a smoking area away from where everyone goes in and out of the main building and the French pitched a fit about it because they thought they should just be able to light up anywhere and any time they desire. You sit beside one of them in a meeting and all that stale smoke and then they aren't big on daily baths, it is awful.

  • pgjacksonpgjackson Posts: 13,289 ✭✭✭✭✭ Graduate

    With literally 1/2 of the known cases in the US coming out of NY, is it a matter of NY testing more people or is there a serious issue up there?

  • razorachillesrazorachilles Posts: 1,273 ✭✭✭✭✭ Graduate

    One recent COVID-related change that already has the potential to dramatically change the way healthcare consultations with physicians and NPs is in the area of telehealth. Some may have missed this detail in one of the daily COVID debriefs last week:

    In short- the FDA has agreed to cover telehealth (Zoom, Skype, Facetime, etc.) under Medicare & Medicaid, as well as halt HIPPA violation enforcements as it pertains to use of electronic devices by physicians.

    Essentially - rather than having at-risk patients travel to the doctor for regular check ins for blood pressure monitoring, review blood level readings monitored at home, etc., this can now be done via a phone or tablet from the patient's home.

    Telehealth options have been in use in some forms for over a decade in the US but a key sticking point has been between health care providers and insurers, with the latter reluctant to compensate the providers for the full price charged to their customers for an in-office visit. The impact post-COVID crisis could be long-lasting with consumers getting a taste of this new way of receiving healthcare services (and preferring in some cases not having to go to the doctor in person).

  • YaleDawgYaleDawg Posts: 5,313 ✭✭✭✭✭ Graduate

    Testing is still important but it's more important towards the beginning of an outbreak. If you can identify the infected early in an outbreak, do rigorous contact tracing, and isolate all of them it goes a long way in preventing widespread transmission. Places like New York are past containment and have moved towards mitigation as well as revamping hospitals to deal with an influx of patients. However, a good portion of the country can still try to contain the virus using testing and contact tracing.

  • CaliforniaDawgCaliforniaDawg Posts: 674 ✭✭✭✭✭ Graduate

    I think there are a few things going on:

    1. New York has a higher population density than other states and so the virus can spread more easily
    2. New York City has three international airports and is a center of international business and so the virus got brought to NYC from China and/or Europe multiple times by people passing through or living there
    3. You have milions of people commuting from large offices with thousands of people and so the virus spread super rapidly. If say one office of 500 got infected and 250 (or whatever the number I'm just makking this up) peole got it and then those 250 went to the suburbs and their church or synagogue, to a restaurant, etc., etc. then that group gets it and then that group becomes another node of spread.

    In addition to that, across the country, there are enough people on the left and the right of things who for one reason or another are defying social distancing norms and so New York, like most of the US, is taking one step forward and two steps back. Until we all do it for 3 weeks, this **** social distancing will go on and on. It's like the kid who keeps misbehaving in class while the rest of the class is waiting to go to recess, but you have to wait for that last kid to behave before everyone can go out.

  • CaliforniaDawgCaliforniaDawg Posts: 674 ✭✭✭✭✭ Graduate

    Yep, that is the strategy California has taken and why I can't get tested. I still feel like I have a small child sitting on my chest with each breath, but I will never know if it is Covid-19 unless I get bad enough that I have to go to the ER as the testing strategy has changed from containment to identifying how to treat a critical patient. In other words, testing in California is now about mitigation. More testing in New York might help people be sure that they have to self-quarantine, but widespread testing only helps with containment. Once you get beyond containment to triage, it's about mitigation.

  • YaleDawgYaleDawg Posts: 5,313 ✭✭✭✭✭ Graduate

    Yeah at this point anyone with symptoms in those population centers being hit hardest are considered positive and told to self isolate for two weeks and only come in during emergencies. Same thing happening in southwest CT at the beginning of the outbreak where a lot of people commute to NYC. CT was only doing 20 tests a day in the state lab, so they just told everyone to assume they had COVID-19 if they had a fever and cough. It was ridiculous.

  • pgjacksonpgjackson Posts: 13,289 ✭✭✭✭✭ Graduate

    Has anyone published hospitalization numbers? We know the confirmed case, and we know death. The WHO and CDC publish that daily. What we don't know is how many are currently hospitalized. Since the big concern is overwhelming hospitals I think that would be important info...moreso than just raw "positives". That 60,000 confirmed US cases includes people who were confirmed early (Jan and Feb) and probably are over it now. It's not a "current" number, it's cumulative. And of that 60,000 about 80% need no medical assistance. So, what is the actual impact on the US health care system right now today?

  • YaleDawgYaleDawg Posts: 5,313 ✭✭✭✭✭ Graduate
    edited March 2020

    So right now NYC says 12% of active cases require a hospital bed and 3% require an ICU bed. They have over 21,000 cases so I just took a few thousand off and did a little math based on the hospitalizations doubling every two days which has been the norm. With 5,000 normal beds and 3,000 ICU beds they would have run out of beds in about a week (This is back of the envelope math with what I could find so take it with a huge grain of salt). Good news is the hospitalization rate as dropped to doubling every four days instead of every two which gives them more time to prepare if it holds the next couple of weeks.

    Edit: this assumes all beds are empty and being used exclusively for COVID-19 patients.

This discussion has been closed.