2019-2020 coronavirus pandemic (Vaccination 2021 Edition)

[Schadrach]

By the way. I received a text message saying I am NOT Covid positive. So that's it with my Covid negative result I'm allowed to go out again.

I got the test 11am Saturday and received my result 7pm Sunday. Poor bastards are putting in major overtime in a lab somewhere I guess.

That's about how long the turnaround on my wife's negative test was. She caught some kind of minor unrelated respiratory virus that made her feel like crap for a week, and onset of symptoms for it made her go get tested.

Today, we're actually going to do the most social thing we've done since the first confirmed case in WV - we're visiting a friend of hers that's giving us another cat in a few weeks (mom and kittens were rescued, we're taking the mom once the kittens are weaned). It's a tortie with an orange patch on its face that resembles the Phantom of the Opera mask.

Our governor has been doing daily briefings regarding COVID, and yesterday started a gradual, non-mandatory reopening (basically as slowly as he can while not pissing off his Republican overlords). He'd previously said that if this causes an uptick in cases things will be shut back down.
As part of his message yesterday he made sure to emphasize that those who choose to open "do so only if they fuckin' follow the guidelines to keep West Virginia safe." He issued a statement later that day claiming that the F-bomb on live TV was an audio glitch.

I'll say this - I might disagree with nearly all of Justice's politics, he might look like someone straight out of casting for "West Virginia Governor" for a movie that wasn't going to be flattering to us, but on the whole he's been handling the epidemic well, and our <3% positive test rate, and only 50 deaths statewide is frankly pretty fantastic.

Hamberders > humans.

The biggest death tolls are in dense urban areas that vote against him anyways, while hamburgers have always had his back. So of course he thinks that. Besides, hamburgers taste better than humans, and you get less shit for eating them.

Carpet sucks I don't get why people want it

Agreed, a thousand times over. First thing we did when I bought my house was tear out all the carpet (which had hardwood floor beneath it), stain and polyurethane where needed.

 

[lil devils x]

Just when you thought it couldn't get worse with Officials trying to hide the death toll, we now have counties trying to keep the public from finding out about COVID-19 testing locations :

County Judge instructed county employees and officials to not share COVID-19 testing information with public
"KAUFMAN COUNTY, Texas — County Judge Hal Richards did not want the public aware of COVID-19 testing ordered by the Governor in Kaufman over the weekend."
"Richards does not have the legal authority to instruct any employee or elected official to withhold public information from anyone according to authorities. "

County Judge instructed county employees and officials to not share COVID-19 testing information with public

KAUFMAN COUNTY, Texas — County Judge Hal Richards did not want the public aware of COVID-19 testing ordered by the Governor in Kaufman over the weekend.

www.inforney.com

And this county is refusing to release the data on the number of cases endangering people further:

Mecklenburg isn’t releasing COVID-19 test details. Why that matters to your health.

As the number of coronavirus cases continues to rise, county officials have refused to reveal demographic data about people who have tested positive, locations where they may have contracted the virus or if they engaged in activities that brought them in close contact with the public.

www.wbtv.com

 

[tstorm823]

What I'd suggest is that the death rate is usually pretty constant for any particular area. One decent estimate is to look at the deaths this year in comparison to an average of the last few years.

I came back to find this because I saw someone else on the internet make a similar comment and suddenly remembered I had a comment to make here.

This is a good way, from a historical perspective, to gauge the impact of covid-19 overall. It is not, however, a good metric for determining policy moving forward. The response to covid is likely to prevent some non-covid deaths (likely fewer flu deaths or workplace accidents) and cause some non-covid deaths (suicides, people not going to the hospital for other things, etc.). So like, PA is pretty harsh with its lockdown, but I'm in a rural area. My county has like a dozen covid deaths among the elderly, but also a large spike in overdoses since we locked down. Looking at the broad numbers to estimate, it's not feasible to separate out all the secondary effects of quarantine, you sort of have to drill things down individually as best you can to figure out when the response is causing more problems than it solves. From the perspective of "how much did covid hurt people", comparing year to year is great, but not necessarily a good estimate of who is dying of specifically covid. All other things aren't equal to a normal year.

 

[Gordon_4]

Dumbasses
In short, eight idiots - and the bar owner - were arrested for violation of the lockdown laws that meant the bar should be closed. But they couldn’t just open up and start serving to make the point. Oh no, these idiots arrived all tooled up. Making what should have been a misguided but legitimate protest into a bigger farce and more dangerous than it should have been. For everyone.

 

[Agema]

So of course he thinks that. Besides, hamburgers taste better than humans, and you get less shit for eating them.

That depends on the sanitary standards of your meat-processing plants.

 

[sneakypenguin]

I wonder what the endgame is. We locked down to flatten the curve now that the overloaded hospitals never materialized its shifted to stay locked down or 2nd wave hits. The cases are going to go up no matter what if we open so do we just stay shutdown for 18 months? Its also stupid how even with the lockdown i can be around 4 or 5 hundred ppl at walmart and the grocery store but not 1 on 1 with a barber. Or my essential job i can fly 100 people from newark to nashville to houston to Baton Rouge La but my previous job of landscaping with 2 other employees be a no go.

States should open and isolate as needed locally but the blanket bans are dumb.

 

[Fieldy409]

I wonder what the endgame is. We locked down to flatten the curve now that the overloaded hospitals never materialized its shifted to stay locked down or 2nd wave hits. The cases are going to go up no matter what if we open so do we just stay shutdown for 18 months? Its also stupid how even with the lockdown i can be around 4 or 5 hundred ppl at walmart and the grocery store but not 1 on 1 with a barber. Or my essential job i can fly 100 people from newark to nashville to houston to Baton Rouge La but my previous job of landscaping with 2 other employees be a no go.

States should open and isolate as needed locally but the blanket bans are dumb.

Right now as far as I can tell the strategy seems to be that every state is competing with each other and Fema to have a big stock of PPE, ventilators, hand sanitisers and whatever else they need ready to fight the virus.

So currently the strategy may be to simply flatten the curve until hospitals can raise the roof on where that curve can peak without it being a disaster. If they're going to let infections spike, it should really be when the healthcare system says it is actually ready.

 

[sneakypenguin]

Right now as far as I can tell the strategy seems to be that every state is competing with each other and Fema to have a big stock of PPE, ventilators, hand sanitisers and whatever else they need ready to fight the virus.

So currently the strategy may be to simply flatten the curve until hospitals can raise the roof on where that curve can peak without it being a disaster. If they're going to let infections spike, it should really be when the healthcare system says it is actually ready.

But isnt that essentially now. Even NY is sending vents to other states cause they didnt need them. Probably half of my family is in the medical field they are all essentially underworked or on part time status cause no one is doing doctor visits and medical procedures are essentially pushed back. Only my wife is still full time cause babies still gotta be delivered . Granted anecdotal but it seems we have the capacity pretty much everywhere. Seems states are realizing that and i bet most are open by june.

My views a little antsy though since this thing will probably put me out of work for 3ish years come october 1st and cost me millions over my career.

 

[tstorm823]

But isnt that essentially now. Even NY is sending vents to other states cause they didnt need them. Probably half of my family is in the medical field they are all essentially underworked or on part time status cause no one is doing doctor visits and medical procedures are essentially pushed back. Only my wife is still full time cause babies still gotta be delivered . Granted anecdotal but it seems we have the capacity pretty much everywhere. Seems states are realizing that and i bet most are open by june.

This is why we are opening. Places do realize all this. People without broad information are looking up just the new case count and thinking "that's not going down, we shouldn't open up", not understanding that we're testing more, and hospitalizations are dropping as the first (and possibly only) wave picked out the most likely to need emergency care, and the new cases are increasingly among the healthy who just need to stay home for a week or two.

 

[Fieldy409]

But isnt that essentially now. Even NY is sending vents to other states cause they didnt need them. Probably half of my family is in the medical field they are all essentially underworked or on part time status cause no one is doing doctor visits and medical procedures are essentially pushed back. Only my wife is still full time cause babies still gotta be delivered . Granted anecdotal but it seems we have the capacity pretty much everywhere. Seems states are realizing that and i bet most are open by june.

My views a little antsy though since this thing will probably put me out of work for 3ish years come october 1st and cost me millions over my career.

They have a finite capacity, whether or not people are currently overworked isn't relevent to that. Like think about this, If I say I'll need to hold 300 litres of water soon and I only have 200 litres of containers would it make sense to say "It should be fine, you have 200 litres worth of empty containers right now!"

Besides, there are certain resources that are choke points like ICU beds which I believe and may be wrong but I believe USA simply has less ICU beds than countries with socialised healthcare because their for profit healthcare doesn't want to waste money on expensive ICU beds that aren't constantly paying for themselves by being in use during good times.

It's all very complicated and nuanced,maybe I'm talking shit but when you think about the details it can obviously get a lot more complicated than 'doctors aren't overworked'

If you want to withhold that information its totally fine but I am curious what state you live in?

 

[sneakypenguin]

They have a finite capacity, whether or not people are currently overworked isn't relevent to that. Like think about this, If I say I'll need to hold 300 litres of water soon and I only have 200 litres of containers would it make sense to say "It should be fine, you have 200 litres worth of empty containers right now!"

Besides, there are certain resources that are choke points like ICU beds which I believe and may be wrong but I believe USA simply has less ICU beds than countries with socialised healthcare because their for profit healthcare doesn't want to waste money on expensive ICU beds that aren't constantly paying for themselves by being in use during good times.

It's all very complicated and nuanced,maybe I'm talking shit but when you think about the details it can obviously get a lot more complicated than 'doctors aren't overworked'

If you want to withhold that information its totally fine but I am curious what state you live in?

Spend about 2/3rd the year between Newark, Chicago, and Houston, but my domicile for tax purposes is an income tax free southern state (not tx) Most of my family though is in philly, boston, and the panhandle.

 

[deleted20220709]

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[lil devils x]

I'm in the psychiatric field and Covid-19 has only affected us in so far that we have more stringent screening routines for flu symptoms for people seeking the psychiatric ER and made a bunch of pre-cautions for when Covid-19 gets onto a ward. The thing is that you can't take a psychiatrist or a GP, for example, and have them work at the ICU as an anesthesiologist (the same goes in reverse, obviously), nor can you take nurses from surgical wards or nursing homes and put them in the ICU. The real limiting factor isn't the actual ventilators, which can be produced fairly quickly by a lot of companies, but the number of doctors and nurses around to operate and monitor them.

What's happening is that some specific parts of the health care system, the ICU, infection and some medical specialties, are getting hit really, really hard and are struggling to scrounge up enough staff to cope with demand. Meanwhile, most other specialties are doing business as before or even less, because people don't want to risk going to the hospital and catching Covid-19 from a co-patient. And this is why NY can send ventilators to other states: They simply don't need them because they don't have staff on hand to operate them.

Sadly, we also have to keep in mind that we have many newly sterilized ventilators available now because those who were using them have now died.

"We have some early published data on percentages which vary widely. A paper from China involved 710 Covid-19 patients; 52 were admitted to an ICU. Of the 22 who eventually required mechanical ventilation, 19 (86%) died. Another early study reported 31 of 32 (97%) mechanically ventilated patients died."

Mortality rate of COVID-19 patients on ventilators - Physician's Weekly

Written by Physician's Weekly Blogger, Skeptical Scalpel Although at the time I wrote this over 33,000 people had died from COVID 19 infections worldwide, the numbers of patients dying in intensive care units and on mechanical ventilation is unknown. We have some early published data on...

www.physiciansweekly.com

Considering we now have over 76,537 confirmed COVID-19 Deaths in the US, doing the math means we should have a lot more ventilators available due to this.

Trump bragging about " people not needing ventilators now" is essentially him bragging that we have had so many of those on ventilators die that we now have their ventilators available for the next round to try their odds. While yes, we do have a shortage of qualified operators, we also have such an extremely high death toll of those using them right now they have a high turn around. That should pretty much make anyone's stomach turn when they think about how bad this really is.

EDIT: If that doesn't make the case of why we need to not only focus on not overwhelming the hospital system, but instead try to buy time to have better treatments available to 1) keep more people off of ventilators all together by preventing it from getting to the point of needing them, and 2) have better treatments so that those on ventilators have a higher probability of survival.

We need more PPE made available to the general public by the US government, because approximately 90% of the new cases are from people who are not able to work from home. They do not have access to PPE and are spreading it like wildfire. This will only get much worse if they reopen while still not providing the general public with PPE to reduce the spread. Because the US government did not provide adequate PPE to everyone from the gas station employees to the guy stocking the fruit, they have been able to spread it far worse than if they had access to basic protection.

 

[deleted20220709]

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[lil devils x]

We should be careful with statistics like that, because they vary wildly from country to country and are largely dependent on factors that aren't directly linked to ventilator care. Early reports in Sweden suggest that over 80% of people treated for Covid-19 in an ICU (thus requiring a ventilator) survive, which is way over the Chinese number and about 50% higher than the equivalent number in Italy. The problem is that survival rate in a ventilator is also directly tied to the status of the patient and thus dependent on the medical decision making around those seriously ill in Covid-19. If Sweden only admits high probably of survival patients (young, previously healthy etc.) to ICU while China puts everyone into a ventilator, even those that stand next to no chance of survival (elderly, multiple other diseases etc.) we are going to see very different survival numbers. Hence, any reliable numbers about survival rates after ICU/ventilator care will only be available when we can satisfactorily divide patients into standardized cohorts. Which is to say that we first need to be able to compare the survival rates among patients of equal age, health and similar factors before any conclusions can be drawn. Otherwise we risk comparing young, healthy Swedish patients with elderly, ill Italian patients which is like comparing apples to oranges.

Yes, I agree about the statistics on ventilators, However, The US COVID-19 statistics are horrible tbh.
"Around 88% of patients with COVID-19 who were put on a ventilator in a New York hospital system died, according to a new study. "

Nearly 9 in 10 COVID-19 patients who are put on a ventilator die, New York hospital data suggests

That doesn't mean the ventilators caused harm, though.

www.livescience.com

In another study I read last week stated that only a little over 3% of US COVID-19 ventilator patients survived in the US. There are a number of factors that impact this, including what I had mentioned before about other nations use of ECMO, and the US has only just recently started to use it, and I have only heard about one patient thus far they did and managed to save:

ECMO Machine Used to Save COVID-19 Patient's Life, Officials Say

For the first time, a medical team at Northwestern University has used a special device to save the life of a patient after they were diagnosed with COVID-19. The machine, known as an Extracorporeal Membrane Oxygenation (ECMO) machine, is used to treat patients whose heart or lungs have stopped...

www.nbcchicago.com

Meanwhile, I remember reading back in January, Germany stockpiled ECMO early on. From my experience, much of whether or not they live or die on vents is also impacted by how they are treating the patient. Sadly, in the US, I have seen far too often, that they are not doing as much as they could have to ensure their survival. I am hoping we see this change, as the current trend is not looking good here.

 

[tstorm823]

Besides, there are certain resources that are choke points like ICU beds which I believe and may be wrong but I believe USA simply has less ICU beds than countries with socialised healthcare because their for profit healthcare doesn't want to waste money on expensive ICU beds that aren't constantly paying for themselves by being in use during good times.

You are incorrect. https://en.wikipedia.org/wiki/List_of_countries_by_hospital_beds
The US may be lackluster on total hospital beds, but has at or nearly the highest per capita ICU capacity on the planet.

 

[deleted20220709]

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[lil devils x]

We shouldn't overstate the need for ECMO, especially in regards to ventilator care, as Sweden only has 3 operational (soon to be 6) ECMOs total and all of them are in Stockholm. Yet Gothenburg still manages an 80%+ survival rate after ICU care. As I said, the differences in survival rate is probably attributable more to the medical decision about who to put in a ventilator then it is any particular proficiency or expertise in the medical and nursing community of that nation.

Because for all its other shortcomings, the main problem the US health care system faces right now is that the rest of the US society was not prepared and the US suffered a massive spike of Covid-19 patients. The health care system is left to cope with a ton of patients and not enough resources. And that's on top of the generally poor level of health of Americans (especially in terms of obesity, one of the major risk factors of Covid-19 complications) compared to Europeans or Chinese, which will likely make more US citizens die of Covid-19 then comparable populations.

At the same time though, I wouldn't want to compare much to Sweden, because Sweden is just letting their higher risk patients die. I would hope that would not be a model anyone would want to follow. Giving someone a death sentence by refusing to treat them is not exactly what anyone would consider an ideal model.
When we even manage to have 101 year old patient survive to return to her knitting, sometimes the risk assessment can be proven wrong, and those that have been denied care should not have their fates decided for them like that.

When you have higher risk populations, you should work harder to mitigate it via universal PPE distribution methods rather than denying care to those most at risk due to healthcare system being overwhelmed. I think how Germany has been doing a better job than most:
https://www.nytimes.com/2020/04/04/world/europe/germany-coronavirus-death-rate.html

ALSO:
“Number four, all things considered, the German health-care system and hospital system has been modernized by the Social Democrats and Christian Democrats over the last 20 years ... this meant we had more hospital beds, more ventilators, more ICU (Intensive Care Units) beds and more hospital doctors, roughly speaking, than any other comparable country in Europe ... So our system is in a reasonable shape for such an epidemic.”

Germany has a low coronavirus mortality rate: Here's why

Germany seems to be taking the epidemic in its stride with a high number of cases but a low number of deaths, thanks to a number of factors.

www.cnbc.com

"Germany is better equipped to treat seriously ill patients, with 28,000 intensive care beds, while in Italy there are only 5,000. In total, there are about 450,000 beds in all general hospitals in Germany. About 100,000 of these are currently empty. "

The mystery behind Germany's low coronavirus death rate

Experts see a number of possible reasons why Germany has fared better than Italy in the pandemic so far.

www.cbsnews.com

"A 50-year-old Chinese man who almost lost his life to Covid-19 was able to leave hospital on Friday after undergoing a complicated medical procedure known as extracorporeal membrane oxygenation. A 50-year-old man infected with the novel coronavirus was admitted to the intensive care unit at Tongji Hospital in Wuhan last month suffering with respiratory failure. Doctors put him on a ventilator, but his blood oxygen saturation remained dangerously low.

As the man was at a high risk of organ failure, the doctors opted to carry out a procedure known as extracorporeal membrane oxygenation (ECMO), which provides prolonged cardiac and respiratory support to people whose heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life.
After eight days, the machine was disconnected and the man was able to breathe on his own. Five days after that he was able to sit up in bed and feed himself. On Friday afternoon he was discharged from hospital.

The lack of availability of such life-saving techniques and equipment could be one of the reasons the death toll in Italy is so high. The country, which is now the epicentre of the pandemic, has had more than 4,032 fatalities from just over 47,021 confirmed infections – a mortality rate of about 8.5 per cent.

Coronavirus: intensive care techniques prove vital to saving lives

Chinese doctors use extracorporeal membrane oxygenation to rescue critically ill patient from verge of death.

www.scmp.com

To make it worse, because Germany did what they were supposed to do and stocked up early, they have other nations trying to take their supply:

Opinion | Germany Has More Than Enough Ventilators. It Should Share Them. (Published 2020)

Without health, all is nothing.

www.nytimes.com

 

[Agema]

This is why we are opening. Places do realize all this. People without broad information are looking up just the new case count and thinking "that's not going down, we shouldn't open up", not understanding that we're testing more, and hospitalizations are dropping as the first (and possibly only) wave picked out the most likely to need emergency care, and the new cases are increasingly among the healthy who just need to stay home for a week or two.

I might point out that the current peak of the US death rate (averaged out) was about 2200 / day. Three weeks after that date, it's still about 90% of peak and seemingly steady, where most other countries at a similar time point were/are about 60-70% peak and declining. A lot of this is due to the fact that the virus had very little spread to much of the USA at peak; the USA was always going to have a longer curve as it took time for the disease to cross the geographical space. Cases are thought to be rising in many states of the USA, offsetting the decline in many of those hit harder earlier.

The principal model the administration is using suggest covid-19 deaths are to increase to ~3000 a day by June. Let's note that early on the administration forecast 60,000 deaths. Towards the end of April, they forecast 74,000. Here we are just about ten days later since the 74,000 prediction, and that forecast has almost doubled, in large part I suspect because the death rate has not declined in the way it did in other countries. If states reopen prematurely, it will probably be even worse.

Even in New York, the hardest hit, the proportion of the population infected so far will be around 20% at most. It really will not have "picked out the most likely to need emergency care", and it's easily few enough for a devastating second wave if there is not sufficient monitoring and control measures.

 

[tstorm823]

I might point out that the current peak of the US death rate (averaged out) was about 2200 / day. Three weeks after that date, it's still about 90% of peak and seemingly steady, where most other countries at a similar time point were/are about 60-70% peak and declining. A lot of this is due to the fact that the virus had very little spread to much of the USA at peak; the USA was always going to have a longer curve as it took time for the disease to cross the geographical space. Cases are thought to be rising in many states of the USA, offsetting the decline in many of those hit harder earlier.

The principal model the administration is using suggest covid-19 deaths are to increase to ~3000 a day by June. Let's note that early on the administration forecast 60,000 deaths. Towards the end of April, they forecast 74,000. Here we are just about ten days later since the 74,000 prediction, and that forecast has almost doubled, in large part I suspect because the death rate has not declined in the way it did in other countries. If states reopen prematurely, it will probably be even worse.

Even in New York, the hardest hit, the proportion of the population infected so far will be around 20% at most. It really will not have "picked out the most likely to need emergency care", and it's easily few enough for a devastating second wave if there is not sufficient monitoring and control measures.

In New York specifically, it absolutely hit the vulnerable like a truck on the first wave, because the state panicked about running out of space and told the hospitals they had to send recovering covid patients back to nursing homes, and the patently obvious played out exactly as you'd suspect.

The numbers lately have gotten a tad questionable. Twice now my state has added in big spikes of deaths and said "oh, we had recorded things incorrectly in the past, here's an update", and on one occasion my county had negative 5 deaths recorded. They keep broadening what they are counting, and plopping the additions onto the end, and it screws up the trends. Even if the numbers they end up at are correct in total, it implies dumb things. If, for example, you had 5 days where the numbers go 3,2,3,2,1, it looks rather consistent. Then they go "oh, we missed 4", and correct the record to go 3,2,3,2,5, now it looks like flat to increasing. When the actual real numbers would have been 5,4,3,2,1. Like, multiple waves in different geographies over a slow spread is part of it, but even within small communities, the reporting is all sorts of screwed up.

And I'm afraid they're walking into a stupid trap. The US has like 7500 deaths a day by default. The majority of those happen in hospitals or nursing homes. Hospitals and nursing homes are all infected with coronavirus right now. Most places are counting everyone who dies with a positive test + any unknown with possible covid symptoms. That's never gonna stop. Meanwhile, we're testing more and more, the number of positives goes up proportionally, and some places are determining reopening based on a number without controlling for testing rate. The decision should be based off of healthcare availability. And I'm pretty confident history will look back at these current death counts as slightly exaggerated compared to the reporting methods of other nations.