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Corona / Covid-19 Virus - General Discussion (politics go to the Off Topic / Politics thread)

Cobalt wrote:

The good news is – there is clearly something going on that slows the spread earlier than one would expect.
death rates are decreasing in many cases, and seem to have nothing to do with lockdowns, which in any case will have a delay of several weeks before they show up in death statistics.

Observations so far show exponential growth (e.g. USA) – a straight line in that graph – while no lockdown is in effect. (Eventually, saturation would level it off, but so far that is happening only locally – e.g. Lombardy, not for the whole countries).

When a western-style lockdown comes into effect (as opposed to China-style full lockdown), the growth transitions to power-law (essentially a polynomial, would be straight line in a graph where both axis are log-scale).

This makes sense – exponential growth requires good mixing. With a lockdown, the social interaction graph gets pruned quite a bit, especially the long links – so the infection spreads more like a wave in a D-dimensional space – hence the power-law. There are some papers about this, I just can’t dig them out now.

Slovakia

Peter wrote:

This is a nice visualisation. Different axes, and time is presented via animation. A pity they don’t appear to have recent data

I’m a fan of those Minute Physics videos! I think you will agree that this one (which is nicely done as always), as they also point out in the video, it’s only about known infections, which I still think isn’t informative.

Cobalt wrote:

Let’s take one example – Lombardy. It has a population of 10 million people, 5,000 people have died of pneumonia while being diagnosed with Covid-19 in the last 30 days. In a normal month, one would expect around 10,000 people to die per month (around 0.1% of the population), so there are 50% more deaths than average, and while I have no idea how many of the 10,000 people who die have pneumonia, I am pretty certain that it isn’t half of them.

I’m probably too tired, I have to admit I am not following your example. You seem to assume that those 5000 are all in excess, and that another 10 000 died as well (the normal number).

kwlf wrote:

An interesting summary of what is happening to patients in intensive care.

Had a quick look, and it seems they present also historic mortality. It’s very refreshing to see that honesty. Will look more into it.

EHLE, Netherlands

The other reason we are trying to keep people out of hospital is because it’s currently a very dangerous place to be. Ordinarily we tend to be very risk averse but now we often judge that the risk of going home early is likely to be less than the risk of staying in.

I think the people building the new hospitals and throwing out patients to make new capacity have some very difficult calls to make. Much is uncertain and they are likely to be severely criticised whether they over or under prepare. It’s a hard call: people who serve the public should be accountable to the public, but they should also be given some latitude where error is inevitable. We need people to step up to these positions, and if the inevitable consequence of doing so is to face a manslaughter charge then you will find it hard to recruit.

Medicine is quite rarely about saving lives. Mostly we manage decline and palliate and tweak things to hopefully improve people’s quality of life here or there. In the next few weeks I think there is likely to be the potential to make a decisive difference for several thousands of active young and middle aged people. This is not an opportunity to be missed.

Last Edited by kwlf at 28 Mar 22:41

[Was going to post this, now it looks like a reply to kwlf. It was not the intention]

https://twitter.com/AT5/status/1243932173985632256

Hospitals in the Netherlands are trying to tell people that they should still go see a doctor if needed. Either fear, or just trying to help not overwhelming services, is leading to empty GP’s offices and Urgency services.

EHLE, Netherlands

The first day after the lockdown was disconcertingly quiet. On subsequent days I have seen fairly appropriate amounts of trauma. I share the concern that there are probably people who should be coming to A&E for medical reasons, who are not doing so.

I think part of the reason we are managing to empty hospitals though, is a willingness to be less cautious than previously. Hospitals are always full of elderly people who are waiting for everything to be done by the book. If we want to send people to a nursing or residential home the nurses have to fill out booklets which are literally dozens of pages long. There are interminable physiotherapy and occupational therapy and social services meetings and assessments. These days it’s happening much faster, or relatives are more willing to take people home with them even if they don’t tick all the boxes. I suspect many patients actually benefit from this more pragmatic approach.

Regardless of your viewpoint could I ask everyone who has an interest to read this article. I am not a fan of Peter Hitchens normally, but my God is he on the money. this is exactly what I and a few others have been trying to convey and say.

https://www.dailymail.co.uk/debate/article-8163587/PETER-HITCHENS-Great-Panic-foolish-freedom-broken-economy-crippled.html

Fly safe. I want this thing to land l...
EGPF Glasgow

I share some of the concerns, but would observe that the restrictions have been imposed in many countries and probably reluctantly, judging by the lateness and half-heartedness with which they were applied. If this were to be a coup against the people, it would have to be a near global one and I can’t bring myself to believe in a global conspiracy.

Some here have argued that there may be many unknown cases diluting the mortality to a much smaller figure than headlined. There will certainly be undiagnosed cases, but in China the feeling was that there were not a large proportion of them.

Within the UK there are fewer than 200k acute hospital beds. At present, estimates for the mortality for confirmed cases run between a fraction of a percent to nearly 10%. The caveat here is that in most places, even the worst hit, hospitals are still accepting cases.

Depending on what you read, 20% of all symptomatic cases may need hospital admission. This is skewed to the elderly, but might include 10% of people in their 50s and 5% of people in their 40s.

Within the UK I think it’s reasonable to assume that most people who have been admitted to ICU would not survive without it. A fair proportion of the people who require merely supportive care will not survive without it. Note that on the ICU document I linked, they do not state whether the patients had ‘comorbidities’, but whether they had ‘severe comorbidities’. 90% didn’t. The vast majority were living independent, active lives.

It may be that this pandemic will be less severe than expected. But it could still also be more severe than expected. It troubles me that I have not seen anyone addressing this fairly obvious question: ‘what happens if we let the hospitals become overwhelmed?’ I worry that this is because the answer is alarming.

What level of mortality might justify the current measures? 1%, 5%, 10%

Last Edited by kwlf at 29 Mar 00:22

@kwlf the whole issue here is about hospitals being overwhelmed. The ‘normal’ mortality does not justify the impact on the economy. But if hospitals are overwhelmed then mortality could increase. I suspect more people will die from the economic impact of this than the medical one.

Last Edited by JasonC at 29 Mar 00:16
EGTK Oxford

That may be true. I hope that we’ll get a handle on the unknowns fairly soon now that it is striking fairly open well resourced countries such as the UK or Italy. Other countries such as China may or may not be being open about their true figures.

After 2 of my 6 partners in surgery covering a 900 bed hospital became infected, one in quarantine and the other intubated in extremis 55 y/o
I decided to take my airplane up and just fly for the heck of it. Believe or not touch and goes are available at KDFW after 3.00 pm. Exhilarating landing in huge runways hard to realize the speed, doing 110 m/ hr when one would be doing 75, optics change with big runways. No traffic at all in my home airport flew 1 hour and no one around, tower people probably playing poker. We had a frontal passage this morning so the air was nice and clear. I am not sure that we will be able to fly privately soon. The airport manager sent today an email, anyone coming from New York, Louisiana, California , New Jersey have to report to a police officer in duty at the airport and quarantine all people deplaning.

KHQZ, United States
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