Corona Virus, general conversation
- Thread starter bob91yj
- Start date
Herbie
Adventurist
Depends on what you're trying to take from the graph with respect to policy decisions.
1) Both axes are unlabeled, so the "X" on the graph could be anywhere in time. Anyone who says "this week" is peak infection is speaking without data. The true identification of peak infection will only happen retroactively - once we have enough data we will be able to say "things peaked on week x".
2) The next thing to consider is area under the curve. The total number of cases for each lump is impossible to calculate from an unlabeled graph. It's entirely possible the number of cases is larger for the red curve, the blue curve, or that they're equal. If you care about how many people get sick, you'd want to pick the curve with the smallest total area - (this presumes you have enough data to accurately predict the shape of both curves)
3) The most important part of the graph is the area above the "Capacity" line. The reason this matters is that with this infection (as with most respiratory infections), the fatality rate for the disease is radically different whether you have "hospital support" or not. (i.e. if you have access to a ventilator or pressurized oxygen, IV fluids, etc. etc.) With the blue curve, the idea is that everyone (or at least almost everyone) who gets infected has hospital support. With the red curve, everyone above the line gets the disease but doesn't have access to a hospital bed - those are the people who are told "Sorry, we can't take you, try the other hospital in town", and many die drowning in their own fluids waiting for a bed (or at least a free ventilator.) This was the hard lesson from the 2002-2004 SARS outbreak.
If you care about the number of people who die from the disease, you want to stay out of the area above the line.
4) This graph was meant to illustrate a concept, it does not reflect real infection rates (hence, it's unlabeled), as such, it artificially places the end of the red curve underneath the peak of the blue curve. In other words, there's no rule that those two points have to line up, and in fact they probably would not line up. Depending on how thoroughly people implement "with protective measures", the blue curve could be VERY long and flat - barely making a hump, but lasting for years and years, or it could be much closer in shape to the red curve, compacted and with a big peak, but hopefully without peaking over the "Capacity" line.
1) Both axes are unlabeled, so the "X" on the graph could be anywhere in time. Anyone who says "this week" is peak infection is speaking without data. The true identification of peak infection will only happen retroactively - once we have enough data we will be able to say "things peaked on week x".
2) The next thing to consider is area under the curve. The total number of cases for each lump is impossible to calculate from an unlabeled graph. It's entirely possible the number of cases is larger for the red curve, the blue curve, or that they're equal. If you care about how many people get sick, you'd want to pick the curve with the smallest total area - (this presumes you have enough data to accurately predict the shape of both curves)
3) The most important part of the graph is the area above the "Capacity" line. The reason this matters is that with this infection (as with most respiratory infections), the fatality rate for the disease is radically different whether you have "hospital support" or not. (i.e. if you have access to a ventilator or pressurized oxygen, IV fluids, etc. etc.) With the blue curve, the idea is that everyone (or at least almost everyone) who gets infected has hospital support. With the red curve, everyone above the line gets the disease but doesn't have access to a hospital bed - those are the people who are told "Sorry, we can't take you, try the other hospital in town", and many die drowning in their own fluids waiting for a bed (or at least a free ventilator.) This was the hard lesson from the 2002-2004 SARS outbreak.
If you care about the number of people who die from the disease, you want to stay out of the area above the line.
4) This graph was meant to illustrate a concept, it does not reflect real infection rates (hence, it's unlabeled), as such, it artificially places the end of the red curve underneath the peak of the blue curve. In other words, there's no rule that those two points have to line up, and in fact they probably would not line up. Depending on how thoroughly people implement "with protective measures", the blue curve could be VERY long and flat - barely making a hump, but lasting for years and years, or it could be much closer in shape to the red curve, compacted and with a big peak, but hopefully without peaking over the "Capacity" line.
BushHead
Adventurist
"Flattening the Curve" is all about slowing down the spread of the virus in order to prevent the overburdening of healthcare resources. So it is theoretically possible for it to be over already if everyone in the country got sick at once. That would have been bad, real bad. One of mu favorite analogies is the workplace bathroom. If everyone at work tries to use the bathroom at the same time... it would be a poop nightmare, even the septic would probably fail. But spread that same amount of people out over the course of the day, not such a big deal. But as long as health care is not under threat of being overwhelmed, social distancing has no real value, it only slows the spread, it still assumes everyone will eventually get the virus, maybe even more.
https://www.livescience.com/coronavirus-flatten-the-curve.html
https://www.livescience.com/coronavirus-flatten-the-curve.html
Kevin LaCroix
Adventurist
The spread of this is not over. there will be more upticks as people start to go about "normal" life. 6 months ago noone had any immunity to this virus. Reiterating what others have stated, the stay at home and personal distancing orders were just about not overwhelming the system. There are a lot of unknowns about this virus. I saw an article referencing a report out of China that different mutations may present different viral loads. I will link the article if anyone wants to read it.
This
jscusmcvet
Adventurist
One issue at hand is that instead of healthcare being overwhelmed, it is being destroyed by being empty. Since most states have forbidden "nonessential" surgeries and services (which is the life blood of most inpatient hospitals... which is most hospitals), those hospitals are sitting half empty, laying off or furloughing staff and running off cash reserves in order to treat the truly sick (those in need of care urgently - "time sensitive" is the key phrase these days). This includes COVID patients, who when they require hospitalization, require a whole lot of care. Something has to change or this will likely destroy health care in at least rural areas of the country... some of who have never seen an active case of COVID.
jscusmcvet
Adventurist
And yes... the field is ready and we can make more field as needed
BushHead
Adventurist
Yea, friend of mine had heart surgery right at the beginning of this mess, decided after surgery wellness checks were to risky, so the other day after starting to feel bad, stood up, wound split back open, puss falling out, now in ICU with open wound flushing, will be lucky to survive. It's enough to piss a person off.
Bryanseye
Adventurist
Hospitals in this area have been furloughing nurses because they have nothing for them to do. Seems completely counter to the headlines, but artificially limiting services in case of a wave of demand that never materialized has created this. Not saying that the later is preferred, I think a lot of the distancing and awareness stiffled the severity of the spread, but it is time to start cautiously pulling back restrictions where able.
Chris St. Clair
Adventurist
Reading some of the posts above made me think of a video I just watched concerning the "reopening" in the United States. The Dr. in the video made a comment about how so far it seems the U.S. has been reactive without data and also too late. Will make decisions about reopening in the same way? Will leaders simply react to their citizen's emotions without any data?
He provides some good goals that we might seek to achieve and also how it should be different for various regions around our country.
https://theincidentaleconomist.com/...BscFfGFX9TckRTMoOrXJMEvurchv4YPIM007I9aQpWZ0Y
He provides some good goals that we might seek to achieve and also how it should be different for various regions around our country.
https://theincidentaleconomist.com/...BscFfGFX9TckRTMoOrXJMEvurchv4YPIM007I9aQpWZ0Y
I think it’s a combination of limiting treatment of other issues to prepare for the surge and people being afraid to go to the hospital for non-emergency anything. People also seem to have also reconsidered what constitutes an emergency as our ERs Arent filled with people who maybe be sick but clearly not in an emergency need. CA Governor announced yesterday they will be opening up elective surgery again so that should start to fill the hospitals again.
Our county administration just yesterday was talking about possibly reopening passive recreation such as parks, lakes, rivers, etc. as well as golf courses with social distancing in place. By the end of the day, the elected county supervisors all announced the reopening. It was an interesting turn of events that makes me wonder what really happened. It certainly felt like once the door was cracked, the electeds rushed out and there was nothing Public Health staff could do about it.
Kevin LaCroix
Adventurist
Elected officials tend towards what they thing will get them re-elected.
smlobx
Adventurist
...and that’s the way it should be...going outdoors with proper separation is easy to do, costs nothing and is healthy.
DoD MEDIA UPDATE 30APR20
U.S. Northern Command continues to support mission assignments across the United States, including embedded medical providers at 22 hospitals.
o The USNS Comfort is departing New York City today.
National Guard
o 45,000+ National Guardsmen are supporting COVID-19 response at the direction of their governors. State priorities remain focused on testing and screening, as well as providing logistical support through warehousing and distribution of medical supplies and food.
More than 1,800 Massachusetts National Guardsmen and women are activated for a variety of missions, to include delivering
personal protective equipment to first responders, food bank operations, drive-thru testing and mobile testing teams, and medical staff assisting at public hospitals.
Oklahoma National Guard members are assisting at two food banks that have seen a 60 percent increase in demand for food assistance while having to decrease volunteers due to essential-staff-only restrictions.
The New Hampshire National Guard continues to support around-the-clock warehousing, creating a steady stream of Personal Protective Equipment to first responders and healthcare professionals across the state. To date, they've delivered 1,700 orders, an estimated 100 tons of freight.
The Rhode Island National Guard delivered more than 800 sampling kits to five locations across the state, and collected over 300 samples for transport.
The West Virginia National Guard is helping the state plan for a safer reopening by providing training to more than 700 retailers and long-term care facilities on proper decontamination techniques.
The North Carolina National Guard has conducted more than 25 delivery missions of Personal Protective Equipment to 80 counties across the state, logging nearly 49,000 miles to ensure medical facilities and other locations have the essential items they need.
Washington National Guard members continue food bank support, providing more than 800,000 meals, approximately 6.4 million pounds of food, and testing more than 1,300 people at testing sites throughout the state.
U.S. Army Corps of Engineers
o USACE is executing 51 FEMA Mission Assignments totaling $1.8 billion, with 15,000 personnel engaged and 1,495 deployed in support of COVID-19 response operations. USACE has assessed 1,130 sites for possible use as Alternate Care Facilities (ACFs). To date, USACE has awarded 34 ACF construction contracts to add 14,779 beds to states with critical bed shortages – 22 of these 34 ACFs are now complete.
o USACE is delivering two non-COVID Alternate Care Facilities to the Navajo Nation. Construction of a 50-bed ACF is ongoing at the Chinle Community Center in Chinle, AZ (ECD: May 1). The second ACF at the Atsa Biyaazh School in Shiprock, NM will provide 40 beds and is expected to be turned-over today.
U.S. Northern Command continues to support mission assignments across the United States, including embedded medical providers at 22 hospitals.
o The USNS Comfort is departing New York City today.
National Guard
o 45,000+ National Guardsmen are supporting COVID-19 response at the direction of their governors. State priorities remain focused on testing and screening, as well as providing logistical support through warehousing and distribution of medical supplies and food.
More than 1,800 Massachusetts National Guardsmen and women are activated for a variety of missions, to include delivering
personal protective equipment to first responders, food bank operations, drive-thru testing and mobile testing teams, and medical staff assisting at public hospitals.
Oklahoma National Guard members are assisting at two food banks that have seen a 60 percent increase in demand for food assistance while having to decrease volunteers due to essential-staff-only restrictions.
The New Hampshire National Guard continues to support around-the-clock warehousing, creating a steady stream of Personal Protective Equipment to first responders and healthcare professionals across the state. To date, they've delivered 1,700 orders, an estimated 100 tons of freight.
The Rhode Island National Guard delivered more than 800 sampling kits to five locations across the state, and collected over 300 samples for transport.
The West Virginia National Guard is helping the state plan for a safer reopening by providing training to more than 700 retailers and long-term care facilities on proper decontamination techniques.
The North Carolina National Guard has conducted more than 25 delivery missions of Personal Protective Equipment to 80 counties across the state, logging nearly 49,000 miles to ensure medical facilities and other locations have the essential items they need.
Washington National Guard members continue food bank support, providing more than 800,000 meals, approximately 6.4 million pounds of food, and testing more than 1,300 people at testing sites throughout the state.
U.S. Army Corps of Engineers
o USACE is executing 51 FEMA Mission Assignments totaling $1.8 billion, with 15,000 personnel engaged and 1,495 deployed in support of COVID-19 response operations. USACE has assessed 1,130 sites for possible use as Alternate Care Facilities (ACFs). To date, USACE has awarded 34 ACF construction contracts to add 14,779 beds to states with critical bed shortages – 22 of these 34 ACFs are now complete.
o USACE is delivering two non-COVID Alternate Care Facilities to the Navajo Nation. Construction of a 50-bed ACF is ongoing at the Chinle Community Center in Chinle, AZ (ECD: May 1). The second ACF at the Atsa Biyaazh School in Shiprock, NM will provide 40 beds and is expected to be turned-over today.
jscusmcvet
Adventurist
Some good news:
A week from today, all hospitals in our system will restart doing nonemergency surgeries. This is good news of course for patients who need surgery for their health and or pain. It is also good news for the hospitals (here and elsewhere) that have been financially devastated by the state restriction against treating nonemergency conditions through surgery. At this point, our system and most others in the country are operating at between 30 and 40% capacity, so this will be a big step in the right direction for hospitals and most importantly for the patients who need these services.
Also our medical fitness centers will restart cardiac rehab operations for patients starting a week from today. Smaller groups than normal, but by spacing them out throughout the day we will be able to serve any patient who will come in.
Some bad news:
North Carolina has a process to challenge a business status as nonessential. With the support of our professional association, who worked with the CDC to get the statement correct, I applied for our fitness centers to be considered essential... but for only physician referred patients and those who are in a directly supervised program. This request for "essential status" was denied.
So, here in NC the following types of stores are considered essential:
Car Washes
Vape Shops
ABC stores (to buy hard liquor... just happens to be run by the state and is a revenue source for the state)
Cigar shops
Book stores
Craft stores
BUT... actually taking care of your own health through methods proven to prevent and treat 80% of chronic illness and injury... not essential. Good grief.
A week from today, all hospitals in our system will restart doing nonemergency surgeries. This is good news of course for patients who need surgery for their health and or pain. It is also good news for the hospitals (here and elsewhere) that have been financially devastated by the state restriction against treating nonemergency conditions through surgery. At this point, our system and most others in the country are operating at between 30 and 40% capacity, so this will be a big step in the right direction for hospitals and most importantly for the patients who need these services.
Also our medical fitness centers will restart cardiac rehab operations for patients starting a week from today. Smaller groups than normal, but by spacing them out throughout the day we will be able to serve any patient who will come in.
Some bad news:
North Carolina has a process to challenge a business status as nonessential. With the support of our professional association, who worked with the CDC to get the statement correct, I applied for our fitness centers to be considered essential... but for only physician referred patients and those who are in a directly supervised program. This request for "essential status" was denied.
So, here in NC the following types of stores are considered essential:
Car Washes
Vape Shops
ABC stores (to buy hard liquor... just happens to be run by the state and is a revenue source for the state)
Cigar shops
Book stores
Craft stores
BUT... actually taking care of your own health through methods proven to prevent and treat 80% of chronic illness and injury... not essential. Good grief.
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