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The same basic info, but from - presumably - a more palatable source.

https://www.syracuse.com/coronavirus/2020/04/ny-projections-on-beds-ventilators-were-off-couldnt-model-love-spirit-cuomo-says.html

As you say, they planned for the worst that was projected, and it didn't come to pass, which is good.

I would say they got lucky, but they didn't - social distancing worked and prevented the worst, per the governor.

Planning for the worst is exactly the right thing to do, so well done NY.

The worst death rate per million of any country is Belgium with as of today 797 per million deaths or 0.0797%.

The highest detected infection rate in a country with substantial numbers is Spain with 6040 cases per million. Or 0.604%.

The Black Death where 1/3 of the population of Europe is wiped out this is not.

Be sensible, have social distancing, don’t go out if unwell with respiratory symptoms, wash your hands and secure those at high risk like the extreme elderly or people with multiple co-morbidities.

Belgium seems to allow docs to put CV 19 on death certs on s basis of if they feel like it, eg without lab confirmation.

I have seen some evidence that that might be the case here too but can't 100% guarantee accuracy.

 queen_annes_revenge wrote:
Belgium seems to allow docs to put CV 19 on death certs on s basis of if they feel like it, eg without lab confirmation.
.

So a professional with years of schooling and experience is allowed to use their professional judgement and save the existing tests for people who aren't dead/dying. Sounds like a good thing. Better than refusing to count someone as dead from Covid-19 unless they are specifically tested for it and making the test impossible to get. Sounds like a great way to cover up the number of fatalities from this pandemic.

Did I express an opinion on the matter either way?

If they do do that, it seems pertinent (to me at least) that the deaths should at least be confirmed at a later date , and totals be amended accordingly, or have a separate category for suspected not confirmed.

 queen_annes_revenge wrote:
Did I express an opinion on the matter either way?

If they do do that, it seems pertinent (to me at least) that the deaths should at least be confirmed at a later date , and totals be amended accordingly, or have a separate category for suspected not confirmed.

I do not recall you displaying nearly the same level of concern for deaths by covid that are not counted as such, of which there are a huge number. Certainly your response given the relative situations seems considerably lopsided, and I am curious as to why that is.

Tests should are in a limited supply and should be limited to those they can help. It's ridiculous to keep dead bodies around to wait for a test that won't help them at all.

Limiting death numbers to those that are 'proven' by tests only has the purpose of empowering bad faith actors that want to lie sbout how bad this disease is to fit their agenda.

Adding a different number for 'suspected' cases only empowers these bad faith actors that would intentionally ignore those numbers and make dishonest arguments.

I'm not sure why you're concluding that the tests on samples from a cadaver are the same as tests for living people. Have you fact checked this at all?

Those who want to manipulate statistics on a more extreme level for an agenda will do so no matter what you present to them. They will use every trick they can (and that's before media twists and spins on reporting) to miss represent.


I think the key is not to necessarily worry about them, but to ensure a fair and accurate production of the data.



If you allow doctors to pronounce a persons condition and cause of death as something without testing for the condition (which we have a test for). Then there is a risk, not just of miss representation of deathrate figures, but that other medical data associated with that patient, might be combined into data in assessing an analysing patterns regarding the disease. It might throw up oddities which might distract investigating researchers who then waste valuable time and resources chasing a red herring that could have been avoided.


The safest approach is to permit doctors to record the suspected cause or contributing factor toward death as being Corona, but to keep that data as a separate group from confirmed cases. That thus means that any research on that data can be conducted in a sensible manner. Abnormalities between the two data groups can then be better understood to potentially be the result of the lack of confirmation within one data group.



Sure someone might then pick the single confirmed number to report on instead of the confirmed and suspected; but they can do that anyway. Heck the UK government for a long while was only reported confirmed cases in hospitals and not including cases outside of hospitals (and deaths) even when they were confirmed with testing. This was done for quite a while, but now that data has been rolled into one.




Keep the source of data clear and don't combine groups that are not the same or which are not proven the same by the same testing processes and such. That at least keeps data clear for study by professionals even if media and government groups then spend time playing with the numbers.

Quite frankly, testing post-mortum is not a good use of lab or technician time. Not to mention, it delays the bodies being released to the families. We can just trust the skilled professionals.

Yes, errors will occur, but we're talking dozens or hundreds out of over 100k deaths already. This is not a statistically significant number. Especially since covid-related deaths are already under reported.

The state of Colorado in the US changed the law so that if anyone had a positive COVID19 diagnosis that was the cause of death.
Until a man was found positive at autopsy for COVID19 after being found dead in a park and declared a COVID19 death early last week.
[url] https://www.dailymail.co.uk/news/article-8324017/Colorado-health-officials-fire-saying-drunk-man-died-coronavirus.html[/ url]

However he also had a blood alcohol level of .55. That is 2 bottles of whiskey in an hour and then maintaining at least 2 drinks per hour to keep it there. The county coroner found he had died from alcohol poisoning, not the coronavirus.

The state had to change the way deaths are reported due to the legal ramifications so now you can die ‘with’ or ‘from’ COVID19, how it should have been from the start.
What if he had been in a car crash and injured someone? His insurance could claim he had coronavirus and coughed, causing the crash as that was the cause of death.

If a patient of mine gets influenza, then pneumonia, I list pneumonia as cause of death with influenza as an antecedent cause.
If a diabetic patient dies from heart attack, diabetes is an antecedent cause, not THE cause of death.

 Waaagh_Gonads wrote:
The state had to change the way deaths are reported due to the legal ramifications so now you can die ‘with’ or ‘from’ COVID19, how it should have been from the start.

Ageed.

Medical questions like these are never simple or cut and dried, that said, such issues aren't new or unique to this disease either, and data is always *far* messier than people think, and there's a reason that often deaths for a certain cause have "-related" attached to them. Same way nobody dies of AIDS directly, it doesn't kill in and of itself, it's the other diseases and conditions it opens the body to that actually does people in. It's also why research takes so long, cleaning data for stuff like that is extremely laborious. I have enough trouble at work just fixing part numbers in database tables

As a somewhat amusing/morbid side note, when people on death row are put to death, it's typically noted as a homicide by the medical examiner.

 skyth wrote:
Quite frankly, testing post-mortum is not a good use of lab or technician time.

It absolutely is. When you're trying to contain a worldwide epidemic, knowing how has it (or had it) and who they come in contact with is very, very helpful.

Knowing whether a household and workplace is potentially exposed to the virus or not is extremely important.

Opting to know less information is never helpful. Knowing more can save lives.

When there is a finite amount of labor and resources sometimes tough calls need to be made on where to allocate them.

There are a number of steps people are using between simple high-flow oxygen and full invasive ventilation, which are successful in many patients. Non-invasive ventilation is really benefiting a lot of patients. Ventilation is also successful for some patients- (in the UK) they are only intubating those patients who are failing to maintain oxygenation on non-invasive ventilation who are going to die anyway, so any of those that survive, survive because of the ventilator.

 Kilkrazy wrote:
London hospitals never got overwhelmed because of several reasons.

For one thing, they set up lots of extra ICU wards in operating theatres and so on.

Another rather creepy factor is the number of people who died in care homes without ever seeing a hospital. It's something ike 5,000.

If a lot of them had been admitted, the NHS might have found something useful to do with the Nightingale Hospital at the Excel.

ITU beds have long been heavily rationed in the UK (and I reckon this is probably true in most countries), that isn't new with the pandemic, it is just even more stringent. Elderly people do really poorly on ITU- once an elderly patient gets onto multi-organ support, it is usually impossible to wean them off, and the ITU bed is really just prolonging the suffering of someone who has reached the end of their life.

So anaesthetists are reluctant to accept all but the fittest of elderly patients for good reason. It is much kinder, and just as effective, to keep elderly patients with end-stage organ failure comfortable. I wouldn't have wanted my grandmother to go onto ITU when she passed away last September- she would have required dialysis to treat her organ damage and that would have been a lot more awful for everyone involved.

So in all honestly, the majority of those 5000 people would likely have died just the same in hospital too- nursing homes and many other care homes have access to oxygen, which is the primary treatment for COVID pneumonia. Unlike bacterial pneumonias, COVID does not typically cause shock and intravenous treatments are not very helpful as a result.

 queen_annes_revenge wrote:
Belgium seems to allow docs to put CV 19 on death certs on s basis of if they feel like it, eg without lab confirmation.

I have seen some evidence that that might be the case here too but can't 100% guarantee accuracy.

It is 100% true, I've discussed this with one of the medical examiners at my hospital. Deaths can be listed as COVID pneumonia for confirmed cases, but as probable COVID pneumonia for unconfirmed cases. The virus actually has a lot of pathognemonic signs on investigations and a characteristic progression in severe cases that make it pretty recognisable. Good examples are the types of xray or CT thorax findings, or the way the pneumonia causes a profound hypoxia without shock. The PCR tests have a fairly high false negative rate, so we are using other signs quite a lot in many patients to guide treatment.

Having said this, I have no idea how the powers that be are using that data when collating statistics, but the data is being collected at least. I doubt the government is using figures with both groups in at present, but who knows?


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There was some discussion awhile ago that I cannot be bothered to dredge up about if/how shift patterns have changed in order to potentially eliminate the weekend effect. This being in relatin to the way COVID statistics are published and there being a spike after the weekend.

I can assure everyone that in England this is the case for sure, and I believe in other regions of the NHS as well (the training organisations differ so the specifics will be different elsewhere). The shift pattern for all junior doctors below registrar has followed an emergency rota completly divorced from the usual week structure and I've frankly lost track of weekends as a result. In my deanery, juniors are on 3 day shifts, followed by 3 days off, followed by 3 night shifts, followed by 3 days off, followed by 3 day shifts- the whole cycle rinsing and repeating. All shifts are 12.5 hours long.

Having half my shifts as nights is totally abnormal, and that aspect of the rota is pretty punishing. Having said that, the rota is actually better than my routine one- I only work 43 hours a week average, rather than 48, and the long shifts mean I am commuting a lot less.

This isn't universal around England, I have a friend who has some blocks of 4 days.

Registrars are on some mad rota at my trust, they have blocks of 4 shifts and blocks of 3.

Consultants have adjusted workloads too- all the medical consultants have been given night shifts to cover the acute medical take- there are not usually consultants overnight for this. There are a lot of medical consultants though, so they get something like 1 night shift in 2 months...

There have also been massive redeployments of doctors to new roles- most of the surgical juniors have been rolled into the medical team to fill the rota. Basically all elective surgery aside from cancer surgery has stopped, and acute surgical admissions are way down on usual.

In short, part of the reason the capacity in the NHS was never filled at the current peak is because huge amounts of reorganisation were carried out behind the scenes to accommodate a big increase in medical patients.

Amazing. its insightful to have information from ground zero as it were. whats the feeling there? are things improving? staying level? worsening?


Automatically Appended Next Post:
https://www.youtube.com/watch?v=DdIIwNyB1AA

Vaccine developments. the video is a doc who analyses news and study updates etc.

seems most vaccines being trialled at the moment arent stopping infection, but are seemingly preventing the virus attacking the lungs as much.

It looks like there's a chance that a vaccine could go the same way as SARS and MERS vaccines, ie the disease burns out before work is finished..

https://news.sky.com/story/coronavirus-disappearing-so-fast-oxford-vaccine-has-only-50-chance-of-working-11993739

That depends though. Wasn't it expected that the summer would cause a drop in new cases, alongside the the UK has been in lockdown which should increase the reduction in overall cases. Any reaction to the steady relaxing of lockdown is likely to take a few weeks to be felt.

Meanwhile there's still high potential that there will be many pockets of the virus around well into the autumn and winter months, thus providing ample regions for it to survive and then rise up once more.


Of course with several strains already out there its possible that an early vaccine might not be targeted toward the variation that rises up in the winter months. Though in theory if we've got one vaccine then development of a modified version for a new strain should potentially be easier/faster



Also if the newspaper is reporting weekend numbers those are generally always lower than the weekly averages by quite a bit; we typically get an early/mid week spike as the data from the weekend filters through the system.

Well, seems like this are not going to be nearly as bad as projected. Hopefully there's a plan for people to get back to working safely.

That stipend's coming out of your taxes next year, kiddos. Don't get too reliant on that.

I guess all we can do is suck it and see. If you look at what prof Karol sikora is saying, he believes it will basically just burn itself out. It might not be as easy as sars 1 and mers but hopefully he's right.

There will be a lot of ass covering to do in hindsight if that is the case though.

Still not seeing the 've day spike' yet either. Give it a week before I'd say anything for definite but it looks like it may have been unfounded.

If it burns itself out then that's utterly fantastic news, I get the feeling it might not and that a vaccine and a winter resurgence are still on the cards.

That said if things turn out only for the best then at the very least this has been a very harsh and rough awakening for the world on the state of how well prepared for epidemics and how fast they can spread. The kind of thing that serves as a powerful lesson to multiple world governments.

Yup. I was surprised to find out that our pandemic plans were based on influenza. I know we've had swine and bird flu recently, but you'd think with sars and mers that they would've at least had those in mind.

On the covid front there's a new movement to refuse to wear masks based on belief of divine protection, people are claiming a right to not wear masks based on their faith.

Also, according to some polls 40% of americans believe that a covid vaccine would be a plot by bill gates to insert microchips into people.

As to the first, people not practicing spread control of covid affects others, so no, it's not a right to refuse to practice viral spread control.

As to the second, hey, fine. If there's a vaccine that protects people i believe people should be able to choose not to get it. Not getting the covid vaccination only puts them in danger, not people who choose to get it.

They’re lucky that stupidity in itself isn’t deadly.

 Matt Swain wrote:
Not getting the covid vaccination only puts them in danger, not people who choose to get it.

That's not quite true. Not taking the vaccine would render a person likely to catch and be a carrier for at least a week (this assumes taking the vaccine means that you cannot become a carrier). As a result any refusing to take it in large enough numbers could represent a threat to population groups who are not receiving the vaccine first in line. Even if we have a vaccine it will not roll out in one day, it will likely take months to filter through the population. So that places people at risk. It also places those abroad at risk if those who refuse to take it then travel to other countries.


Of course there are justifiable reasons not to want to take the vaccine. If its very new and very rushed out, those in "healthy" or low risk groups, esp the young, might want to refuse on the grounds of wanting to wait longer to see if there are potential longer term side effects. This, of course, is a gamble because Corona itself has potential long term effects, even for the young (such as lung damage).

So its not quite clear cut, but yes I'd say if your concern is that Bill Gates is going to start tracking you then, well, honestly I hope those people don't own a mobile phone or tablet because those already track you so that you can get google maps to the nearest restaurant.

 Adeptus Doritos wrote:
Well, seems like this are not going to be nearly as bad as projected. Hopefully there's a plan for people to get back to working safely.

That stipend's coming out of your taxes next year, kiddos. Don't get too reliant on that.

By that do you mean the 'Stimulus Checks' that the US Government handed out to many families?

If so, that's reportedly not the case.

If you're talking about something else...?

https://www.oneblood.org/lp/oneblood-covid-19.stml

Here's a great opportunity to help out, and find out if you've had it- oneblood, a blood collection company in the US, will test your blood for Covid 19 antibodies if you donate.

 Matt Swain wrote:
On the covid front there's a new movement to refuse to wear masks based on belief of divine protection, people are claiming a right to not wear masks based on their faith.

Also, according to some polls 40% of americans believe that a covid vaccine would be a plot by bill gates to insert microchips into people.

As to the first, people not practicing spread control of covid affects others, so no, it's not a right to refuse to practice viral spread control.

As to the second, hey, fine. If there's a vaccine that protects people i believe people should be able to choose not to get it. Not getting the covid vaccination only puts them in danger, not people who choose to get it.

No. Declining a vaccine isn't acceptable. It _does_ put other people at risk. We've been seeing hundreds of cases of measles where there were effectively none exactly because of that kind of idiocy. Deaths from measles shrank from nearly a million a year down to tens or hundreds per year over the course of the 20th century, now its back up over 100,000. That isn't acceptable, and its entirely due to people refusing to have it done.

There are people who can't take a vaccine because of allergies or extensive health problems, voluntarily passing puts those people at risk, as well as children too young to be vaccinated.