[Trinidad]

The institute that coordinates the intensive care units in the Netherlands, publishes data on a daily basis. One of the graphs that interests me shows the cumulative amounts of patients that have left the intensive care. There are three categories:

• Deceased
  
• Left IC alive, went to regular hospital care
  
• Left hospital alive

Today for the first time, the total number of IC patients who left the hospital alive outranked the total number of IC patients that didn't make it.

You have to keep in mind that the patients who die on the IC, do so relatively early, after about two weeks. IC patients that can leave the hospital alive, do so after a few weeks in the IC and a few weeks in the hospital. The curve for the cured is lagging behind by a few weeks.

Rik

[akwoo]

 cherdano, on 2020-May-05, 02:58, said:

I am afraid this belongs in the other thread, too, but I will post it here. Let me get out of my normal cynical/slightly trollish mode here

There are huge discrepancies in how countries handled the early outbreak. That's worth a separate post, but here I will just say that while some did much better than others (in my view), and some of them deserve heavy criticism that isn't just based on hindsight, just a little bit of contemporary common sense---still, it was a completely new situation, where completely unprecedented measures needed to be deployed at a speed beyond anything that ever happens in democratic politics. (When we heard of the strict quarantine in Wuhan, I think most of us thought "Obviously that could never be done here!")

Now, all countries I follow seem to behave much more reasonably. The goal right now is to get down the number of infections as low as possible first. Then once they are at a manageable level, you hope that you can employ effective test-trace-isolate, keeping R at or below one with measures that are still drastic at the individual level (Stay home until I am tested just because I spent 2 hours next to an infected person?? Again?!?? Unthinkable 3 months ago!!!) but allow much more of the society (or "economy", if you prefer to think in monetary terms) to function almost normally. I am not sure we can all become South Korea or Hongkong (I wouldn't be shocked if someone discovered that many more people there have background immunity against SARS-Cov-2 from previous coronavirus infections.), but it's infinitely better than the alternative.

Well, all countries with one big exception, the US. The goal of US policy is ... ??? Letting most people get infected, hoping that the lower estimates of the lethality rate is right, and that only 328 million * 70% * 0.4% = 0.9 million people die? Or to keep the pandemic alive well enough so that 50,000/month die until there is a vaccine? All the while ensuring long-term damage to the economy, because most will still be afraid to go to the hairdresser/theater/restaurant/...???

It seems insane, and a policy disaster at a scale unlike anything we have seen since WW2.

Trump has blasted a ridiculous slam because he was down by 10 IMPs on the last board, and now he is trying to drop one K singleton with his LHO and then play for the triple squeeze with RHO having QJT9 in one suit, KJT in a second, and A in the last because it's the only way to make it.

All Trump cares about is getting re-elected. If the epidemiologists are right, he won't get re-elected no matter what he does. If they are wrong and he opens up the country, then he has a chance. He figures it's about 50/50 (because he has no understanding of probability, so all gambles are 50/50) so why not?

[akwoo]

A distinct second point.

Every couple of years, somewhere in the US, someone who happens to be carrying a gun sees a burglar breaking a window to get into a house and shoots the burglar dead. Then everyone treats the shooter as a hero. I think in most of the rest of the developed world, besides the fact that many fewer people are carrying guns, most people would think that killing someone to prevent a TV or some jewelry from being stolen is insane. (In part, that's why fewer people are carrying guns.)

I think folks in the US generally just value human life, especially lives of people unconnected to themselves, much less than in most of Western Europe.

 cherdano, on 2020-May-05, 02:58, said:

I am afraid this belongs in the other thread, too, but I will post it here. Let me get out of my normal cynical/slightly trollish mode here

There are huge discrepancies in how countries handled the early outbreak. That's worth a separate post, but here I will just say that while some did much better than others (in my view), and some of them deserve heavy criticism that isn't just based on hindsight, just a little bit of contemporary common sense---still, it was a completely new situation, where completely unprecedented measures needed to be deployed at a speed beyond anything that ever happens in democratic politics. (When we heard of the strict quarantine in Wuhan, I think most of us thought "Obviously that could never be done here!")

Now, all countries I follow seem to behave much more reasonably. The goal right now is to get down the number of infections as low as possible first. Then once they are at a manageable level, you hope that you can employ effective test-trace-isolate, keeping R at or below one with measures that are still drastic at the individual level (Stay home until I am tested just because I spent 2 hours next to an infected person?? Again?!?? Unthinkable 3 months ago!!!) but allow much more of the society (or "economy", if you prefer to think in monetary terms) to function almost normally. I am not sure we can all become South Korea or Hongkong (I wouldn't be shocked if someone discovered that many more people there have background immunity against SARS-Cov-2 from previous coronavirus infections.), but it's infinitely better than the alternative.

Well, all countries with one big exception, the US. The goal of US policy is ... ??? Letting most people get infected, hoping that the lower estimates of the lethality rate is right, and that only 328 million * 70% * 0.4% = 0.9 million people die? Or to keep the pandemic alive well enough so that 50,000/month die until there is a vaccine? All the while ensuring long-term damage to the economy, because most will still be afraid to go to the hairdresser/theater/restaurant/...???

It seems insane, and a policy disaster at a scale unlike anything we have seen since WW2.

[johnu]

 akwoo, on 2020-May-06, 19:30, said:

Trump has blasted a ridiculous slam because he was down by 10 IMPs on the last board, and now he is trying to drop one K singleton with his LHO and then play for the triple squeeze with RHO having QJT9 in one suit, KJT in a second, and A in the last because it's the only way to make it.

All Trump cares about is getting re-elected. If the epidemiologists are right, he won't get re-elected no matter what he does. If they are wrong and he opens up the country, then he has a chance. He figures it's about 50/50 (because he has no understanding of probability, so all gambles are 50/50) so why not?

Ironically, the Grifter in Chief's core base is older, working class (white) voters who are at high risk for dying or having serious cases of COVID-19. Killing off 10's of thousands of his core supporters will greatly reduce his chances of winning in close swing state races.

[Cyberyeti]

 johnu, on 2020-May-06, 19:45, said:

Ironically, the Grifter in Chief's core base is older, working class (white) voters who are at high risk for dying or having serious cases of COVID-19. Killing off 10's of thousands of his core supporters will greatly reduce his chances of winning in close swing state races.

I don't know if it's the same in the US as the UK, but here BAME people are 4 times as likely to die of it as white people, and they in the main wouldn't be voting Trump.

Edit: - it appears 4x is the unadjusted figures, but still with all the adjustments, 2x

[barmar]

 johnu, on 2020-May-06, 19:45, said:

Ironically, the Grifter in Chief's core base is older, working class (white) voters who are at high risk for dying or having serious cases of COVID-19. Killing off 10's of thousands of his core supporters will greatly reduce his chances of winning in close swing state races.

We've known since he was elected that his base doesn't think things through rationally like this. They go with their gut, and they like what he's saying.

[y66]

Martin Wolfe at FT:

Quote

The UK government is planning how, and how quickly, to end the lockdown. This necessitates a complex and interlocking set of decisions taken under huge uncertainty. In making them, the government must realise it has a poor record of managing Covid-19 so far. It has to do much better.

The UK’s recorded rate of death per million, almost certainly an underestimate, is the fourth highest among its peers, with only Italy (just), Spain and Belgium ahead. That is so even though these countries suffered the pandemic’s onslaught before the UK. This should have given Britain time to recognise the dangers and respond effectively. Am I surprised by the failure? Not really.

A large number of people believe that, in order to protect the economy, the sensible thing to do was — and still is — to impose few or no restrictions on individual behaviour, other than to tell the most vulnerable to stay at home. Yet countries that refused to impose tight controls such as Sweden and the Netherlands are not now forecast to do better economically. They have had far more deaths than peers such as Austria, Denmark, Finland, Germany or Norway. Yet their growth prospects, at least for now, are not expected to be any better. The assumed trade-off between suppression of the virus and the health of the economy, in the medium term, is illusory.

The Bank of England’s latest forecast of a 14 per cent contraction of gross domestic product this year followed by a 15 per cent expansion in 2021 assumes that “social distancing measures and government support schemes” remain “as they are until early June, before being gradually unwound” by the end of the third quarter. It also assumes very little “scarring” of the economy from the output collapse now under way. Alas, these assumptions look optimistic. Another big spike in infections would certainly make its forecast recovery seem inconceivable. But avoiding such a spike must also mean that distancing measures of some kind will continue far beyond September 30.

Getting people back to work, an excellent study from the Institute for Fiscal Studies, brings out the many obstacles to any such early return to normality. First, uncertainty will not disappear. Second, the impact of the virus on supply and demand for goods and services will be highly heterogeneous. On the supply side, work that demands face-to-face contact or co-operation will continue to be more affected than work that can be done at a distance. The same will be true of the pattern of demand. Third, the impact on the labour supply and on would-be purchasers is also going to be heterogeneous, with the young able to operate much as before and the older and those with health conditions far less so. Fourth, even this ignores the complex impact from the world economy.

An obvious implication is that the structure of supply, demand and available work will alter radically throughout the epidemic. This makes the BoE’s assumption of a smooth economic rebound more implausible. It will also complicate the withdrawal or modification of government support programmes. A further implication is that the effects on different groups will remain unequal. Yet another is that government and business will have to find ways to reassure workers and customers.

The close links among different groups of workers will be particularly hard to manage. Getting parents back to work demands the reopening of schools. That means enticing teachers back to work, too. Getting the young back to work requires the presence of older supervisors and managers. Should non-key-workers go out freely if that puts their partners at risk? The report clarifies these complexities — and many more.

The UK is only at the end of the beginning. It was not a good start either. It seems foolish to imagine the country will swiftly return to life as it was before Covid-19. Things will remain different.

Our least bad future seems to be one in which the disease is suppressed until a vaccine arrives. In the meantime, testing, tracking and quarantine will be required, and government, business and worker representatives will need to make plans that allow as much of the economy as possible to reopen, while protecting the health and livelihoods of the physically and economically vulnerable. It is one of the most complex tasks government has ever attempted. No doubt, there will be surprises. But this time, it really must be thought through.

[Cyberyeti]

y66 That article misses a massive point, comparing Italy with England is very misleading. The populations are approximately equal, but Italy has more than twice the land area, and the capital city is less than half the size. You with all other things equal would expect a lot more deaths in England

[Winstonm]

 Cyberyeti, on 2020-May-08, 08:17, said:

y66 That article misses a massive point, comparing Italy with England is very misleading. The populations are approximately equal, but Italy has more than twice the land area, and the capital city is less than half the size. You with all other things equal would expect a lot more deaths in England

I don't know if it is of value to make a comparison between countries, but it is equally misleading to fail to mention the differences in the culture of Italy and its topography. The Italian language does not even have a word for privacy, their evening strolls, the passeggiata, along with the communal nature of shared piazzas as living rooms brings people into super close contact - and continually, day after day - a cultural thing brought about most likely due to space limitations because of the terrain. A huge mountain range runs down the spine of the country, making that space less inhabitable. Although Italy's biggest city may not be the size of London, the towns and cities that are there are compacted due to the terrain into smaller areas with communal public spaces.

None of these cultural disadvantages (disadvantage to stop a pandemic) apply to England.

[Cyberyeti]

 Winstonm, on 2020-May-08, 10:10, said:

I don't know if it is of value to make a comparison between countries, but it is equally misleading to fail to mention the differences in the culture of Italy and its topography. The Italian language does not even have a word for privacy, their evening strolls, the passeggiata, along with the communal nature of shared piazzas as living rooms brings people into super close contact - and continually, day after day - a cultural thing brought about most likely due to space limitations because of the terrain. A huge mountain range runs down the spine of the country, making that space less inhabitable. Although Italy's biggest city may not be the size of London, the towns and cities that are there are compacted due to the terrain into smaller areas with communal public spaces.

None of these cultural disadvantages (disadvantage to stop a pandemic) apply to England.

England also has some pretty densely packed cities (the regional cities seem to be denser in Italy, but Rome is only 25% smaller than London with less than half the population), one of Italy's problems is that many more people smoke than other places, and old men seem to disproportionately catch this there and many of them die.

[johnu]

 Cyberyeti, on 2020-May-07, 03:51, said:

I don't know if it's the same in the US as the UK, but here BAME people are 4 times as likely to die of it as white people, and they in the main wouldn't be voting Trump.

Edit: - it appears 4x is the unadjusted figures, but still with all the adjustments, 2x

In the US, about 75% of the population identifies as white in the census. Older white people have the highest voting percentages among the age/race groups. Minorities tend to have substantially lower voter turnout than the general population, and Republican governors and state legislatures do everything legally and sometimes illegally to suppress minority voting to try to keep that percentage as low as possible.

Just recently, Republicans in Wisconsin forced that state to have in person voting during the coronavirus lockdown even though that meant exposing voters and poll workers to getting infected. In the suburbs which are substantially whiter, there is usually very short or no lines at the polling places, while heavily populated urban areas (i.e. more minority voters) can have lines that are 6 to 8 hours long in some places. Not surprisingly, many voters choose not to wait in line that long.

[johnu]

 barmar, on 2020-May-07, 10:58, said:

We've known since he was elected that his base doesn't think things through rationally like this. They go with their gut, and they like what he's saying.

If it wasn't for the fact that any of his crazies who get infected could infect and kill an innocent bystander, I would encourage all the MAGA people to go out and fill auditoriums around the country to protest against wearing face masks and social distancing.

[y66]

From Tyler Cowen at Bloomberg:

Quote

One of the common knocks against America is that it is no longer capable of “big projects” such as making an atomic weapon, building an interstate highway system or putting a man on the moon. When it comes to the huge national challenge that is Covid-19, so far this critical charge seems correct.

One possible response to Covid-19 would have been to scale up testing early, as was done in South Korea, China, Iceland and other places. Nobel Laureate Paul Romer has called for testing 20 to 25 million Americans a day as a bare minimum (so far the U.S. has done barely 8 million tests total).

Yet the collective U.S. response to this proposal has been underwhelming. Congress did recently allocate $25 billion for testing, but Romer sees a need for as much as $100 billion. If Covid-19 testing were America’s big project, I would give this country a grade of D+.

A second part of testing is contact tracing those who are carriers of Covid-19, and warning their contacts to get tested. This tracing can be done by smart-phone location apps, and there is a significant human labor component. People who test positive need to be called or otherwise contacted and given advice for treatment. Such a process could require hundreds of thousands of workers, all of whom will need training.

Thankfully Massachusetts is pursuing some hiring toward this end, and New York is implementing a contact tracing program as well. (Bloomberg Philanthropies and Michael Bloomberg, the founder and majority owner of Bloomberg LP, are donating $10.5 million to the effort.) But the contact tracing idea is mostly stillborn at the national level, as there aren’t even any apps available yet, much less the supportive infrastructure, and it’s not clear Americans would be willing to use the apps anyway.

As for contact tracing as a major national project: The grade here is slightly lower than for testing. Improvements may yet come, but right now I give it a D.

Another big project would be to equip every American with a quality mask and promote mask-wearing as “the new normal.” Yet here too the country has largely failed. Early advice from public-health authorities was that mask-wearing was not worthwhile, though this turned out to be incorrect. Meanwhile federal restrictions made it difficult to import masks, even though the country’s mask stockpile had been greatly depleted in 2009 and not replenished. It is still the case that many front-line workers and even medical professionals do not have access to top-quality masks.

There does seem to be a recent improvement in mask-wearing among the general public, at least where I live in northern Virginia. But there is still a long ways to go. So the grade here is C-, though without the very recent progress it might have been an outright F.

How about lockdowns and social distancing? Well, those policies did not deliver benefits as quickly as promised, and now Americans are getting antsy. Many states are reopening or are on the verge of doing so, even as public health experts caution otherwise. This is true in my home state, by the way, which is governed by Democrats.

It seems the U.S. started its lockdowns too late. Countries such as Denmark and Austria, which imposed them early, have had relative success in beating back the virus and minimizing casualties. When it comes to lockdowns and social distancing, at least Americans tried, and perhaps will return to them with greater dedication. But they have not been an unqualified success. I cannot do any better than to give America a C-.

So where are the bright spots?

There are still a few big projects where America might succeed — or more accurately where the global scientific community, led by the U.S., might succeed. Scientists might develop effective antivirals to lower the death rate from Covid-19; they might develop effective antibody treatments; and they might develop vaccines quicker than had been anticipated, among other possible advances. 1

All of these matters remain open questions, so no grades can be assigned as of yet. Still, there is an intense flurry of scientific activity in all these areas, with a furious exchange of research ideas on the internet every day. The internet, of course, was America’s last successful big project and is still marvelously at work.

So can America still do big projects? It’s not out of the running just yet, but it is putting all its eggs into one big basket — that of biomedical researchers. If they are not up to the task, then the U.S. is in big trouble. I am optimistic, however, that they are.

[hrothgar]

 y66, on 2020-May-09, 16:39, said:

From Tyler Cowen at Bloomberg:

The issue is not with America but rather with the Republican party

And seeing Cowan, who enjoys a Koch sinecure, advancing such arguments is laughable

[y66]

I clicked +1 when I meant to click reply. Yes, it's important to know where the funding comes from. Cowen and the Mercatus Center at George Mason do not just get funding from the Koch family who are quintessential corporate bad guys in my book and a gazillion times scarier than the buffoon in the WH. Peter Thiel and the Collison brothers (fellow Irishmen) are also supporters and all similarly libertarian leaning. The Koch family are also big supporters of the Scalia Law School at George Mason. None of that changes the fact that Cowen is one of the most interesting and influential thinkers and writers out there or, as he points out in the story I posted, that America's capacity to do big things is not what it was which I suppose is not news to anyone. I share his optimism about prospects for our biomedical research sector providing some useful leadership. But even if that turns out to be well founded, I don't think it means we're not still in big trouble.

[y66]

The Real Reason to Wear a Mask (April 22) -- good summary by Zeynep Tufekci, Jeremy Howard and Trishs Greenhalgh at The Atlantic:

Quote

Models show that if 80 percent of people wear masks that are 60 percent effective, easily achievable with cloth, we can get to an effective R0 of less than one. That’s enough to halt the spread of the disease. Many countries already have more than 80 percent of their population wearing masks in public, including Hong Kong, where most stores deny entry to unmasked customers, and the more than 30 countries that legally require masks in public spaces, such as Israel, Singapore, and the Czech Republic. Mask use in combination with physical distancing is even more powerful.

[y66]

Virologist Peter Piot, director of the London School of Hygiene & Tropical Medicine, fell ill with COVID-19 in mid-March. He spent a week in a hospital and has been recovering at his home in London since. Climbing a flight of stairs still leaves him breathless. He talks about his experience with Dirk Draulans at the Belgian magazine Knack.

[johnu]

 y66, on 2020-May-09, 18:59, said:

The Real Reason to Wear a Mask (April 22) -- good summary by Zeynep Tufekci, Jeremy Howard and Trishs Greenhalgh at The Atlantic:

Quote

Models show that if 80 percent of people wear masks that are 60 percent effective, easily achievable with cloth, we can get to an effective R0 of less than one. That’s enough to halt the spread of the disease. Many countries already have more than 80 percent of their population wearing masks in public, including Hong Kong, where most stores deny entry to unmasked customers, and the more than 30 countries that legally require masks in public spaces, such as Israel, Singapore, and the Czech Republic. Mask use in combination with physical distancing is even more powerful.

Unfortunately, in the US, right fringe Republicans think wearing masks infringes on their right to infect innocent bystanders, and pseudo Christians think that wearing a mask is an affront to God. Can we give them their own country and throw away the keys to the border?

[Cyberyeti]

https://www.thelance...1025-4/fulltext

Link edited, thx y66

Interesting article that I'd heard nothing about until recently, be interested to see what the trials turns up.

UK does routinely BCG people, was wondering whether the disparity in BAME deaths could be partly because of people coming into the country from places that don't.

[y66]

This link to the BCG vaccine article posted by cyberyeti worked for me:

https://www.thelance...1025-4/fulltext