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FrozenLVFan



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PostPosted: 03/25/20 2:03 pm    ::: Reply Reply with quote

GlennMacGrady wrote:
Is the graph about beds wrong? It certainly contradicts statements I've read in the media.

We know that no one in the U.S. stocked sufficient supplies, or has sufficient trained personnel, for a world-wide pandemic -- not at the hospital level, community level, state level, or federal level, or anywhere else in the world. Those were all independent capacity decisions made by experts on all these levels over decades, presumably based on projections from historical needs, that seemed sufficiently prudent when made.

It doesn't help anything to whine and finger-point about these obvious and universal facts. The serious issues are how to ration the available assets and skills and how to procure more.


All of those decisions were forced by bean-counters at Medicare, managed care organizations, and third party payers, who decided what they were willing to pay for, and not by any overt planning by healthcare providers. (The Medicare program has its fingers in a lot of pies besides paying for seniors' care, one of which is the number of medical students and residents that are trained in this country.)


GlennMacGrady



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PostPosted: 03/25/20 2:08 pm    ::: Reply Reply with quote

GlennMacGrady



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PostPosted: 03/25/20 2:30 pm    ::: Reply Reply with quote

Let's go, California.

GlennMacGrady



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PostPosted: 03/25/20 3:17 pm    ::: Reply Reply with quote

FrozenLVFan wrote:
GlennMacGrady wrote:
Is the graph about beds wrong? It certainly contradicts statements I've read in the media.

We know that no one in the U.S. stocked sufficient supplies, or has sufficient trained personnel, for a world-wide pandemic -- not at the hospital level, community level, state level, or federal level, or anywhere else in the world. Those were all independent capacity decisions made by experts on all these levels over decades, presumably based on projections from historical needs, that seemed sufficiently prudent when made.

It doesn't help anything to whine and finger-point about these obvious and universal facts. The serious issues are how to ration the available assets and skills and how to procure more.


All of those decisions were forced by bean-counters at Medicare, managed care organizations, and third party payers, who decided what they were willing to pay for, and not by any overt planning by healthcare providers.


Do you have any authority to back up that statement. I'm not aware that Medicare or insurance companies tell hospitals how many supplies they can buy, or how many supplies states and the federal government can stockpile.

For example, on the currently hot topic of ventilators, here are the 2015 Ventilator Allocation Guidelines written by the New York Task Force on Life and the Law of the NY Department of Health, a 266 page report. Beginning on p. 28, the report estimates the number of ventilators needed under different pandemic scenarios. On p. 32, the task force recommends against stockpiling for a severe pandemic scenario for financial reasons and because "purchasing additional ventilators beyond a threshold will not save additional lives", because there would be insufficient trained staff to operate them.



This is a clear example of a state making a reasonable stockpiling decision, balancing cost, staff, historic need, and pandemic probabilities against one another, and deciding not to buy additional ventilators. I'm sure all the other states made similar decisions on their own, as did the federal government.

Well, New York and everyone else all guessed wrong. No one was to blame, then or now. All those business decisions were reasonable when made.
FrozenLVFan



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PostPosted: 03/25/20 3:45 pm    ::: Reply Reply with quote

GlennMacGrady wrote:
FrozenLVFan wrote:
GlennMacGrady wrote:
Is the graph about beds wrong? It certainly contradicts statements I've read in the media.

We know that no one in the U.S. stocked sufficient supplies, or has sufficient trained personnel, for a world-wide pandemic -- not at the hospital level, community level, state level, or federal level, or anywhere else in the world. Those were all independent capacity decisions made by experts on all these levels over decades, presumably based on projections from historical needs, that seemed sufficiently prudent when made.

It doesn't help anything to whine and finger-point about these obvious and universal facts. The serious issues are how to ration the available assets and skills and how to procure more.


All of those decisions were forced by bean-counters at Medicare, managed care organizations, and third party payers, who decided what they were willing to pay for, and not by any overt planning by healthcare providers.


Do you have any authority to back up that statement. I'm not aware that Medicare or insurance companies tell hospitals how many supplies they can buy, or how many supplies states and the federal government can stockpile.

For example, on the currently hot topic of ventilators, here are the 2015 Ventilator Allocation Guidelines written by the New York Task Force on Life and the Law of the NY Department of Health, a 266 page report. Beginning on p. 28, the report estimates the number of ventilators needed under different pandemic scenarios. On p. 32, the task force recommends against stockpiling for a severe pandemic scenario for financial reasons and because "purchasing additional ventilators beyond a threshold will not save additional lives", because there would be insufficient trained staff to operate them.



This is a clear example of a state making a reasonable stockpiling decision, balancing cost, staff, historic need, and pandemic probabilities against one another, and deciding not to buy additional ventilators. I'm sure all the other states made similar decisions on their own, as did the federal government.

Well, New York and everyone else all guessed wrong. No one was to blame, then or now. All those business decisions were reasonable when made.


I started to write a volume about hospital reimbursement and funding for physician training, etc., but the bottom line is that whoever controls the purse strings controls what a hospital can purchase and how many physicians are trained.


readyAIMfire53



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PostPosted: 03/25/20 4:56 pm    ::: Reply Reply with quote

GlennMacGrady wrote:
FrozenLVFan wrote:
GlennMacGrady wrote:
Is the graph about beds wrong? It certainly contradicts statements I've read in the media.

We know that no one in the U.S. stocked sufficient supplies, or has sufficient trained personnel, for a world-wide pandemic -- not at the hospital level, community level, state level, or federal level, or anywhere else in the world. Those were all independent capacity decisions made by experts on all these levels over decades, presumably based on projections from historical needs, that seemed sufficiently prudent when made.

It doesn't help anything to whine and finger-point about these obvious and universal facts. The serious issues are how to ration the available assets and skills and how to procure more.


All of those decisions were forced by bean-counters at Medicare, managed care organizations, and third party payers, who decided what they were willing to pay for, and not by any overt planning by healthcare providers.


Do you have any authority to back up that statement. I'm not aware that Medicare or insurance companies tell hospitals how many supplies they can buy, or how many supplies states and the federal government can stockpile.

For example, on the currently hot topic of ventilators, here are the 2015 Ventilator Allocation Guidelines written by the New York Task Force on Life and the Law of the NY Department of Health, a 266 page report. Beginning on p. 28, the report estimates the number of ventilators needed under different pandemic scenarios. On p. 32, the task force recommends against stockpiling for a severe pandemic scenario for financial reasons and because "purchasing additional ventilators beyond a threshold will not save additional lives", because there would be insufficient trained staff to operate them.



This is a clear example of a state making a reasonable stockpiling decision, balancing cost, staff, historic need, and pandemic probabilities against one another, and deciding not to buy additional ventilators. I'm sure all the other states made similar decisions on their own, as did the federal government.

Well, New York and everyone else all guessed wrong. No one was to blame, then or now. All those business decisions were reasonable when made.


This is also an example of why it was crucial to our national security to maintain and listen to a pandemic task force at the national level. Professionals who spend their professional lives only on how to prepare for a pandemic. Professionals who continue to analyze and learn from the Ebola virus - how to save lives. What might be needed.

Disbanding that national security task force saved a little money (like the cost of one wheel of one bomber). And we'll see what the death cost is.

#1 priority of our leaders is keeping us safe. Disbanding this task force is complete and total failure of leadership and is endangering US lives.



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FrozenLVFan



Joined: 08 Jul 2014
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PostPosted: 03/25/20 5:28 pm    ::: Reply Reply with quote

Does anyone know the stats on survival for people who are sick enough to be hospitalized? Sick enough to be intubated?


threadkiller1201



Joined: 19 Sep 2005
Posts: 275
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PostPosted: 03/25/20 6:57 pm    ::: Reply Reply with quote

FrozenLVFan wrote:
Does anyone know the stats on survival for people who are sick enough to be hospitalized? Sick enough to be intubated?


I think I read the stats out of China were 50% of critical patients survived, but I need to go find that reference.


Randy



Joined: 08 Oct 2011
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PostPosted: 03/25/20 8:00 pm    ::: Reply Reply with quote

FrozenLVFan wrote:
Does anyone know the stats on survival for people who are sick enough to be hospitalized? Sick enough to be intubated?


This may help.

https://covid19science.blogspot.com/2020/03/how-deadly-is-corona-virus.html

He also provides links to a study done in the UK which is much more detailed. He more or less give the Cliff notes to that study.



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Howee



Joined: 27 Nov 2009
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PostPosted: 03/25/20 8:04 pm    ::: Reply Reply with quote

Though I've suspected this to be the case, this is the first analysis of it I have seen. Tragedy in the making. Rolling Eyes

Quote:
The number of confirmed cases in Russia has been low compared to other countries. And so daily life for many people is going on as normal.

For some, the virus is something to laugh about. This video jokes about using vodka to beat it. But the number of cases is rising, and doctors say it could soon become much more serious.

President Putin says the virus is under control in Russia. But some people here are suspicious of the official figures. They say that the testing isn't reliable, and that those numbers could be missing tens of thousands of cases.

The Russian Doctors Alliance says the authorities are labeling cases of coronavirus as simply pneumonia.



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FrozenLVFan



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PostPosted: 03/25/20 8:14 pm    ::: Reply Reply with quote

Randy wrote:
FrozenLVFan wrote:
Does anyone know the stats on survival for people who are sick enough to be hospitalized? Sick enough to be intubated?


This may help.

https://covid19science.blogspot.com/2020/03/how-deadly-is-corona-virus.html

He also provides links to a study done in the UK which is much more detailed. He more or less give the Cliff notes to that study.


Thanks, I'll have to read that in the morning.



Howee wrote:
Though I've suspected this to be the case, this is the first analysis of it I have seen. Tragedy in the making. Rolling Eyes

Quote:
The number of confirmed cases in Russia has been low compared to other countries. And so daily life for many people is going on as normal.

For some, the virus is something to laugh about. This video jokes about using vodka to beat it. But the number of cases is rising, and doctors say it could soon become much more serious.

President Putin says the virus is under control in Russia. But some people here are suspicious of the official figures. They say that the testing isn't reliable, and that those numbers could be missing tens of thousands of cases.

The Russian Doctors Alliance says the authorities are labeling cases of coronavirus as simply pneumonia.


Both Russia and India are only reporting 650 cases, where I'd bet they both have tens of thousands, at least.


Genero36



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PostPosted: 03/25/20 8:15 pm    ::: Reply Reply with quote




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Ex-Ref



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PostPosted: 03/25/20 9:57 pm    ::: Reply Reply with quote

We've passed 1,000 deaths. Crying or Very sad

Quote:
America's first death was reported on Feb. 29 and the rate has spiked over the past two weeks as extreme public health measures go into effect to combat the virus. The U.S. death count eclipsed 600 on Tuesday and 900 early Wednesday before reaching 1,031 on Wednesday night, according to the Johns Hopkins University data dashboard..


https://www.usatoday.com/story/news/health/2020/03/25/coronavirus-usa-death-count-dead-1000/5079442002/



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GlennMacGrady



Joined: 03 Jan 2005
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PostPosted: 03/25/20 10:50 pm    ::: Reply Reply with quote

Update 14: Changes in 24 Hours since Last Update

U.S.:
- confirmed cases increased by 13,977 (25%) from 55,041 to 69,018
- deaths increased by 251 from 790 to 1,041
- death rate increased from 1.43% to 1.50%

U.S. deaths each day since March 11 and U.S. cumulative death rate on that day:

? – 3/11 2.89%
2 – 3/12 2.41%
7 – 3/13 2.16%
10 – 3/14 1.93%
12 – 3/15 1.83%
16 – 3/16 1.82%
23 – 3/17 1.70%
42 – 3/18 1.60%
55 – 3/19 1.44%
55 – 3/20 1.32%
76 – 3/21 1.26%
81 – 3/22 1.25%
169 – 3/23 1.26%
204 – 3/24 1.43%
251 – 3/25 1.50%

The reason for the death rate increase the last three days is likely because New York accounts for 48% of the confirmed cases and the attack rate in NY (28%) is about 3.5 times higher than in the rest of the country (8%). The only explanation I've heard for this is that the virus may have been circulating in NY for weeks longer than originally thought.

The U.S. is only 5,400 cases behind second place Italy and may take that spot tomorrow.
readyAIMfire53



Joined: 20 Nov 2004
Posts: 5712
Location: Durham, NC


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PostPosted: 03/25/20 11:47 pm    ::: Reply Reply with quote

GlennMacGrady wrote:
Update 14: Changes in 24 Hours since Last Update

U.S.:
- confirmed cases increased by 13,977 (25%) from 55,041 to 69,018
- deaths increased by 251 from 790 to 1,041
- death rate increased from 1.43% to 1.50%

U.S. deaths each day since March 11 and U.S. cumulative death rate on that day:

? – 3/11 2.89%
2 – 3/12 2.41%
7 – 3/13 2.16%
10 – 3/14 1.93%
12 – 3/15 1.83%
16 – 3/16 1.82%
23 – 3/17 1.70%
42 – 3/18 1.60%
55 – 3/19 1.44%
55 – 3/20 1.32%
76 – 3/21 1.26%
81 – 3/22 1.25%
169 – 3/23 1.26%
204 – 3/24 1.43%
251 – 3/25 1.50%

The reason for the death rate increase the last three days is likely because New York accounts for 48% of the confirmed cases and the attack rate in NY (28%) is about 3.5 times higher than in the rest of the country (8%). The only explanation I've heard for this is that the virus may have been circulating in NY for weeks longer than originally thought.

The U.S. is only 5,400 cases behind second place Italy and may take that spot tomorrow.


Are we great yet? Leading the world in fastest increasing diagnosis and death rates. And I'm sitting her in legal isolation waiting, waiting, waiting for my test results.



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tfan



Joined: 31 May 2010
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PostPosted: 03/25/20 11:56 pm    ::: Reply Reply with quote

GlennMacGrady wrote:


The reason for the death rate increase the last three days is likely because New York accounts for 48% of the confirmed cases and the attack rate in NY (28%) is about 3.5 times higher than in the rest of the country (8%). The only explanation I've heard for this is that the virus may have been circulating in NY for weeks longer than originally thought.

The U.S. is only 5,400 cases behind second place Italy and may take that spot tomorrow.


What is the attack rate? How does longer circulation result in higher death rates? It increases cases in addition to deaths. We still have a "don't do anything until things start getting bad" attitude in most areas.

The USA could easily lead the world in cases. The only two countries with more people took sterner measures. There is the possibility that it will rip through a poor country with little medical care and the 20% who need hospital care all die.


FrozenLVFan



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PostPosted: 03/26/20 1:18 am    ::: Reply Reply with quote

tfan wrote:


The USA could easily lead the world in cases. The only two countries with more people took sterner measures. There is the possibility that it will rip through a poor country with little medical care and the 20% who need hospital care all die.


I’d think that dubious distinction may well be India's. They're only reporting 650 cases, which means their testing is probably poor, huge population and overcrowding making isolation difficult, and a two-tiered healthcare system with woefully inadequate numbers of hospital beds for govt patients. This shoe is going to drop soon.


GlennMacGrady



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PostPosted: 03/26/20 10:56 am    ::: Reply Reply with quote

tfan wrote:
GlennMacGrady wrote:


The reason for the death rate increase the last three days is likely because New York accounts for 48% of the confirmed cases and the attack rate in NY (28%) is about 3.5 times higher than in the rest of the country (8%). The only explanation I've heard for this is that the virus may have been circulating in NY for weeks longer than originally thought.

The U.S. is only 5,400 cases behind second place Italy and may take that spot tomorrow.


What is the attack rate? How does longer circulation result in higher death rates?


Attack rate is the percentage of people who test positive for infection. As I said, I've not heard a clear explanation of why the attack rate is higher in NYC and suburbs than elsewhere. If the virus has been circulating there much longer than we think and much earlier than other places -- as Cuomo, too, seems to think -- then there would be a greater percentage of the NYC population infected than in other places and that would show up in the testing. I'm not sure that this makes sense to me.

However, a much earlier infection timeline would be consistent with the Oxford study yesterday, which in essence debunks the Imperial College study that so scared the UK and the world.

New Oxford study suggests millions of people may have already built up coronavirus immunity

Quote:
A model predicting the progression of the novel coronavirus pandemic produced by researchers at Imperial College London set off alarms across the world and was a major factor in several governments' decisions to lock things down. But a new model from Oxford University is challenging its accuracy, the Financial Times reports.

The Oxford research suggests the pandemic is in a later stage than previously thought and estimates the virus has already infected at least millions of people worldwide. In the United Kingdom, which the study focuses on, half the population would have already been infected. If accurate, that would mean transmission began around mid-January and the vast majority of cases presented mild or no symptoms.
GlennMacGrady



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PostPosted: 03/26/20 11:29 am    ::: Reply Reply with quote

Howee wrote:
Though I've suspected this to be the case, this is the first analysis of it I have seen. Tragedy in the making. Rolling Eyes

Quote:
The number of confirmed cases in Russia has been low compared to other countries. And so daily life for many people is going on as normal.

For some, the virus is something to laugh about. This video jokes about using vodka to beat it. But the number of cases is rising, and doctors say it could soon become much more serious.

President Putin says the virus is under control in Russia. But some people here are suspicious of the official figures. They say that the testing isn't reliable, and that those numbers could be missing tens of thousands of cases.

The Russian Doctors Alliance says the authorities are labeling cases of coronavirus as simply pneumonia.


There's also great confusion and even conspiracy theories about why Japan's testing, infection and death rates are so low, given that Japan is so close to China, has the world's oldest population and has a high percentage of smokers. Some believe the the government is just letting the virus do its thing, with only modest mitigations, and burying the infections and deaths in the general mortality numbers for respiratory infections so as to avoid panic and economic disaster.

Why is Japan still a coronavirus outlier?

Japan’s Virus Success Has Puzzled the World. Is Its Luck Running Out?
GlennMacGrady



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PostPosted: 03/26/20 1:48 pm    ::: Reply Reply with quote

GlennMacGrady wrote:
However, a much earlier infection timeline would be consistent with the Oxford study yesterday, which in essence debunks the Imperial College study that so scared the UK and the world.

New Oxford study suggests millions of people may have already built up coronavirus immunity


More big news just out about the Imperial College study (linked by JIT above), which predicted 2.2 million dead in the U.S. and 500,000 in the U.K.

An author of that study, Neil Ferguson, who himself has contracted CV19, backed massively away from his study in the face of actual data and now predicts only 20,000 U.K. deaths, at most, and says that ICU capacity will be sufficient. Per New Scientist:

Quote:
The UK should now be able to cope with the spread of the covid-19 virus, according to one of the epidemiologists advising the government.

Neil Ferguson at Imperial College London gave evidence today . . . .

He said that expected increases in National Health Service capacity and ongoing restrictions to people’s movements make him “reasonably confident” the health service can cope when the predicted peak of the epidemic arrives in two or three weeks. UK deaths from the disease are now unlikely to exceed 20,000, he said, and could be much lower.

The need for intensive care beds will get very close to capacity in some areas, but won’t be breached at a national level, said Ferguson


You can also read about this big name expert change of opinion on your left or right.
justintyme



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Posts: 8067
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PostPosted: 03/26/20 3:18 pm    ::: Reply Reply with quote

GlennMacGrady wrote:
More big news just out about the Imperial College study (linked by JIT above), which predicted 2.2 million dead in the U.S. and 500,000 in the U.K.

An author of that study, Neil Ferguson, who himself has contracted CV19, backed massively away from his study in the face of actual data and now predicts only 20,000 U.K. deaths, at most, and says that ICU capacity will be sufficient. Per New Scientist

Umm. No.

That is not at all what that New Scientist link said. He did not "back away" from his study, which would imply that he felt that his original numbers were wrong. Those original numbers were what the UK/US would have expected without mitigation. Based upon that study drastic action was taken and the new UK numbers are a result of those mitigating behaviors.

In other words, the Imperial models are saying the UK is successfully flattening the curve. Hopefully the same will be true for the US as we also take action. Minnesota's Governor has said that the models we are using show 2.4 million infections and 74k deaths in the state without mitigation. With stay in place we expect those numbers to be significantly lower.



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GlennMacGrady



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PostPosted: 03/26/20 3:41 pm    ::: Reply Reply with quote

justintyme wrote:
GlennMacGrady wrote:
More big news just out about the Imperial College study (linked by JIT above), which predicted 2.2 million dead in the U.S. and 500,000 in the U.K.

An author of that study, Neil Ferguson, who himself has contracted CV19, backed massively away from his study in the face of actual data and now predicts only 20,000 U.K. deaths, at most, and says that ICU capacity will be sufficient. Per New Scientist

Umm. No.

That is not at all what that New Scientist link said. He did not "back away" from his study, which would imply that he felt that his original numbers were wrong. Those original numbers were what the UK/US would have expected without mitigation. Based upon that study drastic action was taken and the new UK numbers are a result of those mitigating behaviors.

In other words, the Imperial models are saying the UK is successfully flattening the curve. Hopefully the same will be true for the US as we also take action. Minnesota's Governor has said that the models we are using show 2.4 million infections and 74k deaths in the state without mitigation. With stay in place we expect those numbers to be significantly lower.


How long has the U.K. been seriously mitigating? A week? 10 days? Impossible that that could have mitigated from 500,000 deaths to 20,000 or much lower.

No, the Imperial College study was hair-on-fire speculation, as likely is the U. Minnesota study being relied upon by Governor Walz in his (thank god only) two death state.
GlennMacGrady



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PostPosted: 03/26/20 3:44 pm    ::: Reply Reply with quote

I expect the U.S. to pass both Italy and China today to take the world lead in confirmed cases, with much lower death rates than either. (If anyone actually believes the China numbers.)
readyAIMfire53



Joined: 20 Nov 2004
Posts: 5712
Location: Durham, NC


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PostPosted: 03/26/20 4:18 pm    ::: Reply Reply with quote

GlennMacGrady wrote:
I expect the U.S. to pass both Italy and China today to take the world lead in confirmed cases, with much lower death rates than either. (If anyone actually believes the China numbers.)


The percapita numbers for NYC & Italy are very similar.

And Cheeto has ordered a nationwide slowdown of testing. Expect confirmed case #s to level and death #s to go up faster. What is being said is the slowdown is due to shortage of PPE supplies - reserving the scarcity for those treating sick people. Why can't this GREAT country produce this freakingly easy to manufacture supplies??????

I'm glad I got in on the little window of testing in this country. I'm glad I will know. And I know every single solitary person wants to know. This is really, really, really sick (to restrict testing).



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pilight



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PostPosted: 03/26/20 5:04 pm    ::: Reply Reply with quote

justintyme wrote:
That is not at all what that New Scientist link said. He did not "back away" from his study, which would imply that he felt that his original numbers were wrong. Those original numbers were what the UK/US would have expected without mitigation. Based upon that study drastic action was taken and the new UK numbers are a result of those mitigating behaviors.


His original suggestion was that mitigation could cut the numbers in half; 250k dead instead of 500k.



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