Coronavirus Thread

[RonJohn]

LOL, I rest my case. Like I said, this guy below has diabetes. It should be listed as the cause of death, because he might have remembered to take his parachute if not for diabetes.

So a photoshopped joke is the key to your reason for being upset? If you really want to discuss the photoshopped argument, what if he isn't actually skydiving, but his blood sugar is low and he fell out of the airplane while supporting skydivers?

Is CNN reporting that there are 15 gazillion deaths in the US at the moment from COVID-19? Is that the reason you are so upset? Honestly, I am staying as far away from the political and side-against-side arguments as I can. If that is what this is about, then just ignore science and argue about "your side". I am making actual points about epidemiology, not about one side or another side. I don't even know what the "sides" could possibly be in regard to this.

How about just respond to my question. What difference does it make? This isn't an engineering problem of wind load against a building. This is an epidemiological issue that uses rough numbers, statistics, and uncertainty. What difference does one death make if it is miscounted? What difference does 10 make? What difference does 100 make? What is the actual issue that you are upset about?

 

[Deleted member 2897]

What if he isn't actually skydiving, but his blood sugar is low and he fell out of the airplane while supporting skydivers?

That's what I had just stated. Or more specifically, because he had low blood sugar, he wasn't thinking clearly and forgot to take his parachute.

 

[LibertyTurns]

The easiest way of getting to the bottom of the number coronavirus deaths is to compare the current death rate against recent historical death rates.

Coronavirus may kill an obese person with a heart condition that would have not normally died. However, an obese person may go to the hospital because they think they have coronavirus and the doctor may determine emergency surgery is required and the person survives. If there’s one of each, death due to coronavirus is unimpactful at the aggregate level.

Better air quality in LA, less drivers on the road crashing into people, fewer dope peddlers on the street, etc may actually saves lives. On the other hand there might be more suicides, more dudes beating their wives to death, people skipping medical care, etc.

So, do we have more or less people dying every day on average than the expected number or not?

We’ve seen pictures of morgues stacking bodies in hallways so you’d think our death rate is spiking.

 

[RonJohn]

That's what I had just stated.

No, you said that if he has diabetes, then just count it as a diabetes death. My question was what if his blood sugar is low and he fell out of the airplane. If a person is working on steel frame for a building, has an epileptic seizure, and falls to his death. His immediate cause of death is from impact with the ground. Do you ignore that he had epilepsy? Do you prevent epileptics from working on high rise building frames? If so, why if epilepsy doesn't cause someone to die while working on building frames?

As I stated before, I have no idea what is behind your concern. There is absolutely no way that the number of infections, number of people sick enough to be hospitalized, or number of deaths is going to be 100% accurate. Why do you insist that it should?

 

[RonJohn]

The easiest way of getting to the bottom of the number coronavirus deaths is to compare the current death rate against recent historical death rates.

Coronavirus may kill an obese person with a heart condition that would have not normally died. However, an obese person may go to the hospital because they think they have coronavirus and the doctor may determine emergency surgery is required and the person survives. If there’s one of each, death due to coronavirus is unimpactful at the aggregate level.

Better air quality in LA, less drivers on the road crashing into people, fewer dope peddlers on the street, etc may actually saves lives. On the other hand there might be more suicides, more dudes beating their wives to death, people skipping medical care, etc.

So, do we have more or less people dying every day on average than the expected number or not?

We’ve seen pictures of morgues stacking bodies in hallways so you’d think our death rate is spiking.

I agree with that. None of those ways are going to be 100% accurate in detailing exactly how many people die of COVID-19. There is no possible way of knowing for certain exactly how many people died precisely because of COVID-19. I do not understand the concerns with this.

 

[LibertyTurns]

I agree with that. None of those ways are going to be 100% accurate in detailing exactly how many people die of COVID-19. There is no possible way of knowing for certain exactly how many people died precisely because of COVID-19. I do not understand the concerns with this.

It’s political. People think the numbers are being manipulated to tell the story preferable to one side or another. The economy was going to be #1 issue by a wide margin until this. Now how the performance and decisions are judged will go the election.

 

[jwsavhGT]

Welp, guess you'll have to slum it with Mayfield.

 

[FredJacket]

This is for FredJacket.

I'm sorry. I replied to your post in haste late at night and didn't consider what you were actually saying. I try not to do that to anybody, but this time I screwed up royally. Part of the reason for my kneejerk reaction is that I occasionally run into that kind of thinking at conferences. When I do, I try - and usually succeed - to come down on it like a ton of bricks. You're right: this is "Part of the Problem".

But everybody here could get something out of the review of Mayo. Reading the book would be even better.

Maybe I should be more sensitive. It's all good. I started to respond last night that I was marking you down as NOT part of the problem. You reinforced my shallow point that evidence needs to be based on data not feelings.

 

[Deleted member 2897]

@bwelbo will say otherwise, but the only people who are arguing against this are those that are working hard to be sure Trump looks as good as possible coming into the election.
https://www.mediaite.com/news/bill-...m-coronavirus-were-on-their-last-legs-anyway/

I'm not arguing for or against anything. I'm just stating if someone isn't sick in the hospital testing positive for COVID-19, why on God's green earth would they be listed as COVID-19 for a cause of death. I am not trying to state that our death rate is materially impacted by that, its just the principle of it that is bizarre. Look at the arguments for it. We've gotten to the point where someone is actually arguing that a guy who fell to his death parachuting but forgot his parachute should have Diabetes listed on his death certificate because there might be a chance that he had low blood sugar and wasn't thinking right. It might also be bullying - what if he is gay and was getting bullied on social media, so he just jumped to his death? It could be he had a personality disorder and couldn't think straight. It could be any number of things. But it seems like the 1 thing it wasn't was the impact from a 10,000 foot fall.

I don't know why you included the link to that article. I don't recall anybody around her suggesting we write off 85% of the deaths since they were unhealthy anyway. That's not what anybody was debating here.

 

[gtchem05]

If only the global warming people would be this concerned about scientific accuracy. In that world, there are no double blind studies. The people doing the studies get their livelihood from getting the conclusions that they like and know what they need to be. It’s bunk science. If only we could get some consistency.

Dr Fauci said we shouldn’t ever shake hands again. If you’re a germophobe, I could see this anyway. But man, what kind of a statement is that? He also said it’s a conspiracy that we’re over counting deaths because every person with a positive test is listed as a COVID-19 death. I’m losing respect for this guy. That’s not the answer of a scientist. A scientist would say he doesn’t think that’s a material issue because x% is probably a reasonable estimate or something like that. It’s not a conspiracy theory to simply repeat a policy. Nobody’s out there asserting our deaths are 2x as high as they should be or something like that. They’re merely stating the policy is questionable and leads to questionable results. You have to wonder what he’s really about if he gets mad discussing that.

Here's the Time magazine article: https://time.com/5818134/anthony-fauci-never-shake-hands-coronavirus/

I am not impressed with Dr. Fauci on this one either. Here his the actual quote: “I don’t think we should ever shake hands ever again, to be honest with you. Not only would it be good to prevent coronavirus disease; it probably would decrease instances of influenza dramatically in this country”

First of all, avoiding handshaking would not dramatically decrease instances of influenza in this country, but even if it would, why in the world has Fauci not been strongly advocating for stopping handshaking for years? Somehow we have a simple thing that could dramatically decrease influenza and its supposed 20,000-40,000 annual deaths (I won't go down that rabbit hole as I have already done so in other posts) in this country and he hasn't been advocating for it? What are ridiculous statement!

I do not know when he last saw a patient, but he certainly is not acting like a doctor who sees them regularly. Despite all the telemedicine happening right now, which is a good thing, doctors still need to examine their patients sometimes. After a doc listens with a stethoscope, looks in a patient's throat, and palpates an abdomen, does he really expect the doctor not to shake hands with the patient?

This is not meant to criticize someone for being old. There are plenty of wonderful, wise, fantastic elderly people out there with a lot to offer, but he is acting as if he has punched his last skin biopsy and the whole world is just going to hell in a hand basket. Not what we need from someone in a leadership role.

Fauci needs to be honest with the American people about what we can expect over the coming months including what precautions are reasonable and what are not. I suspect that by the end of the month he will either have changed his tune or we will be seeing a lot less of him in front of the cameras and microphones.

 

[Deleted member 2897]

Here's the Time magazine article: https://time.com/5818134/anthony-fauci-never-shake-hands-coronavirus/

I am not impressed with Dr. Fauci on this one either. Here his the actual quote: “I don’t think we should ever shake hands ever again, to be honest with you. Not only would it be good to prevent coronavirus disease; it probably would decrease instances of influenza dramatically in this country”

First of all, avoiding handshaking would not dramatically decrease instances of influenza in this country, but even if it would, why in the world has Fauci not been strongly advocating for stopping handshaking for years? Somehow we have a simple thing that could dramatically decrease influenza and its supposed 20,000-40,000 deaths (I won't go down that rabbit hole as I have already done so in other posts) in this country and he hasn't been advocating for it? What are ridiculous statement!

I do not know when he last saw a patient, but he certainly is not acting like a doctor who sees them regularly. Despite all the telemedicine happening right now, which is a good thing, doctors still need to examine their patients sometimes. After a doc listens with a stethoscope, looks in a patient's throat, and palpates an abdomen, does he really expect the doctor not to shake hands with the patient?

This is not meant to criticize someone for being old. There are plenty of wonderful, wise, fantastic elderly people out there with a lot to offer, but he is acting as if he has punched his last skin biopsy and the whole world is just going to hell in a hand basket. Not what we need from someone in a leadership role.

Fauci needs to be honest with the American people about what we can expect over the coming months including what precautions are reasonable and what are not. I suspect that by the end of the month he will either have changed his tune or we will be seeing a lot less of him in front of the cameras and microphones.

Exactly, and this is the guy who thinks we never should shake hands ever again, but yet it was okay to walk around without a facemask until a few days ago.

 

[RonJohn]

We've gotten to the point where someone is actually arguing that a guy who fell to his death parachuting but forgot his parachute should have Diabetes listed on his death certificate because there might be a chance that he had low blood sugar and wasn't thinking right.

There is serious misstatement about what I said. I asked if he was assisting parachuters but not parachuting himself and fell out of the plane because his blood sugar was low would diabetes not be a contributing factor to his death. I also asked if an epileptic fell off of a building frame during a seizure if epilepsy would not be a contributing factor to his death.

You are making a lot of arguments that are not really related to the issue. I don't understand what point you are actually trying to make.

 

[Deleted member 2897]

There is serious misstatement about what I said. I asked if he was assisting parachuters but not parachuting himself and fell out of the plane because his blood sugar was low would diabetes not be a contributing factor to his death. I also asked if an epileptic fell off of a building frame during a seizure if epilepsy would not be a contributing factor to his death.

You are making a lot of arguments that are not really related to the issue. I don't understand what point you are actually trying to make.

If you don't see the hilarity of what you're typing, I'm not sure what to do. The illustration I gave was a guy who forgot his parachute and fell to his death. But he had Diabetes, so we should put that on his death certificate. You're the one who changed the story to say that Diabetes had actually caused his death. OF COURSE if it actually caused his death it should be listed that way. But that isn't even remotely close to what we're talking about. You're taking stories and then fundamentally changing them to fit a 'what if' narrative. We have never and should never do what-if guesses to pick a favorite cause of death. The real life one was the neighbor who fell, broke his hip, had an internal bleeding problem, then died of an embolism. They listed COVID-19 on his death certificate. You said 'well what if he might have survived the embolism if not for COVID-19' even though he wasn't symptomatic so there is no logical reason to wonder that. I mean if you follow this line of logic, you would have 800 different items listed on every death certificate.

 

[dtm1997]

LOL, I rest my case. Like I said, this guy below has diabetes. It should be listed as the cause of death, because he might have remembered to take his parachute if not for diabetes.

Clouds are upside down.

 

[RonJohn]

If you don't see the hilarity of what you're typing, I'm not sure what to do. The illustration I gave was a guy who forgot his parachute and fell to his death. But he had Diabetes, so we should put that on his death certificate. You're the one who changed the story to say that Diabetes had actually caused his death. OF COURSE if it actually caused his death it should be listed that way. But that isn't even remotely close to what we're talking about. You're taking stories and then fundamentally changing them to fit a 'what if' narrative. We have never and should never do what-if guesses to pick a favorite cause of death. The real life one was the neighbor who fell, broke his hip, had an internal bleeding problem, then died of an embolism. They listed COVID-19 on his death certificate. You said 'well what if he might have survived the embolism if not for COVID-19' even though he wasn't symptomatic so there is no logical reason to wonder that. I mean if you follow this line of logic, you would have 800 different items listed on every death certificate.

You posted a fake, photoshopped photo, that was meant to be a joke. It didn't list anything about diabetes. You then asked if he had diabetes should diabetes be listed as a cause of death. I then pointed out that if he fell out of the plane because of his diabetes that maybe it should. At this point, are you actually intending to say that the person in the photo isn't a joke and he actually died and his death certificate lists COVID-19 as the primary cause of death?

With respect to the neighbor, was COVID-19 listed as the immediate or a contributing cause of death? If it was listed as a contributing, are you actually arguing that it had absolutely nothing to do with him dying? I listed out ways that it could have contributed. White blood cells fight infections. White blood cells also stop bleeding. Excessive bleeding could cause an embolism to break free. A budding infection in the lungs could cause the embolism to create more problems and lead to death.

As an overall issue, I still don't understand what your primary concern is. Are COVID-19 deaths 1% high because some people are counted who shouldn't be? That is possible. Are COVID-19 deaths 1% low because dead people in apartments in NYC haven't been found yet? That is also possible. The big question is: why does it matter? Each death matters, and each death has a devastating impact on those close to them. However, for the pandemic what are you doing to do differently if there are 1% more or 1% fewer deaths? What is the government going to do differently? Why is this of such a great concern to you?

 

[Deleted member 2897]

You posted a fake, photoshopped photo, that was meant to be a joke. It didn't list anything about diabetes. You then asked if he had diabetes should diabetes be listed as a cause of death. I then pointed out that if he fell out of the plane because of his diabetes that maybe it should. At this point, are you actually intending to say that the person in the photo isn't a joke and he actually died and his death certificate lists COVID-19 as the primary cause of death?

With respect to the neighbor, was COVID-19 listed as the immediate or a contributing cause of death? If it was listed as a contributing, are you actually arguing that it had absolutely nothing to do with him dying? I listed out ways that it could have contributed. White blood cells fight infections. White blood cells also stop bleeding. Excessive bleeding could cause an embolism to break free. A budding infection in the lungs could cause the embolism to create more problems and lead to death.

As an overall issue, I still don't understand what your primary concern is. Are COVID-19 deaths 1% high because some people are counted who shouldn't be? That is possible. Are COVID-19 deaths 1% low because dead people in apartments in NYC haven't been found yet? That is also possible. The big question is: why does it matter? Each death matters, and each death has a devastating impact on those close to them. However, for the pandemic what are you doing to do differently if there are 1% more or 1% fewer deaths? What is the government going to do differently? Why is this of such a great concern to you?

HA HA HA HA HA HA HA HA!

 

[gtchem05]

The easiest way of getting to the bottom of the number coronavirus deaths is to compare the current death rate against recent historical death rates.

Coronavirus may kill an obese person with a heart condition that would have not normally died. However, an obese person may go to the hospital because they think they have coronavirus and the doctor may determine emergency surgery is required and the person survives. If there’s one of each, death due to coronavirus is unimpactful at the aggregate level.

Better air quality in LA, less drivers on the road crashing into people, fewer dope peddlers on the street, etc may actually saves lives. On the other hand there might be more suicides, more dudes beating their wives to death, people skipping medical care, etc.

So, do we have more or less people dying every day on average than the expected number or not?

We’ve seen pictures of morgues stacking bodies in hallways so you’d think our death rate is spiking.

Never mind. I wrote something stupid because I didn't read your whole post. By bad.

 

[YJMD]

@YJMD I’m certainly no doctor but was listening to the radio. Guy on said typical protocol for someone in respiratory distress is O2 and/or a ventilator which basically forces air into your lungs. He claimed to be successfully treating patients by O2 and some sort of steroid or something to relax the patient. His premise was along the lines of more pressure in the lungs actually damaged the lungs making more treatment necessary and what was actually needed was just O2.

That's scraping up against the edges of my knowledge base. Generally speaking, though ARDS is something of that state. The lungs are quite fragile, and the appropriate ventilation is trying to be as gentle as possible to the lungs. However, people may require high pressures to simply keep the lungs inflated given all the fluid and debris constantly filling up the lungs. The actual breaths on a ventilator for such a patient are very frequent and shallow. I have heard that ARDS in COVID isn't exactly typical, but I really don't know the differences. I wonder if some of what you understood was referring to people rushing to adding pressure via CPAP/BiPAP or ventilator care before it is necessary and causing unnecessary lung damage / complication. That certainly sounds plausible, but it's just me reading between the lines here. The basic idea of steroids (inhaled, systemic?) to tamp down the inflammatory response in the lungs makes sense as really it's the immune response driving things as much as it is the virus. But the immune system is extremely complex, and steroids are basically blunt instruments. For these things we are running into the same problems as hydroxychloroquine. Empirical evidence is simply of limited utility, and given the seriousness of the illness these patients have people are likely to stick to established protocols for ARDS management as a base. If that turns out to be far from optimal, it's going to take quite a bit of time to figure that out and establish better treatment protocols. The good news here would be that could significantly change future outcomes.

He also mentioned the hydroychloriquine but said it was combined with the wrong drug in those with cardiac issues. Again he alleged if doctors would take a step back they’d realize why that combination failed and move from the bad combination to another more favorable one.

Seems like with hundreds of thousands of cases, doctors would be compiling notes and there would be a handful of likely combinations of treatments worth pursuing. Nightly broadcasts and media reports make it seem like there’s more people preventing any testing (really it should be experimenting real time with lives albeit in a educated fashion) than trying to anything besides using the same low percentage options currently advocated by the experts.

Maybe I’m thinking it looks easier on paper than it is in real life?

Yeah. It's a lot easier on paper. First of all, systems of care (at least in the US) are far to fragmented to really collate data effectively. I'm not sure what level of detail a public health department may have, but that's probably the best bet for study and with an established mechanism to do the study. Otherwise, what you are suggesting is research. It requires IRB approval and consideration for consent. And it's likely to be bad research, all things considered. There are an enormous amount of confounders here, and testing practice and overall treatment protocols and systems between various sites is going to be very different. Perhaps gathering retrospective data from a place with earlier outbreak like China and using that could happen now, but there are a lot of problems with that too. If you are suggesting a doctor run their own mini trials, that's dangerous, and it wouldn't be blinded anyway. No way that's in the general sense anywhere near ethical. What clinical guideline other than research would inform who you would offer treatment to and who you wouldn't? And if there was a clinical reason (illness severity, age, comorbidity, etc.), then that even further taints your small sample non-blinded study. But I do guarantee you, to some extent, doctors right now are doing that and using their empirical experience and the experience of their colleagues to guide their decisions. Problem is, getting into the telephone game here, cognitive biases become massively magnified.

Realistically, it might be prudent to recognize that there can be public health crises which need to facilitate the collection of and analysis of data from multiple sites and clinical trialing of treatments which significantly deviate from the usual protocols because the implications of the results are far more urgent. But that's just not set up in the scale we would need right now. Maybe some other country is in better position here.

 

[MWBATL]

I'm on board with a permanent move to bowing or elbow bumps or something else.

Bowing....

A tribute to our oriental friends.....

 

[GT_EE78]

Supply chain issue or food choice/life style issue? I went to Kroger yesterday for my drive-thru grocery pickup and could only get diet sodas, milk & carrots. They were out of Cheetos, ice cream, grape jelly, and Spam.

funny about the cheetos. My ex said the line was too long for getting in her LA gro store but there was a wine store that was essential as it carried bottled water(and had cheetos) . Her gro so far for the week was wine and cheetos.