Coronavirus Thread

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Come on, Supersize. I know you're a smarter guy than this.

Analgesics, nerve pills, heart pills?

Only two antineoplastics, and the two most common ones? No antivirals at all?

It's because it's a list of the most adverse reactions. A number that's highly influenced by the number of total people taking it.

This is just lying with statistics. You are much, much more likely to die if you take the most toxic chemotherapy drugs than if you take aspirin. It's just that a lot of people take aspirin and very few take the most toxic antineoplastics, so more people die from taking aspirin.


Well, talking about Cuomo in a discussion of why FL nursing homes have largely escaped would be pretty silly in the first instance.

But you bring up an excellent example of lying with incomplete information and politically motivated opinion masquerading as news.

First, you're just factually wrong. NY nursing homes were encouraged and given tests to test residents. They just couldn't require a test before admitting someone, nor could they turn down a patient for being CoViD positive.

Is that great? No. But all the whining about it requires that you studiously ignore the actual situation and alternatives. What would have happened to these people if the NY department of health hadn't prevented nursing homes from turning them away?

They would have died. They are a population that requires intensive hands on care to live day to day. Could they have gone to a hospital? Nope, hospitals in NY were dangerously close to overflowing just with the worst coronavirus cases. There was no room or resources for subacute care of a large new population.

Could they have just gone home? Maybe? Those that had a home to go to, or family to take them in. A few very lucky ones might even have enough combined family free time and care to keep them alive. The remainder would have died of starvation, infected bed sores, opportunistic infections, and all the other miserable deaths that nursing homes are designed to prevent.

What I'm saying is that if you look reality square in the eyes like a man you realize it was the right choice. It was the choice that minimized deaths, full stop. And in a better world, a world where a competent federal government was actively acquiring and distributing PPE in a timely manner and funding a robust response effort, there could have been enough people and resources to deal with an influx of infected in nursing homes. Maybe even a set of new ad hoc facilities for infected but not requiring hospitalization nursing home patients.

If only there were some sort of corps of engineers in this country that had the expertise and competence to quickly build that sort of thing. If only there were some sort of center for controlling diseases that could examine these things and anticipate the need for nursing home capacity for the infected.

But these are all pipe dreams.

LOL
 

IEEEWreck

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LOL. Another idiotic study devoid of science. All they did was try and track stay at home orders with the timing of unemployment claims and anything out of phase was concluded to not be related. Stupid. Some companies like restaurants had to fire people immediately. Others had more money and a slower downturn and had more runway to decide if they should cut headcount to save money or not. Companies are still doing that. Another 2.5m filed unemployment claims last week. It’s not restaurants and hotels filing the claims, so see - it’s not related to stay at home orders, LOL. Ask companies who sell things to restaurants and hospitals and so on if shutting those down and not allowing elective surgeries impacted them LOL. They’ve been hanging on hoping those folks can reopen fast enough to get business back...but many can’t keep waiting to cut costs.
No. That's just flat out wrong. The study examines regionally coupled and high frequency increases of unemployment claims. The frequency domain is not the same as the time domain.

I suppose the fundamental hypothesis is that unemployment is a time invariant system. That actually seems like a fairly valid assumption to me. Various industries may have a time delay in reacting to a shock, but they're unlikely to alter the frequency of their reactions with respect to the frequency of the shock input.

I suppose a delay may introduce some frequency broadening effect because a down stream firm might have a little more time to respond and so they and their competitors reactions are a bit more spread out in time than upstream industries, but they're still going to be pretty high frequency in comparison to other broader trends. No more elective surgeries or no more restaurants buying napkins are uniquely discrete points in time, and a lot of operations research backs up the fact that no one fires employees and scales down operations while there are still orders to fill.
 

Techster

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No. That's just flat out wrong. The study examines regionally coupled and high frequency increases of unemployment claims. The frequency domain is not the same as the time domain.

I suppose the fundamental hypothesis is that unemployment is a time invariant system. That actually seems like a fairly valid assumption to me. Various industries may have a time delay in reacting to a shock, but they're unlikely to alter the frequency of their reactions with respect to the frequency of the shock input.

I suppose a delay may introduce some frequency broadening effect because a down stream firm might have a little more time to respond and so they and their competitors reactions are a bit more spread out in time than upstream industries, but they're still going to be pretty high frequency in comparison to other broader trends. No more elective surgeries or no more restaurants buying napkins are uniquely discrete points in time, and a lot of operations research backs up the fact that no one fires employees and scales down operations while there are still orders to fill.

Well, its my opinion their study is still wrong. And that your opinion at the end "no one fires employees and scales down operations while there are still orders to fill" is also false. When there are black swan types of events like this, its very common for people to both try and get out ahead of the curve as well as hanging on for awhile to give things a chance to turn around. Every company and their business and cash position and ownership philosophy is unique.

I can say that the number of churches in a city is directly related to the number of murders. I can show you charts that show nearly a 1 to 1 correlation. But thats scientifically devoid of any actual causation. Its population that drive both of those, generally speaking.
 

Techster

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Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext

TLDR; After a pretty thorough analysis, Hydroxychloriquine does nothing positive for treating COVID-19.

I just read through it...HOLY SH!T...

Interpretation

We were unable to confirm a benefit of hydroxychloroquine or chloroquine, when used alone or with a macrolide, on in-hospital outcomes for COVID-19. Each of these drug regimens was associated with decreased in-hospital survival and an increased frequency of ventricular arrhythmias when used for treatment of COVID-19.

Again, HOLY SHI!T...
 

takethepoints

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Don't know if this has been posted before:

https://www.vox.com/2020/5/6/21241058/coronavirus-mitigation-suppression-flatten-the-curve

Yglesias is right here, I think. We might have reached a level where the disease will not overwhelm our medical facilities - the so-called "plateau" - but that doesn't mean that a lot of people won't die. As more then one person here has pointed out, mitigation slows down infection rates. It doesn't stop the actual progress of the disease or limit the number of deaths; it spreads both out over a longer time. Suppression of the virus is another story and has worked in several countries, albeit none the size of the US. The main point of the story, however, is that we haven't really tried the contact tracing/isolation strategy yet, largely because we haven't put together a national response based on it. (State-by-state won't work, for obvious reasons.)

We are instead assuming that we can keep deaths at a lower level until a vaccine is developed. That could work, but there's no guarantee that it will. If it doesn't, we are looking at a scenario that'll make 1918 look like a kindergarten picnic. Sooooooo … hope we get something that is at least 85% effective (like flu vaccines) by January/February.
 

GTRX7

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Don't know if this has been posted before:

https://www.vox.com/2020/5/6/21241058/coronavirus-mitigation-suppression-flatten-the-curve

Yglesias is right here, I think. We might have reached a level where the disease will not overwhelm our medical facilities - the so-called "plateau" - but that doesn't mean that a lot of people won't die. As more then one person here has pointed out, mitigation slows down infection rates. It doesn't stop the actual progress of the disease or limit the number of deaths; it spreads both out over a longer time. Suppression of the virus is another story and has worked in several countries, albeit none the size of the US. The main point of the story, however, is that we haven't really tried the contact tracing/isolation strategy yet, largely because we haven't put together a national response based on it. (State-by-state won't work, for obvious reasons.)

We are instead assuming that we can keep deaths at a lower level until a vaccine is developed. That could work, but there's no guarantee that it will. If it doesn't, we are looking at a scenario that'll make 1918 look like a kindergarten picnic. Sooooooo … hope we get something that is at least 85% effective (like flu vaccines) by January/February.

Slight correction. By slowing down infection rate to avoid the situation where our medical facilities are overwhelmed, that in fact allows for better medical care and less deaths. In addition to just a vaccine, more time also allows medical practitioners to find new and better treatments to mitigate severity. While hydroxychloroquine appears to be a bust, remdesivir appears to be somewhat effective and doctors have learned more about other medications, interactions, best uses of ventilators, other problematic side effects previously unknown (blood clotting), etc. Slowing spread has also allowed for more availability of testing, more PPE available to both medical personnel and the public, etc. Slowing transmission will absolutely 100% have a huge impact on reducing the final fatality numbers both in the short and long term.
 

LibertyTurns

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Cuomo didn’t have to send C19 patients to nursing home to explode the death count. He had plenty of options like those below, the Javits Center, etc. He made choice to get on those subways and shove C19 patients into facilities with high numbers of at risk people and got the results any sane person would have expected. Well, there’s another Governor that did it differently and the results were much different.

https://www.militarytimes.com/news/...pitals-went-largely-unused-will-be-shut-down/
 

GTRX7

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Right now we sort of are in a new normal with slow declines largely led by declines in the NYC area with the rest of the country basically being flat to some places with increases. Likely to be that way for awhile. That's alot better than where we were a month ago though. You have positive factors (some percentage of people wearing masks, some percentage of people engaging in social distancing. warmer weather - recent study suggests that could result in up to a 25% decrease in transmission rate) that right now appear to be just offsetting the negative factor (more mobility - though mobility is still well below where it was in early March), keeping the overall R0 just below 1 for the country as a whole.

I tend to keep focus on 2 metrics (7 day rolling avg for both to smooth out the natural data reporting issues)- positive case % (the news people who focus on just cases are overly pessimistic - as you test more you should see more cases - but if your testing is rising faster than the cases the positive % goes down), and deaths (which is unfortunately a pretty significant trailing indicator - but still give some sense of what is going on).
Unfortunately GA is going to have a bad death day today (it is already one of the 8 worst of the pandemic and still has the 7 pm update to go). GA has been basically flat in terms of deaths and cases, but positive case percentage has gone down consistently which is good.
Still avg 20K+ new cases nationwide and 1,300+ deaths nationwide every day is not good on an absolute scale. Yesterday was the worst day yet in terms of reported cases worldwide.
GA is avg about 30 deaths per day and 625 cases. To make a comparison the total confirmed deaths by flu for GA for 2019-20 season through the first week of March was 84. So about every 3 days we are having more people die from the virus than died in 6 months from the flu in the state.

Just sort of a mixed bag. Not great, not horrible.
fivethirtyeight.com has a nice dashboard where they are tracking 9 models. If you use them as an ensemble they have been almost dead on in terms of death predictions with the current US death numbers basically trending right around where the middle of the model projections come out. We are likely looking at hitting 100K deaths the day after Memorial Day and likely somewhere between 150-175K by the beginning of August.

As I said two weeks ago. I'm happy with the direction things are heading, not real happy at the pace. Late June/early July is going to be a time period to watch. That is when some (but not all of the models) project a summer spike - not as large as April but enough to register. We are just barely doing better than treading water which isn't going to allow the economy to take off in any significant way.
This study by 4 UCLA Economic researchers looked to untangle the direct effect of stay at home orders on unemployment claims. They came up with the stay at home orders resulting in roughly 25% of the unemployment claims, the rest were due to other factors (consumer confidence, self-imposed stay at home, supply chain disruptions, etc).
https://voxeu.org/article/unemployment-effects-stay-home-orders

This would largely line up with what we have seen in GA so far where unemployment claims continue to be sky high even 4 weeks after relaxing orders. This past week was the first significant drop in weekly unemployment claims, but they are still 15X above average (180K vs 12K).
It's also been a mixed bag for states that opened up the earliest. GA has been able to keep its transmissions rate likely just under 1 given its positive case %, but Texas is seeing positive case % increase for the last week so even with more testing that suggests that their R0 is likely above 1 right now and they are having some outbreaks.

IMO we are in a better place than we were 1 month ago, but we aren't even close to where we were at the beginning of March and not likely to be there for a long time.
But I do think we are going to get at least some college football later this year and that possibility excites me.

Just to add one thing. I live in the heart of Atlanta. I assume others' experiences are the same, but Georgia "opening up" a few weeks ago was not some sort of immediate transformation. Virtually none of the restaurants, gyms, barber shops, etc that I frequent actually opened then. In my experience, that really only starting to happen in a more meaningful this week, at least for the places I go around midtown/inman/poncy highlands, etc. I also live on the beltline. While traffic is up, it is still way down from the beginning of March and people are still doing a decent job of trying to distance.
 
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Come on, Supersize. I know you're a smarter guy than this.

Analgesics, nerve pills, heart pills?

Only two antineoplastics, and the two most common ones? No antivirals at all?

It's because it's a list of the most adverse reactions. A number that's highly influenced by the number of total people taking it.

This is just lying with statistics. You are much, much more likely to die if you take the most toxic chemotherapy drugs than if you take aspirin. It's just that a lot of people take aspirin and very few take the most toxic antineoplastics, so more people die from taking aspirin.


Well, talking about Cuomo in a discussion of why FL nursing homes have largely escaped would be pretty silly in the first instance.

But you bring up an excellent example of lying with incomplete information and politically motivated opinion masquerading as news.

First, you're just factually wrong. NY nursing homes were encouraged and given tests to test residents. They just couldn't require a test before admitting someone, nor could they turn down a patient for being CoViD positive.

Is that great? No. But all the whining about it requires that you studiously ignore the actual situation and alternatives. What would have happened to these people if the NY department of health hadn't prevented nursing homes from turning them away?

They would have died. They are a population that requires intensive hands on care to live day to day. Could they have gone to a hospital? Nope, hospitals in NY were dangerously close to overflowing just with the worst coronavirus cases. There was no room or resources for subacute care of a large new population.

Could they have just gone home? Maybe? Those that had a home to go to, or family to take them in. A few very lucky ones might even have enough combined family free time and care to keep them alive. The remainder would have died of starvation, infected bed sores, opportunistic infections, and all the other miserable deaths that nursing homes are designed to prevent.

What I'm saying is that if you look reality square in the eyes like a man you realize it was the right choice. It was the choice that minimized deaths, full stop. And in a better world, a world where a competent federal government was actively acquiring and distributing PPE in a timely manner and funding a robust response effort, there could have been enough people and resources to deal with an influx of infected in nursing homes. Maybe even a set of new ad hoc facilities for infected but not requiring hospitalization nursing home patients.

If only there were some sort of corps of engineers in this country that had the expertise and competence to quickly build that sort of thing. If only there were some sort of center for controlling diseases that could examine these things and anticipate the need for nursing home capacity for the infected.

But these are all pipe dreams.
I didn't make up the chart. How can you refute stats like that?
 
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MWBATL

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First, you're just factually wrong. NY nursing homes were encouraged and given tests to test residents. They just couldn't require a test before admitting someone, nor could they turn down a patient for being CoViD positive.

Is that great? No. But all the whining about it requires that you studiously ignore the actual situation and alternatives. What would have happened to these people if the NY department of health hadn't prevented nursing homes from turning them away?

They would have died. They are a population that requires intensive hands on care to live day to day. Could they have gone to a hospital? Nope, hospitals in NY were dangerously close to overflowing just with the worst coronavirus cases. There was no room or resources for subacute care of a large new population.

Actually, I believe you are just factually wrong here.

You must have missed the interview with the Nursing Home Manager who appealed to state officials to put those patients in the Javits Center or on the Hospital ship Comfort.

This is from that totally right wing news source, the NY Times:

New York has faced particular scrutiny for a March 25 state health department directive requiring nursing homes to take recovering coronavirus patients.

“A number of nursing homes have felt constrained by the order and admitted hospital discharged patients without knowing what their COVID status was,” said Chris Laxton, executive director of the Society for Post-Acute and Long-Term Care Medicine. “This order made an already difficult situation almost impossible.”

The order, similar to one in neighboring New Jersey, was intended to help free up hospital beds for the sickest patients as cases surged. But critics have suggested nursing homes were already overwhelmed and a better solution might have been sending them to the virtually empty Jacob K. Javits Convention Center, which was retrofitted to treat COVID-19 patients, or an even less utilized Navy hospital ship that has since left Manhattan.


You might want to double check your own sources before you tell someone else they are factually incorrect.

So, you see, there were beds available, in facilities that were dedicated to covid care, and the state chose not to go that route. As did NJ. This just MIGHT be why NY and NJ have the two highest mortality rates in the USA from covid. Because, you know...facts...
 

MWBATL

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Well, talking about Cuomo in a discussion of why FL nursing homes have largely escaped would be pretty silly in the first instance.

Well, since that all started with a post by me comparing NY death rates to FL death rates, and I was responding to a comment that criticized the FL governor without mentioned the NY Governor...it was actually quite relevant.
 

MWBATL

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And yet it has still proven to be effective in some cases. How do they explain that?
Well, first of all, there is this mistaken assumption out there that chemicals affect all humans the same way. That is not correct. Because humans vary, the affect of any chemical on a specific human can vary. This is why it can be both true that a drug (like Hydroxy..whatever) can save some people, while having no effect of many others, and actually exacerbating and killing a few other people. The medical profession looks at the totality of effects in order to decide whether a drug should be used, is allowed to be used, or is banned from use. It would appear (and I have not read any of the studies posted here or elsewhere) that hydroxy-whatever overall nets out on the negative side. That doesn't mean that it kills everyone, it likely only has negative effects on people with pre-exiting heart issues (whether detected or not).....and it might easily be safe for most patients. (Again, I haven't read up on it, just stating a generalized situation...)

By the way, the most lethal chemical drug you can take which kills the most people in the world every year is dihydroxy oxide. Yet it is not banned.
 

MWBATL

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I actually cut my quote form that article pff too quickly, here is what it says next:

As the virus was racing through his nursing home, the head of Brooklyn’s Cobble Hill Health Center frantically emailed state health officials April 9 asking just that.

"Is there a way for us to send our suspected covid cases to the Javitz center or the ship?” Donny Tuchman wrote.

Tuchman said he was denied permission. Eventually, more than 50 residents at his home would die.


The reason given was that the Feds wouldn't accept such patients. This is of course merely an uncorroborated rumor, not factually supported by any secondary reporting. Given all that the Feds had already done, it strikes me as completely unbelievable that the Feds would have refused to take such patients, given the alternatives...and NO PROOF has been offered in support of that excuse.
 
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Well, first of all, there is this mistaken assumption out there that chemicals affect all humans the same way. That is not correct. Because humans vary, the affect of any chemical on a specific human can vary. This is why it can be both true that a drug (like Hydroxy..whatever) can save some people, while having no effect of many others, and actually exacerbating and killing a few other people. The medical profession looks at the totality of effects in order to decide whether a drug should be used, is allowed to be used, or is banned from use. It would appear (and I have not read any of the studies posted here or elsewhere) that hydroxy-whatever overall nets out on the negative side. That doesn't mean that it kills everyone, it likely only has negative effects on people with pre-exiting heart issues (whether detected or not).....and it might easily be safe for most patients. (Again, I haven't read up on it, just stating a generalized situation...)

By the way, the most lethal chemical drug you can take which kills the most people in the world every year is dihydroxy oxide. Yet it is not banned.
I Googled dihydroxy oxide, and the only thing I could find is dihydrogen monoxide (DHMO). Is that what you are referring to? Neither name appears on the list I posted earlier. Apparently it is used as an ingredient in many other applications, not just drugs. There are apparently many who want it banned and many who don't want it banned. http://www.dhmo.org/facts.html
 

armeck

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And yet it has still proven to be effective in some cases. How do they explain that?
Placebo effect, at best. This study is pretty much definitively saying it has NOT been "proven" to work, so I am unclear why you keep insisting that. Not only does this massive study show you don't get better, it shows a strong association with negative outcomes.
 

armeck

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I Googled dihydroxy oxide, and the only thing I could find is dihydrogen monoxide (DHMO). Is that what you are referring to? Neither name appears on the list I posted earlier. Apparently it is used as an ingredient in many other applications, not just drugs. There are apparently many who want it banned and many who don't want it banned. http://www.dhmo.org/facts.html
You are correct, he meant to say dihydrogen monoxide . Ingestion into the lungs is a major killer of children every summer. Amazingly enough, it is used in many household goods as a solvent! Also, oddly enough it is a required substance for life, but in delicate balance - too little can cause kidney failure among other things, and too much can cause dihydrogen monoxide intoxication where too much salt is flushed from your system causing Hyponatremia.
 
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Placebo effect, at best. This study is pretty much definitively saying it has NOT been "proven" to work, so I am unclear why you keep insisting that. Not only does this massive study show you don't get better, it shows a strong association with negative outcomes.
Are you a doctor? Do you have any facts to support your assumption that it was a placebo? WOW. I have heard actual doctors, NOT PATIENTS, say that it worked for them in some cases they handled. WTH do you REFUSE to believe that? I guarantee you that if Trump had initially said that nobody should take it, then the media would come up with "studies" saying it was highly effective, and that Trump should leave the decisions about it up to doctors. Of course, you will adamantly REFUSE to believe that scenario too.
 
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You are correct, he meant to say dihydrogen monoxide . Ingestion into the lungs is a major killer of children every summer. Amazingly enough, it is used in many household goods as a solvent! Also, oddly enough it is a required substance for life, but in delicate balance - too little can cause kidney failure among other things, and too much can cause dihydrogen monoxide intoxication where too much salt is flushed from your system causing Hyponatremia.
But I don't see anywhere that it is the number one killer drug that he claims it to be.
 
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