Although NY is probably seeing an explosion in infections, this doubling is probably not a true growth in number of cases overnight, but instead representative of massively increased testing in NY.
Yes, absolutely. Even so, and even if there is a lot of noise in the data the trend is alarming to put it mildly. With earlier testing and a more transparent picture people may have taken the warnings more serious. Now they are partying like it is 1999 and the results of that will only become visible two weeks from now. By the time tests will be more common across other populous states the USA will likely be the #1 country in the world regarding case count and the delayed response means they'll peak a lot higher than China.
Is there a reliable link to the number of people on ventilators? I've only been able to find time series data for number of deaths. Which is helpful, but way too much of a lagging indiactor.
The 'critical' column on worldometers is a starting point. The general consensus is that the deaths are the most reliable, the criticals are somewhere in the middle and verified cases the least reliable due to lack of tests. But it is hard to fudge a death.
Not that I think the number of cases is grossly overstated, but Italy lists deaths from coronavirus if the patient dies for ANY reason while they are afflicted by the coronavirus. This would be the source of some "fudging" of the numbers.
For the US that critical column as been way out of date (just from what I knew of one hospital vs what it was reporting for the country several days after; I don't know if it is still far out of date).
Increase of testing is 300% a day at times. For infections to increase greater than that you would need each infected individual to infected 3+ people a day. You may mean that the number of infected is still higher than the number of tests available
The only way to stop the spread is to have accurate testing and a population willing to abide by quarantine measures on a voluntary basis when tested positive as well as immediate tracing of contacts. Anything less than that and the spread will continue.
US was delayed with the onset compared to Europe and the rest of the world. This is not some competition that lowest number of cases wins. If anything else, you need to account for cases/capita. Furthermore, India, a country of 1 billion+ citizens has less than 1000 cases. Why? Because they haven't got enough testing capacity.
Please stop this ranking nonsense. It is not helping in anyway. If we want to assess how effective each country will fare - look no further than totalitarian and authoritarian states. Also, wait for all of this to be over with and then we can assess who did better and who did worse. Amidst the crisis, I am frankly concerned about comments such as this.
Even the aforementioned ranking is useless because the onset is staggered. It is like taking a slice of a timeseries data in the middle of highest rates of changes and saying "Here! Look. We have some definitive answers."
I am in no way opposed to spreading the message to folks in deep south states who are largely ignoring this crisis. But using misleading data to alarm them is not the right way to go about this. The press should be doing their job of communicating what exactly is going on in hospitals, pressuring leaders of the states to consider the warnings, and generally taking an objective, scientific approach in informing the public.
Be concerned all you want, but look at it this way: without the most populous nations (for instance, the USA) at the top of a list like this politicians can downplay the seriousness of the threat. HN has a small army of people who do nothing else than trying to make it seem like this is 'just a flu', or something slightly worse.
All of that taken together translates into people simply ignoring the danger and continuing their life making things much worse in the long run.
Viruses don't have legs, they need people to transport them. And as long as we're willing it gets spread around and some people will die. If rankings like these send the message loud and clear that this also concerns you then I'm all for the rankings, even if they are a bs statistic without taking into account the total population size. People find it much easier to relate to 5000 people dead than they do to 2000 people per million infected.
Agreed that we need to spread the message far and wide. Just slamming down on people that are doing their best to cope with this situation isn't very productive, if not discouraging and harmful. In these times, Solidarity is needed. Just the way we support Italian crisis, we need to do the same to the US and the rest of the countries.
Slam governments, take it up on the streets to address issues after this pandemic is over.
> without the most populous nations (for instance, the USA) at the top of a list like this politicians can downplay the seriousness of the threat
That doesn't make any sense. First, it's not desirable in any way for the US to be near the top of that list. That's a per capita list (for obvious reasons it's better for small nations to dominate that list) and the US has a spread out and very low population density compared to most nations in eg Europe. Having a high population nation doesn't inherently correlate to being near the top of the per capita infection list.
Population density is not your friend when it comes to a highly infectious virus spreading in the population.
Countries in Europe vs the US on population density:
The Netherlands 12x, Belgium 11x, UK 9x, Germany 7x, Switzerland 6x, Italy 6x, France 4x, Poland 4x, Spain 3x.
The US also has no primate cities, whereas Europe has ~25 of them (hyper population concentration). Most nations in Europe have a primate city that dominates the nation in terms of population, acting as a massive potential infection supercenter.
It's entirely unsurprising that smaller European nations with high population densities vs the US would have higher infection rates per capita.
These rankings are important because it helps us get a feel for what type of quarantine action is getting the virus under control.
Any country with sufficient testing that's managed to bring the growth rate below exponential is worth an enormous amount of attention, because we seem to have many countries who have taken action yet failed to stop exponential growth.
Then use cases/capita. US has 330 million people and comparing it with #2 spot (Italy with 60 million) is completely insane, not to mention that the worse is yet to come to US.
I am all for taking a critical look at American systems and their effectiveness of the response, but the ranking by the case numbers is naive, misleading and unproductive.
Every country starts with (let's say) 1 imported case. From there, it grows. Cases/capita doesn't really mean anything until you get into the millions of cases and start thinking about what the upper bound might be.
And so ranking countries by size of outbreak seems reasonable to me.
I edited my comment with some data. The onset is staggered, the entire ranking thing is useless until the pandemic is over. It is simply a tracker, not an objective measure of the efficacy or the effectiveness of the measures each country is taking. It is too soon.
> we seem to have many countries who have taken action yet failed to stop exponential growth
Remember the virus has an incubation period of around 2 weeks. China's numbers appeared to be increasing exponentially for 2 weeks after the lockdown, but those were mostly people infected before the lockdown.
There will be no revisionism, because that would require respect for the value of speaking truthfully and standing behind your words. Rather, bringing this up will just be met with shallow denials that it wasn't important at the time, that nobody could have known, that the questioner is part of the problem, etc.
You can already see the narrative of the ignorance club is shifting to "we're doing a good job" - focusing on current nascent actions and completely ignoring the month long head start given to the pandemic in the US by inaction, incompetence, and outright lies (eg masks).
Not that it makes sense to waste energy bickering about these things when there is still a major problem to be addressed, but the point is that the month or two long societal shutdown we're experiencing is best attributed to a failure of our institutions rather than the force of nature.
Now many people need to be hospitalized vs reported cases? Last I heard here in Los Angeles county we had like 270 reported cases and like 40 people hospitalized. This is in a county of around 10 million people.
I’m pretty doubtful that this is much worse than the flu. But I am self quarantined, stocked up on food etc. my level of doubt is not nearly strong enough to counter the severity of consequences if I am wrong.
My wife has asthma, and my parents are elderly. I’m middle aged. I’m much more concerned about hurting other people.
That said, flu statistics aren’t great. I’m pretty sure I’ve had the flu, due to severity of illness. But I’ve never been tested for it. I don’t know anyone who has. When people die of pneumonia etc they Aren’t automatically tested for flu.
The CDC numbers I found are slightly more than half that for influenza.
Without significant mitigating precautions, which was the context for this discussion, the USA would very likely have more than 100 million Covid-19 infections in the next three months.
Yes, it's technically a logistic process rather than exponential. But there is no pre-existing immunity, so it won't hit the inflection point until it bumps up against the natural limitations. Meaning herd immunity due to a large percentage of potential victims already infected, or limitations in how many people will likely meet a sick person. The latter won't happen without the mitigations I'm talking about.
A third of the population infected seems as reasonable a ball-park guess as any for when the first point would be hit. But I really, really hope that the mitigations prevent this.
From what I can tell (even here on HN by a few bad actors), they seem to have pivoted to a “we simply can’t do this to the economy; it’s not an option for a disease that only kills old and sick people”, without the faintest hint of a plan for what they’d actually do given what we know and the resources that we have.
We can all wish for the culture, test availability, and competent government that South Korea and Singapore and Taiwan apparently have, but we don’t have those. So their “plan” is effectively a plan to just let millions of people 60+ or with pre-existing conditions die without much effort to save them. It’s not only unconscionable, it’s incredibly stupid. Do they think we’re just going to go back to work and restaurants and on vacation while millions of our loved ones take their last gasps in a converted convention center somewhere? The economy grinds to a halt either way, and there’s no moral or political path forward for what they want to do. Which is why they don’t have the courage to even spell it out, it’s just some magic handwaving about how we must do something different.
And all this against the backdrop of them and people like them downplaying this from the start and putting us in this position.
I am actually terrified about home remedies regular people provide without deep understanding of human physiology and medicine.
Please refrain from providing advice to people if you're not in the position to do so unless you're a medical doctor. It sounds good hearted but this is exactly the kind of things we shouldn't be perpetuating. You can cause inadvertent loss of life in worst case.
My parents are forwarding all kinds of shit from social media from fake vaccine news to completely insane home remedies such as going to a sauna when you have fever to "kill the virus". I am not suggesting you're doing this, but just to illustrate extreme case of misinformation.
Yes, I know. I've actually been around this block before.
I have a form of cystic fibrosis, as does my 32 year old son who still lives with me. I left all the CF lists years ago because people with CF live in terror and mostly don't want to take chances on trying anything not prescribed by a doctor, even though they are facing certain death.
Doctors don't know how to fix them. When I was diagnosed in 2001, life expectancy in the US was age 36.
Like anyone who has CF or who has a loved one with CF, I know quite a lot about germ control and daily home management of potentially deadly lung problems. Unlike most people with CF, I'm currently drug free. My condition is managed with diet and lifestyle.
I think it's outright irresponsible to say nothing at all in cases where I know a thing and no one else is speaking up, even though I surely an not the only person who knows X. I've mostly spoken up to say, essentially, "If there aren't enough ventilators to go around, airway clearance techniques have been around forever and some of them are non invasive and don't require mechanical intervention. You may still have options, even if the worst comes to pass, the medical system is overloaded and you are trying to survive a deadline epidemic while locked down at home."
If you want to see my past remarks, I've added the link to that discussion to my profile. I'm disinclined to do too much cage rattling on HN in discussion.
I'm currently working on developing a blog in hopes of putting together useful information about best practices for simply avoiding germs in day-to-day life.
I think I know a lot of useful information. I don't think I'm behaving irresponsibly.
I'm still trying to sort out for myself what I think works going forward. I don't think there's anyone on the planet who can tell me what that is.
I absolutely cannot volunteer in a hospital. Cystic fibrosis puts me in a high risk category. That's like asking me to intentionally become the Typhoid Mary of covid19.
- Spread information about hygiene, CDC recommendations on how to prevent spread of Coronavirus and reiterate/ephasize the importance of washing hands/cleaning public spaces.
- Donate money to medical research, who knows, some of these home remedies may be useful. But not without getting the research done first.
You don't see the danger of providing medical advise to others? I've been wrong many times of something that I thought was intuitive to me but ultimately there was a "oh..." moment when I saw experimental results or some concrete evidence.
There is also a network effect - you say X to person Y. Person Y tells X to 10 other friends who then tell 1000 other people. The misinformation that started from you could potentially affect a lot of people and then you start having deep thoughts such as - I tested X on myself and it worked. But now 100,000 people are doing it - is it safe?
This is why you should stop from providing medical advice to others. I am saying this with respect to you and your earnest intentions from heart.
Cystic fibrosis is supposed to cost up to a quarter of a million dollars per year for medical care per patient. Two members of my household have it. I've supported us all on well under $20k annually for at least eight years and we were homeless for nearly six years.
I often have insufficient money for food. Yet, we are still alive.
I respect your genuine and valid concerns about giving advice in situations where you don't know what you are talking about. Trying to give me advice to do things like volunteer in a hospital or donate money I don't have falls in that category.
Maybe take a few minutes to at least look up cystic fibrosis before commenting further about what you think I should be doing.
I'm sure it's true that it's not intended that way, but it's coming across that way, especially when you do it 5 times. Please don't hound anyone like that on HN.
The whole point of a fever is that the higher temperature harms the disease organism more than the host organism. It is in fact to "kill the virus".
The sauna supports that. The same goes for anything else that would enable the fever of course. You could instead eat hot soup, wear a jacket, or adjust your thermostat.
Going the other way, cooling yourself to suppress a fever, blocks a natural response to infectious disease. Don't do that unless your body has overshot the proper fever temperature by a long ways, to the point that you are at risk of brain damage.
Doreen, your home health care options are good, and I appreciate your comments! You're not making ridiculous claims or pushing some off-label drugs.
I told several friends about your advice to prop up your head and back in bed when feeling shortness of breath.
Cautiously I also recommend tonic water for a cough - not because of a medical benefit, but because the bitterness makes sputum in my mouth and that soothed my sore throat. Also wasabi for a blocked nose. Normally I think cough medicine would be better, but I know that pharmacies are overloaded right now. I also think the placebo effect is very real - doing something positive might help, instead of just sitting and worrying.
Please don't recommend things for a cough that you clearly know nothing about.
Tonic water absolutely has a medical history. It's not hard at all to find that out by reading the label and doing a little online research.
It makes me extremely uncomfortable for you to talk about tonic water for a very long list of reasons.
Because it contains an actual for serious drug -- quinine -- you can get serious side effects from overusing it. These include vision problems, headache and nausea similar to migraines. IIRC, you can cause yourself permanent vision problems.
Because it's a powerful alkaloid, overuse can cause your stomach to become too alkaline. This can cause you to be unable to digest food and can result in vomiting.
The name "tonic water" is medical in origin. The bitter flavor you speak of was common to a class of medicinal herbs typically referred to as "bitters."
Quinine is a drug related to the drug currently being tested as a possible treatment for covid19: Chloroquine. So casual and uniformed use of it could create resistance in the virus, making actual medical treatment less effective in the future.
I highly recommend you keep a journal and actually read up on anything you are finding personally helpful.
I'm not here trying to tell people what to do with home remedies for casual use. My consistent framing has been "If the shit really hits the fan and doctors have nothing for you, there are other options that may make sense to gamble on if your options are take a chance or die."
I know a helluva lot about medical stuff. My mother wanted to be a doctor and she personally changed the practices of two cancer clinics when she kept my dad alive after they wrote him off for dead. I have another relative who works at the CDC and has for years.
I've been surrounded by medically knowledgeable people my entire life. I also absolutely don't hawk home remedies.
I've spent a lot of years trying to figure out if there is any way to effectively share what I know about CF and other health issues to either be helpful or to somehow get actual medical professionals and scientists to do studies.
I would love to finally have credibility and be taken seriously in the world and have actual respect.
And it matters vastly less to me than avoiding potential harm to potentially millions of people because I'm cute and charismatic and people want to be my fwend and it goes amazingly bizarre places and always has.
I know you mean well. I know you think I'm pathetic and sad and a social outcast and a poor person and you think you are doing something nice by publicly patting me on the head.
I absolutely don't see it that way. I'm extremely uncomfortable with you and other people here clearly desiring some kind of feel good emotional attachment to me personally as your primary goal of engaging me, very much at the expense of best practices for disseminating medically useful information.
The tonic water that is available without prescription is too dilute to matter as a drug. You would get the permanent vision problems after using it daily for about 500 years, except that you are unlikely to live 500 years anyway.
Historically, a gin and tonic was developed to be used as a prophylactic against malaria for British soldiers stationed in areas where malaria was a problem. So it was a medicinal drink. This is easy enough to verify:
I've done the math. I know how much tonic water you need to drink to be roughly equivalent to being prescribed quinine as a drug for medical use.
It's a lot, but not so much that you can't consume that much in a single day. I'm not posting the figures I remember here because I'm not interested in encouraging people to do something like that.
And they are entirely ignoring the impact of this virus on our healthcare workers. Due to high exposure levels to the virus, they are at much higher risk of not just getting infected, but also developing higher severity of the disease.
We need to make "Support our Healthcare Workers" a bigger part of the messaging strategy. They are on the front lines of this battle, and when we fail to implement control measures, we are putting their lives at risk.
Another counter-point to the inhumane position you're rebuking - one which speaks to people's self-interest - is that as the healthcare systems become overwhelmed they will eventually stop treating conditions and accidents which afflict everyone including young people.
Isn’t the South Korean government known for massive amounts of corruption between itself and entities like Samsung? The good does not wash away the bad, nor the bad the good...
I'd say that even overt corruption is not necessarily a white or black determinator on the overall health of the institute of government.
South Korea is not only known for "Samsung bribing *," but also countless successful cases of corruption prosecution, including 2 Samsung CEOs in a row going to real jail.
In overall, a health on the very top of society stems from strength at the bottom.
We can’t build temporary quarantine centers, hermetically sealed units, gas mask or ventilators. We could predict all this and did, but incompetence. We could had made a coronavirus vaccine that could had potentially worked now, years ago. We could have general tests or fast tracked specific tests months ago.
All this seems like a much bigger problem than the virus itself. Our system is incapable of being efficient, effective or proactive.
> We could had made a coronavirus vaccine that could had potentially worked now, years ago.
That isn't really true. Some viruses are more susceptible to vaccination than others but all have one thing in common: about 12-18 months between the first confirmed sighting of a virus and the time to make a vaccine if one is possible. And for plenty of Viruses we have not been able to make a vaccine and some of those are coronaviruses.
> We can all wish for the culture, test availability, and competent government that South Korea and Singapore and Taiwan apparently have, but we don’t have those. So their “plan” is effectively a plan to just let millions of people 60+ or with pre-existing conditions die without much effort to save them. It’s not only unconscionable, it’s incredibly stupid.
Why we had to wait until a crisis like this for this to be rendered bare for the wider population?
As I've said countless times before, the West has been on the downward trajectory for a very long time, both as a society, and as state entities.
What I call an "ultrapopulism" has been an ever growing trend in the West since around mid-nineties.
The Western nations are not just weak as societies, and nations, they are diseased (sorry for having to use this word now.)
The reasons for me moving from comfy life in the West to China is not because I so much enjoyed it, but for me having a realisation that this accelerating downward trend will have very real consequences in my lifetime, and that even money alone no longer favours the West.
Well, lets not forget that this whole mess started in China. It was the chinese government which decided to hide information and pretend everything was under control while allowing it to spread all over the world.
> Well, lets not forget that this whole mess started in China.
Yes, China is a patently dysfunctional society. This is what I can say as person whose life and career depends on it, and who actually lived there.
I'd say the "good" performance of Chinese state looks like that only in comparison to catastrophically bad showing from Western nations.
20 year ago, I would've said that what China did after the monumental screw up at the start, would've been an expected level of response from an upstanding Western nation. Now, the West can not do the same what it could've done 20 years ago easily. That's the only message for that particular point.
Is Chinese society a healthy, functioning society? No, but at least critical parts are still coasting on inertia from the time China had half sane political leadership.
Is the West a healthy, functioning society? Some things there work, but the most important, critical parts are failing in broad daylight, and people don't damn care.
The response to this from the western world has indeed been disgraceful. China's was too. They managed to contain due to their authoritarian policies but the real examples of good responses from asian nations are SK, Japan, Singapore, Hong Kong, Taiwan. They've managed to contain it much better than anyone else without the need of massive government overreach.
“Healthcare personnel (HCP) use of homemade masks:
In settings where facemasks are not available, HCP might use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19 as a last resort. However, homemade masks are not considered PPE, since their capability to protect HCP is unknown. Caution should be exercised when considering this option. Homemade masks should ideally be used in combination with a face shield that covers the entire front (that extends to the chin or below) and sides of the face.”
We wont know the extent until 1-2 years from now when statistical studies are done to show the true danger of the Chinese coronavirus. It could very well be the flu, a 10x flu, or worse, or better. It’s the uncertainty that’s killing us, for lack of a better term.
Wonder what degree of revisionism the 'it is just a flu' crowd will engage in where they are on the record.