outbreak! (ebola, sars, coronavirus, etc)

Tamil Nadu man breaks quarantine, runs naked, bites woman to death

Obvious zombie joke aside, I feel the mental health repercussions of lockdown will be with us for some time. I already feel a little batty, having encountered practically no good news for weeks...

reporting live from an inpatient behavioral health unit, and yes, this is going to be a pretty significant mental health issue

omg. are you alright?

in case you forgot, gbx is a licensed psychiatrist (MD)

actually didn't know! that' a relief lol

gbx is fine it's the rest of us you should be worried about

lol sorry to have caused a scare, totally unintentionally bad wording on my part

a friend of a friend of a friend just died by suicide, grim out there.

I’m very sorry to hear this, not sure what else to say. It’s dark right now.

😷😷😷

20 flights arrived yesterday into London from NY.

▪️There was no social distancing on the plane
▪️No checks when they arrived.
▪️these passengers dispersed, many to the Tube.

Meanwhile police drones threaten sole walkers in the Peak District.

Utter nonsense.

— Bernie'sTweets (@berniespofforth) March 29, 2020

This is excellent:

Portugal is regularizing undocumented migrants to protect them – and the wider population – from the virus. Pay heed. https://t.co/xKwh11vsRP

— manu saadia 🖖 (@trekonomics) March 29, 2020

now that we're hitting the other side of the curve on the first wave, i'm starting to actually think about all of the things i deferred worrying about until we passed the spike

so we have an epidemic which is only being controlled by intensive quarantine. all of the normal functions of civil society have been put on indefinite hold. we're all cooped up here, our chief means of communication being incredibly unhealthy and toxic forms of media. we're all of us going crazy, some of us faster than others, and we're all pretty well aware that we are. staggeringly huge numbers of people have lost their jobs. we haven't come close to feeling the full economic impact of this. nobody has any idea about how we're going to pay for the costs of all this.

nobody has any idea what happens from here. i can think of a lot of possibilities, none of them particularly good. i've chosen not to dwell on those possibilities because we've had more important concerns, but i feel like we're reaching the point where those concerns are becoming more pressing?

ok, not to go big, but how do nation-states get to the other side of this without at some point going through the collapse of market capitalism and a lot of the "democratic institutions" that haven't already collapsed?

can we go with Scarlett O'Hara's "I'll think about that tomorrow" for now?

sorry, I don't have the semblance of an answer.

it's ok, i'm not really expecting an answer

i just needed to ask the question

The President’s Coronavirus Guidelines for America

#1. Listen to and follow the directions of your state and local authorities.

How you know that DJT had zero input on this communique...

I think the answer involves getting some combination of drugs approved that lessen the effects of the virus, and putting mass testing into place. Those are the biggest things we need ASAP if we are to have any hope of this not going on for a very long time.

The general idea, I think, is that lockdown levels of suppression stops community transmission enough so that when you slowly start easing restrictions you can isolate and quarantine the cases that do happen and stop outbreaks in their tracks.

Difficulty with that is that in this case is that Coronavirus is so ridiculously transmissible with its 2-week period where you feel fine but are very infectious that it makes the isolate-and-track stuff incredibly difficult.

So you need to get both hardcore on the tracking (see South Korea and phone tracking) and on the hygiene (masks for everyone and wash your hands).

And if it all fails you are back to lockdown again. Repeat until vaccination arrives.

(Or countries like Sweden prove that you can achieve a good enough reduction of transmission with less draconian lockdowns and everyone switches to that model. This is what the UK was initially going for, until it recognised the NHS couldn’t cope with the increased level of cases this route entails)

this is amazing

New Interview: I spoke with law professor Richard Epstein, whose controversial article on coronavirus circulated in the Trump administration, about why he believes many coronavirus models are wrong, and the dangers of sloppy science during a pandemic. https://t.co/kpurftthzw

— Isaac Chotiner (@IChotiner) March 29, 2020

Yeah his descent into defensiveness and ad hominem blathering is something to behold.

Meanwhile, this is interesting: it may have been around for a long time but only just evolved into bring transmittable from human to human:


https://www.scmp.com/news/china/science/article/3077442/coronavirus-pathogen-could-have-been-spreading-humans-decades

Two of the nation’s largest health insurers, Cigna and Humana, agreed to protect their customers from out-of-pocket costs if they need treatment for Covid-19, a decision that represents a rapid change in how companies are responding to the pandemic.

Describing the insurers’ decision as “a big deal,” President Trump on Sunday said the companies don’t “waive co-pays too easily, but we asked them and they did it.”

While insurers and government officials have taken steps in recent weeks to limit people’s out-of-pocket costs when they get tested, the bills associated with treatment for Covid-19 can run in the tens of thousands of dollars for a single hospital stay.

“Let’s take the economic burden and the economic uncertainty off the table,” said David M. Cordani, the chief executive of Cigna, in an interview before the White House briefing.

Under the new policy, customers “don’t have to worry about the financial burden of the virus while their lives are being turned upside down,” said Bruce Broussard, the chief executive of Humana.

the insurers added, "of course, customers will continue to have to worry about the financial burden of other illnesses and diseases while their lives are being turned upside down"

/borowitz

here in oregon insurance companies are being mandated to pay everything.

so, any guesses as to how exactly health insurance companies are going to remain financially solvent? i give it three months before private insurers point out that every single one of them will go bankrupt if _somebody_ doesn't give them a very large amount of money.

I think the answer involves getting some combination of drugs approved that lessen the effects of the virus, and putting mass testing into place. Those are the biggest things we need ASAP if we are to have any hope of this not going on for a very long time.

― Mario Meatwagon (Moodles)

right now we don't have an eta on either of these things. do we need to start calculating an eta until enough of us lose our shit that everything descends into mass chaos?

this is literally a race against time and nobody is acknowledging that

It’s definitely getting acknowledged down here an Australia. These restrictions being put in place are being portrayed as something that will be in place for a minimum of 6 months.

Mass testing, even home testing is coming along at a clip but it’s no s fret that drugs and vaccines take a long time, a lot of work and a good sprinkling of luck.

I had hoped I’d be able to travel overseas again by October but I can’t see that happening. Countries that get convos (mostly) under control are going to want to keep it that way. I can’t see being let out of Australia unless immunity is a real thing, I can prove my antibody status either because I got it or I had the vaccine. It’s going to look a lot like the yellow fever regime.

If I'm looking at the worldometer graph correctly, worldwide deaths dropped today for the first time since March 16. I don't know how much hope I'd pin on that, but it's something.

"so, any guesses as to how exactly health insurance companies are going to remain financially solvent?"

Reserves. Laws mandate a bare minimum of reserves any insurance company must have at all times, and the bigger and/or smarter insurers have much more than that.

Difficulty with that is that in this case is that Coronavirus is so ridiculously transmissible with its 2-week period where you feel fine but are very infectious that it makes the isolate-and-track stuff incredibly difficult.

There's also reinsurance, and a pandemic would def trigger clauses in contracts between insurers and reinsurers that shift some of the burden onto the reinsurer.

Let's not forget the billions for corporations Congress just lined up.

cool, looking forward to seeing that get dragged through the courts

how are the reinsurers on reserves? hope they have lots! icus aren't terribly cheap, even if you cancel all "elective" procedures like, i don't know, gcs

Really feel that the US healthcare system, which has been predatory for who've had to interact with it for at least 40 years, is going to have the worst outcomes of all developed nations.

Everyone knows regularly interacting with the system is a swift path to bankruptcy. Many will choose to die without burdening relatives/estate with the bills. I'm on a high deductible ACA plan, and I've been scanning the the reports of those who've gone through the symptoms. I think I won't trouble my PCP until my fingertip O2 sat falls below 88%, right now. Terrible we live in a society where getting to know one's doctor is a worst case scenario.

It’s definitely getting acknowledged down here an Australia. These restrictions being put in place are being portrayed as something that will be in place for a minimum of 6 months.

― American Fear of Pranksterism (Ed)

oh sure it's no big deal for you your government completely collapses every two weeks on average

take it to the 77 despair thread, y'all

I have this one bookmarked for actual news

gladly

number of new cases decreased for the first time since 3/21...from 19,452 to 18,469. Marginal to where it's really not that impressive considering the inconsistent, insufficient testing.

Deaths, though, were interesting - went down almost by half. From 525 on the 28th to 264 on the 29th. Probably pure coincidence, considering the number of active cases.

still, i'm scouring for good news anywhere I can find it. I wouldn't say this is "good news", as it's a solitary piece of data and probably an outlier, but definitely going to be watching these numbers like a hawk the next few weeks to see if we're affecting the curve at all.

I read all the actual-scientist corrections in that Epstein interview in the voice of Ron Howard's Narrator.

(xpost) I noticed that too, that the deaths went down (above), although you're looking at the States and I was looking at world totals--first time in almost two weeks, globally.

I remember there being a dip last Sunday before a Monday surge so it might just be the reporting. Hopefully I'm mistaken.

entirely possible. was just surprised at the size of the dip, but it could just as easily shoot back up tomorrow.

please for all of your sanity don't read much into one days' data point on any of this stuff. Deaths per day in the US are going to continue to go up before they go down. The IHME projections (for USA and its several States) drive this point home. (They're premised on the continuation of strong distancing measures.)

it's almost as if I JUST FUCKING SAID THAT

the IHME projections at https://covid19.healthdata.org/projections are a curve-fitting exercise, i.e. they're the kind of thing a physicist would do. this doesn't necessarily make them bad, but ... well it kind of does. details below, but basically i wouldn't trust the totals implied by this model to any more than a factor of a few, and i wouldn't trust the details about when things will peak in each state *at all*.

there's no epidemiology in the model. they're literally taking the data for deaths/day by state, and fitting a curve with three parameters. AFAICT they choose the functional form of the curve because it's expedient rather than because it matches anything we know about epidemiology. and the fit involves extrapolating from very, very limited data. that's because we're early in the outbreak and the data is poor/incomplete. (look at the deaths per day plots. they're extrapolating from the solid line to the dashed line.) this situation (limited noisy data which you're forced to extrapolate into the far future) is exactly where some epidemiology would be useful to fill in the blanks or prevent obvious mistakes. a data-driven model is fine when you've got lots of data. we don't!

this is probably the reason there are some extremely dubious claims if you look at things in any kind of detail. e.g. they forecast the NY peak is 7 days away and they will be below 10 deaths/day by may 1 while the washington peak is still 20 days away and they'll be getting >10 deaths/day until almost june. this seems obviously nonsense. there are lots of these examples (NYS is a particular outlier relative to all the other states AFAICT).

https://i.imgur.com/5TEZuYB.png

e.g. this is the model for NYS. they're extrapolating from the solid line to get the dashed line. just by eye, it should be obvious that they're out on a limb here. you could draw lots of dashed lines with the same basic shape and they'd all be reasonable extrapolations from the tiny amount of data we have, with very different peaks and areas under the curve (i.e. total deaths).

Maybe we should just all agree that we can all look at whichever graph makes us feel the best

love this one

https://www.pmel.noaa.gov/co2/files/co2_data_mlo.jpg

The general idea, I think, is that lockdown levels of suppression stops community transmission enough so that when you slowly start easing restrictions you can isolate and quarantine the cases that do happen and stop outbreaks in their tracks.

Difficulty with that is that in this case is that Coronavirus is so ridiculously transmissible with its 2-week period where you feel fine but are very infectious that it makes the isolate-and-track stuff incredibly difficult.

So you need to get both hardcore on the tracking (see South Korea and phone tracking) and on the hygiene (masks for everyone and wash your hands).

And if it all fails you are back to lockdown again. Repeat until vaccination arrives.

(Or countries like Sweden prove that you can achieve a good enough reduction of transmission with less draconian lockdowns and everyone switches to that model. This is what the UK was initially going for, until it recognised the NHS couldn’t cope with the increased level of cases this route entails)

The general idea, I think, is that lockdown levels of suppression stops community transmission enough so that when you slowly start easing restrictions you can isolate and quarantine the cases that do happen and stop outbreaks in their tracks.

Difficulty with that is that in this case is that Coronavirus is so ridiculously transmissible with its 2-week period where you feel fine but are very infectious that it makes the isolate-and-track stuff incredibly difficult.

So you need to get both hardcore on the tracking (see South Korea and phone tracking) and on the hygiene (masks for everyone and wash your hands).

And if it all fails you are back to lockdown again. Repeat until vaccination arrives.

(Or countries like Sweden prove that you can achieve a good enough reduction of transmission with less draconian lockdowns and everyone switches to that model. This is what the UK was initially going for, until it recognised the NHS couldn’t cope with the increased level of cases this route entails)

I’m not sure this is true, as far as is currently known risk of catching from someone with no symptoms is low

You're less infectious (55% is the figure I just saw) but you're higher risk is the point, since you're going about in public rather than hunkering down.

Something I thought worth mentioning is the remarkable fact that 66%-80% of all COVID-patienst in Dutch hospitals and in ICU are obese. Has this been noticed anywhere else? Experts think it could be because people with diabetes are more at risk. Still a very high percentage imo.

From this: "‘Almost all the patients on an IC ward are overweight,’ Peter van der Voort of Groningen University’s teaching hospital said. ‘We don’t know why, but it is very noticeable.’"

In Italy, obesity is the most common comorbidity.

Visceral fat reduces lung tidal volume. And adipose tissue is a endocrine organ, producing more proinflammatory cytokines on its own.

I really wish I'd picked another drug to sedate me through the Trump presidency than alcohol, 7 kcal/g.

i have somehow lost weight during isolation, probably as my diet is now the healthiest diet anyone has ever had ever

(last night's found panettone excepted)