Saturday, March 28, 2020

COVID-19 # 38 (Required Parts Are Highlighted)

There are now 3 cabinet level people with positive diagnoses in the UK. It's starting to sound like Iran a month ago.

Here's the view from New York in "A New York Doctor's Warning" from The Atlantic.
Here, the curve is not flat. We are overwhelmed. There was a time for testing in New York, and we missed it. China warned Italy. Italy warned us. We didn’t listen. Now the onus is on the rest of America to listen to New York.
Do note that the story here is the same as Wuhan — sick-but-not-so-sick patients being sent home only to return later:
Many of my patients clearly haven’t received the message to stay home unless they’re in immediate need of professional medical assistance. Their fevers and coughs alone are not enough to even earn a test. 

...

By next week, we may simply have no choice. Those hundreds of relatively healthy patients we sent home may return to the hospital en masse in respiratory failure. On Wednesday, I greeted a patient I had discharged only one week prior. When I saw his name pop up on the board, my heart sank. He is just shy of 50, with hardly any past medical history, and he had seemed fine. Now he was gasping for air.

...

I do not want you to go to any hospital in the United States. I do not want you to leave your home, except for essential food and supplies.

...

In spite of all this morbidity, the doctors at the hospital received one piece of good news yesterday. A coronavirus patient was successfully taken off a ventilator after two weeks, a first for our Medical ICU and a victory for the staff and, of course, the patient.
That's right. A "first". After two weeks. And don't forget being on a ventilator often means being sedated and/or paralyzed in a medically-induced coma the entire time. This doctor works at Elmhurst Hospital in Queens, which seems to be the worst hit one in New York City at this time.

Here's an outbreak map for NYC

For those of you who don't know NYC, Long Island is the fat thing in the center right. Brooklyn is the dozen or so areas at the west end of Long Island. Queens is everything else to the north and eastern sides of that.The not-quite-quarantined area of New Rochelle that we were all so worried about 2 weeks ago (and have mostly completely forgotten now) is adjacent to and a little above the east side of the orange area at the top (which is almost all of The Bronx).

And there's this:

 The poster is Trump's first FDA commissioner (he left that office last spring).

Yes, those are temporary hospitals on the intramural soccer fields at the University of Washington:
Not sure where you are riding this out, but that may be in your location's future. Washington is doing very, very, well ... but cases are still going up, albeit slowly.

Oooh ... and this is an interesting perspective showing when death rates are going to fall back down to sort'of normal:
Utah is in beige, which means later than some other states. That tweeter has other interesting chloropleths here and here. We are going way past Easter on this in Utah.

Don't fool yourself that we are getting this under control yet. Who got COVID-19 under control in a bad situation? South Korea, that's who. So chew on this: the U.S. had more new positives yesterday than South Korea has found in total. Yes we are several times bigger, but still.

Oh ... and this ...
Subways and banks re-opened in Wuhan yesterday. Videos leaked out show very few people using them (probably because you need that phone app to show green to get in). There are unconfirmed reports that, now that people who show green are allowed to go to crematoria to pick up ashes, that there are 59K urns awaiting pickup. That is far higher than the official number of deaths, but consistent with those reported by those Tencent leaks in late January.

BTW: it's easy to forget that the problem in Wuhan was that news of the epidemic was suppressed until the quarantine. (Recall that the positive cases somehow stayed stuck at 41 for over 2 weeks in early January, and then Beijing brought the hammer down). Anyway, there's new research by Chinese authors in Science on that. They estimate that 82-90% of cases were undocumented at the time quarantine was imposed, and that they were the source for 79% of the cases that were later documented. Again, the 82-90% number is consistent with the information leaked out through Tencent in late January. Of course, we're finding out in the U.S. this month what happens when our government doesn't document the number of cases accurately and early. BTW: Anthony Fauci asserted in an interview that Italy's problem may have been that it was a desirable destination for Chinese doing international travel around their New Year.

Iran is still dark. There are vague reports of people who get news out being arrested. Also, there's no way to know the extent of this, but countries (not just Iran) have increasingly put their internet connection to the world on one single connection that can be cut when those in charge want to (Egypt was the first one to do this back in 2011). What we are able to see out of Iran are propaganda statements about lifting the U.S. embargo. Please keep in mind that the Iran refused aid from the U.S. that was limited to just medical supplies (here's a cite for that from just about the most progressive and anti-Trump publication I can think of), and also refused help from Doctors Without Borders. Is it OK for me to conclude we're in whacky territory here? Oh ... but there are reports the government of Iran will still accept cash donations if they are sent directly to them. Freakier still ... before they were releasing prisoners ... now there's video of prisoners simply running away from prison.


OK. Chill. Take a break:
I laughed. Hope you did too.
P.S. As of last night, we're worried about one person's symptoms in my house.
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