teen persuasion
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Post by teen persuasion on Mar 26, 2020 12:02:10 GMT -5
There's also the fact that alot of people won't get tested at all. A friend and his wife both got sick (fever, headache, cough) about 8 days ago as we were all starting to work from home and as the schools were shutting down. as of today they are both feeling better, but never went to the doctor. One of my brothers just reported this morning that as of last night they have a fever and are achey/headachy with a cough out of the blue (they were fine 24 hours ago). I suspect he will not see a doctor unless it gets way worse (as in they can't breathe). I suspect his wife will get it too and if it's mild/medium she won't go to a doctor. At this point I'm assuming all of the reporting based on actual tests are for people who are sick enough to be in a hospital (or who are sick and already in a medical type environment like a nursing home or assisted living) and for well to do people - they have healthcare and a regular doctor and they are in "important" positions with their employer (like a director or manager or CEO). The average working joe and jane aren't gonna get tested. So, in my head, I'm doubling/tripling the "new cases" numbers - cause if there's 1000 new cases that are confirmed - there's probably actual 2 or 3 times that number in reality... I'm in NYS, but at the opposite end from NYC. NY has been doing lots of testing, but we're still way short on tests locally. The current local numbers are seriously low, because they are only confirmed numbers, and tests ran out last weekend (but a backlog of results shows in the numbers daily since Saturday). They got a new batch of 350 tests maybe a day ago (for a region with a county of > 1 million, and 7 other smaller counties). There was local outrage when Cuomo said "in Buffalo, you can get a test at a hospital" and local officials had to put out their criteria for getting tested (health care workers, threats to health care workers aka critical patients, law enforcement, those with symptoms in group living situations like prisons and nursing homes). So they are only testing the extreme cases and crucial personnel, and saving tests for those people. They have said, assume Covid-19 is everywhere, because it is. The first maybe 4 days of reported cases (from 3-15) were all from people who had travelled (Italy, NYC, and out of state). After that, they were community spread cases that couldn't be tracked back to somewhere else. There's nearly 150 confirmed cases in Erie county (Buffalo), out of maybe 800 tests performed, but the first few days they were testing people who'd been exposed to confirmed cases; now that's dropped. So it's obvious that local numbers are much greater than confirmed numbers. Not sure about NYC - maybe they have more tests, simply because they are a few days ahead of us on the curve. Maybe they are ignoring the mild, stay at home cases, too, because they are overwhelmed. Either way, it definitely skews the stats.
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pulmonarymd
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Post by pulmonarymd on Mar 26, 2020 12:06:19 GMT -5
You think ours are accurate? Absolutely not! I don't think any countries' numbers are accurate at this point, but I definitely don't believe China's. Not sure why you are singling them out, ours are just as fictitious, and since we are a supposedly free country, that is more of a tragedy. I expect them to lie. We got there through a combination of lying and incompetence
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gs11rmb
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Post by gs11rmb on Mar 26, 2020 13:05:02 GMT -5
Like others have said I would think the actual number of infected is much higher than the reported number. Many people who get a cough or even the flu don't go to the hospital unless it gets bad or drags on because they're just going to tell you to stay home, rest, get plenty of liquids, etc. Obviously if you're older or have a compromised immune system then a hospital trip makes more sense but the last thing hospitals need right now is people with mild symptoms showing up. Problem is too many people already treat the ER like their primary care physician and show up when their kid has the sniffles. A nurse friend said last week that their ER was slammed with people wanting to be tested. Atlanta was on the national news last night because our hospitals are at capacity. Unless you are vulnerable or your symptoms are significantly worsening then you need to stay out of the ER's!
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Miss Tequila
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Post by Miss Tequila on Mar 26, 2020 13:51:29 GMT -5
Like others have said I would think the actual number of infected is much higher than the reported number. Many people who get a cough or even the flu don't go to the hospital unless it gets bad or drags on because they're just going to tell you to stay home, rest, get plenty of liquids, etc. Obviously if you're older or have a compromised immune system then a hospital trip makes more sense but the last thing hospitals need right now is people with mild symptoms showing up. Problem is too many people already treat the ER like their primary care physician and show up when their kid has the sniffles. A nurse friend said last week that their ER was slammed with people wanting to be tested. Atlanta was on the national news last night because our hospitals are at capacity. Unless you are vulnerable or your symptoms are significantly worsening then you need to stay out of the ER's! The LAST place I want to be right now is an ER...if you don’t have it when you walk in, you probably will by the time you leave!
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pulmonarymd
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Post by pulmonarymd on Mar 26, 2020 14:50:19 GMT -5
A nurse friend said last week that their ER was slammed with people wanting to be tested. Atlanta was on the national news last night because our hospitals are at capacity. Unless you are vulnerable or your symptoms are significantly worsening then you need to stay out of the ER's! The LAST place I want to be right now is an ER...if you don’t have it when you walk in, you probably will by the time you leave! Not true, the precautions we are taking in most places are pretty aggressive. One reason we have a shortage of PPE, we are burning through it in a rapid manner. Still wouldn't want to go to an ER. The person you do not think has it is the one who is riskiest to you, since you are less wary. One reason we are being excessively vigilant.
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mary2029
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Post by mary2029 on Mar 26, 2020 16:51:04 GMT -5
Absolutely not! I don't think any countries' numbers are accurate at this point, but I definitely don't believe China's. Not sure why you are singling them out, ours are just as fictitious, and since we are a supposedly free country, that is more of a tragedy. I expect them to lie. We got there through a combination of lying and incompetence I will explain. The initial quote I commented on was: If you scroll down the page to some other charts, you'll also find that by this time measured from the first day 100 cases are confirmed, China was starting to level off. They had a another little bump but the curve was flattened. Italy and the US, not so much. And the growth rate in the US is slightly hire than italy, but far less than China. At day 23, China had 2/3 the number of cases we do. So, I am singling out China as China was the first country impacted and China was the subject of the quote.
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teen persuasion
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Post by teen persuasion on Mar 26, 2020 19:33:00 GMT -5
Apparently there's now 221 cases in Erie County. From I thought around 150 earlier today. Ramping up fast.
ETA: just checked - 75 new confirmed TODAY. Three more died TODAY (total 5 deaths now). Hospitalized Tuesday: 9. Hospitalized TODAY: 31.
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CCL
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Post by CCL on Mar 26, 2020 20:29:28 GMT -5
But did they increase their testing? That could make the numbers jump quite a bit. It's so difficult to get accurate numbers for this.
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Tiny
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Post by Tiny on Mar 26, 2020 21:58:41 GMT -5
Like others have said I would think the actual number of infected is much higher than the reported number. Many people who get a cough or even the flu don't go to the hospital unless it gets bad or drags on because they're just going to tell you to stay home, rest, get plenty of liquids, etc. Obviously if you're older or have a compromised immune system then a hospital trip makes more sense but the last thing hospitals need right now is people with mild symptoms showing up. Problem is too many people already treat the ER like their primary care physician and show up when their kid has the sniffles. A nurse friend said last week that their ER was slammed with people wanting to be tested. Atlanta was on the national news last night because our hospitals are at capacity. Unless you are vulnerable or your symptoms are significantly worsening then you need to stay out of the ER's! Holy Crap. Atlanta is the biggest city in Georgia. I googled about the at capacity. And yeah, at capacity. I would have thought a large metropolitan area would have been more prepared (because they have the leadership and infrastructure and resources). Holy Crap. We really may be doomed.
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haapai
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Post by haapai on Mar 27, 2020 9:54:43 GMT -5
I'm gradually coming to the conclusion that we're going to start looking at trend in the number of COVID-19 deaths to know where we are. The constrainst on testing are so severe that the numbers for confirmed cases are meaningless and will probably remain so.
It's shocking to hear someone in public health indicating that we are going to have to use a indicator that lags so badly and is difficult to interpret when the underlying numbers are small.
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teen persuasion
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Post by teen persuasion on Mar 27, 2020 11:13:29 GMT -5
But did they increase their testing? That could make the numbers jump quite a bit. It's so difficult to get accurate numbers for this. They'd run out of tests last weekend (but had a backlog of pending results). Got more tests mid week, but still limited numbers, so reworked who they are testing. Tests reserved for frontlines, essentially: healthcare workers, law enforcement, and those that directly impact them: extreme presumptive Covid-19 patients (endanger healthcare workers), and group living situation people with symptoms only (prisoners and nursing homes). No more testing if you were exposed to someone testing positive, no more tracking contacts and known spots someone testing positive went to in recent days (they did this the first few days, and gave up as community spread cases took over). The jump in hospitalized cases shows that it is getting more severe, and that those are the most likely cases to be confirmed now. Mild, non-hospitalized cases are told to just stay home, no testing, so not counted.
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thyme4change
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Post by thyme4change on Mar 27, 2020 11:20:43 GMT -5
A nurse friend said last week that their ER was slammed with people wanting to be tested. Atlanta was on the national news last night because our hospitals are at capacity. Unless you are vulnerable or your symptoms are significantly worsening then you need to stay out of the ER's! Holy Crap. Atlanta is the biggest city in Georgia. I googled about the at capacity. And yeah, at capacity. I would have thought a large metropolitan area would have been more prepared (because they have the leadership and infrastructure and resources). Holy Crap. We really may be doomed. Creating hospitals, hospital beds and equipment isn't something leadership can just order, and make happen in a short period of time. That "hospital" China built in a few weeks burned to the ground a short time later.
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lurkyloo
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Post by lurkyloo on Mar 27, 2020 12:02:01 GMT -5
I'm gradually coming to the conclusion that we're going to start looking at trend in the number of COVID-19 deaths to know where we are. The constrainst on testing are so severe that the numbers for confirmed cases are meaningless and will probably remain so.
It's shocking to hear someone in public health indicating that we are going to have to use a indicator that lags so badly and is difficult to interpret when the underlying numbers are small.
I have been thinking that as well. MD is reporting infection numbers that are the highest in the immediate region but a low number of related deaths (775/5). Meanwhile DC is at 271/4 and VA at 606/15. Some of that is due to skewing factors like population or mutations that affect the death rate (some of the VA deaths are bc it got into a nursing home , but I think the biggest factor is accessibility to testing. I don’t have a good explanation for Italy‘s rate. There but for the grace of God. I do think that if we can slow the infection rate and develop a good antibody test that detects immunity, we will be in a better place in weeks to a couple of months because we will start to build up a population that has had it and won’t catch it again, who can risk exposure. I am terribly worried about the rate of infection among doctors and other skilled health care workers bc we can’t afford to have all of them down at once with it. Edited to remove a horribly inappropriate emoticon autocorrect
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haapai
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Post by haapai on Mar 27, 2020 12:33:22 GMT -5
You've just pointed out a major downside to using COVID 19 fatality numbers as indicators of whether incidence is going up or down. Transmission of the disease within group living facilities will create spikes that are hard to account for or analyze.
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lurkyloo
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Post by lurkyloo on Mar 27, 2020 12:58:16 GMT -5
You've just pointed out a major downside to using COVID 19 fatality numbers as indicators of whether incidence is going up or down. Transmission of the disease within group living facilities will create spikes that are hard to account for or analyze.
True, but a statistician with access to the underlying data can account for those kinds of spikes. Possibly by looking at death rate sorted by age. I saw an article somewhere where they were looking at flu like deaths as compared to multiple previous years, under the presumption that a large spike relative to previous years patterns would likely be reflective of CV deaths. Statisticians are scary, yo. I have to say MD has been on top of this as it’s possible to be so I do think that it’s plausible that MD is testing more.
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Tiny
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Post by Tiny on Mar 27, 2020 13:03:46 GMT -5
Holy Crap. Atlanta is the biggest city in Georgia. I googled about the at capacity. And yeah, at capacity. I would have thought a large metropolitan area would have been more prepared (because they have the leadership and infrastructure and resources). Holy Crap. We really may be doomed. Creating hospitals, hospital beds and equipment isn't something leadership can just order, and make happen in a short period of time. That "hospital" China built in a few weeks burned to the ground a short time later. I was thinking more along the lines of general preparedness. I fully realize that hospitals are constrained by their size and workforce. What I'm talking about is the preparing part of this during the weeks before it happens. The best emergency plans are set up BEFORE the emergency not during it. I bet there's alot of chaos at hospitals because no one really knows which process to follow. It's not a good plan if all the working parts (the people, the paramedics, the doctors office, the Health department, the nursing homes, the hospitals) are on the same page. I think there's alot of chaos and not so much communication. That's what I'm talking about. (FWIW: in preparation for a surge of patients local hospitals are setting up protocol to get sick people to the right places and right types of treatment - so someone who may be having a heart attack or who has a broken leg doesn't go to the "covid 19" staging area. I'm hearing the hospitals are 'converting' some of the open spaces (lobby) to handle this. sure would suck if they waited until someone in the ER or at the front desk said hey I think we've got a problem look at all these people - some sick some not... maybe we should do something about it. )
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Post by The Walk of the Penguin Mich on Mar 27, 2020 13:05:05 GMT -5
You've just pointed out a major downside to using COVID 19 fatality numbers as indicators of whether incidence is going up or down. Transmission of the disease within group living facilities will create spikes that are hard to account for or analyze.
True, but a statistician with access to the underlying data can account for those kinds of spikes. Possibly by looking at death rate sorted by age. I saw an article somewhere where they were looking at flu like deaths as compared to multiple previous years, under the presumption that a large spike relative to previous years patterns would likely be reflective of CV deaths. Statisticians are scary, yo. I have to say MD has been on top of this as it’s possible to be so I do think that it’s plausible that MD is testing more. The biggest problem is the actual diagnosis. Unless a covid 19 test is done when the patient dies, the death is not attributed to covid 19. From my understanding, there are still some places where testing is not done. I would hazard a guess that covid 19 deaths are being underreported.
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Tiny
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Post by Tiny on Mar 27, 2020 13:06:46 GMT -5
You've just pointed out a major downside to using COVID 19 fatality numbers as indicators of whether incidence is going up or down. Transmission of the disease within group living facilities will create spikes that are hard to account for or analyze.
True, but a statistician with access to the underlying data can account for those kinds of spikes. Possibly by looking at death rate sorted by age. I saw an article somewhere where they were looking at flu like deaths as compared to multiple previous years, under the presumption that a large spike relative to previous years patterns would likely be reflective of CV deaths. Statisticians are scary, yo. I have to say MD has been on top of this as it’s possible to be so I do think that it’s plausible that MD is testing more. Aren't some of these deaths going to be 'buried' or 'hidden' by what's put on the death certificate? you know the way 'suicide' was rarely put on a death certificate because of the stigma? If the writer of the death certificate doesn't have a COVID19 positive diagnosis - odds are they aren't gonna include that the patient had many/all of the symptoms but wasn't tested on the death certificate.
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MN-Investor
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Post by MN-Investor on Mar 27, 2020 13:13:57 GMT -5
Aren't some of these deaths going to be 'buried' or 'hidden' by what's put on the death certificate? you know the way 'suicide' was rarely put on a death certificate because of the stigma? If the writer of the death certificate doesn't have a COVID19 positive diagnosis - odds are they aren't gonna include that the patient had many/all of the symptoms but wasn't tested on the death certificate. I think the majority of COVID-19 deaths will be attributed to pneumonia in absence of a COVID-19 test. Using statistics, they can review all the deaths after the fact and attribute the unexpected increase in pneumonia deaths to COVID-19.
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haapai
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Post by haapai on Mar 27, 2020 13:17:24 GMT -5
I hope for your sake that MD has been on top of things for longer and may be doing more testing.
I live in MI. County health departments stopped reporting the number of tests being performed daily at least 10 days ago and the word emerging from the hardest-hit counties is that they are restricting testing to the hospitalized whose symptoms cannot be explained by other testing, health care personnel, and persons associated with group living facilities. In other words, those counties are severely limiting who is being tested in an effort to preserve medical resources.
I have reason to believe that almost no testing is occurring outside of the hardest hit areas which have access to hospital labs that can do the tests. Those areas have to use either the state lab, which can perform about 300 a day or private labs, often out of state, which have awful turn-around times.
The number of new confirmed positive cases is not changing much day by day. It seems stuck at the same number of new cases per day, probably due to rationing of testing. It is far too early for social distancing measures to have to have had much effect.
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Gardening Grandma
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Post by Gardening Grandma on Mar 27, 2020 13:26:08 GMT -5
I hope for your sake that MD has been on top of things for longer and may be doing more testing.
I live in MI. County health departments stopped reporting the number of tests being performed daily at least 10 days ago and the word emerging from the hardest-hit counties is that they are restricting testing to the hospitalized whose symptoms cannot be explained by other testing, health care personnel, and persons associated with group living facilities. In other words, those counties are severely limiting who is being tested in an effort to preserve medical resources.
I have reason to believe that almost no testing is occurring outside of the hardest hit areas which have access to hospital labs that can do the tests. Those areas have to use either the state lab, which can perform about 300 a day or private labs, often out of state, which have awful turn-around times.
The number of new confirmed positive cases is not changing much day by day. It seems stuck at the same number of new cases per day, probably due to rationing of testing. It is far too early for social distancing measures to have to have had much effect. This chart shows 43 deaths in MI but doubling every day. It's the steepest trajectory on the chart.. www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html?action=click&module=Top+Stories&pgtype=Homepage&fbclid=IwAR2pEaV94lyaD8J1ipIfWVCoxLPuLzUaRFu9aw6T8EaEYOTYt-OuiRqjEtI
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weltschmerz
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Post by weltschmerz on Mar 27, 2020 13:32:08 GMT -5
Holy Crap. Atlanta is the biggest city in Georgia. I googled about the at capacity. And yeah, at capacity. I would have thought a large metropolitan area would have been more prepared (because they have the leadership and infrastructure and resources). Holy Crap. We really may be doomed. Creating hospitals, hospital beds and equipment isn't something leadership can just order, and make happen in a short period of time. That "hospital" China built in a few weeks burned to the ground a short time later. Do you have a link? Did it burn or was it intentionally set on fire when they didn't need it anymore?
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pulmonarymd
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Post by pulmonarymd on Mar 27, 2020 13:33:13 GMT -5
You've just pointed out a major downside to using COVID 19 fatality numbers as indicators of whether incidence is going up or down. Transmission of the disease within group living facilities will create spikes that are hard to account for or analyze.
True, but a statistician with access to the underlying data can account for those kinds of spikes. Possibly by looking at death rate sorted by age. I saw an article somewhere where they were looking at flu like deaths as compared to multiple previous years, under the presumption that a large spike relative to previous years patterns would likely be reflective of CV deaths. Statisticians are scary, yo. I have to say MD has been on top of this as it’s possible to be so I do think that it’s plausible that MD is testing more. So, the number of visits(er, office,hospitalizations) are tracked by cdc. That’s how flu activity is tracked. So, if these sort of visits spike, we know there is significant spread of respiratory illnesses in the community. This, along with positive flu tests help determine what is in the community. So, if we have a spike, but no corresponding increase in flu tests, we can assume it’s COVID, especially if hospitalizations increase as well. Indirect, sure, but has been a time honored way of tracking. This is tracked on a state level, so hotspots can be id. Data usually lags by a few weeks
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weltschmerz
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Post by weltschmerz on Mar 27, 2020 13:36:45 GMT -5
The Next Coronavirus Hot Spot: Louisiana Races to Prepare for the Worst As number of cases jump, ‘It’s like preparing for an invisible hurricane’ Gosh, I wonder why? Remember the Louisiana pastor who defied the governor's order not to hold gatherings larger than 50 people? He held services again on Sunday, and he plans to do so yet again on Tuesday night. On Sunday, Pastor Tony Spell said, his Life Tabernacle Church in Baton Rouge drew about 1,000 people to its services, in part by busing people in from across five parishes. On Tuesday evening, the pastor plans to hold services again, despite the governor's stay-at-home orders, a petition seeking his arrest and a flood of criticism from fellow Christians. www.cnn.com/2020/03/24/us/louisiana-pastor-spell-coronavirus/?hpt=ob_blogfooteroldThe embedded video is frightening. Idiots.
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haapai
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Post by haapai on Mar 27, 2020 13:41:39 GMT -5
It's comforting to hear that we might get a better idea of where the hot spots are in a few weeks but isn't that form of data analysis dependent on people visiting medical facilities as they normally would? I don't think we're doing that now. I'm not sure where I could even be seen if I had shortness of breath now and I'd be staying away for as long as possible for the sake of other people.
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CCL
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Post by CCL on Mar 27, 2020 13:46:59 GMT -5
Can't they arrest that preacher?
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weltschmerz
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Post by weltschmerz on Mar 27, 2020 13:48:58 GMT -5
Can't they arrest that preacher? I'm flummoxed as to how they haven't, yet. He'll probably sue for religious discrimination.
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CCL
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Post by CCL on Mar 27, 2020 13:55:16 GMT -5
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lurkyloo
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Post by lurkyloo on Mar 27, 2020 14:55:19 GMT -5
True, but a statistician with access to the underlying data can account for those kinds of spikes. Possibly by looking at death rate sorted by age. I saw an article somewhere where they were looking at flu like deaths as compared to multiple previous years, under the presumption that a large spike relative to previous years patterns would likely be reflective of CV deaths. Statisticians are scary, yo. I have to say MD has been on top of this as it’s possible to be so I do think that it’s plausible that MD is testing more. Aren't some of these deaths going to be 'buried' or 'hidden' by what's put on the death certificate? you know the way 'suicide' was rarely put on a death certificate because of the stigma? If the writer of the death certificate doesn't have a COVID19 positive diagnosis - odds are they aren't gonna include that the patient had many/all of the symptoms but wasn't tested on the death certificate. Indeed, which is why they will also look at death statistics from flu like symptoms or pneumonia for suspicious spikes, as I noted earlier. I agree that deaths from covid19 will also be underreported but less so than infections. I suspect if things are properly handled and all cases are counted the death rate is around 1.5%, possibly as low as Germany‘s 0.6%. Unfortunately proper handling seems to be in short supply these days :/
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lurkyloo
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Post by lurkyloo on Mar 27, 2020 15:03:50 GMT -5
I hope for your sake that MD has been on top of things for longer and may be doing more testing.
I live in MI. County health departments stopped reporting the number of tests being performed daily at least 10 days ago and the word emerging from the hardest-hit counties is that they are restricting testing to the hospitalized whose symptoms cannot be explained by other testing, health care personnel, and persons associated with group living facilities. In other words, those counties are severely limiting who is being tested in an effort to preserve medical resources.
I have reason to believe that almost no testing is occurring outside of the hardest hit areas which have access to hospital labs that can do the tests. Those areas have to use either the state lab, which can perform about 300 a day or private labs, often out of state, which have awful turn-around times.
The number of new confirmed positive cases is not changing much day by day. It seems stuck at the same number of new cases per day, probably due to rationing of testing. It is far too early for social distancing measures to have to have had much effect. I was wondering if you were in MI or its evil southern neighbor based on something you posted earlier. We have family and friends in MI and I’ve been sorry to see the numbers coming out of there. I think Whitmer is trying. It’s a very tough situation. MD announced a school shutdown basically the minute they had evidence of community spread. They were among the first to shut down restaurants etc as well and our governor has been adjusting well on the fly. I think our infection number is also a significant underestimate, since tests are limited here as well and it sounds like only 15-20% of people get sick enough to require hospitalization. Still, I’m clinging to the death rate as a reason to be optimistic that our infection rate isn’t wildly underreported. Stay safe, if possible.
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