Lizard Queen
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Post by Lizard Queen on May 17, 2020 18:39:46 GMT -5
Just curious, how can you have covid but it didn't contribute to your death,? Well, there's a big hoopla in my town right now because an 88 year old in then nursing home with heart disease had a heart attack and died and it was called a covid death because he had tested positive when they tested the entire facility. Makes no sense because the nurses say he was having no respiratory symptoms. He has a history of heart trouble and had had a massive heart attack a few years prior to being put in the nursing home. That's a hard one to call since Covid causes clotting.
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oped
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Post by oped on May 17, 2020 18:43:32 GMT -5
Yeah this is not just a ‘respiratory’ illness, in fact as they learn more it’s possible the respiratory effects are linked more to clotting issues. That and systemic inflammation.
Lots still to learn.
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pulmonarymd
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Post by pulmonarymd on May 17, 2020 18:47:14 GMT -5
Covid can cause heart failure and myocarditis, so it is possible that it caused his death. Not as straightforward as people want to make it out. There is a case definition, if patients fit it then they have the disease
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pulmonarymd
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Post by pulmonarymd on May 17, 2020 18:48:54 GMT -5
Again, undercounting is far more e likely than over counting
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thyme4change
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Post by thyme4change on May 17, 2020 19:14:00 GMT -5
Just curious, how can you have covid but it didn't contribute to your death,? Well, there's a big hoopla in my town right now because an 88 year old in then nursing home with heart disease had a heart attack and died and it was called a covid death because he had tested positive when they tested the entire facility. Makes no sense because the nurses say he was having no respiratory symptoms. He has a history of heart trouble and had had a massive heart attack a few years prior to being put in the nursing home. Covid aggrevates blood clots and stuff. Right?
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buystoys
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Post by buystoys on May 18, 2020 6:36:07 GMT -5
I saw an interview with someone from Colorado (?) that said their numbers changed drastically once they removed all the presumptive Covid cases and the cases where the person who died had Covid but it wasn't the contributing factor to their death. I had read a few weeks ago that there was a suspicion the numbers were being over-reported. Don't remember where I read that, though. It makes sense, kind of. Just curious, how can you have covid but it didn't contribute to your death,? Heart attack is the first that comes to mind.
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oped
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Post by oped on May 18, 2020 6:54:59 GMT -5
If you have Covid there is literally no way to tell if you would have had a heart attack right then anyway, or if it is triggered by the illness.
If you want to make that distinction ? shrug ?
Seems like more ‘they all would have dyed anyway’ to me... but reality is excess deaths are up up up, beyond what is being counted currently as Covid.
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pulmonarymd
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Post by pulmonarymd on May 18, 2020 8:05:17 GMT -5
Again, all this nonsense about whether COVID caused a death or not is political. A patient with metastatic cancer who is not imminently dying has a big heart attack and dies, died from a heart attack, irrespective of the cancer. No one cares what the death certificate says. But because we have a president and a party that is trying their best to downplay this tragedy, we are now parsing causes of death. If you want to be honest, look at the number of deaths in hard hit areas for the same month in 2019 and 2020. Then you get an idea of the scope of the tragedy, and how many deaths we may have missed
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apple 2
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Post by apple 2 on May 18, 2020 10:38:25 GMT -5
Unbelievable, even death is wrapped in politics.
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Wisconsin Beth
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Post by Wisconsin Beth on May 18, 2020 11:01:31 GMT -5
The stats will change once trump is out anyway. The order will go out to reclassify the data based on some other metric.
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hoops902
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Post by hoops902 on May 18, 2020 11:06:04 GMT -5
If you have Covid there is literally no way to tell if you would have had a heart attack right then anyway, or if it is triggered by the illness. If you want to make that distinction ? shrug ? Seems like more ‘they all would have dyed anyway’ to me... but reality is excess deaths are up up up, beyond what is being counted currently as Covid. Which is exactly why "cause of death" is useless. And precisely why it's important to look back to see the impact after-the-fact. If deaths are consistently X, and death with this virus as the "cause of death" are Y...then it makes a big difference as we learn from this whether actual deaths are closer to X, somewhere between X & X+Y, or far exceed X+Y. It's critical for future diseases and the accuracy of balancing health with economics. You can't balance out 2 things competently if you don't understand the impacts of those 2 things in a way more relevant than just lazily labeling something because it's convenient at the time.
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hoops902
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Post by hoops902 on May 18, 2020 11:07:36 GMT -5
The stats will change once trump is out anyway. The order will go out to reclassify the data based on some other metric. Which is why it's important to look at overall deaths for the year...current statistics are only as good as those classifying things...and it's rarely good data when people are just slapping labels on things without thought or clear direction because they're in the midst of the turmoil.
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pulmonarymd
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Post by pulmonarymd on May 18, 2020 11:23:09 GMT -5
If you have Covid there is literally no way to tell if you would have had a heart attack right then anyway, or if it is triggered by the illness. If you want to make that distinction ? shrug ? Seems like more ‘they all would have dyed anyway’ to me... but reality is excess deaths are up up up, beyond what is being counted currently as Covid. Which is exactly why "cause of death" is useless. And precisely why it's important to look back to see the impact after-the-fact. If deaths are consistently X, and death with this virus as the "cause of death" are Y...then it makes a big difference as we learn from this whether actual deaths are closer to X, somewhere between X & X+Y, or far exceed X+Y. It's critical for future diseases and the accuracy of balancing health with economics. You can't balance out 2 things competently if you don't understand the impacts of those 2 things in a way more relevant than just lazily labeling something because it's convenient at the time. Cause of death is not useless, but it needs to be interpreted in context. People dying from coronavirus use significantly more resources than someone who dies from a heart attack, and planning for that is important. It gives you an idea of the burden of disease. When people who died of AIDS had pneumonia listed and not AIDS, the fact of the omission had significant repercussions on how that pandemic was viewed. Until the death certificates were filled out honestly, places and people could put their heads in the sand and ignore its impact. Same thing here. If we look at the data when this is over, and conclude it is all old and sick people,are we going to say it wasn't that big a deal. If so, why treat any problem in old people. Knowing the excess mortality is important, but what that will likely show is how we were undercounting the deaths from this. it is unlikely that deaths from other causes for the year will be dramatically less.
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teen persuasion
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Post by teen persuasion on May 18, 2020 11:44:48 GMT -5
This was the monitoring dashboard this morning (first number is days of decline, second number is actual number of cases/deaths): This afternoon: Just watched Cuomo's daily conference (here, because Yay, WNY ticked all the boxes to reopen!). Local reporters kept trying to get to the bottom of what goalpost got moved, that we suddenly met 2 metrics we were nowhere near meeting. Cuomo couldn't explain, his assistant didn't explain well. Yeah, we understand 3 day rolling averages. That doesn't explain how a spike in cases turns into zero! Second time a reporter asked, the disjointed explanation seemed to be that the May 15 expiration of the Pause order RESET the baseline to zero, we had declines for Friday, Sat, Sun (after the spike mid last week), apply 3 day average, and Ta-da! we are golden. Umm, what? You threw out the 14 days of data, because the Pause order expired? I hope that's not really what did it, but that's exactly what they bumblingly implied. So we are reopening phase one, tomorrow. Still questions about what falls in which phase. Reporters asked specifically about houses of worship and libraries (me) - houses of worship definitely phase 4 (big congregations of people). Totally ignored the libraries question.
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hoops902
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Post by hoops902 on May 18, 2020 11:52:48 GMT -5
Which is exactly why "cause of death" is useless. And precisely why it's important to look back to see the impact after-the-fact. If deaths are consistently X, and death with this virus as the "cause of death" are Y...then it makes a big difference as we learn from this whether actual deaths are closer to X, somewhere between X & X+Y, or far exceed X+Y. It's critical for future diseases and the accuracy of balancing health with economics. You can't balance out 2 things competently if you don't understand the impacts of those 2 things in a way more relevant than just lazily labeling something because it's convenient at the time. Cause of death is not useless, but it needs to be interpreted in context. People dying from coronavirus use significantly more resources than someone who dies from a heart attack, and planning for that is important. It gives you an idea of the burden of disease. When people who died of AIDS had pneumonia listed and not AIDS, the fact of the omission had significant repercussions on how that pandemic was viewed. Until the death certificates were filled out honestly, places and people could put their heads in the sand and ignore its impact. Same thing here. If we look at the data when this is over, and conclude it is all old and sick people,are we going to say it wasn't that big a deal. If so, why treat any problem in old people. Knowing the excess mortality is important, but what that will likely show is how we were undercounting the deaths from this. it is unlikely that deaths from other causes for the year will be dramatically less. By your own words it is useless. If you're undercounting deaths from it...it's not useful data. It's as "useful" as someone just making up numbers like Trump does. And I hesitate to call his claims "useful"...medical cause of death is no different if it's inaccurate.
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pulmonarymd
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Post by pulmonarymd on May 18, 2020 12:18:50 GMT -5
Cause of death is not useless, but it needs to be interpreted in context. People dying from coronavirus use significantly more resources than someone who dies from a heart attack, and planning for that is important. It gives you an idea of the burden of disease. When people who died of AIDS had pneumonia listed and not AIDS, the fact of the omission had significant repercussions on how that pandemic was viewed. Until the death certificates were filled out honestly, places and people could put their heads in the sand and ignore its impact. Same thing here. If we look at the data when this is over, and conclude it is all old and sick people,are we going to say it wasn't that big a deal. If so, why treat any problem in old people. Knowing the excess mortality is important, but what that will likely show is how we were undercounting the deaths from this. it is unlikely that deaths from other causes for the year will be dramatically less. By your own words it is useless. If you're undercounting deaths from it...it's not useful data. It's as "useful" as someone just making up numbers like Trump does. And I hesitate to call his claims "useful"...medical cause of death is no different if it's inaccurate. There is a difference between not perfect and useless. As the majority of these people die in the hospital, the diagnosis is not in doubt. A death certificate is then accurate, and can be tabulated to be used in a number of different ways. People who die at home without recent contact with the medical profession will be difficult, and the cause of death is unclear. Yet, we have made policy and done extrapolations with this limitation in the past, and can do it in the future. Our ability to make policy decisions and respond to crises such as this are enhanced by accurate data, and cause of death is one piece of information. So, not useless in any way. Imperfect, yes
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Deleted
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Post by Deleted on May 18, 2020 12:25:28 GMT -5
All the deaths in our county have been in one nursing home, nobody has been admitted to the hospital for covid. I don't know who says the cause of death then. Do they go to the coroner?
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oped
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Post by oped on May 18, 2020 12:32:04 GMT -5
I wish I had that data. PA isn’t even giving active/resolved numbers.
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pulmonarymd
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Post by pulmonarymd on May 18, 2020 12:39:32 GMT -5
All the deaths in our county have been in one nursing home, nobody has been admitted to the hospital for covid. I don't know who says the cause of death then. Do they go to the coroner? Depends. All diseases have case definitions, and patients could have been tested premorbid. So, if they had a positive test, especially if they had a respiratory illness, they had covid. For example, we had a patient who was really ill. He had symptoms of the disease, but tested negative twice. In addition, his family tested positive. We treated him as if he had the disease, and his antibody turned positive, and all other tests came back negative. So, if there was a known outbreak in the nursing home, and the patient had an illness consistent with COVID, the cause of death ic COVID. No different than what we do with influenza.
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pulmonarymd
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Post by pulmonarymd on May 18, 2020 12:40:55 GMT -5
Just to add, they didn't likely go to the coroner if they were in a healthcare facility. Attending physician certifies cause of death, as would happen in a hospital
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thyme4change
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Post by thyme4change on May 18, 2020 13:43:12 GMT -5
The stats will change once trump is out anyway. The order will go out to reclassify the data based on some other metric. Which is why it's important to look at overall deaths for the year...current statistics are only as good as those classifying things...and it's rarely good data when people are just slapping labels on things without thought or clear direction because they're in the midst of the turmoil. When they do this, do they take out suicides and car accidents? I hear suicide is up and car accidents are down. I don't know if either of them will dent a statistical outcome. Is there a method to separate people that died because Covid was medically a factor from people who died because they were afraid or unable to seek treatment for other medical problems. Covid would be a factor there, but it seems disingenuous to count it as a Covid death.
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pulmonarymd
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Post by pulmonarymd on May 18, 2020 13:50:40 GMT -5
Which is why it's important to look at overall deaths for the year...current statistics are only as good as those classifying things...and it's rarely good data when people are just slapping labels on things without thought or clear direction because they're in the midst of the turmoil. When they do this, do they take out suicides and car accidents? I hear suicide is up and car accidents are down. I don't know if either of them will dent a statistical outcome. Is there a method to separate people that died because Covid was medically a factor from people who died because they were afraid or unable to seek treatment for other medical problems. Covid would be a factor there, but it seems disingenuous to count it as a Covid death. Here, they did a quick analysis of deaths in April 2020, compared to 2019. If you took the number who died in 2019, added the 2020 covid deaths, then compared it to April 2020 oficial number, we were about 500 short. Over twice as many people died this April compared to last April. You can then do further modifications based on your questions. Deaths from cancer and heart disease are relatively stable year over year, so you can really see the impact this disease can have. Still likely to underestimate true impact even with this analysis
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thyme4change
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Post by thyme4change on May 18, 2020 14:05:20 GMT -5
When they do this, do they take out suicides and car accidents? I hear suicide is up and car accidents are down. I don't know if either of them will dent a statistical outcome. Is there a method to separate people that died because Covid was medically a factor from people who died because they were afraid or unable to seek treatment for other medical problems. Covid would be a factor there, but it seems disingenuous to count it as a Covid death. Here, they did a quick analysis of deaths in April 2020, compared to 2019. If you took the number who died in 2019, added the 2020 covid deaths, then compared it to April 2020 oficial number, we were about 500 short. Over twice as many people died this April compared to last April. You can then do further modifications based on your questions. Deaths from cancer and heart disease are relatively stable year over year, so you can really see the impact this disease can have. Still likely to underestimate true impact even with this analysis So, learning here.... When you say 500 short, you mean the death count is 500 people higher than last year plus Covid count. Therefore it is possible the Covid count is low by 500 people. Correct? Also, as a percentage, how much is 500 people?
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pulmonarymd
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Post by pulmonarymd on May 18, 2020 14:17:56 GMT -5
Here, they did a quick analysis of deaths in April 2020, compared to 2019. If you took the number who died in 2019, added the 2020 covid deaths, then compared it to April 2020 oficial number, we were about 500 short. Over twice as many people died this April compared to last April. You can then do further modifications based on your questions. Deaths from cancer and heart disease are relatively stable year over year, so you can really see the impact this disease can have. Still likely to underestimate true impact even with this analysis So, learning here.... When you say 500 short, you mean the death count is 500 people higher than last year plus Covid count. Therefore it is possible the Covid count is low by 500 people. Correct? Also, as a percentage, how much is 500 people? Correct. So the number of deaths this April is over twice what it was last April. 500 extra deaths is over 10% of total deaths, and 20% of those attributed to COVID. In addition, both here and nationwide, COVID was the leading cause of death in April. The official number is based on death certificates. But even if there are some wrong, it is improbable to believe that none of the unaccounted for deaths were due to COVID. Teasing that out would require medical records and interviews with relatives to see if they were sick. But again you do not usually see that sort of yearly discrepancies in the number of deaths from the causes that are the at the top of the lista. And deaths from cancer and heart disease have been trending downward, albeit slowly
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oped
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Post by oped on May 18, 2020 14:37:36 GMT -5
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TheOtherMe
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Post by TheOtherMe on May 18, 2020 14:51:19 GMT -5
In my county, there have been 10 deaths. 4 of those have been in the Marshallese community. The Marshallese are allowed to live and work in the US but Medicaid was taken away in 1996 so most have no health insurance.
The Marshallese have been hit hard in this area. There are 5 people of Marshallese descent in the ICU currently.
The mayor of Dubuque is asking Congress for help in getting health care for these people, as in getting them coverage under Medicaid.
Due to the radiation they have been exposed to on the islands, they have a lot of pre-existing conditions.
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teen persuasion
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Post by teen persuasion on May 18, 2020 15:09:04 GMT -5
My boss emailed us - looks like we are approved to begin curbside pickup as soon as our region reopens phase one, which is unexpectedly tomorrow! Everyone was not expecting to hit the metrics until June 1. So we are tentatively aiming to begin June 1 curbside pickup.
Now we have to figure out how to do it.
Reopening the building to patrons is likely not until phase 4, so at least 6 weeks out, if everything goes perfectly. Still probably not likely to be able to run a normal SRP level of activities.
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NomoreDramaQ1015
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Post by NomoreDramaQ1015 on May 18, 2020 15:30:41 GMT -5
Our library has curb side pick up. You put a hold on the books that you want. They designated five parking spots in the lot with a number and put a table outside each one. They email you when your book is ready just like always.
Only now instead of going in to pick it up you call the circulation desk and give them your name. They check out your book for you and bring it out in a bag. You don't get out of your car until they leave. They're all wearing mask and gloves too.
Books are returned by the drop off slot only.
IDK how big your library is but it works for our city library pretty well it seems. While I miss going into the library at the same time this system is rather nice.
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Deleted
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Post by Deleted on May 18, 2020 16:57:05 GMT -5
Although my state recorded its single largest single day increase in count this weekend, our governor has announced that bars, daycare facilities, massage and tattoo parlors and such can reopen at 25% capacity. Restaurants can move from 25% to 50% capacity.
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Lizard Queen
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Post by Lizard Queen on May 18, 2020 17:30:18 GMT -5
A couple northern sections of my state are opening up retail and bars at 50%. People are still bitching. People will bitch no matter what this governor does, even though it's pretty similar to other states, and it was hit hard with cases. At this point, I'm all for all the bitchers to go out and get us to herd immunity quicker.
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