COVID-19 Coronavirus current events

deirdre

Senior Member
I guess there must be a thing in US news (and elsewhere?) that means it's okay to do something like that.
I think it's ok to do something like that. they didn't say "this is Belleview Hospital" or anything.

I'm not sure you are even allowed to film patients in the United States. (or to bring a camera crew into covid-19 infected areas!), so I personally didn't think it was a NY hospital. Plus.. I did previously see the 'bubbles-over-their-heads' when they ran out of ventilators with Italian footage, so I took/take that shot as "this is the future of NY because Orange Man bad", which is kinda the context of what they are talking about.

But that's me.
 

Mendel

Active Member
I did previously see the 'bubbles-over-their-heads' when they ran out of ventilators with Italian footage
Do you know if they are in use elsewhere? The University of Chicago did a small study of them 4 years ago, and they're apparently clearly superior to face masks.
https://www.nih.gov/news-events/nih...-based-ventilation-eases-respiratory-distress
"This is the present New York" is footage of people storing bodies in refrigerator trucks.
 

Mendel

Active Member
"this is the future of NY because Orange Man bad"
Who caused the crisis in the US?
https://www.nytimes.com/2020/03/28/us/testing-coronavirus-pandemic.html
The article is quite long and goes into a detailed timeline, but my take is expressed in the summary above: the CDC didn't get its own test out of the door, and the FDA prevented the WHO test from being used after secretary Azar declared the health emergency:
Does Trump come into it?
The question is, would a different president have handled this differently, and would that have made a difference?

I personally hate it when the Chinese get blamed for the delays in the US response. The first Covid-19 case on US soil was well apparent on January 21st, that was the point where it was clear to every US epidemiologist that this global challenge concerned the US directly.
http://www.snohd.org/485/Novel-coronavirus-2019-response-Jan-15-2
snohomish.png
How a country acts on that knowledge is a matter of internal politics.
 

deirdre

Senior Member
Do you know if they are in use elsewhere?
your article there says
but that is from 2016. so maybe they are using them in US hospitals more now. ?
 

Mick West

Administrator
Staff member
The question is, would a different president have handled this differently, and would that have made a difference?
I think you've only got to look at the range of responses from the state governors, or even mayor and councils, to see that different people handle it differently. Mike DeWine (R-OH) was reportedly very proactive, as was Gavin Newsom (D-CA). Greg Abbot (R-TX) maybe less so. State responses have varied quite a bit, but only time will tell what the ultimate effect of their actions will be. This site ranks states by the aggressiveness of their response. There's a variety right now, and it's changed over time.
https://wallethub.com/edu/most-aggressive-states-against-coronavirus/72307/
Metabunk 2020-04-02 10-32-32.jpg

I'm not sure there's much to gain from finger-pointing, especially at Trump. What was done right or wrong two months ago does not really inform what we should be doing right now. Lessons will be learned.
 

deirdre

Senior Member
Who caused the crisis in the US?
what does that have to do with Cuomo blaming Trump because Cuomo didn't lock down his city/state/subways soon enough and now he's angry that NY isn't being sent all the federal supplies when other states might need some too? yesterday or the day before Cuomo even said he thinks other NY hospitals are hoarding ventilators and not sending them to the city.

It's a horrible situation all around. and I think it is enlightening that the federal government (ie cdc) and state governments obviously did not have any pandemic plans written up, even though we knew about a pandemic possibility for years and years! everyone is to blame. it is ridiculous all this infrastructure wasn't set up before hand by federal and state health agencies... years ago!
 

Mendel

Active Member
I'm not sure there's much to gain from finger-pointing, especially at Trump.
This would be easier to heed if Trump didn't point the finger elsewhere at every opportunity. The finger-pointing at him seems to have gotten him to invoke the defense production act, so it does serve some purpose.
 

Mendel

Active Member
everyone is to blame.
I just quoted you the facts why that is not true.
The states did not have any idea of the magnitude of the problem developing for their population because they did not have access to sufficient testing, and that was the fault of the FDA and the CDC, which are federal agencies with regulatory powers, and I believe their heads are appointed by the president?
Plus the president communicated that there is no problem.
So the states were being lied to and had no means to discover the truth, and that's why the US was caught out while other countries did containment by tracking and testing possible infection vectors.
That is the main reason why the states were left with less time to prepare than they could have, and why the curve is not as flat as it could have been.
Obama had an office for this that ran simulations, and they ran one in late 2016 with Trump staff. If you blame the lack of planning, there is a responsibility there, too.

That the crisis responses differ so much among the states appears like a lack of leadership from my perspective, because the German chancellor did coordinate the state responses (without dictating them).

This is a difficult crisis, and it's hard to get everything right, and everyone is doing their best; but some blunders are larger than others.
 

Agent K

Active Member
This would be easier to heed if Trump didn't point the finger elsewhere at every opportunity. The finger-pointing at him seems to have gotten him to invoke the defense production act, so it does serve some purpose.
The DOD uses the DPA 300K times a year.
https://www.nytimes.com/2020/03/31/us/politics/coronavirus-defense-production-act.html
 

deirdre

Senior Member
The DOD uses the DPA 300K times a year.
but the report linked in your quote says
 

Mendel

Active Member
but the report linked in your quote says
This is the said report:
https://www.fema.gov/media-library-...8a6b92617188/2018_DPAC_Report_to_Congress.pdf
The Defense Production Act Committee Report to Congress
Calendar Year 2018
Report to Congress June 24, 2019
Your quote says that number 2) has not been invoked. But to get a company to accept and fulfil (perform) a government contract, they use number 1). See section 2.1 in that report.
 
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Rory

Senior Member
Regarding the Czech Republic and their "what we did to significantly flatten the curve was introduce mandatory facemask wearing" video, here's their latest case graph:

1585926075775.png

So it does look like they're doing pretty well.

Still, while having everyone wear facemasks outdoors is obviously better than not doing so, I still feel somewhat uneasy about the boldness of that video's claims. Early isolation measures must have played a huge part - they introduced a nationwide quarantine before they had 200 confirmed cases - and, perhaps most importantly:
I also notice that the death data on the Wikipedia page has changed:

1585926456988.png

Previously, for the eight days from the 25th of March it read 3-3-0-2-5-7-8-8, and now it's 7-0-2-4-6-6-7-7.
 

deirdre

Senior Member
Your quote says that number 2) has not been invoked. But to get a company to accept and fulfil (perform) a government contract, they use number 1). See section 2.1 in that report.
I already read 2.1. I think 'under contract' means companies they already have contracts with.
and the 'services and facilities' in 2.2 would mean forcing GM (a car company) to make ventilators.

I could be wrong of course, but that is how i'm reading it. and it makes sense because i don't recall in my lifetime the government forcing a company to do anything contrary to what their company was set up to do. (ie making new product).
 

Mendel

Active Member
I already read 2.1. I think 'under contract' means companies they already have contracts with.
and the 'services and facilities' in 2.2 would mean forcing GM (a car company) to make ventilators.

I could be wrong of course, but that is how i'm reading it. and it makes sense because i don't recall in my lifetime the government forcing a company to do anything contrary to what their company was set up to do. (ie making new product).
You are wrong, just check the facts.

https://www.whitehouse.gov/presiden...duction-act-regarding-general-motors-company/

Note the use of the "accept, perform and prioritize" language, which is the same language as used in part 1) of my quote. The memorandum does not use the word "allocate".
 

deirdre

Senior Member
You are wrong, just check the facts.

https://www.whitehouse.gov/presiden...duction-act-regarding-general-motors-company/

Note the use of the "accept, perform and prioritize" language, which is the same language as used in part 1) of my quote. The memorandum does not use the word "allocate".
But GM had already agreed to make ventilators.
https://www.nbcnews.com/politics/do...orce-gm-make-ventilators-coronavirus-n1170746

so I still think making a company produce something they wouldn't normally produce, would be section 2.2.
 

Mendel

Active Member
so I still think making a company produce something they wouldn't normally produce, would be section 2.2.
This is from paragraph 4511 of the law:
https://uscode.house.gov/view.xhtml?path=/prelim@title50/chapter55&edition=prelim

"by any person he finds capable of their performance" means General Motors (remember that corporations are legal persons), if they can build ventilators, it applies

"require acceptance ... of such contracts" means they can be forced to accept a contract; it basically means they can be ordered to accept it

"require ... performance of such contracts" means they can be forced to work on the contract and deliver on it

"shall take priority over performance under any other contract or order" means they have to work on this contract before they work on any other contract

And then the provisions in the other paragraphs apply concerning loans etc.

Allocation like in Part (2) does not involve government contracts at all, the word "contract" is never mentioned. I imagine it could be used to direct companies to supply doctors and hospitals first, or for alcohol-producing companies to sell their output to medical companies before they sell it to liquor or cosmetics producers. That is similar to how I read the summary in the congress report: that if the goverment depletes a market with its priority contracts, it can now regulate that market to avoid undue hardship.

Edit: P.S. I note that you have been shifting the goal posts.
1) I said the finger pointing made Trump use the DPA
2) Agent K said FEMA used it routinely, but it hadn't been used in this crisis
3) You said that there were zero allocations ever
4) I show that Trump's use of the DPA is not an allcation
5) you claim that your comment was not actually meant to address Trump's use of the DPA
 

DavidB66

Active Member
Rory:
The figures from Austria are also interesting. 'Daily new cases' seem to have peaked within about 3 weeks of the first reported case.
https://www.worldometers.info/coronavirus/country/austria/
I don't know what the Austrians were doing at this time, but it may be that they succeeded where most other countries have failed, in containing the outbreak by contact-tracing, etc, at an early stage.
I suggested in a comment a few days ago that Germany and a cluster of nearby countries - Austria, Belgium, Switzerland, Denmark, Sweden - all seemed to have unusually low mortality rates (deaths per infection), and wondered if for some reason they were getting a less virulent form of the virus. This no longer seems to be the case (if it ever was). Measured by the number of deaths per head of population (probably a better measure than deaths per reported infection, which depends heavily on the testing regime), Switzerland and Belgium now have quite high mortality rates (as does the Netherlands, which I don't think I included in this group anyway). Sweden unusually decided against strict 'lockdown' measures, and both new cases and deaths are rising fast. The rate in Austria and Denmark might be called 'moderate'. The mortality rate in Germany itself is still relatively low, but the number of 'daily new deaths' is increasing. It is not clear whether the number of new infections per day is still rising. A few days ago it looked as if it might have reached a peak, but then started rising again.
Several countries (France, Spain, Italy and the UK at least) have recognised that their headline death figures are too low, as they count deaths in hospitals and not elsewhere, notably residential care homes. France has made a big one-off adjustment to the figures. Belgium has stated that its figures have always included these non-hospital deaths, which may help account for their relatively high figures. (I base this on a report in today's UK Times. )
 

deirdre

Senior Member
) you claim that your comment was not actually meant to address Trump's use of the DPA
no I didn't. I waqs responding to Agent K, not to you. I was pointing out to Agent K that even though the government often uses parts of DPA that (selling to our government before other countries etc) that we have never forced a company to make product or provide a service outside of it's original company statement.

and then.. while responding to our disagreement I found out that we didn't force Gm to make ventilators. They already started voluntarily. I apologize that i didnt clarify the point i was making to @Agent K

https://time.com/5811806/trump-general-motors-ventilators/
 

Mendel

Active Member
@DavidB66
Death figures are problematic for several reasons:
a) they lag infections (I'd say ~2 weeks) as the virus needs a bit of time to kill someone
b) most of the dead (>90%) are older than 60, so if you scale by population, you need to scale by that age group
c) a small number retirement home infection events can skew the numbers drastically

Denmark had a dip that lasted 2 weeks and has rising numbers again.
Austria is now one of the few countries with over 1 in 1000 people infected, but they do seem to have their new infections trending down. They're north of Italy and have been hit quite hard as a result (as has Bavaria in Germany). Generally, you can observe quite a variety of infection rates all across Germany, even though public measures were largely the same all across the country. So how small countries are doing may have a moment of randomness to it.
EpiBulletin16-20.png
https://www.rki.de/DE/Content/InfAZ...chte/2020-04-03-en.pdf?__blob=publicationFile

From the same report:
RKI ICU 04-03.png

The RKI is monitoring ILI (influenza-like illnesses), they're easier to test for than Covid-19 since they're much more widespread, and we have historical data. The German public measures have had an immediate very noticeabole effect on these, so if Covid-19 spreads like influenza, we have it beat, we just don't know it yet because the incubation time is so long.
EpiBulletin16-20.png
Source: https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2020/Ausgaben/16_20.pdf?__blob=publication
The green lines are adults, the reddish lines are children, the grey area is flu season, and the blue vertical lines denote when the public measures were started.
 

Mendel

Active Member
we have never forced a company to make product or provide a service outside of it's original company statement.
The main point of using rated orders isn't to compel companies to help. From what I remember of Gov. Cuomo's press conference in Javits Center, the point is that the government can loan companies money for this (e.g. GM has to change their factory to make the new product, this costs money, and they can do it more easily if the government provides it) and that companies are protected against some liabilities (they might have delivery dates with penalties for other customers, and if these get delayed, it could become expensive; but if the delay was caused by working on rated orders, the penalty doesn't apply). It effectively helps companies to do this work if FEMA or the HHS use these rated orders ( DPA contracts).

If you read somewhere that companies have to be forced, that's a hoax.
 

derwoodii

Senior Member

deirdre

Senior Member
If you read somewhere that companies have to be forced, that's a hoax.
it is literally the headline of every article about the issue. (including the articles I linked). You are obviously experiencing different media then we are here in America.
 

Mendel

Active Member
it is literally the headline of every article about the issue. (including the articles I linked). You are obviously experiencing different media then we are here in America.
Yes, but both the time and the NBC article state the facts: that GM's commitment to the ventilator production has "never wavered", and that Trump's intent is to "ensure the quick production of ventilators that will save American lives." The aim is to make it happen faster, not to force it to happen at all.
 

Mendel

Active Member
@derwoodii
https://www.sermo.com/press-release...product-for-pharma-biotech-and-life-sciences/

It sounds like pharma advertising disguised as "education" is part of their business model. Their questionaire feels like telemarketing, most of the questions are designed to raise concern about treating Covid-19 with medication, and a few are designed to suggest that existing medications are effective.

The "or have seen used" question is fishing for hearsay, basically if a GP has patients that are threated by 3 doctors in the hospital, and one of them prescribed Chlorquine to 1 patient, then he's "seen it used" when the file comes back to him.

None of this is a study, this isn't data, and 3/4 of the questions are about epidemiology that the physicians are not well placed to answer. Which is an indication that the answers don't matter, because this is marketing.

Page 4 states:
a) "3 most commonly prescribed treatments amongst COVID-19 treaters are 56% analgesics, 41% Azithromycin, and 33% Hydroxychloroquine."
"Globally, 19% of physicians prescribed or have seen Hydroxychloroquine prophylactically used for high risk patients, and 8% for low risk patients."
This tallies with page 20, which states that only 35% of respondents "Been involved in the care of a patient who has tested positive for COVID-19". And 33% of these prescribed Chloroquine, which is 12% of the total sample. Maybe 700 physicians?

b)
Page 18 states that 47% want more information on the efficacy of existing medications.

image.jpeg
Note that N=6227, so all respondents were asked this question.
image.jpeg
But 47% aren't involved with Covid-19 patients in any way. So how can the table above have high percentages for almost every country?
image.jpeg
This question has N=2171, so it was only put to those who answered that they've "been involved" in the care of a Covid-19 patient. Note that the percentages add up to more than 100, so it was possible to give multiple answers. Also note that "doing nothing" ranks 3rd (first in the US). Another thing to note is that plasma treatment ranks low, but the number of doctors who have used this is also very low. It would be interesting to find out how many of those doctors who actually used it prefer it.

The biggest problem with medication use outside of double-blind studies is the placebo effect: for most conditions, doctor confidence improves the outcome, so if a doctor prescribes Chloroquine, it may affect the outcome even if it does nothing; and the doctor may be inclined to judge the outcome more positively because of confirmation bias.

37% of 2171 = 800 doctors think Chloroquine is among the most effective medications available now, but we don't hear how effective they think it is. 32% = 700 think doing nothing is as effective or better. And 47% of 6227 (2925) think we urgently need more data on how well it works.
image.jpeg
What worries me is that 33% of these "physicians" lack information on how healthcare workers can protect themselves against an infection that uses the same transmission method as the flu. It kinda makes me wonder where they got their degrees.

I'm also wonder why physicians treating severe cases of Covid-19 take the time to answer 22 minute long unpaid marketing surveys.
 
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Arugula

Member
I guess there must be a thing in US news (and elsewhere?) that means it's okay to do something like that.
I used to work in broadcast news and it is extremely common to reuse b-roll like that. It's a mistake but not a malicious one. Editors, production assistants, or interns download footage from satellite feeds, syndication wire, or photographer, label it, and then it exists on the server forever (some more descriptive than others.) So an editor putting together a package searches for terms like "coronavirus hospital ventilators", finds a 5 second clip, and pulls it into their story to illustrate ventilators in hospitals. Happens all the time, especially with followup stories or long-term "developing" stories like this.
 
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Mendel

Active Member
NY Gov Andrew Cuomo on March 22nd on what he wants the Federal government to achieve with the DPA (press conference). I thought he also mentioned that the DPA helped with the funding, but that may have been in the Q&A afterwards that is not in the transcript.
https://www.governor.ny.gov/news/vi...oing-covid-19-pandemic-governor-cuomo-accepts
 

deirdre

Senior Member
e DPA helped with the funding,
i think it can. I was reading about the car industry and WW11, but its a bit tricky to iron out even what "nationalizing" is.

but in this link, funding is an element it seems. ie. "investment". and guaranteed contracts would be funding because they are guaranteeing a purchase of the items.
https://www.heritage.org/defense/re...rtant-national-security-tool-it-requires-work

I thought he also mentioned
it might have been diBlasio.? he is the mayor of NYCity. here is an opinion piece he wrote March 18
https://www.usatoday.com/story/opin...e-scenario-president-trump-column/5070422002/
 

Agent K

Active Member
Dr. Drew Pinsky has publicly apologized. He now admits he was wrong about minimizing the seriousness of Covid-19, and wrong about comparing it to the Flu.
Good of him to apologize. I was wondering if he would. He says he had a lot of different numbers in his head and that he shouldn't have been comparing this outbreak to the flu, but the problem was that he got the numbers wrong. As I pointed out at the time, rather than underestimating the infection fatality rate (IFR) of COVID-19, he overestimated the IFR of seasonal flu to be 0.7%, which is inflated by a factor of seven. He also didn't account for differences in the attack rate.
 

Mendel

Active Member
https://www.vox.com/policy-and-poli...id-19-supplies-fema-states-federal-government

Is that a comspiracy theory, or is it really happening? That federal supplies are being disbursed according to partisan politics, political favoritism or with a view to elections, with states hopeful to swing for the president receiving more aid?
Or did Florida just ask for less, and the states whose requests were denied asked for much more?

As an outsider, I don't understand this at all (same source):
That was two weeks ago, has that changed in the meantime?

Contrast with Germany, March 19:
https://www.ft.com/content/c5fb1f72-6920-11ea-800d-da70cff6e4d3
Basically, logistics is one of the military's core competencies, and they've been buying supplies all over the world and are distributing them to the states. Doing this fairly is a challenge, Germany initially had export restrictions in place which are now lifted, and we're complaining about not getting supplies we've ordered in the US.
 

Mendel

Active Member
I looked at Thurday's White House press briefing, and I'm still not completely sure what is going on, but this is relevant:
https://www.whitehouse.gov/briefing...ers-coronavirus-task-force-press-briefing-17/
The one thing that did for me is put the "stockpile" quote in context. They don't want to move supplies to the states until they see a need; they don't want to stock state warehouses. Naturally, that makes it hard for states to plan.

The briefing was quite interesting in total; Admiral Polowzcyk mentioned that the governement is flying supplies in from other countries that are then sold through private distributors. He also expicitly said "allocate", so it seems they are using that DPA power now.

And Dr. Birx talks about the "logarithmic curve" and how the test rates, how many percent test positive, determine where the hotspots are.
I don't really understand how test coverage is an indicator of how severe the epidemic is. If do 20000 tests per day and have 6% positive and then double the capacity to 40000 tests and 4% of the tests come back positive, the situation hasn't become better, it has become worse, except in the sense that the health authorities are now better able to track and isolate high-risk contacts.
 

deirdre

Senior Member
As an outsider, I don't understand this at all (same source):
the United States is 4 times bigger than Germany. It doesn't matter how much money the Fed has, if there are no ventilators to buy.
To me, the analogy would be more like if the EU was the shipping clerk and Germany etc expected the EU committee to ship them everything they asked for the minute they asked for it.

https://www.washingtonpost.com/health/2020/03/18/ventilator-shortage-hospital-icu-coronavirus/

New York/Cuomo said he needed 30,000. The fed doesn't have 30,000.
New York(pop. 8.5 million) got 4000 ventilators already, Connecticut got 50. (pop 3.6 million)

as far as masks and gowns (note:media reporting so im not verifying accuracy).
https://ctmirror.org/2020/03/20/her...lies-it-requested-while-other-states-did-not/
 

deirdre

Senior Member
I don't really understand how test coverage is an indicator of how severe the epidemic is. If do 20000 tests per day and have 6% positive and then double the capacity to 40000 tests and 4% of the tests come back positive, the situation hasn't become better, it has become worse, except in the sense that the health authorities are now better able to track and isolate high-risk contacts.
you'd have to research more, but my impression from fed, NY and Connecticut press conferences is that states aren't testing to track or isolate at this point. they are really only testing sick people now.
so I guess statistically the numbers (Connecticut at 15%) is a goodish rough estimate.
 

Mendel

Active Member
The FDA approved an antibody test on April 1st. I'm quoting from the IFU:
https://www.fda.gov/media/136625/download

I have a hard time imagining what the use of this test is going to be. It has a false negative rate of 6.2% and a false positive rate of 4%. The false positive rate rate means if you test 1000 people right now, 40 might test positive, but only 1 actually is, since the overall incidence is still below 1 in 1000. If you think you're immune based on this test, you'd be wrong 98% of the time. Obviously that makes it unsuitable for a population survey. Furthermore, the samples tested came from people with acute infections, and it's unclear if the test is sensitive enough to show antibodies in people who are no longer sick.

The false positive rate drops to under 2% if you disregard results where only one stripe triggers, but then you lose half the true positives.


This test is useful in a setting where you already have a good idea that the patient might have a viral pneumonia, and then a hospital can quickly and inexpensively check if it's Covid-19, but would you really want to rely on it?
 

Mendel

Active Member
the United States is 4 times bigger than Germany. It doesn't matter how much money the Fed has, if there are no ventilators to buy.
To me, the analogy would be more like if the EU was the shipping clerk and Germany etc expected the EU committee to ship them everything they asked for the minute they asked for it.
The EU is not a government, that is not a good analogy.
Germany is a federal republic, like the US, and public health and health care is primarily the responsibility of the individual states, like in the US.

New York/Cuomo said he needed 30,000. The fed doesn't have 30,000.
New York(pop. 8.5 million) got 4000 ventilators already, Connecticut got 50. (pop 3.6 million)
New York has 100000 active cases, Connecticut has 5000. Assuming that NY had 3x the numbers of ventilators to start with that Conecticut had, the shortfall is much greater. E.g. assume 1 ventilator per 10000 inhabitants, and 8% ICU rate, then Connecticut has 400 ICU cases and 360+50 ventilators, while New York State (20 million pop) has 8000 ICU cases and 2000+4000 ventilators. (I don't know the true percentages, this is just an example.)
https://www.worldometers.info/coronavirus/country/us/
 

Z.W. Wolf

Senior Member
I was just getting ready to post this story.

https://paloaltoonline.com/news/202...rd-search-for-covid-19-clues-in-blood-samples

They must be using the very test you posted about, non?

The study is being done by Jay Bhattacharya who published that controversial WSJ piece on March 24; summarized here:
https://fsi.stanford.edu/news/coronavirus-deadly-they-say

 
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