Earlier quoted context omitted.
Uh, in what world is wiping out half a population not that bad??
It would be good for the environment
I've noticed it's never people in a vulnerable group that talk this way.
WHO declares coronavirus outbreak a public health emergency
371–380 of 465 posts
Re: WHO declares coronavirus outbreak a public health emergency
#372Earlier quoted context omitted.
...because they are not for profit so people can actually afford to get help even if they are poor
I think you're a bit off the mark. Healthcare is cheap in China, but people are even poorer. Only rich people can afford the important stuff. It's common for young people from poor families to work or forgo their education to pay their sick parent's medical costs. Usually old people just die because they can't afford medical care where in the west, they would be treated. Also doctors are poorly paid and commonly supp…
> Imagine getting a vial of homeopathic diluted water and a sugar pill when you complain about a cough.
This happens regularly in western europe, especially by pediatricians. The charitable interpretation is that the doctor knows the child will get better in a few days anyway, but has to give _something_ to soothe the parents. Giving the substance-free stuff is better than unnecessarily medicating the child, and placebo-effect can also play a positive role.
Re: WHO declares coronavirus outbreak a public health emergency
#373Earlier quoted context omitted.
I think you're a bit off the mark. Healthcare is cheap in China, but people are even poorer. Only rich people can afford the important stuff. It's common for young people from poor families to work or forgo their education to pay their sick parent's medical costs. Usually old people just die because they can't afford medical care where in the west, they would be treated. Also doctors are poorly paid and commonly supp…
> Imagine getting a vial of homeopathic diluted water and a sugar pill when you complain about a cough. This happens regularly in western europe, especially by pediatricians. The charitable interpretation is that the doctor knows the child will get better in a few days anyway, but has to give _something_ to soothe the parents. Giving the substance-free stuff is better than unnecessarily medicating the child, and plac…
Curious about the downvotes -- this is common practice e.g. in Germany, and one that I consider largely beneficial to society.
Re: WHO declares coronavirus outbreak a public health emergency
#374Earlier quoted context omitted.
Those are US numbers only. The CDC estimates that 291,000 to 646,000 people die worldwide every year. You cannot take the US mortality rate and assume it would apply to any other country and especially not China. https://www.cdc.gov/media/releases/2017/p1213-flu-death-esti...
Indeed. China’s medical system is primitive by comparison. They have shiny highways and trains, but hospitals are overcrowded and underfunded.
I wouldn't use the word primitive, but inconsistent, non-patient-focused and underfunded in many places.
Larger cities can have excellent treatment, smaller cities less so. After a car accident I had pin-hole surgery on a badly broken collar bone (three pieces and several fragments) and only afterwards discovered the lead surgeon was internationally published in leading journals for his work, and the second surgeon would soon be departing for Northern Europe for a 2 year secondment to complete his PhD. Physiotherapy with minimal but sufficient. After-patient care consisted of being invited to dinners with other ex-patients for sharing over dinner, which is very unlike the West.
Certainly I was fortunate and the vast majority of care is not like this, which is why I don't use the word 'primitive' but prefer 'inconsistent'. The doctors described hospitals more like factories: There's a lot of throughput. He chuckled "You get lots of practice, but the focus is on how to do things better."
Edit: When I say 'not patient focused' here's a typical process flow:
1. Go to ER. Have a friend, family member or colleague pay a fee for consultation for a General Practitioner, and specify Chinese Medicine or Western Medicine GP.
2. Wait to see the GP, usually in a queue or ticketing system. There's a nurse on front desk and if it's obvious and urgent you'll be fast-tracked.
3. See the GP. They'll have some idea and request further work, like an X-Ray, Blood Test, CT Scan, etc. That's all in ER. Have the friend, family member or colleague pay a fee for that and wait in a queue/ticketing system or get fast-tracked again.
4. Get the results and return to GP for further prognosis. They'll recommend medicine (go to the front desk, pay a fee, etc, then go to a separate part, typically a separate floor, for that), operation, or other work. At this point you're referred to a specialist department and need to make your own way there, or if urgent have a wheelchair or stretcher and nurse take you there.
5. Turn up at the specialist department. Now this varies. For urgent treatment you'll likely be seen immediately, better, larger hospitals work 24/7. For non-urgent there might be a ticketing system. For something like a bone operation as I had there'll be a junior doctor on front-desk who will make a further assessment. If non-urgent and they're busy, schedule a few days later.
6. A ward consists of several rooms, typical Marie-Curie design with a central lift block and wards coming off from that. Rooms are rarely individual, if fortunate you'll have 2 to a room, sometime 8 or more. Some pre-op, some post-op. Nurses don't do a lot other than administer drips, observe, and escalate to the doctor on-call. For stuff like getting in or out of bed when you can't walk, friends, family or colleagues are there for that. Often you'll see family members on rotation with a small chair or camper bed next to the patient. You can also hire private unskilled unqualified helpers.
How to choose a hospital: Always go with a Medical University. It's a rule-of-thumb the world over and especially true in China. They have the most experienced, best qualified, best paid (outside of a handful of private international hospitals in Shanghai/Beijing/etc) doctors. If there's a #1, #2, #3 etc affiliated hospital, go to the #1, if that's too far, go down the numbering system until distance/urgency tradeoff works best. If you're out in the countryside, the quality of the care isn't likely to be the best.
Sorry, wrote quite a lot there. Thought it would be interesting to share with Hacker News as most readers here probably won't have had experiences with hospitals in China.
In the crisis like Wuhan at the moment I imagine they'd be incredibly overworked.
Re: WHO declares coronavirus outbreak a public health emergency
#375Earlier quoted context omitted.
Interesting, however: > Most patients were men, with a mean age of 55·5 years (SD 13·1; table 1). 50 (51%) patients had chronic diseases, including cardiovascular and cerebrovascular diseases, endocrine system disease [and some others] The findings conclude: > In general, the characteristics of patients who died were in line with the early warning model for predicting mortality in viral pneumonia Also the group was s…
>50 years is not old. I don't know what is considered old but I know that >75y has a two magnitudes higher mortality rate with the flu. I doubt that the 50 years old Hospital doctor who died had any serious per-existing health condition. In fact, you could argue hat most doctors have a stronger immune system than average since they are exposed to more germs due to their profession. So this 50y old professional droppi…
"Old" might be the wrong word, but the gist of it is that, like the flu, it's potentially worse around the 50-60+ age group.
Re: WHO declares coronavirus outbreak a public health emergency
#376Earlier quoted context omitted.
The way the central government is handling this is impressive, quarantining a city of that size is unprecedented and has bought the world extra time to prepare. Yes the WHO are playing politics when they focus on the good things China is doing and ignore the bad. But personally I think they are closer to the truth than those who present an entirely negative version of events. China's response has been 70% good :)
> The way the central government is handling this is impressive Not really, they jailed the experts who told them that they needed to act quickly, sat on it for a month, and finally did something about it when it was already out of hand.
> they jailed the experts who told them that they needed to act quickly
If you don't mind me asking, where did you see that info?
Re: WHO declares coronavirus outbreak a public health emergency
#377Earlier quoted context omitted.
« assume that when a case is confirmed the death or cured status is also determined at that moment » This is why epidemiologists (ref: https://pdfs.semanticscholar.org/ebf2/48c9fc0a1a23d1778b9408... or https://news.ycombinator.com/item?id=22195827 for my comment on the paper) prefer instead this formula which only counts patients for which the eventual outcome is already known: deaths / (deaths + recoveries) With thi…
> deaths / (deaths + recoveries) How does that produce a meaningful number? If you got 1000s of infected people, and 1 dies... The formula would be 1 / (1 + 0) = 100%. What does that mean?
It means that nobody has succesfully recovered following a confirmed infection, which is exactly what your data suggests.
Re: WHO declares coronavirus outbreak a public health emergency
#378Earlier quoted context omitted.
I think you're a bit off the mark. Healthcare is cheap in China, but people are even poorer. Only rich people can afford the important stuff. It's common for young people from poor families to work or forgo their education to pay their sick parent's medical costs. Usually old people just die because they can't afford medical care where in the west, they would be treated. Also doctors are poorly paid and commonly supp…
> Imagine getting a vial of homeopathic diluted water and a sugar pill when you complain about a cough. This happens regularly in western europe, especially by pediatricians. The charitable interpretation is that the doctor knows the child will get better in a few days anyway, but has to give _something_ to soothe the parents. Giving the substance-free stuff is better than unnecessarily medicating the child, and plac…
In your subsequent comment you add the important point - this is Germany. Having lived both in Germany and (now) in China, i can confirm that both of these countries have a problem with quack medicine. I've never been anywhere else in the world where you need to argue with pharmacists to persuade them to sell you evidence-based medicine.
In China there is some historical reason for it - Mao needed something to placate the peasants while trying to figure out how to provide healthcare to rural areas[0]. Unfortunately the government is still trying to figure that out.
I don't know what the history is in Germany that caused it to be the way it is.
[0] https://respectfulinsolence.com/2019/05/29/mao-triumphant/
Re: WHO declares coronavirus outbreak a public health emergency
#379We all seem to be talking about guesstimates and data we can't be sure of, but I see little talk of what we can do.
If this were a tech problem - a big problem that seemed insurmountable - I would break it down into chunks as best I could, look at all the parts of the chain, and ask myself which I could be most effective in tackling first. Treat it like a sprint. Which part of the chain would that be?
With the caveat I'm not a domain expert, obviously, I'd go for the lack of testing kits - what makes testing for something like this so hard and so hard at scale?
Maybe it isn't and it's the supply of kits. Is this not something that is also "fixable"? There's a lot of intelligent and capable people on this forum, why not throw some pasta at the wall?
Re: WHO declares coronavirus outbreak a public health emergency
#380Earlier quoted context omitted.
I don't believe that the data on this website is gathered through automatic means. Almost all of it is done by hand by the folks at the Johns Hopkins University's CSSE department. It gets updated around twice a day and they're constantly fiddling with the layout and whatnot.
In other words, it is a plot of data that is regularly updated.
In other words, it is a plot of data that is regularly updated.
No, it's updated quite irregularly. Given the time difference between the East Coast and China I'd expect that quite a bit of delay is to be expected between information being released and CSSE updating their site. They're also combining data from different sources and clearly are batching updates together.
