Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes? • Hacker News Board

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#141

Post by roca » Thu, May 07, 2020, 1:15 AM UTC

newacct583 wrote: post #58

sacks2k wrote: post #45

Earlier quoted context omitted.

"fixed by public policy" Public policy right now is to stay home or die of Covid 19. Many people are scared to even go outside or go to a hospital if they don't have the virus. Starting to open businesses again and requiring social distancing would definitely help with the fear and more people would actually go to the hospital for non-covid health issues.

I don't follow that. Can you walk me through how making people go to work is going to make them less afraid? You make people less afraid by reducing the risk they'll get sick, not increasing it. Releasing lockdowns before the pandemic is controlled increases risk, by definition. This is the big flaw with the "open up" notion: it fundamentally won't work anyway. How is "opening up" the economy going to help Jet Blue w…

What does "well on the way to containment" mean?

The new cases/deaths stats in California, for example, are not showing any long-term decreasing trend: https://www.latimes.com/projects/california-coronavirus-case...

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#142

Post by Animats » Thu, May 07, 2020, 1:18 AM UTC

Yes, Stanford Hospitals actually sent about 20% of their staff home.[1]

Stanford was prepared for a huge influx of coronavirus patients, but they only have 20-30 in the hospital. This despite a steadily climbing death toll. My own GP says, if you get it, go to Stanford; they have the investigational drugs, and they're not overloaded.

Nationally, the US death toll continues to climb. Currently somewhere between 69,000 and 74,000, depending on the source. The SF Bay Area's shelter-in-place thing seems to have helped. We need to get more people wearing masks, though. Seeing too many people without masks. More of the good masks, too. You really need N95 or ASTM Level 3 masks to protect yourself; the cheapies only protect other people. That only works if almost everybody wears the things.

What's happening outside the US? The Financial Times tracker, which has been updated every day for months, shows the US death rate flat. Most other countries have peaked and decreased substantially.[2]

[1] https://www.mercurynews.com/2020/04/27/coronavirus-14000-sta...

[2] https://ig.ft.com/coronavirus-chart/?areas=usa&areas=gbr&cum...

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#143

Post by belltaco » Thu, May 07, 2020, 1:21 AM UTC

zenexer wrote: post #114

mirimir wrote: post #109

Earlier quoted context omitted.

Right, they're likely dying at home, and being counted as COVID-19 deaths. That's the safest guess, in the absence of epidemiologic data. Even so, medical systems and coroners ought to be archiving samples for testing. Eventually there'll be adequate RNA and antibody testing capabilities. Without that data, we won't know what happened.

They’re not being counted as COVID-19 deaths; they’re not being counted at all . A lot of people are living in isolation right now, often with no regular contact with the outside world. The sad truth is that there are probably a lot of people lying dead in their homes right now, and they could go unnoticed for months.

Happened in Ecuador.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#144

Post by jungletime » Thu, May 07, 2020, 1:23 AM UTC

furyofantares wrote: post #122

jungletime wrote: post #13

Doctors in California went on strike and mortality dropped. One reason for the drop may be due to elective surgeries not being performed. And since more people at staying at home in a safe environment, due to COVID there will be fewer accidents. And far fewer medical mistakes too, not COVID related. "The third-leading cause of death in US most doctors don’t want you to know about" https://www.cnbc.com/2018/02/22/medi…

Most interventions are for something that's not going to kill you right away, so I would guess that seeking intervention for a medical problem I'm having would increase my odds of dying right now (due to a mistake, or exposure to other wick people) while increasing my long term odds. I would not expect an increase in mortality when non-emergency doctors go on strike. And I hope to someday live in a world where medica…

There is also another possibility. If you kill of the weak, the remaining strong will show better health outcomes. And if you are a drug company, you can tout that as proof of the success of the treatment.

And I suspect that is exactly what is happening with some of these medical treatments. They take out the weakest patients (with for example chemo therapy) and the remaining stronger ones will do better. But really its a statistical effect.

Same way you can improve test scores in a class, by getting rid of students with low IQ and work ethic. All of sudden, the average test taking ability will go up.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#145

Post by fzeroracer » Thu, May 07, 2020, 1:26 AM UTC

umvi wrote: post #129

fzeroracer wrote: post #117

Earlier quoted context omitted.

Bold of you to assume that a disease can just run its course and then end. Would you say the same thing about the Chickenpox or some of the earlier flu pandemics we've seen? Are you willing to bet on a far deadlier second wave not occurring?

> Bold of you to assume that a disease can just run its course and then end. Not that bold, since it is how most diseases/viruses work (with a few exceptions like HIV, and there's no reason to assume covid-19 is an exception) > Would you say the same thing about the Chickenpox Yes, chickenpox is one-and-done. Once you've had it, you (basically) can't get it again. > Are you willing to bet on a far deadlier second wav…

Okay, I guess I have to explain some things here.

> Not that bold, since it is how most diseases/viruses work (with a few exceptions like HIV, and there's no reason to assume covid-19 is an exception)

This is objectively wrong and I'll lead into why in the next point.

> Yes, chickenpox is one-and-done. Once you've had it, you (basically) can't get it again.

Chickenpox is not one-and-done. If you catch chickenpox, the virus remains latent and can manifest itself as Shingles.

And to explain a bit of history here: I'm not talking about a second wave of the current strain. I'm talking about a deadlier strain. That was what my reference was to earlier flu pandemics and I highly suggest you do a bit of reading on that. The Spanish flu had mutated to a far deadlier version during the second wave and spread all over the world.

For all the comparisons people make with the flu virus, people seem to ignore that viruses can come and go in waves. The flu did not 'end', it mutates every season and the reason why we're able to keep it under control is because of widespread vaccination preventing it from growing exponentially. You claim that's how most diseases work, but that's not how the flu works. The danger of letting the coronavirus run rampant is severely understated by our complete inability to control it right now.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#146

Post by pmiller2 » Thu, May 07, 2020, 1:31 AM UTC

umvi wrote: post #130

pmiller2 wrote: post #90

Earlier quoted context omitted.

Well, do you have research on how many excess deaths there would be if states started opening up now? California is taking a cautious approach by only opening in stages after cases have stabilized, and only after testing is present. Do you have a better plan than what a group of public health experts have come up with?

> Do you have a better plan than what a group of public health experts have come up with? As far as I can tell, public health experts (and basically all medical experts) are in over their heads on this one. It's like 1970s computer scientists issuing guidance on a stuxnet-esque infection. Sure, they are the experts in that they know more about computer science than other people, but they also have no experience with…

And, what knowledge and/or credentials do you have to base the conclusion that "public health experts (and basically all medical experts) are in over their heads" on? Do you know what contained the outbreak in China, South Korea, and other countries?

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#147

Post by diego » Thu, May 07, 2020, 1:33 AM UTC

benburleson wrote: post #55

munk-a wrote: post #35

Earlier quoted context omitted.

Possibly in the short term - in the long term the quarantine is likely going to increase heart disease due to people having more sedentary life styles... It's quite likely this is just a result of the math of going to a hospital shifting - a lot of folks decide not to go to the hospital with minor chest pain due to other obligations[1] and the addition of the outbreak likely adds to the reasons not to go to the hospi…

This is anecdotal, but I've never seen more people out walking around town than the last couple months. Is there research showing people are more sedentary now?

How many of those people would normally be walking in malls, stadiums or even gyms?

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#148

Post by pmiller2 » Thu, May 07, 2020, 1:34 AM UTC

umvi wrote: post #106

pmiller2 wrote: post #34

Earlier quoted context omitted.

No, it doesn't mean "stop sheltering in place," unless cases of COVID-19 have peaked. In order to tell whether they've peaked, you need testing in place, as well. Even if they have peaked, it could mean "relax some of the restrictions, but not fully end SIP, while monitoring cases." Opening things back up prematurely, without sufficient testing, is just going to get people killed.

> Opening things back up prematurely, without sufficient testing, is just going to get people killed. Yep, some people will die. That's unavoidable. Tens of millions die every year. Hundreds of millions will die per year in a few decades. That's life. If you are at-risk, you should continue to avoid contact with others. But there's currently no cure for covid-19 other than your own immune system. The sooner the disea…

No, it's entirely avoidable. I'm referring to unnecessary deaths from COVID-19, which, as we've seen here in California, and the Bay Area specifically, have not hit numbers suggested by initial models because we implemented shelter in place.

I don't see anything more to your argument than what the woman standing with a sign saying "I want a haircut" is saying. Your attitude is dangerous. People will die unnecessarily if state leaders do as you suggest. This is what the modeling says, and you have offered nothing to suggest otherwise.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#149

Post by [deleted] » Thu, May 07, 2020, 1:42 AM UTC

guscost wrote: post #97

calibas wrote: post #92

Earlier quoted context omitted.

Where's the source of "excess mortality is way up"? I didn't see it in the article, though it does suggest there may be fewer heart attacks and strokes because of "a decrease in air pollution and fewer high-fat restaurant meals".

https://www.nytimes.com/interactive/2020/04/21/world/coronav... http://euromomo.eu There's nothing for the USA as a whole, it will be compiled from states' records and estimates eventually. But it already seems obvious to me that the excess deaths in the next few years from secondary effects (avoiding hospitals, drug overdoses, suicides, stress/panic attacks, less traffic/police on roads, etc) will far outnumber the…

[deleted]

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#150

Post by pmiller2 » Thu, May 07, 2020, 1:42 AM UTC

umvi wrote: post #129

fzeroracer wrote: post #117

Earlier quoted context omitted.

Bold of you to assume that a disease can just run its course and then end. Would you say the same thing about the Chickenpox or some of the earlier flu pandemics we've seen? Are you willing to bet on a far deadlier second wave not occurring?

> Bold of you to assume that a disease can just run its course and then end. Not that bold, since it is how most diseases/viruses work (with a few exceptions like HIV, and there's no reason to assume covid-19 is an exception) > Would you say the same thing about the Chickenpox Yes, chickenpox is one-and-done. Once you've had it, you (basically) can't get it again. > Are you willing to bet on a far deadlier second wav…

> Yes - "Survival of the fittest"

Are you suggesting that people who have the ability to isolate themselves at home while still earning a living are somehow "fitter"? As I suggested before, your argument as a whole amounts to nothing more than the woman who waves the sign saying "I want a haircut". Is your life more important than your barber or stylist's? If not, why are you asking them to risk it for you?