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Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

reuters.com

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Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#171
post #62

Earlier quoted context omitted.

A large number of South Korea infections are even younger due to how it spread. Italy: Above 80: 1,532 (18.4)% vs age 20-29: 296 (0.0)% South Korea: Above 80: 243 (3.1)% age 20-29: 2,261 (28.7)% https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_S... https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_I... Of note, neither country has had anyone under 30 die. Deaths in the 80+ age range are 8.23% in So…

I'm not sure how the media should report on deaths over 80, or even over 90. It's not that old people aren't worthy of protection, but when you're 85 in the US you have a 10% chance of dying in the next year for any and all reasons. So saying this disease kills 15% (for example) of 80+ year olds without context sounds horrific, but contextualized in the actual risks of just being very old to begin with, sounds much l…

Also when 85+ year olds die for other reasons, they don't all occupy ICUs for days or even weeks as in the case of COVID-19.

Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#172
post #67
post #33

> South Korea has since reported 67 deaths out of nearly 8,000 confirmed cases, after testing more than 222,000 people. In contrast, Italy has had 1,016 deaths and identified more than 15,000 cases after carrying out more than 73,000 tests on an unspecified number of people. Surely the testing is a huge factor. Test more people you'll find more people infected, so the fatality rate will get smaller. If you're like th…

Singapore is probably doing as best as any country could hope to. https://www.npr.org/sections/goatsandsoda/2020/03/12/8145224... Also, as an American, I'm embarrassed by my country's response and by how my president addresses the nation. PM Lee shows how you talk to your country: https://www.youtube.com/watch?v=3mYs1Uyx3c8 His original address five weeks prior: https://www.youtube.com/watch?v=dExr76Wckr8

Singapore has been competent, but Taiwan's response has been more impressive.

It's very close to the hot zone, millions of people travel to and from mainland China every year, it has roughly the population of Australia living on 10% of the land Japan has, the WHO refuses any cooperation, and yet there have been under 50 cases and no local transmission.

Not only that, but as a democratic state, Taiwan's control measures have been remarkably measured.

I'd credit two factors:

1) Imposing travel limits three weeks before China even admitted there was an outbreak. After SARS, the TW government had a plan for this epidemic and a healthy skepticism for both official news and the WHO.

2) Taiwan has a relatively high trust society. People generally trust the local CDC and make a genuine effort to take preventative measures, even those primarily for the safety of others. A phone alert is generally all that's needed as a quarantine reminder for those exposed.

Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#173
post #166

Earlier quoted context omitted.

Fatality numbers won't reflect those who developed permanent lung damage or had to go into intensive care. Best not to suggest anything that might down play the seriousness considering how infectious this virus is. (Otherwise it may encourage risky behavior.)

but what about the risks of over-selling this disease? Look at Italy for example. I've read self-reports from healthcare workers claiming 200% hospital capacity. I can only image the needless death resulting from such panic. Mind you that isn't covid 19 putting them over-capacity. In the worst hit region in Italy (Lombardy) confirmed covid 19 cases represent enough cases to take up less than 10% of their hospital bed…

Your 10% premise is wrong because you're conflating intensive care capacity and regular hospital beds. You can't just put Covid patients in with the general hospital population and it isn't trivial to convert other hospital beds to the requirements of Covid while ensuring you keep everyone else in the hospital safe from infection. Lombardy does not have anywhere near enough intensive care capacity to handle the cases they've already seen, much less anything further.

You can see that in the death rate, it's happening because they can't care for the volume of older intensive care patients properly. They don't have the medical infrastructure capacity to do it. That's why Italy and other European nations such as France have an extreme variance in mortality rates, despite France and Italy both having similarly old populations. Germany is even older than Italy and I'm skeptical we're going to see anywhere near a 6% mortality rate there (their rate is very low so far). Italy's mortality rate has been abnormally high from the first few thousand cases in, when it quickly began overloading their healthcare system in Lombardy.

Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#174

Earlier quoted context omitted.

My hypothesis is that Japan, Hong Kong, South Korea, Singapore had to contend with earlier SARS outbreak and responded more quickly and comprehensively with contact tracing, social distancing.

and perhaps residual previous-exposure widely-disseminated immunity to the class of viruses?

This is a novel coronavirus, so no real relationship to the previous cases other than the shape.

Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#175
post #166

Earlier quoted context omitted.

but what about the risks of over-selling this disease? Look at Italy for example. I've read self-reports from healthcare workers claiming 200% hospital capacity. I can only image the needless death resulting from such panic. Mind you that isn't covid 19 putting them over-capacity. In the worst hit region in Italy (Lombardy) confirmed covid 19 cases represent enough cases to take up less than 10% of their hospital bed…

Your 10% premise is wrong because you're conflating intensive care capacity and regular hospital beds. You can't just put Covid patients in with the general hospital population and it isn't trivial to convert other hospital beds to the requirements of Covid while ensuring you keep everyone else in the hospital safe from infection. Lombardy does not have anywhere near enough intensive care capacity to handle the cases…

A quick google suggests around 15% of hospital beds are ICU and covid 19 cases that end up in the hospital, only 5% end up in ICU. So that's an interesting line of thinking but it lacks supporting evidence that covid 19 is overwhelming ICU.

https://www.nejm.org/doi/full/10.1056/NEJMoa2002032

edit to address your edit: The mortality rate is often wildly inflated with new diseases. That's because most people don't seem to understand real mortality rate vs confirmed cases mortality rate. Obviously when a disease is new the confirmed cases will be confirmed against the people showing serious symptoms. Then when you pretend deaths/confirmed cases == mortality rate you end up with a wildly inflated mortality rate. Until we understand how many people are asymptomatic we won't have a real mortality rate that is reliable.

Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#176
post #24

Reminder for those in despair... It is merely enough to make the r0 after containment measures less than 1. Then the problem will eventually go away. As someone said, social distancing measures to work must be done when it seems to be overreacting. And if they work, it will seem as if we overreacted.

But, these measures need to hold on for long enough, until all reservoirs are depleted. Relaxing the measures after the transmission rates decrease will only stop it temporarily, so it will flare right back up if it has a source that was missed. Also, the lower the R factor, the faster measures can be relaxed. With an R0, if you want to guarantee putting out everything, you need to hold the measures for the longest p…

Flare up is my biggest concern; this is what the Spanish Flu did.

Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#177
post #160

Earlier quoted context omitted.

I would be proud to vote for someone like this.

Let’s not get carried away in our praise of Singapore’s leaders. Singapore is an authoritarian state and Lee is a part of the ruling family.

For all those interested in how Singapore can possibly be a duality of "sometimes good sometimes bad", just look at how Singapore treats its Malay population as second class citizens.

For example, if a Singaporean Malay marries a Malaysian Malay, there is still a large chance their Permanent Residency application will be denied. This usually doesn't happen to someone who marries Han Chinese, of which Singapore is 70%.

Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#178
post #142

Earlier quoted context omitted.

Until today, European airlines were flying empty “ghost” planes because they had no passengers, but they wanted to keep their landing slots. Yesterday I talked to a colleague who relayed the story of a transatlantic flight this week, where only 6 seats were filled, out of 36 in the section. I don’t think there’s much remaining travel left to be banned. The resulting economic impact therefore can’t be that big.

>> The resulting economic impact therefore can’t be that big. The impact on the spread of the virus can't be that big either. My point though is that big flashy moves like banning all flights appear to do very little compared to more mundane tactics. At least based on the info in the press conference I'm referring to the data doesn't support flight bans, banning large gatherings etc.

You shouldn't discount the psychological factor of these things. Today, 1 day after the big move by the US to ban flights from Europe, we're seeing a lot more movement from various governments and states in taking action against the virus' spread. So even though the action itself might not be that useful, it's big enough that it gets people attention and it seems to have moved people across governments into more action.

Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#179

This outbreak is a litmus test for the competence of countries. It's already shone a bright light on the fragility of global supply lines, cheap travel and open borders. These are the aspects of life most likely to change after this is all over.

>These are the aspects of life most likely to change after this is all over. People will forget about this in a year and go back to life like it's always been. Short term convenience trumps everything except short term negative consequences.

Not for something this big, and for something that won't go away for 18 months MINIMUM

Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#180
post #62

Earlier quoted context omitted.

A large number of South Korea infections are even younger due to how it spread. Italy: Above 80: 1,532 (18.4)% vs age 20-29: 296 (0.0)% South Korea: Above 80: 243 (3.1)% age 20-29: 2,261 (28.7)% https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_S... https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_I... Of note, neither country has had anyone under 30 die. Deaths in the 80+ age range are 8.23% in So…

I'm not sure how the media should report on deaths over 80, or even over 90. It's not that old people aren't worthy of protection, but when you're 85 in the US you have a 10% chance of dying in the next year for any and all reasons. So saying this disease kills 15% (for example) of 80+ year olds without context sounds horrific, but contextualized in the actual risks of just being very old to begin with, sounds much l…

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