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Re: COVID-19 in the United States

Posted: Sat Nov 28, 2020 1:56 am
by Herainestold
Bird on a Fire wrote:
Fri Nov 27, 2020 11:35 pm
FlammableFlower wrote:
Thu Nov 26, 2020 11:08 pm
With the SCOTUS ruling on religious freedoms and the various holidays, the US is in a really bad place as far as I can see.
This post could probably have been made at any point in the last gajillion years, to be fair.
The Beginning of the End.

Re: COVID-19 in the United States

Posted: Fri Dec 04, 2020 6:00 pm
by dyqik
Well, we're now at the point of 100,000 people hospitalized, it about 1 in every 3500 people, and 200k cases a day.

Re: COVID-19 in the United States

Posted: Fri Dec 04, 2020 11:05 pm
by FlammableFlower
Prediction is still for half a million deaths in the USA from COVID by April, even with a vaccine.

And I notice the CDC is now recommending universal mask wearing in indoor locations (that aren't your own home...). Looks like they now feel they can just get on with pouring out that message and ignore Trump.

San Francisco is preparing new stay at home orders too.

It's going to get really bad.

Re: COVID-19 in the United States

Posted: Fri Dec 04, 2020 11:27 pm
by sTeamTraen
The really scary thing is that while EU cases are coming down steadily and deaths, having lagged behind (in the sense of rising while cases were falling), are now levelling off, in the US, cases and deaths are both rising simultaneously. This suggests that even if they get cases under control, further deaths are to be expected after that. They have had a 9/11 each day for the past 3 days.

That said, deaths per million people in the US are still below those in the EU, so their much-derided healthcare system seems to be doing something reasonably well, or at least, not as badly as we might have predicted. (Both plots here show the moving 7-day average per million inhabitants.)

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Re: COVID-19 in the United States

Posted: Sun Dec 06, 2020 12:13 pm
by Woodchopper
Wyoming health official says 'so-called pandemic' a communist plot
Efforts to develop a vaccine is a plot by Russia and China to spread communism worldwide, said department readiness and countermeasures manager Igor Shepherd.
https://www.nbcnews.com/news/us-news/wy ... t-n1250096

Re: COVID-19 in the United States

Posted: Sun Dec 06, 2020 4:31 pm
by monkey
sTeamTraen wrote:
Fri Dec 04, 2020 11:27 pm
The really scary thing is that while EU cases are coming down steadily and deaths, having lagged behind (in the sense of rising while cases were falling), are now levelling off, in the US, cases and deaths are both rising simultaneously. This suggests that even if they get cases under control, further deaths are to be expected after that. They have had a 9/11 each day for the past 3 days.

That said, deaths per million people in the US are still below those in the EU, so their much-derided healthcare system seems to be doing something reasonably well, or at least, not as badly as we might have predicted. (Both plots here show the moving 7-day average per million inhabitants.)


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If you want to see how a healthcare system is going wouldn't a better to look at deaths/hospitalisation? People who need hospital should be mostly the same everywhere, so you don't have demographic stuff clouding things - e.g. the US might have more cases in young people than Europe.

Re: COVID-19 in the United States

Posted: Sun Dec 06, 2020 8:23 pm
by sTeamTraen
monkey wrote:
Sun Dec 06, 2020 4:31 pm
sTeamTraen wrote:
Fri Dec 04, 2020 11:27 pm
The really scary thing is that while EU cases are coming down steadily and deaths, having lagged behind (in the sense of rising while cases were falling), are now levelling off, in the US, cases and deaths are both rising simultaneously. This suggests that even if they get cases under control, further deaths are to be expected after that. They have had a 9/11 each day for the past 3 days.

That said, deaths per million people in the US are still below those in the EU, so their much-derided healthcare system seems to be doing something reasonably well, or at least, not as badly as we might have predicted. (Both plots here show the moving 7-day average per million inhabitants.)
If you want to see how a healthcare system is going wouldn't a better to look at deaths/hospitalisation? People who need hospital should be mostly the same everywhere, so you don't have demographic stuff clouding things - e.g. the US might have more cases in young people than Europe.
Well, I don't have hospitalization data. But in any case there will be problems of comparison (as there are in all comparisons across international borders, state borders, or time) because of different criteria. Maybe US hospitals admit elderly COVID patients more readily than European ones because Medicare is paying. Or maybe something else has a vice-versa effect.

Re: COVID-19 in the United States

Posted: Sun Dec 06, 2020 11:36 pm
by monkey
Didn't want to suggest it was easy, or that you should be the one to do it! Just thinking out loud.

Re: COVID-19 in the United States

Posted: Mon Dec 07, 2020 12:14 pm
by AMS
On the point about the US's "much derided healthcare system", there's nothing wrong with the quality of healthcare, compared to European systems. The issues are all around how it's funded and who can afford it.

The UK and the US both have lots of covid patients in ICUs, but the ones in the UK won't be receiving an invoice afterwards.

Re: COVID-19 in the United States

Posted: Mon Dec 07, 2020 12:25 pm
by Bird on a Fire
Yes, that would be the problem with looking at deaths per hospitalisation - a lot of people who should have been hospitalised will just have died at home instead, and those who were hospitalised may have left it later than they would under a proper healthcare system.

Deaths per case, adjusted for demographics, would be the best measure of a healthcare system's performance, but nobody has case data and you'd have to rely on excess deaths because the recording of deaths has been iffy too.

Re: COVID-19 in the United States

Posted: Mon Dec 07, 2020 12:31 pm
by jimbob
Bird on a Fire wrote:
Mon Dec 07, 2020 12:25 pm
Yes, that would be the problem with looking at deaths per hospitalisation - a lot of people who should have been hospitalised will just have died at home instead, and those who were hospitalised may have left it later than they would under a proper healthcare system.

Deaths per case, adjusted for demographics, would be the best measure of a healthcare system's performance, but nobody has case data and you'd have to rely on excess deaths because the recording of deaths has been iffy too.
Iffy in pretty much every country. The UK death certificate data looks accurate after the first five weeks of the peak, where there was about 2000 deaths per week being undercounted.

Image

But those who claim there's a huge false-positive problem are implying that the fatality rate is higher than the numbers would suggest, which I don't think is their aim at all.

Re: COVID-19 in the United States

Posted: Mon Dec 07, 2020 12:36 pm
by Bird on a Fire
jimbob wrote:
Mon Dec 07, 2020 12:31 pm
Bird on a Fire wrote:
Mon Dec 07, 2020 12:25 pm
Yes, that would be the problem with looking at deaths per hospitalisation - a lot of people who should have been hospitalised will just have died at home instead, and those who were hospitalised may have left it later than they would under a proper healthcare system.

Deaths per case, adjusted for demographics, would be the best measure of a healthcare system's performance, but nobody has case data and you'd have to rely on excess deaths because the recording of deaths has been iffy too.
Iffy in pretty much every country.
Yes, that's what I meant. Comparing between countries is pretty hopeless because most of them are messing up recording the numbers, but messing it up in different ways. Excess deaths is pretty much the only solid data we have for tracking the pandemic, which is a shame because I expect there are quite hard limits to the spatiotemporal resolution we can get from it.

Re: COVID-19 in the United States

Posted: Mon Dec 07, 2020 12:47 pm
by shpalman
US Currently Hospitalized - about 100,000, nearly 20,000 in intensive care.

Comparison with other countries

Note that Italy's death rate and numbers in hospital are both roughly double the UK's.

Yes, the data is inconsistent and incomplete, but that doesn't mean just ignore it and make stuff up.

Re: COVID-19 in the United States

Posted: Mon Dec 07, 2020 1:16 pm
by Bird on a Fire
Yes, the US has more people affected than other, smaller, countries. As steamtrain was talking about per capita, we'd need to divide those numbers by population, which would indeed make it look like the US is doing considerably better Europe.

Europe vs US is a tricky comparison to make because we're comparing 27 countries with either one big country or 50 small states. To get a similar population to Italy, we could take a couple of big states - say California and New York - and add them together.

Population density is also important, of course. Italy would be in the top 10 US states by density: we should expect it to be doing a bit worse than, say, Florida or New York, but a bit better than Maryland or Connecticut.

Re: COVID-19 in the United States

Posted: Mon Dec 07, 2020 1:35 pm
by shpalman
Bird on a Fire wrote:
Mon Dec 07, 2020 1:16 pm
Yes, the US has more people affected than other, smaller, countries. As steamtrain was talking about per capita, we'd need to divide those numbers by population, which would indeed make it look like the US is doing considerably better Europe.

Europe vs US is a tricky comparison to make because we're comparing 27 countries with either one big country or 50 small states. To get a similar population to Italy, we could take a couple of big states - say California and New York - and add them together.

Population density is also important, of course. Italy would be in the top 10 US states by density: we should expect it to be doing a bit worse than, say, Florida or New York, but a bit better than Maryland or Connecticut.
this link should give you state-by-state comparisons

If Lombardy were a separate country (its population is similar in size to that of Belgium [10 million], but in a smaller area, although it's bigger than a Wales) then it would have stood out as by far the worst in Europe in terms of numbers by population during the first wave since it had about half of Italy's cases in 1/6th of the population, and that was with official case numbers lagging the excess deaths such that the real case numbers were probably ten times higher.

Italy has 30391 in non-intensive hospital beds and 3454 in intensive care in total as of yesterday's numbers, Lombardy has 6372 and 807 respectively. These numbers have generally been falling. The peak in Lombardy was 8391+949 on the 22nd of November which is nearly 1 in 1000. There have been 430,000 cases, i.e. 1 in 23 of the population of Lombardy have officially had the covids (and it's 1 in 20 in my own province).

New cases per week per 100,000 (to compare with the number the UK uses) has dropped from over 600 (around the 10th of November) to about 230.

I get all my Italy data from this git.

Re: COVID-19 in the United States

Posted: Mon Dec 07, 2020 1:43 pm
by Bird on a Fire
Yes, Lombardy has been especially badly affected. 1 in 23 is a lot.

Re: COVID-19 in the United States

Posted: Mon Dec 07, 2020 1:58 pm
by shpalman
Coincidentally it's 1 in 20 in Ticino too, and 1 in 19 in Varese which is the other well-populated province with a well-travelled border with Ticino.

(other parts of the border between Italy and Switzerland tend to run across geographical features such as mountain ranges or lakes which is why it's only this zone with obvious equilibrium between the infection rates on either side)

Re: COVID-19 in the United States

Posted: Mon Dec 07, 2020 3:06 pm
by monkey
Bird on a Fire wrote:
Mon Dec 07, 2020 12:25 pm
Yes, that would be the problem with looking at deaths per hospitalisation - a lot of people who should have been hospitalised will just have died at home instead, and those who were hospitalised may have left it later than they would under a proper healthcare system.

Deaths per case, adjusted for demographics, would be the best measure of a healthcare system's performance, but nobody has case data and you'd have to rely on excess deaths because the recording of deaths has been iffy too.
People not having access to healthcare is part of the healthcare system and the death/hospitialisation rate would be higher if people are not going into hospital or late, which wouldn't reflect well on it. The statistic would move in the correct direction, same as it would if hospitals start getting overwhelmed and have to turn people away. I suppose there's a problem in that a death with no hospitalisation affects the numerator and denominator, but a worse/better in hospital treatment or getting to hospital late only affects the numerator, so the measure gives those two things a different weighting. Didn't think of that one before.

And the reason that I thought it might be a useful measure was because it should be somewhat self adjusting for demographics. As far as I'm aware, likelihood of dying or needing hospital with age if you catch the Covids is pretty similar across countries, so the number of hospitalisations should be proportional to the susceptible population and how spready the disease is. Which is why I thought it would measure the healthcare system, not how good people are at staying at home and wearing masks, or their government at making them.

And yes, excess deaths would be best, especially if access to healthcare is a problem and people aren't getting a diagnosis to inform the coroner.

Re: COVID-19 in the United States

Posted: Mon Dec 07, 2020 3:57 pm
by Bird on a Fire
Yes, you're right monkey. I suspect that the hospitalisation rate might be lower in the US than it would be elsewhere, while the death rate might be higher, all else being equal.

The US also has higher levels of things like obesity and diabetes, which are prejudicial - not that the Mediterranean diet seems to have helped Italy much :(

Re: COVID-19 in the United States

Posted: Mon Dec 07, 2020 4:42 pm
by shpalman
Bird on a Fire wrote:
Mon Dec 07, 2020 3:57 pm
Yes, you're right monkey. I suspect that the hospitalisation rate might be lower in the US than it would be elsewhere, while the death rate might be higher, all else being equal.

The US also has higher levels of things like obesity and diabetes, which are prejudicial - not that the Mediterranean diet seems to have helped Italy much :(
It's that whole how-many-more-years-would-someone-have-had-left thing that I tried to discuss in another thread.

Having an older population, which is more at risk despite having survived to such an age with "pre-existing conditions", ought to be balanced against the other country not having such an old population because they're generally unhealthy and die sooner, which covid ought to exacerbate.

Re: COVID-19 in the United States

Posted: Mon Dec 07, 2020 4:46 pm
by shpalman
shpalman wrote:
Mon Dec 07, 2020 1:58 pm
Coincidentally it's 1 in 20 in Ticino too, and 1 in 19 in Varese which is the other well-populated province with a well-travelled border with Ticino.

(other parts of the border between Italy and Switzerland tend to run across geographical features such as mountain ranges or lakes which is why it's only this zone with obvious equilibrium between the infection rates on either side)
1 in 22 in the United States (14.8 million cases, 328.2 million populations).

It's more like 1 in 40 on average in the UK by the way.

Re: COVID-19 in the United States

Posted: Mon Dec 07, 2020 4:47 pm
by bolo
Lack of health insurance is a huge problem, but the uninsured are "only" about 11% of the U.S. population, and they are almost all under 65 because most over-65s are covered by Medicare, so I would be surprised if lack of insurance was a big factor in U.S. hospitalization or death rates relative to other countries.

Re: COVID-19 in the United States

Posted: Mon Dec 07, 2020 4:57 pm
by monkey
bolo wrote:
Mon Dec 07, 2020 4:47 pm
Lack of health insurance is a huge problem, but the uninsured are "only" about 11% of the U.S. population, and they are almost all under 65 because most over-65s are covered by Medicare, so I would be surprised if lack of insurance was a big factor in U.S. hospitalization or death rates relative to other countries.
But you can be insured and still not go to hospital till it's too late because you're scared of going bankrupt due to the co-pay.

Re: COVID-19 in the United States

Posted: Mon Dec 07, 2020 6:51 pm
by dyqik
monkey wrote:
Mon Dec 07, 2020 4:57 pm
bolo wrote:
Mon Dec 07, 2020 4:47 pm
Lack of health insurance is a huge problem, but the uninsured are "only" about 11% of the U.S. population, and they are almost all under 65 because most over-65s are covered by Medicare, so I would be surprised if lack of insurance was a big factor in U.S. hospitalization or death rates relative to other countries.
But you can be insured and still not go to hospital till it's too late because you're scared of going bankrupt due to the co-pay.
Or that the insurance company will deny your coverage, or that the doctor you see will be out of network, so you aren't covered, or that you can't afford your deductable, or a million other things.

Re: COVID-19 in the United States

Posted: Mon Dec 07, 2020 7:03 pm
by jimbob
shpalman wrote:
Mon Dec 07, 2020 4:42 pm
Bird on a Fire wrote:
Mon Dec 07, 2020 3:57 pm
Yes, you're right monkey. I suspect that the hospitalisation rate might be lower in the US than it would be elsewhere, while the death rate might be higher, all else being equal.

The US also has higher levels of things like obesity and diabetes, which are prejudicial - not that the Mediterranean diet seems to have helped Italy much :(
It's that whole how-many-more-years-would-someone-have-had-left thing that I tried to discuss in another thread.

Having an older population, which is more at risk despite having survived to such an age with "pre-existing conditions", ought to be balanced against the other country not having such an old population because they're generally unhealthy and die sooner, which covid ought to exacerbate.
More or Less, early in the pandemic, said that catching COVID-19 basically gave you a year's worth of mortality risk in a couple of weeks - whatever your mortality risk would have been