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Some unique aspects in US which make risks of COVID19 higher than Europe

AzzieElbab 7y ago
What about spare capacity that US medical system possess as opposed to say neighboring Canada? Otherwise, all points are valid.
- claudeganon 7y ago
  They're actually worse off (ranked 36th vs. US' 32nd) https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hospital_beds https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hosp... Here are the full stats: https://stats.oecd.org/index.aspx?queryid=30183 https://stats.oecd.org/index.aspx?queryid=30183
  - OJFord 7y ago
    I think you're agreeing with GP? Who's saying that the US has more spare capacity than Canada. But also, #beds per capita isn't the same as spare capacity.
    - claudeganon 7y ago
      They edited their comment. It was a more general question of comparable rates before.
  - AzzieElbab 7y ago
    See, this is where the stats are wrong. Example; https://www.cbc.ca/news/canada/toronto/daily-bed-census-doesn-t-show-full-extent-of-hall-medicine-problem-1.5003586 https://www.cbc.ca/news/canada/toronto/daily-bed-census-does...
piker 7y ago
It will be interesting to see how elastic the supply of healthcare services is in the US versus the social systems if a pandemic does break out. History has shown that when mobilized for a common cause, the US is a force even when compared to socialist and authoritarian states. Thunder God Mountain may not have been possible in the US, but in the worst case scenario, it will interesting to see what is possible in the US.
- onetimemanytime 7y ago
  >>History has shown that when mobilized for a common cause, the US is a force even when compared to socialist and authoritarian states. true...and then you get the $752,245.88 bill total from 36 different doctors and hospitals for a 7 day hospital stay.
- ailideex 7y ago
  > Thunder God Mountain may not have been possible in the US What would you say would be the biggest impediment here? I would think actually that just government regulation in and of itself would prevent any private company from achieving this feat. And even Federal and State governments are similarly encumbered by regulation.
  - piker 7y ago
    It seems like the US government isn't structured to deploy such resources so quickly (e.g., FEMA's responses to Katrina, Sandy, etc.) and regulation would seem to kill private efforts. Maybe a state or local government could pull it off with accommodation from federal regulators.
    - ethbro 7y ago
      In the US, private industry is broadly empowered to say "No" or "I'll see you in court" to government demands, to a larger degree than many other countries. The side effect of empowering private industry is that organizations like FEMA and the CDC can't force much, and typically advise or request. Which doesn't get things done nearly as efficiently when it's a situation where proposed actions are detrimental to one corporation, even if good for the nation.
      - ailideex 7y ago
        What do you think the US government would have to demand from private industry to do build in the time frame that Thunder God Mountain was built?
moultano 7y ago
I sent this email to my team last night. Feel free to steal it for your own workplaces. We should consider working from home. You may all have seen the news by now. A patient was just diagnosed with COVID-19 at UC Davis after having no known contact with anyone travelling. Importantly, they were diagnosed after being intubated already for 7 days. It is suspected that this is the first known case of public transmission of the virus in the US. From what we know about the incubation times and progression of the illness, that means they contracted it sometime between 14-21 days ago. This is the letter UC Davis sent to their staff. If the virus has already been in the wild in California for 3 weeks, it seems likely to me that it has or will reach the bay area, and given the limited testing capability that has been reported, we may not know until the first cases end up in the ICU, weeks after exposure. The death rate for young healthy people is relatively low, around 0.2%. It is much higher for older people, who it kills in double digit percentages. Still, 20% of the people it infects need intensive hospital care. Many epidemiologists now suspect that it is likely to become endemic, and that 40-70% of the world's population will contract it. https://www.theatlantic.com/health/archive/2020/02/covid-vaccine/607000/ https://www.theatlantic.com/health/archive/2020/02/covid-vac... So what can we do? The most important thing to keep the death rate low is to reduce the burden on the hospital system so that they don't end up with more cases needing critical care than they can handle. And the most important thing for reducing the burden on hospitals is to slow the spread of the virus, so that even if it ends up infecting all of us, it doesn't infect all of us at once. We're fortunate enough that aside from impromptu collaboration and whiteboarding, all of our concrete tasks can be done at home. Most workers will not be in this situation, and will have to come to work to keep the economy running. For those of you familiar with random graph theory, the average number of edges in a graph has an exponential effect on its diameter, and so the best thing we can do is to avoid as much contact as we can. https://www.ndsu.edu/pubweb/~novozhil/Teaching/767%20Data/chapter_3.pdf https://www.ndsu.edu/pubweb/~novozhil/Teaching/767%20Data/ch... For people coming to the office, the WHO has a document on getting your workplace ready for COVID-19 that I'd encourage you to read and internalize. https://www.who.int/docs/default-source/coronaviruse/getting-workplace-ready-for-covid-19.pdf https://www.who.int/docs/default-source/coronaviruse/getting... I'm already conveniently WFH with a cold, which I hope is just a cold, but I think we should consider making this the norm, at least until we have more clarity on what the situation is.
sgt101 7y ago
Horrible thought - given the nature of this disease (kills aged 50+, very infectious) and the demographic of US leadership on all sides... what impact might this have on the dynamics of US politics? (edited to clarify)
- onetimemanytime 7y ago
  Why is it horrible thought though? USA has 300+ Million people and a tested and well thought Constitution in place. We'll survive it...
- ericlewis 7y ago
  The powers that be have access to healthcare the masses could only see in a glint of their eye.
  - ailideex 7y ago
    True even in Norway and China.
  - simonh 7y ago
    There are no magic wands against this thing, at any price. It's too new.
    - ericlewis 7y ago
      No magic wands, but superior health care to stave off the symptoms presented. True it won’t be 100% effective, but more effective than the masses.
- ailideex 7y ago
  Kills 50+ what?
  - ceejayoz 7y ago
    People aged over 50.
  - 7y ago
qubex 7y ago
This is what happens when you totally ignore that healthcare is a public issue that needs to be addressed publicly. One cannot be pro-vaccination and anti-public-healthcare, for example, for reasons extremely analogous to the argument made in the twitter thread.
bart_spoon 7y ago
Who is this person? As far as I can tell it’s just some random person speculating. Is there a reason we should be taking them seriously? Because a lot of this seems like fear mongering.
- oefrha 7y ago
  http://www.brynntannehill.com/about/ http://www.brynntannehill.com/about/ I fail to see any health background.
  - wolfram74 7y ago
    Yeah, but she does have operations research experience with the air force and campaign analysis experience with the navy, and she's not making any biology claims that aren't reasonably supported by the literature, she's drawing conclusions about secondary effects which seems more in her wheel house. Also, she has a BS in computer science, which often seems to qualify anybody in the HN comment sections to be an authority on anything.</sarcasm>
    - oefrha 7y ago
      I’m apparently not saying she’s not entitled to have an opinion and voice it. However, whether she should be taken seriously is a different matter. I certainly don’t take most HN comments on health (or anything) seriously.
    - agumonkey 7y ago
      I love the web era where everything is about asserting expertise
- 1121redblackgo 7y ago
  Which points do you have issues with? I think they all seemed on 'on-base'.
  - lvh 7y ago
    By their own admission, they fail to quantify their findings. So, my issue is that they’re sound bites that a lot of people were predisposed to agree with (eg “American healthcare is bad and expensive”) and therefore unlikely to evaluate critically. People have also argued the opposite: the US is special because we have large natural borders (mostly). Or maybe the US is special because the US has a large Chinese-American population, many of whom travel regularly. Epidemiology is a science. Why listen to Twitter randos when you have specialists?
willvarfar 7y ago
Is Trump setting Pence up as the fall-guy?
- every 7y ago
  If you work for or with Trump you are, by definition, a potential fall-guy. Trump is never culpable, again by definition...
glofish 7y ago
ok, but considering how many fewer people take public transportation in the US, and on average how less dense living conditions are it may be that the risks balance out. Edit: I will also say that health care in the US is excellent for many people. I know it is an unpopular opinion but all I can say that most people I know (myself included) have access to excellent health care, included with the employer-sponsored plan, with all costs covered (I pay directly into a tax-free health saving plan and use that, for the first $5K costs, after which additional costs are covered).
larrysalibra 7y ago
Beds per 1000 people: USA: 2.9 Italy: 3.18 China: 4.36 Hong Kong: 5.4 South Korea: 12.27 Japan: 13.05 Source: https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hospital_beds https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hosp...
throwawycorona 7y ago
I did not know about the screening for coronavirus being ineffective. A 35 y/o guy at work died from the flu a little over a week ago (Denver). If it was coronavirus, they'd know, wouldn't they?
- SpicyLemonZest 7y ago
  No, unfortunately, although most likely wasn’t coronavirus. Countries without (known) outbreaks generally aren’t testing all flu patients.
- bart_spoon 7y ago
  It’s not that screening is ineffective, it’s that the initial kits sent out by the CDC were defective. That isn’t true everywhere (places where patients have been evacuated to have testing capabilities, like California, Chicago, and Omaha), and samples can still be tested at the CDC, it just leads to a delay. It’s not ideal but it isn’t like testing simply isn’t working. As for the man in Denver, it would be very unlikely to be COVID. There is some evidence starting to emerge currently of transmission now occurring in the US, but it’s still very early and concentrated to where you might expect. It takes a while for coronavirus to kill (about 7-14 days after symptoms appear), and so if this dude was sick with it, he would almost certainly have to have had either traveled out of the country (to China), or been close with someone who had. That is something any competent medical staff will ask, and if it were the case, they could send samples to be tested to the CDC. It may be possible moving forward that if community transmission starts spreading here in the US, things could start slipping through the cracks, but at this point it’s highly unlikely that anyone in Colorado who died a week ago was sick with COVID
aripickar 7y ago
This seems like it's missing the forrest for the trees. COVID19 is a strain of flu and like all flus, it affects the respiratory system. For this reason, COVID19's mortality rate is 2.8% among men in China, compared to 1.9% among women, which can at least partially be attributed to men smoking at a rate of >50% whereas women smoke at a rate of 2% in China. [1] I think that the thread's focus on the interplay between the healthcare system and the spread of COVID19, which imho is going to be lessened because of fears of the virus making people more likely to go to the hospital. On the other hand, The US overall has fewer smokers[2], which makes the effects of COVID19 less likely to be severe on those who do get it. Most cases are mild[3], so its more important to see where the severe cases will be, rather than cases overall [1]https://www.nytimes.com/2020/02/20/health/coronavirus-men-women.html https://www.nytimes.com/2020/02/20/health/coronavirus-men-wo... [2]http://worldpopulationreview.com/countries/smoking-rates-by-country/ http://worldpopulationreview.com/countries/smoking-rates-by-... [3]https://www.nytimes.com/2020/02/27/world/asia/coronavirus-treament-recovery.html https://www.nytimes.com/2020/02/27/world/asia/coronavirus-tr...
onyva 7y ago
Considering most of this is common knowledge and was largely discussed elsewhere recently, it’s still shocking to see how normalized is USA’s dystopian existence. It’s like COVID19 is the least of their problems considering what‘s considered “normal”.
catrina11 7y ago
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What about spare capacity that US medical system possess as opposed to say neighboring Canada? Otherwise, all points are valid.

claudeganon 7y ago
They're actually worse off (ranked 36th vs. US' 32nd) https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hospital_beds https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hosp... Here are the full stats: https://stats.oecd.org/index.aspx?queryid=30183 https://stats.oecd.org/index.aspx?queryid=30183
- OJFord 7y ago
  I think you're agreeing with GP? Who's saying that the US has more spare capacity than Canada. But also, #beds per capita isn't the same as spare capacity.
  - claudeganon 7y ago
    They edited their comment. It was a more general question of comparable rates before.
- AzzieElbab 7y ago
  See, this is where the stats are wrong. Example; https://www.cbc.ca/news/canada/toronto/daily-bed-census-doesn-t-show-full-extent-of-hall-medicine-problem-1.5003586 https://www.cbc.ca/news/canada/toronto/daily-bed-census-does...

piker 7y ago

It will be interesting to see how elastic the supply of healthcare services is in the US versus the social systems if a pandemic does break out. History has shown that when mobilized for a common cause, the US is a force even when compared to socialist and authoritarian states. Thunder God Mountain may not have been possible in the US, but in the worst case scenario, it will interesting to see what is possible in the US.

onetimemanytime 7y ago
>>History has shown that when mobilized for a common cause, the US is a force even when compared to socialist and authoritarian states. true...and then you get the $752,245.88 bill total from 36 different doctors and hospitals for a 7 day hospital stay.
ailideex 7y ago
> Thunder God Mountain may not have been possible in the US What would you say would be the biggest impediment here? I would think actually that just government regulation in and of itself would prevent any private company from achieving this feat. And even Federal and State governments are similarly encumbered by regulation.
- piker 7y ago
  It seems like the US government isn't structured to deploy such resources so quickly (e.g., FEMA's responses to Katrina, Sandy, etc.) and regulation would seem to kill private efforts. Maybe a state or local government could pull it off with accommodation from federal regulators.
  - ethbro 7y ago
    In the US, private industry is broadly empowered to say "No" or "I'll see you in court" to government demands, to a larger degree than many other countries. The side effect of empowering private industry is that organizations like FEMA and the CDC can't force much, and typically advise or request. Which doesn't get things done nearly as efficiently when it's a situation where proposed actions are detrimental to one corporation, even if good for the nation.
    - ailideex 7y ago
      What do you think the US government would have to demand from private industry to do build in the time frame that Thunder God Mountain was built?

moultano 7y ago

I sent this email to my team last night. Feel free to steal it for your own workplaces. We should consider working from home. You may all have seen the news by now. A patient was just diagnosed with COVID-19 at UC Davis after having no known contact with anyone travelling. Importantly, they were diagnosed after being intubated already for 7 days. It is suspected that this is the first known case of public transmission of the virus in the US. From what we know about the incubation times and progression of the illness, that means they contracted it sometime between 14-21 days ago. This is the letter UC Davis sent to their staff. If the virus has already been in the wild in California for 3 weeks, it seems likely to me that it has or will reach the bay area, and given the limited testing capability that has been reported, we may not know until the first cases end up in the ICU, weeks after exposure. The death rate for young healthy people is relatively low, around 0.2%. It is much higher for older people, who it kills in double digit percentages. Still, 20% of the people it infects need intensive hospital care. Many epidemiologists now suspect that it is likely to become endemic, and that 40-70% of the world's population will contract it. https://www.theatlantic.com/health/archive/2020/02/covid-vaccine/607000/ https://www.theatlantic.com/health/archive/2020/02/covid-vac... So what can we do? The most important thing to keep the death rate low is to reduce the burden on the hospital system so that they don't end up with more cases needing critical care than they can handle. And the most important thing for reducing the burden on hospitals is to slow the spread of the virus, so that even if it ends up infecting all of us, it doesn't infect all of us at once. We're fortunate enough that aside from impromptu collaboration and whiteboarding, all of our concrete tasks can be done at home. Most workers will not be in this situation, and will have to come to work to keep the economy running. For those of you familiar with random graph theory, the average number of edges in a graph has an exponential effect on its diameter, and so the best thing we can do is to avoid as much contact as we can. https://www.ndsu.edu/pubweb/~novozhil/Teaching/767%20Data/chapter_3.pdf https://www.ndsu.edu/pubweb/~novozhil/Teaching/767%20Data/ch... For people coming to the office, the WHO has a document on getting your workplace ready for COVID-19 that I'd encourage you to read and internalize. https://www.who.int/docs/default-source/coronaviruse/getting-workplace-ready-for-covid-19.pdf https://www.who.int/docs/default-source/coronaviruse/getting... I'm already conveniently WFH with a cold, which I hope is just a cold, but I think we should consider making this the norm, at least until we have more clarity on what the situation is.

sgt101 7y ago

Horrible thought - given the nature of this disease (kills aged 50+, very infectious) and the demographic of US leadership on all sides... what impact might this have on the dynamics of US politics? (edited to clarify)

onetimemanytime 7y ago
Why is it horrible thought though? USA has 300+ Million people and a tested and well thought Constitution in place. We'll survive it...
ericlewis 7y ago
The powers that be have access to healthcare the masses could only see in a glint of their eye.
- ailideex 7y ago
  True even in Norway and China.
- simonh 7y ago
  There are no magic wands against this thing, at any price. It's too new.
  - ericlewis 7y ago
    No magic wands, but superior health care to stave off the symptoms presented. True it won’t be 100% effective, but more effective than the masses.
ailideex 7y ago
Kills 50+ what?
- ceejayoz 7y ago
  People aged over 50.
- 7y ago

qubex 7y ago

This is what happens when you totally ignore that healthcare is a public issue that needs to be addressed publicly. One cannot be pro-vaccination and anti-public-healthcare, for example, for reasons extremely analogous to the argument made in the twitter thread.

bart_spoon 7y ago

Who is this person? As far as I can tell it’s just some random person speculating. Is there a reason we should be taking them seriously? Because a lot of this seems like fear mongering.

oefrha 7y ago
http://www.brynntannehill.com/about/ http://www.brynntannehill.com/about/ I fail to see any health background.
- wolfram74 7y ago
  Yeah, but she does have operations research experience with the air force and campaign analysis experience with the navy, and she's not making any biology claims that aren't reasonably supported by the literature, she's drawing conclusions about secondary effects which seems more in her wheel house. Also, she has a BS in computer science, which often seems to qualify anybody in the HN comment sections to be an authority on anything.</sarcasm>
  - oefrha 7y ago
    I’m apparently not saying she’s not entitled to have an opinion and voice it. However, whether she should be taken seriously is a different matter. I certainly don’t take most HN comments on health (or anything) seriously.
  - agumonkey 7y ago
    I love the web era where everything is about asserting expertise
1121redblackgo 7y ago
Which points do you have issues with? I think they all seemed on 'on-base'.
- lvh 7y ago
  By their own admission, they fail to quantify their findings. So, my issue is that they’re sound bites that a lot of people were predisposed to agree with (eg “American healthcare is bad and expensive”) and therefore unlikely to evaluate critically. People have also argued the opposite: the US is special because we have large natural borders (mostly). Or maybe the US is special because the US has a large Chinese-American population, many of whom travel regularly. Epidemiology is a science. Why listen to Twitter randos when you have specialists?

willvarfar 7y ago

Is Trump setting Pence up as the fall-guy?

every 7y ago
If you work for or with Trump you are, by definition, a potential fall-guy. Trump is never culpable, again by definition...

glofish 7y ago

ok, but considering how many fewer people take public transportation in the US, and on average how less dense living conditions are it may be that the risks balance out. Edit: I will also say that health care in the US is excellent for many people. I know it is an unpopular opinion but all I can say that most people I know (myself included) have access to excellent health care, included with the employer-sponsored plan, with all costs covered (I pay directly into a tax-free health saving plan and use that, for the first $5K costs, after which additional costs are covered).

larrysalibra 7y ago

Beds per 1000 people: USA: 2.9 Italy: 3.18 China: 4.36 Hong Kong: 5.4 South Korea: 12.27 Japan: 13.05 Source: https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hospital_beds https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hosp...

throwawycorona 7y ago

I did not know about the screening for coronavirus being ineffective. A 35 y/o guy at work died from the flu a little over a week ago (Denver). If it was coronavirus, they'd know, wouldn't they?

SpicyLemonZest 7y ago
No, unfortunately, although most likely wasn’t coronavirus. Countries without (known) outbreaks generally aren’t testing all flu patients.
bart_spoon 7y ago
It’s not that screening is ineffective, it’s that the initial kits sent out by the CDC were defective. That isn’t true everywhere (places where patients have been evacuated to have testing capabilities, like California, Chicago, and Omaha), and samples can still be tested at the CDC, it just leads to a delay. It’s not ideal but it isn’t like testing simply isn’t working. As for the man in Denver, it would be very unlikely to be COVID. There is some evidence starting to emerge currently of transmission now occurring in the US, but it’s still very early and concentrated to where you might expect. It takes a while for coronavirus to kill (about 7-14 days after symptoms appear), and so if this dude was sick with it, he would almost certainly have to have had either traveled out of the country (to China), or been close with someone who had. That is something any competent medical staff will ask, and if it were the case, they could send samples to be tested to the CDC. It may be possible moving forward that if community transmission starts spreading here in the US, things could start slipping through the cracks, but at this point it’s highly unlikely that anyone in Colorado who died a week ago was sick with COVID

aripickar 7y ago

This seems like it's missing the forrest for the trees. COVID19 is a strain of flu and like all flus, it affects the respiratory system. For this reason, COVID19's mortality rate is 2.8% among men in China, compared to 1.9% among women, which can at least partially be attributed to men smoking at a rate of >50% whereas women smoke at a rate of 2% in China. [1] I think that the thread's focus on the interplay between the healthcare system and the spread of COVID19, which imho is going to be lessened because of fears of the virus making people more likely to go to the hospital. On the other hand, The US overall has fewer smokers[2], which makes the effects of COVID19 less likely to be severe on those who do get it. Most cases are mild[3], so its more important to see where the severe cases will be, rather than cases overall [1]https://www.nytimes.com/2020/02/20/health/coronavirus-men-women.html https://www.nytimes.com/2020/02/20/health/coronavirus-men-wo... [2]http://worldpopulationreview.com/countries/smoking-rates-by-country/ http://worldpopulationreview.com/countries/smoking-rates-by-... [3]https://www.nytimes.com/2020/02/27/world/asia/coronavirus-treament-recovery.html https://www.nytimes.com/2020/02/27/world/asia/coronavirus-tr...

onyva 7y ago

Considering most of this is common knowledge and was largely discussed elsewhere recently, it’s still shocking to see how normalized is USA’s dystopian existence. It’s like COVID19 is the least of their problems considering what‘s considered “normal”.

catrina11 7y ago

Hello Do you need financial support? Sign up for all kinds of loans and get the money urgently! * Get a stress-free loan today! * No Contest Qualifying! * No credit check, no faxing! * Instant online approvals! * Completely confidential! * Cash in 48 hours! * Appointment between $5,000 and $100,000,000 USD (only one hundred million USD) * Interest rate of 3% * Choose between 1-25 years repayment. * Choose between monthly and annual repayment plan. * Flexibility of loan terms. All these plans and more, please contact us via: catrinaprestamo@outlook.com Enter your data as needed. Name, address, date of birth, monthly income, loan amount required, desired loan term. Administration Catrinaprestamo@outlook.com WHATSAPP: +1(863)410-6179