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Something the article doesn't do a great job of covering is how overall emergency medical incidents went way down more than expected - which is what some of the

Something the article doesn't do a great job of covering is how overall emergency medical incidents went way down more than expected - which is what some of these field hospitals (and the Navy ships) were for. The head of a local hospital network has tweeted wondering where all the heart attack and stroke patients went - both in my lightly impacted region and in disaster NYC. Did the rate go down? Or did people just die at home afraid to go to the hospital? In SF in normal times, over 50% of trauma cases are from car accidents. My completely unscientific theory is that commuting/traffic is way more stressful and physically taxing than people think. https://www.sfexaminer.com/news/half-of-injuries-treated-at-sf-general-hospital-are-from-traffic-collisions/ https://www.sfexaminer.com/news/half-of-injuries-treated-at-...

easytiger 6y ago
> Or did people just die at home afraid to go to the hospital? Probably yes. In the UK there is a significant surge in non covid related deaths above historical stats. Bear in mind also the definition of a covid 19 related death is, err, generous in the first place https://www.spectator.co.uk/article/non-covid-deaths-are-also-surging https://www.spectator.co.uk/article/non-covid-deaths-are-als...
- thebruce87m 6y ago
  Not saying you’re wrong, I do think there would be some of that but I am looking at a way to quantify it, especially since my friend is convinced that the lockdown is worse than the virus. Here is something I found interesting: Spain has a “hard lockdown” too. Their excess mortality has returned to a normal level according to momo: https://www.euromomo.eu/graphs-and-maps/ https://www.euromomo.eu/graphs-and-maps/ Now I realise that some people that would normally die are not (car accidents etc), but at the same time if the lockdown itself was causing significant mortality you wouldn’t expect the excess mortality to drop to normal levels, would you? You would expect a small offset from 0 unless the savings from car crashes are exactly the same compared to “lockdown deaths” - and if they are, and the lockdown is saving “extra” lives then is it not still worth it? We have to wait and see for England to see if it falls back to normal or below normal levels.
  - mgsouth 6y ago
    > Spain has a “hard lockdown” too. Their excess mortality has returned to a normal level according to momo That's probably inaccurate. I've been following MOMO's graphs, and the yellow-band portions (most recent weeks) grossly underreport and are subject to upward correction. Data points get larger and larger as they age. For example, "Spain Week 11" was pretty small when first reported (in week 12?), was larger the next week, and larger still a week later.
- miscPerson 6y ago
  The CDC says we’re slightly under expected deaths in the US, including COVID cases. https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm
  - foota 6y ago
    This isn't true, deaths reported lag, so the numbers continue to go up after the week is over.
  - sgt101 6y ago
    I read that data as showing that the USA has had a sharp excess death event for each of the last four weeks reported. I'm seeing a much greater excess death rate than the official Covid19 reports.
  - alistairSH 6y ago
    Looks at the data by state or city. VA shows a huge spike over normal in early April. NY and NYC show even bigger spikes. And the data is only through April 1. I suspect the excess death rates will be higher nationwide from April 1-May 1.
    - lsllc 6y ago
      Where are you seeing "only through April 1" ? The tables say 2/1/2020 to 5/2/2020 and shows 5 weeks of data for April thru May (the page is updated as-of today, 5/8/2020).
- lostlogin 6y ago
  The article says: “Imperial College London’s Neil Ferguson has said, as many of two-thirds of 'Covid deaths' would have happened anyway” Would these deaths have happened in a massive spike? If not, then it isn’t anything like the same and if so, why?
  - sesutton 6y ago
    Presumably he means they would've happened in the same time period otherwise it's a meaningless statement. On a long enough timescale everyone who died of Covid would've died anyway.
    - dboreham 6y ago
      Whether it's meaningless depends on the timescale. For zero months its very meaningful while for infinity months it's completely meaningless. And in-between it's meaningful, e.g. they would have died in the next 12 months.
  - marcell 6y ago
    The implication is they would have died soon, like in the next 6 months. About half of Covid deaths are in nursing homes. The median lifespan after entering a nursing home is 5 months, and the mean is 13 months. Coronavirus is very infectious, so if it enters a nursing home, it could easily spread and wipe out everyone who was on the brink of dearth, or on a fragile state.
    - lukas099 6y ago
      According to The Economist, the average lifetime lost per covid death is over 10 years. https://www.economist.com/graphic-detail/2020/05/02/would-most-covid-19-victims-have-died-soon-without-the-virus https://www.economist.com/graphic-detail/2020/05/02/would-mo...
      - marcell 6y ago
        Well, it's worth keeping in mind that the risk of death from a coronavirus infection is comparable to the annual risk of death from all causes. Coronavirus infection though is a once per lifetime risk, whereas all-cause mortality occurs every year. Just as a random comparable, the annual risk of getting cancer if you're 35 years old is around 0.1%, and the annual risk of having a heart attack is around 0.5% (higher for men, lower for women). All of those diseases would have similar average lifetime lost as covid, but the risk is continuous, not a once per lifetime occurance.
SnowProblem 6y ago
It's simple. They are being classified as covid. https://imgur.com/a/spXA4q8 https://imgur.com/a/spXA4q8
- magicalist 6y ago
  Considering that 27k residents of NYC alone (not counting the rest of the state included in that chart) died[1] between March 11 and April 25 (not counting the 10 days before included in that chart), I'm going to go out on a limb and say you're working with a made-up chart there. [1] https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-deaths-confirmed-probable-daily-04262020.pdf https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-d...
  - SnowProblem 6y ago
    Check again. Your link backs up the chart I posted. Medicare paying hospitals 8k per covid patient and 39k per ventilator use simply with symptoms, no test required, also does not help. But keep the downvotes coming.
    - riahi 6y ago
      What do you think Medicare pays for ventilator use for non Covid ICD10 claims? Further, analysis by the Washington Post examined excess death by all causes. It’s way up. https://www.washingtonpost.com/investigations/2020/04/27/covid-19-death-toll-undercounted/?arc404=true https://www.washingtonpost.com/investigations/2020/04/27/cov...
      - SnowProblem 6y ago
        Probably ~20% more for covid than non-covid, based on what I've followed from CARES, but I wouldn't focus the incentive problem on ventilators. And you're right. Excess deaths are way up, so I assume there is a problem with my chart. But heart attacks and strokes are also way down, and in every article I've read (NPR, WaPo) there's an assumption that they just aren't coming in. Has nobody read the covid classification guidelines? I stand by that non-covid cases are being massively misclassified as covid.
tathougies 6y ago
> The head of a local hospital network has tweeted wondering where all the heart attack and stroke patients went - both in my lightly impacted region and in disaster NYC. Did the rate go down? Or did people just die at home afraid to go to the hospital? It's at this point that the news media needs to look inwards and wonder if they made such a big hysteria over covid that they failed to point out that people should still go to the ER. I bet many of those who died at home had symptoms of heart attacks/strokes, etc, but didn't want to go out of a mistaken sense of magnanimity (I don't want to take the bed of a COVID patient) as well as a false sense that the hospitals were in any danger of being overloaded (they were not, given the steps we took).
- vkou 6y ago
  What about option #3 - going to hospital puts you in danger of catching COVID? If you have pre-existing conditions, catching COVID is a lot more dangerous than if you don't. Who typically goes to the hospital for medical treatment? People with pre-existing conditions. "I don't want to go to the ER, because I might catch COVID from another patient, or doctor" is a very justifiable fear. This is just the consequence of the virus spreading to the community - not the consequence of mitigating the spread of the virus through the community.
  - ryankemper 6y ago
    > "I don't want to go to the ER, because I might catch COVID from another patient, or doctor" is a very justifiable fear. The mortality risk of undetected/unaddressed heart problems, etc, far supercedes the risk from COVID-19. You could find some limited examples where that's not true but it is overwhelmingly the case. It is becoming increasingly clear that the level of panic associated with COVID-19 is absolutely divorced from the ground truths. But it doesn't just affect non-COVID-19 mortality. It may be that our response is even making COVID-19 mortality worse in some cases: From https://www.nejm.org/doi/full/10.1056/NEJMc2009787?query=recirc_mostViewed_railB_article https://www.nejm.org/doi/full/10.1056/NEJMc2009787?query=rec...): "Social distancing, isolation, and reluctance to present to the hospital may contribute to poor outcomes. Two patients in our series delayed calling an ambulance because they were concerned about going to a hospital during the pandemic." (My note: So the irony here is incredible, these weren't just non-COVID-19 patients afraid to come in but _people who actually had life-threatening COVID-19_.) And from https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30090-0/fulltext https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...: "Third, the COVID-19 epidemic has caused a parallel epidemic of fear, anxiety, and depression. People with mental health conditions could be more substantially influenced by the emotional responses brought on by the COVID-19 epidemic, resulting in relapses or worsening of an already existing mental health condition because of high susceptibility to stress compared with the general population." and "Finally, many people with mental health disorders attend regular outpatient visits for evaluations and prescriptions. However, nationwide regulations on travel and quarantine have resulted in these regular visits becoming more difficult and impractical to attend."
Spooky23 6y ago
I don't know the stats, but I live next to a busy fire station that responds to paramedic calls and is doubled up with trucks due to a COVID outbreak in another house. Today (a Friday, I am working on my front porch, and heard sirens about 4 times from 7AM-3PM). Typically, that number would be 5x that. It's been like that since mid-march.
serf 6y ago
>The head of a local hospital network has tweeted wondering where all the heart attack and stroke patients went - both in my lightly impacted region and in disaster NYC. Did the rate go down? besides the deaths-at-home, shouldn't it be considered that the low-impact low-energy lifestyle that is being promoted right now is less strenuous on the body in the short term? I imagine that the lack of deaths, after deaths-at-home are cancelled from the number, is just seeing a lag time where the lack of physical effort reduces short-term deaths but increases long-term deaths due to lapse in fitness.
- dylan604 6y ago
  How much stress is replaced by "I have no job, and my phone is blowing up with debt collectors, and I have to decide if I buy food or pay bills, do I have corona, etc?"
  - x86_64Ubuntu 6y ago
    But aren't people getting money through unemployment and the CARES Act? Won't that help them keep the stress level down a bit?
    - montecarl 6y ago
      Just an anecdote, but my father lives in Tennessee, and applied for unemployment 6 weeks ago. The website reports he has been paid every week, but he still hasn't seen any money. He has spent about 12 hours on the phone with various agencies and has no answer to why he has not been paid. From what he can tell this is not an uncommon situation in TN.
    - AuryGlenz 6y ago
      At least as a self employed person, unemployment seems...tenuous. And confusing. I’m a photographer. The website says I’m supposed to report income the week I work, not when I actually receive payment. If someone gives me a deposit for a wedding next year should I count it? Should I be reporting the deposits I got last year when I cover a wedding this year? I’m allowed to deduct expenses, but they don’t go in to more detail. If I spend more than I make in a week can I carry over the rest of the expense? It’s pretty stressful just knowing if you’re doing it correctly.
sandworm101 6y ago
>> which is what some of these field hospitals (and the Navy ships) were for. Small detail about the navy ships: they are setup for battlefield injuries. The wards are all open (think what you see on old episodes of MASH) with little to no separation between patients. That is fine for traumatic injuries (earthquakes, fires, war etc) but less than useful for control of infectious disease. The plan was for them to take non-covid patients to relieve hospitals but it never really worked out. The risk of a ship becoming a hotspot should one covid infection slip through into an open ward was too great.
- SlowRobotAhead 6y ago
  This is not entirely correct. The US Comfort in NYC specifically is as you described, but, lost 1/2 it's capacity by setting up with protections between beds. It still saw almost no people because the need just wasn't there. Under 80 people last I heard. I am not aware of any reports that said fear was a factor in it not being used, do you have that source?
  - maxerickson 6y ago
    Their initial criteria was that a patient had to go get a Covid test at another hospital before they could board the ship. At least some of the reason it didn't treat many patients is that they made it hard to become a patient.
  - ethbro 6y ago
    There's a few factors at play here. 1) Hospitals generally get paid (by someone) for treating patients. So they want to run at 100% capacity, even with covid patients. 2) You can't really just "build an ICU." You can stand up a field hospital that's able to provide similar, degraded services. But it's not going to be the same. Imagine if someone said "set up a datacenter in a field," and then a customer had a choice to colo their server in a purpose-built DC or your field DC. Which do you think they'd pick? 3) The units that staffed these facilities were heavily augmented by military reserves. Corpsmen may have non-medical civilian jobs, but what do you think military reserve critical care nurses and doctors do for a living? If these field hospitals were packed to the brim, all of those people would be locked in place. Possibly while they were needed in their civilian positions, in their home cities (although the military seems to have done a pretty good job about preferentially pulling non-Covid-civilian personnel). 4) Exponential growth with unknown but high R_t. +1 week before we locked down would have looked very different. ... all of that to essentially say that these facilities were designed as surge capacity, in the event they were needed. We intentionally filled up hospitals first. USD$660M seems like a reasonable price to pay, strictly as insurance, given the very real risk that hospitals would have been overfilled and covid-related mortality would have spiked due to lack of care.
Kerrick 6y ago
NPR covered that in another recent story: > The fallout from such fear has concerned U.S. doctors for weeks while they have tracked a worrying trend: As the pandemic took hold, the number of patients showing up at hospitals with serious cardiovascular emergencies such as strokes and heart attacks has shrunk dramatically. > Across the U.S., doctors call the drop-off staggering, unlike anything they've seen. And they worry a new wave of patients is headed their way — people who have delayed care and will be sicker and more injured when they finally arrive in emergency rooms. https://www.npr.org/sections/health-shots/2020/05/06/850454989/eerie-emptiness-of-ers-worries-doctors-where-are-the-heart-attacks-and-strokes https://www.npr.org/sections/health-shots/2020/05/06/8504549...
- lumberingjack 6y ago
  My father needs medical help RN but everyone is putting him off just sending RX over phone no (pain pills though) saying "stay home". ASAP they open we all wheeling him in there for a MRI if we have to camp outside in a waiting line so be it.
  - forgot_again 6y ago
    You should bring him to an emergency room now.
  - threecheese 6y ago
    I don't know where you are, but in my area (east of NYC) the ERs are non-COVID and strictly separated. Weigh the risk, but know that the ERs are not necessarily warzones. Call the hospital and ask them, but don't delay care just because you don't know the real risks. I've been (physically) to an urgent care clinic, a specialist's office, and a dentist in the past week, because I waited two months for care, and I'm feeling pretty stupid (I'm high risk). The protocols are different, waaaaahhy more strict, but they are treating people.
thaumaturgy 6y ago
The CDC has been monitoring a broad-spectrum increase in mortality across the US even after accounting for covid19-related deaths. From https://www.usatoday.com/story/news/investigations/2020/04/29/far-greater-u-s-covid-19-death-toll-indicated-cdc-data/3048381001/ https://www.usatoday.com/story/news/investigations/2020/04/2... > The "excess deaths" surpassed COVID-19 fatalities in those states by a combined 4,563 people. Experts suspect that unconfirmed coronavirus cases could be responsible for some of those deaths, but it might also be related to a shift in other causes of death. For example, some doctors speculate people might be dying from illnesses from which they would normally recover because the pandemic has changed access to health care. > “Our ER, as well as many others, are seeing far fewer patients because people are scared to come in.” There are graphs. This has added to a lot of the confusion and misinformation surrounding coronavirus response, since people are hearing that hospitals and ERs around the country are seeing fewer patients -- dramatically fewer, in some cases -- and conflating that with the coronavirus risk being unexpectedly low, which isn't true.
- abfan1127 6y ago
  The original risk associated with Covid19 was lack of hospital resources. With most hospitals having plenty of capacity, the risk of getting Covid19 and not getting access to hospital resources is much lower than expected, so it was true.
  - thaumaturgy 6y ago
    Yeah. It's really a shame that there were all these efforts to prevent our health care system from being overwhelmed. Oh well. It looks like enough people would like to run this particular experiment that we just might get to see what it looks like after all. Yay?
    - abfan1127 6y ago
      I don't understand your comment. We made decisions based on information. The results of our original experiment turned out to be different than our expectations. Further, others were hurt substantially due to these decisions. Those hurt are requesting (or demanding) to change course so as to not be hurt further. Seems reasonable to change course, with each US State (or country) changing course differently based on their circumstances.
briandear 6y ago
Friend of mine is a trauma nurse at Stanford and she said their most common trauma patient is from bicycle accidents. Just an anecdote, but an interesting one.
FireBeyond 6y ago
> Or did people just die at home afraid to go to the hospital? Sadly I think this is a partial answer. Working as a paramedic, for all the times I saw people saying “y’know, maybe I don’t really need to go to the ER”, there were also the people who really did need to but were too scared. Be it 90 year olds with severe lacerations or heart attacks, there was a fear that we had to manage and balance.
robbiep 6y ago
All cause mortality is down 9% over the last couple of months in Rome (sorry, on mobile, not easy to add reference which I would have to trawl for) - just to get in front of any covid-seriousness deniers, Rome has not been badly hit. In Australia, significant decreases in STEMI (serious heart attack presentations) although nothing published yet. Everyone wondering what’s going on - going to be some interesting studies coming out after this in terms of population health and additional/reduced morbidity and mortality
- Scipio_Afri 6y ago
  Less pollution, pollution especially PM smaller than 2.5 you get from the tail of an exhaust pipe sitting in front of you in traffic is not good for cardiovascular health and also is known to cause strokes. We have a significant decline in pollution and people driving.
ezoe 6y ago
It's been said one month ago. They just die in their home. https://www.reddit.com/r/Coronavirus/comments/g0p3po/deaths_from_heart_attacks_have_surged_in_new_york/fnauu9r/ https://www.reddit.com/r/Coronavirus/comments/g0p3po/deaths_...

easytiger 6y ago

> Or did people just die at home afraid to go to the hospital? Probably yes. In the UK there is a significant surge in non covid related deaths above historical stats. Bear in mind also the definition of a covid 19 related death is, err, generous in the first place https://www.spectator.co.uk/article/non-covid-deaths-are-also-surging https://www.spectator.co.uk/article/non-covid-deaths-are-als...

thebruce87m 6y ago
Not saying you’re wrong, I do think there would be some of that but I am looking at a way to quantify it, especially since my friend is convinced that the lockdown is worse than the virus. Here is something I found interesting: Spain has a “hard lockdown” too. Their excess mortality has returned to a normal level according to momo: https://www.euromomo.eu/graphs-and-maps/ https://www.euromomo.eu/graphs-and-maps/ Now I realise that some people that would normally die are not (car accidents etc), but at the same time if the lockdown itself was causing significant mortality you wouldn’t expect the excess mortality to drop to normal levels, would you? You would expect a small offset from 0 unless the savings from car crashes are exactly the same compared to “lockdown deaths” - and if they are, and the lockdown is saving “extra” lives then is it not still worth it? We have to wait and see for England to see if it falls back to normal or below normal levels.
- mgsouth 6y ago
  > Spain has a “hard lockdown” too. Their excess mortality has returned to a normal level according to momo That's probably inaccurate. I've been following MOMO's graphs, and the yellow-band portions (most recent weeks) grossly underreport and are subject to upward correction. Data points get larger and larger as they age. For example, "Spain Week 11" was pretty small when first reported (in week 12?), was larger the next week, and larger still a week later.
miscPerson 6y ago
The CDC says we’re slightly under expected deaths in the US, including COVID cases. https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm
- foota 6y ago
  This isn't true, deaths reported lag, so the numbers continue to go up after the week is over.
- sgt101 6y ago
  I read that data as showing that the USA has had a sharp excess death event for each of the last four weeks reported. I'm seeing a much greater excess death rate than the official Covid19 reports.
- alistairSH 6y ago
  Looks at the data by state or city. VA shows a huge spike over normal in early April. NY and NYC show even bigger spikes. And the data is only through April 1. I suspect the excess death rates will be higher nationwide from April 1-May 1.
  - lsllc 6y ago
    Where are you seeing "only through April 1" ? The tables say 2/1/2020 to 5/2/2020 and shows 5 weeks of data for April thru May (the page is updated as-of today, 5/8/2020).
lostlogin 6y ago
The article says: “Imperial College London’s Neil Ferguson has said, as many of two-thirds of 'Covid deaths' would have happened anyway” Would these deaths have happened in a massive spike? If not, then it isn’t anything like the same and if so, why?
- sesutton 6y ago
  Presumably he means they would've happened in the same time period otherwise it's a meaningless statement. On a long enough timescale everyone who died of Covid would've died anyway.
  - dboreham 6y ago
    Whether it's meaningless depends on the timescale. For zero months its very meaningful while for infinity months it's completely meaningless. And in-between it's meaningful, e.g. they would have died in the next 12 months.
- marcell 6y ago
  The implication is they would have died soon, like in the next 6 months. About half of Covid deaths are in nursing homes. The median lifespan after entering a nursing home is 5 months, and the mean is 13 months. Coronavirus is very infectious, so if it enters a nursing home, it could easily spread and wipe out everyone who was on the brink of dearth, or on a fragile state.
  - lukas099 6y ago
    According to The Economist, the average lifetime lost per covid death is over 10 years. https://www.economist.com/graphic-detail/2020/05/02/would-most-covid-19-victims-have-died-soon-without-the-virus https://www.economist.com/graphic-detail/2020/05/02/would-mo...
    - marcell 6y ago
      Well, it's worth keeping in mind that the risk of death from a coronavirus infection is comparable to the annual risk of death from all causes. Coronavirus infection though is a once per lifetime risk, whereas all-cause mortality occurs every year. Just as a random comparable, the annual risk of getting cancer if you're 35 years old is around 0.1%, and the annual risk of having a heart attack is around 0.5% (higher for men, lower for women). All of those diseases would have similar average lifetime lost as covid, but the risk is continuous, not a once per lifetime occurance.

SnowProblem 6y ago

It's simple. They are being classified as covid. https://imgur.com/a/spXA4q8 https://imgur.com/a/spXA4q8

magicalist 6y ago
Considering that 27k residents of NYC alone (not counting the rest of the state included in that chart) died[1] between March 11 and April 25 (not counting the 10 days before included in that chart), I'm going to go out on a limb and say you're working with a made-up chart there. [1] https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-deaths-confirmed-probable-daily-04262020.pdf https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-d...
- SnowProblem 6y ago
  Check again. Your link backs up the chart I posted. Medicare paying hospitals 8k per covid patient and 39k per ventilator use simply with symptoms, no test required, also does not help. But keep the downvotes coming.
  - riahi 6y ago
    What do you think Medicare pays for ventilator use for non Covid ICD10 claims? Further, analysis by the Washington Post examined excess death by all causes. It’s way up. https://www.washingtonpost.com/investigations/2020/04/27/covid-19-death-toll-undercounted/?arc404=true https://www.washingtonpost.com/investigations/2020/04/27/cov...
    - SnowProblem 6y ago
      Probably ~20% more for covid than non-covid, based on what I've followed from CARES, but I wouldn't focus the incentive problem on ventilators. And you're right. Excess deaths are way up, so I assume there is a problem with my chart. But heart attacks and strokes are also way down, and in every article I've read (NPR, WaPo) there's an assumption that they just aren't coming in. Has nobody read the covid classification guidelines? I stand by that non-covid cases are being massively misclassified as covid.

tathougies 6y ago

> The head of a local hospital network has tweeted wondering where all the heart attack and stroke patients went - both in my lightly impacted region and in disaster NYC. Did the rate go down? Or did people just die at home afraid to go to the hospital? It's at this point that the news media needs to look inwards and wonder if they made such a big hysteria over covid that they failed to point out that people should still go to the ER. I bet many of those who died at home had symptoms of heart attacks/strokes, etc, but didn't want to go out of a mistaken sense of magnanimity (I don't want to take the bed of a COVID patient) as well as a false sense that the hospitals were in any danger of being overloaded (they were not, given the steps we took).

vkou 6y ago
What about option #3 - going to hospital puts you in danger of catching COVID? If you have pre-existing conditions, catching COVID is a lot more dangerous than if you don't. Who typically goes to the hospital for medical treatment? People with pre-existing conditions. "I don't want to go to the ER, because I might catch COVID from another patient, or doctor" is a very justifiable fear. This is just the consequence of the virus spreading to the community - not the consequence of mitigating the spread of the virus through the community.
- ryankemper 6y ago
  > "I don't want to go to the ER, because I might catch COVID from another patient, or doctor" is a very justifiable fear. The mortality risk of undetected/unaddressed heart problems, etc, far supercedes the risk from COVID-19. You could find some limited examples where that's not true but it is overwhelmingly the case. It is becoming increasingly clear that the level of panic associated with COVID-19 is absolutely divorced from the ground truths. But it doesn't just affect non-COVID-19 mortality. It may be that our response is even making COVID-19 mortality worse in some cases: From https://www.nejm.org/doi/full/10.1056/NEJMc2009787?query=recirc_mostViewed_railB_article https://www.nejm.org/doi/full/10.1056/NEJMc2009787?query=rec...): "Social distancing, isolation, and reluctance to present to the hospital may contribute to poor outcomes. Two patients in our series delayed calling an ambulance because they were concerned about going to a hospital during the pandemic." (My note: So the irony here is incredible, these weren't just non-COVID-19 patients afraid to come in but _people who actually had life-threatening COVID-19_.) And from https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30090-0/fulltext https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...: "Third, the COVID-19 epidemic has caused a parallel epidemic of fear, anxiety, and depression. People with mental health conditions could be more substantially influenced by the emotional responses brought on by the COVID-19 epidemic, resulting in relapses or worsening of an already existing mental health condition because of high susceptibility to stress compared with the general population." and "Finally, many people with mental health disorders attend regular outpatient visits for evaluations and prescriptions. However, nationwide regulations on travel and quarantine have resulted in these regular visits becoming more difficult and impractical to attend."

Spooky23 6y ago

I don't know the stats, but I live next to a busy fire station that responds to paramedic calls and is doubled up with trucks due to a COVID outbreak in another house. Today (a Friday, I am working on my front porch, and heard sirens about 4 times from 7AM-3PM). Typically, that number would be 5x that. It's been like that since mid-march.

serf 6y ago

>The head of a local hospital network has tweeted wondering where all the heart attack and stroke patients went - both in my lightly impacted region and in disaster NYC. Did the rate go down? besides the deaths-at-home, shouldn't it be considered that the low-impact low-energy lifestyle that is being promoted right now is less strenuous on the body in the short term? I imagine that the lack of deaths, after deaths-at-home are cancelled from the number, is just seeing a lag time where the lack of physical effort reduces short-term deaths but increases long-term deaths due to lapse in fitness.

dylan604 6y ago
How much stress is replaced by "I have no job, and my phone is blowing up with debt collectors, and I have to decide if I buy food or pay bills, do I have corona, etc?"
- x86_64Ubuntu 6y ago
  But aren't people getting money through unemployment and the CARES Act? Won't that help them keep the stress level down a bit?
  - montecarl 6y ago
    Just an anecdote, but my father lives in Tennessee, and applied for unemployment 6 weeks ago. The website reports he has been paid every week, but he still hasn't seen any money. He has spent about 12 hours on the phone with various agencies and has no answer to why he has not been paid. From what he can tell this is not an uncommon situation in TN.
  - AuryGlenz 6y ago
    At least as a self employed person, unemployment seems...tenuous. And confusing. I’m a photographer. The website says I’m supposed to report income the week I work, not when I actually receive payment. If someone gives me a deposit for a wedding next year should I count it? Should I be reporting the deposits I got last year when I cover a wedding this year? I’m allowed to deduct expenses, but they don’t go in to more detail. If I spend more than I make in a week can I carry over the rest of the expense? It’s pretty stressful just knowing if you’re doing it correctly.

sandworm101 6y ago

>> which is what some of these field hospitals (and the Navy ships) were for. Small detail about the navy ships: they are setup for battlefield injuries. The wards are all open (think what you see on old episodes of MASH) with little to no separation between patients. That is fine for traumatic injuries (earthquakes, fires, war etc) but less than useful for control of infectious disease. The plan was for them to take non-covid patients to relieve hospitals but it never really worked out. The risk of a ship becoming a hotspot should one covid infection slip through into an open ward was too great.

SlowRobotAhead 6y ago
This is not entirely correct. The US Comfort in NYC specifically is as you described, but, lost 1/2 it's capacity by setting up with protections between beds. It still saw almost no people because the need just wasn't there. Under 80 people last I heard. I am not aware of any reports that said fear was a factor in it not being used, do you have that source?
- maxerickson 6y ago
  Their initial criteria was that a patient had to go get a Covid test at another hospital before they could board the ship. At least some of the reason it didn't treat many patients is that they made it hard to become a patient.
- ethbro 6y ago
  There's a few factors at play here. 1) Hospitals generally get paid (by someone) for treating patients. So they want to run at 100% capacity, even with covid patients. 2) You can't really just "build an ICU." You can stand up a field hospital that's able to provide similar, degraded services. But it's not going to be the same. Imagine if someone said "set up a datacenter in a field," and then a customer had a choice to colo their server in a purpose-built DC or your field DC. Which do you think they'd pick? 3) The units that staffed these facilities were heavily augmented by military reserves. Corpsmen may have non-medical civilian jobs, but what do you think military reserve critical care nurses and doctors do for a living? If these field hospitals were packed to the brim, all of those people would be locked in place. Possibly while they were needed in their civilian positions, in their home cities (although the military seems to have done a pretty good job about preferentially pulling non-Covid-civilian personnel). 4) Exponential growth with unknown but high R_t. +1 week before we locked down would have looked very different. ... all of that to essentially say that these facilities were designed as surge capacity, in the event they were needed. We intentionally filled up hospitals first. USD$660M seems like a reasonable price to pay, strictly as insurance, given the very real risk that hospitals would have been overfilled and covid-related mortality would have spiked due to lack of care.

Kerrick 6y ago

NPR covered that in another recent story: > The fallout from such fear has concerned U.S. doctors for weeks while they have tracked a worrying trend: As the pandemic took hold, the number of patients showing up at hospitals with serious cardiovascular emergencies such as strokes and heart attacks has shrunk dramatically. > Across the U.S., doctors call the drop-off staggering, unlike anything they've seen. And they worry a new wave of patients is headed their way — people who have delayed care and will be sicker and more injured when they finally arrive in emergency rooms. https://www.npr.org/sections/health-shots/2020/05/06/850454989/eerie-emptiness-of-ers-worries-doctors-where-are-the-heart-attacks-and-strokes https://www.npr.org/sections/health-shots/2020/05/06/8504549...

lumberingjack 6y ago
My father needs medical help RN but everyone is putting him off just sending RX over phone no (pain pills though) saying "stay home". ASAP they open we all wheeling him in there for a MRI if we have to camp outside in a waiting line so be it.
- forgot_again 6y ago
  You should bring him to an emergency room now.
- threecheese 6y ago
  I don't know where you are, but in my area (east of NYC) the ERs are non-COVID and strictly separated. Weigh the risk, but know that the ERs are not necessarily warzones. Call the hospital and ask them, but don't delay care just because you don't know the real risks. I've been (physically) to an urgent care clinic, a specialist's office, and a dentist in the past week, because I waited two months for care, and I'm feeling pretty stupid (I'm high risk). The protocols are different, waaaaahhy more strict, but they are treating people.

thaumaturgy 6y ago

The CDC has been monitoring a broad-spectrum increase in mortality across the US even after accounting for covid19-related deaths. From https://www.usatoday.com/story/news/investigations/2020/04/29/far-greater-u-s-covid-19-death-toll-indicated-cdc-data/3048381001/ https://www.usatoday.com/story/news/investigations/2020/04/2... > The "excess deaths" surpassed COVID-19 fatalities in those states by a combined 4,563 people. Experts suspect that unconfirmed coronavirus cases could be responsible for some of those deaths, but it might also be related to a shift in other causes of death. For example, some doctors speculate people might be dying from illnesses from which they would normally recover because the pandemic has changed access to health care. > “Our ER, as well as many others, are seeing far fewer patients because people are scared to come in.” There are graphs. This has added to a lot of the confusion and misinformation surrounding coronavirus response, since people are hearing that hospitals and ERs around the country are seeing fewer patients -- dramatically fewer, in some cases -- and conflating that with the coronavirus risk being unexpectedly low, which isn't true.

abfan1127 6y ago
The original risk associated with Covid19 was lack of hospital resources. With most hospitals having plenty of capacity, the risk of getting Covid19 and not getting access to hospital resources is much lower than expected, so it was true.
- thaumaturgy 6y ago
  Yeah. It's really a shame that there were all these efforts to prevent our health care system from being overwhelmed. Oh well. It looks like enough people would like to run this particular experiment that we just might get to see what it looks like after all. Yay?
  - abfan1127 6y ago
    I don't understand your comment. We made decisions based on information. The results of our original experiment turned out to be different than our expectations. Further, others were hurt substantially due to these decisions. Those hurt are requesting (or demanding) to change course so as to not be hurt further. Seems reasonable to change course, with each US State (or country) changing course differently based on their circumstances.

briandear 6y ago

Friend of mine is a trauma nurse at Stanford and she said their most common trauma patient is from bicycle accidents. Just an anecdote, but an interesting one.

FireBeyond 6y ago

> Or did people just die at home afraid to go to the hospital? Sadly I think this is a partial answer. Working as a paramedic, for all the times I saw people saying “y’know, maybe I don’t really need to go to the ER”, there were also the people who really did need to but were too scared. Be it 90 year olds with severe lacerations or heart attacks, there was a fear that we had to manage and balance.

robbiep 6y ago

All cause mortality is down 9% over the last couple of months in Rome (sorry, on mobile, not easy to add reference which I would have to trawl for) - just to get in front of any covid-seriousness deniers, Rome has not been badly hit. In Australia, significant decreases in STEMI (serious heart attack presentations) although nothing published yet. Everyone wondering what’s going on - going to be some interesting studies coming out after this in terms of population health and additional/reduced morbidity and mortality

Scipio_Afri 6y ago
Less pollution, pollution especially PM smaller than 2.5 you get from the tail of an exhaust pipe sitting in front of you in traffic is not good for cardiovascular health and also is known to cause strokes. We have a significant decline in pollution and people driving.

ezoe 6y ago

It's been said one month ago. They just die in their home. https://www.reddit.com/r/Coronavirus/comments/g0p3po/deaths_from_heart_attacks_have_surged_in_new_york/fnauu9r/ https://www.reddit.com/r/Coronavirus/comments/g0p3po/deaths_...