As an Italian, I really hoped the horror stories that are coming out of Italy right now could help raise awareness of how things could look like when a government reacts too late to this threat.
I hope you won't have to be as scared as I currently am for my parents. My dad is in one of the categories that has low priority for an ICU bed. Older than 65 and diabetic. If he gets sick and require an ICU chances are he'll die because medics, rightly so, will choose someone with better survival chances.
"will choose someone with better survival chances."
How does this differ from the death panels that used to be brought up in the US? Serious question as I didn't follow politics too much when I was younger.
Normal triage is when you prioritize the most seriously injured patients so they don't die waiting for treatment. That's what hospitals typically do.
In a mass casualty event, hospitals engage in reverse triage which optimizes for throughput. They prioritize cases that can be discharged quickly so that they can treat as many people as possible. This means they'll label the most serious cases "expectant" and let them die. After all, it's better to save two or three easier people than to squander limited resources on one person who is unlikely to survive.
It is extremely rare for hospitals in the US to use reverse triage. I think the most recent time was during Katrina. The stories of that are not pretty.[1]
Yes, that sounds accurate. I am not super familiar with all the terms, as I guess is evident.
The second thing is what's happening in a few hospitals in Italy right now and it's gut wrenching for everyone. The staff involved are human too and already stressed and to have to make those kinds of calls is awful.
> And it's the doctors deciding based on who is most likely to pull through
I don’t see a distinction. Both of them are making a “for the good of many over the good of one” decision.
The “death panels” rhetoric was just that. In practical terms, we already have death panels both within hospitals and within health insurance companies and neither is terribly transparent.
That; and who on balance has the most benefit from being saved to begin with. There is a definite negative weight assigned to age, they would rather save a teenager than someone who is 95. (presented without any kind of bias towards whether this practice is good or bad)
Italy went from 0 known cases a month ago to 10,000+ today (with some recovered at this point) in less than a month. We'll be there far sooner, especially given the massive failure at the federal level to do much of anything, and given that the infections in the US are not evenly distributed, but are going to hit certain places first in larger numbers.
A quick, very low sample, back of the envelope calculation: 36,000 participants. Out of that, 1 case that was pretty close (underlying condition, medically-induced coma). Assuming that 5% of population goes into similar state, we should expect more than (1 / 5%) = 20 people in milder states.
This would be 20 / 36,000 = 0.05% infected, in the sample consistent with RSA conference on Feb 28th. Assuming doubling rate of 5 days, today is March 10th. So ~ 0.5% infected. And log2(100 / 0.5) * 5 = 38. So, Yes. 28 days sounds about right.
Disclaimer: very small sample. Definitely not representative. Statistics is broken here. I'm not a medical field professional and not familiar with virology field. I'm a software engineer and researcher with interest in a number of fields. Exposure to the field limited to reading Nature, coding a bit for medical equipment and college-prep for medical school.
Not sure about "death panels" specifically, but like was mentioned, this is called "triage".
Basically we don't have resources to help everyone. The resources we do have need to be strategically used, spreading them too thin might not benefit anyone at all. So a tough decision has to be made: "Where do we spend our resources for maximum efficiency?"
Not saying that it's the correct decision, that there isn't bad stuff going on, etc. But when health infrastructure is overwhelmed be events such as this, the tough decisions have to be made - you can't save everyone.
"Death panels" was the claim that a group of government bureaucrats would decide who lives and dies by denying treatment under something like Obamacare.
It was a rather baffling talking point, given that this already happens regularly with private insurers and Medicare approvals in the current system.
It's the difference between a doctor, or more likely a highly trained nurse in most facilities, making the decision and government bureaucrat making the decision. It likely also implied the decision being made based on what choice saves the most lives (doctor/nurse) vs what is economically or politically desirable for the decider (bureaucrat).
It's a conversation that sometimes comes up with universal healthcare, for example (I'm not taking a stance here) - "Is it worth spending $$$$ tax payer money on an operation with a 20% success rate on 95 year old who also has diseases X, Y and Z?"
If such rules are written then it would be bureaucratic.
The difference is that doctors are making this decision in Italy due to a medical system that is overloaded and cannot treat everyone vs. in the US, the insurance companies are always, not just in times of crisis, making this decision so they can profit more.
The "death panels" actually didn't even refer to triage, it was a reference to a proposal to pay doctors for providing counseling on end of life directives and living wills.
The semi-manufactured concern was that doctors would basically be telling people how to end their lives earlier. I only say this is a "semi" manufactured concern rather then a completely fabricated one because I have enough doctor's in my family to know that doctors generally have a view on end of life care that's distinct from the rest of the population.
Anyways, that gripe about about a detail of a bill got turned into "Death Panels" and promoted by right wing media into doctors deciding to cut care off in non emergency situations.
My office is a couple of blocks away from Moscone and I was pretty surprised by the fact that RSA didn't cancel. It seemed clear at the time that the spread wasn't going to be contained and getting a bunch of people to fly in from all over the world to sit in cramped auditoriums and shake hands with one another was a really bad idea.
All of the restaurants, streets, and coffee shops around the conference center were packed that week, and I fear that it will have made a material contribution to the speed with which this virus will have spread.
ADDED: The Houston Rodeo with a couple million attendees is also going ahead.
My anecdotal impression is that tech and tech adjacent events are canceling in significantly great numbers than non-tech. Part of the difference is probably that so many tech companies are telling employees not to attend large events, or even events at all, that even if a tech conference organizer wanted to go ahead, they'd lose half their attendees.
I think the amount of international travel is huge part (the Houston rodeo might have 2M+ attendees, but I'll bet 90% of them are from Texas), but so are economics- It wouldn't suprise me if cancelling CONEXPOCONAGG or the Houston Rodeo would bankrupt the sponsoring organizations, whereas google won't even notice cancelling their events.
SXSW in Austin was recently cancelled and the organization is considering bankruptcy. They laid off 1/3 of their full-time staff due to the cancellation.
>whereas google won't even notice cancelling their events
That's something of an overstatement. Companies don't put these things on for fun. But, yeah, they'll manage. And, to a first approximation, all the other companies and individuals who were sponsoring/attending/etc. will manage too and relatively few individuals will be directly and personally out of pocket.
That said, there will be startups who were planning launches around the Google events, there will be indirect downstream effects on people who organize events, do professional speaking, etc.
Google doesn't exactly do it for fun, but I'm sure it isn't a significant source of revenue. Given that most corporate conferences are essentially about marketing, the incentive is to be break-even, or even run at a loss. That's very different than people trying to make a living from an event.
Yeah, obviously it's not an easy decision, but my definition of "won't even notice" is that it even if it's a $20M write off, it's like 0.06% of their 2019 net income. For a lot of independent events (like SWSX) canceling the event means losing most of their operating budget.
While not a universal (I see replies to that tweet about CONEXPOAGG that mention folks from Canada), I feel like tech conferences have an increased amount of international attendance -- definitely I expect a greater worldwide contingent at most tech conferences vs. the Houston rodeo. Imagine if this had gotten loose at CES...
There's probably truth to that. Certainly it was a factor in MWC canceling while there were still other events, including RSA, going forward as planned. (Some companies did pull out of RSA but it didn't reach the critical mass for the organizers to pull the plug on the event.)
Unbelievable these events are going ahead. A number of travelers returning to Australia from the USA have contracted COVID19, indicating the disease is more widespread than admitted by the government.
The Formula 1 Grand Prix is going ahead in Australia this weekend, which is equally poor.
I always thought the majority of income for F1 is unrelated to the live visitors. and as such it should be fine to do it just without live publicum. ...
I wonder if I'm wrong about it or they are just too irresponsible to cancel the parts involving crowdes?
Irresponsible mostly.
Bahrain has already said it plans to hold their Grand Prix in an empty grandstand.
I do think the host tracks would prefer to have a full Grand Stand, due to ticket sales, but I'm not sure how much it would affect F1 as a whole.
Sadly, there seems to be a sense of invincibility almost towards the virus in Western Countries until all of a sudden it arrives and you are dealing with hundreds or thousands of cases.
It's really hard at this point not to feel like people deserve what's coming. The vast majority of regular Joes still don't care and think I'm crazy for simply telling them to be responsible and buy some non perishable goods.
Meanwhile Mecca is shut down, Italy instituted a Nationwide lockdown overnight, UK hospitals are running out of capacity, China shut down it's entire industry for two months, Independent reports Trump admin may be considering declaring a Nationwide state of emergency...I'm losing track of all the clear, obvious evidence of imminently approaching danger from literally all over the world.
It seems pretty clear at this point that there's not going to be a shortage of nonperishable goods. Everywhere that's been hit by coronavirus, food's still available and stores are still open - the only severe shortage so far has been ICU beds. People seem more receptive (although still not universally receptive) to more helpful advice like "start washing your hands a lot more" or "don't go to any big events".
If there is an outbreak, you want to avoid going to places like stores - not just for yourself but to minimize your chances of contracting the virus and exposing others. It's the socially responsible thing to do.
It's about risk mitigation. It's not 100% guaranteed physically impossible to pick up the virus from a delivery package, but it's a very low risk, much lower than other infection vectors most people will be exposed to. Unless you're planning to hermetically seal yourself into your home for the next 8 weeks, the risk is probably so low it's not worth thinking about.
Minimum wage coughing worker. I'm just figuring it's lower risk than going to a store with numerous coughing/breathing customers and employees everywhere. I believe the risk is higher when you're directly exposed to another person, compared to the virus being on an object's surface.
> It's really hard at this point not to feel like people deserve what's coming.
Please try harder. The people most harmed by this will not be the people making the dumb decisions. It'll be the people they infect. And of course their loved ones, some of whom will soon be watching caskets get lowered into the earth.
> It's really hard at this point not to feel like people deserve what's coming. The vast majority of regular Joes still don't care and think I'm crazy for simply telling them to be responsible and buy some non perishable goods.
Because you have a lot of so-called authority figures (in the USofA at least) telling people it's all under control.
Have officials in the US ever been prosecuted for telling voters lies that they want to hear in order to validate their own delusions?
We can draw a meandering line from this tweet back through at least 2000, when a US presidential candidate dismissed his opponent's quantitative reasoning about climate change as "fuzzy math".
> Meanwhile Mecca is shut down, Italy instituted a Nationwide lockdown overnight, UK hospitals are running out of capacity, China shut down it's entire industry for two months
Those countries are not American. They are reacting reasonably to a virus that has 20x the mortality rate of the flu, with no known vaccine.
Then click on Italy. 2 weeks ago they had 320 cases. Compare that to your country now. Look at the trend line for your country.
I’ve yet to hear someone explain to me how most countries won’t end up like Italy. The ones that stand out are Korea and China, but nobody seems to be taking the same action as them.
It's all over the internet at this point. Major outlets are reporting on it. Why the hell do you think the stock market tanked into recession territory? They're already calling it "Black Monday" in the news.
Why would I bother continuing to post references when I only have downvotes to look forward to for my effort? Spend two minutes on Google. Do you know how many billions of dollars have been already lost to cancelled events? SXSW was cancelled. Japan has been talking about postponing the Olympics for months. What more do you need spoon-fed?
It's not like you even need to do anything drastic! Just stock up on some non perishables and be prepared to stay home for a while if you can. That's literally all a responsible adult needs to be doing right now.
But whatever. I'm not taking this personally. Everything will be clear in the next 1-4 weeks. We're lagging behind European countries by 10-20 days, and like a typical epidemic the growth is exponential. Things are about to get interesting locally. I certainly hope I'm wrong but the constant trickle of literature out of China since early January (in legit journals like Lancet and PubMed) paints a very dire picture.
> Why the hell do you think the stock market tanked into recession territory? They're already calling it "Black Monday" in the news.
There was a small matter of oil prices dipping as a result of negotiations breaking down between Saudi Arabia and Russia, which may have played a minor role in Monday’s events.
I don’t disagree with your general sentiment, but there was more to the events on Monday than a virus.
It is breathtaking that conferences organized and attended by affluent tech employees are not being canceled when conferences like SXSW and ComicCon are being canceled.
It hurts the people behind SXSW and Comiccon much more to cancel their events but they did it anyways. Is our industry really so much more unethical than average?
I will give you the benfit of the doubt and assume you didn't read TFA - If you had, I assume you wouldn't have made this joke as the individual in question had a pre-existing condition that made him succeptible to pneumonia, and is now in a medically induced coma.
I'm not sure I need a tinfoil hat at this point to imply that the people who are supposed to mitigate the effects of this pandemic have no objective quantification of how pervasive the spread of this disease is already.
I'd be willing to wager that if there was a good enough historic and near enough to realtime dataset of individuals entering the ER with pneumonia, and this disease is actually atypical for the season: that the ramp actually started more than a month ago in some regions.
Although I do wonder if the necessity of some pre-existing condition to perpetuate the development of the disease might present some type of choke in the significance of the anomalous nature of the thing..
Anyone know of any dataset like this? It would be really interesting to consider.
The Seattle Flu Study collects sample from people in the community, even before they are sick. Those samples will now be retested to look for this new coronavirus https://seattleflu.org/updates
Yeah, I'm not entirely sure this is interesting. The media seems overly concerned with 'COVID-19' specifically and I'm sure the backers of this project like to see relevant keywords, but I think in terms of an outbreak it would be more useful to consider specifically how this has immediately contributed to deviance from normal.
"... we've found 19 cases of covid-19 in [insert place]", or "35 deaths from coronavirus" deprived of context has nearly no utility.
However, it seems every major country is sadly going down the same path: https://twitter.com/MarkJHandley/status/1237119688578138112 .
I hope you won't have to be as scared as I currently am for my parents. My dad is in one of the categories that has low priority for an ICU bed. Older than 65 and diabetic. If he gets sick and require an ICU chances are he'll die because medics, rightly so, will choose someone with better survival chances.