
Some unique aspects in US which make risks of COVID19 higher than Europe - DyslexicAtheist
https://threadreaderapp.com/thread/1232666666645016576.html
======
aripickar
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-
wo...](https://www.nytimes.com/2020/02/20/health/coronavirus-men-women.html)

[2][http://worldpopulationreview.com/countries/smoking-rates-
by-...](http://worldpopulationreview.com/countries/smoking-rates-by-country/)

[3][https://www.nytimes.com/2020/02/27/world/asia/coronavirus-
tr...](https://www.nytimes.com/2020/02/27/world/asia/coronavirus-treament-
recovery.html)

------
bart_spoon
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.

~~~
1121redblackgo
Which points do you have issues with? I think they all seemed on 'on-base'.

~~~
lvh
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?

~~~
blaser-waffle
Why listen to HN randos for that matter?

(Counterpoint: HN has a huge selection bias for educated, technical types and
a higher overall pool of talent. Doesn't mean disinformation campaigns and
marketing won't work on this crowd, though)

~~~
lvh
Sure! If the thread had been posted on HN I'd raise similar skepticism :)

------
glofish
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
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_hosp...](https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hospital_beds)

------
sgt101
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)

~~~
ericlewis
The powers that be have access to healthcare the masses could only see in a
glint of their eye.

~~~
simonh
There are no magic wands against this thing, at any price. It's too new.

~~~
ericlewis
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.

------
moultano
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-
vac...](https://www.theatlantic.com/health/archive/2020/02/covid-
vaccine/607000/)

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/ch...](https://www.ndsu.edu/pubweb/~novozhil/Teaching/767%20Data/chapter_3.pdf)

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...](https://www.who.int/docs/default-
source/coronaviruse/getting-workplace-ready-for-covid-19.pdf)

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.

~~~
sonicxxg
I wonder why people/news seem so obsessed about the death rate itself, while
ignoring the incidence of permanent organ tissue damage caused in survivors,
as some papers already indicate. I'm assuming this has to be studied further.

~~~
ZanyProgrammer
Do you have any links for this? Otherwise you’re injecting a lot of scary,
unsubstantiated info here, implying the survivors are gonna envy the dead.

------
throwawycorona
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?

~~~
bart_spoon
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

------
piker
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.

~~~
ailideex
> 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
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
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
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?

------
onyva
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”.

------
AzzieElbab
What about spare capacity that US medical system possess as opposed to say
neighboring Canada? Otherwise, all points are valid.

~~~
claudeganon
They're actually worse off (ranked 36th vs. US' 32nd)

[https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hosp...](https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hospital_beds)

Here are the full stats:

[https://stats.oecd.org/index.aspx?queryid=30183](https://stats.oecd.org/index.aspx?queryid=30183)

~~~
OJFord
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
They edited their comment. It was a more general question of comparable rates
before.

------
willvarfar
Is Trump setting Pence up as the fall-guy?

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

------
qubex
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.

