- Average age of death due to Coronavirus in Italy is 82 
- In Italy, 3.65% of the population is 80 or older .
- In Korea, 1.75% of the population is 80 or older 
In Italy, it is almost customary to pop medication that contains antibiotics whenever you feel a bit under the weather. I lived in Italy, I experienced this first hand even from my more educated friends.
Because of this Italians have an antibiotics resistance of 26.8% .
I do not have data for South Korea but in Germany, where I live, antibiotics are not available over the counter. You always need to see a professional and then they are much more expensive that e.g. in Italy.
The resistance rate here in Germany is 0.4% . That's 67 times (!) lower than in Italy.
Surely this should be considered a major public health emergency in itself?
Are the countries with high percentages taking steps to limit antibiotic use? Coming from the UK the idea of letting people buy antibiotics as easily as painkillers seems crazy.
And what the hell is going on in Greece!?
Indeed. There's an episode of Sam Harris's podcast with Matt MCarthy from last summer. The episode title is The Plague Years, and they go into quite a bit of detail on this sort of thing and ruminate about how low on the radar it is for most people (if it even registers at all), despite the seriousness of the situation.
The actual ratio is currently 7.9: 827 out of 12462 cases in Italy (6.6%), 66 out of 7869 cases in South Korea (0.84%).
Above 80: 1,532 (18.4)% vs age 20-29: 296 (0.0)%
Above 80: 243 (3.1)% age 20-29: 2,261 (28.7)%
Of note, neither country has had anyone under 30 die. Deaths in the 80+ age range are 8.23% in South Korea and 13.2% in Italy.
PS: South Korea saw 2 deaths under age 50 where Italy has seen 1. So this age is by far the largest factor.
Another possibility is that Italy doesn't have a handle on who is or isn't infected so what they report are the obvious infections, who tend to be older.
This is very likely the case, as can be seen in the positive test outcome rates.
16.7% in Italy vs. 3.6% in South Korea
Italy has run around 60k tests.
South Korea are testing around 15k people/day and have tested 234k people in total. They've even setup drive-through testing centers where anyone can drive through, get tested, and get results via SMS in under a day.
The result of this is likely a much larger number of asymptomatic or mild cases in the South Korean numbers, which based on the China data, tend to be a lot younger.
North Italy has a population of 27 people btw so the 10K that are registered as positive as a drop in the bucket.
"Why must I always explain" Bob Dylan
FAFAIK, we've never had a policy to pre-emptively test every returning tourist, and even now we don't test everybody. The current policy is to test new cases only if they have no relation to an already-established case. For example, people living in the same house as a known Corona case will not get tested. If they start showing symptoms, they're automatically assumed to have contracted it.
It's not that old people aren't worthy of protection, but when you're 85 in the US you have a 10% chance of dying in the next year for any and all reasons.
So saying this disease kills 15% (for example) of 80+ year olds without context sounds horrific, but contextualized in the actual risks of just being very old to begin with, sounds much less scary.
If Italy, for example, were to report on the number of fatal infections in people younger than the natural life expectancy, the fatality rate would drop in half.
Best not to suggest anything that might down play the seriousness considering how infectious this virus is. (Otherwise it may encourage risky behavior.)
Mind you that isn't covid 19 putting them over-capacity. In the worst hit region in Italy (Lombardy) confirmed covid 19 cases represent enough cases to take up less than 10% of their hospital beds. So it seems incredibly unlikely anything but panic is to blame for such absurdly high over capacity.
Do you have a source for this comment? This WaPo story from 6 hours ago says differently:
> Giulio Gallera, Lombardy’s health chief, said Thursday that the region would reach its capacity in “five, six or seven days,” even if it tried to add more beds in hospital “cellars.” In an interview with Italy’s La7 channel, Gallera described the possibility of adding 500 intensive-care beds at Milan’s expo center, the kind of rapidly assembled zone that China created in the hard-hit Wuhan area.
the math for that adds up to 31,800 hospital beds
7280 confirmed cases is 22% - so my sources were off or wiki is wrong as originally I recall reading lombardy has a 16MM population.
I will say that your article claims they haven't run out of ICU beds yet but that number is surprisingly high for ICU needs to cover covid 19. The article implies 600 ICU cases from covid 19 - that's over 12% ICU from confirmed covid 19 cases, which is more than twice what china reported.
It's also very surprising how few ICU beds they have allocated towards ICU....
The USA has something like 14% of hospital beds as ICU beds  but Italy appears to only have have less than 3% of their beds available for covid 19 ICU
What's not plausible is ICU beds being taken up by people who don't have the disease (maybe miild-to-moderate flus or bad colds) and are just panicking. Emergency room lines, sure. Test shortages, absolutely. But hospitals will not put someone who's just scared and doesn't even need to be admitted at all into the ICU.
Remember that there's a difference between hospital beds and ICU beds.
In the UK, we maintain 80% utilisation of our ICU beds all year round, with very little change in the number of beds available in real number terms. We have ~4100 total ICU beds, which can be expanded to ~5000 if all operating theatres, etc are shut down and used as ICU equivalent instead.
While getting past flu season will help the total number of beds, it does nothing for the ICU.
This is the other reason why it's increasingly important to https://www.FlattenThesCurve.com and employ social distancing techniques. The rate of patients being admitted into ICUs needs to be slowed as much as possible. Once we're out of capacity, every additional patient has a much higher probability of dying than the overall fatality statistics indicate.
2. Other things still happen to people and those people need to have their hospital beds.
3. I'm not a hospital planner but I think there may be other things that determine capacity than just hospital beds. I worry that the hospital bed metric is actually a bad metric. Obviously adding hospital beds implies adding people to staff those beds, but also adding people probably also means adding all sorts of other infrastructure to support those people.
As a developer it reminds me of a project that goes way off schedule, you don't bring the project back on track just by adding developers because of the overhead more developers add to your system. Probably most hospital administrators have never actually experienced operating at capacity, so estimations of what would happen could be off and are being corrected now.
You can see that in the death rate, it's happening because they can't care for the volume of older intensive care patients properly. They don't have the medical infrastructure capacity to do it. That's why Italy and other European nations such as France have an extreme variance in mortality rates, despite France and Italy both having similarly old populations. Germany is even older than Italy and I'm skeptical we're going to see anywhere near a 6% mortality rate there (their rate is very low so far). Italy's mortality rate has been abnormally high from the first few thousand cases in, when it quickly began overloading their healthcare system in Lombardy.
edit to address your edit: The mortality rate is often wildly inflated with new diseases. That's because most people don't seem to understand real mortality rate vs confirmed cases mortality rate. Obviously when a disease is new the confirmed cases will be confirmed against the people showing serious symptoms. Then when you pretend deaths/confirmed cases == mortality rate you end up with a wildly inflated mortality rate. Until we understand how many people are asymptomatic we won't have a real mortality rate that is reliable.
There is plenty of evidence that in Italy COVID-19 has overwhelmed ICU beds. They are trying to transport people to ventilators via helicopter. We do have at least twice the ICU bed capacity in the US (compare info from , ). But many other people need these ICU beds -- it's not like other illnesses will just stop for our convenience.
Edited to add: remember, included in most totals of ICU beds are neonatal and pediatric ICU beds, which won't help much with COVID-19.
Toolz, I just don't understand your math. You seem to assume that a neonatal ICU bed is just as good for a 55-year-old man as an adult one, and that no one is going to have any other ICU-needing illnesses for the duration of this epidemic. That's quite puzzling. Can you support these ideas?
737 ICU beds available isn't the same as the total number of ICU beds. Normal health problems that need hospital treatment (strokes, heart attacks, car accidents, etc.) are still happening during this outbreak (well, car accidents are probably reduced now with Italy's lockdown protocols).
This probably won’t kill millions (though it could worst case) but hospitals being overwhelmed would lead to an exponential rise in deaths, and many deaths from other causes as other treatments are abandoned. The situation is serious and will require significant measures to bring it under control, it is not yet being taken seriously enough in the US.
Evidence  (partly based on COVID-19, parly on MERS) also says that NIV has a significantly worse outcome than ventilation. People are already getting NIV in some hospitals because they ran out of tubed ventilators.
And they live in Italy
Still the heat wave in 2003 killed 18 thousands people in a month and 15k in France in only half a month.
Old people are vulnerable to many things, unfortunately
80+ age category has a 21.9% death rate in confirmed cases.
Some of the people that die from this would have died anyway, but for the most part this is on top of that 10% chance. Same for young people, there's something like a 0.2 chance of death every year and this is basically doubling that.
The real answer is simply that the number of tests is not equal to the number of cases.
The number of positive tests is a factor of the number of tests done, and how selective the testing was allowed to be. It is only loosely related to the number of infected people (technically it is the lower bound).
I think you are right, but, assuming all the deaths are reported, the obvious implication is that the mortality rate is a lot lower than 3%
If fact, looking to Germany, I would say that it's around 0.2, 0.3 %
That would be the good news, the bad news is that it's extremely contagious, probably because nobody is immune to this thing.
Of course, I'm only a random guy in the Internet, so take it with a grain of salt.
Ye olde "3.6 roentgens. Not great but not terrible" factor.
https://www.theatlantic.com/ideas/archive/2020/03/who-gets-h... "Doctors and nurses are unable to tend to everybody. They lack machines to ventilate all those gasping for air."
https://www.euronews.com/2020/03/12/coronavirus-italy-doctor... "Another nurse working in Lombardy, the Italian region the worst hit by COVID-19, told Euronews the situation was "dire" and far worse than it is being portrayed in the media.
Speaking to Euronews on the condition of anonymity, she said: "We have hundreds of cases in our hospital. Half of our operating block has been dedicated to COVID-19 patients. The situation is dire. Anesthetists – despite them playing it down a little bit on the media – have to choose who they attach to the machine for ventilation, and who they won’t attach to the machines"
A first person report from Seattle ICU doctor https://www.facebook.com/marie.e.will/posts/1016307125424515... "Remdesivir might work, some hosps have seen improvement with it quite rapidly, marked improvement in 1-3 days. ARDS trajectory is impressive with it, pts improve much more rapidly than expected in usual ARDS. Recommended course is 10d, but due to scarcity all hosps have stopped it when pt clinically out of the woods - none have continued >5d.
I decode this as they have half the amount of Remdesivir they need, only treating for 5 days when recommended course is 10.
The other thing that appears to be going on, and it's also hinted at in report from Seattle, is that old patients are being moved to hospice or "comfort care" who would not have been three months ago because of lack of supplies/personnel/equipment.
#1 provides no numbers and no details beyond a claim that "They lack machines to ventilate all those gasping for air."
#2 does not even go that far: it speaks of "a huge turnover issue and leaving hospitals at near capacity" (near, not above, contradicting #1)
#3 is from an intensivist in Seattle, Washington, not from Italy.
I chose the Washington Post link because it provides numbers: "Lombardy has just 737 intensive-care beds available for coronavirus patients. More than 600 are filled. [...] The region is racing to bring more beds online; it added 127 on Thursday."
(Lombardy is the region with most cases.)
This is consistent with the claim in your link #2 that hospitals are near capacity (and not above it, as suggested by your link #1).
The point of all this pedantry is simply that I don't think saturation can be invoked yet to explain the high Italian mortality rate.
Here's a slightly older Italian source (March 11) which puts nation-wide ICU capacity in Italy at 5090, with 887 in use:
Note this is first time it's been triggered which indicates it's a difficult and risky process.
Article also notes "The people in charge of intensive care in Lombardy have sent a dramatic appeal to Governor Attilio Fontana: "Healthcare facilities are under greater pressure than any possibility of adequate response", the doctors write. "Despite the enormous commitment of all healthcare personnel and the deployment of all available tools, correct management of the phenomenon is now impossible."
This sounds like a system that's out of ICU beds.
see also https://jamanetwork.com/journals/jama/fullarticle/2763188 "As of March 8, critically ill patients (initially COVID-19–negative patients) have been transferred to receptive ICUs outside the region via a national coordinating emergency office."
This should imply heavy fines. Creating panic while covered by anonymity is very easy and it brings no value to society. If officials later on try to bring real numbers nobody listens.
In South Korea it started in a cult, where most people were young < 40, and moslty women (which have less CFR than man for COVID-19).
And the rest was South Korean lack of regard for privacy (they have a map for each case where you can trace where and when a given infected person was - so you can check if you were near him/her) and technological superiority.
Italy's patient #1 is 38 (see the article). Patient #0 has not been identified.
> In South Korea it started in a cult, where most people were young < 40
That would be the Shincheonji Church of Jesus:
I don't know what their age profile is, but the outbreak began with a 61-year old ("Patient 31"), and several people mentioned here are above 50 (the founder is 88):
SK leads the world. 3,692 / 1MM pop vs Italy 826 / 1MM pop.
The PPP is also about 10% higher than Italy and has about half the unemployment rate.
Most importantly it has one of the most advanced healthcare systems in the world. https://en.wikipedia.org/wiki/List_of_countries_by_quality_o...
They still suffered a shortage of hospital beds in the hard-hit area around Daegu, so much so that some people died while waiting.
Italy and other countries with fewer hospital beds will have to resort to what China did: build makeshift hospitals, fast.
were not hospitals at all, just isolation units for temp quarantine
People want to use CFR as a measure of how worried they should be, or as some kind of comparison between countries, and it's totally inappropriate for either purpose.
The statistics always seem to go up no matter what kind of interpretation.
When the health system is severely overburdened, that subset because a smaller and smaller proportion, as scarce resources are used for testing of people presenting at hospitals rather than population-based testing.
People who are asymptomatic or have minor symptoms don't present at a hospital, so they don't get tested, so they never get recorded as a case (which, by definition, requires a test and a diagnosis).
The real population fatality rates are guaranteed to be lower than the CFR unless you believe that every person who is infected is being tested and diagnosed, and it's my opinion that they'll be much lower.
And additionally the spread of virus is not uniform as it depends on social circles, so it's very hard to compare the situations using just general population stats. In South Korea one of the early patients infected more than a thousand other people, while some patients infected no one else or only a few. It's totally random event, and a few patients like that can create a huge differences in the spread of the disease. In Italy they've had the bad luck that early on virus got into hospitals and retirement homes, so the most sensitive population was massively affected.
In Europe pretty much nobody owned a mask prior to COVID-19. And masks have been sold out for weeks. If masks were easily available you'd see people wearing them I'm sure.
Even putting aside the whole deliberate sharing germs and force building body resistance, wearing a mask is seen as anti-social, somewhat selfish, weak and alarming.
People's reactions to a mask is really ranging from "you shouldn't wear it at all, we're among friends (at work)" to "if you're that ill you shouldn't get out of your home and take a sick leave". There few middle ground, accepting wearing a mask just in a case, or for some benign infection.
I think most europeans look down on wearing masks as something stupid, most europeans also think hand sanitizer is stupid. (This just applies to my dutch family and friends over there, I am currently in Thailand and always wearing a mask and hand sanitizer)
Really? That's horrifying. Any links about that?
Have people looked that it is not age, but baseline damage to your lungs that is the main factor in serious cases? Older people will have more exposure to local air pollution, just from having lived longer. That existing damage can be what contributes to complications, right?
Edit: Milan is much closer to Seoul  than to Wuhan.
Edit: and the air being better after the quarantine would support my hypothesis. It wasn't that that helped, but the better air. (Which is still very bad)
And again, China was worse. Italy is just worse than all places I checked that had a lot of cases, but not as many severe cases.
Take this over to Australia [below], and you can see that even they had terrible air as recently as mid January.
Contrast to Norway [also below], which has hovered on fine air quality for the entire time. Same for Japan, all told.
Basically, the worse your air quality, the more severe cases you are seeing. To a marked degree.
Edit: Just eyeballing, Milan is worse than Seoul. Agreed not as bad as Hubei. But between.
Because they are overwhelmed Italian hospitals basically send people home if they have a fever or other symptoms with no test administered, instructed to come back in case the symptoms worsen, only people having trouble breathing being admitted in the ICU.
Italy could easily have in reality 10 times the number of reported total cases or more.
> only people having trouble breathing being admitted in the ICU.
Well, why would you put someone without respiratory failure in an ICU to egin with?
Also, Italy performs 1 test per 1000 people . Surely there are more cases than the reported ones, but 10 times? I am no statistician, but wouldn't it require extreme bad luck to miss so many cases with such extensive testing?
In the initial weeks of the crisis, the Italian government said that they would switch to only reporting symptomatic cases  ("because that what every body else is doing") instead of all positive tests. I do not know if they followed through, but that would make a large difference if Korea was reporting everything.
edit: as far as I understand, that only changes what they report in the official numbers that make the news. The actual medical data might contain the real numbers.
edit2: if they started doing what they said they would, the actual positive rate would be even higher. So the issue is likely that they are just not testing as much.
 https://www.wired.it/scienza/medicina/2020/02/28/coronavirus... (in Italian)
Agree, is the logical thing. The bigger the sample, the better the results.
Another possible option could be that caucasian people is more susceptible for some reasons than asian people. The reasons could be genetic or cultural (i.e previous exposition to similar viruses by gastronomy). Without more data, I would take the first option as closer to truth.
Here, there are health care workers who can't get a test! They deal with people with significant health problems every day and could be spreading it all over -- but because they didn't travel, they can't get a test.
There's plenty of blame, but I'd assign most of it to US politics.
SK has 12 hospital beds per 1,000 people vs 3 in Italy.
I think much better explanation would be that Italy has a lot of tourism, it is basically a tourism hub for northern and eastern Europe. Tourism == a lot of people moving about, very frequently, then leaving the country. Almost all initial cases here in Poland seem to be connected with somebody coming back from vacation in Italy.
Surely the testing is a huge factor. Test more people you'll find more people infected, so the fatality rate will get smaller. If you're like the US and test very few you get the huge fatality rates we saw in Washington.
If you could quickly and accurately test everyone in the country today we would know how to isolate and the whole thing would be over very soon. Not having a reliable test makes this whole problem as bad as it is.
Also, as an American, I'm embarrassed by my country's response and by how my president addresses the nation. PM Lee shows how you talk to your country:
His original address five weeks prior:
It's very close to the hot zone, millions of people travel to and from mainland China every year, it has roughly the population of Australia living on 10% of the land Japan has, the WHO refuses any cooperation, and yet there have been under 50 cases and no local transmission.
Not only that, but as a democratic state, Taiwan's control measures have been remarkably measured.
I'd credit two factors:
1) Imposing travel limits three weeks before China even admitted there was an outbreak. After SARS, the TW government had a plan for this epidemic and a healthy skepticism for both official news and the WHO.
2) Taiwan has a relatively high trust society. People generally trust the local CDC and make a genuine effort to take preventative measures, even those primarily for the safety of others. A phone alert is generally all that's needed as a quarantine reminder for those exposed.
That's not surprising, since the WHO doesn't recognise Taiwan as an independent country and refuses to help them, I'm glad they were able to take their own successful measurements.
No trust in government and a general attitude of "it's just a flu, and I got things to do"...
Which is notable that the US CDC seems to be following WHO closer than anyone, at least early on...
Taiwan has had a spectacular response to the virus - that is the gold standard that Italy (or Korea) should be compared against.
Taiwan implemented more stringent inspection requirements for people arriving from the Wuhan area as soon as China notified WHO, on 31 Dec 2019.
For example, if a Singaporean Malay marries a Malaysian Malay, there is still a large chance their Permanent Residency application will be denied. This usually doesn't happen to someone who marries Han Chinese, of which Singapore is 70%.
> 67 deaths out of nearly 8,000 cases
> 1,016 deaths and identified more than 15,000
> Surely the testing is a huge factor.
No, you can not be sure at all, especially since it is well-known that hospitals have limited capacity to treat pneumonia (ventilators and doctors trained to use them). Get sick when hospital has no capacity to treat you, and you're more likely to die. Death rate will increase very rapidly when rates of infection pass a certain point.
Testing is important, yes, but the real important part is slowing the transmission rate to a manageable level.
> If you could quickly and accurately test everyone in the country today we would know how to isolate and the whole thing would be over very soon.
Only if you can do it more-or-less completely. Otherwise, you're actually prolonging the problem. The reason we want to slow the transmission of the virus is to keep life-threatening cases at a reasonably low rate.
Uh, yes, South Korea testing lots of people shows the overall fatality rate given a functioning medical system. It also allows much better isolation, understanding of the progression of the disease, stopping that progression and so-forth. So sure, the Korea rates don't prove Korea has magic dust that cures the problem but shows the Korean model is effective.
Most of the fatality rate in Washington is due to it spreading in a single nursing home. IIRC, it was 19 deaths from that one nursing home.
More vigorous testing comparable to SK likely wouldn't have caught the issue in this one nursing home in time as it spread like wildfire there. Only if the testing had caught the single employee that was the source would it have made a difference.
I think the masks are more likely to be having an impact.
Imagine 100 people contract the virus, 10 develop serious symptoms, and one dies.
In country A, with widespread testing, 40 of the 100 are identified. The visible statistics are 40 cases, one death, death rate of 2.5%.
In country B, with poor testing, only the 10 with serious symptoms are identified. The visible statistics are 10 cases, one death, death rate of 10%.
Again, this is about the reported statistics, not the underlying truth of the disease.
Right now I see so many people carrying on their life as usual, because they think there aren't many infected people around them. That impression is a consequence of the lack of testing. It's likely that there are quite a few people around them who are sick and spreading this disease, and if more people realized that they'd act differently.
Resources and isolation measures are also directed to places where there are a lot of known infections, but if those infections are undetected very little gets done about them.
The relative lack of testing is a nightmare in the making.
1. Death from complications takes some time. You won't really know the real numbers until enough time has passed for the serious cases to resolve one way or the other.
2. Treatment makes a difference. Odds of death increase dramatically when treatment is not available.
i don't understand. let's say that tests are super accurate, a negative test result does not mean you won't spread virus in the future. You may have virus the next day or an hour later. tests are important for treatments but i don't think they are effective as a basis for isolation.
These outright lies are propagated by the political parties that are far more concerned with 'the economy' than with any public health. It is really saddening that his is going on.
The Port of New Orleans is testing embarking cruise ship passengers but not disembarking (!) ones. This when we have community spread in the parish already and have gone from 1 to 6 to 11 cases this week alone.
Although it is technically correct, this is the least contagious way. AFAIK most sick people were near sick persons for a considerable amount of time.
It seems false positives are a real thing  but can we afford even one asymptomatic infected individual that might be a super spreader? In shifting away from containment are we just accepting these?
> Although the possibility of transmission from an asymptomatic person has been reported （https://www.nejm.org/doi/full/10.1056/NEJMc2001468）, little is known on how Coronavirus disease 2019 (COVID-19) spreads from person to person.
Generally speaking, with most respiratory viruses, people are thought to be most contagious when they are most symptomatic. https://www.cdc.gov/coronavirus/2019-ncov/about/transmission...
That CDC link  states that:
> People are thought to be most contagious when they are most symptomatic (the sickest).
Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads.
Just a question, if I may: how do you know that? Which international sources do you have that justify you releasing such a strong statement?
There were HUGE discrepancies between those 2 sources of 'information', the quotes being added for the former case.
As such I have 100% certainty. I was validated later that night when despite our health minister claiming that 'we have it 100% under control' and our prime minister stating we were NOT going to be moving beyond 'stage 2' for now, a few hours later we moved to 'stage 3' and declared a national emergency.
Now for the speculation: Among those closer and more knowledgeable than me the rumor has it the health sector threatened the government to go public with the real state of affairs in the hospitals and in first line care if they would continue to refuse to take serious action.
Primarily you need to consider the behaviour of people. This is going to go on for a while no matter what we do and if we lockdown people now, by the time we hit the peak they will be ready to give up and go outside again. We need to save the drastic measures for the peak in order to spread the damage out and make sure they are effective. I was previously critical of the government but honestly I think it makes a lot of sense.
We need to consider the effectiveness of measures. Banning all flights into the US from Europe may sound like a grand plan but in reality it's not going to make a big dent and the economic damage is going to be huge. But it sounds good and in the current climate where we're being led by panic that's the plan people will like.
Yesterday I talked to a colleague who relayed the story of a transatlantic flight this week, where only 6 seats were filled, out of 36 in the section.
I don’t think there’s much remaining travel left to be banned. The resulting economic impact therefore can’t be that big.
The impact on the spread of the virus can't be that big either. My point though is that big flashy moves like banning all flights appear to do very little compared to more mundane tactics. At least based on the info in the press conference I'm referring to the data doesn't support flight bans, banning large gatherings etc.
The peak is coming either way. Continuing to allow people to mix with each other as normal will make it steeper and more intense.
This article  makes the case well.
Boris Johnson looked very tired, but actually - and I can’t believe I think this - did a good job yesterday.
I was thinking after — they’re damned if they do and damned if they don’t.
Many people seem to want draconian measures now, judging from the WhatsApp photos going around.
Then there’s the markets etc etc who want stability etc.
The “any fever or persistent cough = self isolate” was a good call i think.
It takes a lot of untested sick people - potential cases - out of circulation before all hell breaks loose.
It buys time with minimum disruption - many people might take the time off sick anyway if they’re already ill.
Also buys time to implement infra. and org. planning.
If you only act when you hit the peak, any measures will be moot. Countries need to act now to reduce that peak and flatten the curve.
But sure, why not letting thousands of Atletico supporters into Liverpool, while Madrid has 1k+ cases. Was it also a "drastic measure" to play a football match behind closed doors?
> "Also, because the vast majority of people get a mild illness, to build up some kind of herd immunity so more people are immune to this disease and we reduce the transmission.”
They’re not acting only when the peak hits. They’re staging the response.
More serious measures come in as the number of transmission go up. And that’s all about managing the resources of the NHS over a long period of time.
Introduce lockdown now, sure, you delay the peak. But you don’t spread it out over a longer time period. People will stop caring and start ignoring advice.
The timing is critical.
Germany is doing a bit better in this respect, it took them 1000 cases to 'get' the first death, showing that they have caught it very very early, due to their decentralized testiing system. That said, NPI must be ramped up significantly...
The US is maybe the most troublesome target for this virus in the developed world. A healthcare system that works well for few rich cancer patients is the opposite of what you want for a disease like COVID19.
This is why I'm terrified of people that want to centralize things even more in the federal government.
Centralization produces systems that are not anti-fragile.
That doesn't seem to be the case - a man from Baden-Württemberg, who died earlier this month, was only tested positive AFTER he was already dead for a few days and counted towards the statistic.
This means your general statement cannot be true.
EDIT: I do not mean to imply that Italy failed in any respect. Italy has one of the best HC systems in the world.
The only reason this testing aspect worked out well for Germany is a very localized testing system. This type of 'federalism' is now a big issue though, as the gov can't simply ban events - only the states and communes can.
I don't have time to do the full correlation, but here's the data:
Select "Curative (acute) care beds"
Scroll down to the Per 1000 population.
Korea (assuming South): 7.14
The list of countries in that table is a good bit shorter than the countries fighting Covid-19, but I think it might be illuminating.
Can someone draw that up? Compare, perhaps, current death rate by country with available "Curative (acute) care beds" per 1000?
United States: 2.44
Interestingly, that's 20% lower than in 2000 (3.04)
At least Japan is in an OK spot, at 7.79
Almost the exact trend in Canada. I hope this is just a quirk of the data, because we would be screwed for this in 2000, and being at least 20% more screwed means we're extra screwed.
In effect, it seems that in Canada have fewer overall hospital beds per capita than Italy has acute care beds.
We are completely unprepared, and in terms of time, not far behind Italy.
They're just normal hospital beds.
example, the netherlands have a total of around 1300 ICU beds (source https://healthmanagement.org/c/icu/issuearticle/organisation...).
the number there is 50k ... which is indeed about the amount of normal beds excluding ICU and other few specific beds.
Perhaps because hospitals there (and in general) are always running at 80-100% capacity, so it didn't take much for the extra COVID-19 cases to max them out.
For instance, in my home town (Kraków, Poland), hospitals cancelled planned procedures yesterday - not due to the amount of COVID-19 patients itself (Poland still has double-digit number of reported cases), but because the hospitals run out masks, gowns and gloves. Which means that once coronavirus patients start appearing, things will get really ugly real fast.
Symptomatic patients are probably not going to be transferred over long distances, right?
People will forget about this in a year and go back to life like it's always been. Short term convenience trumps everything except short term negative consequences.
We are seeing a real pandemic - something that has been the stuff of Hollywood movies for most in our generation. Maybe it's comparable in some aspects to the only other WHO-official pandemic: HIV/AIDS.
But this has an order of magnitude more impact on the entire planet and societies as we know them.
The stock markets look like load test graphs I see in Grafana every day. Steady ramp up and then after 90 minutes boom its over back to 0.
9/11 was not just a battle. It started a war the terrorists have been winning ever since. That's probably why there haven't really been any major attacks since then. Why try to attack America when us idiot Americans are attacking each other and bringing down the empire ourselves? The terrorists are just watching with glee.
Debatable if the Arab Spring would have occurred without it, as the Middle East might have been much more stable.
Would Brexit have happened without 9/11?
There's an ancient TIME article I have in my archives highlighting how the Dubya admin ignored Clinton's intelligence team's attempts to hand over info about the threat of a terrorist attack in the US. Would 9/11 have been prevented if Gore had won 2000? God damn hanging chads and rigged elections...
It doesn't go anywhere because there is now a lot of private industry in it for contract money to supply the spectacle whom have the lobbying power to keep it in place, but it is a total waste of money and gross violation of privacy for no positive benefit to society.
In particular you'll see other countries focus on measures like interviewing (briefly) the passengers as they board.
It's not the same stuff! Terrorism is backed by people actively wanting to harm other human beings, while the appearance of a new dangerous virus is a random process.
Expect even emptier shelves way earlier when the next epidemic comes.
I'm sure that if everything ends well I'll remember being at home for a few weeks. I'm sure this is going to be a major turning point in history (more than Chernobyl and 9/11) but I'm not betting on what's going to be the direction it takes.
I'd like to hope, wishful thinking here, that there might be a trend towards requiring more scientific competence in our leaders going forward.
Are you serious? Those are the things that have given us so much prosperity in the last decades, and indeed no government has dared interrupt the flow until it has become unavoidable due to major national heath danger.
If you think half the country infected with a virus and a million deaths is enough to topple a several hundred billion dollar insurance racket that has endured for over half a century exploiting health and wellbeing for profit...
I wish we would get single payer out of this, but the plague of greed in medicine is way too deep to be excised in a few months from a regular old viral plague.
If enough people will believe that it is possible to change, it will change.
Things take time.
Of course, there are a variety of other factors at work. Italy is the second "oldest" country in the world after Japan so Coronavirus infections just would be more deadly there. Also a lot of the Korean infections were confined to a single city in Korea (though the Italian infections also had an epicenter).
There is one difference in Japan to Italy that might explain the lower infection rates: it's socially accepted to wear face masks (not only since covid but since the 90ies actually!)
Making mask wearing more acceptable might be a cultural adjustment humanity has to make as we become more urbanized and globalized if it'll help reduce the severity of disease transmission. Looks like Japan's stumbled onto a very useful societal adaptation.
Germany 3.7 24.6
France 3.3 9.3
England 2.7 3.3
USA 2.4 20
Canada 2.4 13.5
Japan 2.2 4 to 5
2. Number of ICU beds (per 100,000 population)
Edit: Never mind, that was total number of hospital beds. The number of ICU units is really small.
Edit: nevermind, I misunderstood the definition of "Curative care (acute care) beds in hospitals".
A lot of people seem to think that Japan must somehow have a higher infection rate but I haven't seen any evidence that this is true.
For all the docileness of the mainstream media and the lame-duck politics it is a free and democratic society. The government couldn't hide a mass outbreak of corona virus anymore than it has been able to hide any other scandal. In fact almost certainly less given the levels of public interest.
The Ministry of Health and Welfare publishes updated statistics daily (https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000164708_... -- in Japanese). looking at the current stats published there's not really any obvious problems. They're seeing about an 8% positive rate on corona virus tests and 1.8% of those with confirmed infections have died. This is well below the rates seen in Iran, Italy, America and China suggesting they've been relatively thorough in catching infections, although less so than South Korea.
In truth the Japanese healthcare system is probably the best in the world at providing population level care. Since long before Corona virus standards of hygiene have been very high. Masks and hand sanitizer bottles have been a common site for a long time, hand washing and gargling is heavily encouraged, and direct contact (hand shakes, hugs, back pats .etc.) is very restrained.
Whats more for all the criticism it copped the Japanese government has been pretty decisive in responding to corona virus. It's shut down schools. It's shut down public spaces (museums, libraries .etc.). It's discouraged crowds. It's encourage working from home. It's restricted travel from hot spots. It's isolated those with infections. Also most age homes seem to have gone into lock down weeks ago.
But none of posts should be construed as "Joe's complete model of Coronavirus dynamics." There are many things we don't know and can't predict. My main argument is every country needs much testing and much surveillance of the situation - IE, the Korean model is good, that is all.
I'm inclined to go with the other comment nearby that says not to trust any figures coming out of Japan as a better explanation for the disparity.
The problem was so bad that, even before the current epidemic, other "regular" churches had a sign saying "No member of Sincheonji is allowed in our church." So, yeah, not exactly your garden variety Christian church.
When you think about it, this behavior would make Sincheonji a perfect vector for spreading the virus. And that's what happened. Yikes.
Or worse, even after the outbreak, some didn't reveal their affiliation with the cult. In one instance, a dude leading Daegu city's outbreak management team, didn't reveal his affiliation with the cult until after test came positive and coworker were also infected. They also refused to give names of their cult members, even as most of new Wuhan virus cases were linked to the cult and the gov't actively sought their members for quarantine.
a generally compliant national attitude, combined with aggressive testing, and community-orientation probably had as much to do with south korea's success so far.
By median age Germany is actually older than Italy, though. Not sure how age really correlates here.
Median and average don't matter. Density of senior citizens does.