Reply
 
Thread Tools Display Modes
  #1  
Old 04-06-2020, 02:17 AM
Jim B.'s Avatar
Jim B. is offline
Charter Member
 
Join Date: Mar 2002
Posts: 2,143

Why Is the Coronavirus Pandemic Worse in the USA?


I don't have a cite. Actually I heard it on TV. But the numbers of people infected in the U.S. are far worse than Italy and Spain. Ironically even worse than China at this point.

Why?

Are we dealing with it less effectively? And what about universal health care? I'm not saying it's a factor. But okay, is it?

Thank you in advance for your kindly replies.

__________________
"Love takes no less than everything." (from "Love Is", a duet by Vanessa Williams and Brian McKnight)
  #2  
Old 04-06-2020, 02:36 AM
Francis Vaughan is offline
Guest
 
Join Date: Sep 2009
Location: Adelaide, Australia
Posts: 5,319
It isn't clear one way or the other. The US has a population nearly 7 times that of Spain. But the US is also much more complicated and might be better thought of a set of separate regions each with its own parameters and place on the timeline. Where it gets hard is comparing like with like. Infection numbers are wobbly, and not trivial to compare.
https://fivethirtyeight.com/features...e-meaningless/

Death counts are harder to get wrong, but not impossible. Counting deaths as Covid-19 simply because they tested positive through to not even bothering to test the dead (it won't do them any good after all) are extremes that seem to be in play across the planet.
  #3  
Old 04-06-2020, 03:05 AM
Banksiaman is offline
Guest
 
Join Date: Apr 2012
Location: Straya
Posts: 1,371
Basically, what Francis V said.

A useful chart is this global one at Worldometer. If you click on the column 'Deaths/1m pop' it gives you a pretty simple snapshot of how different countries are faring. A trick is to click 'Yesterday' rather than now, as it will give a full day's picture rather than one which is stlll in progress.

While San Marino has a death rate per million people that is almost 4x as bad as Italy and Spain, you should ignore any little countries because this calculation produces weird results. As of yesterday Spain has 270 deaths per million, Italy 263, USA 29 and one-time poster child Singapore 1. Note that when you compare, consider Italy and Spain have been hit really hard for a month, while the US is just starting to get widespread outbreaks outside the urban centres.

If you go to the individual countries you can look at their curves in detail.
  #4  
Old 04-06-2020, 03:08 AM
Banksiaman is offline
Guest
 
Join Date: Apr 2012
Location: Straya
Posts: 1,371
Basically, what Francis V said.

A useful chart is this global one at Worldometer. If you click on the column 'Deaths/1m pop' it gives you a pretty simple snapshot of how different countries are faring. A trick is to click 'Yesterday' rather than now, as it will give a full day's picture rather than one which is stlll in progress.

While San Marino has a death rate per million people that is almost 4x as bad as Italy and Spain, you should ignore any little countries because this calculation produces weird results. As of yesterday Spain has 270 deaths per million, Italy 263, USA 29 and one-time poster child Singapore 1. Note that when you compare, consider Italy and Spain have been hit really hard for a month, while the US is just starting to get widespread outbreaks outside the urban centres.

If you go to the individual countries you can look at their curves in detail.
  #5  
Old 04-06-2020, 03:16 AM
Smapti is offline
Charter Member
 
Join Date: Mar 2002
Location: Olympia, WA
Posts: 16,930
This is one of the situations where it's less useful to think of the US as one country, and instead think of it as 50 sovereign polities. The federal government doesn't have the constitutional authority to enact preventative measures on a nationwide scale, and it's been largely absent in terms of things that it does have authority over, so containing the virus is pretty much being handled at the state level to varying degrees of success.
  #6  
Old 04-06-2020, 03:35 AM
nelliebly is offline
Guest
 
Join Date: Jul 2017
Location: Washington
Posts: 3,065
Thanks for the link, Francis V, and the excellent post. I'm a big fan of Nate Silver. One caveat here is that "mild" cases are merely those that don't require hospitalization. In NYC,even a person suffering a temp of 102 with a dry cough or chest pain and labored breathing would not be hospitalized, and anyone not requiring hospitalization didn't qualify to be tested. Some people, like Chris Cuomo, hallucinate. That's still considered mild COVID-19.

Silver says few of the mild cases get tested and equates a mild case of COVID-19 with "a mild flu or a bad cold." In point of fact, many of these "mild cases" are quite ill and cannot get tested.
  #7  
Old 04-06-2020, 04:34 AM
RivkahChaya's Avatar
RivkahChaya is offline
Guest
 
Join Date: Feb 2012
Posts: 10,863
We need better terms. There's such a big gap between "positive test, asymptomatic," and "home convalescent, but protracted, miserable, can barely get out of bed, and lose 15 lbs." There are a lot of people who apparently have a few days of low fever, dry cough that is controllable with OTC meds, and mild GI symptoms, and bounce back in 3 days. Then other people who have a bad cold, and a lot of is it/isn't it; the fall in between to protracted home cases, and the "shook it off in a few days."

We needs something like numbers, where 1 is asymptomatic; 2 is "walking symptoms that resolve in days"; 3 is "bad cold"; 4 is "home in bed for more than a week"; 5 is hospital but good prognosis; and 6 is hospital, poor prognosis.

Something like that. IANAD, and not knowledgeable enough really to know where to draw lines. I'm just saying that "completely asymptomatic," "mild" and "hospitalized," don't offer enough information.

Also, yeah: per capita, rather than whole stats would be more useful, and looking at individual states is also more useful. NY may be worse off than Italy, but no other state.
__________________
"There's always a non-Voodoo explanation for everything." ~Adrian Monk
  #8  
Old 04-06-2020, 04:47 AM
Grim Render is offline
Guest
 
Join Date: Feb 2012
Posts: 1,411
Quote:
Originally Posted by Jim B. View Post
And what about universal health care? I'm not saying it's a factor. But okay, is it?
Probably not, really. Surprisingly. But... this is a new virus. There is no vaccine so the healthcare system can't stop people from getting it. There are no treatments and antivirals against this one.

So what can the healthcare system actually do about it?

It can give care to the worst cases, and buy them some time so their own bodies systems can fight off the virus. IVs, respirators etc. And so pull a few of the borderline cases down on the right side of the border. But compared to what we can do against many other diseases, thats not a lot.

The numbers of people we can save once its respirator time, is pretty small it seems.

And no healthcare system can handle it when 2-5% of the population need intensive care at the same time. All a difference in systems can do is break at a slightly different point.
  #9  
Old 04-06-2020, 04:54 AM
Francis Vaughan is offline
Guest
 
Join Date: Sep 2009
Location: Adelaide, Australia
Posts: 5,319
There will probably some longer term effects of the healthcare system. Someone who has survived but is pretty beaten up by the experience will benefit from additional care once they get home. That will typically be covered by private health, but not by the state. Long term morbidity might become a significant divide between the haves and have nots. Worst case might be a new underclass of physically incapacitated working poor.

Last edited by Francis Vaughan; 04-06-2020 at 04:55 AM.
  #10  
Old 04-06-2020, 05:03 AM
Ulfreida is offline
Guest
 
Join Date: Oct 2011
Location: pangolandia
Posts: 4,222
The combination of a president who is very close to insane, a truly horrible health care system, a abyss of a partisan divide with nearly half the country on the side of anti-science and anti-anything the media says unless it is Fox news, and a cumbersome labyrinthine bureaucracy, have all contributed to a woefully inadequate and criminally late response in the US.

Even with an intelligent dynamic leader as president who could create a coordinated response throughout the country, however, we would still be in bad shape, like everyone else. Just not in nearly such bad shape as we are.

It is also true that some countries are clearly withholding information about their status. There was an article in the NYT I think yesterday about how tracking google searches for "I lost my sense of smell" is predictive of trouble coming. One of the spikes for this is Ecuador, which has reported little. Just as an example, and there are probably others like it.
  #11  
Old 04-06-2020, 05:04 AM
glee is offline
Guest
 
Join Date: Aug 1999
Location: Obama country
Posts: 15,962
If the effects of the Pandemic are worse in the US, I would suggest some likely factors are:

- US health care strongly biased towards the wealthy (so poor people are reluctant to seek medical help)
- poor leadership (Trump concerned more with his image, the Stock Market Index and punishing those who disagree with him)
- right-wing religious fanatics determined to hold live mass services (to keep the donations flowing)
- Republicans who believe it's all a hoax
__________________
Arnold Winkelried:
'glee, I take my hat off to you.... at first I thought you were kidding with your cite but I looked it up and it was indeed accurate. (Still in awe at the magnificent answer)'
  #12  
Old 04-06-2020, 05:05 AM
jtur88 is offline
Guest
 
Join Date: Aug 2011
Location: Cebu, Philippines
Posts: 15,770
A few guesses:

-- US responses fragmented, with 50 governors running opposite directions, instead of a unified response

-- A Constitution that makes it hard to order anybody to do anything

-- A mindset to save the economy, rather than save lives.
  #13  
Old 04-06-2020, 05:13 AM
glee is offline
Guest
 
Join Date: Aug 1999
Location: Obama country
Posts: 15,962
sorry - double post
__________________
Arnold Winkelried:
'glee, I take my hat off to you.... at first I thought you were kidding with your cite but I looked it up and it was indeed accurate. (Still in awe at the magnificent answer)'

Last edited by glee; 04-06-2020 at 05:14 AM.
  #14  
Old 04-06-2020, 06:38 AM
Miss_Gnomer is offline
Guest
 
Join Date: Sep 2008
Location: Australia
Posts: 234
Quote:
Originally Posted by Jim B
And what about universal health care? I'm not saying it's a factor. But okay, is it?
Quote:
Originally Posted by Grim Render View Post
Probably not, really.
<snip>

And no healthcare system can handle it when 2-5% of the population need intensive care at the same time. All a difference in systems can do is break at a slightly different point.
Having a population with a greater proportion of people with untreated existing disorders will increase the risk of death. Having universal health care would create a healthier population and people able to access care when needed. I would also expect a health care system that is expected to treat the whole population is likely to be better prepared than a system that only budgets to treat a smaller number.

No country could prepare for this ... but you'd hope that the breaking point was further down the track rather than early on in the pandemic.

What is the current situation for someone who needs intensive care, ventilator etc but has no health care coverage in the USA? Do they even get in the door? Are hospitals choosing to only treat insured people? How would anyone ever pay off a bill like that?!?!
  #15  
Old 04-06-2020, 09:56 AM
Urbanredneck is offline
Guest
 
Join Date: Mar 2014
Posts: 8,503
I think alot is just time and statistics.

I dont know if its really worse in the US rather because we are still on our upward slope while for other countries like Italy have already hit their peak. I think they are saying the US will peak in about another 2 weeks.

It seems the US also is still on the lag time for cases that can be classified as "recovered". Doesnt it take like a month or so before they can say a person has "recovered"?

Here in Kansas while the number of deaths keeps going up the number of persons diagnosed with it is going down and so far I cannot find any rate for recovery.
  #16  
Old 04-06-2020, 10:31 AM
RivkahChaya's Avatar
RivkahChaya is offline
Guest
 
Join Date: Feb 2012
Posts: 10,863
Quote:
Originally Posted by Miss_Gnomer View Post
Having a population with a greater proportion of people with untreated existing disorders will increase the risk of death.
Wow. I'll bet that's a huge part of it.

I think another part is that while on one hand, distribution of resources and decisions about closings, curfews, is all happening as though each state is an independent, sovereign entity, but interstate travel is still happening as though the US is a single nation.

We shouldn't be trying to have it both ways. Either each state should be operating as sovereign, with the ability to close, or at least stringently regulate its borders, OR there ought to be a stronger centralized national leadership.

I realize that people worry about transporting goods from one state to another presents problems, but trucks could be driven to borders, and the trailer decoupled from the bobtail, connected to a new bobtail from the neighboring state, and the trip continued. That way, the truckers themselves wouldn't move from state to state. If very careful sanitary measures were taken in packing trailers in the first place, and again when they are unpacked, transmission that way would be minimized, and at any rate, the chances of Covid-19 being transported in the air on on the goods in a trailer are pretty slim, since the stuff is in the trailer usually more than 24 hours. The concern is more for the bobtail and the truckers themselves.

If the trucker observes social distance, and is the only one to touch the bobtail (barring it needing mechanical work) you minimize the risk of truckers carrying virus from state to state. It doesn't take all that long to decouple and recouple a trailer.

I can think of other ways on minimizing interstate travel. Any lots of the interstate travel happening now is happening for non-personal reasons, and much of that can be stopped with relay systems like this.

We really have it backwards, running the states like independent nations, but traveling like the US in one country. We should be treating the states like independent nations, but running the US, at least in regard to a Covid-19 plan, as one country.

It's really a problem unique to the US, though. The Canadian provinces, I don't think, have the kind of independence that the US states do. Even when there was a Soviet Union, and the SSRs were former independent nations, they didn't have the self-governence of the states. They may have been homes to people of separate ethnicities and languages, but they were much more subject of the Supreme Soviet than the US states are of the Federal government.
__________________
"There's always a non-Voodoo explanation for everything." ~Adrian Monk
  #17  
Old 04-06-2020, 10:41 AM
CarnalK's Avatar
CarnalK is offline
Guest
 
Join Date: Jul 2000
Posts: 20,125
Before you guys explain why the US is doing poorly, could you perhaps explain by what metric the US is doing comparatively poorly in? There's nothing super shocking when you look at graphs comparing the US to other western countries that I see.
  #18  
Old 04-06-2020, 10:41 AM
dorvann is offline
Guest
 
Join Date: Oct 2005
Location: New Hampshire
Posts: 1,055
Quote:
Originally Posted by Ulfreida View Post
..... a abyss of a partisan divide with nearly half the country on the side of anti-science and anti-anything the media says unless it is Fox news,
Part of the problem with framing this as a simple left-right, Republican-Democrat issue ignores the fact that the largest political block in this country are the non-voters. And on this issue it actually matters because even if the vast majority of Republicans and Democrats agree to curtail all social engagements and the nonvoters/politically noninvolved decided to do their own thing it would undermine any efforts everyone else was making to mitigate the spread of Corona.
  #19  
Old 04-06-2020, 10:42 AM
Kovitlac is offline
Guest
 
Join Date: Oct 2019
Posts: 697
Quote:
Originally Posted by Miss_Gnomer View Post
Having a population with a greater proportion of people with untreated existing disorders will increase the risk of death. Having universal health care would create a healthier population and people able to access care when needed. I would also expect a health care system that is expected to treat the whole population is likely to be better prepared than a system that only budgets to treat a smaller number.

No country could prepare for this ... but you'd hope that the breaking point was further down the track rather than early on in the pandemic.

What is the current situation for someone who needs intensive care, ventilator etc but has no health care coverage in the USA? Do they even get in the door? Are hospitals choosing to only treat insured people? How would anyone ever pay off a bill like that?!?!
Yes, they get in the door. They go to the ER, which is where people without health insurance often go, and it's likely determined there if a test is warranted or not. And someone experiencing breathing problems and a severe fever IS going to go, regardless of what their eventual costs might be. Unless they have a death wish, they're going.

As a side note: I went without health insurance for awhile, and had zero problem getting in to see a GP.

People outside the US like to imagine people with heart-attacks being turned down at the operating room entrance because they don't have insurance I'm not saying denying someone care has never happened, but it's hardly the scenario you're picturing. People receive care without insurance every day.
  #20  
Old 04-06-2020, 10:43 AM
doreen is offline
Charter Member
 
Join Date: Dec 1999
Location: Woodhaven,Queens, NY
Posts: 7,090
Quote:
Originally Posted by nelliebly View Post
Thanks for the link, Francis V, and the excellent post. I'm a big fan of Nate Silver. One caveat here is that "mild" cases are merely those that don't require hospitalization. In NYC,even a person suffering a temp of 102 with a dry cough or chest pain and labored breathing would not be hospitalized, and anyone not requiring hospitalization didn't qualify to be tested.
It's not accurate to say that in NYC people who didn't require hospitalization didn't qualify to be tested - I know plenty of people who were not hospitalized and were tested. But they weren't tested at hospitals. What I think the author of that article was trying to say was that her particular hospital wouldn't test ER patients that didn't require admission - but there were drive-up testing centers and urgent care centers that were testing those not requiring hospitalization. (although they were not testing simply anyone who asked for a test)
  #21  
Old 04-06-2020, 10:45 AM
Carryon is offline
Guest
 
Join Date: Nov 2012
Posts: 927
If look you also see success stories. California is doing very well considering it has around 40 million people, same could be said of Texas.

When I look at stats the only really one that stands out is Michigan. Which like NYC can be explained by conspiracy theories
  #22  
Old 04-06-2020, 11:37 AM
engineer_comp_geek's Avatar
engineer_comp_geek is online now
Robot Mod in Beta Testing
Moderator
 
Join Date: Mar 2001
Location: Pennsylvania
Posts: 26,643
Moderator Note

Quote:
Originally Posted by Ulfreida View Post
The combination of a president who is very close to insane
Quote:
Originally Posted by glee View Post
- poor leadership (Trump concerned more with his image, the Stock Market Index and punishing those who disagree with him)
Keep the political comments out of the Quarantine Zone.
Reply

Bookmarks

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off

Forum Jump


All times are GMT -5. The time now is 04:19 AM.

Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2020, vBulletin Solutions, Inc.

Send questions for Cecil Adams to: cecil@straightdope.com

Send comments about this website to: webmaster@straightdope.com

Terms of Use / Privacy Policy

Advertise on the Straight Dope!
(Your direct line to thousands of the smartest, hippest people on the planet, plus a few total dipsticks.)

Copyright 2019 STM Reader, LLC.

 
Copyright © 2017