Remember that scene in The Stand (book) where the President is giving a speech about Captain Trips, but it’s obvious something is wrong and the man was interrupted by his own coughing?
“In a press conference yesterday an Iranian government spokesman confidently asserts they have “no problem” containing coronavirus. Alongside him, the country’s deputy health minister appears symptomatic, but takes no precautions to cover/isolate himself”
“Today the deputy health minister–who’d “been briefing briefing officials & journalists”, presumably without a mask–casually announces he’s tested positive.”
Nevermind the vast numbers of people who, in addition to having either crap or no insurance, also have no paid sick time or risk being fired for not coming to work who therefore have a definite economic incentive (read “arm-twisting”) to go to work even when they are sick.
Can’t stay home when, due to lack of income, you no longer have a home to go to.
Well, we just canceled our plans to go to Taiwan and Japan, so I guess there is enough uncertainty and instilled fear and speculation in the media that caused us to do this. I’m pretty bummed about it, but Taiwan and Japan will be there for many years to come.
In the United States, what happens if you walk into a clinic and need service for something severe enough to warrant getting antibiotics or a plaster cast, and you tell them you can’t afford the medical service or have no insurance, are they going to refuse you treatment or are they obligated to help you, and bill you later (or scrap the bill entirely)? In Canada, even if you don’t have medical coverage, you can still walk into a clinic or the hospital and be treated for your issue. It’s not “free” medical - it’s paid by all of us and goes into a big pool, so there’s lots of money available for treatment, however (in)significant it is.
Whelp, looks like it won’t be contained. On the good side, it seems to have a relatively low mortality rate, especially among the young. This is likely to kill a lot of people (possibly including me) but it’s not going to end civilization or anything.
This is where I’m happy that I and all my co-workers can work from home. Last time my analyst had flu (he actually tested positive for flu) I told him I would consider it a personal favor of he stayed home until he was well, and suggested some useful work he could probably do while he was still under the weather, if he didn’t want to burn his sick time.
No medical provider is required to treat you… except the emergency room, which MUST treat you if your life is in immediate danger. Otherwise - no, you can be completely and totally denied any treatment whatsoever.
In reality, though many clinics/hospitals/doctors will try to do something - you can attempt to negotiate a payment plan. After the fact they can try to bill you, even send you to collections (although if you really have no money or assets they still won’t get anything). If it’s something easily treatable by common antibiotics or the like the clinic might write off your appointment and send you to a local pharmacy that provides several very common medications for free. If you need something more than that, though, you’re screwed.
But yeah - you can be completely turned away if you have no insurance and/or cannot pay. (On this forum there are some threads from back in, oh, it must have been 2008 when, because I had no insurance I was refused treatment even though I had the money in hand to pay for it) I did, eventually, get a doctor’s appointment but access here is so tied to private insurance than even WITH money you can have problems if you don’t have health insurance. Crazy, huh?
There is nothing about my current job that can be done from home. Ditto for my coworkers.
The only advantage I have over many of my peers is that I have about 6 months worth of living expenses in savings. If I had to stay home for a week, or 14 days, or a month, it would not break me financially. The same can not be true of the majority of the Americans in my socio-economic group.
I’m worried about the response to this more than I am the disease itself. The CDC is telling people today that Americans should start preparing for daily life to be disrupted. Quarantines, food shortages, school closures (and disruption to my kids’ education), my 401K…all of these things seem scarier than actually getting the virus.
And my wildest imagination runs to how this could affect the upcoming election and how the Trump administration will act if they feel like this is a threat to them winning or if they can somehow get an advantage using this.
It’s a perfectly American pandemic. We elected a moron who ignores the threat as to not spook markets, while at the same time sick people must avoid going to hospital for the coronavirus test because they can’t afford the fees, but they still have to go to work because there’s no income safety net in this country.
Harvard’s Marc Lipsitch expects that 40-70% of the world’s population will become infected this year, which is actually somewhat conservative because it now appears that the reproductive number R0 is somewhere between 2 and 3 (80-90% infection rate). COVID-19 likely has a higher R0 than the 1918 Spanish Flu that killed 50-100 million people.
For the US, 40-70% translates to 130-230 million Americans contracting COVID-19. Even if the CFR of the virus was only 1% this would cause 1-2 million US deaths and 30-50 million deaths worldwide.
CDC’s Director of National Center for Immunization and Respiratory Diseases, Dr. Nancy Messonnier, said the virus, called COVID-19, is “rapidly evolving and spreading” and that "successful containment at U.S. borders is becoming problematic." The bug will soon be here, IOW.
Total deaths in the US in 2018 from everything was about 8.6 per 1000, or 2,839,205. Not age-adjusted, which accounts for the difference between that number and the 7.3 ish number for 2016 and 2017. This disease, by itself, even assuming the CFR in the quoted post, will be adding anywhere from another 50 to 100 percent more deaths to the total the US public health system has to deal with.
(I’ve seen 2.5 ish as a guideline CFR. Granted those are using Chinese numbers, as they are the vast majority of the known cases so far. A non-Chinese, non-Iranian CFR I calculate as about 1.2, from here. Thank God it didn’t turn out to be the 13-14 an early pre-print epidemiology paper predicted that I mentioned here about a month ago.)
Your guess is as good as mine where the necessary ventilators, PPE (a large amount of the materials are made in China), ICU/CCU space, and additional skilled practitioners are going to come from.
**Surreal **and Grey Ghost - you are both confusing “confirmed case fatality rate” with “infection mortality rate”. The two are very very very very different things.
“Confirmed case fatality” is a subset of those who are notably sick - those who are sick enough to have gotten tested with the very limited resource of testing kits. Those who are notably sick are a subset of those who infected.
As the cited Marc Lipsitch, who expects large numbers of infected individuals, explains:
His estimate of the potential number infected is based on his past modeling with swine flu in Mexico in which
Note that the upper limit of that range would exceed for COVID-19 would exceed the population of all of Hubei.
It may be that 40 to 70% of Hubei has been infected, with orders of magnitude more infected but not sick than sick, as Lipsitch posits. But we still have out of the 60,000,000 who have been living there under 2600 deaths to date. That’s an excess mortality rate of 4 per 100,000 within Hubei. Significantly less than the “average annual mortality excess rate per 100,000 ranged from 11.6 to 41.2 with most of the influenza-associated deaths”
Let me be very clear - I would be very surprised if this does not spread worldwide. I expect I will be having many many children with it but minimally ill, no different in appearance than many other viral illnesses, coughing in my face.
And even as an over 60 year old man I am not any more worried than I am about influenza every year, and more worried about drivers while I am on my bike.
Dseid would you as an over 60 year old man worry overmuch about traveling to non-Chinese Asia in the near future? I’m supposed to be in Japan and SE Asia soonish and am considering otherwise.
Some people thought the Zika virus would lead to the cancellation of the Rio Olympics in 2016. That didn’t happen either.
Am I concerned? Yes, for people who live in China and their contacts. Do I think this is a real-life Captain Trips? NO.
Yesterday, I stopped by a hospital in town to get a blood draw I need for an appointment I have scheduled next week. There were the usual flu warning signs, and also signs stating, “If you have been in China in the past 14 days, inform a staff member immediately.” I feel that’s as appropriate as the other signs they’ve had up for the past 5 years that say, “If you have traveled outside the U.S. in the past 30 days and have the following symptoms…(fever, headache, vomiting, diarrhea, etc.)…tell a staff member immediately.”
I also heard earlier today that a number of people are currently housed in the Biocontainment Unit at the University of Nebraska, the same one where 3 Ebola patients were treated in 2014 (and they sent two of them home ). Two are being treated in isolation and the others are in quarantine, and they’ve used it for other quarantines in the meantime.
Here’s a 25-minute video they made when it opened. It’s worth a view, and there’s an underlying theme that they were hoping they would never need to use it.
More than once, administration wanted this unit to open up because the ICU was full, and they refused because they said that’s all they wanted to use it for, and even transferred patients rather than house them there. That’s dedication.
). Two are being treated in isolation and the others are in quarantine, and they’ve used it for other quarantines in the meantime.