COVID-19 Research, Drug trials and Pathophysiology

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You are looking at nationwide data. I was referring to specific areas or epicenters, a.k.a. in the lay press, hot spots, varying from calmer ones with an 80% surge to very active ones like NY-NJ with 300% in certain weeks. Yes, it was a very different table, actually a database rather than a table, very hard to consult because of literally thousands of rows (4,318 over 12 columns and with various ways to organize it (the instructions are huge, found elsewhere) so it took me a long time to painfully browse to areas and time ranges that interested me, with each state starting with Alabama listed for all weeks in alphabetical order, and no way to search other than clicking on next next next etc. Sorry, I'm not about to repeat this exercise. Here, if you want to play with it:

https://data.cdc.gov/NCHS/Weekly-Counts-of-Deaths-by-State-and-Select-Causes/muzy-jte6

Then you can compare with another database even bigger, with the same info for the 2014-2018 years. It's a very time-consuming process if you feel so inclined. One would need a research assistant (preferably cute) to go through all of this.

 

There is no need to spend too much time on it, unless that time it is spent with female assistant.
The bottom line is that we are in the recovery, no lock-down no masks needed.
New York is already has below average death rate, all other regions will be there soon.

 

Agreed regarding the cute female assistant.

But my point wasn't recovery or not. I was pointing out that COVID-19 deaths are not being over-counted.

You are now introducing another issue - are we in the recovery? I'm really not sure. Seems like we plateaued on about 66K newly diagnosed cases per day for a few days now. But I mean, we've had calm(er) periods before... just to see new flare-up, later, as the virus moved from one epicenter to the next. We still have a HUGE susceptible population. So where this is going is anybody's guess. This kind of thing tends to come and go in waves, and I expect some trouble if we get a severe seasonal flu in the winter to add to the trouble.

I mean, let's not start shouting "Victory!" lest we see another "Mission Accomplished" fiasco. Remember, the Spanish Flu's second and third waves were *way* worse than the first one.

And that's not a great plateau, 66K per day. I think it was one of the governors who said, "We plateaued but with very high numbers. It's like saying that we are no longer increasing the speed of a car but we're stuck at 95 miles per hour. I'd like to see that speed drop before I rejoice."

I think the ship has sailed for lockdowns. We didn't do them very well, especially because we failed to secure the kind of widespread payroll protection that might have allowed us to keep it going a little longer with smaller economic impact. We ended up with huge economic impact, and insufficient epidemiological control... the worst of two worlds. And now there is no political appetite to try again. So now I don't favor them. I don't think we would be able to do it well, so we'd just add even more pain and suffering and unintended consequences. We should have done it better the first time, to do it just once and be done. We dropped that ball.

Compare to Germany: huge payroll protection, more sustained and homogeneous lockdown... came out of it with much smaller death rate per capita, much smaller unemployment, and with the contagion effectively curbed.

Yes, sure, New York has calmed down. How many more New Yorks will we have until it's over, though? Only God knows.

I place my hope on vaccines. I think so far things are looking very bright regarding vaccines. I just hope the virus doesn't mutate and doesn't defeat the whole thing.

 

Germany has no reason to report fake numbers, US does.
1. No one is compensated for COVID-19 in Germany
2. Germany has no HateTrump campaign.
3. Number of fatalities (relative numbers of course) almost exactly the same US vs Europe.

 

On the matter of fake numbers due to supposed compensation for a COVID-19 diagnosis, I posted recently (like yesterday, it shouldn't be hard to find in my posting history) a long explanation on how this is not accurate. I won't repeat these arguments here, because they are long, but feel free to look up what I posted elsewhere if this is a question that interests you.

Sure, Germany has no Hate Trump campaign. That's one of the reasons I've been saying to people who see COVID-19 (or the reactions to it) as just a vast conspiracy by Democrats to take Trump down, that this is a pandemic affecting 215 countries and only 1 has a president named Donald J. Trump seeking re-election this year. So, the virus is indifferent to all of this and continues its march everywhere, and it is a dangerous virus. Sure, both parties here, the Dems AND the GOP, seek to spin these events in order to achieve an electoral advantage, but the events themselves are real. So, yes, this virus kills and maims a lot, no need to inflate numbers. It's been equally killing and maiming a lot in 214 other countries that don't have a Trump v. Biden election.

Number of fatalities per million of population of course are similar because it's the same virus attacking the same species (humans) and that's the situation everywhere, with some regional differences due to medical resources, density of population, availability of public health infrastructure, PPE, etc. But basically this virus kills and maim a steady number of people everywhere (by maim, I mean permanent organ damage to lungs, kidneys, livers, brains, blood vessels, hearts, etc., which we're seeing in growing numbers among those who survive therefore do not beef up the death stats - deaths aren't the whole picture for this virus). The difference, though, is that while the contagion is generally in decline in Europe, it is going up here (minus a very recent plateau that isn't reassuring me yet).

 

....and it never really got started in most of non-China Asia and Oceania. Again, they don't have a President named Donald J. Trump.

 

From your article.
The CDC guidance says that officials should report deaths in which the patient tested positive for COVID-19 — or, if a test isn’t available, “if the circumstances are compelling within a reasonable degree of certainty.” It further indicates that if a “definite diagnosis of COVID–19 cannot be made, but it is suspected or likely (e.g., the circumstances are compelling within a reasonable degree of certainty), it is acceptable to report COVID-19 on a death certificate as ‘probable’ or ‘presumed.'”

It is just laughable.
Of course anyone will suspect COVID-19 with Dollars sign on the surface.

 

Nothing laughable about it. That you think so, betrays a lack of familiarity with how diagnoses and causes of death are addressed in all of Medicine, not just regarding COVID-19. How many of the billions of deaths that happen in the planet, you think go to detailed autopsies or have tests that confirm the cause with 100% certaintly? Very few, in proportion. Autopsies, usually only in suspected foul play or some circumstances like a family requesting one for malpractice lawsuit purpose. And a large number of causes of death go unconfirmed by diagnostic testing. Usually a death certificate is written taking into account the physician's clinical judgment and understanding of the chain of events leading to the death.

So, think of it.

We are in the middle of a freaking pandemic.

Some senior citizen gets in contact with a person known to be positive for the agent of said pandemic which is highly infectious. 4 to 7 days later the senior citizen experiences body aches, severe fatigue, fever, and loses his sense of smell. Four days after that he starts developing shortness of breath. He is rushed to the small local hospital in his rural area. His pulse ox is measured and is falling below 94 so he is admitted. Then he develops signs of worsening pneumonia and it is noticed that his lungs are filling up with fluid. He gets intubated and put on a ventilator, but develops renal failure, cardiac inflammation, and a catastrophic auto-immune, multi-organ reaction, then experiences disseminated intravascular coagulation and dies.

Well, that hospital ran out of test kits for COVID-19. The dead gentleman was never tested.

Hm... what do you suppose the doctor should write in his death certificate??? What other cause of death should apply, IN THE MIDDLE OF A FREAKING PANDEMIC OF COVID-19, FOR A CASE THAT HAS EVERY. SINGLE. HALLMARK. OF COVID-19? Pray tell, what kind of mysterious illness do you suppose might be mimicking COVID-19 for this gentleman, without being COVID-19????

I guess that in your view, if the doctor writes up "presumed COVID-19" in the death certificate because he didn't have an RT-PCR test to confirm it, it means that this doctor is involved in a vast conspiracy to bring Trump down or is involved in fraud to get some COVID-19 funds, right?

Newsflash: there are no dollar signs. That's a myth. Read what I wrote elsewhere about how billing happens (hint, it goes by procedures and treatments administered, not by diagnosis). Except for a marginal increase in Medicare compensation from the CARE act, to ease for hospitals the burden of treating uninsured COVID-19 patients (you don't want your local hospital to go bankrupt in the middle of a freaking pandemic, right?), with so far no evidence whatsoever that these funds were misused or fraudulently claimed.

For your information, fraud in healthcare for higher federal compensation is a federal felony that would land a doctor in federal prison and stripped of his/her license to practice medicine. Doctors are typically not interested in this kind of fraud. When they write down COVID-19 in a death certificate, it's simply because they are decent people with ethical concerns and trying to do a decent job, and the patient has indeed died of COVID-19.

Could it happen that some bad apple somewhere would behave differently? I suppose so. All professions have bad apples. After all, there is the odd case here and there of Medicaid and Medicare fraud that has landed some rare doctors in federal prison, minus their licenses. But to suppose that such event is the rule rather than a rare and fringe exception, is what is laughable.

 

There is no fraud.
Patients are coming in with pneumonia and the doctor do not bother investigate what is a root cause, suspecting COVID-19 as primary reason.
That is it.
But that is not true statistics, the results are skewed.

 

Please provide the evidence for this wild claim. A simple pneumonia is WAY DIFFERENT from a death by COVID-19 and every doctor worth his/her weight in salt knows the difference by now. COVID-19 is not even still considered to be a pneumonia-driven illness but rather an illness of the endothelium (the inner layer of blood vessels).

"The doctor does not bother investigate what is a root cause"

I guess, take a look at my avatar on the top left corner of this message to see how I react to this statement, in this hugely regulated field of medical practice in the US, ridden with ambulance-chasing lawyers, with the hospital's Standards of Care committee looking at doctors' practices, plus the Risk Department, plus the Infections Control Nurse, plus the State Medical Board and various regulatory agencies, including, with whistleblower incentives to report substandard or fraudulent practices.

Yes, sure, "the doctor does not bother." Right.

 

It's not just about the death rate. We don't know much about the long-term consequences of contracting COVID-19.

 

if mortality low the complications should be proportionally low as well.

 

Maybe. Maybe even probably. But maybe not. We don't know.

 

This is very encouraging - 20%-50% of natural immunity in the population, T-cell mediated, due to previous encounters with other coronaviruses, would be of great help:

https://science.sciencemag.org/content/early/2020/08/04/science.abd3871

 

Not necessarily. Read this:
https://jamanetwork.com/journals/jamacardiology/fullarticle/2768916

 

They do not get compensated in Germany for treating C19 case ?

Really, how come?

 

Which is BS. If you go to the hospital, you get tested. One of my employees had a minor surgery, in and out within 2 hours, she was tested, had to, 2 days before surgery.
A other employee came down with pneumonia, 4 times in the hospital over 2 month, each time she was tested.

You are making BS up.

 

@kreo might have gotten more things wrong if he had kept typing.

“Hospitals, rehabilitation facilities, contract doctors and nursing facilities are supported to shoulder the effects of the corona epidemic. This will enable hospitals to provide care capacity to a growing number of patients with coronavirus infection. The loss of fees paid by resident doctors is also cushioned. Nursing homes are also temporarily relieved of bureaucracy and also financially supported.

• Hospitals receive financial compensation for rescheduled operations and treatments to free up capacity to treat patients with coronavirus infection. For each bed that is not occupied in the period from March 16, 2020 to September 30, 2020, or for every patient who was not treated as an inpatient compared to the previous year, the hospitals receive a flat rate of 560 euros per patient who has stayed away . The compensation is paid from the health fund’s liquidity reserve and refinanced from the federal budget.
• Hospitals receive a bonus of EUR 50,000 for every intensive care bed they create. The costs for this are financed from the health fund’s liquidity reserve. In addition, the federal states are to finance further necessary investment costs in the short term.
• For additional costs, especially for personal protective equipment, hospitals receive a supplement of 50 euros per patient from April 1 to June 30, 2020, which can be extended and increased if necessary.”

https://mapmedtech.com/2020/04/germany-laws-passed-to-support-healthcare-system-through-covid-19/


Red is US. Blue EU.


https://www.gzeromedia.com/the-graphic-truth-are-new-us-covid-deaths-surging-vs-eu

 

That is exactly what is happening, they get tested as positive,then die from other reason, as result the death is reported as COVID-19 related.

 

EU health care system is not for profit.
Doctors are not compensated directly for treating C19.

 

This chart is not statistically valid, the chart should show excess deaths numbers.
Since there is no standards in reporting COVID-19 death, the charts are meaningless.

 

What, EU health care system, but you know there is no EU health care system, don't you ?

Where do you come up with BS like this.

Do you know that German health insurances have made Billions in profit.

Doctors do not directly get compensated, what kinde BS is that?

 

Which chart ?

 

What BS is that, they do not get counted, if C19 was not the direct cause for the death. My county has 3 death from C19 and one death with C19. The Coroner reports it on the death certificate and that's how they get counted.