A DOctor's perspective on the COVID 19

I was sent this by a friend who is an older Doctor:

A quick apology was given that mortality rates were the main statistic used, but it still makes you wonder why things are so messed up right now given the following stats:

As of 3/27/20 at 1p.m.

COVID 19
Worldwide--577,660 cases
26,448 deaths

U.S. - 94,425 cases
1,429 deaths

This makes the death rate 1.5% in the US and the Doctor went on to say that it is actually is lower because the "deaths" included people who died of other causes like car accidents or other medical problems but tested + for COVID 19 at autopsy or hospital.

In New York ( which is the hardest US hit city the death rate was 1.1%)


Per the CDC:

2017/2018

in the US Flu hospitalized 810,000 and killed 61,000 which makes it 42.7 times more lethal so far than COVID 19)


Per the Medical Publication - The Lancet (12/13/19)

Flu kills 291,000 - 646,000 per year world-wide

2017 Malaria killed 435,000 world-wide


Per the CDC:

In the US--

Smoking killed 480,000 LAST YEAR including 41,000 from second-hand smoke,

Alcohol killed 88,000 every year from 2006 - 2010,

Last year 19,510 were murdered in the US

47,173 died from suicide in the US,

40,992 died from sepsis in the US,

38,800 died in traffic accidents in the US.

Again, there may be facts we are not being told, but the response to this crisis seems unprecedented .

Hope this brings some perspective though, and hope calm thoughtful minds prevail.

Tough to know where to start here. First and foremost though you are comparing full year statistics of mostly avoidable things with fairly stable death rates to a virus that has been around in the US for about 2 months and is growing exponentially. Two days ago 268 people died of the virus. Yesterday 401 died. Today it'll probably top 500. Tomorrow what'll it be?

It's true roughly 40,000 people die per year in car accidents. That's 100 per day. If that were doubling every three or 4 days days though, you can bet your bottom dollar folks would be very concerned about cars.

If you don't want to die from smoking, don't smoke.

If you don't want to die from Alcohol, don't drink.

Avoiding COVID-19 is not so simple.

Hopefully this thing will just go away. Hopefully it'll stop spreading exponentially. Hopefully hospitals won't get swamped. Hopefully the number dying daily will start to decline. Hope though, is not a strategy.

Stay safe sir!

Comparisons to things like auto deaths and smoking are invalid. Auto deaths don’t spread or grow at a great rate. And in a parallel to sheltering in place to slow the spread of the coronavirus, there are a host of things we do to reduce auto deaths--traffic laws, signage, stop lights, mandatory seatbelts, airbags, safety glass, other technology, etc.

Smoking is a choice. Drinking is a choice.

There’s so much misinterpretation with what you posted and JPurdue made a great initial dissection.

You say he’s a “doctor.” So is my mom but you better cal 911 if she’s in the room and someone loses consciousness.

Is he an MD? DVM possibly? PhD?

These comparisons to things like car accidents are downright comical.

Wash your hands and be smart about who you’re around in the meantime.

Stay safe,

JB

Edited.... you beat me to it tallgrass

The most important thing was the flu deaths as they are in the same category as covid.
I agree the test don’t matter.
But I agree with the point he is making which is disastrous over reaction.

The flu kills more people, but with a much lower death rate. Of everybody infected by the flu, less than .01% die from it. It’s FAR less lethal than Covid-19. People really need to stop comparing the 2. And these kinds of posts/email chain serve no purpose other than to make people think this is no big deal, and in turn will put themselves at risk. After all a “doctor” said it’s not even that bad.

The person who posted it was a emergency room physician in the DFW metroplex.
I’m assuming the point was, that there are a lot of things that kill us that there have been and are a number of things that have and do cause deaths in the population to a much greater degree than we see with the Covid virus that don’t and haven’t resulted in the behaviors we see now.
However I plan on trying hard to avoid getting sick

This and great post OP, a little realism as opposed to panic monkey posts

Massive overreaction that will make a few people much richer and a lot of folks much poorer. For some, that is also a choice, like smoking or drinking.

The comparison to the flu is stupid, and irresponsible. Not fear mongering but theres no comparison yet. Most people with covid get sent home without diagnosis. The flu rarely goes undiagnosed because test are easily available. The real reason I say theres no comparison is because the testing is vastly different. When covid test are as readily available as flu test then comparisons can be made. Until test are available we are all only guessing at the real numbers, although I think the experts can probably get close

For the good of the collective remain in your safe space until released.

Well said.
The folks who continue to downplay this pandemic are living in a bubble that will burst soon.
Comparing causes of death as if that somehow lessens the seriousness of this virus is foolish.
Today the first infant died.
A month ago everyone thought only the elderly and people with preexisting conditions were in serious danger. Obviously that's been proven wrong.

The more we test the lower the death rate. Initially they were only testing those admitted to a hospital. There are far more walking around with it and not even aware.

I don't downplay the pandemic. If you are in the high risk pool get away from everyone. Isolate yourself. You have a 1 in 6 chance of dying. Treating everyone the same is ridiculous and our economy cannot sustain such folly.

Except that none of the things you posted have as high of a mortality rate as Coronavirus currently has. So none of them are causing deaths to a greater degree than Covid-19.

You don’t get it. You can’t only put the high risk away. The number of infected people would be so astronomical without what we are currently doing that the medical system would collapse and we would end up in a far worse economical state by the time it was over. Our current course of action is the best course of action to actually make a dent in the spread, and maintain some semblance of an economy.

It’s not the death toll that really matters in how this effects us. It’s in the number of people who would need medical assistance. If you put the high risk population away, and the other 70% of the population got vivid within 2 weeks of each other, we would be in FAR worse shape than we are now.

I'm not sure it's been proven wrong

17 year old with no prior medical issues died this week in LA. Several people in the 50s who were otherwise healthy have died. An infant has died. Middle aged people are requiring medical assistance in hospitals, and are on ventilators. It’s not just the 80 year olds with emphysema who are struggling.

OK. The collective has spoken. I have a layoff list ready to go. I'll let them know on Monday. I will abide by the collective rules.

I'll learn to be callous to the youngs and disregard their future. All hail the doctors. Screw the economists. What do they know anyway?

Not taking a side, just pointing this out.
Original post (4) hours ago:
94,425 cases, 1429 deaths

Information just now from John Hopkins University:
119,748 cases, 1991 deaths, 921 recovered

4 hours!

What do you think would happen to the economy is half of Americans needed hospitals and doctors at the same time? The economy would die completely. You couldn’t treat 400 million Americans at once. You act like the people whole are getting this just stay home with a cold until they are better. That is not the case for most of them, but even if it was, would you expect people who were sick to come to work anyways? If we go back to no quarantines, and take our chances, it’s a near certainty that we would be in worse shape than we are now.

So, let’s say we do it your way. How do you treat 400,000,000 Americans at the same time?

How long are you willing to stay in National lock-down? Give a timeline and what victory looks like.

3.5 million out of work and we toss them $1,200 for being a good sport. Give a timeline and exit strategy.

Sounds like most of the experts are saying May 1st or so we should be far enough ahead of it to start getting back to normal rules. We should have infrastructure in place by then the keep up. I think 5 more weeks of this would do less harm than ending it today and letting everybody get sick at one time. I think our current situation with the lockdowns might cause irreparable damage. I feel confident removing restrictions 100% destroys the economy. I think too many people think letting us all go back to work will save the economy. I think it holds a higher risk of destroying it.

I answered your question, answer mine. How do we treat everybody if we let 4/5 people catch it within the next 2 weeks?

Your chicken little “the sky is falling” posts/ threads do nothing other than to cause more stupid people to panic. Who is doing a greater disservice? The OP, or you?

There is a great model in this article near the bottom. If you don't like the NYT I understand that, don't read a word in the article. It's the model at the bottom that's highly informative. It lets you adjust all the variables from R0 to hospitalization rate to how long we stay under "shelter in place." Adjust those how you see fit and then it'll show you how many get hospitalized and how many die. All models are wrong, but some models are useful.

https://www.nytimes.com/interactive...p-reopen-america.html?auth=linked-google

And the models run on data, which we need more of, which means testing, testing, testing. And the article states what I said earlier, "It is a false choice to say that we must accept the deaths of senior citizens to keep small businesses going."

I don't disagree there at all TG. They need aggressive testing of COVID-19, they need aggressive testing for the antibodies to see who's had it and has recovered. They also need large random samples of both so we can statistically nail down exactly what the situation is. The main driver in that model is R0, it matters far more than any other variable. We need to figure that out.

At my local Walmart yesterday I was amazed, flabbergasted, astounded, dismayed and utterly dumbfounded to see that only 3 other people besides myself were wearing mask and gloves. One older gentleman made a home made mask but at least he was trying. There were many couples with 3-4 kids roaming the isles and touching everything. I understand that mask and gloves aren't readily available but you don't have to take your whole family shopping with you. I get the impression that many think " oh, that won't happen to me ". Well it has and will. I was also semi-shocked that the employees working the deli weren't wearing mask or gloves.
Maybe I'm just over reacting.

I've been making a once per week grocery run. I wear an N95 and latex gloves. Today I was the only person in the store with a mask. It's not clear to me how much this PPE actually helps, but I've got to believe it offers at least some protection or doctors wouldn't wear them. I really hope this whole thing is over blown, but I plan to take as few chances as possible until we know for sure.

As an FYI, when I get back to the truck I put my mask in a paper bag. I let it sit in there for 72 hours. Then during the week when I get a sunny day I bake it in the sun for 2 hours per side. UV light kills the virus. I have 10 masks, but using this method, I think I can keep reusing the masks for this sort of thing indefinitely. Call me crazy, but I thought I'd share my method for those interested. Stay safe!

First off, dont be childish. There is Always a monetary value on life. If only 1000 people were going to die would we shut the economy down? Of course not. Secondly, whats really happening? I think we are being lied to. H1n1 killed a lot more and what does testing do to save anyone? Your either sick or not sick.

Who has heard that the hardest hit and most deaths are people who are taking Vivid and Advil?

They will catch it anyway. It has a couple week head start on the wizards who are tracking it. They show up just in time to put on the toe tags.

Removing restrictions would have 99% of those who catch it recover in two to three weeks. The "Herd" would have immunity against the next cycle.

I thought all the science guys were for Darwin's law...until they decide to fight it.

I think some people like staying home. The media says there are no underlying conditions.

I notice folks with little fat in the fire love the lock down.

When you have family member or close friend gets it that is when your perspective will really change.

That's why you're not a medical doctor or an epidemiologist.

lotta nastiness goin round

03/28/2020 07:07 pm
The confirmed cases are growing about 1000 per hour right now. Any reason to be concerned?

How is provide actual data being chicken little? A lot of guys here are lying to themselves to keep from realizing the magnitude of all of this.

Guys, of course the numbers are growing. They told us that. It will keep growing no matter what is done for at least a week. Its science. Then it should strart to drop. Its not the zombie apocalypse so chill.

What's the RO of this virus? Zero way to know whether cases will drop without knowing that.

Judging from what I saw at the grocery store today I'm highly skeptical this is going to slow down anytime soon.

There’s a reason for that Gig. Masks are for the sick people. It’s so you don’t infect others with YOUR germs. If you’re sick, you should be at home. That’s not to say there’s not a group at Walmart that might open mouth sneeze on you but Covid 19 has to be in a droplet. You can’t breathe it in like the measles or a true aerosol contagion.

If you see someone walking around with a mask on it’s really only for one of three reasons:

1) You’re sick
2) You’re uneducated regarding the specifics of the virus
3) You need it as a reminder to not touch your face

Other great choices might be that you’re Chinese or just making a fashion statement. That’s why the social distancing works. Your snot, saliva, etc leaves the area when you do. Other viruses don’t play so nice.

Stay safe folks,
JB

P.S. Before you post a link where someone says it’s an aerosol, check Medline for peer reviewed literature to back up the claim.

Im not a. Entomologists but they say it will continue to rise regardless. We are just flattening the curve.
So by tuesday you will see the numbers go up dramatically

Why are people saying it has only been here 2 months? That is lie.

I personally know 1 person and have heard of several others that had an unknown virus 4 or 5 months ago.

Long before tests were available.

The folks wearing masks and gloves need to be sure to decon the packages you bought at the store before you put them up at home.

Are you this hysterical about all things in life?

The infant tested positive for the virus, but it will be Tuesday or Wednesday before they actually know the cause of death. Might want to tap the brakes there.

Tell me, specifically, how said “unknown virus” test was confirmed? I’ve yet to hear of that unknown virus test.

The German Institute of Virology that developed the first assay to test for the novel Coronavirus did so in mid-January 2020 which is actually the same time the guy from California brought the virus home from Wuhan.

Unless you know a lot of people from Wuhan then there’s no way your buddy had this particular virus. It’s been in the US almost exactly two months like others have said.

If you have evidence otherwise, let’s have a look.

I had an unknown virus that almost killed me in 2012. Using your logic, Covvid was here then!

Yes, the numbers will grow. Along this thread, there has been some discussion about the number of deaths, and the death rate. All of these are our current best-of-care managed outcomes using a healthcare system that can absorb the punch. Soon, it will become overwhelmed in certain areas and no longer be able to save the percentage of cases as it is doing right now. Whatever that percentage is, however you calculate it, the reality is it will get worse simply from lack of care.

Without flattening the infection rate, more regions will saturate and begin to track higher deaths per 1000 cases. On March 28, we had 411 new deaths. That number has been doubling every 3 days. The curve track says March 31 will have ~822 deaths in a single day. April 3 it will likely hit ~3200 NEW deaths PER day. Unchecked, that won't slow down until it can't find enough new victims to infect. Lets run some "oh carp" (but unfortunately reasonable data tracking) numbers for the next 7 days.

March 28 total is 1707. Lets add: 1707 + 411 + 822 + 822 + 1644 + 1644 + 3288 + 3288 = ~10,338 total predicted death toll just 7 days away. That will be just getting started, sadly. In just two additional days it will likely top 20,000. Whatever the real numbers are, there will be an ever-worsening outcome from the lack of care. How long will you stay on board with "the loss is acceptable to keep the economy going" approach? Hint: the impact of this toll will be so shocking that the economy is going to be trashed if you choose the very option some of you believe will save it.

Yeah, uh huh.
That makes as much sense as saying the person tested positive for AIDS but it will be Tuesday or Wednesday before they actually know the cause of death.
The cause of death is most likely pneumonia, which the infant wouldn't have had if not for the virus.
If you died tomorrow following a car accident would you feel better if the LEO/medical examiner listed the cause of death as severe head trama?

Actually it does. They could have had a heart attack brought on by stress. Eventually we will have people who at death, test positive but the virus had nothing to do with how they died... it just happened to be present when they got in a car wreck.

Okay got it.
The infant was stressed out and had a heart attack.
The virus was irrelevant.

What matters is to find out. It wasn’t supposed to hurt the really young. So why is this one different? What comorbidities were in play?

Why are Americans between the ages of 20-44 accounting for a higher percentage (29%) of the hospitalizations than those in the 65-84 (25%) age group? Many questions don't have answers at this time and may never have answers.

Are you? I don't think medical doctors or an epidemiologist care about the economy or the destruction they are doing.

Yeah, but some of you all continue to ignore those killed or injured by the drunk drivers or drivers texting and etc.. Those innocent people did not have a "choice". I suspect the overall number of these innocent people getting killed from drunks, the flu, cancer, and all those other things the past decade and future ones will far exceed these COVID-19 deaths.

The end mathematical result can not be ignored - a moderate amount of deaths each year for many years from drunks and etc or a large number in a short period of time because of a virus is the contextual argument.

I guess it depends on what you are most "scared" of on a personal level.

Lots of scientists are working trying to figure this out. You are probably right, but the reality is they do not know for sure yet. This article says WHO doesn't know for sure and accuses them of being irresponsible telling folks the virus cannot be aerosolized. This virus is brand new. Until we know for sure for sure, I plan to keep wearing N95 masks on grocery runs. I know you are no dummy, but I take exception to calling someone uneducated who wears a mask.

https://www.npr.org/2020/03/28/8232...-on-coronavirus-transmission-through-air

Are you also sanitizing the toilet paper you hoarded?

You’re correct. It’s everyone’s personal choice how they choose to stay safe in these crazy times.

At first they were carefully rationing those to hospital workers where aerosols are generated routinely but I can assure you that if I was up at a hospital I’d be wearing one.

We all need to take precautions so I’ll happily retract my statement.

According to CNN article the average age of deaths in Italy is 78 years old.

No need to retract the statement. You are probably right. I very much appreciate your highly informed fact sharing and opinions on our situation. It's much needed on this site!

A question for some of those who know the science and are not just speculating. Does flattening the curve reduce the number who get the virus or does it just spread it out so that those who have it will be able to get into the hospital if needed? I know I am not very well informed about the details, but it seems to me that it doesn't really reduce the number who get it, but increases their chances of survival by giving them access to medical care which they may not otherwise be able to get.

I tried washing mine with hot water before I used it. Sure is hard to get back on the roll.

In theory it does not reduce the number who get it, it only spreads it out over time. That said, I think there is a chance that buying time will help science come up with solutions that could reduce the total number infected.

https://www.livescience.com/coronavirus-can-spread-as-an-aerosol.html

The novel coronavirus SARS-CoV-2 can survive in the air for several hours in fine particles known as aerosols, according to preliminary research.

The coronavirus, which causes the respiratory infection COVID-19, can be detected up to 3 hours after aerosolization and can infect cells throughout that time period, the study authors found. The study, first posted March 10 on the preprint database medRxiv, is still preliminary, because it has not undergone extensive peer-review. The authors did receive comments from one prospective scientific journal, and posted an updated version of the study on March 13 reflecting the revisions.

And just like that, all the folks who said "All lives matter" decided the stock market mattered more.

So no peer review Hancock? I wonder why not?

Because it was only published 2 weeks ago Dr.?

Even if it does not change the number of people who get infected, it will save lives because the healthcare system won't be overwhelmed. That's the whole idea.

So you want to go ahead and get the coronavirus hoping you can recover at home but knowing that you could end up in a hospital where 440,000 die every year from medical errors?
Makes perfect sense.

That would be one way to look at it but we’d have to ignore 98% of the other information available to us and that’s hard to do.

Lol I have some rolls if you run out, you can pick them up from me down the road at HC while I'm fishing there this week.

CDC doesn't seem as certain as you do.

Mode of transmission: Early reports suggest person-to-person transmission most commonly happens during close exposure to a person infected with COVID-19, primarily via respiratory droplets produced when the infected person coughs or sneezes. Droplets can land in the mouths, noses, or eyes of people who are nearby or possibly be inhaled into the lungs of those within close proximity. The contribution of small respirable particles, sometimes called aerosols or droplet nuclei, to close proximity transmission is currently uncertain. However, airborne transmission from person-to-person over long distances is unlikely.

I’m not sure how we disagree. That’s exactly what I’ve read and believe. The NEJM article you referenced earlier will never withstand scientific scrutiny because it doesn’t mimic anything found in nature. There model was from data generated subjecting particles to jet collision nebulizers and yes, some suspended for three hours. It begs the question though..... How many jet collision nebulizers do you come in contact with? Read the critiques from their colleagues and yes..... in as little as two weeks.

We disagree on calling something that is relatively new an absolute and that people taking precautions on the unknown\uncertain\unlikely are 'uneducated'.

My boat is in the shop. Come by my dock and pick me up!

Here’s an interesting summary from a lot of different sources. I think there’s some crossover in the definitions of an airborne virus vs being an aerosol.

https://www.statnews.com/2020/03/16/coronavirus-can-become-aerosol-doesnt-mean-doomed/

We should all form our own conclusions from this but I stand by what I’ve posted. This thing only gets airborne in the most rare of circumstances (certain hospital settings) and wearing a mask in social settings is more to help you not spread your germs or not touch your face. If the Covid 19 hospital rooms test negative for airborne virus than surely Walmart is okay but I wouldn’t fault anyone for wearing a Hazmat suit to Wally World.

Stay safe gang. I’m headed to the lake to self isolate.

JB

Dr Bean,

Go and enjoy, and thank you for all of your advice, much appreciated at these trying times

You will get it unless you are lucky on the first wave. There's always a second wave coming. Instead of arguing with me why don't you listen to the rest of the experts conversation? I'd rather get it when I'm healthy enough to have a fighting chance. That part the fear-mongers keep ignoring.

My point is solid and spot on. You can't hide this out. They're only slowing the spread until enough death beds are available.

But even healthy people end up in the hospital with it and need serious medical care. What happens when otherwise healthy you gets it, and there aren’t enough hospital beds for you to get medical treatment, so they have to turn you away? Do you have a ventilator at home?

140,000+ people have recovered. That's good.

Sorry for being positive.

Do you? You might want to get one to stash in your saferoom. I really don't think you are listening to me. I don't live in fear. I'm not wired that way.

I don't care if I get it now although the gestapo of the OT says if I do I should not receive treatment. How bout dat!

https://www.foxnews.com/media/doctor-david-price-coronavirus