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Am I going to die? trying to keep things in perspective

#1 User is online   pilowsky 

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Posted 2020-March-06, 22:33

Disclaimer: what you are about to read has nothing and everything to do with bridge. It is based on my own views and research. It is my own opinion and you can take it for what it is worth. Here I will use China as the 'Canary in the mine' because they have had the most cases, the problem started there, and they have handled it as aggressively as possible.

There are a lot of 'statistics' floating about concerning coronavirus. It is being variously termed a 'pandemic', 'epidemic', disaster', and all sorts of other things. It is being managed in different nation-states by different people according to their different cultural norms. I grew up in several different countries and have experienced many different cultures so I have my own ideas about the merits or otherwise of these different methods - but that's another story.


One thing I am absolutely dispassionate about is data. The outbreak of this particular strain of coronavirus has sparked strange behaviour all over the world. In Australia, for example, everyone is buying vast quantities of toilet paper. I cannot understand why having a clean anus during an outbreak of an upper respiratory tract infection is a priority but a lot of people seem to think I'm a little odd.


So what do we know about coronavirus so far?


The current population of China is 1,437,555,827. Every year some die. The death rate (per 1000) hovers between 7.097 (2017) and 7.402 (2020). That's roughly (7.2/1000)*1,437,000,000 to give an approximate total number of deaths each year of 10,346,400. An approximate rate of (10346400*100/1,437,555,827) or 0.72% each year. As I write, a TOTAL of 3019 people have died with coronavirus as a diagnosis on their death certificate (according to this link, so I cannot vouch for its accuracy). This number includes people that died before January and after February. Here is another source: https://tinyurl.com/ucz85c9

So, yes people die IN PART from coronavirus infection. We do not know what their co-morbidities were. What we do know is that the death rate is much higher in the elderly. But even a cursory glance at the data will tell you that the death rate is high in the elderly from any cause. If you do NOT have a KNOWN pre-existing condition the death rate stands at 0.9%. Remember though that not everyone who appears 'healthy' is always completely healthy. Some people have undiagnosed pre-existing conditions.

Fact: 3019 deaths are attributed to coronavirus so far in China to date (this includes deaths from 2019, but let's include them in 2020 anyway). This would mean that the annualised total number of deaths for 2020 for the first two months of the year is 3019*6 = 18114. Remember this number could be increased or decreased by many variables; new mutations of the virus, reduced number of victims, improved treatment and so forth. It could be more, it could be less. Current data from China suggests that it will be less because the rate of increase is now slowing. Here is even better data from the BBC. I also note that the map from the BBC source shows that spread has occurred throughout China so that these data are likely to be reasonable. Perhaps the best current tool available comes from Johns Hopkins and is available here. It is an interactive map of coronavirus.


What does this mean to you and me? First, it means stop buying toilet paper.

Secondly, it means this: Of the ~10,000,000 people that die every year in China about 18,000 of these deaths MIGHT be attributed to coronavirus. This does NOT mean they died FROM coronavirus. In most cases, it means they reached the age of 70+; Saw wonderful and terrible things, perhaps played bridge, smoked or drank too much, fell in or out of love, argued endlessly about Acol vs SAYC; and then developed cardiovascular disease, cancer, cirrhosis, or some other pre-existing morbidity so that when a respiratory infection struck and reduced their oxygen-carrying capacity below a critical threshold they stopped breathing and died.

None of this is intended to minimise the tragedy or sadness that comes with the loss of a loved one - or any person. Many of us have experienced death first hand. For those of you that have not, I sincerely hope that you never have to. It is a terrible experience to be unable to provide help to someone in the form that they want it.


Before COVID-19, and before influenza, pneumonia was termed (in 1892 by the great Sir William Osler a British-Canadian-American who, with three others started Johns Hopkins) 'The old man's friend'. And, from another source, "Pneumonia is called the old man's friend because, left untreated, the sufferer often lapses into a state of reduced consciousness, slipping peacefully away in their sleep, giving a dignified end to a period of often considerable suffering."
non est deus ex machina; även maskiner behöver lite kärlek; Schämen sich Roboter, wenn sie lügen?
J'ai toujours misé sur l'étrange gentillesse des robots
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#2 User is offline   FelicityR 

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Posted 2020-March-07, 04:39

Both tabloid, broadsheet and online journalism have to sensationalise something. First Brexit, then Megxit, now Crexit (My husband's term for the absurd amount of absurd newspaper column inches devoted to what basically is a nasty strain of flu that will kill off a sizeable amount of the population who are elderly and/or have other medical conditions.)

Yes, we should all be concerned with coronavirus, but not disproportionately so. Flu kills thousands every year, not just in the UK but all around the world.

If Africa can deal with numerous Ebola outbreaks until they are brought under control, then many of the first world countries with their top notch medical facilities and isolation units and public awareness through social media should be able to do similarly.

We all just need to be more careful hygienically and take sensible precautions.

EDIT: Just read this article online this morning. At least The Guardian hasn't been so sucked into the mass (media) hysteria. Coronavirus will kill thousands but it's not the Black Death of 1348 - thankfully...

https://www.msn.com/...red/ar-BB10RvyV
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#3 User is offline   cherdano 

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Posted 2020-March-07, 15:25

I think your post is rather misguided, pillowsky.

I agree it is reassuring that Chinese measures were so effective at reducing the effect of new infections. But first of all, these were some extreme measures, slowing down the economy to a standstill, putting an entire province, with a population a more than double that of Australia, under quarantine. Even if those measures were 100% effective, they'd still be worth preparing for, and they'd have a dramatic effect on the world-wide economy if a major economy were forced to act similarly.

Second, other countries seem react extremely incompetent even though they had a chance to prepare. I don't like overlapping with the longest-running WC thread, but the reaction by the US federal and local governments so far has been an absolute utterly horrible despicable irresponsible *****-show.

Third, the death rate of coronavirus is hard to know at this point; estimates vary between 0.5% and 4%, all much higher than influenza or similar. If spread of the virus can't be stopped, and half the population gets sick, that's a lot more deaths than the natural death rate!

Fourth, the impact of the number of people needing intensive care on the health system could be immense. Currently, the ICU admissions in Italy due to coronavirus are doubling every 2.6 days. Doesn't take very advanced math to figure out that it won't take long until every hospital will be overwhelmed.

Finally, having argued about ACOL vs SAYC is not a fullfilled life!! ;)
The easiest way to count losers is to line up the people who talk about loser count, and count them. -Kieran Dyke
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#4 User is online   kenberg 

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Posted 2020-March-07, 21:22

View Postpilowsky, on 2020-March-06, 22:33, said:



I like to choose my friends on my own. Having encountered pneumonia twice, first in 1944 and then in 2019, I am not planning on a further get together. But to each his own, far be it from me to criticize another person's choice of friends.

Ken
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#5 User is online   pilowsky 

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Posted 2020-March-07, 22:33

What we want and what we get are not always the same thing. I also had pneumonia twice (once when I was 16). And, no doubt like you, other problems, I agree - it's not a competition (mastersicknesspoints!). I sit now in a small room with a slight cough, writing, thinking, surrounded by computers and bridge books worried like everyone else. I'm just trying to throw some light into the darkness.
non est deus ex machina; även maskiner behöver lite kärlek; Schämen sich Roboter, wenn sie lügen?
J'ai toujours misé sur l'étrange gentillesse des robots
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#6 User is online   kenberg 

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Posted 2020-March-08, 06:36

View Postpilowsky, on 2020-March-07, 22:33, said:


What we want and what we get are not always the same thing. I also had pneumonia twice (once when I was 16). And, no doubt like you, other problems, I agree - it's not a competition (mastersicknesspoints!). I sit now in a small room with a slight cough, writing, thinking, surrounded by computers and bridge books worried like everyone else. I'm just trying to throw some light into the darkness.


It's useful to discuss such matters, and I think useful to think about the various levels of responsibility. My wife and I are retired. We had lunch with friends in a crowded restaurant yesterday and nobody was much worried. We are less likely now than a month ago to buy plane tickets, partly because if we bought them for, say, a flight six weeks from now I think it is very hard to say just what the situation will be then. But this is just us watching out for ourselves. Suppose we still had young kids. Would I be comfortable having them run off unsupervised to the local playground? For where I live, for right now, yes, I think so. If I lived in Seattle? Maybe not. Actually, probably not.

Then there are people with professional responsibilities, but not directly related to the virus. My older daughter travels a fair amount, internationally,, some places better than others, for work. Recently they cancelled one of her trips. I believe the thinking was something like "Well, it would probably be ok, but there is email, there is skype or zoom or whatever, do we really have to fly around?" If flight is needed, that's one thing, if it is optional, that's another.

And then there are the people who have responsibilities concerning containment. I won't go on too much there. For us, in this country, I wish someone else were president. I am not saying D instead of R, I am saying someone other than Donald Trump. Today is Sunday, but if Donald Trump told me it is Sunday I would become less confident that it is so. Enough said of that.
Ken
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#7 User is offline   Winstonm 

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Posted 2020-March-08, 10:16

I think it is way too early to be discounting the dangers or lack thereof for this species of coronavirus. I have seen but cannot confirm that the CDC in the US is now suggesting PPE precautions for airborne transmission. If accurate, that would make transmission of the virus as easy as measles.
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#8 User is online   pilowsky 

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Posted 2020-March-08, 14:05

Obviously danger should not be 'discounted'. Read the post more carefully. Nowhere did I say anything about whether or not catching coronavirus was or was not dangerous. This is the same advice that I gave to my children about looking both ways before crossing the road. The point of the post, and a key thing missing from some of the conversations elsewhere, is perspective. In mathematics and epidemiology, this perspective is known as an 'age-specific mortality rate' for which you need an accurate numerator and denominator. This is not 'advanced mathematics' - it's simple and important. Otherwise, you cannot assess the risk or 'danger' properly. I focussed on China because when you look at the data, the disease strike rate appears to be levelling out. NOT spiralling out of control. I strongly urge you not to say things that you cannot confirm - you might mislead people. By the way, unlike you, coronavirus is a 'strain' or a 'type', not a species. Here is the link about the different types of coronaviruses from the CDC https://www.cdc.gov/...irus/types.html.
non est deus ex machina; även maskiner behöver lite kärlek; Schämen sich Roboter, wenn sie lügen?
J'ai toujours misé sur l'étrange gentillesse des robots
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#9 User is offline   barmar 

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Posted 2020-March-08, 14:51

It's true that most of the people who have died from this were elderly and in poor health, so they didn't have very long to live to begin with. But if they had common conditions of the elderly, they were probably treating them, and perhaps had a number of years left. The virus turned out to be a "last straw" that totally overwhelmed them, cancelling out whatever treatments they were using for their existing conditions, turning years into weeks.

I don't think anyone expects this to be comparable to the Black Death, but it's not too unreasonable to compare it to the 1918 Spanish Flu pandemic. Luckily, medical science has advanced tremendously in the century since then -- viruses hadn't even been discovered at the time, and treatment was almost medieval.

There are also secondary effects. I heard this morning about a hospital that quarantined 40 practicioners who had contacted a patient with COVID-19. So these people are not available to treat other patients, let alone coronavirus. This is clearly not sustainable -- people may die not because they have the virus, but because they couldn't get effective treatment for whatever they have.

#10 User is online   pilowsky 

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Posted 2020-March-08, 15:29

That's a very important point. The same thing happens when any disaster occurs. Entire books are devoted to this topic and disaster preparedness is a significant component of health professional training. Here is one link. It is said that for physicians, things go wrong in hours, for surgeons, in minutes and for anaesthesiologists in seconds. A disaster is defined as an occurrence where the normal resources available to the professional are overwhelmed. Health professionals train for many hours to cope with these eventualities as best they can. To make a silly Bridge analogy, a disaster is like a five-nil trump split: very unexpected things do happen, you train for them and cope as best you can. Unfortunately, the nature of a disaster is such that even the best-laid plans will sometimes not be effective.
non est deus ex machina; även maskiner behöver lite kärlek; Schämen sich Roboter, wenn sie lügen?
J'ai toujours misé sur l'étrange gentillesse des robots
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