Jump to content

Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


InkaUtexas

Recommended Posts

16 minutes ago, Dahobbs said:

Well, we will find out if our measures have been effective in the next 10 days or so. You'll have your answer then. Of course, the next question, is whether we'll learn the right lesson or decide we overreacted. 

What do you think we'll learn in 10 days?  Data 3-4 weeks from now is more realistic IMO (per my prior post earlier today).  

Link to comment
Share on other sites

1 minute ago, Pato del Muerto said:

I’m assuming if elective surgeries have still been happening, that we have plenty of gloves, masks, gowns, disposable tool kits, and whatever else gets used during surgery, such that we can afford to burn them on nose jobs and such. 

Wife's system stopped them a few days ago over those questions.

Link to comment
Share on other sites

3 minutes ago, Pato del Muerto said:

Can I get an acronym legend please?

Sure

  • DRG - diagnostic related group (basically a bucket that determines how hospitals are paid for a stay)
  • LOS = length of stay (how long someone is in the facility, basically time between admission and discharge)
  • SNF = skilled nursing facility (what most people think of as a nursing home)
  • OR = Operating Room (where surgery happens)
  • LOC = Line of Credit
  • Like 2
Link to comment
Share on other sites

1 minute ago, Skipper said:

What do you think we'll learn in 10 days?  Data 3-4 weeks from now is more realistic IMO (per my prior post earlier today).  

I expect we'd start to see a flattening of the curve in 10 days. But, there may be additional lag due to expansion of testing. And, of course, you are right, we'll have more solid data in 3 to 4 weeks. 

Link to comment
Share on other sites

Uh oh

https://www.cnn.com/world/live-news/coronavirus-outbreak-03-16-20-intl-hnk/h_6e1f01640b115ad8c8c625f496fd06a5?fbclid=IwAR3KqemQjRrYDAZI1qr0FOQ5QNZq3Ry31J0yn7mBi6VyOelvYrFM--zECqA

Quote
21 hr 44 min ago

Pennsylvania closes all state liquor stores indefinitely

 

All Pennsylvania state liquor stores and licensee service centers will close indefinitely tomorrow at 9 p.m. ET, the Pennsylvania Liquor Control Board announced.

“This was a tremendously difficult decision to make, and we understand the disruption our store closures will have on consumers and licensees across the commonwealth,” Board Chairman Tim Holden said in a statement.

Holden continued:

“But in these uncertain and unprecedented times, the public health crisis and mitigation effort must take priority over the sale of wine and spirits, as the health and safety of our employees and communities is paramount.”

The liquor control board handles all beverage alcohol distribution in Pennsylvania, operating nearly 600 wine and spirits stores statewide. It licenses 20,000 alcohol producers, retailers, and handlers, according to the statement.

 

Link to comment
Share on other sites

2 minutes ago, ChiTownDoc said:

His email to me and the hospital systems. 

heh didn't realize you were the one that posted this. Was going to try to subscribe! 

Strata has some interesting products - last place I was was in the process of implementing their tools on the financial side. 

This is going to close a ton of rural facilities that are already just barely hanging on - Texas has lost 20 in the last 10 years - which is a damn shame.

It is going to be interesting to see how this impacts small(er) independent systems and smaller health systems (multi facility systems) over the next month or so. Going to see how far planning and preparation can get people and see who is good (or bad) at it. 

The financial scenarios are *not good* for a ton of smaller places, this is beyond just budgeting but how are you going to bring in cash and collect from patients if this continues for very long, which will crater those guys. 

It's going to really be tough out there. 

Link to comment
Share on other sites

4 minutes ago, Dahobbs said:

I expect we'd start to see a flattening of the curve in 10 days. But, there may be additional lag due to expansion of testing. And, of course, you are right, we'll have more solid data in 3 to 4 weeks. 

We are on a projection for 300 deaths/day in 10 days (Mar 27). 

20 deaths yesterday × 1.3^11 = 362 deaths. My model says 387.

We'll know by then if we will do better than that.

  • Like 1
Link to comment
Share on other sites

6 minutes ago, Cheeseweasel said:

Very Facebookie

naw, Strata is a legit company and what he is saying is legit. Ignore it if you want, but basically everything he said is accurate. I would be quite curious how many places are reaching out to bond holders to discuss their cash on hand covenants and to try and ask for a waiver for their next reporting period. 

OR's are the financial driver for a ton of places - and you generally aren't making a ton on trauma cases. "Elective" surgeries (vs emergent/urgent) are where the money is for a ton of places. So now you have the financial driver slowed way down (fewer cases) + places are going to have a hard time collecting (where are you spending your money if you are in the service industry - medical debt or rent?) and that combo is a double whammy almost everywhere. 

This is without considering what happens when healthcare workers - docs, APP's or nurses - get sick and can't come in and you still have to backfill with either folks on OT (more $ out the door) or with agency staff ($$$)

It's going to be a very tough Q2 for hospitals. 

Edited by NoName
  • Like 3
Link to comment
Share on other sites

4 minutes ago, NoName said:

heh didn't realize you were the one that posted this. Was going to try to subscribe! 

Strata has some interesting products - last place I was was in the process of implementing their tools on the financial side. 

This is going to close a ton of rural facilities that are already just barely hanging on - Texas has lost 20 in the last 10 years - which is a damn shame.

It is going to be interesting to see how this impacts small(er) independent systems and smaller health systems (multi facility systems) over the next month or so. Going to see how far planning and preparation can get people and see who is good (or bad) at it. 

The financial scenarios are *not good* for a ton of smaller places, this is beyond just budgeting but how are you going to bring in cash and collect from patients if this continues for very long, which will crater those guys. 

It's going to really be tough out there. 

I’m sure the insurance companies will be on top of it, and paying promptly. 

Link to comment
Share on other sites

Just now, Dahobbs said:

I expect we'd start to see a flattening of the curve in 10 days. But, there may be additional lag due to expansion of testing. And, of course, you are right, we'll have more solid data in 3 to 4 weeks. 

10 days is probably a best case scenario from simply getting testing at scale and that may still be optimistic.   Then you take into account a 4-7 day (average) incubation period, mild symptoms at first so almost certainly a lag between onset of symptoms until obtaining a test (assuming wider availability) then a lag in obtaining/publishing results, my best guess is data isn't even worth really paying attention to for a couple of weeks then we really start analyzing and looking for flattening as we approach weeks 3 into 4.  This is why some people I talked to that are putting this modified shutdown at 3 weeks max are being overly optimistic.  If data starts looking good week 3 they won't want to immediately open things back up.

I'm calling my shot at Monday April 20th as the day CDC guidelines are loosened (maybe back up to no more than 50 and restaurants opening up at half capacity).   Obviously purely a guess. We should start a pool.

  • Like 2
Link to comment
Share on other sites

2 minutes ago, JBJ said:

We are on a projection for 300 deaths/day in 10 days (Mar 27). 

20 deaths yesterday × 1.3^11 = 362 deaths. My model says 387.

We'll know by then if we will do better than that.

Most of the March 27 dead are already infected, right?  Or would get infected around now?

Link to comment
Share on other sites

2 minutes ago, Pato del Muerto said:

Most of the March 27 dead are already infected, right?  Or would get infected around now?

Yeah.  I think Skipper is right about the results lagging the response by 2 weeks or more.  It just sucks to think about.

Edited by JBJ
Link to comment
Share on other sites

Just now, Pato del Muerto said:

Most of the March 27 dead are already infected, right?  Or would get infected around now?

March 27 dead have already been sick for a while.   Need to find the estimate but it's something like average of 3 weeks from first symptoms to death.  If infected today you are still in very early mild stage on 3/27.   

Link to comment
Share on other sites

3 minutes ago, Skipper said:

This is why some people I talked to that are putting this modified shutdown at 3 weeks max are being overly optimistic.  If data starts looking good week 3 they won't want to immediately open things back up.

We can't shut everything down forever. Deaths and overcrowded hospitals or not, at some point we have to ensure the economy doesn't go past a point of no return. 

  • Like 1
Link to comment
Share on other sites

2 minutes ago, Skipper said:

10 days is probably a best case scenario from simply getting testing at scale and that may still be optimistic.   Then you take into account a 4-7 day (average) incubation period, mild symptoms at first so almost certainly a lag between onset of symptoms until obtaining a test (assuming wider availability) then a lag in obtaining/publishing results, my best guess is data isn't even worth really paying attention to for a couple of weeks then we really start analyzing and looking for flattening as we approach weeks 3 into 4.  This is why some people I talked to that are putting this modified shutdown at 3 weeks max are being overly optimistic.  If data starts looking good week 3 they won't want to immediately open things back up.

I'm calling my shot at Monday April 20th as the day CDC guidelines are loosened (maybe back up to no more than 50 and restaurants opening up at half capacity).   Obviously purely a guess. We should start a pool.

What we don’t know is when the death total flatten out, then what happens next. China figures are dubious, Korea didn’t have enough deaths to be relevant and who knows with Iran. 
Italy:

3/17  345

3/16  349

3/15  368

Link to comment
Share on other sites

Just now, Skipper said:

March 27 dead have already been sick for a while.   Need to find the estimate but it's something like average of 3 weeks from first symptoms to death.  If infected today you are still in very early mild stage on 3/27.   

Right, so measures enacted in the last couple days will have little or no effect on hospitalization and death 2 weeks from now. The variables are all tied to healthcare. Staffing, beds, ppe, etc. 

Link to comment
Share on other sites

9 minutes ago, NoName said:

naw, Strata is a legit company and what he is saying is legit. Ignore it if you want, but basically everything he said is accurate. I would be quite curious how many places are reaching out to bond holders to discuss their cash on hand covenants and to try and ask for a waiver for their next reporting period. 

OR's are the financial driver for a ton of places - and you generally aren't making a ton on trauma cases. "Elective" surgeries (vs emergent/urgent) are where the money is for a ton of places. So now you have the financial driver slowed way down (fewer cases) + places are going to have a hard time collecting (where are you spending your money if you are in the service industry - medical debt or rent?) and that combo is a double whammy almost everywhere. 

This is without considering what happens when healthcare workers - docs, APP's or nurses - get sick and can't come in and you still have to backfill with either folks on OT (more $ out the door) or with agency staff ($$$)

It's going to be a very tough Q2 for hospitals. 

Very informative.  Just this morning I was thinking of industries aside from hospitals which would be coming out ahead during this whole thing.  Yet, it never even occurred to me ORs are the financial lifeline for most hospitals and what we’re about to see across the country is very trauma-heavy.  

Amazing how seemingly every industry will be harmed.  

Link to comment
Share on other sites

4 minutes ago, Pato del Muerto said:

Right, so measures enacted in the last couple days will have little or no effect on hospitalization and death 2 weeks from now. The variables are all tied to healthcare. Staffing, beds, ppe, etc. 

It should have a significant impact on hospitalization and deaths 4 to 6 weeks from now though.

Link to comment
Share on other sites

All y’all talking about deaths per day understand those people didn’t actually die that day in most cases. It’s the trickle out of reporting typically on deaths over the last 2-7 days.

So there is some noise even in that statistic associated with timing of reporting.

Carry on with the maths.

Link to comment
Share on other sites

10 minutes ago, Pato del Muerto said:

Most of the March 27 dead are already infected, right?  Or would get infected around now?

Yeah, that window starts with last weekend more or less. At least, it was a significant cross-exposure event for enough people that it let the spread continue more quickly with the secondary infections centering around late march

Link to comment
Share on other sites

1 hour ago, Eastwood said:

It only took 2 days trapped in the house to realize how being able to go out and grab something real quick was seriously taken for granted. If I feel like a certain beer, food, or item, I go out and get it. Not anymore. Now, I have to go in and consciously focus on not touching anything I don't have to, keeping my hands off my face, keeping my distance from people, getting the item, sanitize the item when I get home, wash my hands, and then have a small nagging worry in the back of my head if that was the time I went out and brought it home.

It doesn't take up a whole lot of my head space, but enough to not make trips worth it. My power supply for my PC absolutely died yesterday right when the work day started. Ordered a new one from Best Buy instead of Altex because Best Buy was closer. The parking lot was half full and people are just walking around the store browsing. Not there for any other reason, which is asinine at this point. Go there to pick it up and wait in line at the very end of the line area to make room for the person at the counter. Person is clueless and walks away to talk on the phone about what he needs to pick up. I get waved up, I'm ready with everything I need, and the dude who just got out of line walks up and gets literally shoulder to shoulder with me. Just complete idiocy. And those people, who have zero disregard for what is going on in the world right now, are everywhere.

The point is: stay home unless absolutely necessary. The quicker we all do that, the quicker all of this is over with. I work from home and needed that power supply. If I didn't need it, I wouldn't have gone out there. I immediately regretted doing so the moment that goober decided he wanted to be at the counter the same time as me. One sneeze right there is all it would take. Avoid idiots. Stay home.

There is a smaller Buccee's in my neighborhood in Greatwood, of which I have been a very frequent customer for the past 4-5 years since we first moved here. 

Two days ago I just unthinkingly went in there and got me a soda and ordered my usual sandwich for lunch and as I was standing in the checkout line I realized that the whole place is full of a constantly rotating cast of people from all classes and social strata from everywhere in the area... and there is no way to know what germs are being passed all around inside that place. Scared the heck out of me. 

I paid for my stuff and left and resolved not to go back inside there for at least 6 months. 

Link to comment
Share on other sites

Last Monday (3/9) the 4-yr-old had a low fever. Tues it spiked to 103 with diarrhea. Got it back down with meds. Stayed in the low 99s until Friday when it was gone. 6-yr-old started a fever with diarrhea on Friday, got up tp 102, then down to normal by Sunday. Wife started having diarrhea with no fever yesterday. I have it today.

 

Wife got an email from the school nurse that a kid in the school had been diagnosed with Shigella so that's probably what we've been dealing with. Kids aren't always careful about handwashing and we've been having a good time learning how to do it right and using hand sanitizer after every bathroom visit.

 

4-yr-old had her 4-yr immunizations delayed at her dr appt well-check because of the fever and is supposed to go in Thurs to do them. As of now they want her to still come in.

 

 

Link to comment
Share on other sites

12 minutes ago, JBJ said:

Yeah.  I think Skipper is right about the results lagging the response by 2 weeks or more.  It just sucks to think about.

Doubt I can find it now, for the link, but some epidemiologist wrote last week that today's numbers are a snapshot of 9 days ago infection rate.

Link to comment
Share on other sites

7 minutes ago, ztejas said:

We can't shut everything down forever. Deaths and overcrowded hospitals or not, at some point we have to ensure the economy doesn't go past a point of no return. 

Hence my prediction of initial loosening a little over 1 month from now.  And I'm guessing it will be a slow loosening of the standards.  Those thinking this is a 2 week thing are living in a fantasy world IMO.  The numbers are going to look horrible 2 weeks from now but that's all going to be infections/severe cases from the weeks leading up to this.  The reason this disease is such a problem is because it doesn't have a short incubation period with quick onset of symptoms like the flu.  If everyone was knocked on their ass with high fever 2-3 days after becoming infected it would be a lot less problematic.  

Link to comment
Share on other sites

  • hayden_horn changed the title to Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


×
×
  • Create New...