COVID-19 isn't the flu; we didn't test and quarantine when it started, so now we need to "flatten the curve"

I’ve seen several people compare COVID-19 to the flu, often accompanied with bad information, mostly downplaying the severity of this crisis, and brushing off the absolute necessity of dramatically reducing our contact with each other.

Unlike the flu, noone has resistance or immunity to any strain of COVID-19 yet, which is one reason it’s spreading very fast. It’s also several times deadlier than the flu. The flu kills about 0.1% of those it infects. The best estimates, so far, of the rate of death for COVID-19 are between 0.7% and 3.5%. The flu kills tens of thousands in the US each year, in spite of widespread resistance. Without aggressively and preemptively quarantining ourselves, COVID-19 is expected to infect half the population. Given the average rate people die from this disease, if left to infect half the US or more, over a million people could die from it in the next year. The flu is no joke. COVID-19 is even worse, and therefore needs to be taken very seriously. The faster we respond, the fewer people will be infected and die, and the better care those who are infected will get from hospitals, since there are a finite amount of resources available at any hospital.

Italy’s a worst case scenario for hospital overload, given how fast COVID-19 was allowed to spread. They didn’t contain it quickly enough, so now their health system is severely overloaded. The World Health Organization rated their health system as the second most capable in the world, yet now in many places there are more than twice the number of critically-ill people than hospital beds available. Only a fraction of those infected are receiving the care they need. Containment and quarantine procedures have been even slower here in the US, and the WHO ranks our health system as 37th. We are grossly unprepared for an Italy-level outbreak.

If we had begun testing and quarantining when we should have, we might not have to resort to so many closures, cancelations, and quarantines. As a best case example, even though it’s literally a city (meaning there are a lot of people in a relatively small amount of space), Hong Kong did everything as well as possible, so very few people have been infected so far, and their hospitals aren’t strained. As soon as the virus was announced, and it was known to have originated from a particular province in China, they began testing and quarantining everyone who had recently traveled in from Hubei province, and tried locating everyone who had come into contact with them, and quarantined them as well. The people of Hong Kong began self-quarantining immediately, too, and the Hong Kong government eventually issued strict quarantine rules. Because of that, there are still fewer than 150 confirmed cases of COVID-19 infections in the country, and infections of all communicable diseases have dropped. Very few people will die from this disease there, even though cities are one of the places most at risk for mass infection. Here, instead, the White House refused to do more than contain the spread, for weeks after a containment strategy was useful, and even refused to test and quarantine dozens of infected or likely-infected people traveling in from known infected areas, so now the infection is likely everywhere in the country, and we need to take extreme measures to contain the spread.

There are several actions we, communally, can take right now to reduce the spread of COVID-19. The most important one is simply reducing how much we’re around other people, especially large groups of people. And when we do need to go out (as most of us have to for work—at least until Congress is able to pass a bill guaranteeing paid sick leave, if not also rent relief), we should wear a mask (obtain one if you don’t have any yet), use appropriate hand sanitizer after touching things, and wash our hands very well whenever possible.

Doing these will “flatten the curve” from a sharp and large spike of infections, to a longer but smoother hill of infections, ultimately:

  • reducing the total number of people who get infected, and therefore are subject to lasting harm (there are reports of permanent lung damage), or death

  • giving hospitals a better chance to respond adequately, by having to deal with fewer patients at a time

  • giving labs more time to develop a vaccine or cure, further reducing transmission, harm, and death

We’re all in this together.

"How the Senate Paved the Way for Coronavirus Profiteering, And How Congress Could Undo It"

Poignantly relevant to the current presidential primary…

Ryan Grim and Aída Chávez reporting in The Intercept:

…The public puts in the money, and private companies keep whatever profits they can command. But it wasn’t always that way. Before 1995, drug companies were required to sell drugs funded with public money at a reasonable price. Under the Clinton administration, that changed.

In the 1994 midterms, the Republican Revolution, built largely around a reaction to Bill Clinton’s attempt to reform the health care system, swept Democrats out of Congress. On its heels, in April 1995, the Clinton administration capitulated to pharmaceutical industry pressure and rescinded the longstanding “reasonable pricing” rule.

…

The move was controversial, and a House member from Vermont, independent Bernie Sanders, offered an amendment to reinstate the rule. It failed on a largely party-line vote, 242-180.

Then in 2000, Sanders authored and passed a bipartisan amendment in the House to reimpose the “reasonable pricing” rule. In the Senate, a similar measure was pushed by the late Paul Wellstone of Minnesota.

“Many in Congress find it hard to argue with Sanders’ line that ‘Americans must pay twice for life-saving drugs, first as taxpayers to develop the drug and then as consumers to pad pharmaceutical profits,’” Nature wrote at the time.

Then-Sen. Joe Biden of Delaware voted to table Wellstone’s amendment, and it was defeated 56-39.

Source: https://theintercept.com/2020/03/02/corona...

Medicare for All will create jobs, reduce our taxes, and save us trillions in tax $

Jason Lemon, writing about a couple recent studies in Newsweek:

A new analysis of the economic impact of a Medicare for All health care reform, like the signature policy proposal of Democratic presidential candidate Bernie Sanders, suggests that such a plan would not only increase wages for workers but also create additional jobs.

…

"The grain of truth in some of the claims is that, like any productivity improvement, the adoption of a reform like M4A would require the redeployment of workers from one sector (the health insurance and medical billing complex) to other sectors (mostly the delivery of health care)," he wrote. "But there is little in the M4A-induced redeployment of workers that would greatly stress the American labor market over and above the uncertainty and churn that characterizes this labor market every year."

…

…a study by researchers at Yale University, the University of Florida and the University of Maryland published in mid-February found that universal health care would actually save about $450 billion per year in health care costs. Additionally, it projected that a Medicare for All system would prevent at least 60,000 unnecessary deaths every year, as tens of millions of uninsured Americans would receive full health coverage under the system.

Source: https://www.newsweek.com/bernie-sanders-me...

Medicare for All is a necessity, and the clearest moral choice

Healthcare is a human right, and we should pay for it through progressive taxation, and make it free at point of service. By forcing people to pay at multiple points in the system, no matter how poor they may be, we doom emergency response.

@peterkrupa thinking out loud on Twitter about being tested for COVID-19:

Continued, via ThreadReader:

even if the cost of the covid-19 test is covered, what about related care? the first thing they do is test you for flu to rule it out. boom, that'll be $700, for nothing, because i don't care if i have flu or not. 

and then if i get the covid-19 test... what? oh good job, i've spent hundreds, possibly thousands of dollars of my own money to add a single data point to the body of public knowledge on this epidemic? fuck off, that's what i pay taxes for, i'm not doing this. 

to say nothing of the stigma so many workers with mild symptoms will face... the pressure to skip work and lose a paycheck, etc., which they won't do, because they have to pay rent. 

all the incentives in the US healthcare system are lined up AGAINST people voluntarily contributing to the public knowledge of what's going on with this outbreak. it's a disaster. 

"Trump’s Speech Shows He Has No Idea What to Do About the Coronavirus"

Trump’s gross negligence and incompetence are Constitutionally impeachable offenses.

Jonathan Chait covers the ignorance and incompetence in Trump’s address regarding the coronavirus outbreak, in New York magazine:

Trump’s speech had no mention of the central problem in the American response to the coronavirus, which is the lack of a functioning testing regime. Having falsely promised on Friday that everybody who currently wants a test can get one, Trump simply ignored the question altogether. At the moment, people who have symptoms do not know what they can do about it. The number is due to explode, and Trump offered them no guidance.

…

Even the nonsensical measure of the travel ban contains its own nonsensical exemption for the United Kingdom. Why Trump left out a country that has far more confirmed cases than many of the countries whose residents are banned, he did not say. Political affinity with its Prime Minister? A personal business stake for his European golf resorts, which are coincidentally located in exempted countries? No account was even offered.

Perhaps most astonishingly, the White House had to retract two policy announcements that Trump erroneously made either because he failed to read his text properly, or his speechwriters failed to describe his position. Trump announced his European travel ban would apply to “trade and cargo,” before the White House announced this was an error. Trump also told his audience, “I met with the leaders of health insurance industry who have agreed to waive all co-payments for coronavirus treatments, extend insurance coverage to these treatments and to prevent surprise medical billing.” The Insurance Industry quickly announced it had only agreed to cover testing, not treatment, for the coronavirus.

The cliche about Trump’s presidency is that it is malevolence tempered by incompetence. His haplessness would undermine his corruption and authoritarianism. But now, finally, the country faces a crisis in which Trump’s incompetence will not save us from him. His wholesale unfitness was on bright display from the Oval Office. It may be the most unsettling moment yet of this bleak era.

Source: https://nymag.com/intelligencer/2020/03/tr...

What to do if you get COVID-19

@smashingteacups, an RN, explains what to do if you contract the virus:

Via threadreader:

I know we’re all tired of hearing/talking about it, but one thing I HAVEN’T really seen going around is advice for what happens if you DO get coronavirus (many of us will), only advice for how to try to AVOID it. So as your friendly neighborhood RN, a wee thread: 

Things you should *actually* buy ahead of time (Erm, not sure what the obsession with toilet paper is?): Kleenex, Acetaminophen (Tylenol) in 350 mg tablets, Ibuprofen (Advil) in 200 mg tablets, Mucinex, Robitussin or DayQuil/NyQuil, whatever your cough medicine of choice is. 

If you don’t have a humidifier, that would also be a good thing to get. (You can also just turn the shower on hot and sit in the bathroom breathing in the steam). Also a good time to make a big batch of your favorite soup to freeze and have on hand. 

If you have a history of asthma and you have a prescription inhaler, make sure the one you have isn’t expired and refill it/get a new one if it is. 

You basically just want to prepare as though you know you’re going to get a nasty respiratory bug like bronchitis or pneumonia. You just have the foresight to know it’s coming. 

For symptom management, use the meds I mentioned. For a fever over 101, alternate Tylenol and Advil so you’re taking a dose of one or the other every 3 hours. Use both cough suppressants and expectorants (most cough meds have both). Drink a ton, hydrate hydrate. Rest lots. 

You should not be leaving your house except to go to the doctor, and if you do, wear a mask (regular is fine, you don’t need an N95). You DO NOT NEED TO GO TO THE ER unless you are having trouble breathing or your fever is very high and unmanaged with meds. 

90% of healthy adult cases thus far have been managed at home with basic rest/hydration/over-the-counter meds. We don’t want to clog the ERs unless you’re actually in distress. The hospital beds will be used for people who actively need oxygen/breathing treatments/IV fluids. 

If you have a pre-existing lung condition (COPD, emphysema, lung cancer) or are on immunosuppressants, now is a great time to talk to your PCP or specialist about what they would like you to do if you get sick. They might have plans to get you admitted and bypass the ER entirely. 

One major relief to you parents is that kids do VERY well with coronavirus— they usually bounce back in a few days, no one under 18 has died, and almost no kids have required hospitalization (unless they have a lung disease like CF). Just use pediatric dosing of the same meds. 

Source: https://twitter.com/smasheroteacups/status...