> “No one is qualified to discuss this sort of news at all,” Haririchi said
This almost made me laugh out loud, tragic though any deaths and disablement are. It does seem to get to the heart of the matter, and not just in Iran either.
Sounds like a slightly mangled quote - I think he's saying that no-one outside of the ministry has access to the Coronavirus mortality figures, so the lawmaker is presumably pulling the figures out of his butt.
The immediate sentence following gp’s out of context quote:
> adding that lawmakers have no access to coronavirus statics and could be mixing figures on deaths related to other diseases like the flu with the new virus, which first emerged in China in December.
So, not necessarily out of his butt, could be mixed up.
In any case, 12 dead out of 61 (a quickly rising figure) is already terrible.
The 61 is almost certainly rising much more quickly than the 12. Many cases don't get counted early on, so the fatality rate at this stage is overstated and largely meaningless. Same thing happened everywhere else with a suddenly-noticed largeish outbreak.
> Same thing happened everywhere else with a suddenly-noticed largeish outbreak.
I’ve been paying pretty close attention since early on and nowhere else with a suddenly-noticed largish outbreak had a temporary death rate remotely close to 20%. Not even in Wuhan. In fact 12 deaths currently ranks #3 on the global death count chart when each Chinese province is counted as a separate entity, and any comparable entity has an order of magnitude more cases at least.
Also, it was 8 deaths out of 43 yesterday, so 61 isn’t growing faster than 12.
Without more info, I blame this on shitty medical treatment. 20% roughly matches the percentage of severe cases elsewhere.
I’ve seen that terrible argument with “closed figures” a couple of times now but don’t really have the time or patience to write a long rebuttal.
That, and the fact that the post you responded to is comparing apples to apples and does not rely on the validity of any one fatality rate estimation methodology.
This would be a fantastic time for Iran to drop it's bs sponsorship of Hezbollah, Assad, Shiite militias, Houthi rebels, work with the US, and save lives both there and in the rest of the world.
Why is that the bar for preventing a pandemic? I guess it makes sense if you're generally okay with sanctions: killing off a population slowly to force unrest. However, I just don't see why this is the requirement for something that won't be regionally restricted. It's cutting your nose to spite your face.
A zero-sum game is a zero-sum game is a zero-sum game. If it spreads, it's likely to do so to other MidEast countries and Africa. And while, in an ideal world, the US would like to be friends with everybody, they are cozying up to China. If that happens, the old adage goes: We had to destroy the village in order to save it.
Leftists love to virtue signal with Iranophilia. Meanwhile, Iranians literally chant "death to America" every day in their streets and in their national parliament. I've never seen a crowd of thousands of Americans chanting death to any nation, including Iran.
Politics operates at a level beyond the common senses of public.
Sure that would be great but if USA offers aid, it could be viewed as an insult as if they are unable to handle things themselves and with that - pride comes into play (often does with country politics).
If Iran asks for help, they would probably have the USA low down on that asking list and again, pride also comes into play.
But let's put all that aside and ask the question: what could the USA do that Iran could not do currently in this situation?
> what could the USA do that Iran could not do currently in this situation?
Promise not to punish anyone for breaking sanctions if they sell medical supplies to Iran.
Edit: Seems like the US will only consider that if they can use it to attack the Iranian government: https://www.nytimes.com/2020/01/30/us/politics/us-iran-sanct... ("opened access to medicine for cancer and organ transplant patients", I guess other medicine is still subject to sanctions)
No, it would be a terrible one. Geopolitical power is a zero-sum game. From the perspective of the US/Israel/Saudi Arabia: the more dead Iranians, the better.
Right, but you are not the U.S. government. When I think about it, the statement could be expanded. If we are strictly dealing with geopolitical power, we can replace "Iranians" with "non-Americans" and it will still be correct: a world in which all non-Americans are dead will be a world of great geopolitical power for the Americans.
yet you are getting downvoted for a legitimate concern. either iranian government trolls are lurking and downvoting or the 5th column in the us which takes side with iran just to spite trump and republicans.
What are you talking about. The media is reporting whats happening as it gets it, if Iran's media is being silenced that got nothing to do with the virus itself and more about the control of panic.
> We also need the immediate relaxation of sanctions around this on Iran
I'm pretty sure the WHO couldn't give a rats about US sanctions when it comes to human rights and world health.
> The media is reporting whats happening as it gets it,
No they simply are not. Should I be watching Fox?
Iran has 12 people dead atm. This is unheard of in any country other than China. We have known this high toll for 3 days. Last Friday is was thought to be 9! Who has headlined this?
CNN has Italy and South Korea as it's headlines right now and today, they pail in comparison to Iran.
This is not a high toll, this is out of control spread of the disease. I feel like this is a clown world. Korea and Italy are not the same as what's going on in Iran.
It's taken this latest report of 50, to make any headway in the news.
As to the WHO not caring I doubt that, but it's still not the point, companies need to be able to free allow supplies in. I don't know what sanctions are in place but companies for instance that supply gasses like oxygen need to know they are allowed to export it to Iran and how do they receive funds?
Why does this article not mention the sanctions if the media is on top of this?
The NY Times app has consistently had the outbreak in one of the top 2-3 spots for weeks now. Their live updates listed right now show official figures from Iran, Italy, and South Korea, as well as news about China and global markets reacting to the news. I’ve been closely watching both the NYT and the more panic-driven subreddits for a month now and I haven’t seen anything of substance that the NYT has missed. They usually lag by minutes to as much as a day, likely because they’re actually fact-checking instead of just mashing the post button like Reddit.
If you’re looking for large news organizations to freak out about every little unsubstantiated rumor or crackpot theory that circulates the web, then I don’t know what to tell you. Except that you’re willfully ignoring the 90% of the time those crackpot ideas turn out to be wrong and spreading them to billions of people would do far more harm than good, especially compared to just waiting to get the facts straight.
The reason the sanctions are not mentioned is because the sanctions have no effect here - all medical supplies are allowed.
The problem is a regime which is utterly indifferent to its populace and intentionally delayed disease response for political purposes. As one report has it:
"Iranian officials have remained outwardly calm. An official with the Health Ministry told Javan newspaper that the majority of those who have been infected with the coronavirus do not need special care and will recover, adding that only 3% of those infected are likely to die from the virus."[0]
"Only" 3% => 2.4 million people if entire population is eventually infected. If "only" 5% are eventually infected that's 120,000 people.
That level of criminal indifference is an argument for stricter sanctions against the regime eventually...
Some further context on the discrepancy between this figure and official figures:
> The Iranian government has denied trying to cover up the full extent of the coronavirus outbreak after reports suggested that the death toll from the disease was more than four times higher than official figures claim.
> On Monday, a lawmaker from Qom – a Shia holy city 120 km (75 miles) south of the capital Tehran which has seen a cluster of cases – accused Iran’s health minister of “lying” about the scale of the outbreak.
> According to the semi-official ILNA news agency, which is close to reformists, the lawmaker, Ahmad Amirabadi Farahani, said there had been “50 deaths” from the coronavirus in Qom alone.
> “The rest of the media have not published this figure, but we prefer not to censor what concerns the coronavirus because people’s lives are in danger,” ILNA editor Fatemeh Madiani told Agence France-Presse (AFP).
> But the country’s deputy health minister rejected the report. In a news conference broadcast live on state television, Iraj Harirchi said that 12 people had died from the coronavirus and 66 had been infected.
> “I categorically deny this information,” said Iraj Harirchi.
> “This is not the time for political confrontations. The coronavirus is a national problem,” he added.
Is it time to start treating this like a big deal yet? Their first case was three weeks ago and 50 deaf already? This virus is unprecedented and it is only responsible for individuals with means to start preparing. No reason to wait for the government to tell you to do so. Plus each person that does it early is one less for the potential store rush.
Everyone who had history in high school has historical information about this. There have been numerous plagues throughout history with higher infectivity, higher lethality, and both relatively and absolutely higher death counts. Don't put the burden of looking up simple and easily findable information on other posters when you can easily google it yourself.
There is a lot of misinformation out there too, and not everyone has the skills to "easily Google" for something outside of their sphere of competence. It would be helpful if those who do have hard facts to share do so directly. That's much more efficient than hoping that everyone will simply discover the facts as a matter of course.
…and many of these would have infectivity and lethality similar to coronavirus if same standard of sanitary, containment effort and intensive care was available then.
> Everyone who had history in high school has historical information about this
I don't recall any such information.
There's people on this site of all different ages, who grew up in all sorts of different places. How do you know what their high-school history covered?
In my school, history was mandatory in the first year of high-school, and I think it might have been in the second year as well. Hardly anyone did it as a subject for
the remainder of their high-school years.
Needless to say, the content taught in those first 1-2 years barely even scratched the surface of historical topics.
Regarding your second paragraph, I never said that I’d never heard the terms. I said that they weren’t covered in high school history for me.
There’s so many topics that can be covered in high-school history classes, and so little actual aggregate time for those classes - why would you expect those topics be amongst them?
Also, why do you think that criticising such history classes, and the country they're in, somehow negates the point i made?
You should read about R0 and CFR estimates for recent publications our of China. Conservative estimates put this well past Spanish Flu territory. That doesn't even get into the various rumors coming from the weaker papers.
There are less than 100,000 ICU beds in the United States. ≈15% of cases in healthy individuals require critical care. With current R0 it will not take long to fill those beds and experience the chaos that is bring down the Chinese Empire. Their GDP is shut down. Why do you think stocks tanked 4% today? At the very least we're already talking the start of a potential global recession because of a virus.
If nothing else this is shaping up to be an event which will define a generation before it's all over.
This is already at least as bad as the Spanish Flu in terms of R0 and CFR. Yes, unprecedented.
Spanish Flu has an R0 of about 2[1]. Current published estimates for 2019-ncov are 2.3-3.8 for this paper [1] and there's another floating around which gets as high as 6-8.
Look at the rate of spread in Korea and Italy recently. Where numbers aren't being cooked like in China. 3 weeks from first infection to Nationwide pandemic. Unprecedented.
This is the first time something so virulent has struck humans living with this kind of density. This will have massive ramifications for global geopolitics because it will show the weakness of centralizing production in third world countries and becoming dependent. Rumors abound in china about elites, professors, researchers, lawyers speaking out against the government. 2500 of them allegedly signed a petition demanding free speech. This virus will test the resilience and ingenuity of the human race.
I don’t know in what way it isn’t treated as a big deal. There are daily updates from every country; the news covers the epidemic in detail; China quarantined tens of millions of people; major trade shows are being cancelled. Unless you literally mean bubonic-plague levels of panic, I’m not sure what else remains to be done in places where the disease has not yet fully spread.
I personally know experts in virology who are not working on a vaccine for this virus.
Until all labs, equipment and experts are reassigned from whatever they are doing to finding a vaccine or cure, humanity is far from 'maximum response'.
Assuming that world leaders are working in the best interests of their populations, that leads me to believe that whatever these experts and labs are currently studying is considered more important than this. Or to say it another way, world leaders have decided the hundreds of millions of dollars necessary to persuade these experts and labs to switch to studying this virus isn't worth the money. Which means those leaders believe that either the virus won't hit pandemic levels, or if it does, the economic impact will be less than hundreds of millions of dollars.
What are your experts telling you about this virus?
Surely they are reading all the available literature that has been published, they would be poor experts if they weren’t keeping up with the hottest topic in their field in like forever.
You should get them to come here and do an informational, break down some of the more specialized technical information, about how the virus behaves, attacks, etc. clearing up any confusion the technically minded, lay virologists among us.
You realize there are other diseases right? There is a world of difference between thinking it's a big deal and "reassigning all labs equipments and experts from whatever they are doing to finding a vaccine or cure". This would stall progress on so many other important stuff that it would cause much more damage than it's trying to prevent.
As an example, there is currently the worst epidemic of dengue in South America's history right now. (3 million infected and 1500+ deaths in 2019). https://www.bbc.com/mundo/noticias-51496280
Every expert? There are other out breaks and issues happening now and could happen in the future.
From my minor lay person knowledge, every year there’s a decent sized (not in a good way of course) outbreak in Africa, South Asia, and/or more rarely, South America. If not multiple.
Why would you re-assign people working on those or other things that are serious?
I don’t want to put words into your mouth, but personally I know one person who essentially said because the African or South Asian issues are localized. He only cares if it’ll possibly affect him. Again not saying you are saying this.
What 50 dead means is, vastly larger numbers of mild infections being covered up or not reported. It doesn't mean it got deadly. It means they're lying how big it is.
On the contrary, it travels faster than Corona and is more lethal. And that's exactly why it isn't such a huge problem, a typical Ebola outbreak burns out so fast that it doesn't spread beyond the community it starts in.
If Ebola would ever start off in a major population center that would be an entirely different problem.
The turnouts were very low this time because they allowed only conservative candidates to run, they have enough ways to rig their elections they'll do #2 just for fun tho.
True that. The point is that the Iranian authorities knew in advance about the disease, yet underplayed it so that the already low turnout won't be lower.
Not only that, they kept regular civilian flights to China upto a few days ago while nearly everyone else was restricting flight.
I guess Iran is like the South Korea problem spread across the entire country. The vast majority of cases in South Korea are in a religious sect. For Iran mosques are places where so many are in close proximity.
There's a cluster in Singapore that spread at a church.
But what does it mean? In Berlin or Paris it could suddenly spread on the trains, or at a spectator sport event. Being secular isn't going to stop you from breathing in air that other people are breathing out.
Doesn't spread by air from all current evidence. Spreads by saliva and nasal fluid droplets.
In the churches in Singapore, it is thought that the spread happened from the congregation eating food from shared bowls after the service. Communion service in catholic churches is also a potential vector. There are two big church linked clusters in Singapore.
Langar in Sikh gurdwaras are probably less risky because generally cutlery and plates are not shared but best to be cautious about shared/buffet type setups. Public transport is considered relatively safer in Singapore especially as cleaning has been steeped up.
There's a story in Hong Kong about the whole big family getting it after sharing a traditional Chinese meal.
Its disappointing, China seemed a lot more open and transparent this time around compared to SARS. Unfortunately i still don't trust the numbers they publish.
not in the field, but transparency/non-transparency of china has very little to do with being able to effectively contain something with a 14 day incubation period that is spread through indirect contact.
We could have stopped it completely with total travel bans but the WHO advised against it because it could be damaging to the world economy.
Why is the WHO concerned about the economy? Well I have no idea. And is this virus going pandemic going to be more or less economically painful than the travel bans might have been? My guess would be we will feel significantly more pain from a pandemic.
You know what's serious? If the entire population is scared shitless and runs to the next hospital and overwhelms the system. This is a lot scarier than the actual infections.
I know nothing about the CDC, but of course any health care organization prepares for "something very serious" that comes on top of the existing flu cases, because hospitals are already at close to maximum capacity.
Don't you see that this is always a tradeoff? If the economy tanks, people lose their jobs, which could result in a lot more social unrest than if a virus spreads around the world.
I think it's tough to contain a virus like that with such a long incubation time. But the early efforts might have slowed the virus down somewhat at first, giving us more time to develop vaccines.
There's no tradeoff if you never actually trade, is there?
There's not actually any wise balance and other mumbo-jumbo fart-heads in the WTO like to spew out, if under no circumstance do you ban travelling or take any meaningful action.
It's just words for the idiots to feel secure while all it really matters is economic growth.
I'd love to be proven otherwise, but then, under what circumstances would WTO advice a full ban on travel to/from China?
Perhaps never?
There you have it.
Just words after the fact, rationalizing inaction to two year olds -- "there's nothing to worry about", "the chinese are taking outstanding measures", "maybe there's something to worry about, but mah economy", "perhaps its too late to contain this"
I find that argument fundamentally flawed. Travel bans are momentarily painful and the unrest is localized. The world economy would feel the pain but most nations would be spared.
Compare that to what might happen when this virus hits NYC. There will be a run on cash and groceries. People will stop commuting. Schools will close. Restaurants and shops will be empty. Now consider the same thing happening in Seoul, Berlin, London, San Francisco, etc. The economic impacts from this could be catastrophic.
And the most ironic thing is that if this truly does get out of hand we will get travel bans. Nations will close their borders. People will willingly (and forcefully) stop traveling via boat or air. We'll circle back to needing travel bans and the only price we'll have paid is millions of lives and a global economic catastrophe. All so that we could avoid some minor short term economic pain.
Travel bans were also advised against for another reason: People will always break the travel ban, and they will actively avoid law enforcement especially when they get sick, meaning that infections will spread worse and be harder to control than if you let people in but keep a track of them. Restrict and monitor is better than a ban.
It’s pretty difficult to cross the ocean by yourself. The only way for this virus to have infected Japan or the US is via plane or boat. Both could have been prevented.
What will be more damaging to Japans economy? Banning travel to and from China or dealing with widespread panic, disease, and death?
You restrict and monitor if the bans fail. Which is the only thing we can do now because the incompetent WHO blasted any country or person who suggested travel bans would help.
Xtra History has a good intro series on the 1918 pandemic. They liken it to trying to fight off an alien invasion. These things become that serious so quickly.
Around 99% of the patients developed a high temperature, while more than half experienced fatigue and a dry cough. About a third also experienced muscle pain and difficulty breathing.
Research from the Chinese Center for Disease Control suggests that around 80% of coronavirus cases are mild. Around 15% of patients have gotten severe cases, and 5% have become critically ill.
Here's how symptoms progress among typical patients:
- Day 1: Patients run a fever. They may also experience fatigue, muscle pain, and a dry cough. A small minority of them may have had diarrhea or nausea one to two days before.
- Day 5: Patients may have difficulty breathing — especially if they are older or have a preexisting health condition.
- Day 7: This is how long it takes, on average, before patients are admitted to a hospital, according to the Wuhan University study.
- Day 8: At this point, patients with severe cases (15%, according to the Chinese CDC) develop acute respiratory distress syndrome (ARDS), an illness that occurs when fluid builds up the lungs. ARDS is often fatal.
- Day 10: If patients have worsening symptoms, this is the time in the disease's progression when they're most likely to be admitted to the ICU. These patients probably have more abdominal pain and appetite loss than patients with milder cases. Only a small fraction die: The current fatality rate hovers around 2%.
- Day 17: On average, people who recover from the virus are discharged from the hospital after two-and-a-half weeks.
Are you aware if there is any data yet on what proportion of recoveries will experience lasting lung/other damage? For example, is the permanent lung damage seen so far (which I've only anecdotally read about, I must admit) mostly related to ARDS?
I don't think it is possible to derive any reliable facts from the data right now. Even if the patients who recovered from COVID-19 still find that there is something wrong with them, that could still go away in a week or a month or a year.
However, here is a tiny bit of information on the long-term effects of the 2003 SARS outbreak:
> A small percentage of patients had long-term effects from their illness, including depression or anxiety, cough, shortness of breath, chronic lung disease or kidney disease. However, most patients fully recovered.
Yes, I think you may be right. I did find this, on the long-term effects of ARDS, and the effects are frankly a bit scary. Whether you survive or not, ARDS is clearly something to be avoided.
Is that "day 1" before, after or during the 14 day incubation period that I keep seeing repeated? Do you have some good sources about the length of incubation?
The 14 day figure is more of a recommendation for the duration of quarantine, intended to cover incubation period in excess.
As a sample of a timeline that actually happened, you can check out the short paper about German cases reported in January[0].
It appears to have taken 3–6 days from infection until symptoms started, and subsequently 2–4 days until patients felt healthy again (no symptoms anymore, virus still detected in saliva).
Thanks! Based on that paper it seems likely that a vast number of people could have already been infected and simply have thought it was a "traditionally common" infection (common cold, for example).
That’s what it appears to be. This might complicate the situation for older patients or patients with complications, who would have more difficulties dealing with this infection relative to common cold or flu, especially if they get admitted to a hospital late.
While 2% is indeed the WHO's current official early estimate, it's still very early to give accurate numbers here.
https://www.worldometers.info/coronavirus/
Using the "closed cases" figures on this page (currently: 27892 closed cases, 25265 recovered, 2627 deaths), we get a fatality rate closer to 9.4%, but I've been monitoring this page for a while, and the fatality rate based on this calculation has improved a lot. For example, on 2020-02-10, the figures were 4376 closed cases, 3466 recovered, 910 deaths, resulting in a fatality rate of 20.8%. (https://web.archive.org/web/20200210100748/https://www.world... <3 archive.org)
There are multiple forces at play. On the one hand, as you note, it takes time for people to die, which could initially bias the fatality rate downward. On the other hand, a lot of milder cases will be missed entirely, which would bias the rate upward. My understanding is that the latter factor is considered more significant in the early stages of an epidemic like this.
World-o-meter isn't the definitive source for that information. Does the big counter at the top include the large number of people who contracted the disease, but never progressed past a mild stage, and so never reported it to their doctor?
The WHO number is based on more than just the known cases vs deaths tally.
> Does the big counter at the top include the large number of people who contracted the disease, but never progressed past a mild stage, and so never reported it to their doctor?
The big counter is based on official stats reported by the various countries and is equal to the numbers published by the WHO. Obviously, nobody knows the number of people who had it but didn't report it. You could do random sampling and get an estimate for the particular population that you tested, but let's forget about that for a moment.
The WHO's fatality estimate may or may not turn out correct at some point for the entire outbreak, but sadly there is no denying that the number isn't correct for the people who were tested positive a couple weeks ago, and the WHO published their estimate a couple weeks ago too.
> You could do random sampling and get an estimate for the particular population that you tested, but let's forget about that for a moment.
If there was some benefit to the disaster that was the Diamond Princess, I guess it was that we have a pretty good idea about the range of disease symptoms. The various evacuees too - living in quarantine till they get the disease or don't.
They are hosting preliminary research, case reports, commentary and discussion from qualified experts in the area, many of which are on the ground in affected areas.
> Stay vigilant, stay careful, but most importantly, do not spread mass hysteria and panic.
In the last month almost 1% of the current population of the earth quarantined in China [0].
What exactly worries you about mass hysteria and panic? Why would that be worse than what is likely to happen as Covid-19 spreads outside of China?
I'm all in favor of not overselling the danger; but this virus is a real concern. I mean, unless someone has a very good argument why Hubei are somehow special and it can't happen again elsewhere everyone should be stocking up on supplies in case they are caught in a serious quarantine. The actions taken don't seem to be stopping exponential growth of this virus; if anything all that seems to be actively measured is how good countries are at producing testing kits.
> Only a small fraction die: The current fatality rate hovers around 2%.
If 2% of the people I know died this year, that would be the worst disaster in my country in my lifetime.
>What exactly worries you about mass hysteria and panic? Why would that be worse than what is likely to happen as Covid-19 spreads outside of China?
Because then in addition to the damage caused by the outbreak, we will also have the additional often useless and counterproductive damage caused by hysteria and panic.
That is just understood as the hypothesis and the framing of the question. What is the nature of the useless and counterproductive damage caused by hysteria and panic? (I could speculate that it changes economic flows that upsets long term planning and so on, but I would like to hear the opinion of experts on the matter anyway).
>What is the nature of the useless and counterproductive damage caused by hysteria and panic?
Of the top of my head.
Hoarding of supplies causing shortages and harming people who actually need them right now. Progressing to health professionals lacking supplies (masks, etc.) due to shortages (and diverting of dedicated supplies). Unnecessary ER visits which stress the health system thus making it less able to react to an actual problem (as health professionals are tired and burned out). Stress and unnecessary interventions/ER visits increasing people's risk and exposure to existing diseases.
edit: That's not counting real panic which involves mobs with metaphorical pitchforks and the military in streets enforcing some semblance of order (with bullets).
Right, but stressing the importance of avoiding "hysteria and panic" is also extremely popular with authoritarian regimes justifying censorship and trying to cover up their own incompetence.
There was a window of opportunity during which this virus could have been contained. The Chinese dictatorship has squandered it in the name of "avoiding panic and hysteria".
Panic and hysteria should be avoided by being transparent, not by playing down the dangers or praising the efforts of an intransparent self-serving regime as the WHO has done from very early on.
'But' what? Would you characterise the OP as avoiding being transparent, or playing down the dangers? Is anyone here acting like an authoritarian regime, or is anyone here saying anything contrarian to your point?
>Would you characterise the OP as avoiding being transparent, or playing down the dangers?
Yes, I would indeed. gzer0's original wording, which has now been edited out (without comment), was:
"Stay vigilant, stay careful, but most importantly, do not spread mass hysteria and panic"
Now the wording was changed to:
"Stay vigilant, stay careful, but most importantly, do not spread false information."
I welcome the change, because saying that the most important thing in the face of danger is to avoid panic and hysteria is wrong and characteristic of authoritarian language.
The West has also squandered its opportunity in the name of “non-discrimination” and “political correctness”. The right (with hindsight) response would have been to ban all flights / arrivals from China / Asia, but I guess that’s wrong-speak in the age of “open borders” as the only non-Nazi political option.
I would suggest that being in favour of open borders for some purposes whilst closing borders in completely different circumstances for completely different reasons should be permissible even in our very polarised political climate.
What does non-discrimination and political correctness have to do with the white Americans that were evacuated from Wuhan lmao? And the ones that returned from China in general? Or for that matter, American citizens in general?
Also, the U.S. has banned flights to/from certain countries during certain times.
I also find it interesting that inside of the US, states are engaging in NIMBYism to keep evacuees from being quarantined. Alabama's senator boasted of this yesterday, and I believe there was a lawsuit or something in California blocking some patients from being quarantined at a particular location.
> Panic and hysteria should be avoided by being transparent, not by playing down the dangers or praising the efforts of an intransparent self-serving regime as the WHO has done from very early on.
Yes. And the way to avoid it is to switch communication strategies to inform the public without inciting panic. Also to recruit people into being part of the solution at the local level. This could just mean signing up to volunteer to deliver meals, or check on neighbors or just report all's clear if there's a lockdown. The more agency that you give to people, the less panic there is.
I found this article from two risk communications strategists, posted to the blog of a noted virologist, interesting:
Past Time to Tell the Public: “It Will Probably Go Pandemic, and We Should All Prepare Now”
> What exactly worries you about mass hysteria and panic? Why would that be worse than what is likely to happen as Covid-19 spreads outside of China?
Think houses getting torched because the inhabitants are suspected of having the virus. Judging from what happened in Ukraine, we're getting closer to that kind of hysteria.
In same situation in USA, government informed people, so conflict was resolved via court. In Ukraine, government kept peoples uniformed, then used armed police against people, despite the law.
So does Poland. Poland has >400 'suspect cases' as of right now, and strict protocol of testing only patients who have been to China/Wuhan. Despite this everything is fine make believe we had 2 hospitals disinfected yesterday, 'just in case' according to authorities, but still no tests. Whats more Poland doesnt even have tests available locally. Our hospitals were sending samples to Switzerland.
Ukraine simply doesnt test anyone, even suspected cases with direct Wuhan link.
> If 2% of the people I know died this year, that would be the worst disaster in my country in my lifetime.
Not trying to downplay the seriousness of this virus, but it's very unlikely to kill 2% of the people in any country — it kills (maybe, approximately) 2% of the people who are infected, but far less than 100% of the population in your country will ever be infected.
> far less than 100% of the population in your country will ever be infected
Do we have solid information to assert that? SARS and the flu spread from people who are exhibiting symptoms. This new virus is different in that regard, which seems like an open invitation to approach 100% infection rates.
I don’t know either way, but it certainly doesn’t seem unlikely that a solid majority could be infected.
There's a flu going around in The Netherlands right now, it progresses like this:
- Day 1: Fever, fatigue and muscle pain with a dry itchy cough.
- Day 2+: Nausea and diarrhea can be experienced as well as the first day symptoms.
It takes about a week for the worst of the symptoms to die down however the stomach ache, cough and light tiredness last weeks.
My entire family and most of my son's class at school has had it and they're all still recovering. My wife is, after 3 weeks, still really ill. Probably because she's working full time and breastfeeding.
This is what makes the Corona-virus hard: at the start the symptoms are extremely similar to existing flu. Unless the case is extremely severe most people won't see a doctor let alone a hospital.
Why are you letting your wife work, when she is not in good condition. You take up the work and let her take rest, and also make sure that she eats and sleeps well.
Give some good fruits and cook proper vegetarian dish.
Netherlands though, not the US. If they're anything like most of Europe then a doctors note is all you need to still be paid while sick more than 1-2 days.
I think it's even possible to get a sick leave from a business you own in some European countries.
But how about if you run the business on your own, and you're concerned that if you take two weeks off the business will lose many customers who won't come back?
(I was shocked when I saw the they put the name of the illness on the note. That's so far from my employers business that it should be illegal to even ask. Employees and consumers rights in Germany seem to be seriously limited.)
"(I was shocked when I saw the they put the name of the illness on the note. That's so far from my employers business that it should be illegal to even ask. Employees and consumers rights in Germany seem to be seriously limited.)"
You get multiple papers in Germany. The one without (!) diagnosis is for your employer.
You can buy insurance from it. It's generally there to cover you from being unable to work for a period of more than a week. So serious stuff.
As an employee the employer will have insurance but basically have to eat the cost of short sickness.
I'm a freelancer but I've chosen not to buy the insurance. It's very expensive and can survive on her income. I put the money I would have spent into a buffer.
It is an option (full pay, no black marks at work) for a lot of people. That was the setup for professionals in all large companies that I worked for and people would still come to work really sick and spread the good stuff around. Grrrr!
One of my colleagues literally apologized when he had to call out (with pneumonia) after coming in progressively more sick for a week. We have fully paid and (IMO) stigma-free sick leave, but nobody ever apologizes similarly for coming in sick and increasing the viral load of the office.
Not working while ill is a fundamental human right, and as such is implemented in all European jurisdictions. There are very, very few cases when you can't exercise this right.
Not wanting to is another issue though, but it's often irrational.
> Not working while ill is a fundamental human right, and as such is implemented in all European jurisdictions.
It's also implemented in all U.S. jurisdictions, for everyone except for prisoners: per the 13th Amendment, no-one not convicted of a crime can be forced to perform any work.
> Being sick means being unpaid, and many people cannot afford to go unpaid.
In Germany being sick means full payment by the employer for 6 weeks, after that you'll receive around 90% of your last net income by your healh insurance company for 72 weeks, after that slightly lower unemployment payments for another 12 month. So around 2.5 years of being sick are required until you're actually unpaid.
That's only for salaried employees. As a freelancer, you're generally out of luck AFAIK. (Unless you are a member of the Künstlersozialkasse or similar.)
I was surprised to find this downvoted, as it's a harsh fact of life for many people, but not the majority of people. I should have said "For some people, being sick means...". The gist of the argument still applies: It is incorrect to assume everyone can afford to take a month off work when they are sick.
I'm in a European juristiction - the UK. We have reasonable labour protections here. But they don't protect everyone.
If you are self-employed, then taking time off means going unpaid. It's that simple. Zero income. I have been in that position. Took a month off due to flu once (not the current flu). Lost 1 month income.
There is a government system called "Statutory Sick Pay" (SSP), but it is not paid to the self-employed, and if it did it would only start after a few weeks.
If you are a "casual" worker, then taking time off also means going unpaid because you don't have a contract of employment or regular hours to refer to. Sucks to be you, but it's harsh reality for many.
For salaried workers, the employer pays salary for a while. But it's time limited, depending on the employer. Some are more generous than others. The less generous will switch over to Statuory Sick Pay, which is not much money. It is rarely enough to cover rent or mortgage, for example, let alone food and bills.
A lot of people are self-employed, casual workers, or have household bills exceeding SSP. Taking a few weeks off due to sickness has a serious financial impact for those people, unfortunately, and it is wrong to assume everyone can afford to do so.
Coming from the UK, it shocked me to learn that you basically get full pay for two years of sickness in The Netherlands. The protection is so much better than the UK's system.
It can be abused though: I know of several cases where people are ill for two years, miracuously get better, work a month, then get ill for another two years.
Overall it's preferable to the UK situation.
Like you though I'm a freelancer; you earn more for less net work time so it's good.
> Like you though I'm a freelancer; you earn more for less net work time so it's good.
I do too, but it is important to recognise that many people earn a lot less when freelancing than a typical salary. There are a lot of very poorly paid "self-employed" in the UK.
I've known freelancers in the UK paid less than £3 an hour, legally because "self-employed". Think things like Uber drivers, data entry on a "per document" basis or article writing "per word".
It is tough for them.
For perspective, that is less than half the legal minimum wage, and they have no sick pay, maternity, pension or other worker protections.
I am genuinely surprised people on HN think zero pay on sick days is unusual. So I'll quote from a BBC article:
https://www.bbc.co.uk/news/uk-51738837
But TUC general secretary Frances O'Grady said two million workers do not earn enough to qualify.
Prospect union added that freelancers and self-employed people would continue to face "the dilemma of no pay or going to work when it may be putting their colleagues at risk".
Labour leader Jeremy Corbyn asked Mr Johnson if the sick pay announcement would help those currently not eligible for statutory sick pay - such as those on zero hours contracts, or self-employed people.
I agree. However it's not possible: she's a pharmacist and because of the flu they're both really busy and low staffed. As long as she can just about handle it she works.
They all get it every year anyway because they're constantly coming into contact with sick people so there's less benefit for staying at home.
Pharmacists clearly seem like a huge potential vector for disease transmission.
The pharmacy itself should have policies preventing sick employees from attending work and have generous paid sick leave.
We could reduce disease transmission and thus social cost dramatically if we reduced transmission in medical contexts (e.g. hospitals are one of the main places people GET sick -- from other patients).
It would ultimately save money if there was overstaffing requirements and stringent no sick staff allowed in any medical context.
The problem is that cost reduction is at a societal level while individual firms don't have the incentive to do this. But socialized healthcare systems should be able to solve this easily.
They do have generous sick leave, that's why there are so many people ill at the moment. Sure they could have more staff, but someone has to pay for that. In her situation her staffing levels are above the norms used by Den Haag (we put patient service above profit).
I really wish that the situation could be better but unfortunately the huge cuts made since the financial crisis have made that impossible.
It's Swine Flu. We have it in our country too.
Flu is ok. Swine Flu is bad. Corona is bad. Coinfection of Swine Flu + Corona is super bad because it causes HIV like symptoms, so it's better to be vaccinated against A H1N1 Flu, to worry about 1 virus only.
Regarding an uncontrolled outbreak (we can't just quarantine everyone, everywhere without secondary effects from economic collapse getting more deadly than the disease itself), the number I find myself speculating about most is how many would be dead or permanently harmed in absence of intensive care? Because no health system in the world would have the capacity to put more than about one in thousand people in intensive care. Even Hubei is still below 0.2% total known infections, surely in large parts thanks to measures that would be impossible to scale globally.
On the other hand diseases don’t reach 100% of the population on the same day. Quarantine has been surprisingly effective in China, though at significant economic cost. That seems to be a much larger concern than the capacity of heathcare systems.
If this becomes a true epidemic it’s going to be bad, but societies have been dealing with epidemics for a long time.
> On the other hand diseases don’t reach 100% of the population on the same day.
That's absolutely true, even in Wuhan the %age of infected people on the total population is relatively small, but much larger than the # of ICU beds that existed.
And the virus had a long time to spread around there before any countermeasures were taken.
Even so, ventilators and ICU beds are not normally all available either.
> Quarantine has been surprisingly effective in China, though at significant economic cost.
It would have been a lot more effective if they had done it sooner.
> That seems to be a much larger concern than the capacity of heathcare systems.
Yes, and I'm sure that at some level that's the right trade-off, I'm just not sure what that level is and whether or not we are already past it.
> If this becomes a true epidemic it’s going to be bad, but societies have been dealing with epidemics for a long time.
In Italy they went from 0 dead and a handful of cases to 7 dead and > 200 cases. Most of them are old people and people that were already ill.
Historically the way we deal with epidemics is by developing medication. That takes time and in the meantime the damage could be substantial.
> Historically the way we deal with epidemics is by developing medication.
Effective medication is a very recent thing. Variolation dates back to the 10th century and was moderately effective, but quarantine is thousands of years old. Avoiding cannibalism and thus prion diseases is also from antiquity, but that’s simply another type of avoidance.
> It would have been a lot more effective if they had done it sooner.
China startet radical measures after a rather low number of mystery lung issues. I really doubt that any other government would have taken decisive action much earlier. What would you expect, martial law whenever a doctor isn't quite sure about a diagnosis?
The initial silencing of the first public reports is very unfortunate and puts the government rightfully in a very bad light, but I'm not sure that it had any influence on the speed of countermeasure implementation at all. I see that more as a case of one part of a huge organisation not knowing what the other is doing, not as a government-wide attempt at ignoring the problem. The authoritarian version of a PR department still sending out denials while the rest of the company is already working on a fix (and too busy to rein in the PR department/thought police)
In the US, a 2 week stay in the hospital will cost you upwards of $50,000. Even if you have insurance, understand it will be a significant cost to you. If you’re uninsured like 20 million Americans or underinsured like 80 million, going to the hospital means automatic bankruptcy.
Every day our broken healthcare system will force many people to choose between all their families assets and getting care. This should not be a consideration, but often is.
If you are traveling to the US, please make sure you get as much travelers health insurance as possible.
It is my understand that it is highly unlikely an uninsured person would ever pay anything close to the billed "price." Same is true for insurance companies.
Edit: Some are telling me this isn't true, but what does a hospital have to gain from someone filing bankruptcy? Why would they charge such high prices that no one can afford? I would think that some money is better than no money.
Good God. I had a small surgery in Germany about 10 years ago that is usually outpatient, but I passed out afterwards, so the doctor had me admitted for overnight observation. Total bill for surgery, lab and the stay in a room with another American lady who was on bedrest with triplets (!!!): 1400 EUR, which my American insurer paid with absolutely no arguments. This was the full retail, premium “private patient” rate - most Germans wouldn’t have even seen a bill that size.
A friend in the US had the same procedure outpatient, and it was $6000, $1200 of which she was responsible for. On the upside, they gave her 30 Vicodin for the post-op pain and no follow-up about said opioids, where I only got a week's worth of Tramadol (much less potent) and a follow-up with my regular doc who wanted to know at what rate I was taking them. My friend was slightly tempted to sell her leftovers...
Bankruptcy results in them getting as much money from you as possible as well as funds from the government. Further, as most hospitals are local monopolies they have little incentive to change. It’s a win win for them as long as they can receive significant amounts of money.
Actual poor people are a slightly different story and often left alone fairly easily.
There are many complicated reasons that a hospital would charge more than people can afford. One factor is that it looks better on their balance sheet to have uncompensated medical costs. This is exactly why insurance companies never pay the full price, and why nobody pays the difference. It’s accounting magic to make hospitals etc look like nonprofits and claim subsidies.
That being said, there’s been a trend in the US recently, where hospitals have very aggressively gone after unpaid bills of the uninsured, because some administrators see it as money they’re leaving on the table. It’s more prevalent in rural areas, where there’s often only one hospital to go to, and consumers have no choice but to go to the hospital with a terrible reputation.
In some cases, they’ve convinced the judicial system to garnish the uninsured person’s wages, to get “their money back”. IMO it’s clearly illegal and it won’t last much longer, but yeah the system is crazy. :/
So what's your plan? Socialized medicine? I mean, it's working out so great for those Chinese folks, right?
Making everyone else pay for you is no better of a solution, it's just shifting the costs around someplace else, which honestly is selfish of you to decide how I should deploy my ever-dwindling supply of cash reserves. I have two kids to put through college but Bernie and all his Democrat pals want to confiscate as much of my money as possible to pay for someone else's stuff, probably the 20 million illegals who showed up here unannounced, or maybe just swindle the money the way Democrats have done for DECADES.
It's coming to the point where guys like me might as well take up arms against people like YOU and just put and end to it. Get my drift?
Just downvote comments you don't think add to the discussion. That's what the feature is for. It's not up to you to censor the comments section, and your comment is even less useful than the one you're replying to.
Don't insulate yourself from the reality of other people's opinions, because for every one comment you see, you can be assured there are many others not writing it, or on this site.
It's actually very informative, to me. Sorry you don't see it that way.
I agree with that, and saying that would be a better comment than just calling for something to be deleted. Explaining why something doesn't belong, or even just saying "this doesn't belong here", is better than a demand something be deleted.
Healthcare is not socialized in China, the best facilities are private, and the public ones are still paying (usually requiring proof that they will be able to pay before admitting patients). Quite often, they provide different levels of healthcare depending on how much the patient pays.
It's easy to think that China is run as a socialist country because there's "communist" in the name of the ruling party, but the truth is very far from that; in many aspects China is a ruthless capitalistic free-for-all society with less socialist policies than even the US.
> confiscate as much of my money as possible to pay for someone else's stuff
_You_ get healthcare as well. It's not just "someone else", it's you, your family, your friends, and everyone you care about. No one should go into a spiraling life of debt because they broke an arm or got sick at an inopportune time.
> So what's your plan? Socialized medicine? I mean, it's working out so great for those Chinese folks, right?
China has until recently had a less socialized healthcare system than the US. They've made massive strides towards trying to provide a universal system over the last few years, but they are still a developing country, so I'm not sure why you think comparing with China is a good idea, other than, I guess a knee jerk (and incorrect) assumption that it'd all be government run...
Meanwhile socialized healthcare systems are working out fantastically well for large parts of the developed world, but really the most important factor is universal healthcare - universal systems range from fully private multi-payer systems with some system for subsidizing those who can't pay, to fully socialized single payer systems.
What the vast majority of them have in common is that they result in far lower total healthcare spending than in the US thanks to actually regulating healthcare with the public in mind rather than insurers and healthcare providers. In fact, a large number of countries spend less total on healthcare per capita than US taxpayers pay towards Medicare and Medicaid alone, before you even factor in US private insurance.
Unrequested anecdata: my partner got a bad case of the flu (and epiglottis) a couple of years ago, and ended up spending 10 days in hospital - 7 in ICU, 3 on a normal ward. Total cost: $0.
Thanks Canada!
(Having said that, if you're visiting Canada you'll need to check your health coverage. Medical coverage is provided to Canadian residents, not just anyone who happens to be in Canada at the time.)
Before implying that Canada has the final answer to health care, note the other side of the tradeoff from a recent report published Dec 2019:
"Fraser Institute has—for over two decades—surveyed specialist physicians across 12 specialties and 10 provinces.
This edition of Waiting Your Turn indicates that, overall, waiting times for medically necessary treatment have increased since last year. Specialist physicians surveyed report a median waiting time of 20.9 weeks between referral from a general practitioner and receipt of treatment—longer than the wait of 19.8 weeks reported in 2018."
1. the Fraser institute is a right-wing think tank. They very much have an axe to grind here.
2. "medically necessary" does not tell you anything about the severity of illness or appropriateness of waiting. There are many medically necessary things for which it's okay to wait some time. In the Canadian system, things are dealt with at the level of urgency appropriate to the severity of the issue. Yes, it's not perfect, but it does result in generally better population-wide health outcomes in Canada than the US.
> the Fraser institute is a right-wing think tank.
That's very much an ad hominem fallacy, and unless you have specific evidence that they falsified the data in question, I'm just going to leave it at that (similarly to how you conclude that 'right wing' is enough of a reason to dismiss something). Last I checked, science doesn't care who you voted for. Once we start dismissing research based on the opinions of the researchers, we've essentially implemented thought crime. All research is motivated by prior opinion. We call it a hypothesis. Whether it happens to align with a political ideology doesn't invalidate it. If the research is somehow wrong, then there will be a way to disprove it through science. Using politics to argue against science isn't appropriate.
No, it would be an ad hominem if I said "the Fraser institute produced it, so you can safely line your bird cage with it". I didn't say that, I just pointed to the institution's well-known bias.
> Using politics to argue against science isn't appropriate.
Oh yeah, how dare I impugn non-peer reviewed "science" written by two non-PhD's, where 25% of the citations are to other non-peer reviewed reports written by the Fraser Institute and the others are random statscan links. This "science" is just a summary of responses to a questionnaire.
My argument still stands that Canadian health care should not be considered the final word in health care (which is not a very controversial opinion if we're being honest). I'll cite another report by the Wait Time Alliance, but I'll first quote their mission statement so we can rest assured that it won't have any taint of political bias:
> Mission Statement: WTA physicians are concerned over delayed access to health care for Canadians. We work collaboratively with our stakeholders to inform, advocate, and provide solutions to achieve timely, appropriate and equitable access to high-quality health care.
And now from the 2015 report itself (the most recent one):
> "Ontario reports that the maximum amount of
time that nine out of 10 patients with complex needs
spent to complete their ED visit and be admitted to the
hospital was 25.7 hours (June 2015). The maximum
amount of time that nine out of 10 patients with minor or
uncomplicated conditions stayed in the ED was 4 hours.
As outlined in previous WTA reports, many of the factors
responsible for the lengthy waits to be admitted to a
hospital bed are system-wide failures such as high
numbers of ALC patients and a lack of community-based
supports."
On primary care:
> Wait times are reported for each of the five regional
primary care networks in the province. The average wait
time for an appointment between January and March
2015 was 23 days, ranging from 0 to 72 days.
I can see a primary care doctor within 1-2 days here in the US. Even when I was on welfare, the wait times were no more than a few days.
So this report seems to be consistent with the one you were complaining about (which by the way was circulated and referenced widely by mainstream media). However, I see no evidence of "political bias" in this one so I hope you can accept that this isn't that controversial. These wait times are clear facts, not opinions. An opinion would be "Canada has the best health care system", which I am arguing against, citing facts.
> Before implying that Canada has the final answer to health care
You are the only person who's brought this up. I literally said "it's not perfect."
Here's what it comes down to. Population-wide health outcomes in Canada are certainly no worse than they are in the US. Arguably by a number of measures they're better. Health outcomes for the most economically-vulnerable segment of the population are much, much better in Canada. Nobody is bankrupted in Canada by medical care. It's the leading cause of bankruptcy in the US. Canada spends much less of its GDP per capita on healthcare than does the US. A large portion of the US is already covered by a patchwork-quilt national healthcare system.
Now whether you want to go with the Canadian system, or the UK's system, or the French system or the Swiss system - honestly I don't give a shit. People are dying because they can't afford to deal with the nightmare of a system here.
> Before implying that Canada has the final answer to health care
I provided details on a single instance of an interaction with the health system. Hence 'ancedata'. I made no claim that every interaction will have the same outcome.
> waiting times for medically necessary treatment have increased since last year
Do you have the data for wait times for other countries? And, I suppose, wait times of those in the US with and without private insurance?
If the healthcare industry could help cause coronavirus to spread in the USA, it would be worth billions. It would never happen, but the incentives happen to be very strange and I bet a movie could be made about a scenario like it
That number is still only for extremely at risk segments of the population, and the study has such a small sample size that it should be taken with large grains of salt.
...also important to remember that those who recover from severe symptoms (~10%) have permanently damaged lung function due to lesions that formed during infection.
Of closed cases (people that have recovered or died) the fatality rate is more like 10%. It's only 2% of total that have it, meaning a lot of people have neither recovered or died as it spreads and they're waiting to find out if they fall in the 10% or the other 90%.
Yes, the closed cases has been steadily dropping but remains well above 2% - however, we expect that number to be higher than the actual mortality rate while the infection is still spreading/growing, as recovering from the disease takes longer than dying from it.
What I find more concerning is that the current ratio of deaths to cases is 3%, which I would expect to be an underestimate. Hopefully this is due to under-reporting of the mild cases, but it does imply either a major under-reporting of active cases or a significantly higher mortality rate than has been estimated so far (most likely the former).
I would take that number with a grain of salt too, as there is a lot of asymmetry with how and when that data is reported. There may be a large number of "recovering" cases that are not completely closed yet but have essentially zero chance of death in the future. The definition of recovered seems open to interpretation while death is not, and so the deaths would have a more immediate reporting period, as well as a shorter average interval of time since infection started.
The WHO has come across as pretty incompetent in my opinion. We could have stopped this disease from spreading outside of China but the WHO consistently downplayed the severity and claimed travel bans were overkill and would be too damaging economically.
Now they’re saying it’s likely too late to contain the virus.
Well I wonder what will be more damaging to the economy? The proposed travel bans or the catastrophic effects of a worldwide pandemic? How many people will die in underdeveloped countries because the WHO didn’t act aggressively enough when they had a chance? If this hits Africa 10 million could die.
Do you remember the uproar and all the anti-vaccine sentiment after WHO was seen to "cry wolf" during the last H1N1 outbreak in 2014 or so?
That's probably the reason they were more careful this time. It's hard to know early on exactly how a disease will spread, and how dangerous it will turn out to be.
If the WHO is scared to be aggressive in their recommendations because of blowback six years ago then they are even more incompetent than I thought.
It’s not as if outbreaks like this happen often. It would be difficult for the WHO to be labeled as overreacting when they only get an opportunity to react once or twice a decade.
The fact that it’s hard to know how dangerous a disease will be is a reason to be extra careful, not the other way around. Not knowing how dangerous something is doesn’t mean we should blunder forward and hope for the best.
Anyone that trusts the WHO is a plank anyway. These weirdo globalist fuckers are probably connected to those responsible for its deployment. Don’t trust the WHO or the UN for a second.
I can see an argument for the WHO not being very good. But the end of your response to them being the ones also creating and pushing the virus in the first place...come on
There's people on this site of all different ages, who grew up in all sorts of different places. How do you know what their high-school history covered?
In my school, history was mandatory in the first year of high-school, and I think it might have been in the second year as well. Hardly anyone did it as a subject for the remainder of their high-school years.
Needless to say, the content taught in those first 1-2 years barely even scratched the surface of historical topics.
Possibly these countries have no way of monitoring and reporting COVID-19? In which case we are likely to have new, large clusters added in the coming weeks.
The thing is, although COVID-19 has a long incubation period in some cases, in many cases it has a short one. And about 15-20% of people will end up in hospital. So it can only spread under the radar for a limited period of time before it becomes obvious. The symptoms are well known by this point, dry cough, fever, shortness of breath.
Detecting small numbers of COVID-19 cases against the larger background of flu and other respiratory illnesses is not easy. It's quite likely to go undetected clinically until there is a fairly large number of unexplained pneumonia deaths of related people in a specific location. By this time there has been a lot of local exposure and spread.
Yes, a small number of cases could go unnoticed. But you were talking about large clusters. Say 100 people are infected and 15 turn up at hospital with difficulty breathing. For at least one of them, a doctor is going to take a history and notice the characteristic progression (this disease is the most famous disease in the world right now), then report it to their health authority. The large % of cases that require hospitalisation is a terrifying aspect of COVID-19, but it does increase the chance of detection.
I believ the sanction put on Iran by the Trump administration is of the main factors for very high mortality rate of Covid-19. This has caused suffering not just for the Iranian people but the whole region as now Iran lacks the equipments and medicines to put the epidemic under control. But I doubt the current President cares about that...
the iranian government should have thought about the consequences before making threats of developing nukes. stop taking sides with dictatorships and star worrying more about the people of iran murdered by that barbarian regime.
Many view sanctions as war crimes because sanctions, though they superficially target officials/companies/etc, are meant to undermine a nation's economy and hurt the civilian population to pressure foreign governments. Essentially the goal is to starve the men, women and children in order to punish foreign governments. If it was iran or china or russia doing it, we would be calling it a war crime or a crime against humanity. But since we are doing it, we just call it "economic warfare".
sure, let them develop an economy and build nukes / destabilise the region even more. if anything there is already a bad experience with saudi arabia, and we dont want a repeat. the people of iran if they dont support that murderous government should overthrow it. simple as.
particularly the US. i hear democracy is bad and apparently the us is ebil for giving those people an opportunity to organise instead of terrorise. funny world we live in. where we now support dictators and call those who liberate “destabilisers”. but yeah the others are pretty toxic.
I've seen speculation that the virus in Iran has mutated (or the environment is somehow different), and is producing extremely aggressive complications, killing patients within hours of their hospitalization.
At this time of year, there will be even more mass face-kissing and hand-shaking going on than usual. There are entire communities of travelling super-spreaders in Iran right now, this is extremely serious.
Probably not. Most likely it's just become widespread there and they haven't been containing or testing. The deaths and serious cases are the tip of the iceberg.
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[ 3.6 ms ] story [ 257 ms ] threadThis almost made me laugh out loud, tragic though any deaths and disablement are. It does seem to get to the heart of the matter, and not just in Iran either.
> adding that lawmakers have no access to coronavirus statics and could be mixing figures on deaths related to other diseases like the flu with the new virus, which first emerged in China in December.
So, not necessarily out of his butt, could be mixed up.
In any case, 12 dead out of 61 (a quickly rising figure) is already terrible.
I’ve been paying pretty close attention since early on and nowhere else with a suddenly-noticed largish outbreak had a temporary death rate remotely close to 20%. Not even in Wuhan. In fact 12 deaths currently ranks #3 on the global death count chart when each Chinese province is counted as a separate entity, and any comparable entity has an order of magnitude more cases at least.
Also, it was 8 deaths out of 43 yesterday, so 61 isn’t growing faster than 12.
Without more info, I blame this on shitty medical treatment. 20% roughly matches the percentage of severe cases elsewhere.
That, and the fact that the post you responded to is comparing apples to apples and does not rely on the validity of any one fatality rate estimation methodology.
Leftists love to virtue signal with Iranophilia. Meanwhile, Iranians literally chant "death to America" every day in their streets and in their national parliament. I've never seen a crowd of thousands of Americans chanting death to any nation, including Iran.
No sympathy for these savages.
Sure that would be great but if USA offers aid, it could be viewed as an insult as if they are unable to handle things themselves and with that - pride comes into play (often does with country politics). If Iran asks for help, they would probably have the USA low down on that asking list and again, pride also comes into play.
But let's put all that aside and ask the question: what could the USA do that Iran could not do currently in this situation?
Promise not to punish anyone for breaking sanctions if they sell medical supplies to Iran.
Edit: Seems like the US will only consider that if they can use it to attack the Iranian government: https://www.nytimes.com/2020/01/30/us/politics/us-iran-sanct... ("opened access to medicine for cancer and organ transplant patients", I guess other medicine is still subject to sanctions)
Hell in the Ukraine they were throwing rocks at busses repatriating their own countrymen who had caught corona virus
yet you are getting downvoted for a legitimate concern. either iranian government trolls are lurking and downvoting or the 5th column in the us which takes side with iran just to spite trump and republicans.
Who to trust?
Iran had obviously lost total control two days ago.
Yet the media is still going on about South Korean and Italy, it seems clueless.
We also need the immediate relaxation of sanctions around this on Iran. I 'think' WHO might be breaking some sanctions by currently helping Iran.
What are you talking about. The media is reporting whats happening as it gets it, if Iran's media is being silenced that got nothing to do with the virus itself and more about the control of panic.
> We also need the immediate relaxation of sanctions around this on Iran
I'm pretty sure the WHO couldn't give a rats about US sanctions when it comes to human rights and world health.
No they simply are not. Should I be watching Fox?
Iran has 12 people dead atm. This is unheard of in any country other than China. We have known this high toll for 3 days. Last Friday is was thought to be 9! Who has headlined this?
CNN has Italy and South Korea as it's headlines right now and today, they pail in comparison to Iran.
This is not a high toll, this is out of control spread of the disease. I feel like this is a clown world. Korea and Italy are not the same as what's going on in Iran.
It's taken this latest report of 50, to make any headway in the news.
As to the WHO not caring I doubt that, but it's still not the point, companies need to be able to free allow supplies in. I don't know what sanctions are in place but companies for instance that supply gasses like oxygen need to know they are allowed to export it to Iran and how do they receive funds?
Why does this article not mention the sanctions if the media is on top of this?
Yes I blame the media.
https://www.presstv.com/Detail/2020/02/23/619365/Iran-corona...
If you’re looking for large news organizations to freak out about every little unsubstantiated rumor or crackpot theory that circulates the web, then I don’t know what to tell you. Except that you’re willfully ignoring the 90% of the time those crackpot ideas turn out to be wrong and spreading them to billions of people would do far more harm than good, especially compared to just waiting to get the facts straight.
I'm not sure why you're getting upset/annoyed with the media. They're not going to cure / help with anything other than information.
No need for the tinfoil hat.
The problem is a regime which is utterly indifferent to its populace and intentionally delayed disease response for political purposes. As one report has it:
"Iranian officials have remained outwardly calm. An official with the Health Ministry told Javan newspaper that the majority of those who have been infected with the coronavirus do not need special care and will recover, adding that only 3% of those infected are likely to die from the virus."[0]
"Only" 3% => 2.4 million people if entire population is eventually infected. If "only" 5% are eventually infected that's 120,000 people.
That level of criminal indifference is an argument for stricter sanctions against the regime eventually...
[0] https://www.al-monitor.com/pulse/originals/2020/02/iran-coro...
> The Iranian government has denied trying to cover up the full extent of the coronavirus outbreak after reports suggested that the death toll from the disease was more than four times higher than official figures claim.
> On Monday, a lawmaker from Qom – a Shia holy city 120 km (75 miles) south of the capital Tehran which has seen a cluster of cases – accused Iran’s health minister of “lying” about the scale of the outbreak.
> According to the semi-official ILNA news agency, which is close to reformists, the lawmaker, Ahmad Amirabadi Farahani, said there had been “50 deaths” from the coronavirus in Qom alone.
> “The rest of the media have not published this figure, but we prefer not to censor what concerns the coronavirus because people’s lives are in danger,” ILNA editor Fatemeh Madiani told Agence France-Presse (AFP).
> But the country’s deputy health minister rejected the report. In a news conference broadcast live on state television, Iraj Harirchi said that 12 people had died from the coronavirus and 66 had been infected.
> “I categorically deny this information,” said Iraj Harirchi.
> “This is not the time for political confrontations. The coronavirus is a national problem,” he added.
https://www.theguardian.com/world/live/2020/feb/24/coronavir...
I think you need to read up on your history.
I don't recall any such information.
There's people on this site of all different ages, who grew up in all sorts of different places. How do you know what their high-school history covered?
In my school, history was mandatory in the first year of high-school, and I think it might have been in the second year as well. Hardly anyone did it as a subject for the remainder of their high-school years.
Needless to say, the content taught in those first 1-2 years barely even scratched the surface of historical topics.
Even if you didn't, I've noticed it in practically all possible media hundreds of times in all possible topics.
There’s so many topics that can be covered in high-school history classes, and so little actual aggregate time for those classes - why would you expect those topics be amongst them?
Also, why do you think that criticising such history classes, and the country they're in, somehow negates the point i made?
https://en.wikipedia.org/wiki/List_of_epidemics
https://en.wikipedia.org/wiki/Spanish_flu
I don't enjoy your snark, I think this is a very serious issue!
But whatever doctor, like any coronavirus, hygiene and good considerate practices will help.
The mortality rate is still around 2%-ish and hugely dependent on the health condition of the patient at time of contracting.
Its annoying, its serious and it's spreading for sure. But it is not Armageddon-scale unprecedented contagion.
If nothing else this is shaping up to be an event which will define a generation before it's all over.
Spanish Flu might have killed 100M but that doesn't affect me. This thing does.
Spanish Flu has an R0 of about 2[1]. Current published estimates for 2019-ncov are 2.3-3.8 for this paper [1] and there's another floating around which gets as high as 6-8.
1. https://www.ncbi.nlm.nih.gov/pubmed/19545404/
2. https://www.sciencedirect.com/science/article/pii/S120197122...
Look at the rate of spread in Korea and Italy recently. Where numbers aren't being cooked like in China. 3 weeks from first infection to Nationwide pandemic. Unprecedented.
This is the first time something so virulent has struck humans living with this kind of density. This will have massive ramifications for global geopolitics because it will show the weakness of centralizing production in third world countries and becoming dependent. Rumors abound in china about elites, professors, researchers, lawyers speaking out against the government. 2500 of them allegedly signed a petition demanding free speech. This virus will test the resilience and ingenuity of the human race.
Unprecedented.
Maybe send hearing aids?
Until all labs, equipment and experts are reassigned from whatever they are doing to finding a vaccine or cure, humanity is far from 'maximum response'.
Assuming that world leaders are working in the best interests of their populations, that leads me to believe that whatever these experts and labs are currently studying is considered more important than this. Or to say it another way, world leaders have decided the hundreds of millions of dollars necessary to persuade these experts and labs to switch to studying this virus isn't worth the money. Which means those leaders believe that either the virus won't hit pandemic levels, or if it does, the economic impact will be less than hundreds of millions of dollars.
Surely they are reading all the available literature that has been published, they would be poor experts if they weren’t keeping up with the hottest topic in their field in like forever.
You should get them to come here and do an informational, break down some of the more specialized technical information, about how the virus behaves, attacks, etc. clearing up any confusion the technically minded, lay virologists among us.
As an example, there is currently the worst epidemic of dengue in South America's history right now. (3 million infected and 1500+ deaths in 2019). https://www.bbc.com/mundo/noticias-51496280
From my minor lay person knowledge, every year there’s a decent sized (not in a good way of course) outbreak in Africa, South Asia, and/or more rarely, South America. If not multiple.
Why would you re-assign people working on those or other things that are serious?
I don’t want to put words into your mouth, but personally I know one person who essentially said because the African or South Asian issues are localized. He only cares if it’ll possibly affect him. Again not saying you are saying this.
Ebola is a virus that could be unprecedented. That's a serious killer and I am glad it is not traveling as fast as Corona.
If Ebola would ever start off in a major population center that would be an entirely different problem.
1) Find out about disease outbreak before elections.
2) Tell your people that the reports are a Western conspiracy to lower turnout. (e.g. [0])
3) Get utterly shocked when people die. How could you have known!?
[0] https://twitter.com/Reuters/status/1231530523740266496
Not only that, they kept regular civilian flights to China upto a few days ago while nearly everyone else was restricting flight.
But what does it mean? In Berlin or Paris it could suddenly spread on the trains, or at a spectator sport event. Being secular isn't going to stop you from breathing in air that other people are breathing out.
Everyone's susceptible to this.
In the churches in Singapore, it is thought that the spread happened from the congregation eating food from shared bowls after the service. Communion service in catholic churches is also a potential vector. There are two big church linked clusters in Singapore.
Langar in Sikh gurdwaras are probably less risky because generally cutlery and plates are not shared but best to be cautious about shared/buffet type setups. Public transport is considered relatively safer in Singapore especially as cleaning has been steeped up.
There's a story in Hong Kong about the whole big family getting it after sharing a traditional Chinese meal.
https://apnews.com/32540d09ec101aac057660ef1b0aa970
https://www.reuters.com/article/us-china-health-italy-death/...
https://www.theguardian.com/world/live/2020/feb/24/coronavir...
https://www.theguardian.com/world/live/2020/feb/24/coronavir...
Why is the WHO concerned about the economy? Well I have no idea. And is this virus going pandemic going to be more or less economically painful than the travel bans might have been? My guess would be we will feel significantly more pain from a pandemic.
I trust the CDC, and the CDC is preparing for something very serious, not something akin to the flu.
I know nothing about the CDC, but of course any health care organization prepares for "something very serious" that comes on top of the existing flu cases, because hospitals are already at close to maximum capacity.
Don't you see that this is always a tradeoff? If the economy tanks, people lose their jobs, which could result in a lot more social unrest than if a virus spreads around the world.
I think it's tough to contain a virus like that with such a long incubation time. But the early efforts might have slowed the virus down somewhat at first, giving us more time to develop vaccines.
There's not actually any wise balance and other mumbo-jumbo fart-heads in the WTO like to spew out, if under no circumstance do you ban travelling or take any meaningful action.
It's just words for the idiots to feel secure while all it really matters is economic growth.
I'd love to be proven otherwise, but then, under what circumstances would WTO advice a full ban on travel to/from China?
Perhaps never?
There you have it.
Just words after the fact, rationalizing inaction to two year olds -- "there's nothing to worry about", "the chinese are taking outstanding measures", "maybe there's something to worry about, but mah economy", "perhaps its too late to contain this"
Compare that to what might happen when this virus hits NYC. There will be a run on cash and groceries. People will stop commuting. Schools will close. Restaurants and shops will be empty. Now consider the same thing happening in Seoul, Berlin, London, San Francisco, etc. The economic impacts from this could be catastrophic.
And the most ironic thing is that if this truly does get out of hand we will get travel bans. Nations will close their borders. People will willingly (and forcefully) stop traveling via boat or air. We'll circle back to needing travel bans and the only price we'll have paid is millions of lives and a global economic catastrophe. All so that we could avoid some minor short term economic pain.
What will be more damaging to Japans economy? Banning travel to and from China or dealing with widespread panic, disease, and death?
You restrict and monitor if the bans fail. Which is the only thing we can do now because the incompetent WHO blasted any country or person who suggested travel bans would help.
What do you mean why?
Wasn't there recently some news about a US official threatening some UN high figure?
There is no such thing in the modern world. The influenza pandemics in the 19th, 20th and 21st centuries couldn't be stopped, just mitigated.
Just take the US - you'd need to shut every air route, every land border and every shipping port for upwards of 18 months. Untenable.
Best advice: Wash you hands.
https://www.youtube.com/watch?v=XQ9WX4qVxEo
Research from the Chinese Center for Disease Control suggests that around 80% of coronavirus cases are mild. Around 15% of patients have gotten severe cases, and 5% have become critically ill.
Here's how symptoms progress among typical patients:
- Day 1: Patients run a fever. They may also experience fatigue, muscle pain, and a dry cough. A small minority of them may have had diarrhea or nausea one to two days before.
- Day 5: Patients may have difficulty breathing — especially if they are older or have a preexisting health condition.
- Day 7: This is how long it takes, on average, before patients are admitted to a hospital, according to the Wuhan University study.
- Day 8: At this point, patients with severe cases (15%, according to the Chinese CDC) develop acute respiratory distress syndrome (ARDS), an illness that occurs when fluid builds up the lungs. ARDS is often fatal.
- Day 10: If patients have worsening symptoms, this is the time in the disease's progression when they're most likely to be admitted to the ICU. These patients probably have more abdominal pain and appetite loss than patients with milder cases. Only a small fraction die: The current fatality rate hovers around 2%.
- Day 17: On average, people who recover from the virus are discharged from the hospital after two-and-a-half weeks.
----
[1] https://jamanetwork.com/journals/jama/fullarticle/2761044
[2] https://www.businessinsider.com/coronavirus-covid19-day-by-d...
Not allowed to do this and not sure how long this will be up; the entire UpToDate reprint on the latest we know about COVID-19 (Coronavirus)
[3] https://www.scribd.com/document/448592904/COVID-19
----
Stay vigilant, stay careful, but most importantly, do not spread false information.
We are seeing patients well beyond the day 5: difficulty breathing condition.
Your last statement is imperative.
[1] https://www.ncbi.nlm.nih.gov/pubmed/?term=32053470
Not allowed to do this and not sure how long this will be up; the entire UpToDate reprint on the latest we know about COVID-19 (Coronavirus)
[2] https://www.scribd.com/document/448592904/COVID-19
Edit: adding the SCRIBD to the main post. It's free. All 18 pages if anyone is interested.
I don't think it is possible to derive any reliable facts from the data right now. Even if the patients who recovered from COVID-19 still find that there is something wrong with them, that could still go away in a week or a month or a year.
However, here is a tiny bit of information on the long-term effects of the 2003 SARS outbreak:
https://www.lung.org/lung-health-and-diseases/lung-disease-l...
> A small percentage of patients had long-term effects from their illness, including depression or anxiety, cough, shortness of breath, chronic lung disease or kidney disease. However, most patients fully recovered.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5757654/
The 14 day figure is more of a recommendation for the duration of quarantine, intended to cover incubation period in excess.
As a sample of a timeline that actually happened, you can check out the short paper about German cases reported in January[0].
It appears to have taken 3–6 days from infection until symptoms started, and subsequently 2–4 days until patients felt healthy again (no symptoms anymore, virus still detected in saliva).
[0] https://www.nejm.org/doi/10.1056/NEJMc2001468
https://www.worldometers.info/coronavirus/ Using the "closed cases" figures on this page (currently: 27892 closed cases, 25265 recovered, 2627 deaths), we get a fatality rate closer to 9.4%, but I've been monitoring this page for a while, and the fatality rate based on this calculation has improved a lot. For example, on 2020-02-10, the figures were 4376 closed cases, 3466 recovered, 910 deaths, resulting in a fatality rate of 20.8%. (https://web.archive.org/web/20200210100748/https://www.world... <3 archive.org)
It seems like they just are taking all the new patients, and not calculating it correctly. I expect this number to grow.
The WHO number is based on more than just the known cases vs deaths tally.
The big counter is based on official stats reported by the various countries and is equal to the numbers published by the WHO. Obviously, nobody knows the number of people who had it but didn't report it. You could do random sampling and get an estimate for the particular population that you tested, but let's forget about that for a moment.
The WHO's fatality estimate may or may not turn out correct at some point for the entire outbreak, but sadly there is no denying that the number isn't correct for the people who were tested positive a couple weeks ago, and the WHO published their estimate a couple weeks ago too.
If there was some benefit to the disaster that was the Diamond Princess, I guess it was that we have a pretty good idea about the range of disease symptoms. The various evacuees too - living in quarantine till they get the disease or don't.
Just because we don't know the exact number doesn't mean there aren't ways to estimate.
My point is that estimating a mortality rate involves a lot more than simply doing a single arithmetic operation.
https://www.thelancet.com/coronavirus
They are hosting preliminary research, case reports, commentary and discussion from qualified experts in the area, many of which are on the ground in affected areas.
Good source you mention as well.
In the last month almost 1% of the current population of the earth quarantined in China [0].
What exactly worries you about mass hysteria and panic? Why would that be worse than what is likely to happen as Covid-19 spreads outside of China?
I'm all in favor of not overselling the danger; but this virus is a real concern. I mean, unless someone has a very good argument why Hubei are somehow special and it can't happen again elsewhere everyone should be stocking up on supplies in case they are caught in a serious quarantine. The actions taken don't seem to be stopping exponential growth of this virus; if anything all that seems to be actively measured is how good countries are at producing testing kits.
> Only a small fraction die: The current fatality rate hovers around 2%.
If 2% of the people I know died this year, that would be the worst disaster in my country in my lifetime.
[0] https://en.wikipedia.org/wiki/2020_Wuhan_lockdown
Because then in addition to the damage caused by the outbreak, we will also have the additional often useless and counterproductive damage caused by hysteria and panic.
Of the top of my head.
Hoarding of supplies causing shortages and harming people who actually need them right now. Progressing to health professionals lacking supplies (masks, etc.) due to shortages (and diverting of dedicated supplies). Unnecessary ER visits which stress the health system thus making it less able to react to an actual problem (as health professionals are tired and burned out). Stress and unnecessary interventions/ER visits increasing people's risk and exposure to existing diseases.
edit: That's not counting real panic which involves mobs with metaphorical pitchforks and the military in streets enforcing some semblance of order (with bullets).
There was a window of opportunity during which this virus could have been contained. The Chinese dictatorship has squandered it in the name of "avoiding panic and hysteria".
Panic and hysteria should be avoided by being transparent, not by playing down the dangers or praising the efforts of an intransparent self-serving regime as the WHO has done from very early on.
Yes, I would indeed. gzer0's original wording, which has now been edited out (without comment), was:
"Stay vigilant, stay careful, but most importantly, do not spread mass hysteria and panic"
Now the wording was changed to:
"Stay vigilant, stay careful, but most importantly, do not spread false information."
I welcome the change, because saying that the most important thing in the face of danger is to avoid panic and hysteria is wrong and characteristic of authoritarian language.
Also, the U.S. has banned flights to/from certain countries during certain times.
Yes. And the way to avoid it is to switch communication strategies to inform the public without inciting panic. Also to recruit people into being part of the solution at the local level. This could just mean signing up to volunteer to deliver meals, or check on neighbors or just report all's clear if there's a lockdown. The more agency that you give to people, the less panic there is.
I found this article from two risk communications strategists, posted to the blog of a noted virologist, interesting:
Past Time to Tell the Public: “It Will Probably Go Pandemic, and We Should All Prepare Now”
https://virologydownunder.com/past-time-to-tell-the-public-i...
Think houses getting torched because the inhabitants are suspected of having the virus. Judging from what happened in Ukraine, we're getting closer to that kind of hysteria.
https://www.dw.com/en/coronavirus-riots-erupt-in-ukraine-as-...
Not trying to downplay the seriousness of this virus, but it's very unlikely to kill 2% of the people in any country — it kills (maybe, approximately) 2% of the people who are infected, but far less than 100% of the population in your country will ever be infected.
Do we have solid information to assert that? SARS and the flu spread from people who are exhibiting symptoms. This new virus is different in that regard, which seems like an open invitation to approach 100% infection rates.
I don’t know either way, but it certainly doesn’t seem unlikely that a solid majority could be infected.
Given most people don't live to be 100, I would guess the world death rate is well over 1%.
I'm not disagreeing with you, just something to think about when considering mortality rates.
- Day 1: Fever, fatigue and muscle pain with a dry itchy cough.
- Day 2+: Nausea and diarrhea can be experienced as well as the first day symptoms.
It takes about a week for the worst of the symptoms to die down however the stomach ache, cough and light tiredness last weeks.
My entire family and most of my son's class at school has had it and they're all still recovering. My wife is, after 3 weeks, still really ill. Probably because she's working full time and breastfeeding.
This is what makes the Corona-virus hard: at the start the symptoms are extremely similar to existing flu. Unless the case is extremely severe most people won't see a doctor let alone a hospital.
I don't see how it can be stopped.
Give some good fruits and cook proper vegetarian dish.
In my opinion it’s high time to call in sick. She is neither helping herself nor her coworkers by going to work.
I lot of people cannot call in sick.
Being sick means being unpaid, and many people cannot afford to go unpaid.
But how about if you run the business on your own, and you're concerned that if you take two weeks off the business will lose many customers who won't come back?
(I was shocked when I saw the they put the name of the illness on the note. That's so far from my employers business that it should be illegal to even ask. Employees and consumers rights in Germany seem to be seriously limited.)
You get multiple papers in Germany. The one without (!) diagnosis is for your employer.
As an employee the employer will have insurance but basically have to eat the cost of short sickness.
I'm a freelancer but I've chosen not to buy the insurance. It's very expensive and can survive on her income. I put the money I would have spent into a buffer.
Not wanting to is another issue though, but it's often irrational.
It's also implemented in all U.S. jurisdictions, for everyone except for prisoners: per the 13th Amendment, no-one not convicted of a crime can be forced to perform any work.
In Germany being sick means full payment by the employer for 6 weeks, after that you'll receive around 90% of your last net income by your healh insurance company for 72 weeks, after that slightly lower unemployment payments for another 12 month. So around 2.5 years of being sick are required until you're actually unpaid.
Zero-hour contracts are illegal in Germany.
I'm in a European juristiction - the UK. We have reasonable labour protections here. But they don't protect everyone.
If you are self-employed, then taking time off means going unpaid. It's that simple. Zero income. I have been in that position. Took a month off due to flu once (not the current flu). Lost 1 month income.
There is a government system called "Statutory Sick Pay" (SSP), but it is not paid to the self-employed, and if it did it would only start after a few weeks.
If you are a "casual" worker, then taking time off also means going unpaid because you don't have a contract of employment or regular hours to refer to. Sucks to be you, but it's harsh reality for many.
For salaried workers, the employer pays salary for a while. But it's time limited, depending on the employer. Some are more generous than others. The less generous will switch over to Statuory Sick Pay, which is not much money. It is rarely enough to cover rent or mortgage, for example, let alone food and bills.
A lot of people are self-employed, casual workers, or have household bills exceeding SSP. Taking a few weeks off due to sickness has a serious financial impact for those people, unfortunately, and it is wrong to assume everyone can afford to do so.
It can be abused though: I know of several cases where people are ill for two years, miracuously get better, work a month, then get ill for another two years.
Overall it's preferable to the UK situation.
Like you though I'm a freelancer; you earn more for less net work time so it's good.
I do too, but it is important to recognise that many people earn a lot less when freelancing than a typical salary. There are a lot of very poorly paid "self-employed" in the UK.
I've known freelancers in the UK paid less than £3 an hour, legally because "self-employed". Think things like Uber drivers, data entry on a "per document" basis or article writing "per word".
It is tough for them.
For perspective, that is less than half the legal minimum wage, and they have no sick pay, maternity, pension or other worker protections.
I am genuinely surprised people on HN think zero pay on sick days is unusual. So I'll quote from a BBC article:
They all get it every year anyway because they're constantly coming into contact with sick people so there's less benefit for staying at home.
The pharmacy itself should have policies preventing sick employees from attending work and have generous paid sick leave.
We could reduce disease transmission and thus social cost dramatically if we reduced transmission in medical contexts (e.g. hospitals are one of the main places people GET sick -- from other patients).
It would ultimately save money if there was overstaffing requirements and stringent no sick staff allowed in any medical context.
The problem is that cost reduction is at a societal level while individual firms don't have the incentive to do this. But socialized healthcare systems should be able to solve this easily.
I really wish that the situation could be better but unfortunately the huge cuts made since the financial crisis have made that impossible.
Doctors have the same problem.
It should be illegal to go to work sick with easily transmittable diseases.
Try one in ten thousand. And that's in the most developed countries with the best healthcare.
If this becomes a true epidemic it’s going to be bad, but societies have been dealing with epidemics for a long time.
That's absolutely true, even in Wuhan the %age of infected people on the total population is relatively small, but much larger than the # of ICU beds that existed.
And the virus had a long time to spread around there before any countermeasures were taken.
Even so, ventilators and ICU beds are not normally all available either.
> Quarantine has been surprisingly effective in China, though at significant economic cost.
It would have been a lot more effective if they had done it sooner.
> That seems to be a much larger concern than the capacity of heathcare systems.
Yes, and I'm sure that at some level that's the right trade-off, I'm just not sure what that level is and whether or not we are already past it.
> If this becomes a true epidemic it’s going to be bad, but societies have been dealing with epidemics for a long time.
In Italy they went from 0 dead and a handful of cases to 7 dead and > 200 cases. Most of them are old people and people that were already ill.
Historically the way we deal with epidemics is by developing medication. That takes time and in the meantime the damage could be substantial.
Effective medication is a very recent thing. Variolation dates back to the 10th century and was moderately effective, but quarantine is thousands of years old. Avoiding cannibalism and thus prion diseases is also from antiquity, but that’s simply another type of avoidance.
China startet radical measures after a rather low number of mystery lung issues. I really doubt that any other government would have taken decisive action much earlier. What would you expect, martial law whenever a doctor isn't quite sure about a diagnosis?
The initial silencing of the first public reports is very unfortunate and puts the government rightfully in a very bad light, but I'm not sure that it had any influence on the speed of countermeasure implementation at all. I see that more as a case of one part of a huge organisation not knowing what the other is doing, not as a government-wide attempt at ignoring the problem. The authoritarian version of a PR department still sending out denials while the rest of the company is already working on a fix (and too busy to rein in the PR department/thought police)
After SARS a month of inaction is too long.
Yes, but we’re still often left with millions or tens of millions dead.
Every day our broken healthcare system will force many people to choose between all their families assets and getting care. This should not be a consideration, but often is.
If you are traveling to the US, please make sure you get as much travelers health insurance as possible.
Edit: Some are telling me this isn't true, but what does a hospital have to gain from someone filing bankruptcy? Why would they charge such high prices that no one can afford? I would think that some money is better than no money.
Insurance/“cash” can “negotiate” but at the end of the day the average hospital stay is near $4000/day.
A friend in the US had the same procedure outpatient, and it was $6000, $1200 of which she was responsible for. On the upside, they gave her 30 Vicodin for the post-op pain and no follow-up about said opioids, where I only got a week's worth of Tramadol (much less potent) and a follow-up with my regular doc who wanted to know at what rate I was taking them. My friend was slightly tempted to sell her leftovers...
Actual poor people are a slightly different story and often left alone fairly easily.
That being said, there’s been a trend in the US recently, where hospitals have very aggressively gone after unpaid bills of the uninsured, because some administrators see it as money they’re leaving on the table. It’s more prevalent in rural areas, where there’s often only one hospital to go to, and consumers have no choice but to go to the hospital with a terrible reputation.
In some cases, they’ve convinced the judicial system to garnish the uninsured person’s wages, to get “their money back”. IMO it’s clearly illegal and it won’t last much longer, but yeah the system is crazy. :/
Making everyone else pay for you is no better of a solution, it's just shifting the costs around someplace else, which honestly is selfish of you to decide how I should deploy my ever-dwindling supply of cash reserves. I have two kids to put through college but Bernie and all his Democrat pals want to confiscate as much of my money as possible to pay for someone else's stuff, probably the 20 million illegals who showed up here unannounced, or maybe just swindle the money the way Democrats have done for DECADES.
It's coming to the point where guys like me might as well take up arms against people like YOU and just put and end to it. Get my drift?
It's actually very informative, to me. Sorry you don't see it that way.
It's easy to think that China is run as a socialist country because there's "communist" in the name of the ruling party, but the truth is very far from that; in many aspects China is a ruthless capitalistic free-for-all society with less socialist policies than even the US.
_You_ get healthcare as well. It's not just "someone else", it's you, your family, your friends, and everyone you care about. No one should go into a spiraling life of debt because they broke an arm or got sick at an inopportune time.
China has until recently had a less socialized healthcare system than the US. They've made massive strides towards trying to provide a universal system over the last few years, but they are still a developing country, so I'm not sure why you think comparing with China is a good idea, other than, I guess a knee jerk (and incorrect) assumption that it'd all be government run...
Meanwhile socialized healthcare systems are working out fantastically well for large parts of the developed world, but really the most important factor is universal healthcare - universal systems range from fully private multi-payer systems with some system for subsidizing those who can't pay, to fully socialized single payer systems.
What the vast majority of them have in common is that they result in far lower total healthcare spending than in the US thanks to actually regulating healthcare with the public in mind rather than insurers and healthcare providers. In fact, a large number of countries spend less total on healthcare per capita than US taxpayers pay towards Medicare and Medicaid alone, before you even factor in US private insurance.
Thanks Canada!
(Having said that, if you're visiting Canada you'll need to check your health coverage. Medical coverage is provided to Canadian residents, not just anyone who happens to be in Canada at the time.)
And it's a he.
"Fraser Institute has—for over two decades—surveyed specialist physicians across 12 specialties and 10 provinces.
This edition of Waiting Your Turn indicates that, overall, waiting times for medically necessary treatment have increased since last year. Specialist physicians surveyed report a median waiting time of 20.9 weeks between referral from a general practitioner and receipt of treatment—longer than the wait of 19.8 weeks reported in 2018."
Source: https://www.fraserinstitute.org/studies/waiting-your-turn-wa...
2. "medically necessary" does not tell you anything about the severity of illness or appropriateness of waiting. There are many medically necessary things for which it's okay to wait some time. In the Canadian system, things are dealt with at the level of urgency appropriate to the severity of the issue. Yes, it's not perfect, but it does result in generally better population-wide health outcomes in Canada than the US.
That's very much an ad hominem fallacy, and unless you have specific evidence that they falsified the data in question, I'm just going to leave it at that (similarly to how you conclude that 'right wing' is enough of a reason to dismiss something). Last I checked, science doesn't care who you voted for. Once we start dismissing research based on the opinions of the researchers, we've essentially implemented thought crime. All research is motivated by prior opinion. We call it a hypothesis. Whether it happens to align with a political ideology doesn't invalidate it. If the research is somehow wrong, then there will be a way to disprove it through science. Using politics to argue against science isn't appropriate.
No, it would be an ad hominem if I said "the Fraser institute produced it, so you can safely line your bird cage with it". I didn't say that, I just pointed to the institution's well-known bias.
> Using politics to argue against science isn't appropriate.
Oh yeah, how dare I impugn non-peer reviewed "science" written by two non-PhD's, where 25% of the citations are to other non-peer reviewed reports written by the Fraser Institute and the others are random statscan links. This "science" is just a summary of responses to a questionnaire.
> Mission Statement: WTA physicians are concerned over delayed access to health care for Canadians. We work collaboratively with our stakeholders to inform, advocate, and provide solutions to achieve timely, appropriate and equitable access to high-quality health care.
And now from the 2015 report itself (the most recent one):
> "Ontario reports that the maximum amount of time that nine out of 10 patients with complex needs spent to complete their ED visit and be admitted to the hospital was 25.7 hours (June 2015). The maximum amount of time that nine out of 10 patients with minor or uncomplicated conditions stayed in the ED was 4 hours. As outlined in previous WTA reports, many of the factors responsible for the lengthy waits to be admitted to a hospital bed are system-wide failures such as high numbers of ALC patients and a lack of community-based supports."
On primary care:
> Wait times are reported for each of the five regional primary care networks in the province. The average wait time for an appointment between January and March 2015 was 23 days, ranging from 0 to 72 days.
I can see a primary care doctor within 1-2 days here in the US. Even when I was on welfare, the wait times were no more than a few days.
So this report seems to be consistent with the one you were complaining about (which by the way was circulated and referenced widely by mainstream media). However, I see no evidence of "political bias" in this one so I hope you can accept that this isn't that controversial. These wait times are clear facts, not opinions. An opinion would be "Canada has the best health care system", which I am arguing against, citing facts.
Source: http://www.waittimealliance.ca/wp-content/uploads/2015/12/EN...
No, I do not think the US has the best system either, but pointing to Canada as a target benchmark is a non-starter from the way I see it.
> Before implying that Canada has the final answer to health care
You are the only person who's brought this up. I literally said "it's not perfect."
Here's what it comes down to. Population-wide health outcomes in Canada are certainly no worse than they are in the US. Arguably by a number of measures they're better. Health outcomes for the most economically-vulnerable segment of the population are much, much better in Canada. Nobody is bankrupted in Canada by medical care. It's the leading cause of bankruptcy in the US. Canada spends much less of its GDP per capita on healthcare than does the US. A large portion of the US is already covered by a patchwork-quilt national healthcare system.
Now whether you want to go with the Canadian system, or the UK's system, or the French system or the Swiss system - honestly I don't give a shit. People are dying because they can't afford to deal with the nightmare of a system here.
I provided details on a single instance of an interaction with the health system. Hence 'ancedata'. I made no claim that every interaction will have the same outcome.
> waiting times for medically necessary treatment have increased since last year
Do you have the data for wait times for other countries? And, I suppose, wait times of those in the US with and without private insurance?
https://www.cihi.ca/sites/default/files/document/text-altern...
29% of Canadians report waiting 4 or more hours the last time they went to the hospital emergency department.
Patients who reported waiting 4 or more hours: Country results from highest to lowest
Canada, 29% (below average); Sweden, 20%; Norway, 13%; United States, 11%; Commonwealth Fund average, 11%; Australia, 10%; New Zealand, 10%; United Kingdom, 8%; Switzerland, 7%; Netherlands, 4%; Germany, 3%; France, 1%
https://www.scribd.com/document/448385523/s-2213260020300795...
It’s not a dismissal to acknowledge the limitations of your linked study; to do otherwise would be fearmongering in my opinion.
https://news.ycombinator.com/newsguidelines.html
Edit: https://www.worldometers.info/coronavirus/ Looks like its now only 9%, it was 10% a day or two ago.
What I find more concerning is that the current ratio of deaths to cases is 3%, which I would expect to be an underestimate. Hopefully this is due to under-reporting of the mild cases, but it does imply either a major under-reporting of active cases or a significantly higher mortality rate than has been estimated so far (most likely the former).
Full of self reported made up numbers.
Now they’re saying it’s likely too late to contain the virus.
Well I wonder what will be more damaging to the economy? The proposed travel bans or the catastrophic effects of a worldwide pandemic? How many people will die in underdeveloped countries because the WHO didn’t act aggressively enough when they had a chance? If this hits Africa 10 million could die.
Thanks WHO
That's probably the reason they were more careful this time. It's hard to know early on exactly how a disease will spread, and how dangerous it will turn out to be.
It’s not as if outbreaks like this happen often. It would be difficult for the WHO to be labeled as overreacting when they only get an opportunity to react once or twice a decade.
The fact that it’s hard to know how dangerous a disease will be is a reason to be extra careful, not the other way around. Not knowing how dangerous something is doesn’t mean we should blunder forward and hope for the best.
This is implying that fact-based comments do damage. Reminds me of Biden's "truth over facts" gaffe.
Moreover, their blind acceptance of official Chinese data is so naive, it is ludicrous.
[1]: https://youtu.be/02TwdiRUJTA
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...
https://jagjapan.maps.arcgis.com/apps/opsdashboard/index.htm...
There's people on this site of all different ages, who grew up in all sorts of different places. How do you know what their high-school history covered?
In my school, history was mandatory in the first year of high-school, and I think it might have been in the second year as well. Hardly anyone did it as a subject for the remainder of their high-school years.
Needless to say, the content taught in those first 1-2 years barely even scratched the surface of historical topics.
Possibly these countries have no way of monitoring and reporting COVID-19? In which case we are likely to have new, large clusters added in the coming weeks.
"Problems with CDC coronavirus test delay expanded U.S. screening" - https://www.politico.com/news/2020/02/20/cdc-coronavirus-116...
https://www.hrw.org/report/2019/10/29/maximum-pressure/us-ec...
At this time of year, there will be even more mass face-kissing and hand-shaking going on than usual. There are entire communities of travelling super-spreaders in Iran right now, this is extremely serious.
relax.