Gallows humor = staying sane in an unprecedented situation. At least it bluntly makes a case about flattening the curve as this thing seems to be ramping up in various parts of the US. I’m actually trying to impose a personal news update moratorium today and escaping into Parks and Recreation and maybe some muscle car garage shows.
Two weeks ago I was down for a week with the worst flu of my life. Went to urgent care, they couldn’t test me. I didn’t get health insurance until about four years ago, but the previous two decades I had nothing so I just got used to not having a doctor. There’s a whole generation like me out there. If anything has made me resolve to search out a PCP, this is it. Too bad I didn’t learn how to navigate the American health care system back when I was 24 and graduated college and lost my parents insurance. That would have been a good time to learn how to do these things.
Admittedly it’s on me, for not seeking one out sooner, but I have had ZERO guidance on how to do any of this. So I’ll admit it. I did this to myself, but the rest of the country needs to come along with me and admit “WE FUCKED OURSELVES”. We ignored systemic problems for decades and now we’re screwed.
BTW, the demographic that has me most nervous are the kids in their 20s and 30s who either don’t stick to a job long enough to get insurance, or work the “Gig Economy”. I was one of the former for a long time. Service, retail, hospitality. That kid across the counter has only been working there for a month or two and he’s going to be gone in another month. Tying health insurance to your occupation was great when people worked the same job for 30 years (OK Boomer), but it fell apart when corporations realized that higher turnover meant they could scrap all the benefits they used to pay for.
Corporate greed fucks us again.
consciousness razorsays
About “flattening the curve”…. I know the main idea is to slow the virus down, to reduce the shock to the system. But shouldn’t it also be that the area under the flattened curve is smaller (or in the worst case, equal) compared to the curve with the higher peak? A bunch of the graphics for it that I’ve seen don’t give that impression.
redwoodsays
Ray Ceeya@3. This reminds me of a woman I met once who had just gotten out of the hospital after six months of kidney problems. She was a Christian and had moved to my college town to work after deciding not to take a different job in another part of the country. She had prayed and prayed about what to do and then chose what she thought Dog wanted her to do. Then she got sick and was sure that it was her fault for not understanding Dog’s will clearly enough and making the wrong choice, thus being punished with a terrible illness. I was stunned to hear this and wanted to tell her that it wasn’t her fault. It was the fault of religion for making her feel like that. In Ray’s case, it’s not his fault for not knowing how to navigate the health care system, it’s the government’s fault for having a health care system that requires navigation. You should be able to go to a doctor at any time and be able to afford doing so. No navigation required, you go to the doctor and get the needed tests and you don’t get bankrupted in the process. This is what health care is like in a civilized country. Hang in there, Ray!
I’m sorry, but currently the UK and the USA seem to be in a head to head race about who’s handling this any worse. I’m not going to sing praise for the German government, but they look really competent compared to this.
Not to mention the US populace who think this is a terrorist attack and therefore going out and meeting people in bars is the way to go.
the case can be made that the response to flatten the curve will cause crash to the economy and that every crash to the economy means a spike in suicides, deaths related to substance abuse, bankruptcies, violent crime and a whole cascade of misery.
Also, it can be argued that you cannot save a life – you can only postpone death, so prolonging someone’s life from 30 to 70 is worth more than prolonging lives of two 80-year olds by 2 years.
You may see politicians tempted to pursue that course, hoping that unscathed economy with reduced number of pensioners will result in bounce back after pandemia.
And there may be countries who will decide to go that way, not caring if it is immoral or not.
The danger here is, the more people are infected, the more copies of the virus are created and bigger the risk we will see mutation that is much more deadlier, infectious or resistant. And that means, wherever in the world you live, you need to push your country to limit the spread – both to prevent your country from being the place where virus mutates and to exercise pressure on other countries who would be tempted to be reckless.
4 consciousness razor But shouldn’t it also be that the area under the flattened curve is smaller (or in the worst case, equal) compared to the curve with the higher peak?
I think that plot is just an illustration but there is no reason for the flatter curve to have less area under the curve under the assumption of equal number of cases. I think it is an “All else being equal” scenario.
consciousness razorsays
I think that plot is just an illustration but there is no reason for the flatter curve to have less area under the curve under the assumption of equal number of cases. I think it is an “All else being equal” scenario.
I don’t understand. Unless I’m misinterpreting what those graphs are supposed to be about, the area (i.e., the integral) represents the total number of cases accumulated over time. It should be a lower or equal number of cases for the flattened curve, not a higher number of cases.
You can dismiss it as “just an illustration,” but it’s a bad one, because it’s illustrating that a flattening strategy will be worse for us in the long run, which is simply incorrect. The problem is that people are drawing these very narrow and not-so-tall spikes for the “non-flattened” curves, which incorrectly have a smaller area than the very wide (and still relatively tall) “flattened” ones.
You could choose to scale the graphs in different ways (for the purposes of displaying the information on TV, for an image online, etc.) and you could come up with different projections about how successful flattening might be, but in no case should it be worse than not flattening.
They have told Trump to fuck off. If you’re lucky he’ll die from a temper tantrum because for once he couldn’t get what he wanted via bribery and bullying.
xohjoh2nsays
@11
I just don’t understand what the hell they thought they were trying to achieve…
The ‘curve flattening” is about protecting the health system from severe overload. Therefore, more patients that need acute care will receive it and have a significantly lower chance of dying. Not a bad outcome.
microraptorsays
@12: It’s just Trump employing the only two means of succeeding at something he knows- offering money (that he almost certainly has no intention of actually giving) and cheating.
Marissa van Ecksays
It’s like this administration has been carefully planning to do the exact worst thing at the exact worst time to produce the exact worst possible outcome. Hanlon’s Razor has lost its edge; this level of incompetence is itself malicious.
I don’t know what I was expecting for 2020, but it wasn’t this. I’m a pharmacy technician and will likely be indirectly responsible for infecting and killing many elderly customers, as I will likely get the virus and recover quickly, but have to work because 1) there is no plan for closure and 2) like all poor Americans, I very literally cannot afford not to work.
When this all clears out, I hope like hell the US will realize that we need universal healthcare as a matter of cost savings and national security. And I hope every single Republican politician dies of the virus and wakes up in Hell to the sensation of a double lungful of exudate boiling off…
brightmoonsays
I’m a Christian I just never thought the Antichrist ( Trump) would be stupid .! Yeah that’s what I call him!
Czech Americansays
xohjoh2n @12
The right wing in the US want to go back to the 1950’s, a perceived period of US economic success. What success there was happened because the US was relatively untouched by WW2 compared to the rest of the world, or at least the other big economies of the time.
Yeah, I know, that’s probably way to complicated for Trump. He probably just sees money and power in it, but it’s an interesting thought.
Czech Americansays
Giliell @6
And, oddly, the Netherlands. Though I don’t know the Netherlands very well, so I’m probably not a great judge of how odd that is.
blfsays
Czech American@20, I also don’t know the Netherlands. The UK is changing course from letting people get sick to hopefully develop herd immunity that will hopefully make second and subsequent phases less severe to a self-quarantine & social distancing strategy. The reason they’re changing (albeit far too slowly) is the realisation the NHS would be completely overwhelmed — as has happened in N.Italy — if they let the disease spread.
A proxy, then, for measuring medical system resilience (ability to cope) is, perhaps, hospital beds per capita. From Ye Pffft! of All Knowledge (2017 figures unless stated):
(I’m a bit surprised the US has slightly more hospital beds per capita than the UK.)
The Netherlands is in slightly better shape than Italy (and certainly better than the UK), but it doesn’t look too good. So if the UK is (ponderously) changing course, it does seem the Netherlands should also reconsider.
consciousness razorsays
(I’m a bit surprised the US has slightly more hospital beds per capita than the UK.)
I’m no expert, but the US has a much larger land area with a lower population density. Wiki gives these numbers:
US: 33.6/km^2
UK: 270.7/km^2
The US actually seems to be lacking in hospitals in some rural places. But at any rate, you do still need them spread around all over the country, even if the surrounding area has a small population.
consciousness razorsays
A proxy, then, for measuring medical system resilience (ability to cope) is, perhaps, hospital beds per capita.
Also, just so nobody gets confused, the numbers you cited are per 1000 people, not per capita. No country has more hospital beds than people.
stroppysays
Flattening the curve. Good question.
You’d probably have to go to the literature for a detailed explanation of the modeling. That particular chart was made to illustrate a principle and to keep it simple for mass consumption. As it is, it may already be too sophisticated for a large swath of panicked population–see video at the top.
(I suppose you could invent a theoretical scenario where acting to successfully flatten the curve in certain ways would result a greater number of cases over all. Given a cause, there’s no reason to assume that area under the curve has to remain constant, or that flattening would necessarily squash a number of bugs.)
a_ray_in_dilbert_spacesays
Marissa van Eck: “Hanlon’s Razor has lost its edge; this level of incompetence is itself malicious.”
Um. Actually, that is the whole point (edge?) of Hanlon’s Razor–malicious outcomes do not require malicious intent. Bland, blinkered stupidity is the most destructive force in the Universe.
blfsays
consciousness razor@22 & @23, Thanks for the corrections and clarifications!
The spread of COVID-19 is not going to follow an exponential curve — and grave errors will follow if analysts believe it will. The number of new cases rises rapidly, peaks, and then declines. It’s called the epidemiological curve. It’s not a theory or hypothesis; it plays out that way every flu season. It is how it has played out in China and Korea for COVID-19. Flattening the peak to avoid overloading the healthcare system is the main medical goal of the seemingly extreme containment policies we have seen to date.
DanDaresays
The flatten the curve thing has multiple values.
Time delay.. get a vaccine developed and out to people who would othetwise have got sick and died earliet. Get more ICU beds in place.
Health System protection…ensure numbers competing for health resources, virus or other, are less than capacity.
Hopefully this will be funny in the future.
@2- whywhywhy
Gallows humor = staying sane in an unprecedented situation. At least it bluntly makes a case about flattening the curve as this thing seems to be ramping up in various parts of the US. I’m actually trying to impose a personal news update moratorium today and escaping into Parks and Recreation and maybe some muscle car garage shows.
Two weeks ago I was down for a week with the worst flu of my life. Went to urgent care, they couldn’t test me. I didn’t get health insurance until about four years ago, but the previous two decades I had nothing so I just got used to not having a doctor. There’s a whole generation like me out there. If anything has made me resolve to search out a PCP, this is it. Too bad I didn’t learn how to navigate the American health care system back when I was 24 and graduated college and lost my parents insurance. That would have been a good time to learn how to do these things.
Admittedly it’s on me, for not seeking one out sooner, but I have had ZERO guidance on how to do any of this. So I’ll admit it. I did this to myself, but the rest of the country needs to come along with me and admit “WE FUCKED OURSELVES”. We ignored systemic problems for decades and now we’re screwed.
BTW, the demographic that has me most nervous are the kids in their 20s and 30s who either don’t stick to a job long enough to get insurance, or work the “Gig Economy”. I was one of the former for a long time. Service, retail, hospitality. That kid across the counter has only been working there for a month or two and he’s going to be gone in another month. Tying health insurance to your occupation was great when people worked the same job for 30 years (OK Boomer), but it fell apart when corporations realized that higher turnover meant they could scrap all the benefits they used to pay for.
Corporate greed fucks us again.
About “flattening the curve”…. I know the main idea is to slow the virus down, to reduce the shock to the system. But shouldn’t it also be that the area under the flattened curve is smaller (or in the worst case, equal) compared to the curve with the higher peak? A bunch of the graphics for it that I’ve seen don’t give that impression.
Ray Ceeya@3. This reminds me of a woman I met once who had just gotten out of the hospital after six months of kidney problems. She was a Christian and had moved to my college town to work after deciding not to take a different job in another part of the country. She had prayed and prayed about what to do and then chose what she thought Dog wanted her to do. Then she got sick and was sure that it was her fault for not understanding Dog’s will clearly enough and making the wrong choice, thus being punished with a terrible illness. I was stunned to hear this and wanted to tell her that it wasn’t her fault. It was the fault of religion for making her feel like that. In Ray’s case, it’s not his fault for not knowing how to navigate the health care system, it’s the government’s fault for having a health care system that requires navigation. You should be able to go to a doctor at any time and be able to afford doing so. No navigation required, you go to the doctor and get the needed tests and you don’t get bankrupted in the process. This is what health care is like in a civilized country. Hang in there, Ray!
I’m sorry, but currently the UK and the USA seem to be in a head to head race about who’s handling this any worse. I’m not going to sing praise for the German government, but they look really competent compared to this.
Not to mention the US populace who think this is a terrorist attack and therefore going out and meeting people in bars is the way to go.
the case can be made that the response to flatten the curve will cause crash to the economy and that every crash to the economy means a spike in suicides, deaths related to substance abuse, bankruptcies, violent crime and a whole cascade of misery.
Also, it can be argued that you cannot save a life – you can only postpone death, so prolonging someone’s life from 30 to 70 is worth more than prolonging lives of two 80-year olds by 2 years.
You may see politicians tempted to pursue that course, hoping that unscathed economy with reduced number of pensioners will result in bounce back after pandemia.
And there may be countries who will decide to go that way, not caring if it is immoral or not.
The danger here is, the more people are infected, the more copies of the virus are created and bigger the risk we will see mutation that is much more deadlier, infectious or resistant. And that means, wherever in the world you live, you need to push your country to limit the spread – both to prevent your country from being the place where virus mutates and to exercise pressure on other countries who would be tempted to be reckless.
Then, there’s this:
https://www.theguardian.com/us-news/2020/mar/15/trump-offers-large-sums-for-exclusive-access-to-coronavirus-vaccine
4 consciousness razor
But shouldn’t it also be that the area under the flattened curve is smaller (or in the worst case, equal) compared to the curve with the higher peak?
I think that plot is just an illustration but there is no reason for the flatter curve to have less area under the curve under the assumption of equal number of cases. I think it is an “All else being equal” scenario.
I don’t understand. Unless I’m misinterpreting what those graphs are supposed to be about, the area (i.e., the integral) represents the total number of cases accumulated over time. It should be a lower or equal number of cases for the flattened curve, not a higher number of cases.
You can dismiss it as “just an illustration,” but it’s a bad one, because it’s illustrating that a flattening strategy will be worse for us in the long run, which is simply incorrect. The problem is that people are drawing these very narrow and not-so-tall spikes for the “non-flattened” curves, which incorrectly have a smaller area than the very wide (and still relatively tall) “flattened” ones.
You could choose to scale the graphs in different ways (for the purposes of displaying the information on TV, for an image online, etc.) and you could come up with different projections about how successful flattening might be, but in no case should it be worse than not flattening.
They have told Trump to fuck off. If you’re lucky he’ll die from a temper tantrum because for once he couldn’t get what he wanted via bribery and bullying.
@11
I just don’t understand what the hell they thought they were trying to achieve…
Who’s “they”?
Trump and his folks.
The ‘curve flattening” is about protecting the health system from severe overload. Therefore, more patients that need acute care will receive it and have a significantly lower chance of dying. Not a bad outcome.
@12: It’s just Trump employing the only two means of succeeding at something he knows- offering money (that he almost certainly has no intention of actually giving) and cheating.
It’s like this administration has been carefully planning to do the exact worst thing at the exact worst time to produce the exact worst possible outcome. Hanlon’s Razor has lost its edge; this level of incompetence is itself malicious.
I don’t know what I was expecting for 2020, but it wasn’t this. I’m a pharmacy technician and will likely be indirectly responsible for infecting and killing many elderly customers, as I will likely get the virus and recover quickly, but have to work because 1) there is no plan for closure and 2) like all poor Americans, I very literally cannot afford not to work.
When this all clears out, I hope like hell the US will realize that we need universal healthcare as a matter of cost savings and national security. And I hope every single Republican politician dies of the virus and wakes up in Hell to the sensation of a double lungful of exudate boiling off…
I’m a Christian I just never thought the Antichrist ( Trump) would be stupid .! Yeah that’s what I call him!
xohjoh2n @12
The right wing in the US want to go back to the 1950’s, a perceived period of US economic success. What success there was happened because the US was relatively untouched by WW2 compared to the rest of the world, or at least the other big economies of the time.
Yeah, I know, that’s probably way to complicated for Trump. He probably just sees money and power in it, but it’s an interesting thought.
Giliell @6
And, oddly, the Netherlands. Though I don’t know the Netherlands very well, so I’m probably not a great judge of how odd that is.
Czech American@20, I also don’t know the Netherlands. The UK is changing course from letting people get sick to hopefully develop herd immunity that will hopefully make second and subsequent phases less severe to a self-quarantine & social distancing strategy. The reason they’re changing (albeit far too slowly) is the realisation the NHS would be completely overwhelmed — as has happened in N.Italy — if they let the disease spread.
A proxy, then, for measuring medical system resilience (ability to cope) is, perhaps, hospital beds per capita. From Ye Pffft! of All Knowledge (2017 figures unless stated):
2. S.Korea: 12.27
4. Germany: 8.00
10. France: 5.98 [France believes it lacks sufficient beds]
19. China: 4.34
24. Netherlands: 3.32
26. Italy: 3.18
29. Spain: 2.97
32. USA: 2.77 (2016)
35. UK: 2.54
(I’m a bit surprised the US has slightly more hospital beds per capita than the UK.)
The Netherlands is in slightly better shape than Italy (and certainly better than the UK), but it doesn’t look too good. So if the UK is (ponderously) changing course, it does seem the Netherlands should also reconsider.
I’m no expert, but the US has a much larger land area with a lower population density. Wiki gives these numbers:
US: 33.6/km^2
UK: 270.7/km^2
The US actually seems to be lacking in hospitals in some rural places. But at any rate, you do still need them spread around all over the country, even if the surrounding area has a small population.
Also, just so nobody gets confused, the numbers you cited are per 1000 people, not per capita. No country has more hospital beds than people.
Flattening the curve. Good question.
You’d probably have to go to the literature for a detailed explanation of the modeling. That particular chart was made to illustrate a principle and to keep it simple for mass consumption. As it is, it may already be too sophisticated for a large swath of panicked population–see video at the top.
(I suppose you could invent a theoretical scenario where acting to successfully flatten the curve in certain ways would result a greater number of cases over all. Given a cause, there’s no reason to assume that area under the curve has to remain constant, or that flattening would necessarily squash a number of bugs.)
Marissa van Eck: “Hanlon’s Razor has lost its edge; this level of incompetence is itself malicious.”
Um. Actually, that is the whole point (edge?) of Hanlon’s Razor–malicious outcomes do not require malicious intent. Bland, blinkered stupidity is the most destructive force in the Universe.
consciousness razor@22 & @23, Thanks for the corrections and clarifications!
Here’s a rather good chart showing some of the reasoning behind flattening the curve, https://voxeu.org/sites/default/files/Flatten%20the%20curve%20mine.png
It’s part of It’s not exponential: An economist’s view of the epidemiological curve:
The flatten the curve thing has multiple values.
Time delay.. get a vaccine developed and out to people who would othetwise have got sick and died earliet. Get more ICU beds in place.
Health System protection…ensure numbers competing for health resources, virus or other, are less than capacity.