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NewfoundlandFreeFrog

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NewfoundlandFreeFrog last won the day on April 6

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About NewfoundlandFreeFrog

  • Birthday 06/23/1951

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  1. Disagree, though, re. "feeble minded"...more along the lines of authoritarian-followers who can often be quite bright but see a path to money and power by going along and shaping the electorate into a favorable subset rather than winning the electorate as a whole.
  2. Bad day for young advanced care medic son. Guy collapsed and died in the crosswalk in the middle of one of the busier intersections in the city--4 lanes crossing a busy 2 lanes with an additional Y plus turn lanes involved as well. They pulled up and had to put on full space gear first then try to revive him with CPR and defibs from inside the gear. Probably dead already w/ a massive heart attack, but that is not fully clear at the moment. Left him a bottle of wine and a loaf of fresh homemade bread on the front porch for him to pick up on the way home. Unfortunately cannot see him due to the nature of his work.
  3. From the article... "The data that we do have, meanwhile, could end up being terminally skewed, particularly the data that’s been coming out of China." The USA data is terribly skewed due to the testing foulups. Re. the rest, the newspaper article glosses over things pretty terribly, IMO. The NVSS document it references is quite detailed and the guidelines are no different from other related guidelines. In particular, it notes that lab tests may not be done on MANY corpses from many causes of death yet a cause is still entered on the death certificate based on other clinical data. For example, no testing at death was ever been done on any of the deaths in my own near family yet all were certified with a listed cause. I would bet that is the experience of many here which the author misses. Here is the coding document in full rather than summarized by a nontechnical journalist. I've used health records in the past and I see nothing particularly concerning about these guidelines for aggregate statistical purposes. In particular, they are by no means "profoundly vague" as the newspaper article author says. When someone has a bullet through the brain, you rarely run a full body scan looking for, say, COVID as a cause of death unless there is a very good (usually criminal investigation) reason to do so!! COVID-19 Alert No. 2 March 24, 2020 New ICD code introduced for COVID-19 deaths This email is to alert you that a newly-introduced ICD code has been implemented to accurately capture mortality data for Coronavirus Disease 2019 (COVID-19) on death certificates. Please read carefully and forward this email to the state statistical staff in your office who are involved in the preparation of mortality data, as well as others who may receive questions when the data are released. What is the new code? The new ICD code for Coronavirus Disease 2019 (COVID-19) is U07.1, and below is how it will appear in formal tabular list format. U07.1 COVID-19 Excludes: Coronavirus infection, unspecified site (B34.2) Severe acute respiratory syndrome [SARS], unspecified (U04.9) The WHO has provided a second code, U07.2, for clinical or epidemiological diagnosis of COVID-19 where a laboratory confirmation is inconclusive or not available. Because laboratory test results are not typically reported on death certificates in the U.S., NCHS is not planning to implement U07.2 for mortality statistics. When will it be implemented? Immediately. Will COVID-19 be the underlying cause? The underlying cause depends upon what and where conditions are reported on the death certificate. However, the rules for coding and selection of the underlying cause of death are expected to result in COVID19 being the underlying cause more often than not. What happens if certifiers report terms other than the suggested terms? If a death certificate reports coronavirus without identifying a specific strain or explicitly specifying that it is not COVID-19, NCHS will ask the states to follow up to verify whether or not the coronavirus was COVID-19. As long as the phrase used indicates the 2019 coronavirus strain, NCHS expects to assign the new code. However, it is preferable and more straightforward for certifiers to use the standard terminology (COVID-19). What happens if the terms reported on the death certificate indicate uncertainty? If the death certificate reports terms such as “probable COVID-19” or “likely COVID-19,” these terms would be assigned the new ICD code. It Is not likely that NCHS will follow up on these cases. If “pending COVID-19 testing” is reported on the death certificate, this would be considered a pending record. In this scenario, NCHS would expect to receive an updated record, since the code will likely result in R99. In this case, NCHS will ask the states to follow up to verify if test results confirmed that the decedent had COVID19. Do I need to make any changes at the jurisdictional level to accommodate the new ICD code? Not necessarily, but you will want to confirm that your systems and programs do not behave as if U07.1 is an unknown code. Should “COVID-19” be reported on the death certificate only with a confirmed test? COVID-19 should be reported on the death certificate for all decedents where the disease caused or is assumed to have caused or contributed to death. Certifiers should include as much detail as possible based on their knowledge of the case, medical records, laboratory testing, etc. If the decedent had other chronic conditions such as COPD or asthma that may have also contributed, these conditions can be reported in Part II. (See attached Guidance for Certifying COVID-19 Deaths)
  4. BTW, I was fiddling with some more basic models just more detailed than the quickie I posted yesterday. If one assumes that people who get infected will not pass on the infection after 14 days, you get about a 20% reduction in total infections after 30 days.and nearly 50% after 60 days. Still mind-numbing totals if the curve isn't bent down.
  5. Quickie graphic showing total deaths as a function of rate over 60 days. The growth factors are in 10s so 1 = 10%/day and so on. 10 is close to Washington State. 40 is a bit worse than NY. At the moment it really looks like one should look to what WA is doing and what they are doing and have done is to implement distancing measures early starting on Mar 11. NYC was a week to 10 or more days later. In between NY and WA we basically see the population of a small city of deaths difference after 60 days. Even 30 days shows basically a 2x difference.
  6. You are talking totals, As I tried to communicate, rate of growth is the key parameter to compare between locales when an exponential term is involved as it quickly overwhelms every other factor in the math after several compoundings (calculus, sorry). Here NY is the highest, but as I said, the real outlier is Washington State. Why? Inslee intervened early and hard and the population largely followed suit is one likely explanation. CA is somewhat on the low side as well, but not an outlier, I suspect for many of the same reasons as WA: Distancing simply works to slow exponential growth. Compounding at 12% daily is just different from compounding 20-36% daily.
  7. Going with the data so far, NY is a bit worse but not a terrible outlier by any means--especially as it took off there early and it is an anthill. The REAL outlier is where it started in the US: Washington State. They have limited the death rate quite significantly over every other state reporting 50+ dead to date. Even though they have been dealing with things the longest. Note that rate growth (first derivative) here is an exponential factor which is compounded daily. It is much more indicative of the future course than simple totals to date.
  8. AFF and interested parties: 538 has a good article on pandemic forecast models here: https://fivethirtyeight.com/features/best-case-and-worst-case-coronavirus-forecasts-are-very-far-apart/ It makes the point that the lack of testing data is key to the large error bars since modeling with insufficient data is especially fraught. As well they make the point that the WH model--if there is one, that is actually unknown given the secrecy--is a bit of an outlier on the lower end (though at least it is on the scale). Of course the WH model could well turn out to be "correct" since the time frame was not defined and in an exponential model that is a rather key omission. That will allow later for the WH to say, for example, "well we were only talking about up to July" (or whatever).
  9. I managed about 30 or 40 computers at that time. About 5 or 6 as I remember failed with the Y2K bug and fixed in advance. Therefore there was no Y2K problem. Yeah! great logic!
  10. Disagree they are garbage. The 2 come from different sources and have different underlying assumptions. The 1.7 million dead number from the CDC for medical purposes assumes (at the grossest level) a .005% death rate and a near 100% infection rate. This is an important number to be aware of in preparing and we could well reach it regardless of strategy over time if no vaccine comes on line. The lower number from WH for political purposes assumes that either the death rate is far lower or the herd to be infected is 10x smaller like perhaps through a quickly available vaccine (unlikely). Or possibly if we can break the back of the exponential curve and get some test kits we can go back to methods which are known to work: Extreme testing of all persons and contact tracing/quarantine of contacts. It also neglects to state time course which is a key omission which I doubt is accidental. Haven't talked to many docs, but the few I have are thinking much over the WH rate even with social distancing over the next year. The up side is the system won't get overwhelmed a la the graphic I posted this morning.
  11. On that, I think, you will find almost universal agreement.
  12. Yeah. As I mentioned on the science thread, this is precisely the opposite of how one provides scientifically valid numbers. That said, predictions where exponents are involved are very, very tricky (hence the problem with much of economics). Anyone who goes more than a very few iterations ahead is adding in a lot of assumptions many of which are likely to change slightly--which is enough to throw the models out of whack.
  13. In the interests of fairness, I don't think that's what he said. He said, as I have, that there are economic consequences--and as you note health consequences as well--to all possible future routes. Rather that it is by no means clear the consequences--even solely economic ones--of not social distancing are better than engaging in it.
  14. Indiana is a hot spot as well. Not exact an anthill like some of the other places.
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