Coronavirus

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cowboypack02
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lumberpack5 said:

cowboypack02 said:

lumberpack5 said:

There is an underlying American policy issue here that could stand some discussion - the amount of medical treatment given to Septuagenarians, Octogenarians, and Nonagenarians. The health profession that we are attempting to protect is most vulnerable when they are treating the very old. The cost/benefit to society is very high when you lose a healthcare or emergency responder for several really old people.

The laws, payments systems, and training all encourage heroic and expensive treatments for those in their last 10% of life.

Personally I think society should spend more on the very young. That's the better economic choice.


I don't think that's very fair to those people considering that they have paid into the system their entire life
Paying into a system should cause you to get how big a benefit? Resources are not finite. I agree it's not "fair" but life is not fair. Does it make sense to spend so much on those that will not contribute back to society? From an economic standpoint a lot of resources are wasted on the very old.


Does it make sense to spend so much on a segment of the population that has not contributed yet instead of the segment of the population that worked for that money to be there?

To answer your question...yes, you should get the benefit when you are the one that created the benefit to start with
Daviewolf83
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lumberpack5 said:

cowboypack02 said:

lumberpack5 said:

There is an underlying American policy issue here that could stand some discussion - the amount of medical treatment given to Septuagenarians, Octogenarians, and Nonagenarians. The health profession that we are attempting to protect is most vulnerable when they are treating the very old. The cost/benefit to society is very high when you lose a healthcare or emergency responder for several really old people.

The laws, payments systems, and training all encourage heroic and expensive treatments for those in their last 10% of life.

Personally I think society should spend more on the very young. That's the better economic choice.


I don't think that's very fair to those people considering that they have paid into the system their entire life
Paying into a system should cause you to get how big a benefit? Resources are not finite. I agree it's not "fair" but life is not fair. Does it make sense to spend so much on those that will not contribute back to society? From an economic standpoint a lot of resources are wasted on the very old.
My son is taking a bio-ethics course next semester (part of his pre-med curriculum) and I am sure this will be a topic for discussion.
IseWolf22
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cowboypack02 said:

lumberpack5 said:

cowboypack02 said:

lumberpack5 said:

There is an underlying American policy issue here that could stand some discussion - the amount of medical treatment given to Septuagenarians, Octogenarians, and Nonagenarians. The health profession that we are attempting to protect is most vulnerable when they are treating the very old. The cost/benefit to society is very high when you lose a healthcare or emergency responder for several really old people.

The laws, payments systems, and training all encourage heroic and expensive treatments for those in their last 10% of life.

Personally I think society should spend more on the very young. That's the better economic choice.


I don't think that's very fair to those people considering that they have paid into the system their entire life
Paying into a system should cause you to get how big a benefit? Resources are not finite. I agree it's not "fair" but life is not fair. Does it make sense to spend so much on those that will not contribute back to society? From an economic standpoint a lot of resources are wasted on the very old.


Does it make sense to spend so much on a segment of the population that has not contributed yet instead of the segment of the population that worked for that money to be there?

To answer your question...yes, you should get the benefit when you are the one that created the benefit to start with

There is no guarantee that the person reaping the benefit of that care late in life have paid in or contributed. Lots of people are free loaders and some treatments are more resource intensive than an average worker makes in their life.
You can also argue that spending more on the young instead of the old would be an investment that paid off in economic returns over an entire life rather than concentrated on an older person in their last year of life
RunsWithWolves26
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IseWolf22 said:

cowboypack02 said:

lumberpack5 said:

cowboypack02 said:

lumberpack5 said:

There is an underlying American policy issue here that could stand some discussion - the amount of medical treatment given to Septuagenarians, Octogenarians, and Nonagenarians. The health profession that we are attempting to protect is most vulnerable when they are treating the very old. The cost/benefit to society is very high when you lose a healthcare or emergency responder for several really old people.

The laws, payments systems, and training all encourage heroic and expensive treatments for those in their last 10% of life.

Personally I think society should spend more on the very young. That's the better economic choice.


I don't think that's very fair to those people considering that they have paid into the system their entire life
Paying into a system should cause you to get how big a benefit? Resources are not finite. I agree it's not "fair" but life is not fair. Does it make sense to spend so much on those that will not contribute back to society? From an economic standpoint a lot of resources are wasted on the very old.


Does it make sense to spend so much on a segment of the population that has not contributed yet instead of the segment of the population that worked for that money to be there?

To answer your question...yes, you should get the benefit when you are the one that created the benefit to start with

There is no guarantee that the person reaping the benefit of that care late in life have paid in or contributed. Lots of people are free loaders and some treatments are more resource intensive than an average worker makes in their life.
You can also argue that spending more on the young instead of the old would be an investment that paid off in economic returns over an entire life rather than concentrated on an older person in their last year of life


I sure am glad you ain't in charge of things for my grandma's sake.
Danny Teal
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Damn some of the comments on here are cold!
acslater1344
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Some of y'all must really hate your in laws
Glasswolf
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RunsWithWolves26 said:

IseWolf22 said:

cowboypack02 said:

lumberpack5 said:

cowboypack02 said:

lumberpack5 said:

There is an underlying American policy issue here that could stand some discussion - the amount of medical treatment given to Septuagenarians, Octogenarians, and Nonagenarians. The health profession that we are attempting to protect is most vulnerable when they are treating the very old. The cost/benefit to society is very high when you lose a healthcare or emergency responder for several really old people.

The laws, payments systems, and training all encourage heroic and expensive treatments for those in their last 10% of life.

Personally I think society should spend more on the very young. That's the better economic choice.


I don't think that's very fair to those people considering that they have paid into the system their entire life
Paying into a system should cause you to get how big a benefit? Resources are not finite. I agree it's not "fair" but life is not fair. Does it make sense to spend so much on those that will not contribute back to society? From an economic standpoint a lot of resources are wasted on the very old.


Does it make sense to spend so much on a segment of the population that has not contributed yet instead of the segment of the population that worked for that money to be there?

To answer your question...yes, you should get the benefit when you are the one that created the benefit to start with

There is no guarantee that the person reaping the benefit of that care late in life have paid in or contributed. Lots of people are free loaders and some treatments are more resource intensive than an average worker makes in their life.
You can also argue that spending more on the young instead of the old would be an investment that paid off in economic returns over an entire life rather than concentrated on an older person in their last year of life


I sure am glad you ain't in charge of things for my grandma's sake.
curious to see if this posters mind set will change when they reach a certain age in life
Payton Wilson on what he thought of Carter Finley: Drunk Crazy Crowded

cowboypack02
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IseWolf22 said:

cowboypack02 said:

lumberpack5 said:

cowboypack02 said:

lumberpack5 said:

There is an underlying American policy issue here that could stand some discussion - the amount of medical treatment given to Septuagenarians, Octogenarians, and Nonagenarians. The health profession that we are attempting to protect is most vulnerable when they are treating the very old. The cost/benefit to society is very high when you lose a healthcare or emergency responder for several really old people.

The laws, payments systems, and training all encourage heroic and expensive treatments for those in their last 10% of life.

Personally I think society should spend more on the very young. That's the better economic choice.


I don't think that's very fair to those people considering that they have paid into the system their entire life
Paying into a system should cause you to get how big a benefit? Resources are not finite. I agree it's not "fair" but life is not fair. Does it make sense to spend so much on those that will not contribute back to society? From an economic standpoint a lot of resources are wasted on the very old.


Does it make sense to spend so much on a segment of the population that has not contributed yet instead of the segment of the population that worked for that money to be there?

To answer your question...yes, you should get the benefit when you are the one that created the benefit to start with

There is no guarantee that the person reaping the benefit of that care late in life have paid in or contributed. Lots of people are free loaders and some treatments are more resource intensive than an average worker makes in their life.
You can also argue that spending more on the young instead of the old would be an investment that paid off in economic returns over an entire life rather than concentrated on an older person in their last year of life


I firmly believe that we as a society should take care of the elderly, young children, and the disabled. If you are just freeloading my tax dollars shouldn't be going to help you. If you made a living laying on your back my tax dollars shouldn't be going to help you. If you are making a living off of the women who are making theirs by laying on their back my tax dollars shouldn't be helping you
barnburner
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Pretty good information from yesterday from State Senator Jeff Jackson.. it's long.. most interesting is part about PPE and what NC and other states are dealing with there..

Friend,
CURRENT NC STATS
  • 6,300+ positive cases (we've got 13 labs running but we're still strictly rationing our tests)
  • 429 currently hospitalized
  • 174 deaths
SOCIAL DISTANCING IS WORKING
We are winning the battle against peak infection. We can see that in the numbers. The statewide doubling time has gone from 2.5 days to 10 days. That means it's slowing down.
Mecklenburg has not made quite as much progress. Our doubling time has gone from 2.85 days to 6 days - still slowing, but not as much as the rest of the state. That could be because of general density, or different levels of testing, or the presence of more specific hot spots like nursing homes, or some combination.
But let's zoom out and look at the big picture for North Carolina.
[url=https://act.myngp.com/el/05oU9kKNS2Yxit6n83qLBXUr8nS3DNrZOWaoGkeT-ww=/DVyA_AKkVbutc-S8N1Ox9aixO9BrfvNNm8O3TMu3OZc=?width=600&format=png&auto=webp&s=7925117db9bffd1a797bb0142a9ec63a9eee42de][/url]
It's been just over two full weeks since the stay at home order went into effect. That means we're just now getting the earliest possible snapshot of the results (given incubation time + time it takes to get tested + time it takes to be hospitalized).
And the early returns look pretty good.
You can see that hospitalizations are not growing as quickly as they were two weeks ago.
If we continue to see the rate of hospitalization slow down, then that means we are on course to get past the peak while minimizing the loss of life in our state. In short, if we keep this up then we won't max out our ICU capacity.
That's a remarkable accomplishment, especially given that our collective action as individuals was overwhelmingly responsible for making it happen. This is a citizen-led pandemic response, and it appears to be working.
That means we're now in a position to start having a realistic conversation about what reopening will look like.
WE ONLY WANT TO REOPEN ONCE
The early idea about when to reopen was that we first had to get past the peak and then watch the downward trend continue for about two weeks to make sure we had this under control. (And that's currently the formal guidance coming from the White House, despite certain tweets suggesting otherwise...)
But in North Carolina we've got at least three different models for the state projecting different peak times, with one model saying our state peaked a few days ago and the model that Mecklenburg is using saying our county will peak in early June. The problem is that the more effective we are at flattening the curve, the more it will push the peak out.
That may be why Mecklenburg's County Manager said this week that it might be possible to at least partially reopen before we know we've passed the peak, as long as we've severely flattened the curve and met other conditions (i.e., increase in testing) that give us real confidence that we've got this under control.
But keep in mind that from the standpoint of the rest of the state, Mecklenburg poses the biggest risk. We have twice as many cases as any other county. Our reopening will receive more scrutiny than anyone else's.
When our state does start to reopen, you can expect it to come in phases, you can expect a major emphasis on wearing masks, and you can expect lots of folks getting their temperatures checked on a regular basis.
Why the caution? Because while different models show different peak times, all the models we're using agree on what happens if we let up before we have this under control: We get a viral surge that undoes all the sacrifice people have made.
Remember: The nightmare scenario from an economic standpoint is that we reopen before we're ready, infection spikes, and we have to reclose. We cannot let that happen. We only want to restart this economic engine once because every time you turn it off it does a ton of damage.
And the only way we can reopen and remain open is if flatten the curve AND get widespread testing. Which brings us to...
TESTING UPDATE
We're making some progress on this front. Take a look.

[url=https://act.myngp.com/el/05oU9kKNS2Yxit6n83qLBXUr8nS3DNrZOWaoGkeT-ww=/dqm4tpdu7oY9EF5dxEyAc6RfKE_f-qqkpfiZE8HF1ls=?width=600&format=png&auto=webp&s=bac93b5928877d33920283dc413c393dec503378][/url]
But Sec. Cohen (NC DHHS) says we need to at least double our testing capacity from here. That's because once we reopen the odds of future localized outbreaks in North Carolina are 100%. When they happen, we're either going to have to reclose OR have access to widespread testing that allows us to quickly identify and contain the outbreak.
There's no third option. It's reclosures or much more testing.
Right now the biggest bottleneck for testing is the PPE that health care workers have to wear to administer the tests. Yes, we still don't have as many test kits as we'd like, but that's not the critical shortage right now. (And specifically, the most critical PPE shortage we have in North Carolina is surgical gowns.)
The big problem here is that we're still in a bidding war against other states. We've made over $150m worth of bids and only a fraction have been filled. This is now a national problem and it probably requires some federal coordination to solve. It's the wild west getting your hands on PPE right now and we need a smarter approach. This directly impacts our ability to scale up testing, which directly impacts our ability to reopen and remain open.
QUICK ITEMS
  • Please don't worry about getting you car inspected right now. When we go back into session this month we're going to retroactively extend vehicle inspection deadlines.
  • The unemployment system has made major staffing additions that are helping bring down wait times, but they're still swamped. If you are self-employed or a contractor, they will be ready to accept your application on April 25th. If you are self-employed or a contractor and have already filed and been denied, DES is saying that you will "most likely need to re-apply." 636,000 North Carolinians have filed for unemployment insurance in the last five weeks. As of today, $358 million in benefits has been sent to 211,000 claimants.
  • We've had a major outbreak at Neuse Correctional Institution in Goldsboro. Out of 700 inmates, 259 have tested positive. 98% were asymptomatic. In North Carolina, prison officials have been allowing some nonviolent offenders - the vast majority of whom are either pregnant or over the age of 65 - to complete their sentence under community supervision.
  • The state has launched two mental health hotlines. For the general population there's Hope4NC Hotline: 1-855-587-3463. For first responders and health care workers, there's Hope4Healers Hotline: (919) 226-2002.
  • About 56% of child care providers are currently open. DHHS now has an emergency subsidy to cover the cost of childcare for parents who are classified as essential workers and have no other child-care options while also falling below 300% of the federal poverty line. Call (888) 600-1685.
  • We're scheduled to go back into session on April 28th. It looks like we'll still be voting in the senate chamber although we'll no longer have to be at our assigned desks to vote - we'll just have to be physically in the chamber. But committee meetings are going to be held virtually. It's also looking we're going to have two sessions this year instead of one. The first will start on April 28th and will likely be very short. The next will be in late summer and will be longer.

EMAIL
For those of you who received this email from a kind friend who forwarded it to you, if you'd like to sign up you can do that here.

More updates soon,

Sen. Jeff Jackson

District 37
Mecklenburg
Wayland
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That linked model that Meck County uses is a joke. They plugged some numbers in a UPenn website that they were not qualified to use and then quoted the results as actual analysis. And no one called them out on it.

You can heavily manipulate the curves on the UPenn model with the Social Distancing input, basically making it say whatever you want. Try it. https://penn-chime.phl.io
Daviewolf83
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Thanks for posting Senator Jackson's update. I read his update last night, after it was posted on Facebook by a friend of mine. With regards to the hospitalization chart he posted, it is a little misleading, since you can not see the rate of change and it makes it appear that hospitalizations are continuing to trend up. The bump up earlier this week in the hospitalizations was due to a reporting delay due to the Easter weekend and likely not due to a significant increase in cases. If you look at hospitalizations and normalize for the reporting delay, the rate of change of hospitalizations is flat. It has averaged 398 people over the past nine days.

The model he mentions Mecklenburg County is using is the one the state is using. It is not the IHME model that the Federal government and some other states have been using for their projections. All versions of the IHME models have overstated the total number of deaths and the impact to healthcare capacity and the model Mecklenburg County is using is even more overstates what the IHME model projects. Earlier this week, the Mechlenburg County model was projecting that Charlotte would need to ask the Federal government to construct a field hospital to handle an overload in hospitalizations By the middle of the week, the two major hospitals sent a letter to the Mecklenburg County manager, saying they will NOT need additional capacity and can handle any hospitalizations they have with current capacity.

In Senator Jackson's update last week, he focused on the Abbott Labs rapid test and how the state did not have enough of those tests to scale testing. I am not sure why he focused on this particular test, since it is not considered the testing method to be used for the majority of testing, due to his low daily capacity (approx. 4 tests per hour). The large scale testing will be handled by other types of test equipment, since it offers much greater through-put and capacity. According to Admiral Giroir, the private labs have excess capacity sitting idle, waiting for the states to send them samples to test.

If Dr. Cohen's estimates are accurate (need to double testing), the state of NC currently has the physical capacity necessary for the doubling, based on the information Dr. Birx provided on Friday. According to Dr. Birx, NC currently has capacity to complete 500,000 to 999,000 tests per month. Currently, NC is averaging 3,322 completed tests per day. If you double this and project across 31 days, NC will need to complete 205,964 tests per month. This amount is less than half of the lower range for current monthly testing capacity for NC. Also, in the update Admiral Giroir provided on Friday, he indicated that the CDC will assist with sentinel testing for the at-risk populations in nursing homes and in large metro areas. The CDC will be sending 16 people to NC to coordinate the testing.

Admiral Giroir also pointed out that testing does not need to include large percentages of the population. For example, he said if you are testing 100 people to find 10 cases, you are over-sampling and this level of testing is not required. He said the states need to test enough people to find 1 out of 10 infected people and they need to test enough to reach this percentage. Currently, NC is finding about 0.8 out of 10 infected people, based on the NCDHHS statistics, so they are not far off from the 1 out of 10 percentage required.

As to PPE, we do know this has been a problem and the federal government HAS been assisting. I am not sure why he gives the impression that the Federal government has not been involved. The Federal government is looking to the states to procure their own PPE, but they have been working with lots of manufacturers to increase the supply of this critical item. Additionally, the federal government has also been flying in PPE for the past several weeks. The procurement and transportation of the Federal government is being handled by the US military logistics arm. In my opinion, this is the best organization in the world for handling this type of logistical operation. I firmly believe the supply of PPE will continue to improve, especially as the number of cases continues to decline in many of the hardest hit areas like NY and NJ.
Wayland
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Wayland said:

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https://www.ncdhhs.gov/covid-19-case-count-nc

3/31/2020 Morning DHHS update

NC Cases*
1,498
NC Deaths**
8
Currently Hospitalized
157

4/1/2020 Morning DHHS update

NC Cases*
1584
NC Deaths**
10
Currently Hospitalized
204


4/2/2020 Morning DHHS update (as of 11:00am)

NC Cases*
1857
NC Deaths**
16
Currently Hospitalized
184

4/3/2020 Morning DHHS update (as of 11:25am)

NC Cases*
2093
NC Deaths**
19
Currently Hospitalized
259

Guilford now shows 3 deaths and Mecklenburg 2.

15 deaths > 65 age (20% of positive cases)
2 deaths between 50-64 age (28% of positive cases)
2 deaths between 25-49 age (43% of positive cases)

2919 additional completed tests, 236 positive results for a 8.1% positive test rate day to day.

4/4/2020 Morning DHHS update (as of 11:00am)

NC Cases*
2402
NC Deaths**
24
Currently Hospitalized
271

Looks like DHHS is lagging in numbers today, since we should have had at least 5 more deaths in the morning count. Guilford only showing 3 deaths in this count and they are at 5 or 6. DHHS only reports lab confirmed reported deaths, so maybe the local health departments either aren't reporting or don't have lab confirmation on the media counts?

Congregate Data:
6 Nursing Homes, 4 Residential Care, 2 Correctional Facilities, and 1 Other have 2 more more lab confirmed cases. Considered Outbreak.
4/5/2020 Morning DHHS update (as of 11:00am)

NC Cases*
2585
NC Deaths**
31
Currently Hospitalized
261

Deaths in NC
26 > 65 years of age
3 Between 50-64 years of age
2 Between 25-49 years of age



4/6/2020 Morning DHHS update (as of 11:00am)

NC Cases*
2870
NC Deaths**
33
Currently Hospitalized
270



4/7/2020 Morning DHHS update (as of 10:15am)

NC Cases*
3221
NC Deaths**
46
Currently Hospitalized
354

Worst day. Although some of that total looks to be the lag that the media had that DHHS wasn't reported. 80% of total deaths 65+ years of age.

The highest day for positive cases by collective sample is still 3/23/2020 second highest is 4/1/2020. But positive cases still awful metric since testing is not consistent.
4/8/2020 Morning DHHS update (as of 11:00am)

NC Cases*
3326
NC Deaths**
53
Currently Hospitalized
386
Completed Tests
42987


4/9/2020 Morning DHHS update (as of 11:00am)

NC Cases*
3651
NC Deaths**
65
Currently Hospitalized
398
Completed Tests
47809

Looks like deaths now align with media totals for the morning. 82% of deaths > 65

16 Nursing Homes, 4 Residential Care Facilities, 4 Correctional Facilities, and 1 Other with outbreaks.
4/10/2020 Morning DHHS update (as of 11:00am)

NC Cases*
3908
NC Deaths**
74
Currently Hospitalized
423
Completed Tests
57645

A 2.5% positive test rate is insanely low.

23 Nursing Homes, 6 Residential Care Facilities, 5 Correctional Facilities, and 1 Other with outbreaks.

7 Additional nursing home since YESTERDAY (and 2 additional residential care). Just goes to show you how ineffective this has all been when we aren't actually protecting the most vulnerable. Time for a shift in strategy.
4/11/2020 Morning DHHS update (as of 11:38am)

NC Cases*
4312
NC Deaths**
80
Currently Hospitalized
362
Completed Tests
60393

Hospitalizations down.

Media reporting 84 deaths (so still a gap in reporting there)

2 more Nursing Homes 1 more Residential to add to outbreaks.


4/12/2020 Morning DHHS update (as of 10:45am)

NC Cases*
4520
NC Deaths**
81
Currently Hospitalized
331
Completed Tests
62139


4/13/2020 Morning DHHS update (as of 10:45am)

NC Cases*
4816
NC Deaths**
86
Currently Hospitalized
313
Completed Tests
63,388

4/14/2020 Morning DHHS update (as of 11:00am)

NC Cases*
5024
NC Deaths**
108
Currently Hospitalized
418
Completed Tests
65039

Now up to 30 nursing home outbreaks, 9 residential care, 6 correctional, and 1 other. Continues to explode here.
4/15/2020 Morning DHHS update (as of 11:00am)

NC Cases*
5123
NC Deaths**
117
Currently Hospitalized
431
Completed Tests
67827

4/16/2020 Morning DHHS update (as of 11:00am)

NC Cases*
5465
NC Deaths**
131
Currently Hospitalized
452 (88% hospital reporting)
Completed Tests
70917


Interesting the >65 death rate seems to have spiked. It was around 80% for a long time, and is now at 84%


4/17/2020 Morning DHHS update (as of 11:00am)

NC Cases*
5859
NC Deaths**
152
Currently Hospitalized
429 (87% hospital reporting)
Completed Tests
72981
4/18/2020 Morning DHHS update (as of 11:00am)

NC Cases*
6140
NC Deaths**
164
Currently Hospitalized
388 (88% hospital reporting)
Completed Tests
76211

59 Deaths are now Congregate (+5 since yesterday)
18 Deaths can't be confirmed Con/Not (+2 since yesterday)

55 Congregate Facilities now have an outbreak.


4/19/2020 Morning DHHS update (as of 11:00am)

NC Cases*
6493
NC Deaths**
172
Currently Hospitalized
465
Completed Tests
78772

66 Deaths are now Congregate (+7 since yesterday)
18 Deaths can't be confirmed Con/Not

That means 7 of the 8 deaths added to the total since yesterday are congregate deaths

59 Congregate Facilities now have an outbreak. (+4)

WRAL is at 188 (+2) and NandO is at 185. Again, the lag, I am guess is coming in trying to confirm death location. Don't know why the lag since WRAL was in the 180s on Friday.

85% of the deaths are 65+. That number keeps creeping up.
Wayland
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Looking at the WRAL case map, they have Henderson county with 0 long term care cases. While the DHHS has 3 congregate outbreaks there which makes more sense as to why they have 12 deaths. Lots of disconnects in the various reporting data sources.
Daviewolf83
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I predict at least half the deaths when this is over will be from the long-term care facilities and congregate facilities. This would map to what Spain, Italy, France, and other European countries reported. I would also predict the average age of death is 80+.
Wayland
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Daviewolf83 said:

I predict at least half the deaths when this is over will be from the long-term care facilities and congregate facilities. This would map to what Spain, Italy, France, and other European countries reported. I would also predict the average age of death is 80+.


NandO reporting Meck County has 7 nursing home outbreaks.
Daviewolf83
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Wayland said:

Daviewolf83 said:

I predict at least half the deaths when this is over will be from the long-term care facilities and congregate facilities. This would map to what Spain, Italy, France, and other European countries reported. I would also predict the average age of death is 80+.


NandO reporting Meck County has 7 nursing home outbreaks.
If NC continues to split out cases and deaths from congregate facilities, I believe I will be able to present graphs that show for the general population that cases and deaths are actually falling. This would say we need to focus on protecting the congregate facilities and start moving into Phase 1 for the general population. Phase 1 calls for the continued lock-down of congregate facilities and hospitals, so moving to Phase 1 should be able to happen by end of April.

I also am a realist and recognize the leadership of this state and the news media are not smart enough to understand this nuance and move into Phase 1.
Wayland
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Daviewolf83 said:

Wayland said:

Daviewolf83 said:

I predict at least half the deaths when this is over will be from the long-term care facilities and congregate facilities. This would map to what Spain, Italy, France, and other European countries reported. I would also predict the average age of death is 80+.


NandO reporting Meck County has 7 nursing home outbreaks.
If NC continues to split out cases and deaths from congregate facilities, I believe I will be able to present graphs that show for the general population that cases and deaths are actually falling. This would say we need to focus on protecting the congregate facilities and start moving into Phase 1 for the general population. Phase 1 calls for the continued lock-down of congregate facilities and hospitals, so moving to Phase 1 should be able to happen by end of April.

I also am a realist and recognize the leadership of this state and the news media are not smart enough to understand this nuance and move into Phase 1.
Keep pressing media and other sources as well. You do a great job presenting the data and summarizing the overall status. Enjoy reading what you have to say.

Also, as the spread continues in these nursing facilities your are going to get an increased number of deaths picked up as corona that were otherwise inevitable. Since 250-300 people die a day in North Carolina, you will pick up a couple crossover deaths.

Really want to see congregate numbers out of Mecklenburg. They just updated their counts from 1178 cases 24 deaths to 1183 cases and 29 deaths. Are they doing probables now or just lab cases because 5 for 5 is something. Maybe old deaths that just came back now? Would love to see real trend data if counties are going to start going back and adding from previous days/weeks.
packgrad
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SC expected to open beaches and some retail stores this week.
packgrad
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Wrightsville too.

Bismarck
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Can I say that reading much of this thread and the quality info. provided makes me proud of my State degree. Cuts through a lot of the garbage out there and gets to practical, useful info.

Go Pack!
Pacfanweb
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Bismarck said:

Can I say that reading much of this thread and the quality info. provided makes me proud of my State degree. Cuts through a lot of the garbage out there and gets to practical, useful info.

Go Pack!
One of the reasons that what little I post now, I do it here and not on another site. Shame what's happened there.
I do enjoy the serious discussion here without having to scroll through pages of trolling to figure out what's happening.
Steve Williams
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Staff
Pacfanweb said:

Bismarck said:

Can I say that reading much of this thread and the quality info. provided makes me proud of my State degree. Cuts through a lot of the garbage out there and gets to practical, useful info.

Go Pack!
One of the reasons that what little I post now, I do it here and not on another site. Shame what's happened there.
I do enjoy the serious discussion here without having to scroll through pages of trolling to figure out what's happening.
Definitely. This thread has been my go-to for C-19 info.
Wayland
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I was talking to my sister over the weekend, and she was telling me about the situation in Boise. They have drive through testing there, she said there were people in essentially full hazmat suits standing in the middle of an empty parking lot. She had only ever seen one or two cars go through the drive through testing.

While I do think we should have some sort of public test site identified and available, we are well beyond needing 'mass testing'. We need rapid testing to handle congregate or other outbreaks and surveillance and trace, but the actual raw numbers of tests to achieve that should be relatively low.

Testing plans should be focused and targeted at this point and not broad sweeping actions. I feel like we are already past some of the targets that the government seems to be focused on for testing efforts. Maybe I am wrong though.
IseWolf22
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Glasswolf said:

RunsWithWolves26 said:

IseWolf22 said:

cowboypack02 said:

lumberpack5 said:

cowboypack02 said:

lumberpack5 said:

There is an underlying American policy issue here that could stand some discussion - the amount of medical treatment given to Septuagenarians, Octogenarians, and Nonagenarians. The health profession that we are attempting to protect is most vulnerable when they are treating the very old. The cost/benefit to society is very high when you lose a healthcare or emergency responder for several really old people.

The laws, payments systems, and training all encourage heroic and expensive treatments for those in their last 10% of life.

Personally I think society should spend more on the very young. That's the better economic choice.


I don't think that's very fair to those people considering that they have paid into the system their entire life
Paying into a system should cause you to get how big a benefit? Resources are not finite. I agree it's not "fair" but life is not fair. Does it make sense to spend so much on those that will not contribute back to society? From an economic standpoint a lot of resources are wasted on the very old.


Does it make sense to spend so much on a segment of the population that has not contributed yet instead of the segment of the population that worked for that money to be there?

To answer your question...yes, you should get the benefit when you are the one that created the benefit to start with

There is no guarantee that the person reaping the benefit of that care late in life have paid in or contributed. Lots of people are free loaders and some treatments are more resource intensive than an average worker makes in their life.
You can also argue that spending more on the young instead of the old would be an investment that paid off in economic returns over an entire life rather than concentrated on an older person in their last year of life


I sure am glad you ain't in charge of things for my grandma's sake.
curious to see if this posters mind set will change when they reach a certain age in life
Lol, both of you get off your high horse.

The context of the discussion was whether the allocation of finite resources is shifted too far toward the elderly and at the expense of the young. Over half of the healthcare money spent over the course of an average person's life is spent after they are a senior citizen. That spending concentrates further in the last year of life. Modern medicine is really good at getting a few extra months out of elderly patients with a low quality of life. The money spent on end of life hero measures would do better for society allocated to something like universal pre-K. That is an investment that pays societal dividends over decades.

Given my parents taught me to think this way and have made me aware of their end of life orders since I was a teenager, I doubt my mindset will change as I get older. Our family was taught to value is quality of life, and not to focus on prolonging quantity unnecessarily when the end inevitably approaches.
Wayland
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4/17/2020 Morning DHHS update (as of 11:00am)

NC Cases*
5859
NC Deaths**
152
Currently Hospitalized
429 (87% hospital reporting)
Completed Tests
72981

4/18/2020 Morning DHHS update (as of 11:00am)

NC Cases*
6140
NC Deaths**
164
Currently Hospitalized
388 (88% hospital reporting)
Completed Tests
76211

4/19/2020 Morning DHHS update (as of 11:00am)

NC Cases*
6493
NC Deaths**
172
Currently Hospitalized
465
Completed Tests
78772

66 Deaths are now Congregate (+7 since yesterday)
18 Deaths can't be confirmed Con/Not

That means 7 of the 8 deaths added to the total since yesterday are congregate deaths

59 Congregate Facilities now have an outbreak. (+4)

WRAL is at 188 (+2) and NandO is at 185. Again, the lag, I am guess is coming in trying to confirm death location. Don't know why the lag since WRAL was in the 180s on Friday.

85% of the deaths are 65+. That number keeps creeping up.
--------------------------------------------------------------------------------------------------------------------------------------
4/20/2020 Morning DHHS update (as of 11:00am)

NC Cases*
6764
NC Deaths**
179
Currently Hospitalized
373
Completed Tests
79484

73 Deaths are now Congregate (+7 since yesterday)
20 Deaths can't be confirmed Con/Not (+2)

NC Deaths went up by 7 but Congregate/unconfirmed went up by 9.

61 Congregate Facilities now have an outbreak. (+2)

WRAL is at 196 (+2) and NandO is at 199. Again, the lag, I am guess is coming in trying to confirm death location. Don't know why the lag since WRAL was in the 180s on Friday. Maybe counties are reporting deaths that aren't lab confirmed?

Deaths under 50 down to 4%

Still don't know why the crazy lag on DHHS. They are now 13-16 deaths behind yesterdays media counts.
statefan91
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So the State + Lab Companies completed < 1000 tests from yesterday's update to today's?

Seriously what the **** are they doing?
Wayland
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statefan91 said:

So the State + Lab Companies completed < 1000 tests from yesterday's update to today's?

Seriously what the **** are they doing?
Again could be weekend lag, but based on the crazy high positives in that small sample that is most likely coming out of that prison corona outbreak (and other congregate facilities).
Daviewolf83
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I am only attaching one chart right now that shows the Actual Deaths compared with all of the versions/updates to the IHME model. Of course, I am using the official death count from the NCDHHS website, so it is behind the count from the N&O and WRAL. Since the actual reported deaths seem to be lagging and they are above the 4/17 projections for the date of 4/20, I suspect a projection between the 4/13 and the 4/17 model projections is more inline with actual deaths. As such, I would project, given current trends, that actual total deaths will come in a little higher than 300 when this surge in the virus ends. As I have said before, we will continue to have cases and deaths from the virus, even after stay-at-home restrictions are lifted and likely even after the vaccine is made available.

It is interesting that all of the new daily deaths reported by NCDHHS yesterday were from Congregate facilities. There were no deaths reported by them from the general population and the day before only 1 of the 8 deaths reported were from the non-Congregate (general) population. It will be interesting to see if this trend holds and if it it does, I believe it is a sign that the stay-at-home restrictions for the general population could be relaxed some. Also, it is interesting that hospitalizations fell by 92 after going up by 77 the previous day. Seems to be some reporting delays, but I would call the number of people hospitalized flat right now.


Wayland
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Interesting, those 5 late deaths by Mecklenburg (post Sunday evening) are included in the totals by DHHS, which means those likely came out of a congregate setting. But I still suspect they also likely occurred some days ago in the past and are not 'weekend' deaths

(Side Note. Cuomo reports under 500 deaths today in NY. Lowest since April 2)
RunsWithWolves26
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IseWolf22 said:

Glasswolf said:

RunsWithWolves26 said:

IseWolf22 said:

cowboypack02 said:

lumberpack5 said:

cowboypack02 said:

lumberpack5 said:

There is an underlying American policy issue here that could stand some discussion - the amount of medical treatment given to Septuagenarians, Octogenarians, and Nonagenarians. The health profession that we are attempting to protect is most vulnerable when they are treating the very old. The cost/benefit to society is very high when you lose a healthcare or emergency responder for several really old people.

The laws, payments systems, and training all encourage heroic and expensive treatments for those in their last 10% of life.

Personally I think society should spend more on the very young. That's the better economic choice.


I don't think that's very fair to those people considering that they have paid into the system their entire life
Paying into a system should cause you to get how big a benefit? Resources are not finite. I agree it's not "fair" but life is not fair. Does it make sense to spend so much on those that will not contribute back to society? From an economic standpoint a lot of resources are wasted on the very old.


Does it make sense to spend so much on a segment of the population that has not contributed yet instead of the segment of the population that worked for that money to be there?

To answer your question...yes, you should get the benefit when you are the one that created the benefit to start with

There is no guarantee that the person reaping the benefit of that care late in life have paid in or contributed. Lots of people are free loaders and some treatments are more resource intensive than an average worker makes in their life.
You can also argue that spending more on the young instead of the old would be an investment that paid off in economic returns over an entire life rather than concentrated on an older person in their last year of life


I sure am glad you ain't in charge of things for my grandma's sake.
curious to see if this posters mind set will change when they reach a certain age in life
Lol, both of you get off your high horse.

The context of the discussion was whether the allocation of finite resources is shifted too far toward the elderly and at the expense of the young. Over half of the healthcare money spent over the course of an average person's life is spent after they are a senior citizen. That spending concentrates further in the last year of life. Modern medicine is really good at getting a few extra months out of elderly patients with a low quality of life. The money spent on end of life hero measures would do better for society allocated to something like universal pre-K. That is an investment that pays societal dividends over decades.

Given my parents taught me to think this way and have made me aware of their end of life orders since I was a teenager, I doubt my mindset will change as I get older. Our family was taught to value is quality of life, and not to focus on prolonging quantity unnecessarily when the end inevitably approaches.


Just to clarify. Are you saying that my 83 year old grandma, who worked her entire life and paid into the system her entire life, doesn't deserve the same care or amount of care as someone who is 30 and hasn't?
Wayland
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Next NC briefing at 2pm today.

https://www.ncdps.gov/storm-update

When asked about time frame or specifics. All Cohen could say is we have a lot of data that we need to 'think' about. I know she isn't authorized to give a real answer, but amazing talking in circles.

Was funny though when she was asked about that April 6 crap study that was done and the dance she did about imperfect models and that she didn't know if those 'independent researchers' had updated their model. Someone must have realized what a joke that was and didn't want to revisit it.
Daviewolf83
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I sent the following earlier today to Tyler Dukes of WRAL. He provided his contact info on Twitter and he has been one of the main people at WRAL reporting on the virus.

I have been following your Tweets and articles on WRAL with regards to the Coronavirus over the past several weeks and have found them quite informative. As I am sure you know, we are all interested in what is happening with the virus and North Carolina's response to dealing with it. I have been maintaining time-series data on the virus in North Carolina, since the first testing began and update a spreadsheet daily with the updates from NCDHHS's website. I have also closely following the updates from the Federal taskforce and partigularly the updates from Dr. Birx and Dr. Fauci. Given my engineering education and background, I find the statistics of the virus, cases, and deaths to be interesting to track, along with the performance of the IHME model that is used by the Federal government and several other states.

To this end, there are a couple of questions I have that hopefully you can pursue.
1. Over the past couple of days, NCDHHS has begun separating out cases and deaths based on Congregate and Non-Congregate facilities. I had been tracking your updates to a map posted on WRAL, but having this more official information is helpful. I can only imagine how difficult it is to keep track of this information. The early data seems to indicate that the growth in daily new cases and daily deaths is starting to come more from the Congregate facilities and the daily new cases and deaths from Non-Congregate populations (the general public) are starting to fall. We also know from the data from many of the countries in Europe that approximately 50% of the deaths are coming from Congregate facilities. With this in mind, I have a couple of questions:
a. Given the large increases in Congregate deaths, what additional steps is the state of NC implementing to limit the spread?
b. The Federal government's phased approach calls for the continued lockdown of Congregate facilities and hospitals, even as society opens. As a result is seems like steps could be taken to reopen, even as cases rise in the Congregate facilities. If trends continue to hold for the general population with regards to declining cases and deaths, does this have any effect on the timeline for reopenign the economy?

2. With regards to testing, Dr. Cohen stated in an update last week that NC would need to double testing in NC to facilitate an reopening. Currently, NC is averaging 3,322 completed tests per day. If you double this and project across 31 days, NC will need to complete 205,964 test per month. This amount is less than half the capacity Dr. Birx indicated as existing in NC in last Friday's briefing. She indicated that NC has the capacity to test 500,000 to 999,000 tests per month, given current test facilities. Does Dr. Cohen agree with this capacity assessment, what are the current inhibitors in NC to being able to being able to test 200,000 peeople per month, and what actions are being taken to address these issues? What are the timelines and dates for when we can expect to see more testing implement in the state?

You can see the most recent graph that displays actual deaths in comparison every version of the IHME model that has been released. While all models have over-estimated the total deaths to this point, the most recent update seems to be the closest when comparing it to the reported NCDHHS reports. I have additional graphs that look at Daily New Cases and Hospitalizations (both have linear and logarithmic plots). I find Hospitalizations an interesting statistic to follow, since it is not impacted by the daily fluctuations case testing. If you are interested in seeing the IHME Model Performance graph, it can be viewed at the following link:

IHME Model Performance for North Carolina
Daviewolf83
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I just saw part of Dr. Cohen's update and one thing absolutely stunned me. For Congregate facilities and prisons, they are only testing if there is a person in the facility displaying symptoms. If they are found to be positive, they will then do contact testing in the facility, but still may not test everyone. So, the state is not proactively testing any Congregate facilities, prisons or jails. There has to be a person with symptoms first, before they will begin testing in the facility.
Wayland
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Daviewolf83 said:

I just saw part of Dr. Cohen's update and one thing absolutely stunned me. For Congregate facilities and prisons, they are only testing if there is a person in the facility displaying symptoms. If they are found to be positive, they will then do contact testing in the facility, but still may not test everyone. So, the state is not proactively testing any Congregate facilities, prisons or jails. There has to be a person with symptoms first, before they will begin testing in the facility.
Most of the questions were on prisons today, not a lot on nursing homes. Although, I did appreciate Sprayberry saying that they had been sending some of the volunteer medical support to nursing homes and other congregate facilities for support.

But absolutely, if we have excess testing capacity it should all be used for congregate facilities while we have bandwidth.

I was just going through my old posts and apparently in the 3/27 Governor's briefing they claimed that they were working on a surveillance plan and it would be out that week. Here we are 3 weeks later and they still don't know what they are doing.
CLA327
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This is a fantastic interview conducted with Dr. Jay Bhattacharya, who led the covid testing in Santa Clara. He talks about the results of that testing, and current testing he is doing with Major League Baseball. Additionally, he talks about the actual prevalence of covid in the current population, the impracticability of contact tracing if the infection rate is as high as the testing revealed. He also has some very good ideas on restarting the economy based on what we now know about the virus.

Two very remarkable statements the Dr. makes is 1) that he believes based on the Santa Clara results the covid virus will have no higher mortality rate than the seasonal flu. And 2) there has been no federal money from either the stimulus package or grants allocated to fund any seriologic studies.

https://www.hoover.org/research/fight-against-covid-19-update-dr-jay-bhattacharya

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