How does what is happening in NYC factor into your thinking about Covid-19
We’ve had a post that focused on why Sweden shows that the US took the wrong path and over reacted to Covid-19. I think that the facts on the ground tell the other side of the story.
For me, what is happening in New York City affirms the decision for large scale stay at home orders. But clearly, most of the US is not seeing the same level of impact. How does what is happening in NYC factor into the thinking of others on the board? Did social distancing avert widespread deaths similar to New York City across much if the country or do you think shutdowns were justified in NYC and maybe a few other places, but not for so much of the US? Or do you think that even in NYC, the costs of the stay at home order to the economy are to great to justify the stay at home orders? Do you think that people are over reacting to what is happening in NYC either because it is not all that bad or because NYC is a unique situation and it is unlikely other parts of the US could be hit as badly? If you think orders should have been issued more judiciously, how would you have set criteria absent more test data?
I have also provided some information about what is happening in New York City.
The current population is about 8.3 million. As of Sunday afternoon there were about 6700 deaths, including 531 in the last 24 hour reporting period.
To provide a bit of context for those numbers, NYC averages about 150 deaths a day. Last Tuesday NYC reported over 800 deaths due to Covid-19, more than 5 times the average number of deaths. At the apex of the Spanish Flu Epidemic of 1918, NYC was seeing about 400 to 500 deaths per day. The population was about 5.6 million, adjusted to today’s population that would be about 600 to 750 people per day. In a typical flu season, NYC has about 2000 city residents die (so in the last 30 days there have been 3 times as many Covid-19 deaths in NYC as there are in an entire typical flu season).
New York City has seen about 800 deaths from Covid-19 per million residents so far and the number continues to climb. This compares to Italy which has about 329 deaths per million and Spain which has has 368. Statewide New York has 478 per million. As a whole the US has 67 per million. Eight States, including New York and Michigan (149 per million) are above the national average. On the opposite end of the spectrum in the US, there are 9 States with less than 10 deaths per million.
There are many reasons to explain why New York City was hit so badly. It has the highest population density of any large US city at about 27,000 people per square mile. San Fransisco is second at about 17,200 per square mile. It has the most use of public transit with over 56% of commuters using mass transit. Washington DC is second at about 37%. JFK airport has the most international flights at over 15,000. LAX is second at about 11,000. Mew York did not act as quickly as some other places did. San Fransisco had a stay at home order on March 16. New York did not issue one until almost a week later (March 22).
While these facts and figures may explain why NYC got so bad so fast, I personally don’t think we have any reason to expect that other areas of the country aren’t also susceptible to significant Covid-2019 outbreaks, even though it may have taken more time for it to spread. It would have been great if we’d had more information to be more targeted in our approach, but it is not clear to me how we could have done that. What say other mgobloggers?
Detroit Lions move up to the number one spot and draft Shea Patterson.
Over the next ten years does Shea unexpectedly lead his team to seven straight super bowl wins.
Shea Patterson = the GOAT
Does this shit give you a lot of validation or something? Seriously, what do you get out of this? Does it make you feel good? You really, really need to work on your mental health.
timmmaay, i think i remember a day months ago when he let his guard down a little, might not have been sincere but it seemed that way. has issues, lonely, needs attention, and maybe we'd do better to be sympathetic. his posts don't bother me, though i do wish he'd get on to a different humor.
As long as we have a football season, he’ll at least be able to fixate on a different quarterback.
April 13th, 2020 at 10:10 AM ^
Eh, I think this is Mineral King's little brother.
April 13th, 2020 at 10:14 AM ^
Mineral prince?
April 13th, 2020 at 11:57 AM ^
I have no dog in a defending anyone hunt...
...but that would be a very Lions thing to do.
You really, really need to work on your mental health.
I think that's exactly what he's doing. In a very Lions kind of way.
April 13th, 2020 at 11:59 AM ^
+1...
didn't scroll down far enough to see your post. Ha!
how would you have set criteria absent more test data?
Let Governors set standards that meet local conditions.
Governors do make the decisions. They do get to set the standards they use. Absent testing, how would you figure out what local conditions to use as your criteria. In other words, if you were a governor, how would you decide?
It's clear that governors are testing - even in Texas and Louisiana, where the number of confirmed cases are lower than Michigan. Texas has done more than 125,000 tests, Louisiana and Florida almost 110,000 each. Michigan has done only about 80,000. Across the U.S., 2.8 million tests have been performed as of this morning, with a positivity rate of about 25%.
To answer your OP question, I think it's too early to know for sure. All of the factors you mentioned probably contribute, as do poverty, lack of access to healthcare driving higher underlying co-morbidity, etc.
But that still doesn’t get to the question of did governors in states that are only seeing low numbers of deaths overreact, or are the low numbers they are now seeing a result of the orders?
This is an impossible question to answer, and you're being unrealistic to ask it. The only answer is both - the orders have undoubtedly contributed to less deaths, and some areas (most?) haven't seen quite the level of spread that NYC has. As always, the answer is somewhere in the middle - all of the above, if you will.
There is no one answer that is correct over the others.
It may be an impossible question to answer, butt all of out]r governors have had to weigh in on that impossible question with less information than we have today. I guess what I’m asking is, if you were a governor, how would you have made the call on stay at home order and once they are lifted, how would you evaluate that in the future (hopefully with more information).
My sense is that many people on this blog still think that stay at home orders made sense, clearly some don’t. This was mostly aimed at the group that seems to think many states stay at home orders were over reach to ask how they would decide where it was appropriate and where it wasn’t.
April 13th, 2020 at 10:25 AM ^
each side will spin the results to fit their agenda
April 13th, 2020 at 12:34 PM ^
Agreed both sides have politicized this. Today Witmer is on at 3. Trump at 5. As long as we continue to watch them, we are just feeding it. Didn't the presidents used to use a press secretary to inform people.
As a Gov I would understand it is not a zero sum game.
I would try to balance the safety of my citizens with the impact of stay at home orders has on my state's suicide rate, domestic and sexutal abuse rates - that are significantly rising due to the stay at home order - as well as the long term economic impact.
I would also want to understand the ability we have to fight the virus as well as our hospital capacity and capability. Also I want to ensure we have the ability to test on a large scale.
I'd try to provide ways for the at-risk population to continue to stay home safely if they desire.
I'd focus on how quickly can we get some of the population back to work while containing the virus within our capability to adequately address it.
All I have seen from out Governor is pandering to special interests (unions, churches) while trying to keep everything else on lockdown.
It would suck to be a Gov - doing too little increases the virus death rate - too much snuffs out the economy and increases byproducts like suicides, domestic abuse and sexual abuse.
Completely disagree, unless those same Governors restrict state to state travel (which I hear may be happening in FL and LA?)?
Other than that's it's not happening. What's the point if say the NY Governor puts a shelter in place order, but NJ doesn't. It only takes a few sick people to infect hundreds.
April 13th, 2020 at 12:57 PM ^
Restricting state to state, and even county go county travel makes a ton of sense. Nobody from NYC should be going anywhere.
April 13th, 2020 at 10:46 AM ^
Let Governors set standards that meet local conditions.
If you don't have an adequate amount of testing, how can you know what those conditions are?
Officially, Michigan's first confirmed case was documented on March 10. Something like 20 states documented the virus before Michigan did. Based on that one would assume we were on the tail end of the outbreak. And yet, it's now clear from the evidence that there was community spread in this state early, it just escaped detection due to insufficient testing.
The big takeaway for me is that you can't fight a virus blind. The South Korean strategy of aggressively testing and contact tracing right at the outset is the way you've got to do it.
Wake County, NC which includes Raleigh and the surrounding area has 0 deaths from Covid 19. I’ve been to both NYC and Raleigh and they seem like different places to me but it all makes my little head hurt so I’m just waiting on Dear Leader Fauci to tell me what to do. Am I allowed to get my mail today? Is there an assigned time for each person?
You’ve complained enough that we did the wrong thing, why not tell us what the right thing to do would have been. Do you base stay at home orders on demographic criteria like population density? Do you wait for a certain number of hospitalizations or deaths per capita? New Orleans is also different from NYC and Wake County, NC do we need stay at home orders there? How about Detroit?
Why did you edit your comment? I preferred your original post.
You fucking people, man... the fuck is wrong you? Closed head injury?
April 13th, 2020 at 10:23 AM ^
He watches TV. It may be his primary source of information. He often hears that snotty affluent urban liberals are tellin' him what to do and he's sore about it.
April 13th, 2020 at 10:49 AM ^
I am a snooty urban liberal. Let's just boil this down into a 2 x 2 matrix. The axes are: low/high risk from the disease and low/high economic risk. I'm in the box for low risk from the disease and high economic risk. I've spent the last four weeks thinking about how and when to potentially lay off hundreds of workers at a business I've helped to build basically from scratch. I'm guessing most of my opposition on this board is in the box with high risk from the disease and low economic risk. Congratulations on your ivory tower view, I've enjoyed the moralistic sermons from you all.
April 13th, 2020 at 10:58 AM ^
I'm going to put this as politely as possible:
Find us some @#$%ing posts that downplay the effect on the economy. Not saying they don't exist, but I can't remember any. Who TF is saying that? Many people here are probably in the high 'n high quadrant whether they know it or not.
We're in the beginning of an economic shit show. Sorry to hear about your business.
What exactly is your macro solution? Should it be designed entirely around a single business? Sorry if that sounds harsh.
April 13th, 2020 at 12:55 PM ^
I think very few people here reacting harshly to my posts are at high economic risk. They're just reflecting their own self interest and framing it as moralism. South Carolina had a good solution as of a week ago, although I would have left the kids in school. Unemployment filings in SC in March were less than half of those in MI when adjusted for population. This is going to become a local issue shortly, which I think will help.
At a national level if people want to be angry, take it out on the FDA. There are at least three proven or very promising treatments for the cytokine reaction syndrome that is killing people. Those are IL-6 inhibitors (e.g. actemra), CCR5 antagonists (e.g. leronlimab) and stem cell treatments. Actemra especially looks like a slam dunk. Roche will spend the next two months, at least, in clincial trials on it, while people die.
There's trials going on all over the world for a lot of different drugs and they are proceeding as fast as they can with as much money as they need. And the thing about them is if it's a miracle cure, they'd know it had a positive efficacy early in the trial.
So other than spamming all the drugs to all the hospitals, which there's not even enough supply to do, they are going as fast as they can.
Don't take your anger out on the people exposing themselves to this virus trying to help you.
If you want an interesting read, google "actemra covid 19." It's an IL-6 inhibitor that's been used in the treatment of rheumatoid arthritis since 2010. Roche sells over $2 billion of it every year. Since a cytokine release involving IL-6 is what's killing people with Covid-19, you would think they would be rushing it into service within days. Nope. Every indication, including a study in China seems to suggest it's a miracle cure, but Roche and FDA are putting it through a two-month trial. This crisis is really exposing some flaws in our western way of doing things. The Chinese must be laughing their asses off at us.
You are very, very wrong. This is basically shutting down 75% of my business. Who is in the ivory tower?
April 13th, 2020 at 10:59 AM ^
You still haven’t answered the question. Is the low risk from the disease region specific? Do you agree that it is higher risk in NYC? Do you think the lower density in places like Raleigh and Greenville is enough to lower the risk relative to NYC? How would you define the criteria for what a high risk or low risk health area is?
I’m not making a moralistic sermon. I’m asking you an admittedly hard question to actually understand your position.
April 13th, 2020 at 12:21 PM ^
If cases in the RTP area are low good for them but I think they got lucky. Because of the companies and universities based in the area they get a lot of travel from outside the region. I’ve been there 7-8 times myself in the last 2 years for work and I’m in Toronto.
A business with hundreds of employees and no warchest to weather short term losses is not a very well run business. But sure, blame everybody else.
Yep. Individuals are advised to have, at minimum, 3-6 months in savings to cover all their expenses in the event of a job loss or other situation causing loss of income.
Businesses should be doing the same. If not, there's always chapter 11.
April 13th, 2020 at 10:30 AM ^
The South has barely been hit yet. I'd give a few weeks before you starting talking shit, especially since I'm gonna go out on a limb and say Easter was a day where a lot of people broke quarantine meet up with each other
April 13th, 2020 at 12:44 PM ^
Louisiana is definitely in the South and they've been clobbered.
Lots of variables that have impacted things over the last month not the least of which is social distancing. When we go back to work on a large scale, particularly when the weather cools, we will get some answers. Accurate serological testing on a large scale would also be a big help to find out to what extent the country now has heard immunity.
I'm most focused on what is happening here in Southeast Michigan, especially in the city of Detroit.
Detroit, with a population of 672,000, has 6,502 confirmed cases and 368 Covid-19 deaths. The mayor (Mike Duggan) has said that if five unrelated Detroiters gather together, one is probably Covid-positive.
Overall the tri-county area has had 1,250 deaths. The rest of the state is doing much better and hasn't had much of an outbreak, which makes Michigan's overall numbers look not that bad, but my friends who work in the Beaumont system have been through hell this last month.
I absolutely believe that social distancing has prevented further outbreaks. Detroit had early community spread and is paying the price, but other parts of the state have largely been spared.
Michigan is a very good example of how hard this question is? Was a statewide order the right thing, should it have been focused solely on Southeast Michigan?
If the quarantine had been localized to Wayne/Oakland/Macomb, the outbreak would have spread beyond it and the order would have finally become statewide. Washtenaw County had some early cases but things have never gotten as bad as in the tri-county area, probably because the order came just in time.
Agreed. Many people would have fled to their second homes or relative's homes outside of the SE Michigan area in order to avoid the unequal measures. And of course, they would be bringing the virus with them.
And wherever the border of the quarantine was, customers would rush beyond it to shop, dine, etc. - some bringing the virus with them.
Having Michigan and Ohio working in lockstep also was beneficial - you couldn't cross the state line to escape the quarantine. People have had little choice but to follow the order and it appears to be paying off now.
April 13th, 2020 at 10:14 AM ^
Which is what happened on Long Island as people left NYC for what appeared to be a safer place.
April 13th, 2020 at 10:42 AM ^
Let's face it some people are not following the stay at home order. Those people don't care if the mandate is there or not. There was an article in the lansing state journal this weekend. They are tracking cell phone movement.
In Wuhan they figure 80% of the cases were transmitted in the home. The 20% are the problem.
In Durand, eight nursing home workers were tested positive for the virus. Makes you wonder if they were taking their temperatures before entering. My mom was at that facility a year ago and we pulled her out. They weren't bathing her or changing her bedding.
April 13th, 2020 at 10:57 AM ^
Of course there will be idiots who don't respect the rules. That's true for everything. But without the order there'd be a lot more people going around spreading the disease and a lot of us who are now staying at home would be getting infected, too.
April 13th, 2020 at 11:13 AM ^
I agree but as long as those people are out there this won't end. I believe they will open it back up May 1st even if they shouldn't.
My nephew who wasn't working in another state came up to visit his at risk grandmother driving through three states with mandates.
We are all screwed. Mandate or not.
April 13th, 2020 at 11:19 AM ^
That's why we've got to go to mass testing, even of asymptomatic people. I don't know how far away we are from that goal, but we've got to do that. Figure out how many people are infected and get them out of circulation.
April 13th, 2020 at 12:22 PM ^
That sounds good if you can get the irresponsible people to take the test. Then it is only good until they run into someone who has it.
I come from a very poor and ignorant family. I deal with them daily. The only way my brother would be tested is if you withheld his bridge card. Same with brother in law and his son.
April 13th, 2020 at 12:22 PM ^
That sounds good if you can get the irresponsible people to take the test. Then it is only good until they run into someone who has it.
I come from a very poor and ignorant family. I deal with them daily. The only way my brother would be tested is if you withheld his bridge card. Same with brother in law and his son.