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Doesn't directly blame Trump, therefore must be a racist.

 

For a little perspective;

 

https://www.nhtsa.gov/risky-driving/distracted-driving

 

Distracted driving is dangerous, claiming 2,841 lives in 2018 alone. Among those killed: 1,730 drivers, 605 passengers, 400 pedestrians and 77 bicyclists.
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Presents Iceland study that suggests asymptomatic transmission maybe much closer to 1%.

 

https://www.government.is/news/article/2020/03/15/Large-scale-testing-of-general-population-in-Iceland-underway/

 

The model from the UK Imperial College assumed it was 50% (which is rare for a virus): Report 9

 

https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/news--wuhan-coronavirus/

 

That is a significant discrepancy and accounts in part for the model's predictions.

 

Without wanting to disparage Iceland in any way, there is any number of reasons why transmission in Iceland might be less. For example, as I write this the weather in Reykyavik is 0 degrees C, its 8km wind and its 60 percent precipitation (its snowing).

Maybe the majority of people in Reykyavik are walking around wearing gloves and a facemask anyway this time of year.

Edited by Stuart Galbraith
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Clever.

 

Here is the British MOD response to the crisis.

And russian one - Latest news on our local TV: after telephone talks between Italian PM and Rus President, RusAF is creating taskforce to airlift Rus Army NBC units to Italy to assist decontaimination of vehicles, plus Rus mil hospitals to assist Italian doctors.

Official release in Russian: Минобороны России:

По поручению Верховного Главнокомандующего Вооруженными Силами России Владимира Путина министром обороны генералом армии Сергеем Шойгу даны указания о создании авиационной группировки для оперативной доставки начиная с 22 марта помощи Итальянской республике в борьбе с коронавирусом.

По готовности итальянской стороны задействованные самолёты военно-транспортной авиации ВКС России доставят в республику 8 мобильных бригад российских военных специалистов-вирусологов и медиков, автомобильные комплексы аэрозольной дезинфекции транспорта и территории, а также медицинское оборудование.

 

Well thats one major advantage you have, your Army has some of the best equipped NBC units in the world. I do honestly think you would be better off keeping them at home though.

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Read yesterday that there are only 4,000 ventilators for adults in all of the UK, one of the lowest numbers in Europe. Good grief, there's 25,000 over here, and even that is eyed sceptically now. The French military already had to airlift patients out of the particularly bad-hit Alsace region for treatment elsewhere. Germany and Switzerland are taking in some of them.

 

The below comes with the "Spiegel"'s left-wing slant, but some of the issues like the nursing staff shortage are real.

 

The Battle Begins

Are Hospitals Ready for the Coming Wave of Corona Cases?

The German health-care system is considered one of the best in the world. But the corona-virus is mercilessly exposing its weaknesses, with some hospitals already facing difficulties. Can Germany prevent the kind of collapse seen in Italy?

21.03.2020, 10:58 Uhr

By Matthias Bartsch, Jörg Blech, Annette Bruhns, Lukas Eberle, Katrin Elger, Markus Feldenkirchen, Kristina Gnirke, Annette Großbongardt, Hubert Gude, Veronika Hackenbroch, Julia Jüttner, Martin U. Müller, Cornelia Schmergal and Steffen Winter

The man with the white shock of hair in Room 4 of the intensive care unit wasn’t able to breathe. But now, a tube has been placed in his throat and oxygen is flowing into his lungs. You can see through the window on the door to the room how his chest is moving up and down in time with the ventilator, 28 times a minute. The 83-year-old is fighting the SARS-CoV-2 virus.

It’s Monday, and during the course of the day, nurses and doctors have to watch as his condition deteriorates. They notify his wife and daughter, who arrive around noon. Under the new rules for these corona times, only one relative is allowed into the isolation room for 30 minutes. The woman sits beside her husband in full protective clothing and gloves and places one hand on his forehead and one near his heart. The head of the ward responsible for care decides to bring the daughter in as well. He equips her with protective clothing and lets her go to her father. Both are permitted to sit there for as long as they want.

The man passes away at 3:15 p.m., with the resident issuing the death certificate. The immediate cause of death given: "Hypoxic respiratory failure. A complication stemming from COVID-19 pneumonia."

The man passed away at St. Antonius Hospital in Eschweiler, North Rhine-Westphalia, only 30 kilometers (19 miles) from Heinsberg, the largest known cluster of infections in Germany to date. A ventilator was available for him, but the help came too late.

There’s some good news and some bad news for people in Germany right now. The good news is that Germany is home to one of the most modern, richest and most powerful health-care systems in the world. We have an "excellent health-care system, perhaps one of the best in the world,” German Chancellor Angela Merkel said in her address to the nation on Wednesday night. It is better equipped for dealing with the corona epidemic than the systems of many other countries.

The bad news is that large parts of this system are already overwhelmed. Depending on how fast the number of infections increases in the days and weeks to come, we could experience a collapse and failure of the system. And it will be deemed to have failed if people have to die because of a shortage in staff, beds and equipment -- and not because this illness is incurable.

[...]

In recent days, a chief physician from the Rhineland had to admit to a colleague that he only has seven ventilators at his hospital. He said he needs 13 in order to get through a major wave of serious infections.

And that wave will come - that much is certain. "We expect that things will really heat up in the next two weeks, also here in Germany," says Axel Fischer, managing director of the München Klinik, a Munich-based chain of hospitals. His hospital treated the first patients infected with the coronavirus in January. He fears the crisis will have a "massive impact.”

The coronavirus is mercilessly exposing the problems that have been burdening the German health-care system for years: the pitfalls of profit-driven hospital financing. The pressure to cut spending. The chronic shortage of nursing staff. The often poor equipping of public health departments. The lag in digitalization.

"We are preparing for imminent catastrophe,” says Rudolf Mintrop, head of the Dortmund Klinikum, the city’s main hospital. He calculates that the wave of sick will hit hospitals at full force in 10 to 14 days. The chancellor has warned that German hospitals will be "completely overwhelmed" if too many patients with serious coronavirus infections have to be admitted within a very short period.

Ultimately, the question of life and death will be decided in the intensive care units. The answer will depend on how many ventilator beds there are, how many doctors are on call and how many nurses are able to provide care for critically ill patients.

To prevent a collapse of intensive care units, the German federal and state governments have taken drastic measures that are bringing public life in the country to an almost complete standstill. They have closed stores, sealed borders and shuttered schools, daycare centers and playgrounds.

One of the primary reasons for the steps taken is the imminent shortage of ventilators. German hospitals currently have access to around 25,000 deployable ventilators. The federal government is making efforts to acquire thousands of additional devices, but their manufacture and delivery may take time. There are far more of the devices available in Germany than in Italy and there are also more health-care workers to operate them. But doctors and medical experts still fear supplies could fall short here.

The number of infected in Germany who will have to be provided with artificial respiration will depend on whether people get serious about what virologists and politicians have been warning about for weeks: social distancing. The more consistently all contact is avoided, the greater the chances are of slowing down the rapid rise in new infections.

Another determining factor will be whether doctors and hospital directors go along with the government’s request that they clear their wards in preparation for the expected onslaught of coronavirus patients, particularly given that there is often already a lack of nursing staff and equipment even at hospitals that are operating under normal circumstances.

Under the German Social Code, health-care providers are required to promise every insured patient an economical and efficient treatment based on state-of-the-art knowledge. It does not entail any restrictions. "Rationing” is a word that has never been heard before in our postwar health-care system. But it appears to be one that people in Germany might have to get used to, right along with the even scarier word "triage.”

In any case, the fight against the virus in German hospitals has already begun. The coming weeks will determine whether it can be won.

Intensive Care Beds

Last week, German Health Minister Jens Spahn sent a personal letter to the managing directors of almost 2,000 hospitals in Germany. To keep enough intensive care beds free, he requested: "In principal, all operations and procedures that can be planned in advance are to be postponed and suspended immediately in all hospitals, from Monday onward.” Almost pleadingly, Spahn asked for doctors to be brought out of retirement, for students to be hired to help and for more intensive care beds to be made available. "Now!"

Some hospital bosses like Michael Albrecht at University Hospital in Dresden followed suit. The hospital said beds would be deliberately cleared and operations postponed if possible. "But it’s hard to decide sometimes,” says Albrecht. "Should a necessary tumor operation be postponed because of corona?" He says you can set priorities, but you can’t make overly hasty decisions.

"Right now, we’re only postponing operations if the patients won’t suffer disproportionately as a result,” says Andreas Meier-Hellmann, the head of the coronavirus crisis team at the Helios Kliniken chain of private hospitals. Helios is also permitting tumor operations to go on "even if the patients might have to be put in the intensive care unit afterward.”

Many hospital managers are actively ignoring Spahn's appeal. This could in part be due to the fact that their facilities are under economic pressure and depend on the revenues provided by procedures like knee prostheses, hip replacements or heart catheter examinations. These kinds of procedures, which experts say are often unnecessary, are the most lucrative for the hospitals.

[...]

Nursing Shortage

It’s in the nursing divisions that Germany is currently the most ill-equipped for dealing with the crisis. One 50-year-old nurse who works in an intensive care unit at a university hospital in Lower Saxony says she and her colleagues were already pushed to their limits before the coronavirus struck. She asked to remain anonymous out of fear of reprisals. "The system actually doesn't have any buffers anymore, and we often exceed our capacity."

She says some of the intensive care beds in her hospital can’t be used because of a lack of staff. When she first started working in the field 25 years ago, she says, one nurse was responsible for taking care of one or two ICU patients, but now that number is two or three. "We're writing overload reports that should be called danger reports." At the end of the shift, she sometimes feels her feet are "three times as thick, and as if somebody beat me up. Then I practically crawl home.”

The nurse sees serious ethical conflicts ahead for society. "Everyone has become accustomed to the maximum care system, under which everyone gets everything they can." But this cannot be sustained if the number of critically ill people increases as feared.

It’s a problem that Health Minister Spahn has identified. A law was passed requiring hospitals to have a minimum number of nursing staff in 2018. But it has barely gone into effect, and Spahn will now have to suspend it again -- otherwise the hospitals won’t be able to cope

The staff shortage in German hospitals is chronic, with at least 17,000 nursing positions vacant in the country. The hospitals share some of the blame for this state of affairs. They’ve been cutting back spending in recent years, especially on nursing staff. At the same time, the German states have withheld billions of euros from the hospitals that should have been spent on investments in infrastructure.

"The reductions in beds and staff shortages didn’t occur suddenly and unexpectedly," says Asklepios Group works council Chairman Martin Schwärzel, whose organization represents employees in the hospital chain. "The number of nursing staff in the clinics was used as a key financial figure in the hospitals and was reduced as far as possible. Now, everyone is working at their limit."

[...]

The Lessons

Germany, which exalts about having one of the world’s best health-care systems, has a number of dangerous weak spots. Contrary to popular belief, the system has not been starved by budget cuts. Instead, health spending has been going up for years. Between 2009 and 2019, Germany’s spending on public health insurance has risen from 167 billion to 246 billion euros.

But the money was often channeled to the wrong places, to radiologists and orthopedists instead of general practitioners, who represent a desperately needed place of first resort for rattled patients. And the money has definitely not gone to the nurses.

The poor monetary distribution has a lot to do with the financing of German hospitals. Since 2003, hospital services have been remunerated on the basis of set prices for procedures, according to which hospitals receive a set amount of money for every knee or spinal surgery -- no matter how many days the patient has to spend in the hospital, or the extent of his or her care. For hospital managers, this means pre-scheduled operations are the best way to make money, provided that as little as possible is spent on care.

And as a result, Germany, one of the world’s richest industrialized nations, has operating rooms with cutting-edge technology, but fewer nurses per hospital bed than Estonia or Slovakia. Karl Lauterbach, a respected health-care policy expert with the center-left Social Democrats, puts it in dramatic terms: "Since the implementation of the set prices, a doctor has become an investment, but nurses are a financial burden.” For years, the health economist has warned that the set-price policy increases incentives for poor care.

Doctors are also suffering under the system. "For years now, hospitals have been subjected to an industrial logic. But it doesn’t make any sense to run hospitals like factories. It cannot primarily be about money,” says Peter Hoffmann, the chief physician at a Munich hospital and chairman of the Association of Democratic Doctors, which views itself as a counterpoint to the traditional doctor’s associations.

"We will not simply be able to return to everyday life after this,” says München Klinik Managing Director Fischer. "We will need to conduct a review of our entire health-care system."

Perhaps a pandemic was needed to come to that realization.

 

https://www.spiegel.de/international/germany/the-big-wave-of-corona-cases-will-hit-german-hospitals-in-10-to-14-days-a-45cd754c-e179-4dbb-8caf-8f6074e641cf

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CNN reports Hong Kong is reporting an outbreak, and that civil servants there are being sent to work from home, and new arrivals sent to self quarantine.

 

Interestingly most of them seem to come from the US and Europe.

https://news.sky.com/story/coronavirus-hong-kong-has-highest-daily-increase-as-thousands-fly-in-to-avoid-self-isolation-11960972

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Okay, that says about 8,000 ventilators, which is better but still quite a bit from the 30,000 suggested to be required. No wonder carmakers everywhere are investigating plans of retooling to make the damn things. Though I understand that might take time we don't have.

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our highly paid 709 (at least most of them would not have made such an ammount in private sector BEFORE being Bundestag member) members of Bundestag are supposed to have been busy preparing / protecting the Bürger from things like this, instead of Dauer-kissing Green ass, or discussing mayby if God should stay "der" Gott or perhaps be changed to "das" Gott.

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Brother Poland claims to have invented a device that allows a ventilator to ventilate 2 people at once, which if it DOES work (and I need to be careful not to make running assumptions which seem to be very common these days) its going to take up a lot of the capacity problem. The speed of production looks worrying low though.

https://www.express.co.uk/news/science/1258491/Coronavirus-ventilators-COVID-19-treatment-latest-coronavirus-news

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our highly paid 709 (at least most of them would not have made such an ammount in private sector BEFORE being Bundestag member) members of Bundestag are supposed to have been busy preparing / protecting the Bürger from things like this, instead of Dauer-kissing Green ass, or discussing mayby if God should stay "der" Gott or perhaps be changed to "das" Gott.

 

There are several reasons why it was impossible to prepare for this:

 

- It came from China, therefore not our problem, can't get here (this line was repeated by every government everyhwere)

- It was poorly understood: the high/low impact of 80% mild/20% critical cases is something no one was prepared for. Worst case apocalypsis assumes a high death rate, early burnout, Business as usual was everyone infected, a few die (ie the flu). Instead what you get is a "everyone infected, shitload of ICU cases, lots of deaths because... everyone infected" - Only China and Taiwan reacted appropiately (although the PRC was late) by massive test, contact tracing and isolation of all possitives - Can't do that over here, becuase we are better than China of course... NIH

- Precedent of swine flu where WHO came out as histerically overreacting meaning they went very, very careful around this and of course, wouldn't want to piss off PRC

- It would be a very valiant politician indeed the one that locked down a country with just a handful fo cases.

 

So lesson learned, just like 9-11, World travel needs to change, PRC needs to change or else.

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If politicians had "prepared" for this by enacting legislation to put the citizenry under house arrest, track everybody's cellphone with no warrant, build up massive healthcare capacities etc. with no urgent cause at hand, the outcry across the political board would have been epic ...

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If politicians had "prepared" for this by enacting legislation to put the citizenry under house arrest, track everybody's cellphone with no warrant, build up massive healthcare capacities etc. with no urgent cause at hand, the outcry across the political board would have been epic ...

 

Indeed, but such measures are not needed outright, see South Korea or Taiwan - the first step would have been some humility regarding that this may get out of hand and it wasn't necessarily a PRC issue only, the second step would be the tracing of travelers from China and the proactive testing of everyone to check who is possitive and who isn't and then isolate the positives.

 

Properly explained, no outcry would have ensued and no countrywide restrictions would be needed. But it always get back to the first point, sheer arrogance in seeing this all as a Chinese problem - and not only by politicians, but also by experts.

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is not calling for draconian measures, such as total curfew or being prepared by providing a million ventilators / etc etc.

 

It means being BETTER prepared. Having a look at our way of life / dependancies and anticipating perhaps a sudden change in our 70 year safety period. Could be different dangers, epidemies, the famous asteroid impact, some crazy country letting loose an atomic bomb.

Just be concerned as politician with essential matters.

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I think there was too much poor atitude about it being a China problem. Other assumptions feeding into it are that the Chinese are incompetent and that the central government doesn't care or may even use it as an opportunity to kill off undesirable because of bad human right's record. This atitude made it socially awkard to take a close look at Chinese efforts in tackling the challenge and more specifically how the treating process has been going, so as to take notes in what was good/not good in addressing it. And by doing so, the medical staff of other countries could be better prepared should it happen. By late Jaunary to early February, basics like the importance of ventalitors, test kits, and a stock of medical masks should have been apparant. And so at the very least, getting these supplies ready just in case should not be too much to do before disaster strikes. But now instead, lots of countries now a receving 100s of thousands of madical mask and such from China. As was discussed before, the industries around Wuhan show an international set of companies in Wuhan. So the manager sorts of those businesses in Wuhan should have had the contact to virus related info. Japanese, French, and American auto companies are in the Wuhan area. Additional, when Wuhan was hit, there was plenty of news reports about nationals of other countries leaving Wuhan by charter flights back home, including Japanese, Koreans, Americans, and Europeans. So some first hand info must surely have been available if greater inquiry was taken up. But maybe they never bothered to learn Chinese? Who knows. But I do think the Japanese have done at least some of the homework with typical Japanese precaution. Japan was one of the first countries to get a virus positive yet still no spike in infections. Some point out PCR test numbers, but greater testing at random has risks. One, it puts greater risks to medical staff to fatigue. Comes fatigue higher chance to make a mistake in getting infected. It also increases consumption of medical materials for the tremendous amount of negatives. Japan seems to have been doing more or less targeted testing. When an infected person is found, then they investigate recent path and activities and test a some 100s or 1000s that may have crossed that path. Or whstever their doing.. it seems to be working relatively. Well not wotking good enough, cases keep rising, but its nothing like in other advanced countries. There's a debate point, even in Japan, that the Japanese goverment doesn't do massive testing so as to keep official case count low. But if that's really the case, then the result should be a swelling of infected people remaining in circulation thus resulting in an explosion of cases later down the road. So I don't think the government is just keeping testing low to keep the official number low.

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If politicians had "prepared" for this by enacting legislation to put the citizenry under house arrest, track everybody's cellphone with no warrant, build up massive healthcare capacities etc. with no urgent cause at hand, the outcry across the political board would have been epic ...

There was much room between doing nothing and a nationwide curfew. And there was much time to do something. But nothing was done because China is far away, so is Iran and Italy...

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is not calling for draconian measures, such as total curfew or being prepared by providing a million ventilators / etc etc.

 

It means being BETTER prepared. Having a look at our way of life / dependancies and anticipating perhaps a sudden change in our 70 year safety period. Could be different dangers, epidemies, the famous asteroid impact, some crazy country letting loose an atomic bomb.

Just be concerned as politician with essential matters.

You're right.

 

My country for example had massive provendor stores for of dried food for distribution after nuclear attack. When the Yugoslav civil war kicked off, we sent it to Bosnia for distribution to the displaced population, and never replaced it. Then the stores were sold off and were either demolished or used for something else. Even that was regarded as probably being too limited to be useful.

https://www.subbrit.org.uk/features/strategic-food-stockpile/

 

We dont take crises seriously until we bump into them, and if history is any guide, by then its usually too late.

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Thanks.

I´m for the reduction of Bundestag from 709 members to about 200. They don´t seem to have much important work to do, coming up with stuff like Verbot of plastic straws and plastic bags, and changing the grammatical gender of God.

Little respect, I must say.

 

 

would also free up 509 people for skilled labor shortage. They could easily work as nurses, technicians, programmers etc.

Edited by Martin M
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I fully agree that we have become unprepared for crises since the 90s. However, in the absence of crises that's probably an inevitable development in democratic capitalist societies where governments must justify their use of power and money. Doing that for something that might happen will get you criticized, often by the same people who will later complain you were unprepared.

 

What, telling business they shouldn't outsource to China? What are you, some commie economic dirigist? What, giving intelligence more powers of surveillance to counter terrorist plots? What do you want, a police state? What, equipping the military against a threat from Russia? Warmonger! What, spending money on increased healthcare capabilities? Socialist! What, somebody blew up a couple buildings, Russia invaded Ukraine, and supply of goods from China broke down because of a pandemic now killing our elderly? How could you let that happen?

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Not that, the inaction after the outbreak began. Screening travelers from high risk areas. China's neighbors did that very quickly, Germany still doesn't. Or not reacting to various warnings from within the medical community and industry.

 

Fortunately private industry is not asleep at the wheel. Clothing and car parts manufacturers have switched to protective gear and Bavarian distillers divert ethanol to disinfectant producers.

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I think, I believe, hope really, that the only good aftermath of this will be a requirement of Goverments to recognise Black Swan events occur, and we start preparing for them.(Or at least, the more plausible ones) There is a case for saying as mankind expands into parts of the world where such diseases reside, we are going to get these kind of things much more often, and with mass transit far more effective than ever before the means of delivering it are so much easier.

 

They call this a once in a hundred year event, but we dont know that really. Not considering in the last 2 decades we had SARS and Ebola coming closer to encroaching on developed societies than ever before.

Edited by Stuart Galbraith
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And what is the right level of preparedness for such a case. This time you need ventilators, next time you might need something else. This time 5% of the patients need intensive care, next time it might be 25% or 50% or 0,001%.

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