Crochet hook is a great idea!
Mine has separate OOP.
It’s 3k deductible/5k OOP for in network, 5k deductible and 10k OOP for out of network.
Oh and this is a “good” plan – costs my employer $680 a month.
I fucking hate this country.
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Ooof. That sucks.
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That’s how my plan works too.
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Yuck. That sucks…
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Yep. The freedom…it’s so great /s
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Circling back to this question…can I start panicking yet?
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I personally think the reactions are absolutely nuts. If you look at the raw numbers and the mortality rate as more and more testing is done, the reaction to this is ridiculous.
The real issue is just sheer numbers - our health care system can’t handle the number of people all needing care at once. So we have to slow down transmission, and that requires social distancing. It makes complete sense from a public health point of view.
Now, the panic buying of toilet paper, that is insane.
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But why are so many people needing hospital care, is it because of severity of the virus (even when people don’t die) or because people are taking such extreme precautions? The average influenza season even post-vaccine has a similar mortality rate but infects several orders of magnitude more people, yet hospitals aren’t swamped then AFAIK.
Edit (brain still waking up): are hospitals swamped because so many corona victims need critical care just to survive or because when they present at hospital they’re sealed up and quarantined? Because there are many, many critical flu cases every year - several orders of magnitude more - but hospitals aren’t overwhelmed then.
I see the raw numbers of cases and just don’t comprehend.
My reading says the fatality rate is ten times that of the season flu. There is no vaccine or herd immunity. I think the reactions are actually reasonable and probably not enough.
The hospitals here aren’t currently swamped as we’re still in the somewhat optimistic “contain it through isolation phase” in the hope to flatten the curve so when it does get bad the hospitals can cope.
I’ve been reading some stories out of the worst impacted parts of Italy (a first world country with a good medical system) and it’s pretty grim. Italy went from 8O cases to an entire country in lock down pretty bloody quickly.
I think downplaying it by comparing to the flu happened early in the piece - I see heaps or articles from early Feb.
I’m not a doctor, but my work has started implementing a split workforce whereby only half the office comes in each day. Personally I think we should all work from home.
I’ve started consciously reducing time in crowded places and public toilets.
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The country that’s done the most testing is South Korea and their mortality rate is 0.6% and falling, which is well within the bounds of seasonal flu, which varies in mortality rate year to year
I think this is the real issue. If we all caught seasonal flu within the same three to six month period, our hospital system just wouldn’t cope.
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And, of course, it’s additional to the flu etc. Australia is heading into flu season.
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And additional to an already stretched health system at the best of times.
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If comparing it to the flu gives you comfort then by all means go ahead.
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Even with the vaccine there are many, many more cases of influenza each year that require hospitalization which is why I’m puzzled about the hospital systems being “overwhelmed”.
Because they all turn up at once. Because there is no immunity.
Countries don’t have large empty hospitals waiting to treat pandemics.
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This is key. And we can’t compare the standard of US hospitals to those in other countries, either, we have no idea what they look like.
I work in a hospital, and while the west coast has been hit pretty hard (~160 cases and ~20 deaths alone in Seattle), that’s with strict quarantine procedures and hospitals with excellent quality of cleanliness and sterilization.
The emergency room lobby at the hospital I work out of is always full. Some of these folks may have the virus, and they’re all crowded too close together so transmission is higher. If more of those folks are elderly, their survival is most at stake. Younger folks have had less severe symptoms and are rapid carriers.
That’s assuming none of your staff are carrying or are sick.
All of this on top of the regular flu season and all other ailments patients come to a hospital for, in a best case scenario facility (other than the cost of health care, because we all know that sucks).
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Article: The number of people found to be infected with covid-19 doubles every 3 to 6 days. With a doubling rate of three days, that means the number of people found to be infected can increase 100 times in three weeks (it’s not actually quite this simple, but let’s not get distracted by technical details). One in 10 infected people requires hospitalization for many weeks, and most of these require oxygen. Although it is very early days for this virus, there are already regions where hospitals are entirely overrun, and people are no longer able to get the treatment that they require (not only for covid-19, but also for anything else).
Dr. Antonio Pesenti, head of the regional crisis response unit in a hard-hit area of Italy, said, “We’re now being forced to set up intensive care treatment in corridors, in operating theaters, in recovery rooms… One of the best health systems in the world, in Lombardy is a step away from collapse.”
This is not like the flu
The flu has a death rate of around 0.1% of infections. Marc Lipsitch, the director of the Center for Communicable Disease Dynamics at Harvard, estimates that for covid-19 it is 1-2%. The latest epedemiological modeling found a 1.6% rate in China in February, sixteen times higher than the flu1 (this might be quite a conservative number however, because rates go up a lot when the medical system can’t cope). Current best estimates expect that covid-19 will kill 10 times more people this year than the flu (and modeling by Elena Grewal, former director of data science at Airbnb, shows it could be 100 times more, in the worst case). This is before taking into consideration the huge impact on the medical system, such as that described above. It is understandable that some people are trying to convince themselves that this is nothing new, an illness much like the flu, because it is very uncomfortable to accept the reality that this is not familiar at all.
For each person that has the flu, on average, they infect 1.3 other people. That’s called the “R0” for flu. If R0 is less than 1.0, then an infection stops spreading and dies out. If it’s over 1.0, it spreads. R0 currently is 2-3 for covid-19 outside China. The difference may sound small, but after 20 “generations” of infected people passing on their infection, an R0 of 1.3 would result in 146 infections, but an R0 of 2.5 would result in 36 million infections! (This is, of course, very hand-wavy and ignores many real-world impacts, but it’s a reasonable illustration of the relative difference between covid-19 and flu, all other things being equal).
Note that R0 is not some fundamental property of a disease. It depends greatly on the response, and it can change over time2. Most notably, in China R0 for covid-19 has come down greatly, and is now approaching 1.0! How, you ask? By putting in place measures at a scale that would be hard to imagine in a country such as the US—for instance, entirely locking down many giant cities, and developing a testing process that allows more than a million people a week to be tested.
Another thing which makes it hard to intuitively understand the impact of covid-19 in your local community is that there is a very significant delay between infection and hospitalization — generally around 11 days. This may not seem like a long time, but when you compare it to the number of people infected during that time, it means that by the time you notice that the hospital beds are full, community infection is already at a level that there will be 5-10 times more people to deal with.
Note that there are some early signs that the impact in your local area may be at least somewhat dependent on climate. The paper Temperature and latitude analysis to predict potential spread and seasonality for COVID-19 points out that the disease has so far been spreading in mild climates.
It’s not just about you
If you are under 50, and do not have risk factors such as a compromised immune system, cardiovascular disease, a history of previous smoking, or other chronic illnesses, then you can have some comfort that covid-19 is unlikely to kill you. But how you respond still matters very much. You still have just as much chance of getting infected, and if you do, just as much chance of infecting others. On average, each infected person is infecting over two more people, and they become infectious before they show symptoms. If you have parents that you care about, or grandparents, and plan to spend time with them, and later discover that you are responsible for infecting them with covid-19, that would be a heavy burden to live with.
Even if you are not in contact with people over 50, it is likely that you have more coworkers and acquaintances with chronic illnesses than you realize. Research shows that few people disclose their health conditions in the workplace if they can avoid it, for fear of discrimination. Both of us are in high risk categories, but many people who we interact with regularly may not have known this.
And of course, it is not just about the people immediately around you. This is a highly significant ethical issue. Each person who does their best to contribute to controlling the spread of the virus is helping their whole community to slow down the rate of infection. As Zeynep Tufekci wrote in Scientific Amercian: “Preparing for the almost inevitable global spread of this virus… is one of the most pro-social, altruistic things you can do”. She continues:
We should prepare, not because we may feel personally at risk, but so that we can help lessen the risk for everyone. We should prepare not because we are facing a doomsday scenario out of our control, but because we can alter every aspect of this risk we face as a society. That’s right, you should prepare because your neighbors need you to prepare—especially your elderly neighbors, your neighbors who work at hospitals, your neighbors with chronic illnesses, and your neighbors who may not have the means or the time to prepare because of lack of resources or time.
Richard Besser, who was acting director of the Centers for Disease Control and Prevention during the 2009 H1N1 pandemic, says that in the US “the risk of exposure and the ability to protect oneself and one’s family depends on income, access to health care, and immigration status, among other factors.” He points out that:
The elderly and disabled are at particular risk when their daily lives and support systems are disrupted. Those without easy access to health care, including rural and Native communities, might face daunting distances at times of need. People living in close quarters — whether in public housing, nursing homes, jails, shelters or even the homeless on the streets — might suffer in waves, as we have already seen in Washington state. And the vulnerabilities of the low-wage gig economy, with non-salaried workers and precarious work schedules, will be exposed for all to see during this crisis. Ask the 60 percent of the U.S. labor force that is paid hourly how easy it is to take time off in a moment of need.
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