The interesting thing is many parts of the USA have “yoloed” it when it comes to COVID, but their death/serious case numbers aren’t all that much worse than places with severe restrictions. Silvaire may well be right.
Silvaire wrote:
I don’t believe anybody understands what has driven infection numbers up or down beyond the simplest models with their unrealistic and naive assumptions.
I am not so sure.
The mechanism of transmission is pretty ease to grasp. I dont think it is especially discriminating.
High population density, people in close proximity on a regular basis, lack of basic precautions, weather dictating people spend more time in enclosed spaces without good supplies of fresh air, this is the combination for any respiratory infection.
I think it is pretty basic at this level, and where we see the highest rates of infection (and the lowest) we also see exactly this combination, or lack of.
I agree Silvaire, the models probably dont handle the demographics very well, or should I say rather, they dont distinguish between different sets of demographics. A model for London will not work very well for the Highlands of Scotland (or many parts of the USA with low population density), and it will not work for a aged population living in a golfing enclave in Florida compared with students in a University campus for reasonably obvious reasons, but it will indicate broad trends in most settings.
The interesting thing is many parts of the USA have “yoloed” it when it comes to COVID, but their death/serious case numbers aren’t all that much worse than places with severe restrictions. Silvaire may well be right.
You can only YOLO for so long. Ask the brazilians.
alioth wrote:
The interesting thing is many parts of the USA have “yoloed” it when it comes to COVID, but their death/serious case numbers aren’t all that much worse than places with severe restrictions. Silvaire may well be right.
Deaths per capita – UK is 8th highest, US is 14th highest so far.
Infections per capita – UK is 32nd highest, US is 8th highest so far.
You were more likely to get sick in the US, but more likely to die in the UK.
Americans are not as risk averse in their behavior but have very good health care. Based on comparison between US states and between European countries, I don’t think trying to legally control public behavior makes a strong contribution, nor does government trying to control health care make a strong contribution. Those are illusions that make people and politicians feel a false sense of control, when they would be better off concentrating on what may actually solve the problem, i.e. vaccine development and distribution.
Obviously those rankings will change given that CV cases in the world as a whole are increasing, not strongly contracting as in the US and UK.
I think deaths per capita is important. It could be an indication of how effective different health services have been, and this is indeed a logical conclusion.
However, I am not sure it is.
The dear NHS is far from perfect, but I would say it isnt that bad either. The raw data at first blush might suggest otherwise.
Again, I suspect the real answer is very complicated.
Demographics of the population will be a factor. The best health service will not do well with a slanted old and unhealthy population.
Accuracy of reporting cause of depth will be a factor.
How the virus has spread in the community will be a factor.
As ever the raw data can be very misleading if you rush to conclusions.
One thing one learns very quickly when spending any time there is that there is no such thing as “THE USA”
I am using the numbers per 100k – ranking alone is not very meaningful.
So for deaths
– Deaths per 100k: UK 189, US 165, EU average 133.
but in the US, the top three are:
– New Jersey: 272
– New York (state, not NYC): 254
– Massachusetts: 246
somewhere in the middle:
– California:146 (most populous state, more than 10% of the US population)
– Texas: 163 (second most populous state)
and at the other end of the scale: (just picking a few, Vermont being the lowest in the contiguous states)
– Washington (state, not D.C.): 68
– Maine: 54
– Vermont: 35
Fuji_Abound wrote:
Again, I suspect the real answer is very complicated.
Yes, a lot will depend on % of the people in population centres, but a massive factor will also be luck. If the virus gets into a population centre B one week later than it arrived in population centre A, B population centre will have only between 10-30% of the cases that A has, even if A and B are EXACTLY the same in all other respects and both take the same measures at the same time.
It is pretty clear that @Silvaire is at least half right. There are a lot of factors that we do not understand (weather? there is a reason why common respiratory infections are called “colds”, not “warms”), and there are certainly a lot of unnecessary lockdowns (because “something must be done”, and because of “solidarity”).
The last attempt we saw at figuring out common factors was mostly BS, I am not aware of another one – anybody seen one?
The dear NHS is far from perfect, but I would say it isnt that bad either.
The UK NHS is actually really good, once you get “into the system”. Justine slipped on some mud the other day, dislocated her arm, and they turned up in 4 vehicles, 8 people. The place was very hard to reach; they really struggled. The NHS does very well considering the “UK health” landscape which often resembles a scene from Mad Max.
The difficulties are elsewhere; they are mostly before you get into the system (the whole GP setup is petty dreadful and smarter/wealthier people, perhaps a few % of the population, manage that process themselves, by “going private”) and then a lot of the peripheral stuff is dodgy e.g. nutrition advice which simply cannot be given in most cases (“Mr Smith, the reason why your leg joints are fuct is because you weight 200kg, so what you actually need to do is eat less” is not possible).
It is pretty clear that @Silvaire is at least half right
Definitely.
there are certainly a lot of unnecessary lockdowns (because “something must be done”, and because of “solidarity”).
Definitely, and it is really frustrating to see patently stupid stuff done for the latter reason – because the place is full of politicians who exploit every “inequality” for their own ends. That’s the price of a country with centuries of freedom 
Peter wrote:
the whole GP setup is petty dreadful
This is all a hangover from how it was originally set up. As a concession to the power and independence that doctors were losing they were allowed to operate their GP practices as independent businesses with the NHS as a customer, paid per patient on the list. A poorly-conceived system from the outset, it took a turn for the worse after a renegotiation some years ago where many/most opted out of providing out-of-hours care. I simplify greatly but the practices were inexplicably offered an option roughly along the lines of getting 90% of the money for doing ~80% of the work where the 20% excluded was the most unsociable hours, which of course is very attractive for any professional looking to spend more time with their family or on the golf course.
It could be corrected with some pretty straightforward (major) changes, but it has never been politically desirable to do so.
Then you throw in the fact that GPs spend 90% of their time seeing about 2% of the patients on their list (frequent flyers) and thus the only way order can be kept is having ‘brusque’ receptionists closely controlling access to the doctors, so for the rest of us who use the service very rarely it becomes, if not actually unpleasant, a load of hassle that one tends to avoid if at all possible.
For those of us who actively manage our own health the GP is really just a gatekeeper. We go there knowing what sort of specialist we need to see, and we just need the GP to refer us because the system requires it.
Pretty accurate IMHO…
Unfortunately for some reason there are [almost?} no private GPs.
