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Member since: Sun Jun 4, 2017, 04:46 PM
Number of posts: 1,660

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Is anyone else putting together a DNR or Advance Care Directive?

I'm 69 years old. I have asthma, hypertension and heart failure. After reading a couple of doctors' descriptions of late stage Covid-19, I finally decided to set down my wishes for my partner and doctors. My directive specifies sedation instead of intubation, and includes an "Allow Natural Death" clause. I will also be adding a request for medical assistance in dying if I end up in that state, if that is possible. If not, sedation will have to suffice.

I've lived my life, and I'm quite satisfied with it. I don't want to suffer at the end, and I want to make sure I don't use medical supplies and attention that are needed more urgently by others.

Who else is making such preparations?
Posted by The_jackalope | Tue Mar 24, 2020, 11:02 AM (6 replies)

US cases have been increasing by 33%/day for the last 3 weeks.

That means the case count is doubling every 2.5 days. The behavior is remarkably consistent since at least March 2, when there were only 105 cases. If that exponential behavior remains in place for just another two weeks, there will be on the order of 2.5 million cases in the USA.

The global All Case Fatality Ratio (including cases that are still active) has gone up to 4.4%, and the Case Fatality Ratio for resolved cases (those who have recovered or died) has risen to 13.9% from 5.6% two weeks ago.

That last number scares the living shit out of me. Unless something really major happens to change the epidemiology of this thing, the USA is looking at an unavoidable human catastrophe that will make the argument over stimulus packages look like playground name-calling.
Posted by The_jackalope | Mon Mar 23, 2020, 02:56 PM (18 replies)

Keeping up with the numbers

Data comes from https://www.worldometers.info/coronavirus/ as of 4:00 pm March 18 and 11:30 pm March 21

Global data:

March 18: Cases are increasing by over 17,000 per day. Deaths are increasing by almost 1,000 per day.
March 23: Cases are increasing by over 32,000 per day. Deaths are increasing by almost 1,700 per day.

March 18:The "All Case" CFR (Total Cases/Deaths) is 4.1%. The "Closed Case" CFR ((Recoveries+Deaths)/Deaths) is 9.6%
March 23:The "All Case" CFR (Total Cases/Deaths) is 4.25%. The "Closed Case" CFR ((Recoveries+Deaths)/Deaths) is 11.9%

What I call the "All Case" CFR is what Wikipedia calls the preliminary CFR. The Closed Case CFR approximates what Wikipedia calls the "final CFR". The article contains this caution:
The preliminary CFR, for example, during the course of an outbreak with a high daily increase and long resolution time would be substantially lower than the final CFR.

The global infection curve is showing no signs of decelerating into a sigmoid inflection. Simple, high-correlation quadratic projections show 9 million infections and 600,000 deaths world-wide in two months. These are increases of 30+ times today's numbers.

My concern, frankly, is that these projected numbers will prove to be too low.

Different nations will show different CFR values depending on their demographics, population density, the timing and urgency of the testing and distancing measures they undertake, and the quality of their health care system. National values currently vary from a "Closed Case" CFR of 3.5% in South Korea to about 40% for Italy and Spain. The USA isn't doing well yet, with a Closed Case CFR of 66%

The numbers are bad, getting worse fast, and there is no end in sight. If you're not an essential worker, stay home and wash your hands. If you are an essential worker, bless you and may you stay safe.
Posted by The_jackalope | Sat Mar 21, 2020, 11:11 PM (4 replies)

Tonight I'm feeling like

Mother Nature has sent us all to our rooms to think about what we've done.
Posted by The_jackalope | Fri Mar 20, 2020, 09:50 PM (1 replies)

My latest COVID-19 numbers and estimates

Data comes from https://www.worldometers.info/coronavirus/ as of 4:00 pm March 18, 2020.

Global data:

Cases are increasing by over 17,000 per day.
Deaths are increasing by almost 1,000 per day.

The "All Case" CFR, using the data for all cases and deaths is 4.1% It has been climbing continuously for the last month up from 2.8%.

The "Closed Case" CFR using the data for recoveries and deaths is 9.6%, and has been climbing steadily for a week and a half, up from 5.6%.

Projections based on quadratic fits to the month of global data since 19 February, and extended out to April 15 indicates 600,000 cases for a second-order fit (R^2=0.976), and 1.4 million for a tighter third order fit (R^2=0.998).

US Data:

American cases are rising by 1500 per day, but there really isn't enough data yet to be confident of the trends.
Based on data from 1 March, projections indicate between 70,000 and 225,000 cases by April 13.
Posted by The_jackalope | Wed Mar 18, 2020, 03:39 PM (14 replies)

Every fruit tree benefits from pruning

A design trends forecaster calls the coronavirus “an amazing grace for the planet”

Dutch trends forecaster Li Edelkoort has a provocative outlook on Covid-19, the deadly coronavirus strain that has upended manufacturing cycles, travel plans, and conference schedules around the world. Speaking at Design Indaba, a conference in Cape Town last week, the celebrated 69-year old design industry advisor pictured Covid-19 as a sobering force that will temper our consumerist appetites and jet-setting habits.

“The virus will slow down everything,” Edelkoort notes. “We will see an arrest in the making of consumer goods. That is terrible and wonderful because we need to stop producing at such a pace. We need to change our behavior to save the environment. It’s almost as if the virus is an amazing grace for the planet.”

But after the coronavirus, utopia looms, Edelkoort suggests. Indeed, Covid-19 could open new avenues for innovation, akin to how the bubonic plague ushered in an era of labor reforms and improvements in medicine in the Middle Ages. Being confined to our own towns or cities could foster a revival of cottage industries and an appreciation for locally made goods, she says. “There are so many possibilities,” Edelkoort says. “I’m strangely looking forward to it.”

I think this is the perspective I was missing in my support for the virus.
Posted by The_jackalope | Mon Mar 16, 2020, 10:54 PM (13 replies)

One month global COVID-19 case load projection with and without Chinese data

The data for this post is taken from https://www.worldometers.info/coronavirus/ retrieved March 16 at 4:00 pm EST.

This graph doesn't address deaths, just the identified cases from Feb 19 to March 16, with projections out to April 16. The projections are all third-order quadratic fits, and the tightness of the fits is given by the R-squared value for each curve. The dividing line between actual and projected cases is the thick line at today's date.

I had previously been plotting both second- and third-order fits, but the current data is diverging further from the second-order fit, resulting in a steadily dropping accuracy. As a result I don't think the second-order fit is useful any more, at least for this dataset. The third-order fits are remarkably tight.

It's clear from the shape of their green line that China has a handle on their spread. To segregate that effect, I plotted the Chinese data separately, and graphed the world data both with and without the Chinese data included. It's evident that the global spread is now being driven by non-Chinese cases. At the moment the major contributors are Italy, Iran, Spain, S. Korea, Germany, France and the USA.

In one month, if social distancing is not effective, the world could have close to one and a half million cases, with almost all of them (1.4 million) outside China.

As of today, the "Total Case" CFR is 4.2%, and the "Closed Case" CFR is 8.3%, based on the reported data for active cases, recovered cases and deaths from the source listed above. It's still early days, of course, but the fatality ratios based on reported data are still climbing.

We're walking (or running?) deeper into the woods

Posted by The_jackalope | Mon Mar 16, 2020, 03:15 PM (1 replies)

Well, I'm in the grip of dread tonight.

I feel like I just saw the Japanese tsunami 200 meters offshore.

My partner and I are 77 and 69 respectively. She has immune problems, I have asthma and a bum heart. So, we're in isolation. We have enough food and TP for at least a couple of weeks, maybe a couple more if we stretch. We've put strict entry rules in place - mostly for me if I have to go out. I doubt we'll be letting anyone in.

Some of you may know that I've been a long-time doomer. I've been preparing myself psychologically for the end of global industrial civilization for 15 years now. But it still surprised me. I thought it would be climate change that would toll the bell, but I know that major depopulation events are always diseases.

I've been running the numbers and reading epidemiologist reports online tonight, and I'm freaked right the fuck out. This thing is far bigger, way more severe and moving much faster than most people realize, or even could realize. Even than I, with all my practice, could realize. I wouldn't be surprised if, when all is said and done, much will have been said, but we'll all be done.

For example, many of us thought it didn't affect younger people so much. I just saw the demographics of positive cases in China, and 30% of them were 20 to 29 years old. Maybe not symptomatic, but definitely contagious.

My curve plots project over a million cases globally by mid-April, but those are based on diagnosed cases. The word from Harvard and Yale is that for every diagnosed case there are 10 to 50 unknown cases, walking around breathing and touching doorknobs.

To quote Kurtz from Joseph Conrad's "Heart of Darkness", "The horror! The horror!"

Sorry to be a Debbie Downer. I'll make sure to call my aged father in his locked-down retirement home regularly to make up for it.
Posted by The_jackalope | Sun Mar 15, 2020, 02:13 AM (43 replies)

I just realized that this feels like watching the Japanese tsunami come ashore

Right now the thin, innocuous white like on the horizon is about 200 metres offshore, and we're running for high ground. When it hits, it will sweep all before it.

Posted by The_jackalope | Sat Mar 14, 2020, 05:47 PM (6 replies)
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