Jump to content

Why have so few people recovered in the US?


RoseGoesToYale

Recommended Posts

RoseGoesToYale

I'll preface this with some good news... even though the number of cases in increasing, the percentage of mild cases as opposed to critical cases is also (albeit slowly) increasing.

 

Anyway. Community spread has been going on for quite a while in the US. It's the third highest country ranked by total cases, behind China and Italy. But of those top 10 countries ranked by total cases, the US is recovering at an absolutely glacial pace. Here are the ratios of total recovered patients to active cases for those countries. Recovered in blue, active in orange.

 

China- 18.8:1

Italy- 1: 6.1

US- 1:163.6

Spain- 1:7.5

Germany- 1:9.5

Iran- 1:1.6

France- 1:5.1

Switzerland- 1:81

UK- 1:66

South Korea- 1:1.4

 

Does anyone know what's up with that? Is there still a lag in adequate testing? Or is it as I hypothesized before, that recovered people aren't going back for proper testing required to officially clear them? I feel like there's no way the recovery rate could be that slow unless the number of active cases is really increasing at an alarming rate compared to the other countries. Which would incidentally mean that containment efforts in the US are horrendous, and I firmly believe they are (people are still congregating at beaches in my state and the governor sides with Trump).

 

 

Link to post
Share on other sites
14 minutes ago, RoseGoesToYale said:

Is there still a lag in adequate testing?

Yes, as far as I've heard.

 

14 minutes ago, RoseGoesToYale said:

that recovered people aren't going back for proper testing required to officially clear them?

Interesting idea, but I would hope beyond hope the people in charge of monitoring them would know who's infected and check in with them. What if that person died? Would they just wait to hear about it in the obituaries? 

 

14 minutes ago, RoseGoesToYale said:

the number of active cases is really increasing at an alarming rate compared to the other countries.

This is what I've heard. I don't have numbers or sources, just media paranoia, so take that as you will. 

 

14 minutes ago, RoseGoesToYale said:

Which would incidentally mean that containment efforts in the US are horrendous, and I firmly believe they are (people are still congregating at beaches in my state and the governor sides with Trump).

YEP! Other than the problems other countries are also facing of people not taking it seriously and ignoring the quarantine and social distancing, our federal government is not taking it seriously at all. Trump refuses to be honest about efforts. A CNN article I read said he's calling South Korea and asking for help, but denying he's asking for help and continuing to say the US is treating it wonderfully and he wants to end the quarantine by Easter.

When's Easter, btw? I don't pay attention to that holiday ever since I dropped the religion.

Link to post
Share on other sites

China was slow in reporting the emergence of the virus and the US was slow in responding to it once it became known. I think the real thing hampering the US response is our public health care system has been underfunded for decades. The conquest of polio lulled us into a false sense of invulnerability. AIDS was a wake up call but the general consensus was that only social pariahs like gays and drug addicts contracted this disease. It wasn't our problem. It was their problem. Thus, a public health system as useful as a fire alarm with a dead battery. I speak from experience. I worked nearly 30 years as a state employee in the public health department. My section was little more than a welfare system for incompetent professionals. Well, what goes around comes around and it certainly has, hasn't it?

Link to post
Share on other sites

Disastrous leadership and unequal access to healthcare?

Link to post
Share on other sites
Unleash the Echidnas

My understanding is also that US test capacity remains inadequate. I can't keep track all of the different protocols different countries (and in the US probably individual states) use in reporting but, in general, recovery is associated with cessation of viral shedding and negative test results. So, in a confirmed US case, someone probably has to get sick enough to make priority to be tested and then I would guess (at least for now) probably doesn't get tested to confirm recovery because it's higher priority to test for new cases. Right now the US CDC doesn't seem to be reporting recovered cases and I don't see citations for worldometer's recovered US cases. So maybe there's also bias in the numbers because only certain states are reporting recovery at this point.

 

Recovery also takes time and I can't reproduce the 1:164 ratio of the original post. At the moment, worldometer has 68,203 cases and 394 recoveries for the US and, computed without lag adjustment, this gives 68203/394 = 173.1. However, like most C19 calculations, this number is biased for the reasons worldometer discusses. With the US in particular there are so many potential confounding factors I'm hesitant to suggest a method for a more accurate estimate as epidemiology isn't my field. But informed guesses at lag adjusted recovery ratio coming out an order of magnitude lower seem plausible.

 

 

1 hour ago, SithEmpress said:

When's Easter, btw?

April 12th. I had to look it up.

Link to post
Share on other sites

Like others mentioned, our testing is just inadequate. Since we don't have all that many tests, very few people get two consecutive days of additional testing after showing no more symptoms.

This number will definitely increase as we get more tests... assuming we properly follow up on those cases (which will likely only be the case for serious cases right now where people already are in the hospital, so numbers might remain quite a bit lower than reality for the foreseeable future, though the factor should decrease.

Link to post
Share on other sites
WinterWanderer

I work in this field. Yes, testing is very limited. I don't trust the national numbers much at the moment. But as testing expands, we should be able to get a clearer idea of mortality rates, recovery rates, etc. 

Link to post
Share on other sites

I can think of a couple of reasons. Active cases doesn't include those who haven't been tested, so makes the recovery rate seem low. For example, as recently asde last week the British government were estimating that the actual number of cases was ten times higher than the recorded number. Then the case acceleration started later in the USA than in other countries, so if, hypothetically, it takes two weeks from being declared positive to being declared cleared, it's inevitable that there will be a lag. 

Link to post
Share on other sites
2 minutes ago, Skycaptain said:

I can think of a couple of reasons. Active cases doesn't include those who haven't been tested, so makes the recovery rate seem low. For example, as recently asde last week the British government were estimating that the actual number of cases was ten times higher than the recorded number. Then the case acceleration started later in the USA than in other countries, so if, hypothetically, it takes two weeks from being declared positive to being declared cleared, it's inevitable that there will be a lag. 

I think part of the advice was if you are self isolating, you don't need testing. 

----

Another thing is to be classified as recovered, you need 2 negative tests. 

With testing difficulties on getting the initial positive test, this means two further tests are difficult to get

Link to post
Share on other sites
Anthracite_Impreza

I thought they weren't even bothering to keep track anymore unless you died tbh...

Link to post
Share on other sites

Perhaps a comparison would help paint a broader picture. British Comlumbia and Alberta are the two provinces that got hit first and had less time to react. As such, British Columbia has the greatest death rate in Canada. Other provinces where healthcare is faster than other provinces, like Alberta, or had more time to prepare, like Quebec, had a significantly lower death rate. Actualy, Alberta and Quebec, when taken deaths to per cases, have an approximate death rate, even if Quebec is probably the worst province generaly when it comes to public health service. And I want to add that Quebec has the most cases of COVID-19 but the 3rd amount of deaths related to the illness within Canada.

The USA was hit earlier than Canada, had less time to prepare and though reputed for its quality of care is not reputed for its accessability. I think it's a mix of these two variables that makes the fight on COVID-19 so darn hard in the USA. I heard that only 100 billion $ was earmarked for healthcare in the stimulus package. I'm unsure of my source, but if it's correct, the USA is not out of its suffering.

Link to post
Share on other sites

I'm not sure how mortality was counted. Recovering takes time. The spread of COVID in the whole USA is more recent than in other regions. Hopefully you will have the time to prepare your hospitals to handle the peak.

 

Link to post
Share on other sites
1 hour ago, Perspektiv said:

Juuuust a hunch, but just maybe:

 

  Reveal hidden contents

 

 

This does not seem reassuring. Hopefully the Government of each State will be more proactive than your Federal Government.

Link to post
Share on other sites
RoseGoesToYale

Well, we seem to have gotten our testing shit together and now have the infamous position of having waaay more cases than any other country.

 

Considering the US isn't even the largest country population-wise... the only way it could've gotten this bad is because the federal government SNAFU'd literally every step and protocol it could've taken to slow containment.

Link to post
Share on other sites
andreas1033

European doctors say obesity is the most dangerous of pre existed conditions to have, while you have covid19.

 

This may answer your question. Meaning america has be far the biggest obesity problem of all major countries. I doubt the media in america are telling americans obesity is by far the worst pre existing medical problem to have, if you get covid19.

 

Usa may not have the biggest population, it is long way ahead in terms of big countries having obesity as a health problem.

 

Obesity is by far the worst health condition to have, if you get covid19, and it becomes serious, for you to goto hospital.

Link to post
Share on other sites
11 minutes ago, RoseGoesToYale said:

Considering the US isn't even the largest country population-wise... the only way it could've gotten this bad is because the federal government SNAFU'd literally every step and protocol it could've taken to slow containment.

Funny thing is USA was quicker to limit international flights than Canada, at least on the federal level. It was the provincial gov'ts that acted quickly to impose domestic measures. I suppose that domestic measures are more efficient than restricting borders.

Link to post
Share on other sites
RoseGoesToYale
7 minutes ago, andreas1033 said:

European doctors say obesity is the most dangerous of pre existed conditions to have, while you have covid19.

It's not so much the obesity itself as the complications highly associated with it. There are higher instances of diabetes, high blood pressure, heart disease, and breathing problems... all the coronavirus killers.

 

Incidentally, the top states in the US for obesity are rural republican states. So a bunch of Trump supporters, and Trump isn't taking any of it seriously enough (if at all). In red states their governments think coronavirus is barely a threat, are refusing to put lockdowns in place. They want people to keep working, and people think it's safe to keep working. One thing limiting spread there is rural land, so people living farther apart from each other. But it's also the Bible Belt. One church gathering could be enough to infect an entire community.

Link to post
Share on other sites
andreas1033
8 minutes ago, RoseGoesToYale said:

It's not so much the obesity itself as the complications highly associated with it. There are higher instances of diabetes, high blood pressure, heart disease, and breathing problems... all the coronavirus killers.

 

Incidentally, the top states in the US for obesity are rural republican states. So a bunch of Trump supporters, and Trump isn't taking any of it seriously enough (if at all). In red states their governments think coronavirus is barely a threat, are refusing to put lockdowns in place. They want people to keep working, and people think it's safe to keep working. One thing limiting spread there is rural land, so people living farther apart from each other. But it's also the Bible Belt. One church gathering could be enough to infect an entire community.

Yep, but thats still obesity.

 

If a person is obese, and they get into a bad situation with covid19, its less likely they will overcome that problem, if they are hospitalised. The problems that obesity brings the body, will just make it alot harder for the body to cope, and respond.

 

For me, thats why usa figures are as they are, and you asked.

 

On your second point. This virus does not care about a persons arrogance.

Link to post
Share on other sites
Anthracite_Impreza

The UK has similar obesity rates, but we seem to be faring far better. Could it be our (albeit deliberately crippled but still standing) NHS...? 😨

Link to post
Share on other sites

It doesn't help that people are slow to seek help. Having a private insurer, lack of paid work leave, lack of sufficient testing resources, etc, most people are very slow to accept that they are sick, much less able to get tested and take the time to isolate. I certainly don't know what I would do if I got sick, and I have decent insurance.

Link to post
Share on other sites

I think this obesity thing is a bit of a red herring. The Chinese and Iranians certainly don't have a history of obesity, more the opposite. Certainly there will be cases where obesity is comorbid with something else that's a risk factor, atherosclerosis, T2 diabetes etc. I wonder whether recovery rates vary according to current/past smoking history, working in polluted environments etc. 

Link to post
Share on other sites

Smoking is likely a factor given the effect the virus has on breathing. 

Link to post
Share on other sites

Any US numbers are likely inaccurate because most cities are still only doing priority testing and testing centers are backlogged. 

Link to post
Share on other sites

Global figures today (approximate) 

 

758000 cases

139000 recovered

36200 dead

583000 active cases 

 

A lot of active cases are probably people who've never had an "All clear" test 

 

However to put this in perspective the UK government estimate that 2-3% population have been infected, and maybe 5% of the London population. This would mean, at the low end, 1.4 million cases, or almost as many as the total recorded cases globally 

 

 

 

Link to post
Share on other sites
On 3/25/2020 at 6:41 PM, RoseGoesToYale said:

I'll preface this with some good news... even though the number of cases in increasing, the percentage of mild cases as opposed to critical cases is also (albeit slowly) increasing.

 

Anyway. Community spread has been going on for quite a while in the US. It's the third highest country ranked by total cases, behind China and Italy. But of those top 10 countries ranked by total cases, the US is recovering at an absolutely glacial pace. Here are the ratios of total recovered patients to active cases for those countries. Recovered in blue, active in orange.

 

China- 18.8:1

Italy- 1: 6.1

US- 1:163.6

Spain- 1:7.5

Germany- 1:9.5

Iran- 1:1.6

France- 1:5.1

Switzerland- 1:81

UK- 1:66

South Korea- 1:1.4

 

Does anyone know what's up with that? Is there still a lag in adequate testing? Or is it as I hypothesized before, that recovered people aren't going back for proper testing required to officially clear them? I feel like there's no way the recovery rate could be that slow unless the number of active cases is really increasing at an alarming rate compared to the other countries. Which would incidentally mean that containment efforts in the US are horrendous, and I firmly believe they are (people are still congregating at beaches in my state and the governor sides with Trump).

 

 

The problem is that the disease doubles much faster than the time it takes for people to recover or die. Say 100 people are infected.  It takes about 3 weeds for the disease to run its course, but it doubles in about 2.5 days.  (before social distancing).  So in the time they recover (or die). 2^6  (64) times as many people have been infected. So you have 6400 cases, with only 100 recovered (or dead)

China and S. Korea are special cases because they took extreme measures (isolation for China, Tracking for S. Korea) and beat the disease, so most of their people have already recovered (or died) and the disease is almost destroyed.  The rest of the world, and especially the US did not take such measures, so its still growing quickly, and the death toll will soon be horrific. 

Link to post
Share on other sites

Archived

This topic is now archived and is closed to further replies.

×
×
  • Create New...