US response compared to South Korea, Australia, Germany, and Singapore - Printable Version
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RE: US response compared to South Korea, Australia, Germany, and Singapore - Goose - 06-25-2020
(06-24-2020, 10:46 PM)BostonCard Wrote: It indeed does get old, because Germany has had a grand total of 9,996 deaths, or just over 1 death per 10,000 of its people; the US has over three times the mortality. Its seven day moving average of daily deaths is 11 total; we'd be thrilled to have a number 10 times as high. Germany has reopened shops, museums, churches, hair salons, and many schools. Very early on this board, a number of people here were wondering why the apparent case fatality rate from COVID-19 was so low in Germany. It's because they tested a lot more than fellow European countries and a lot more than the US. In the critical mid-March period where every day was critical, Germany had tested 30 times as many people per capita as the US. Goose will remind us that in some ways they were a bit lucky, and that is true (as you can read in the article I link below), but they also played the hand they were dealt well.
We have obviously been doing this too long! Yes, they were lucky to some significant extent. I also believe the death count is artificially low because the German health system generally reports the proximate cause of death (i.e. pneumonia) even when the patient is COVID-19 positive. Steps have been taken to correct that, but it can't back-correct the totals from the beginning. I totally agree the Germans played their hand very well, and I further believe that was due to very competent state health departments.
Quote:They knew where COVID-19 was spreading and were able to act accordingly. The US pretty much didn't, and only intervened when it was too late.True. Why did Germany know? First, their "State" health departments are fairly well resourced and staffed. They weren't strong enough or large enough to be a Taiwan or a Korea, but they were up to the task of doing enough surveillance testing (and even significant contact tracing) to determine that they would be overwhelmed. If one looks at the link posted by GR, you will see that Bavaria actually beat the initial infection. This is despite the fact the source of the infection was a "super spreader" who gave the disease to people that would not normally qualify as "contacts". However, when North Rhine-Westphalia and Berlin both started reporting lots of cases it was clear there was no hope of containment.
The test developed by Berlin Charité was probably not manufactured there. I don't know who did the manufacturing, but I am pretty sure it was an ad hoc effort. It might have been done by several groups. In any case, they did what was necessary to get it done. Probably didn't go through the contracts department. The USA by contrast relied on the CDC to manufacture the test. This was a known weakness from 2008 that was never addressed. First big difference. Second, our State public health services are nothing like the German ones in terms of prestige or competence. In the US, the concept of "poor doctors for poor people" comes to mind. Probably a bit unfair, but for sure these organizations are not nearly as proactive as the German ones. It is not just that the German organizations are larger, rather that it is considered an important part of the State's function.
The good data coupled with the respect and trust the state health departments provided the federal government a credible picture of the problem, which makes decision making significantly easier. It would still be possible to not "do the right thing", but for sure you would get lots of push back from the state health departments if you didn't. One great strength (and sometimes weakness) of the German political system is that it tends to defer to expertise (Ms. von der Leyen non-withstanding). The federal health system is a two track organization (as I understand it), sort of like the US GS system. However, in Germany, the "Technical Track" has lots of influence.
Quote:This article compares Germany's response to France's.BC, the VOX article is long on unsupported assertions and short on facts. It doesn't actually compare anything to anything. If one examines the timelines of the response in Germany one sees the states were leading the way in the middle of March (with the Federal government trying to slow them down a bit). Both France and Germany started a nationwide response at about the same time, as near as I can see. The Germans enforced theirs, the French didn't. I would argue the superior result in Germany was due to far superior testing and tracing coupled with universal compliance. Superior compliance is easier to obtain if you can show people the actual extent of the disease. The Germans could do that.
https://www.vox.com/2020/4/17/21223915/coronavirus-germany-france-cases-death-rate
The bottom line, "Germany followed the playbook for saving lives. France didn’t." At least France seems to have learned its lesson; it has driven its infection rate down to about 450 new cases a day (7-day moving average) and its deaths to 22.
RE: US response compared to South Korea, Australia, Germany, and Singapore - BostonCard - 06-25-2020
(06-25-2020, 10:08 AM)Goose Wrote: I also believe the death count is artificially low because the German health system generally reports the proximate cause of death (i.e. pneumonia) even when the patient is COVID-19 positive.
I've seen that argument made several places, but I haven't seen any evidence that this is the case. In fact, analyses of excess mortality in Germany (mortality above and beyond what would have been expected, which would catch COVID-19 related deaths that were attributed to something else) don't suggest there is a large number of deaths reported as being caused by something else that were really called by COVID-19. Here are a couple of articles:
https://www.dw.com/en/coronavirus-germany-sees-increase-in-excess-mortality/a-53537500
Quote:Germany saw a slight increase in the average number of deaths in April, the Federal Statistics Office reported on Friday. April's death rate was around 5% more than the average number of deaths in April between 2016 and 2019....
"Excess mortality in Germany is low compared to other European countries," the statisticians reported. "Italy reports 49% more deaths in March 2020 than in the years 2015 to 2019, on average [...] Sweden reports twice as many deaths in the agglomeration area of Stockholm for weeks 14 to 16 [mid-April] as, on average, the five years before."
https://www.ft.com/content/a26fbf7e-48f8-11ea-aeb3-955839e06441
Through May 24, the FT identified 9200 excess deaths in Germany. Through May 24, Germany had reported 8,371 COVID-19 deaths, which is 90% of the excess deaths, which is within the error of the method of identifying expected mortality based on prior years at the same time. Moreover, the gap is lower than it is in other European countries. Also, excess deaths would include deaths due to other reasons (for example heart attacks) that were impacted by delay in seeking care either because of lockdown or fear of contracting COVID-19 in a hospital.
I conclude that German reports of COVID-19 deaths are a reasonably accurate reflection of the true number of deaths that occurred in Germany due to COVID-19, and that the idea that Germany was systematically mis-coding cause of death is either apocryphal or does not significant impact the numbers.
BC
RE: US response compared to South Korea, Australia, Germany, and Singapore - Genuine Realist - 06-25-2020
(06-25-2020, 10:08 AM)Goose Wrote:Germany's response since everyone got religion since March 10th (or thereabouts) has indeed been interesting, and possibly exemplary, though its demographic and homogenous population makes it questionable whether the protocols could be exported to the US. We have a totally different culture.(06-24-2020, 10:46 PM)BostonCard Wrote: It indeed does get old, because Germany has had a grand total of 9,996 deaths, or just over 1 death per 10,000 of its people; the US has over three times the mortality. Its seven day moving average of daily deaths is 11 total; we'd be thrilled to have a number 10 times as high. Germany has reopened shops, museums, churches, hair salons, and many schools. Very early on this board, a number of people here were wondering why the apparent case fatality rate from COVID-19 was so low in Germany. It's because they tested a lot more than fellow European countries and a lot more than the US. In the critical mid-March period where every day was critical, Germany had tested 30 times as many people per capita as the US. Goose will remind us that in some ways they were a bit lucky, and that is true (as you can read in the article I link below), but they also played the hand they were dealt well.
We have obviously been doing this too long! Yes, they were lucky to some significant extent. I also believe the death count is artificially low because the German health system generally reports the proximate cause of death (i.e. pneumonia) even when the patient is COVID-19 positive. Steps have been taken to correct that, but it can't back-correct the totals from the beginning. I totally agree the Germans played their hand very well, and I further believe that was due to very competent state health departments.
Quote:They knew where COVID-19 was spreading and were able to act accordingly. The US pretty much didn't, and only intervened when it was too late.True. Why did Germany know? First, their "State" health departments are fairly well resourced and staffed. They weren't strong enough or large enough to be a Taiwan or a Korea, but they were up to the task of doing enough surveillance testing (and even significant contact tracing) to determine that they would be overwhelmed. If one looks at the link posted by GR, you will see that Bavaria actually beat the initial infection. This is despite the fact the source of the infection was a "super spreader" who gave the disease to people that would not normally qualify as "contacts". However, when North Rhine-Westphalia and Berlin both started reporting lots of cases it was clear there was no hope of containment.
The test developed by Berlin Charité was probably not manufactured there. I don't know who did the manufacturing, but I am pretty sure it was an ad hoc effort. It might have been done by several groups. In any case, they did what was necessary to get it done. Probably didn't go through the contracts department. The USA by contrast relied on the CDC to manufacture the test. This was a known weakness from 2008 that was never addressed. First big difference. Second, our State public health services are nothing like the German ones in terms of prestige or competence. In the US, the concept of "poor doctors for poor people" comes to mind. Probably a bit unfair, but for sure these organizations are not nearly as proactive as the German ones. It is not just that the German organizations are larger, rather that it is considered an important part of the State's function.
The good data coupled with the respect and trust the state health departments provided the federal government a credible picture of the problem, which makes decision making significantly easier. It would still be possible to not "do the right thing", but for sure you would get lots of push back from the state health departments if you didn't. One great strength (and sometimes weakness) of the German political system is that it tends to defer to expertise (Ms. von der Leyen non-withstanding). The federal health system is a two track organization (as I understand it), sort of like the US GS system. However, in Germany, the "Technical Track" has lots of influence.
Quote:This article compares Germany's response to France's.BC, the VOX article is long on unsupported assertions and short on facts. It doesn't actually compare anything to anything. If one examines the timelines of the response in Germany one sees the states were leading the way in the middle of March (with the Federal government trying to slow them down a bit). Both France and Germany started a nationwide response at about the same time, as near as I can see. The Germans enforced theirs, the French didn't. I would argue the superior result in Germany was due to far superior testing and tracing coupled with universal compliance. Superior compliance is easier to obtain if you can show people the actual extent of the disease. The Germans could do that.
https://www.vox.com/2020/4/17/21223915/coronavirus-germany-france-cases-death-rate
The bottom line, "Germany followed the playbook for saving lives. France didn’t." At least France seems to have learned its lesson; it has driven its infection rate down to about 450 new cases a day (7-day moving average) and its deaths to 22.
What gets old is the notion that in the first two months of this year ANY nation (including Germany) successfully evaluated the risk and responded effectively to it. German mobilization began approximately the same date as the US. Check the Wikipedia link and you'll find that Germany was also short of some essential medical supplies at the outset.
RE: US response compared to South Korea, Australia, Germany, and Singapore - burger - 06-25-2020
(06-25-2020, 11:15 AM)Genuine Realist Wrote: Germany's response since everyone got religion since March 10th (or thereabouts) has indeed been interesting, and possibly exemplary, though its demographic and homogenous population makes it questionable whether the protocols could be exported to the US. We have a totally different culture.
What gets old is the notion that in the first two months of this year ANY nation (including Germany) successfully evaluated the risk and responded effectively to it. German mobilization began approximately the same date as the US. Check the Wikipedia link and you'll find that Germany was also short of some essential medical supplies at the outset.
Actually, what gets old is your constant repeating of the false claim that no country was able to control the virus. The trajectories of the various countries show exactly the opposite. Go look at this graph and tell me how all those countries with case loads far below ours did not get the virus under control. Certainly they did relative to us: https://ourworldindata.org/coronavirus-data-explorer?zoomToSelection=true&country=USA~GBR~CAN~DEU~FRA~ITA~AUT~BEL~DNK~FIN~ESP~SWE&casesMetric=true&totalFreq=true&perCapita=true&smoothing=0&pickerMetric=gdp_per_capita&pickerSort=desc
And I'm not even including the Asian countries that did far better than we did in my graph.
As for homogeneous populations, what do you even mean by that? I have looked at the numbers for mask usage, etc., and the only distinction that really matters in surveys of mask wearing is political party. Republicans, taking their cues from Trump, are far less likely to use masks: https://www.pewresearch.org/fact-tank/2020/06/23/most-americans-say-they-regularly-wore-a-mask-in-stores-in-the-past-month-fewer-see-others-doing-it/ft_2020-06-23_masks_02/
If you're going to keep repeating the same claims over and over, can you please cite some sources in the future?
RE: US response compared to South Korea, Australia, Germany, and Singapore - oregontim - 06-25-2020
(06-25-2020, 11:42 AM)burger Wrote: Go look at this graph and tell me how all those countries with case loads far below ours did not get the virus under control. Certainly they did relative to us:
Here's the chart from Burger's link above, as an image:
![[Image: EbYTCNWUcAA722W?format=jpg]](https://pbs.twimg.com/media/EbYTCNWUcAA722W?format=jpg)
RE: US response compared to South Korea, Australia, Germany, and Singapore - Goose - 06-25-2020
(06-25-2020, 11:15 AM)Genuine Realist Wrote: Germany's response since everyone got religion since March 10th (or thereabouts) has indeed been interesting, and possibly exemplary, though its demographic and homogenous population makes it questionable whether the protocols could be exported to the US. We have a totally different culture.We do have a totally different culture. While not having a homogeneous population contributes to this difference in culture, it is not the driving factor IMHO. I believe that the culture in the USA proceeds from the notion that the individual owes society only minimal adherence to the law and nothing else, period. Your "fellow man" gets help from you only in so far as you freely chose to provide it. That is true regardless of your "fellow man's" race, sex, religion, national origin or political affiliation. Not quite the same in Germany. Several of my European/Australian friends/customers have commented on this. That doesn't mean Americans are not generous, but it does mean it is at will.
Quote:What gets old is the notion that in the first two months of this year ANY nation (including Germany) successfully evaluated the risk and responded effectively to it. German mobilization began approximately the same date as the US. Check the Wikipedia link and you'll find that Germany was also short of some essential medical supplies at the outset.Depends on what you mean by "effectively". As I have pointed out many times to those who wonder why the US couldn't do what Korea did, you can only respond with what you have, not what you wish you had. Shortages of PPE that you didn't order in October can't be repaired in March. I think Germany responded as well as was possible (played the hand they had). The difference from France was that the states had provided compelling data that this was for real. France was kind of like the US, where there were hot spots but it was unclear (at least to the public) it was actually a general problem for everyone to deal with. Thus poor compliance.
RE: US response compared to South Korea, Australia, Germany, and Singapore - Genuine Realist - 06-25-2020
(06-25-2020, 11:42 AM)burger Wrote:I continue to point out the obvious reality in with respect to January February 2020. you continue to post data from March 1st on, and somehow think the data is apposite.(06-25-2020, 11:15 AM)Genuine Realist Wrote: Germany's response since everyone got religion since March 10th (or thereabouts) has indeed been interesting, and possibly exemplary, though its demographic and homogenous population makes it questionable whether the protocols could be exported to the US. We have a totally different culture.
What gets old is the notion that in the first two months of this year ANY nation (including Germany) successfully evaluated the risk and responded effectively to it. German mobilization began approximately the same date as the US. Check the Wikipedia link and you'll find that Germany was also short of some essential medical supplies at the outset.
Actually, what gets old is your constant repeating of the false claim that no country was able to control the virus. The trajectories of the various countries show exactly the opposite. Go look at this graph and tell me how all those countries with case loads far below ours did not get the virus under control. Certainly they did relative to us: https://ourworldindata.org/coronavirus-data-explorer?zoomToSelection=true&country=USA~GBR~CAN~DEU~FRA~ITA~AUT~BEL~DNK~FIN~ESP~SWE&casesMetric=true&totalFreq=true&perCapita=true&smoothing=0&pickerMetric=gdp_per_capita&pickerSort=desc
And I'm not even including the Asian countries that did far better than we did in my graph.
As for homogeneous populations, what do you even mean by that? I have looked at the numbers for mask usage, etc., and the only distinction that really matters in surveys of mask wearing is political party. Republicans, taking their cues from Trump, are far less likely to use masks: https://www.pewresearch.org/fact-tank/2020/06/23/most-americans-say-they-regularly-wore-a-mask-in-stores-in-the-past-month-fewer-see-others-doing-it/ft_2020-06-23_masks_02/
If you're going to keep repeating the same claims over and over, can you please cite some sources in the future?
(06-25-2020, 12:47 PM)Goose Wrote:There are so many reasons - cultural, political, social, legal [the use of social media, far more intensive policing, etc.] why the US could not emulate Korea that dialog is useless. There was also the fact that Korea was able to isolate a zero cluster.(06-25-2020, 11:15 AM)Genuine Realist Wrote: Germany's response since everyone got religion since March 10th (or thereabouts) has indeed been interesting, and possibly exemplary, though its demographic and homogenous population makes it questionable whether the protocols could be exported to the US. We have a totally different culture.We do have a totally different culture. While not having a homogeneous population contributes to this difference in culture, it is not the driving factor IMHO. I believe that the culture in the USA proceeds from the notion that the individual owes society only minimal adherence to the law and nothing else, period. Your "fellow man" gets help from you only in so far as you freely chose to provide it. That is true regardless of your "fellow man's" race, sex, religion, national origin or political affiliation. Not quite the same in Germany. Several of my European/Australian friends/customers have commented on this. That doesn't mean Americans are not generous, but it does mean it is at will.
Quote:What gets old is the notion that in the first two months of this year ANY nation (including Germany) successfully evaluated the risk and responded effectively to it. German mobilization began approximately the same date as the US. Check the Wikipedia link and you'll find that Germany was also short of some essential medical supplies at the outset.Depends on what you mean by "effectively". As I have pointed out many times to those who wonder why the US couldn't do what Korea did, you can only respond with what you have, not what you wish you had. Shortages of PPE that you didn't order in October can't be repaired in March. I think Germany responded as well as was possible (played the hand they had). The difference from France was that the states had provided compelling data that this was for real. France was kind of like the US, where there were hot spots but it was unclear (at least to the public) it was actually a general problem for everyone to deal with. Thus poor compliance.
To be blunt, there is no way on earth that the US could adopt South Korean practice, then or now. And that is probably a good thing in the larger cultural context.
RE: US response compared to South Korea, Australia, Germany, and Singapore - burger - 06-25-2020
GR, remind me again why March 1st is some magical date before which the lack of action by the US was excusable?
RE: US response compared to South Korea, Australia, Germany, and Singapore - Goose - 06-25-2020
(06-25-2020, 11:05 AM)BostonCard Wrote:BC, I have located a couple of references to this subject. However, I can't find the one that I saw early on about how deaths were reported. The references I have are to the fact that if you died without a COVID-19 test having been performed, you wouldn't be reported as a COVID case no matter what. Even if the symptoms matched COVID-19, without a positive test, it wasn't COVID-19. That probably mattered some in the early going (March early April) but not much in the last two months or so when testing was very plentiful. One of the links is:(06-25-2020, 10:08 AM)Goose Wrote: I also believe the death count is artificially low because the German health system generally reports the proximate cause of death (i.e. pneumonia) even when the patient is COVID-19 positive.
I've seen that argument made several places, but I haven't seen any evidence that this is the case. In fact, analyses of excess mortality in Germany (mortality above and beyond what would have been expected, which would catch COVID-19 related deaths that were attributed to something else) don't suggest there is a large number of deaths reported as being caused by something else that were really called by COVID-19. Here are a couple of articles:
https://www.businessinsider.com/why-germany-has-a-low-covid-19-mortality-rate-2020-4
I have a couple of similar links, but you get the idea.
The link I can't find is to an article that specifically said that in Germany cause of death reports are listed as the proximate cause, not the underlying cause. The example given was Pneumonia as a cause of death even though the patient was COVID-19 positive. The government put out a directive to stop doing that, as I guess that was the standard of practice in Germany. I am sure I read this early on in the game, but I can't locate it now.
By this point in time, both these effects probably have washed out, to whatever unknown extent they mattered early on. Germany, like the rest of Europe, has pretty well flattened their curve and can start opening up with some hope of a predictable outcome. We in the USA certainly have not.
Quote:https://www.dw.com/en/coronavirus-germany-sees-increase-in-excess-mortality/a-53537500But it would also include fewer deaths due to the lack of activity during the lockdown, such as traffic accidents, industrial accidents etc., would it not? Certainly traffic accidents would be significant. This could be normalized out by looking at each cause of death and compensating accordingly by historical data on each cause. Do they do that? It also would include fewer deaths due to other infectious diseases that are suppressed by the lockdown, like flu. If they don't "correct" the numbers, it would artificially reduce the excess deaths, so this would be important.
Quote:Germany saw a slight increase in the average number of deaths in April, the Federal Statistics Office reported on Friday. April's death rate was around 5% more than the average number of deaths in April between 2016 and 2019....
"Excess mortality in Germany is low compared to other European countries," the statisticians reported. "Italy reports 49% more deaths in March 2020 than in the years 2015 to 2019, on average [...] Sweden reports twice as many deaths in the agglomeration area of Stockholm for weeks 14 to 16 [mid-April] as, on average, the five years before."
https://www.ft.com/content/a26fbf7e-48f8-11ea-aeb3-955839e06441
Through May 24, the FT identified 9200 excess deaths in Germany. Through May 24, Germany had reported 8,371 COVID-19 deaths, which is 90% of the excess deaths, which is within the error of the method of identifying expected mortality based on prior years at the same time. Moreover, the gap is lower than it is in other European countries. Also, excess deaths would include deaths due to other reasons (for example heart attacks) that were impacted by delay in seeking care either because of lockdown or fear of contracting COVID-19 in a hospital.
Quote:I conclude that German reports of COVID-19 deaths are a reasonably accurate reflection of the true number of deaths that occurred in Germany due to COVID-19, and that the idea that Germany was systematically mis-coding cause of death is either apocryphal or does not significant impact the numbers.I would go with not significant. Even a 25% undercount isn't going to change the basic idea that they got better results. The articles I have read attribute this to better testing, better contact tracing, better ICU availability (although it is not clear that this ever actually mattered), and better compliance. Seems reasonable to me. Many articles throw in references to lucky timing both in initial cases and in a significant delay before the full onset, which helped as well.
BC
RE: US response compared to South Korea, Australia, Germany, and Singapore - BostonCard - 06-25-2020
By the way, here's that thread about Germany and "what are they doing right?"
https://thecardboard.org/board/showthread.php?tid=19107&highlight=germany
A few places (including a tweet by Taleb) suggested that the discrepancy might have been cause of death attribution, but I didn't find anything conclusive.
And I agree with your point. Regardless of how stringent their case definition was, their undercount is probably not significant, and is comparable or lower than a lot of other countries (where people were dying without ever getting tested). The Economist doesn't have Germany but COVID-19 accounted for about 2/3 of overall excess deaths in Spain, Italy, and the Netherlands, 4/5 in the UK and New York, and excess deaths were more or less fully accounted for in France, Belgium, and Sweden. Excess deaths are woefully underaccounted for in Turkey, Indonesia, and Austria.
https://www.economist.com/graphic-detail/2020/04/16/tracking-covid-19-excess-deaths-across-countries
BC
RE: US response compared to South Korea, Australia, Germany, and Singapore - Farm93 - 06-25-2020
GR -
I gets a bit tiring to see your inaccurate and never sourced claims.
I am not sure how you can claim Korea was able to isolate a "zero cluster".
Korea not only had the first super spreader event outside of China, they went through great lengths to inform the rest of the world about that case. I have linked it before. It is known around the world as the story of Patient 31.
https://www.aljazeera.com/news/2020/03/31-south-korea-sudden-spike-coronavirus-cases-200303065953841.html
https://graphics.reuters.com/CHINA-HEALTH-SOUTHKOREA-CLUSTERS/0100B5G33SB/index.html
FWIW - I see the detail on the tracing of that first outbreak and I get depressed. The level of detail Korea had on cases and links to other people during February was just amazing. Sucks to be us, I guess.
I am not a big fan of aljazeera, but there is a photo in that story that is stunning. People were standing in line to buy facemasks as soon as they were told about COVID. In the USA we rushed to get toilet paper....in Korea they got PPE.
K-POP recently punked President Trump's Tulsa rally, but those that follow K-POP knew in late January that a very deadly virus was already impacting the world.
I will add a link, in honor of Blackpink's comeback tomorrow, about Lisa Manoban's inability to go back to China for a show she was filming.
https://www.msn.com/en-my/entertainment/asianbuzz/supernumbershowbiz-blackpinks-lisa-cancels-filming-in-china/ar-BBZvvbr
FWIW - I kick myself about this story everyday because I saw it at the time. I knew in late January that Koreans were very concerned about the pandemic and were laser focused on making sure that everyone returning from China get tested.
K-POP fans knew in January what you claim our POTUS could not act upon until March?
It is a pretty low bar when we are saying Korean teenagers are expected to have greater savvy about global pandemics than a POTUS.
RE: US response compared to South Korea, Australia, Germany, and Singapore - Goose - 06-25-2020
(06-25-2020, 04:47 PM)Farm93 Wrote: It is a pretty low bar when we are saying Korean teenagers are expected to have greater savvy about global pandemics than a POTUS.I would suggest that Korean teenagers have seen epidemics from China reach them with significant ill effects during their (relatively shorter) lifetimes, while the POTUS (along with all other Americans) have not had that experience. That probably matters a bit, don't you think?
(06-25-2020, 04:27 PM)BostonCard Wrote: By the way, here's that thread about Germany and "what are they doing right?"BC, do you have any insight into how they "normalize" for the lockdown effects (both increases and decreases due to change in the "normal" condition)? Or do they? I would think it would be pretty necessary. Maybe in most cases the effects are so overwhelming it doesn't matter, but it would still be nice to know they addressed it.
https://thecardboard.org/board/showthread.php?tid=19107&highlight=germany
A few places (including a tweet by Taleb) suggested that the discrepancy might have been cause of death attribution, but I didn't find anything conclusive.
And I agree with your point. Regardless of how stringent their case definition was, their undercount is probably not significant, and is comparable or lower than a lot of other countries (where people were dying without ever getting tested). The Economist doesn't have Germany but COVID-19 accounted for about 2/3 of overall excess deaths in Spain, Italy, and the Netherlands, 4/5 in the UK and New York, and excess deaths were more or less fully accounted for in France, Belgium, and Sweden. Excess deaths are woefully underaccounted for in Turkey, Indonesia, and Austria.
https://www.economist.com/graphic-detail/2020/04/16/tracking-covid-19-excess-deaths-across-countries
BC
lex24 - lex24 - 06-25-2020
(06-25-2020, 04:47 PM)Farm93 Wrote: GR -
I gets a bit tiring to see your inaccurate and never sourced claims.
I am not sure how you can claim Korea was able to isolate a "zero cluster".
Korea not only had the first super spreader event outside of China, they went through great lengths to inform the rest of the world about that case. I have linked it before. It is known around the world as the story of Patient 31.
https://www.aljazeera.com/news/2020/03/31-south-korea-sudden-spike-coronavirus-cases-200303065953841.html
https://graphics.reuters.com/CHINA-HEALTH-SOUTHKOREA-CLUSTERS/0100B5G33SB/index.html
FWIW - I see the detail on the tracing of that first outbreak and I get depressed. The level of detail Korea had on cases and links to other people during February was just amazing. Sucks to be us, I guess.
I am not a big fan of aljazeera, but there is a photo in that story that is stunning. People were standing in line to buy facemasks as soon as they were told about COVID. In the USA we rushed to get toilet paper....in Korea they got PPE.
K-POP recently punked President Trump's Tulsa rally, but those that follow K-POP knew in late January that a very deadly virus was already impacting the world.
I will add a link, in honor of Blackpink's comeback tomorrow, about Lisa Manoban's inability to go back to China for a show she was filming.
https://www.msn.com/en-my/entertainment/asianbuzz/supernumbershowbiz-blackpinks-lisa-cancels-filming-in-china/ar-BBZvvbr
FWIW - I kick myself about this story everyday because I saw it at the time. I knew in late January that Koreans were very concerned about the pandemic and were laser focused on making sure that everyone returning from China get tested.
K-POP fans knew in January what you claim our POTUS could not act upon until March?
It is a pretty low bar when we are saying Korean teenagers are expected to have greater savvy about global pandemics than a POTUS.
No one is defending Trump. There is an election coming. He’s gonna get this shoved down his throat. What gets old is the suggestion that it all on Trump. Were it so simple.
RE: US response compared to South Korea, Australia, Germany, and Singapore - terry - 06-25-2020
The available evidence contradicts the idea that the administration didn't know enough to take aggressive action until mid-March.
In my last post, I gave some examples of what the administration knew in January and February. For example, in January, people within the administration were saying things like "the system was blinking red," "the Richter scale hit 8," "any way you cut it, this is going to be bad," "Now I’m screaming close the colleges and universities," and the like. January, not March.
U.S. intelligence agencies were warning about the risk of a pandemic starting in early January. The Defense Intelligence Agency, the Director of National Intelligence, the National Security Council, and the State Department were among these agencies. One of the news articles I linked said this: "Intelligence agencies 'have been warning on this since January,' said a U.S. official who had access to intelligence reporting . . . . 'Donald Trump may not have been expecting this, but a lot of other people in the government were — they just couldn’t get him to do anything about it.'" January, not March.
The administration's China travel restrictions prove the point that the administration recognized the risk we were facing. By January 31, the administration knew that aggressive action was needed. So they announced the China travel restrictions. The administration acknowledged the risk to the U.S., citing the CDC's conclusion that "the virus presents a serious public health threat."
But the travel restrictions weren't enough to protect Americans. The travel restrictions were too little, too late, and more importantly, they weren't accompanied by any other aggressive actions to prepare for the pandemic. One need only read the proclamation announcing the China travel restrictions to see why those restrictions wouldn't be enough to keep the virus out of America. The proclamation stated that the virus already was present in 22 countries including the U.S., that it had spread to people who had not visited China, and that human-to-human transmission was occurring in the U.S. and elsewhere. The idea that they could stop the virus merely by limiting some (but not all) travel from China was never going to work, not with the virus already being transmitted in 22 countries including ours. Relying only on the travel restrictions was woefully inadequate. The administration thought that the China travel restrictions were a silver bullet and they could go back to denying the problem and declare victory. Wrong. Much more was needed.
What needed to happen was for the administration to lead a concerted effort to educate the public, prepare for arrival of the virus, organize supplies of PPE and ventilators, coordinate the efforts of federal, state, and local authorities, develop testing and tracing, and so forth. Taking the virus seriously in early days could have made a big difference. If the U.S. had been brought to the point of imposing "shelter in place" a couple weeks earlier, or even just a few days earlier, it would have made a big difference in the numbers of cases and fatalities. Strong leadership could have made that happen. But that didn't happen, and couldn't happen, because the President was pursuing a different policy -- a policy of ignorance, denial, and inaction.
lex24 - lex24 - 06-25-2020
(06-25-2020, 06:16 PM)terry Wrote: The available evidence contradicts the idea that the administration didn't know enough to take aggressive action until mid-March.
In my last post, I gave some examples of what the administration knew in January and February. For example, in January, people within the administration were saying things like "the system was blinking red," "the Richter scale hit 8," "any way you cut it, this is going to be bad," "Now I’m screaming close the colleges and universities," and the like. January, not March.
U.S. intelligence agencies were warning about the risk of a pandemic starting in early January. The Defense Intelligence Agency, the Director of National Intelligence, the National Security Council, and the State Department were among these agencies. One of the news articles I linked said this: "Intelligence agencies 'have been warning on this since January,' said a U.S. official who had access to intelligence reporting . . . . 'Donald Trump may not have been expecting this, but a lot of other people in the government were — they just couldn’t get him to do anything about it.'" January, not March.
The administration's China travel restrictions prove the point that the administration recognized the risk we were facing. By January 31, the administration knew that aggressive action was needed. So they announced the China travel restrictions. The administration acknowledged the risk to the U.S., citing the CDC's conclusion that "the virus presents a serious public health threat."
But the travel restrictions weren't enough to protect Americans. The travel restrictions were too little, too late, and more importantly, they weren't accompanied by any other aggressive actions to prepare for the pandemic. One only has to read the proclamation announcing the China travel restrictions to see why those restrictions wouldn't be enough to keep the virus out of America. The proclamation stated that the virus already was present in 22 other countries including the U.S., that it had spread to people who had not visited China, and that human-to-human transmission was occurring in the U.S. and elsewhere. The idea that they could stop the virus merely by limiting some (but not all) travel from China was never going to work, not with the virus already being transmitted in 22 countries including ours. Relying only on the travel restrictions was woefully inadequate. The administration thought that the China travel restrictions were a silver bullet and they could go back to denying the problem and declare victory. Wrong. Much more was needed.
What needed to happen was for the administration to lead a concerted effort to educate the public, prepare for arrival of the virus, organize supplies of PPE and ventilators, coordinate the efforts of federal, state, and local authorities, develop testing and tracing, and so forth. Taking the virus seriously in early days could have made a big difference. If the U.S. had been brought to the point of imposing "shelter in place" a couple weeks, or even just a few days earlier, it would have made a of immense proportions difference in the numbers of cases and fatalities. Strong leadership could have made that happen. But that didn't happen, and couldn't happen, because the President was pursuing a different policy -- a policy of ignorance, denial, and inaction.
Ok. Great. He was also in an impeachment trial. Might have been better for Pelosi and Schumer to be hammering home the coming wave. And warning people.
By the way – I don’t believe Trump had the authority to order states to tell people to shelter in place. Anymore than he had the authority to order states to open up their economies. You no doubt remember when he made that comment and was blasted for it. As he should’ve been.
Further, if you think that governors mayors etc. of blue state and cities we’re going to coordinate anything with Trump then you simply are not paying attention. Color me cynical – but the last thing that the leaders of blue states wanted was a coordinated solution that would end up making Trump look good. That might help him get reelected. Not that they really had to worry about it - Trump is incapable of acting in such a manner anyway.
As I said, no one is defending Trump. But there is blame to go around. After all Andrew Cuomo ordered nursing homes to take Covid patients. de Blasio as late as March 5 told New Yorkers that even though the virus could be anywhere in the city they need to continue with their daily lives. They delayed their SIP. Following instead a “policy of ignorance, denial, and inaction.” NY and NJ has been our epicenter. Had they acted sooner, things might have been different. Are you seriously suggesting that if Trump had suggested SIP, Cuomo and de Blasio would have listened.
Nancy Pelosi cavorted around Chinatown in late February to quell fears about the outbreak saying “it’s exciting to be here, especially at this time. To be able to be unified with our community.“ She urged people to come to Chinatown. So does she get some of the blame? I mean, she’s Speaker. She had to know of the danger. Right?
If you really want to break it down – the fact that we are so divided on almost everything (something Trump didn’t start by the way – he just is a master at exploiting it) contributed to this. The administration didn’t respond quickly enough and it’s messaging has been atrocious. A hell of a lot of state and local leaders (both red and blue) didn’t respond well. The media didn’t cover it well.
We have lost the capability to actually have a reasoned discussions across the aisle on anything. A virus shouldn’t be political. But it was and is. And here we are.
RE: US response compared to South Korea, Australia, Germany, and Singapore - Genuine Realist - 06-25-2020
(06-25-2020, 01:21 PM)burger Wrote: GR, remind me again why March 1st is some magical date before which the lack of action by the US was excusable?You might take a look at the earlier posts, and acquaint yourself with the gist of the argument, before blasting off.
RE: lex24 - BostonCard - 06-25-2020
(06-25-2020, 06:47 PM)lex24 Wrote: Ok. Great. He was also in an impeachment trial. Might have been better for Pelosi and Schumer to be hammering home the coming wave. And warning people.
While I get your point, Trump was non-responsive to the impeachment trial. He didn't testify. He didn't answer questions. He didn't allow anyone in the administration to testify. And his Republican colleagues shielded him from having any witnesses at all called. His acquittal was a foregone conclusion. So, the guy should have been able to walk and chew gum at the same time. Plus, it's not like there wasn't any precedent for a President getting impeached. Maybe he should have learned something.
BC
lex24 - lex24 - 06-25-2020
(06-25-2020, 07:02 PM)BostonCard Wrote:(06-25-2020, 06:47 PM)lex24 Wrote: Ok. Great. He was also in an impeachment trial. Might have been better for Pelosi and Schumer to be hammering home the coming wave. And warning people.
While I get your point, Trump was non-responsive to the impeachment trial. He didn't testify. He didn't answer questions. He didn't allow anyone in the administration to testify. And his Republican colleagues shielded him from having any witnesses at all called. His acquittal was a foregone conclusion. So, the guy should have been able to walk and chew gum at the same time. Plus, it's not like there wasn't any precedent for a President getting impeached. Maybe he should have learned something.
BC
Maybe he did – it’s the economy stupid. Which is probably part of the reason he reacted so slowly. In any event I’m done. My point is not the Trump handled this well - he didn’t. My point is that to put all this on Trump is simplistic and absurd. We have a precedent – and that’s Katrina. Where Bush got all the blame heaped upon him. When in fact there again was plenty of blame to go around Federal state local media etc.
RE: US response compared to South Korea, Australia, Germany, and Singapore - Genuine Realist - 06-25-2020
(06-25-2020, 06:16 PM)terry Wrote: The available evidence contradicts the idea that the administration didn't know enough to take aggressive action until mid-March.These would be cogent comments, if the United States was the only country in the world, or if other nations had reacted to the information available about Covid-19 with strong countermeasures and more alacrity. But - as I have pointed out at wearismone length - no Western nation did so. (The island and peninsular nations that are proximate to China are outliers, which is why I always qualify the point with the word 'Western'. There's a lot of history there we don't know. Methinks both nations were on high alert because of negative experiences with SARS a few years earlier, and serendipity blessed them.)
In my last post, I gave some examples of what the administration knew in January and February. For example, in January, people within the administration were saying things like "the system was blinking red," "the Richter scale hit 8," "any way you cut it, this is going to be bad," "Now I’m screaming close the colleges and universities," and the like. January, not March.
U.S. intelligence agencies were warning about the risk of a pandemic starting in early January. The Defense Intelligence Agency, the Director of National Intelligence, the National Security Council, and the State Department were among these agencies. One of the news articles I linked said this: "Intelligence agencies 'have been warning on this since January,' said a U.S. official who had access to intelligence reporting . . . . 'Donald Trump may not have been expecting this, but a lot of other people in the government were — they just couldn’t get him to do anything about it.'" January, not March.
The administration's China travel restrictions prove the point that the administration recognized the risk we were facing. By January 31, the administration knew that aggressive action was needed. So they announced the China travel restrictions. The administration acknowledged the risk to the U.S., citing the CDC's conclusion that "the virus presents a serious public health threat."
But the travel restrictions weren't enough to protect Americans. The travel restrictions were too little, too late, and more importantly, they weren't accompanied by any other aggressive actions to prepare for the pandemic. One only has to read the proclamation announcing the China travel restrictions to see why those restrictions wouldn't be enough to keep the virus out of America. The proclamation stated that the virus already was present in 22 other countries including the U.S., that it had spread to people who had not visited China, and that human-to-human transmission was occurring in the U.S. and elsewhere. The idea that they could stop the virus merely by limiting some (but not all) travel from China was never going to work, not with the virus already being transmitted in 22 countries including ours. Relying only on the travel restrictions was woefully inadequate. The administration thought that the China travel restrictions were a silver bullet and they could go back to denying the problem and declare victory. Wrong. Much more was needed.
What needed to happen was for the administration to lead a concerted effort to educate the public, prepare for arrival of the virus, organize supplies of PPE and ventilators, coordinate the efforts of federal, state, and local authorities, develop testing and tracing, and so forth. Taking the virus seriously in early days could have made a big difference. If the U.S. had been brought to the point of imposing "shelter in place" a couple weeks, or even just a few days earlier, it would have made a of immense proportions difference in the numbers of cases and fatalities. Strong leadership could have made that happen. But that didn't happen, and couldn't happen, because the President was pursuing a different policy -- a policy of ignorance, denial, and inaction.
Which means you can go on castigating the US administration for lacking a clairvoyance that no one anywhere seems to have had, or move on to what to me is the far more interesting question of what it was about that data available on Covid-19 that caused EVERY health service in the Western world to be caught flatfooted.
Health intelligence is not like military and political intelligence. It's freely shared and circulated. The opposition in the US had the same brerfings, as did other nations in the WEst. There was no wave of action in the West, no op-eds, no leaks trumpeted on the front pages of the Times - in fact, the general tone both in the US and abroad was concern about overreaction in a xenophobic direction. The warnings are never quoted in full - I'd bet money that the reporters these days are quoting the fortune teller language common to all intelligence briefings, and ignoring the gist. I base this intuition on the utter lack of action in response to these dire warnings by anyone. Adam Schiff and the gang are not exactly noted for patience in these matters. But there was dead, cold silence, and even grumbling about what the Administration did do.
And I am now thoroughly sick of reiterating a point that I have made over and over and over, with the opposition endlessly running back to the US experience (as if it were singular and unique), and never anyone posting a contrary data point.
So fire away. I'm done.
RE: lex24 - BostonCard - 06-25-2020
(06-25-2020, 07:10 PM)lex24 Wrote: Maybe he did – it’s the economy stupid. Which is probably part of the reason he reacted so slowly. In any event I’m done. My point is not the Trump handled this well - he didn’t. My point is that to put all this on Trump is simplistic and absurd. We have a precedent – and that’s Katrina. Where Bush got all the blame heaped upon him. When in fact there again was plenty of blame to go around Federal state local media etc.
If you've read what I've posted on here long enough, you will know that I didn't think much of Cuomo's response, and I thought Di Blasio was downright awful. I've praised Republicans like Mike DeWine (and Democrats) that have responded well, and blasted Democrats that have responded poorly (along with a fair share of Republicans). I have evaluated the response on the basis of its relative competence or lack thereof. Trump gets mentioned most of all, because the buck ostensibly stops there. While public health response is by definition a state and local one in our federal system, the tone is set at the top. And the tone set at the top of this country was one at indifference at the coming crisis.
Now, maybe it wouldn't have made a damned bit of difference, but imagine a world in which a President John Kasich warns all Americans in late January about how dangerous this virus could be, breaks through the bureaucracy and silos that exist between the FDA and CDC to prioritize widespread testing, stresses the importance of taking measures to protect the American public, coordinates the purchase of PPE, ventilators, and other supplies at a federal level so that states aren't competing with one another, sets up a task force to come up with guidelines for how and when states should impose measures of social distancing, browbeats governors who dilly dally while cases accumulate, and goes to congress to get money appropriated for an emergent pandemic response that uses a Manhattan project-like effort to quickly develop widespread testing and hire and train and deploy contact tracers like hundreds of thousands of lives and trillions of dollars depended on it. Maybe it doesn't make a damned bit of difference and we are still looking at hundreds of thousands of deaths at this point in time despite our best efforts (I don't think that would have been the case, but I don't know the counterfactual), and maybe the opposition tries to stymie him at every turn and Americans ignore him and the sclerotic bureaucracy can't be whipped into shape. But at least I would be able to point to his actions and say that he took the pandemic seriously, and did all he could. Instead, we have a president who has at his best been indifferent to the virus, and at his worst actively undermined efforts to contain the pandemic. So forgive me if I draw a straight line between his actions (or lack thereof) and the toll of the pandemic. The title of this post contrasted the US response to that of South Korea, Australia, Germany, and Singapore. Goose has pointed out that we didn't have the built capacity of those other countries ready to deploy. Fair enough. But what kills me is that by and large we didn't even try.
BC