The social distancing for my family started one week ago tomorrow. It was a Thursday afternoon. We probably should have been more aggressive, and started earlier, but we waited until after there were actually confirmed cases in Michigan before we made the call to keep the kids home from school and start working from home. I’m sure, looking back on the decision, we’ll regret having waited so long. We knew that the virus was probably out there, spreading through the community, but, like almost everyone else, I guess we were just in denial. And denial was relatively easy at that point, given that the administration of Donald “I don’t take any responsibility at all” Trump had so throughly botched the coordinated rollout of test kits. We didn’t get news that people around us were infected, because they weren’t being tested, and so we kept on living our lives.
Maybe we shied away from crowds a bit pre-lockdown, and wiped down the occasional doorknob, but we kept going to the gym, seeing friends, and eating out… But then the tests came. It was a week ago yesterday that we heard that we actually had confirmed cases here in Michigan. There were two at first. And, then, just like we knew that it would, the numbers began to grow exponentially, as testing spread, and as people infected over the previous weeks began to feel the effects of the illness and seek help. Today, according to WDIV in Detroit, the Michigan Department of Health and Human Services (MDHHS) is reporting that we have 110 confirmed cases. Here’s the chart showing the growth of confirmed cases thus far. The black dot in the bottom right, by the way, is our first COVID-19 death, which happened earlier today. [The man who passed away was in his 50s. According to reports, he had underlying health conditions.]
It’s sobering to look at, especially when you consider the fact that the trajectory we’re seeing here tracks pretty closely with what we saw in the early days of the Italian outbreak, where they’re now losing 475 people a day. [Italy’s population is six times Michigan’s, so our numbers likely won’t be as high, but the trajectory is still the same.] And we need to ready ourselves for the eventuality that, when we actually get the results back from this first wave of testing, we’ll discover that the virus is pretty much everywhere.
Yesterday, according to the New York Times, there were over 1,300 new cases of coronavirus diagnosed in the United States, and that’s with us still screening significantly fewer people than other developed nations. [Italy, a country of 60 million is now screening well over 10,000 people a day, whereas the United States, with 330 million people, was only testing about 2,500 a day up until a few days ago.] Here are two charts from the New York Times showing how we compare to other nations on the testing front.
And this, of course, is made worse by the fact that, even when people are being tested here, they aren’t receiving their results for several days. I have a friend here in Michigan, for instance, who was tested several days ago, and told that she’d have the results within 72 hours, a deadline which has long since come and gone, as she continues to wait in isolation.
I’d intended to go on, but it will have to wait for tomorrow.
Good night, my friends. Best of luck to you all.
update: While I had to stop for the night, an anonymous reader of this site, who works in the health care field here in Michigan, stepped in to pick things up where I left off. Here’s his comment.
You don’t need massive influx of cases to cause a problem. All it takes is a doubling of people who come to the hospital with viral pneumonia for a prolonged period of time, maybe from 2-3/day to 4-5/day for a moderate sized hospital. They have to be sorted into corona patients and non corona patients so that they can go into appropriate wards. The worst case is putting a corona patient into a non corona patient ward. Then you could end up with a Kirkland nursing home type outbreak.
The immediate problem is the sort. There are very few places where the test can be performed in a day. My state lab has backed up from 1-2 days to 2 days plus. The commercial labs have backed up from 3-5 days to 10 days plus. What do you do with the viral pneumonia patient now? You put them in the corona ward to be safe, where they will cause usage of masks whether they are truly a corona patient or not. After 3 days, test comes back negative. That patient is moved out. Meanwhile, the small bump in viral pneumonia patients continues. New patients are coming in, masks are in short supply, and test turnaround is increasing. The corona ward is expanded, making the other wards smaller. Car accidents, heart attacks, strokes, cancer, all is still happening.
At some point, testing is meaningless because after two weeks, patients have either gotten through the worst of it on their own or they are in really bad shape. That’s the problem.
It’s not a dramatic failure like an earthquake or flood. It’s more like termites or rust. It’s looks good from the outside until it doesn’t work, and then it falls apart slowly, then quickly, and there is nothing anyone can do…For observant listeners and readers, the key immediate point is near the end. The special collection nasopharyngeal swabs needed for any testing is in short supply, being made in Italy. It won’t matter if tests are available if you can’t collect the material in a form that is acceptable for the test to run on
73 Comments
The man who passed away HAD underlying health conditions.. This is a mild flu like diseases for 80% of folks who get it. Let’s not create more panic.
The population of the US is actually just a little over 330 million, by the way.
China has reported no new domestic cases for first time.
Europe’s total cases and deaths have now surpassed China’s totals.
It seems very unlikely that China is being truthful and forthcoming regarding their totals. They do say they have 34 new cases, but they claim they are among people who have just arrived from other countries.
You don’t need massive influx of cases to cause a problem. All it takes is a doubling of people who come to the hospital with viral pneumonia for a prolonged period of time, maybe from 2-3/day to 4-5/day for a moderate sized hospital. They have to be sorted into corona patients and non corona patients so that they can go into appropriate wards. The worst case is putting a corona patient into a non corona patient ward. Then you could end up with a Kirkland nursing home type outbreak.
The immediate problem is the sort. There are very few places where the test can be performed in a day. My state lab has backed up from 1-2 days to 2 days plus. The commercial labs have backed up from 3-5 days to 10 days plus. What do you do with the viral pneumonia patient now? You put them in the corona ward to be safe, where they will cause usage of masks whether they are truly a corona patient or not. After 3 days, test comes back negative. That patient is moved out. Meanwhile, the small bump in viral pneumonia patients continues. New patients are coming in, masks are in short supply, and test turnaround is increasing. The corona ward is expanded, making the other wards smaller. Car accidents, heart attacks, strokes, cancer, all is still happening.
At some point, testing is meaningless because after two weeks, patients have either gotten through the worst of it on their own or they are in really bad shape. That’s the problem.
It’s not a dramatic failure like an earthquake or flood. It’s more like termites or rust. It’s looks good from the outside until it doesn’t work, and then it falls apart slowly, then quickly, and there is nothing anyone can do.
Aloha, got an email from IHA on the closure of two of there urgent care facilities and their conversion to virus triage sites. Referral only. Includes the new EMU facility.
From now on Im going to refer to the 1918 flu as the Kansas Flu in keeping with the right wings need for geographic labels, since Ft. Levenworth KS seems to be where it originated. This new flu has a lot of killing to do before it catches up with the 50 million the Kansas flu killed. The USA is number 1.
What will you call ebola though?
I’m really not looking forward to your dispatch from 12 weeks into the pandemic.
But historians will find it helpful.
Even HWs comments.
I’ve been predicting a dempanic for a while now.
Dempanic?
Is that watch Trump has?
Don’t get Sassy with me.
Thanks, Jean. I’ll change it. I swear that, according to what I read yesterday, the man who passed had no underlying health issues. From what I see now, though, he did not.
Have you been by UM Med Center in the last couple days? What’s it looking like over there?
I also corrected the US population number. Thanks, Robert.
Reuters: “Special Report: How Korea trounced U.S. in race to test people for coronavirus”
Read more:
https://www.reuters.com/article/us-health-coronavirus-testing-specialrep/special-report-how-korea-trounced-u-s-in-race-to-test-people-for-coronavirus-idUSKBN2153BW
“The administration of President Donald Trump was tripped up by government rules and conventions, former officials and public health experts say. Instead of drafting the private sector early on to develop tests, as South Korea did, U.S. health officials relied, as is customary, on test kits prepared by the U.S. Centers for Disease Control and Prevention, some of which proved faulty. Then, sticking to its time-consuming vetting procedures, the U.S. Food and Drug Administration didn’t approve tests other than the CDC’s until Feb. 29, more than five weeks after discussions with outside labs had begun.”
You should acknowledge this in your own words and act accordingly.
Censorship is wrong but so is dangerous lying. Please ban Warlord at this point, Mark. His bullshit is ugly and blatantly stupid and false. Seriously. Fuck this guy and Qanon crap already.
“The second death of a patient with COVID-19 has been reported at McLaren Oakland Hospital in Pontiac.
The patient was a woman in her 50s.“
(From WXYZ TV)
A third COVID-19 death has been reported in Michigan. Details are just now becoming available.
“An 81-year-old patient died at Henry Ford Hospital in Detroit.”
(From WXYZ TV)
Aloha, this is a pretty good article on the Trump meed to find racial scapegoats.
https://organizingupgrade.com/we-cant-stop-coronavirus-without-confronting-rightwing-nationalism/?fbclid=IwAR0yX7DPenfv2ptct2A8S8uPIw9O54JYpjtPBwTSKYum9nY-fae8N3gqnC8
What fuckin’ lie, Bob? You are just saying that because you are scared of me and want me gone before I do more damage to your stupid “narrative”. You are the liars which I have proven over and over. Here I used Baynard’s article to easily waste him. You must hate that it is so effortless for me to destroy your propaganda.
https://apple.news/AFOl6uXuiSvu7FEMZxaqMaw
This comment section is like next door on steroids and testosterone. Imagine how much more pleasant it would be without all the male display going on. The pissing contests, the rutting, the puffed up chests. It’s ridiculous. And sensible people stay away.
Jean, your schtick is so played. Tell us again about how you rejected the good life in favor of whatever mediocrity it is you seem to brag about.
https://www.npr.org/2020/03/18/817934587/ohio-sees-massive-unemployment-surge-due-to-coronavirus
For observant listeners and readers, the key immediate point is near the end. The special collection nasopharyngeal swabs needed for any testing is in short supply, being made in Italy. It won’t matter if tests are available if you can’t collect the material in a form that is acceptable for the test to run on.
Both of you are fucked. I told you I’m not the one to fuck with. I am extremely nice to people who don’t lie about me and threaten me. I’ll still take your argument apart but if you are respectful I will be respectful to you personally. If you cannot handle someone with a dissenting and superior argument and you attack them I don’t think you should be surprised when they respond in kind.
Confirming Mark’s timeline on previous post
“The chairman of the Senate Intelligence Committee warned a small group of well-connected constituents three weeks ago to prepare for dire economic and societal effects of the coronavirus, according to a secret recording obtained by NPR.
The remarks from U.S. Sen. Richard Burr were more stark than any he had delivered in more public forums.”
https://www.npr.org/2020/03/19/818192535/burr-recording-sparks-questions-about-private-comments-on-covid-19
Bob– it’s not the good life. It’s a very bad life that I rejected. A terrible one full of compromises but with more security. I never questioned it until my family experienced health issues that were very expensive. I have a good life. I had the luxury of choosing it and of not wanting another one or a more privileged one. There is no greater privilege than self-agency.
When Bob suggested banning HW for supposedly telling dangerous lies; did Bob not realize that HW was quoting the article MMeta offered?
We would have to consult with the humor experts but I think that should be considered funny, right?
So Bob wants to ban HW for quoting Mark’s post. I’m no expert, but that is funny.
There is serious talk about Fox News hosts being held responsible for deliberately lying to millions of people about this situation. They probably cost people their lives. Why should this forum really be any different? God help us but some people probably actually consider it a legitimate news source. Shouldn’t some journalistic standards be in place? People like H Dumbs are intentionally spreading dangerous lies. They should pay.
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You’re a bad human as well FF. With any luck it will be confined to idiots like you. EOS and HW.
According to Johns Hopkins, we now have 171 confirmed cases in the state of Michigan.
It’s been reported by the state government that we actually have more than 300 confirmed cases in Michigan now.
336 positive
That is not the bad news.
Take a look at the positive/negative ratio and compare to other states. Michigan numbers seem likely to explode, I think.
Maybe we can spin the marketing to tourists: “Italy of the Midwest”.
Senator Burr and his cronies need to be charged with reckless endangerment AND insider trading:
https://www.propublica.org/article/senator-dumped-up-to-1-6-million-of-stock-after-reassuring-public-about-coronavirus-preparedness
Definition of predatory.
Unless someone smarter than me can explain to me that I am wrong. Michigan is mega fucked.
The ratio is funny because doctors have been focusing the tests with quicker turnaround to people who are likely to be hospitalized so they can be sorted appropriately. Those people who aren’t ill enough to be in the hospital have had those tests sent to a private lab, where the results are taking more than a week to come back. That’s where a lot of the negatives will live. I guess I’m smarter than you.
Please do keep showing me how dumb I am about this!!!!!
That sounds more hopeful. Thank you! So, you think Michigan’s testing strategies regarding quick turn around tests for severe cases and slow turnaround for milder cases is not a strategy other states employed? Because our ratio of pos/neg is very very discouraging relative to other states if they employed similar strategies. If you know then thanks for answering. If you have other reasons which explain it away then please shed light on it. The state to state relative ratios freaked me out!
“Please do keep showing me how dumb I am” FF
It’s a start.
Great. Do it! Go!
(Those numbers looked bad.)
Slow turnaround time was the norm until recently when labs were able to produce tests on their own. Those older statistics were based on uniformly slower turnaround times. Check the timelines. New York State was one of the first state labs to develop their own CDC independent tests. Is it any surprise why they have the highest total of test confirmed patients? Most other states are still waiting for results to come back for patients beyond their own small testing capacity.
“Most other states are still waiting for results to come back for patients beyond their own small testing capacity.”
But most ALL other states have much more hopeful looking pos/neg ratios compared with us—just from a quick glance—not even close. Did NY have similarly bad ratios in the beginning of testing? Thanks.
You can only do this strategy if you have access to testing in house, which is a recent phenomenon. Michigan’s data will trend back when those delayed test results come back in. Remember that the commercial labs only got their testing online for just a short while and were able to turn around tests in 2-4 days in the beginning. Now they are backed up to over a week. Michigan is at the early part of the data collection and we have a wide time spread now between different categories of results. Other states either are uniformly delayed or the result acceleration from an acute testing strategy is lost in the larger background of already accumulated cases. All this information is too delayed to make useful operational decisions at the hospital level. What is important is the daily rate of hospitalization versus the rate of isolation unit discharge to floor and the rate of discharge from floor to outpatient status.
“Frosted Flakes
Posted March 19, 2020 at 12:38 pm | Permalink
When Bob suggested banning HW for supposedly telling dangerous lies; did Bob not realize that HW was quoting the article MMeta offered?
We would have to consult with the humor experts but I think that should be considered funny, right?”
Mark Meta; that could be his blogger name, kind of like punk names. Then I could call him Barky Beta ahahaha!
“Other states either are uniformly delayed or the result acceleration from an acute testing strategy is lost in the larger background of already accumulated cases.“
That sets me at ease. Thank you for explaining that.
Once viral nasopharyngeal swan collection kits become more scarce, the logical strategy to extend the clinical utility of the collection kits is to selectively collect for testing only those patients that are sick enough to be admitted to the hospital or get viral pneumonia while in the hospital. As each hospital reaches that stage, eventually all states will have their data skewed by case selection for ill patients until either new collection kits are made available, which will case a skew back, or they run out, in which the rate of increase will level off as fewer and fewer tests are performed. The absence of evidence is not evidence of absence. The lieutenant governor of Ohio‘s statement is very insightful and true.
Michigan is 8th in the country for cases.
Community spread in Washtenaw County.
Sleep tight.
Good old chloroquine to the rescue.
Any tips for making it through the self isolation orders HW?
You always have a lot of good tips.
Any practical advice for getting through these difficult times?
The only scores I could find from the Wuhan Military Games:
Malaria 5
Corona 0
Make big pots of soup or chili you can eat for days. Then you don’t have to cook all the time but all that home cooked goodness is there whenever you need it. That’s not any different than normal for me but it might be a little more necessary for fast “food”-ies right now.
They have good popcorn at the co-op. Throw out the microwave and become a popcorn ninja making it the old way on the stove. When it is done popping remove it and melt your butter with the heat of the pan. Cooking tips with HW haha.
What would we do without all that good advice?
Fiend out for a cheap burger I guess.
We sent the kids out to In-and-Out yesterday :) I got groceries via Shipt though as I actually plan on making a huge pot of chili for dinner tonight. Alas, they were out of a key ingredient (crushed tomatoes) so I may venture out to the grocery store to see if they have gotten any in since yesterday. The guy who rents a room in the basement went out on a beer run last night and luckily for me he likes the cheapo daytime beer I like so now I have 14 cans of PBR to help me get through the isolation.
I am back in California where things are pretty bad in terms of the lockdown. The whole state is on lockdown! What that means is that a lot of businesses are closed and a lot of people are laid off. It is going to have a pretty major consequence in terms of the economy. I had been not too worried about my job until the businesses, which are some of our core customers, shut down. I am hoping this doesn’t cause a significant number of them to go out of business. On the plus side, my company has a new product we are just rolling out that helps connects these businesses with their customers when their customers are not in their stores.
I very rarely give the Trump administration any good feedback because they mostly don’t deserve it but I gotta say, the direct payments to those Americans on the lower end of the scale is going to help. I have to laugh though because there are already people on my feed whining about how they are being punished for working hard since they will be receiving a reduced payment (those with incomes less than $75k single and $150k married get reduced payment).
Oops. I meant to say that those with incomes HIGHER than $75k or $150k for joint filers will get reduced payments.
Lots of delivery services opening up, Lynne. Please try to find a way to get those maters on-line if possible. Glad you made it back to CA ok.
I’m finding every day that I am further limiting the scope of my activities. Thank goodness the woods are always empty and Spring is here at last.
Today is my favorite day of the year, the first day warm enough to draw cold-blooded creatures out onto logs and rocks to sun themselves and slowly wake up. It’s a 1 or 2-day event. Amazing to see hundreds of turtles frogs and snakes in one place at one time.
Every day a new sound is added to the woodland chorus. A week ago it was red-winged blackbirds. The Sandhill cranes. Then the Canada geese were doing their mating dance display thing. Yesterday it was the peeps. Today bullfrogs. Each creature has its own instrument. If I were a musician, I would write music introducing each sound, building to full crescendo.
627 COVID-19 fatalities reported in Italy in the last 24 hours.
What’s the governor waiting for?
Is there a magic death number we need to reach like California and NewYork?
What specific actions are you thinking she should have already taken, Sad?
How is everyone doing so far?
I’ve had some mild cold symptoms, but no fever or coughing.
I thought she would have followed the other states with a shelter in place decree. She was so early on the schools and then she pulled back.
But that’s why she’s Governor and I’m commenting on a blog.
She did order restaurants and bars limited to pick-up and delivery. Most states haven’t done that either.
One might think that Washtenaw County is off the hook based on the small number of reported numbers to date. That’s only because not a lot of test results have come back yet because they were sent either to the state (with just over 100 tests per day throughput) or to commercial labs (with a ten day and up turnaround). Look for the numbers to pop once Michigan Medicine gets their own in house test online and start reporting numbers to the state.
A closer look at the Trump timeline
https://therecount.com/watch/trump-coronavirus-calendar/2645515793?fbclid=IwAR0nWrnJtMn8eDS0jPje6Ntu2vSMxueFCOfGitYx6rU32E6SwXf-6XotTSw
Michigan now has 24 COVID-19 fatalities, and a total of 1,791 confirmed cases.
Henry Ford Hospital in Detroit has reached capacity. The West Bloomfield Hospital has as well.
CBS’s 60 Minutes is covering the situation in NYC.