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Best case? Perhaps look to Iceland

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Iceland has done the most testing per capita of any nation in the world for COVID-19.

Its population is about 360K.

It currently has 1,135 cases. It has 2 deaths. Its case mortality rate is currently 0.17%, which is comparable to the flu (0.1%).

Why is this so low? Is it just lag time? Better health care in Iceland? Is it because Iceland has tested more people, so it's a more accurate picture of infection mortality rates?

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20 minutes ago, admin_270 said:

Iceland has done the most testing per capita of any nation in the world for COVID-19.

Its population is about 360K.

It currently has 1,135 cases. It has 2 deaths. Its case mortality rate is currently 0.17%, which is comparable to the flu (0.1%).

Why is this so low? Is it just lag time? Better health care in Iceland? Is it because Iceland has tested more people, so it's a more accurate picture of infection mortality rates?

My guess is that if they are testing more people, they are also reacting to it quicker. Our main issue is that we don't have enough tests, and people are wandering around that are infected and don't even know it (25% of people don't show symptoms apparently). I also don't know how strict Iceland's lockdown is. Perhaps climate has something to do with it too. 

I wouldn't use Iceland mortality rates as a symbol of mortality rates elsewhere. It could be argued that if our country had enough tests, ventilators, a quicker response, and a better president for this crisis, that we might have a lower mortality rate. However, as stated, don't know if the climate of Iceland or other factors makes their mortality rate unique or if the US and other countries have just flubbed on the response. 

@Actinguy would be more of an authority here than you or I. 

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10 minutes ago, vcczar said:

that we might have a lower mortality rate.

We don't really know what the infection mortality rate is in the States at this point. A bunch of guesswork.

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8 minutes ago, admin_270 said:

We don't really know what the infection mortality rate is in the States at this point. A bunch of guesswork.

The problem is we aren't testing near enough, so it'll keep spreading as long as people don't know they have it and are transmitting it. I'm from Iowa and we aren't testing near enough, but we're 300% better than Nebraska, who is barely testing at all.

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1 hour ago, admin_270 said:

Iceland has done the most testing per capita of any nation in the world for COVID-19.

Its population is about 360K.

It currently has 1,135 cases. It has 2 deaths. Its case mortality rate is currently 0.17%, which is comparable to the flu (0.1%).

Why is this so low? Is it just lag time? Better health care in Iceland? Is it because Iceland has tested more people, so it's a more accurate picture of infection mortality rates?

Well, given the virtual lockdown of most air travel everywhere, you better start swimming (and the water's cold up there).

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2 hours ago, vcczar said:

 

@Actinguy would be more of an authority here than you or I. 

Appreciate it, but I would only be guessing.  

If I had to guess, I'd say some combination of population differences (364k in Iceland, 326 million in USA), cultural differences, weather differences, perhaps they're better at sheltering in place or just had fewer public gatherings to start with.  Certainly there are travel differences.  

There might be something to the fact that their living arrangements aren't necessarily as tight as some of ours are.  Their largest city has 128k people living in it.  For comparison, NYC has more than 8 million residents.  To get down to 128k living in a single city, you'd be looking at Fargo, North Dakota.

Of course, the flip side of that is nearly 1/3 of their population lives in a single city.  So you could look at it from either angle.

But having done absolutely no research on this at all, my best guess would be:

Few people go to Iceland in the first place, so there wasn't wide contamination to begin with.

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I've looked it up.  Iceland had around 2 million tourists in 2017 (most recent year data is available) -- which is way more people than actually live in their country.  Weird.

USA had 77 million tourists in 2017.

So the United States has 3,750% more annual foreign visitors than Iceland does.
 

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2 hours ago, Hestia11 said:

The problem is we aren't testing near enough, so it'll keep spreading as long as people don't know they have it and are transmitting it. I'm from Iowa and we aren't testing near enough, but we're 300% better than Nebraska, who is barely testing at all.

UNMC is doing a good job here, and we're not barely testing at all. Could be doing better sure. But Iowa isn't doing 300% better. That's laughable. 

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3 minutes ago, SilentLiberty said:

UNMC is doing a good job here, and we're not barely testing at all. Could be doing better sure. But Iowa isn't doing 300% better. That's laughable. 

Agreed. UNMC is wonderful, but no one else helps. We've tested 3x what Nebraska has.

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45 minutes ago, Actinguy said:

Few people go to Iceland in the first place, so there wasn't wide contamination to begin with.

Not as true as you'd think. Thanks to your idol, George W. Bush, and setting up the KGB Border Guard - err, the TSA - when the DHS as a whole was established, Icelandair decided to capitalize on Canadian travellers to (or through) Europe who didn't want to deal with bullshit like intrusive searches and questions, racial profiling, no-fly lists, and being sent back home from vacation plans that didn't involve the U.S. at all, but just stopped over in U.S. airports or flew over U.S. airspace, by offering flights from 11 main Canadian airports right over the high North Atlantic to Iceland, and then directly to 27 different major European airports.

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32 minutes ago, Patine said:

Not as true as you'd think. Thanks to your idol, George W. Bush, and setting up the KGB Border Guard - err, the TSA - when the DHS as a whole was established, Icelandair decided to capitalize on Canadian travellers to (or through) Europe who didn't want to deal with bullshit like intrusive searches and questions, racial profiling, no-fly lists, and being sent back home from vacation plans that didn't involve the U.S. at all, but just stopped over in U.S. airports or flew over U.S. airspace, by offering flights from 11 main Canadian airports right over the high North Atlantic to Iceland, and then directly to 27 different major European airports.

Interesting.  I’ve actually made a connecting flight in Iceland myself, when I was enroute to Iraq.  Nonetheless, if someone is just making a connecting flight, they’re not exposing the general local populace.

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1 hour ago, Hestia11 said:

Agreed. UNMC is wonderful, but no one else helps. We've tested 3x what Nebraska has.

Ricketts is a shit governor to begin with, but we are moving in the right direction and with the new report coming out of Council Bluffs the two states might increase their partnership on this issue. 

 

I do know that Omaha and the surrounding spots aren't exactly following quarantine orders as best as they should. That's a people thing though. 

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12 minutes ago, SilentLiberty said:

Ricketts is a shit governor to begin with, but we are moving in the right direction and with the new report coming out of Council Bluffs the two states might increase their partnership on this issue. 

 

I do know that Omaha and the surrounding spots aren't exactly following quarantine orders as best as they should. That's a people thing though. 

He is not very good lol. Reynolds is only marginally better. 

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New data out of Iceland.

While US testing has largely been limited to those who are symptomatic and high-risk (because there aren't enough tests to check everyone), Iceland's low overall population has made this more feasible -- they've now tested 5% of their general population.

Based on those tests, 50% of those who tested positive say they have no symptoms and did not realize they were sick.  

This is another reason it's so important for everyone to stay home to the best of their ability.  You may think you're fine, while you're infecting other people.

https://www.cnn.com/2020/04/01/europe/iceland-testing-coronavirus-intl/index.html

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2 hours ago, Actinguy said:

You may think you're fine, while you're infecting other people.

What evidence is there that asymptomatic infectees are also infectors?

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4 minutes ago, admin_270 said:

What evidence is there that asymptomatic infectees are also infectors?

...what?  

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Just now, Actinguy said:

...what?  

Can you link to the evidence that asymptomatics are spreading the disease? What exactly are the methods of transmission for asymptomatics? How likely are they to spread the disease compared to symptomatics?

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He's got a point, I believe the only methods of transmission were passing droplets of water or something, something less likely to happen to someone asymptomatic who doesn't experience the coughing symptoms.

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2 minutes ago, ThePotatoWalrus said:

He's got a point, I believe the only methods of transmission were passing droplets of water or something, something less likely to happen to someone asymptomatic who doesn't experience the coughing symptoms.

 

5 minutes ago, admin_270 said:

Can you link to the evidence that asymptomatics are spreading the disease? What exactly are the methods of transmission for asymptomatics? How likely are they to spread the disease compared to symptomatics?

Less likely, sure.  But even when I'm perfectly healthy, I sometimes sneeze because of dust particles in my nose.  I sweat.  I cough, I clear my throat.  And each time I do, if I have COVID-19, I am just as dangerous to you as if I were fully symptomatic.

Here's a basic run down on things to know.  This doesn't perfectly answer your question above, because it's the first time I've heard someone say "Who cares if people around me are infected, as long as they don't cough?"

1737068650_JohnsHopkinsCOVIDtips.thumb.PNG.73029029cda400c022e32dc0147518a2.PNG

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Just now, Actinguy said:

it's the first time I've heard someone say

You've never heard someone ask about methods of transmission in asymptomatics? Incredibly obvious question.

I'm not asking for bullet-point action guides here (as important as they are), I'm asking for actual research relevant to this kind of virus which assesses asymptomatic spread risk. (It's a genuine question, I'm not trying to be hostile to your statement.)

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16 minutes ago, admin_270 said:

You've never heard someone ask about methods of transmission in asymptomatics? Incredibly obvious question.

I'm not asking for bullet-point action guides here (as important as they are), I'm asking for actual research relevant to this kind of virus which assesses asymptomatic spread risk. (It's a genuine question, I'm not trying to be hostile to your statement.)

https://abcnews.go.com/Health/asymptomatic-transmission-coronavirus/story?id=69901758

ABC kinda looked into it with this.

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16 minutes ago, admin_270 said:

You've never heard someone ask about methods of transmission in asymptomatics? Incredibly obvious question.

I'm not asking for bullet-point action guides here (as important as they are), I'm asking for actual research relevant to this kind of virus which assesses asymptomatic spread risk. (It's a genuine question, I'm not trying to be hostile to your statement.)

I'm not a medical researcher.  I enjoy coming to the forum for a moment of reprieve during long, stressful days, but I can't take on homework assignments right now.

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20 minutes ago, admin_270 said:

You've never heard someone ask about methods of transmission in asymptomatics? Incredibly obvious question.

Media questions about the actual disease are referred to the CDC or State Health official.  My meetings and communications are about how our hospitals are going to survive the coming waves of extremely sick individuals, especially as our own staff start becoming patients.  The people I spend my time with right now are hospital leadership making emergency management decisions unlike any we've faced before.  We are not the ones curing the disease -- just the ones trying to keep people alive in the meantime.

 

6 minutes ago, Hestia11 said:

Thanks, this is helpful.  Anecdotally, a friend of mine back in Pittsburgh was just diagnosed with the disease.  No idea how she got it, she's stayed in her apartment for weeks now -- only going out when absolutely necessary and maintaining social distancing when doing so.  But her 10-year-old just came home from spending time with her dad.  So she could have gotten it from her asymptomatic daughter.  Or from a shopping cart during an urgent grocery run.  They don't know.  But that's just one example of why asymptomatic people matter.

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So ... everyone has to stay home all the time, because they might have an infection without knowing it (although we can't really say what the % is), and if so, they might be contagious (although we can't really say how much or in which exact ways). A lot of uncertainty in our knowledge of this.

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