Covid, the "lockdowns" etc.

[Zirunel]

Here we go, a thread for discussing covid , lockdowns, health and economic effects, to keep the subject off the main gaming forum, so have at it!

[Zirunel]

Question for HappyDaze, from the main forum

So leaving aside long-term economic effects and sticking to your lane (which I can respect), what are your thoughts on the impact of the "lockdown" or whatever you choose to call it, on treatment of non-covid disease? I know in my jurisdiction ongoing treatment e.g. chemo etc. has continued uninterrupted, but in general, access to non-covid medical care is reduced and for anyone not already involved in a treatment program, there must be some whose conditions have gone undiagnosed, or whose diagnosis or surgery has been delayed (potentially leading to poorer outcomes later on)

[Spinachcat]

I'm sure the 18.6% increase in anti-depressant users and 14.8% increase in sleep medication users will have NO negative side effects.
https://nypost.com/2020/05/25/americans-are-gobbling-anti-anxiety-meds-due-to-coronavirus/

That's gonna be some tasty long term profits from totally-not-habit-forming medications.

[HappyDaze]

I'll give you an answer after I get back from work tomorrow afternoon. I'm already up too late for a work night as is.

[dkabq]

This I agree with, but the tricky part is trying to determine precisely where the line of what is necessary is to be found. Part of this is because of the lagging nature of the indicators--the effects of a measure are often not fully apparent for 2-4 weeks (and the ripples from those, such as the economic issues, can take far longer. This means that a strong tendency to overcorrect is evident for many reasons, some medical/scientific, and others that are solely political.


This too is inaccurate or, at the least, misleading. Depending on the sources you use, the list of comorbidities is rather long, and can include such things as asthma, hypertension, and even obesity. Such issues impact vast portions of the population. Further, heavy exposure (close & prolonged) can put even the young & healthy at risk of severe infection, and this often impacts health care workers (which then creates secondary issues with caring for others).

By age:
~60% of COVID deaths are 75 or older
~80% of COVID deaths are 65 or older
~93% of COVID deaths are 55 or older
~97% of COVID deaths are 45 or older

https://data.cdc.gov/NCHS/Provisional-COVID-19-Death-Counts-by-Sex-Age-and-S/9bhg-hcku


As for comorbidity, yes the list is long, and there is the issue of how they are correlated with each other (e.g., obesity is correlated with many other health issues in the list) and age (i.e., older people are more likely to have chronic health issues). And, yes the list covers a large segment of the population. Regardless, if you have none of the conditions on the list, it is highly unlikely that you will die from COVID.

https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/
https://whdh.com/news/nearly-every-mass-coronavirus-death-was-patient-with-underlying-medical-condition-data-shows/
https://www.nytimes.com/2020/04/23/health/coronavirus-patients-risk.html
https://www.valleypres.org/For-Patients/Covid-19/Facts.aspx
https://www.usatoday.com/in-depth/news/2020/04/15/coronavirus-risk-90-patients-had-underlying-conditions/2962721001/
https://www.bloomberg.com/news/articles/2020-03-18/99-of-those-who-died-from-virus-had-other-illness-italy-says


One could argue that it is the morbidities that kill, with COVID as the comorbidity (i.e. the straw that breaks the camel's back).

[HappyDaze]

So leaving aside long-term economic effects and sticking to your lane (which I can respect), what are your thoughts on the impact of the "lockdown" or whatever you choose to call it, on treatment of non-covid disease? I know in my jurisdiction ongoing treatment e.g. chemo etc. has continued uninterrupted, but in general, access to non-covid medical care is reduced and for anyone not already involved in a treatment program, there must be some whose conditions have gone undiagnosed, or whose diagnosis or surgery has been delayed (potentially leading to poorer outcomes later on)

I can speak generally about my system and specifically about my orthopedic group. Non-emergent and non-critical care for some conditions has been delayed or reduced, but there are multiple efforts to compensate. Telemedicine/telehealth has grown tremendously from the pandemic, and it's far easier to schedule telehealth visits now. For many things that might have otherwise required a primary care or urgent care visit (particularly those that can be fixed with a simple script or two), a few minutes with a smartphone can get you what you need. The other big push has been for an increase in preventative care--you know, getting patients to do what they are supposed to be doing to stay healthy. The focus on washing hands, wearing masks, and not touching faces can be a sort of a trial for some people to see if/how they can adopt the self-discipline necessary for employing measures to prevent (or, failing that, control) other conditions. Unfortunately, many of them really lack any self-discipline.

Sorry, dinner calls. More later.

[oggsmash]

According to the media, Covid is canceled now right?  Once riots were on the menu it seems concerns for the virus went poof.  I think we are going to have serious economic consequences from our lockdown, as well as small business that do survive now have some repairs to pay for.   Stack that with what I would expect to see a huge surge in cases if the media had even a modicum of truth to their support of lockdowns.

[Zirunel]

I can speak generally about my system and specifically about my orthopedic group. Non-emergent and non-critical care for some conditions has been delayed or reduced, but there are multiple efforts to compensate. Telemedicine/telehealth has grown tremendously from the pandemic, and it's far easier to schedule telehealth visits now. For many things that might have otherwise required a primary care or urgent care visit (particularly those that can be fixed with a simple script or two), a few minutes with a smartphone can get you what you need. The other big push has been for an increase in preventative care--you know, getting patients to do what they are supposed to be doing to stay healthy. The focus on washing hands, wearing masks, and not touching faces can be a sort of a trial for some people to see if/how they can adopt the self-discipline necessary for employing measures to prevent (or, failing that, control) other conditions. Unfortunately, many of them really lack any self-discipline.

Sorry, dinner calls. More later.

Thanks for this. Yes wrt primary care, that has been my experience. Faster and more convenient to access than ever, as long as things can be dealt with virtually. I like that a lot, and I hope that is a lasting legacy of this pandemic. In-person visits and gp-ordered tests do still exist, though they have been truncated. Not sure how hard they are to get, it hasn't come up.

And Emergency is way quiet now. And fast, faster than ever. That's one rapid way to get diagnosis for more serious conditions and access to specialist care.

It's not like non-Covid medicine doesn't exist, in some ways it seems more streamlined now, but I still can't help wondering how many chronic, slowly emerging conditions are slipping between the cracks.

EDITED TO ADD: where I am, hospital resources have been carefully marshalled in anticipation of an overwhelming surge. The overwhelming surge never happened, and our curve is flat now. Covid never did overwhelm capacity, so things are already going back to normal. That may or may not mean the marshalling was never necessary or that it was an overreaction. Or that it won't be necessary in the future. We certainly had case clusters and death clusters. I honestly don't know. There's going to be a whole lot of Monday-morning quarterbacking over this.

[DocJones]

According to the media, Covid is canceled now right?  Once riots were on the menu it seems concerns for the virus went poof.  I think we are going to have serious economic consequences from our lockdown, as well as small business that do survive now have some repairs to pay for.   Stack that with what I would expect to see a huge surge in cases if the media had even a modicum of truth to their support of lockdowns.

Just three weeks ago the media was in horror at the audacity of protestors of the 'lockdown'.  Telling us how irresponsible these protestors were and how thousands would be infected and die because of their selfishness.  Some of these protestors in various States were even armed with rifles,  and yet no windows were broken, no businesses were looted, and no buildings were burned.

Would it be a crazy conspiracy theory to suggest that the some on the left were so upset that businesses are reopening and the economy might recover, that they are behind the destruction as a way to get more favorable election returns?

[Zirunel]

Would it be a crazy conspiracy theory to suggest that the some on the left were so upset that businesses are reopening and the economy might recover, that they are behind the destruction as a way to get more favorable election returns?

Yes, I believe that would be a crazy conspiracy theory.

[HappyDaze]

A truly unexpected barrier to lockdown healthcare is that of closed hairdressers. No, I'm serious. We've had numerous appointments cancelled because grandma won't "go out in public" to her appointment until she's had her hair done. And, until very recently, that just wasn't happening and even now many of them are saying their hairdressers are backed up for weeks. Now our appointments are not life and death (orthopedics, remember), but delayed treatments can lead to worsened outcomes (usually requiring more invasive treatments), more pain, and a decline in quality of life. That last part is important because the loss of mobility can quickly lead to other conditions worsening too. So, perhaps hairdressers need to be considered essential personnel too?

[Shasarak]

"Essential" business is a ridiculous category in any case and results in stupid examples of Governors and Mayors who get hair cuts and go to the gym while telling everyone else that they can not.

[Pat]

It's impacting supply chains in many unexpected ways, because breaking even one link impacts everything downstream. So-called "essential" retailers or services, or non-essential ones that are finally permitted to reopen, are ending up with erratic, delayed, and partial shipments. There's also a lag, so starting up everything at once means the shelves will be empty until new products work themselves through the entire chain. This is just another variation of the same problem that faces socialism: The economy's just too complex for a few central planners to decided what's essential and what's not.

[Kiero]

I wonder when people will get angry at this incredibly damaging fraud committed by numerous governments? There was no cause for the lockdowns, nothing but the knee-jerk panic of numerous governments who preferred the optics of following the herd to taking a stand against the hysterical bollocks in the media.

For the sake of "saving" a few thousand of the sickest people who always die in a bad flu season, many thousands more will die as a result of missed diagnoses and treatments, suicides, domestic violence and many other causes. Not to mention the tens of thousands more who will die when this recession bites. One that promises to be the deepest in centuries.

[GeekyBugle]

Just gonna leave this here without comment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232869/