April 29, 2020

"[T]he mortality rate among patients over age 65 exceeded 26 percent, and almost all patients over 65 who needed mechanical ventilation during that period died."

According to a new JAMA article (which studied coronavirus patients in Northwell Health hospitals "in and around New York City"), reported in "Do You Want to Die in an I.C.U.? Pandemic Makes Question All Too Real/Sobering statistics for older patients sharpen the need to draw up advanced directives for treatment and share them with their families" (NYT).
A new study in JAMA Internal Medicine questioned 180 patients over age 60 with serious illnesses; most said they would trade a year of life if that meant they could avoid dying in an I.C.U. on life support.... “Many older patients we’ve encountered with Covid-19 have opted not to undergo ventilation and an I.C.U.,” Dr. White said. “No one should impose that on a patient, though if there’s true scarcity, that may arise. But patients might choose it for themselves.”...
While you're thinking about that, here's the ad the NYT served up for me in the middle of the article:



"More than 20% of Americans think vampires are real/More than 25% think climate change is not"... therefore you might want to donate $1,000 to the World Health Organization. We're supposed to worry that a fifth to a quarter of Americans are so science-ignorant that we should give money to an organization that may or may not represent good science. How would I know? Well, one thing is: I'm wondering if it is really true that 20% of Americans think vampires are real, because if they don't, then the organization is passing on fake statistics and that's evidence against its dedication to good science!

Here's a study from last year (at YouGov) that says 13% of Americans believe in vampires — 14% of Republicans and 8% of Democrats. And here's an IPSOS survey from last year that said "Almost half of Americans believe that ghosts are real (46%), and a third believe that aliens visit earth (32%), while only a small amount believe in vampires (7%) and zombies (6%)."

For $1,000, you need to do better with the statistics. And now I'm wondering about the value of the statistics about how likely you are to die if you're over 65 and end up on a ventilator. Just as the World Health Organization wants its donations, the health care system would benefit if you decline its services and accept home-based death.

122 comments:

wendybar said...

Why not donate $1000. to the homeless shelters in the hardest hit areas in the USA, or is taking care of our own too much to ask??

rehajm said...

How many believe Blasey Ford? How many believe Trump-Russian collusion?

Dave Begley said...

This is one of the best things I've seen about CAGW in some time.

A completely discredited organization that is a shill for China - the WHO - is trying to tie the wildly wrong and failed covid19 models to the even more wrong global warming models.

Any reasonably intelligent person really must conclude that CAGW is a scam based on models that have been wrong for 30 years and are completely wrong today. Wrong just like the UW model and Imperial College models are wrong about covid19. If these models can't be remotely right 90 days out, then how can models about the entire planet be correct 30 years out? They can't!

This is the BIG LIE technique tied into tribalism and the appeal to authority. Translation: those deplorable Trump voters don't believe in global warming and WHO and are totally ignorant of the science as expounded by us experts. Ergo, give money to us: The Good Guys.

The CAGW scam is over. And the Dems and Greens know it.

Temujin said...

About 19% of Americans believe that Journalism! is real.

Rocketeer said...

I wonder if there is something about the way this virus propagates in the lungs that makes the use of ventilators actively detrimental...

rehajm said...

Apply liberal thinking: If almost all of those over 65 who needed mechanical ventilation die, then ventilators are causing elderly deaths.

Clyde said...

"Figures lie and liars figure."

As with coronavirus, many people are realizing that shutting down our economy to "save the planet" from "climate change" would be a case of the cure being worse than the disease. We're not a 19th Century agrarian society, and trying to return to one in order to "save the planet" from "climate change" would result in the death of billions of people world-wide. For the Greenies, that's not a bug, it's a feature.

rehajm said...

The distortion in the climate change stat: According to 'experts' if I disagree with an asinine and destructive political policy reaction to climate change I do not believe in climate change.

narciso said...

the stats are incomplete to promote panic, see Justin harts analysis, so is the info about hcq zpack zinc treatment

Brian said...

That is the worst ad I've ever seen.

I immediately thought it was a "anti" Climate Change ad. Or a fake since it came from the UN and WHO.

Lucid-Ideas said...

CoofMorbidities.

Oso Negro said...

Wrong, wrong, wrong! The health care system is the vampire sucking the last of the money out of the old before they die in its evil embrace. Dying at home without their help benefits them .... how? They are NOT overloaded.

Don B. said...

It depends on the question. Vampire bats are of course real. Bela Lugosi type of vampires are not.

Robt C said...

I just finished reading "How We Die" by Nuland. An excellent book about "life's final chapter." He mentions that the number of people dying in the hospital has risen from 50% in the '50s to 80% (in 1995, I'm sure it's higher now). He also mentions that a surprising number of folks who have "no extreme measures" documents on file change their mind when at the last stages. I have one on file and intend to stick to it.

It seems that 80% of people with Wuhan who are put on respirators die. I for one wouldn't want to have them sedate me knowing my chances of ever waking up again are 4 to one against.

Fernandinande said...

I believe in vampire bats even though I've never seen one except at the Arizona-Sonora Desert Museum.

rcocean said...

Doctors were misapplying the ventilators and the ventilators themselves were that advanced. The survival stats are much higher now. and isn't bizarre the way the liberal/left will support ANYTHING that Trump opposes? The Babylon bee satirical article is accurate:

At his press conference last night, President Trump told everyone to stay hydrated and drink lots of water.

"Water's tremendous, very powerful stuff," he said. "You won't believe the things they can do with water. Water balloons. Water slides. Water beds. It's amazing. You can freeze it and make ice, I'm told. Ice is great for lots of things. Ice cream. Ice cubes. Igloos."

"Anyway, drink water."

Horrified journalists scrambled to warn Americans not to drown themselves in their pools and bathtubs.

"Trump says water is good -- but this is very misleading," said Rachel Maddow. "Did you know that water kills many people every year? These dangerous, unhinged remarks from the president could cause many to drown themselves. Plus, do you know what's hidden in water? Sharks. This president wants you to die from a shark attack!"

Bob Boyd said...

the health care system would benefit if you decline its services and accept home-based death.

How so?
Are hospitals not charging or collecting insurance payments for treatment of Commie Bat Pox, I mean Covid 19?

Josephbleau said...

"[T]he mortality rate among patients over age 65 exceeded 26 percent, and almost all patients over 65 who needed mechanical ventilation during that period died."

I guess the study included a mixture of people who needed mechanical ventilation and those who actually got it, I would just say people diagnosed as requiring a ventilator.

I believe in vampires, not the supernatural version, but the human blood sucker. These polls fail because there is no operational definition of "vampire" given, just an imprecise spectrum of vampireness.

Here is a new perspective on the variation in crono death rates:
https://theconversation.com/three-charts-that-show-where-the-coronavirus-death-rate-is-heading-137103

AlbertAnonymous said...

Raises a good question though...

How do we help the 75% of American who apparently think “Climate Change” is real? Have we lost them already? Too far gone? Do we just work on the next generation to “learn ‘em better”?

robother said...

So, a study of 65000 Italians who were on the hydroxyquinine medication before the virus hit shows only 20 tested positive for the virus, and none of those needed hospitalization. And docs who are in hospitals treating virus are taking it and giving it to their families. But Trump is bad for letting the general public know, because (like N95 masks) the medical establishment needs to make sure there's no shortage for them. Sounds like the vaccine was there all along, but in a generic out of patent drug, so who cars about that?

https://www.iltempo.it/salute/2020/04/28/news/coronavirus-farmaci-efficaci-news-danni-cura-annalisa-chiusolo-artrite-terapia-idrossiclorochina-sars-cov2-1321227/

hawkeyedjb said...

"Climate change is not [real]"

I guess that depends on how you define "climate change." Do you mean the hair-pulling hysterics of the "world's gonna end in 12 years" crowd? This subject, perhaps more than any other, seems to demand total and absolute acceptance of the wildest, most nonsensical and destructive set of beliefs to allow one to avoid the label "denier." I think it's safe to say, at this point, that the Green New Deal will look very much like our present situation, with mass unemployment, drastically reduced economic activity, and cleaner air. So, do you accept that this situation is unsustainable and damaging to human well-being? Or are you an economic denier?

TreeJoe said...

Speaking of science: Has anyone considered that the death rate among ventilated patients combined with the massive urge to build more ventilators may actually be BAD SCIENTIFIC/MEDICAL-COMMUNITY POLICY?

If your standard of care at a certain milestone in the patients disease progression has a nearly 100% mortality rate, maybe your fucking standard of care needs to be challenged.

Nearly everyone uses the phrase "follow the science" - but no one likes to recognize that science will often lead you to the wrong conclusion during the data gathering process. And those conclusions can take years/decades to unwind and change once they are in effect. In a fast moving environment, the reality is not so much "follow the science" as it is "Recognize the risks and shortcomings in the imperfect data you have access to and make the best calls you can knowing you are almost certainly wrong in some cases and need to be open to rapidly changing when new data emerges."

But instead we treat a scientific policy statement as the equivalent to court precedent - as if it should be a monumental thing to change the policy rather than the original policy should constantly be challenged.

That's how we got 50 years worth of a food pyramid which promoted diabetes and CV disease, avoid food based cholesterol when those foods were actually healthier than their alternatives, and avoid excessive salt for hypertension when dietary salt has practically no impact on normal hypertension levels.

/Rant on ventilators and science

Todd said...

"More than 20% of Americans think vampires are real/More than 25% think climate change is not"

What is your definition of "vampire"? There is a medical condition whereas persons either like or think that they NEED to drink blood. Does that make them vampires?

What is your definition of "climate change"? If it is "that climate changes", the actual count of "believers" would be close to 100%. If it is that "man is f*ing up the climate due to their capitalistic actions and we are all DOOMED unless we revert to 14th century living" then the believers is closer to 1%.

All depends on your definitions...

West Texas Intermediate Crude said...

I have previously stated in this space that Nobody Knows Anything with respect to the Wuhan virus.
I'm now retracting that statement.
We now know that everything we thought we knew a month ago was wrong- the virus will not cause a ventilator shortage, it will not kill a million Americans, the vast majority of the USA did not need to commit economic suicide, we did not need to close the schools.
We still don't know for sure if herd immunity will be effective, but we do know it works for other viral diseases and we based our over-reaction this this virus on our knowledge of the behavior of other viruses.
If we believe that her immunity is effective, we should have left the schools open and quarantined the old and compromised.
We still don;t know the right way to reverse our economic suicide gesture, but if we wait until we know for sure, we will all be economically and biologically dead.
Time to open up, see what works, protect the vulnerable.

JPS said...

The great thing about that ad: At a glance, I see:

UNITED NATIONS VAMPIRES ARE REAL.
CLIMATE CHANGE IS NOT.
DONATE $1000

and I wonder what soon-to-be-fired subversive put that out there.

madAsHell said...

The ventilator is like that 'M' they paint on your head during triage.

Todd said...

Oh, and WHO has shown they can not be trusted to give honest, fact filled answers to world health issues. Why would ANYONE believe WHO any more?

320Busdriver said...

Just ask how many of those patients who died were obese, diabetic, or hypertensive or all 3.

Dan said...

Even if the statistics are accurate, I don't get the point. Are they saying that they'll fight to educate people so that fewer people disbelieve their climate theory than believe in the existence of fictional characters? They want more vampire believers than climate change disbelievers?

madAsHell said...

Is that a gay vampire??

JPS said...

Prof. Althouse:

"I'm wondering if it is really true that 20% of Americans think vampires are real"

Well, 14% of Republicans plus 8% of Democrats, that's 22%, then they rounded to one sig. fig.

Before anyone corrects me, I'm just imagining the level of critical thought and statistical rigor that goes into statistics like this.

RK said...

The ad should be effective. The best way to get money out of progs is to exploit their contempt for other Americans. It should work on Europeans too.

Bay Area Guy said...

13% of Americans believe in vampires — 14% of Republicans and 8% of Democrats.

It's funny what passes as journalism these days.

No, I don't believe in vampires, simply because I haven't seen any. If I see one, I'll start believing in them.

However, if some doofus from YouGov was taking a poll and asked me that question, I would definitely say Yes just to magnify their own stupidity.

Limited blogger said...

That advertisement is real?

JPS said...

Still another way to read that wonderful ad:

Americans are gullible and foolish.

Americans: Give the UN more money!

Nonapod said...

We're supposed to worry that a fifth to a quarter of Americans are so science-ignorant that we should give money to an organization that may or may not represent good science.

Not to be reductive, but it is an ad. Ads lie. Always rememember that whenever you see a statistic quoted in any ad you should just assume that the numbers are either partial or complete BS. The product this ad is selling is self virtue and the self perception of ones intelligence. Give us money and you'll demonstrate to yourself that you're both more virtuous and more intelligent than those fools who believe that climate change is false and/or vampires are real. (As a humorous aside, logically there's some subgroup of people who believe that both vampires are real and climate change is real.)

Ken B said...

Be your own death panel.

WisRich said...

robother said...
So, a study of 65000 Italians who were on the hydroxyquinine medication before the virus hit shows only 20 tested positive for the virus, and none of those needed hospitalization. And docs who are in hospitals treating virus are taking it and giving it to their families. But Trump is bad for letting the general public know, because (like N95 masks) the medical establishment needs to make sure there's no shortage for them. Sounds like the vaccine was there all along, but in a generic out of patent drug, so who cars about that?
-------

Mmm,that's pretty incredible.

Craig said...

I agree with Brian, that is the worst ad ever.

I'm glad that most marketing people are stupid. Otherwise, they could be very persuasive.

Ken B said...

RK nails it. The ad is an appeal to prejudice.

n.n said...

I believe that garlic is an effective social distance multiplier, and will keep vampires, and extraterrestrials, but not most aliens, at bay, too.

narciso said...

the antibody tests, prove many more cases, conversely much lower mortality,

dreams said...

"I'm wondering if it is really true that 20% of Americans think vampires are real"

No, it's just another way to put down the peoples, the deplorable peoples that vote for Trump.

Bob Boyd said...

It's well known that if you say you believe in spooks you are less likely to see one.

n.n said...

Is that a gay vampire??

Transgender? He's not very gay. Quite reserved... sullen, actually. Get off my bat!

Darrell said...

I don't believe that Democrats are real.

Birkel said...

20% of people lie to pollsters because that industry is GIGO.

n.n said...

Vampires of the humanoid kind may well be real, but not observable nor reproducible in a limited frame of reference (e.g. near-domain), thus not a scientific phenomenon.

Sebastian said...

"[T]he mortality rate among patients over age 65 exceeded 26 percent, and almost all patients over 65 who needed mechanical ventilation during that period died."

But we needed to shut the country down to flatten the curve to preserve ventilator capacity.

"A new study in JAMA Internal Medicine questioned 180 patients over age 60 with serious illnesses; most said they would trade a year of life if that meant they could avoid dying in an I.C.U. on life support"

You mean, like, very old and very sick people don't want what alarmists and politicians have told use we should ruin the economy for? You mean, like, the actual goal was itself inhumane?

"But patients might choose it for themselves.”

Next, they are going to discover that old, sick patients might "choose for themselves" not to demand that younger generations waste millions of dollars to somehow extend their old, sick lives by a year or so.

bagoh20 said...

World Hubris Organization

Michael K said...

robother, I could not read the Italian link but the Science Direct article was interesting,.

Many patients would be expected to become infected with COVID-19 in the setting of cluster outbreaks associated with LTCHs. In this study, there were no additional confirmed cases among exposed patients and caregivers; however, it is not clear whether PEP was effective because there was no control group. Both chloroquine and HCQ had antiviral activity against SARS-CoV-2 in vitro [3], [4], [5], [6]. Furthermore, clinical data from China and France showed chloroquine was superior to control treatment, leading to the recommendation that chloroquine could be administered to patients with mild to severe COVID-19 pneumonia [

They used HCQ as post exposure prophylaxis (PEP) and there was no serious case.

Fernandinande said...

UNITED NATIONS VAMPIRES ARE REAL.
CLIMATE CHANGE IS NOT.
DONATE $1000


I'd do it for $500.

Spiros said...

"By some measures, the Empire State has the worst health care in the nation."

https://www.cityandstateny.com/articles/policy/health-care/why-new-york-hospitals-have-terrible-federal-rankings.html

Dude1394 said...

It sure would be nice if we could get confirmation or information from actual doctors on the front lines. Maybe they could have a news conference and lay out their opinions about it.

Unless of course it contradicts the WHO, then Google will decide to censor their news conference and take down all vestiges of their dissension.

If only we had a first amendment right from Google.

bagoh20 said...

What are the chances that the poll is correct? What are the chances any poll on public opinion is correct? People's answers on such things are pretty suspect to me, not to mention the methodology of the pollster. I don't put any faith in such claim like this about us. Hell, we don't even know what we really believe on most subjects.

robother said...

Why donate to The Who? They must be getting rich off all the replays of their G-G-G-Generation song:"Hope I die before I get old" is so perfect for these times. An oldie but a goodie, so to speak.

narciso said...

like so"

Karen said...

The ventilators are not helping because it is not the long that is the problem. The problem is that the iron in the blood gets detached from the oxygen by the virus and no matter how hard the long works, it’s pushing around blood that has no oxygen in it so the vital organs do not get enough oxygen.

tcrosse said...

Applaud if you believe in Fairies, or Tinker Bell will die.

Big Mike said...

Getting back to Althouse’s original question, if I am going to get really sick I think I would rather be in someplace where I have roughly 3:1 odds in favor of recovery than someplace where the odds are much closer to zero.

Lucien said...

Not only that, but Mark Zuckerberg has decreed that anything that contradicts the WHO’s position on COVID19 is “misinformation” ( including using Facebook to coordinate protests against government lockdown orders). Can’t wait until he decides to censor everyone who disagrees with the SPLC on “hate group” issues. He’s learned a lot through kowtowing to the Chinese government.

n.n said...

People at risk should isolate themselves with a full body condom or in open spaces without the greenhouse effect (i.e. restricted convection).

n.n said...

New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19?

The multiple molecular mechanisms by which chloroquine can achieve such results remain to be further explored. ... preliminary data indicate that chloroquine interferes with SARS-CoV-2 attempts to acidify the lysosomes and presumably inhibits cathepsins, which require a low pH for optimal cleavage of SARS-CoV-2 spike protein

Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture

The disinfectant cocktail of choice. Available with prescription.

Jupiter said...

"They used HCQ as post exposure prophylaxis (PEP) and there was no serious case."

Which is to say, there are doctors who have been telling everyone who would listen how to treat this disease for over a month now, but the talking heads in white coats have been sitting on their overpaid asses watching people die, because they have a vague recollection that somewhere back in med school, someone explained to them why you shouldn't use treatments that have not been proven by controlled, double-blind tests.

gilbar said...

does murdering unborn children for their stem cells, count as Vampirism?
does having another child to get organ replacements, count as Vampirism?
does (metaphorically) sucking the life out of person, count as Vampirism?
does conning $1,000 from stupid liberal dumbfucks, count as Vampirism?

Count ME as a believer


Jupiter said...

"The disinfectant cocktail of choice. Available with prescription."

Unfortunately, not available without prescription. You have to pay the quack.

exiledonmainstreet, green-eyed devil said...

Of course we believe in vampires. We've seen Pelosi and Schumer on TV.

iowan2 said...

There are bats that suck blood. If you take President Trump literally, you are forced to acknowledge vampires exist.

Clayton Hennesey said...

"Wrong, wrong, wrong! The health care system is the vampire sucking the last of the money out of the old before they die in its evil embrace. Dying at home without their help benefits them .... how? They are NOT overloaded."

Once a hospital confirms you have insurance, they will try to serve you everything billable on the buffet.

I was hospitalized with a little heart thing and was simultaneously put on furosemide to reduce excess fluid in my lungs and nebulized breathing treatments to increase it, both billed to my insurance.

Milo Minderbinder said...

Watch it soon before YouTube takes it down: https://youtu.be/BR05LEDo5nM

elkh1 said...

Republicans believe vampires are real, the vampires that suck dry our hard earned dollars are real.

Josephbleau said...

“If only we had a first amendment right from Google.“

“Google shall make no EULA regarding...”

Josephbleau said...
This comment has been removed by the author.
Michael said...

Even to speak of "climate change" is intellectually dishonest. Everyone knows that the climate changes, and has since forever. What the alarmists are pushing is "catastrophic anthropogenic global warming," which is a theory of future climate change for which the evidence is far from conclusive. This change in terminology was made quite deliberately because "global warming" wasn't selling and they wanted a term which allowed them to ridicule people who disagreed with them.

Char Char Binks, Esq. said...

Wouldn’t it be roflcopter funny if turns out that many lives could have been saved if covid patients had been given HCQ instead of having ventilator tubes forced down their throats?

Original Mike said...

So 75% believe anthropogenic global warming is real? Isn't that enough for them?

Fritz said...

And yet 25% of people from NYC test positive for WuFlu. If 25% of 26% of the 65 and over population died; we'd know about.

Joe Biden, America's Putin said...

"What we do in the shadows"

Anyone watch that yet? New Zealand movie and series about vampires. Kinda funny. different.

on Hulu (I despise hulu) but I think you can find it on Amazon or netflix for a small fee, if ya don't have hulu.

mandrewa said...

Thanks for linking to Murder going on in New York hospitals, Milo Minderbinder.

Unfortunately I do think Youtube will be taken down pretty quickly. Sadly I imagine what she is saying is probably more or less true.

To provide some context, most people are going to think that people being put on a ventilator are being treated for Covid-19. And yes, in some specific situations, they are. But as Roger Seheult explored in one of his Coronavirus Epidemic Updates, I think it was update 53, one of the big differences between the flu and this coronavirus is that the reason for people not being able to breathe with the Covid-19 coronavirus is not insufficient air in their lungs, but rather their capillaries are not absorbing oxygen from the air.

So if this is the situation, and with many of the more seriously ill it is, then putting a person on an invasive ventilator will not help at all. It will just make things worse, either killing the person or doing permanent life-long damage.

So what this woman is alleging is happening is deliberate inappropriate treatment.

Part of the reason she alleges that they are doing this is that treating the patients with the right treatment would expose the medical staff to more of the virus.

Michael said...

I would like to know how many of these over 60 fatalities were in spanking good health with no obesity before catching the Virus. ? 20%? 2?

MadisonMan said...

I see that 'over 65' stat a lot, but I think the reality is 'over 65 with a pre-existing health issue'. Maybe I'm whistling in the dark.

Still, I am reassured that far more people survive COVID than die from it. A life lived in fear of death isn't very satisfying.

iowan2 said...

However, if some doofus from YouGov was taking a poll and asked me that question, I would definitely say Yes just to magnify their own stupidity.

Stupid question require stupid answers.

RigelDog said...

Sorry I can't deal with the NYT registration policy so I didn't read the article. Other articles over the past month or so have noted that the most extreme form of ventilation (complete sedation/breathing tube) should be the last possible resort with this virus and we still don't know if it may do more harm than good even then. However, milder forms of getting oxygen into the lungs, such as a CPAP kind of device, seem to help without causing harm. We've also discovered that putting patients on their stomach instead of their back improves oxygenation levels. Treatment protocols are being modified to reflect this data.

daskol said...

the Arizona-Sonora Desert Museum

What a great "museum." I did not see a vampire bat there, although I believe in them. I did see that most felicitously named porcine the javelina, though. Ugly fuckers.

RigelDog said...

Bleach Bit and Hammers asks: "What we do in the shadows"

Anyone watch that yet? New Zealand movie and series about vampires. Kinda funny. different.}}}

We just discovered the movie and the TV series, and have been enjoying. It's effective distraction which is pretty much all we live for these days. BTW your commenter-name is my personal favorite!

Beaumont said...

One should generally be skeptical of statistics, however quantification is an important part of science (and economics). The movement towards open science can serve to challenge some of the statistical deception that is presented as fact. Open science is the movement to make scientific research and its dissemination more accessible to many more levels of an interested individual or society, amateur or professional.

"For $1,000, you need to do better with the statistics. And now I'm wondering about the value of the statistics about how likely you are to die if you're over 65 and end up on a ventilator. Just as the World Health Organization wants its donations, the health care system would benefit if you decline its services and accept home-based death."

By benefit, do you mean benefit financially? If so, the "Health Care System" would not be able to bill for the intervention of a ventilator if one accepts a home-based death. On the other hand, the health care system could bill for home health care, palliative care and/or hospice care services in the event that someone would prefer to die at home. One could construct all sorts of surreptitious (and not so hidden) motives for the presentation of a particular outcome. I guess the trick is to not jump to premature conclusions, to slog on and gather more information, and attempt to be open to where the data takes you.

Michael K said...

Once a hospital confirms you have insurance, they will try to serve you everything billable on the buffet.

To some extent that was true before 1986 when DRGs were introduced for Medicare. Private insurance pretty much followed along. The diagnosis generates an average bill payment. It does no good to provide additional services unless the diagnosis is manipulated, which is sometimes done.

Joe Biden, America's Putin said...

RigelDog - thanks!

Yeah- I'm not in love with the series, but it is funny. distraction --- check!

ga6 said...

"confirms you have insurance, they will try to serve you everything billable on the buffet."

Also known as a "wallet "biopsy"

(thank you to whoever I stole that phrase I cannot remember where.)

Lurker21 said...

As a humorous aside, logically there's some subgroup of people who believe that both vampires are real and climate change is real.

Not so small a group, perhaps.

What could be more frightening than a vampire? Global warming.

In a new action-horror series from Image Comics, global warming takes on the role of a super villain.

“Dark Fang” is the story of Valla, a vampire who realizes that climate change is going to wipe out her food supply … humans. So she sets out to take down the fossil fuel industry.


It's two, two, two memes in one.

Yancey Ward said...

If 90% of the people die with a given treatment, one might want to reconsider the treatment. The first step is to find out if the rate of death is actually higher without the treatment.

I wrote a similar comment almost a month ago in regards to Italy and their results with intubation of COVID-19 patients. The above applies to all hospital treatment, in my opinion, but it takes some courage actually experiment in such a way. You get less blame for failing while following the herd than you will get when failing as a maverick.

stlcdr said...

When asked, I categorically say I don't believe in Climate Change. Except that I do believe the climate is changing, but (C)limate (C)hange is a socio-political phrase and has nothing to do with the climate.

So, put me down as an unedumacated hillbilly who believes in vampires, ghosts, the coronavirus 'hoax'.

hombre said...

Fake statistics, fake news, what’s the diff? It’s the New York Times.

BTW, in conjunction with the ChiCom Virus we have now learned from several sources, some scientific, essentially that, “Computer modeling is always wrong, but sometimes helpful.”

Someone needs to pass that along to the IPCC and it’s legions of warmists.

Sam L. said...

I believe climate change is real, but really, Really, REALLY sloooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooow.

Sebastian said...

"We now know that everything we thought we knew a month ago was wrong"

"We"?

Some us called BS from day one. We allowed for the possibility of a spike in hospital demand, but of course even that did not justify general shutdowns instead of a targeted approach to ramping up supply. We knew the age and sickness profile of WuFlu victims everywhere else, so we advocated a targeted approach to isolating the vulnerable. From the CFRs reported in the absence of population testing, we inferred, correctly, that WuFlu had to be much less deadly than "we thought." From the shape of all prior epidemics, we inferred, correctly, that even with minimal "mitigation," the thing would peak soon and then decline. We now know that everything we thought about the panic as panic was right.

A month ago, there was no excuse to think This Time Is Different! 11 Million could die! This is the plague! We just don't know!

Sebastian said...

West: "We now know that everything we thought we knew a month ago was wrong"

"We"?

Some us called BS from day one. We allowed for the possibility of a spike in hospital demand, but of course even that did not justify general shutdowns instead of a targeted approach to ramping up supply. We knew the age and sickness profile of WuFlu victims everywhere else, so we advocated a targeted approach to isolating the vulnerable. From the CFRs reported in the absence of population testing, we inferred, correctly, that WuFlu had to be much less deadly than "we thought." From the shape of all prior epidemics, we inferred, correctly, that even with minimal "mitigation," the thing would peak soon and then decline. We now know that everything we thought about the panic as panic was right.

A month ago, there was no excuse to think This Time Is Different! 11 Million could die! This is the plague! We just don't know!

DavidUW said...

Sebastian - exactly.
the wiser among us were saying exactly that.

this is a glorified flu and some measures might be necessary to keep beds available at the hospitals but you, I, others, were consistently stating this wasn't worth shooting the economy in the face for and still isn't, as moronic "I'll show you, Trump" democrats like Newsom keep some states locked down for no reason but spite.

Bill Peschel said...

"I'm wondering if it is really true that 20% of Americans think vampires are real"

How many of them are pulling the pollster's leg? A lot of them. I know I would.

Anonymous said...

Sebastian-
I agree with you completely.
I was making sport of the "experts" who were spreading the doom-and-gloom, making unsupported predictions, and demanding the economic suicide that we unfortunately have committed.
I have said from the start that this whole thing was 20% Science, 40% Hysteria (as in toilet paper hoarding), and 40% Agenda Driven.
You can adjust the sliders to fit local conditions (more Science in NYC, more Agenda on the west coast), but the principle applies.
We have done the wrong thing for the wrong reason.

Anthony said...

BleachBit-and-Hammers said...
"What we do in the shadows"

Anyone watch that yet? New Zealand movie and series about vampires. Kinda funny. different.


GAWD I love the Hulu show. I never saw the movie, the the show slays me.

hombre said...

If you believe that 20% of Americans, mostly Republicans, believe zombies are real, you probably believe Trump recommended that people inject themselves with Lysol.

What is interesting is the false prophesies about the ChiCom Virus being attributed to computer modeling with perhaps a “scientific consensus” now observing, “Computer modeling is always wrong, but sometimes helpful.” Could there be a lesson there for the IPCC and their legions of hysterical warmists? Probably not. They too always have fake stats and fake news.

steve uhr said...

Former WHO director Margaret Chan once stayed at a hotel at $1008 per night.

Mike (MJB Wolf) said...

I for one was unaware that Global Warming was infectious and needed to be battled by the WHO. We Won't Be Fooled Again.

Mike (MJB Wolf) said...

Institutional advertising should never venture into sarcasm and irony. Irony is dead. Events have overtaken our ability to comprehend information contaminated with bullshit.

Achilles said...

The "curve is flattened."

Why have the Governor's not relinquished their new found power?

Some of these questions answer themselves.

One thing that I have noticed about being right is that the people that were wrong resent you more than they resent being wrong.

Sebastian said...

West: "Sebastian-I agree with you completely."

And I wasn't trying to pick a fight with you! Just hitting the slow curve ball you pitched . . .

Aggie said...

This morning on NPR I heard a distinguished young researcher aver that Fire Ants, the scourge of Texas and the Gulf Coast, are made more aggressive by interactions with water, as in floods (where entire mound populations are seen floating, in a ball). And therefore, with rising sea levels due to Climate Change, we can expect highly aggressive Fire Ants to become a BIG PROBLEM in the near future.

She actually tried to make this alarmist case, knowing that virtually everyone is aware that (a) a mound lasts for about a year, maybe and (b) sea level rise is measured in millimeters per decade, and (c) nobody has ever, ever seen a fire ant mound on a beach, anywhere - for completely obvious reasons of insect survival. I can imagine an entire regional listening audience, shaking their heads as they drove.

RobinGoodfellow said...


Blogger Rocketeer said...
I wonder if there is something about the way this virus propagates in the lungs that makes the use of ventilators actively detrimental...


I read a pretty long article a out this a few weeks ago. Very tech heavy, mainly about oxugen transport in the lungs, and complaining about how ventilators only add pressure, not oxygen. And they cause lots of damage

The doctor who wrote the article recommended giving oxygen and having the patients lie on their stomachs.

YMMV.

narciso said...

lets bow to our ant overlords,

Lucien said...

Well, if the mortality rate among people in ICUs who are put on ventilators is higher than that of ICU patients who are not put on ventilators, and there are no published double-blind randomized studies showing ventilators work for COVID19 patients, doesn't that mean that ventilators are an unproven, quack remedy for COVID19?

Because I'm pretty sure some people use the same logic to discuss hcq.

tcrosse said...

From the Telegraph, A piece about anosmia and Covid-19.

Wince said...

Althouse, at her sardonic best.

mikee said...

Polls that don't have objective observations to validate the selections of those polled are pretty damn worthless. I remember being polled as a middle schooler on illicit drug use - it was a big Nixon anti-drug push - and about 90% of my class responded that they smoked pot daily, used heroin on weekends, and could buy speed from teachers or classmates any time.
And we were the mildest of whitebread 1970s suburban kids, who wouldn't know an 8-ball if it was thrown at us.

mandrewa said...

Lucien said,

"Well, if the mortality rate among people in ICUs who are put on ventilators is higher than that of ICU patients who are not put on ventilators, and there are no published double-blind randomized studies showing ventilators work for COVID19 patients, doesn't that mean that ventilators are an unproven, quack remedy for COVID19?

Because I'm pretty sure some people use the same logic to discuss hcq.


That may indeed be how some people talk about hydroxychloroquine but it is not in fact
true.

We still have good reason to believe that hydroxychloroquine will work on the
Covid-19 virus and in total contrast we now have very good reason to believe that putting air under pressure into Covid-19 patients with ventilators does not work. Now I need to
qualify that because there are different kinds of ventilators and different patients
and for some patients the ventilators are appropriate and in particular the more passive
ventilator use tends to be more helpful.

So why then do some people think that the evidence is strong that hydroxychloroquine does not work?

I do not know really. It's like too many people don't know how to think.

The basic problem is expecting hydroxychloroquine to do something it cannot do. It is questionable and it has always been questionable what hydroxychloroquine can do for someone that has reached an intensive care unit.

The appropriate time to use hydroxychloroquine is early in the illness, the earlier the better, and in fact the best time would be when someone first shows symptoms of the illness. But all the way up to before a person goes into a hospital is likely appropriate as was demonstrated by the 1,000 person French study in Marseille where people were treated an average of 6 days after first symptoms.

Our evidence that hydroxychloroquine works is from in vitro studies and cell culture studies. If something is working in a cell culture then the odds are pretty high, not certain, but pretty high, that they will work in an intact human being.

Very few, maybe only one, human trial of hydroxychloroquine has been done on people that were ill but not yet seriously ill. If a person is trying to prove this doesn't work, that would be only way to prove it.

Asking the wrong question doesn't prove anything.

But in case I don't think human trials are all that appropriate at this point. Really the focus should be on animal trials. For all the talk of animals being different than people, it's true, but also mostly bullshit. If it works in animals it is almost certainly going to work in people and we can do double-blind, placebo controlled trials with large numbers of animal subjects that we can never do with people.

KellyM said...

Yes, I believe vampires are real.... Keith Richards is still walking the earth despite the odds.

MD Greene said...

50 percent of Americans are smart. They are the ones who don't ask questions from pollsters.

Megaera said...

robother -- thank you for the Italian reference; Michael K: I pulled up robother's cite in Chrome and at the top of the page is a box with Italian/English as options - click on English and it should pull up a translation of the article. Granted, it's probably an auto-translate function so it occasionally strays into Biden-speak territory, but it's sufficient unto the evils of the day. Initially focuses on the action of the virus on hemoglobin, then moves to why HCQ works (such that it's being widely used sub rosa by Italian medical staff as a prophylactic, and finally moves to reporting a survey of Italian rheumatologists who prescribe HCQ for their lupus, etc. patients. Clearly this was not some formal government-sanctioned survey, but these doctors' HCQ prescribees numbered roughly 65000; the docs were asked to ascertain their COVID status. Of the 65000 patient population a total of 20 were reported as COVID positive; none had been hospitalized. What the medical establishment in this country has been doing re HCQ is the functional equivalent of murder.

mandrewa said...

Roger Seheult just put up a video, Coronavirus Pandemic Update: Is Covid-19 a disease of the endothelium (blood vessels and clots), that seems relevant to this topic.

It will probably make it clear, or clearer, just why the ventilators aren't helping.

Megaera said...

There seems to have been, from rather early on, that COVID pneumonia patients were more in need of high levels of O2 than they were of actual forced inspiration/exhalation; the latter is what a mechanical vent does. The problem, from a hospital's standpoint is that vents allow you to trap/filter exhaled air -- permitting some limitation on the viral particles exhaled by each patient into the air everyone else is breathing. Most other straight O2 delivery systems (mask, nasal cannula, CPAP and BIPAP machines) are far less invasive and less likely to cause barotrauma in already damaged lungs, but they also exhaust directly into the surrounding air. I saw a video from a self-described respiratory tech standing in a roomful of 02 delivery equipment, all unused. He explained that his hospital (unidentified) had explicitly ruled out using this equipment, and chose to go directly to mechanical ventilation; presumably they had decided that the risk of aerosol spread was greater than the risk to any individual vent patient who would be at the point of circling the drain anyway.

daskol said...

That's a lot of biochemistry to slog through, but fascinating hypothesis on the nature of the disease. Thanks for posting that!

Michael McNeil said...

I believe ghosts are real. I do! Real entities — “programs” if you will — that “live” within the brains of people.

WZimmerman said...


If "vampire" means "one who lives by preying on others" - as per www.merriam-webster/dictionary/vampire - then I think "vampires" are real.