- Day 1: Fever, fatigue and muscle pain with a dry itchy cough.
- Day 2+: Nausea and diarrhea can be experienced as well as the first day symptoms.
It takes about a week for the worst of the symptoms to die down however the stomach ache, cough and light tiredness last weeks.
My entire family and most of my son's class at school has had it and they're all still recovering. My wife is, after 3 weeks, still really ill. Probably because she's working full time and breastfeeding.
This is what makes the Corona-virus hard: at the start the symptoms are extremely similar to existing flu. Unless the case is extremely severe most people won't see a doctor let alone a hospital.
I don't see how it can be stopped.
In my opinion it’s high time to call in sick. She is neither helping herself nor her coworkers by going to work.
They all get it every year anyway because they're constantly coming into contact with sick people so there's less benefit for staying at home.
The pharmacy itself should have policies preventing sick employees from attending work and have generous paid sick leave.
We could reduce disease transmission and thus social cost dramatically if we reduced transmission in medical contexts (e.g. hospitals are one of the main places people GET sick -- from other patients).
It would ultimately save money if there was overstaffing requirements and stringent no sick staff allowed in any medical context.
The problem is that cost reduction is at a societal level while individual firms don't have the incentive to do this. But socialized healthcare systems should be able to solve this easily.
I really wish that the situation could be better but unfortunately the huge cuts made since the financial crisis have made that impossible.
Doctors have the same problem.
I lot of people cannot call in sick.
Being sick means being unpaid, and many people cannot afford to go unpaid.
In Germany being sick means full payment by the employer for 6 weeks, after that you'll receive around 90% of your last net income by your healh insurance company for 72 weeks, after that slightly lower unemployment payments for another 12 month. So around 2.5 years of being sick are required until you're actually unpaid.
Zero-hour contracts are illegal in Germany.
But how about if you run the business on your own, and you're concerned that if you take two weeks off the business will lose many customers who won't come back?
(I was shocked when I saw the they put the name of the illness on the note. That's so far from my employers business that it should be illegal to even ask. Employees and consumers rights in Germany seem to be seriously limited.)
You get multiple papers in Germany. The one without (!) diagnosis is for your employer.
As an employee the employer will have insurance but basically have to eat the cost of short sickness.
I'm a freelancer but I've chosen not to buy the insurance. It's very expensive and can survive on her income. I put the money I would have spent into a buffer.
I'm in a European juristiction - the UK. We have reasonable labour protections here. But they don't protect everyone.
If you are self-employed, then taking time off means going unpaid. It's that simple. Zero income. I have been in that position. Took a month off due to flu once (not the current flu). Lost 1 month income.
There is a government system called "Statutory Sick Pay" (SSP), but it is not paid to the self-employed, and if it did it would only start after a few weeks.
If you are a "casual" worker, then taking time off also means going unpaid because you don't have a contract of employment or regular hours to refer to. Sucks to be you, but it's harsh reality for many.
For salaried workers, the employer pays salary for a while. But it's time limited, depending on the employer. Some are more generous than others. The less generous will switch over to Statuory Sick Pay, which is not much money. It is rarely enough to cover rent or mortgage, for example, let alone food and bills.
A lot of people are self-employed, casual workers, or have household bills exceeding SSP. Taking a few weeks off due to sickness has a serious financial impact for those people, unfortunately, and it is wrong to assume everyone can afford to do so.
It can be abused though: I know of several cases where people are ill for two years, miracuously get better, work a month, then get ill for another two years.
Overall it's preferable to the UK situation.
Like you though I'm a freelancer; you earn more for less net work time so it's good.
I do too, but it is important to recognise that many people earn a lot less when freelancing than a typical salary. There are a lot of very poorly paid "self-employed" in the UK.
I've known freelancers in the UK paid less than £3 an hour, legally because "self-employed". Think things like Uber drivers, data entry on a "per document" basis or article writing "per word".
It is tough for them.
For perspective, that is less than half the legal minimum wage, and they have no sick pay, maternity, pension or other worker protections.
I am genuinely surprised people on HN think zero pay on sick days is unusual. So I'll quote from a BBC article:
https://www.bbc.co.uk/news/uk-51738837
But TUC general secretary Frances O'Grady said two million workers do not earn enough to qualify.
Prospect union added that freelancers and self-employed people would continue to face "the dilemma of no pay or going to work when it may be putting their colleagues at risk".
Labour leader Jeremy Corbyn asked Mr Johnson if the sick pay announcement would help those currently not eligible for statutory sick pay - such as those on zero hours contracts, or self-employed people.Not wanting to is another issue though, but it's often irrational.
It's also implemented in all U.S. jurisdictions, for everyone except for prisoners: per the 13th Amendment, no-one not convicted of a crime can be forced to perform any work.
It should be illegal to go to work sick with easily transmittable diseases.
https://www.scribd.com/document/448385523/s-2213260020300795...
It’s not a dismissal to acknowledge the limitations of your linked study; to do otherwise would be fearmongering in my opinion.
https://www.thelancet.com/coronavirus
They are hosting preliminary research, case reports, commentary and discussion from qualified experts in the area, many of which are on the ground in affected areas.
Good source you mention as well.
Every day our broken healthcare system will force many people to choose between all their families assets and getting care. This should not be a consideration, but often is.
If you are traveling to the US, please make sure you get as much travelers health insurance as possible.
Thanks Canada!
(Having said that, if you're visiting Canada you'll need to check your health coverage. Medical coverage is provided to Canadian residents, not just anyone who happens to be in Canada at the time.)
And it's a he.
"Fraser Institute has—for over two decades—surveyed specialist physicians across 12 specialties and 10 provinces.
This edition of Waiting Your Turn indicates that, overall, waiting times for medically necessary treatment have increased since last year. Specialist physicians surveyed report a median waiting time of 20.9 weeks between referral from a general practitioner and receipt of treatment—longer than the wait of 19.8 weeks reported in 2018."
Source: https://www.fraserinstitute.org/studies/waiting-your-turn-wa...
2. "medically necessary" does not tell you anything about the severity of illness or appropriateness of waiting. There are many medically necessary things for which it's okay to wait some time. In the Canadian system, things are dealt with at the level of urgency appropriate to the severity of the issue. Yes, it's not perfect, but it does result in generally better population-wide health outcomes in Canada than the US.
That's very much an ad hominem fallacy, and unless you have specific evidence that they falsified the data in question, I'm just going to leave it at that (similarly to how you conclude that 'right wing' is enough of a reason to dismiss something). Last I checked, science doesn't care who you voted for. Once we start dismissing research based on the opinions of the researchers, we've essentially implemented thought crime. All research is motivated by prior opinion. We call it a hypothesis. Whether it happens to align with a political ideology doesn't invalidate it. If the research is somehow wrong, then there will be a way to disprove it through science. Using politics to argue against science isn't appropriate.
No, it would be an ad hominem if I said "the Fraser institute produced it, so you can safely line your bird cage with it". I didn't say that, I just pointed to the institution's well-known bias.
> Using politics to argue against science isn't appropriate.
Oh yeah, how dare I impugn non-peer reviewed "science" written by two non-PhD's, where 25% of the citations are to other non-peer reviewed reports written by the Fraser Institute and the others are random statscan links. This "science" is just a summary of responses to a questionnaire.
> Mission Statement: WTA physicians are concerned over delayed access to health care for Canadians. We work collaboratively with our stakeholders to inform, advocate, and provide solutions to achieve timely, appropriate and equitable access to high-quality health care.
And now from the 2015 report itself (the most recent one):
> "Ontario reports that the maximum amount of time that nine out of 10 patients with complex needs spent to complete their ED visit and be admitted to the hospital was 25.7 hours (June 2015). The maximum amount of time that nine out of 10 patients with minor or uncomplicated conditions stayed in the ED was 4 hours. As outlined in previous WTA reports, many of the factors responsible for the lengthy waits to be admitted to a hospital bed are system-wide failures such as high numbers of ALC patients and a lack of community-based supports."
On primary care:
> Wait times are reported for each of the five regional primary care networks in the province. The average wait time for an appointment between January and March 2015 was 23 days, ranging from 0 to 72 days.
I can see a primary care doctor within 1-2 days here in the US. Even when I was on welfare, the wait times were no more than a few days.
So this report seems to be consistent with the one you were complaining about (which by the way was circulated and referenced widely by mainstream media). However, I see no evidence of "political bias" in this one so I hope you can accept that this isn't that controversial. These wait times are clear facts, not opinions. An opinion would be "Canada has the best health care system", which I am arguing against, citing facts.
Source: http://www.waittimealliance.ca/wp-content/uploads/2015/12/EN...
No, I do not think the US has the best system either, but pointing to Canada as a target benchmark is a non-starter from the way I see it.
> Before implying that Canada has the final answer to health care
You are the only person who's brought this up. I literally said "it's not perfect."
Here's what it comes down to. Population-wide health outcomes in Canada are certainly no worse than they are in the US. Arguably by a number of measures they're better. Health outcomes for the most economically-vulnerable segment of the population are much, much better in Canada. Nobody is bankrupted in Canada by medical care. It's the leading cause of bankruptcy in the US. Canada spends much less of its GDP per capita on healthcare than does the US. A large portion of the US is already covered by a patchwork-quilt national healthcare system.
Now whether you want to go with the Canadian system, or the UK's system, or the French system or the Swiss system - honestly I don't give a shit. People are dying because they can't afford to deal with the nightmare of a system here.
I provided details on a single instance of an interaction with the health system. Hence 'ancedata'. I made no claim that every interaction will have the same outcome.
> waiting times for medically necessary treatment have increased since last year
Do you have the data for wait times for other countries? And, I suppose, wait times of those in the US with and without private insurance?
https://www.cihi.ca/sites/default/files/document/text-altern...
29% of Canadians report waiting 4 or more hours the last time they went to the hospital emergency department.
Patients who reported waiting 4 or more hours: Country results from highest to lowest
Canada, 29% (below average); Sweden, 20%; Norway, 13%; United States, 11%; Commonwealth Fund average, 11%; Australia, 10%; New Zealand, 10%; United Kingdom, 8%; Switzerland, 7%; Netherlands, 4%; Germany, 3%; France, 1%
China has until recently had a less socialized healthcare system than the US. They've made massive strides towards trying to provide a universal system over the last few years, but they are still a developing country, so I'm not sure why you think comparing with China is a good idea, other than, I guess a knee jerk (and incorrect) assumption that it'd all be government run...
Meanwhile socialized healthcare systems are working out fantastically well for large parts of the developed world, but really the most important factor is universal healthcare - universal systems range from fully private multi-payer systems with some system for subsidizing those who can't pay, to fully socialized single payer systems.
What the vast majority of them have in common is that they result in far lower total healthcare spending than in the US thanks to actually regulating healthcare with the public in mind rather than insurers and healthcare providers. In fact, a large number of countries spend less total on healthcare per capita than US taxpayers pay towards Medicare and Medicaid alone, before you even factor in US private insurance.
_You_ get healthcare as well. It's not just "someone else", it's you, your family, your friends, and everyone you care about. No one should go into a spiraling life of debt because they broke an arm or got sick at an inopportune time.
It's easy to think that China is run as a socialist country because there's "communist" in the name of the ruling party, but the truth is very far from that; in many aspects China is a ruthless capitalistic free-for-all society with less socialist policies than even the US.
It's actually very informative, to me. Sorry you don't see it that way.
Edit: Some are telling me this isn't true, but what does a hospital have to gain from someone filing bankruptcy? Why would they charge such high prices that no one can afford? I would think that some money is better than no money.
That being said, there’s been a trend in the US recently, where hospitals have very aggressively gone after unpaid bills of the uninsured, because some administrators see it as money they’re leaving on the table. It’s more prevalent in rural areas, where there’s often only one hospital to go to, and consumers have no choice but to go to the hospital with a terrible reputation.
In some cases, they’ve convinced the judicial system to garnish the uninsured person’s wages, to get “their money back”. IMO it’s clearly illegal and it won’t last much longer, but yeah the system is crazy. :/
Actual poor people are a slightly different story and often left alone fairly easily.
Insurance/“cash” can “negotiate” but at the end of the day the average hospital stay is near $4000/day.
A friend in the US had the same procedure outpatient, and it was $6000, $1200 of which she was responsible for. On the upside, they gave her 30 Vicodin for the post-op pain and no follow-up about said opioids, where I only got a week's worth of Tramadol (much less potent) and a follow-up with my regular doc who wanted to know at what rate I was taking them. My friend was slightly tempted to sell her leftovers...
In the last month almost 1% of the current population of the earth quarantined in China [0].
What exactly worries you about mass hysteria and panic? Why would that be worse than what is likely to happen as Covid-19 spreads outside of China?
I'm all in favor of not overselling the danger; but this virus is a real concern. I mean, unless someone has a very good argument why Hubei are somehow special and it can't happen again elsewhere everyone should be stocking up on supplies in case they are caught in a serious quarantine. The actions taken don't seem to be stopping exponential growth of this virus; if anything all that seems to be actively measured is how good countries are at producing testing kits.
> Only a small fraction die: The current fatality rate hovers around 2%.
If 2% of the people I know died this year, that would be the worst disaster in my country in my lifetime.
Think houses getting torched because the inhabitants are suspected of having the virus. Judging from what happened in Ukraine, we're getting closer to that kind of hysteria.
https://www.dw.com/en/coronavirus-riots-erupt-in-ukraine-as-...
Because then in addition to the damage caused by the outbreak, we will also have the additional often useless and counterproductive damage caused by hysteria and panic.
There was a window of opportunity during which this virus could have been contained. The Chinese dictatorship has squandered it in the name of "avoiding panic and hysteria".
Panic and hysteria should be avoided by being transparent, not by playing down the dangers or praising the efforts of an intransparent self-serving regime as the WHO has done from very early on.
Yes, I would indeed. gzer0's original wording, which has now been edited out (without comment), was:
"Stay vigilant, stay careful, but most importantly, do not spread mass hysteria and panic"
Now the wording was changed to:
"Stay vigilant, stay careful, but most importantly, do not spread false information."
I welcome the change, because saying that the most important thing in the face of danger is to avoid panic and hysteria is wrong and characteristic of authoritarian language.
Yes. And the way to avoid it is to switch communication strategies to inform the public without inciting panic. Also to recruit people into being part of the solution at the local level. This could just mean signing up to volunteer to deliver meals, or check on neighbors or just report all's clear if there's a lockdown. The more agency that you give to people, the less panic there is.
I found this article from two risk communications strategists, posted to the blog of a noted virologist, interesting:
Past Time to Tell the Public: “It Will Probably Go Pandemic, and We Should All Prepare Now”
https://virologydownunder.com/past-time-to-tell-the-public-i...
Also, the U.S. has banned flights to/from certain countries during certain times.
Of the top of my head.
Hoarding of supplies causing shortages and harming people who actually need them right now. Progressing to health professionals lacking supplies (masks, etc.) due to shortages (and diverting of dedicated supplies). Unnecessary ER visits which stress the health system thus making it less able to react to an actual problem (as health professionals are tired and burned out). Stress and unnecessary interventions/ER visits increasing people's risk and exposure to existing diseases.
edit: That's not counting real panic which involves mobs with metaphorical pitchforks and the military in streets enforcing some semblance of order (with bullets).
Not trying to downplay the seriousness of this virus, but it's very unlikely to kill 2% of the people in any country — it kills (maybe, approximately) 2% of the people who are infected, but far less than 100% of the population in your country will ever be infected.
Do we have solid information to assert that? SARS and the flu spread from people who are exhibiting symptoms. This new virus is different in that regard, which seems like an open invitation to approach 100% infection rates.
I don’t know either way, but it certainly doesn’t seem unlikely that a solid majority could be infected.
Given most people don't live to be 100, I would guess the world death rate is well over 1%.
I'm not disagreeing with you, just something to think about when considering mortality rates.
Try one in ten thousand. And that's in the most developed countries with the best healthcare.
If this becomes a true epidemic it’s going to be bad, but societies have been dealing with epidemics for a long time.
That's absolutely true, even in Wuhan the %age of infected people on the total population is relatively small, but much larger than the # of ICU beds that existed.
And the virus had a long time to spread around there before any countermeasures were taken.
Even so, ventilators and ICU beds are not normally all available either.
> Quarantine has been surprisingly effective in China, though at significant economic cost.
It would have been a lot more effective if they had done it sooner.
> That seems to be a much larger concern than the capacity of heathcare systems.
Yes, and I'm sure that at some level that's the right trade-off, I'm just not sure what that level is and whether or not we are already past it.
> If this becomes a true epidemic it’s going to be bad, but societies have been dealing with epidemics for a long time.
In Italy they went from 0 dead and a handful of cases to 7 dead and > 200 cases. Most of them are old people and people that were already ill.
Historically the way we deal with epidemics is by developing medication. That takes time and in the meantime the damage could be substantial.
Effective medication is a very recent thing. Variolation dates back to the 10th century and was moderately effective, but quarantine is thousands of years old. Avoiding cannibalism and thus prion diseases is also from antiquity, but that’s simply another type of avoidance.
China startet radical measures after a rather low number of mystery lung issues. I really doubt that any other government would have taken decisive action much earlier. What would you expect, martial law whenever a doctor isn't quite sure about a diagnosis?
The initial silencing of the first public reports is very unfortunate and puts the government rightfully in a very bad light, but I'm not sure that it had any influence on the speed of countermeasure implementation at all. I see that more as a case of one part of a huge organisation not knowing what the other is doing, not as a government-wide attempt at ignoring the problem. The authoritarian version of a PR department still sending out denials while the rest of the company is already working on a fix (and too busy to rein in the PR department/thought police)
After SARS a month of inaction is too long.
Yes, but we’re still often left with millions or tens of millions dead.
[1] https://www.ncbi.nlm.nih.gov/pubmed/?term=32053470
Not allowed to do this and not sure how long this will be up; the entire UpToDate reprint on the latest we know about COVID-19 (Coronavirus)
[2] https://www.scribd.com/document/448592904/COVID-19
Edit: adding the SCRIBD to the main post. It's free. All 18 pages if anyone is interested.
I don't think it is possible to derive any reliable facts from the data right now. Even if the patients who recovered from COVID-19 still find that there is something wrong with them, that could still go away in a week or a month or a year.
However, here is a tiny bit of information on the long-term effects of the 2003 SARS outbreak:
https://www.lung.org/lung-health-and-diseases/lung-disease-l...
> A small percentage of patients had long-term effects from their illness, including depression or anxiety, cough, shortness of breath, chronic lung disease or kidney disease. However, most patients fully recovered.
Edit: https://www.worldometers.info/coronavirus/ Looks like its now only 9%, it was 10% a day or two ago.
What I find more concerning is that the current ratio of deaths to cases is 3%, which I would expect to be an underestimate. Hopefully this is due to under-reporting of the mild cases, but it does imply either a major under-reporting of active cases or a significantly higher mortality rate than has been estimated so far (most likely the former).
https://www.worldometers.info/coronavirus/ Using the "closed cases" figures on this page (currently: 27892 closed cases, 25265 recovered, 2627 deaths), we get a fatality rate closer to 9.4%, but I've been monitoring this page for a while, and the fatality rate based on this calculation has improved a lot. For example, on 2020-02-10, the figures were 4376 closed cases, 3466 recovered, 910 deaths, resulting in a fatality rate of 20.8%. (https://web.archive.org/web/20200210100748/https://www.world... <3 archive.org)
The WHO number is based on more than just the known cases vs deaths tally.
The big counter is based on official stats reported by the various countries and is equal to the numbers published by the WHO. Obviously, nobody knows the number of people who had it but didn't report it. You could do random sampling and get an estimate for the particular population that you tested, but let's forget about that for a moment.
The WHO's fatality estimate may or may not turn out correct at some point for the entire outbreak, but sadly there is no denying that the number isn't correct for the people who were tested positive a couple weeks ago, and the WHO published their estimate a couple weeks ago too.
If there was some benefit to the disaster that was the Diamond Princess, I guess it was that we have a pretty good idea about the range of disease symptoms. The various evacuees too - living in quarantine till they get the disease or don't.
Just because we don't know the exact number doesn't mean there aren't ways to estimate.
My point is that estimating a mortality rate involves a lot more than simply doing a single arithmetic operation.
It seems like they just are taking all the new patients, and not calculating it correctly. I expect this number to grow.
The 14 day figure is more of a recommendation for the duration of quarantine, intended to cover incubation period in excess.
As a sample of a timeline that actually happened, you can check out the short paper about German cases reported in January[0].
It appears to have taken 3–6 days from infection until symptoms started, and subsequently 2–4 days until patients felt healthy again (no symptoms anymore, virus still detected in saliva).
We are seeing patients well beyond the day 5: difficulty breathing condition.
Your last statement is imperative.
Research from the Chinese Center for Disease Control suggests that around 80% of coronavirus cases are mild. Around 15% of patients have gotten severe cases, and 5% have become critically ill.
Here's how symptoms progress among typical patients:
- Day 1: Patients run a fever. They may also experience fatigue, muscle pain, and a dry cough. A small minority of them may have had diarrhea or nausea one to two days before.
- Day 5: Patients may have difficulty breathing — especially if they are older or have a preexisting health condition.
- Day 7: This is how long it takes, on average, before patients are admitted to a hospital, according to the Wuhan University study.
- Day 8: At this point, patients with severe cases (15%, according to the Chinese CDC) develop acute respiratory distress syndrome (ARDS), an illness that occurs when fluid builds up the lungs. ARDS is often fatal.
- Day 10: If patients have worsening symptoms, this is the time in the disease's progression when they're most likely to be admitted to the ICU. These patients probably have more abdominal pain and appetite loss than patients with milder cases. Only a small fraction die: The current fatality rate hovers around 2%.
- Day 17: On average, people who recover from the virus are discharged from the hospital after two-and-a-half weeks.
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[1] https://jamanetwork.com/journals/jama/fullarticle/2761044
[2] https://www.businessinsider.com/coronavirus-covid19-day-by-d...
Not allowed to do this and not sure how long this will be up; the entire UpToDate reprint on the latest we know about COVID-19 (Coronavirus)
[3] https://www.scribd.com/document/448592904/COVID-19
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Stay vigilant, stay careful, but most importantly, do not spread false information.