G7 Countries;
Japan. 9 Deaths per million in population
Germany 111
Canada. 239
France. 466
USA. 524
Italy. 586
UK. 609
other developed nations;
Netherlands. 360
Sweden. 573
Belgium. 857
Spain. 613
Switzerland. 230
Ireland. 359
Denmark. 107
Norway. 48
Austria. 51
China. 3
You let me know when you see something that doesn't make much sense.
Even among those sixteen countries--all of which had less time to prepare than the U.S.--out of several hundred, the U.S. is in the bottom half. There are only a handful of countries in the entire world who have higher mortality rates than the U.S. that are not on those two lists. And if you look at just the past couple of months, the U.S. has the highest rate in the world, possibly excepting a few South American countries.
I have not seen your post.
I now see that Cuomo has published a report, two months after my post upthread, which makes basically the same points I did, along with some others, based on data that weren't available to me. I will just mention two of the key issues.
First, it's been known for at least four months that infectiousness peaks prior to appearance of symptoms, and is mostly gone within a few days to a week after. Several lines of evidence support this, including measurement of active virus as well as contact tracing studies. So any patient ready to be discharged from a hospital would be highly unlikely to be infectious. This information has been available to anyone who follows the science, but most journos have totally ignored it, and the few who didn't apparently can't put two and two together.
Your link, or a link within that link, says:
Dr. Mark Dworkin, a former Illinois state epidemiologist, said the finding that people don’t transmit the virus after nine days of illness applies in the population at large, but it’s not clear whether that’s true of nursing home residents who may have weaker immune systems and shed the virus longer.
For starters, this is purely speculative--there is no evidence at all bearing on the relationship of immune system strength and shedding. Second, the nine days is a maximum estimate. Infectiousness is thought to be very low sooner than that, within a week or less after symptoms appear. Third, according to the Cuomo report, nine days was the median length of the patient's stay in the hospital, but as also pointed out in the report, the patient usually doesn't go to the hospital the first day symptoms emerge. Patients generally wait several or more days before taking that step. So the nine days is a large underestimate of the time since symptom emergence. This point also addresses the other criticism in the link, that if nine days was the median period, there would have been some patients who had spent less time in the hospital than that before being admitted to the NH. That's true, but again, nine days in the hospital is much longer than nine days with symptoms, which itself is longer than is likely to be necessary..
There is further evidence, which your link ignores. Cuomo's team is aware of it, but IMO didn't fully capitalize on it.For the 44 states that reported nursing home deaths at the end of May, there was a very high correlation, close to 0.90, between deaths in NH and outside of them. The states with the highest number of NH deaths also had the highest number of deaths in the general population. IOW, what's driving NH deaths can't be hospital patients, but the same factors driving deaths outside of them. This is simply case rate, which in turn is highly correlated with population density. NJ, RI, CT and MA have the four highest PD in the country, and NYC has by far the highest of any city. So the entire NE corridor has been a breeding ground for the virus.
That NH deaths correlate with case rate in the surrounding community, rather than with patient transfers, is illustrated by many specific examples. CA, despite allowing transfer of hospital patients, has one of the lowest rates of NH deaths in the country, which is consistent with a more widely distributed population. (Note: by rate, I don't mean NH deaths as a % of total deaths, which is also relevant, but for a different reason. I mean NH deaths as a % of total NH population in that state). MA, which initially allowed transfer, but quickly reversed under pressure, has one of the highest rates (about 10%), consistent with its being in the NE corridor (these states all had rates on the order of 8-13%). Other states that ordered NH to accept hospital patients include PA, IL, MI and MN. All of them had moderate NH death rates (3-5%), nowhere near as high as those in the NE, but again, consistent with the presence of large urban areas. So even if one wants to claim that NY undercounted its NH deaths, which I'm quite willing to entertain, the correlation stands. It simply does not support the notion that hospital patient transfers had a significant effect on NH deaths.
All of this points to the conclusion of the Cuomo report, which I hadn't even seen before: NH deaths mostly have resulted from staff members, who go in and out daily, bringing in the virus, and the higher the case rate in the surrounding community, the more likely they are to be infected. The highest % of NH deaths tend to have occurred in states like MA, which was lax in testing during this period.
None of this is to say that Cuomo was blameless. As you probably know, Chris, many Democrats dislike Cuomo intensely. There's a reason that despite being governor of one of the most populous states in the U.S., in an election year when relatively few candidates had such impressive credentials, he didn't run for President.
At the time of his order, we didn't know how infectious these patients would be, and there is never zero risk. He can certainly be criticized for not testing the transferred patients. As I said before, I can even believe there's been an undercount of NH deaths, because the reported % of NH deaths/deaths outside of NH in NY is much lower than the national mean, as your link indicates. That is the other sense of rate of NH deaths, and certainly suggests undercounting.
But all this talk about how Cuomo has thousands of deaths on his hands is baloney. Nothing supports it at all. Your link speculates, plays what if games, which is fair enough in a serious life and death matter. It's entirely proper that the report should be criticized in the most detailed manner possible, so that something like this doesn't happen again. But the overwhelming evidence is against the conclusion that patient transfers were the source of many NH deaths. It's unsupported by measures of infectiousness, and totally inconsistent with the close correlation of NH deaths with other deaths throughout the entire country. There are other valid points made in the report, such as a lack of correlation with timing of patient transfers to peak of deaths.
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