words and acronyms

spread, like spread the virus, spred Bund-BTP, spread the goodness of the web GNUtella. Just because I want to talk about Fold@home that reminds me of SETI@home that was alive at the time DIvX Napster and Indymedia were born (GNUtella followed suit, once Napster was killed)

PEEP and PEPP, easy to confuse, both actual now:

PEEP some parameter in ventilators, the reason you can’t hack together a mechanichal ventilator, PEEP must be managed by some electronics and specific mechanics

PEPP is some Pandemic Emergency something  created by the ECB, which will buy bods for 750 billions, it already started buying Italy’s Btp and that should allow Italy to stay comfortably in 5% deficit for 2020, BOTs have already a buyr, Over that level,  check twice

From Trolley to Mechanical Ventilator

how “problems” change over time, one day everybody is musing on a robot car who (that) must choose who to kill, then a small rna virus arrives and everybody turns to the problem of mechanical ventilators, except that not, nobody wants to acknowledge that in the Covid19 epidemics thousand of critical patients are subject to rationing life/death decisions based of a simple rule or a more complex clinical evalution algorithm? And the dilemma goes: you save a 60-yearld old man in perfect shape of a 35-year old pregnant woman with breast cancer ?

Facing Covid-19 in Italy — Ethics, Logistics, and Therapeutics on the Epidemic’s Front Line

New England Journal of Medicine has a retrospective on the ICU crisis in Italy where decisions around scarce mechanical ventilators are actually done, at time of writing over 4,000 people dead and this charts show the problem in stricking clarity

Death definition in Germany in a plague

(originates from widespread ideas in Italy that when you die of Coronavirus in Germany with comorbidity the death is then attribute to the comorbidity, so they come out better at numbers

info page on case collection at Robert Koch Institute https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Fallzahlen.html

RKI is mandated to keep tabs on  plagues by the Infection Protection Act https://www.rki.de/EN/Content/infections/inf_dis_down.pdf?__blob=publicationFile

The new normal (Covid edition)

How is going to be after we contain the epidemic ?

Pandemics don’t go away with the season, not for good, expect to see a new outbreak in Autumn

This is what this simulation says https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf and it hypothesizes a policy framework like thisScreenshot 2020-03-17 at 21.33.48

suppression strategies to cap ICU cases and preserve public health, awaiting a vaccine 18 months away

This is also what we know from a previous pandemic, the Asian Flu. Not quite a coronavirus but both rhinoviruses, quite as deadly and infectious although the Asian would kill the elder and the little kinds with Covid19 kills only the former.

It had 2 peaks in USA, in September and February and raged for 3 year in total

virus, big brother and little father

big brother 1984 Orwell

little father Josif Stalin

Korea contains the epidemic with snooping technologies and quarantine

China (and Italy) is ordering everybody home in a general lockdown

fighting a virus is at the opposite end of liberal laissez faire, fighting the epidemic requires applying some power of restriction and the target of this power unveils two different model and ideas of power.

The jury is out wheter the 2 different way of tackling the epidemic are equally effective. Korea seems to have blocked it in a shorter time with less economic damage, compared to China. Will Italy’s blockade succeed in flattening the curve ?

 

 

how a fast learning curve looks like

Screenshot 2020-03-08 at 10.35.07

gore edition, new cases and deaths, divergence in growth as case grows and experience is built on how to treat critical patients of a novel disease

But in a “learning curve” framework that works you need to be able to cope with demand, your service should not run into some sort of “diminishing return” at the margin or in a more discrete case, being able to serve the customers in order to have the very same outcomes that you are measutring gains against

In other words, ICU’s might have overflown, critical patients might have gone untreated, mortality might have spiked as a consequence, nd thereafter kept a steeper profile

Screenshot 2020-03-11 at 00.05.17

the disaster medicine protcol was issued by the society of anestesiologists on the 6th, clearly a situation was building up and its exponential nature was not lost on doctors fighting the disease https://www.esanum.it/today/posts/covid-19-le-raccomandazioni-della-siaarti

Normal accident

“If interactive complexity and tight coupling—system characteristics—inevitably will produce an accident, I believe we are justified in calling it a normal accident, or a system accident.”

this should go in laws, all sort of laws.  Charles Perrow