a thoughtful web.
Good ideas and conversation. No ads, no tracking.   Login or Take a Tour!
comment by Cumol
Cumol  ·  1689 days ago  ·  link  ·    ·  parent  ·  post: Obesity is major COVID-19 risk factor, says French chief epidemiologist

Could this lead to the worst outcomes in the US? Obesity is another pandemic sweeping the states in the past years...





b_b  ·  1688 days ago  ·  link  ·  

In a word, yes. I am certainly no covid authority, but I do have regular conversations with the chief of pulmonary ICU at my hospital (which is the biggest hospital in the second worst hit city in the states, so no shortage of experience). Her experience (anecdotal, obviously) is that obesity is probably among the worst predictors of bad outcomes. Kidney disease is also a particularly bad one. Many patients on vents progress to kidney disease and require dialysis, so if one comes in ahead of that curve, it's a really bad sign. Diabetes, obviously, is correlated with obesity, heart disease, kidney disease, and many other conditions. So diabetes is one of the worst things, since the more co-morbid conditions one has, the worse their prognosis. Unfortunately, in the inner cities in America, diabetes is ubiquitous. And the people who have diabetes are the most likely to be poor, to be unable to "shelter in place", and to have irregular (or any) healthcare visits in normal times. All of these factors will likely lead to higher transmission rates and worse outcomes per case than in the healthier suburbs. I suspect on average the numbers in the states will look like Europe in a lot of ways, but the difference will be that there will be a stark bifurcation between cities and suburbs (which is basically always the case in America--the rich areas have as good or better health outcomes as anywhere in the world, whereas the poor areas are like 3rd world countries).

am_Unition  ·  1688 days ago  ·  link  ·  

Public transport is now a liability. It's almost certainly why NYC is a hotbed.

I've been trying to drink less, but the stress doesn't help.

b_b  ·  1688 days ago  ·  link  ·  

Detroit is weird, because only poor people take the bus. Literally everyone else drives. It's really jarring to a Detroiter when you go to another city where bus transportation is a normal means of travel. That is almost certainly a factor in transmission in Detroit, because the shitty old buses are super crowded.

As I walked into the hospital yesterday, they were wheeling out an obviously incredibly sick old man on a gurney who was coughing underneath his mask. My first instinct was like, get him the fuck away from me. Then I regrouped and realized I was in a hospital, and I have it better than 99% of the rest of the people who work there, so I need to shut the fuck up and be grateful for the people who are in real danger. Gut reactions are hard to control, however.

kleinbl00  ·  1688 days ago  ·  link  ·  

Metro in LA is similar. I've gone 45 minutes being the only white guy on the train.

b_b  ·  1688 days ago  ·  link  ·  

One of Detroit's big problems is that the metro area comprises 3 counties and there isn't any regional authority. It's each county for itself. Wayne is where Detroit is. Oakland is where the money is. And Macomb is where the blue collar racists (oops, I mean "Reagan Democrats") are (I can say that because some of my best friends are blue collar racists). in 2016 we had a vote on a regional transit authority that could have changed the whole nature of public transportation around here. Wayne voted for it almost unanimously, because they want to be able to get to the jobs in Oakland. Oakland grudgingly voted for it, because white guilt is a thing. And Macomb voted against it, because, well they're Reagan Democrats. The measure lost by, ummm, almost the exact same margin as Trump's Michigan victory. Go figure.

As an aside, I've been to LA many times, and it was like probably the 6th time I was there that I even realized they had a metro.