Coronavirus

[zeke4ahs]

Please stop making political points out of a virus. It's not helpful. Segmenting everyone you interact with into groups is not a good thing to do. Just interact with people like people.

The general feeling by many is that it will die off in summer as viruses like these don't do well in hot weather.

I stand by my point that by July this will be in the rear view mirror.

Sorry, but it’s hard not to be political about it, particular when less than two weeks ago Trump called it a Democratic Hoax and some of his base still believe it. I’ve heard several scientists say they think it will go away in the summer and then roar back in the fall. Why I’m tossing the dice on some travel in hot weather and cheap tickets.

 

[sglowrider]

Here's how the US health care system makes it harder to stop coronavirus

Everyone has gripes about the American health care system. But now that the US is facing a coronavirus pandemic, the flaws have far greater -- and even deadly -- repercussions.

The issues go beyond early missteps by federal officials, such as delays in distributing testing kits.
While countries around the globe are struggling to deal with the coronavirus, people in the US must contend with a fragmented health system where just going to get tested can mean hundreds or thousands of dollars in medical bills -- a risk those in other developed countries don't face.

"When you get to a highly communicable disease, that's when we all suffer the consequences," said Alan Weil, editor-in-chief of Health Affairs, a health policy journal. "My fate is very much tied to everyone else's fate."

Here are three problems the US must contend with:

1) Lack of coverage and high costs

The US is the only developed nation without universal health care. Nearly 28 million non-elderly Americans, or 10.4%, were uninsured in 2018, according to the most recent Census Bureau data available.

This is an improvement from what it was before the Affordable Care Act was passed in 2010. That year, 46.5 million non-elderly people -- or 17.8% -- lacked coverage. But the uninsured rate has started ticking up again over the past two years.

The uninsured largely depend on a patchwork of community clinics and hospital emergency rooms for care. This means they often wait until their conditions become serious before seeking medical help -- which could lead to their infecting many others during viral outbreaks like coronavirus.

But even those who have insurance may not seek care that quickly, largely because they face hefty deductibles and out-of-pocket costs for doctor's visits, emergency room trips and treatment.
The roughly 153 million Americans who have insurance through their jobs have seen their deductibles double over the past decade, according to the Kaiser Family Foundation's 2019 Employer Health Benefits Survey. A worker now has to shell out about $1,655 a year, on average, before coverage kicks in.

Plus, more than a quarter of covered workers -- including 45% of those at smaller firms -- have an average deductible of at least $2,000 a year.

"Addressing coronavirus with tens of millions of people without health insurance or with inadequate insurance will be a uniquely American challenge among developed countries," tweeted Larry Levitt, executive vice president for health policy at Kaiser. "It will take money to treat people and address uncompensated care absorbed by providers."

Concerned that high costs may dissuade people from getting checked out if they feel ill, many insurers and several states are waiving co-pays for the coronavirus test for certain policyholders. But patients will still have to pay for the visit, other testing and any treatment for the coronavirus or other illness they may turn out to have.

2) Lack of paid sick leave

Another weak point in the nation's fight against the coronavirus' spread is the lack of national standards on paid sick leave, a rarity among industrialized nations.

Federal and state officials are asking those who feel ill to stay home from work, but that's not easy for many to do if it means forgoing a paycheck or getting on the bad side of the boss. Nearly a quarter of workers don't have paid sick leave, according to federal data. And among those in the leisure and hospitality industries, who often deal with the public at places like restaurants and hotels, fewer than half can take a paid sick day.

Among the lowest-paid employees, only half have access to sick leave.

And many gig economy workers, such as those who drive for Uber and Lyft and who deliver food, are considered independent contractors and don't receive benefits such as sick days.

"Of course, another effect of the lack of paid sick leave is that many people will go to work sick, causing the virus to spread more widely," Dean Baker, senior economist at the left-leaning Center for Economic and Policy Research, wrote in a blog post.

Over the years, some states and municipalities have stepped in to fill the gap -- a dozen states plus the District of Columbia, require employers to provide paid sick leave for certain workers. At least 18 cities and counties have done the same.

However, some state legislatures have also banned municipalities from enacting paid sick leave laws.
Meanwhile, fewer than 30% of workers can work from home, according to Bureau of Labor Statistics. Those who can are more likely to be in higher-paying industries, such as finance or professional services. But in leisure and hospitality, fewer than 1 in 10 are able to work from home.

Congressional Democratic leaders are pushing to expand paid sick leave to try to contain the virus, a measure the White House has also weighed. President Donald Trump also said Monday he would press lawmakers to ensure assistance is available to hourly workers.

3) Lack of primary care doctors, ICU beds and respirators

Instead of rushing to the emergency room or urgent care, those who feel feverish or short of breath should call their doctor, federal officials advise. That will both minimize the chances to spread the coronavirus and avoid overburdening hospitals and clinics.

But many Americans don't have a regular primary care doctor, and those that do could have trouble reaching them after hours or on weekends, said Dr. David Blumenthal, a primary care physician and president of The Commonwealth Fund, a health care research and policy organization.
The nation's medical system is oriented to specialty care. Primary care doctors typically are paid less, and the field carries less prestige, he said.

The US has roughly 3 general or family practitioners per 10,000 people, compared to 7.5 in the United Kingdom, 9 in France and 13 in Canada, according to a Commonwealth Fund analysis.
"We lack that front line of screening and advice that primary care can provide," Blumenthal said, adding that these doctors are in a better position to decide whether their patients have pre-existing conditions that would require more treatment.

While health officials say the vast majority of those diagnosed with coronavirus, formally known as Covid-19, will be able to recover at home, some will need to be hospitalized. If those numbers rise sharply, hospitals may have trouble accommodating them.

Many hospitals have a limited number of intensive care unit rooms and staff trained to handle patients in them, said Eric Toner, a senior scholar at Johns Hopkins Center for Health Security.
"Intensive care unit beds are incredibly expensive to build and maintain. We don't have many more of them than we need on an average daily basis. So when we have an unexpected surge like we're anticipating with COVID-19, we'll exceed that capacity," said Toner.

That's a main concern for John Hick, medical director of emergency preparedness for Minneapolis-based Hennepin Healthcare, which is already contending with flu season. Of the 400-plus ICU beds in the metro area, only a handful were available, he said last week.

If many coronavirus patients appear, some hospitals may have to take over other wings that contain a lot of technology, such as surgical recovery or cardiac units -- requiring the postponement of other patients' procedures, Toner said.

"Unlike the Chinese, we can't build hospitals in three days," Blumenthal said.

Having enough supplies, particularly N95 respirators, is also a concern, Hick said. Even though Hennepin had not seen any coronavirus patients as of late last week, dozens of people are coming in to be checked out. The staff uses the respirators if they suspect someone might have the illness.
N95 respirators have been in short supply globally as countries treat their coronavirus patients. Last week, the federal government put out a solicitation to purchase 500 million of the devices over the next 18 months to refill America's reserve supply.

Meanwhile, hospitals like Hennepin that aren't in hot spots have to make do.
"The rest of us all get a percentage of what we usually order, but that doesn't begin to keep up with what is required," Hick said. "So we're stuck."

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

1) As far as I know, in most countries the costs of the test, treatment, hospitalisation have been free for COVID-19 patients. Test kits can vary from $30 up to $140 in some countries.

2) Over here you still get paid during enforced home quarantine; either through gov't grants or if you are a gov't employee, you for sure get paid for two weeks.

3) Lack of primary care is a huge problem regardless. Its the old adage of prevention is better (and cheaper) than cure. And yet there is an increasing shortage of primary caregivers. China's has had a massive shortage of primary caregivers and facilities. They tend to be tertiary care/support focus though they are shifting a lot of resources recently to help manage their burgeoning chronic disease problem.
This lack of primary care capacity in China, I am sure has contributed to the Covid explosion.

 

[sglowrider]

 

[TheOriginalHappyGoat]

View embedded media

Great! Now the sun's infected, and we're all f***ed!

 

[sglowrider]

Great! Now the sun's infected, and we're all f***ed!

Maybe we can nuke the sun then?

 

[HillzHoozier]

You don’t, or don’t have the intellectual capacity to, get it. Read the part from Jamie’s linked article about the St. Louis v Philadelphia reaction to the terrible flu of 1918.

You’d be the mayor of Philadelphia, cuz you’re tuff.

From Jamie's link: (hyper link near the top of the stat analysis 'one in 10 infected people'

Report of the WHO-China Joint Mission
on Coronavirus Disease 2019 (COVID-19)
16-24 February 2020

Contact Tracing
China has a policy of meticulous case and contact identification for COVID-19. For example,
in Wuhan more than 1800 teams of epidemiologists, with a minimum of 5 people/team, are tracing tens of thousands of contacts a day. Contact follow up is painstaking, with a high percentage of identified close contacts completing medical observation. Between 1% and 5% of contacts were subsequently laboratory confirmed cases of COVID-19, depending on location. For example:

• As of 17 February, in Shenzhen City, among 2842 identified close contacts, 2842
(100%) were traced and 2240 (72%) have completed medical observation. Among
the close contacts, 88 (2.8%) were found to be infected with COVID-19.

• As of 17 February, in Sichuan Province, among 25493 identified close contacts,
25347 (99%) were traced and 23178 (91%) have completed medical observation.
Among the close contacts, 0.9% were found to be infected with COVID-19.

• As of 20 February, in Guangdong Province, among 9939 identified close contacts,
9939 (100%) were traced and 7765 (78%) have completed medical observation.
Among the close contacts, 479 (4.8%) were found to be infected with COVID-19.​

Roughly 40000 close-contacts were tested and observed resulting in between 0.9 % and 4.8 % positive cases. (Not everyone in close contact will get sick. At highest 1 in 20 with CLOSE CONTACT)

From the same PDF,

As of 20 February, 2114 of the 55,924 laboratory confirmed cases have died (crude fatality ratio [CFR2] 3.8%) (note: at least some of whom were identified using a case definition that included pulmonary disease). The overall CFR varies by location and intensity of transmission (i.e. 5.8% in Wuhan vs. 0.7% in other areas in China).

In China, the overall CFR was higher in the early stages of the outbreak (17.3% for cases with symptom onset from 1-10 January) and has reduced over time to 0.7% for patientswith symptom onset after 1 February (Figure 4). The Joint Mission noted that the standard of care has evolved over the
course of the outbreak.
​

I feel better, don't you?

​

(Emphasis mine all mine.)

 

[sglowrider]

From Jamie's link: (hyper link near the top of the stat analysis 'one in 10 infected people'

Report of the WHO-China Joint Mission
on Coronavirus Disease 2019 (COVID-19)
16-24 February 2020

Contact Tracing
China has a policy of meticulous case and contact identification for COVID-19. For example,
in Wuhan more than 1800 teams of epidemiologists, with a minimum of 5 people/team, are tracing tens of thousands of contacts a day. Contact follow up is painstaking, with a high percentage of identified close contacts completing medical observation. Between 1% and 5% of contacts were subsequently laboratory confirmed cases of COVID-19, depending on location. For example:

• As of 17 February, in Shenzhen City, among 2842 identified close contacts, 2842
(100%) were traced and 2240 (72%) have completed medical observation. Among
the close contacts, 88 (2.8%) were found to be infected with COVID-19.

• As of 17 February, in Sichuan Province, among 25493 identified close contacts,
25347 (99%) were traced and 23178 (91%) have completed medical observation.
Among the close contacts, 0.9% were found to be infected with COVID-19.

• As of 20 February, in Guangdong Province, among 9939 identified close contacts,
9939 (100%) were traced and 7765 (78%) have completed medical observation.
Among the close contacts, 479 (4.8%) were found to be infected with COVID-19.​

Roughly 40000 close-contacts were tested and observed resulting in between 0.9 % and 4.8 % positive cases. (Not everyone in close contact will get sick. At highest 1 in 20 with CLOSE CONTACT)

From the same PDF,

As of 20 February, 2114 of the 55,924 laboratory confirmed cases have died (crude fatality ratio [CFR2] 3.8%) (note: at least some of whom were identified using a case definition that included pulmonary disease). The overall CFR varies by location and intensity of transmission (i.e. 5.8% in Wuhan vs. 0.7% in other areas in China).

In China, the overall CFR was higher in the early stages of the outbreak (17.3% for cases with symptom onset from 1-10 January) and has reduced over time to 0.7% for patientswith symptom onset after 1 February (Figure 4). The Joint Mission noted that the standard of care has evolved over the
course of the outbreak.
​

I feel better, don't you?

​

(Emphasis mine all mine.)

Hillz you can be selective in your information ie confirmation bias.

We just had a new cluster where one guy went to a formal social dinner. He infected everyone in his table and two of them went on to infect a whole bunch. Its all tracked and mapped, and on-line. This cluster, emanating from that one man/table went on to spread to nearly 70 people.

You can go into denial all you want, but its not doing anyone any favours. Not suggesting that we all run out and buy toilet papers -- I didnt three months ago and not planning on doing so anytime soon. Those are ignorant, susceptible folks.

But that's what is missing in the whole 'game plan' the lack of information and education. There has been well over almost four months of data to extract.

The problem is that it's only now, hitting the American shores and you are acting like it never happened anywhere else.

 

[HillzHoozier]

Hillz you can be selective in your information ie confirmation bias.

We just had a new cluster where one guy went to a formal social dinner. He infected everyone in his table and two of them went on to infect a whole bunch. Its all tracked and mapped, and on-line. This cluster, emanating from that one man/table went on to spread to nearly 70 people.

You can go into denial all you want, but its not doing anyone any favours. Not suggesting that we all run out and buy toilet papers -- I didnt three months ago and not planning on doing so anytime soon. Those are ignorant, susceptible folks.

But that's what is missing in the whole 'game plan' the lack of information and education. There has been well over almost four months of data to extract.

The problem is that it's only now, hitting the American shores and you are acting like it never happened anywhere else.

There is a lot of data to interpret. People should be as cautious as makes them comfortable. The panic 'cat' is out of the bag, but I'm not participating.

As for me, my wife and I are going south for a long-awaited vacation. The doctors she works with know we are going and insisted we keep our plans.

If I never get it, I cant spread it. I like my chances. We plan to behave responsibly and will be keeping paparazzi, et al, at arm's length .

Cheers!

 

[sglowrider]

There is a lot of data to interpret. People should be as cautious as makes them comfortable. The panic 'cat' is out of the bag, but I'm not participating.

As for me, my wife and I are going south for a long-awaited vacation. The doctors she works with know we are going and insisted we keep our plans.

If I never get it, I cant spread it. I like my chances. We plan to behave responsibly and will be keeping paparazzi, et al, at arm's length .

Cheers!

Best of luck! Most of us will survive it even if we get infected.

But just don't pass it on to the elderly and vulnerables.

 

[Marvin the Martian]

It turned out that what Trump said in the speech, that all people and goods from non-UK Europe was blocked was wrong. First a correction was made via tweet that goods were not impacted. Then a correction was made that it was only part of Europe, then a correction was made that Americans were not impacted.

The markets heard that and went from a rise in expectations of some brilliant plan to down 1000. We hear that Trump's words mean nothing. His words mean he fails to exude calm leadership in a crisis. That too is part of a president's job.

He was reading from a teleprompter. Was the speech not vetted and edited? Did he just go rogue? How does that happen?

 

[Marvin the Martian]

538 has a story up about what we do not know about COVID-19. That is, is it seasonal.,the fact we do not know is why this is being fought so hard. If it is seasonal and we cannot eradicate it now, it will come back Every.Single.Year

This ties to a second story I read, the COVID deaths are not in lieu of flu deaths. It is an additive.

What is it worth to stop a 2nd seasonal flu, for lack of a better term, from entering the human populace?

 

[sglowrider]

538 has a story up about what we do not know about COVID-19. That is, is it seasonal.,the fact we do not know is why this is being fought so hard. If it is seasonal and we cannot eradicate it now, it will come back Every.Single.Year

This ties to a second story I read, the COVID deaths are not in lieu of flu deaths. It is an additive.

What is it worth to stop a 2nd seasonal flu, for lack of a better term, from entering the human populace?

Most experts here expect it to recycle now onwards simply because its almost impossible to stop the flow of human traffic in with the advent of cheap transportation.

And of course, it's in not in lieu of seasonal flu. We just dont get seasonal flu/deaths in the tropics ..and so here we are with the Coronavirus.

 

[sglowrider]

It turned out that what Trump said in the speech, that all people and goods from non-UK Europe was blocked was wrong. First a correction was made via tweet that goods were not impacted. Then a correction was made that it was only part of Europe, then a correction was made that Americans were not impacted.

The markets heard that and went from a rise in expectations of some brilliant plan to down 1000. We hear that Trump's words mean nothing. His words mean he fails to exude calm leadership in a crisis. That too is part of a president's job.

He was reading from a teleprompter. Was the speech not vetted and edited? Did he just go rogue? How does that happen?

You say all this... despite the fact that the good man donated his ALL salary to charity?

 

[Marvin the Martian]

You say all this... despite the fact that the good man donated his ALL salary to charity?

Which would be more impressive if he ever had donated money to charity before (you know, items other than giant portraits of himself).

 

[sglowrider]

 

[Bill4411]

View embedded media

You know this is all your fault don't you? You and your "foreign virus".

 

[sglowrider]

You know this is all your fault don't you? You and your "foreign virus".

My peeps! Its retaliation for the tariffs.

Just like the movies, 15,072 Asians will die before one whitey perishes. Nevertheless, it shows true commitment on the part of President Xi and my peeps.

 

[Bill4411]

My peeps! Its retaliation for the tariffs.

Just like the movies, 15,072 Asians will die before one whitey perishes. Nevertheless, it shows true commitment on the part of President Xi and my peeps.

Yup. Creating that "foreign bug" in your labs just to screw with Trump and his reelection was unfair.

 

[JamieDimonsBalls]

Sorry, but it’s hard not to be political about it, particular when less than two weeks ago Trump called it a Democratic Hoax and some of his base still believe it. I’ve heard several scientists say they think it will go away in the summer and then roar back in the fall. Why I’m tossing the dice on some travel in hot weather and cheap tickets.

In other words, you are incapable

 

[Daydreamer]

Latest Drudge. No fear mongering there at all.

So which of those are lies telling us we're all going to die? If those are the worst headlines you can dig up, I'd say you're the one who's panicking because almost of them are completely benign and completely accurate.

 

[Daydreamer]

There is a lot of data to interpret. People should be as cautious as makes them comfortable. The panic 'cat' is out of the bag, but I'm not participating.

As for me, my wife and I are going south for a long-awaited vacation. The doctors she works with know we are going and insisted we keep our plans.

If I never get it, I cant spread it. I like my chances. We plan to behave responsibly and will be keeping paparazzi, et al, at arm's length .

Cheers!

That's a fine approach and how practically everyone is going about it. There is no mass panic like you are claiming. The mass panic is coming from politically motivated conspiracies designed to make people like you believe that science and expertise are bad things.
People in leadership positions are making responsible decisions to try to slow the spread so it doesn't get out of hand and none of those decisions hurt you. It's really difficult to understand why you have such a problem with that.

 

[zeke4ahs]

In other words, you are incapable

Whatevs....

 

[sglowrider]

Yup. Creating that "foreign bug" in your labs just to screw with Trump and his reelection was unfair.

First Trump; then Putin and eventual the world. Global domination.

Our first rule will be to take away all forks and knives. Everyone has to learn to use a chopstick or face a firing squad.

If you want to live longer, watch this video:

 

[sglowrider]

 

[CO. Hoosier]

Sorry, but it’s hard not to be political about it, particular when less than two weeks ago Trump called it a Democratic Hoax and some of his base still believe it. I’ve heard several scientists say they think it will go away in the summer and then roar back in the fall. Why I’m tossing the dice on some travel in hot weather and cheap tickets.

The problem with being political is that your mind will filter information through a political filter and let in only that information consistent with your politics. This leads to false impressions. Your post is a perfect example of that.

 

[sglowrider]

103-yr-old oldest to beat virus

A 103-year-old woman has become the oldest person to beat coronavirus and return home.

Zhang Guangfen recovered from the disease after receiving treatment for just six days at a hospital in Wuhan – the Chinese city at the centre of the outbreak.

The centenarian’s quick recovery was down to her having no underlying health conditions apart from mild chronic bronchitis, her doctor Dr Zeng Yulan told reporters.

She was diagnosed at Liyuan Hospital, Tongji Medical College, in Wuhan on 1 March, Chutian Metropolis Dailyreports.
The newspaper published a video showing the woman being escorted out of the hospital to a waiting ambulance by a group of medical workers as she was discharged on Tuesday.

Older people and those with pre-existing medical conditions are more at risk of developing severe coronavirus symptoms.

The grandmother has become the oldest person to recover from the deadly disease so far – days after a 101-year-old man also beat the virus in Wuhan.

 

[twenty02]

The problem with being political is that your mind will filter information through a political filter and let in only that information consistent with your politics. This leads to false impressions. Your post is a perfect example of that.

The Federal govt has fallen flat on their face during this crisis. The President lies daily and has no ability to lead through something like this.... why he should never have never been anywhere near the office he sits in.

 

[anon_mlxxvlbug9dpa]

First Trump; then Putin and eventual the world. Global domination.

Our first rule will be to take away all forks and knives. Everyone has to learn to use a chopstick or face a firing squad.

If you want to live longer, watch this video:

View embedded media

I’ma Wizard with chopsticks

 

[anon_mlxxvlbug9dpa]

The Federal govt has fallen flat on their face during this crisis. The President lies daily and has no ability to lead through something like this.... why he should never have never been anywhere near the office he sits in.

Plenty of his disciples will find plenty of good in all of the non-good that he’s done. We are in a post-reason world.

 

[Cortez88]

Plenty of his disciples will find plenty of good in all of the non-good that he’s done. We are in a post-reason world.

It’s hard to keep the discussion apolitical when you consider the country is in this position because so many people thought it was a good idea to elect an incompetent, unfit and dangerous person to run the country. He doesn’t simply lack leadership skills, he is actually the opposite of every great leader in all facets. His fans cheered and enabled the ignorance, cruelty and disregard for expertise. Now we are trying to navigate a serious national emergency with an administration that has no ability to do the job.

 

[sglowrider]

The Federal govt has fallen flat on their face during this crisis. The President lies daily and has no ability to lead through something like this.... why he should never have never been anywhere near the office he sits in.

Et Tu Twenty?!!

 

[sglowrider]

Plenty of his disciples will find plenty of good in all of the non-good that he’s done. We are in a post-reason world.

At least trump is practising good hand hygiene by tai-chi-ng it off to Poor Ol' Mike.

 

[iuwclurker]

Spent a lot of time with several GPs this evening. Most think it will spread across the country. Also think that for 90% it's not a big deal to get. All agreed it's very nasty for 70+ year olds. Do what you will with that.

Yeah and 99% of scientists believe in global warming. What does that prove? Squat.

 

[Marvin the Martian]

I will say that Fred Hoiberg showing up to that game last night was absolutely irresponsible. It was before COVID, why do we assume it is our right to infect other people with the flu? I can't believe Nebraska let him go out there.

I'll admit, I used to take great pride in going to work sick, it was a sign of being tough. But it was several years ago when it became obvious that making everyone else sick is just stupid.

 

[Bill4411]

At least trump is practising good hand hygiene by tai-chi-ng it off to Poor Ol' Mike.

Who is coming off way better than No.1.

 

[iuwclurker]

Why do you continue to post that garbage chart? Most sane and well-adjusted people go from #2 straight back to #1. Those who get caught up in the chart are the same ones who stay in bed with a bottle of Xanax on the bedside table.

He says, after popping three Trump Condones...

 

[sglowrider]

He says, after popping three Trump Condones...

 

[sglowrider]

I will say that Fred Hoiberg showing up to that game last night was absolutely irresponsible. It was before COVID, why do we assume it is our right to infect other people with the flu? I can't believe Nebraska let him go out there.

I'll admit, I used to take great pride in going to work sick, it was a sign of being tough. But it was several years ago when it became obvious that making everyone else sick is just stupid.

Is this what they call the sharing economy?

 

[anon_mlxxvlbug9dpa]

It’s hard to keep the discussion apolitical when you consider the country is in this position because so many people thought it was a good idea to elect an incompetent, unfit and dangerous person to run the country. He doesn’t simply lack leadership skills, he is actually the opposite of every great leader in all facets. His fans cheered and enabled the ignorance, cruelty and disregard for expertise. Now we are trying to navigate a serious national emergency with an administration that has no ability to do the job.

Which is exactly why many of us conservatives held our nose and voted for the unlikeable Hillary.

 

[iuwclurker]

Here's how the US health care system makes it harder to stop coronavirus

Everyone has gripes about the American health care system. But now that the US is facing a coronavirus pandemic, the flaws have far greater -- and even deadly -- repercussions.

The issues go beyond early missteps by federal officials, such as delays in distributing testing kits.
While countries around the globe are struggling to deal with the coronavirus, people in the US must contend with a fragmented health system where just going to get tested can mean hundreds or thousands of dollars in medical bills -- a risk those in other developed countries don't face.

"When you get to a highly communicable disease, that's when we all suffer the consequences," said Alan Weil, editor-in-chief of Health Affairs, a health policy journal. "My fate is very much tied to everyone else's fate."

Here are three problems the US must contend with:

1) Lack of coverage and high costs

The US is the only developed nation without universal health care. Nearly 28 million non-elderly Americans, or 10.4%, were uninsured in 2018, according to the most recent Census Bureau data available.

This is an improvement from what it was before the Affordable Care Act was passed in 2010. That year, 46.5 million non-elderly people -- or 17.8% -- lacked coverage. But the uninsured rate has started ticking up again over the past two years.

The uninsured largely depend on a patchwork of community clinics and hospital emergency rooms for care. This means they often wait until their conditions become serious before seeking medical help -- which could lead to their infecting many others during viral outbreaks like coronavirus.

But even those who have insurance may not seek care that quickly, largely because they face hefty deductibles and out-of-pocket costs for doctor's visits, emergency room trips and treatment.
The roughly 153 million Americans who have insurance through their jobs have seen their deductibles double over the past decade, according to the Kaiser Family Foundation's 2019 Employer Health Benefits Survey. A worker now has to shell out about $1,655 a year, on average, before coverage kicks in.

Plus, more than a quarter of covered workers -- including 45% of those at smaller firms -- have an average deductible of at least $2,000 a year.

"Addressing coronavirus with tens of millions of people without health insurance or with inadequate insurance will be a uniquely American challenge among developed countries," tweeted Larry Levitt, executive vice president for health policy at Kaiser. "It will take money to treat people and address uncompensated care absorbed by providers."

Concerned that high costs may dissuade people from getting checked out if they feel ill, many insurers and several states are waiving co-pays for the coronavirus test for certain policyholders. But patients will still have to pay for the visit, other testing and any treatment for the coronavirus or other illness they may turn out to have.

2) Lack of paid sick leave

Another weak point in the nation's fight against the coronavirus' spread is the lack of national standards on paid sick leave, a rarity among industrialized nations.

Federal and state officials are asking those who feel ill to stay home from work, but that's not easy for many to do if it means forgoing a paycheck or getting on the bad side of the boss. Nearly a quarter of workers don't have paid sick leave, according to federal data. And among those in the leisure and hospitality industries, who often deal with the public at places like restaurants and hotels, fewer than half can take a paid sick day.

Among the lowest-paid employees, only half have access to sick leave.

And many gig economy workers, such as those who drive for Uber and Lyft and who deliver food, are considered independent contractors and don't receive benefits such as sick days.

"Of course, another effect of the lack of paid sick leave is that many people will go to work sick, causing the virus to spread more widely," Dean Baker, senior economist at the left-leaning Center for Economic and Policy Research, wrote in a blog post.

Over the years, some states and municipalities have stepped in to fill the gap -- a dozen states plus the District of Columbia, require employers to provide paid sick leave for certain workers. At least 18 cities and counties have done the same.

However, some state legislatures have also banned municipalities from enacting paid sick leave laws.
Meanwhile, fewer than 30% of workers can work from home, according to Bureau of Labor Statistics. Those who can are more likely to be in higher-paying industries, such as finance or professional services. But in leisure and hospitality, fewer than 1 in 10 are able to work from home.

Congressional Democratic leaders are pushing to expand paid sick leave to try to contain the virus, a measure the White House has also weighed. President Donald Trump also said Monday he would press lawmakers to ensure assistance is available to hourly workers.

3) Lack of primary care doctors, ICU beds and respirators

Instead of rushing to the emergency room or urgent care, those who feel feverish or short of breath should call their doctor, federal officials advise. That will both minimize the chances to spread the coronavirus and avoid overburdening hospitals and clinics.

But many Americans don't have a regular primary care doctor, and those that do could have trouble reaching them after hours or on weekends, said Dr. David Blumenthal, a primary care physician and president of The Commonwealth Fund, a health care research and policy organization.
The nation's medical system is oriented to specialty care. Primary care doctors typically are paid less, and the field carries less prestige, he said.

The US has roughly 3 general or family practitioners per 10,000 people, compared to 7.5 in the United Kingdom, 9 in France and 13 in Canada, according to a Commonwealth Fund analysis.
"We lack that front line of screening and advice that primary care can provide," Blumenthal said, adding that these doctors are in a better position to decide whether their patients have pre-existing conditions that would require more treatment.

While health officials say the vast majority of those diagnosed with coronavirus, formally known as Covid-19, will be able to recover at home, some will need to be hospitalized. If those numbers rise sharply, hospitals may have trouble accommodating them.

Many hospitals have a limited number of intensive care unit rooms and staff trained to handle patients in them, said Eric Toner, a senior scholar at Johns Hopkins Center for Health Security.
"Intensive care unit beds are incredibly expensive to build and maintain. We don't have many more of them than we need on an average daily basis. So when we have an unexpected surge like we're anticipating with COVID-19, we'll exceed that capacity," said Toner.

That's a main concern for John Hick, medical director of emergency preparedness for Minneapolis-based Hennepin Healthcare, which is already contending with flu season. Of the 400-plus ICU beds in the metro area, only a handful were available, he said last week.

If many coronavirus patients appear, some hospitals may have to take over other wings that contain a lot of technology, such as surgical recovery or cardiac units -- requiring the postponement of other patients' procedures, Toner said.

"Unlike the Chinese, we can't build hospitals in three days," Blumenthal said.

Having enough supplies, particularly N95 respirators, is also a concern, Hick said. Even though Hennepin had not seen any coronavirus patients as of late last week, dozens of people are coming in to be checked out. The staff uses the respirators if they suspect someone might have the illness.
N95 respirators have been in short supply globally as countries treat their coronavirus patients. Last week, the federal government put out a solicitation to purchase 500 million of the devices over the next 18 months to refill America's reserve supply.

Meanwhile, hospitals like Hennepin that aren't in hot spots have to make do.
"The rest of us all get a percentage of what we usually order, but that doesn't begin to keep up with what is required," Hick said. "So we're stuck."

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1) As far as I know, in most countries the costs of the test, treatment, hospitalisation have been free for COVID-19 patients. Test kits can vary from $30 up to $140 in some countries.

2) Over here you still get paid during enforced home quarantine; either through gov't grants or if you are a gov't employee, you for sure get paid for two weeks.

3) Lack of primary care is a huge problem regardless. Its the old adage of prevention is better (and cheaper) than cure. And yet there is an increasing shortage of primary caregivers. China's has had a massive shortage of primary caregivers and facilities. They tend to be tertiary care/support focus though they are shifting a lot of resources recently to help manage their burgeoning chronic disease problem.
This lack of primary care capacity in China, I am sure has contributed to the Covid explosion.

I thought insurance was for catastrophic...

I repeat (from long ago): Insurance is the abdication of responsibility.

Maybe some of you conscientious objectors will now have an epiphany.