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The Healing American Healthcare Podcast
The Healing American Healthcare Podcast

Episode 3 · 2 years ago

The COVID-19 Pandemic - How Is The US Doing?

ABOUT THIS EPISODE

The United States is still the global epicenter of the COVID-19 pandemic, but how is it faring compared to other countries? In the episode, the progress of each of the US states as the well the world at large against the virus are broken down and examined.

Hello, I am at Ikorn. I'm the founder of healing American healthcare and the healing American healthcare coalition, and today we're going to provide important information to you from a series of studies that my colleague John Dalton is done over the last several months where we actually compare apples to apples. So John is going to report on the COVID nineteen pandemic and how the US is doing compared with a number of other nations in the world. Let me first begin by introducing John to you. John Dalton is a fellow of the Healthcare Finance Management Association and Senior Emeritus Adviser at Bessler, and he's also our executive director of the healing American healthcare coalition. He's a former chapter president and national board member of the Healthcare Finance Management Association and he is the two thousand and one winner of the Morgan Award for lifetime achievement in healthcare financial management, and he's the only New Jersey chapter leader to receive this honor. He also serves on the Financial Committee at Children's specialized hospital and was named the two thousand and Seventeen hospital trustee of the year by the New Jersey Hospital Association, and at the end of this presentation you'll see a slide with John's contact information if you'd like to ask him many questions or if you have thoughts that you like to share about this presentation. So, without any further ado, let me turn this over to my colleague and good friend John Dalton. Good Morning John, good morning head, thank you for hosting this podcast. As you can see from the slide, it said part three. This is part three of the three part series that I've been writing through the quarterly Matt News Magazine of Our Professional Organizations, New Jersey chapter. Originally I thought it would probably be a just a four par series, but covid nineteen is sticking Arass I think it's when a wind up going probably into next summer. Ed and I share in Mutual Passion for guiding America on its path through universal healthcare and over the last several years and most of my research has focused on the member nations of the Organization of Economic Cooperation and Development. Currently there are thirty seven member nations. These are the countries that constitute the develop world. Sadly, the United States of America is the only member nation where it's citizens do not have universal healthcare. We got part way there with the affordable care act back in two thousand and nine, but does you're well aware of the four years of trump administration. I've went away at that so that the number one issued in the US radius leave that amount in any of the other thirty six countries that are member nations. So in this article at this is part three. I wrote the first article for our spring issue as of May first. We were at that point just here in New Jersey, The New York Cnro area just beginning to come down from being the global eper center of the pandemic. Northern New Jersey, New York conch pall in area went through six weeks of absolute health from mid Mars through the end of April. As think pandemic filled our overfilled ury ice you beds to an extent where we actually had free field hospitals operating in New Jersey, one of each in north, Central and South Jersey. New York City had field hospitals in the jacket center and I think you all remember seeing the hospital ship sale up the Hudson River Document Hanan. Fortunately the hospital ship never needed to be used, but it was all hands on deck in terms of coping with the pandemic. So the first out of that wrote really laid out what had been happening with the virus invading the US and the entire world, and at that point in time a lot of people were concerned about so many best...

...year. Something thats there and we weren't really focusing on what I view is a key metrics. So I laid out the whole case for looking at the countries in terms of what's the fatality ring? How many deaths for a hundred thousand? How is that happening over time? Where the deaths occurring? That was the first article. Second Article is written as the old Chum of equinocks, September twenty one for a fall issue, and in that article I layed out again where we were in terms of the pandemic have the US compared to the other member nations. And also in net article we spent a lot of time talking about what we've learned thus far from our spurious throughout the pandemic. For example, as a global every center, back in March and April, one out of every six hospitalized patients died from covid nineteen. Today that number is more like one out of sixteen. Six percent fatality rate, or is, if you're hospitalized in the New York Menu area with covid nineteen, you're one of sixteen chance of dying. That's far better than where we were in April and that resulted from a lot of learnings dealing with proning. You don't always have to put a patient on intubate and put them on a ventilator. These you see PAP BYPAP, other methodologies to assist with greeting. So we learned a lot and the third article is written as amber thirty submitted December five for publication. So let's say go look at where we are currently in terms of how the US is performing in the pandemic. First chart is the covid nineteen fatality rates for a hundred thousand for twenty of the OECD member countries and obviously the US, with the three and twenty eight million people, is the most populous of the countries. Have a thirty seven number nations in the chart. I'm just showing results for twenty that I've been tracting tracking a thirty seven, but these are twenty that are most interest New Zealand, South Korea, Japan, and Australia have coped well with the pandemic. There are all well under ten deaths per hundred thousand people. Belgium has been off the chart ever since I began tracking. For whatever reasons, when the pandemic first Belgium, their decision was to hospitalized patients from the community who had covid nineteen, but they basically ignored ore we called nursing homes. In Europe they're usually called care homes. So they had a enormous death rate in their nursing homes and in fact, when they came out of the first way, the government had the goal to Brag about how well it had handle a pandemic because, as I see you, beds never were full. Meantime, there are body bags all over the nursing homes, in vils. They have continued to lead. Leads the wrong word, because there are the bottom of the barrel. They've led the developed world and fatality rings. As of the end of last month, US was in a virtual dead heat with both Mexico and Chile. The thirty one place in the UK and then trailed by the United Kingdom, Italy, Spain and Belgium. They all remember the story from Italy. was actually lumbardy that got hit hardest, where Milan again is the global hub for people traveling to and from Italy. So the LAN was hit early on and hit hard again. The story we keep seeing over and over again politics over public health. That caused a lot of the high death rates in Lombardy. The rest of the really learned from that. So they did. As you look at them, over time, they did get a better control of situation. Spain, same story in the DRID, the global hub for people traveling to and from Spain. First big spike was in Madrid. Any of the other provinces of Spain got better control of the disease in terms of prevention. And then,...

...of course, there was US, the United States, the global hubs of travel to and from the US. Something like two point two million visitors came through the Guardian New York and Kennedy during February from Europe, many of them bringing with them the coronavirus. Same thing happened in Massachusetts, the Boston a lot of visitors coming back bringing the coronavirus with them. Was An additional event in Boston, which we'll talked about later, and that was cryogen's early February international conference. That ended up producing about three hundred thousand covid nineteen cases throughout the world. So, looking at the chart, we've in our three men to read that we proposed twice a month we've given coverage to each of the many of these countries. But New Zealand, that Ireland nation, has about the same population as iron and they're both dialand nations. And you look at New Zealand compared Ireland, Ireland hasn't done a bad job and New Zealand has just been phenomenal. Last week, for the second time during the pandemic, prime minister just into during declared that New Zealand is coronavirus free. But they've done lockdowns, they closed their borders and they realized they're early on, that they did not have enough. I see you bed capacity. They only have about eight point nine. I see you beds for a thousand, a thousand people, far less than what we see throughout the EU and the US. So they had to take durassic measures, but they work. Next up South Korea. South Korea confirmed its first covid nineteen case the same day as the United States. South Korea only Latin the curve. They crushed the current from when you look at where they are today compared to the United States, we both had the same opportunity. South Korea do very well. We're not doing so well. Fortunately we have a couple of folks who were doing worse than us. But we look at US versus the rest of the world, we're not doing well. Among the five major Western democracies, UK's Bay and France, Germany, Italy, we are the only one doing well. All along has been journey. We covered that early on allot that reason we evolved from the fact that they have a scientist. that their chance to as uncle and Martin understand the science on a stand politics. She came on art and quick in terms of getting the various regions of Germany to agree to certain mitigation measures, and they work. Journey's also were early into the pandemic and a little biotech firm, Copio and tech, came up with a formula. In fact, the guy that outfit it in about half an hour, as we subsemently learning, and that's the one that fiser has parted with. That is now being administered throughout the US. A success to it. So among the major ust the democracies. Here's Jeremy Right here at about twenty one hundred thousand fatality. And course I think the data is very interesting and I assume, John, and correct me if I'm wrong, you know the countries of New Zealand, self, Korea, Japan, Australia all acted relatively quickly and all adopted mitigation strategies to allow them to control the spread of the virus when compared with other nations around the world. Is that a reasonable assumption? Yeah, that's a that's a good assumption. And also remembered these are the countries that back in thousand and three were confronted with the SARS epidemic. As you know, Covid nineteen is ours go V to. It's just the same basic virus, very similar, and that, that also is part of the reason why we were able to love the vaccines so quickly to so much research went on from the stars, e ademic. But the other thing is that country like Japan, mask wearing is tolerated well. Australia, for example, you see...

...little bump here in this chart. They had an outbreak in Melbourne. The two biggest cities in Australia are Sydney and Melbourne both about little over five million people in their metropolitan areas. Melbourne and New South Wales loosened up more so than the rest of Australia and paid the price. They end up walking down the province actually closing the border to visitors from other provinces in Australia. But it worked. There's still doing a better job than most countries in terms of containing the endemic. But I think a lot of what asked for the Pacific Rim countries doing well is the the stars that ademic that can old three and having to deal with that. So the population already was conditioned to having to deal with a pandemic and a potentially lethal virus. The one thing that deep go off that chart to me was in the prior to charts they have done little. Slovakia, capital Bratislava, had been number four, between Japan and or Australia. But something pomp so I took a deeper died Thanto, looking at the Central European countries, and here's what I found. There is a letten weeks between the second and third article. During that eleven weeks we saw major spikes in the fatality rates in all of the Central European countries. So looking at the lucky hand axis, that is fatality rate, with that four hundred thousand, the Blue Boar is as of September twenty and the Orange Bar is as of November thirty. And you can see. Just look at the check republic. But you're doing quite well all along. So a twentyfold increased in their fatality. Slovakia, they had a huge increase in fatality.'s still doing relatively well, but a big spike. Slovenia, for the first lady immigrated from so a huge increase. Even Switzerland, with its superb healthcare system and the stable government, also saw a spike. Germany, you see, Germany went all the way up to twenty, almost twenty four kind of thousand fatality. Why? Well, as we all know, August is the month Europe's sound. Everybody goes on vacation to the south of Europe. Unfortunately, many of them work back coronavirus. So even with mitigation measure was in place, we're seeing a spike and I heard earlier this week the Czech Republic has gone to complete lock down. Germany again as having to shut down the Christmas markets. This virus can find it. It doesn't matter when your Democrat, Republican or Independent. It's going to find you and it will affect if you don't take the right precautions. Next, let us look at back in June at again looking at the states, because we had expen the spring break start to trigger a summer sun belt. Serge consistently looked at the states with the highest materiality, Ras, the ones that got hit early and hardest, and several others. So I do mix it Max but I show on these charts like as a unionitied states did on the other chart, California is the most populous of the states. On this chart, Washington, state of Washington recorded the first confirm covid nineteen case back in January, the same day as southforee recorded its first covid case. Washington has a robust healthcare system and the long history of being at the forefront of developing new ways of dealing with patients. So it's very progressive state in terms of healthcare. Even though they had that big at break at the Kirkland Nursing Home, they have been able to keep the virus under control. So you don't really control of the virus. He prevented from affecting people and they've done a better job of that than many other states. They're still in the mid teams in terms of fatality rate.

That pass but why is Louisiana up there on the chart? What happens? In early February? Mardi Gras. Even in early February, the coronavirus was here in the United States. And why? The infecting people. So if you're on Bourbon Street during Marty Gar you likely wound up with a potential covid nineteen infection. Then there's the northeast, connecticant Massachusetts, New York, New Jersey. We got hammered from mid March to the end of April. It was just held on rules throughout the whole New York Metro area. It got widespread coverage but, as we'll see in a later chart, once we got to understand what we were dealing with, we did a very good job of mitigation and flattening the curve. And it's still a challenge, as we're seeing that with the second surge. But we understand the disease better, we understand the virus better and the good news is that starting this week, for being vaccinated by the hundreds of thousands. So that's part of us. Looking across with art you see the beginning of that midway. That's summer surge. So here now is all of a sudden got Florida, South Carolina, Georgia, Arizona showing up with increased fatality. Right it's Texas spring break and summer surge. A lot of that would resulted in the fact that many of the southern states did not undertake mitigation measures as we did here in the northeast, ending up the State's Michigan, Illinois and so forth. So that's that's where we were as of the end of November. So it was going going to be doing this contest and took another look as of the fifteen and again we're seeing some real issue. He saw in a previous slide there was a sturgis sixteen Dangel sturgis motorcycle rally held in the small town of Sturgis, Dakota, population seven thousand. Ranch August seven to sixteen. It normally attracts a half million motorcyclists from all over the plains and Matt Rocky Mountain and up the Midwest states and fact from all over the country. This year they're huge to shut it down. They attracted about a half million people as were packed and then they went home. So now all a sudden we're seeing a huge surge in the upper midwest. Was Shot me when I did that chart as of earlier this week is look who's on the chart now, right between Louisiana and Connecticut, North Dakote. They got our fast again. It's let's popular state, but the fatality rate for thousand is right up with us in the northeast. That is no excuse for that. We've had nine had almost the entire year to learn how to deal with this and yet they ignored all of the all of what we learned on the side staff to Goo so that their code is there was an article in the Times a couple weeks ago that came for the Dakotans and it's still happening. My colleagues out in that part of the country there are no IC beds available and in many cases patients are having to be airlifted to other states to be treated. So we really need to learn from that as a today, both Mississippi and southern California reportedly have no beds available. Yeah, there's a story. Having at this point on because it. You mentioned it before and I think it's worth discussing as you have this graph up and that is the biogen meeting that occurred in Boston in February. That was before a great deal was known about the virus and it was very normal for companies to have regional or national meetings to discuss, you know, the strategies of a company. So there were ninety five people that attended this meeting in Boston and the article that recently came out from their efforts to look at community...

...spread determined that, as you mentioned earlier, over three Hundredzero people got the virus based on the ninety five people that started out at that conference in February. When you think about the that and compared to the South Dakota motorcycle event with five hundred thousand people in attendance, you know the potential multiple of infection is astronomical and could have affect a number of communities and states around our country. And if if you looked at the daily maps that were shown in a number of newspapers in October and November, the states with the highest infection rates were the ones in the middle of the United States, from South Dakota, the North Dakota, you know, Minnesota, Wisconsin, Michigan and other states that surrounded them that probably had visitors to the rally who intended to go despite the issue of the pandemic. And the other story that we've talked about that talks about mitigation is the comparison of Taiwan to Florida. Taiwan has a population of about twenty four million and Florida, I believe, has a population of twenty one million and mitigation was a big priority in Taiwan and as a result, I believe at the end of October they had a six hundred and seventy cases in the island of Taiwan. At the same time in Florida, the number of cases, where there was no statewide effort for everyone using mitigation approaches and beaches were open and there are a lot of people on the beaches, the number of infections through the end of October there was eight hundred and Thirtyzero. So I think you know that example really underscores what you've been reporting on in the idea that mitigation works and if you don't mitigate effectively then the infection spreads. Speaking of Larida, there's an interesting twist on the why gem story. That study was done by an epidemiologist from Massachusetts General Hospital. I saw it last week. They were able to trace the virus by his genome and apparently, of the three hundred thousand potential cases around the world, Seventyzero plucks of them landed in Florida. So while we all thought that spring break was what triggered the sun belt summer surge, by Agen might have had a hand in that. Also very interesting. Yeah, finally, as long as I was doing it, update as of the seven hundred and fifteen, I took a look at the right hand side of our chart, the northeast movement hardest hit early on, to see whether over time we managed to keep the curve flat and keep our infection rates in under control. So I ran up just a little table on in that cell to look at where are water fatality rate was as of the end of June, and so you see Connecticut with one hundred twenty one high, Massachusetts one hundred and seventeen point three, New Jersey on undred sixty nine point one, highest in the country, and New York not far behind at one and sixty one point five. At that point throughout the country the fatality was thirty eight point six as of December fifteen. Can tickets at one hundred and fifty two point five, Massachusetts one hundred and sixty five. We just hit two hundred over eighteen thousand dead now in New Jersey and New York was at one eighty two point one. The country had increased the ninety one point eight. So you can see the difference in terms of percentage change. Your New Jersey, New York actually has done the best. There's only I've been a twelve percent, almost thirteen percent increase in fatality rate between in the five and a half months since the end of June. New...

Jersey eighteen point three percent institutes a forty point seven percent. But we look at the country as a whole, it's more than double. A hundred thirty one hundred thirty eight percent increase in fatality rates journey by comparison, because I always used them as a measuring stickum kind of fund of the German healthcare system, and that's they had more than double, but it was a doubling from ten point eight four hundred thousand to twenty seven point five four hundred thousand. so that a seven and seventeen point difference. So the lesson wash your hands, watch your distance. Where I'm ask be careful out there a life? You say, maybe your own, and I said No. I think that's really well done, John. Thanks for sharing your research with us. I want to invite everyone to join us on our weekly Podcast, which we you know, have for the healing American healthcare coalition, and all of the information that we generally talked about in our podcasts are available through our biweekly news week by weekly newsletter, the three minute read, and you can join our coalition online at the healing American healthcare coalition, and by doing so you get a free copy of our book that describes our healthcare plan, which is the all care plan, that describes how we can actually provide universal healthcare in the United States and, at the same time, save our society as much as a trillion dollars a year on healthcare costs. So we love to have you join us or send US questions and comments. As you can see, John's information slide is the last line of our presentation and want to thank you for joining us today and we look forward to being in touch with you in our future podcasts and through our news letter at the healing American healthcare coalition. Take Care.

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