Covid-19 facts and data vs misconceptions.

It's the RT trend that I watch here in Georgia it's been going down for weeks down to 1.06

Mid to late March it was plus 2.25 off the charts,

Rt, a key measure of how fast the virus is growing. It’s the average number of people who become infected by an infectious person. If Rt is above 1.0, the virus will spread quickly. When Rt is below 1.0, the virus will stop spreading

rt.live...

originally posted by: Flesh699
MASK FACTS

Surgical masks are designed to protect patients from a surgeon’s respiratory droplets, aren’t effective at blocking particles smaller than 100 μm.

Filter efficiency was measured across a wide range of small particle sizes (0.02 to 1 µm) at 33 and 99 L/min.

N95 respirators had efficiencies greater than 95% (as expected).

T-shirts had 10% efficiency,

Scarves 10% to 20%,

Cloth masks 10% to 30%,

Sweatshirts 20% to 40%, and

Towels 40%.

All of the cloth masks and materials had near zero efficiency at 0.3 µm, a particle size that easily penetrates into the lungs.

Another study evaluated 44 masks, respirators, and other materials with similar methods and small aerosols (0.08 and 0.22 µm).

N95 FFR filter efficiency was greater than 95%.

Medical masks – 55% efficiency

General masks – 38% and

Handkerchiefs – 2% (one layer) to 13% (four layers) efficiency.

Conclusion: Wearing masks will not reduce SARS-CoV-2.

N95 masks protect health care workers, but are not recommended for source control transmission.

Surgical masks are better than cloth but not very efficient at preventing emissions from infected patients.

Cloth masks will be ineffective at preventing SARS-CoV-2 transmission, whether worn as source control or as personal protective equipment (PPE).

Ugh, why do you all keep spreading misinformation on purpose. You just cherrypicked your own link (with an obvious agenda). Why did you leave out the general sizes of respiratory particles that transmit covid? Kind of important.

Covid-19 is spread through respiratory droplets which the virus attaches itself to which are much larger than if it traveled on its own. This is particularly why masks are so effective. The numbers you pulled are in reference to smaller particles that were studied and decidedly NOT the main size of the particles that are transmitting the virus in close quarters. Those particles are large enough to be deterred by masks.

The cherrypicked single study you referenced...

Filter efficiency was measured across a wide range of small particle sizes (0.02 to 1 µm) at 33 and 99 L/min.

That's an incredibly narrow study particle size-wise. And only a study of the smallest of particles, also not the main size of the particles that are transmitting it in close quarters (larger particles) which are highly deterred by masks.

The massively wide range of sizes of particles that transmit covid-19 (from your link)...

Virus is transmitted through respiratory droplets produced when an infected person coughs, sneezes or talks. Larger respiratory droplets (>5 μm) remain in the air for only a short time and travel only short distances, generally less than 1 meter. They fall to the ground quickly.
Virus-laden small (less than 5 μm) aerosolized droplets can remain in the air for at least 3 hours and travel long distances.

That's a huge swath of particle sizes (that weren't in the study you referenced). Blocking the bulk of the larger droplets that are doing the bulk of the transmission is the idea. It isn't rocket science. Only in the USA (and Brazil - shocker) is this some sort of weird political issue. Using cherrypicked and junk science will not replace actual science.

a reply to: okrian

Cherry picked? That's from the Association of American Physicians and Surgeons.

Apparently facts are of political lean? Just doing my part in denying ignorance.

originally posted by: Flesh699
a reply to: okrian

Cherry picked? That's from the Association of American Physicians and Surgeons.

Apparently facts are of political lean? Just doing my part in denying ignorance.

Yep cherry picked

The AAPS is not a medical organisation

en.m.wikipedia.org...

"Just the facts Ma'am, just the facts."

Where is police detective Sergeant Joe Friday when you need him? I'm sure he'd tell me that he actually said, “All we want are the facts, ma’am”. The guy is a stickler for details.

originally posted by: ScepticScot

originally posted by: Flesh699
a reply to: okrian

Cherry picked? That's from the Association of American Physicians and Surgeons.

Apparently facts are of political lean? Just doing my part in denying ignorance.

Yep cherry picked

The AAPS is not a medical organisation

en.m.wikipedia.org...

Gonna have to do better than that. Those studies are cited.

www.youtube.com...

Africa Leader Finally Reject & Exposes Bill Gate Deadly Vaccine For Africa

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699
a reply to: okrian

Cherry picked? That's from the Association of American Physicians and Surgeons.

Apparently facts are of political lean? Just doing my part in denying ignorance.

Yep cherry picked

The AAPS is not a medical organisation

en.m.wikipedia.org...

Gonna have to do better than that. Those studies are cited.

If individual studies are cited is irrelevant to the interpretaion of the studies from a think tank that the poster erroneously seems to think are a medical organisation.

originally posted by: ScepticScot

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699
a reply to: okrian

Cherry picked? That's from the Association of American Physicians and Surgeons.

Apparently facts are of political lean? Just doing my part in denying ignorance.

Yep cherry picked

The AAPS is not a medical organisation

en.m.wikipedia.org...

Gonna have to do better than that. Those studies are cited.

If individual studies are cited is irrelevant to the interpretaion of the studies from a think tank that the poster erroneously seems to think are a medical organisation.

So you're saying that the cdc is now wrong? www.cdc.gov...
"Masks are not usually recommended in non-healthcare settings..." Notice that only patients with the INFECTION are required to wear masks as to not spread it. That's to catch droplets from mouth. Those particles can still be caught if you're wearing inappropriate PPE which is exactly what these mandates are about. They're forcing inappropriate masks that are proven through studies that they do not work.

And unfortunately for people like you citation is a big deal when it comes to research. Especially medical. One of your major grades in university curriculum is citation on research papers for a reason.

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699
a reply to: okrian

Cherry picked? That's from the Association of American Physicians and Surgeons.

Apparently facts are of political lean? Just doing my part in denying ignorance.

Yep cherry picked

The AAPS is not a medical organisation

en.m.wikipedia.org...

Gonna have to do better than that. Those studies are cited.

If individual studies are cited is irrelevant to the interpretaion of the studies from a think tank that the poster erroneously seems to think are a medical organisation.

So you're saying that the cdc is now wrong? www.cdc.gov...
"Masks are not usually recommended in non-healthcare settings..." Notice that only patients with the INFECTION are required to wear masks as to not spread it. That's to catch droplets from mouth. Those particles can still be caught if you're wearing inappropriate PPE which is exactly what these mandates are about. They're forcing inappropriate masks that are proven through studies that they do not work.

And unfortunately for people like you citation is a big deal when it comes to research. Especially medical. One of your major grades in university curriculum is citation on research papers for a reason.

Your link is for seasonal flu.

Would you like to try again?

originally posted by: ScepticScot

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699
a reply to: okrian

Cherry picked? That's from the Association of American Physicians and Surgeons.

Apparently facts are of political lean? Just doing my part in denying ignorance.

Yep cherry picked

The AAPS is not a medical organisation

en.m.wikipedia.org...

Gonna have to do better than that. Those studies are cited.

If individual studies are cited is irrelevant to the interpretaion of the studies from a think tank that the poster erroneously seems to think are a medical organisation.

So you're saying that the cdc is now wrong? www.cdc.gov...
"Masks are not usually recommended in non-healthcare settings..." Notice that only patients with the INFECTION are required to wear masks as to not spread it. That's to catch droplets from mouth. Those particles can still be caught if you're wearing inappropriate PPE which is exactly what these mandates are about. They're forcing inappropriate masks that are proven through studies that they do not work.

And unfortunately for people like you citation is a big deal when it comes to research. Especially medical. One of your major grades in university curriculum is citation on research papers for a reason.

Your link is for seasonal flu.

Would you like to try again?

Prove those citations wrong. The burden of proof is on you. Click each one, write notes, come back.

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699
a reply to: okrian

Cherry picked? That's from the Association of American Physicians and Surgeons.

Apparently facts are of political lean? Just doing my part in denying ignorance.

Yep cherry picked

The AAPS is not a medical organisation

en.m.wikipedia.org...

Gonna have to do better than that. Those studies are cited.

If individual studies are cited is irrelevant to the interpretaion of the studies from a think tank that the poster erroneously seems to think are a medical organisation.

So you're saying that the cdc is now wrong? www.cdc.gov...
"Masks are not usually recommended in non-healthcare settings..." Notice that only patients with the INFECTION are required to wear masks as to not spread it. That's to catch droplets from mouth. Those particles can still be caught if you're wearing inappropriate PPE which is exactly what these mandates are about. They're forcing inappropriate masks that are proven through studies that they do not work.

And unfortunately for people like you citation is a big deal when it comes to research. Especially medical. One of your major grades in university curriculum is citation on research papers for a reason.

Your link is for seasonal flu.

Would you like to try again?

Prove those citations wrong. The burden of proof is on you. Click each one, write notes, come back.

You also don't seem to.understand the burden of proof.

originally posted by: ScepticScot

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699
a reply to: okrian

Cherry picked? That's from the Association of American Physicians and Surgeons.

Apparently facts are of political lean? Just doing my part in denying ignorance.

Yep cherry picked

The AAPS is not a medical organisation

en.m.wikipedia.org...

Gonna have to do better than that. Those studies are cited.

If individual studies are cited is irrelevant to the interpretaion of the studies from a think tank that the poster erroneously seems to think are a medical organisation.

So you're saying that the cdc is now wrong? www.cdc.gov...
"Masks are not usually recommended in non-healthcare settings..." Notice that only patients with the INFECTION are required to wear masks as to not spread it. That's to catch droplets from mouth. Those particles can still be caught if you're wearing inappropriate PPE which is exactly what these mandates are about. They're forcing inappropriate masks that are proven through studies that they do not work.

And unfortunately for people like you citation is a big deal when it comes to research. Especially medical. One of your major grades in university curriculum is citation on research papers for a reason.

Your link is for seasonal flu.

Would you like to try again?

en.m.wikipedia.org...
The New England Journal of Medicine (NEJM) is a weekly medical journal published by the Massachusetts Medical Society. It is among the most prestigious peer-reviewed medical journals[1][2] as well as the oldest continuously published one.[1]

www.nejm.org...
"We know that wearing a mask outside health care facilities offers little, if any, protection from infection. Public health authorities define a significant exposure to Covid-19 as face-to-face contact within 6 feet with a patient with symptomatic Covid-19 that is sustained for at least a few minutes (and some say more than 10 minutes or even 30 minutes). The chance of catching Covid-19 from a passing interaction in a public space is therefore minimal. In many cases, the desire for widespread masking is a reflexive reaction to anxiety over the pandemic."

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699
a reply to: okrian

Cherry picked? That's from the Association of American Physicians and Surgeons.

Apparently facts are of political lean? Just doing my part in denying ignorance.

Yep cherry picked

The AAPS is not a medical organisation

en.m.wikipedia.org...

Gonna have to do better than that. Those studies are cited.

If individual studies are cited is irrelevant to the interpretaion of the studies from a think tank that the poster erroneously seems to think are a medical organisation.

So you're saying that the cdc is now wrong? www.cdc.gov...
"Masks are not usually recommended in non-healthcare settings..." Notice that only patients with the INFECTION are required to wear masks as to not spread it. That's to catch droplets from mouth. Those particles can still be caught if you're wearing inappropriate PPE which is exactly what these mandates are about. They're forcing inappropriate masks that are proven through studies that they do not work.

And unfortunately for people like you citation is a big deal when it comes to research. Especially medical. One of your major grades in university curriculum is citation on research papers for a reason.

Your link is for seasonal flu.

Would you like to try again?

en.m.wikipedia.org...
The New England Journal of Medicine (NEJM) is a weekly medical journal published by the Massachusetts Medical Society. It is among the most prestigious peer-reviewed medical journals[1][2] as well as the oldest continuously published one.[1]

www.nejm.org...
"We know that wearing a mask outside health care facilities offers little, if any, protection from infection. Public health authorities define a significant exposure to Covid-19 as face-to-face contact within 6 feet with a patient with symptomatic Covid-19 that is sustained for at least a few minutes (and some say more than 10 minutes or even 30 minutes). The chance of catching Covid-19 from a passing interaction in a public space is therefore minimal. In many cases, the desire for widespread masking is a reflexive reaction to anxiety over the pandemic."

You didn't read your own link did you.

Fact. States and hospitals are being paid tax dollars when reporting positive cases.
Not reallly much to debate.

originally posted by: AceWombat04
So either one accepts that covid-19 caused this spike in deaths, or one must posit some other novel cause of death increase, serendipitously coinciding with the pandemic surge.

I posit the government response to COVID caused that death increase. Most major cities shut their non-emergency/Non-COVID medical care off entirely for March, April, well into May. How many people had untreated, but normally treatable, illnesses and died from those during that time frame purely because their medical facilities were closed, they did not think they should go to the ER for it until it was literally too late, or they were petrified of going to a doctor thanks to the fear mongering the media and their adherents were parroting at that time? The effects of that shutdown persist to today as well, as medical facilities have seen a massive backlog of patients who were forced to kick the can down the road on top of the usual care the facilities are rendering now that they are mostly re-opened.

Decisions have consequences and, frankly, I think the mask issue is a careful ruse the powers that be came up with to take heat off of their own fumbling of this with the shutdowns, lockdowns, and continued malfeasance and perpetual fear mongering. Those woke enough to see the masks are pointless exercises in virtue signaling weren't going to stop being pissed at the leaders who screwed us all... so there was no risk of angering that segment of society by passing mask mandates, BUT those still snoozing, those who actually still believe this wasn't all carefully manufactured and manipulated by state, local, and global governments see the mask mandates as "OMG, finally SOMETHING WE MUST DO!!!" and, as people are prone to do, they bought it whole hog. So now the villains in their minds aren't the governments that screwed us all, but anyone who dares question the actions, embrace the ideology of personal freedoms, or otherwise behave like free thinking individuals where COVID is concerned. They found their scapegoats: Americans who don't wear masks and don't support killing every significant ideal in America along with our economy, in the name of fighting an invisible enemy that, if it is as bad ass as we are trying to be manipulated into believing it is, isn't fightable anyway.

originally posted by: ScepticScot

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699
a reply to: okrian

Cherry picked? That's from the Association of American Physicians and Surgeons.

Apparently facts are of political lean? Just doing my part in denying ignorance.

Yep cherry picked

The AAPS is not a medical organisation

en.m.wikipedia.org...

Gonna have to do better than that. Those studies are cited.

If individual studies are cited is irrelevant to the interpretaion of the studies from a think tank that the poster erroneously seems to think are a medical organisation.

So you're saying that the cdc is now wrong? www.cdc.gov...
"Masks are not usually recommended in non-healthcare settings..." Notice that only patients with the INFECTION are required to wear masks as to not spread it. That's to catch droplets from mouth. Those particles can still be caught if you're wearing inappropriate PPE which is exactly what these mandates are about. They're forcing inappropriate masks that are proven through studies that they do not work.

And unfortunately for people like you citation is a big deal when it comes to research. Especially medical. One of your major grades in university curriculum is citation on research papers for a reason.

Your link is for seasonal flu.

Would you like to try again?

en.m.wikipedia.org...
The New England Journal of Medicine (NEJM) is a weekly medical journal published by the Massachusetts Medical Society. It is among the most prestigious peer-reviewed medical journals[1][2] as well as the oldest continuously published one.[1]

www.nejm.org...
"We know that wearing a mask outside health care facilities offers little, if any, protection from infection. Public health authorities define a significant exposure to Covid-19 as face-to-face contact within 6 feet with a patient with symptomatic Covid-19 that is sustained for at least a few minutes (and some say more than 10 minutes or even 30 minutes). The chance of catching Covid-19 from a passing interaction in a public space is therefore minimal. In many cases, the desire for widespread masking is a reflexive reaction to anxiety over the pandemic."

You didn't read your own link did you.

You need to dispute citations. Every one wants to push masks on others but when others say "No why?" people like you give nothing to counter other than talking points you heard on TV. Or "OMG that's a conservative think tank!" Or "you didn't read your own link?"
Why should anyone take a left or right leaning "think tank" as the word of divine knowledge? Also, you cannot use wikipedia in any official capacity in research papers, it'll be rejected for good reason.

"...It is also clear that masks serve symbolic roles. Masks are not only tools, they are also talismans that may help increase health care workers’ perceived sense of safety, well-being, and trust in their hospitals. Although such reactions may not be strictly logical, we are all subject to fear and anxiety, especially during times of crisis. One might argue that fear and anxiety are better countered with data and education than with a marginally beneficial mask, particularly in light of the worldwide mask shortage, but it is difficult to get clinicians to hear this message in the heat of the current crisis. Expanded masking protocols’ greatest contribution may be to reduce the transmission of anxiety, over and above whatever role they may play in reducing transmission of Covid-19. The potential value of universal masking in giving health care workers the confidence to absorb and implement the more foundational infection-prevention practices described above may be its greatest contribution. ..."

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699

originally posted by: ScepticScot

originally posted by: Flesh699
a reply to: okrian

Cherry picked? That's from the Association of American Physicians and Surgeons.

Apparently facts are of political lean? Just doing my part in denying ignorance.

Yep cherry picked

The AAPS is not a medical organisation

en.m.wikipedia.org...

Gonna have to do better than that. Those studies are cited.

If individual studies are cited is irrelevant to the interpretaion of the studies from a think tank that the poster erroneously seems to think are a medical organisation.

So you're saying that the cdc is now wrong? www.cdc.gov...
"Masks are not usually recommended in non-healthcare settings..." Notice that only patients with the INFECTION are required to wear masks as to not spread it. That's to catch droplets from mouth. Those particles can still be caught if you're wearing inappropriate PPE which is exactly what these mandates are about. They're forcing inappropriate masks that are proven through studies that they do not work.

And unfortunately for people like you citation is a big deal when it comes to research. Especially medical. One of your major grades in university curriculum is citation on research papers for a reason.

Your link is for seasonal flu.

Would you like to try again?

en.m.wikipedia.org...
The New England Journal of Medicine (NEJM) is a weekly medical journal published by the Massachusetts Medical Society. It is among the most prestigious peer-reviewed medical journals[1][2] as well as the oldest continuously published one.[1]

www.nejm.org...
"We know that wearing a mask outside health care facilities offers little, if any, protection from infection. Public health authorities define a significant exposure to Covid-19 as face-to-face contact within 6 feet with a patient with symptomatic Covid-19 that is sustained for at least a few minutes (and some say more than 10 minutes or even 30 minutes). The chance of catching Covid-19 from a passing interaction in a public space is therefore minimal. In many cases, the desire for widespread masking is a reflexive reaction to anxiety over the pandemic."

You didn't read your own link did you.

You need to dispute citations. Every one wants to push masks on others but when others say "No why?" people like you give nothing to counter other than talking points you heard on TV. Or "OMG that's a conservative think tank!" Or "you didn't read your own link?"
Why should anyone take a left or right leaning "think tank" as the word of divine knowledge? Also, you cannot use wikipedia in any official capacity in research papers, it'll be rejected for good reason.

"...It is also clear that masks serve symbolic roles. Masks are not only tools, they are also talismans that may help increase health care workers’ perceived sense of safety, well-being, and trust in their hospitals. Although such reactions may not be strictly logical, we are all subject to fear and anxiety, especially during times of crisis. One might argue that fear and anxiety are better countered with data and education than with a marginally beneficial mask, particularly in light of the worldwide mask shortage, but it is difficult to get clinicians to hear this message in the heat of the current crisis. Expanded masking protocols’ greatest contribution may be to reduce the transmission of anxiety, over and above whatever role they may play in reducing transmission of Covid-19. The potential value of universal masking in giving health care workers the confidence to absorb and implement the more foundational infection-prevention practices described above may be its greatest contribution. ..."

You are the one using a political think tank as a source.

The article from NEJM lists a number of positives of wearing masks and does not support your position

Not going to respond to individuals or anecdotes, but will respond to broader points.

Hospitals do not receive federal funding for fabricated or inflated covid-19 patient numbers

It is true that the CARES Act pays an additional 20% over existing Medicare rates for the duration of the declared public health emergency. That is simply a fact, and was established consequent to the perceived need to support the care of covid-19 patients and reduce the burden on facilities in anticipation of potential large surges.
Source

However, it must be understood what these "funds" actually are and how criteria are established for the claims they are reimbursing on. This requires an understanding of how Medicare claims and reimbursements actually work and how medical necessity for services rendered are documented.

The "federal funds" hospitals receive "for covid-19 patients" are, like all Medicare payments of this kind, reimbursements for services rendered. And all services, materials, etc. must be documented and establish real medical necessity, which also must be documented. Hospitals can't simply tick a box somewhere that says "covid-19," and somehow automatically receive Medicare reimbursements. It also only applies to Medicare patients... which not all covid patients are.
Source

The sizes of the actual payments are predicated upon what services are provided, how long patients stay, etc. How claims are reimbursed is also not uniform across the medical system or the country. Some hospitals get paid based on DRG, some are not. Severity and nature of illness also affects payment. E.g. there are different medical problems coded for and reimbursed for treatment of related to covid-19, not just a generic "covid-19 payment." Stemi pays more than dehydration, etc. Medicare also adapts payment amount based on geographic location, local rates and costs, etc. It is far from uniform or simple. Nor is it automatic. It's a complex system.
Source

It is illegal to report a diagnosis or suspected diagnosis on a claim which is not documented by a physician based on clear criteria being met. There are specific, documented diagnostic codes used to establish the presence of covid-19 or suspected covid-19 for the purposes of claims. To do otherwise would constitute insurance fraud.

The OIG as well as state governments who license hospitals take these matters very, very seriously. Hospitals can be, and have been, shut down for such actions. Arrests can be made. This is not something that could simply be swept under the rug and gotten away with if it were happening.
Source

Are there possible exceptions and examples of corruption or serious blunders? Absolutely, as in any complex system employing hundreds of thousands of people. There's even a task force that deals with fraud schemes. But that is not the norm or representative of what is happening throughout the broader systemic pandemic dynamics, which is what the data and studies being conveyed by this topic address.

As Medicare themselves stated, "Claims with inaccurate diagnosis or DRG would be subject to recoupment and/or other potential civil or criminal charges for false claims." And people need to understand that that is always the case, not just for covid-19 patients. False or inaccurate filings are taken very, very seriously, and are a financial risk - not benefit - to hospitals and medical institutions. Source

For the same reasons, patients are not being unnecessarily vented for profit

Medical necessity must be established for patients receiving critical care (including invasive/mechanical ventilators) in the intensive care setting. In order for the claim to be valid in Medicare's eyes, that medical necessity has to be supported through documentation. Without establishment and documentation of that medical necessity, claims are denied.

The criteria that need to be met are:

"... A critical illness or injury acutely impairs one or more vital organ systems such that there is high probability of imminent or life-threatening deterioration in the patient’s condition. Critical care involves high complexity decision making to assess, manipulate, and support vital system s) to treat single or multiple vital organ system failure and/or to prevent further life-threatening deterioration of the patient’s condition.”

"Patient must be critically ill or injured
One or more vital organ systems must be acutely impaired with high probability of imminent or life-threatening deterioration
Prevention of further life-threatening deterioration must be done"

Source
Source

In addition to the claim being denied, failure to support medical necessity would be malpractice and fraud, and the ordering physician would be subject to lawsuits, disciplinary action by the medical licensing board, and criminal charges.

Another overlooked factor by those unfamiliar with the medical setting where all of this happens, is that there are respiratory therapists who manage the vents who are also licensed. They too would be subject to such action potentially if this was happening as alleged.

These things do not happen in a vacuum, with no oversight, documentation, and criteria. Mechanical vents are a limited resource. They are very carefully managed, and engaging in the sorts of malpractice being alleged would not benefit individual physicians, respiratory therapists, or hospitals in any way, shape, or form.

What is happening, is a reassessment of when a vent is actually necessary. People need to understand that SARS-CoV-2 is called a novel coronavirus for a reason. It is entirely new in the experience and history of medicine, and is requiring dramatic, on the fly, rapid learning and adaptation as we learn more and more about it. Venting early in the pandemic was a reasonable and evidence-based response to patients experiencing respiratory failure or other impediments to natural breathing, and it remains so for many patients. But we are now beginning to reassess that as our knowledge grows.
See for example: www.statnews.com...

Even as early as April that reassessment was ongoing.

This is not evidence of some malicious conspiracy to increase vent use. It is, as my opening post explained, an example of evolution and adaptation in response to greater experience with treating the virus.

(Continued...)

Reiterating an earlier point: There is a difference between data and policy and this applies to hospital administration as well

None of the above is to deny that it is at least plausible that some unscrupulous hospital administrators may create an environment conducive to more citations of cases than would ordinarily be established, in order to avail themselves of this additional Medicare reimbursement rate. This would be a policy implementation. However, data and policy are not the same thing.

What needs to be understood - again - is that this does not eliminate the need to establish medical necessity, to document suspected or confirmed cases via specific criteria, and to properly file claims. Even if more cases are being cited in claims filed, and even if, hypothetically, this is in response to some unscrupulous administrator's policy implementation, there is no financial incentive to file false claims. Even considering the 20% Medicare reimbursement enhancement.

Again, claims require supporting documentation by physicians. They are legal documents. Failure to provide such is, again, insurance fraud, potentially malpractice, and places the care provider and the hospital at enormous financial and even criminal risk.

And finally...

Cases and deaths were happening prior to the passage of the CARES Act, and declined after its passage.

Confirmed covid-19 cases increased daily from March 13 2020 (532 confirmed cases a day) to March 26 2020 (16,858 confirmed cases a day.) Daily deaths followed suit during the same period. Both cases and daily deaths continued to increase for some time after passage of the CARES Act (March 27.)

Then they began to decline in late April. Between April 24 and May 26th, daily confirmed cases declined from 37,437 to 19,282. (A 48% decrease.) Deaths declined from 2,024 to 605 a day (a 70% decrease) between the same dates.

Source

This simply does not support the allegation that positive cases and deaths are being artificially inflated in order to benefit from the CARES Act reimbursement enhancement.

Cases subsequently plateaued, while deaths continued to decline due to patients skewing younger, better therapeutic interventions, and general care approaches improving. Cases then began to rise again. Deaths continued to decline until this week or last, when they began to creep upwards again.



Source
Side note: appreciate also the increase in hospitalizations associated with this second surge shown above. This isn't something that can be fabricated, either. Patients are either present or not. And whether or not a hospital receives reimbursement from Medicare or not is contingent, again, upon specific criteria being met, and medical necessity being supported.

Now moving on to epidemiology points raised:

Masks work (Take 2)

Again, watch this discussion of new research by epidemiologists (already posted in the opening post, reposting) from 30 minutes on:
www.youtube.com...

Perfect protection does not exist. The goal is reduction and mitigation, not elimination.

Yes, the physical reality of droplet and aerosol transmission and how different masks affect them are well understood. Yes, N95 masks are vastly superior... but again, perfect protection does not exist. The goal is reduction. Systemic analysis of existing literature still supports mask use.

Transmission of viruses was lower with physical distancing of 1 m or more, compared with a distance of less than 1 m (n=10 736, pooled adjusted odds ratio [aOR] 0·18, 95% CI 0·09 to 0·38; risk difference [RD] −10·2%, 95% CI −11·5 to −7·5; moderate certainty); protection was increased as distance was lengthened (change in relative risk [RR] 2·02 per m; pinteraction=0·041; moderate certainty). Face mask use could result in a large reduction in risk of infection (n=2647; aOR 0·15, 95% CI 0·07 to 0·34, RD −14·3%, −15·9 to −10·7; low certainty), with stronger associations with N95 or similar respirators compared with disposable surgical masks or similar (eg, reusable 12–16-layer cotton masks; pinteraction=0·090; posterior probability >95%, low certainty). Eye protection also was associated with less infection (n=3713; aOR 0·22, 95% CI 0·12 to 0·39, RD −10·6%, 95% CI −12·5 to −7·7; low certainty). Unadjusted studies and subgroup and sensitivity analyses showed similar findings.

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A specific case study in the real world:

Absence of Apparent Transmission of SARS-CoV-2 from Two Stylists After Exposure at a Hair Salon with a Universal Face Covering Policy

A good expert discussion of these dynamics, watch from 3 minutes on:
www.youtube.com...

A combination of distancing, masks, and other mitigating precautions obviously is best. Nevertheless...

CDC calls on Americans to wear masks to prevent COVID-19 spread

“The concept is risk reduction rather than absolute prevention,” said Chin-Hong. “You don’t throw up your hands if you think a mask is not 100 percent effective. That’s silly. Nobody’s taking a cholesterol medicine because they’re going to prevent a heart attack 100 percent of the time, but you’re reducing your risk substantially.”

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Peace.