Coronavirus and Walt Disney World general discussion

[MisterPenguin]

I don't see what is wrong with not counting positive tests twice over in the the daily count. For example, if I test positive Monday, and then go get tested Friday, the other methods would count me as a positive case twice. If anything, that inflates numbers in a way to me. I am not two separate people who contracted the virus.

The different ways to measure positivity give you different slices of information. It's good and honest and transparent to put out all three. So far, all three have pretty much agreed on the overall trends (see chart above).

It's disingenuous to switch to the one that fits one's narrative best and claim it's the right one and ignore the other methods.

And, as I've said several times: positivity can misleading if you're only testing the people who chose to get tested. A large number of people worried about having COVID but having no symptoms will drive positivity down. OTOH, if the vast majority of people getting tested are doing so because they have symptoms, then the rate shoots up.

Only randomized sampling will give a true snapshot. (And before anyone asks, you entice the people you're targeting with a reward or some type of coupon since it's voluntary to get tested.)

 

[SamusAranX]

The different ways to measure positivity give you different slices of information. It's good and honest and transparent to put out all three. So far, all three have pretty much agreed on the overall trends (see chart above).

It's disingenuous to switch to the one that fits one's narrative best and claim it's the right one and ignore the other methods.

And, as I've said several times: positivity can misleading if you're only testing the people who chose to get tested. A large number of people worried about having COVID but having no symptoms will drive positivity down. OTOH, if the vast majority of people getting tested are doing so because they have symptoms, then the rate shoots up.

Only randomized sampling will give a true snapshot. (And before anyone asks, you entice the people you're targeting with a reward or some type of coupon since it's voluntary to get tested.)

I am definitely in favor of randomized testing, OR, rapid onsite testing to resume some events (i.e. even limited capacity football games should be doing this; yes they are "distanced" and masks are required, but if they rapid tested for admittance, they could make more money by letting more in).

I really like what TIA is doing; you can pay a reduced cost to get onsite, rapid tested, even up to 48 hours after your flight. This will allow you to avoid quarantine and improve traveling. Why all airlines and municipalities who are economically dependent on tourists aren't looking into this, I do not know.

 

[GoofGoof]

https://fee.org/articles/physicians...st-covid-19-on-death-certificates-here-s-why/

Also, I guess this is proof to some extent? First question asked - https://www.doh.wa.gov/Portals/1/Do...rtDeathsReCOVID.pdf?ver=2020-06-17-151822-090 - This was updated in June - "Until now, we counted all people who died that tested positive for COVID-19."

Even if someone had "facts" proving a hospital inflated their numbers, it still wouldn't prove all hospitals or most hospitals are doing it. You're essentially telling someone to prove via facts the unprovable in order to back up an opinion (claim). There is supporting evidence (linked above) for their claim though.

I don't know what to think, maybe some are inflating, maybe their not. Some hospitals that are in bad shape financially may be gaming the system to get additional funds. That is the only reason I can think that some facilities would artificially raise their numbers. Blind faith in any institution or government or organization is usually not a good idea.

I don’t doubt that hospital executives would prefer a case to be labeled Covid vs not to get paid more money, that economic incentive is absolutely real. Where I am skeptical is that doctors just go along with this blindly with no personal benefit. I’m not risking my medical license because some administrator tells me to sign off on something that isn’t true.

As far as the first attached article the first paragraph also makes me skeptical:
“When Drs. Dan Erickson and Dr. Artin Massihi of Accelerated Urgent Care held a press conference last week, their goal was to galvanize policymakers to reopen the economy.”
So these 2 guys held a press conference with the agenda of pushing policy makers to reopen the economy. Obviously if Covid cases are way over stated that would be a major piece of support for a policy change to reopening faster.

The article goes on to say:
“Dr. Erickson noted he has spoken to numerous physicians who say they are being pressured to add COVID-19 to death certificates and diagnostic lists—even when the novel coronavirus appears to have no relation to the victim’s cause of death.“
So the doctor isn’t saying he’s personally being pressured to do anything, he’s just talked to other doctors who were. Again, a bit of a red flag to me. I can say I talked to other people about anything without any evidence especially when it helps support my narrative.

I have no idea if these doctors are being honest or just telling stories to support their agenda. I would be a lot more compelled to believe the story if it came from a doctor who was blowing the whistle on their own hospital for doing something like this. There may be some doctors who would blindly go along with it, but a lot would have an objection and many would likely push back. If this was a widespread problem I believe there would be numerous whistleblower stories out there. Again, just some food for thought on stories like this.

 

[JoeCamel]

I am definitely in favor of randomized testing, OR, rapid onsite testing to resume some events (i.e. even limited capacity football games should be doing this; yes they are "distanced" and masks are required, but if they rapid tested for admittance, they could make more money by letting more in).

I really like what TIA is doing; you can pay a reduced cost to get onsite, rapid tested, even up to 48 hours after your flight. This will allow you to avoid quarantine and improve traveling. Why all airlines and municipalities who are economically dependent on tourists aren't looking into this, I do not know.

The answer to your question is in this paragraph from the airport website

"Testing services will be offered on a walk-in basis from Thursday, October 1st to October 31st, seven days a week from 8 a.m. until 2 p.m. The pilot will be open to all ticketed passengers who are flying or have flown within three days and can show proof of travel. The PCR COVID-19 test costs $125 and the antigen test costs $57."

If you want to pay for it fine but no way they can pay for it.

TPA launches first in the nation COVID-19 testing for all departing and arriving passengers

Editor's Note: The TPA COVID-19 testing site closed operations on May 7, 2021. Visit the Florida Dept. of Health for testing locations and availability.Tampa International Airport, in partnership with BayCare Health System, announced the launch of the country’s first airport testing pilot that...

news.tampaairport.com

 

[MisterPenguin]

"Testing services will be offered on a walk-in basis from Thursday, October 1st to October 31st, seven days a week from 8 a.m. until 2 p.m. The pilot will be open to all ticketed passengers who are flying or have flown within three days and can show proof of travel. The PCR COVID-19 test costs $125 and the antigen test costs $57."

That poor pilot who has to test everyone!!

 

[Heppenheimer]

I am definitely in favor of randomized testing, OR, rapid onsite testing to resume some events (i.e. even limited capacity football games should be doing this; yes they are "distanced" and masks are required, but if they rapid tested for admittance, they could make more money by letting more in).

I really like what TIA is doing; you can pay a reduced cost to get onsite, rapid tested, even up to 48 hours after your flight. This will allow you to avoid quarantine and improve traveling. Why all airlines and municipalities who are economically dependent on tourists aren't looking into this, I do not know.

One problem with the rapid tests, though. If you don't have symptoms, the sensitivity sucks.

 

[SamusAranX]

One problem with the rapid tests, though. If you don't have symptoms, the sensitivity sucks.

If only we could get this one:

Rapid 90-minute COVID-19 test shown to be highly accurate

A 90-minute COVID-19 test has been shown to have over 94 percent sensitivity, and 100 percent specificity in a new study.

medicalxpress.com

my point was this; these multibillion dollar airlines, sports franchises, etc. should be looking into options like the link above. This could allow them to resume more travel and sales, but only to a certain limit of course; a significant subset of people will not be traveling because of anxiety over COVID. Maybe onsite testing will alleviate that for some, who knows. But the airlines, sports leagues, concert venues, etc. can't cry "poor" if there potential solutions out there and they aren't even trying.

 

[SamusAranX]

The answer to your question is in this paragraph from the airport website

"Testing services will be offered on a walk-in basis from Thursday, October 1st to October 31st, seven days a week from 8 a.m. until 2 p.m. The pilot will be open to all ticketed passengers who are flying or have flown within three days and can show proof of travel. The PCR COVID-19 test costs $125 and the antigen test costs $57."

If you want to pay for it fine but no way they can pay for it.

TPA launches first in the nation COVID-19 testing for all departing and arriving passengers

Editor's Note: The TPA COVID-19 testing site closed operations on May 7, 2021. Visit the Florida Dept. of Health for testing locations and availability.Tampa International Airport, in partnership with BayCare Health System, announced the launch of the country’s first airport testing pilot that...

news.tampaairport.com

I did note in my my post you still have to pay a reduced cost; I know the PCR test costs more then $125, so the tests are definitely being subsidized some.

 

[Parker in NYC]

That poor pilot who has to test everyone!!

But what if the pilot ate the fish?!

I just posted this GIF because "nun on a surfboard" is forever.

 

[SamusAranX]

But what if the pilot ate the fish?!

I just posted this GIF because "nun on a surfboard" is forever.

I still die laughing at that part every time I watch

 

[SorcererMC]

I don’t doubt that hospital executives would prefer a case to be labeled Covid vs not to get paid more money, that economic incentive is absolutely real. Where I am skeptical is that doctors just go along with this blindly with no personal benefit. I’m not risking my medical license because some administrator tells me to sign off on something that isn’t true.

As far as the first attached article the first paragraph also makes me skeptical:
“When Drs. Dan Erickson and Dr. Artin Massihi of Accelerated Urgent Care held a press conference last week, their goal was to galvanize policymakers to reopen the economy.”
So these 2 guys held a press conference with the agenda of pushing policy makers to reopen the economy. Obviously if Covid cases are way over stated that would be a major piece of support for a policy change to reopening faster.

The article goes on to say:
“Dr. Erickson noted he has spoken to numerous physicians who say they are being pressured to add COVID-19 to death certificates and diagnostic lists—even when the novel coronavirus appears to have no relation to the victim’s cause of death.“
So the doctor isn’t saying he’s personally being pressured to do anything, he’s just talked to other doctors who were. Again, a bit of a red flag to me. I can say I talked to other people about anything without any evidence especially when it helps support my narrative.

I have no idea if these doctors are being honest or just telling stories to support their agenda. I would be a lot more compelled to believe the story if it came from a doctor who was blowing the whistle on their own hospital for doing something like this. There may be some doctors who would blindly go along with it, but a lot would have an objection and many would likely push back. If this was a widespread problem I believe there would be numerous whistleblower stories out there. Again, just some food for thought on stories like this.

FYI on Erickson and Massihi.

ACEP-AAEM Joint Statement on Physician Misinformation

The American College of Emergency Physicians (ACEP) and the American Academy of Emergency Medicine (AAEM) jointly and emphatically condemn the recent opinions released by Dr. Daniel Erickson and Dr. Artin Massihi. These reckless and untested musings do not speak for medical societies and are...

www.acep.org

 

[DC0703]

https://fee.org/articles/physicians...st-covid-19-on-death-certificates-here-s-why/

Also, I guess this is proof to some extent? First question asked - https://www.doh.wa.gov/Portals/1/Do...rtDeathsReCOVID.pdf?ver=2020-06-17-151822-090 - This was updated in June - "Until now, we counted all people who died that tested positive for COVID-19."

Even if someone had "facts" proving a hospital inflated their numbers, it still wouldn't prove all hospitals or most hospitals are doing it. You're essentially telling someone to prove via facts the unprovable in order to back up an opinion (claim). There is supporting evidence (linked above) for their claim though.

I don't know what to think, maybe some are inflating, maybe their not. Some hospitals that are in bad shape financially may be gaming the system to get additional funds. That is the only reason I can think that some facilities would artificially raise their numbers. Blind faith in any institution or government or organization is usually not a good idea.

These doctors have been widely debunked for their claims. They gave some interviews in the spring that used all kinds of dubious math based on anecdotal evidence to imply that almost nobody dies of COVID and this was grounds to open up the economy without any restrictions. They have largely spread conspiracy theories.

Erickson was also part of the notorious (and later banned) viral video of "America's Frontline Doctors" which spread over the summer, which was famously led by the female doctor with crazy theories about alien/demon DNA.

These men are not a valid source of information.

Regarding the inflated hospital numbers, I have yet to see any hard evidence of this. I have seen various iterations of this theory debunked repeatedly over the last few months and the main source of information on this claim is usually social media, often with posts that state "A friend of friend works in a hospital and says..."

 

[DisneyCane]

That is a standard response when someone can't provide evidence to back up a claim. If you cannot provide facts to back your opinion, then please stop posting it.

I can tell you for a fact that it is in the financial best interest of any hospital to treat a COVID patient. If somebody is in the hospital for any issue but tests positive for COVID they will 100% be "treated for COVID" even if they have no symptoms. If they die, no matter what the reason, COVID will be listed among the causes of death. Between the agreements the insurance companies made to reimburse COVID treatment and the giant pile of government money for people without private insurance, it would be incompetent for them not to do this.

There seems to be a perception that everybody who dies gets an autopsy and the medical examiner or coroner (depending on jurisdiction) is actually making a determination that COVID caused a death. That's not the reality. The vast majority of death certificates are filled out based on the medical records if somebody died in a hospital.

 

[DisneyCane]

This one is simple, they'll just ask you.

For example, doesn't WDW already ask if someone has a fever, is sick, or had a recent COVID exposure?

I went to the dentist recently, and they asked a litany of screening questions. It's easy to see them adding one more. This will just become more common at more businesses. Like signing the liability waiver at an adventure park.

With no proof required, a better question might be, what's the recourse when someone just lies?

The answer to that question probably has more to do with liability suits, and insurance cost and availability.

When you check in for a flight (at least on Southwest and American which I have flown recently), the app (or website) makes you state that you haven't had any COVID-like symptoms yet I have heard people on flights with a cough. They may not have COVID but they certainly lied about not having COVID-like symptoms.

 

[Heppenheimer]

I can tell you for a fact that it is in the financial best interest of any hospital to treat a COVID patient. If somebody is in the hospital for any issue but tests positive for COVID they will 100% be "treated for COVID" even if they have no symptoms. If they die, no matter what the reason, COVID will be listed among the causes of death. Between the agreements the insurance companies made to reimburse COVID treatment and the giant pile of government money for people without private insurance, it would be incompetent for them not to do this.

There seems to be a perception that everybody who dies gets an autopsy and the medical examiner or coroner (depending on jurisdiction) is actually making a determination that COVID caused a death. That's not the reality. The vast majority of death certificates are filled out based on the medical records if somebody died in a hospital.

Oh, stop this nonsense. The death certificate is almost always filled out by the attending physician, the one who knows the case best. In every state where I have worked, there is a final box you must check where you certify that what you have written is accurate to the best of your knowledge, and that you are aware of the potential penalties for deliberately falsifying the medical record. There simply is no incentive for an attending physician, who is already well-compensated either by their hospital employer, or by the insurance company if they work as an indenpendent with admitting privileges, to risk their license or being kicked off an insurance plan, if they are found to have falsified the record. Because guess what? Medicare, medicaid, and most commercial insurance companies will conduct an audit if they think something fishy is going on.

It is the best financial interest of any hospital to consistently have no COVID patients, because then they can resume the elective procedures and services that really pay the bills.

 

[DisneyCane]

The different ways to measure positivity give you different slices of information. It's good and honest and transparent to put out all three. So far, all three have pretty much agreed on the overall trends (see chart above).

It's disingenuous to switch to the one that fits one's narrative best and claim it's the right one and ignore the other methods.

And, as I've said several times: positivity can misleading if you're only testing the people who chose to get tested. A large number of people worried about having COVID but having no symptoms will drive positivity down. OTOH, if the vast majority of people getting tested are doing so because they have symptoms, then the rate shoots up.

Only randomized sampling will give a true snapshot. (And before anyone asks, you entice the people you're targeting with a reward or some type of coupon since it's voluntary to get tested.)

In my opinion, the only useful information gained by the percentage of positive tests is to ensure that you have enough testing capacity. Without random sampling it doesn't really provide that accurate a picture of community spread on its own.

For example, Miami-Dade County has a new case positivity around 5% on average the past two weeks. The University of Miami which is located in the heart of Miami-Dade County requires all people that step onto campus to be tested once every two weeks. For the 30 days ending 10/14 when this policy was put into place, the positivity has been 0.74%. The latter is overall not specifically new case.

The data from the University of Miami testing is a much better approximation of disease prevalence and is much more valuable to determine the trends, especially looking at week over week type numbers. I guess since they require once every two week testing the best comparison would be two week periods. The last two 14 day periods in this data were 0.68% and 0.62%. This seems to indicate that the rate of spread hasn't really changed in the past month.

 

[DisneyCane]

Oh, stop this nonsense. The death certificate is almost always filled out by the attending physician, the one who knows the case best. In every state where I have worked, there is a final box you must check where you certify that what you have written is accurate to the best of your knowledge, and that you are aware of the potential penalties for deliberately falsifying the medical record. There simply is no incentive for an attending physician, who is already well-compensated either by their hospital employer, or by the insurance company if they work as an indenpendent with admitting privileges, to risk their license or being kicked off an insurance plan, if they are found to have falsified the record. Because guess what? Medicare, medicaid, and most commercial insurance companies will conduct an audit if they think something fishy is going on.

It is the best financial interest of any hospital to consistently have no COVID patients, because then they can resume the elective procedures and services that really pay the bills.

There is no falsification. They will note that the patient was COVID positive which is a fact.

 

[Heppenheimer]

There is no falsification. They will note that the patient was COVID positive which is a fact.

No, you said that if they "tested positive for COVID", it will be listed on the certificate as contributing to the death, no matter if that is true or not. Unless someone is knowingly commiting fraud with the medical record, that is not going to happen.

 

[The Mom]

I can tell you for a fact that it is in the financial best interest of any hospital to treat a COVID patient. If somebody is in the hospital for any issue but tests positive for COVID they will 100% be "treated for COVID" even if they have no symptoms. If they die, no matter what the reason, COVID will be listed among the causes of death. Between the agreements the insurance companies made to reimburse COVID treatment and the giant pile of government money for people without private insurance, it would be incompetent for them not to do this.

There seems to be a perception that everybody who dies gets an autopsy and the medical examiner or coroner (depending on jurisdiction) is actually making a determination that COVID caused a death. That's not the reality. The vast majority of death certificates are filled out based on the medical records if somebody died in a hospital.

I understand all of this. I just don't see it as a "Let's treat all patients as Covid patients because we'll get paid more" versus "If a patient with any condition tests positive for Covid we are going to assume - and list it - as contributing to their treatment and/or death." To ignore someone's Covid status in a treatment plan could be considered malpractice.

The question also becomes, "Would this person be here (hospitalized) if not for Covid? If the answer is no, then it is Covid related.

Even if that treatment only involves PPE and testing- which would not be the case prior to the pandemic -the supplies/tests themselves add to the cost of treatment.

A death certificate can list multiple medical issues that are not directly related to death, but just exist at the time of death. And the DOH needs to know the number of verified Covid cases in their jurisdiction.

 

[DCBaker]