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We have less than a fifth of California's population, but more than 1 1/2 times as many coronavirus deaths

Daily Covid-19 deaths for MA, CA

Daily Covid-19 deaths in Mass. (red) and Calif. (blue)

Maybe because we haven't had the sort of hospital crisis New York did, it's a bit easier to not realize just how bad Covid-19 really is in Massachusetts. But the state Department of Public Health reported today that we have now had 3,153 residents die from the virus - compared to 1,809 in California, a state with five times our population.

Today's stats show that Massachusetts has 1,005 patients on ventilators - the sickest of the sick - compared to 1,181 in California.

Part of that might be because of the state of our nursing homes. At a press briefing yesterday, Baker said that many Massachusetts nursing homes were older facilities grandfathered from regulations regarding such things as how many residents can be in a room, making explosive growth in Covid-19 cases easier among the state's most vulnerable population - people above retirement age with serious underlying health conditions.

Yesterday, Baker said 56% of the state's Covid-19 deaths were among residents in nursing homes and other long-term care facilities, making Massachusetts a hotspot for such deaths. Today's figures show the percentage is closer to 63%.

But are there other factors at work?

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Comments

Could another reason be that we ended up with a lot of community spread due to the Biogen conference before we got serious with the distancing and other practices to reduce the chance of exposure?

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Biogen was a canary in the coal mine that it was already out of control. Circulating for weeks before that.

So interesting how the most cases are not concentrated in the biggest city (unlike NY). Again speaks to the devastation wrought in nursing homes which are generally in the suburbs.

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IMAGE(https://i.imgur.com/b0FFNkh.jpg)
Look at Franklin. 33 total deaths but high (46) rate. Nursing home clusters, I'd suspect. Worcester, for a fairly large city is fairly low.

I read somewhere that if you remove the NYC area, the rest of the country, compared to the rest of the world, looks pretty good.

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How about if you remove Wuhan's numbers, does the rest of China look good?

I read somewhere that if you remove the NYC area, the rest of the country, compared to the rest of the world, looks pretty good.

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Also see Hampden County, home of the Holyoke Soldiers' Home.

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Average Age of Deaths in Confirmed COVID-19 Cases: 82

When is 82 the average age for anything?

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I mean its about right for death.

In 2016 the average age of death in MA was 80 Years and 8 Months.

https://www.mass.gov/news/life-expectancy-rises-in-massachusetts-breakin...

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Baseball fandom.

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Hi Adam, thank you so much for posting this. I did not know Pat O’Neill very well, but she was a wonderful lady and one of those great community glue people who make neighborhoods work. I keep thinking that in normal times, she would have had one of those grand, crowded wakes, that bring a whole neighborhood out to remember someone. She and her family deserved to have that.

Thanks again.

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She was, by all accounts, a wonderful person, but while she did indeed die last week, it was not because of Covid-19. I saw the Reporter piece about the horrible isolation forced by the virus at her burial and jumped to conclusions, unfortunately.

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but the DHS analysis indicated a minuscule half-life of SARS-CoV-2 when exposed to sunlight, and it's also significantly heat-averse when you start getting into the 80s/90s °F.

Obviously that's irrelevant when it comes to people hanging around and infecting each other indoors.

But it does become an issue when it comes to the virus hiding on outdoor doorknobs, benches, trash cans, people's hands when they go outside, spit on the sidewalk that can be tracked into someone's house on shoes, etc.

So CA has a huge advantage over MA in that respect.

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Perhaps all the Sun has something to do with it.
https://www.google.com/amp/s/www.bbc.com/news/amp/health-52371688

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Massachusetts, 2018: 885 per square mile
California, 2018: 254 per square mile

We've limited the rate of death from a contagious disease to 1.5x that of the Golden State with 3.5x the population density. I'd say we're kicking their asses.

Hell, I'll make it fair and subtract the square mileage of each state's federally-controlled land (which ostensibly has no residents) and redivide:

CA: 74,154 sq mi of federal land (https://www.vox.com/2015/2/16/8046349/federal-government-land-by-state) of 155,973 total square miles

MA: 149 sq mi (!) of federal land. Doesn't sound right, but I multiplied the 1.9% in that same link by 7,838 (https://www.netstate.com/states/geography/ma_geography.htm)

Land area for each state minus federal land:

CA: 81,819 sq mi
MA: 7,689 sq mi

CA 2018 population: 39.46 million
MA 2018 population: 6.883 million

Persons per square mile based on 2018 population and state land area excluding federal land:

CA: 483 persons/sq mi
MA: 896 persons/sq mi

We have 1.85x their population density when excluding federal land, but only 1.5x the COVID-19 deaths. Still punching above our weight.

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I'm not sure that just looking at population density over an entire state is that useful. The population in California is highly clustered. Among other things, LA is the densest metro area in the country, and the city of San Francisco is denser than the city of Boston.

https://www.worldofmaps.net/en/north-america/map-california/map-polulati...

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At least not from the context of cities or states.

Yes, NYC got whacked, and yes NYC has high population density. But if you look at data (and not anecdote) it turns out that population density doesn't have much to do with this.

The big problem with comparing statistics: the stats are badwhere every, and bad in different ways in different places.

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Sounds like an out-of-town gunslinger in an old western.

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I think that population density definitely has something to do it.
To carry the CA-MA comparison further - look at MA-NJ. NJ is densest-population state, about 50% more people than MA - roughly twice the deaths. Higher totals and higher per-capita counts seem like they have some variability but at least correlation to town population density - especially for suburbs on NYC mass-transit commuter corridors.

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MA has more and less dense clusters, but it does not have the "dots on a map" pattern common to Western states.

California has "dots on a map" - areas that are clustered and highly populated, but effectively isolated from other communities.

MA is the size of a couple of Western counties and you are never outside of a municipality. The population is dense and concentrated in spots, but it is also highly contiguous and interactive.

While the LA and SFO areas are densely populated, very few people live in regions of California that would swallow New England - thinking Death Valley (National Park is half the size of MA), Humbolt County, etc.

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I think this is best explanation I've read here. It's not just the hot spots, but the spaces between them. It's all about flow.

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Yesterday, Baker said 56% of the state's Covid-19 deaths were among residents in nursing homes and other long-term care facilities, making Massachusetts a hotspot for such deaths. Today's figures show the percentage is closer to 63%.

With over 3/5ths of the MA deaths in nursing homes, perhaps it's time to investigate the nursing homes and their cozy relations/donations to Baker, Polito, Spilka, DeLeo and the usual suspects. The donations are easily searched on the OCPF website. With such a shocking nursing home death rate, a reasonable juror might ask if the donations resulted in any leniency or things being overlooked? This ch. 5 story got little attention in the early virus panic but it reports nursing home residents were suddenly evicted "relocated" by Baker's people, against the will of the families, so the nursing homes could make room for more. Since when can a Governor, without court eviction hearing, remove a senior from her home, nursing or otherwise? How many of those abruptly "relocated" to unfamiliar nursing homes died? Hopefully, the US Attorney looks at this during his criminal investigation into the Holyoke atrocity.

As for the extension of the lockdown, is there any science behind it, especially with average age of Covid death at 82, already well beyond normal life expectancy? Healthy people under 60 have little chance of death from the disease and many don't know they've already had it. With the healthcare system laying off in droves, what is the objective again?

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Yes again, why is the guy who was dog whistling on a murdered BLS alum story still allowed to post, and who is now spewing bullshit that those under 60 have nothing to fear, and offering those over 82 to die. Didn't realize Fishy was also on the government death panel that "conservatives" love so much.

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What did he say that was incorrect?

MA has 1.18 million residents over the age of 60
MA has 5.72 million resident under the age of 60 .

22,608 COVID cases over 60
35,410 COVID cases under 60

3,931 hospitalizations of those over 60
1,582 hospitalizations of those under 60

3,000 deaths of those over 60.
150 deaths of those under 60.

About 1.9% of those over 60 have caught COVID
About 0.6% of those under 60 have caught COVID

0.3% of those over 60 have been hospitalized from COVID
0.03% of those under 50 have been hospitalized from COVID

.25% of those over 60 have died from COVID.
.0026% of those under 60 have died from COVID.

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As the Bakersfield doctors said: this is the first time in history where we are quarantining the healthy.

I get that it took us a long time to get data, but now that it is emerging, why don't we lead with science instead of fear? The secondary effects of our self-imposed hysterics will end up being far more devastating over the long-term.

Let's get the low-risk individuals who are both able and willing to work back into the economy. Let's protect and help those who cannot/will not.

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Who said “those under 60 have nothing to fear” and who “offered those over 82 to die?”

Did the comment get deleted or something? I don’t see anything remotely close to what you suggested.... but let me know.

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[...] especially with average age of Covid death at 82, already well beyond normal life expectancy? Healthy people under 60 have little chance of death from the disease and many don't know they've already had it.

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I still missed the whole “nothing to fear” and “offering to die” comments.

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With over 3/5ths of the MA deaths in nursing homes, perhaps it's time to investigate the nursing homes and their cozy relations/donations to Baker, Polito, Spilka, DeLeo and the usual suspects.

When you hear hoofbeats, the first hypothesis ought to be "horses" and not "zebras".

Here on my planet, nursing homes have predominantly old, sick people. Unlike old, sick people who are at home, the old, sick people in nursing homes live in close proximity to other old, sick people. And, 3 shifts daily, staff members who have been out in the community come into the building and are in close contact with residents. And some of the residents have dementia and are unable to reliably follow handwashing instructions and other infection control measures.

So a high rate of infection and death in nursing homes is not particularly surprising.

Which is not, of course, to say that there aren't shitty nursing homes who aren't doing a good job.

But I don't think the death rate in nursing homes is, on the whole, shocking.

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I hit "thumbs up" just for the zebra quote.

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The fact the deaths are mostly elderly in nursing homes is evidence the lockdowns are working. Had there not been any lockdowns, the number killed would be much, much higher.

The reason why things aren't as bad as they could be is because the state has been pretty good about social distancing.

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not sure we actually know that to be true though. Sure, its probably likely, but then look at models like Sweden, with no formal lockdown, fairing pretty well through this storm. Tokyo another example is the densest city in the world, but has almost no cases! You have to wonder if other factors play into it, perhaps weather. It's been mostly gloomy and 40-50deg here for the past 2 months, which allegedly is perfect coronavirus conditions. If we had more sun or warmer weather, would it be any different?

Going on week 6 now of lockdown, how do we still have almost 2000 new cases a day?

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Sweden only has 10 million people, nationalized healthcare, paid sick leave, social safety nets that actually work, etc...

We could do what they did if we could guarantee testing, healthcare, and keeping your job when you stay home due to illness. Good luck with that. Enough people still don’t get that those things are in our economic and national security best interests.

https://apple.news/AukOXsfuJTvyqKbsTPBd68Q

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Tokyo another example is the densest city in the world, but has almost no cases!

From Saturday:

The latest figures bring total coronavirus infections in Japan's capital city to 3,836 cases...

Where do you get your information?

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If total cases in Tokyo = 3,836, then that's amazingly few indeed. Tokyo's total population is about 9.3 million. That makes the infection rate approximately .0003%

Suldog

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Check your math. 0.03%

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The source of the data upon which math was performed was never linked by the OP.

Also important to note: you don't have a confirmed case if you don't test. We all know that tests are in short supply in many places, and sometimes for that very reason.

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Math is the issue. That was the issue raised by the other respondent, so I answered it in kind.

Suldog

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Sweden is getting hit pretty hard. Not as bad as Mass. with 2355 deaths for a population of 10M. to our 3153 deaths. But their neighbors (Finland/Norway) who did lockdowns are a third of Sweden's. And without lockdowns, they are likely to continue to get hit hard for a longer time. it took us 6 weeks after shutting everything down before the number of deaths started to drop.

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"Sweden, with no formal lockdown, fairing pretty well through this storm"

Where indeed do you get your information? I know the right wing has been flogging Sweden the past two weeks but you might want to look again. They have more deaths than California with 1/4 the population.

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Old people are having a hard time staying alive while everyone else in Sweden goes about their business.

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also keeps people indoors, contributing to social distancing. Which effect dominates, I don't know.

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Not anymore: https://www.businessinsider.com/photos-norway-sweden-different-coronavir...

They hoped to leverage their inherent health resilience - their high baseline health, good elder health, lack of health disparities, high access to care, and treatment of aging populations. They are now paying for that - although not nearly as much as the US would have given our poor health indicators, poverty, and health disparities in much of the country.

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Per John DeYonghe:

"What proponents of the Swedish model miss is that Sweden is much healthier than us in the first place, has much better healthcare infrastructure, and does a much better job of preventative medicine (as I observed before, if we had invested more in healthcare we might not be in this position). Can Sweden’s strategy work if you aren’t Sweden? A few comparative stats:"

Life expectancy at birth: Sweden 82.5, US 78.6
Adults with multiple chronic conditions: Sweden 18%, US 28%
Obesity: Sweden 13%, US 40%
Diabetes: Sweden 5%, US 11%
Physicians/1k population: Sweden 4.1, US 2.6

Sweden is just so much healthier than the USA is, that you can't meaningfully extrapolate from what is and isn't working in Sweden to what would and wouldn't work here.

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Stockholm on a few visits, and on one trip into the interior (to visit the hometown of some of my ancestors), people just *look* a heckuva lot healthier than Americans. Much better fitness in general, and they love their outdoor sports and leisure activities. That actual stats don't surprise me.

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Think of how demoralizing it must be to be one of the approximately seven physically unattractive people in Sweden.

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The fact that the deaths are disproportionately the elderly in long-term-care & assisted living facilities (as appears to be the case in other places, too) indicates there are different circumstances and higher risk factors there. As others have pointed out - pre-existing conditions, population density, staff & community activity that could inflate transmission....

The questions that need to be asked:

1. Yes, the hospital capacity needed to be ramped up quickly, but what could be done differently/better in crisis response regarding LTC and assisted-living facilities? That applies to "what can we still change now?" as well as "what should be done differently in the next crisis?"

2. What can be done differently in "normal" times at LTC/AL to be a buffer against future crises? ...and who will be willing to pay for it?

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With over 3/5ths of the MA deaths in nursing homes...

One fifth is 20%.
3/5ths is 60%.
56% is not "over 3/5ths."

The rest of this oafish comment is equally well thought out.

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63% > 3/5

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it stings!

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perhaps it's time to investigate the nursing homes and their cozy relations/donations to Baker, Polito, Spilka, DeLeo and the usual suspects. The donations are easily searched on the OCPF website. With such a shocking nursing home death rate, a reasonable juror might ask if the donations resulted in any leniency or things being overlooked?

Donations got fuckall to do with it. Not having a public health system that was geared up to handle a virus this contagious and this infectious has everything to do with it.

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In Holyoke, the highest number of deaths at any nursing home in the country, is a terrible scandal and tragedy. I hope it gets properly investigated and the true facts come out. If that was my granddad I'd be beyond angry.

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The point of the story is MA vs. CA, but the original chart I had showed daily deaths in Massachusetts and Boston, which was a bit confusing. I've replaced that with a chart showing daily deaths so far in April in the two states.

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Consider this: California has around 100,000 people in certified nursing facilities and a total population of 39.5 million. MA has close to 39,000 with a population near 7 million.

A comparable number of skilled nursing residents in California would be 250,000.

Add in the double-bunking that has been grandfathered in for Massachusetts and we get the current mayhem.

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Do we know that California is categorizing its deaths properly? Are there people who are dying outside of hospitals because they are afraid to go to the hospital? How is the cause of death being recorded for those people?

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Today's stats show that Massachusetts has 1,005 patients on ventilators - the sickest of the sick - compared to 1,181 in California.

First -- its Fake News that there are 1005 patients on Ventilators -- there are a total of 1005 patients in the ICU -- not by any means all on Ventilators -- Google Boris Johnson, UK PM [in ICU for a couple of days on Oxygen but never on a Ventilator]

Look at the MA reports about COVID-19 related Deaths or just look at the headlines:

  • More than 70 veterans dead in ‘horrific’ coronavirus outbreak at Holyoke Soldiers’ Home

    -- read that as a WWII Vets home -- avg age 90

  • three more died at the Chelsea Soldiers' Home -- Twenty-three residents have now died in total, with 17 of those veterans testing positive for the disease.

    -- again 80's +

  • 30 Deaths, Another 86 Positive Tests: Nearly All Belmont Manor Nursing Home Residents Have The Coronavirus

Overall -- More than 1/2 of all of the COVID-19 related deaths in MA have been associated with Nursing Homes and similar facilities caring for sick old folks

MA COVID-19 daily data dump [04/28/20]:

  1. 98.1% of Deaths with "underlying conditions"
  2. 59% Deaths with a Previous Hospitalization* [only 11% deaths known to not have had previous hospitalization -- nearly 30% unknown]
  3. Age of Death:
    1. 63% of deaths were people 80+
    2. 20% of the deaths were people from 70 to 80 years old
    3. 10% of the deaths were people from 60 to 69 years old
    4. 5% of deaths were people below 60 years old

For Reference purposes:
the average Life Expectancy of someone in MA is just about 80

For the 58,844 people who died in 2017[2017 MA Mortality Report is the latest available] *
2017 Age at Death:

  1. 22,663 were at least 85 years old
  2. 22,991 were from 65 to 84 pears old
  3. 9516 were from 45 to 64 years old
  4. 3674 were 45 or younger

So the 65+% population was responsible for 77+% of the total deaths

On an average day in 2017: 161 deaths occurred of which:

  1. 35 cancer
  2. 33 heart disease
  3. 16 respiratory condition
  4. 7 Stroke
  5. 3 Diabetes
  6. 4 Infectious Disease [including the Flu and pneumonia]
  7. 13 injury
    1. 7 poisonings including opioid overdoses
    2. 2 Suicides
    3. 1 automobiles
    4. and a bit less than 1 from firearms

For comparison -- since early April an average of somewhat more than 100 people have died each day from COVID-19 and contributing co-morbity factors versus the 98 who died daily in 2017 from essentially the same "co-morbidity factors" without the COVID-19

Obviously -- we will have to wait until all the tallies are in for 2020 to see the full impact of the COVID-19 on Life Expectancy and total fatalities in MA

However -- perhaps part of why we have such a "high" death rate for the COVID-19 [4.5 deaths for every 10,000 residents] --- might have something to do with the fact that we have a lot of sick old people -- particularly a lot of sick old people clustered together in places such as the Holyoke Soldiers Home or even the Belmont Manor

Further -- By the way of comparison -- two countries in Europe with about the same population as CA:
Poland 11273 cases 524 deaths
Ukraine 9410 cases 239 deaths

So -- Possibly being close to the radiation from Chernobyl is beneficial ????

*
Summary from:
2017 mortality data and statistics for the 2017 calendar year: Massachusetts Deaths Highlights

• From 2016 to 2017, the age-adjusted mortality rate for Massachusetts residents changed from 668.9 deaths per 100,000
• The average life expectancy of Massachusetts residents was 80.6 years in 2017
• Every day in 2017, there were on average 161 deaths, which included 35 cancer deaths, 33 heart disease deaths, 16 respiratory condition deaths, and 13 injury deaths (Figure 7). Of the 13 injury deaths, 7 deaths were due to poisonings, which include opioid overdoses.
• Poisonings, which include opioid overdoses, continued to be the largest cause of injury deaths in 2017, however the injury death rate due to poisoning was 35.4 per 100,000 in 2016 and 33.8 per 100,000 in 2017 (Table 18).

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That actually had some interesting oddball Massachusetts stats in it, because it was yet another attempt to blame Chinese people in general, and Chinatown in particular, for the explosion of cases here, when, in fact, we have no proof that happened, that, in fact, evidence from New York is that their contagion started with people returning there from EUROPE, that the first big outbreak here, that Biogen meeting in February, was sparked by, as Gov. Baker has said, two people from EUROPE and that, unlike California, Massachusetts has an annual school vacation week in February, where people have been known to go to EUROPE and, OK, also Florida.

EUROPE in all caps because while, yes, the evidence does indeed show the virus started in China, I am, to be honest, sick of people desperate to find a scapegoat to blame for what's happening in the US now. Then again, I am a Jew, so I'm maybe more attuned to that (and, in fact, the anti-Semites in other states have been having a grand time somehow blaming Jews for this as well).

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I was going to reply to Swirly's bit about her husband's corporate travel, and point that out as another example of something that hopefully goes away post COVID-19.

You want to fly me and everyone who works here across the country annually? Why don't we make it biannually, and you give me the cash instead?

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Nobody seems to ever mention the thousands upon thousands of people who crowded into the Garden for Celtics and Bruins games in February.

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Anyone who would give Jeremy Jacobs money at this point is probably already diseased.

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As evidenced by the Nextstrain sequencing project, that showed the Boston strain matching the Italian strain.

Newton and other highschools had trips to Europe in late January, and those students and teachers were asked to stay home rather than return to school. As someone who went on two of those spring-semester trips 40 years ago, I can see exactly how that infection would run.

Between college students/personnel, HS kids and business travellers, Boston, NYC, and DC were going to get hammered by anything with a 2-week incubation period.

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Any idea why the dips and peaks in these graphs track each other so well? Although the totals are different why should the trends track each other so similarly -- declines around the same time and peaks at the same time, etc...

Adam - I see above you mentioned swapping out graphs at some point. Is the graph I'm looking at actually Boston and MA with the deaths tracking each other tightly? On Facebook I see another graph with the red line being low on the y axis with a few bumps at the end of the time period. It says that it's Boston/MA deaths - but is that actually MA-CA deaths? Trying to make sense of this....failing as the covfefe hasn't kicked in yet.

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The graph on Facebook shows the daily deaths for Massachusetts and statewide. It's basically an updated version of a chart I've run before.

When I woke up this morning, though, I realized that, in context, it was a bit confusing, because it was on a story basically comparing Massachusetts and California. So I went to the California state Covid-19 site and grabbed their death data and created a new chart comparing that with our deaths.

Tl;dr: The original chart, still on the Facebook page, shows Mass. and Boston deaths in April. The new chart, on the UHub post you're looking at, shows Mass. and CA deaths in April.

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Ok, I got it - in terms of the two different graphs.

But don't any of the smarty-pants who posted above have any theories as to why the number of deaths over time in Mass should follow similar trends in the ups and downs to California at the same time?

I mean I would expect Fishy to at least post that it's another example of MuslimObamaDarkyCommies conspiring to drain our vital bodily fluids or something....

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Whether the weekend difference is due to delayed/inaccurate reporting due to administrative staffing levels, or whether decisions to remove a patient from life support are more often made when full support staff are available, or whether there are other medical/sociological/?? reasons, or all of the above, I don’t know. But California does have the same weekends we do.

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yup - both places have falling trends on the weekend -- good catch. But it doesn't explain the similar dips and curves during the week. I'm still perplexed.

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Mass

Total COVID-19 deaths reported by Mass DPH 4/28/2020: 3153
Long-term care facility COVID-19 deaths reported by Mass DPH 4/28/2020: 1810
Percent in long-term care facilities: 57%

New York State
Total COVID-19 deaths reported 4/28/2020: 17638
Estimated deaths in long-term care facilities: 3600
Percent in long-term care facilities: 20%

An estimated 2100 of those nursing home deaths in NY State occurred in NY City.

Nationwide, an estimated 27% of COVID-19 deaths occurred in nursing homes and other LTC facilities.

Scary stuff in this NY Times article: https://www.nytimes.com/2020/04/28/opinion/coronavirus-nursing-homes.html

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It is not surprising we have so many nursing home deaths. The state does not have a standard of care. You go to some places and residents are eating together in a cafeteria while others are isolated in their rooms. I also agree that nurses and aids working in multiple facilities are moving this thing around. Essentially those people are the most vulnerable and are sitting ducks.

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There are so many damn ways to parse the data, and the limited testing combined with the asymptomatic aspect of the virus make it hard to get a real sense of where we are.

It might be helpful to look at the infections and deaths by facility. What ones are able to limit spread, and what ones are not. Staffing, physical configuration, use of PPE, anything that might indicate what are best practices. I wonder if the residents are being brought to the hospital soon enough, which affects the survival rate.

One thing for sure, this is not "just another flu." We've never had a seasonal flu that caused so many nursing home residents to die.

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The average age of a death in MA by COVID-19 is 82, but that is skewed greatly by the fact that ~60% of the deaths were in nursing homes. I wonder what the average age is for non-nursing home deaths, i.e. people living at home, going to the market, trying to live their lives? That would be a more meaningful number.

Stay safe, gang.

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The nursing home deaths are also a result of a complete lack of early interest in providing/funding adequate protective gear to their employees - who are largely underpaid and not nearly as numerous as they should be.
An argument could be made that this due to our cultural attitude of ignoring the older population and unconsciously wishing that they would just go away.

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A friend of mine suggests MA has tested at twice the rate of CA. So I think that has something to do with it. We're also on the whole Northeast Corridor, in which every coastal state from here to MD has been hit. Lastly, there's some suspicion that the East Coast was seeded NOT with a strain from Asia, but Europe, and that this strain is more lethal.

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