Health Economics During Pandemic

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 “there are no shortcuts” to defeating the virus 

*Read More on this Exclusive Interview with Marissa J Carter MA PhD with Clinical Research News Online 

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COVID 19 CLINICAL RESEARCH SERVICES - USA is very close to a tipping point
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Ok, things are hotting up…

If you haven’t created a pandemic plan and started implementing, now’s the time to start.

I want to show you how fast a pandemic will go. The serious hot spots are of course South Korea and Iran. In the former country we have well over 3,000 cases. I have modeled this mathematically because it represents what will happen in the USA. The data (Fig 1) show a doubling time of around 2 days which is far less than originally thought although some Los Alamos scientists came to the same conclusion as I have (https://medrxiv.org/content/10.1101/…). If this rate hold, South Korea will have 100,000 cases by March 8th or 9th.

Now we have four cases in the USA spread out on the West Coast. None of these originated from any other hot spot we know so they represent the start of the pandemic in this country. This will mean at least 4 foci. The modeling of this situation is show in Fig 2. If we assume roughly the same infection rates as we saw in South Korea, we can see that by the end of March we will have 15,000-20,000 cases. Such rates assume that we will not undertake any drastic measures such as took place in China. You can see that by April 8-9th we will reach a million cases. By that time, we will stop a lot of testing and our case definition will be clinical simply because we will have run out of testing kits and the ability to process that many.

Let’s move on to Figure 3. This looks at a projection of what we saw in Figure 2 for 2 scenarios: the first in which we do minimal quarantining (mostly self-isolation and social distancing, plus some other measures) (green line). By the end March we will have around 200,000 cases which could reach 10 million by as early as 8 days after that. The [projection at this point gets very wobbly because we are talking very high numbers of infected cases and lot of other things will kick in. One thing that will happen by sure is that by the time we have 5 million cases, our hospitals and healthcare systems will be totally overwhelmed. That could happen as early as the second week in April. If these rates are far less then it might take another week or two. Looking at second scenario (red line): this is a situation that mirrors what happened in China and is instituted when we have around 60-80,000 cases. Projections follow what happened in China, with the result that after a week or so the infection rate starts to noticeably flatten out with relative control being achieved 2-4 weeks later. These measures would be without precedent and very harsh.

I really hope my projections are wrong. In particular no one knows how long high rates of infection can be sustained and they could be lower than projected here. But I will be updating the models as often as necessary.

The mortality rate is holding at around 2-2.5% with critically ill patients at a rate of 5-5% and those requiring hospitalization around 15%. There is no indication that the virus has mutated. But there is a documented case of a patient being infected, recovering, and being re-infected. Which is worrisome. It would mean that even if you had the virus and were sick, your immunity might not last long.
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Ok, things are hotting up…

If you haven’t created a pandemic plan and started implementing, now’s the time to start.

I want to show you how fast a pandemic will go. The serious hot spots are of course South Korea and Iran. In the former country we have well over 3,000 cases. I have modeled this mathematically because it represents what will happen in the USA. The data (Fig 1) show a doubling time of around 2 days which is far less than originally thought although some Los Alamos scientists came to the same conclusion as I have (https://www.medrxiv.org/content/10.1101/2020.02.07.20021154v1). If this rate hold, South Korea will have 100,000 cases by March 8th or 9th.

Now we have four cases in the USA spread out on the West Coast. None of these originated from any other hot spot we know so they represent the start of the pandemic in this country. This will mean at least 4 foci. The modeling of this situation is show in Fig 2. If we assume roughly the same infection rates as we saw in South Korea, we can see that by the end of March we will have 15,000-20,000 cases. Such rates assume that we will not undertake any drastic measures such as took place in China. You can see that by April 8-9th we will reach a million cases. By that time, we will stop a lot of testing and our case definition will be clinical simply because we will have run out of testing kits and the ability to process that many.

Let’s move on to Figure 3. This looks at a projection of what we saw in Figure 2 for 2 scenarios: the first in which we do minimal quarantining (mostly self-isolation and social distancing, plus some other measures) (green line). By the end March we will have around 200,000 cases which could reach 10 million by as early as 8 days after that. The [projection at this point gets very wobbly because we are talking very high numbers of infected cases and lot of other things will kick in. One thing that will happen by sure is that by the time we have 5 million cases, our hospitals and healthcare systems will be totally overwhelmed. That could happen as early as the second week in April. If these rates are far less then it might take another week or two. Looking at second scenario (red line): this is a situation that mirrors what happened in China and is instituted when we have around 60-80,000 cases. Projections follow what happened in China, with the result that after a week or so the infection rate starts to noticeably flatten out with relative control being achieved 2-4 weeks later. These measures would be without precedent and very harsh.

I really hope my projections are wrong. In particular no one knows how long high rates of infection can be sustained and they could be lower than projected here. But I will be updating the models as often as necessary.

The mortality rate is holding at around 2-2.5% with critically ill patients at a rate of 5-5% and those requiring hospitalization around 15%. There is no indication that the virus has mutated. But there is a documented case of a patient being infected, recovering, and being re-infected. Which is worrisome. It would mean that even if you had the virus and were sick, your immunity might not last long.
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01. quality procedures

Your decision to use Strategic Solutions, Inc. will be met with quality procedures from individuals who have the education, experience, techniques and skills to provide you with outstanding personal performance.

02. evidence-based medicine

Originally founded by Bonnie Hibschman and Dr. Marissa Carter, Strategic Solutions, Inc. has a firm commitment to excellence and our dedication to writing/editing the words that you need the most, offer to maximize your potential

03.research projects

We also are willing to collaborate in research projects. Areas that we already collaborate in include wound care, ophthalmology, cost-effectiveness of medical interventions, evidence-based medicine, oncology and nutrition, and infectious diseases.

Health Economic Research
Over the last several years we have critiqued hundreds of clinical studies either informally or as part of a systematic review. In every instance we have come across problems — some small, but many that can be regarded as design flaws. We cannot fix design flaws! What we can do, however, is help you plan a study so that it doesn’t have any.

Clinical Research services by Marissa Carter

clinical trial design and analysis

Consulting

For example, is there evidence to perform a credible HE study?

type of study

Cost-minimization, cost-effectiveness, cost-utility, cost-benefit, cost consequence

data input

Obtaining data input

cost effectiveness

Carrying out simple cost effectiveness calculations

modeling

Discrete events modeling

Markov

Markov modeling