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COVID Outliers

HALL85

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https://clinicaltrials.gov/ct2/show/NCT04347538

Most of the countries that have the lowest COVID death rates are African countries and there are a number of unconfirmed theories (under reporting, weather, stronger immune systems, average age of population - much younger, etc.). One that sticks out in that lowest death category is Thailand. An infectious disease doc suggested that one reason was that the Thai culture does daily nasal cleansing (like the Net-pot) which removes germs, particulate from the sinuses. Actually found this on the clinical trial .gov website and there are numerous articles suggesting that the cleaning can have an impact on minimizing the effects of the disease and more importantly spreading. Roughly 80% of Thai's do this religiously. Seems like simple hygiene that should be prioritized along with hand washing and mask wearing.
 
https://clinicaltrials.gov/ct2/show/NCT04347538

Most of the countries that have the lowest COVID death rates are African countries and there are a number of unconfirmed theories (under reporting, weather, stronger immune systems, average age of population - much younger, etc.). One that sticks out in that lowest death category is Thailand. An infectious disease doc suggested that one reason was that the Thai culture does daily nasal cleansing (like the Net-pot) which removes germs, particulate from the sinuses. Actually found this on the clinical trial .gov website and there are numerous articles suggesting that the cleaning can have an impact on minimizing the effects of the disease and more importantly spreading. Roughly 80% of Thai's do this religiously. Seems like simple hygiene that should be prioritized along with hand washing and mask wearing.
Can’t see why that wouldn’t make sense. Overall cleansing of nasal passages have to lead to healthier membranes and the flushing of infectious materials.
 
http://healthindustryadvisor.com/pdfs/covid-19-2020-12-23-day244.pdf

For the data geeks. Good summary of stats and what is anticipated in the months to come. Also below is a summary of the data and other industry trends:

Also, we will receive more good news on the vaccine front today? There are reports that Pfizer and the U.S. government are finalizing a deal for a second round of 100 million doses of the Pfizer vaccine. A key question is whether this round will become available in the second or third quarter of 2021. Our vaccination-availability model (presented in yesterday's report, linked here) suggests that the impact of this timing could translate to a 3-10 day difference in when all interested Americans would receive an initial dose of a vaccine.



For those of you like me who truly respect Dr. Anthony Fauci - and, hang on his every word - Andy Slavitt had him as a guest on Andy's daily "Inside the Bubble" podcast released this morning (linked here). Dr Fauci's telling of how we were able to develop the vaccine so quickly is a fascinating listen - spoiler alert, the underlying development of the mRNA platform for was underway for years.



Today's report is linked here for your review. Highlights:

Case, Hospitalization & Death Projections

Each Tuesday, the Covid19 Forecast Hub produces an ensemble, 4-week forecast from more than 50 research and academic organizations

The ensemble forecast suggests a modest increase in detected cases next week, before these level off through mid-January

Deaths with the coronavirus are projected to increase, albeit slightly, this week and each of the next three weeks of the projection


By the middle of January, the ensemble forecast projects just fewer than 400,000 total deaths with the coronavirus in the U.S

The Institute for Health Metrics and Evaluation (IHME) routinely produces its own forecasts; two advantages of the IHME model - first, it extends to April 1 and, it includes scenarios for rapid vaccine rollout, mask mandates and easing of restrictions

IHME's model suggests that true infections (as opposed to detected cases) may have peaked on December 19

Under most of its scenarios, IHME projects that infections will decline significantly each month, from January through the beginning of April
(the eased restrictions model suggests increasing infections until January 23)

Average daily deaths with the coronavirus are projected to continue to increase until about January 6, under the IHME's current projection (even later under the eased restrictions scenario). Following that, IHME projects a slowing in deaths in January and then more significant slowing in February and March

Tragically, IHME projects more than 500,000 cumulative deaths by March

IHME's projection of Covid-19 hospital bed requirements suggests that the strain from Covid-19 patients will increase for another three weeks - peaking at 40% higher than current levels - before falling sharply from that point forward


Current case and infection rates

Consistent with both IHME's and Gu's models (presented yesterday as linked here), newly-detected cases have been relatively flat for the past ten days

Countering expectations, the trend for 7-day new cases per capita is running lower than the pre-Thanksgiving trend and is now showing no increase in new cases per day

On a state-level, newly-detected cases per capita declined week-over-week in thirty-four states, including thirteen of the fifteen states that had the highest rates a week ago. The most significant exceptions to this are California and Tennessee, which now have the highest rates in the country


Hospital Use

There were 117,000 Covid-19 patients in the hospital yesterday, occupying 37.6% of all inpatient beds

Nevada, California and Arizona have the highest occupancy rates, with more than 2/3 of beds in use by Covid-19 patients; Hawaii, Vermont and North Dakota have the lowest rates, with fewer than 10% of beds in use by Covid-19 patients

Twenty-four states experienced increasing Covid-19 inpatient census week-over-week; twenty-four states experienced declining census; two states held steady week-over-week
 
If I heard this correctly tonight on news; 1% of our population is in long term care facilities, and 38% of COVID fatalities have come from patients in those facilities.

Vaccines began being administered today by Walgreens and CVS (another OWS coordinated effort).

When the virus got here a year ago many states did not prioritize Getting PPE for care workers in nursing homes.
 
If I heard this correctly tonight on news; 1% of our population is in long term care facilities, and 38% of COVID fatalities have come from patients in those facilities.

Vaccines began being administered today by Walgreens and CVS (another OWS coordinated effort).

When the virus got here a year ago many states did not prioritize Getting PPE for care workers in nursing homes.
i cant tell if 38% is a high or low number. obv based on 1% pop it looks good but i wonder what the remaining %s are. our demo categories need to shift from 65+ to 65-74 and 75+
 
i cant tell if 38% is a high or low number. obv based on 1% pop it looks good but i wonder what the remaining %s are. our demo categories need to shift from 65+ to 65-74 and 75+
I think it's pretty obvious that it's a big number and looking back, we did a pretty poor job of caring for the most compromised. Lack of procedures in place at these nursing homes, lack of oversight from some states, lack of prioitization to get long term care workers PPE....it all created rampant spread and death.
 
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I think it's pretty obvious that it's a big number and looking back, we did a pretty poor job of caring for the most compromised. Lack of procedures in place at these nursing homes, lack of oversight from some states, lack of prioitization to get long term care workers PPE....it all created rampant spread and death.
well its subjective whether you think its only a worry for elderly living folks or if you still should have some concern for yourself.

ive always had a negative stigma for those homes
 
well its subjective whether you think its only a worry for elderly living folks or if you still should have some concern for yourself.

ive always had a negative stigma for those homes

I'd do all I can to keep any elderly relatives out of those facilities. I have felt this way both before and after this year.
 
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I'd do all I can to keep any elderly relatives out of those facilities. I have felt this way both before and after this year.
honest question for advice. what would you do with that person who needs that type of care? one of those communities? do you trust in home nurses?
 
well its subjective whether you think its only a worry for elderly living folks or if you still should have some concern for yourself.

ive always had a negative stigma for those homes
I never said the virus is only a worry for the elderly. We should all be concerned and using common sense to avoid getting it and if you do, get treatment immediately. I think the data shines a light on the mistakes that were made.
 
honest question for advice. what would you do with that person who needs that type of care? one of those communities? do you trust in home nurses?
If I could afford it, I would have them live with me or on their own with live-in care. At the end of the day you need to do the research and find a care giver you can trust. Whether it's a nursing home aide or in-home, do your homework.
 
If I could afford it, I would have them live with me or on their own with live-in care. At the end of the day you need to do the research and find a care giver you can trust. Whether it's a nursing home aide or in-home, do your homework.
all the homework in the world and you could still end up with the below

 
honest question for advice. what would you do with that person who needs that type of care? one of those communities? do you trust in home nurses?

Have not been in that situation so can't say for sure, but I'd do my best to care for them in their own home or hire a home health aid.
 
honest question for advice. what would you do with that person who needs that type of care? one of those communities? do you trust in home nurses?

Be very, very wealthy when the time comes. You get what you pay for and it’s really expensive.
 
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Be very, very wealthy when the time comes. You get what you pay for and it’s really expensive.
The price we pay for being a society that no longer values the nuclear family and taking care of its own.
 
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Be very, very wealthy when the time comes. You get what you pay for and it’s really expensive.
That said, anyone interested in discussing long term care insurance, I’d be happy to educate. Merge is right, care is super expensive and you need to be very wealthy or properly insured (or best... both).
 
That said, anyone interested in discussing long term care insurance, I’d be happy to educate. Merge is right, care is super expensive and you need to be very wealthy or properly insured (or best... both).
Sami, I had looked into this some time ago and I couldn’t get my head around the expense. I figured it just made sense to plan for it with investments. Fortunately, we don’t have excessive taste and hoping one of our kids will take us in:).
 
The price we pay for being a society that no longer values the nuclear family and taking care of its own.
Why are so many obsessed here with this nuclear family narrative....i just dont get it....good people can come from all walks of life, you dont not need a traditonal biological mother and father to be loved, raised with good morals and become a productive selfless citizen...i know plenty of children from "nuclear families" that are greedy, self centered snobs
 
Why are so many obsessed here with this nuclear family narrative....i just dont get it....good people can come from all walks of life, you dont not need a traditonal biological mother and father to be loved, raised with good morals and become a productive selfless citizen...i know plenty of children from "nuclear families" that are greedy, self centered snobs
What are you talking about? I never differentiated anyone as good or bad. The point is outsourced care of the elderly outside of family has consequences.
 
Sami, I had looked into this some time ago and I couldn’t get my head around the expense. I figured it just made sense to plan for it with investments. Fortunately, we don’t have excessive taste and hoping one of our kids will take us in:).
Long term care insurance itself is costly, especially if over 50... but alternatively there are life insurance options with long term care (chronic illness) riders that allow you to pull death benefit to use for care in the event of need. It depletes the death benefit but is a way to help pay for in home and eventually admitted care. Various products have been introduced to try to solve the problem, and most don’t have the stigma (or stink) of older style LTC insurance that was a use it or lose it proposition.

Life insurance with LTC riders
LTC insurance with death benefits
Annuities with 8% annual death benefit roll up that can be used for LTC if triggered

There’s even an annuity product that can take qualified (retirement) money to convert to LTC benefit.

Something you should raise with your advisor if you have one, or I’m always happy to educate.
 
Sami, I had looked into this some time ago and I couldn’t get my head around the expense. I figured it just made sense to plan for it with investments. Fortunately, we don’t have excessive taste and hoping one of our kids will take us in:).
my grandmother currently there. dementia, health risk, fall risk etc. paying a family member is working out better than a nurse imo but its really tough on that family member to have to live through that. maybe in the next 50 yrs we can just download our brains to a video game
 
my grandmother currently there. dementia, health risk, fall risk etc. paying a family member is working out better than a nurse imo but its really tough on that family member to have to live through that. maybe in the next 50 yrs we can just download our brains to a video game
The good news is that we are living longer; the bad news is that we are living longer...
 
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Long term care insurance itself is costly, especially if over 50... but alternatively there are life insurance options with long term care (chronic illness) riders that allow you to pull death benefit to use for care in the event of need. It depletes the death benefit but is a way to help pay for in home and eventually admitted care. Various products have been introduced to try to solve the problem, and most don’t have the stigma (or stink) of older style LTC insurance that was a use it or lose it proposition.

Life insurance with LTC riders
LTC insurance with death benefits
Annuities with 8% annual death benefit roll up that can be used for LTC if triggered

There’s even an annuity product that can take qualified (retirement) money to convert to LTC benefit.

Something you should raise with your advisor if you have one, or I’m always happy to educate.
Thanks Sami. This is obviously in your wheelhouse! Appreciate the advice.

Maybe I just don’t understand the products as much as I should. Let’s say I live another 20 years and pass without requiring any care. If I had taken that money to buy an LTC policy, do my beneficiaries get any value versus if I had just invested the money?
 
Why are so many obsessed here with this nuclear family narrative....i just dont get it....good people can come from all walks of life, you dont not need a traditonal biological mother and father to be loved, raised with good morals and become a productive selfless citizen...i know plenty of children from "nuclear families" that are greedy, self centered snobs
Your overreactions are priceless
 
Thanks Sami. This is obviously in your wheelhouse! Appreciate the advice.

Maybe I just don’t understand the products as much as I should. Let’s say I live another 20 years and pass without requiring any care. If I had taken that money to buy an LTC policy, do my beneficiaries get any value versus if I had just invested the money?
Very much in my wheelhouse. And know that I like what I do and am good at it, and actually get something out of helping people even if it doesn't eventually lead to business. If 30 minutes of my time helps change someone's life/prospects, it's worth it. So don't feel the offer has expectations behind it, please reach out.

To avoid having my email inundated by those who don't appreciate my board presence, feel free to message or connect through LinkedIn. If you're not on LinkedIn, I'll get you my email through Dan. Happy to have a call or provide some info by email.

Keith's LinkedIn
 
Very much in my wheelhouse. And know that I like what I do and am good at it, and actually get something out of helping people even if it doesn't eventually lead to business. If 30 minutes of my time helps change someone's life/prospects, it's worth it. So don't feel the offer has expectations behind it, please reach out.

To avoid having my email inundated by those who don't appreciate my board presence, feel free to message or connect through LinkedIn. If you're not on LinkedIn, I'll get you my email through Dan. Happy to have a call or provide some info by email.

Keith's LinkedIn
Just sent you an invite on LinkedIn. Thanks for the offer!
 
Keith is a good man.

LTC insurance is something definitely worth looking into but you have to be able to afford it. I can tell you I talked my parents into it when it was a new product in the 90's and we saved over $500k+ in the cost of their care. Neither are with us anymore but both unfortunately required a lot of long-term care and it was hard. Financially the LTC insurance protected their assets significantly and allowed us to care for them in the way needed. Amazing how fast assets can be depleted by the cost of care in a facility and at home. And if you get a full time live-in they can take over your house and effectively become a squatter - it has its risks. Paying for home health care with a reputable company is a good but expensive option and unfortunately with my Dad during his last 3 years he had Alzheimers and Parkinsons we had no choice but to move him into a home - worst day of my life easily. With my Mom we cared for her the last 6 years in her home. Without LTC care their assets would not have lasted and we would have had to get reverse mortgages etc to pay for their care. Downside is the current policies are not as good as they once were, so the key is finding the balance between getting protection to help preserve your assets and paying some of the care costs on your own. Most good policies cover around 3 years and you can pay more or less to get additional years or fewer of coverage. All the plans have caps and you have to look at it as protection of your assets and as part of your financial plan. I also looked into the combined LTC/life insurance plans too - very expensive with the positive of getting a death benefit so your funds are not wasted but big up front costs. If you are in your mid to late 50's or early 60's its a good time to look into this seriously to weigh your options and Keith can help you do that I am certain. Good luck!

And for those that say I would never put my loved one in a home, my family said that too and we were very involved in our parents care. Sometimes the condition requires it to protect the patient unfortunately. Aging sucks!
 
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Keith is a good man.

LTC insurance is something definitely worth looking into but you have to be able to afford it. I can tell you I talked my parents into it when it was a new product in the 90's and we saved over $500k+ in the cost of their care. Neither are with us anymore but both unfortunately required a lot of long-term care and it was hard. Financially the LTC insurance protected their assets significantly and allowed us to care for them in the way needed. Amazing how fast assets can be depleted by the cost of care in a facility and at home. And if you get a full time live-in they can take over your house and effectively become a squatter - it has its risks. Paying for home health care with a reputable company is a good but expensive option and unfortunately with my Dad during his last 3 years he had Alzheimers and Parkinsons we had no choice but to move him into a home - worst day of my life easily. With my Mom we cared for her the last 6 years in her home. Without LTC care their assets would not have lasted and we would have had to get reverse mortgages etc to pay for their care. Downside is the current policies are not as good as they once were, so the key is finding the balance between getting protection to help preserve your assets and paying some of the care costs on your own. Most good policies cover around 3 years and you can pay more or less to get additional years or fewer of coverage. All the plans have caps and you have to look at it as protection of your assets and as part of your financial plan. I also looked into the combined LTC/life insurance plans too - very expensive with the positive of getting a death benefit so your funds are not wasted but big up front costs. If you are in your mid to late 50's or early 60's its a good time to look into this seriously to weigh your options and Keith can help you do that I am certain. Good luck!

And for those that say I would never put my loved one in a home, my family said that too and we were very involved in our parents care. Sometimes the condition requires it to protect the patient unfortunately. Aging sucks!
Thank you for the kind words. One thing that resonated with me was our CEO talking about a seminar where the speaker was discussing buying LTC for his ex-wife. As he put it, it wasn’t for her... it was for his kids. Tremendous stress children have and unfortunately many people address their future LTC when going through the struggle real time with their parents.
 
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honest question for advice. what would you do with that person who needs that type of care? one of those communities? do you trust in home nurses?
My grandfather was a perfect example. When he couldn't really live on his own anymore he moved into my parents two family home, he was still very healthy & efficient, but my mom did his shopping, cooking, laundry, etc.. that worked for many years, into his mid 90s.

As he got older, and my parents couldn't provide care, they hired a live in women to take care of all his needs. She was a wonderful woman, she stayed with him for about 2 years basically using his remaining savings to pay her salary, but cost was well worth it.

As he ran out of money/assets, he moved into a nursing home. Lasted only about a month in home before he died.

Would definitely try the live in before going in a home, especially if have family local to keep an eye on pitch in when needed.
 
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