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At what point did you / will you take the coronavirus epidemic seriously?

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  • Originally posted by Jarid in Cedar View Post
    No, but the primary mechanism of the disease is driven by injury caused by the immune response to the virus instead of just the direct cytotoxicity of the virus itself. That is how they are similar to COVID-19.
    So, I didn't realize this. The virus itself doesn't necessarily cause the damage, but instead it's the severity of the immune system's response. Am I reading this correctly?
    Jesus wants me for a sunbeam.

    "Cog dis is a bitch." -James Patterson

    Comment


    • Originally posted by Green Monstah View Post
      So, I didn't realize this. The virus itself doesn't necessarily cause the damage, but instead it's the severity of the immune system's response. Am I reading this correctly?
      Partially. The virus does cause direct injury to targeted cells. This causes the typical early symptoms people experience, cough, sore throat, alterations of smell, etc. But some of those who get more severe manifestations, the vascular injury, the cytokine storm patients, eg. Much of that disease process occurs after the initial viral injury, and the damage caused by the over response by the immune system.
      "The first thing I learned upon becoming a head coach after fifteen years as an assistant was the enormous difference between making a suggestion and making a decision."

      "They talk about the economy this year. Hey, my hairline is in recession, my waistline is in inflation. Altogether, I'm in a depression."

      "I like to bike. I could beat Lance Armstrong, only because he couldn't pass me if he was behind me."

      -Rick Majerus

      Comment


      • Originally posted by Jarid in Cedar View Post
        Partially. The virus does cause direct injury to targeted cells. This causes the typical early symptoms people experience, cough, sore throat, alterations of smell, etc. But some of those who get more severe manifestations, the vascular injury, the cytokine storm patients, eg. Much of that disease process occurs after the initial viral injury, and the damage caused by the over response by the immune system.
        Interesting, sounds like what was so bad about the 1918 flu. Except that one seemed to hit the young and healthy really hard due to their robust immune systems. Scary stuff.

        Comment


        • Originally posted by Flystripper View Post
          Thanks Jarid. I appreciate it when we hear from you on this. Your insight is highly informed not only from personal front-line experience, but also because you have followed the treatments as they have evolved.

          That being said WTF. Huntington Beach used to be so chill. God help us.


          https://www.instagram.com/tv/CCoYH6e...d=d5w8kaqcs2m2


          Sent from my iPhone using Tapatalk
          It's unbelievable. I live in OC. I pull out my mask whenever I'm around anyone...that often offends people. People are crazy. I watched the OC Board of Education meeting. The first comment from the public after they voted to recommend kids going back to school immediately was bizarre. The woman compared the members of the board to Oskar Schindler and Anne Frank. I know one of the members of this board, he's in my stake. The dude is a real mouth-breather. No where near Anne Frank territory. The thought of some of these people in the voting booth keeps me up at night.

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          • Well.. good thing that masks are a political point of contention in this country. Huntington Beach is like Republican Central-- that explains that video probably more than thinking all Americans are extra dumb.
            "I'm anti, can't no government handle a commando / Your man don't want it, Trump's a bitch! I'll make his whole brand go under,"

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            • Originally posted by Commando View Post
              Well.. good thing that masks are a political point of contention in this country. Huntington Beach is like Republican Central-- that explains that video probably more than thinking all Americans are extra dumb.
              Videos like that contribute to it being a point of contention. I'm all for masks indoors and where social distancing isn't possible, but confronting people who are outdoors where transmission rates are low is obnoxious and divisive.

              Comment


              • Originally posted by YOhio View Post
                Videos like that contribute to it being a point of contention. I'm all for masks indoors and where social distancing isn't possible, but confronting people who are outdoors where transmission rates are low is obnoxious and divisive.
                And, if you noticed, the box was empty by the end. They gave out a lot of masks (if there were any in there at all)!

                But, I still laughed at the video.
                Ain't it like most people, I'm no different. We love to talk on things we don't know about.

                "The only one of us who is so significant that Jeff owes us something simply because he decided to grace us with his presence is falafel." -- All-American

                GIVE 'EM HELL, BRIGHAM!

                Comment


                • Originally posted by YOhio View Post
                  Videos like that contribute to it being a point of contention. I'm all for masks indoors and where social distancing isn't possible, but confronting people who are outdoors where transmission rates are low is obnoxious and divisive.
                  I acknowledge they were probably out there all day and only got a couple crazies- I get the point of making a video like this. It's the wide shots of absolutely nobody wearing a mask that is cringe.
                  "I'm anti, can't no government handle a commando / Your man don't want it, Trump's a bitch! I'll make his whole brand go under,"

                  Comment


                  • Walmart is going to start requiring all customers to wear a mask. If you thought the amount of crazy shown by some Costco members was interesting, wait until you see the level of crazy that comes from Walmart customers

                    https://twitter.com/Walmart/status/1283419050039668736

                    The replies on their twitter thread truly make me weep over the level of stupid prevalent in the USA.

                    Comment


                    • Seemed like Walmart was already doing this... maybe my short term memory is failing me...
                      "I'm anti, can't no government handle a commando / Your man don't want it, Trump's a bitch! I'll make his whole brand go under,"

                      Comment


                      • Originally posted by Commando View Post
                        Seemed like Walmart was already doing this... maybe my short term memory is failing me...
                        Walmarts in states or counties with mask requirements were already doing it. The change is to make it nationwide, regardless of the specific state or county's requirement.

                        Comment


                        • Originally posted by Moliere View Post
                          Can’t wait for the vaccine skeptics (mbn and nwc) to come and throw rain clouds all over this sunshine.


                          Sent from my iPhone using Tapatalk
                          ???
                          Give 'em Hell, Cougars!!!

                          For all this His anger is not turned away, but His hand is stretched out still.

                          Not long ago an obituary appeared in the Salt Lake Tribune that said the recently departed had "died doing what he enjoyed most—watching BYU lose."

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                          • Originally posted by myboynoah View Post
                            ???
                            LOL I didn't know you were a 'vaccine skeptic!'
                            "I'm anti, can't no government handle a commando / Your man don't want it, Trump's a bitch! I'll make his whole brand go under,"

                            Comment


                            • Originally posted by Mormon Red Death View Post
                              I appreciate your response and I have a couple of questions/comments:

                              1. What happened with Washington? They were the epicenter at the beginning but seem to have not been ravaged like the other early states you mentioned. Just happenstance or did they do something different?

                              2. How much do you count in the missteps the states took? I'm with you on the argument of "well we treat better now that is why first states were were hit so hard". However, the magnitude of the difference seems to much to just call it chance. For example, Michigan .06% while NY is .17%. I think NY's sending back infected to the nursing home is the difference between the #s. They did create a makeshift hospital but they never used it. Since 80% of the deaths from covid are 65 and older that misstep is the biggest reason they have so many deaths.

                              3. My original post was that I had seen so much on how the florida governor was killing everybody that is why I showed the death rate by population. While I'm no fan of his I dont think that can be argued.

                              1. A bit of happenstance. The biggest difference between Washington(and the west coast in general) was a lack of a large influx of undetected cases from foreign countries. This is primarily due to the shutdown of travel from China on January 30th. With the exception of the one cruise ship that docked in Santa Clara, the majority of the initial outbreaks on the west coast can be traced to American citizens returning from China. It is well known that patient 0 in Washington was a student who returned from Wuhan. If you think of the 50 day scale I described originally, Washington was aware of their outbreak on about day 15 or so. The best analogy is a grass fire. The initial outbreak in Washington was a single moderate sized fire that was found within hours after it started. It did damage, but the damage was localized. On the East coast, their outbreak was 1500 small fires started in random locations in the field that were not recognized for a few days.

                              2. I knew I forgot to cover something last night, and this was it. The decision to force patients back into nursing homes was the type of decision that gets made when all of the options are bad choices. I always say that the view from the cheap seats are pretty damn good. Everyone always criticizes the decision from the cheap seats, but they do that without looking through a prospective lens. What were all of the options? What are the potential consequences of each decision? What is the immediacy of needed decision? So what was the situation on March 25th when the mandate was made? On that day, nursing homes and assisted living centers were not just refusing COVID+ patients, they were refusing to take ANY patient that had been in a hospital for any reason, even for just a visit to the ER for a fall, etc. They wouldn't take them until they had a negative COVID test, and some were requiring 2 negative tests. At that time, testing turn around was horrid, around 3-5 days. It was more stringent for any COVID+ patients. They wouldn't take them until they were symptom free 14 days and had a negative test. This was regardless of whether they were actually sick enough to require hospitalization. So these patients, that would typically met criteria for discharge to a nursing home or assisted living center. So, now you have a large group of patients, that do not need to be in a hospital (based on meeting discharge criteria), but are now stuck in the hospital for 3-5 days, and even longer if they are COVID+. On top of that, the ER's are starting to burst at the seams needing to admit patients to beds that are filled with patients who don't need to be there, but can not be discharged anywhere. So your choices are to force centers to take back patients to clear hospital space, or do you acquiesce to the nursing homes, keeping those patients in the hospital and turning away patients from the ER that need hospitalized. There are few other options, but they would require substantial time ( one would be to force a few homes to be COVID centers and move all of their other patients to other places, which the care centers would fight tooth and nail through legal channels). So given those two choices what was the correct choice of two very bad options? Which would result in fewer deaths? No one knows because one path was taken. This is another one of those things that fits into the category of poor care decisions that were prompted by the avalanche of patients. No other states have been forced to make that decision. In Utah, we have had to jump through all of the same hoops for patients that we send to nursing homes, psychiatric facilities, and assisted living centers. But we have had the luxury of holding the patients in the hospital until testing comes back because we have not been in a bed crunch in any meaningful way. And there are now centers designated on the Wasatch Front that are COVID centers because they have already had cases.

                              As far as the Javit's center field hospital is concerned, it came on line on April 1st, but it was originally slated as a COVID free center (as was the Naval Hospital Ship). This was determined by Agent Orange and the military. They thought they would take all of the non ICU, non covid patient's from the hospitals to free up room. Trouble was that wasn't the need. They needed extra space for COVID patients. That did not change until my second week in New York, so sometime around April 21st. By then it was too late for the nursing homes, and the hospitals had already reconfigured all of their own space to manage their loads. So the Javit's center was virtually unused. I did transfer 2 patients there during my stay. To me the Javit's center is the living symbol of the ineptitude of the US response to this pandemic. It was a grand facility that did not fill any meaningful need at the time when it was needed most.

                              3. As I have been saying, I don't think that much information can be gathered to compare the states responses. This is a race with a staggered start, and it is only about 1/4 of the way completed. I do think that the reopening strategy of Florida's governor (and Arizona's) was haphazard and reckless. In doing so, they have squandered the advantages that they were handed. Time will tell.
                              "The first thing I learned upon becoming a head coach after fifteen years as an assistant was the enormous difference between making a suggestion and making a decision."

                              "They talk about the economy this year. Hey, my hairline is in recession, my waistline is in inflation. Altogether, I'm in a depression."

                              "I like to bike. I could beat Lance Armstrong, only because he couldn't pass me if he was behind me."

                              -Rick Majerus

                              Comment


                              • Originally posted by Jarid in Cedar View Post
                                2. I knew I forgot to cover something last night, and this was it. The decision to force patients back into nursing homes was the type of decision that gets made when all of the options are bad choices. I always say that the view from the cheap seats are pretty damn good. Everyone always criticizes the decision from the cheap seats, but they do that without looking through a prospective lens. What were all of the options? What are the potential consequences of each decision? What is the immediacy of needed decision? So what was the situation on March 25th when the mandate was made? On that day, nursing homes and assisted living centers were not just refusing COVID+ patients, they were refusing to take ANY patient that had been in a hospital for any reason, even for just a visit to the ER for a fall, etc. They wouldn't take them until they had a negative COVID test, and some were requiring 2 negative tests. At that time, testing turn around was horrid, around 3-5 days. It was more stringent for any COVID+ patients. They wouldn't take them until they were symptom free 14 days and had a negative test. This was regardless of whether they were actually sick enough to require hospitalization. So these patients, that would typically met criteria for discharge to a nursing home or assisted living center. So, now you have a large group of patients, that do not need to be in a hospital (based on meeting discharge criteria), but are now stuck in the hospital for 3-5 days, and even longer if they are COVID+. On top of that, the ER's are starting to burst at the seams needing to admit patients to beds that are filled with patients who don't need to be there, but can not be discharged anywhere. So your choices are to force centers to take back patients to clear hospital space, or do you acquiesce to the nursing homes, keeping those patients in the hospital and turning away patients from the ER that need hospitalized. There are few other options, but they would require substantial time ( one would be to force a few homes to be COVID centers and move all of their other patients to other places, which the care centers would fight tooth and nail through legal channels). So given those two choices what was the correct choice of two very bad options? Which would result in fewer deaths? No one knows because one path was taken. This is another one of those things that fits into the category of poor care decisions that were prompted by the avalanche of patients. No other states have been forced to make that decision. In Utah, we have had to jump through all of the same hoops for patients that we send to nursing homes, psychiatric facilities, and assisted living centers. But we have had the luxury of holding the patients in the hospital until testing comes back because we have not been in a bed crunch in any meaningful way. And there are now centers designated on the Wasatch Front that are COVID centers because they have already had cases.
                                I appreciate your opinion on this. The continuous victory lap that Cuomo is doing is very unseemly, but like you say, there were no good options with the nursing home residents early on. It wasn't 100% ineptitude that some of his detractors are claiming. Lots of people died based on that decision, but it was the result of a cascade of bad outcomes. He doesn't deserve all of the vilification, but it would help to be way more humble in the face of all that death.
                                "...you pointy-headed autopsy nerd. Do you think it's possible for you to post without using words like "hilarious," "absurd," "canard," and "truther"? Your bare assertions do not make it so. Maybe your reasoning is too stunted and your vocabulary is too limited to go without these epithets."
                                "You are an intemperate, unscientific poster who makes light of very serious matters.”
                                - SeattleUte

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