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

[old_gregg]

i'd rather choke to death on my own gooey phlegm than go to javits

[Northwestcoug]

I agree we will know soon based on what happens in nyc. I think within the week. Do you think an Italy/Spain overstressing of the system in nyc is inevitable? What if they successfully ramp up to meet demand and/or critical cases are lower than feared? Wouldnt it then be time to recalibrate our national strategy? (Not that we have a great one at the moment)

Regarding you last paragraph, I think many are unsympathetic, or at least underestimating, the economic impact. The fact that you call it a worry of a serious downturn reflects that. This isnt a worry of a downturn that might materialize. It is an economic cliff that we have driven off. Its already here. We just have to see if we decide to deploy a parachute or not.

Again this isnt to argue current measures arent necessary. I think they clearly are. But economic impact has to be a continuing component of the discussion. Trump is obviously the worst messenger ever on this but the sentiment that we need to get back to work as soon as it is reasonably safe to do so is correct.

I heard Cuomo say today that hundreds of thousands may have been infected and they didnt know it and they should he tested for antibodies so they can go back to work. Sounds good to me but Is that even a thing that could be done?

My opinion is colored by my location. Our local health care system employs just enough clinicians and operates just enough ICU beds to handle the local needs in 'good' times. There is very little room for ramping up that coverage in bad times. And I assume most hospitals in the US operate similarly. If it is similar in NYC (and most of the evidence suggests that it is), it will not take much at all to have the same dynamic as we're seeing in Europe. I'm guessing our population advantage could help marshal reserves from other areas in the country. But after seeing the mask/ventilator/testing debacle so far, I'm not so sure we have that big of an advantage.

Yes, I think many people probably underestimate the economic impact of doing the best scenario of fighting the virus with the least amount of casualties. I see Twitter cries of 'shut the whole country down' all the time. And yes, the downturn is already here. But this discussion we've had the last few days is still centered on 'either/or' scenarios; i.e. the people in charge are only considering the health effects and giving no thought to the economy. Right now, our intact health care system is saving our economic downturn from disaster. If we've driven off the cliff like you say, an intact health system is providing a pillow to land on. If our general well-being is affected by a collapsed health care system, that will reverberate longer than if we shut 'everything' down temporarily.

Serologic/antibody testing is just barely coming online. We just had a hospital meeting deciding on whether we should implement it. It's not FDA approved yet, and the sensitivity/specificity is around 85-90%. So it's not a terribly great screening tool if you're basing all decisions on that test value. But it could become a part of a more general algorithm. We decided not to go that route. We are still waiting for DNA based tests. We thought we'd have that up and running by next week. But priority is going to Washington and California, so who knows when our rural area will get that. Again, another debacle that has been exacerbated by serious deficiencies in our US system.

[Color Me Badd Fan]

The site I track, worldometers.info, lists Gov Cuomo claiming that NY is now within 3 weeks of peak. I would think then NY is starting to clear up and return to some level of normalcy by the end of May. Others will lag behind NY but hopefully by the end of June the rest of the country is starting to make plans to come out of this deep freeze.

One of the problems of our modern world is the reality that it is so complex but yet the information is so easy to disseminate. So few people have the scientific or statistical background to comprehend what is really going on. In that awkward environment where folks feel as inadequate as Ned Flanders when they are serving footlong hotdogs, we are all prone to entrench into our echo chambers where we hear what we want to hear.

There's no other place like New York in the US, it's the most densely populated city. People also rely more on public transportation there than any other place by far. The only other places in the US that could possibly come within any reasonable range of New York is San Francisco or possibly LA if it gets into the homeless population.

[Color Me Badd Fan]

These memes were going around weeks ago, they're still really funny. It should be altered to fit that idiot Rand Paul who was going to the congressional gym while awaiting the results from his test.

8ab.jpg

[Uncle Ted]

I think we are going to see some clarity pretty soon with what happens in New York. Even if the most dire scenarios do not materialize, the health system will be strained more than we have seen in our lifetimes. If the health system there breaks, all the discussions of 'wildly overestimated mortality rates', herd immunity, and 'how much do we allow the economy to suffer to save 'X' amount of deaths' will become useless mind exercises. Once all needed ventilators and ICU rooms are taken up by COVID-19 patients, both the COVID and general mortality rates will rise. Once health care workers become infected, the mortality rate of inpatients will rise. Once both younger COVID and general patients start dying at a higher rate, the economic toll will rise. These worst case scenarios are most likely in the biggest urban centers, but no area in the country is going to remain unaffected.

No one is unsympathetic to the worry of a serious and maybe unneeded economic downturn. But the majority of evidence so far has been fairly well predicted by the adults in the room. We should continue to pay attention.

Yeah, it is too bad Gov. Cuomo pissed away the good people of NY's money alway on some dumb solar energy company instead of prepping for a pandemic such as this:

We didn’t have to have ventilator shortage — leaders chose not to prep for pandemic
[...]
In 2015, that task force came up with rules that will be imposed when ventilators run short. *Patients assigned a red code will have highest access, and other *patients will be assigned green, yellow or blue (the worst), *depending on a “triage officer’s” decision.

In truth, a death officer. Let’s not sugar-coat it. It won’t be up to your own doctor.

In 2015, the state could have purchased the additional 16,000 needed ventilators for $36,000 apiece, or a total of $576 million. It’s a lot of money, but in hindsight, spending half a percent of the budget to prepare for pandemic was the right thing to do.
[...]

https://nypost.com/2020/03/19/we-didnt-have-to-have-ventilator-shortage-leaders-chose-not-to-prep-for-pandemic/

Now Cuomo is blaming the Feds on picking who dies. Someone needs to pull out his task force rules... Cuomo has already decided that when he "invested" the NY people's money in solar sh*t companies (that most likely lined his pocket with money) that went under instead of ventilators.

Cuomo is a dumbass.

[SeattleUte]

Per Cuomo, we aren't flattening the curve. It's spiking in 2-3 weeks. So none of this is doing any good anyway?!

[SeattleUte]

Yeah, it is too bad Gov. Cuomo pissed away the good people of NY's money alway on some dumb solar energy company instead of prepping for a pandemic such as this:

https://nypost.com/2020/03/19/we-didnt-have-to-have-ventilator-shortage-leaders-chose-not-to-prep-for-pandemic/

Now Cuomo is blaming the Feds on picking who dies. Someone needs to pull out his task force rules... Cuomo has already decided that when he "invested" the NY people's money in solar sh*t companies (that most likely lined his pocket with money) that went under instead of ventilators.

Cuomo is a dumbass.

Your last comment is absolutely true. We spent gobs on climate change while ignoring the ever present risk of pandemic.

My faith in government is trying to find a bottom. Hasn’t yet.

[Omaha 680]

My opinion is colored by my location. Our local health care system employs just enough clinicians and operates just enough ICU beds to handle the local needs in 'good' times. There is very little room for ramping up that coverage in bad times. And I assume most hospitals in the US operate similarly. If it is similar in NYC (and most of the evidence suggests that it is), it will not take much at all to have the same dynamic as we're seeing in Europe. I'm guessing our population advantage could help marshal reserves from other areas in the country. But after seeing the mask/ventilator/testing debacle so far, I'm not so sure we have that big of an advantage.

Yes, I think many people probably underestimate the economic impact of doing the best scenario of fighting the virus with the least amount of casualties. I see Twitter cries of 'shut the whole country down' all the time. And yes, the downturn is already here. But this discussion we've had the last few days is still centered on 'either/or' scenarios; i.e. the people in charge are only considering the health effects and giving no thought to the economy. Right now, our intact health care system is saving our economic downturn from disaster. If we've driven off the cliff like you say, an intact health system is providing a pillow to land on. If our general well-being is affected by a collapsed health care system, that will reverberate longer than if we shut 'everything' down temporarily.

Serologic/antibody testing is just barely coming online. We just had a hospital meeting deciding on whether we should implement it. It's not FDA approved yet, and the sensitivity/specificity is around 85-90%. So it's not a terribly great screening tool if you're basing all decisions on that test value. But it could become a part of a more general algorithm. We decided not to go that route. We are still waiting for DNA based tests. We thought we'd have that up and running by next week. But priority is going to Washington and California, so who knows when our rural area will get that. Again, another debacle that has been exacerbated by serious deficiencies in our US system.

Economically speaking, the healthcare system doesnt do much to provide a soft landing if we do this for too long. If we do this for 6 months and half the small business fail and 30 million jobs disappear, the healthcare system wont help us dig out of that crater on the other side of this.

We need to prevent death and suffering as much as possible. That's why I am fully on board with the current distancing measures until we know the extent of what we are facing. But it should not be verboten to discuss all these issues simultaneously and publicly. We should expect our leaders to be doing no less. Again, having trump as messenger makes this very difficult.

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[Omaha 680]

Per Cuomo, we aren't flattening the curve. It's spiking in 2-3 weeks. So none of this is doing any good anyway?!

I'm not convinced he really knows that one way or the other. Fortunately we should know for sure soon.

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[Jeff Lebowski]

Good leadership here in Utah:

Embedded Tweet

[Northwestcoug]

Yeah, it is too bad Gov. Cuomo pissed away the good people of NY's money alway on some dumb solar energy company instead of prepping for a pandemic such as this:

https://nypost.com/2020/03/19/we-didnt-have-to-have-ventilator-shortage-leaders-chose-not-to-prep-for-pandemic/

Now Cuomo is blaming the Feds on picking who dies. Someone needs to pull out his task force rules... Cuomo has already decided that when he "invested" the NY people's money in solar sh*t companies (that most likely lined his pocket with money) that went under instead of ventilators.

Cuomo is a dumbass.

Nice of you to parrot Trump’s talking points from his town hall this am.

Show of hands, who is doing better at managing the crisis: Trump or Cuomo?

Economically speaking, the healthcare system doesnt do much to provide a soft landing if we do this for too long. If we do this for 6 months and half the small business fail and 30 million jobs disappear, the healthcare system wont help us dig out of that crater on the other side of this.

We need to prevent death and suffering as much as possible. That's why I am fully on board with the current distancing measures until we know the extent of what we are facing. But it should not be verboten to discuss all these issues simultaneously and publicly. We should expect our leaders to be doing no less. Again, having trump as messenger makes this very difficult.

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I can’t put a firm dollar amount on the contribution of health care to the overall economy. Much of its value is hard to quantify. But it is maintaining the general health of the population, so they can continue to work and contribute to the economy. When we cant adequately treat adults who are not infected with virus but have other curable ailments, then we are not only losing the elderly to the virus but also adult workers. This scenario is becoming increasingly likely in the urban centers.

[Northwestcoug]

Expect more of these in the future. Hopefully they will have some role in treatment. But there is no way these treatments are going to live up to the hype Trump and others have given them:

First, in a small study involving 30 patients, hydroxychloroquine, used on top of conventional treatments, cleared the virus in 13 (86.7%) cases on day 7, while 14 (93.3%) patients in the control group had the virus cleared, according to a study abstract Raffat obtained. One patient on the malaria med progressed to severe during the treatment.

The median duration from hospitalization to virus-negative testing, as well as the median time to body temperature normalization, were also similar between the two arms. The only positive signal was disease progression shown on CT scans, which five hydroxychloroquine cases showed, versus seven in the control group. But Raffat said the trial size was simply too small to draw conclusions.

https://www.fiercepharma.com/pharma-...point-clinical

[wuapinmon]

My friend's wife was exposed at work. She has to isolate at home for 14 days. Their four kids are there with them. I'm hoping that none of them get sick. Luckily, their contract has them get paid as if they were working. 6 ICU nurses, all down for two weeks due to someone not being stringent enough about moving a patient to a COVID area, and they all got exposed, despite repeatedly suggesting to the person in charge that the patient was COVID+. Ugh!

[myboynoah]

Every governor, the leaders on the front line of this, is pushing for dealing with the health crisis first, and then move to the economy.

Deal with coronavirus first, then economy ‘will come roaring back,’ Texas Gov. Greg Abbott says

Full churches on Easter is a recipe for disaster in terms of spreading this disease. It was a church that spread it in Korea and it is churches now (that are still meeting) that act as spreaders, even as the numbers are decrease in general.

[myboynoah]

Like I've been saying, this isn't rocket science. We need data to fight this thing. We should just test the whole country.

Why Germany’s coronavirus death rate is so much lower than other countries’ rates

The biggest reason for the difference, infectious disease experts say, is Germany’s work in the early days of its outbreak to track, test and contain infection clusters. That means Germany has a truer picture of the size of its outbreak than places that test only the obviously symptomatic, most seriously ill or highest-risk patients.

“At the beginning, when we had relatively few cases, when it came to finding them and isolating them, we did quite well in Germany,” said Reinhard Busse, head of the department of health care management at the Berlin University of Technology. “That’s the major reason.”

. . . . . .

Germany has not carried out mass testing of the kind employed in countries such as South Korea. But initially, at least, the country’s health authorities tracked infection clusters meticulously. When an individual tested positive, they used contact tracing to find other people with whom they had been in touch and then tested and quarantined them, which broke infection chains.