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The Next Pandemic: SARS-CoV-2/COVID-19


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14 minutes ago, Buffalo Bills Fan said:

 

 

I got a prescription for it last Thursday.  They're furloughing the CRNA's so I'll be working at the main hospital.  I'm going to start taking it today.

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Trump Derangement Syndrome is Bad for Your Health

by Steven Hayward

Original Article

 

Senate Democrats shocked everyone Sunday afternoon when they blocked passage of a stimulus plan to try to hold the economy together. Stock market futures immediately plunged to the limit, signaling another dismal day on Wall Street at Monday’s open.

 

Even the New York Times can’t conceal this churlishness. Note their headline: Senate Democrats block action on a trillion-dollar stimulus plan 

 

The party-line vote was a stunning setback after three days of fast-paced negotiations between senators and administration officials to reach a bipartisan compromise on legislation that is expected to be the largest economic stimulus package in American history . . .

 

 

Are Democrats Refusing to Support $2 Trillion Stimulus Bill Unless It Includes a Bailout forPlanned Parenthood?

by Rick Moran

Original Article

 

 

 

Democrats Block Senate Coronavirus Package

by Sean Moran

Original Article

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1 hour ago, GG said:

 

This question came up when analysts were discussing the statistics from Italy, and someone suggested that CV-related deaths there could have been overstated by as much as 80%, because of other contributing factors.   One way to ascertain the CV impact is to compare it to a normalized baseline, which would be the death rate in prior years

 

I don't know if they are being overstated. Italy normaly loses, on average, 1,600-1,800 people per day to all other causes (Between 7,000-8,000 per day in the US). It would be interesting to see comparison figures, by cause (i.e.; influenza, pneumonia, cancer, diabetes, heart disease).

Edited by billsfan1959
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Not enough hospital beds in New Hampshire? Blame needless regulations

Union Leader [Manchester, NH], by Greg Moore

Original Article

 

ACROSS the country, state leaders have raised the alarm over the lack of enough beds should the COVID-19 pandemic create a surge in serious and critical cases. They are concerned that they simply won’t have enough hospital beds to care for ill patients and are taking drastic steps to “flatten the curve” – spreading out the timeline of the disease so that the health care system can manage the influx of new cases. This is just as true in New Hampshire as across the country. However, the prime reason we don’t have more hospital beds is not a lack of demand, but government regulation.

 

 

 

Coronavirus: Why Two Weeks Matters

by Melissa Mackenzie

Original Article

 

 

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6 minutes ago, billsfan1959 said:

 

I don't know if they are being overstated. Italy normaly loses, on average, 1,600-1,800 people per day to all other causes (Between 7,000-8,000 per day in the US). It would be interesting to see comparison figures, by cause (i.e.; influenza, pneumonia, cancer, diabetes, heart disease).

I believe what GG is referring to is simply what is the variance from the norm. Not saying anything is overstated, but this type of view would provide at least a directional idea of incremental deaths due to Covid-19 versus an expectation. It would also reduce the bias that we’re seeing in the data caused by different recording/classification criteria by country/state.

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14 minutes ago, fansince88 said:

Is it claimed to keep you from getting it?

Doc, on this very site is I believe an anesthesiologist in CT, posted today that his hospital was issuing Hydroxychloquine to staff as a preventive measure.

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1 minute ago, 3rdnlng said:

Doc, on this very site is I believe an anesthesiologist in CT, posted today that his hospital was issuing Hydroxychloquine to staff as a preventive measure.

 

 

************

 

The turtle rarely yells -- but he's close to screaming on the floor of the Senate right now talking about the bill. 

 

******************

 

 

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13 hours ago, GG said:

 

I just read his first piece, and it's hot garbage in retrospect, yet he crows that he got 40 millions hits.  Only because he's perpetuating the falsehoods that is now gospel, but will likely look foolish when this is said and done.

 

It's actually good to read his second piece after the first, because you realize that he doesn't address his wrong prognostications at all and continues with the alarmist tone.  South Korea exponential growth?  Mmm, never mind.  According to him it's because they went through SARS, and knew what to do.  Which is what ....?   

Seems to me he was pretty clear in what was done: 

Quote

Containment is making sure all the cases are identified, controlled, and isolated. It’s what Singapore, Hong Kong, Japan or Taiwan are doing so well: They very quickly limit people coming in, identify the sick, immediately isolate them, use heavy protective gear to protect their health workers, track all their contacts, quarantine them… This works extremely well when you’re prepared and you do it early on, and don’t need to grind your economy to a halt to make it happen.

Washington State follow up?   Nope, not a peep.

In the first article he used examples to show how to estimate the number of true cases since testing was so limited.  He used Washington, SF, and a few countries. Unfortunately, it still took Washington State a long time to get testing ramped up--it's only been the last week.  Since he is focused on predicting situations for countries, I'm not sure what your issue is here?

 

Diamond Princess?  Clearly a statistical anomaly.  But Italy isn't. 

He used DP also as an example for estimating the CFR, which he said would be between 1-6%.  Again, not sure what the issue is here?   My view is DP is a good example of how to keep it contained by extreme quarantining of people, as everyone was confined to their cabins, which limited the cases.

 

He lumped the Swiss as one of the countries who were late in responding, without noting that the country has negligible deaths from CV.

Based on the article, he was predicting what would happen to countries based on their responses. He predicted the growth in the # of cases for the swiss would accelerate because of their late response. As of the date of his prediction, 3/5, Swiss had 120 cases and 1 death; currently they have 8500 cases and 118 deaths.  I don't know what your definition of negligible is...?

 

Which brings me to the biggest problem of painting this virus with as broad brush as possible.  As we're about to finish the third month in a pandemic, clear patterns are emerging despite what people like Puevo want you to believe, and that pattern is much closer to Leavitt's & Ginn's theories.

 

 

Culture, demographics and climate all play a major role in the spread, and that's why you are seeing an explosion in Lombardy & NYC (Australia is not a problem btw).  Other areas of the Italy are faring much better, and don't get me started on NYS north of Orange County compared to the NY metro area.  Even the NY's first major outbreak in New Rochelle appears to be abating, similarly to what happened in Washington.  But that's not NYC because people are on top of one another, and they're stupid.  I witnessed what Cuomo was talking about first hand yesterday.  All along the West Side, it was as if there's no danger lurking.   

He states that demographics and climate to play a roll.  

Quote

Note that the age distribution in each country will also have an impact: Since mortality is much higher for older people, countries with an aging population like Japan will be harder hit on average than younger countries like Nigeria. There are also weather factors, especially humidity and temperature, but it’s still unclear how this will impact transmission and fatality rates.

 

 

Very few people are getting airtime to propose commonsense solutions.  Hype sells.

 

We keep getting bombarded by stories of Chinese, South Korean and Singapore lockdowns, without getting much details of what happened.  Reality is none of these countries truly locked down.  And here's where experience with SARS and their culture came in to curb the spread.  EVERYONE obeyed common social norms, they wore masks, they kept their distance and they washed their hands.   Lo and behold, the spread slowed down and spread.  Not so hard.  Avoid direct contact and keep washing yourself.

Regarding how SKorea did it, he linked to this video in the second article which explains it. 

https://www.bbc.com/news/av/world-asia-51897979/coronavirus-south-korea-seeing-a-stabilising-trend

Regarding Singapore, he linked to this article: https://academic.oup.com/jtm/advance-article/doi/10.1093/jtm/taaa039/5804843

Neither SK or Singapore needed to use lockdowns, so I"m not sure where that statement comes from?

Regarding China, did you not see videos of their lockdown?

 

It seems you are putting your own spin on his basic analysis.  Here's what he is saying in my view.

1. Countries that acted quickly to limit the spread (as described in the above two pieces) experienced low CFRs and for the most part number of cases.  SKorea had the issue of on super-predator underlying a significant number of cases.  That CFR is was between 0.5 - 1.0%. 

2. Countries that reacted late will experience exponential growth and higher CFR, between 3-5%. This is due to the healthcare system being overwhelmed, not the actual death rate from the virus itself, as in #1.

3. Countries in the latter group, if they act fast and use extreme measures (what he calls the hammer) can reduce the death rate.  It's all about getting R0 near or below 1.

4. In article 2, he puts together a hypothetical chart 15 which looks at different measures that reduce R0. The first two points listed are climate and pop density. He also tries to provide estimates of economic impact from the various strategies, and he says policy makers need to weigh the cost-benefits of implementing.  Maybe we read different articles?

5. His conclusion, based on the Chinese evidence of extreme quarantine, is that it would take about 2 weeks of the extreme measures to get us close to 1.  However, this strategy also means that many people will most likely get it in the next season, but he says that buys us time to prepare and we won't have to take extreme measures. I've seen criticisms that his estimate of 2 weeks is too short.  

 

So, from what I see, he admits that climate, pop density, and demographics all impact the spread and therefore the CFR, so he covers your criticisms. It seems to me, all the countries that delayed their responses are experiencing exponential growth as predicted, including Switzerland.  

My guess is that it will take 3-4 weeks for us to reduce the spread because so many people are #######s who don't heed the quarantine, your "culture" variable I guess...

 

If the bill being discussed was set up to keep people employed by government support, then the economy could recover more quickly. Unfortunately, most of it seems to be a corporate boost controlled by the Munchkin, much like what Paulson's original bailout proposal was.   

 

 

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Just now, westside2 said:

Didn't the President mention that drug last week but was laughed at and ridiculed by the left and msm?

 

Yes. He was grilled for it, and blasted reporters who used it to drive a wedge between him and Fauci. 

 

It's a CLEAR example of how badly the national media has lost its way.

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ROGER KIMBALL: COVID-19, the Elephant, and the House Cat.

 

 

 

 

SEN. AMY KLOBUCHAR SAYS HER HUSBAND HAS TESTED POSITIVE FOR CORONAVIRUS: “After a persistent temperature and a ‘bad, bad’ cough, [John] Bessler began coughing up blood, Klobuchar [D-MN] said, prompting him to get a coronavirus test and a chest X-ray. He checked into a hospital in Virginia and ‘now has pneumonia and is on oxygen but not a ventilator,’ Klobuchar said.”

 

 

 

 

 Hillary and Chinese Gov’t Reading From Same Script In Calling Trump Racist Over “Chinese Virus”.

 

 

 

 

AN ARGUMENT FOR LOCALISM: Disaster in New York does not require the same policy everywhere.

 

New York State has a whopping 810 cases per million residents, closing in on both Italy and Switzerland fast. And the vast majority of those cases are concentrated in the City and nearby commuter counties. Franklin County, in the Adirondacks (and where your Editor has been known to spend some time) has not yet had a single confirmed case.

 

By contrast, the other 49 states combined, including such hot zones as Washington and California, are at 54 cases per million residents. That puts the per million infection rate in the “other 49” just between Australia and North Macedonia. Or China, if you care to believe Commie numbers. Which we don’t.

 

One question, of course, is whether the rest of the country is just “behind” New York by a few days, or whether there are important differences that should inform policy. We suspect some of both is true. Yes, New York is the land of stainless steel subway poles, where the virus once deposited will linger a particularly long time, cheek-by-jowl restaurant tables, and terribly crowded sidewalks. But New York is also testing heaving masses of people, so it may be revealing its own infections more completely than other states that will soon catch up in the world’s most dubious league table.

 

Regardless, the vast difference in the apparent rate of infection between downstate New York and the rest of the country (and the considerable differences among the remaining 49 states) suggests that we need not apply precisely the same policies in every jurisdiction. Even in New York State, we do not understand the logic, beyond mere political calculus, for imposing the same burdens on the already poor towns of the Adirondacks as are the bare minimum, if that, in the boroughs.

 

Read the whole thing.

 
 
 
 
 
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1 hour ago, 3rdnlng said:

Doc, on this very site is I believe an anesthesiologist in CT, posted today that his hospital was issuing Hydroxychloquine to staff as a preventive measure.

Awesome. Didnt see that thanks. BTW, I work for a Drug Chain distribution center based out of NY. We are having trouble procuring thst product at the moment.

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A very important point to remember........discuss it with you family

 

 

 

"As an ER doctor, I am already faced with patients who arrive too sick to tell me their wishes, with no documentation of what those were when they were well enough to articulate them..."

 
"... and with family members who never asked and, as a result, just don’t know. It is in these situations, as I place tubes and lines in this failing body, that I worry we are not providing care that is concordant with their goals. If I had known that the 68-year-old with recently diagnosed metastatic breast cancer is more worried about being uncomfortable at the end of her life, rather than prolonging it, we wouldn’t have placed that breathing tube and would instead have focused our intensive efforts on making her comfortable. If I had known that the 81-year-old had always hoped to die at home, I would have spent more time trying to mobilize our home hospice team rather than defaulting to a hospital admission.... I recently had this conversation with my own father and found out that he worried more about getting overly aggressive care than he did about not getting enough.... I wish we didn’t have to make and share these difficult decisions, but I worry that we are in a situation that necessitates it even more than usual."

From "Do your loved ones a favor. Find out now how they want to die. I’m an ER doctor, and we need to know what matters most to your family member" by Emily Aaronson (in WaPo).

One thing that Aaronson doesn't talk about is how bad it is in a time of shortage to use hospital equipment and services on people who would prefer to be left at home and to struggle to breathe or die without the invasion of ventilator tubes.

Perhaps the inference is so obvious it's just brutal to specify it. That's a little ironic in an article about the problem of failing to "articulate" things. But I can see why Dr. Aaronson keeps quiet about anything that feels like utilitarianism.

 

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19 hours ago, TPS said:

Cases in Italy declined 15% compared to yesterday. Hopefully they’re turning the corner.

Cases are down another 14% from previous day. 

3/21  6557

3/22  5560

3/23  4789

 

This is why you take extreme measures of quarantining, to bring the rate of contagion down.

This is good news

@PaoloBillsFanFromItaly

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1 minute ago, TPS said:

Cases are down another 14% from previous day. 

3/21  6557

3/22  5560

3/23  4789

 

This is why you take extreme measures of quarantining, to bring the rate of contagion down.

This is good news

@PaoloBillsFanFromItaly

 

Yes, extreme measures are beginning to give results, I was expecting the lowering of the cases one week before (15 days after the decree) so I was very pessimistic until today.

Today it seems that the lowering trend is for real.

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Just now, PaoloBillsFanFromItaly said:

 

Yes, extreme measures are beginning to give results, I was expecting the lowering of the cases one week before (15 days after the decree) so I was very pessimistic until today.

Today it seems that the lowering trend is for real.

 

Glad there's light at the end of the tunnel for you and yours, Paolo. :beer: Let's keep it up.

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I find more and more that I'm wondering about the long term ramifications of the current social distancing measures being implemented. For example, teleworking has jumped forward a decade in some fields and business operations are changing as companies are forced to expose antiquated policies are not actually essential, as they've insisted to avoid change. Similar with school. I wonder if there are any long term changes there that come out of this.

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