Covid-19 discussion and humor thread [Was: CDC says don't touch your face to avoid Covid19...Vets to the rescue!

[MJS]

4 hours ago, BillsFan4 said:

That’s not the only difference though.

 

For example, another difference is the hospitalization rates that we’ve seen so far.

 

for H1N1, it looks like it was something like 22 per every 100,000 people.

From 2009-10  on h1n1 hospitalization rates: https://www.cdc.gov/H1N1flu/hosp_deaths_ahdra.htm

 

For covid-19 it’s something like 1 in every 5-7 people. So far, 15+% of people in all age groups 20 and over have needed hospitalization (closer to 15% for younger, and more like 30+% for older patients). If this keeps spreading at the rate it is right now, our hospitals aren’t going to be able to handle it and a lot more people are going to die because they can’t get the proper care. 

 

we never saw swine flu do what covid19 is doing in 1st world countries like Italy, Spain and the U.S.

 

Here’s quick chart showing some of the differences between influenza and covid-19:

 

 

Those are all things that we can't measure till afterward because we don't know how many actual cases there are. There is a bias to more severe cases because those people are seeking medical help, whereas those who aren't exhibiting severe symptoms likely are not, and even if they are they have not been given tests unless they have some connection to an existing case. So we don't know the true hospitalization rate and won't for quite some time.

[Sundancer]

The most frustrating thing here is that there is still no national plan in place for how long this lasts and how to come out of this. 

 

Even this would be ok to me:

 

1. We need to have this stockpile in place at hospitals: # ppe. # tests. # beds. 

 

2. We need this on hand as national stockpile to move as needed. # of this and that including ventilators. Also treatment drugs. 
 

3. We need quarantine centers set up in regions that have clear rules about intake and how to use them. 
 

4. We need testing centers separate from 1 and 3 with # tests. 
 

5. We need everyone to get on board with tracking contacts for a time and here’s our system for doing that. 
 

Once  we have 1-5, we will *start* to reopen the economy sector by sector while encouraging as much distancing as possible. 
 

There will be outbreaks. People will end up back in quarantine In clusters. But this is the plan to both reopen and stay on this. 
 

This has to be centralized and it needs to be out there soon so we know what the timing is. The above is the Korea plan. It’s not novel. 
 

Healthcare workers, the economy, patients. We all need this plan. If we just reopen in two weeks in a kind of free for all, the last few weeks bought us time only to do #1 and maybe a little of the others but not in an organized way so it was a sacrifice without much purpose. That would be tragic. This shutdown should be for a definitive reason with clear goals. 

Edited March 26, 2020 by Sundancer

[Pine Barrens Mafia]

[Halloween Land]

1 hour ago, Sundancer said:

The most frustrating thing here is that there is still no national plan in place for how long this lasts and how to come out of this. 

 

Even this would be ok to me:

 

1. We need to have this stockpile in place at hospitals: # ppe. # tests. # beds. 

 

2. We need this on hand as national stockpile to move as needed. # of this and that including ventilators. Also treatment drugs. 
 

3. We need quarantine centers set up in regions that have clear rules about intake and how to use them. 
 

4. We need testing centers separate from 1 and 3 with # tests. 
 

5. We need everyone to get on board with tracking contacts for a time and here’s our system for doing that. 
 

Once  we have 1-5, we will *start* to reopen the economy sector by sector while encouraging as much distancing as possible. 
 

There will be outbreaks. People will end up back in quarantine In clusters. But this is the plan to both reopen and stay on this. 
 

This has to be centralized and it needs to be out there soon so we know what the timing is. The above is the Korea plan. It’s not novel. 
 

Healthcare workers, the economy, patients. We all need this plan. If we just reopen in two weeks in a kind of free for all, the last few weeks bought us time only to do #1 and maybe a little of the others but not in an organized way so it was a sacrifice without much purpose. That would be tragic. This shutdown should be for a definitive reason with clear goals. 

This is the right plan, but it will be a long ongoing process to get there unfortunately. It seems that NY State is getting hit the most, meaning that it is entering it's peak. Meaning that we will be on the better side of it hopefully. 

[Sundancer]

33 minutes ago, Halloween Land said:

This is the right plan, but it will be a long ongoing process to get there unfortunately. It seems that NY State is getting hit the most, meaning that it is entering it's peak. Meaning that we will be on the better side of it hopefully. 

The current peak (cases that were in progress before distancing) in NY is to come, and the much bigger peak if there’s a re-opening without the above plan in place would make this initial peak look like a picnic. That’s why we can’t reopen without a national plan and that’s why we can’t waste more time. I want to get back to work ASAP. 

[K-9]

16 minutes ago, Sundancer said:

The current peak (cases that were in progress before distancing) in NY is to come, and the much bigger peak if there’s a re-opening without the above plan in place would make this initial peak look like a picnic. That’s why we can’t reopen without a national plan and that’s why we can’t waste more time. I want to get back to work ASAP. 

We have needed this national plan for over two months. If it hasn’t happened by now with all we know and see, I have no illusions it’s gonna happen at all. This is up to 50 governors to implement; 50 separate entities. 
 

Shameful.

[Cripple Creek]

Sorry if already posted.

 

ER Doc's quick account of his normal day.

https://threadreaderapp.com/thread/1242302400762908685.html

 

 

Evidence that we're working in a vacuum:

https://www.cnn.com/2020/03/25/politics/us-military-coronavirus-tests/index.html

Edited March 26, 2020 by Cripple Creek

[TigerJ]

11 hours ago, Doc Brown said:

Pry not.  I'm also hoping the warmer weather cities like LA and Miami don't see as wide of an outbreak.

The main way that warm weather affects the spread of disease is through human behavior changes.  In cold weather, people will tend to gather in groups in contained spaces.  Personal space increases out doors where there is so much more space available.  People need to understand that the virus doesn't automatically become less virulent because the temperature goes up.  Social  distancing and good hygiene are still critically important.

Edited March 26, 2020 by TigerJ

[Bob in Mich]

11 minutes ago, TigerJ said:

The main way that warm weather affects the spread of disease is through human behavior changes.  In cold weather, people will tend to gather in groups in contained spaces in cold weather.  Personal space increases out doors where there is so much more space available.  People need to understand that the virus doesn't automatically become less virulent because the temperature goes up.  Social  distancing and good hygiene are still critically important.

 

True, it is not the warmer weather so much as open windows and less time indoors close with others. 

 

Given those reasons though, I wonder about hot weather and using the AC.  On hot days, people go inside to the cooler temps....and they keep the windows shut to keep out the outside air.  Doesn't that sort of replicate the cold weather situation of crowding indoors?

[plenzmd1]

 

 

Interesting Twitter thread here...maybe some hope for optimism? I have no clue as the the veracity of the authors or SME

 

 

[Hapless Bills Fan]

10 hours ago, MJS said:

I think it's totally fine to take this seriously, but mark my words (and I'll own up to it if I'm wrong): this disease will pass with fewer cases and fewer deaths than the H1N1 (swine flu) did about a decade ago that infected more than 60 million Americans and killed over 12,000.

 

Part of that might be because of the extreme measures the country is taking. If so, good for us. We seem to have gotten the drop on this disease far quicker than we did with H1N1. But it makes me wonder why we didn't take such extreme measures then. Was it simply because it had already spread so much by the time we really knew about it and so there was no stopping it?

 

Well, some people are impossible to convince. 

 

Several things that make covid-19 more of a problem than H1N1 or any seasonal flu.

1) basic reproduction number - how many people get sick from contact with an infected person.  Flu, 1.3.  Covid-19, 2.0-2.4.  In terms of disease spread, that means about 45 people ill with flu for the same number of infection cycles that give ~500 Covid-19 patients.  H1N1 was a bit higher - 1.46-1.48, still way lower than covid-19

2) Incubation time for the disease - 3 days vs up to 14 days.  That means people who are sick, but don't know it yet, circulate in society and spread the disease

3) Higher morbidity, including in 20-54 age group: far larger number of people get seriously ill and require prolonged hospitalization or critical care. ~15-20%, hospitalized, 3-5% critical.   H1N1 estimate 0.4%  That's a key piece of information you're omitting about H1N1: 240,000 people hospitalized.

4) Higher mortality, maybe 1% (0.7-1.4) given widespread surveillance testing and contact tracing (China, Taiwan, S. Korea) and excellent hospital care that is not overwhelmed.  But because of the very high transmissivity and morbidity, the hospitals where it is unchecked ARE becoming overwhelmed.  In Italy, death rate running 10%.  Wuhan initially, >5%.

 

Here's my bottom line: doctor after doctor involved in outbreak areas are saying "this is not flu; we are seeing many more patients who are much sicker than with flu, and many of them are younger." 

 

I believe doctors.

 

1 hour ago, K-9 said:

We have needed this national plan for over two months. If it hasn’t happened by now with all we know and see, I have no illusions it’s gonna happen at all. This is up to 50 governors to implement; 50 separate entities. 
 

Shameful.

 

Yes.  And they are in a situation where they are bidding against each other (and the federal gov't) for critical supplies like N95 masks and throat swabs, and there appears to be no central planning and command and control effectively overseeing distribution of the National Stockpile and backup ventilators etc.

[Sundancer]

58 minutes ago, plenzmd1 said:

 

 

Interesting Twitter thread here...maybe some hope for optimism? I have no clue as the the veracity of the authors or SME

 

 

 

 I have been following the "1/2 to 2/3 of the UK already has it or already had it and got over it" movement.

 

I have a simple pin to prick that bubble: If half the UK had it or has it, why are we suddenly seeing an uptick in hospitalizations right now? Were all the other cases non-hospitalized cases? And now we are just seeing a random spike?  

 

Ferguson's actual remarks, by the way, suggest continued social distancing and increased testing to follow Korea's model. He is not saying that we are 2-3 weeks away from this being over as the Tweeter Berenson suggests.

 

I would LOOOOOOOVE to be wrong. 

Edited March 26, 2020 by Sundancer

[MJS]

30 minutes ago, Hapless Bills Fan said:

 

Well, some people are impossible to convince. 

 

Several things that make covid-19 more of a problem than H1N1 or any seasonal flu.

1) basic reproduction number - how many people get sick from contact with an infected person.  Flu, 1.3.  Covid-19, 2.0-2.4.  In terms of disease spread, that means about 45 people ill with flu for the same number of infection cycles that give ~500 Covid-19 patients.  H1N1 was a bit higher - 1.46-1.48, still way lower than covid-19

2) Incubation time for the disease - 3 days vs up to 14 days.  That means people who are sick, but don't know it yet, circulate in society and spread the disease

3) Higher morbidity, including in 20-54 age group: far larger number of people get seriously ill and require prolonged hospitalization or critical care. ~15-20%, hospitalized, 3-5% critical.   H1N1 estimate 0.4%  That's a key piece of information you're omitting about H1N1: 240,000 people hospitalized.

4) Higher mortality, maybe 1% (0.7-1.4) given widespread surveillance testing and contact tracing (China, Taiwan, S. Korea) and excellent hospital care that is not overwhelmed.  But because of the very high transmissivity and morbidity, the hospitals where it is unchecked ARE becoming overwhelmed.  In Italy, death rate running 10%.  Wuhan initially, >5%.

 

Here's my bottom line: doctor after doctor involved in outbreak areas are saying "this is not flu; we are seeing many more patients who are much sicker than with flu, and many of them are younger." 

 

I believe doctors.

 

As already mentioned, items 3 and 4 are not accurate until we know the number of cases, which we don't. All estimates to this point are guesses and the real numbers will be different.

 

I'm not saying that this disease is not serious or that the measures taken are not right. I'm saying most of the numbers quoted are not real because they are all based on a guess of the number of cases which can't actually be determined until after the outbreak is over. I've also seen that these things have been well overestimated in the past, and don't see a reason why this disease would be any different.

[Sundancer]

3 minutes ago, MJS said:

 

As already mentioned, items 3 and 4 are not accurate until we know the number of cases, which we don't. All estimates to this point are guesses and the real numbers will be different.

 

 

Let's stick with #3 (hospitalizations) for a moment. Setting aside that the exact % who require it may be unknown, which I agree with, we can all agree that letting this thing loose without distancing, testing, and quarantining will obliterate our health care workers and system. Even with distancing, it already is in places where it's gotten a little loose. 

Edited March 26, 2020 by Sundancer

[Hapless Bills Fan]

4 minutes ago, MJS said:

 

As already mentioned, items 3 and 4 are not accurate until we know the number of cases, which we don't. All estimates to this point are guesses and the real numbers will be different.

 

I'm not saying that this disease is not serious or that the measures taken are not right. I'm saying most of the numbers quoted are not real because they are all based on a guess of the number of cases which can't actually be determined until after the outbreak is over. I've also seen that these things have been well overestimated in the past, and don't see a reason why this disease would be any different.

 

Like I said, some people are impossible to convince.

 

Like I also said, and you cut: Doctor after doctor working in outbreak areas is saying "this is not like flu.  We are seeing many more people who are sicker, including healthy young people".

 

I believe doctors when they tell me what they're seeing.  This ain't their first rodeo.

 

Find me evidence that any flu epidemic since 1918 had a country-wide, during outbeak, case fatality rate of 10% during the epidemic (Italy now).  You're correct that the true numbers will only be known when the dust settles, but in the meantime look at the numbers we have.  Find me evidence that any flu epidemic since 1918, had a world wide case fatality rate of 4.5% during the epidemic - regardless of those numbers changing afterwards.

 

How does the fact that things are overestimated in the past, and will change, vitiate what the data in front of you says?  Nevermind.  I know.  Some people are impossible to convince.

 

 

[MJS]

6 minutes ago, Hapless Bills Fan said:

 

Like I said, some people are impossible to convince.

 

Like I also said, and you cut: Doctor after doctor working in outbreak areas is saying "this is not like flu.  We are seeing many more people who are sicker, including healthy young people".

 

I believe doctors when they tell me what they're seeing.  This ain't their first rodeo.

 

Find me evidence that any flu epidemic since 1918 had a country-wide, during outbeak, case fatality rate of 10% during the epidemic (Italy now).  You're correct that the true numbers will only be known when the dust settles, but in the meantime look at the numbers we have.  Find me evidence that any flu epidemic since 1918, had a world wide case fatality rate of 4.5% during the epidemic - regardless of those numbers changing afterwards.

 

How does the fact that things are overestimated in the past, and will change, vitiate what the data in front of you says?  Nevermind.  I know.  Some people are impossible to convince.

Convince of what, exactly? And I made no claim that Coronavirus is anything like the flu. I used H1N1 as an example of a disease that, while it was still happening, experts estimated an impact that was much higher than reality. Their projections were incorrect. What exactly are you thinking I need to be convinced of?

15 minutes ago, Sundancer said:

 

Let's stick with #3 (hospitalizations) for a moment. Setting aside that the exact % who require it may be unknown, which I agree with, we can all agree that letting this thing loose without distancing, testing, and quarantining will obliterate our health care workers and system. Even with distancing, it already is in places where it's gotten a little loose. 

 

I agree with that completely. I think these are smart measures to take and part of me wonders if these measures were taken with past pandemics if there would have been fewer cases and fewer deaths.

[Hapless Bills Fan]

3 hours ago, Sundancer said:

The current peak (cases that were in progress before distancing) in NY is to come, and the much bigger peak if there’s a re-opening without the above plan in place would make this initial peak look like a picnic. That’s why we can’t reopen without a national plan and that’s why we can’t waste more time. I want to get back to work ASAP. 

 

Yes.  We are at least 3 weeks short of peak in NYC, and that is if:

1) everyone there is doing what they're supposed to do

2) we don't see a surge of HCW working with insufficient PPE falling ill

 

[Cripple Creek]

Latest from Italy, 5210 new cases yesterday.

 

https://www.statista.com/chart/21099/coronavirus-in-italy/

 

Spain 5553 confirmed new cases yesterday.

 

https://www.statista.com/chart/21195/coronavirus-in-spain/

 

 

What Americans are worried about:

 

https://www.statista.com/chart/21193/worries-of-americans-covid-19/

Edited March 26, 2020 by Cripple Creek

[Hapless Bills Fan]

6 minutes ago, Cripple Creek said:

What Americans are worried about:

https://www.statista.com/chart/21193/worries-of-americans-covid-19/

 

I'm surprised only 30% are worried about having to go to work while sick.

 

A lot of people are rightly worried about the impact on their financial situation; I wonder if some of our leaders translate that to "therefore they all want to go back to work ASAP"?  Most of the small business owners I've been in contact with are scared of the impact on their businesses and sick about the impact on their employees, but they don't want to reopen because then they're scared about their employees getting sick or about spreading illness.  They recognize it's a "damned if you do, damned if you don't" situation.

[BillsFan4]

 

[K-9]

9 minutes ago, Hapless Bills Fan said:

 

I'm surprised only 30% are worried about having to go to work while sick.

 

A lot of people are rightly worried about the impact on their financial situation; I wonder if some of our leaders translate that to "therefore they all want to go back to work ASAP"?  Most of the small business owners I've been in contact with are scared of the impact on their businesses and sick about the impact on their employees, but they don't want to reopen because then they're scared about their employees getting sick or about spreading illness.  They recognize it's a "damned if you do, damned if you don't" situation.

Better to be damned if you don’t in this case. 

6 minutes ago, BillsFan4 said:

 

Why this isn’t glaringly obvious to everyone is beyond comprehension. It is willful ignorance. 

[B-Man]

 

[K-9]

I wonder if the situation in Mississippi, where the governor signed an executive order superseding local authorities’ ability to close businesses, will be a microcosm of a federal order to do the same nationally in a few weeks. 

[BillsFan4]

https://www.theverge.com/2020/3/25/21193670/trump-easter-coronavirus-isolation-relax-rules-economy-social-distancing

‘Relaxing isolation rules won’t help the economy, say economists’

 

 

 

[MJS]

11 minutes ago, BillsFan4 said:

https://www.theverge.com/2020/3/25/21193670/trump-easter-coronavirus-isolation-relax-rules-economy-social-distancing

‘Relaxing isolation rules won’t help the economy, say economists’

 

Stocks have actually been way, way up the past few days. Probably a result of the impending stimulus package. But I bet they drop again soon.

[K-9]

1 minute ago, BillsFan4 said:

https://www.theverge.com/2020/3/25/21193670/trump-easter-coronavirus-isolation-relax-rules-economy-social-distancing

‘Relaxing isolation rules won’t help the economy, say economists’

 

 

 

This concept put forth by Glen Beck, Dan Patrick and others that the “economy” is “America” and “America” is the “economy” is strange. The economy will recover like it always has. I wish I could say the same for people with upper respiratory infections. 

[John in Jax]

1 hour ago, B-Man said:

 

WOW! This is AMAZING.

[B-Man]

 

[Hapless Bills Fan]

6 minutes ago, B-Man said:

 

 

??

I guess it's being a party-pooper, but ya know, they could have been asked to do this back in February....in which case, doctors, nurses and first responders might all be equipped with face shields today and less likely to fall ill.....horse barn left locked, I know

[K-9]

8 minutes ago, Hapless Bills Fan said:

 

??

I guess it's being a party-pooper, but ya know, they could have been asked to do this back in February....in which case, doctors, nurses and first responders might all be equipped with face shields today and less likely to fall ill.....horse barn left locked, I know

Good point about the timing and, while it’s too late for some areas, this can really benefit areas that are still ahead of the curve. I read somewhere that Nike is gonna produce PPE but I don’t know if that’s true or not. 

[Halloween Land]

2 hours ago, BillsFan4 said:

 

Best doctor in the world! Just a really nice guy that is working his but off! 

[Hapless Bills Fan]

https://www.theverge.com/2020/3/26/21194485/public-health-distancing-state-federal-power-trump-coronavirus-covid-19

 

Info about roles and responsibilities (excerpts of longer article)

(...)

During a public health crisis like this one, they [governors and local officials] are the ones who have the final say, says Ross Silverman, professor of health policy and management at Indiana University. “Public health powers are generally handled at the state level,” he says. The federal government plays a major role in resource allocation and can offer states suggestions and expertise, but state and local governments are largely responsible for on-the-ground decision-making.  “For the most part, when we have public health concerns, they arise mostly at the local and state level. The way the system is constructed really reflects that history as far as public health is concerned,” Silverman says.

Legally, the states can maintain social distancing orders and business closures, even if Trump says that they shouldn’t, but that can create communication problems. “It sends really mixed messages,” Silverman says. (...)
 

While states can make their own decisions about the types of public health responses they think are necessary, they’re reliant on resources and regulations from the federal government during an unprecedented crisis like the COIVD-19 pandemic. For example: states had to wait for COVID-19 tests to be approved and manufactured at the federal level. Mismanagement and errors at the Centers for Disease Control and Prevention meant they had to wait longer to receive federal tests, and Food and Drug Administration regulations meant they (State and local DOH, Universities) weren’t allowed to make their own for weeks. (...)
 

The federal government also, in theory, has access to reserves of drugs and protective equipment through the Strategic National Stockpile. States do not have direct access to the stockpile. The federal government can put pressure on companies to produce things like masks, either informally or under the Defense Production Act, which lets the president require companies to take on federal contracts for certain items. It also has a far more extensive and flexible budget. “States respond to the crisis first and foremost with the resources they have,” Silverman says. “The way it’s set up to work is that the feds provide a boost, and are the backup if states run out of something.”

In this crisis, though, states have struggled to access that boost. The national stockpile is more limited than the situation requires, Trump hasn’t used the Defense Production Act to boost manufacturing of masks and ventilators, and the federal government has largely left the states to negotiate for and purchase supplies on their own.

 

 

[Hardhatharry]

Over 80k cases int he US and by tomorrow will pass China and Italy.

[Hapless Bills Fan]

This article contains some good factual information about different public policy scenarios and their potential impact on the current epidemic.

 

The Atlantic, of course, is biased in its political views, which probably biases the writing in ways I'm not well equipped to detect.   Please try to read it for the facts and the productive suggestions, which as far as I can tell are verifiably correct and expert-endorsed (I could not find another article that put them all together - if anyone has one, send it to me please).  Keep in mind that when public health and epidemiology experts are  speaking of "worse" etc, they are speaking of verifiable factual actions that were taken or not taken.

 

If you feel it is factually incorrect, please let me know.  Be aware knee-jerk political comments here will be shot out the airlock.  Take it over to PPP if that's your need.

https://www.theatlantic.com/health/archive/2020/03/how-will-coronavirus-end/608719/

 

“No matter what, a virus [like SARS-CoV-2] was going to test the resilience of even the most well-equipped health systems,” says Nahid Bhadelia, an infectious-diseases physician at the Boston University School of Medicine. More transmissible and fatal than seasonal influenza, the new coronavirus is also stealthier, spreading from one host to another for several days before triggering obvious symptoms. To contain such a pathogen, nations must develop a test and use it to identify infected people, isolate them, and trace those they’ve had contact with. That is what South Korea, Singapore, and Hong Kong did to tremendous effect. It is what the United States did not.

(....)
In a crucial month when the American caseload shot into the tens of thousands, only hundreds of people were tested. That a biomedical powerhouse like the U.S. should so thoroughly fail to create a very simple diagnostic test was, quite literally, unimaginable. “I’m not aware of any simulations that I or others have run where we [considered] a failure of testing,” says Alexandra Phelan of Georgetown University, who works on legal and policy issues related to infectious diseases.
(....)
A pandemic-preparedness office that was part of the National Security Council was dissolved in 2018. On January 28, Luciana Borio, who was part of that team, urged the government to “act now to prevent an American epidemic,” and specifically to work with the private sector to develop fast, easy diagnostic tests. But with the office shuttered, those warnings were published in The Wall Street Journal, rather than spoken into the president’s ear. Instead of springing into action, America sat idle.

(....)

America has mishandled the COVID-19 crisis to a substantially worse degree than what every health expert I’ve spoken with had feared. “Much worse,” said Ron Klain, who coordinated the U.S. response to the West African Ebola outbreak in 2014. “Beyond any expectations we had,” said Lauren Sauer, who works on disaster preparedness at Johns Hopkins Medicine. “As an American, I’m horrified,” said Seth Berkley, who heads Gavi, the Vaccine Alliance. “The U.S. may end up with the worst outbreak in the industrialized world.”

[as Hard Hat Harry said, by the end of the week we will overtake China and Italy for # of cases, and reportedly we are still only testing a fraction of symptomatic people]

(....)

Having fallen behind, it will be difficult—but not impossible—for the United States to catch up. To an extent, the near-term future is set because COVID-19 is a slow and long illness. People who were infected several days ago will only start showing symptoms now, even if they isolated themselves in the meantime. Some of those people will enter intensive-care units in early April.
(....)
Italy and Spain offer grim warnings about the future. Hospitals are out of room, supplies, and staff. Unable to treat or save everyone, doctors have been forced into the unthinkable: rationing care (...)The U.S. has fewer hospital beds per capita than Italy. A study released by a team at Imperial College London concluded that if the pandemic is left unchecked, those beds will all be full by late April. By the end of June, for every available critical-care bed, there will be roughly 15 COVID-19 patients in need of one.  By the end of the summer, the pandemic will have directly killed 2.2 million Americans, notwithstanding those who will indirectly die as hospitals are unable to care for the usual slew of heart attacks, strokes, and car accidents. This is the worst-case scenario. To avert it, four things need to happen—and quickly.
-The first and most important is to rapidly produce masks, gloves, and other personal protective equipment [to keep HCW healthy] (...some mfrs already making equipment, but invoke the Defense Production Act to get more of them on board and to control prices and distribution...)  A “massive logistics and supply-chain operation [is] now needed across the country,” says Thomas Inglesby of Johns Hopkins Bloomberg School of Public Health. That can’t be managed by small and inexperienced teams scattered throughout the White House. The solution, he says, is to tag in the Defense Logistics Agency—a 26,000-person group that prepares the U.S. military for overseas operations and that has assisted in past public-health crises, including the 2014 Ebola outbreak.
-This agency (Defense Logistics Agency) can also coordinate the second pressing need: a massive rollout of COVID-19 tests. Those tests have been slow to arrive because of five separate shortages: of masks to protect people administering the tests; of nasopharyngeal swabs for collecting viral samples; of extraction kits for pulling the virus’s genetic material out of the samples; of chemical reagents that are part of those kits; and of trained people who can give the tests. (...) As capacity expands, tests must be used carefully. The first priority, says Marc Lipsitch of Harvard, is to test health-care workers and hospitalized patients, allowing hospitals to quell any ongoing fires. Only later, once the immediate crisis is slowing, should tests be deployed in a more widespread way.

--These measures will take time, during which the pandemic will either accelerate beyond the capacity of the health system or slow to containable levels. Its course—and the nation’s fate—now depends on the third need, which is social distancing. Think of it this way: There are now only two groups of Americans. Group A includes everyone involved in the medical response, whether that’s treating patients, running tests, or manufacturing supplies. Group B includes everyone else, and their job is to buy Group A more time. Group B must now “flatten the curve” by physically isolating themselves from other people to cut off chains of transmission. Given the slow fuse of COVID-19, to forestall the future collapse of the health-care system, these seemingly drastic steps must be taken immediately, before they feel proportionate, and they must continue for several weeks. [basically, until PPE and testing is in place]

Persuading a country to voluntarily stay at home is not easy, and without clear guidelines from the White House, mayors, governors, and business owners have been forced to take their own steps. Some states have banned large gatherings or closed schools and restaurants. At least 21 have now instituted some form of mandatory quarantine, compelling people to stay at home. And yet many citizens continue to crowd into public spaces.

-In these moments, when the good of all hinges on the sacrifices of many, clear coordination matters—the fourth urgent need. The importance of social distancing must be impressed upon a public who must also be reassured and informed.

The whole article is good, and I encourage everyone to read it, but I do recognize while I believe the facts are good and the sources legitimate and well-regarded, the writing will strike some as biased.  Please read it anyway and try to work beyond that.

Discussion welcome; again, if you feel it is factually incorrect, please let me know, and again be aware knee-jerk political comments here will be shot out the airlock.  Take it over to PPP and have-at-it if that is your personal need.

[RocCityRoller]

Been a while since I posted here.

 

It is important to note that globally the number of people with Coronavirus is under reported.

There are probably hundreds of thousands, or even millions of people with the virus who show little to no symptoms.

Many show cold or flu type symptoms, or none at all.

They get the virus, feel a bit off or nothing and move on with life.

 

After the pandemic scare is over I am willing to bet 20-50% of the world population will test positive for Coronavirus antibodies, meaning that the person was infected but showed few symptoms, much like swine flu.

 

The good news is that many people with Coronavirus just feel 'sick' or even nothing at all.

The bad news is that many people with little to no symptoms can spread the virus without knowing it.

This is the drive for social distancing, don't infect those weaker than you just because you do not show symptoms.

 

As for the 'epidemic' in NY

NY has conducted far more Coronavirus testing than any other state

Hence it looks like the virus is spreading faster in NY than other states. You can't confirm a case without testing.

 

NY has over 37k confirmed Coronavirus infections

NJ 6800

CA 3247

MI 2805

WA 2600

 

NY also has also tested over 103k people, this accounts for 20% of testing in the USA.

NY 103479

WA 34292

FL  22142

MA 17794

CA 18329

 

It's not possible to have more coronavirus confirmed infected than the count tested.

Since NY has tested more people, the count of people infected looks high.

CA has only tested 18329, they couldn't possibly have 37,000 cases..... but they might.

 

Data from:

https://www.kff.org/health-costs/issue-brief/state-data-and-policy-actions-to-address-coronavirus/

 

lot's of goodies to how states are responding to coronavirus

also good stats on testing and infected cases.

 

Basing any stats on those ill enough to go to a doctor or hospital admission is faulty.

It skews the bad numbers (hospitalizations and deaths) higher than what is actually happening.

 

We do need to be wary that the cure is not worse than the disease, while trying to protect our most vulnerable.

 

PS almost half a million tests have been conducted in the USA since 3/16. The results have been found to be accurate.

This is why you develop a proper test. almost 500k tests have now been analyzed. I expect that rate to escalate over the next 2-4 weeks.

 

The news and social media will have a field day with the epidemic spreading. The truth is the number of tests being conducted is increasing yielding more confirmed cases.

 

I expect this to plateau in NY and NJ in 2 weeks.

The rest of the USA in 4-6 weeks.

 

and then it will be over

 

 

 

 

 

 

 

[Sundancer]

18 minutes ago, RocCityRoller said:

 

The news and social media will have a field day with the epidemic spreading. The truth is the number of tests being conducted is increasing yielding more confirmed cases.

 

I expect this to plateau in NY and NJ in 2 weeks.

The rest of the USA in 4-6 weeks.

 

and then it will be over

 

 

 

It may slow because we are quarantined, but once we lift that, it will spike unless we are much, much, much more prepared. 

 

On another note, sounds like we are moving to a national view of things as the government will start classifying counties by risk. 

[BringBackFergy]

39 minutes ago, Sundancer said:

 

It may slow because we are quarantined

Isn’t that what “flattening the curve” means....stay inside to slow it so it doesn’t peak at an unmanageable level. That’s what we’re doing...most of us anyway. 

[Sundancer]

3 minutes ago, BringBackFergy said:

Isn’t that what “flattening the curve” means....stay inside to slow it so it doesn’t peak at an unmanageable level. That’s what we’re doing...most of us anyway. 

 

Yes, but quarantining is a TEMPORARY measure and we need to re-open in a way that's ready for the next wave that will happen when we re-open.

 

I'm not knocking the effect of the quarantines, but noting they are not a solution. They are just triage.  

 

[BillsFan4]

https://www.worldometers.info/coronavirus/

 

USA now #1 in coronavirus cases. 

 

[Hapless Bills Fan]

10 minutes ago, BringBackFergy said:

Isn’t that what “flattening the curve” means....stay inside to slow it so it doesn’t peak at an unmanageable level. That’s what we’re doing...most of us anyway. 

 

Yes, I believe that's Sundancer's point - the social distancing is to "flatten the curve" so it stays manageable - but then unless we have measures in place to control it as restrictions are lifted, it will simply peak again.

 

Unless, of course, those who predict a warm-weather diminishment are correct - but then, be prepared for another surge in fall.