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

[BillsFan4]

https://www.beckershospitalreview.com/patient-flow/our-backs-are-to-the-wall-texas-hospital-to-turn-away-covid-19-patients-with-poor-survival-chances.html
'Our backs are to the wall': Texas hospital to turn away COVID-19 patients with poor survival chances

 

 

Quote

Rio Grande City, Texas-based Starr County Memorial Hospital, implemented an ethics committee and a triage committee to review incoming COVID-19 patients, Starr County Health Authority Jose Vazquez, MD, said during a July 21 videoconference call. The committees will determine what type of treatment patients will likely require and whether they are likely to survive. Those deemed too fragile, sick or elderly will be advised to go home. Patients with low recovery chances will be better cared for at home with loved ones rather than dying at a hospital thousands of miles away, Dr. Vazquez said. 
 

"There is nowhere to put these patients. The whole state of Texas and neighboring states have no ICU beds to spare for us," Dr. Vazquez said.

?

 

Edited July 24, 2020 by BillsFan4

[K-9]

33 minutes ago, BillsFan4 said:

https://www.beckershospitalreview.com/patient-flow/our-backs-are-to-the-wall-texas-hospital-to-turn-away-covid-19-patients-with-poor-survival-chances.html
'Our backs are to the wall': Texas hospital to turn away COVID-19 patients with poor survival chances

 

 

?

 

Also hearing reports of oxygen shortages in this area as well. My heart goes out to these care givers and the sick people and their families they have to turn away. Fear porn, my ass. 

[plenzmd1]

6 minutes ago, K-9 said:

Also hearing reports of oxygen shortages in this area as well. My heart goes out to these care givers and the sick people and their families they have to turn away. Fear porn, my ass. 

the fear has always been when it gets to rural areas..these places just cannot handle more than a few cases of anything, let alone Covid. And sure as hell sucks for everyone involved...certainly most for those that die and their families, the doctors that need to make these ethical decisions, just everyone.

 

Having said that, Starr County has a population of 66K, is very rural and is facing many of the same challenges from a health care perspective that rural hospitals are facing everywhere, way before Covid hit.  Just a fact of life health care in rural counties in the US is dismal..but that's another debate for another time

 

https://www.ajmc.com/conferences/academyhealth-2019/understanding-the-health-challenges-facing-rural-communities

 

https://jamanetwork.com/channels/health-forum/fullarticle/2759647

 

And certainly understand the "fear porn" comment, but context is always important in these discussions

 

Quote

The county’s lone hospital, Starr County Memorial Hospital, is overwhelmed as COVID-19 hospitalizations continue to increase.

A month ago, the hospital didn’t have a single coronavirus patient. Now, there are 28 patients and three are intubated — two in the COVID unit and one in their emergency department.

The numbers fluctuate daily, he said. Yesterday, they had seven intubated patients but ow they have only three.

“Some of these patients have died; some of them have been transferred out of the Valley to other, distant places,” Vazquez said, “including Lubbock, Amarillo and even outside of the state to Oklahoma City.”

Those transfers had become complicated and come at a great cost to the hospital which had to find an available bed in order to transfer patients that required a more advanced level of care than was available in Starr.

https://www.themonitor.com/2020/07/22/starr-county-issue-shelter-place-order-end-week/

Of course any death is one too many...but the reality is these are small hospitals just not equipped to handle many illnesses. 

 

 

[Gugny]

20 hours ago, Hapless Bills Fan said:

 

Looks good so far.  Well referenced .  She has a talent for the bottom line:

Remember the formula: Successful Infection = Exposure to Virus x Time

 

Like most of us, it's hard to keep up and there's sometimes newer stuff that contradicts.

 

She's a he.  Who the hell names their son Erin??

[Hapless Bills Fan]

5 hours ago, BillsFan4 said:

https://www.beckershospitalreview.com/patient-flow/our-backs-are-to-the-wall-texas-hospital-to-turn-away-covid-19-patients-with-poor-survival-chances.html
'Our backs are to the wall': Texas hospital to turn away COVID-19 patients with poor survival chances

 

But wait, I thought Death Panels were anathema to those folks?  Isn't that why we couldn't get Medicare for All type health insurance - the unsubstantiated claim was, it meant there would be "Death Panels"?
 

"Rio Grande City, Texas-based Starr County Memorial Hospital, implemented an ethics committee and a triage committee to review incoming COVID-19 patients, Starr County Health Authority Jose Vazquez, MD, said during a July 21 videoconference call. The committees will determine what type of treatment patients will likely require and whether they are likely to survive. Those deemed too fragile, sick or elderly will be advised to go home. Patients with low recovery chances will be better cared for at home with loved ones rather than dying at a hospital thousands of miles away, Dr. Vazquez said. "

 

Isn't that precisely a  "death panel" - a group deciding who gets treatment, and who dies?   And what does "too sick" mean?

 

Of course, if they go home with loved ones, those loved ones may also be vulnerable to covid-19 and may die.  Weren't we upset about sending covid-19 + back to a place where they could possible infect others with covid-19 and cause more cases/deaths?

[Hapless Bills Fan]

3 hours ago, plenzmd1 said:

the fear has always been when it gets to rural areas..these places just cannot handle more than a few cases of anything, let alone Covid. And sure as hell sucks for everyone involved...certainly most for those that die and their families, the doctors that need to make these ethical decisions, just everyone.

 

Having said that, Starr County has a population of 66K, is very rural and is facing many of the same challenges from a health care perspective that rural hospitals are facing everywhere, way before Covid hit.  Just a fact of life health care in rural counties in the US is dismal..but that's another debate for another time

 

https://www.ajmc.com/conferences/academyhealth-2019/understanding-the-health-challenges-facing-rural-communities

 

https://jamanetwork.com/channels/health-forum/fullarticle/2759647

 

And certainly understand the "fear porn" comment, but context is always important in these discussions

 

https://www.themonitor.com/2020/07/22/starr-county-issue-shelter-place-order-end-week/

Of course any death is one too many...but the reality is these are small hospitals just not equipped to handle many illnesses.

 

The reality is also, that Starr County officials had a plan to contain covid-19

And Governor Abbott overruled it, with deadly consequences

 

https://www.theguardian.com/us-news/2020/jul/10/texas-starr-county-covid-19-model-greg-abbott?CMP=Share_iOSApp_Other

 

But Starr county’s public officials knew months ago that is was especially vulnerable to the coronavirus pandemic: roughly one in three residents lives in poverty, a sizable slice of the population doesn’t have health insurance, and risk factors such as diabetes and obesity prevail. To protect their constituents, who are more than 96% Hispanic or Latino, they acted fast to curtail the contagion.

They developed what officials said was at the time the only drive-through testing site south of San Antonio. They closed schools. They implemented a stay-at-home order, curfew and mandatory face coverings. Only when necessary, they flexed their authority to fine and even jail anyone who flouted the law.

Their strategy worked. The first few coronavirus cases trickled into Starr county in late March, but for three weeks in April, there were no new infections. Before the end of May, weekly tallies of new confirmed positives never once reached double digits. Even seasonal influenza, coughs, colds and fevers that would normally travel through the community suddenly vanished.

“What we did here was a model for the rest of the nation to follow, but it was lost,” said Joel Villarreal, the mayor of Rio Grande City, one of four small cities in the county. “In fact, I think we had it right.”

The inflection point came when the Texas governor, Greg Abbott, unilaterally decided to reopen the state, and stripped local governments of their power in the process.

[Buddo]

7 minutes ago, Hapless Bills Fan said:

 

The reality is also, that Starr County officials had a plan to contain covid-19

And Governor Abbott overruled it, with deadly consequences

 

https://www.theguardian.com/us-news/2020/jul/10/texas-starr-county-covid-19-model-greg-abbott?CMP=Share_iOSApp_Other

 

But Starr county’s public officials knew months ago that is was especially vulnerable to the coronavirus pandemic: roughly one in three residents lives in poverty, a sizable slice of the population doesn’t have health insurance, and risk factors such as diabetes and obesity prevail. To protect their constituents, who are more than 96% Hispanic or Latino, they acted fast to curtail the contagion.

They developed what officials said was at the time the only drive-through testing site south of San Antonio. They closed schools. They implemented a stay-at-home order, curfew and mandatory face coverings. Only when necessary, they flexed their authority to fine and even jail anyone who flouted the law.

Their strategy worked. The first few coronavirus cases trickled into Starr county in late March, but for three weeks in April, there were no new infections. Before the end of May, weekly tallies of new confirmed positives never once reached double digits. Even seasonal influenza, coughs, colds and fevers that would normally travel through the community suddenly vanished.

“What we did here was a model for the rest of the nation to follow, but it was lost,” said Joel Villarreal, the mayor of Rio Grande City, one of four small cities in the county. “In fact, I think we had it right.”

The inflection point came when the Texas governor, Greg Abbott, unilaterally decided to reopen the state, and stripped local governments of their power in the process.

 

Hopefully, someone sues him. Seems to me that unnecessarily removing local government powers, has directly impacted those communities. In a very bad way.

 

In far too many places, around the world, politics has got well in the way of attempts to mitigate covid.

 

A classic case of 'if it ain't broke, don't fix it'.

[plenzmd1]

@Hapless Bills Fan, good points. Again, I am not justifying or condoning or dismissing what is happening there. My only point was the article seemed to indicate that many many decisions were going to be needed to made in a daily basis, when in fact they have 3 people in ICU at the moment. 
 

as I mentioned and I talk to my wife all the time, I think this virus is following a pattern of going where it has not been before , and seems to me rural areas could be next. For all the reasons mentioned above, plus, and I am making a generalization here , the propensity of the rural population to be more “independent “ when it comes to some “ rules” scares the bejesus out of me.  I worry for all the folks in rural areas now, I think that is where true carnage could happen with flu season. 

[K-9]

54 minutes ago, Hapless Bills Fan said:

 

But wait, I thought Death Panels were anathema to those folks?  Isn't that why we couldn't get Medicare for All type health insurance - the unsubstantiated claim was, it meant there would be "Death Panels"?
 

"Rio Grande City, Texas-based Starr County Memorial Hospital, implemented an ethics committee and a triage committee to review incoming COVID-19 patients, Starr County Health Authority Jose Vazquez, MD, said during a July 21 videoconference call. The committees will determine what type of treatment patients will likely require and whether they are likely to survive. Those deemed too fragile, sick or elderly will be advised to go home. Patients with low recovery chances will be better cared for at home with loved ones rather than dying at a hospital thousands of miles away, Dr. Vazquez said. "

 

Isn't that precisely a  "death panel" - a group deciding who gets treatment, and who dies?   And what does "too sick" mean?

 

Of course, if they go home with loved ones, those loved ones may also be vulnerable to covid-19 and may die.  Weren't we upset about sending covid-19 + back to a place where they could possible infect others with covid-19 and cause more cases/deaths?

 

40 minutes ago, Hapless Bills Fan said:

 

The reality is also, that Starr County officials had a plan to contain covid-19

And Governor Abbott overruled it, with deadly consequences

 

https://www.theguardian.com/us-news/2020/jul/10/texas-starr-county-covid-19-model-greg-abbott?CMP=Share_iOSApp_Other

 

But Starr county’s public officials knew months ago that is was especially vulnerable to the coronavirus pandemic: roughly one in three residents lives in poverty, a sizable slice of the population doesn’t have health insurance, and risk factors such as diabetes and obesity prevail. To protect their constituents, who are more than 96% Hispanic or Latino, they acted fast to curtail the contagion.

They developed what officials said was at the time the only drive-through testing site south of San Antonio. They closed schools. They implemented a stay-at-home order, curfew and mandatory face coverings. Only when necessary, they flexed their authority to fine and even jail anyone who flouted the law.

Their strategy worked. The first few coronavirus cases trickled into Starr county in late March, but for three weeks in April, there were no new infections. Before the end of May, weekly tallies of new confirmed positives never once reached double digits. Even seasonal influenza, coughs, colds and fevers that would normally travel through the community suddenly vanished.

“What we did here was a model for the rest of the nation to follow, but it was lost,” said Joel Villarreal, the mayor of Rio Grande City, one of four small cities in the county. “In fact, I think we had it right.”

The inflection point came when the Texas governor, Greg Abbott, unilaterally decided to reopen the state, and stripped local governments of their power in the process.

If you or another mod feels the need to delete this, I will understand. But I have to say that, given the sheer demographics of which groups suffer most from this pandemic, I firmly believe that a certain political group thinks it is just fine with these outcomes. 

Edited July 24, 2020 by K-9

[Augie]

9 hours ago, plenzmd1 said:

no matter what ya think of Fauci, this is pretty damn funny

 

 

 

Please tell me he’s really a leftie with a great sense of humor.......

 

Good thing he had that doctor thing as a fallback profession.

[Punching Bag]

5 hours ago, BillsFan4 said:

https://www.beckershospitalreview.com/patient-flow/our-backs-are-to-the-wall-texas-hospital-to-turn-away-covid-19-patients-with-poor-survival-chances.html
'Our backs are to the wall': Texas hospital to turn away COVID-19 patients with poor survival chances
?

 

 

According to some COVID-19 is fake news - that is load of bull the size of Texas and that is a lot of bull.

[The Dean]

1 hour ago, plenzmd1 said:

@Hapless Bills Fan, good points. Again, I am not justifying or condoning or dismissing what is happening there. My only point was the article seemed to indicate that many many decisions were going to be needed to made in a daily basis, when in fact they have 3 people in ICU at the moment. 
 

as I mentioned and I talk to my wife all the time, I think this virus is following a pattern of going where it has not been before , and seems to me rural areas could be next. For all the reasons mentioned above, plus, and I am making a generalization here , the propensity of the rural population to be more “independent “ when it comes to some “ rules” scares the bejesus out of me.  I worry for all the folks in rural areas now, I think that is where true carnage could happen with flu season. 

 

Possibly, I suppose. But I think it's much more likely the virus is going where it has easy access. Where people are going, unmasked, into public and indoors. 

 

[BillsFan4]

1 hour ago, The Dean said:

 

Possibly, I suppose. But I think it's much more likely the virus is going where it has easy access. Where people are going, unmasked, into public and indoors. 

 

I agree. We are seeing spikes in places that already dealt with covid cases and shut down once. People keep saying these states with large outbreaks are just dealing with covid for the first time but that’s not entirely true. Texas issued disaster and emergency declarations way back in March. Florida dealt with a large covid outbreak in April. And AFAIK All of these states currently dealing with outbreaks have had covid cases for months. 
 

So, what was the national “pause” for if it wasn’t to get covid under control and stop these large outbreaks/spikes?
 

Am I wrong for thinking that these large outbreaks still going on in June and July didn’t have to happen? I get that some covid spread is unavoidable. We can’t keep the case count at zero. But I don’t think you need to have a big outbreak before you can then control the spread.

 

I feel at this point in the pandemic we seem to have a pretty effective method to control the spread - wear masks, social distance and avoid the indoor activities that present the highest risk to be covid super spreader events. Oh, and reopen following the CDC guidelines. That also seems to be a big factor so far in these spikes. The places that have followed the reopening guidelines most strictly seem to be doing the best. The places dealing with spikes, it seems like for the most part, did not follow the guidelines nearly as strictly when reopening. We will see how long it holds. 
 

I feel like the #1 lesson we should have learned by now is if you let your guard down, this virus will spread and it can/will spread fast if allowed. We can’t just go back to acting like everything is normal as places reopen. 

[Punching Bag]

As long as we have asymptomatic people who still spread virus new outbreaks are inevitable.

There will be people who will travel from one area to another and introduce another strain of virus which people will not have immunity to and those heavily exposed or weaker in health will succumb to and spread.

 

Think of all the versions of the flu and number of different versions of virus in vaccines.

 

The problem is until an effective vaccine and like the flu one which may be recreated every year.

It will like spread from China since like US some will not change patterns / use safety equipment / good food preparation hygiene. 

 

I would say the ceiling for this virus is a lot higher and every year we will have people whose health will be damaged.

 

i do not think we will have a massive change in this country like after 9/11. 

Changes were made in extreme after 9/11 because corporations saw way to turn it into an industry.

Edited July 25, 2020 by Limeaid

[Hapless Bills Fan]

4 hours ago, plenzmd1 said:

@Hapless Bills Fan, good points. Again, I am not justifying or condoning or dismissing what is happening there. My only point was the article seemed to indicate that many many decisions were going to be needed to made in a daily basis, when in fact they have 3 people in ICU at the moment.

 

How many ICU beds do they have?  3 may not sound like a lot, but if they have 4, they're almost full.  And actually, the small rural hospitals I know of may have 4 beds, but what they're usually short of is the nursing staff to properly care for 4 patients week in week out. 

 

 

 

[Hapless Bills Fan]

1 hour ago, BillsFan4 said:

I agree. We are seeing spikes in places that already dealt with covid cases and shut down once. People keep saying these states with large outbreaks are just dealing with covid for the first time but that’s not entirely true. Texas issued disaster and emergency declarations way back in March. Florida dealt with a large covid outbreak in April. And AFAIK All of these states currently dealing with outbreaks have had covid cases for months. 

 

Correct.

 

1 hour ago, BillsFan4 said:

So, what was the national “pause” for if it wasn’t to get covid under control and stop these large outbreaks/spikes?

 

It was supposed to do what was done in a handful of states - buy desperately needed time to build testing capacity, build contact tracing capacity, and then gradually turn the dial and open back up, stepwise, seeing what works and what is problematic.

 

Instead, there was a loss of patience.  People looked at the cases and said "why it's not that bad here, we have no reason to be shut down!", not making the connection that it wasn't that bad here BECAUSE of the shutdown.

 

1 hour ago, BillsFan4 said:

Am I wrong for thinking that these large outbreaks still going on in June and July didn’t have to happen? I get that some covid spread is unavoidable. We can’t keep the case count at zero. But I don’t think you need to have a big outbreak before you can then control the spread.

 

In fact the point was, to control the spread enough to where test-trace-isolate could KEEP it under control, which you can not do with a big out break.

 

Instead, we got a message "fake virus" "99% harmless" "Oh it's infecting young people now, so we won't see the death rate" "we MUST reopen NOW for the sake of the economy!"

 

A chap I follow on Facebook put it pretty well.  Young people are the fuel.  They will spread the disease and amplify the cases, until it infects enough vulnerable people that we see the hospitalizations rise.  Then 3-4 weeks later, the deaths will follow.  I don't think more young people are getting infected now than in Feb-March.  I think they are asymptomatic or mildly symptomatic and were never tested back in Feb and March, but they're the reason the epidemic took off as fast as it did - it was already far more widespread than we knew.

 

1 hour ago, BillsFan4 said:

 

I feel at this point in the pandemic we seem to have a pretty effective method to control the spread - wear masks, social distance and avoid the indoor activities that present the highest risk to be covid super spreader events. Oh, and reopen following the CDC guidelines. That also seems to be a big factor so far in these spikes. The places that have followed the reopening guidelines most strictly seem to be doing the best. The places dealing with spikes, it seems like for the most part, did not follow the guidelines nearly as strictly when reopening. We will see how long it holds. 
 

I feel like the #1 lesson we should have learned by now is if you let your guard down, this virus will spread and it can/will spread fast if allowed. We can’t just go back to acting like everything is normal as places reopen. 

 

This.  As someone said, what NYS actually did while reopening was pretty much just follow the CDC guidelines.

[Hapless Bills Fan]

4 hours ago, plenzmd1 said:

@Hapless Bills Fan, as I mentioned and I talk to my wife all the time, I think this virus is following a pattern of going where it has not been before , and seems to me rural areas could be next. For all the reasons mentioned above, plus, and I am making a generalization here , the propensity of the rural population to be more “independent “ when it comes to some “ rules” scares the bejesus out of me.  I worry for all the folks in rural areas now, I think that is where true carnage could happen with flu season. 

 

I too, am very scared for rural areas.  It's where most of our relatives live.  Several of them are nurses, one is a social worker with Senior Services.  We hear a lot about hospital capacity or the lack thereof.  And, many of the residents in rural areas are high risk - hypertension, diabetes, obesity, heart disease.

 

I'm not so sure the virus is "going where it has not been before".  As someone else pointed out, Florida AZ and Tx all had outbreaks.  But they were contained with closures to the point where they didn't put a real scare into the population.   I think what's happening is that wherever there are areas where people don't take it seriously and don't use masks or employ social distancing, all it takes is one infected person and We're Off.

 

I saw this contact tracing chart from a Facebook follow.  Someone asked me "is that a realistic situation?"  It's not only realistic it's real.   Near Quincy IL

One index case.  One family event, outdoors: spread to 18 cases across 3 states.  At the point this chart was drawn up, it involved 84 cases, 5 places of business (one of them apparently a Senior Living facility).

 

 

It could easily be 338 or 672 cases by now, if people don't follow instructions to quarantine or if test results are delayed for 1-2 infection cycles (6-10 days)

 

[K-9]

1 minute ago, plenzmd1 said:

Love ya bro...but this is the kind of talk that just divides our country to point of chaos.I am as anti Maga as you can get. However,  I am great friends with several MAGA supporters, have family members, including my son,  that i love dearly that are Maga, and to suggest they want to see people to die to advance a political ideology is just beyond the pale to me. I mean christ, you think my son wants to see people die??? the very thought that people would people would think this make me sick.

 

We have got to stop this rhetoric..it is not what we are about as a country.

We are all friends with MAGA supporters; I understand that. And I won’t go as far as saying they all advocate all of the same aims as their political leaders. Regardless, when it comes to certain things, including the idea that a pandemic which disproportionately sickens and kills a constituency of an opposing ideology that they otherwise seek to silence at the polls by other means, then I think that leadership is fully on board. 
 

No, I don’t think your son wants to see people die. But I don’t think the leadership of his political party cares one way or the other. What else explains the lack of a unified national plan to combat this thing after nearly seven months IN SPITE of the best advice from our own experts otherwise? 
 

While the very thought of my having these thoughts might sicken you, the very thought that our MAGA friends aren’t front and center in condemning what we see occurring on a daily basis sickens me even more. 
 

I’m sure this post will get deleted and perhaps it should if it crossed a boundary. But I’m not apologizing for it. I hope you can understand that. 

[K-9]

Just now, plenzmd1 said:

its just wrong dude...different political views does not mean they want to see people die. To say people of either party do not care if people die is just flat out wrong to me.

 

To me, the very thought that Democratic leaders  and followers do not see who lockdowns affect the most, why and who  closing schools against all scientific evidence affects the most, who refuse to acknowledge that minorities and immigrants are being absolutely used and abused by their policies..is absolutely disgusting to me.

 

It is not about what is best for the country for so many, It is what is best for my political point point of view. Unfortunately, what is best for both parties seems to be the the absolur worst for those that have the least. but

 

But for so many on the left, all that matters is what is best to get Trump out of office...and it is freaking criminal to this never Trumper. I will never abandon my principals for advancement of political ideals. 

My principals are at the very CENTER of my dissent. Make it about republicans vs. democrats if you must, but I can assure you I am not. This is about so much more than that. 

 

Anyway, I’ve said too much for this forum. I’ll let it go at that. 

[Buddo]

10 hours ago, plenzmd1 said:

you good with suing Cuomo and Murphy for making nursing homes takes positive cases against local  objections? 

I can assure the Republicans fear this hitting rural areas more than any other..that is their base from a pure politics perspective. 

No problems with people anywhere, trying to hold any politician to account, whatever their stripe. 
Any sort of pandemic is not the time to be partisan, but unfortunately politicians the world over, really don’t seem to get that. 
 

There are exceptions, and oddly enough, those are places where things seem to be under far greater control. 

[plenzmd1]

11 hours ago, BillsFan4 said:

I agree. We are seeing spikes in places that already dealt with covid cases and shut down once. People keep saying these states with large outbreaks are just dealing with covid for the first time but that’s not entirely true. Texas issued disaster and emergency declarations way back in March. Florida dealt with a large covid outbreak in April. And AFAIK All of these states currently dealing with outbreaks have had covid cases for months. 
 

 

I don't see the large outbreaks. All states issued disaster and emergency declarations to open up federal funds and assistance when everyone shut down in March .

 

I don't see the spike you are talking about in these states before late June. Graphs courtesy of worldometers, maybe there is a different sire that shows something different? BTW, i am somewhat technologically challenged, TBD would not let me post the CA graph, will do in the next post. But CA was one of the first to close and last to open, and graph looks quite similar to Florida and Texas. 

 

I am not making the argument that people's behavior does not impact the spread of the virus. I am saying we erred as a country shutting down the entire country when it appears, at least to me, lockdowns should have occured, and should be occurring now, in those areas that have these types of outbreaks.

 

 

 

 

 

 

 

 

Edited July 25, 2020 by plenzmd1

[plenzmd1]

All very similar patterns to NY ..my gut says if we had testing in January and February, NY would look just like these graphs 

 

[BillsFan4]

2 hours ago, plenzmd1 said:

I don't see the large outbreaks. All states issued disaster and emergency declarations to open up federal funds and assistance when everyone shut down in March .

 

I don't see the spike you are talking about in these states before late June. Graphs courtesy of worldometers, maybe there is a different sire that shows something different? BTW, i am somewhat technologically challenged, TBD would not let me post the CA graph, will do in the next post. But CA was one of the first to close and last to open, and graph looks quite similar to Florida and Texas. 

 

I am not making the argument that people's behavior does not impact the spread of the virus. I am saying we erred as a country shutting down the entire country when it appears, at least to me, lockdowns should have occured, and should be occurring now, in those areas that have these types of outbreaks.

 

 

 

 

 

 

 

 

CA is also seeing another spike. I probably should have included them with the other states I mentioned.
 

I went over some of the numbers from Florida within the last few pages of this thread. I posted a timeline of covid in Florida. They had over 20,000 covid cases in April. DeSantis shut down specifically to get covid under control. 
 

On 7/20/2020 at 1:55 PM, BillsFan4 said:

Florida already had to shut down once a few months ago to get an outbreak under control.
 

30 day stay at home order, issued April 1st:

https://www.clickorlando.com/news/local/2020/04/01/coronavirus-florida-governor-issues-statewide-30-day-stay-at-home-order/
 

timeline of covid in Florida:

https://www.clickorlando.com/news/local/2020/03/20/timeline-the-spread-of-coronavirus-in-florida/

 

6000 cases on March 31st. Over 12,000 by April 5th. Over 21,000 positive cases by April 13th (almost double in 8 days. Starting to find thousand+ new cases every day). Over 26,000 by April 19th. Over 29,000 by April 23rd and 1000+ deaths. 

37,000 by May 4th.
 

Then they started opening again in mid May, with bars, tattoo shops (etc) and some theme parks opening in early-mid June. 
 

I don’t know if I’d call it a second spike or just a continuation of their first wave?

 

If the above isn’t an outbreak, then what is? 

 

The first outbreak in Texas wasn’t as bad as Florida, but they still had an outbreak. Their first case was way back in March. 
 

and again, I don’t think you need to have a large outbreak before you’re able to start limiting the spread of covid. The goal of all these guidelines is to avoid these large outbreaks at all.

Edited July 25, 2020 by BillsFan4

[Hapless Bills Fan]

On 7/24/2020 at 7:07 AM, plenzmd1 said:

no matter what ya think of Fauci, this is pretty damn funny

 

 

 

Did I call it, or What?  I said he'd muff it!  But LOL at the comment!  He was social distancing that pitch!

 

2 hours ago, plenzmd1 said:

All very similar patterns to NY ..my gut says if we had testing in January and February, NY would look just like these graphs 

 

 

I think your gut is correct.  There is a true statement being misinterpreted widely in the media right now.

The true statement is right now, the demographics of positive tests are showing more younger people infected.

The misinterpretation is "more young people are being infected than were infected in February/March".

 

The point is, we weren't testing asymptomatic people or contact tracing and testing in February and March.  We barely had enough tests to test sick people.  We weren't even broadly testing employees of nursing homes!!!!!  If we had been, I think what we'd see is this:

-young people get infected with few or no symptoms

-young people are the fuel who carry the fire to adults and elders

-~4-6 weeks later, enough adults and elders become seriously ill to fill up the hospitals

-18-21 days later, death rate starts to soar

[plenzmd1]

38 minutes ago, BillsFan4 said:

CA is also seeing another spike. I probably should have included them with the other states I mentioned.
 

I went over some of the numbers from Florida within the last few pages of this thread. I posted a timeline of covid in Florida. They had over 20,000 covid cases in April. DeSantis shut down specifically to get covid under control. 
 

 

If the above isn’t an outbreak, then what is? 

 

The first outbreak in Texas wasn’t as bad as Florida, but they still had an outbreak. Their first case was way back in March. 
 

and again, I don’t think you need to have a large outbreak before you’re able to start limiting the spread of covid. The goal of all these guidelines is to avoid these large outbreaks at all.

Well, i can tell you right now in Virginia we are averaging over 1K cases a day..or 30K a month..and certainly no talk here about an "outbreak" or cutting back on any thing that is open today..restaurants, churches, gyms( i am doing hot yoga again)..all retail..everything except inside bars really. So no, i would not agree that 20K cases in the 3rd most populous state in April would be considered an outbreak.

 

Agree on last sentence..i believe Northam's mask mandate was wise here in VA early on, before most states. As said, i think the hotspot states right now should have stricter lockdowns..but i dont think NY should ..do you? NY  had 906 new cases yesterday...900x30= 27K new cases over a month...less than the 20K cited above

[Hapless Bills Fan]

3 hours ago, plenzmd1 said:

I don't see the large outbreaks. All states issued disaster and emergency declarations to open up federal funds and assistance when everyone shut down in March .

 

This becomes a quibble about "what constitutes a large outbreak?"

 

The point is, covid-19 was in these states and widespread enough, with clear enough indications of community transmission, that public health officials looked at the daily case logs and said "yeah, this will blossom Big Time unless we shut stuff down until we get our testing and contact tracing in place"

 

But then instead of waiting for their metrics to meet the CDC guidelines and reopening gradually, these states all said "Outbreak?  We don't see no Stinkin' Outbreak here!  We don't need to do what NY did!  We're OPEN!"

 

It's not that the disease is magically travelling to places it hasn't been before WRT cities in FL, Texas, Arizona, Cali.   From a public health standpoint, there were significant outbreaks in many of these places.  They just figured they didn't need to do what NYC etc did because the disease wasn't that bad or something.  And now they're seeing that's wrong.

 

There ARE places where the disease was not a significant problem during the shutdown who are now seeing heavy blooms.  Places like SW MO and many rural counties in MO would be an example.  Again, these are places where the disease was unable to spread during a shutdown, but it was there - a few cases here and there - and once they re-opened, it spread.

People don't "Get It".  They're like "my county has 4 cases so why does my bar (or my church, or both) need to shut down and we need to abstain from large family social events?"  They don't "get it" that maybe their county only has 4 cases BECAUSE those things were shut down.

 

3 minutes ago, plenzmd1 said:

Well, i can tell you right now in Virginia we are averaging over 1K cases a day..or 30K a month..and certainly no talk here about an "outbreak" or cutting back on any thing that is open today..restaurants, churches, gyms( i am doing hot yoga again)..all retail..everything except inside bars really. So no, i would not agree that 20K cases in the 3rd most populous state in April would be considered an outbreak.

 

Agree on last sentence..i believe Northam's mask mandate was wise here in VA early on, before most states. As said, i think the hotspot states right now should have stricter lockdowns..but i dont think NY should ..do you? NY  had 906 new cases yesterday...900x30= 27K new cases over a month...less than the 20K cited above

 

It all depends upon the distribution of those new cases, the amount and availability of testing that is being done, and the % positive tests.

To just look at statewide data (VA or NY) and make statements like this - well, you aren't an epidemiologist.

 

The Devil is always in the details.

 

[plenzmd1]

14 minutes ago, Hapless Bills Fan said:

 

This becomes a quibble about "what constitutes a large outbreak?"

 

The point is, covid-19 was in these states and widespread enough, with clear enough indications of community transmission, that public health officials looked at the daily case logs and said "yeah, this will blossom Big Time unless we shut stuff down until we get our testing and contact tracing in place"

 

But then instead of waiting for their metrics to meet the CDC guidelines and reopening gradually, these states all said "Outbreak?  We don't see no Stinkin' Outbreak here!  We don't need to do what NY did!  We're OPEN!"

 

It's not that the disease is magically travelling to places it hasn't been before WRT cities in FL, Texas, Arizona, Cali.   From a public health standpoint, there were significant outbreaks in many of these places.  They just figured they didn't need to do what NYC etc did because the disease wasn't that bad or something.  And now they're seeing that's wrong.

 

There ARE places where the disease was not a significant problem during the shutdown who are now seeing heavy blooms.  Places like SW MO and many rural counties in MO would be an example.  Again, these are places where the disease was unable to spread during a shutdown, but it was there - a few cases here and there - and once they re-opened, it spread.

People don't "Get It".  They're like "my county has 4 cases so why does my bar (or my church, or both) need to shut down and we need to abstain from large family social events?"  They don't "get it" that maybe their county only has 4 cases BECAUSE those things were shut down.

 

 

It all depends upon the distribution of those new cases, the amount and availability of testing that is being done, and the % positive tests.

To just look at statewide data (VA or NY) and make statements like this - well, you aren't an epidemiologist.

 

The Devil is always in the details.

 

so just to play devils advocate..when should places open up? What constitutes an "outbreak"....purely low positivity rates? how many tests per capita?# of cases? 

[Hapless Bills Fan]

18 hours ago, Buddo said:

 

Hopefully, someone sues him. Seems to me that unnecessarily removing local government powers, has directly impacted those communities. In a very bad way.

 

In far too many places, around the world, politics has got well in the way of attempts to mitigate covid.

 

A classic case of 'if it ain't broke, don't fix it'.

 

I'm not a fan of lawsuits.  But it does seem to be an observation that some folks are against government overreach and interference with local government issues - right up until it gores their political Ox.  Then they're all for it.  Convenient.

Historically, local governments and states were given precedence to issue orders for the Public Health because it was recognized that the government of (say) St Louis needed latitude to deal effectively with a typhoid epidemic from contaminated water that wasn't state-wide.  And at times, disease outbreaks were recognized as multi-state issues (malaria mosquitos don't recognize state lines, I promise!) and the Federal government took a hand.  Widespread PR campaigns, promotion of window screens, and spraying of DDT in houses in Southern states during WWII is an example.

 

History lesson: When was the US Center for Disease Control established and why?  Answer: it was established in 1946, as the Malaria Control in War Areas project was coming to an end, because it was recognized that some Public Health threats affect the entire country or entire regions of the country if left unchecked, therefore as the war effort ramped down, continued coordinate Federal action on these was necessary for the health and safety of the country (which allow it to function as a Country)

 

By 1951, Malaria was considered eliminated in the United States, and at this point (69 years later) seems we've completely forgotten the Public Health lessons of the past.

If a local government or state government feels a public health measure is necessary in their area, given their demographics and their situation, interference should be cautious.

[Hapless Bills Fan]

9 minutes ago, plenzmd1 said:

so just to play devils advocate..when should places open up? What constitutes an "outbreak"....purely low positivity rates? how many tests per capita?# of cases? 

 

Well, the actual CDC guidelines seem to be working pretty well in NYS.

 

But what would have made sense, IMO, was to follow the CDC guidelines (at least the guidelines as of April) which specify: how many tests must be done per 100,000 population to maintain surveillance; how many contact tracers must be in place; a specific decline in positive tests and % of positive tests for 14 days while test targets per 100,000 are still being met; and specific targets for capacity in hospital beds and ICUs. 

For a disease like this where we're still learning about transmission, phased reopening from perceived lowest risk, to highest risk with a chance to pause if things start to flare also makes sense. 

 

All from an epidemiological perspective.  It was epidemiology that set the # tests/100,000; # contact tracers/100,000; positive test %, and decline guidelines.

 

As for your question about "what constitutes an outbreak", it's not susceptible to a simple cut-and-dried answer. 

https://en.wikipedia.org/wiki/Disease_outbreak

 

 

[Hapless Bills Fan]

3 hours ago, plenzmd1 said:

I am not making the argument that people's behavior does not impact the spread of the virus. I am saying we erred as a country shutting down the entire country when it appears, at least to me, lockdowns should have occured, and should be occurring now, in those areas that have these types of outbreaks.

 

In other words, we should have waited to lock the barns until AFTER the horse fled? 

 

All the countries which shut down, and now have the virus contained - Italy, Spain, Germany, etc etc - faced this exact same situation on a smaller scale.  There were stricken areas, and there were areas with few cases, and they all shut down.

 

Why?  Because while necessary commerce takes place and travel is not strictly prohibited, contagious disease will spread.  You can't stop the spread of disease by shutting down local areas in the age of unrestricted automobile and airplane travel.  You need to deal with it in a coordinate way. 

 

And clear, effective communication about the need for these measures and the when/why of lifting them must take place.  There can not be mixed messages.

 

I think we erred in the opposite direction.  I just put this article up in the Facts thread.  Consider this figure:

 

The top is the impact of measures in NYC.  The blue smear in the bottom panel, indicates the time period over which variable measures were enacted in different states.  I don't think it takes a very vivid imagination to see that if there had been a single blue line, covid-19 across the country would have leveled off shortly after that point, and if the face coverings had been uniformly enacted at the same point, the same decline could have occurred.  Then the level of disease in the community would have been lowered to the point where testing and contact tracing could have contained it, country wide.

[BillsFan4]

2 hours ago, plenzmd1 said:

Well, i can tell you right now in Virginia we are averaging over 1K cases a day..or 30K a month..and certainly no talk here about an "outbreak" or cutting back on any thing that is open today..restaurants, churches, gyms( i am doing hot yoga again)..all retail..everything except inside bars really. So no, i would not agree that 20K cases in the 3rd most populous state in April would be considered an outbreak.

 

Agree on last sentence..i believe Northam's mask mandate was wise here in VA early on, before most states. As said, i think the hotspot states right now should have stricter lockdowns..but i dont think NY should ..do you? NY  had 906 new cases yesterday...900x30= 27K new cases over a month...less than the 20K cited above

We will agree to disagree I guess.

 

NY issued their state wide stay at home order when there was 21,000 total cases in the state.
 

MA issued theirs with less than 1000 total cases in the state.

 

MI had 1,791 cases when they issued their stay at home orders.

 

NJ had 1,327 at the time of the stay at home order

 

Those were all places considered to have early outbreaks.

 

edit - my only real point was that Florida isn’t seeing this current surge because covid just got to their state.

 

Edited July 25, 2020 by BillsFan4

[Figster]

At this point it appears testing is only catching 10% of the actually true number of people walking around with Covid 19. The long incubation period is making it impossible to control.

 

Home test kits and a per individual lockdown until testing negative twice through a one week time span might be the best way to corral Covid 19 in my humble opinion. One month and we could have the US back on track for a full recovery IMO. Having 90% of our Covid 19 case load walking the streets does not cut it.  

 

 

[Hapless Bills Fan]

[Hapless Bills Fan]

1 hour ago, BillsFan4 said:

We will agree to disagree I guess.

 

NY issued their state wide stay at home order when there was 21,000 total cases in the state.
 

MA issued theirs with less than 1000 total cases in the state.

 

MI had 1,791 cases when they issued their stay at home orders.

 

NJ had 1,327 at the time of the stay at home order

 

Those were all places considered to have early outbreaks.

 

Given the limited testing capacity, all of those responses were late in coming.

New Zealand, which has limited its covid-19 cases to ~1500, went to level 4 lock down mid-March when they had ~100 cases.

As the prime minister said: "we only have 100 cases now, but Northen Italy had 100 cases at one time"

An effective pandemic response requires containment action BEFORE the problem outgrows the capacity of the government in question to test, trace, and isolate.

 

[Hapless Bills Fan]

1 hour ago, Figster said:

At this point it appears testing is only catching 10% of the actually true number of people walking around with Covid 19. The long incubation period is making it impossible to control.

 

The first statement may be correct in some parts of the US but not all.  Would you mind giving a source though? 

 

The "impossible to control" is an indefensible statement. It's a self-justificatory excuse for politicians who lack the public interest or the balls and the guts to actually take effective action to control covid-19, and for citizens who accept and enable this behavior. 

 

Norway - controlled. Denmark- controlled.  Ireland - controlled.  S. Korea - controlled.  Austria - controlled. Switzerland - controlled.  Germany - controlled.  Canada - controlled.  Italy - controlled.  Portugal - controlled.  Belgium - controlled.  France - controlled.  All Democracies.  Many of them miles of open borders.  (source: Worldometer)

 

354 million people live in those countries.

 

That's not to say it's easy - there are also a couple countries where control looks tenuous (Greece) or which had the epidemic reined in, but didn't have the proper containment measures in place when they eased off too far and are now surging - Spain, Australia, Japan, Israel (so much for "only flaring in places where it hasn't been before").

 

But to say it's "impossible to control" simply flies in the face of evidence of many countries which ARE controlling it - many of which were closed for less time and now have fewer restrictions.

 

By the way, It's not the "long incubation period" that's the challenge, it's pre- or a-symptomatic transmission, combined with the large number of asymptomatic or mildly symptomatic carriers.

 

If people mask up in public to cut down on transmission, avoid the highest-risk situations (being unmasked in crowds especially indoors), covid-19 can be contained as long as there's enough tracing capacity to trace all contacts, enough testing capacity to get prompt results on all contacts as well as to conveniently test all people who are symptomatic and all workers in care homes, there's no epidemiologic reason covid-19 can't be controlled.

 

Quote

Home test kits and a per individual lockdown until testing negative twice through a one week time span might be the best way to corral Covid 19 in my humble opinion. One month and we could have the US back on track for a full recovery IMO. Having 90% of our Covid 19 case load walking the streets does not cut it. 

 

1) we do not have accurate home test kits at the present time, let alone kits with high sensitivity

2) epidemiologically, your per individual timeline would not work on a one week time span.  

 

Nevertheless, there are measures that would work, with the tools we have in hand today.  We just don't want to use them.  I guess it's normal that everyone thinks he's an epidemiologist, but the fundamental problem here is not that we don't have damned good experienced epidemiologists who can figure out measures to take (short of locking down except in a few areas that are out of control currently - locking down was always a "hail Mary" desperation move).  It's that we're not giving authority to our epidemiologists with wholehearted and unconflicted support of our political leaders.

[Figster]

38 minutes ago, Hapless Bills Fan said:

 

The first statement may be correct in some parts of the US but not all.  Would you mind giving a source though? 

 

The "impossible to control" is an indefensible statement. It's a self-justificatory excuse for politicians who lack the public interest or the balls and the guts to actually take effective action to control covid-19, and for citizens who accept and enable this behavior. 

 

Norway - controlled. Denmark- controlled.  Ireland - controlled.  S. Korea - controlled.  Austria - controlled. Switzerland - controlled.  Germany - controlled.  Canada - controlled.  Italy - controlled.  Portugal - controlled.  Belgium - controlled.  France - controlled.  All Democracies.  Many of them miles of open borders.  (source: Worldometer)

 

354 million people live in those countries.

 

That's not to say it's easy - there are also a couple countries where control looks tenuous (Greece) or which had the epidemic reined in, but didn't have the proper containment measures in place when they eased off too far and are now surging - Spain, Australia, Japan, Israel (so much for "only flaring in places where it hasn't been before").

 

But to say it's "impossible to control" simply flies in the face of evidence of many countries which ARE controlling it - many of which were closed for less time and now have fewer restrictions.

 

By the way, It's not the "long incubation period" that's the challenge, it's pre- or a-symptomatic transmission, combined with the large number of asymptomatic or mildly symptomatic carriers.

 

If people mask up in public to cut down on transmission, avoid the highest-risk situations (being unmasked in crowds especially indoors), covid-19 can be contained as long as there's enough tracing capacity to trace all contacts, enough testing capacity to get prompt results on all contacts as well as to conveniently test all people who are symptomatic and all workers in care homes, there's no epidemiologic reason covid-19 can't be controlled.

 

 

1) we do not have accurate home test kits at the present time, let alone kits with high sensitivity

2) epidemiologically, your per individual timeline would not work on a one week time span.  

 

Nevertheless, there are measures that would work, with the tools we have in hand today.  We just don't want to use them.  I guess it's normal that everyone thinks he's an epidemiologist, but the fundamental problem here is not that we don't have damned good experienced epidemiologists who can figure out measures to take (short of locking down except in a few areas that are out of control currently - locking down was always a "hail Mary" desperation move).  It's that we're not giving authority to our epidemiologists with wholehearted and unconflicted support of our political leaders.

https://www.yahoo.com/lifestyle/cdc-study-covid-19-cases-may-be-10-times-higher-than-reported-214522682.html

 

Its averaged out and again 10 is the reoccurring number I keep hearing.

 

Myself personally, its obvious we don't have all the tools and resources needed to get a handle on the virus in my humble opinion Hapless.  For many of the reasons mentioned. I beg to differ on the long incubation period. 

 

Priortize the work force and begin testing at testing centers.  

 

2 week time span on testing negative, thanks

 

In other countries hit hard the virus has thoroughly run its course through them and built up some herd immunity IMO.     

Edited July 25, 2020 by Figster

[Hapless Bills Fan]

20 minutes ago, Figster said:

https://www.yahoo.com/lifestyle/cdc-study-covid-19-cases-may-be-10-times-higher-than-reported-214522682.html

Its averaged out and again 10 is the reoccurring number I keep hearing.

 

Thanks.  Note that the study was conducted between March 23 and May 12, when case counts were higher and testing capacity lower.
 

Example from NYS (because they make it easy to find # tests, # positive tests, % positive tests):

https://forward.ny.gov/percentage-positive-results-region-dashboard
 

Note that during that time frame, the number of daily tests was lower, and the fraction of tests that were positive was much higher - 40% at one point!

With more tests and lower positivity rate, 10x no longer applies.

 

Now of course, in states which have a % positive rate and a # infected that is starting to look more like NYC in March, it could now be true again.

 

You "beg to differ" on the control aspect of the long incubation period of up to 14 days, then you propose as a solution having everyone test negative twice in a 1 week time span as a control measure?  I mean no offense, Figster, but you don't have to be an epidemiologist to see that 1) this is illogical - if the 14 day incubation period is what makes control problematic, two negative tests in a week won't cut it 2) ...Nah, I can't even.  Go offer your services to epidemiologists as a disease control expert and see what they say "is it a long incubation that makes a disease hard to control if people only become contagious once they're symptomatic?" "is a short incubation time easy to control if many infectious people are asymptomatic or presymptomatic?" 

 

See what they say

 

I notice you had nothing to say about my rebuttal to your "impossible to control" excuse.

[Figster]

4 hours ago, Hapless Bills Fan said:

 

Thanks.  Note that the study was conducted between March 23 and May 12, when case counts were higher and testing capacity lower.
 

Example from NYS (because they make it easy to find # tests, # positive tests, % positive tests):

https://forward.ny.gov/percentage-positive-results-region-dashboard
 

Note that during that time frame, the number of daily tests was lower, and the fraction of tests that were positive was much higher - 40% at one point!

With more tests and lower positivity rate, 10x no longer applies.

 

Now of course, in states which have a % positive rate and a # infected that is starting to look more like NYC in March, it could now be true again.

 

You "beg to differ" on the control aspect of the long incubation period of up to 14 days, then you propose as a solution having everyone test negative twice in a 1 week time span as a control measure?  I mean no offense, Figster, but you don't have to be an epidemiologist to see that 1) this is illogical - if the 14 day incubation period is what makes control problematic, two negative tests in a week won't cut it 2) ...Nah, I can't even.  Go offer your services to epidemiologists as a disease control expert and see what they say "is it a long incubation that makes a disease hard to control if people only become contagious once they're symptomatic?" "is a short incubation time easy to control if many infectious people are asymptomatic or presymptomatic?" 

 

See what they say

 

I notice you had nothing to say about my rebuttal to your "impossible to control" excuse.

 

 The virus running its course through a country I don't consider controling. The virus running its course around the world I don't consider control. Instead of the allowing the virus to run its course here in the US we tried to intervene. Without a unified plan in place it created a situation that extended and worsened the hardships of the pandemic on the American people IMO. 

 

Allow me to explain myself,  If you test at the middle of the two week stay at home order and at the end you would have covered the incubation period IMO. ( two negatives a week apart) If you tested negative on the 1st day of a 14 day stay at home I don't think it tells you anything. Thus, why I thought two test at the middle and end of the 14 day stay at home would work as a double check and a wiser use of resources IMO. 

 

Updated Article on 90% of Covid 19 case load (on average) going undetected.

 

https://ktla.com/news/coronavirus/antibody-tests-show-coronavirus-rates-10-times-higher-than-reported-cases-in-most-u-s-regions-cdc/

 

 The 14 day incubation period does present a problem IMO. Especilly considering you can spread the virus before or without symptoms.

 

 

Edited July 25, 2020 by Figster

[plenzmd1]

9 hours ago, BillsFan4 said:

We will agree to disagree I guess.

 

NY issued their state wide stay at home order when there was 21,000 total cases in the state.
 

MA issued theirs with less than 1000 total cases in the state.

 

MI had 1,791 cases when they issued their stay at home orders.

 

NJ had 1,327 at the time of the stay at home order

 

Those were all places considered to have early outbreaks.

 

edit - my only real point was that Florida isn’t seeing this current surge because covid just got to their state.

 

And sure as chit as soon as I said no talk of walking back...

 

lord knows  we are all screwed up with this thing. 
 

sorry if I come across as an ass, ( course it’s cause I am) this poop is just getting to me. 
 

 

[BillsFan4]

16 minutes ago, plenzmd1 said:

And sure as chit as soon as I said no talk of walking back...

 

lord knows  we are all screwed up with this thing. 
 

sorry if I come across as an ass, ( course it’s cause I am) this poop is just getting to me. 
 

 

It’s all good. Nothing to apologize for. I understand. I think this stuff is taking its toll on a lot of us.