Coronavirus Thread

[Deleted member 2897]

I simply do not understand why this discussion has to be a politically driven all one-side or the other-side diatribe. Why can we not discuss what can be done within limits to minimize health care strain and open areas of the economy in ways that pose lower risk than a free for all?

Because 1 side signaled from the beginning they would try to use this to their advantage and the guy on the other side...well he's a , so they both feed off each other. Its like Seinfeld's Festivus where both sides have their daily airing of grievances. The nature of the topic also makes it very difficult - I mean think about what we are discussing - what is the sweet spot that keeps parts of the economy running while staying under the hospital system's capacity. That's basically a death/sickness versus money calculation. That will always tend to rub people the wrong way I think.

 

[RonJohn]

The nature of the topic also makes it very difficult - I mean think about what we are discussing - what is the sweet spot that keeps parts of the economy running while staying under the hospital system's capacity. That's basically a death/sickness versus money calculation. That will always tend to rub people the wrong way I think.

Except a month ago, epidemiologists were saying that it isn't a death/sickness decision. The virus will cause some number of sickness and death no matter how flat the curve is. The only death benefit of slowing things down was preventing deaths from lack of access to medical care if the medical system was overwhelmed.

 

[WreckinGT]

Respectfully, you're still not getting the main point of flattening the curve. Its a morbid topic, but it is what it is. If you go look up pictures of flattening the curve, its all about staying under the hospital system's capacity - its not trying to get the disease close to zero or even remotely close to that. We've learned enough about this disease now to know that all these people wanting to go back to work are not at any material chance of dying from it. The high high majority of people at risk are the ones not working anyway. Our GDP equates to $2 Trillion per month. Having to inject that into our economy from the government every month is unsustainable. We're already going to be around a $4 Trillion deficit as it stands right now without any further bailout/stimulus bills. And there will be more.

Once again, nobody is saying get the curve to zero. There is evidence that easing social distancing restrictions before you really have a handle on the problem leads to resurgence. If we were worried that the initial spread of the virus might overwhelm hospitals then why are we so sure that a resurgence will not overwhelm hospitals? Again I ask, why have a shutdown in the first place if you are going to risk ending it early and being right back to where you started?

 

[RamblinRed]

Exactly. It's hard for me to understand why so many can't grasp this.

FWIW, was looking at research into this over the weekend.
The current numbers I saw for mortality rates were basically as follows. (what that translates to in deaths if you apply it to the American population in those age ranges)
19-25 yr olds - 0.001 (0.1%) (28,021)
26-34 - 0.002 (79,181)
35-54 - 0.005 (409,953)
55-65 - 0.013 (362,668)

More importantly I want to get off the death total as it is helpful to understand how long the recovery process is.
The government of New South Wales in Australia has been going back out to every one that has come down with COVID19 and survived to see how they are recovering.
Here is what they found.

Recovered within 16 days - 50%
Recovered within 3 weeks - 75%
Recovered within 6 weeks - 90%

When 50% of your patients who have symptoms take more than 2 weeks to recover, that is really bad. The fact the 1/4 take 3 weeks is just alot of suffering.

 

[Deleted member 2897]

Once again, nobody is saying get the curve to zero. There is evidence that easing social distancing restrictions before you really have a handle on the problem leads to resurgence. If we were worried that the initial spread of the virus might overwhelm hospitals then why are we so sure that a resurgence will not overwhelm hospitals? Again I ask, why have a shutdown in the first place if you are going to risk ending it early and being right back to where you started?

And nobody is accusing you have demanding to get the curve to zero. Flattening the curve is sustaining a level of activity that keeps things moving, keeps milk on the table, but keeps hospital systems from being overwhelmed. Its as simple as that. We engaged in a shutdown because we were worried with the exponential rocketship of cases that we would break that hospital capacity line. And we did in a few places. Now that we know in the vast majority of locations we're not going to even come close to it, we don't need to be shutdown anymore. Its time to gradually open things back up. Nobody is going to completely end it and go back to normal. Its going to be done in slow phases so we can see the impact of those changes. Then they'll either back off again, hold pat with where they are, or add more things back. That's always been the plan that the health experts advocated. That's what flattening the curve looks like. That's always been the plan.

 

[WreckinGT]

And nobody is accusing you have demanding to get the curve to zero. Flattening the curve is sustaining a level of activity that keeps things moving, keeps milk on the table, but keeps hospital systems from being overwhelmed. Its as simple as that. We engaged in a shutdown because we were worried with the exponential rocketship of cases that we would break that hospital capacity line. And we did in a few places. Now that we know in the vast majority of locations we're not going to even come close to it, we don't need to be shutdown anymore. Its time to gradually open things back up. Nobody is going to completely end it and go back to normal. Its going to be done in slow phases so we can see the impact of those changes. Then they'll either back off again, hold pat with where they are, or add more things back. That's always been the plan that the health experts advocated. That's what flattening the curve looks like. That's always been the plan.

So there are many health experts that agree with Kemps decision?

 

[grandpa jacket]

I think everyone knows the geographic areas that needed quarantine along with the demographics that needed it as well.

The hard parts are things like nursing homes. You got young nurses, assistants, staff, etc and a lot of feeble older folks. How you attack that problem is vexing.

The remainder of things, ie beaches are fairly simple. Yeah having big spring break beer bong and wet tshirt contests is riskier as you’ve got large crowds congregating. Some surfers, a boat ramp, etc has little to no danger and dealing with them in a similar fashion is nonsensical.

That being said if we give our nation the straight facts not agenda driven drivel, people will make solid personal decisions more often than not based on their level of risk they’re willing to tolerate.

Some people seem to think we can protect all the people all the time from any undesirable life events and that’s just not possible. Not here, not in Commie China, not in Canada, nowhere is that possible.

What demographics are you speaking of, Tom Hanks, George Stephanopoulous, his wife, Brook Baldwin ,Cuomo, the WHITE congress member in Utah.

 

[RamblinRed]

FWIW 05, I thought it was a great read, even if I disagreed with the conclusion.

05, I also forgot to mention, basically I think the herd immunity strategy doesn't really translate well in real life due to 2 assumptions that don't hold well at least with this virus.

First is the idea of we can the high at risk safe. This is the Sweden Strategy. They basically tried to keep the elderly isolated and largely let everyone else work while asking them to use good social distancing measures. Like pretty much every other country they are now finding they can't keep them safe and the public there is starting to get angry because of it.

Second, the herd immunity idea basically relies on an assumption that you can have controlled chaos. That you can sort of manage the outbreaks. But I think the outbreaks just spiral out of control too quickly. The R0 for this thing is so high that it simply becomes impossible to manage.

The third assumption which i will bring up is natural herd immunity basically assumes that the younger population that isn't isolated is ok with getting sick and potentially dying (even though the latter is a small statistical probability). In reality i would expect alot of the remaining work force would not readily agree to getting very, very sick (hospitalization rates are over 15% for 18-29 and over 30% for 30-50) or being one of the unlucky ones that does die because we have no idea who would get really sick and who wouldn't. It's sort of playing Russian Roulette.

 

[Deleted member 2897]

FWIW, was looking at research into this over the weekend.
The current numbers I saw for mortality rates were basically as follows. (what that translates to in deaths if you apply it to the American population in those age ranges)
19-25 yr olds - 0.001 (0.1%) (28,021)
26-34 - 0.002 (79,181)
35-54 - 0.005 (409,953)
55-65 - 0.013 (362,668)

More importantly I want to get off the death total as it is helpful to understand how long the recovery process is.
The government of New South Wales in Australia has been going back out to every one that has come down with COVID19 and survived to see how they are recovering.
Here is what they found.

Recovered within 16 days - 50%
Recovered within 3 weeks - 75%
Recovered within 6 weeks - 90%

When 50% of your patients who have symptoms take more than 2 weeks to recover, that is really bad. The fact the 1/4 take 3 weeks is just alot of suffering.

80% of the workforce is under 54 according to the BLS. In the past its been more like 90%, but the economy was so strong recently that a lot of older people were doing some extra hustling. Suffice it to say that the vast vast majority of the workforce doesn't have a material mortality risk related to COVID-19. And we know who 99.999% of those are - severely obese, etc.

 

[Deleted member 2897]

So there are many health experts that agree with Kemps decision?

I don't live in Georgia. I don't know what he's doing. Why don't you ask some health experts if you are interested in finding out.

In South Carolina where I live, what our Governor just did was completely mis-reported on the news. The news said all these businesses and beaches are opening back up. That's false. The beaches are left to the local municipalities to decide, and so far, they've all said no. But they will eventually, with police enforced social distancing rules. On the businesses re-opening, its a small minority of the overall number of businesses. Masks should be worn, social distancing should be practiced, and only 5 people per 1,000 square feet are allowed in a business. Maximum traffic will be 20% of normal capacity.

 

[WreckinGT]

I don't live in Georgia. I don't know what he's doing. Why don't you ask some health experts if you are interested in finding out.

In South Carolina where I live, what our Governor just did was completely mis-reported on the news. The news said all these businesses and beaches are opening back up. That's false. The beaches are left to the local municipalities to decide, and so far, they've all said no. But they will eventually, with police enforced social distancing rules. On the businesses re-opening, its a small minority of the overall number of businesses. Masks should be worn, social distancing should be practiced, and only 5 people per 1,000 square feet are allowed in a business. Maximum traffic will be 20% of normal capacity.

I don't need to ask, some have already chimed in:

Dr. Marc Lipsitch, a professor of epidemiology at Harvard’s T.H. Chan School of Public Health, put it this way: “If you open up enough it’s almost for certain” the virus will hit Georgia again. “It’s just waiting for more susceptible people and more contacts. That’s how viruses work.”

Former George W. Bush administration adviser and renowned cardiologist Dr. Jonathan Reiner warned that Kemp's decision was "a dereliction of duty ... this crisis has not abated in that state."
Reiner said that the positivity rate of those tested in Georgia was an "enormous 23%." In Germany, which has had a widespread testing program and began a cautious reopening of small shops and business Monday, the positivity rate of a higher per capital testing level is 7%.
"In Georgia, the virus is still very, very active and this behavior is frankly reckless,"

Dr. Harry Heiman of Georgia State University’s School of Public Health said he was skeptical that Georgia was ready for a “worst-case scenario” if the disease re-emerges.

I just can't find any that supported Kemp's move.

 

[RamblinRed]

I will say I don't have an issue with slowly and carefully re-opening the economy. We can't stay locked down forever and we aren't supposed to.
But that said there are a couple of issues.
First, why did he choose the businesses he chose to start with? To me most don't make alot of sense. Bowling alleys? movie theaters (there are currently no scheduled releases until late June and those are likely to get pushed). I get the hair and nail salons since people are feeling shaggy, but I don't know how you actually run those businesses and keep to good social distancing.

Second, I just think it is still too early. I don't think anybody would argue that GA right now does meet the re-opening guidelines put out last week. I would have aimed for Memorial Day myself.
As we have found out more about this virus I think the mindset has changed somewhat with the experts who study it. The transmission rates keeps getting inched upwards. That's scary because it means fewer people have to get infected for it to start to run out of control.

So all it takes is a handful of people and/or businesses to ignore the guidelines that will be issued to have this go sideways.
i think this was always going to be a case (and it was laid out as such) that we would have to employ strong mitigation measures, then we will be able to relax them for awhile, then have to tighten them up some (though hopefully not as much as the first time) and repeat until we have therapies and/or vaccines that work. i think that was the idea of the new normal.

Last night I was working on the stats for GA. Here are some of the charts that make me nervous and why i would have liked to wait a little longer before loosening.
This is GA's 5 Day rolling avg deaths. To my eye it doesn't look like we have really bent it down much yet. Also, i do find it ironic that Gov Kemp chose to announce re-opening on the highest death day so far for GA.

This one is the 5 day rolling avg cases. At best we may be starting to plateau.

These next 2 are the 2 that concern me the most. The experts seem to be aligned right now with the idea that to really be able to manage this from a test and trace perspective, you need a positive case rate between 5-10%, any more than that and you aren't testing enough to stay in front of the virus rather than reacting to it. GA hasn't had just a single day where the positive test % rate was lower than 21% (and that was on the second day they started providing testing numbers).

FWIW, on a nationwide level the postive test percentage has been in the upper teens for most of the last week, so GA is well below the avg in this measure.

My hope is that everything goes well and that we can keep it under control. My concern is that we may be re-opening too early and that is could cause us to lose control of the situation quickly.

one last none GA note. Munich cancelled Oktoberfest today. First time since WWII. Only the third time ourside of the war. 1854, 1873.
Germany had already cancelled large public gatherings through August so this was not unexpected - but is quite a hit to their economy (they get about $1.3B yr from it).

 

[Deleted member 2897]

I don't need to ask, some have already chimed in:



I just can't find any that supported Kemp's move.

Then why did you ask the question?

I will point out that most of these responses seem to ignore the point of flattening the curve. "If you open up enough it’s almost for certain” the virus will hit Georgia again." I mean of course, that's the point. Turn the economy back on, the virus activity will increase, but lets keep it under the hospital capacity.

 

[684Bee]

Then why did you ask the question?

I will point out that most of these responses seem to ignore the point of flattening the curve. "If you open up enough it’s almost for certain” the virus will hit Georgia again." I mean of course, that's the point. Turn the economy back on, the virus activity will increase, but lets keep it under the hospital capacity.

Yep. There will be increased cases. But, if we don't overrun the hospitals, and most cases are either asymptomatic, mild, or recovered from without hospitalization, then we're OK.

I also don't get some people saying things like, "I don't see how a massage therapist, etc. can safely do business". How did they safely operate before? When you went to get a massage, haircut, etc. in the past, did you know the health status of every person in the place? No, you didn't. Were there tons of germs in there then? Yes, there was. So, you were taking a risk then, and you will be now. I just don't see that the risk-reward decision has gotten that much worse for the vast majority of people (with what we know now).

 

[WreckinGT]

Then why did you ask the question?

I will point out that most of these responses seem to ignore the point of flattening the curve. "If you open up enough it’s almost for certain” the virus will hit Georgia again." I mean of course, that's the point. Turn the economy back on, the virus activity will increase, but lets keep it under the hospital capacity.

I asked the question because in your words:

That's always been the plan that the health experts advocated. That's what flattening the curve looks like. That's always been the plan.

If we are following the plan that health experts advocated and we are reopening at the appropriate time then there should be some health experts that support the move. Kemp said that he consulted with health experts, he just refuses to name any of them.

As for the flattening of the curve/hospital situation. We apparently did not think we had the capacity originally to support the influx of patients due to COVID-19. That is why we shut down in the first place. If we are now certain that we can support it and the additional influx that will possibly come from easing social distancing restrictions, what exactly changed? Did we over estimate what we would need in the first place, meaning the shut down was not needed at all? Did we increase our capabilities with additional resources? Are we seeing fewer patients now even though we are actually still at the peak of confirmed cases? What changed to give us the peace of mind that our hospitals are more than ready for even higher numbers than what we see now?

 

[dtm1997]

FWIW, Cuomo is on now discussing a regional approach to reopening/reimagining New York.

They're also flashing stats that are trending in the right direction.

Unemployment IT systems has collapsed under volume, but NY has 1,000 people taking phone calls and emails to make progress. Benefits are retroactive.

Despite the **** show here in NYC, where I think I'm 6 more weeks of work from home, I have faith in the state leadership.

De Blasio is a clown, but Cuomo has his act together.

 

[Deleted member 2897]

I asked the question because in your words:

If we are following the plan that health experts advocated and we are reopening at the appropriate time then there should be some health experts that support the move. Kemp said that he consulted with health experts, he just refuses to name any of them.

As for the flattening of the curve/hospital situation. We apparently did not think we had the capacity originally to support the influx of patients due to COVID-19. That is why we shut down in the first place. If we are now certain that we can support it and the additional influx that will possibly come from easing social distancing restrictions, what exactly changed? Did we over estimate what we would need in the first place, meaning the shut down was not needed at all? Did we increase our capabilities with additional resources? Are we seeing fewer patients now even though we are actually still at the peak of confirmed cases? What changed to give us the peace of mind that our hospitals are more than ready for even higher numbers than what we see now?

You will always be able to find someone somewhere that will complain about something. Our national experts that lead the CDC and NIH are the main ones we should be listening to.

On the rest of your questions - if you have any confusion, you could see if there is an email address or live chat with folks in some of those agencies you could speak with.

 

[684Bee]

I asked the question because in your words:

If we are following the plan that health experts advocated and we are reopening at the appropriate time then there should be some health experts that support the move. Kemp said that he consulted with health experts, he just refuses to name any of them.

As for the flattening of the curve/hospital situation. We apparently did not think we had the capacity originally to support the influx of patients due to COVID-19. That is why we shut down in the first place. If we are now certain that we can support it and the additional influx that will possibly come from easing social distancing restrictions, what exactly changed? Did we over estimate what we would need in the first place, meaning the shut down was not needed at all? Did we increase our capabilities with additional resources? Are we seeing fewer patients now even though we are actually still at the peak of confirmed cases? What changed to give us the peace of mind that our hospitals are more than ready for even higher numbers than what we see now?

Of course you consult with health experts, but then you have to make a decision based on all the information you have. Just like in business. You consult with lawyers, but then you have to make a business decision.

 

[RonJohn]

I don't need to ask, some have already chimed in:



I just can't find any that supported Kemp's move.

“If you open up enough it’s almost for certain” the virus will hit Georgia again.

How much is enough? If you stay clamped down, it is almost certain that the need to stay shutdown will last a very long time. Why do we not discuss what can be relaxed and what can't? We are well below the curve of medical resources. Some things can be relaxed if the actual goal is to stay below that curve.

Let's discuss what can be relaxed and to what level instead of bantering about going back to the way it was vs. sleeping in cryogen. That would be a much more productive conversation.

 

[RonJohn]

If we are now certain that we can support it and the additional influx that will possibly come from easing social distancing restrictions, what exactly changed?

Has any government official on the planet even suggested that things should go back to the way they were before right now?

You are talking as if all social distancing guidelines are being removed immediately. I do think there should be more communication about what the new guidelines actually are. I do think that requiring everyone in public to wear a face covering is probably a good idea. Why can't we talk about what limited reduction in restrictions can possibly take place? Why can't we discuss the failure of the governor and the press of detailing what the new guidelines are? There is too much politics being played by everyone. It is one-"side" vs the other-"side". Let's please have actual detailed discussion instead of political drivel.