Gap said:

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Proposition Joe said:

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I dont disagree. But at this point its foolish to continue to act like this is all purely media driven.

Some posters made up their minds that this was a nothing burger months ago and have dug their heels in so far theyll listen to a blowhard like Clay Travis but claim the CDC is lying to make sure Trump isnt re-elected.

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What are people claiming the CDC is lying about? I must have missed that.

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People want to believe that CDC is trying to undermine Trump.

Nevermind that the DHHS secretary and CDC director are political appointees that serve at the pleasure of the president.

Facts don't matter in the face of wild speculation.

cone said:

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I'm hoping for Japan. I thought it would go bad for them and it hasn't.

SoKo is testing like crazy. they have enough information to work with. we aren't there yet and won't be for maybe two months.

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But yet you'll say crap like this implying that we're headed towards the Italy outcome....

Quote:

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I'll say this - it sucks that this is happening to Italy and it's heartbreaking but at least we have real outbreak data in a cohort closer to what we'll see here

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IrishTxAggie said:

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Nice of him to ignore S. Korea to make it fit his narrative.

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Here is a chart with S. Korea included...

cone said:

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so self quarantine isn't needed?

old people won't get it and die as long as we don't overreact and go along as normal?

yeah I don't think so

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That's not what I said, and now you're moving the goal posts

Infection_Ag11 said:

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cone said:

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because the outbreak is huge

and a bunch of older people are dying all at the same time

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Incorrect

Now since I'm an infectious disease physician who works in a major urban tertiary referral center every day and am fielding multiple calls per hour about this at times, allow me to learn ya somethin'.

The medical systems in these countries initially become saturated not because of the overwhelming numbers of critically ill patients, but by the innumerable patients who present with viral symptoms in a panic they have this. And because of disorganized or completely absent screening protocols, many of these otherwise reasonably healthy people are getting admitted for rule out. Which is fine, until it isn't. Now you've got a ton of beds eaten up by people not that sick, most of whom do not have the disease anyway, and suddenly they realize "****, now were intubating people in the hallway".

Most US hospitals in major urban centers are operating at or above capacity right now, despite almost nobody actually having the virus. That isn't because a bunch of extra dying 80 year olds are in house.

So yes, this is a big deal. Elderly people are going to die who otherwise didn't have to. But it's not because of the overwhelming virulence of this bug. It's because of media fueled public panic and incompetent state and federal public health leadership.

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You probably shouldn't make assumptions. I can link you to a thread on another site in I'M if you wish. We have an ongoing discussion with an Italian doc who pretty much says exactly the opposite of what your think has transpired.

There has been several others on other sites but those have been statements rather than discussions.

Bottom line, they weren't overrun by panicked worrywarts. They are overrun by serious cases.

Japan closed down all their schools at almost the outset

We aren't following either playbook, yet

The next two months are critical. I really hope we avoid an Italian outbreak in one of the coastal metro areas.

Someone at our huge Seattle area site tested positive ysterday. Everyone I know over there says it's a nut house this morning. It'll be fun to see how they're impacted because it's only a matter of time before the same happens over here.

AggieChemist said:

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Bullpen Chias said:

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Is a mall a public gathering. Malls do 20,000 people a day

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Really?

I bet I haven't been in a mall in nearly a decade.

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Depends on the mall, the season and day...

But a popular mall will definitely do 20k+ in a day.

Memorial City Mall in Houston runs about 16 million people per year... On an even spread, that would be 43K+ per day but we know that is definitely skewed towards holidays and weekends more than weekdays. So my guess would be a standard weekend would do at least that if not much more...
I drove past it this weekend. Parking lot was as full as any other weekend.

PJYoung said:

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IrishTxAggie said:

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Nice of him to ignore S. Korea to make it fit his narrative.

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S. Korea has done what exactly NO other country has done - amazing widespread early testing to contain the epidemic. Daily numbers are now going down precisely because they led the world in aggressive early testing. China had the option to lock down 150 million people and they took it.

The United States is in exactly the opposite corner - for 6 weeks now we have barely tested at all while half of the country ignored it as a hoax or media hype.

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Sigh

i'll never forget the general right of center commentariat's reaction to Nancy Messonnier sounding the alarm two weeks ago

saboteur? panicking woman? rod rosenstein's sister and therefore her intent was to harm Trump?

if anything, she did a public service. she cut through the bull**** and told us it wasn't going to be business as usual. it can't be if we want to avoid outbreaks like Italy.

he's right though

although i'd argue that we're more paranoid than Italians so that helps

cone said:

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he's right though

although i'd argue that we're more paranoid than Italians so that helps

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We also don't kiss every stranger we meet at every casual introduction.

We will not be Italy

We have the conundrum of demanding civil liberties and freedoms be observed and upheld, while being threatened by a commons issue in regards to a communicable disease threatening epidemic. This requires a high degree of personal and social responsibility to combat effectively, but with any group you have nonconformists that in the case of disease will continue risky behaviors. Many would regard this as selfish, and it is, but it is difficult for us to deal with lawfully using government as a mechanism, as civil authorities are viewed as heavy handed and any other legal mechanism is reactive.

We have to ask ourselves what is the social balance we are willing to settle on to temporarily forfeit by choice some individual liberties of movement and association in order that we as a group better suppress the contagion.

Yeah, we hardly ever have the common cold or the flu here.

Chicago Bridal Wholesale Market cancelled.

lots of this happening:
https://nypost.com/2020/02/29/new-york-wedding-boutiques-scrambling-to-please-brides-amid-coronavirus-delays/

One more from Italy:

Quote:

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Silvia Stringhini
@silviast9
I may be repeating myself, but I want to fight this sense of security that I see outside of the epicenters, as if nothing was going to happen "here". The media in Europe are reassuring, politicians are reassuring, while there's little to be reassured of.

2/ This is the English translation of a post of another ICU physician in Bergamo, Dr. Daniele Macchini. Read until the end "After much thought about whether and what to write about what is happening to us, I felt that silence was not responsible.

3/ I will therefore try to convey to people far from our reality what we are living in Bergamo in these days of Covid-19 pandemic. I understand the need not to create panic, but when the message of the dangerousness of what is happening does not reach people I shudder.

4/ I myself watched with some amazement the reorganization of the entire hospital in the past week, when our current enemy was still in the shadows: the wards slowly "emptied", elective activities were interrupted, intensive care were freed up to create as many beds as possible.

5/ All this rapid transformation brought an atmosphere of silence and surreal emptiness to the corridors of the hospital that we did not yet understand, waiting for a war that was yet to begin and that many (including me) were not so sure would ever come with such ferocity.

6/ I still remember my night call a week ago when I was waiting for the results of a swab. When I think about it, my anxiety over one possible case seems almost ridiculous and unjustified, now that I've seen what's happening. Well, the situation now is dramatic to say the least.

7/ The war has literally exploded and battles are uninterrupted day and night. But now that need for beds has arrived in all its drama. One after the other the departments that had been emptied fill up at an impressive pace.

8/ The boards with the names of the patients, of different colours depending on the operating unit, are now all red and instead of surgery you see the diagnosis, which is always the damned same: bilateral interstitial pneumonia.

9/ Now, explain to me which flu virus causes such a rapid drama. [post continues comparing covid19 to flu, link below]. And while there are still people who boast of not being afraid by ignoring directions, protesting because their normal routine is"temporarily" put in crisis,

10/ the epidemiological disaster is taking place. And there are no more surgeons, urologists, orthopedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us.

11/ Cases are multiplying, we arrive at a rate of 15-20 admissions per day all for the same reason. The results of the swabs now come one after the other: positive, positive, positive. Suddenly the E.R. is collapsing.

12/ Reasons for the access always the same: fever and breathing difficulties, fever and cough, respiratory failure. Radiology reports always the same: bilateral interstitial pneumonia, bilateral interstitial pneumonia, bilateral interstitial pneumonia. All to be hospitalized.

13/ Someone already to be intubated and go to intensive care. For others it's too late... Every ventilator becomes like gold: those in operating theatres that have now suspended their non-urgent activity become intensive care places that did not exist before.

14/ The staff is exhausted. I saw the tiredness on faces that didn't know what it was despite the already exhausting workloads they had. I saw a solidarity of all of us, who never failed to go to our internist colleagues to ask "what can I do for you now?"

15/ Doctors who move beds and transfer patients, who administer therapies instead of nurses. Nurses with tears in their eyes because we can't save everyone, and the vital parameters of several patients at the same time reveal an already marked destiny.

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I'll admit is probably a dumb question, but if the Italian Hospitals are getting full of "otherwise healthy people", as you put it, why aren't they being discharged to make room for the seriously ill? Wouldn't it be easy to send those patients home for self quarantine?

Is it some sort of legal issue with discharging patients?

we have a lot of things going for us in lieu of the testing we'd like to see (but hasn't materialized):

hygiene
paranoia
bought time

plus (h/t to Keegan99 for spelling it out in starker terms):

Quote:

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and many attributes of American society that are bemoaned by a certain segment of our populace become considerable strengths in this situation:

Lack of public transit
Low urban densities
Large, freestanding homes
Big box retail
Older generations living on their own

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so every culture is going to be different. every city/region is going to be different. the Texas response will be different than the Washington State response.

but there's always going to be the potential for this thing to get away from you, especially if you don't do the things that seem to be working - closing schools, shutting down public gatherings, aggressive testing, strong decontamination efforts in businesses

The Woodlands Mall reports 14MM annual visitors. So, they are almost double my 20k/day number.

Some Walmart and Target stores can do 8-10k customers/day.

His view is based on the assumption that their capacity is sufficient for actual ICU cases if they were managed properly. I don't think this assumption is correct. Most of the cases are concentrated in two provinces, and using published figures about ICU beds per capita its pretty clear they don't have sufficient resources to handle the reported serious / critical cases all at once.

Nice warm and humid weather coming to Texas now.
God bless Texas

cone said:

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i'll never forget the general right of center commentariat's reaction to Nancy Messonnier sounding the alarm two weeks ago

saboteur? panicking woman? rod rosenstein's sister and therefore her intent was to harm Trump?

if anything, she did a public service. she cut through the bull**** and told us it wasn't going to be business as usual. it can't be if we want to avoid outbreaks like Italy.

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She did a crappy job early on. There's a reason she didn't have seat at the table on the task force.

i'm not excusing the CDC's **** ups

but she still did us a service by letting the mask fall

How long has this thing been in Italy?

i don't know if this is true, but if it is holy ****

I'm pretty sure that it is true. I remember reading about that early in the outbreak. Seems like the perfect opportunity for spreading a virus.

Illuminaggie said:

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Infection_Ag11 said:

---

cone said:

---

because the outbreak is huge

and a bunch of older people are dying all at the same time

---

Incorrect

Now since I'm an infectious disease physician who works in a major urban tertiary referral center every day and am fielding multiple calls per hour about this at times, allow me to learn ya somethin'.

The medical systems in these countries initially become saturated not because of the overwhelming numbers of critically ill patients, but by the innumerable patients who present with viral symptoms in a panic they have this. And because of disorganized or completely absent screening protocols, many of these otherwise reasonably healthy people are getting admitted for rule out. Which is fine, until it isn't. Now you've got a ton of beds eaten up by people not that sick, most of whom do not have the disease anyway, and suddenly they realize "****, now were intubating people in the hallway".

Most US hospitals in major urban centers are operating at or above capacity right now, despite almost nobody actually having the virus. That isn't because a bunch of extra dying 80 year olds are in house.

So yes, this is a big deal. Elderly people are going to die who otherwise didn't have to. But it's not because of the overwhelming virulence of this bug. It's because of media fueled public panic and incompetent state and federal public health leadership.

---

You probably shouldn't make assumptions. I can link you to a thread on another site in I'M if you wish. We have an ongoing discussion with an Italian doc who pretty much says exactly the opposite of what your think has transpired.

There has been several others on other sites but those have been statements rather than discussions.

Bottom line, they weren't overrun by panicked worrywarts. They are overrun by serious cases.

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Practitioners see everything through the lens of their specialty, and I'm no different. The thing is this IS my specialty, and while many providers see how it is effecting their practice and habits ID docs are forced in this instance to see the totality of the issues.

Critical care doctors are posting from the front lines in the unit where they are seeing elderly people die from this at rates higher than seasonal flu. They are overworked, their beds are full and it's emotionally draining to watch people die. I emphathize with them. That being said, they became acutely aware of this things impact when **** hit the fan. ID docs and those in infection control/prevention watched this happen over the preceding 2.5 months and a better grasp of how we got here.

Wondering if the Nascar Cup race in Fort Worth will get canceled or postponed. It is still scheduled for 3-29
100K+ crowd.

KorbinDallas said:

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I'll admit is probably a dumb question, but if the Italian Hospitals are getting full of "otherwise healthy people", as you put it, why aren't they being discharged to make room for the seriously ill? Wouldn't it be easy to send those patients home for self quarantine?

Is it some sort of legal issue with discharging patients?

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It's a cascade effect, and their healthcare facilities are playing from behind.

Imagine weeks ago, a hospital at well over capacity with many mildly to moderately ill patients with various afflictions, many there for rule out of COVID or with mild symptoms being monitored. Then suddenly, as more people contract it, this influx of people much sicker than those currently admitted. Even with their heroic efforts to make beds available, you just can't do it fast enough and ultimately other actually sick patients with unrelated conditions also do worse because the staff is stretched thin.

They're trying and doing the best they can, but this thing was brewing long before the big spike in sick elderly patients.