So here we are...

108 last week.
1019 today.

Italy quarantined 16 million people. Prisoners break out in a panic.
New York is gonna quarantine a posh neighborhood. Washington preparing to quarantine western part of state
Universities are closing for the year.
Hospitals admit they are going to be overrun within weeks, with catastrophic impacts on regular operations.
Supply chains are effed for at least a month.

Yup, every reason to think life will return to normal in a week or so...

Just curious on something. If you were given magic czar powers and could put together the US response to this without reservation, what would be your plan?

so let me put you on the spot

you think Redfield is right to suggest people with COVID symptoms should just go to the ER or their PCP rather than get tested in a separate dedicated facility?

because this seems to me like a complete ****-up

What about people that bought tickets? Are they going to be refunded?

so send them to their PCP or urgent cares or ERs?

you can triage tests at dedicated facilities away from the waiting rooms

this is a looming disaster

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Reducing the spread and the peak is fine but if we have a long-flat peak (upside down U) versus a short high-peak (upside down V), is that really worth it in the long run? Especially if estimates are that 60-70% of the population is going to get it anyways? Should we suffer now greatly now and get is over with or suffer less but more slowly over time? Again I'm glad I don't have to make these decisions.

And by rationing I would also consider it to include time, money and general happiness. From the outside, the young and healthy appear to be taking the brunt of the effort, lifestyle change and monetary loss.

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I mean, basically every country's equivalent of the CDC and every infectious disease doc is saying - this is the way to handle epidemics and save lives.

There was a paper that said in China during the outbreak Hubei province / Wuhan had a death rate of ~5% and the rest of China was ~0.7%. The difference was degradation of care. At the global scale, that could be the difference in millions of lives.

As for your second paragraph, that's kind of my point when I say we are a nation of narcissists - people who consider their general happiness the ultimate good or who are incapable of thinking beyond that.

Skillet Shot said:

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lunchbox said:

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Whiskey Jacket said:

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Swine flu had 12,000 deaths...you think this is going to be 15-20X more? Everyone is entitled to their opinions, I am just trying to understand the rationale for coming to this conclusion.

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Well, during testimony before Congress this morning, Dr. Fauci (Head of Natl Inst of Infection Diseases) said that if the U.S. remains complacent, there will be millions of infected individuals.

What raised my eyebrow is that he said "remains complacent"...as if everything done so far falls under the "complacent" category.

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Minimal testing, no screening at airports, multiple diagnosed cases throughout the US and quarantines unlikely until the spread is exponential (which we don't really know because we don't test). The only thing we did correct was shut down travel early on, but it's here now, and we need to continue to get ahead of this.

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There is screening at airports. Perhaps not enough, but there is screening.

Rapier108 said:

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AgsMyDude said:

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cone said:

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this is the fed's response

which is basically **** you we don't want to mass test

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Gotta keep the numbers low.

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"I would rather because I like the numbers being where they are," Trump continued. "I don't need to have the numbers double because of one ship that wasn't our fault. "

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Talking about a cruise ship (likely the one in Japan based on how the statement is phrased) is completely separate from anything about cases here.

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He was talking about the cruise ship that was out SF and docked in Oakland.

KorbinDallas said:

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Link to article

https://www.businessinsider.com/coronavirus-testing-covid-19-tests-per-capita-chart-us-behind-2020-3

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"You may not like it but this is what peak government competence looks like."

Nuclear Scramjet said:

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KorbinDallas said:

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Link to article

https://www.businessinsider.com/coronavirus-testing-covid-19-tests-per-capita-chart-us-behind-2020-3

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"You may not like it but this is what peak government competence looks like."

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Agree. So why give government our health care? Or our guns?

Cone I'm curious on your thoughts on this as well. If you were given magic czar powers and could put together the US response to this without reservation, what would be your plan?

cone said:

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so send them to their PCP or urgent cares or ERs?

you can triage tests at dedicated facilities away from the waiting rooms

this is a looming disaster

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Agree. This is what happens when we depend on government for our health care. Disaster.

that's not what Redfield is suggesting though

Here's the paper.

https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30068-1/fulltext

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...In-depth analysis of these data show clear disparities in mortality rates between Wuhan (>3%), different regions of Hubei (about 2.9% on average), and across the other provinces of China (about 0.7% on average). We postulate that this is likely to be related to the rapid escalation in the number of infections around the epicentre of the outbreak, which has resulted in an insufficiency of health-care resources, thereby negatively affecting patient outcomes in Hubei, while this has not yet been the situation for the other parts of China (figure A,B). If we assume that average levels of health care are similar throughout China, higher numbers of infections in a given population can be considered an indirect indicator of a heavier health-care burden. Plotting mortality against the incidence of COVID-19 (cumulative number of confirmed cases since the start of the outbreak, per 10,000 population) showed a significant positive correlation (figure C), suggesting that mortality is correlated with health-care burden.

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Aggie1205 said:

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Just curious on something. If you were given magic czar powers and could put together the US response to this without reservation, what would be your plan?

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Given the CDC has already botched getting out ahead in testing...

First step would be test more, to find out what the numbers really look like in the USA.

Second would be education of the at risk population. Elderly, chronic conditions, immune compromised. I would suggest nursing homes and hospitals cut down on visitation heavily.

Depending on number 1, Decide if events need to be cancelled. If regions need to be quarantined, etc. also look at stoping travel to Italy, which you can see in my post history I have been recommending for at least a week or two. Look into what other countries need to be cut off also.

That's the top of my head stuff

cone said:

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so let me put you on the spot

you think Redfield is right to suggest people with COVID symptoms should just go to the ER or their PCP rather than get tested in a separate dedicated facility?

because this seems to me like a complete ****-up

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It's pretty simply, If you are a healthy individual and you are experiencing symptoms. You should stay home, rest, and drink plenty of fluids. If after a 3 to 5 days you aren't getting better go to the doctor.

double post

dp

Good news is the # of flu cases dropped significantly over past 4 weeks. Cut over half.

what i don't know is the depth of the failure

i do think that this **** will get spread in waiting rooms like crazy, so it would be directionally better to allow first-pass diagnosis at separate, dedicated locations

i don't know enough about the limits on tests. i do know that docs can't just call up for a test and get one without having to jump through a ton of hoops and get permission from local health officials. so it's not even really a decision between docs and patients. it's between docs and patients and local authorities.

Fair enough, thanks for responding.

What do you think of the current education efforts?

k2aggie07 said:

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Here's the paper.

https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30068-1/fulltext

Quote:

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...In-depth analysis of these data show clear disparities in mortality rates between Wuhan (>3%), different regions of Hubei (about 2.9% on average), and across the other provinces of China (about 0.7% on average). We postulate that this is likely to be related to the rapid escalation in the number of infections around the epicentre of the outbreak, which has resulted in an insufficiency of health-care resources, thereby negatively affecting patient outcomes in Hubei, while this has not yet been the situation for the other parts of China (figure A,B). If we assume that average levels of health care are similar throughout China, higher numbers of infections in a given population can be considered an indirect indicator of a heavier health-care burden. Plotting mortality against the incidence of COVID-19 (cumulative number of confirmed cases since the start of the outbreak, per 10,000 population) showed a significant positive correlation (figure C), suggesting that mortality is correlated with health-care burden.

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Unfortunately I don't think certain people here care what actual experts think about this.

It's amazing to me that some people either don't understand the implications of the collapse of a local health care system during an outbreak or simply don't care because they are young and think it won't affect them.

aginlakeway said:

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Nuclear Scramjet said:

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KorbinDallas said:

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Link to article

https://www.businessinsider.com/coronavirus-testing-covid-19-tests-per-capita-chart-us-behind-2020-3

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"You may not like it but this is what peak government competence looks like."

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Agree. So why give government our health care? Or our guns?

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Wasn't saying that, just making fun of our government. However, they do need to be making much more realistic observations and recommendations because what is happening in Italy could easily happen here with our large Boomer population that is in poor health.

Nuclear Scramjet said:

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aginlakeway said:

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Nuclear Scramjet said:

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KorbinDallas said:

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Link to article

https://www.businessinsider.com/coronavirus-testing-covid-19-tests-per-capita-chart-us-behind-2020-3

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"You may not like it but this is what peak government competence looks like."

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Agree. So why give government our health care? Or our guns?

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Wasn't saying that, just making fun of our government. However, they do need to be making much more realistic observations and recommendations because what is happening in Italy could easily happen here with our large Boomer population that is in poor health.

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Understand. But those who are complaining about the government's handing of this should now be the first to insist that the government doesn't get to run our health care. Right?

AG 2000' said:

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tysker said:

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k2aggie07 said:

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We get it. The desired effect is to keep a segment of society alive longer to eventually die of the same disease anyways. By delaying the inevitable we'll hopefully save lives of the other unhealthy people that also need medical care. The reason the government and media aren't relaying the message is that it sucks and sounds like a form of rationing.

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No. The desired effect is to reduce the spread, to reduce the peak. This saves more lives in the long run by affording better care to those who are inevitably going to get it and who are at higher risk.

It also prevents the rationing that will a matter of fact if the number of cases exceeds capacity.

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Reducing the spread and the peak is fine but if we have a long-flat peak (upside down U) versus a short high-peak (upside down V), is that really worth it in the long run? Especially if estimates are that 60-70% of the population is going to get it anyways? Should we suffer now greatly now and get is over with or suffer less but more slowly over time? Again I'm glad I don't have to make these decisions.

And by rationing I would also consider it to include time, money and general happiness. From the outside, the young and healthy appear to be taking the brunt of the effort, lifestyle change and monetary loss.

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Yes, because shortening the peak / elongating it gives our health care system the best possible chance to try and deal with it and not impode.

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But other parts of the economy are grinding to a halt for the foreseeable future. I'll admit that it's an ugly thing to say but it's not clear to me that elongating the length of time for this disease to spread is better for the country as whole over the long run. It may be better for saving human lives and better working conditions in hospitals but stalling the inevitable doesn't look all that great for other aspects of society at least on the surface.

crud, dp

Curious what these "dedicated facilities" might be.

I don't know that I have seen any education efforts coming out of the government. I'm sure the CDC and other local health authorities have info on their webpages, but that's dependent on people going to them.

aginlakeway said:

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Nuclear Scramjet said:

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aginlakeway said:

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Nuclear Scramjet said:

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KorbinDallas said:

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Link to article

https://www.businessinsider.com/coronavirus-testing-covid-19-tests-per-capita-chart-us-behind-2020-3

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"You may not like it but this is what peak government competence looks like."

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Agree. So why give government our health care? Or our guns?

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Wasn't saying that, just making fun of our government. However, they do need to be making much more realistic observations and recommendations because what is happening in Italy could easily happen here with our large Boomer population that is in poor health.

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Understand. But those who are complaining about the government's handing of this should now be the first to insist that the government doesn't get to run our health care. Right?

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I don't want the government anywhere near anything vitally important because in large part they always screw it up. Even if private orgs also screw it up, government has so much bureaucracy that it makes success almost impossible for certain things.

FriscoKid said:

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What about people that bought tickets? Are they going to be refunded?

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Why can't they play at oracle arena, in Oakland? Where they played up until this season. I don't think Oakland has this prohibition yet...

tysker said:

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k2aggie07 said:

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Quote:

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We get it. The desired effect is to keep a segment of society alive longer to eventually die of the same disease anyways. By delaying the inevitable we'll hopefully save lives of the other unhealthy people that also need medical care. The reason the government and media aren't relaying the message is that it sucks and sounds like a form of rationing.

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No. The desired effect is to reduce the spread, to reduce the peak. This saves more lives in the long run by affording better care to those who are inevitably going to get it and who are at higher risk.

It also prevents the rationing that will a matter of fact if the number of cases exceeds capacity.

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Reducing the spread and the peak is fine but if we have a long-flat peak (upside down U) versus a short high-peak (upside down V), is that really worth it in the long run? Especially if estimates are that 60-70% of the population is going to get it anyways? Should we suffer now greatly now and get is over with or suffer less but more slowly over time? Again I'm glad I don't have to make these decisions.

And by rationing I would also consider it to include time, money and general happiness. From the outside, the young and healthy appear to be taking the brunt of the effort, lifestyle change and monetary loss.

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I'm a retiree, and 95% of my best friends, siblings, cousins, in-laws, and favorite hunting & fishing buddies are in the age range of 60 to 90 (including many Trumper friends who I love dearly). So I too am glad you are not the one making these decisions.

Well, my mom told me earlier today that her cousin and his wife canceled their Mediterranean tour and they've been told no refund so they're out $5,000. They decided the morning they were supposed to fly out that losing $5,000 was worth not taking the risk. Little did they know the main part of their trip, visiting Israel, wouldn't have happened anyway.

Another cousin is also finishing up her 14 days of stay at home because she had been in Japan, but not in an area where the virus has been active nor did she fly through Tokyo in either direction. Thankfully she's responsible enough to know that it is far better safe than sorry.

Rapier108 said:

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Another cousin is also finishing up her 14 days of stay at home because she had been in Japan, but not in an area where the virus has been active nor did she fly through Tokyo in either direction. Thankfully she's responsible enough to know that it is far better safe than sorry.

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Although she's not out of the woods, because she can still get it here.