Coronavirus

[mswlogo]

Another great speech.

I love two lines she made.

The Healthy will Doom the Vulnerable.
How can Watching Netflix on the counch be helping?

 

[mswlogo]

NY’s steeper curve is also about the incredible job it’s doing in ramping up testing. Per capita, they are number one in the world right now.
Robin

And they also said they expect 40-80% of the population to get COVID-19.

 

[Matias]

But I get your point, considering we are more prosperous on an absolute basis than we were 80 years ago, we should be able to survive a few months of this without too much hardship.

Psychology might be different. After VW2 people knew that it was over. They started rebuilding with full effort.

Economic depression doesn’t necessarily work the same way. But of course I rather take economic depression than war.

 

[Daniel in SD]

We really can't track with Italy, no matter how hard we try to screw this up, because the demographics of their cases is so heavily weighted toward the 80+ age group living with immediate family. The median age if Italian CV deaths is 80.2 years and the vast majority live at home

We have a modestly smaller percentage in that group and they're much more easily isolated here.

Which is what we need to be doing. Testing and isolating those most susceptible to infection. I think we'll quickly realized locking down is counterproductive and we'll begin easing it as soon as late next week.

For your plan to work it seems like we'd somehow need to isolate everyone over 45 or we'd run out of ICU beds. That does not seem practical.

I'm having a hard time imagining the counterfactual where the economy keeps purring along. Do you believe that economic activity in Italy would be anywhere close to normal now if the government had continued saying "It's just like the flu"?

 

[TheTalkingMule]

Found out something interesting last night. Apparently Swine Flu hit kids the hardest in the 2009 outbreak and didn't really impact the elderly. Makes sense I guess since it was a variant of Spanish Flu that's been around forever and most older people have some immunity to.

Also makes sense that this CV outbreak would impact elderly immunocompromised folk most since it's not anything their system's seen before. For younger people it's dangerous, but not life threatening because it's ultra-fast spread and has such a long incubation period. Wider spread, relatively less deadly.

If any or all of those out-of-my-ass conclusions hold true, might bode well for next season as the herd will have a decent amount of antibodies by then. Obviously way to early to think that rosily, just thinking out loud.

 

[TheTalkingMule]

For your plan to work it seems like we'd somehow need to isolate everyone over 45 or we'd run out of ICU beds. That does not seem practical.

I'm having a hard time imagining the counterfactual where the economy keeps purring along. Do you believe that economic activity in Italy would be anywhere close to normal now if the government had continued saying "It's just like the flu"?

No, Italy cannot and could not take any action other than shutdown. They have way too many intermingled high risk citizens and a mouth-to-face-based greeting society.

We could and probably should be doing about half the level of lockdown and a LOT more testing. Students and 45 year old teachers are at almost zero risk of death, so are 20-50 Tesla Fremont workers. Isolate the endangered population and test test test.

 

[SageBrush]

Looking on the bright side for a moment, COVID-19 has taught millions of people the value of logarithmic scales on graphs...

As Covid-19 spreads exponentially, understanding exponents expands linearly

 

[Singuy]

Just note of a potential bias. We had a pt who was 82 with all sorts of underlining conditions showed up with COVID pos. Family member refused treatment and signed DNR.

It's a potential bias people may not be aware of is that the elderly pt dying to this virus had so many underlying conditions that they are literally one hospital visit away from family members calling it quit. If it wasn't the coronavirus, it could of been a slip and fall. So when looking at deaths and treatments, keep this in mind since we didn't even get one dose of hydroxychloroquine into this pt before all pressors were discontinued and supportive care was initiated only.

For reference, DNR was signed PRIOR to confirming COVID pos.

 

[Daniel in SD]

Students and 45 year old teachers are at almost zero risk of death, so are 20-50 Tesla Fremont workers.

You keep missing the fact that a large percentage of those age groups require hospitalization and ICUs. How are you determining how many would die without sufficient medical care? Also after a stay in the ICU is there permanent lung damage for younger people?
Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19

 

[MXLRplus]

The density of reported cases, Italy is quickly approaching 0.10%, the US just passed 0.01%:

 

[SageBrush]

If any or all of those out-of-my-ass conclusions hold true

Sorry

 

[deonb]

We could and probably should be doing about half the level of lockdown and a LOT more testing. Students and 45 year old teachers are at almost zero risk of death, so are 20-50 Tesla Fremont workers. Isolate the endangered population and test test test.

They are at “zero” risk of death because they have hospital care. Currently 30% of Coronavirus hospitalizations in the US is under 55s.

So to enact your plan you’d have to anyway lock the entire country down for long enough to build the 5 million hospital beds and ventilators for the 5% of under 50s that you end up sending to the hospital at the same time.

By the time you’re done building those, the virus would be long gone.

Unless your plan is literally just - screw it, nobody gets hospital treatment. Now go to work!

 

[Singuy]

I think after this ends, it will be interesting to see exactly how this virus contributed to the overall death rate baseline. Is it meaningful if the virus shorten the life of the super sick by a few weeks or months? Too many ways for 80+ yo sick people to die, is the virus a meaningful contributing factor say compared to all the other ways they could have died? It'll be a very interesting study to see.

It'll also be meaningful to see the death caused by the economic impact of this virus compared to baseline. Everything can cause death, just need to find a balance point.

 

[traxila]

Where did you see that? Would be very disappointing if true. Are they shutting down all of the drive through testing stations as well? All I am seeing is that they are doing a ton of testing and its still ramping up?

Coronavirus in NY: 20,875 cases confirmed as testing ramps up

Sorry, looks like an NYC thing. My bad.

NYC Cancels Coronavirus Testing By Appointment, Urges Providers Not To Test Patients Unless Hospitalization Is Required

 

[jbcarioca]

The talk this morning from the NEJM is about triaging:
https://www.nejm.org/doi/full/10.1056/NEJMp2005689?query=RP
https://www.nejm.org/doi/full/10.1056/NEJMsb2005114?query=RP


So that physicians directly taking care of patients do not have to make these decisions, there is talk of setting up "triage committees" who would be responsible for reviewing risk factors, patient acuity, etc. and deciding how to best allocate resources.

Scary.

I wanted to disagree with the prospect. When preparations haven't been adequate for the event, whatever the event may be, triage must happen. I'm sorry to say I've been around several mass tragedies. Sadly, this did not need to be one of those.

Germany did not close local and regional hospitals, nor did they reduce stocks of PPE. They did act with alacrity so responded the moment the potential appeared. Such discipline is hard to come by. Strange that Italy shut off flights to cope with COVID-19 before anyone else. Sadly they do not have the infrastructure to cope, coupled with an elderly, less than ideally healthy populace.

Hopefully we'll have worldwide learning.

 

[deonb]

Italy:
New cases: 4790 (8%)
Deaths: 602

Looks like Italy peaked.

 

[cusetownusa]

That is what I saw. They do not have the PPE for it.

Sorry, looks like an NYC thing. My bad.

NYC Cancels Coronavirus Testing By Appointment, Urges Providers Not To Test Patients Unless Hospitalization Is Required

So frustrating.

 

[mswlogo]

No, Italy cannot and could not take any action other than shutdown. They have way too many intermingled high risk citizens and a mouth-to-face-based greeting society.

We could and probably should be doing about half the level of lockdown and a LOT more testing. Students and 45 year old teachers are at almost zero risk of death, so are 20-50 Tesla Fremont workers. Isolate the endangered population and test test test.

People just don't get it. Younger healthier may not be as high risk to themselves, but they are just as high a risk to spread it.

It's all about stopping the spread now. And enough testing is probably still weeks away.

As the Video I posted said.

"The Healthy will doom the Vulnerable".

Meanwhile Lockdown, Lockdown, Lockdown.

 

[StarFoxisDown!]

People just don't get it. Younger healthier may not be as high risk to themselves, but they are just as high a risk to spread it.

It's all about stopping the spread now. And enough testing is probably still weeks away.

As the Video I posted said.

"The Healthy will doom the Vulnerable".

Meanwhile Lockdown, Lockdown, Lockdown.

People keep using this response when those of us say let the younger workforce back into economy and their daily lives. I don't get it. It's not like we're saying let everyone out of quarantine. We're clearly saying that the at risk age groups need to stay in quarantine. For me that anyone above the age 50+ is not allowed back at work. Employers could easily institute age scanning and anyone above the age of 50 is sent back home and/or reported for breaking their quarantine. At a certain point, it become personal responsibility for those that are at high risk to protect themselves and if they chose to ignore their quarantine orders, than so be it.

There are other options that are just as effective as Lockdown, Lockdown, Lockdown without crumbling the world's economy.

 

[Quesder]

Italy new death numbers declined from 793, 651, to 601.
I hope this is a good sign.