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Untitled grundle COVID-19 thread

Old 03-21-20, 08:17 AM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by General Zod View Post
Yep. If we go with Newsome's estimate of 25m who will get it over the next 8 week period and we just go with the 1% that's 250,000 people that will die from it - and that's just here in California. I mean this is a really big scary deal if the numbers hold up. Not to mention the ones that don't die from it a certain percentage are still going to be hospitalized - but where? This could get completely out of control very fast. That's why all the panic and the regulations.

Get it now grundle?

Why are you assuming that Newsome's estimatation is accurate?
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Old 03-21-20, 08:30 AM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by Groucho View Post
Let's suppose that we do nothing, as you seem to be advocating. And let's suppose, say 40% of the USA get COVID-19. So, about 130 million people. Now let's say just 1% of those die (a conservative number). That's 1.3 million people. Do you understand now?

As I explained here, I think the death rate has been highly overstated:

Originally Posted by grundle View Post
It's possible that most of the U.S. population has already been infected, but hasn't gotten sick, and so hasn't gotten tested.

The death rate is calculated by dividing the number of people who die by the number who are infected. So far they're saying that it's a few percent.

But while we do have accurate information about the numerator, we really have no idea what the denominator is. It's possible that the real denominator is magnitudes bigger than what is being reported, because most infected people have no symptoms, and thus, don't get tested. If this is indeed the case, then it's possible that the real death rate is far, far lower than the few per cent that is being reported.
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Old 03-21-20, 08:35 AM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by VinVega View Post
Just open the schools and movie theaters back up. It's no biggie.

Singapore didn't close its schools.

Italy did.

Spoiler:


https://www.nytimes.com/2020/03/10/o...l-closing.html

Opinion

We Don’t Need to Close Schools to Fight the Coronavirus

Shutdowns could likely do more harm than good, since there’s little evidence that children are a major source of the spread.


By Jennifer Nuzzo

Dr. Nuzzo is a senior scholar at the Johns Hopkins Center for Health Security.


March 10, 2020

Facing an accelerating spread of Covid-19, Italy and Japan have closed schools to impede the epidemic. Some communities in the United States have done so too, agreeing to significantly disrupt people’s lives on the theory that it will prevent deaths and serious illness.

But there is no clear evidence that such measures will slow this outbreak.


Most of what we know about the impact of school closings on disease transmission relates to influenza, to which children can be particularly vulnerable, sometimes dying or becoming seriously ill from it.

Children are important drivers of influenza infections because they have more interactions with people than do most adults and also give off more of the virus. Closing schools, it is assumed, reduces the number of contacts and thus the rate of transmission.

During the 2009 H1N1 influenza pandemic, schools across the country were closed. A C.D.C. study showed that parents largely supported these measures, but other studies found that children frequently got together outside the home or visited public sites, despite official recommendations not to do so. Fortunately, schools reopened in less than three days in most cases because data showed the flu strain wasn’t as severe as had been feared.

Still, some evidence suggests that these measures didn’t reduce the number of infections and only slowed the spread — although that could help reduce burdens on health systems.

That’s influenza, though. Covid-19 is different.

There have been very few reports of children contracting Covid-19. It’s not clear why. It’s possible that children do get infected, but so mildly that it is not noticed or tested.

If children don’t experience severe illness from or contribute to the spread of Covid-19 — and so far we have found no clear evidence that they do — it’s likely that school closings will have little effect on its spread.

Not all affected countries have closed schools. Singapore, which has been heralded for its response to Covid-19, decided that closing schools would do more harm than good. Political leaders and health officials there have addressed concerns about Covid-19 through clear, consistent and transparent communications about their response to the virus.

If schools remain open, officials could enact measures to limit any potential spread among children and staff. All students could be checked daily for fever, a possible sign of Covid-19 infection. Even more attention should be given to hand washing and reminding children not to touch their faces. Children should be taught to sneeze into their sleeves. Schools can consider changing seating arrangements to keep children six feet apart. As the weather warms, lessons can be taken outside, if possible.

Nonetheless, government officials may feel pressure to close schools. For true effectiveness, schools need to close before even 1 percent of the population is infected and they need to stay closed until the epidemic is over, which could mean months. Children couldn’t gather in other settings, which would be very difficult to enforce.

If schools close, child care programs will likely close too and working parents may have to stay home to watch their children. Health care and critical infrastructure workers would not be able to do their jobs for the same reason. Those parents may not be paid, which would be a tremendous hardship. States would have to consider expanding unemployment benefits and help employers to allow workers to stay home if needed.

Communities would need to feed and educate children while they are out of school. Closing schools can interrupt social services like programs that provide lunches to more 30 million children and breakfast to 11 million. For some children, including homeless youth, schools can be the safest place and denying these children access may deny them much needed support, even something as basic as a place to wash their clothes.

Children will need to continue learning. Interruptions in education can profoundly harm child development and make it harder to reduce the achievement gap between high- and low-income families. Schools may consider online education as an alternative but need to ensure that all families have access to the technologies required for these approaches.

If schools close, knowing when to reopen them would be difficult. To have any public health impact, school closings would have to be maintained for the duration of the epidemic.

State and local governments will have to clearly explain the reasons for closing schools and how they would decide to reopen them so parents and employers can plan how to manage daily routines.

Above all, officials need to be honest about what is known and what isn’t about the impact of these measures.

Though there may be an inclination to present school closings as a well-established tool to protect public health, their full impact is simply unknown.

Downplaying the disruption these measures may cause or overstating their benefits can erode public confidence in government at a time when it is needed the most.

Jennifer Nuzzo is a senior scholar at the Johns Hopkins Center for Health Security and an associate professor at the university’s school of public health.

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Old 03-21-20, 08:45 AM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by B5Erik View Post
I was actually really surprised by the number of cars on the road today. It's like only 1/3 of the population is taking this thing seriously.

I will only be making limited runs outside the house for the next few weeks (groceries, food, other necessities).

Why do you and so many other people here think that the supermarket is safer than other places?

If this virus is as scary as so many of you are saying, why aren't you avoiding going to the supermarket?


https://www.usatoday.com/story/news/...germs/4341739/

Eww, reusable grocery bags' germs can make you sick

January 6, 2014

PALM SPRINGS, Calif. — Jamie Norton considered himself an early adopter of reusable shopping bag, keeping them in the trunk of his car so they're on hand whenever he stops for groceries."If it gets too dirty, I just toss it out," Norton, 61, said as he walked out of Jensen's grocery store here with one of his bags full of food. "I have never washed a reusable bag."

Research shows the vast majority of shoppers are like Norton. A 2011 study from scientists at the University of Arizona and Loma Linda University found only 3% of shoppers with multi-use bags said they regularly washed them. The same study found bacteria in 99% of bags tested; half carried coliform bacteria while 8% carried E. coli, an indicator of fecal contamination.

"I classify them as pretty dirty things, like the bottom of your shoes," said Ryan Sinclair of the Loma Linda University School of Public Health, a co-author of the study.

He is finalizing another study he hopes to publish soon looking at how pathogens spread through grocery stores with the help of reusable bags. The study, conducted at a central California grocery store in early 2013, involved spraying bags with a bacteria not harmful to humans but transported in a similar way to norovirus, a leading cause of gastrointestinal disease linked to more than 19 million illnesses each year in the United States.

The tracer bacteria was detected in high concentrations on shopping carts, at the checkout counter and on food items shoppers had touched but kept on the shelf.


Sinclair said the contamination cycle often began right after shoppers entered the store and placed their bags in the bottom or the baby carrier of a shopping cart, two places notorious for germs.

"The baby carrier portion of the grocery cart is the most contaminated public surface you ever come in contact with," he said.

Reusable bags, often given away as event swag or sold for around $1 at grocery stores, are becoming more common, and 69 local bans on the thin, single-use plastic alternatives, have passed in California.
But Sinclair doesn't think habits about washing the bags are changing much in the years since the study he helped create was published.

The researchers found that bacteria thrived and multiplied on bags stored in the trunks of cars and that machine or hand washing reduced bacteria on bags by more than 99.9%. A separate study published in 2012 traced a norovirus outbreak among a girls' soccer team from Oregon to a reusable bag stored in a hotel bathroom used by an ill team member.

Norton, a Palm Springs resident, said the flimsy plastic bags come in handy, especially for cleaning up after his dog, but he supports bans."I really do think plastic bags are a blight," he said.

A proposed ban here would prohibit most stores from giving out thin plastic shopping bags and instead require them to charge 10 cents for a recycled paper bag. Plastic bags for meat, produce and takeout food still would be allowed, as would heavier plastic bags such as ones often given out at clothing retailers.

A similar ban took effect in Los Angeles on New Year's Day. San Franciso passed its ban in 2007, the first city in the nation to do so.

For their study, Sinclair and other scientists collected bags from shoppers in California and Arizona, offering them a replacement bag or money as compensation and swabbed the bags for any contamination. Shoppers also were questioned about how often they use and wash their bags.
Sinclair recommended that the bags be treated like the dirtiest laundry and washed in hot water with a detergent and disinfectant. He said he puts his own bags in the washer with socks and underwear, and that even the polyurethane bags can be washed five or six times before they start to fall apart.

Putting the bags in the washing machine and dryer about once a week is a good strategy, Sinclair said. Washing with a spray cleaner and cloth isn't effective, he said, because it tends to miss dirt deep in corners and creases.

The study recommended more public awareness efforts about washing reusable bags and that manufacturers print laundering directions on the bags.

Sinclair and other authors faced some criticism after the study was published because the American Chemical Council partially paid for the research. The trade organization has advocated against reusable shopping bags on behalf of its members who manufacture the thinner, petroleum-based plastic bags.

Sinclair said he wasn't aware of the association's support until after the study was published and that the money doesn't discount the finding or recommendations.

"Personally, my recommendation is to use reusable bags, but just wash them. It's not a big deal," he said.

At the grocery store, Sinclair recommends that shoppers use cleaning wipes if the store has them available for carts and that foods be washed before going into storage at home. Separate bags also should be used for meats and vegetables.

Betsy Hammes of Palm Springs grabbed a shopping cart outside Jensen's and placed her reusable bag in the bottom. She said she's diligent about washing the bags with a spray cleaner and then throwing them away after a few washings.

Before entering the store, Hammes pulled a disinfectant wipe from the dispenser and cleaned the shopping cart handle.

"I always do that," she said. "You never know who was using it before."

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Old 03-21-20, 08:53 AM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by grundle View Post
Because on the cruise ship, everyone was tested, not just people with symptoms.

And to quote myself from an earlier post:





The cruise ship is the only scenario where the denominator is accurate, because everyone on the cruise ship was tested.
The cruise also was primarily elderly people as well. A data analyst projected that the mortality rate would have been around 0.25% if the age of the people on board had been representative of the average worldwide.

For another example, although the denominator is by no means complete, look at Germany. A mortality rate of 0.35%, simply because they test more than everywhere else. The bottom line, the greater percentage of people who get tested, the lower the death rate. In the U.S., the rate is falling every day because testing is being ramped up, now at around 1.3%.

I think when it's all said and done, the death rate will be a little higher than the flu, with the main difference being that, since it's more infectious, a lot more people will get it. However unlike the flu, many people feel little to no symptoms.

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Old 03-21-20, 08:56 AM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by grundle View Post
Why do you and so many other people here think that the supermarket is safer than other places?

If this virus is as scary as so many of you are saying, why aren't you avoiding going to the supermarket?
I never said the supermarket was safer. But we DO need to eat. We DON'T need to go to movies (that option's off the table now, anyway), we DON'T need to go to parties or family get togethers, and we DON'T need to go to any other public gatherings, either.

But we do need to eat. Can't get around that one.
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Old 03-21-20, 08:59 AM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by Dan View Post
Yup.
It's the lily pad thing that I think someone else posted before.
Say you have a pond with a single lily pad.
Every day, the number of lily pads doubles.
It takes 45 days for the pond to be covered in lily pads.
How much of the pond is covered on day 44?
How much of the pond is covered on day 40?


Point being...
It won't seem like a lot, until it's a lot.
And when it's a lot... we're already fucked.

Happy Friday!

1 / 2

1 / 32

Of course there's no pond in the world that's big enough for your numbers. The example that you are referring to usually takes place over 20 days, not 45.


Originally Posted by zyzzle View Post
... And as I said before, the grasp of exponential growth is lost to the average American.

What starts out looking like exponential growth often ends up being an S-shaped curve.
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Old 03-21-20, 09:02 AM
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Re: COVID-19 NON-POLITICAL Thread

Everyone... just bail on this thread. Let grundle talk to himself.
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Old 03-21-20, 09:06 AM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by dex14 View Post
Everyone... just bail on this thread. Let grundle talk to himself.
That’s fine with me. Never liked the idea of separating the conversation in the first place.
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Old 03-21-20, 09:08 AM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by bruceames View Post
The cruise also was primarily elderly people as well. A data analyst projected that the mortality rate would have been around 0.25% if the age of the people on board had been representative of the average worldwide.

For another example, although the denominator is by no means complete, look at Germany. A mortality rate of 0.35%, simply because they test more than everywhere else. The bottom line, the greater percentage of people who get tested, the lower the death rate. In the U.S., the rate is falling every day because testing is being ramped up, now at around 1.3%.

I think when it's all said and done, the death rate will be a little higher than the flu, with the main difference being that, since it's more infectious, a lot more people will get it. However unlike the flu, many people feel little to no symptoms.

Great points all around!
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Old 03-21-20, 09:12 AM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by B5Erik View Post
I never said the supermarket was safer. But we DO need to eat. We DON'T need to go to movies (that option's off the table now, anyway), we DON'T need to go to parties or family get togethers, and we DON'T need to go to any other public gatherings, either.

But we do need to eat. Can't get around that one.

Yes, we do need to eat.

But humans can survive for several weeks without food. If this virus was as dangerous as some people here are saying, they'd avoid going to the supermarket for at least two weeks.

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Old 03-21-20, 09:58 AM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by Hadrian7 View Post
I naively thought having a non-political thread would allow discussions about the actual medical side of this disease and our inadequate response to it, but I guess that was a misguided notion. Decker is having to pay scalper prices for cleaning supplies just to disinfect his medical practice. I am literally having to compound hand sanitizer so that I can give it to my employees and keep my pharmacy running. Tanman and other healthcare professionals are working tirelessly every day and yet here we have trolls arguing over straw man arguments without any insight into what is actually going on and instead playing armchair doctor.
I apologize if my remarks were out of line in this thread. I was responding to Grundle's comments and apparently there is some disagreement of what should be allowed here. I'll post instead in the political thread (which has way too much political talk, which I don't care for) where I won't be called a troll for posting my opinion.
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Old 03-21-20, 10:15 AM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by bruceames View Post
I apologize if my remarks were out of line in this thread. I was responding to Grundle's comments and apparently there is some disagreement of what should be allowed here. I'll post instead in the political thread (which has way too much political talk, which I don't care for) where I won't be called a troll for posting my opinion.
You and grundle are fixated on the death rate, which is arguably not even the most concerning thing about this virus. Just as concerning as the death rate is how contagious it is and the hospitalization rate and length of stay required for care. What's at risk is overloading our healthcare system so that people can't get the care they need for this virus, the flu, cancer, etc. How many people are you willing to see die of other health complications because the healthcare system is overloaded with coronavirus patients? These measures have to be taken so we can flatten the curve and mitigate against that. This video explains it very succinctly:
https://www.ksdk.com/video/news/heal...12?jwsource=cl
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Old 03-21-20, 10:30 AM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by kefrank View Post
You and grundle are fixated on the death rate, which is arguably not even the most concerning thing about this virus. Just as concerning as the death rate is how contagious it is and the hospitalization rate and length of stay required for care. What's at risk is overloading our healthcare system so that people can't get the care they need for this virus, the flu, cancer, etc. How many people are you willing to see die of other health complications because the healthcare system is overloaded with coronavirus patients? These measures have to be taken so we can flatten the curve and mitigate against that. This video explains it very succinctly:
https://www.ksdk.com/video/news/heal...12?jwsource=cl
Yes I'm aware of how contagious is it, and that and the length of hospitalization and incubation periods are all factors which make this much more serious than the flu. Thus all the lockdown and shelter in place mandates which I think are entirely necessary. I was never taking those things into question. Again, apologies if I came across as trivializing this terrible virus. It greatly affects of all.

Last edited by bruceames; 03-21-20 at 10:36 AM.
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Old 03-21-20, 07:35 PM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by grundle View Post
1 / 2

1 / 32

Of course there's no pond in the world that's big enough for your numbers. The example that you are referring to usually takes place over 20 days, not 45.





What starts out looking like exponential growth often ends up being an S-shaped curve.
That's my hope in COVID-19, if it is handled *right* and people stay at home as ordered. In Calif, 1/2 to 2/3rd seem to be flagrantly disregarding that order, so all bets are off.
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Old 03-21-20, 10:34 PM
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Re: COVID-19 NON-POLITICAL Thread

Talking about the pros and cons of shutting down schools. The bolding is mine:


https://www.cdc.gov/coronavirus/2019...ol-closure.pdf

Considerations for School Closure

Recommendations on school closure based on available science, reports from other countries and consultation with school health experts.

1. There is a role for school closure in response to school-based cases of COVID-19 for decontamination and contact tracing (few days of closure), in response to significant absenteeism of staff and students (short to medium length, i.e. 2-4 weeks of closure), or as part of a larger community mitigation strategy for jurisdictions with substantial community spread* (medium to long length, i.e. 4-8 weeks or more of closure).

2. Available modeling data indicate that early, short to medium closures do not impact the epi curve of COVID-19 or available health care measures (e.g., hospitalizations). There may be some impact of much longer closures (8 weeks, 20 weeks) further into community spread, but that modelling also shows that other mitigation efforts (e.g., handwashing, home isolation) have more impact on both spread of disease and health care measures. In other countries, those places who closed school (e.g., Hong Kong) have not had more success in reducing spread than those that did not (e.g., Singapore).

3. In places where school closures are necessary, the anticipated academic and economic impacts and unintended impacts on disease outcomes must be planned for and mitigated. Provision of academic support (e.g., tele-ed), alternatives for school-based meals as well as other services (e.g., behavioral and mental health services) for economically and physically vulnerable children, support for families for whom telework and paid sick leave is not available, ensuring that high risk individuals continue to be protected must all be addressed. Special consideration must be given for health care workers so that school closures do not impact their ability to work.

*Substantial community spread is defined as large scale community transmission, health care staffing significantly impacted, multiple cases within communal settings

Points for further consideration, regardless of degree of spread or length of potential closure

• Clear rationale, decision-making and communication with all stakeholders is extremely important. Families need to know who is making decisions, what those decisions are and when school-based mitigation efforts are planned to start and end.

• While we have data that can contribute to decisions about when to dismiss schools, there is almost no available data on the right time to re-start schools. We would advise to plan for a length of time and then evaluate based on continued community spread.

• The relationship between state and local education agencies and state and local public health must be strong and communication must be clear and thorough.

• Critical academic infrastructure and service provision must be considered during school closure.
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Old 03-21-20, 10:34 PM
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Re: COVID-19 NON-POLITICAL Thread

This link is to an article about whether or not Starbucks is "essential." But what I'm posting here is not the article, but instead, a reader comment, which is actually (in my opinion) a lot more revealing than the article:


https://www.yahoo.com/lifestyle/star...200300804.html

I work at Starbucks and I have had a lot of seniors come in our drive thru and thank us for being open. They are too scared to go to grocery. They have asked for venti cold milk, frozen bagels, frozen sous vide bites, bottles of water, uncooked oatmeal.

I’m also giving them hand sanitizer and gloves and even toilet paper if needed to help.

So yeah, it’s just coffee sometimes but there is also a whole other level of need and support that some of our customers need.

I also love going to work and be able to add laughter and joy to people.

One customer came in for her bday reward and we sang happy bday to her, she was a nurse and has been so focused that she realized no one even said happy birthday to her. She left with a huge smile, laughing and u could literally see the stress being swept away.

This is why I go to work.
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Old 03-22-20, 11:55 AM
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Re: COVID-19 NON-POLITICAL Thread

Going to consolidate my thoughts and questions ...

Re: School Closures & Grundle's post (which I have seen a few times now) -- At the risk of my question sounding culturally insensitive ... what is the school environment/process in those countries? Meaning, what percentage of kids are normally attending school on a daily basis and what is the environment like? I will risk saying anybody who thinks keeping schools open in this country has not spent any amount of time arounds hundredes of school kids in a contained environment.

Re: Essential -- I'm withholding many of comments here because they boil down to politics. It is making my response seem somewhat incomplete, so I will try to sanitize this and then ask any discussion on that track to continue in the politics thread: My cynicism is based on the fact that industries are lobbying our leaders to declare them as essential. (Specifically, buying a car is not essential right now.)

Re: Hawaii's hotel quarantine -- How is that going to work? Who is paying for the 14 days? (It may be worth it for me to fly to Hawaii ...)

Re: Mrs. Danger's post -- Truly harrowing, but a good honest inside look. I'm glad your friend is recovering.

Re: Impact on my life -- Sadly, I was unemployed leading into this. It has put a damper on any realistic job hunting that I can do and all of the things I was doing to fill the gap. I had started to substitute teach and had a full schedule of umpiring scheduled for the next few months -- all that is gone now. I have a prospect that would entail relocating, but it is education-based also, so I'm sure that is on hold.

My wife and one of my daughters work in hospitals. Both work limited hours due to being in school also, but at some point I imagine the hospitals will be using everybody as much as they can. My wife is pluging away on as much of her RN studies as she can when she is home.

My daughter's boyfriend (who lives with us) works at the county jail. Between the three of them, I am pretty certain one of them will bring it home.

My youngest daughter (special needs) and son (college student) don't do much anyway, so it is pretty normal for them. My oldest daughter (the only one who doesn't live with us) was planning on moving in with her boyfriend (2 hours away) this weekend ... she was still planning on going through with it.

Seems I am the only one in my family taking this seriously (not going out, trying not to spend money, etc.), but I am trying to be upbeat and gently nudge them. Being home isn't bothering me, as I have lots to do to keep me busy (home repairs, projects, etc.). Having everybody else home is stressing me, as they all think I have nothing to do but play waitress/maid/butler. Feels like I have no "decompress" time to myself. Trying to stake those claims as I can.

Oh, and we already have an inch of snow on the ground this morning.

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Old 03-23-20, 11:19 AM
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Re: COVID-19 NON-POLITICAL Thread

This doctor says we should let healthy adults and children go back to work and school, and let them develop a herd immunity. He also says we should concentrate our limited health care resources on those who are most vulnerable. I think he makes sense:



https://www.nytimes.com/2020/03/20/o...istancing.html

Opinion

Is Our Fight Against Coronavirus Worse Than the Disease?

There may be more targeted ways to beat the pandemic.

By David L. Katz

Dr. Katz is president of True Health Initiative and the founding director of the Yale-Griffin Prevention Research Center.


March 20, 2020

We routinely differentiate between two kinds of military action: the inevitable carnage and collateral damage of diffuse hostilities, and the precision of a “surgical strike,” methodically targeted to the sources of our particular peril. The latter, when executed well, minimizes resources and unintended consequences alike.

As we battle the coronavirus pandemic, and heads of state declare that we are “at war” with this contagion, the same dichotomy applies. This can be open war, with all the fallout that portends, or it could be something more surgical. The United States and much of the world so far have gone in for the former. I write now with a sense of urgency to make sure we consider the surgical approach, while there is still time.

Outbreaks tend to be isolated when pathogens move through water or food, and of greater scope when they travel by widespread vectors like fleas, mosquitoes or the air itself. Like the coronavirus pandemic, the infamous flu pandemic of 1918 was caused by viral particles transmitted by coughing and sneezing. Pandemics occur when an entire population is vulnerable — that is, not immune — to a given pathogen capable of efficiently spreading itself.

Immunity occurs when our immune system has developed antibodies against a germ, either naturally or as a result of a vaccine, and is fully prepared should exposure recur. The immune system response is so robust that the invading germ is eradicated before symptomatic disease can develop.

Importantly, that robust immune response also prevents transmission. If a germ can’t secure its hold on your body, your body no longer serves as a vector to send it forward to the next potential host. This is true even if that next person is not yet immune. When enough of us represent such “dead ends” for viral transmission, spread through the population is blunted, and eventually terminated. This is called herd immunity.

What we know so far about the coronavirus makes it a unique case for the potential application of a “herd immunity” approach, a strategy viewed as a desirable side effect in the Netherlands, and briefly considered in the United Kingdom.

The data from South Korea, where tracking the coronavirus has been by far the best to date, indicate that as much as 99 percent of active cases in the general population are “mild” and do not require specific medical treatment. The small percentage of cases that do require such services are highly concentrated among those age 60 and older, and further so the older people are. Other things being equal, those over age 70 appear at three times the mortality risk as those age 60 to 69, and those over age 80 at nearly twice the mortality risk of those age 70 to 79.

These conclusions are corroborated by the data from Wuhan, China, which show a higher death rate, but an almost identical distribution. The higher death rate in China may be real, but is perhaps a result of less widespread testing. South Korea promptly, and uniquely, started testing the apparently healthy population at large, finding the mild and asymptomatic cases of Covid-19 other countries are overlooking. The experience of the Diamond Princess cruise ship, which houses a contained, older population, proves the point. The death rate among that insular and uniformly exposed population is roughly 1 percent.


We have, to date, fewer than 200 deaths from the coronavirus in the United States — a small data set from which to draw big conclusions. Still, it is entirely aligned with the data from other countries. The deaths have been mainly clustered among the elderly, those with significant chronic illnesses such as diabetes and heart disease, and those in both groups.

This is not true of infectious scourges such as influenza. The flu hits the elderly and chronically ill hard, too, but it also kills children. Trying to create herd immunity among those most likely to recover from infection while also isolating the young and the old is daunting, to say the least. How does one allow exposure and immunity to develop in parents, without exposing their young children?

The clustering of complications and death from Covid-19 among the elderly and chronically ill, but not children (there have been only very rare deaths in children), suggests that we could achieve the crucial goals of social distancing — saving lives and not overwhelming our medical system — by preferentially protecting the medically frail and those over age 60, and in particular those over 70 and 80, from exposure.

Why does this matter?

I am deeply concerned that the social, economic and public health consequences of this near total meltdown of normal life — schools and businesses closed, gatherings banned — will be long lasting and calamitous, possibly graver than the direct toll of the virus itself. The stock market will bounce back in time, but many businesses never will. The unemployment, impoverishment and despair likely to result will be public health scourges of the first order.

Worse, I fear our efforts will do little to contain the virus, because we have a resource-constrained, fragmented, perennially underfunded public health system. Distributing such limited resources so widely, so shallowly and so haphazardly is a formula for failure. How certain are you of the best ways to protect your most vulnerable loved ones? How readily can you get tested?

We have already failed to respond as decisively as China or South Korea, and lack the means to respond like Singapore. We are following in Italy’s wake, at risk of seeing our medical system overwhelmed twice: First when people rush to get tested for the coronavirus, and again when the especially vulnerable succumb to severe infection and require hospital beds.

Yes, in more and more places we are limiting gatherings uniformly, a tactic I call “horizontal interdiction” — when containment policies are applied to the entire population without consideration of their risk for severe infection.

But as the work force is laid off en masse (our family has one adult child home for that reason already), and colleges close (we have another two young adults back home for this reason), young people of indeterminate infectious status are being sent home to huddle with their families nationwide. And because we lack widespread testing, they may be carrying the virus and transmitting it to their 50-something parents, and 70- or 80-something grandparents. If there are any clear guidelines for behavior within families — what I call “vertical interdiction” — I have not seen them.

Such is the collateral damage of this diffuse form of warfare, aimed at “flattening” the epidemic curve generally rather than preferentially protecting the especially vulnerable. I believe we may be ineffectively fighting the contagion even as we are causing economic collapse.

There is another and much overlooked liability in this approach. If we succeed in slowing the spread of coronavirus from torrent to trickle, then when does the society-wide disruption end? When will it be safe for healthy children and younger teachers to return to school, much less older teachers and teachers with chronic illnesses? When will it be safe for the work force to repopulate the workplace, given that some are in the at-risk group for severe infection?

When would it be safe to visit loved ones in nursing homes or hospitals? When once again might grandparents pick up their grandchildren?


There are many possible answers, but the most likely one is: We just don’t know. We could wait until there’s an effective treatment, a vaccine or transmission rates fall to undetectable levels. But what if those are a year or more away? Then we suffer the full extent of societal disruption the virus might cause for all those months. The costs, not just in money, are staggering to contemplate.

So what is the alternative? Well, we could focus our resources on testing and protecting, in every way possible, all those people the data indicate are especially vulnerable to severe infection: the elderly, people with chronic diseases and the immunologically compromised. Those that test positive could be the first to receive the first approved antivirals. The majority, testing negative, could benefit from every resource we have to shield them from exposure.

To be sure, while mortality is highly concentrated in a select groups, it does not stop there. There are poignant, heart-rending tales of severe infection and death from Covid-19 in younger people for reasons we do not know. If we found over time that younger people were also especially vulnerable to the virus, we could expand the at-risk category and extend protections to them.

We have already identified many of the especially vulnerable. A detailed list of criteria could be generated by the Centers for Disease Control and Prevention, updated daily and circulated widely to health professionals and the public alike. The at-risk population is already subject to the protections of our current policies: social distancing, medical attention for fever or cough. But there are several major problems with subsuming the especially vulnerable within the policies now applied to all.

First, the medical system is being overwhelmed by those in the lower-risk group seeking its resources, limiting its capacity to direct them to those at greatest need. Second, health professionals are burdened not just with work demands, but also with family demands as schools, colleges and businesses are shuttered. Third, sending everyone home to huddle together increases mingling across generations that will expose the most vulnerable.

As the virus is already circulating widely in the United States, with many cases going undetected, this is like sending innumerable lit matches into small patches of tinder. Right now, it is harder, not easier, to keep the especially vulnerable isolated from all others — including members of their own families — who may have been exposed to the virus.


If we were to focus on the especially vulnerable, there would be resources to keep them at home, provide them with needed services and coronavirus testing, and direct our medical system to their early care. I would favor proactive rather than reactive testing in this group, and early use of the most promising anti-viral drugs. This cannot be done under current policies, as we spread our relatively few test kits across the expanse of a whole population, made all the more anxious because society has shut down.

This focus on a much smaller portion of the population would allow most of society to return to life as usual and perhaps prevent vast segments of the economy from collapsing. Healthy children could return to school and healthy adults go back to their jobs. Theaters and restaurants could reopen, though we might be wise to avoid very large social gatherings like stadium sporting events and concerts.

So long as we were protecting the truly vulnerable, a sense of calm could be restored to society. Just as important, society as a whole could develop natural herd immunity to the virus. The vast majority of people would develop mild coronavirus infections, while medical resources could focus on those who fell critically ill. Once the wider population had been exposed and, if infected, had recovered and gained natural immunity, the risk to the most vulnerable would fall dramatically.

A pivot right now from trying to protect all people to focusing on the most vulnerable remains entirely plausible. With each passing day, however, it becomes more difficult. The path we are on may well lead to uncontained viral contagion and monumental collateral damage to our society and economy. A more surgical approach is what we need.
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Old 03-23-20, 04:29 PM
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Re: COVID-19 NON-POLITICAL Thread

https://www.cdc.gov/flu/weekly/index.htm

CDC estimates that so far this season there have been at least 38 million flu illnesses, 390,000 hospitalizations and 23,000 deaths from flu.

Why is there no panic over this?
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Old 03-23-20, 04:34 PM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by slop101 View Post
Talking to a lot of our clients and vendors... the fear of shutdown and going out of business is far, FAR greater than the fear of the virus, both contracting it and spreading it. The business aspect feels more tangible/real to them. And I'm sure the virus will be more tangible soon, but I'm worried that it won't be soon enough.
Some are trying to balance working while staying safe, but it's a weird tightrope.
I hope that in the future, sociologists, doctors, and others will publish peer reviewed studies to see if the panic caused more harm than good. Shutting everything down does save lives. But it also costs lives too, such as in the form of suicides and drug overdoses, which tend to correlate with higher levels of unemployment.
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Old 03-23-20, 04:41 PM
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Originally Posted by hal9000 View Post
One more week of this shutdown in Los Angeles will absolutely destroy the restaurant industry here. Unless there is some sort of Federal and Local tax amnesty for the remainder of the year, top to bottom for all sales (alcohol included) including payroll, vendor, etc.. The mom and pop restaurants that you love including some chains, like Denny's and I-Hop will not be able to reopen without a massive bailout. The chains that will survive are the obvious ones like Starbucks, McDonalds, Jack in the Box, IN-n-Out and the like that already have drive-thru windows. The chains that are trying to survive, for example, Buffalo Wild Wings are doing a fraction of their business, this is very bad especially when a majority of their sales/profit comes from alcohol.

I'm calling it now, sadly 50% of the restaurants you know and love will cease to exist when this is all over. Here's the biggest idiocy of all of this, people are still going through drive-thru's/markets/Costco/etc and people are still exchanging money, all of a sudden currency is immune to transferring COVID-19? Don't believe the hype people! What a scam.

Well that depends. Does cocaine kill the virus?

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Old 03-23-20, 04:46 PM
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Re: COVID-19 NON-POLITICAL Thread

Originally Posted by grundle View Post
Well that depends. Does cocaine kill the virus?
Shhhhhhh, the last thing we need is cocaine prices skyrocketing!
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Old 03-23-20, 04:49 PM
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Originally Posted by DVD Polizei View Post
But how many from actual flu, though. The flu kills around 80K a year in the US. That's like 6,500 a month. Look up Illinois for flu averages. Seeing people die at hospitals isn't something new.

Also, here's a reality on flu vaccines. The CDC reported they were 45% successful in the last flu season:

https://www.cdc.gov/mmwr/volumes/69/...cid=mm6907a1_w

So maybe this year, 50,000 will die from the flu. And 30,000 will die from COVID-19, but still test positive for the flu. which would have killed them anyway if they hadn't contracted COVID-19.

In other words, its possible that COVID-19 will end up causing zero net increase in the annual death rate.

So many people talk about the number of people who could die from COVID-19. But we also need to take into account that almost all of these people have a serious, potentially fatal comorbidity that likely would have killed them anyway.

If a person is already in a nursing home with stage 4 cancer, and after their death they test positive for COVID-19, then that's nowhere near the same thing as an otherwise healthy person dying from COVD-19.

Last edited by grundle; 03-23-20 at 05:12 PM.
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Old 03-23-20, 05:03 PM
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Originally Posted by hal9000 View Post
Where do you want me to start? Tom Hanks and his wife, to the hourly press conferences on how we are handling COVID-19 and yet doing nothing to save businesses, "shelter in place" in LA and yet millions of people are lined up and shopping at Target, Walmart, Costco, Sam's Club, Ralph's, Vons, Trader Joe's interacting with each other under the guise of an imaginary six foot bubble.

I know of not one person who has COVID-19 or even knows a friend of a friend who has it. BUT I have plenty of friends on social media who are now claiming that they had it in January of this year, no, idiots, you had a bad cold or maybe even the flu. This, the overreaction, the misdiagnosed "flu" that kills someones uncle who had a preexisting condition and who had no connection with anyone who traveled to China or Italy. The half-assed shut down of society, what's it going to be, I was still rubbing elbows with people in the market yesterday guess I'll have to wait 14 days to see if I caught anything.

Want an eye opener, read this article, and then read it again and make an educated conclusion on how blown-out of proportion this "insert the latest virus here: SARS, Mad Cow, Ebola, Swine, Bird Flu" same dance, different day:
https://www.latimes.com/california/s...inment-testing

I agree. A "quarantine" or "shelter in place" doesn't mean anything if people are still going shopping for groceries.

And yes, a lot of people who are "dying from COVID-19" already had other preexisting conditions that would have killed them anyway.
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