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Government Response To The Coronavirus (2 Viewers)

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SaintsInDome2006 said:
And testing is key to this. The social shutdown only works if those infected are identified and quarantined. Every 2 weeks we wait without a test for all protocol (and we’ve already waited quite a while) extends the length we have to wait further out.
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Certainly.  More testing is important so we can get into more isolated quarantines and precautions and away from where we are now.  But that is the point, we need an endgame to this massive shutdown which is tanking the economy and putting millions out of work.  

 
zoonation said:
Thanks for this. Question:  is the tension between disciplines based on the shortage of resources for treatments (lupus for example) with proven efficacy to throw a hail Mary at covid?  Surely they can’t just start handing out snake oil in an uncontrolled way?!

and, thank you for illustrating perfectly why calling it the “Chinese virus” is xenophobic and dangerous. 
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What I meant about the tension is that there is disagreement about what PPE is needed in which situations, how we can improvise, when we can "bend the rules" due to shortages, etc. In my opinion it is leading to a lot of wasted time and also at times eroding trust between providers. 

We aren't hearing much about the drugs really at all. I know that some of the ICU docs have been using them in select cases. I can't say I blame them for trying something is a last resort; that kind of thing happens sometimes when you are trying to save a life and are out of other options. But their use doesn't seem to be widespread in our institutions. I don't think anyone really believes they are going to make a significant difference. 

 
msommer said:
Just the regular oxygen thing? Would suck but beats the hell out of full blown tracheostomy and respirator
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Not sure what you mean by the regular oxygen thing. A breathing tube, once inserted into the trachea, is connected to a ventilator. Only consider traching someone if they are quickly desatting and you couldn’t get a breathing tube in for one reason or another. 

 
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fruity pebbles said:
He put a breathing tube down his throat
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Yes we normally due this through endotracheal intubation: tube through the mouth into the trachea. We have modified our typical procedure for this in order to limit the amount of virus that is aerosolized. And obviously are wearing more extensive PPE for this than we typically do or in other situations. 

Cricothyrotomy and/or tracheostomy (cutting the neck) would be contraindicated because those procedures are likely to aerosolize huge amounts of virus. There are a lot of discussions going on at the hospital committee level about what procedures are safe to do and which are high risk for spreading the virus. One thing that hasn't happened yet but probably will at some point is we will stop doing CPR because it is so high risk for spreading the virus and it is essentially futile now anyway (the mortality of people that sick who are infected approaches 100%). 

 
Ryan Struyk@ryanstruyk

Reported US coronavirus cases via@CNN:

3/1: 89

3/2: 105 3/3: 125 3/4: 159 3/5: 227 3/6: 331 3/7: 444 3/8: 564 3/9: 728 3/10: 1,000 3/11: 1,267 3/12: 1,645 3/13: 2,204 3/14: 2,826 3/15: 3,505 3/16: 4,466 3/17: 6,135 3/18: 8,760 3/19: 13,229 3/20: 18,763 3/21: 25,740

Now: 32,502

 
The White House coronavirus Task Force has two estimates being used now:

- Optimistic scenario: Peak virus will come 1 month from Saturday March 14.

- Pessimistic scenario: peak virus 3 months from March 14.

- CNBC

 
jon_mx said:
Let's say it is costing the economy $1 billion per live saved (which may not be as much off as you might think) and the average age is about 80 years old.  You could feed a million people on that amount of money or provide health care to hundreds of thousands for each life you are trying to save.  Can you not even conceive where there might be a point where it does not make any economic sense to continue?  We are possibly killing more people in the long run and definitely causing severe economic hardship to tens of millions of people.  But even to suggest such makes one a despicable human being.  We as a society has always accepted there is some economic limit to preventing deaths, but in this case we act as though we are willing to accept unlimited hardship and economic consequences to save 'x' amount of lives.  There has to be an end game somewhere.
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It seems like there are a growing number of people, mostly conservative, who are making this argument, which is essentially that we should call off the shutdown, go back to our normal lives, and let the virus run its course. Apparently some guy on Fox was very explicit about this last night, and Trump watched it and that’s when he sent out the tweet. 

IMO, this argument is being made now because we have not yet seen the worst outcome of this virus. Per the medical experts, that will happen when the hospitals are filled with patients needing beds and ventilators and there is no room. It is predicted that this is about to occur within a week or two, possibly even sooner, in most of our larger cities. Once that occurs, I doubt this argument will continue to be pursued, but we’ll see. In the meantime, it would be disastrous IMO for President Trump to publicly suggest,  against the advice of the health experts, that we “return to normal”. 

 
the moops said:
jon_mx said:
fruity pebbles said:
Definitely seems like we’re past the optimistic scenario. 
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The dates are 1 and 3 months FROM March 14th, not March 14th.
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I don't know how anyone can think that this peaks on APR 14. I am unsure if JUN is more likely, but I can't see a decline in 3 weeks
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Based on graphs I saw over the weekend, Apr 14 would likely be a worst case.  The peak is so fast, so soon, and so much higher because we failed to contain it.   Not pretending to know if that is what the task force means by these dates, but isn't the point is to slow everything down?  At least on the health side?

ETA: Guess I should have said "graphs".   As they are state by state https://covidactnow.org/

 
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timschochet said:
It seems like there are a growing number of people, mostly conservative, who are making this argument, which is essentially that we should call off the shutdown, go back to our normal lives, and let the virus run its course. Apparently some guy on Fox was very explicit about this last night, and Trump watched it and that’s when he sent out the tweet. 

IMO, this argument is being made now because we have not yet seen the worst outcome of this virus. Per the medical experts, that will happen when the hospitals are filled with patients needing beds and ventilators and there is no room. It is predicted that this is about to occur within a week or two, possibly even sooner, in most of our larger cities. Once that occurs, I doubt this argument will continue to be pursued, but we’ll see. In the meantime, it would be disastrous IMO for President Trump to publicly suggest,  against the advice of the health experts, that we “return to normal”. 
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Didn’t you post here that you wanted everyone to get the virus?

 
the moops said:
I don't know how anyone can think that this peaks on APR 14. I am unsure if JUN is more likely, but I can't see a decline in 3 weeks
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You don't see how cancelling all these events, shutting down restaurants and other businesses, teleworking, etc. might lead to a decline?

 
timschochet said:
It seems like there are a growing number of people, mostly conservative, who are making this argument, which is essentially that we should call off the shutdown, go back to our normal lives, and let the virus run its course. Apparently some guy on Fox was very explicit about this last night, and Trump watched it and that’s when he sent out the tweet. 

IMO, this argument is being made now because we have not yet seen the worst outcome of this virus. Per the medical experts, that will happen when the hospitals are filled with patients needing beds and ventilators and there is no room. It is predicted that this is about to occur within a week or two, possibly even sooner, in most of our larger cities. Once that occurs, I doubt this argument will continue to be pursued, but we’ll see. In the meantime, it would be disastrous IMO for President Trump to publicly suggest,  against the advice of the health experts, that we “return to normal”. 
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Yep. Wait until it’s not just Coronavirus patients being pushed aside because of full hospitals but kids coming in with acute appendicitis, guys in their 50s who have had a heart attack, women in their 20s who have an ectopic pregnancy. 

 
John Blutarsky said:
Didn’t you post here that you wanted everyone to get the virus?
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No, I posted a few weeks ago that I wanted a lot of people to get the virus and quickly recover, because at the time I thought the mortality rate was low and I was unaware of the high risks for old and unhealthy people. I was uninformed and it was a foolish idea. It was quickly corrected and I saw my error. 

 
timschochet said:
“We can’t let the cure be worse than the disease.” 

Does this suggest to anyone else that President Trump is considering ending the social distancing in a few weeks and just letting people get sick? 
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1) Whatever you believe him to mean is going to be your reality so why even ask?

2) If you really are concerned about the well being of other and the loss of human life, then you'll have to wrap your mind around the fact that at some point the current response to the virus (shutting down society) will kill far more people than the virus itself.

 
timschochet said:
It seems like there are a growing number of people, mostly conservative, who are making this argument, which is essentially that we should call off the shutdown, go back to our normal lives, and let the virus run its course. Apparently some guy on Fox was very explicit about this last night, and Trump watched it and that’s when he sent out the tweet. 

IMO, this argument is being made now because we have not yet seen the worst outcome of this virus. Per the medical experts, that will happen when the hospitals are filled with patients needing beds and ventilators and there is no room. It is predicted that this is about to occur within a week or two, possibly even sooner, in most of our larger cities. Once that occurs, I doubt this argument will continue to be pursued, but we’ll see. In the meantime, it would be disastrous IMO for President Trump to publicly suggest,  against the advice of the health experts, that we “return to normal”. 
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Its an argument that shouldn't even be given serious thought.  Its ludicrous given the exponential spread and what doing nothing means.  Absolutely ridiculous to let this thing just go and watch our healthcare system completely crumble.  Think about how quickly we then end up with nurse shortages...wipe out entire families...possibly entire businesses as people don't quarantine when sick and go to work.

The mortality rate is lowered because of how quarantining and distancing and these measures work...want to see it increase at an alarming rate...take the acton being considered here because its too economically costly to try and slow it down.  Honestly...I cannot think of a worse idea.

 
fruity pebbles said:
Yep. Wait until it’s not just Coronavirus patients being pushed aside because of full hospitals but kids coming in with acute appendicitis, guys in their 50s who have had a heart attack, women in their 20s who have an ectopic pregnancy. 
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College friend...46 years old...just found out he had a heart attack yesterday.  While he is certainly worried now about his own future and that of his wife and his kids (one still in HS one early in college I believe)....its hard to claim he is lucky...but probably lucky it happened when it did...and not a week or two from now when hospitals are overrun.

 
Mr Anonymous said:
1) Whatever you believe him to mean is going to be your reality so why even ask?

2) If you really are concerned about the well being of other and the loss of human life, then you'll have to wrap your mind around the fact that at some point the current response to the virus (shutting down society) will kill far more people than the virus itself.
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I don’t understand your first point. When I wrote that last night I was asking a question because it was my impression, and I wanted to see if anyone shared it. I didn’t have the backstory about the guy on Fox I do now. 

As to your second point, my understanding is that the shutdown of society is in order to “flatten the curve”- which means bring the virus spread down to a manageable basis, and that once we do that we can get back to normal living. Do you disagree with this solution? 

 
NorvilleBarnes said:
I haven't heard anyone, conservative or otherwise, make this case. 
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Exactly. I've seen that we have to find answers and other methods aside from shutdown to respond and the reality is that we do. And I believe we will. People simply have to go back to work soon. And we must find a way to do that with some safety measures.

 
timschochet said:
No, I posted a few weeks ago that I wanted a lot of people to get the virus and quickly recover, because at the time I thought the mortality rate was low and I was unaware of the high risks for old and unhealthy people. I was uninformed and it was a foolish idea. It was quickly corrected and I saw my error. 
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And you admit that...rather than trying to play it off and act like it was still a good idea.  But some can't see past what was said 2 weeks ago and how things have "bigly" changed since then now that we know even more information.

Imagine if we had this information in February instead of March...while our POTUS was downplaying this and we were not given the right information from the top level down?

 
timschochet said:
It seems like there are a growing number of people, mostly conservative, who are making this argument, which is essentially that we should call off the shutdown, go back to our normal lives, and let the virus run its course. Apparently some guy on Fox was very explicit about this last night, and Trump watched it and that’s when he sent out the tweet. 

IMO, this argument is being made now because we have not yet seen the worst outcome of this virus. Per the medical experts, that will happen when the hospitals are filled with patients needing beds and ventilators and there is no room. It is predicted that this is about to occur within a week or two, possibly even sooner, in most of our larger cities. Once that occurs, I doubt this argument will continue to be pursued, but we’ll see. In the meantime, it would be disastrous IMO for President Trump to publicly suggest,  against the advice of the health experts, that we “return to normal”. 
Click to expand...
We are not returning to normal.    There is a point somewhere in the middle where we can start opening up some business while taking more sanitary precautions and while isolating at risk people or tested positive people or other people who have been exposed.  We need to massively rapidly ramp up our PPE supplies and medical and distribute them to Hospitals and nursing homes.  At some point the cost of this shutdown has to be taken into the equation. It is literally costing our economy tens or hundreds of millions of dollars per live saved, which is an obscene amount we never have spent before.  The curve will be flattened by the actions we have taken and by taking extra precautions when we do start to reopen businesses.  Other countries have opened up and have been successful without remaining in a shut down status.  

 
Mr Anonymous said:
Exactly. I've seen that we have to find answers and other methods aside from shutdown to respond and the reality is that we do. And I believe we will. People simply have to go back to work soon. And we must find a way to do that with some safety measures.
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This appears to be double talk to me. You just agreed that there is no argument being made to end the shutdown. Yet in the same post you appear to be arguing to end the shutdown. Do you want to end it or not? 

 
timschochet said:
As to your second point, my understanding is that the shutdown of society is in order to “flatten the curve”- which means bring the virus spread down to a manageable basis, and that once we do that we can get back to normal living. Do you disagree with this solution? 
Click to expand...
I agree wholeheartedly with the attempt of a shutdown. And I do think it will make a dent. But it has to be brief whether it works or not. It's a mere band-aid, not a solution. This talk of shutdowns lasting 3-6 months is nonsense. So I really do hope Trump is anxious for society to return to work. I also know that it will require lots of masks, gloves, PPE, and drugs that are working. It's a race to open society in a safer way before the damage of the shutdown becomes far worse than the virus itself.

 
jon_mx said:
We are not returning to normal.    There is a point somewhere in the middle where we can start opening up some business while taking more sanitary precautions and while isolating at risk people or tested positive people or other people who have been exposed.  We need to massively rapidly ramp up our PPE supplies and medical and distribute them to Hospitals and nursing homes.  At some point the cost of this shutdown has to be taken into the equation. It is literally costing our economy tens or hundreds of millions of dollars per live saved, which is an obscene amount we never have spent before.  The curve will be flattened by the actions we have taken and by taking extra precautions when we do start to reopen businesses.  Other countries have opened up and have been successful without remaining in a shut down status.  
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I don’t understand this “‘middle” idea- I can’t see how it would work. If you end the shutdown, social distancing ends, and the virus spreads, full stop. 

 
Mr Anonymous said:
I agree wholeheartedly with the attempt of a shutdown. And I do think it will make a dent. But it has to be brief whether it works or not. It's a mere band-aid, not a solution. This talk of shutdowns lasting 3-6 months is nonsense. So I really do hope Trump is anxious for society to return to work. I also know that it will require lots of masks, gloves, PPE, and drugs that are working. It's a race to open society in a safer way before the damage of the shutdown becomes far worse than the virus itself.
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Of course if we come up with a drug that works and is accessible, we can end the shutdown. That would be great. 

But the other stuff you mention- that’s not going to work. Social distancing is the key and we can’t go back to work and keep up social distancing. It’s not possible. 

 
timschochet said:
There are two posters here who appear to have made it this morning. And a guy on Fox made it very explicitly last night, impressing President Trump. 
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See what I mean about believing what you want to believe. Saying society must re-open soon doesn't mean re-open without thought to the virus. You really need to open your mind. You are a person who thinks the worst in others who don't share your point of view.

All we have today is a rudimentary solution. We need to attack this in a much more nuanced way soon or the shutdown kills more than the problem which caused it.

 
jon_mx said:
We are not returning to normal.    There is a point somewhere in the middle where we can start opening up some business while taking more sanitary precautions and while isolating at risk people or tested positive people or other people who have been exposed.  We need to massively rapidly ramp up our PPE supplies and medical and distribute them to Hospitals and nursing homes.  At some point the cost of this shutdown has to be taken into the equation. It is literally costing our economy tens or hundreds of millions of dollars per live saved, which is an obscene amount we never have spent before.  The curve will be flattened by the actions we have taken and by taking extra precautions when we do start to reopen businesses.  Other countries have opened up and have been successful without remaining in a shut down status.  
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They opened back up after the peak though jon...not on the increasing side of the equation...that is the point.

It sucks its costing a lot...but the economy and money can/will recover.  People don't, lives don't.

This is where we adjust (as I thought about this last week and now see a few local restaurants doing this) local place now offering "groceries" in a way if you are ordering takeout.  Need a gallon of milk, some bread, even a few meats...they will add it in a box to your takeout order because they are using their distributor rather than a grocer.  You may pay a premium price for some of it...but beats going to a store and finding it empty (because people are still stupidly shopping rather than letting the supply chain work properly).  This will help the restaurant as well as their food distributor who is hurting because less people are eating out.

But that is the type of stuff we must do...adjust to the circumstances...businesses like we have seen adjusting to produce PPE and so on.

 
timschochet said:
I don’t understand this “‘middle” idea- I can’t see how it would work. If you end the shutdown, social distancing ends, and the virus spreads, full stop. 
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Of course you don't.  It is easier to take apart the back to normal argument which no one is making.   There are steps to improve social distancing and sanitation without shutting down things.

 
timschochet said:
Of course if we come up with a drug that works and is accessible, we can end the shutdown. That would be great. 

But the other stuff you mention- that’s not going to work. Social distancing is the key and we can’t go back to work and keep up social distancing. It’s not possible. 
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A widely available drug could be a year away.  A lengthy shutdown will absolutely devastate our economy to a point it may take decades to recover.  

 
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