Covid 19 thread

[GBRam15]

 

[Dieter the Brock]

Your post is full of suppositions and assertions that are unsupported by data. The 2.2. million figure was never supported by any actual data, it was just supported by a fear-mongering computer model for which the author now won't even release his code. And again, his initial estimate overstated his current estimate by a factor of 25. If you followed the reasoning, the author stated that the virus has probably been transmitted much more widely than previously believed, which means many more than just those who tested for it have come into contact with it, and thus the virus is not nearly as deadly as originally feared. And here we are, a few months into this pandemic, and in a country of 330 million people, we finally topped 1000 deaths. Given that the lockdowns didn't start until about mid-March, two and a half months into the year if the virus has been spreading for all of that time, then it really isn't anywhere near as deadly as the doomsayers would have us believe. For people without pre-existing medical conditions, it suggests a probability of death in line with probability of death for all causes, i.e. no effective change.

Yet based on that model, we shut down our economy to the tune of 3.3 MILLION new jobless claims this week. In a labor force of approximately 164 million, that represents a near-instantaneous 2% jump in the unemployment rate, which was hovering around 3% prior to that, which translates now into about a 5% unemployment rate. A few pages back, I posted a link to an article with regard to the economic costs of a continued shutdown. Pertinent quote:



We've just seen a 2% jump in unemployment. At one additional suicide per 100,000 population that adds up to 6600 additional suicides. So tell me, why are 1000 Wuhan virus deaths more tragic than 6600 suicides? Why is the virus death total unacceptable, but the death total from additional unemployment-fueled suicides is just hunky fucking dory no problem whatsoever? You complain about people diminishing the dead at the beginning of this thread, yet I see you doing the same thing now when it comes to the human toll of an economic meltdown - one that is almost entirely fueled by our current response to this crisis.

A lot of those jobs won't come back either. Many businesses are going to fold (some already have) and many people will lose their livelihoods. And if we take your approach you appear to favor, staying locked down for a long time, it will be much, much worse. That's not just people worrying about the Dow or their 401ks, that's people worrying about making a living, worrying about how to save for their kids education, worrying about putting food on the table. There is a serious human cost in responding to this virus the way we are doing it, and from the data we know now, it's exceeding the cost of the Wuhan virus by leaps and bounds.

An effective response to a crisis like this requires balancing three things - security (which includes public health), civil liberties, and economics. Right now the response throughout most of the country is focusing almost entirely on the first with a near total disregard for the other two. And from the tone of your post above, as well as others you have written in this thread, you are just fine with that, oblivious to the costs from ignoring the other two. You previously stated that you are in an at-risk category, and if so, you should take extra care to quarantine yourself. But when you complain about other people taking walks or exercising, you are suggesting that their rights should be limited, which suggests at best a tepid commitment to the rights and liberties of others. Complaining about businesses you consider to be non-essential to be open, as well as your apparent fervor for a long-term lockdown suggests at best a tepid commitment to the economic aspect of the crisis. And you don't seem to have a problem imposing your preferred solution on an entire population, irrespective of the fact that your preferred solution doesn't enhance their security, curtails their civil liberties, and diminishes their economic prospects.

If you are that scared, quarantine yourself. Those who are in the at-risk categories should be doing so anyway. But any sympathy I have for your condition goes out the window the instant you let your fear override your judgment to the point that you advocate taking away the rights of others for your preferred solution, and that's where you are at now.

The words below aren't mine, but the thoughts behind them comport with what I am thinking. YMMV.

View attachment 34978

I tend to agree and at the same time not agree Thirteen.

Right now I am battling to keep my businesses and home afloat. I am in a weird position cause I bring in large amounts of money - in turn I have higher bills - so when the spigot is shut off it’s not like I can sell a my record collection to keep myself afloat - it’s a drop in the bucket. I mean I am the highest risk of losing it all. I have even posted about some of my issues on here, but deleted those posts cause I am determined to fight through this and be victorious instead of whining or giving up. It would be easy to give up right now. But I can’t so it. I am gonna fight tooth and nail to come out of this victorious.

With that said, I think keeping things locked down for another month or two is reasonable considering this shit is already underway and we haven’t seen the worst of it yet. Look what happened in Italy with the Champions League game

Coronavirus: How a Champions League match contributed to Italy's COVID-19 outbreak

Atalanta hosted Valencia on Feb. 19, right before cases were confirmed in the country

www.google.com

I mean we can’t have this shit happening. It would happen right now if we said “play ball!” There is a reality that we - despite our love for freedom and making money - have to face. There is a chance you could fucking die - despite you thinking you’re fit. I mean this shit is real.

So despite this taking a huge fucking toll on my brand, my home, I think we need to keep shit safe for at least the end of April and into May to make sure we at least get a grip.

All I can say is Science is gonna save our fucking ass. God bless all those nerds who are working as hard as they can - cooperating across international lines - to find antibodies and to create vaccines for this shit. We should just bite the bullet and know our economy will recover when all this is over. It will recover. That is a fucking fact.

Anyway, stream of conscious ramble over

 

[thirteen28]

I tend to agree and at the same time not agree Thirteen.

Right now I am battling to keep my businesses and home afloat. I am in a weird position cause I bring in large amounts of money - in turn I have higher bills - so when the spigot is shut off it’s not like I can sell a my record collection to keep myself afloat - it’s a drop in the bucket. I mean I am the highest risk of losing it all. I have even posted about some of my issues on here, but deleted those posts cause I am determined to fight through this and be victorious instead of whining or giving up. It would be easy to give up right now. But I can’t so it. I am gonna fight tooth and nail to come out of this victorious.

With that said, I think keeping things locked down for another month or two is reasonable considering this shit is already underway and we haven’t seen the worst of it yet. Look what happened in Italy with the Champions League game

Coronavirus: How a Champions League match contributed to Italy's COVID-19 outbreak

Atalanta hosted Valencia on Feb. 19, right before cases were confirmed in the country

www.google.com

I mean we can’t have this shit happening. It would happen right now if we said “play ball!” There is a reality that we - despite our love for freedom and making money - have to face. There is a chance you could fucking die - despite you thinking you’re fit. I mean this shit is real.

So despite this taking a huge fucking toll on my brand, my home, I think we need to keep shit safe for at least the end of April and into May to make sure we at least get a grip.

All I can say is Science is gonna save our fucking ass. God bless all those nerds who are working as hard as they can - cooperating across international lines - to find antibodies and to create vaccines for this shit. We should just bite the bullet and know our economy will recover when all this is over. It will recover. That is a fucking fact.

Anyway, stream of conscious ramble over

Well, thanks for your post and I hope you and your business come through just fine. That being said, I just don't think the empirical data we actually have now - related to both the virus as well as the unemployment numbers, the effects thereof, and other secondary effects, can support shutting things down into May. The various parts of the country only started implementing these lockdowns in the past two weeks or so, and look what we already have - a 2% jump in unemployment. If we go to May as you suggest, that number will get much, much, bigger, and will dwarf any impact of the virus even if we had done nothing. You can't just say "oh, the economy will recover." In the wake of the 1929 crash, the unemployment rate ballooned to over 30% and led to a depression that lasted an entire decade and took the world to a very, very dark place. It took a wartime footing in this country to really drive down unemployment, and still there was plenty of hardship even on the homefront. Saying the economy will just somehow magically recover after we basically shut it down for two months is wishful thinking at best. It's even harder to say now after the ranks of the employed fell by 3.3 million in just the short time this country has been locked down.

Nobody is saying we should do nothing about the Wuhan virus, but right now we are taking a battle axe to something that requires a scalpel. We can be much smarter and much more targeted in our response. People who are at risk should definitely quarantine. Doing quarantine in multi-generational households should be avoided though. Something Wuhan, Lombardy, Madrid, and Queens in NYC have in common is a large numbers of multi-generational households, where young and healthy can bring the virus in and infect the old and sick under the same roof. We can also vary response by geography - Idaho, which has a much lower population density, should not be forced to respond the same way that is occurring in NYC. And generally, younger, healthier people should be able to get back out and get to work. Will that increase the number of deaths from the virus? Possibly, but no more so than shutting down the economy, forcibly taking away people's livelihoods, and driving many into depression and eventually suicide. But the risk is acceptable. Right now, the percentage of deaths relative to confirmed cases is holding steady at about 1.4%, which means the actual death rate is probably much lower. If we can risk being one of 35,000 annual automobile deaths, then we can tolerate the risk of sending healthy/younger people can go back to work and keep the economic damage to the minimum. The longer we wait, the deeper the hole we will be in, and the more the cure will be worse than the disease.

 

[Dieter the Brock]

Well, thanks for your post and I hope you and your business come through just fine. That being said, I just don't think the empirical data we actually have now - related to both the virus as well as the unemployment numbers, the effects thereof, and other secondary effects, can support shutting things down into May. The various parts of the country only started implementing these lockdowns in the past two weeks or so, and look what we already have - a 2% jump in unemployment. If we go to May as you suggest, that number will get much, much, bigger, and will dwarf any impact of the virus even if we had done nothing. You can't just say "oh, the economy will recover." In the wake of the 1929 crash, the unemployment rate ballooned to over 30% and led to a depression that lasted an entire decade and took the world to a very, very dark place. It took a wartime footing in this country to really drive down unemployment, and still there was plenty of hardship even on the homefront. Saying the economy will just somehow magically recover after we basically shut it down for two months is wishful thinking at best. It's even harder to say now after the ranks of the employed fell by 3.3 million in just the short time this country has been locked down.

Nobody is saying we should do nothing about the Wuhan virus, but right now we are taking a battle axe to something that requires a scalpel. We can be much smarter and much more targeted in our response. People who are at risk should definitely quarantine. Doing quarantine in multi-generational households should be avoided though. Something Wuhan, Lombardy, Madrid, and Queens in NYC have in common is a large numbers of multi-generational households, where young and healthy can bring the virus in and infect the old and sick under the same roof. We can also vary response by geography - Idaho, which has a much lower population density, should not be forced to respond the same way that is occurring in NYC. And generally, younger, healthier people should be able to get back out and get to work. Will that increase the number of deaths from the virus? Possibly, but no more so than shutting down the economy, forcibly taking away people's livelihoods, and driving many into depression and eventually suicide. But the risk is acceptable. Right now, the percentage of deaths relative to confirmed cases is holding steady at about 1.4%, which means the actual death rate is probably much lower. If we can risk being one of 35,000 annual automobile deaths, then we can tolerate the risk of sending healthy/younger people can go back to work and keep the economic damage to the minimum. The longer we wait, the deeper the hole we will be in, and the more the cure will be worse than the disease.

I mean I can’t argue with what you’re saying. Only that the circumstances around something like the Great Depression are different from what we have happening right now. So although it’s apples to apples I’d say it’s granny smith to Bartlett pear in that regard. And so again we don’t exactly know for certain one way or another only that this virus is a huge issue

Personally I want nothing more than getting back to normal. But I think we are in it to at least end of April and possibly May. We just gotta battle through. I know the economy will get back to humming - it always has

 

[thirteen28]

Personally I want nothing more than getting back to normal. But I think we are in it to at least end of April and possibly May. We just gotta battle through. I know the economy will get back to humming - it always has

How long will that take though? There's a big different between unemployment hitting, say, 10%, and hitting 25%. If we hit the latter, we are probably economically fucked for a decade.

 

[Dieter the Brock]

How long will that take though? There's a big different between unemployment hitting, say, 10%, and hitting 25%. If we hit the latter, we are probably economically fucked for a decade.

I don’t know.
This has never happened before. We are gonna have to pay the price somehow for our inability and unwillingness to prepare for this kinda of situation. God willing in the future we will be way more prepared and this sorta thing will be a major consideration moving forward. But to think there won’t be a price to pay whether it be lives or the economy is just unavoidable at this point.

We will get through this though, and I think there will be an enthusiasm to get back to business when it’s all under control. That’s just what i think. This is a unique situation and I don’t think you can exactly compare what’s happening now to the great depression or 9-11 etc., cause NOTHING has ever happened like this before. Where the entire economy is just shut down. Again my thinking is once things open back up we’ll all get after it. It’ll take some time to get back up to speed but we’ll get back.

 

[Mackeyser]

Your post is full of suppositions and assertions that are unsupported by data. The 2.2. million figure was never supported by any actual data, it was just supported by a fear-mongering computer model for which the author now won't even release his code. And again, his initial estimate overstated his current estimate by a factor of 25. If you followed the reasoning, the author stated that the virus has probably been transmitted much more widely than previously believed, which means many more than just those who tested for it have come into contact with it, and thus the virus is not nearly as deadly as originally feared. And here we are, a few months into this pandemic, and in a country of 330 million people, we finally topped 1000 deaths. Given that the lockdowns didn't start until about mid-March, two and a half months into the year if the virus has been spreading for all of that time, then it really isn't anywhere near as deadly as the doomsayers would have us believe. For people without pre-existing medical conditions, it suggests a probability of death in line with probability of death for all causes, i.e. no effective change.

Yet based on that model, we shut down our economy to the tune of 3.3 MILLION new jobless claims this week. In a labor force of approximately 164 million, that represents a near-instantaneous 2% jump in the unemployment rate, which was hovering around 3% prior to that, which translates now into about a 5% unemployment rate. A few pages back, I posted a link to an article with regard to the economic costs of a continued shutdown. Pertinent quote:



We've just seen a 2% jump in unemployment. At one additional suicide per 100,000 population that adds up to 6600 additional suicides. So tell me, why are 1000 Wuhan virus deaths more tragic than 6600 suicides? Why is the virus death total unacceptable, but the death total from additional unemployment-fueled suicides is just hunky fucking dory no problem whatsoever? You complain about people diminishing the dead at the beginning of this thread, yet I see you doing the same thing now when it comes to the human toll of an economic meltdown - one that is almost entirely fueled by our current response to this crisis.

A lot of those jobs won't come back either. Many businesses are going to fold (some already have) and many people will lose their livelihoods. And if we take your approach you appear to favor, staying locked down for a long time, it will be much, much worse. That's not just people worrying about the Dow or their 401ks, that's people worrying about making a living, worrying about how to save for their kids education, worrying about putting food on the table. There is a serious human cost in responding to this virus the way we are doing it, and from the data we know now, it's exceeding the cost of the Wuhan virus by leaps and bounds.

An effective response to a crisis like this requires balancing three things - security (which includes public health), civil liberties, and economics. Right now the response throughout most of the country is focusing almost entirely on the first with a near total disregard for the other two. And from the tone of your post above, as well as others you have written in this thread, you are just fine with that, oblivious to the costs from ignoring the other two. You previously stated that you are in an at-risk category, and if so, you should take extra care to quarantine yourself. But when you complain about other people taking walks or exercising, you are suggesting that their rights should be limited, which suggests at best a tepid commitment to the rights and liberties of others. Complaining about businesses you consider to be non-essential to be open, as well as your apparent fervor for a long-term lockdown suggests at best a tepid commitment to the economic aspect of the crisis. And you don't seem to have a problem imposing your preferred solution on an entire population, irrespective of the fact that your preferred solution doesn't enhance their security, curtails their civil liberties, and diminishes their economic prospects.

If you are that scared, quarantine yourself. Those who are in the at-risk categories should be doing so anyway. But any sympathy I have for your condition goes out the window the instant you let your fear override your judgment to the point that you advocate taking away the rights of others for your preferred solution, and that's where you are at now.

The words below aren't mine, but the thoughts behind them comport with what I am thinking. YMMV.

View attachment 34978

[Insert facepalm gif here]

Marie Kondo couldn't unpack this, so yeah, I'm not even gonna try. ffs...

 

[WestCoastRam]

Inside a Brooklyn Hospital Right Now

Brooklyn Mount Sinai Hospital’s chief medical officer, on mounting deaths, overflowing waiting rooms, and the mobile morgue parked outside his window.

nymag.com

From the moment he wakes up, Dr. Peter Shearer, the chief medical officer at Mount Sinai hospital in Brooklyn, spends his day thinking about coronavirus. As one of the hospital’s leaders, his job entails coordinating with the doctors, nurses, and technicians on the front lines of patient care, something that has gotten increasingly difficult as Mount Sinai tries to contain the spread among its own employees. Like every other hospital in the city, Shearer’s ER and ICU are now inundated with COVID-positive patients. With 10 to 15 percent of his staff now sick themselves and three to four COVID-19 deaths per day, Shearer says that it’s hard to imagine things being worse than they are now. And yet scientists still estimate that the virus won’t peak for another two to four weeks. As a testament to that, a 20-foot cooler truck is now parked right outside Shearer’s window, a mobile morgue meant to house bodies when the hospital’s facilities inevitably overflow. Shearer knows this is only the beginning, and so he and his Mt. Sinai Brooklyn colleagues have agreed to keep us updated on life inside the hospital. This is the first dispatch.

I wake up around five o’clock and I start thinking about coronavirus. I look at my phone to see which patients decompensated [organ or system failure resulting in an urgent change in vital signs] or coded [a failure of the heart or lungs requiring resuscitation] overnight. And then I start to think about what the hospital resources are and look at the current status of my inpatient units, and my ICUs — plural because we’ve created an extra one — and my emergency department. And then I start to try and figure out how we’re going to get through another day.

The number of very sick COVID patients coming in is tremendous. I don’t know if the word is exponentially or logarithmically, but the curve goes up steeply. It’s scary. Mount Sinai Brooklyn is a moderate-sized community hospital. We have 220 beds, we’ve planned a surge of up to 240 to 260. At the current moment I have 135 COVID-positive patients. There are probably another 10 or 15 that just don’t have test results back yet. And they are sick. They are the ones who need to be admitted to the hospital. It’s a few debilitated elderly from nursing homes, but there’s a lot of patients who are between the ages of 40 to 60 who may have some underlying health problems like obesity, diabetes and high blood pressure, and their lungs are very inflamed. They go from being moderately sick to crashing and needing to put on ventilators very quickly.

I don’t think medical science has an understanding yet of why some people do so much worse than others. There are theories out there about the viral load and probably some genetic variation. It’s unclear. Certainly underlying things like diabetes and high blood pressure add to the equation. Smoking, lung disease, vaping absolutely doesn’t help. But I don’t think we know enough about the science of this yet to say what makes one person crash and burn when another person just has a fever and aches for a week.

The emergency department is just patient-to-patient lined up and packed in. It’s that awful picture you see of an overcrowded emergency department, just patient upon patient next to each other endlessly. It sounds like a low-level buzz of chaos. We have a no-visitor policy so that helps maintain a bit of control over things and allows a little bit of sanity, but it’s minimal. If every patient had one or two family members next to them, it would be unbearable.

Three weeks ago when we started to plan for this we came up with ideas like, This is the room that we’ll put a [seriously ill] coronavirus patient in. And then if there are a bunch of other patients, maybe four or five who are slightly sick, we’ll put them in this area where we close the door and keep them separate from everyone else. We were thinking about this room and that room. And now I’m up to 27 patients in my emergency department who are positive, waiting for beds in the hospital, and another 24 who are under evaluation. Those plans are ancient history now. In an ideal world, everyone has their own room, they would have negative pressure airflow and a face mask on and a dedicated nurse to care for them with a moderate ratio of patients. We can’t do that. No one can do that right now. Every hospital in New York is a variation of mine.

I would say 10 to 15 percent of the staff is out [sick with COVID]. Many of them have been tested, while some have just had symptoms and we know clinically that they’re positive. Some of the employees that are at higher risk for contracting the illness are our respiratory therapists. They’re putting people on ventilators and working around the part of the patient where they might get some aerosolized particles. They are uniquely skilled employees, and they’re dropping like flies. Normally I would have five on during a shift. I have two today, at the exact time I have more patients on ventilators than before.

I think we’re seeing three to four COVID deaths a day now. And that has changed in the past couple of days. There have been some younger people. The more upsetting things are the 50- and 60-year-old people are getting put on ventilators. They haven’t died yet. But there’s no treatment for this. We’re just giving supportive care to buy them some time, where we hope their lungs will heal. There’s no real improvement therapy. Everything you hear about things like Plaquenil (hydroxychloroquine) for the critically ill, it’s probably much less effective.

We’ve had some tragic situations. We’ve had two married couples where they’re both hospitalized. There was a couple in their late 80s. The husband died and his wife is in another ward of the hospital. They’re both isolated. We couldn’t even get her there. We have another married couple in their late 50s where one is doing much worse than the other and is on a ventilator. It’s very overwhelming.

We have very small morgues that can only hold five bodies at a time and they do tend to get picked up relatively quickly. There’s a truck parked outside my window now. It’s around 20 feet long, I assume it could hold 30 bodies minimum. It looks like a big trailer with a refrigerator unit on it. We haven’t had to use it yet. Inside it’s just a cold metal space. It’s not very respectful at the moment. I’m not going to hang curtains in it, but it needs to be a little bit more … something.

People have compared this to the early days of HIV. It feels like I can imagine how that was, but the numbers are more now. If you went back to that time, it was predominantly the gay community and focused in certain geographic parts of the city. This is every single hospital in the city, multiple patients dropping their oxygen levels surprisingly fast and being put on ventilators with no way to make them better. I’ve been through the blackout. I’ve been through Sandy. I’ve been through the 2009 H1N1 influenza pandemic. And this is different. 9/11 was a horrendous thing, but there was no impact like this on hospitals. Sandy, some hospitals were completely devastated, and it was horrendous and awful, but the weather got better. And you could start cleaning up. But this is just getting worse. I have never been in a war. It feels like a war.

From the governor’s office, and from the modeling I get through the Mount Sinai health system, the peak will be somewhere between two to four weeks from now. But it’s pretty fucking awful right now. To think that somehow it’s going to get worse is hard to imagine. The governor has charged us with doubling the capacity of our hospital. I can put three people in rooms that should accommodate two. But I need nurses to care for them. It’s going to be tough.

I think conversations [about triage] will come into play in the next week or so. We don’t have medical therapy for this, all we have is supportive care. There are patients for whom that’s not going to save their life, it may actually add to their suffering. There are some patients who it’s not even really an option to put them on a ventilator. Just because you can do something doesn’t mean you should. My father died in mid-December before this all started, at the age of 85. It was an acute perforation of his bowels. And in that situation, the doctor comes to you and says, “He’s dying and there’s nothing we can do, and we will make him comfortable and make sure that he doesn’t suffer.” And those are the conversations that we need to be having with patients and families now for whom ventilation is not an option.

We’re not quite there yet in terms of [choosing which patients should get ventilators over others], allocating resources. It’s hard to know, things change very quickly. There’s a document from the New York State Department of Health which has guidelines for how to allocate ventilator resources at the time of a pandemic. Basically, you give scores to patients based on how sick they are, and that helps you to assign a triage level to different people and then make those decisions of: I have one ventilator and two patients, which one am I choosing. Or: I have a 30-year-old in my ER and an 87-year-old in my ICU, and it gives you guidance to take the person in the ICU off the ventilator and give it to the 30-year-old.

Two weeks ago as we were ramping up, myself and the other members of our leadership team would round on the units and talk to the staff, because we knew they were becoming concerned and worried about what was coming. It was important for us to be out there to meet with the night shift, the day shift, nurses, techs, all those people, to really help prepare them and to show that we had their backs. I’m not doing that as much now because I don’t want to over-risk my exposure. I’m just one person and there’s not another department where other people can replace me. But I feel very badly about it, because I think the staff definitely needs it. It’s a sort of a sad part of this. Now we’re doing everything on the phone. We feel a bit more disconnected. It’s difficult. At a time where everyone needs to feel closer, we’re feeling apart.

I have a COVID-positive 41-year-old who just died about five minutes ago. I just got the message. He’s been in the unit for about a week. Initially he seemed to be doing better and then he didn’t. In terms of preexisting conditions, he had obesity and maybe some diabetes. Not a lot. We’re very tight on visitors, but they were able to get his wife up there a few times. It’s devastating. But I’m not the one at his bedside taking care of him, which would be our ICU director and the nurses. Among my people, people already know that for medical staff, the repercussions of this months and years down the road are going to be extreme. It goes back to the wartime analogy — people being in World War One being shell-shocked. Now you call it PTSD. It will be like that.

 

[Mackeyser]

Well, thanks for your post and I hope you and your business come through just fine. That being said, I just don't think the empirical data we actually have now - related to both the virus as well as the unemployment numbers, the effects thereof, and other secondary effects, can support shutting things down into May. The various parts of the country only started implementing these lockdowns in the past two weeks or so, and look what we already have - a 2% jump in unemployment. If we go to May as you suggest, that number will get much, much, bigger, and will dwarf any impact of the virus even if we had done nothing. You can't just say "oh, the economy will recover." In the wake of the 1929 crash, the unemployment rate ballooned to over 30% and led to a depression that lasted an entire decade and took the world to a very, very dark place. It took a wartime footing in this country to really drive down unemployment, and still there was plenty of hardship even on the homefront. Saying the economy will just somehow magically recover after we basically shut it down for two months is wishful thinking at best. It's even harder to say now after the ranks of the employed fell by 3.3 million in just the short time this country has been locked down.

Nobody is saying we should do nothing about the Wuhan virus, but right now we are taking a battle axe to something that requires a scalpel. We can be much smarter and much more targeted in our response. People who are at risk should definitely quarantine. Doing quarantine in multi-generational households should be avoided though. Something Wuhan, Lombardy, Madrid, and Queens in NYC have in common is a large numbers of multi-generational households, where young and healthy can bring the virus in and infect the old and sick under the same roof. We can also vary response by geography - Idaho, which has a much lower population density, should not be forced to respond the same way that is occurring in NYC. And generally, younger, healthier people should be able to get back out and get to work. Will that increase the number of deaths from the virus? Possibly, but no more so than shutting down the economy, forcibly taking away people's livelihoods, and driving many into depression and eventually suicide. But the risk is acceptable. Right now, the percentage of deaths relative to confirmed cases is holding steady at about 1.4%, which means the actual death rate is probably much lower. If we can risk being one of 35,000 annual automobile deaths, then we can tolerate the risk of sending healthy/younger people can go back to work and keep the economic damage to the minimum. The longer we wait, the deeper the hole we will be in, and the more the cure will be worse than the disease.

Right. We COULD have done MASSIVE testing immediately, quarantining those who tested positive and KEPT testing. We'd be most of the way done with this with very few deaths.

But we didn't. And AS OF TODAY, we still have people, at least in Florida, who can't fucking listen to save their lives...literally. They're still gathering in groups, throwing backyard BBQ parties, gathering in groups and all sorts of other mess. My son works in a grocery store and some very elderly fucknut actually yelled at him for doing his job of sanitizing the carts!

This may sound political, but it really isn't. Ask a conservative anywhere else in the world and they'll tell you that universal healthcare is just sane. It removes a lot of other safety net needs, bolsters small business more than any other measure and reduces the requirement for gov't to intervene into the economy every time it hits a speed bump. Instead of having 50 different states with 50 different health departments, we could simply for instances like this, have a singular entity managing the pandemic response. Businesses would have more universal information.

But yeah, we COULD have had it much easier, but spent months calling it a hoax and "not that bad" and now we're on the precipice. /shrug.

All we can do is ride out this nonsensical response because between the Reps and Dems, I'm not sure how they could have done worse...as we're about to see.

 

[Mackeyser]

Inside a Brooklyn Hospital Right Now

Brooklyn Mount Sinai Hospital’s chief medical officer, on mounting deaths, overflowing waiting rooms, and the mobile morgue parked outside his window.

nymag.com

From the moment he wakes up, Dr. Peter Shearer, the chief medical officer at Mount Sinai hospital in Brooklyn, spends his day thinking about coronavirus. As one of the hospital’s leaders, his job entails coordinating with the doctors, nurses, and technicians on the front lines of patient care, something that has gotten increasingly difficult as Mount Sinai tries to contain the spread among its own employees. Like every other hospital in the city, Shearer’s ER and ICU are now inundated with COVID-positive patients. With 10 to 15 percent of his staff now sick themselves and three to four COVID-19 deaths per day, Shearer says that it’s hard to imagine things being worse than they are now. And yet scientists still estimate that the virus won’t peak for another two to four weeks. As a testament to that, a 20-foot cooler truck is now parked right outside Shearer’s window, a mobile morgue meant to house bodies when the hospital’s facilities inevitably overflow. Shearer knows this is only the beginning, and so he and his Mt. Sinai Brooklyn colleagues have agreed to keep us updated on life inside the hospital. This is the first dispatch.

I wake up around five o’clock and I start thinking about coronavirus. I look at my phone to see which patients decompensated [organ or system failure resulting in an urgent change in vital signs] or coded [a failure of the heart or lungs requiring resuscitation] overnight. And then I start to think about what the hospital resources are and look at the current status of my inpatient units, and my ICUs — plural because we’ve created an extra one — and my emergency department. And then I start to try and figure out how we’re going to get through another day.

The number of very sick COVID patients coming in is tremendous. I don’t know if the word is exponentially or logarithmically, but the curve goes up steeply. It’s scary. Mount Sinai Brooklyn is a moderate-sized community hospital. We have 220 beds, we’ve planned a surge of up to 240 to 260. At the current moment I have 135 COVID-positive patients. There are probably another 10 or 15 that just don’t have test results back yet. And they are sick. They are the ones who need to be admitted to the hospital. It’s a few debilitated elderly from nursing homes, but there’s a lot of patients who are between the ages of 40 to 60 who may have some underlying health problems like obesity, diabetes and high blood pressure, and their lungs are very inflamed. They go from being moderately sick to crashing and needing to put on ventilators very quickly.

I don’t think medical science has an understanding yet of why some people do so much worse than others. There are theories out there about the viral load and probably some genetic variation. It’s unclear. Certainly underlying things like diabetes and high blood pressure add to the equation. Smoking, lung disease, vaping absolutely doesn’t help. But I don’t think we know enough about the science of this yet to say what makes one person crash and burn when another person just has a fever and aches for a week.

The emergency department is just patient-to-patient lined up and packed in. It’s that awful picture you see of an overcrowded emergency department, just patient upon patient next to each other endlessly. It sounds like a low-level buzz of chaos. We have a no-visitor policy so that helps maintain a bit of control over things and allows a little bit of sanity, but it’s minimal. If every patient had one or two family members next to them, it would be unbearable.

Three weeks ago when we started to plan for this we came up with ideas like, This is the room that we’ll put a [seriously ill] coronavirus patient in. And then if there are a bunch of other patients, maybe four or five who are slightly sick, we’ll put them in this area where we close the door and keep them separate from everyone else. We were thinking about this room and that room. And now I’m up to 27 patients in my emergency department who are positive, waiting for beds in the hospital, and another 24 who are under evaluation. Those plans are ancient history now. In an ideal world, everyone has their own room, they would have negative pressure airflow and a face mask on and a dedicated nurse to care for them with a moderate ratio of patients. We can’t do that. No one can do that right now. Every hospital in New York is a variation of mine.

I would say 10 to 15 percent of the staff is out [sick with COVID]. Many of them have been tested, while some have just had symptoms and we know clinically that they’re positive. Some of the employees that are at higher risk for contracting the illness are our respiratory therapists. They’re putting people on ventilators and working around the part of the patient where they might get some aerosolized particles. They are uniquely skilled employees, and they’re dropping like flies. Normally I would have five on during a shift. I have two today, at the exact time I have more patients on ventilators than before.

I think we’re seeing three to four COVID deaths a day now. And that has changed in the past couple of days. There have been some younger people. The more upsetting things are the 50- and 60-year-old people are getting put on ventilators. They haven’t died yet. But there’s no treatment for this. We’re just giving supportive care to buy them some time, where we hope their lungs will heal. There’s no real improvement therapy. Everything you hear about things like Plaquenil (hydroxychloroquine) for the critically ill, it’s probably much less effective.

We’ve had some tragic situations. We’ve had two married couples where they’re both hospitalized. There was a couple in their late 80s. The husband died and his wife is in another ward of the hospital. They’re both isolated. We couldn’t even get her there. We have another married couple in their late 50s where one is doing much worse than the other and is on a ventilator. It’s very overwhelming.

We have very small morgues that can only hold five bodies at a time and they do tend to get picked up relatively quickly. There’s a truck parked outside my window now. It’s around 20 feet long, I assume it could hold 30 bodies minimum. It looks like a big trailer with a refrigerator unit on it. We haven’t had to use it yet. Inside it’s just a cold metal space. It’s not very respectful at the moment. I’m not going to hang curtains in it, but it needs to be a little bit more … something.

People have compared this to the early days of HIV. It feels like I can imagine how that was, but the numbers are more now. If you went back to that time, it was predominantly the gay community and focused in certain geographic parts of the city. This is every single hospital in the city, multiple patients dropping their oxygen levels surprisingly fast and being put on ventilators with no way to make them better. I’ve been through the blackout. I’ve been through Sandy. I’ve been through the 2009 H1N1 influenza pandemic. And this is different. 9/11 was a horrendous thing, but there was no impact like this on hospitals. Sandy, some hospitals were completely devastated, and it was horrendous and awful, but the weather got better. And you could start cleaning up. But this is just getting worse. I have never been in a war. It feels like a war.

From the governor’s office, and from the modeling I get through the Mount Sinai health system, the peak will be somewhere between two to four weeks from now. But it’s pretty fucking awful right now. To think that somehow it’s going to get worse is hard to imagine. The governor has charged us with doubling the capacity of our hospital. I can put three people in rooms that should accommodate two. But I need nurses to care for them. It’s going to be tough.

I think conversations [about triage] will come into play in the next week or so. We don’t have medical therapy for this, all we have is supportive care. There are patients for whom that’s not going to save their life, it may actually add to their suffering. There are some patients who it’s not even really an option to put them on a ventilator. Just because you can do something doesn’t mean you should. My father died in mid-December before this all started, at the age of 85. It was an acute perforation of his bowels. And in that situation, the doctor comes to you and says, “He’s dying and there’s nothing we can do, and we will make him comfortable and make sure that he doesn’t suffer.” And those are the conversations that we need to be having with patients and families now for whom ventilation is not an option.

We’re not quite there yet in terms of [choosing which patients should get ventilators over others], allocating resources. It’s hard to know, things change very quickly. There’s a document from the New York State Department of Health which has guidelines for how to allocate ventilator resources at the time of a pandemic. Basically, you give scores to patients based on how sick they are, and that helps you to assign a triage level to different people and then make those decisions of: I have one ventilator and two patients, which one am I choosing. Or: I have a 30-year-old in my ER and an 87-year-old in my ICU, and it gives you guidance to take the person in the ICU off the ventilator and give it to the 30-year-old.

Two weeks ago as we were ramping up, myself and the other members of our leadership team would round on the units and talk to the staff, because we knew they were becoming concerned and worried about what was coming. It was important for us to be out there to meet with the night shift, the day shift, nurses, techs, all those people, to really help prepare them and to show that we had their backs. I’m not doing that as much now because I don’t want to over-risk my exposure. I’m just one person and there’s not another department where other people can replace me. But I feel very badly about it, because I think the staff definitely needs it. It’s a sort of a sad part of this. Now we’re doing everything on the phone. We feel a bit more disconnected. It’s difficult. At a time where everyone needs to feel closer, we’re feeling apart.

I have a COVID-positive 41-year-old who just died about five minutes ago. I just got the message. He’s been in the unit for about a week. Initially he seemed to be doing better and then he didn’t. In terms of preexisting conditions, he had obesity and maybe some diabetes. Not a lot. We’re very tight on visitors, but they were able to get his wife up there a few times. It’s devastating. But I’m not the one at his bedside taking care of him, which would be our ICU director and the nurses. Among my people, people already know that for medical staff, the repercussions of this months and years down the road are going to be extreme. It goes back to the wartime analogy — people being in World War One being shell-shocked. Now you call it PTSD. It will be like that.

That is just heartbreaking. I truly think for a good many people, this will define this decade and this generation.

I dunno how medical personnel cope. My sister works in an elder care facility and has held people's hands as they die. I couldn't do it. She's 1000x the person I am and I would like to think I'm a pretty good person, but not "hold the hand of the dying" good. I'd have PTSD for sure. These folks are doing "God's work" as we call it and I really hope we remember this once this is over.

 

[Dieter the Brock]

Inside a Brooklyn Hospital Right Now

Brooklyn Mount Sinai Hospital’s chief medical officer, on mounting deaths, overflowing waiting rooms, and the mobile morgue parked outside his window.

nymag.com

From the moment he wakes up, Dr. Peter Shearer, the chief medical officer at Mount Sinai hospital in Brooklyn, spends his day thinking about coronavirus. As one of the hospital’s leaders, his job entails coordinating with the doctors, nurses, and technicians on the front lines of patient care, something that has gotten increasingly difficult as Mount Sinai tries to contain the spread among its own employees. Like every other hospital in the city, Shearer’s ER and ICU are now inundated with COVID-positive patients. With 10 to 15 percent of his staff now sick themselves and three to four COVID-19 deaths per day, Shearer says that it’s hard to imagine things being worse than they are now. And yet scientists still estimate that the virus won’t peak for another two to four weeks. As a testament to that, a 20-foot cooler truck is now parked right outside Shearer’s window, a mobile morgue meant to house bodies when the hospital’s facilities inevitably overflow. Shearer knows this is only the beginning, and so he and his Mt. Sinai Brooklyn colleagues have agreed to keep us updated on life inside the hospital. This is the first dispatch.

I wake up around five o’clock and I start thinking about coronavirus. I look at my phone to see which patients decompensated [organ or system failure resulting in an urgent change in vital signs] or coded [a failure of the heart or lungs requiring resuscitation] overnight. And then I start to think about what the hospital resources are and look at the current status of my inpatient units, and my ICUs — plural because we’ve created an extra one — and my emergency department. And then I start to try and figure out how we’re going to get through another day.

The number of very sick COVID patients coming in is tremendous. I don’t know if the word is exponentially or logarithmically, but the curve goes up steeply. It’s scary. Mount Sinai Brooklyn is a moderate-sized community hospital. We have 220 beds, we’ve planned a surge of up to 240 to 260. At the current moment I have 135 COVID-positive patients. There are probably another 10 or 15 that just don’t have test results back yet. And they are sick. They are the ones who need to be admitted to the hospital. It’s a few debilitated elderly from nursing homes, but there’s a lot of patients who are between the ages of 40 to 60 who may have some underlying health problems like obesity, diabetes and high blood pressure, and their lungs are very inflamed. They go from being moderately sick to crashing and needing to put on ventilators very quickly.

I don’t think medical science has an understanding yet of why some people do so much worse than others. There are theories out there about the viral load and probably some genetic variation. It’s unclear. Certainly underlying things like diabetes and high blood pressure add to the equation. Smoking, lung disease, vaping absolutely doesn’t help. But I don’t think we know enough about the science of this yet to say what makes one person crash and burn when another person just has a fever and aches for a week.

The emergency department is just patient-to-patient lined up and packed in. It’s that awful picture you see of an overcrowded emergency department, just patient upon patient next to each other endlessly. It sounds like a low-level buzz of chaos. We have a no-visitor policy so that helps maintain a bit of control over things and allows a little bit of sanity, but it’s minimal. If every patient had one or two family members next to them, it would be unbearable.

Three weeks ago when we started to plan for this we came up with ideas like, This is the room that we’ll put a [seriously ill] coronavirus patient in. And then if there are a bunch of other patients, maybe four or five who are slightly sick, we’ll put them in this area where we close the door and keep them separate from everyone else. We were thinking about this room and that room. And now I’m up to 27 patients in my emergency department who are positive, waiting for beds in the hospital, and another 24 who are under evaluation. Those plans are ancient history now. In an ideal world, everyone has their own room, they would have negative pressure airflow and a face mask on and a dedicated nurse to care for them with a moderate ratio of patients. We can’t do that. No one can do that right now. Every hospital in New York is a variation of mine.

I would say 10 to 15 percent of the staff is out [sick with COVID]. Many of them have been tested, while some have just had symptoms and we know clinically that they’re positive. Some of the employees that are at higher risk for contracting the illness are our respiratory therapists. They’re putting people on ventilators and working around the part of the patient where they might get some aerosolized particles. They are uniquely skilled employees, and they’re dropping like flies. Normally I would have five on during a shift. I have two today, at the exact time I have more patients on ventilators than before.

I think we’re seeing three to four COVID deaths a day now. And that has changed in the past couple of days. There have been some younger people. The more upsetting things are the 50- and 60-year-old people are getting put on ventilators. They haven’t died yet. But there’s no treatment for this. We’re just giving supportive care to buy them some time, where we hope their lungs will heal. There’s no real improvement therapy. Everything you hear about things like Plaquenil (hydroxychloroquine) for the critically ill, it’s probably much less effective.

We’ve had some tragic situations. We’ve had two married couples where they’re both hospitalized. There was a couple in their late 80s. The husband died and his wife is in another ward of the hospital. They’re both isolated. We couldn’t even get her there. We have another married couple in their late 50s where one is doing much worse than the other and is on a ventilator. It’s very overwhelming.

We have very small morgues that can only hold five bodies at a time and they do tend to get picked up relatively quickly. There’s a truck parked outside my window now. It’s around 20 feet long, I assume it could hold 30 bodies minimum. It looks like a big trailer with a refrigerator unit on it. We haven’t had to use it yet. Inside it’s just a cold metal space. It’s not very respectful at the moment. I’m not going to hang curtains in it, but it needs to be a little bit more … something.

People have compared this to the early days of HIV. It feels like I can imagine how that was, but the numbers are more now. If you went back to that time, it was predominantly the gay community and focused in certain geographic parts of the city. This is every single hospital in the city, multiple patients dropping their oxygen levels surprisingly fast and being put on ventilators with no way to make them better. I’ve been through the blackout. I’ve been through Sandy. I’ve been through the 2009 H1N1 influenza pandemic. And this is different. 9/11 was a horrendous thing, but there was no impact like this on hospitals. Sandy, some hospitals were completely devastated, and it was horrendous and awful, but the weather got better. And you could start cleaning up. But this is just getting worse. I have never been in a war. It feels like a war.

From the governor’s office, and from the modeling I get through the Mount Sinai health system, the peak will be somewhere between two to four weeks from now. But it’s pretty fucking awful right now. To think that somehow it’s going to get worse is hard to imagine. The governor has charged us with doubling the capacity of our hospital. I can put three people in rooms that should accommodate two. But I need nurses to care for them. It’s going to be tough.

I think conversations [about triage] will come into play in the next week or so. We don’t have medical therapy for this, all we have is supportive care. There are patients for whom that’s not going to save their life, it may actually add to their suffering. There are some patients who it’s not even really an option to put them on a ventilator. Just because you can do something doesn’t mean you should. My father died in mid-December before this all started, at the age of 85. It was an acute perforation of his bowels. And in that situation, the doctor comes to you and says, “He’s dying and there’s nothing we can do, and we will make him comfortable and make sure that he doesn’t suffer.” And those are the conversations that we need to be having with patients and families now for whom ventilation is not an option.

We’re not quite there yet in terms of [choosing which patients should get ventilators over others], allocating resources. It’s hard to know, things change very quickly. There’s a document from the New York State Department of Health which has guidelines for how to allocate ventilator resources at the time of a pandemic. Basically, you give scores to patients based on how sick they are, and that helps you to assign a triage level to different people and then make those decisions of: I have one ventilator and two patients, which one am I choosing. Or: I have a 30-year-old in my ER and an 87-year-old in my ICU, and it gives you guidance to take the person in the ICU off the ventilator and give it to the 30-year-old.

Two weeks ago as we were ramping up, myself and the other members of our leadership team would round on the units and talk to the staff, because we knew they were becoming concerned and worried about what was coming. It was important for us to be out there to meet with the night shift, the day shift, nurses, techs, all those people, to really help prepare them and to show that we had their backs. I’m not doing that as much now because I don’t want to over-risk my exposure. I’m just one person and there’s not another department where other people can replace me. But I feel very badly about it, because I think the staff definitely needs it. It’s a sort of a sad part of this. Now we’re doing everything on the phone. We feel a bit more disconnected. It’s difficult. At a time where everyone needs to feel closer, we’re feeling apart.

I have a COVID-positive 41-year-old who just died about five minutes ago. I just got the message. He’s been in the unit for about a week. Initially he seemed to be doing better and then he didn’t. In terms of preexisting conditions, he had obesity and maybe some diabetes. Not a lot. We’re very tight on visitors, but they were able to get his wife up there a few times. It’s devastating. But I’m not the one at his bedside taking care of him, which would be our ICU director and the nurses. Among my people, people already know that for medical staff, the repercussions of this months and years down the road are going to be extreme. It goes back to the wartime analogy — people being in World War One being shell-shocked. Now you call it PTSD. It will be like that.

Man this is a sobering read.

 

[Mackeyser]

Atlanta is a day or so from being in that same spot and New Orleans is pretty close, too.

 

[Corbin]

View: https://youtu.be/-zcNoAQi04g


People don’t say anything but they look at you different. You can see it in their eyes for doing what you had to in the service and how they interact with you afterwards.

Watching these people and listening to this actually makes me feel like a normal person. These people don’t know what desperate is with their cushioned lives.

It’s insane the sanity going on, my brother works in the meat department as a Sams Club and comes home every day with crazy stories of people and their panic and selfishness. Smh

 

[Pancake]

People being selfish pieces of shit is the biggest problem with this whole thing.

 

[kurtfaulk]

.

In Australia, Chinese companies with subsidiaries here told their employees to stop regular work in January and start sourcing for masks, hands sanitiser, thermometers, medical supplies, etc. Then they flew the stock over to China. Like a 100 tonnes at a time.

We never stood a chance with supplies. Once we even knew there might be a threat everything was gone from the shelves.

Retailers and suppliers ought to be ashamed of themselves. Threw the Australian public under the bus for easy sales.

How many other countries had the same fate.

.

 

[XXXIVwin]

Man this is a sobering read.

Yes. Terrifying article. Two weeks from now in NYC... unimaginable.

Americans need to get a look inside these hospitals to get a visceral gut-punch of what is coming. Here’s a video from a hospital in Italy.


View: https://m.youtube.com/watch?v=Ee7FRSPo76M

 

[thirteen28]

Marie Kondo couldn't unpack this, so yeah, I'm not even gonna try. ffs...

Thanks for underscoring my point that you are looking at this from only one perspective, completely ignoring the economic consideration and attendant costs thereof.

[Insert facepalm gif here]

Don't touch your face. That's how you spread the disease.

Ask a conservative anywhere else in the world and they'll tell you that universal healthcare is just sane.

Italy has universal healthcare. How'd things work out there?

So does China for that matter. So does Spain.


"The whole aim of practical politics is to keep the populace alarmed (and hence clamorous to be led to safety)" - H.L. Mencken

 

[12intheBox]

3/27/2020

553,244 confirmed
25,035 dead

4.5 %

 

[Merlin]

Numbers are up today for the US: 86,012 cases with 1,301 dead so we're at 1.5%. The obvious downward trend we were seeing with mortality has stopped for the past week or so.

I feel like we're at a crossroads tbh, where we have to more closely balance the risk of trying to shut everything down vs the spread with more of an eye towards ensuring stores don't run out of food and people don't starve to death.

 

[Merlin]

American military bases have gone too Health Protection Level Charlie.

Yeah my youngest is now going into month 7 of deployment to the gulf and it looks like they're gonna halt rotation of personnel for upwards of 2 or 3 months. Told my youngest it builds character (part of serving and all that) but this is definitely affecting the military.

Got friends on ships who are facing very long periods at sea without port calls too, which sucks. And we're going to see a lot of impact overall to the military as the testing for them comes online (many bases and remote sites have not been testing the sick) and they become aware of where they have the biggest outbreaks in the next month which IMO is why there's a rotational halt. Good thing here is most of these kids won't have too much prob with the virus but they're definitely being impacted.