Miscellaneous And Off Topic Subjects

[iam416]

I am personally sick and tired of the paranoia over this. Is anyone actually looking past the case counts, the deaths, the visuals of people on vents and body bags stacked up, sad personal stories of suffering and doing the fucking math? Nope. Yet everyone is fine with the economy tanking. Fucking stupid and stupid to the power of 100 maybe more.

The numbers are the numbers. Those aren't going to change and there's no sense in pretending they will. We still don't know what the numbers are with sufficient certainty, but we're getting there.

Sheltering in place was intended as a way to flatten the curve to avoid the "Italian surge" scenario. It was not intended as a way to avoid the virus entirely. Unfortunately, I think the view has shifted to the latter. People need to make peace with the numbers. They absolutely suck. They are catastrophic. My mother is hugely at risk. But that's the situation.

[AlabamAlum]

[Dr. Strangelove]

Let me throw this out there: if we reopen and a local healthcare system looks like it's being overrun, do you shut down again or not? I guess what I'm asking is, once we reopen is that it? No more going back? Because I think I'm on the side of you only shut down once and that's your shot. So when you choose to reopen it should done in mind that you're very, very confident that the hospitals won't be overrun. And maybe we're there.

[THE_WIZARD_]

Jeffrey Epstein was in lockdown for his protection too. How'd that work out....

[AlabamAlum]

Let me throw this out there: if we reopen and a local healthcare system looks like it's being overrun, do you shut down again or not? I guess what I'm asking is, once we reopen is that it? No more going back? Because I think I'm on the side of you only shut down once and that's your shot. So when you choose to reopen it should done in mind that you're very, very confident that the hospitals won't be overrun. And maybe we're there.

[iam416]

Let me throw this out there: if we reopen and a local healthcare system looks like it's being overrun, do you shut down again or not? I guess what I'm asking is, once we reopen is that it? No more going back? Because I think I'm on the side of you only shut down once and that's your shot. So when you choose to reopen it should done in mind that you're very, very confident that the hospitals won't be overrun. And maybe we're there.

I think you have to move through the gated approach. I don't think this is some sort of throw the doors open shit. I don't think a Phase 1 reopen is going to overrun hospitals. I think that's the point. I think a blanket "back to normal!" reopen could, but that's not what's going to happen.

We actually need to talk about reopening in terms of -- and I can't believe I'm saying this -- the Federal guideline plans. And I'm sure the Governors will augment that.

[THE_WIZARD_]

FLATTEN THE CURVE!! LISTEN TO US!! WE KNOW BETTER!! YES OUR MODELS AND PROJECTIONS HAVE BEEN GARGANTUANLY OFF BUT WE KNOW BETTER!! STAY AT HOME!! TRUST US!!

[AlabamAlum]

But, make no mistake: the threat of Covid-19 is very real. But this shutdown isolation medicine, taken long enough, will be worse than the disease itself.

[Dr. Strangelove]

It's just one hospital system in NY but 88% of their COVID patients that got put on a ventilator ended up dying. Hopefully we're past the point of worrying about ventilator shortages but if some smaller places start having to prioritize other conditions versus covid patients, maybe it's actually the covid pateients that have to wait. As sad as that is.

https://www.cnn.com/2020/04/22/health/coronavirus-ventilator-patients-die/index.html

[THE_WIZARD_]

But, make no mistake: the threat of Covid-19 is very real. But this shutdown isolation medicine, taken long enough, will be worse than the disease itself.

I agree with my esteemed colleague from Bumfuck Bammer

[Jeff Buchanan]

DSL, on the question of do you wait until you only need to open up once; not shutting down once you've reopened. That's a good question, actually. In a perfect or near-perfect world, yes, that's exactly what you do. Interestingly, Austrailia and NZ are good examples of that approach working pretty well. Both countries have small populations, open spaces and very few COVID cases or deaths. Both governments reacted quickly and earlier than most in the west. Per the article I read this morning, the gist of it was, those governments have avoided the politics of it compared to the US and the EU/UK all three mired in it - the US the worst. There GR, CFR and Case #s parallel SK and Taiwan who also took steps similar to those of NZ and Austrailia. Fine. At this point it does not matter what the US should have done. It's done.

Now what? I thought, among others here, that the Birx authored Reopen America Plan was, as a guideline for the states, a good one. That plan is very much a reflection of where the US is - the shit sandwich we all know the US is in. If you read it carefully, there is room for alternate ways to measure control as a means of getting through the gates and then each phase - of course, the pundits advocating for stay closed until no one will die, complain when one of those gates isn't met ....... OMG, they are reopening - GA and other states in the SE are examples.

R0 (now the less static Rt) is getting a lot of press. Remember you heard about R0, later Rt, first here because I brought it to your attention weeks ago. There are other measures such as hospital admissions, ED presentation, ICU usage rates that can be very sensitive indicators of control or lack thereof at the county level - the infrastructure for reporting such data is in place in most states. But all we here about is case #s and deaths rising. I stopped giving a shit about those freaky numbers at least 3w ago because the underlying processes producing them was flawed and drawing conclusions from flawed processes is inappropriate. Still ..... our "experts keep doing it.

So, now, the correct approach is to let the Governor's provide the data and guidelines that the county officials need to make opening decisions based on measures of disease control available to them. I'd do it in sequential steps that make sense - the federal phase 1, 2, 3 approach is very clear and makes sense to me.

It's like turning on a faucet. You do it a little bit at a time. My take is that approach is going to produce a minimum of new cases and deaths; early indicators of the opposite happening, are going to come from those data sources I listed above. You don't open the faucet any further until those indicators look good again..... and they well if this is done correctly. I suppose you coould dial back the faucet but my take is that won't be necessary becasue of all the math I've posted her. The numbers I've been presenting back this approach up when it is taken on a local level. You cannot talk nationally about this or even by states. Stupidly, pundits keep doing this. It's misleading.

The one thing I will acknowledge that "experts" are calling for is that some level of testing, ID, quarantining, tracking and tracing of contacts is necessary to support reopening plans. Nationally, the US is light on that but getting better when looked at the places testing is most critical to assess control (e.g., NY, FL, LA and other places where there are a lot of cases). I do not agree that it has to be universal (everyone has to get tested). It is unrealistic to demand that testing capacity be at a level where everyone gets tested. Economies won't survive that wait. You start opeining now and do testing consistent with your state and local PHS resources - and, of course, I believe that you work to put resources in place to expand PHS capacity to test, ID, Quarantine, Track and Trace where it's needed the most (see above). When resources are limited, you target test and trace hot spots as they emerge with a goal of expanding local capacity to do more testing.

One more thing on ventilators. I posted a few days ago the emerging standards of care for critically ill patients infected with SARS-COV-2......... AVOID MECHANICAL VENTILATION. It's no surprise that ventilator needs NEVER exceeded what was available.

[Jeff Buchanan]

This isn't going to go anywhere but it is nonetheless interesting. Correct me if I'm wrong, talent (and I know you will), but if something like this ever went to the World Court in the Hague, I think it would be a loser because while damages are clearly present, fault, i.e., negligence, would have to be established, right? The Chinese propaganda machine has been at work for months to eliminate that possibility.

https://www.taiwannews.com.tw/en/news/3919329

In any event fuck the fucking Chinese government.

[iam416]

You typically can't sue sovereigns.

It's no surprise that ventilator needs NEVER exceeded what was available.

Yeah, but never forget the panic and hysteria. Right? WE'RE SO UNPREPARED!!!!!!!!!

[lineygoblue]

Change that 72 to a 66, and I guess its so-long to me, huh?

[Jeff Buchanan]

Here's another interesting item from today's UofM Consumer Confidence report. No surprise it's way down but, it appears to have stabilized (nonetheless at a low level). Going forward the survey signals it will improve by mid-summer..... unless there is a second wave.

Now, I'm a betting man in this game. If you want to improve then leverage consumer confidence (and this clearly means people will go out for dinner, shop brick and mortal retail, join fitness clubs - all of that) you start opening up and show the dip-shits predicting catastrophe if we do that they are are FOS.

Boom times.

https://www.marketwatch.com/story/consumer-sentiment-stabilizes-at-end-of-april-unrealistic-hopes-of-quick-recovery-2020-04-24?mod=us-markets