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Posted

Yeah, I agree with Viking. They should really get an army of contact tracers and testing facilities installed as quickly as possible. Any outbreak will just totally undermine the economy if we start up and get large scale outbreaks again. Outbreaks will happen, so it is important get people confident that can be squashed quickly. Sounds like each state will have to figure out on their own how to do it, unless Trump provides a credible framework.

 

Just uttering 10x in each WH briefing “ we have to open the economy “ is not going to do so. I actually agree we need to open it come May, but it is critical that it is done right.

 

The crazy thing is we have all these unemployed people. We want to pay them for doing nothing.

 

We also have this virus thing where we need a bunch of people to staff up a bunch of different things (like contact tracing)...

 

Too obvious a fit? I am buying into the suggestion that Trump simply does not want to get involved. Too much personal risk. Better to let States and Municipalities struggle their way through it. Then he can come in after the fact and ‘throw some paper towel rolls to the needy’. Much better to sit in the weeds, let others fight the good fight and then come in as the dust settles with money, lots of ‘i told you so’ and look like the saviour.

 

We lack the institutional capability to do it through existing institutions.  The CDC isn't staffed to do nationwide contact tracing and neither are county departments of health. 

 

One would hope the CDC would have already created a set of best practices on testing, contact tracing and isolation of the infected, including, where feasible, isolating infected individuals away from their co-habitants (there are plenty of empty hotel rooms to use!).  The responsibility for implementing would then flow down to state, then to county, then to townships/cities, then to individual precincts/wards/neighborhoods/blocks.  Based on the desire to help that I've seen among my neighbors, I believe there would be a surplus of volunteers willing to, for example, deliver food to the houses of those required to stay at home because of actual or suspected infection.

 

If the President/Governors were to announce that this level of organization needed to happen, and all of our modern communication tools, including Facebook, were harnessed, I believe many areas would be organized down to the block level within a week.  But, to my knowledge, none of this has been asked of us, and nothing of the sort is being organized anywhere in the United States.  I don't understand why we haven't been preparing for that, even if we hope never to have to use it.

 

The other big benefit of federal leadership would be funding support from the President and Senate Republicans. The money for needed expensive new initiatives needs to come from congress.

Posted

Thread on England vs ireland:

It's essential to question the decisions taken during this outbreak but some of the variables are a result of historical path-dependency or previous decisions that have built on over time. With the next item on the headlines, it's possible that the driven off character will come back galloping.

 

When comparing UK and Ireland, much is in common including genetics but there were critical different variables:

-median age, higher in UK

-% of older individuals, much higher in UK

-degree of urbanization, higher in UK

 

In my (our) country, there are significant regional differences and tough questions need to be asked but, in my province, the % of older people living in chronic-care institutions is very different (much higher) from the rest of the country. This trend is a result of decisions taken over many years. Crises should not be wasted as they often are, to various degrees.

Posted

I didn't realize that ventilators only save 20%.

Most Covid-19 patients will die after being placed on ventilators, with the mortality rate reaching up to 80% in intubated coronavirus patients, Smith said.

https://www.cnn.com/2020/04/11/health/nurse-last-words-coronavirus-patient-trnd/index.html

Mortality is indeed very high in the very sick. The typical person comes with respiratory distress, with the COVID-19 component being responsible for 1-99% of the presentation , with the % causation graph very highly skewed to the left.

It's interesting, at least for some places, that a significant % of people coming with breathing difficulty already have DNR status or acquire it during their stay. Dying with a tube in your throat is no fun. This COVID-19 episode may provide an oppotunity to think about end of life care (individual or society level).

If interested, this is a relevant recent example:

https://www.nejm.org/doi/full/10.1056/NEJMoa2004500?query=featured_home

Posted

Thread on England vs ireland:

It's essential to question the decisions taken during this outbreak but some of the variables are a result of historical path-dependency or previous decisions that have built on over time. With the next item on the headlines, it's possible that the driven off character will come back galloping.

 

When comparing UK and Ireland, much is in common including genetics but there were critical different variables:

-median age, higher in UK

-% of older individuals, much higher in UK

-degree of urbanization, higher in UK

 

In my (our) country, there are significant regional differences and tough questions need to be asked but, in my province, the % of older people living in chronic-care institutions is very different (much higher) from the rest of the country. This trend is a result of decisions taken over many years. Crises should not be wasted as they often are, to various degrees.

 

The more striking comparison is Portugal vs Spain where Portugal looks way better right now, despite a similar socioeconomic profile and Spain having a better health care system.

Posted

The more striking comparison is Portugal vs Spain where Portugal looks way better right now, despite a similar socioeconomic profile and Spain having a better health care system.

Always beware of self-congratulatory praise but policy action in the right direction can make a significant difference:

https://www.theportugalnews.com/news/portugal-quicker-to-take-action-than-italy-spain-and-uk/53552

 

However, urban population rate is somewhat higher in Spain and it appears (looking at evolving data, SARS and others) that the density of international traffic (travel and trade) matters. The % of direct trade with China is higher in Spain.

Posted

https://www.statnews.com/2020/03/23/antibiotic-resistance-hidden-threat-lurking-behind-covid-19/

 

Antibiotic resistance: the hidden threat lurking behind Covid-19

 

Already, some studies have found that 1 in 7 patients hospitalized with Covid-19 has acquired a dangerous secondary bacterial infection, and 50% of patients who have died had such infections.

 

The 2009 H1N1 influenza pandemic, for example, claimed nearly 300,000 lives around the world. Many of those deaths — between 29% and 55% — were actually caused by secondary bacterial pneumonia, according to the Centers for Disease Control and Prevention.

 

Treatments and outcomes:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30566-3/fulltext#tbl2

 

181 (95%) patients received antibiotics and 41 (21%) received antivirals (lopinavir/ritonavir; table 2).

 

 

Posted

The more striking comparison is Portugal vs Spain where Portugal looks way better right now, despite a similar socioeconomic profile and Spain having a better health care system.

Always beware of self-congratulatory praise but policy action in the right direction can make a significant difference:

https://www.theportugalnews.com/news/portugal-quicker-to-take-action-than-italy-spain-and-uk/53552

 

However, urban population rate is somewhat higher in Spain and it appears (looking at evolving data, SARS and others) that the density of international traffic (travel and trade) matters. The % of direct trade with China is higher in Spain.

 

What many people in this forum and in other places forget is that for a complex system (social, economic and biology) there will always be many contributing factors that are in many cases closely intertwined. The above example and COVID-19 related deaths due to other pre-existing conditions are good examples. That should not make us interpret that some of these measures being prescribed by experts (such as imposing shelter-in-place early) are not effective. In-fact, by imposing shelter-in-place early on in the pandemic affects other variables described above in a positive way. It becomes less likely that international travelers will go to a region where there is such shelter imposed, trade to that regions will go down as well, etc.

 

So the argument of what is the *real* cause and effect is not always helpful, there will be many. The goal should be to come up with as short a list of policy prescriptions as possible that will address most of these factors.

Posted

The more striking comparison is Portugal vs Spain where Portugal looks way better right now, despite a similar socioeconomic profile and Spain having a better health care system.

Always beware of self-congratulatory praise but policy action in the right direction can make a significant difference:

https://www.theportugalnews.com/news/portugal-quicker-to-take-action-than-italy-spain-and-uk/53552

 

However, urban population rate is somewhat higher in Spain and it appears (looking at evolving data, SARS and others) that the density of international traffic (travel and trade) matters. The % of direct trade with China is higher in Spain.

 

What many people in this forum and in other places forget is that for a complex system (social, economic and biology) there will always be many contributing factors that are in many cases closely intertwined. The above example and COVID-19 related deaths due to other pre-existing conditions are good examples. That should not make us interpret that some of these measures being prescribed by experts (such as imposing shelter-in-place early) are not effective. In-fact, by imposing shelter-in-place early on in the pandemic affects other variables described above in a positive way. It becomes less likely that international travelers will go to a region where there is such shelter imposed, trade to that regions will go down as well, etc.

 

So the argument of what is the *real* cause and effect is not always helpful, there will be many. The goal should be to come up with as short a list of policy prescriptions as possible that will address most of these factors.

 

I agree.  I do think that Portugal and Spain are quite similar, as is Italy and Spain in terms of socioeconomic factors somit is reasonable to look at those comps.It makes more sense than to compare the USA to Europe for example of even more so Montana with Florida.

 

I do think that there are a lot of interesting experiments  going on soon where different counties try different things. For example it will be interesting if Sweden can keep their economy partially open or hat happens when Denmark opens their kindergarten after eastern. However, just because Sweden managed to avoid a shutdowns doesn’t mean that a shutdown in Italy or XYZ was a bad idea just point out one example.

 

Also, just comparing a Shelter I place here in MA doesn’t really compare with a similar thing in Europe. Even if it’s called the same, the details can be quite different. For example, Austria has been way more stringent then Germany and certainly the US (at least compared to where I live). So that will explain some differences in outcome as well.

Guest cherzeca
Posted

a very level-headed take: 

Posted

After a good deal more reflection and analysis I think it is only fair for the government to pick up the tab(as it is doing) for the small businesses and people displaced by this. The reason being, is that everything was humming along just fine until THEY forced, as in deliberately compelled people to stay home and businesses to shutter. The socialists will call foul(or promote the now popular theme "capitalists want bailouts", but giving out freebies to those who are incapable, lazy, or incompetent, during times where the free market is prevailing, is vastly different than telling businesses "you have to close your doors". Its very similar to the logic behind the FNMA thesis. The government can not take control without compensation. In a lot of ways, I think Trump allowing this is a major failure of his. Let people live their lives and take their own risks. Open the economy up, and let people make their own choices.

 

Oil, is a different story. But small business or restaurant thats been open for 40 years shuttering because the government imposes lockdowns of questionable constitutional legitimacy? The government should be on the hook for the cost of that business and the wages of it's employees, or at least, bridging the gap until those associated are whole again.

Posted

a very level-headed take: 

Boris Johnson was a big fan of heard immunity for the UK and wanted to get it done as fast as possible. You want to ask him about his thoughts on the subject again?

Posted

a very level-headed take: 

Boris Johnson was a big fan of heard immunity for the UK and wanted to get it done as fast as possible. You want to ask him about his thoughts on the subject again?

 

He got sick.. wasn't that the point?

Posted

After a good deal more reflection and analysis I think it is only fair for the government to pick up the tab(as it is doing) for the small businesses and people displaced by this. The reason being, is that everything was humming along just fine until THEY forced, as in deliberately compelled people to stay home and businesses to shutter. The socialists will call foul(or promote the now popular theme "capitalists want bailouts", but giving out freebies to those who are incapable, lazy, or incompetent, during times where the free market is prevailing, is vastly different than telling businesses "you have to close your doors". Its very similar to the logic behind the FNMA thesis. The government can not take control without compensation. In a lot of ways, I think Trump allowing this is a major failure of his. Let people live their lives and take their own risks. Open the economy up, and let people make their own choices.

 

Oil, is a different story. But small business or restaurant thats been open for 40 years shuttering because the government imposes lockdowns of questionable constitutional legitimacy? The government should be on the hook for the cost of that business and the wages of it's employees, or at least, bridging the gap until those associated are whole again.

 

How long will the government be able to keep consumers, small businesses and corporations on life support? At the same time they are ramping up health case spending? 8 weeks? 12 weeks? At what point does the cost become prohibitive?

 

Absent a treatment (which would provide a short term solution) what it suggests is leadership will determine which countries are relative winners and losers. (The virus is the same everywhere.)

Guest Schwab711
Posted

a very level-headed take: 

 

There's no herd immunity for lots of viruses. It's annoying when people make statements unequivocally that are not 100% correct right now. That's where all our issues have stemmed from. Often, herd immunity does stop spread of disease. Herd immunity is sometimes only gained from vaccines because immunity gained from fighting off the disease doesn't last long enough for enough people to be simultaneously immune to disperse spread.

 

There's no proof that fighting off COVID-19 provides immunity to an individual for a sufficient period of time such that 'herd immunity' can be gained. It's likely that herd immunity will only be gained when a vaccine provides it. Maybe this is wrong, but from what I've read, this is where the facts are pointing. We are going to live with COVID-19 until a vaccine is distribute globally.

 

My frustration is the black and white between total indefinite lockdown and natural herd immunity. You are setting up the populace to become disenchanted with what will happen.  We have to be smart about reducing damage because COVID-19 is here to stay. That does not mean shut all commerce down forever. It does mean that the federal government actually has to provide a unified plan at some point.

 

To anon's point of building out sufficient capacity (particularly equipment, testing, and protocols to follow for regional outbreaks), I totally agree. Why hasn't the White House discussed these protocols? Why have we left all of these tasks to individual states? This is going to cause 50 different plans/protocols and expose the US to future outbreaks. I don't actually care if Trump is at blame right now or fighting over his % of blame. I just want intelligent policies to be put in to place so we can prepare to reopen. I want language pared down so that people don't think the disease is done (and only a cumulative 60k will die) when we soft reopen in the summer. Further lying is going to lead to more distrust and make things worse.

Posted

How long really shouldn't matter(although now it does). America is about freedoms and businesses and the people risking their lives(even before covid19) to show up to work every day should be free to make that choice. The government stole that from businesses and their employees. All the liberals consistently do is whine and make up fake bs about Trump the dictator, Trump the swamp creature, but overseeing and allowing state governors to basically commander peoples rights is literally the worst display of Communist and dictator like tactics this country has ever seen.

 

I used to frequent a small Bergen County deli in Paramus. This place was the last to shut down in Bergen County. They stayed open and fought and at one point the owner said they were doing 300% more business because they were one of the few ones open during the crazy stretch. The governor literally forced them to send their employees home and shut the doors. That is astoundingly anti American and 100% where the fault lies at Trumps feet. Give people the choice to chose the fate of their business, their employees, etc. Right thing to do is close? OK, make your choice and live with it. Want to stay open? Have the employee support to do so? Ok, go get em. And live with it.

Guest Schwab711
Posted

Totally agree with folks on helping SMB out. If the worst externality of all of this is inflation, great. The Fed wanted inflation anyway.

 

My only issue is that 10's millions of individuals that were absolutely screwed (furloughed, so no UE benefits in many states, likely no job to return to whenever they are finally laid off, and no money now so they fall further and further behind on rent/mortgages/bills). All we did for them is send one check for $1,200/person. In major cities (say restaurant workers in NYC), that isn't enough to pay rent, much less food and other bills. We are paying all expenses for small businesses for 2-3 months. We should be doing the same for individuals!

 

This pandemic is currently just going to increase the income and wealth inequalities and lead to UBI at some point. I think whatever policy is agreed to for small businesses should extend to individuals. To avoid double paying people (continue to receive wages due to SBA plan), send 2 checks to everyone not on payrolls (according to ADP/PAYX) and 1 check to everyone in the country. Similar plans could work. I don't know how to make it work but there are ways to avoid having anyone "win" from the USG stimulating the country to keep it healthy.

 

 

I think the explanation that the state forced you to close, so you deserve money, is legally terrible. The state forces all sorts of businesses to close for all sorts of reasons. I can think of all sorts of reasons to not reimburse businesses/people in the future, despite telling them to temporarily close. Running certain types of businesses is a privilege sanctioned by your locality and behold to the rules of such.

Posted

“I used to frequent a small Bergen County deli in Paramus. This place was the last to shut down in Bergen County. They stayed open and fought and at one point the owner said they were doing 300% more business because they were one of the few ones open during the crazy stretch. The governor literally forced them to send their employees home and shut the doors. That is astoundingly anti American...”

 

Wow, I don’t know where to start ... but that is some definition of the American people.

 

Because they were willing to stay open and thereby contribute to the spread of a deadly virus their sales were up 300% due to the fact that more responsible outlets closed to protect their staff and patrons. This deli was simply profiteering at the expense of their competitors - and customers.

 

By the way, I just have to ask, have you taken any steps to avoid catching or spreading the virus? Did you risk going to the deli when it remained open?

Posted

“I used to frequent a small Bergen County deli in Paramus. This place was the last to shut down in Bergen County. They stayed open and fought and at one point the owner said they were doing 300% more business because they were one of the few ones open during the crazy stretch. The governor literally forced them to send their employees home and shut the doors. That is astoundingly anti American...”

 

Wow, I don’t know where to start ... but that is some definition of the American people.

 

Because they were willing to stay open and thereby contribute to the spread of a deadly virus their sales were up 300% due to the fact that more responsible outlets closed to protect their staff and patrons. This deli was simply profiteering at the expense of their competitors - and customers.

 

By the way, I just have to ask, have you taken any steps to avoid catching or spreading the virus? Did you risk going to the deli when it remained open?

 

Profiteering? You mean running their business the same as they had the past 30+ years? Letting their employees earn a wage(and a good one at that as grateful patrons were tipping insane because they appreciated have this business open)? They arent contributing to the spread of anything. They're following rules and regs with regard to safety. They are meeting a demand(without raising prices). This is profiteering? You think the best measure to stay safe is to stay home? The YOU stay home. You have the right to make that choice. Dictating to others and ruining millions of lives in the process is disgustingly anti-American in every way imaginable. The amount of lives and businesses ruined because of this will greatly exceed that of the virus, which wouldn't you know, seem on pace to resemble a bad year of the flu!

 

Its ironic, but the reason Trump supporters loved Trump was his ability to say F you liberal media. F you critics. And I guarantee the reason he is standing for this nonsense is because he doesnt have the spine to call out state governors and deal with the media heat he'd get. Because if he did, he'd have to take responsibility for the outcome. Which, as Ive said all along, doesnt really have anything to do with him since he isn't really responsible for the decisions being made.

 

Personally, the steps I take, are the same I took in January and February. Maintain a little distance, wash my hands, use common sense. Works fine. Hiding in a box seems to work for others. Many different ways to skin a cat.

Posted

There's this weird notion that the only thing "American" is this sense of unbridled freedom. But if you look through history you see some of the most successful and defining periods of "America" being ones where the federal government did, in fact, do lots of dictating: the civil war, the buildup and execution in WW2, and cold war are the three that immediately come to mind.

 

I think a term like "democratic adaptability" is a more generalist description of American behavior, if I had to choose one. And this idea that rugged individualism as a defining American characteristic is pretty off-the-mark.

 

To bring it back, this deli owner pretty much said, "Screw all the sacrifice that the rest of society is making". Not illegal (or maybe it was - not sure what the laws in Jersey are) - but dickish behavior.

Posted

There's this weird notion that the only thing "American" is this sense of unbridled freedom. But if you look through history you see some of the most successful and defining periods of "America" being ones where the federal government did, in fact, do lots of dictating: the civil war, the buildup and execution in WW2, and cold war are the three that immediately come to mind.

 

I think a term like "democratic adaptability" is a more generalist description of American behavior, if I had to choose one. And this idea that rugged individualism as a defining American characteristic is pretty off-the-mark.

 

To bring it back, this deli owner pretty much said, "Screw all the sacrifice that the rest of society is making". Not illegal (or maybe it was - not sure what the laws in Jersey are) - but dickish behavior.

 

If it’s a public safety issue, the the state can absolutely shut this business down. This deli owner affects the live of other people even those that don’t frequent his deli.

He is unlikely to compensate for any damages or halte issue he may cause.

Posted

So when safety comes to discretionary calls of elected officials, we hoot and whine about violations of freedom, ie the Patriot Act, because, you know, safety be damned they dont got no business reading my text messages, but we're willing to crush businesses and livelihoods in the blink of an eye over a virus thats effect on 95% of the population is negligible? Interesting.

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