Gregmal Posted May 9, 2020 Posted May 9, 2020 Huckabee recently stated that any elected official supporting a shutdown, should not be allowed to take a paycheck until their constituents are allowed to get back to work. So simple, but yet so true. Why are these guys getting paid? Total scum.
Cigarbutt Posted May 9, 2020 Posted May 9, 2020 Random thoughts: -For the Kawasaki disease question, viral diseases can result in unusual outcomes including triggering an autoimmune response in susceptible individuals and i agree with Spekulatius that these reports in children are now published in correlation to the prevalence of the CV virus more than a specific problem related to that specific coronavirus. -For the semen quality question, the information is fragmentary and it's still early. However, sexual transmission seems unlikely. There's more work though showing that, in general, virus presence in semen is associated with a significant impact on fertility. -For the spread extrapolation and controversial herd immunity questions, a lot of data and analysis suggest a more optimistic take. The R0 number is a theoretical construct and it assumes a homogeneous transmission pattern in a homogeneous population. More evidence is building up showing that the R0 number is significantly affected by many critical variables and it may be better to use a dynamic Rt {effective R} number. The theoretical construct needs to take into account the facts that some individuals spread the virus much more and outbreaks tend to happen in clusters. Population density and crowded conditions are key variables. So, as areas open up, the virus will tend to spread to areas where there will be a lower amount of susceptible individuals (spreaders and sick) and less dense or crowded populations. The 'price' to pay for less severe resurgence activity may be a much longer or even seasonal or chronic course but the dynamic level of herd immunity required may be much lower than presently conveyed. The following reference is interesting for that aspect: https://www.medrxiv.org/content/10.1101/2020.04.27.20081893v1.full.pdf -An interesting aspect is the regional variation for the application of lock-down or easing protocols which will help to define the best path but will also create tensions as regions may suffer from consequences of decisions made in other regions. It seems that leadership is needed on top to create a sense of togetherness despite the differences. For instance, trust could help to share best practices and there are self evidences that need to be maintained, for instance the indication for appropriate vaccination (existing and future). It's been reported (see below) that regular vaccinations have been postponed or eliminated. Also, if a vaccine becomes available, reaching a sufficient amount of people is key for effectiveness. https://www.statnews.com/2020/05/08/childhood-vaccinations-decline-coronavirus-pandemic/ https://theconversation.com/a-majority-of-vaccine-skeptics-plan-to-refuse-a-covid-19-vaccine-a-study-suggests-and-that-could-be-a-big-problem-137559 Skeptics are essential but so is reaching a critical mass. From a biological perspective, FWIW i continue to be relatively optimistic about the virus but unusually cautious about the host.
Liberty Posted May 9, 2020 Posted May 9, 2020 Taiwan is now just one day away from completing two 14-day incubation periods with zero locally transmitted cases. Hong Kong is at 20 consecutive days with no new local cases https://www.scmp.com/news/hong-kong/health-environment/article/3083627/coronavirus-hong-kong-records-no-new-cases-covid While these are success stories now, I'm afraid once they open up the borders/businesses again... Boom. Boom? They'll keep screening people at the border and international travel will be pretty low until there's a vaccine or at least better therapies. Any time they gain now by crushing the curve and containing it is fewer deaths before a vaccine.
Liberty Posted May 9, 2020 Posted May 9, 2020 https://www.washingtonpost.com/investigations/in-the-early-days-of-the-pandemic-the-us-government-turned-down-an-offer-to-manufacture-millions-of-n95-masks-in-america/2020/05/09/f76a821e-908a-11ea-a9c0-73b93422d691_story.html In the early days of the pandemic, the U.S. government turned down an offer to manufacture millions of N95 masks in America It was Jan. 22, a day after the first case of covid-19 was detected in the United States, and orders were pouring into Michael Bowen’s company outside Fort Worth, some from as far away as Hong Kong. Bowen’s medical supply company, Prestige Ameritech, could ramp up production to make an additional 1.7 million N95 masks a week. He viewed the shrinking domestic production of medical masks as a national security issue, though, and he wanted to give the federal government first dibs. “We still have four like-new N95 manufacturing lines,” Bowen wrote that day in an email to top administrators in the Department of Health and Human Services. “Reactivating these machines would be very difficult and very expensive but could be achieved in a dire situation.” But communications over several days with senior agency officials — including Robert Kadlec, the assistant secretary for preparedness and emergency response — left Bowen with the clear impression that there was little immediate interest in his offer. “I don’t believe we as an government are anywhere near answering those questions for you yet,” Laura Wolf, director of the agency’s Division of Critical Infrastructure Protection, responded that same day. Bowen persisted. “We are the last major domestic mask company,” he wrote on Jan. 23. “My phones are ringing now, so I don’t ‘need’ government business. I’m just letting you know that I can help you preserve our infrastructure if things ever get really bad. I’m a patriot first, businessman second.” In the end, the government did not take Bowen up on his offer. Even today, production lines that could be making more than 7 million masks a month sit dormant.
clutch Posted May 9, 2020 Posted May 9, 2020 Taiwan is now just one day away from completing two 14-day incubation periods with zero locally transmitted cases. Hong Kong is at 20 consecutive days with no new local cases https://www.scmp.com/news/hong-kong/health-environment/article/3083627/coronavirus-hong-kong-records-no-new-cases-covid While these are success stories now, I'm afraid once they open up the borders/businesses again... Boom. Boom? They'll keep screening people at the border and international travel will be pretty low until there's a vaccine or at least better therapies. Any time they gain now by crushing the curve and containing it is fewer deaths before a vaccine. Well, let's see what happens. I'm just very curious to see how these countries start to easy the lockdown measures, and how they will handle potential 2nd or 3rd waves... Just look at Singapore, and now S. Korea where a single club goer has caused another possible outbreak... which led the government to shut down bars/clubs again. Seems like they will have to go back and forth with measures, for the next 12+ months... At some point, I'm afraid that the whole society will lose its patience/integrity.
Jurgis Posted May 9, 2020 Posted May 9, 2020 I am confused with this: “We are the last major domestic mask company,” he wrote on Jan. 23. “My phones are ringing now, so I don’t ‘need’ government business. I’m just letting you know that I can help you preserve our infrastructure if things ever get really bad. I’m a patriot first, businessman second.” In the end, the government did not take Bowen up on his offer. Even today, production lines that could be making more than 7 million masks a month sit dormant. So is his phones ringing? If so, why the production lines are dormant? I (and millions of others I think) would like to buy N95 masks regardless of government purchases. I'd think states and private businesses would like to buy them too - so it's not even b2consumer issue. So why are the lines dormant?
Liberty Posted May 9, 2020 Posted May 9, 2020 Well, let's see what happens. I'm just very curious to see how these countries start to easy the lockdown measures, and how they will handle potential 2nd or 3rd waves... Just look at Singapore, and now S. Korea where a single club goer has caused another possible outbreak... which led the government to shut down bars/clubs again. Seems like they will have to go back and forth with measures, for the next 12+ months... At some point, I'm afraid that the whole society will lose its patience/integrity. That's why you need a crapload of testing, good contact tracing, people wearing masks, discourage large events, etc.. This is how you avoid huge outbreaks that lead to large shutdowns. Easier to keep it to a simmer and crush little embers when they show up if you have measures to keep R0 as low as possible (under 1 ideally) and good testing to immediately catch things when they begin. If you don't have that, outbreaks go undetected long enough that you can't contain them and you have to do larger shutdowns again and again. Doing it right is easier than doing it wrong, which is the huge problem with the incompetence at the federal level in the US. A lot of all this could've been avoided with a competent early response (and I don't even mean super early like in January, but even later it would've made a big different because of the inherent properties of exponential growth).
Liberty Posted May 9, 2020 Posted May 9, 2020 I am confused with this: “We are the last major domestic mask company,” he wrote on Jan. 23. “My phones are ringing now, so I don’t ‘need’ government business. I’m just letting you know that I can help you preserve our infrastructure if things ever get really bad. I’m a patriot first, businessman second.” In the end, the government did not take Bowen up on his offer. Even today, production lines that could be making more than 7 million masks a month sit dormant. So is his phones ringing? If so, why the production lines are dormant? I (and millions of others I think) would like to buy N95 masks regardless of government purchases. I'd think states and private businesses would like to buy them too - so it's not even b2consumer issue. So why are the lines dormant? I'm confused too. That part is strangely written, I get the feeling that the backstory on this was cut out of the story and the line is now lacking context.
Jurgis Posted May 9, 2020 Posted May 9, 2020 I am confused with this: “We are the last major domestic mask company,” he wrote on Jan. 23. “My phones are ringing now, so I don’t ‘need’ government business. I’m just letting you know that I can help you preserve our infrastructure if things ever get really bad. I’m a patriot first, businessman second.” In the end, the government did not take Bowen up on his offer. Even today, production lines that could be making more than 7 million masks a month sit dormant. So is his phones ringing? If so, why the production lines are dormant? I (and millions of others I think) would like to buy N95 masks regardless of government purchases. I'd think states and private businesses would like to buy them too - so it's not even b2consumer issue. So why are the lines dormant? I'm confused too. That part is strangely written, I get the feeling that the backstory on this was cut out of the story and the line is now lacking context. Maybe he needs financing to start the lines. But even that is weird. If he went to Amazon or Walmart or ??? and offered 7m masks per month with prepayment terms, I'd think he would get easy deals, no? Edit: maybe it's the question of price? Maybe his prices are uneconomical and would be considered price gouging if compared to other sources?
Spekulatius Posted May 9, 2020 Posted May 9, 2020 Taiwan is now just one day away from completing two 14-day incubation periods with zero locally transmitted cases. Hong Kong is at 20 consecutive days with no new local cases https://www.scmp.com/news/hong-kong/health-environment/article/3083627/coronavirus-hong-kong-records-no-new-cases-covid While these are success stories now, I'm afraid once they open up the borders/businesses again... Boom. Boom? They'll keep screening people at the border and international travel will be pretty low until there's a vaccine or at least better therapies. Any time they gain now by crushing the curve and containing it is fewer deaths before a vaccine. Well, let's see what happens. I'm just very curious to see how these countries start to easy the lockdown measures, and how they will handle potential 2nd or 3rd waves... Just look at Singapore, and now S. Korea where a single club goer has caused another possible outbreak... which led the government to shut down bars/clubs again. Seems like they will have to go back and forth with measures, for the next 12+ months... At some point, I'm afraid that the whole society will lose its patience/integrity. The whole society will lose their integrity because they can’t go to bars? C’mon. Also, we keep talking about lockdowns, but the US and Europe never had any “lockdowns”. We had “shelters in place” that are quite leaky, in some countries/ states more so than others. In my state, many stores were open (hardware, groceries, liquor and of course drugstores), parks open, takeout food available and many business declared essential etc so people still went to work as usual. That’s not what I call a “lockdowns. lockdown is what the Chinese did when they prevented people from leaving their apartment for any reason. We never had a lockdown in the US or Europe.
clutch Posted May 9, 2020 Posted May 9, 2020 Well, let's see what happens. I'm just very curious to see how these countries start to easy the lockdown measures, and how they will handle potential 2nd or 3rd waves... Just look at Singapore, and now S. Korea where a single club goer has caused another possible outbreak... which led the government to shut down bars/clubs again. Seems like they will have to go back and forth with measures, for the next 12+ months... At some point, I'm afraid that the whole society will lose its patience/integrity. That's why you need a crapload of testing, good contact tracing, people wearing masks, discourage large events, etc.. This is how you avoid huge outbreaks that lead to large shutdowns. Easier to keep it to a simmer and crush little embers when they show up if you have measures to keep R0 as low as possible (under 1 ideally) and good testing to immediately catch things when they begin. If you don't have that, outbreaks go undetected long enough that you can't contain them and you have to do larger shutdowns again and again. Doing it right is easier than doing it wrong, which is the huge problem with the incompetence at the federal level in the US. A lot of all this could've been avoided with a competent early response (and I don't even mean super early like in January, but even later it would've made a big different because of the inherent properties of exponential growth). Yeah, too late for the US. So not sure how these success stories would help them at this point. Also, I'm not even sure how the measures such as "a crapload of testing, good contact tracing, people wearing masks, discourage large events, etc." would be able to be sustained for a year... If you look up images of schools that have opened up so far in other countries... I see the perfect resemblance of a dystopia and make me depressed.
clutch Posted May 9, 2020 Posted May 9, 2020 Taiwan is now just one day away from completing two 14-day incubation periods with zero locally transmitted cases. Hong Kong is at 20 consecutive days with no new local cases https://www.scmp.com/news/hong-kong/health-environment/article/3083627/coronavirus-hong-kong-records-no-new-cases-covid While these are success stories now, I'm afraid once they open up the borders/businesses again... Boom. Boom? They'll keep screening people at the border and international travel will be pretty low until there's a vaccine or at least better therapies. Any time they gain now by crushing the curve and containing it is fewer deaths before a vaccine. Well, let's see what happens. I'm just very curious to see how these countries start to easy the lockdown measures, and how they will handle potential 2nd or 3rd waves... Just look at Singapore, and now S. Korea where a single club goer has caused another possible outbreak... which led the government to shut down bars/clubs again. Seems like they will have to go back and forth with measures, for the next 12+ months... At some point, I'm afraid that the whole society will lose its patience/integrity. The whole society will lose their integrity because they can’t go to bars? C’mon. Also, we keep talking about lockdowns, but the US and Europe never had any “lockdowns”. We had “shelters in place” that are quite leaky, in some countries/ states more so than others. In my state, many stores were open (hardware, groceries, liquor and of course drugstores), parks open, takeout food available and many business declared essential etc so people still went to work as usual. That’s not what I call a “lockdowns. lockdown is what the Chinese did when they prevented people from leaving their apartment for any reason. We never had a lockdown in the US or Europe. The bars were just a recent example from S. Korea... Nice reading comprehension. I'm talking about all the measures as a whole... and i'm just using "lockdown" in the sense used by the media.
Spekulatius Posted May 9, 2020 Posted May 9, 2020 The mortality rate will be lower as the older/vulnerable population die first and as schools open and more kids get infected. (I know, that sounds horrible) But I 100% agree with you that these projections are never brought up by the government. It's not just the WH, but many other governments who have gone the lockdown route and are now stuck on what to do next. I think we will have to learn how to live with this virus... I also think mortality rate will come down because we will learn how to treat patients better over time. That’s why I personally think it is better to get infected late rather than early personally. I also know for sure they Germany and many other European states try to avoid the herd immunity route. Germany and opened schools again and some business and does test and trace to contain new outbreaks. Same with other Scandinavian states. Perhaps Italy is too far in and Spain in some areas at least to try this, I don’t really know. I do think that the US has lost the optionality to avoid the herd immunity route, because the shelter in place were were lifted early, so the case load is probably too high for test and trace to work. We will see how it works out, I don’t really know what the best route is. I hope the best for Sweden, Germany, the US and all other nations to obtain a workable solution with a manageable human cost, but some area quite clearly doing much better than others for a variety of reasons.
dwy000 Posted May 10, 2020 Posted May 10, 2020 She’s good: she's hilarious. Which is really weird given all she does is lip sync word for word.
clutch Posted May 10, 2020 Posted May 10, 2020 https://www.nytimes.com/2020/05/09/world/asia/coronavirus-south-korea-second-wave.html So only few days after they have lifted social distance measures, there is now a community outbreak created by a single spreader. The latest number of confirmed cases from this incident is 54. Compared to the numbers in the US, that might look trivial. However, people are now pushing for delaying the reopening of high schools. Well, that sounds like an overreaction... but I believe this is what a lockdown does to your society. Even if what you have done so far is considered as the gold standard by other countries. As restrictions are lifted, and as the public sees the sudden increase in cases, the fear spreads again and you have nowhere to go but to return to your restrictions. In fact, this rebound effect might be stronger for those countries who have taken more stronger measures and been successful so far. The chance of a big 2nd wave is greater while the public expectation is much higher. It's a double edged sword situation. At one hand, you can go to the Swedish route but risks many more deaths immediately. On the other hand, stronger lockdown measures can prevent such deaths now but now you are stuck in a limbo always fearing the 2nd wave and almost impossible to return back to normal. And I believe that we will only know which was better after this pandemic is over. Disclosure: has many relatives in S. Korea
Spekulatius Posted May 10, 2020 Posted May 10, 2020 Hmm, who could have known: https://www.channel3000.com/72-got-covid-19-after-being-at-large-event/
Liberty Posted May 10, 2020 Posted May 10, 2020 She’s good: she's hilarious. Which is really weird given all she does is lip sync word for word. I think it's because we've become desensitized to Trump over time and judge him to a totally different standard than a normal human. So when we hear his words said by someone different, we can judge them more on their own merit and realize how crazy and stupid he sounds. Someone should lip-synch Trump to video of other presidents (from both parties -- Bush or Reagan or Clinton or Obama -- saying some of these things).
Gamecock-YT Posted May 10, 2020 Posted May 10, 2020 Germany is now estimating a R0 above 1, granted a small sample size but it was in the .7's a week or two ago. https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsberichte/2020-05-09-en.pdf?__blob=publicationFile The number of incident cases estimated using the nowcasting approach is presented as a moving 4-day average to compensate for random effects of individual days (Fig. 5). With this approach, the point estimate of R for a given day is estimated as the quotient of the number of incident cases on this day divided by the number of incident cases four days earlier. The current estimate is R= 1.10 (95% prediction interval: 0.90- 1,34) and is based on electronically notified cases as of 09/05/2020, 12:00 AM. Today’s estimate of the reproduction number R is above 1. Any interpretation of this number needs to take into account that the estimate is linked to a degree of uncertainty that is reflected by the prediction interval published daily alongside the actual number. A low number of case reports could increase the statistical variation. Thus, it is too early to infer whether the number of new infections will continue to decrease as in passing weeks or increase again. The increase of the reproduction number R necessitates a close monitoring of the situation in the coming days.
Spekulatius Posted May 10, 2020 Posted May 10, 2020 Germany is now estimating a R0 above 1, granted a small sample size but it was in the .7's a week or two ago. https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsberichte/2020-05-09-en.pdf?__blob=publicationFile The number of incident cases estimated using the nowcasting approach is presented as a moving 4-day average to compensate for random effects of individual days (Fig. 5). With this approach, the point estimate of R for a given day is estimated as the quotient of the number of incident cases on this day divided by the number of incident cases four days earlier. The current estimate is R= 1.10 (95% prediction interval: 0.90- 1,34) and is based on electronically notified cases as of 09/05/2020, 12:00 AM. Today’s estimate of the reproduction number R is above 1. Any interpretation of this number needs to take into account that the estimate is linked to a degree of uncertainty that is reflected by the prediction interval published daily alongside the actual number. A low number of case reports could increase the statistical variation. Thus, it is too early to infer whether the number of new infections will continue to decrease as in passing weeks or increase again. The increase of the reproduction number R necessitates a close monitoring of the situation in the coming days. Ye, and increasing infection rate is expected when you open the economy back up. Germany has opened up some schools, more stores are open and some factories (automobile) have started back up again. It is interesting to note that there was also an outbreak cluster in meat processing plant as well ( Coesfeld). That triggered a setback for this county in terms of opening the economy further son e a threshold of 50 new cases/100k population was exceeded. Almost logical. :o https://www.dw.com/en/coronavirus-outbreak-closes-german-meat-packing-plant/a-53374478 As in the US the meatpacking plant outbreak occurred with guest workers (from Bulgaria) with not that great working and living conditions. The virus is very good at finding weak spots apparently.
Viking Posted May 10, 2020 Posted May 10, 2020 For those who like a historical perspective... How Pandemics End - https://www.nytimes.com/2020/05/10/health/coronavirus-plague-pandemic-history.html?action=click&module=Top%20Stories&pgtype=Homepage When will the Covid-19 pandemic end? And how? According to historians, pandemics typically have two types of endings: the medical, which occurs when the incidence and death rates plummet, and the social, when the epidemic of fear about the disease wanes. “When people ask, ‘When will this end?,’ they are asking about the social ending,” said Dr. Jeremy Greene, a historian of medicine at Johns Hopkins. In other words, an end can occur not because a disease has been vanquished but because people grow tired of panic mode and learn to live with a disease. Allan Brandt, a Harvard historian, said something similar was happening with Covid-19: “As we have seen in the debate about opening the economy, many questions about the so-called end are determined not by medical and public health data but by sociopolitical processes.” Endings “are very, very messy,” said Dora Vargha, a historian at the University of Exeter. “Looking back, we have a weak narrative. For whom does the epidemic end, and who gets to say?”
Liberty Posted May 10, 2020 Posted May 10, 2020 We're still learning so much about this. Another reason to try not to get sick in the early phase of this.. On blood oxygen levels and ventilators: https://www.wsj.com/articles/some-doctors-pull-back-on-using-ventilators-to-treat-covid-19-11589103001 Doctors have dubbed these patients “happy hypoxemics,” a reference to the paradox of abnormally low levels of oxygen found in their blood combined with an ability to breathe relatively easily. In recent weeks, doctors at Stony Brook Hospital have used ventilators less on these patients, turning instead to the CPAP or BiPAP machines or high-flow nasal cannulas.
samwise Posted May 11, 2020 Posted May 11, 2020 For those who like a historical perspective... How Pandemics End - https://www.nytimes.com/2020/05/10/health/coronavirus-plague-pandemic-history.html?action=click&module=Top%20Stories&pgtype=Homepage When will the Covid-19 pandemic end? And how? According to historians, pandemics typically have two types of endings: the medical, which occurs when the incidence and death rates plummet, and the social, when the epidemic of fear about the disease wanes. “When people ask, ‘When will this end?,’ they are asking about the social ending,” said Dr. Jeremy Greene, a historian of medicine at Johns Hopkins. In other words, an end can occur not because a disease has been vanquished but because people grow tired of panic mode and learn to live with a disease. Allan Brandt, a Harvard historian, said something similar was happening with Covid-19: “As we have seen in the debate about opening the economy, many questions about the so-called end are determined not by medical and public health data but by sociopolitical processes.” Endings “are very, very messy,” said Dora Vargha, a historian at the University of Exeter. “Looking back, we have a weak narrative. For whom does the epidemic end, and who gets to say?” We are already seeing people tired of the restrictions. I think human society will accept a reduced human life expectancy. If life expectancies fall by 5-10 years (worst case, probably much less than that in reality), that only takes us back to 1950s, a period of good economic growth. And humans have lived with diseases which had no cure for hundreds of years. Society will accept that too. The plagues we hear about in history had horrible death rates. Diseases with lower death rates were just a part of normal life. If this happens within a year (or a cure or vaccine is found), then the stock market is realistically priced right now. If society decided to “stay calm and carry on” as they did in wartime Britain in 1918, the economic losses would be much smaller, sharper, and more focused on travel and entertainment. The human losses would be large. So the current pain is a choice. .... Since it’s a choice, there is a limit to how much people will tolerate. Edit: Near term, we still want to ensure everyone who needs it gets ICU treatment though. So probably have a year of some restrictions ahead of us. But i’m thinking of this becoming a part of seasonal diseases. Part of the worst case scenario with no cure and no vaccine and no lasting immunity.
Viking Posted May 11, 2020 Posted May 11, 2020 “I think human society will accept a reduced human life expectancy.“ Sam, the problem is we still do not understand the virus very well. If you let the genie out of the bottle the death toll may spike much higher than expected. And at that point you have made the wrong decision but you are screwed. My guess is the health authorities in Wuhan, in Northern Italy and in Iran all made what they thought at the time were rational decisions based on their projections of what the virus would do (based on the actions they were taking). My guess is that today ‘human society’ in those regions are not happy with the decisions made. It is not as simple as virus or economy. The two are actually highly linked. When you have this much incomplete information there is no right answer; just a bunch of options with probability distributions (that likely are not very accurate). We are flying blind. PS: i am not proposing a specific course of action. I really have no idea. It will be very interesting to see how it plays out :-)
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