orthopa Posted March 10, 2020 Posted March 10, 2020 Testing doesnt prevent the spread of the disease. Once you understand this it makes wrapping your head around the utility of testing much easier. If you dont test everyone, your effort will be futile. Which strains are you testing for? What your sensativity? Specificity? How are you going to deal with false positives? Negatives? Assuming that testing prevents the spread of the disease is ignorant. That is not the case. It will help quarantine but the fact that there are asymptomatic patients, even 1% ruins the whole notion.
Kaegi2011 Posted March 10, 2020 Posted March 10, 2020 Testing doesnt prevent the spread of the disease. Once you understand this it makes wrapping your head around the utility of testing much easier. If you dont test everyone, your effort will be futile. Which strains are you testing for? What your sensativity? Specificity? How are you going to deal with false positives? Negatives? Assuming that testing prevents the spread of the disease is ignorant. That is not the case. It will help quarantine but the fact that there are asymptomatic patients, even 1% ruins the whole notion. I'm not sure where I land on this issue as I'm definitely not a qualified expert, but perhaps I can ask you, who is someone more qualified - why are countries such as South Korea testing like crazy? I'm trying to put myself in your shoes, and please don't take offense, but I'm having a hard time reconciling what govts are doing vs. someone on the internet saying it doesn't matter.
Read the Footnotes Posted March 10, 2020 Posted March 10, 2020 WASHINGTON POST - Gov. Andrew M. Cuomo (D) on Tuesday announced schools and places of worship within a one-mile zone of the city of New Rochelle will close their doors for 14 days, and National Guard troops will help deliver food and disinfect common areas inside the zone. I wonder if the National Guard can deliver food to every town? Does anyone know if there are any neighborhood banks in New Rochelle trading at Tangible Book Value? It's not just a question of whether the National Guard has the capacity to deliver food to every town, but a question of whether we should even want them to. We have a very efficient food retailing system in North America based on grocery stores which provide a typical American with a choice of more than 40,000 stock keeping units per store, refreshed regularly and with due care for food safety through effective cold-chain management. As long as you can keep those stores open, it strikes me that you wouldn't want the military to be delivering food baskets that probably don't have the assortment of food that most people want and that probably focuses on non-perishables (due to the need for a cold chain). The reason why a grocery store might need to close would be if a large portion of its employees refused to go to work out of fear of getting infected by colleagues or customers. I am convinced that there will definitely be some of this. There are some employees who work in a grocery store as a retirement job, but if I were 65 years old and just working at Safeway for something do do, I would be looking at the Covid mortality numbers and questioning how badly I really need that $10/hour. Similarly, a husband and wife making a family income of $200k who have a 17 year-old daughter working part-time at a grocery store, might naturally question how badly the family needs the daughter to earn the $10/hour. But, by and large, I can't see labour shortages (work refusals) being so severe that the existing supply chain would need to be replaced by centrally controlled food distribution. SJ Rate the following public relations messages: Option 1) We are sending the National Guard to help deliver food and disinfect common areas. Option 2) We are deploying the National Guard to establish a perimeter in anticipation of locking down the town within the next 3-5 days. We would appreciate it if no one left in the meantime.
StubbleJumper Posted March 10, 2020 Posted March 10, 2020 WASHINGTON POST - Gov. Andrew M. Cuomo (D) on Tuesday announced schools and places of worship within a one-mile zone of the city of New Rochelle will close their doors for 14 days, and National Guard troops will help deliver food and disinfect common areas inside the zone. I wonder if the National Guard can deliver food to every town? Does anyone know if there are any neighborhood banks in New Rochelle trading at Tangible Book Value? It's not just a question of whether the National Guard has the capacity to deliver food to every town, but a question of whether we should even want them to. We have a very efficient food retailing system in North America based on grocery stores which provide a typical American with a choice of more than 40,000 stock keeping units per store, refreshed regularly and with due care for food safety through effective cold-chain management. As long as you can keep those stores open, it strikes me that you wouldn't want the military to be delivering food baskets that probably don't have the assortment of food that most people want and that probably focuses on non-perishables (due to the need for a cold chain). The reason why a grocery store might need to close would be if a large portion of its employees refused to go to work out of fear of getting infected by colleagues or customers. I am convinced that there will definitely be some of this. There are some employees who work in a grocery store as a retirement job, but if I were 65 years old and just working at Safeway for something do do, I would be looking at the Covid mortality numbers and questioning how badly I really need that $10/hour. Similarly, a husband and wife making a family income of $200k who have a 17 year-old daughter working part-time at a grocery store, might naturally question how badly the family needs the daughter to earn the $10/hour. But, by and large, I can't see labour shortages (work refusals) being so severe that the existing supply chain would need to be replaced by centrally controlled food distribution. SJ Rate the following public relations messages: Option 1) We are sending the National Guard to help deliver food and disinfect common areas. Option 2) We are deploying the National Guard to establish a perimeter in anticipation of locking down the town within the next 3-5 days. We would appreciate it if no one left in the meantime. Ha ha! You are even more paranoid than me! I hadn't even considered the possibility that they were using this explanation as a plausible excuse for deploying the NG to a staging area where they could then be later deployed for sealing off the town. Maybe I am too trusting of government... SJ
orthopa Posted March 10, 2020 Posted March 10, 2020 Testing doesnt prevent the spread of the disease. Once you understand this it makes wrapping your head around the utility of testing much easier. If you dont test everyone, your effort will be futile. Which strains are you testing for? What your sensativity? Specificity? How are you going to deal with false positives? Negatives? Assuming that testing prevents the spread of the disease is ignorant. That is not the case. It will help quarantine but the fact that there are asymptomatic patients, even 1% ruins the whole notion. I'm not sure where I land on this issue as I'm definitely not a qualified expert, but perhaps I can ask you, who is someone more qualified - why are countries such as South Korea testing like crazy? I'm trying to put myself in your shoes, and please don't take offense, but I'm having a hard time reconciling what govts are doing vs. someone on the internet saying it doesn't matter. Likely due to patient demand, and in an about face due to the fall out from SARS and MERS from years ago. The more you test the more positives/negatives you will get. What does that get you? IMHO it probably lowers your death rate. Does it prevent the spread. NO!!!!! If you have even 1% of population asymptomatic it will defeat the entire purpose of testing. Again testing is not a zero sum game. It will not catch everyone. Anyone aware of what the sensitivity, specificity etc is? What do you do with an even 1% false negative rate (which is extra ordinary in non serum test). That person has it, and walks, and spreads it. Either you test every soul, ALL OVER THE WORLD, or you are essentially delaying the envitible infection of every human in the world. Whats the qualification to get the disease? Your a human. Eventually everyone will get this, very little relatively speaking will die.
Read the Footnotes Posted March 10, 2020 Posted March 10, 2020 Testing doesnt prevent the spread of the disease. Once you understand this it makes wrapping your head around the utility of testing much easier. If you dont test everyone, your effort will be futile. Which strains are you testing for? What your sensativity? Specificity? How are you going to deal with false positives? Negatives? Assuming that testing prevents the spread of the disease is ignorant. That is not the case. It will help quarantine but the fact that there are asymptomatic patients, even 1% ruins the whole notion. I'm not sure where I land on this issue as I'm definitely not a qualified expert, but perhaps I can ask you, who is someone more qualified - why are countries such as South Korea testing like crazy? I'm trying to put myself in your shoes, and please don't take offense, but I'm having a hard time reconciling what govts are doing vs. someone on the internet saying it doesn't matter. Different random guy on the internet here, but I believe the experience in China was that even though all they had to offer was palliative care, early diagnosis improved patient outcomes. In addition, not only can you quarantine the infected, but the belief is that sicker patients tend to shed the virus at much higher rates and therefore reduce the risk of spreading the virus including to attending medical personnel.
Viking Posted March 10, 2020 Posted March 10, 2020 Here is a summary of something I posted on another thread: The science - we know very little about this virus. But we do know enough: it is highly contagious and it spreads very easily if precautions are not taken; and it is very bad for seniors or people who are deemed ‘high risk’. Real world examples - we already have lots of information of the impact of the virus on other countries, their response and the health and economic fall out. Every country where it surfaced made the decision that it had to be contained regardless of the economic cost. Read this last sentence again. The sooner the country comes to this decision the Better the health outcome and the lower the economic cost. And the effort the first 2 or 3 weeks is a key (clusters, if allowed to form, make containment much more difficult and raises the cost significantly). The virus did not hit every country in the globe at the same time; it started in Wuhan, China, and then spread to Asia and Europe and then (I think… this is my guess) to North America with a 2 or 3 week lag (perhaps due to Trump’s travel ban?). My view is we can see the future here in North America. History does not repeat but it rhymes (I think Mark Twain said this). China and Europe can provide us with lots of examples of how our future will likely turn out. It has so far. Two weeks ago we know 2 cases of ‘community spread’ were discovered in the US. Cases of community spread mean the walls have been breached and are a big red flag. What I also learned 2 weeks ago was the US had completely screwed up the testing for the virus. Testing did not happen (test kit was faulty). Then when the testing did start it was much too restrictive (so much so it was almost useless). And even today, two weeks after community spread was discovered the US is still not testing everyone who need it. Political leadership is the key factor in the response. Because this affects the speed and scope of the response. With great planning, coordination, effort and sacrifice on part of all players the spread of the virus can be slowed greatly and perhaps even stopped. Look at China’s or South Korea’s reported cases; they have fallen dramatically. Now look at the effort they put in place and just as importantly what they are doing today to keep reported cases low. Testing… who cares? Testing is at the core of the whole virus response for a country. Facts and science drive the response. Without testing, as the doctor on CNBC said a week ago the US is ‘flying blind’. Bottom line, the US has squandered the 2 or 3 week head start it was given. In addition to testing, the US has messed up in some other important areas. I have no idea where this virus is going to go in the US. Maybe a white swan comes out of the wood work to save everyone. But based on what i have seen the past 2 weeks and what i am seeing from political leadership, the relevant federal departments and the inability of the system to hold anyone accountable it does not look good. My uninformed guess is it will get worse and when it gets worse enough the US will finally mobilize to contain the virus. We will only know more in 2 or 3 weeks; until then, everything people say about everything (eventual response, magnitude, economic impact) is simply an uninformed guess. As Mark Twain said: "its not what you know that gets you in trouble, its what you know that ain't so." Two things mobilize all people the world over: health and money. As the health part of the equation rapidly deteriorates in the coming weeks politicians will finally see Jesus. Imagine a Senator or Representative telling their elderly constituents “we could do more but the cost is a little too high. Sorry 15% of you are going to have to die. But the rest of us are better off so i am sure you understand.”
Read the Footnotes Posted March 10, 2020 Posted March 10, 2020 WASHINGTON POST - Gov. Andrew M. Cuomo (D) on Tuesday announced schools and places of worship within a one-mile zone of the city of New Rochelle will close their doors for 14 days, and National Guard troops will help deliver food and disinfect common areas inside the zone. I wonder if the National Guard can deliver food to every town? Does anyone know if there are any neighborhood banks in New Rochelle trading at Tangible Book Value? It's not just a question of whether the National Guard has the capacity to deliver food to every town, but a question of whether we should even want them to. We have a very efficient food retailing system in North America based on grocery stores which provide a typical American with a choice of more than 40,000 stock keeping units per store, refreshed regularly and with due care for food safety through effective cold-chain management. As long as you can keep those stores open, it strikes me that you wouldn't want the military to be delivering food baskets that probably don't have the assortment of food that most people want and that probably focuses on non-perishables (due to the need for a cold chain). The reason why a grocery store might need to close would be if a large portion of its employees refused to go to work out of fear of getting infected by colleagues or customers. I am convinced that there will definitely be some of this. There are some employees who work in a grocery store as a retirement job, but if I were 65 years old and just working at Safeway for something do do, I would be looking at the Covid mortality numbers and questioning how badly I really need that $10/hour. Similarly, a husband and wife making a family income of $200k who have a 17 year-old daughter working part-time at a grocery store, might naturally question how badly the family needs the daughter to earn the $10/hour. But, by and large, I can't see labour shortages (work refusals) being so severe that the existing supply chain would need to be replaced by centrally controlled food distribution. SJ Rate the following public relations messages: Option 1) We are sending the National Guard to help deliver food and disinfect common areas. Option 2) We are deploying the National Guard to establish a perimeter in anticipation of locking down the town within the next 3-5 days. We would appreciate it if no one left in the meantime. Ha ha! You are even more paranoid than me! I hadn't even considered the possibility that they were using this explanation as a plausible excuse for deploying the NG to a staging area where they could then be later deployed for sealing off the town. Maybe I am too trusting of government... SJ It may be paranoid, and I did intend it as a joke, but it is also a known technique to deal with epidemics. If you telegraph a closure, it will be ineffective. Basic game theory too.
DRValue Posted March 10, 2020 Posted March 10, 2020 Every country where it surfaced made the decision that it had to be contained regardless of the economic cost. Read this last sentence again. When you compare what we've been told against the actions that are being taken, this is the most important part. The current paradigm is that all problems are simply economic and infinite growth solves them all. This means decision makers have sat in a room and determined the economic cost of a total shut down is LESS than allowing the virus to spread. You don't take that decision lightly.
krazeenyc Posted March 10, 2020 Posted March 10, 2020 Testing doesnt prevent the spread of the disease. Once you understand this it makes wrapping your head around the utility of testing much easier. If you dont test everyone, your effort will be futile. Which strains are you testing for? What your sensativity? Specificity? How are you going to deal with false positives? Negatives? Assuming that testing prevents the spread of the disease is ignorant. That is not the case. It will help quarantine but the fact that there are asymptomatic patients, even 1% ruins the whole notion. I'm not sure where I land on this issue as I'm definitely not a qualified expert, but perhaps I can ask you, who is someone more qualified - why are countries such as South Korea testing like crazy? I'm trying to put myself in your shoes, and please don't take offense, but I'm having a hard time reconciling what govts are doing vs. someone on the internet saying it doesn't matter. Likely due to patient demand, and in an about face due to the fall out from SARS and MERS from years ago. The more you test the more positives you will get. What does that get you? IMHO it probably lowers your death rate. Does it prevent the spread. NO!!!!! If you have even 1% of population asymptomatic it will defeat the entire purpose of testing. Again testing is not a zero sum game. It will not catch everyone. Anyone aware of what the sensitivity, specificity etc is? What do you do with an even 1% false negative rate (which is extra ordinary in non serum test). That person has it, and walks, and spreads it. Either you test every soul, ALL OVER THE WORLD, or you are essentially delaying the envitible infection of every human in the world. Whats the qualification to get the disease? Your a human. Eventually everyone will get this, very little relatively speaking will die. Like Viking said, testing gives you more information and a better picture of the facts -- to make appropriate decisions. -- not 3 confirmed cases out of 9 tests bullshit that we've gotten so far. That gives people a sense that it's not here. Delaying is the key and why Italy is locked down, why school is out in Japan, Taiwan, South Korea, and Hong Kong among other places. Why is delaying so important -- it gives hospitals MORE time to prepare, it gives schools the ability to launch virtual classes, the federal and state governments MORE time to prepare it gives researchers MORE time to possibly come up with a vaccine or medicine. Yes nobody can stop the disease but delaying and slowing the spread is crucial. If we continue to go out about our daily lives like they did in italy, what makes you think we won't be experiencing the same exact problems they're facing now. Having returned from Japan a couple weeks ago there was literally 0 screening at JFK. It seems to me that our government has completely dropped the ball on this one.
sleepydragon Posted March 10, 2020 Posted March 10, 2020 Someone in our town was just diagnosed with the virus. This person is now in induced coma (he is high risk group due to some heart problems). He got infected after returning from a “security conference in SF” at the end of February. I googled. And this is the conference I found in SF that is in the area of securities: https://www.rsaconference.com/-/media/rsac/usa/2020/files/daily-addendum/addendum_us20_2_28_20.pdf?la=en&hash=EB85A0855094D24B7B3A863BAC96EF5A09EBF87C All those people attending, probably all at risk.
orthopa Posted March 10, 2020 Posted March 10, 2020 Here is a summary of something I posted on another thread: The science - we know very little about this virus. But we do know enough: it is highly contagious and it spreads very easily if precautions are not taken; and it is very bad for seniors or people who are deemed ‘high risk’. Real world examples - we already have lots of information of the impact of the virus on other countries, their response and the health and economic fall out. Every country where it surfaced made the decision that it had to be contained regardless of the economic cost. Read this last sentence again. The sooner the country comes to this decision the Better the health outcome and the lower the economic cost. And the effort the first 2 or 3 weeks is a key (clusters, if allowed to form, make containment much more difficult and raises the cost significantly). The virus did not hit every country in the globe at the same time; it started in Wuhan, China, and then spread to Asia and Europe and then (I think… this is my guess) to North America with a 2 or 3 week lag (perhaps due to Trump’s travel ban?). My view is we can see the future here in North America. History does not repeat but it rhymes (I think Mark Twain said this). China and Europe can provide us with lots of examples of how our future will likely turn out. It has so far. Two weeks ago we know 2 cases of ‘community spread’ were discovered in the US. Cases of community spread mean the walls have been breached and are a big red flag. What I also learned 2 weeks ago was the US had completely screwed up the testing for the virus. Testing did not happen (test kit was faulty). Then when the testing did start it was much too restrictive (so much so it was almost useless). And even today, two weeks after community spread was discovered the US is still not testing everyone who need it. Political leadership is the key factor in the response. Because this affects the speed and scope of the response. With great planning, coordination, effort and sacrifice on part of all players the spread of the virus can be slowed greatly and perhaps even stopped. Look at China’s or South Korea’s reported cases; they have fallen dramatically. Now look at the effort they put in place and just as importantly what they are doing today to keep reported cases low. Testing… who cares? Testing is at the core of the whole virus response for a country. Facts and science drive the response. Without testing, as the doctor on CNBC said a week ago the US is ‘flying blind’. Bottom line, the US has squandered the 2 or 3 week head start it was given. In addition to testing, the US has messed up in some other important areas. I have no idea where this virus is going to go in the US. Maybe a white swan comes out of the wood work to save everyone. But based on what i have seen the past 2 weeks and what i am seeing from political leadership, the relevant federal departments and the inability of the system to hold anyone accountable it does not look good. My uninformed guess is it will get worse and when it gets worse enough the US will finally mobilize to contain the virus. We will only know more in 2 or 3 weeks; until then, everything people say about everything (eventual response, magnitude, economic impact) is simply an uninformed guess. As Mark Twain said: "its not what you know that gets you in trouble, its what you know that ain't so." Two things mobilize all people the world over: health and money. As the health part of the equation rapidly deteriorates in the coming weeks politicians will finally see Jesus. Imagine a Senator or Representative telling their elderly constituents “we could do more but the cost is a little too high. Sorry 15% of you are going to have to die. But the rest of us are better off so i am sure you understand.” How can you have a highly contagious disease that spreads rapidly that wil over load health systems all over world killing millions and after 4 months has been attributable to 4090 deaths? The first part of that sentence doesnt mesh with the last. Can anyone please recitfy this for me? And no quaranteening isnt doing it, either are standard precautions for reasons I have exhausted discussing before. Testing isnt doing it either, thats bullshit, and if you dont believe me flesh out for me how even a 1% false negative rate or 99% sensitivity would not make high volume testing completely useless. The more you test the more false negatives you get!!!!! I have no dog in this fight, no money to be made, no axe to grind.
DRValue Posted March 10, 2020 Posted March 10, 2020 Having returned from Japan a couple weeks ago there was literally 0 screening at JFK. It seems to me that our government has completely dropped the ball on this one. I don't see what screening could be done as it's an asymptomatic spread.
orthopa Posted March 10, 2020 Posted March 10, 2020 Testing doesnt prevent the spread of the disease. Once you understand this it makes wrapping your head around the utility of testing much easier. If you dont test everyone, your effort will be futile. Which strains are you testing for? What your sensativity? Specificity? How are you going to deal with false positives? Negatives? Assuming that testing prevents the spread of the disease is ignorant. That is not the case. It will help quarantine but the fact that there are asymptomatic patients, even 1% ruins the whole notion. I'm not sure where I land on this issue as I'm definitely not a qualified expert, but perhaps I can ask you, who is someone more qualified - why are countries such as South Korea testing like crazy? I'm trying to put myself in your shoes, and please don't take offense, but I'm having a hard time reconciling what govts are doing vs. someone on the internet saying it doesn't matter. Likely due to patient demand, and in an about face due to the fall out from SARS and MERS from years ago. The more you test the more positives you will get. What does that get you? IMHO it probably lowers your death rate. Does it prevent the spread. NO!!!!! If you have even 1% of population asymptomatic it will defeat the entire purpose of testing. Again testing is not a zero sum game. It will not catch everyone. Anyone aware of what the sensitivity, specificity etc is? What do you do with an even 1% false negative rate (which is extra ordinary in non serum test). That person has it, and walks, and spreads it. Either you test every soul, ALL OVER THE WORLD, or you are essentially delaying the envitible infection of every human in the world. Whats the qualification to get the disease? Your a human. Eventually everyone will get this, very little relatively speaking will die. Like Viking said, testing gives you more information and a better picture of the facts -- to make appropriate decisions. -- not 3 confirmed cases out of 9 tests bullshit that we've gotten so far. That gives people a sense that it's not here. Delaying is the key and why Italy is locked down, why school is out in Japan, Taiwan, South Korea, and Hong Kong among other places. Why is delaying so important -- it gives hospitals MORE time to prepare, it gives schools the ability to launch virtual classes, the federal and state governments MORE time to prepare it gives researchers MORE time to possibly come up with a vaccine or medicine. Yes nobody can stop the disease but delaying and slowing the spread is crucial. If we continue to go out about our daily lives like they did in italy, what makes you think we won't be experiencing the same exact problems they're facing now. Having returned from Japan a couple weeks ago there was literally 0 screening at JFK. It seems to me that our government has completely dropped the ball on this one. Testing does not give you a better picture of facts and information unless you test EVERYONE!!! Tell me what you do with your vaccine when covid 19 mutates and its useless. Your aware this happens every year with the flu shot correct? Its too late the stop the spread, its all over world, in every state, in every community. Corona has been in US for months. How come the hospitals are overloaded in the US? I thought this was an exponential parabolic etc.
alwaysdrawing Posted March 10, 2020 Posted March 10, 2020 You test widely for two reasons: to know the extent of the problem, and to contact trace positive results to know who to test next and quarantine. That is why South Korea is falling off the curve here, as they were able to quickly scale testing and identify cases. The US is not widely testing, and thus we have no idea of the current scale of the problem, and the virus spread will get much worse before we do. We are likely already outside of the ability to contact trace in large cities, and it is likely to shut down the entire US economy similar to Italy if we hope to contain this and prevent the entire US healthcare system from becoming overwhelmed. Italy has more doctors per 1000 residents (Italy 4.0 vs. US 2.6) and more hospital beds per 1000 residents than the US (Italy 3.2, US 2.8). ICUs only have so much capacity, and without taking largescale action NOW, we will see not just the 1% case fatality rates, but many times more than that, as those patients who could have survived with hospital level or ICU care will not be able to access care. Read Gates's article in the New England Journal of Medicine (https://www.nejm.org/doi/full/10.1056/NEJMp2003762), and listen to Marc Lipsitch's (Harvard Epidemiologist) interview on the Deep Background podcast (https://podcasts.apple.com/us/podcast/the-coronavirus-isnt-going-away/id1460055316?i=1000466938203). We must flatten the curve using Non-Pharmaceutical-Interventions (NPIs) to stop this from being truly awful. The US is so far behind the curve, it's crazy. This is not about panic buying toilet paper.
orthopa Posted March 10, 2020 Posted March 10, 2020 Someone in our town was just diagnosed with the virus. This person is now in induced coma (he is high risk group due to some heart problems). He got infected after returning from a “security conference in SF” at the end of February. I googled. And this is the conference I found in SF that is in the area of securities: https://www.rsaconference.com/-/media/rsac/usa/2020/files/daily-addendum/addendum_us20_2_28_20.pdf?la=en&hash=EB85A0855094D24B7B3A863BAC96EF5A09EBF87C All those people attending, probably all at risk. Agree, as well as the cab/uber driver that took him too and from the airport, EVERYONE in the airport. The guy who touched his baggage on accident at the carrosel. The guy who touched the elevator button after he did. The guy that touched the escaltor rail after he did. The woman that picked up his scarf when he dropped it leaving the air port. The attendant he bought a magazine from in the airport. EVERYONE on the plane. EVERYONE in the hotel, the person that touched the door knob into the hotel after he did, the cleaning lady who cleaned his room, the waiter that waited on him. The people that sat next time in the restaurant he went to. The woman who he handed a tip to at the bar. The person that sat in the same chair at the airport after his flight left, and everyone at the conference that had the same interactions he did. Ok guys, your turn, of the above who do we test?
Read the Footnotes Posted March 10, 2020 Posted March 10, 2020 [image omitted] You test widely for two reasons: to know the extent of the problem, and to contact trace positive results to know who to test next and quarantine. That is why South Korea is falling off the curve here, as they were able to quickly scale testing and identify cases. The US is not widely testing, and thus we have no idea of the current scale of the problem, and the virus spread will get much worse before we do. We are likely already outside of the ability to contact trace in large cities, and it is likely to shut down the entire US economy similar to Italy if we hope to contain this and prevent the entire US healthcare system from becoming overwhelmed. Italy has more doctors per 1000 residents (Italy 4.0 vs. US 2.6) and more hospital beds per 1000 residents than the US (Italy 3.2, US 2.8). ICUs only have so much capacity, and without taking largescale action NOW, we will see not just the 1% case fatality rates, but many times more than that, as those patients who could have survived with hospital level or ICU care will not be able to access care. Read Gates's article in the New England Journal of Medicine (https://www.nejm.org/doi/full/10.1056/NEJMp2003762), and listen to Marc Lipsitch's (Harvard Epidemiologist) interview on the Deep Background podcast (https://podcasts.apple.com/us/podcast/the-coronavirus-isnt-going-away/id1460055316?i=1000466938203). We must flatten the curve using Non-Pharmaceutical-Interventions (NPIs) to stop this from being truly awful. [image omitted] The US is so far behind the curve, it's crazy. This is not about panic buying toilet paper. This is all well said and the right way to think about things. With that said, Orthopa does have a point that it is standard medical practice not to test unless there is some indication. The point should not necessarily be to test everyone which would produce tons of false positives, as he asserts, plus false negatives that might provide false reassurance, and there would be an economic cost too. The problem is that tests have been late, too few, with too many restrictions. In addition the administration likes to talk about how many test kits have shipped. That does not at all answer the question that is being asked. What you want to know is how many people have been tested. The tests produce false negatives and tests have been administered many times on some individuals.
orthopa Posted March 10, 2020 Posted March 10, 2020 You test widely for two reasons: to know the extent of the problem, and to contact trace positive results to know who to test next and quarantine. That is why South Korea is falling off the curve here, as they were able to quickly scale testing and identify cases. The US is not widely testing, and thus we have no idea of the current scale of the problem, and the virus spread will get much worse before we do. We are likely already outside of the ability to contact trace in large cities, and it is likely to shut down the entire US economy similar to Italy if we hope to contain this and prevent the entire US healthcare system from becoming overwhelmed. Italy has more doctors per 1000 residents (Italy 4.0 vs. US 2.6) and more hospital beds per 1000 residents than the US (Italy 3.2, US 2.8). ICUs only have so much capacity, and without taking largescale action NOW, we will see not just the 1% case fatality rates, but many times more than that, as those patients who could have survived with hospital level or ICU care will not be able to access care. Read Gates's article in the New England Journal of Medicine (https://www.nejm.org/doi/full/10.1056/NEJMp2003762), and listen to Marc Lipsitch's (Harvard Epidemiologist) interview on the Deep Background podcast (https://podcasts.apple.com/us/podcast/the-coronavirus-isnt-going-away/id1460055316?i=1000466938203). We must flatten the curve using Non-Pharmaceutical-Interventions (NPIs) to stop this from being truly awful. The US is so far behind the curve, it's crazy. This is not about panic buying toilet paper. Glad you contributed, please answer my question above. Whats your plan? Likelyhood of completing? Expected outcome?
alwaysdrawing Posted March 10, 2020 Posted March 10, 2020 Testing does not give you a better picture of facts and information unless you test EVERYONE!!! Tell me what you do with your vaccine when covid 19 mutates and its useless. Your aware this happens every year with the flu shot correct? Its too late the stop the spread, its all over world, in every state, in every community. Corona has been in US for months. How come the hospitals are overloaded in the US? I thought this was an exponential parabolic etc. This has only been a few weeks....look at the curves. This is still exploding and we don't even have accurate test numbers. Add in an incubation period before people need hospitalization and ICU level care, and you can see what's coming. Just wait two weeks and look at Seattle, SF, NYC. Then see who has the next clusters.... Seasonal flu changes because influenza is cultivated by ducks (which are crucibles for changes in the influenza virus) which live near livestock (pigs) that can transmit the flu to pigs, which are intermediate carriers but can transmit the flu to humans. Coronaviruses are primarily from bats, and bats rarely interact with humans (but sometimes do). There may be mutations, but as with many pandemic viruses for which vaccines exist, the conditions for significant mutation do not exist the same way as for influenza. That's not to say that a vaccine is a sure thing, however it's possible (although the development of vaccines is 18-24 months at best). Buying time through social distancing, NPIs, school closures and other measures is the best way to prevent a pandemic from becoming even more massive, and spacing out the spread of cases to keep it within the capacity of hospitals.
StubbleJumper Posted March 10, 2020 Posted March 10, 2020 Someone in our town was just diagnosed with the virus. This person is now in induced coma (he is high risk group due to some heart problems). He got infected after returning from a “security conference in SF” at the end of February. I googled. And this is the conference I found in SF that is in the area of securities: https://www.rsaconference.com/-/media/rsac/usa/2020/files/daily-addendum/addendum_us20_2_28_20.pdf?la=en&hash=EB85A0855094D24B7B3A863BAC96EF5A09EBF87C All those people attending, probably all at risk. Agree, as well as the cab/uber driver that took him too and from the airport, EVERYONE in the airport. The guy who touched his baggage on accident at the carrosel. The guy who touched the elevator button after he did. The guy that touched the escaltor rail after he did. The woman that picked up his scarf when he dropped it leaving the air port. The attendant he bought a magazine from in the airport. EVERYONE on the plane. EVERYONE in the hotel, the person that touched the door knob into the hotel after he did, the cleaning lady who cleaned his room, the waiter that waited on him. The people that sat next time in the restaurant he went to. The woman who he handed a tip to at the bar. The person that sat in the same chair at the airport after his flight left, and everyone at the conference that had the same interactions he did. Ok guys, your turn, of the above who do we test? I've got a better one for you: https://globalnews.ca/news/6639525/ontario-covid-19-case-las-vegas/ Some guy in Toronto took public transit to and from work for three days before he bothered to seek medical attention for Covid-19. So that's the problem with this virus. The people who don't have serious symptoms merrily go about their day to day life, banging off their R0=3. And then guys like this who do seek medical attention eventually self-isolate, but any bets on how many people he infected by taking the bus and the subway for three days? Lots of luck on the trace-backs. I have always tried to avoid using the handrail on the escalator when exiting the subway because I have always believed they were the most filthy surface known to man. Now it is not just the most filthy, but it is possibly outright dangerous! SJ
ERICOPOLY Posted March 10, 2020 Posted March 10, 2020 Stop eating animals. I'm vegan and if you were all like me then nobody would be dying.
krazeenyc Posted March 10, 2020 Posted March 10, 2020 Someone in our town was just diagnosed with the virus. This person is now in induced coma (he is high risk group due to some heart problems). He got infected after returning from a “security conference in SF” at the end of February. I googled. And this is the conference I found in SF that is in the area of securities: https://www.rsaconference.com/-/media/rsac/usa/2020/files/daily-addendum/addendum_us20_2_28_20.pdf?la=en&hash=EB85A0855094D24B7B3A863BAC96EF5A09EBF87C All those people attending, probably all at risk. Agree, as well as the cab/uber driver that took him too and from the airport, EVERYONE in the airport. The guy who touched his baggage on accident at the carrosel. The guy who touched the elevator button after he did. The guy that touched the escaltor rail after he did. The woman that picked up his scarf when he dropped it leaving the air port. The attendant he bought a magazine from in the airport. EVERYONE on the plane. EVERYONE in the hotel, the person that touched the door knob into the hotel after he did, the cleaning lady who cleaned his room, the waiter that waited on him. The people that sat next time in the restaurant he went to. The woman who he handed a tip to at the bar. The person that sat in the same chair at the airport after his flight left, and everyone at the conference that had the same interactions he did. Ok guys, your turn, of the above who do we test? An employee working at facebook tested positive for coronavirus. I know someone who works very near that person (also at FB) with all the symptoms.. can't get tested. (this is my only personal story). A nurse who treated a coronavirus patient has all the symptoms! Can't get a test -- denied by the CDC -- told... if you took the proper precautions you won't need it! This tells me, the US is not prepared.
alwaysdrawing Posted March 10, 2020 Posted March 10, 2020 Stop eating animals. I'm vegan and if you were all like me then nobody would be dying. Never meet your heros
ERICOPOLY Posted March 10, 2020 Posted March 10, 2020 I wonder if spotting sarcasm is a generational thing.
StubbleJumper Posted March 10, 2020 Posted March 10, 2020 Someone in our town was just diagnosed with the virus. This person is now in induced coma (he is high risk group due to some heart problems). He got infected after returning from a “security conference in SF” at the end of February. I googled. And this is the conference I found in SF that is in the area of securities: https://www.rsaconference.com/-/media/rsac/usa/2020/files/daily-addendum/addendum_us20_2_28_20.pdf?la=en&hash=EB85A0855094D24B7B3A863BAC96EF5A09EBF87C All those people attending, probably all at risk. Agree, as well as the cab/uber driver that took him too and from the airport, EVERYONE in the airport. The guy who touched his baggage on accident at the carrosel. The guy who touched the elevator button after he did. The guy that touched the escaltor rail after he did. The woman that picked up his scarf when he dropped it leaving the air port. The attendant he bought a magazine from in the airport. EVERYONE on the plane. EVERYONE in the hotel, the person that touched the door knob into the hotel after he did, the cleaning lady who cleaned his room, the waiter that waited on him. The people that sat next time in the restaurant he went to. The woman who he handed a tip to at the bar. The person that sat in the same chair at the airport after his flight left, and everyone at the conference that had the same interactions he did. Ok guys, your turn, of the above who do we test? I've got a better one for you: https://globalnews.ca/news/6639525/ontario-covid-19-case-las-vegas/ Some guy in Toronto took public transit to and from work for three days before he bothered to seek medical attention for Covid-19. So that's the problem with this virus. The people who don't have serious symptoms merrily go about their day to day life, banging off their R0=3. And then guys like this who do seek medical attention eventually self-isolate, but any bets on how many people he infected by taking the bus and the subway for three days? Lots of luck on the trace-backs. I have always tried to avoid using the handrail on the escalator when exiting the subway because I have always believed they were the most filthy surface known to man. Now it is not just the most filthy, but it is possibly outright dangerous! SJ And, this just in: https://montrealgazette.com/news/local-news/coronavirus-quebecer-with-covid-19-travelled-by-metro-and-bus Somebody in Montreal who has tested positive for Covid took public transit on February 24 and March 6. What could possibly go wrong? SJ
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