COVID-19 updates

[Alan Goldhammer]

Well, China probably has the vaccine.

They have a candidate vaccine in clinical trials just as we have one in the US.  Nobody has a proven vaccine that works.  Posts such as this are not helpful.

[armand]

Making more ventilators is not enough in itself, somebody has to take care of those patients and we have yet to reach immediate cloning or learn how to practice medicine by downloading a program.


Currently more and more hospitals are running out protective equipment. I saw this coming since several weeks ago when we started to ration things even with no covid case in sight. Because of this, the medical personal is asked to take more and more risks, and there is that much that many will be willing to do. Our precautions already looked a little wimpy compared to other countries, with the decreasing safety more medical personal will get sick which will leave even less to take care of patients. Some will also die although this doesn't seem of concern to many, for whatever reason they think it's ok for caregivers to take one for the team.

Currently CDC says that if you run out of PPE, you can also use a bandanna. Rambo jokes aside, it's ridiculous that the responsible parties can't get their shit together and fix at least this part.

[JoeKitchen]

The problem with you theory Joe is that people won’t be able to work if the place where they work remain closed. You can’t force a business to open just because you don’t like the program.

Sure there may be an outlaw business here and there who decides the heck with it, but the major s will follow the rules.  I suspect most restaurants will too since they rely upon a supply chain they can’t control.  Very few businesses are self suficient.  And I really wonder how businesses would feel about restarting just to see it’s workforce become ill and head back home.  Not sure that might happen but it is a possibility.

Building new wards is a nice thought but we can’t stock the ones we have.  I’m not sure who gets the blame one this one but I’m really surprised the hospitals don’t have inventory. This is not a thing the government should have handled, it’s a hospital problem imo.   But without a US based production capacity and a reliance on offshore suppliers it’s out of our hands.

Which brings us back to shutting down and staying home.  Resources are limited.  More will not come on line in any reasonable amounts anytime soon.  Opening the workplace back to business as usual will simply crush the medical system.  If the spread is not slowed it’s going to be a nightmare. 

Slowing it requires people stay at home it’s just that simple.   

Anyways we have beaten this horse to death.  No sense beating it any longer.

Chicken egg problem. 

Is it business that drives commerce with shoppers responding?  Or is it shoppers that drive commerce with businesses responding? 

I believe in the latter, and eventually business people will respond.  If I owned a hardware store I would be thinking about what additional product I could realistically sell that people cant get anymore, and I would not blame any who do so. 

Wendy Williams is ready to go back to work next week.  The UFC has promised it's fight in mid-April will go on regardless.  The media can piss and moan all they want here, but I guarantee you when that is the only sport available to broadcast, the networks will pay, and pay handsomely, for the rights.  Companies will pay handsomely for the ad space.  UFC, a fringe sport, may even become mainstream with the move since it will the only thing sport fans can tune into. 

Not only is the virus going to effect the long term viability of many business sectors, but our response will probably effect other secotrs that would have be unscathed by it. 

[Alan Klein]

Thanks, Keith, appreciate the concern. I am in the 11th day of persistent dry cough, very exhausting. I try to save energy by sleeping most of the time.

My symptoms are not apparently serious enough to warrant testing. Some of my friends are not that lucky. A violinist in the band that was playing on March 7, where we got the bug, is hospitalized with pneumonia and corona positive. Some of you might remember a few pics of him I posted. A healthy guy, late 20s, early 30s, non smoker, non drinker.

Hope you get well soon Slobo, and your friend too.

[JoeKitchen]

This is not what I’ve been reading. Yes, There has been a wide range of total death predictions, but I haven’t read any source that says what we do doesn’t matter. The majority of sources I see are writing that moderate social distancing will be moderately helpful in reducing both the rate of the spread and total infections, and that extreme distancing will be more effective.
There are other possibilities besides “end it” and “delay the inevitable,” neither of which seems like the likely result. Every article I’ve read from a scientific source has suggested that reducing the rate of spread (through social distancing) also reduces the  total number of infections. Of immediate benefit is that it will reduce the demand pressure on the available medical care so that a greater percentage of victims will be able to get the care they need. Longer term, it will give time for treatments to be tested and manufacturing scaled, and for a vaccine to be developed. With conflicting voices in the air, I choose to trust those with epidemiological cred, and those voices all seem to be saying that social isolation is the best tool we have until treatments have been developed.

We should assume that there will be a second wave. But if we have been successful in developing therapies during this first wave, the second should have less-severe consequences.

I’ve seen reports of hospital ships being dispatched to hot cities, and of university dormitories being offered up for hospital use. Neither of these provide ICU beds, but they do provide ways to relieve some of the pressure in hospitals by removing other patients with less-severe disease. That said, this ad-hoc approach is nowhere near sufficient, and the power to ramp up production and distribution of ventilators, etc rests with the POTUS, who seems unwilling to use it.
It seems to me irrational to keep asking for an ”end game” at this stage. It’s like asking for an end game in a war—you know the end game is to defeat the enemy, but you can’t know how long it will take to do that, or what the cost will be. But without total commitment to defeating the enemy, you are bound to lose the war.

There will be economic disruption in any case.

If we enforce “shelter in place” for two months, and it slows the infection curve, there will be much economic hardship.

If we do nothing, and our hospitals are overwhelmed and the virus kills by the thousands, people will shut themselves off, demand will tank, and there will be much economic hardship.

If millions of people die, demand will tank and there will be much economic hardship.

Given that economic pain is unavoidable, it seems to me that the logical choice is to lock the country down for as long as it takes and get the greatest economic pain over with up front so we can start rebuilding sooner.

Well, that horse has already left the barn at the national level, but there is some very good leadership stepping up at the state level. Governors and state-level CDC directors lack the power to redirect manufacturing and distribution, but some are doing a very good job of articulating policy that should slow the spread of the disease and providing good information on what to do and why. But we really are suffering from the lack of leadership at the federal level.

When at war, the country typically has a plan; generals dont ad hoc it. 

Perhaps we are already screwed just by the fact that we moved all of our manufacturing overseas. 

[Alan Klein]

Alan, please send Mrs Klein my sincere greetings, sympathies and admiration, I can only imagine what it's like.... I'm 6000 miles and your'e driving me nuts!! 

I would pass on your salutations.  But she isn't talking to me right now. 

[D Fuller]

Let's do a thought experiment.  Let's imagine that for the most part businesses in PA follow the rules, with the exceptions, at first.  What happens when stores that are exempt start selling product they do not normally carry and that other locations do that had to close? 

For instance, hardware stores can remain open.  Now every hardware store I have been to is rather large with lots of storage and display space, so it would be easy for them to add more merchandise.  What if they suddenly start selling office supply, a category not allowed to remain open?  It's not a stretch.  Eventually we will need paper and envelopes; someone is going to have to fill that need.  What if they start selling furniture?  Also not a stretch; hardware already supplies many other home goods.  Sporting goods?  Many-d-it-yourselfers are sports fans; it would be a good way help take care of your customers to provide additional products they enjoy but cant get elsewhere currently. 

What happens when those other businesses start seeing stores allowed to remain open start selling the merchandise they normally sell?

I don’t see this as very likely to be a problem for a couple of reasons: first, supply chains are going to be disrupted enough that business who are open will have enough to do keeping their normal suite of items stocked. Second, Amazon. Hardware stores are considered essential because if your toilet is leaking, you need to fix it today. If you need envelopes, ordering online is plenty soon enough, and you don’t have to go out in public.

[D Fuller]

When at war, the country typically has a plan; generals dont ad hoc it. 

Perhaps we are already screwed just by the fact that we moved all of our manufacturing overseas.

They have a plan for the near future, but not, in the beginning, for the war as a whole. That develops as they learn about the enemy.

[Alan Klein]

 

You keep bringing up economic costs. Fair enough, they are real enough and need to be kept in mind. But if no measures were taken and the virus made billions sick at the same time, resulting in millions directly dead with much collateral death, that would also have a major economic impact. I'm just saying that we shouldn't pretend that it's one OR the other.

I'm taking this very seriously.  I'm 75 and have medical issues that put me in the target.  I haven;t been out of my house in 3-4 days except to go to the mailbox and and put the garbage cans out by the curb.  I've been walking around the house disinfecting things, driving the missus crazy she's not being antiseptic enough.  We ain't talking now.   Economically, I'm OK.  WE both are on SS and get pensions from the government.  I'm actually spending less than I ordinarily do since we aren;t going out for entertainment and restaurants. 

But the economic issue is very great.  I know people who are now out of work with no income except unemployment checks.  They're really scared how they're going to make it having car bills, rent and mortgages, etc.  I have to finish dental work I'm in the middle of.  But that won't happen.  I was suppose to see my endocrinologist for a diabetes exam.    That also was cancelled.  My dentist closed his office until May 4, at least.  I live in a 55+ community where everyone's old.  They need to see doctors for regular things, cancer follow ups, etc.  That isn't happening it seems.  Like war when civilians get killed often more than combatants, what are the casualties of the whole population.  So the economic issues are great as well as they reflect the things that are not getting taken care of like medical checkups and having money to buy food.   Sure, we can live with this for a short time, but how long?  Will there be a recovery if it goes on too long?  Maybe I'm ahead of the thinking.  But I don't think it will be too long before everyone starts to think seriously about the contingent problems. 

The loss of wealth of a country is more than just having money for buying nice cars and going on vacations.  The country's wealth provides for other health services and requirement humans need beyond Play things.  If the economies of the world are damaged, then there will be other damages that could hurt people more.  The cure could wind up being worse than the disease.

[Alan Klein]

The epidemics curve behaves like that. China was the first to be hit, it is the first to get out of it. Europe is now approaching peak epidemics (which in the risisng phase it's an exponential curve). In Portugal cases are doubling every 2 or 3 days. No need for speculations and conspiracy theories.

China has a delegation in Italy, trying to help. Spain is following suit. They did not pay heed to China's doctors warnings they should have closed down sooner.

There are many scientific papers published, we should listen to the science, not politics.

Paulo, If that's all that happened in CHina, a few thousand dead in a country of 1.3 billion, why are we so concerned?  Is this disease over raed? You didn't answer the question I had about that.  What did they do that we're not doing?  Why did it stop with so little damage or deaths (comparably)?  Do they know something we don't? Sure the press keeps talking about people dying, and they are.  But the numbers don't (yet) compare to how many die every year from the regular seasonal flu.  Why not??

[Alan Klein]

I dont, not at the expense of their lives.  Eventually not working will entail greater risks than the virus for many, especially given who this virus is mainly killing.  That without a real plan is not a great recipe for confidence. 

Gov. Wolf delays enforcement of order closing 'non-life-sustaining' businesses amid COVID-19

My neighbor, who is a dentist, thought it would be good to plan out some projects this weekend and went to a garden center.  It was open when it was suppose to be closed and he was not even aware it was suppose to be.  Our governor is delaying the enforcement because stores are remaining open.  Until this hits hard, I dont see how you can enforce this. 

I want to see a military like operation in increase ICU beds; without it I just don't think much of this will matter.  The only story I have seen that relates to this is NJ trying to reopen a hospital that closed down last year, and already is working with the CORP on another.  This is what we need, and it is stories like this we need to talk about to instill confidence. 

Some cruise ship line has offered their ships to be used as hospital ships. 

[Alan Klein]

They have a candidate vaccine in clinical trials just as we have one in the US.  Nobody has a proven vaccine that works.  Posts such as this are not helpful.

So who here should be allowed to post their opinions?  Which second-hand stories you read are more acceptable than others to be posted? 

[Alan Klein]

Making more ventilators is not enough in itself, somebody has to take care of those patients and we have yet to reach immediate cloning or learn how to practice medicine by downloading a program.


Currently more and more hospitals are running out protective equipment. I saw this coming since several weeks ago when we started to ration things even with no covid case in sight. Because of this, the medical personal is asked to take more and more risks, and there is that much that many will be willing to do. Our precautions already looked a little wimpy compared to other countries, with the decreasing safety more medical personal will get sick which will leave even less to take care of patients. Some will also die although this doesn't seem of concern to many, for whatever reason they think it's ok for caregivers to take one for the team.

Currently CDC says that if you run out of PPE, you can also use a bandanna. Rambo jokes aside, it's ridiculous that the responsible parties can't get their shit together and fix at least this part.

3M says they'll be making 400 million N95 masks this year.  How soon they roll out I don't know. 

[Alan Klein]

When at war, the country typically has a plan; generals dont ad hoc it. 

Perhaps we are already screwed just by the fact that we moved all of our manufacturing overseas. 

I read yesterday that not only is the government going to force manufacturing of certain items like pharmaceuticals back to America, but that companies like Walmart and so many other are going to diversify their supply chains so they're not just relying on China or other single countries.  Ironic that Trump may get American companies to start producing here because of the virus when tariffs couldn't get them to do it. 

[kers]

Some cruise ship line has offered their ships to be used as hospital ships.

One way to still earn some money at the moment..

[texshooter]

There are 7 types of human coronaviruses

Human coronavirus OC43
Human coronavirus HKU1
Human coronavirus NL63
Human coronavirus 229E
Human coronavirus MERS
Human coronavirus SARS
Human coronavirus Covid-19

Guess how many have vaccines.

[Alan Klein]

One way to still earn some money at the moment..

I thought of that.  They could make millions on a ship that's just sitting idle in port.   It also gives them arguments for getting bailout money.  But let's not look a gift horse in the mouth.  The point is they're available.  They have thousands of cabins that could be set up as recovery rooms.  They could within days be pulled into any port and most big cities are on the ocean, or nearby.  They have staff that could be trained to help out, clean up, as patients are moved in and out. 

[D Fuller]

Paulo, If that's all that happened in CHina, a few thousand dead in a country of 1.3 billion, why are we so concerned?  Is this disease over raed? You didn't answer the question I had about that.  What did they do that we're not doing?  Why did it stop with so little damage or deaths (comparably)?  Do they know something we don't? Sure the press keeps talking about people dying, and they are.  But the numbers don't (yet) compare to how many die every year from the regular seasonal flu.  Why not??

Alan, that's a very myopic view. If we wait until the numbers exceed the seasonal flu numbers, it will be far too late to do anything useful to stem the disease.

We are concerned because achieve the result they did, China shut the country down. We are doing nothing like that. There are now several case studies to be made: China, South Korea, Italy, Spain, Iran. Look at the infection curves and the death curves and what actions they took. We are already well behind schedule for any of the best-case scenarios. I don't expect that our results will look like Italy, but I do expect them to look a lot like Spain. On the other hand, Spain is enforcing its lockdown now. We are not.

We are concerned because the Covid-19 virus is both deadlier and more contagious than most flus. While its hard to determine precise numbers because of the lack of testing capacity, it's estimated that the R0 value for Covid-19 os about 3.

Scientists measure the spread of an epidemic by a number called R0, or “R naught.” That number is calculated this way: for every person who develops the illness, how many other people do they give it to before they are cured (or dead) and no longer infectious? The R0 for coronavirus, in the absence of a control strategy, appears to be a number close to 3 – maybe a bit higher or lower, but in that ballpark. This is an extremely frightening number for such a deadly disease.
Suppose you catch the virus. You will give it to 3 other people, and they will each give it to three others, and so forth. Here is how the math works, where you, the “index case,” are the first line:
1
3
9
27
81
243
729
2,187
6,561
19,683
59,046
177,147
531,441
1,594,323
4,782,969
14,348,907
So, in just 15 steps of transmission, the virus has gone from just one index case to 14.3 million other people. Those 15 steps might take only a few weeks. The index person may be young and healthy, but many of those 14 million people will be old and sick, and they will likely die because they got a virus that started in one person's throat.

[Alan Klein]

Alan, that's a very myopic view. If we wait until the numbers exceed the seasonal flu numbers, it will be far too late to do anything useful to stem the disease.

We are concerned because achieve the result they did, China shut the country down. We are doing nothing like that. There are now several case studies to be made: China, South Korea, Italy, Spain, Iran. Look at the infection curves and the death curves and what actions they took. We are already well behind schedule for any of the best-case scenarios. I don't expect that our results will look like Italy, but I do expect them to look a lot like Spain. On the other hand, Spain is enforcing its lockdown now. We are not.

We are concerned because the Covid-19 virus is both deadlier and more contagious than most flus. While its hard to determine precise numbers because of the lack of testing capacity, it's estimated that the R0 value for Covid-19 os about 3.

So despite your claims of the seriousness of it, we are doing a half-a$$ed job of it.  Everyone blames Trump for acting too late, something that could be argued both ways.  Meanwhile, with all that, Democrat Mayor and Governors of NY where most of the viruses are currently located are just starting now to gear up getting serious about it. 

"The mayor earlier this week told residents to prepare for a "shelter in place order," a declaration that was met with backlash from the state's governor, who said he wasn't going to "imprison" residents.

Instead, both leaders initially implemented less restrictive measures, including converting bars and restaurants to only takeout services and limiting public gatherings. Schools across the state were also ordered closed until April 1.

But on Friday, New York. Gov. Andrew Cuomo went a step further, signing an order directing the state's non-essential workers to stay home starting Sunday.
Businesses that don't comply will be met with mandatory closures and civil fines, Cuomo said.

"We need everyone to be safe, otherwise no one can be safe," he added."
https://www.cnn.com/2020/03/21/health/new-york-coronavirus-cases-epicenter/index.html

[armand]

3M says they'll be making 400 million N95 masks this year.  How soon they roll out I don't know.

That's not enough.

1. I don't know how many US will get.
2. That's likely over 1 year, we need them yesterday
3. For every patient that needs this there are at least 5-6 caregivers/24h that need to go in and out at least several times each, so let's be conservative and say 30+ masks/person/day. Many will need many more. For easy math choose 50/patient/day on average, for all sick patients. Let's say 3M brings 1 mil masks/day (now that's more fantasy than anything), so you can have masks for 20K sick patients (mostly ICU).

I also recall somebody said we'll be able to test a lot many weeks ago and here are, struggling to get testing.