COVID-19 updates

[Alan Klein]

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.

That's only one manufacturer.  There are others. 

In any case, what's your point? In war, there's usually not enough weapons when it first starts.  In WWI and WWII, soldiers were marching with broomsticks.  There weren't enough rifles to go around.  You're probably one of those who wants to hollow out defense spending and then complain when there aren't enough weapons once the war starts.  I understand that many medical supplies had to be discarded because they were past the expiry date, like film.  Should we raise your taxes to pay for larger storage facilities?  Now that oil prices have cratered, Trump want to refill our defense oil storage facilities.  Many like yourself say that's a waste of money that should be spent elsewhere.  When is enough, enough?  It's impossible to prepare for every contingency that could possibly happen.  A month ago we had 3 1/2% unemplyment rates, everything wa booming with no end in sight.  God has a strange sense of humor.

[D Fuller]

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. 
https://www.cnn.com/2020/03/21/health/new-york-coronavirus-cases-epicenter/index.html

Alan, these are not my claims. I’m not sure what your point is. Are you deflecting blame from Trump? Are you saying that no public officials have taken the virus seriously enough? It’s hard to tell from what you wrote.

If your point is the latter, I agree with you. If the former, we’ll have to disagree.

[faberryman]

Alan, these are not my claims. I’m not sure what your point is. Are you deflecting blame from Trump? Are you saying that no public officials have taken the virus seriously enough? It’s hard to tell from what you wrote. If your point is the latter, I agree with you. If the former, we’ll have to disagree.

Trump is distracted at the moment. He is having to close down his hotels, golf courses, and resorts. He acted quickly though by laying off all his employees.

[Alan Klein]

Alan, these are not my claims. I’m not sure what your point is. Are you deflecting blame from Trump? Are you saying that no public officials have taken the virus seriously enough? It’s hard to tell from what you wrote.

If your point is the latter, I agree with you. If the former, we’ll have to disagree.

Well, everyone in America is talking about lowering the curve, not stopping it like the Chinese.  I don;t want to get this thing tomorrow or 6 months from now.  Who are we kidding?

[armand]

I'm trying to get some deep breaths before I call you out on this, I hope it's just ignorance on your part.

This not a war, caregivers didn't sign up to die on the front lines. They are taking a risk because we want to do our job but don't treat us as soldiers.
I always find it amazing how generous are people with other people lives and health, it never cease to amaze me. We are not expendables so somebody can make a buck or save political face.

Stop defending Trump! He's the head of the screw up and shares part of the blame. We had a 2 months warning that went wasted trying to say it's not big deal, and last week now he says he knew all along this will be bad. So he was lying then or he is lying now. They had multiple warning signs; they even run the damn simulation and knew how unprepared we are, look up Crimson contagion. But then most people that knew got fired or left and now we deal with this shit.

How can you even claim that's just life, not having the most basic supplies when this system has the highest amount of money poured in. The blame is shared, no doubt, at all levels. The government has the responsibility to plan for this kind of shit and have some general strategy. And they did run the simulation but they did nothing with the results.

Are you comfortable going to the hospital now?

[Manoli]

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.

Whether or not the death curve looks like Italy, really depends on how fast USGOV can play catchup.
As the pandemic rages across Europe and America, it is beginning to take hold in Africa and Latin America, too. By March 18th there were 134,000 registered infections outside China in 155 countries and territories. That is an increase of almost 90,000 cases and 43 countries and territories, in just seven days.  I don't have the latest data.

Nor do I have the chart but it was widely displayed on the news yesterday. Italy, France & Spain all have their own exponential COVID-19 takeup curves, UK is notably exhibiting a faster take-up ramp than either of the three.

Countries doing the best and worst jobs fighting coronavirus

[Manoli]

Stop defending Trump! He's the head of the screw up and shares part of the blame. We had a 2 months warning that went wasted trying to say it's not big deal, and last week now he says he knew all along this will be bad.

Not just Trump.
Covid-19 and the Stiff Upper Lip — The Pandemic Response in the United Kingdom (NEJM)

[Craig Lamson]

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.

I kind of asked this quetion a few days ago but the answer was mostly "its complicated".

You are an insider, what happened?  Why do hospitals not have enough stock of these items?  Do they need to depend on the government to keep themselves prepared or did they just drop the ball and are now looking for a scapegoat?

It seems to me its the job of the hospital corps. to handle this kind of stuff, to keep proper levels of supplies on hand and not depend on just in time delivery.  I can understand the government keeping a stockpile as well ...just in case...but at this point covid-19 has not seemed  to over-run the system yet, but every hosptial seems to be without supplies.  Why?

I'm not trying to lay blame, only to find answers.

[armand]

Not just Trump.
Covid-19 and the Stiff Upper Lip — The Pandemic Response in the United Kingdom (NEJM)

I'm sure he's not the only one but it doesn't make it any better now. From my limited view of politics lately I get the feeling that UK and US take turns on holding the beer.

[Alan Klein]

I'm trying to get some deep breaths before I call you out on this, I hope it's just ignorance on your part.

This not a war, caregivers didn't sign up to die on the front lines. They are taking a risk because we want to do our job but don't treat us as soldiers.
I always find it amazing how generous are people with other people lives and health, it never cease to amaze me. We are not expendables so somebody can make a buck or save political face.

Stop defending Trump! He's the head of the screw up and shares part of the blame. We had a 2 months warning that went wasted trying to say it's not big deal, and last week now he says he knew all along this will be bad. So he was lying then or he is lying now. They had multiple warning signs; they even run the damn simulation and knew how unprepared we are, look up Crimson contagion. But then most people that knew got fired or left and now we deal with this shit.

How can you even claim that's just life, not having the most basic supplies when this system has the highest amount of money poured in. The blame is shared, no doubt, at all levels. The government has the responsibility to plan for this kind of shit and have some general strategy. And they did run the simulation but they did nothing with the results.

Are you comfortable going to the hospital now?

I never said the combatants were the caregivers.  If you understood that to mean that, then I wasn't clear and apologize.  I'm very appreciative of their sacrifice.  The point I was making was that the combatants are the ones who get sick.  Everyone else are "civilians", who depending what their situation is, will get affected more or less seriously.  That was my point.  That there are coincidental casualties to war.  We have to think of that as well.

While Trump could have done more in the beginning, people aren't going to shut down the economy at that time because it didn't seem that serious.  I mentioned democrats Governor and Mayor of NY because here we are two months later, and they're still hesitant about shutting things down.  So it's not fair to just blame the President.  All leaders are hesitant to want to be blamed for going overboard and destroying the economy.  So when you blame Trump, in fairness you should be just as critical of Democrats.  Or be honest that more would not be done regardless of who was president, governor or mayor.  If this thing fizzles out, and let's hope it does, there are going to be a lot of criticism of who screwed up the economy, put millions out of work and destroy businesses including many who own small photography businesses here who will have to start over. 

[armand]

I kind of asked this quetion a few days ago but the answer was mostly "its complicated".

You are an insider, what happened?  Why do hospitals not have enough stock of these items?  Do they need to depend on the government to keep themselves prepared or did they just drop the ball and are now looking for a scapegoat?

It seems to me its the job of the hospital corps. to handle this kind of stuff, to keep proper levels of stuff on hand and not depend on just in time delivery.  I can understand the government keeping a stockpile as well ...just in case...but at this point covid-19 has not seemed  to over-run the system yet, but everyhosptial seems to be without supplies.  Why?

I'm not trying to lay blame, only to find answers.

I don't have all the answers now. I suspect part of this is for profit medicine where most go on day to week supplies because it's more cost effective and the financial people have the power. If they hear from the authorities that it will get bad and you need to prepare that will carry enough weight to accomplish more.
So yes, hospital definitely have their share of blame but I partially understand why they haven't stockpiled on supplies without a clear reason; for this you need some strategic vision and guidance which wasn't there strong enough, early enough. Not to mention a lot of supplies are coming from China which is battling its own demons.

[armand]

I never said the combatants were the caregivers.  If you understood that to mean that, then I wasn't clear and apologize.  I'm very appreciative of their sacrifice.  The point I was making was that the combatants are the ones who get sick.  Everyone else are "civilians", who depending what their situation is, will get affected more or less seriously.  That was my point.  That there are coincidental casualties to war.  We have to think of that as well.

While Trump could have done more in the beginning, people aren't going to shut down the economy at that time because it didn't seem that serious.  I mentioned democrats Governor and Mayor of NY because here we are two months later, and they're still hesitant about shutting things down.  So it's not fair to just blame the President.  All leaders are hesitant to want to be blamed for going overboard and destroying the economy.  So when you blame Trump, in fairness you should be just as critical of Democrats.  Or be honest that more would not be done regardless of who was president, governor or mayor.  If this thing fizzles out, and let's hope it does, there are going to be a lot of criticism of who screwed up the economy, put millions out of work and destroy businesses including many who own small photography businesses here who will have to start over.

Many share blame here. Trump was the face of the government and maybe they were doing more in the background but what he was saying publicly wasn't what he should have said.
Right now I could care less about their political affiliation; even now in the 11th hour they can't get together.

My frustration comes from the fact that we had the knowledge and means to deal with this much better. It would still be bad but at least have the basics covered.
That's it, I'm done venting for today.

[Alan Goldhammer]

This not a war, caregivers didn't sign up to die on the front lines. They are taking a risk because we want to do our job but don't treat us as soldiers.
I always find it amazing how generous are people with other people lives and health, it never cease to amaze me. We are not expendables so somebody can make a buck or save political face.

My daughter is a music therapist at UCSF Children's Hospital and is going to work every day to help the kids who are hospitalized.  The hospital has drastically curbed visitors to control the possibility of spreading COVID-19.  She didn't ask for this to be part of her work but realizes that if she can help with the kid's mental health during a time where they might only be able to see one parent if that it is worth it to her.  There are enough f**k ups in many areas that have gotten us to this point.  The focus should be on managing the situation the best way possible so that we can regain a sense of normalcy as quickly as possible.

[Craig Lamson]

I don't have all the answers now. I suspect part of this is for profit medicine where most go on day to week supplies because it's more cost effective and the financial people have the power. If they hear from the authorities that it will get bad and you need to prepare that will carry enough weight to accomplish more.
So yes, hospital definitely have their share of blame but I partially understand why they haven't stockpiled on supplies without a clear reason; for this you need some strategic vision and guidance which wasn't there strong enough, early enough. Not to mention a lot of supplies are coming from China which is battling its own demons.

So the long and short of it is its really the fault of the hospital corps. and they are looking for a scapegoat. Fair enough.

Do you guys not do your own research and look ahead to potential threats? You need the government to tell you how to do your jobs?  That seems a little short sighted if you ask me.

You continually gripe about Trump not doing enough when it looks most likely that your own industry is who dropped many of the balls. 

Just sayin.

[John Camp]

One of the reasons that the government and hospitals weren't prepared is that this is a classic "black swan" event and you simply can't be prepared for black swans. A meteor could hit, the North Koreans could lose their shit and lob a nuke into San Francisco, it could turn out that Wells Fargo has been running a giant ponzi scheme and suddenly goes belly-up, Arab terrorists could run an airliner into the Twin Towers -- wait, that already happened -- and so on. You can't prepare because it's simply too costly to prepare. The N95 masks actually have a limited lifetime, and if you had a billion of them in storage, you'd have to throw them away every few years and get another billion, while you wait for the black swan to come in, one that might never arrive. So, when a black swan arrives, you do the best you can. One thing that could have been done, I suppose, is to have the *machinery* to make masks built and then carefully mothballed, so it could be rolled out on demand, although you'd still have to worry about where the manufacturing materials would come from. But, basically a black swan is what it is.

[Alan Klein]

So the long and short of it is its really the fault of the hospital corps. and they are looking for a scapegoat. Fair enough.

Do you guys not do your own research and look ahead to potential threats? You need the government to tell you how to do your jobs?  That seems a little short sighted if you ask me.

You continually gripe about Trump not doing enough when it looks most likely that your own industry is who dropped many of the balls. 

Just sayin.

This is what happens when you depend on the government.  Personal initiative gets lost.  Everyone thinks and expects the government to handle it.  PLus, hospitals don't want to spend money.  It costs a lot to buy stock, set aside expensive storage facilities.  Especially when it wasn't needed before. 

People tend to wake up after the crisis. It's human nature.  So now going forward, we'll spend a lot of money on stuff.  Just like FEMA has bought trailers for people who lost homes during flood and hurricanes, we'll now spend money for FEMA to store medical materials.  OF course, the next tragedy will be something else we're not prepared for.  Climate change?

[Rob C]

To make matters worse, UK tv news channels I watch are running Trump addresses each day. I just switched him off a few minutes ago. I don't care what he has to say, especially now that he appears to be writing his own incoherent speeches all by himself.

If you want to watch tautological hype, watch his addresses to the nation. How anyone can require four different versions of exactly the same sentence in order to state something is a wonder of its own. As great a wonder is that the rest of the world seems to air this crap every day: surely, there are enough local incompetents of our own that we can watch - should we desire to give one space in our home?

Perhaps it's all an internationally agreed distraction from the figures of death.

[Craig Lamson]

One of the reasons that the government and hospitals weren't prepared is that this is a classic "black swan" event and you simply can't be prepared for black swans. A meteor could hit, the North Koreans could lose their shit and lob a nuke into San Francisco, it could turn out that Wells Fargo has been running a giant ponzi scheme and suddenly goes belly-up, Arab terrorists could run an airliner into the Twin Towers -- wait, that already happened -- and so on. You can't prepare because it's simply too costly to prepare. The N95 masks actually have a limited lifetime, and if you had a billion of them in storage, you'd have to throw them away every few years and get another billion, while you wait for the black swan to come in, one that might never arrive. So, when a black swan arrives, you do the best you can. One thing that could have been done, I suppose, is to have the *machinery* to make masks built and then carefully mothballed, so it could be rolled out on demand, although you'd still have to worry about where the manufacturing materials would come from. But, basically a black swan is what it is.

Heres my problem with that.  The hospitals are out of supplies even BEFORE the bulk of the covid 19 cases  has hit them.  They were under prepared for even the flu season.  They deserve a big part of the blame if we are playing the blame game.

I totally agreethat we have cut our own throats by moving so much manufacturing off shore.  For the most part the US "manufactures" far less than we should.  Even "Made in America" has come to mean assembled in America using off shore materials. For that Corporate American takes the bulk of the blame.

My point is that we can't just say...This Adminsitration screwed this up.  They missed a lot to be sure but I'm not confident any other adminsitration would have done better.  There is a desire to point a finger at someone and way, its your fault.  Even more so in an election year.  Its not helping.

There is more than enough blame to go all around.

[armand]

My daughter is a music therapist at UCSF Children's Hospital and is going to work every day to help the kids who are hospitalized.  The hospital has drastically curbed visitors to control the possibility of spreading COVID-19.  She didn't ask for this to be part of her work but realizes that if she can help with the kid's mental health during a time where they might only be able to see one parent if that it is worth it to her.  There are enough f**k ups in many areas that have gotten us to this point.  The focus should be on managing the situation the best way possible so that we can regain a sense of normalcy as quickly as possible.

That's what we do, trying to do the best of what we have.

However that doesn't mean we just have to accept what's happening and not trying to get people rectify as much as possible either. If we accept that this is what you get, live with it, they won't make any effort to get this better. What's few bodies as opposed to millions of votes.

[Rob C]

That's what we do, trying to do the best of what we have.

However that doesn't mean we just have to accept what's happening and not trying to get people rectify as much as possible either. If we accept that this is what you get, live with it, they won't make any effort to get this better. What's few bodies as opposed to millions of votes.

Not so fast: there have been numerous occasions when dead persons have made postal votes!

In case anyone thinks that insensitive, reflect on the fact that it's true. Today, with all the Intenet collating of personal information, the percentage of dead voters can only rise. Your name and details are for sale, and no, you don't get any royalties.