All things political. Coronavirus Edition. (18 Viewers)

[Maxp]

I fear we are really going to be in a bad place due to the obvious cuts to the federal agencies that deal with infectious disease, but also the negative effect the Affordable Care act has had on non urban hospitals. Our front line defenses are ineffectual and our ability to treat the populous is probably at an all time low. Factor in the cost of healthcare and I can see our system crashing. What do you think about the politics of this virus?

 

[SystemShock]

There are a couple of parts to this. First, I continue to advocate for government assistance for people put out of work due to this crisis.

Second, I still don't think you have commented on what a pandemic does to the economy even if we don't shut down. Most of what I've read states that a pandemic where hundreds of thousands of people will die would cause longer economic damage than a couple of month lockdown. A pandemic that is not controlled significantly alters people's economic behavior, hospitalization rates are also high, and a significant portion of our population can't afford those bills, raising medical bankruptcy, plus each person who dies creates a permanent loss of economic activity and contribution to GDP. So, a few months of lock down, followed by a controlled re-opening with testing and contact tracing and a data driven model that gives policy makers a tradeoff on what to shut down for greatest impact with least damage, would be present a very significant economic damage in the short term. However, not controlling the pandemic represents greater economic damage in the long term. I prefer to take my medicine up front.

Finally, this is probably for another thread, but what does it say about our economy if we supposedly went from the best economy ever to disaster if 50% of people and businesses can't stay home from work for 6-8 weeks?




I clearly am not being clear b/c I've addressed all this before. I'll see if I can reiterate. The models suggests, left uncontrolled the pandemic will kill between 500,000 and 2 million people. That's a pretty significant number, even if it's only 0.15% to .8% of the population, right? Seems like a reasonable investment can be made to protect those lives right? We lost 3000 people on 9/11 and completely re-ordered our society and spent trillions in an attempt to make sure we aren't vulnerable again - so this is not an unprecedented course of action, and it's a lot more known how many people will die from this pandemic than it is from terrorism.

Since I've typed a lot in other posts, you probably missed the part where I've already talked about the trade-offs for lives saved. I'm not going to type it all out again, but I'm not a "if it saves one life it will be worth it person". I am a "human lives have both intrinsic worth and economic worth, and it's worth a significant investment to save hundreds of thousands of lives" person.

I'm still not sure why you keep citing the flu. Are you under the impression that I'm trying to get to 0 deaths from Covid-19? B/c that isn't the goal. If you are going to use the same methodology for flu deaths and Covid-19 deaths, meaning counting only the deaths listed as the primary cause on the death certificate, using the same guidelines on how those deaths are listed (ie, if some comes into the hospital with the flu and dies, it is listed as a flu death even if they have bad kidneys or lungs or diabetes or whatever)... there have been about 15,000 flu deaths this year and 75,000 Covid deaths. And we know the flu is more prevalent than Covid-19, and that Covid-19 is just getting started.

Are you saying it isn't reasonable to treat Covid-19 more seriously than the flu? Why not?



Probably not. For profit healthcare cannot prepare for pandemics -- it's wasted capital most of the time.

I am going to make a mess of your post if I break it down by quotes, so:

Remember how a few posts back you corrected me about the death count for the 2017-2018 flu season? That it was the models that said 80,000 people died and 900,000 people were hospitalized, but in reality only 15,000 people died? Aren't those the same models they are using now to predict the hundreds of thousands (if not millions) of deaths?

As for 9/11, that was a completely different set of circumstances. We didn't go through all we went through because 3000+ people died, but rather, because of the crippling effects such attacks could have to our way of life.

As to why I keep citing the flu, I guess this time it is me that has not made himself clear. I keep citing the flu, because we very much accept the fact that thousands of people are going to die of it every year, and we don't do anything to prevent that. We let everyone fend for themselves.

And no, we DO NOT KNOW that the flu is more prevalent than covid-19. We do not have those numbers.

Last, as for the impact to the economy of 1,000,000 all of the sudden not spending money forever, I say, the impact of 300,000,000 spending little money for a sustained period of time is bigger.

 

[The moose]

For fairness, Italy's national health care system nearly collapsed because of it.

Yeah but at least all the PPE and meds and whatever else was needed it was not being fought for and making suppliers filthy rich.

They almost fell apart all working together.

We are a long way from this being over. I would not count chickens before they hatch.

 

[UncleTrvlingJim]

I am going to make a mess of your post if I break it down by quotes, so:

Remember how a few posts back you corrected me about the death count for the 2017-2018 flu season? That it was the models that said 80,000 people died and 900,000 people were hospitalized, but in reality only 15,000 people died? Aren't those the same models they are using now to predict the hundreds of thousands (if not millions) of deaths?

Not exactly, they use similar methodology though. I'm not sure of your point. I was using that to show that Covid-19 is much more serious than the flu. If you want to use similar numbers based on similar methodology, you have to compare 15,000 flu deaths to 75,000 covid-19 deaths. 75,000 is obviously significantly higher, right? If you want to do estimations, it's 60,000 flu deaths to some number that hasn't been estimated for Covid-19 b/c they haven't figured out what multiplier to use for unreported covid-19 deaths.

For future projections, that's a different methodology based on what the mortality and infectious rate is. Which is why we have a range. We don't have any immunity to covid-19 like we do with the flu. Having antibodies from previous flu strains provides partial protection for current flu strains, so it slows the spread and lessens the severity. That doesn't exist with covid-19 yet.

As for 9/11, that was a completely different set of circumstances. We didn't go through all we went through because 3000+ people died, but rather, because of the crippling effects such attacks could have to our way of life.

You don't think a highly infectious disease running through society and killing hundreds of thousands of people would affect our way of life?

As to why I keep citing the flu, I guess this time it is me that has not made himself clear. I keep citing the flu, because we very much accept the fact that thousands of people are going to die of it every year, and we don't do anything to prevent that. We let everyone fend for themselves.

Two points. One we do have a vaccine to prevent the flu that does lower the death rate.
Second, over a million people dying is worse than 60,000 people, right? You don't think it's reasonable to take extra measures for something that has decent likelihood of killing hundreds of thousands of people until we get vaccine, just because we can live with 60,000 deaths from another disease that does have a vaccine? Scale means nothing to you?

And no, we DO NOT KNOW that the flu is more prevalent than covid-19. We do not have those numbers.

Yes, we do have a pretty good idea. We have decades of studies of the flu and how it moves through the country. And we now have a few months of data on Covid-19, and covid-19 is not evenly distributed through the country yet, and we have some decent preliminary models of what we're likely to see in terms of infection rates.

Last, as for the impact to the economy of 1,000,000 all of the sudden not spending money forever, I say, the impact of 300,000,000 spending little money for a sustained period of time is bigger.

I don't know what to tell you other than economic models say differently. Because you have to account for the fact that if the pandemic is not controlled, those 330,000,000 people are still going to spend less plus you'll have a million less people later.

 

[Beach Friends]

I agree with what @UncleTrvlingJim is saying. We often miss the in-between discussion, of how do we do it? How do we balance the two major ideas.

What is constantly ignored is the fact that the virus, left unchecked, will force closures far worse than what we forced on ourselves. But, extending closures means we need to extend aid. Unemployment has been far too slow. The Fed Stimulus was far quicker, at least for me. I hear stories of landlords issuing pay or quit notices, expecting that these people have already received stimulus and unemployment.

so, does this mean, to remain closed, we need another round of direct Fed stimulus?

When we slowly re-open, how many people are going to jump to go back to Restaurants? (maybe more than we think). What about the Bus? Street Cars? Planes? Bars? Night Clubs? Tour busses? Tour boat rides?

What are the plans in place for each of those types of jobs, to have reasonable sanitizing, do you push masks? How do you wear a mask and drink?

There is a whole lot of "how do we do this and ensure a reasonable amount of public safety", otherwise we're in for a serious round two, with a 900k case head start (subtracting the dead and recovered).

How does each business prepare? What is their responsibility vs the local gov't vs state?

I'm sure a bit of this has been figured out, but again, what's the plan?

We could be spending this time sharing what we know about each local and state plan, and discuss the differences or issues. If we need to be sheltered in place longer, how do we meet people's basic needs, financial needs?

It's another reason why testing, tracing, and isolation is critical to get around this. We blew that so badly. This where the Chinese setting up 'fever clinics' and keeping folks there was pretty smart.

What kind of tracing do you have in mind?

Certainly people can see we don't need businesses to maintain customer logs like that fool in NOLA thinks she can mandate.

 

[FullMonte]

Two points. One we do have a vaccine to prevent the flu that does lower the death rate.

That's just one of the reasons a comparison to the flu is a horrible comparison.

Yes, we have a vaccine. That vaccine lowers your chance of becoming infected, as well as lessening the severity of an infection if you are infected.

We also have standard, proven, documented medications and treatments for the flu. There are multiple medications that are given to help cure people who are infected, usually in a very short time.

But the most important reason that a comparison to the flu isn't valid is because of the most dangerous difference between the two. As a rule, the flu cannot be transmitted by asymptomatic patients. So, if you come in contact with a person on Sunday, and you develop symptoms on Tuesday, and you stay home from work....the only people who are potentially at risk from being infected by you are those persons living in your household. If you come in contact with someone who is infected with COVID on Sunday, and develop symptoms on Tuesday, and you stay home from work...the people who are potentially at risk from being infected by you are everyone in your household, everyone you came in contact with on Monday, everyone they came in contact with after they came in contact with you..etc.

 

[JimEverett]

That's just one of the reasons a comparison to the flu is a horrible comparison.

Yes, we have a vaccine. That vaccine lowers your chance of becoming infected, as well as lessening the severity of an infection if you are infected.

We also have standard, proven, documented medications and treatments for the flu. There are multiple medications that are given to help cure people who are infected, usually in a very short time.

But the most important reason that a comparison to the flu isn't valid is because of the most dangerous difference between the two. As a rule, the flu cannot be transmitted by asymptomatic patients. So, if you come in contact with a person on Sunday, and you develop symptoms on Tuesday, and you stay home from work....the only people who are potentially at risk from being infected by you are those persons living in your household. If you come in contact with someone who is infected with COVID on Sunday, and develop symptoms on Tuesday, and you stay home from work...the people who are potentially at risk from being infected by you are everyone in your household, everyone you came in contact with on Monday, everyone they came in contact with after they came in contact with you..etc.

What do we know about the asymptomatic transmission of the coronavirus?

We are not even sure if influenza can be spread asymptomatically, or at least the extent of its actual spread by asymptomatic people. We do know that they shed the influenza virus though, just like some people are pointing out that asymptomatic people do shed the coronavirus.
I am not sure why you are saying that as a rule the flu cannot be transmitted by asymptomatic people.

 

[wardorican]

What do we know about the asymptomatic transmission of the coronavirus?

We are not even sure if influenza can be spread asymptomatically, or at least the extent of its actual spread by asymptomatic people. We do know that they shed the influenza virus though, just like some people are pointing out that asymptomatic people do shed the coronavirus.
I am not sure why you are saying that as a rule the flu cannot be transmitted by asymptomatic people.

Another question is, if someone is asymptomatic and spreading the virus, are they always asymptomatic, or do they always later develop the symptoms? i..e is it a timing thing, or an absolute?

It's a lot scarier to think of people with zero symptoms, and never symptoms later spreading something, vs Bill down the street may have said hi yesterday, felt fine, and is now sick as a dog, so you might want to clean your door knobs and get checked yourself.

 

[The moose]

What kind of tracing do you have in mind?

Certainly people can see we don't need businesses to maintain customer logs like that fool in NOLA thinks she can mandate.

Well considering south Korea did it thru cell phones and that would open a huge Pandora's box of litigation I see volunteering your info as a easy solution. Just like you would on a mailing list.

I want to know if I followed an infected person so I can stay clear of the elderly.

But then again I want to be tested so I know to stay clear of the elderly but that ain't happening.

But then again others are more worried about a tiny bit of inconvenience and call it loss of freedom.

I guess when that inconvenience could save a life it will be well worth it.

 

[Dragon]

Lifestyle and powerty has been mentioned as one of the primary factors as why african americans are hit harder by Covid-19 but maybe the truth is much more complicated. Four years ago the renovned Pasteur institute published an interesting study..

In a large-scale study published this week in the prestigious journal Cell, scientists from the Institut Pasteur and the CNRS unraveled the immune responses of 200 African and European individuals. They show that there is indeed a difference in the way these populations respond to infection, that this response is largely controlled by genetics, and that natural selection has played an important role in shaping such immune profiles. They also offer proof that the genetic legacy passed on by Neanderthals to Europeans has significantly influenced their ability to respond to viral challenges.

Africans and Europeans have genetically different immune systems... and Neanderthals had something to do with it

The immune system can be highly active in some people but much less effective in others. This has major implications for the protection of the organism against pathogens – but what is the reason for these differences? To lay the foundations for the establishment of personalized medicine, we need...

www.pasteur.fr

 

[Surviving Saint]

Does this count as a coronavirus death?

In Turkey, Kazakh native Olesya Suspitsyna perished in front of her female friend who was taking the photograph in the tourist city of Antalya in the south-west of the country.

The incident occurred on Sunday after the government lifted the coronavirus quarantine in the city.

Woman falls to her death while posing for a photo on Turkish cliff

Kazakh native Olesya Suspitsyna perished in front of her female friend who was taking the photograph in the tourist city of Antalya in the south-west of the country.

www.dailymail.co.uk

Absolutely it does
She was trying to have some semblance of life and Corona took it.

It's killing in more ways than one. It's definitely killing common sense.

 

[Beach Friends]

Lifestyle and powerty has been mentioned as one of the primary factors as why african americans are hit harder by Covid-19 but maybe the truth is much more complicated. Four years ago the renovned Pasteur institute published an interesting study..

Africans and Europeans have genetically different immune systems... and Neanderthals had something to do with it

The immune system can be highly active in some people but much less effective in others. This has major implications for the protection of the organism against pathogens – but what is the reason for these differences? To lay the foundations for the establishment of personalized medicine, we need...

www.pasteur.fr

I have heard a theory of vitamin D deficiency as well. Darker skin is not selected for the northern climate.

 

[FullMonte]

What do we know about the asymptomatic transmission of the coronavirus?

We are not even sure if influenza can be spread asymptomatically, or at least the extent of its actual spread by asymptomatic people. We do know that they shed the influenza virus though, just like some people are pointing out that asymptomatic people do shed the coronavirus.
I am not sure why you are saying that as a rule the flu cannot be transmitted by asymptomatic people.

I was basing that on this article from the National Institute of Health, which says in the synopsis: "Based on the available literature, we found that there is scant, if any, evidence that asymptomatic or presymptomatic individuals play an important role in influenza transmission."

Does Influenza Transmission Occur from Asymptomatic Infection or Prior to Symptom Onset? - PMC

A better understanding of transmission dynamics is essential in influenza pandemic planning. If a substantial proportion of transmissions were to occur during the presymptomatic phase or from asymptomatic individuals, then infection control measures ...

www.ncbi.nlm.nih.gov

The CDC says that "most healthy adults may be able to infect others beginning 1 day before symptoms develop."

How Flu Spreads

Flu viruses spread by droplets made when people cough, sneeze or talk.

www.cdc.gov

Another question is, if someone is asymptomatic and spreading the virus, are they always asymptomatic, or do they always later develop the symptoms? i..e is it a timing thing, or an absolute?

It's a lot scarier to think of people with zero symptoms, and never symptoms later spreading something, vs Bill down the street may have said hi yesterday, felt fine, and is now sick as a dog, so you might want to clean your door knobs and get checked yourself.

I've heard at least one report of an individual who tested positive twice in a 30 day span, and never developed symptoms. Now, it's possible that they did have symptoms, but they attributed them to something like allergies.

 

[Dragon]

I have heard a theory of vitamin D deficiency as well. Darker skin is not selected for the northern climate.

This study has nothing to do with environment or climate but with imuno response systems - the most fundamental part of our defense against infections. Since we all basically have the same ancestors if we go far enought back. The main difference here is the 4% Neanderthal genetic materials which are found in many Europeans.

 

[V Chip]

Its quite obvious that a nursing home is quite the opposite of isolation. You demonstrate the stupidity of governments confining large groups in buildings with shared ventilation while closing outdoor areas.

My, also obvious point, remains. If you isolate yourself, the actions of others put you at no risk.

No unfortunately your statement is completely illogical. Some — most I would say — people who are at-risk CANNOT self-isolate. They NEED other people to get groceries, medicine, maybe take care of them in some way. People who are at risk cannot go out and get supplies and live like normal BECAUSE THEY ARE AT RISK. They can’t withdraw completely for weeks and not rely on others — and since idiots who don’t need to be out doing non-essential things are in many cases unknowing carriers, they spread COVID to others. The more people who think they are not going to get sick and just do whatever they want, the more people who are at-risk and trying to stay home and isolated as much as possible are at risk. That’s incontrovertible.

 

[Archies Ghost]

No unfortunately your statement is completely illogical. Some — most I would say — people who are at-risk CANNOT self-isolate. They NEED other people to get groceries, medicine, maybe take care of them in some way. People who are at risk cannot go out and get supplies and live like normal BECAUSE THEY ARE AT RISK. They can’t withdraw completely for weeks and not rely on others — and since idiots who don’t need to be out doing non-essential things are in many cases unknowing carriers, they spread COVID to others. The more people who think they are not going to get sick and just do whatever they want, the more people who are at-risk and trying to stay home and isolated as much as possible are at risk. That’s incontrovertible.

So why are these caregivers, who know they will be in contact with at risk individuals, engaging in non-essential activities where they can come in contact with other folks engaged in non-essential activities?

Or have you decided that some people are non-essential and can be denied their rights in order to protect the essential people?

 

[Richard]

So why are these caregivers, who know they will be in contact with at risk individuals, engaging in non-essential activities where they can come in contact with other folks engaged in non-essential activities?

Or have you decided that some people are non-essential and can be denied their rights in order to protect the essential people?

I don't know about others, but I know I have done what I could to protect my 83-year old mother. She hasn't been out of her home or yard for almost two months other than an occasional drive. I bring her food and supplies, leaving them on the sunny porch. Until our stay at home order was changed, I only left home for food myself or to take something to my mother, so I took part in no non-essential activities. I have worn masks, used hand sanitizer, washed my hands religiously and wiped down everything with disinfectant. But on my last trip out, I had to buy gas, so I masked up and stopped at the nearest station to my house. They serve a plate lunch at this station, so I thought I might duck in and buy a hot lunch for my mother. When I opened the door, there were at least 40 people crowded around the counter trying to order and pick up food. Not a mask in sight and not a soul practicing social distancing. I believe it can be safely assumed that they behave the same way at other stops in my small community. I didn't enter the building.

I can do everything I can to stay safe and limit non-essential activities, but if no one else is doing the same, the likelihood is that I will be continually at risk of coming into contact with a carrier of the virus who is just exercising his rights. I don't believe any of these people think they are immune or that risk of infection is gone. I do think that people are either poorly informed or that they are confused by the mixed messages they are receiving. I refuse to accept that they believe that their right to assemble in groups at a lunch counter is more important than the lives of at risk individuals.

 

[UncleTrvlingJim]

Another challenge with just trying to isolate the at risk population is how big that at risk populations is.

16.2% of the US is over the age of 60.
10% of the population has diabetes
48% of the population has some form of hypertension or other heart disease (that sounds way high, but I got it off of here https://www.sciencedaily.com/releases/2019/01/190131084238.htm)
15% of the population has chronic kidney disease (https://www.kidney.org/news/newsroom/factsheets/KidneyDiseaseBasics)

Obviously there's going to be overlap between those groups. But the point is, we aren't a healthy population, trying to isolate only the at-risk population is probably more difficult and expensive than just having mass testing, contact tracing and targeted lockdowns.

 

[Richard]

Mississippi will probably be a good test case for the success of the reopening of the economy before meeting the thresholds recommended by the CDC. Using statistics from the latest health figures I could find (2017), the state ranked first or second nationally in deaths related to kidney disease, flu/pneumonia, diabetes and chronic lower respiratory disease. Almost 40% of our population is obese and nearly a third report no leisure time physical activity (2018 numbers). So we are a very unhealthy population with what I would characterize as a cavalier attitude toward coronavirus safety recommendations. Though some are careful in their personal interactions, I believe a large majority are not, so we should be able to tell something in about three weeks. If the cases and deaths spike by the end of May, the reopening will have been a monumental failure.