All things political. Coronavirus Edition. (11 Viewers)

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    Maxp

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    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?
     
    What the health experts in my state are being optimistic about is that we have now vaccinated around 60% of the 70+ age group. And their cases, hospitalizations and deaths are already declining. This age group is where most of the severe disease occurs. We are now concentrating on the 60+ age group, which is another group where severe disease is more likely. (we have already done medical personnel and front line). So the outlook from our public health experts is much more optimistic than what I read above from Osterholm. I saw this article in the Atlantic that also seems more optimistic. Haven’t read all of it yet.

    I'm curious to see exactly what Jha said about the variants because Osterholm is painting a different picture and he's be right all along the way.

    Despite some concerns about new coronavirus variants, Ashish Jha, the dean of the Brown University School of Public Health, told me that he doesn’t see viral mutation as a reason to expect that most people couldn’t be well protected within that time frame.

    OK, a couple of questions about what you've said. I also am reading about this Bristol variant that has also emerged named for a town in the U.K. that also carry some of these qualities, characteristics that you've just talked about. So what are you hearing and understanding about this new variant?
    Well, you know, Kerri for the couple of people in this audience who are old enough to remember the 1960s music scene, there was a famous song by The 5th Dimension called the "Age of Aquarius, Let The Sunshine In." And I have to tell you, day after day after day, and this is happening for the last six weeks, I just keep hearing in my head, this is the dawning of the age of the variants.

    They have fundamentally changed the game with this particular pandemic. And we have to respect them, we have to try to understand what they mean. I actually think I know less about these viruses today than I did six weeks ago.

    The more we learn, the more questions we have about what's going to happen. I haven't even mentioned the other variants, one you mentioned, but also one called P.1 from Brazil or B.1.3.5 from South Africa, which have acquired part of one and two characteristics, more transmissibility is more serious illness. But what's really concerning is they've acquired a third bucket of opportunity. In other words, being able to evade the immune protection, at least to some degree from the vaccines or natural infection.

    So expect we're going to see many, many more variants. There was a confusing article in the media just in the last two days about a series of new variants here in the United States. And the researchers that did the work were absolutely right on target, their message was correct. But they said these variants aren't causing us any unique problems, meaning that they weren't one of the three buckets, the media took that to mean variants don't cause problems. And I just come back to reaffirm, some of them are real big problems.

    To be clear, this is not unusual in a virus that variants would emerge. But you're saying you really can't track the path of what these variants will do, because they're kind of new beasts to be studied?
    Well, what's happened is, they've acquired an ability to mutate that we haven't seen before. In fact, in the early days of the pandemic, when we had talked about kind of aging the virus and that it was relatively new into humans, likely having been in animals first, we actually base that on what was that time some kind of orderly increase in mutations that would occur. Now we're seeing viruses go from, you know, three or four mutations to 23 mutations just like that.

    Remember, a year ago, right now, this virus had hardly even tamed the world at all. I mean, it was not there. And so what's happened is over the course of the past year, particularly as we've had more and more immunity, developing people previously infected, for this virus to survive, and actually proliferate, one of the things that wants to do is basically get around that immune protection that our previous infections for vaccines have given us. They didn't have to worry about that a year ago, because there was really very few people out there.

    We call this basically microevolution, the virus is adapting to the conditions. And the problem is the way it's adapting. It's concerning us about our immunity. The second thing, it's kind of in the survival of the fittest, this B.1.1.7 is much more capable of being transmitted. That's why we're so concerned that the conditions that we took even six to 10 weeks ago, may not be sufficient to reduce transmission now.

    Meaning if I went to an indoor air environment, and there was some virus in there, because somebody was infected, but I had a mask on, I didn't spend too much time in there, I might not have gotten infected today, that might be a situation where you would get infected just because of the increased virus. That's what makes us so challenging right now. It's not being transmitted any different ways than we see with the previous viruses. It's just that there's more of it. There's more of it in the air, and it's more likely to to infect you.

    When you said, the darkest days of the pandemic, may be ahead. You said that on Meet the Press and you're this morning saying yes, this is what I see. Does that mean darkest days being when we were at the top of these spikes in November, December, January? Is that what this is going to look like in the next 60 days?
    Well, let me just give a sense of what we call shifting baselines, it’s something I've been trying to help people understand because it really reflects and how they think about where we're at and what's going on.

    We are today at, you know, 75,000 cases reported today, and everybody is feeling really good about that — 75,000 cases a day in July was a “house on fire” event. But if you go back to the beginning of the pandemic, you know, the first real big peak we saw in the United States was in April, when New York in particular was hit, but Chicago, Detroit, Atlanta, Seattle, Boston, you know, very little even activity in the upper Midwest, we hit 32,000 cases a day. And that was really bad.

    We got down by Memorial Day to 20,000 cases. And then the southern states from Southern California to Georgia lit up in July, we went up to 70,000 cases, remember, 32,000 was really bad. And then we got back down to 26,000 cases at Labor Day. And in fact, it was on Meet the Press shortly after that. And I said, I thought we'd hit 200,000 cases by Thanksgiving. People thought that was crazy.

    On Nov. 20, we hit 200,000 cases, then we came back down to 160,000 cases in mid-December. But then look what happened in early January, it hit 300,000 cases. So you see as a curve line here with the number of cases just keep going up and up and up for the highs and the lows.

    So what I'm concerned about is we're in one of those decreasing case number times, which is great, but none of us want to see anybody get infected, sick or hospitalized or die. So listen, we have to celebrate this. But what this has done is given us this false sense of security: we've won. If you just think about this right now we're loosening up everything, governors and mayors are under such pressure to loosen up everything. When you look at vaccine, it's coming and it's in right now with the B.1.1.7. This vaccine will work but we're not going to have nearly enough in time. Our studies have shown that if we keep up the current vaccine efforts we’re doing now, by the end of March we will still have 30 million out of 54 million persons in this country over age 65 who have not had a drop of vaccine. Those people are going to be at high risk for this virus. And I think it's going to take off in early to mid-March. And we're gonna see that next big peak, and it will very possibly exceed what we saw in January.


    If it ends up being only 30 million out of 54 million people over 65 that have any of the vaccine and people who have already had covid could become infected with the new variant I don't see how we won't be another spike. Osterholm goes into good detail on the 3 possible problems with the new variants.
     
    Moderna and Pfizer both reiterated their supply commitments, and with the J&J vaccine being approved any day. Every single adult who wants a shot will have one before even the summer. The last leg of this will be getting the anti-vaccine group on board.
    I know these people won't listen, but the mRNA vaccines were possible because of the work on cancer vaccines. If they get cancer 10 years from now, chances are they are going to take a mrna cancer treat.
    From what I've read nowhere near as many people will have the vaccine by the summer. Where did you see that claim?
     
    From what I've read nowhere near as many people will have the vaccine by the summer. Where did you see that claim?

    Supply commitments:


    Pfizer has said that it expects to deliver 120 million doses to the U.S. by the end of March, 20 million ahead of its original schedule. Moderna has said it will deliver 100 million doses. Assuming these production schedules hold, that means that 220 million doses, enough to fully vaccinate 110 million people, will be delivered within a month and a half from today.

    That alone is over half the adult population vaccinated by April. We will quickly run into issues finding willing people to get the shot.
     
    Supply commitments:




    That alone is over half the adult population vaccinated by April. We will quickly run into issues finding willing people to get the shot.
    Supply commitments are one thing, but at our current pace of administering the vaccine we should have half of the country at least partially vaccinated by August.
    Screenshot_20210222-070310_NYTimes.jpg
     
    Supply commitments are one thing, but at our current pace of administering the vaccine we should have half of the country at least partially vaccinated by August.
    Screenshot_20210222-070310_NYTimes.jpg
    I don't think our pace has been linear. But I haven't kept up the last week or two.
     
    Supply commitments:




    That alone is over half the adult population vaccinated by April. We will quickly run into issues finding willing people to get the shot.
    To be fair, that's just under 1/3rd of the US population. 100M vaccinated. Doses divided by 2.
     
    To be fair, that's just under 1/3rd of the US population. 100M vaccinated. Doses divided by 2.

    The adult population in this country is around 200 million. There is no currently approved vaccine for children.

    I also didn't include the J&J vaccine, and it could be approved for use next week. That's going to add to these numbers. We are quickly going to be down to the anti-vaxxers.
     
    The adult population in this country is around 200 million. There is no currently approved vaccine for children.

    I also didn't include the J&J vaccine, and it could be approved for use next week. That's going to add to these numbers. We are quickly going to be down to the anti-vaxxers.

    Indeed, and it's not gonna take until August, much less January of '22. I think we'll be in good shape by May/June.
     
    Indeed, and it's not gonna take until August, much less January of '22. I think we'll be in good shape by May/June.

    Yeah, the other point being brought up is capping capacity to administer the vaccine. That may happen, we may have a upper limit, but it must be much higher then it is now. I can only speak anecdotally, but all my local pharmacies have supply issues.

    I don't see how by June everyone who wants the vaccine doesn't have it.

    The real issue will be the anti-vaxxers. They will see plummeting numbers, and won't feel motivated to get the vaccine.
     
    Yeah, the other point being brought up is capping capacity to administer the vaccine. That may happen, we may have a upper limit, but it must be much higher then it is now. I can only speak anecdotally, but all my local pharmacies have supply issues.

    I don't see how by June everyone who wants the vaccine doesn't have it.

    The real issue will be the anti-vaxxers. They will see plummeting numbers, and won't feel motivated to get the vaccine.

    Yeah it's a problem but..once we get down to the point that it's just the anti-vaxxers it'll then be time to let up on most restrictions (sans maybe masks, handshaking, etc stuff like that).

    There is no eradicating this virus so let the ones who don't want to get the vaccine deal with the risks and we can really get back to proceeding as normal.
     
    Indeed, and it's not gonna take until August, much less January of '22. I think we'll be in good shape by May/June.
    That was from the New York Times based on the current daily vaccination rate. Supply issues will continue for the next few months, but not having enough people to administer the vaccine is also a problem.

    Where are you seeing projections that most people will be vaccinated by May/June?
     
    That was from the New York Times based on the current daily vaccination rate. Supply issues will continue for the next few months, but not having enough people to administer the vaccine is also a problem.

    Where are you seeing projections that most people will be vaccinated by May/June?

    If you figure we've been vaccinating people at a million+ per day, and with more vaccines coming online, we should be seeing 1.5 to 2 million/day before long. That's a lot of people getting vaccinated. If we're talking say 200 million adults, most of those who want to get vaccinated will be able to do so within the next 5-6 months. That's just math. Now there may be bottlenecks that can slow things down, but once the logistics kinks get ironed out, I think we'll see increasing numbers of people getting vaccinated in pretty short order.
     
    Yeah it's a problem but..once we get down to the point that it's just the anti-vaxxers it'll then be time to let up on most restrictions (sans maybe masks, handshaking, etc stuff like that).

    There is no eradicating this virus so let the ones who don't want to get the vaccine deal with the risks and we can really get back to proceeding as normal.

    I think the mask thing is here to stay on some level. It will never be weird to see someone with a mask on in a store.
     

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