COVID-19

[Stoner]

I can't believe we're not past "this is the just the flu." Do we really need to review all the ways this isn't the flu? We could start with CDC figures from 17-18 that say less than 2% of people with the flu needed to hospitalized.

[LTS]

 

16 hours ago, Indabuff said:

I'm trying to wrap my head around this response.  If my mother-in-law who has a  significant amount of underlying health issues is infected you think it would be okay if she was unable to get necessary medical attention here because people from 300 miles away were brought here to be treated for the infection?  You would be okay with your own family member or friend not being able to receive medical treatment because of this scenario?

Bigger picture, you actually think ADDING infected people to an area that is just beginning to see an increase in infections is a good idea?  Please explain to me the logic in that.  

 

What's okay?  Whose life is more important? To you, your mother-in-law, to the person whose loved one needs treatment, it's their loved one.  You are both right and both wrong. 

There are many possible ways to deal with something like this. None of them are good. There is nothing good about this situation. It's an absolute mess.  These are the types of scenarios that you don't plan for because people don't want to hear about it. They are the situations that when you do plan for them and tell people to expect the worst they dismiss it because they refuse to accept that something can have such an impact.  "Your problem is not my problem, my problem is more important than yours." We largely live a life where its all about us and people we know and those we don't are irrelevant or at the very least not as important. 

Let's talk about moving people around so as to reduce the strain and impact on medical professionals.  Let's talk about moving people around to distribute the infected cases to reduce strain on supply chain logistics and other related issues that arise when too much of one thing is in one area. Let's tell the tale of two cities here with Woody and North Buffalo who are each in different hospitals with vastly different experiences in patient composition.  Does it make sense to subject Woody to patients from New Rochelle?  Does it make sense to leave North Buffalo in the middle of an incredibly dense outbreak of the COVID virus and wish him luck?  Hell does it make sense to make it worse? 

In a situation where you have patient A who might need treatment and patient B who does need treatment, who do you choose? The threat indicator would suggest that patient B is in a more pressing situation. All lives being equal, patient B gets treated first and if patient A needs treatment once patient B is consuming the systems resources, then patient A is an unfortunate consequence of circumstance.

Let's complicate the discussion.  Let's riff of what Woody posted above.  Patient A may need treatment. Patient B needs treatment but has a terminal illness already.  Do you consume resources working on Patient B at the expense of Patient A?  If Patient A needs treatment after B starts do you shift resources to A?  After all, Patient B is going to die from another cause even if you can get them to survive COVID. 

The situations are not as simple as one would like to make it. It's natural to get emotional and say, "My family member is more important." It's natural, but in the objective view of the world, it's not true.  Certainly one could go down the slippery slope of comparing the value of a persons life relative to what they create in society.  That's not a road I would go down.

[Wyldnwoody44]

34 minutes ago, SwampD said:

Do you think it’s because we’ve never had this level of social media usage before?

I think that is part of it, not all of it, but it's not helping. 

[Wyldnwoody44]

16 minutes ago, PASabreFan said:

I can't believe we're not past "this is the just the flu." Do we really need to review all the ways this isn't the flu? We could start with CDC figures from 17-18 that say less than 2% of people with the flu needed to hospitalized.

It's not the flu as in influenza, but it's grossly similar, it's a virus, a novel virus similar to the flu, a novel virus (swine). 

I'm indurated with information about all of this stuff, but I also have real life experience working through H1N1, we easily could have had this level of involvement with H1N1 but we didn't, even with many more deaths than what the predictions are here with this virus. 

The Info I'm seeing and hearing from colleagues and news media are varying from day to day and site to site. It's hard to grasp exactly. 

[Indabuff]

27 minutes ago, LTS said:

 

 

It's natural to get emotional and say, "My family member is more important." It's natural, but in the objective view of the world, it's not true.  Certainly one could go down the slippery slope of comparing the value of a persons life relative to what they create in society.  That's not a road I would go down.

I never said my family member was more important than anyone else.  I used my MIL as an example.  Not sure where you pulled that from my responses but that is clearly not the argument I'm making.  If someone 300 miles away is in the process of receiving or is in need of receiving medical treatment for the virus, I find it ridiculous they would a) be transported to an area from dense infection to an area of low infection jeopardizing the new area to further probability of increasing infections and b) potentially deprive someone locally (MIL, you, me, Sabretooth) of any locality for that matter (patient from Detroit, MI->Sharon, PA) of necessary medical treatment for the virus. 

I voiced my opinion on the topic, received a seemingly snarky retort, and asked for a logical explanation from the poster.  I followed that up with a statement that I wasn't interested in a pissing match (see last night posts) and still have no interest in said pissing match.    

[nfreeman]

The question of whether a city could legally refuse to accept patients from another city, especially in the same state, and especially where the hospitals receive state money, is interesting. I doubt that a city could do this.

The question of whether it would be morally right to do so is a separate and also interesting question.  I think in considering that question, weighing one city’s lives against the other’s is unavoidable.

[Taro T]

1 hour ago, LTS said:

 

What's okay?  Whose life is more important? To you, your mother-in-law, to the person whose loved one needs treatment, it's their loved one.  You are both right and both wrong. 

There are many possible ways to deal with something like this. None of them are good. There is nothing good about this situation. It's an absolute mess.  These are the types of scenarios that you don't plan for because people don't want to hear about it. They are the situations that when you do plan for them and tell people to expect the worst they dismiss it because they refuse to accept that something can have such an impact.  "Your problem is not my problem, my problem is more important than yours." We largely live a life where its all about us and people we know and those we don't are irrelevant or at the very least not as important. 

Let's talk about moving people around so as to reduce the strain and impact on medical professionals.  Let's talk about moving people around to distribute the infected cases to reduce strain on supply chain logistics and other related issues that arise when too much of one thing is in one area. Let's tell the tale of two cities here with Woody and North Buffalo who are each in different hospitals with vastly different experiences in patient composition.  Does it make sense to subject Woody to patients from New Rochelle?  Does it make sense to leave North Buffalo in the middle of an incredibly dense outbreak of the COVID virus and wish him luck?  Hell does it make sense to make it worse? 

In a situation where you have patient A who might need treatment and patient B who does need treatment, who do you choose? The threat indicator would suggest that patient B is in a more pressing situation. All lives being equal, patient B gets treated first and if patient A needs treatment once patient B is consuming the systems resources, then patient A is an unfortunate consequence of circumstance.

Let's complicate the discussion.  Let's riff of what Woody posted above.  Patient A may need treatment. Patient B needs treatment but has a terminal illness already.  Do you consume resources working on Patient B at the expense of Patient A?  If Patient A needs treatment after B starts do you shift resources to A?  After all, Patient B is going to die from another cause even if you can get them to survive COVID. 

The situations are not as simple as one would like to make it. It's natural to get emotional and say, "My family member is more important." It's natural, but in the objective view of the world, it's not true.  Certainly one could go down the slippery slope of comparing the value of a persons life relative to what they create in society.  That's not a road I would go down.

All good points.  But in all of this, there is still one additional level of "heightened interaction" for lack of a better phrase; but, especially while the incidence of patients upstate remains "low" (however designated) and there have been additional structural resources brought in to NYC & surrounding (Javitts Center prepped for patient admittance / screening; at least 1 Naval medical ship, additional respirators delivered, etc.), another possible remedy (not saying it is the right one, but it is one) is for medical personnel from less taxed regions voluntarily helping with the effort.  

When areas are hit with disasters, non-locals often help out the relief effort.  That, at 1st glance, makes more sense than shipping contagious people from where they are from to get added to the population of another area.

And, if that isn't feasible (it may not be), transferring non-COVID 19 patients to other regions may have a similar effect on reducing the load on providers and supplies (though obviously not ventilators) to allow the staff and facilities in NYC have the capacity to keep up with the demand.  (Which also may not be feasible, but it would, again on 1st glance, seem as feasible as transporting the patients that already have the virus.)

[Eleven]

53 minutes ago, nfreeman said:

The question of whether a city could legally refuse to accept patients from another city, especially in the same state, and especially where the hospitals receive state money, is interesting. I doubt that a city could do this.

The question of whether it would be morally right to do so is a separate and also interesting question.  I think in considering that question, weighing one city’s lives against the other’s is unavoidable.

To me, it comes down to FIFO.  Gotta treat the patient who is ill NOW, and hope that the bed frees up for someone who becomes ill later.  I have no problem with the idea of St. Josephs taking in patients from Elmhurst.  I don't know how they'd get here, though.

2 hours ago, Wyldnwoody44 said:

I Was at Millard suburban that year I believe, we were using thr GI endoscopy suite as overflow from the ER due to the bad flu, the same precautions held, if you're young and healthy, stay home drink soup. Older people and those who are immuncompromised need us more. 

This is very similar and the ER's are getting overrun across the globe, I just have seen so much worse in other countries before, including ebola, and some time in Iraq, so it's hard for me to have the same level of panic and fear personally that many others have in society. 

Were you at Suburban in 2013 by any chance?

[Wyldnwoody44]

2 minutes ago, Eleven said:

To me, it comes down to FIFO.  Gotta treat the patient who is ill NOW, and hope that the bed frees up for someone who becomes ill later.  I have no problem with the idea of St. Josephs taking in patients from Elmhurst.  I don't know how they'd get here, though.

Were you at Suburban in 2013 by any chance?

I believe I was 

[Zamboni]

Abbott Launches 5-Minute Virus Test for Use Almost Anywhere!

https://www.bloomberg.com/news/articles/2020-03-27/abbott-launches-5-minute-covid-19-test-for-use-almost-anywhere?utm_campaign=news&utm_medium=bd&utm_source=applenews

 

[Stoner]

3 hours ago, Wyldnwoody44 said:

It's not the flu as in influenza, but it's grossly similar, it's a virus, a novel virus similar to the flu, a novel virus (swine). 

I'm indurated with information about all of this stuff, but I also have real life experience working through H1N1, we easily could have had this level of involvement with H1N1 but we didn't, even with many more deaths than what the predictions are here with this virus. 

The Info I'm seeing and hearing from colleagues and news media are varying from day to day and site to site. It's hard to grasp exactly. 

H1N1. Is that the one that hospitalized an estimated 4.5% of those who got it and killed .02%? That's five times lower than the death rate for influenza. The scale of Covid 19 is what is terrifying governments. One in five going to the hospital and one in 20 needing ICUs and one in 100 dying... you just can't let that roll through the population. Early in the pandemic, hospitals in some places are getting overrun. What would it have looked like if no mitigation had been done?

Edited March 28, 2020 by PASabreFan

[LTS]

2 hours ago, Taro T said:

All good points.  But in all of this, there is still one additional level of "heightened interaction" for lack of a better phrase; but, especially while the incidence of patients upstate remains "low" (however designated) and there have been additional structural resources brought in to NYC & surrounding (Javitts Center prepped for patient admittance / screening; at least 1 Naval medical ship, additional respirators delivered, etc.), another possible remedy (not saying it is the right one, but it is one) is for medical personnel from less taxed regions voluntarily helping with the effort.  

When areas are hit with disasters, non-locals often help out the relief effort.  That, at 1st glance, makes more sense than shipping contagious people from where they are from to get added to the population of another area.

And, if that isn't feasible (it may not be), transferring non-COVID 19 patients to other regions may have a similar effect on reducing the load on providers and supplies (though obviously not ventilators) to allow the staff and facilities in NYC have the capacity to keep up with the demand.  (Which also may not be feasible, but it would, again on 1st glance, seem as feasible as transporting the patients that already have the virus.)

I'm not in disagreement with you here.  There are all kinds of options and at the moment so many are just options, not actions. Overall the key is to take a deep breath and then let it out slowly.  

[Randall Flagg]

39 minutes ago, PASabreFan said:

H1N1. Is that the one that hospitalized an estimated 4.5% of those who got it and killed .02%? That's five times lower than the death rate for influenza. The scale of Covid 19 is what is terrifying governments. One in five going to the hospital and one in 20 needing ICUs and one in 100 dying... you just can't let that roll through the population. Early in the pandemic, hospitals in some places are getting overrun. What would it have looked like if no mitigation had been done?

Straight comparison of those stats doesn't tell us much. Wasn't it as recently as a week or so ago that almost nobody in the US could get a test? So you're comparing a post-analysis count for hospitalizations and deaths as a fraction of known cases (which they're likely far more confident in after they could do things like the antibody tests they're talking about developing for coronavirus) to numbers of known coronavirus hospitalizations/deaths (pretty well known) as a fraction of a much more uncertain number, that is DEFINITELY a tiny fraction of actual total US (or anywhere else) cases, since we just started testing people like a week ago. It's pretty meaningless until we get more data on how many Americans have contracted this disease. You'd need to compare to a couple weeks into an H1N1 scare, and even then who knows what similarities and differences there were in our ability to get data on either of these diseases in real time. 

The big scary numbers should almost certainly be a LOT smaller once we have real data. I'd put a lot of money on the 3-4% fatality rate being an order of magnitude too high, and possibly two. This isn't to say that coronavirus is no big issue - obviously we need to bulk up our hospitals should this thing stick around for the long haul, because it is causing chaos and scary amounts of death and permanent lung damage, etc. The biggest issue really appears to be the fact that we don't have the resources to care for all of these patients in addition to our typical number of patients. That's why "second-wave" doom and gloom isn't as scary to me as it is for others - no, we don't need to sit in our houses for the next 18 months, because it's not like a brief summer respite will be spent by humans forgetting everything that happened and just waiting to get walloped again - we will be more and more ready for each successive wave 

(This is all opinion, I am an expert in nothing) 

Edited March 28, 2020 by Randall Flagg

[Eleven]

1 hour ago, Zamboni said:

Abbott Launches 5-Minute Virus Test for Use Almost Anywhere!

https://www.bloomberg.com/news/articles/2020-03-27/abbott-launches-5-minute-covid-19-test-for-use-almost-anywhere?utm_campaign=news&utm_medium=bd&utm_source=applenews

 

Is it reliable?  Article doesn't discuss that.

[Zamboni]

5 minutes ago, Eleven said:

Is it reliable?  Article doesn't discuss that.

I honestly don’t know.

But I guess another question would be, if it isn’t reliable, why did the FDA approve it? And another one would be, why are they gonna have thousands of them online to do tests if it’s not a reliable test?

I just thought it was hopeful, positive news I wanted to share.  ?‍♂️

[Eleven]

6 minutes ago, Zamboni said:

But I guess another question would be, if it isn’t reliable, why did the FDA approve it? And another one would be, why are they gonna have thousands of them online to do tests if it’s not a reliable test?

Well, the answer to question one is that we're throwing everything against the wall right now, as we should be.  To question two, to make money.

I didn't mean to imply that you should have all the answers, sorry!

[Taro T]

1 hour ago, Zamboni said:

Abbott Launches 5-Minute Virus Test for Use Almost Anywhere!

https://www.bloomberg.com/news/articles/2020-03-27/abbott-launches-5-minute-covid-19-test-for-use-almost-anywhere?utm_campaign=news&utm_medium=bd&utm_source=applenews

 

?

If it is accurate, it could be a game changer.

Wonder what accuracy level would be required to have this test be used for recommending those to be be quarantined to have an appreciable effect on slowing the spread of the virus? Obviously, it would need to be over 90%, curious how much over that it needs to be to be more useful in the grand scheme than the current 5 day test?

[Indabuff]

One thing is certain, for me at least.  If you were to tell me a year ago this was going to happen I would have told you to get off the crack pipe.

[Marvin]

2 hours ago, Zamboni said:

Abbott Launches 5-Minute Virus Test for Use Almost Anywhere!

https://www.bloomberg.com/news/articles/2020-03-27/abbott-launches-5-minute-covid-19-test-for-use-almost-anywhere?utm_campaign=news&utm_medium=bd&utm_source=applenews

 

My sister's company is helping with the testing of these machines.  The one caveat she gives is that many of these kinds of tests are not full tests (those usually take days), so they often have high false positive and/or false negative rates.  There are ways around this, but with throughput being a major issue, I don't know what may be needed that I don't know about.

[North Buffalo]

Also the deaths being reported by John's Hopkins seems to be a couple days behind., eg. Westchester only reported to be 10... there was in New Rochelle yesterday and at least 2 at StJoes in Yonkers

[Stoner]

1 hour ago, Randall Flagg said:

Straight comparison of those stats doesn't tell us much. Wasn't it as recently as a week or so ago that almost nobody in the US could get a test? So you're comparing a post-analysis count for hospitalizations and deaths as a fraction of known cases (which they're likely far more confident in after they could do things like the antibody tests they're talking about developing for coronavirus) to numbers of known coronavirus hospitalizations/deaths (pretty well known) as a fraction of a much more uncertain number, that is DEFINITELY a tiny fraction of actual total US (or anywhere else) cases, since we just started testing people like a week ago. It's pretty meaningless until we get more data on how many Americans have contracted this disease. You'd need to compare to a couple weeks into an H1N1 scare, and even then who knows what similarities and differences there were in our ability to get data on either of these diseases in real time. 

The big scary numbers should almost certainly be a LOT smaller once we have real data. I'd put a lot of money on the 3-4% fatality rate being an order of magnitude too high, and possibly two. This isn't to say that coronavirus is no big issue - obviously we need to bulk up our hospitals should this thing stick around for the long haul, because it is causing chaos and scary amounts of death and permanent lung damage, etc. The biggest issue really appears to be the fact that we don't have the resources to care for all of these patients in addition to our typical number of patients. That's why "second-wave" doom and gloom isn't as scary to me as it is for others - no, we don't need to sit in our houses for the next 18 months, because it's not like a brief summer respite will be spent by humans forgetting everything that happened and just waiting to get walloped again - we will be more and more ready for each successive wave 

(This is all opinion, I am an expert in nothing) 

When the pre-eminent infectious disease expert in the country says he thinks the mortality rate is/will be about 1%, that's good enough for me.

2 hours ago, LTS said:

I'm not in disagreement with you here.  There are all kinds of options and at the moment so many are just options, not actions. Overall the key is to take a deep breath and then let it out slowly.  

True. Especially since the rate of increase in hospitalizations in NYC has been slowing in recent days. And the number of people being admitted to the hospital and the number being sent to ICUs went down from yesterday to today (or maybe it was Thursday to Friday).

Edited March 28, 2020 by PASabreFan

[Indabuff]

On 3/27/2020 at 9:24 AM, Crosschecking said:

A couple of pictures. The top one is an exemption memo from the USDA. The second one is that trailer full of apples. Keep in mind that this is a 53'/16.15m trailer with a refrigeration unit on it.

 

 

 

Just curious, were those US origin apples you were hauling?

[dudacek]

Here’s an interesting example of how dangerous it is to compare numbers for jurisdiction to jurisdiction.

Nearly half of the positive cases in my province, British Columbia, are now deemed “recovered” while barely anyone else in Canada has met that standard. This article explains why.

https://www.vancouverislandfreedaily.com/news/b-c-is-seeing-the-highest-rate-of-covid-19-recovery-in-canada-and-theres-a-few-reasons-why/

Who you are testing, how many, and how put a lot of variables in the soup.

[FogBat]

2 hours ago, Indabuff said:

Just curious, were those US origin apples you were hauling?

I believe they were. The place I picked them up from specialized in produce, and i didn't need a TWIC card to get in.

[Indabuff]

7 minutes ago, Crosschecking said:

I believe they were. The place I picked them up from specialized in produce, and i didn't need a TWIC card to get in.

I may have missed where you picked up the load as well.  Care to share?  Nothing nefarious just wondering.