Will the Coming Season be Different Because of COVID-19?

[steelreserve]

Good read:
https://api.nationalgeographic.com/d...mpression=true

It appears that even back then, they knew the two best ways to fight a pandemic: social distancing and washing one’s hands. Weird.

Worth noting: The measures lauded in the article as a smashing success were much less extreme than today's.

Following the links back to the research underlying the famous Philadelphia vs. St. Louis example that is cited to death ... it would appear the difference in cumulative death rate was on the order of 350 in 100,000. In other words, a difference of 0.35%. No, literally. Science.

If we lived in a vacuum, then clearly you would favor the more extreme approach. Since we don't live in a vacuum, if the tradeoff would be 0.35% in exchange for ... this? Time to have a drink and throw a parade. No lockdown doubles the relatively low death rate? Cool, no lockdown.

Here's the thing, though. Even the "no lockdown" approach, advocated by the science-denying Neanderthals such as myself - would be pretty similar to the St. Louis approach from 1918. It is not even asking for anything radically different from that. It is advocating the same "reasonable precautions," but we have a frame shift - what is considered reasonable or even acceptable has lately been moved dramatically. Some would say almost to the point of insanity. We have actually moved way, way far beyond the reasonable precautions that have proven to be effective. But we are not allowed to talk about that.

The other very important difference is that medical care in 1918, for lack of a better way of putting it, couldn't really do shit for you in a case like this. In the hospital, out of the hospital, whatever - no real treatment other than lay there and hope you get better. At least today they know things now like ... how the lungs work, or how to treat the symptoms of viral pneumonia so they kill you less often. One would think that brings the gap down even lower. If we are using 1918 as an example, and the difference between reasonable precautions and utter recklessness was 0.35%, what would that be today? Half that? A third? But we are not allowed to talk about that either.

Lockdown or death; shame on anyone seeking a practical frame of reference. Shame! Shame! That's the discussion.

[tom444]

[AtlantaDan]

Linking to an interview with former Jags great Tony Boselli, who got the virus and landed in the ICU for 5 days - so much for only the elderly and those in poor health needing to be really concerned

https://www.jacksonville.com/news/20200402/tony-boselli-coronavirus-rsquoburied-mersquo-jaguars-great-says

[teegre]

Worth noting: The measures lauded in the article as a smashing success were much less extreme than today's.

Following the links back to the research underlying the famous Philadelphia vs. St. Louis example that is cited to death ... it would appear the difference in cumulative death rate was on the order of 350 in 100,000. In other words, a difference of 0.35%. No, literally. Science.

If we lived in a vacuum, then clearly you would favor the more extreme approach. Since we don't live in a vacuum, if the tradeoff would be 0.35% in exchange for ... this? Time to have a drink and throw a parade. No lockdown doubles the relatively low death rate? Cool, no lockdown.

Here's the thing, though. Even the "no lockdown" approach, advocated by the science-denying Neanderthals such as myself - would be pretty similar to the St. Louis approach from 1918. It is not even asking for anything radically different from that. It is advocating the same "reasonable precautions," but we have a frame shift - what is considered reasonable or even acceptable has lately been moved dramatically. Some would say almost to the point of insanity. We have actually moved way, way far beyond the reasonable precautions that have proven to be effective. But we are not allowed to talk about that.

The other very important difference is that medical care in 1918, for lack of a better way of putting it, couldn't really do shit for you in a case like this. In the hospital, out of the hospital, whatever - no real treatment other than lay there and hope you get better. At least today they know things now like ... how the lungs work, or how to treat the symptoms of viral pneumonia so they kill you less often. One would think that brings the gap down even lower. If we are using 1918 as an example, and the difference between reasonable precautions and utter recklessness was 0.35%, what would that be today? Half that? A third? But we are not allowed to talk about that either.

Lockdown or death; shame on anyone seeking a practical frame of reference. Shame! Shame! That's the discussion.

As I posted earlier, people refused to adhere to the precautions and/or to act reasonably. Hence, mandates were made.

[Mojouw]

Worth noting: The measures lauded in the article as a smashing success were much less extreme than today's.

Following the links back to the research underlying the famous Philadelphia vs. St. Louis example that is cited to death ... it would appear the difference in cumulative death rate was on the order of 350 in 100,000. In other words, a difference of 0.35%. No, literally. Science.

If we lived in a vacuum, then clearly you would favor the more extreme approach. Since we don't live in a vacuum, if the tradeoff would be 0.35% in exchange for ... this? Time to have a drink and throw a parade. No lockdown doubles the relatively low death rate? Cool, no lockdown.

Here's the thing, though. Even the "no lockdown" approach, advocated by the science-denying Neanderthals such as myself - would be pretty similar to the St. Louis approach from 1918. It is not even asking for anything radically different from that. It is advocating the same "reasonable precautions," but we have a frame shift - what is considered reasonable or even acceptable has lately been moved dramatically. Some would say almost to the point of insanity. We have actually moved way, way far beyond the reasonable precautions that have proven to be effective. But we are not allowed to talk about that.

The other very important difference is that medical care in 1918, for lack of a better way of putting it, couldn't really do shit for you in a case like this. In the hospital, out of the hospital, whatever - no real treatment other than lay there and hope you get better. At least today they know things now like ... how the lungs work, or how to treat the symptoms of viral pneumonia so they kill you less often. One would think that brings the gap down even lower. If we are using 1918 as an example, and the difference between reasonable precautions and utter recklessness was 0.35%, what would that be today? Half that? A third? But we are not allowed to talk about that either.

Lockdown or death; shame on anyone seeking a practical frame of reference. Shame! Shame! That's the discussion.

Once again, your inability to understand the inter-relationships between variables and the contributing factors to what does or does not shift the order of magnitude of a given variable is just so much more than you appear to actual comprehend.

It is not as simple as 350 in 100,000. I am just going to assume your math is actually correct on that. Because what does 350 more patients in a given place mean? If 350 were already sick and there were only enough medical resources for 500 total patients, well then 350 more patients means a great deal. If there are medical resources for 1000, well then it might not mean that much. If there is only capacity for 250 patients and you add another 350 that is already 100 over capacity -- well then everyone is well and truly screwed. I concede that I know nothing about hospital capacities at early 20th century hospitals, but that is the point. Neither do you. And that is a critical variable that give explanatory utility to any numbers that are getting tossed around. Just simple counting or rate stats are difficult to use because they lack any surrounding context or benchmark references.

Take a look at those graphs in the article that Teegre linked to or the one that you linked to. The idea is that if the entire country experiences a Philly style peak, healthcare collapses. So then death rate overall goes up and blah, blah, blah -- the math looks terrifying. Remember, that there was a natural seasonal ebb and flow to influenza that was a serious mitigating factor in 1918. Early data indicates that there is no such luck with this bug. So, all of your math is based on a "static" model. Where you can just keep feeding numbers in and the rates don't change. What health care experts are saying is that if you keep feeding numbers (patients) in, those rate variables are going to spike as the healthcare system fails to keep pace. Essentially there is a 14-21 day delay from "today" to when we see the impact of those actions. From a reading of your posts, you repeatedly and consistently fail to take that dynamism into account.

[teegre]

Also, flattening the curve means stretching the number “in the hospital” at any one time. It’s not solely about the numbers over the course of the pandemic.

But, let’s assume it is about total numbers of deaths. If I am reading what you wrote correctly, the difference would reduce the number of deaths by 350 for every 100,000 people... quick math says that that would save a total of 1,155,000 people. Maybe I’m missing something...

[steelreserve]

Once again, your inability to understand the inter-relationships between variables and the contributing factors to what does or does not shift the order of magnitude of a given variable is just so much more than you appear to actual comprehend.

It is not as simple as 350 in 100,000. I am just going to assume your math is actually correct on that. Because what does 350 more patients in a given place mean? If 350 were already sick and there were only enough medical resources for 500 total patients, well then 350 more patients means a great deal. If there are medical resources for 1000, well then it might not mean that much. If there is only capacity for 250 patients and you add another 350 that is already 100 over capacity -- well then everyone is well and truly screwed. I concede that I know nothing about hospital capacities at early 20th century hospitals, but that is the point. Neither do you. And that is a critical variable that give explanatory utility to any numbers that are getting tossed around. Just simple counting or rate stats are difficult to use because they lack any surrounding context or benchmark references.

Take a look at those graphs in the article that Teegre linked to or the one that you linked to. The idea is that if the entire country experiences a Philly style peak, healthcare collapses. So then death rate overall goes up and blah, blah, blah -- the math looks terrifying. Remember, that there was a natural seasonal ebb and flow to influenza that was a serious mitigating factor in 1918. Early data indicates that there is no such luck with this bug. So, all of your math is based on a "static" model. Where you can just keep feeding numbers in and the rates don't change. What health care experts are saying is that if you keep feeding numbers (patients) in, those rate variables are going to spike as the healthcare system fails to keep pace. Essentially there is a 14-21 day delay from "today" to when we see the impact of those actions. From a reading of your posts, you repeatedly and consistently fail to take that dynamism into account.

No, I mean those are the total numbers. Not there were an additional 350 per 100,000 sick people in the system and then it had other unknown effects snowballing beyond that to who knows what extent. The overall final score, if you will.

One place exercised caution, the other was not very cautious, and after accounting for everything that happened - the hospitals being overwhelmed or not; people ignoring the precautions or not - that was the difference in the death count. 0.35%. I didn't even do any math, it was part of the study.

Yes, clearly, this is not the same exact thing as the 1918 flu, or the H1N1 virus, or the regular flu; none of them are exactly the same. But since the 1918 flu was being used as the example, and is the frequent fear-inspiring comparison to today as the "granddaddy of them all" that people are afraid of, there's sense in addressing it.

By that standard, unless the coronavirus is orders of magnitude more contagious and deadly than the 1918 flu, right now we are sitting at about half to one-third the duration and one one-thousandth the death count, despite triple the population. Barring a complete and wild departure from all of those trends, it is going to come nowhere close. Yes, I am aware of the CONSTANTLY repeated maxim of overwhelming the health care system, ("flatten the curve!") and the reasoning behind that. It does not mean I have not considered it, rather that I have considered it and wondered how in the fuck you can get those numbers even if the hospitals were all overrun tomorrow.

Right now we have something that is, ignoring the hospital-overwhelming theory, on the order of one-thousandth as deadly as the big bad 1918 pandemic. What happens if, starting tomorrow, no one else can get into a hospital at all? Does it become 1,000 times more deadly? That's a bit of a stretch, because the numbers so far are more like just shy of 3% of detected cases end up going on a ventilator, and the survival rate from there is about 50% anyway. So that would seem to indicate even completely overwhelming the health care system would not come even close to increasing the danger 1,000-fold. To a complete dumbass like me, it looks like that would roughly double it, and even allowing for another 10x greater effect just because I'm a dumbass, it's still not even in the ballpark.

This is the part where you are supposed to shake your head and go, "why wont he just listen to the experts," but no really - has anyone even addressed that? Is there an explanation of how we actually get from Point A to Point B, or do we just talk about overwhelming the hospitals and leave our imaginations to fill in the difference?

The one very interesting piece of data from the 1918 study is that it would appear overwhelming the medical system and local resources resulted in about double the risk of dying (coincidentally very similar to what the percentages would suggest among those needing acute treatment today). If there is something special that would throw that off by 500 times or more if and only if the worst cases don't get treatment, why is that not patently obvious and being trumpeted everywhere.

I don't understand why it is heresy to even ask these things. A fundamental tenet of science is that it gladly accepts inquiry from all directions and meets the challenges or adjusts the hypothesis. It does not say "How dare you." Yet that is all I see in the public discourse. It is much closer to a religious argument than a scientific one.

[Mojouw]

No, I mean those are the total numbers. Not there were an additional 350 per 100,000 sick people in the system and then it had other unknown effects snowballing beyond that to who knows what extent. The overall final score, if you will.

One place exercised caution, the other was not very cautious, and after accounting for everything that happened - the hospitals being overwhelmed or not; people ignoring the precautions or not - that was the difference in the death count. 0.35%. I didn't even do any math, it was part of the study.

Yes, clearly, this is not the same exact thing as the 1918 flu, or the H1N1 virus, or the regular flu; none of them are exactly the same. But since the 1918 flu was being used as the example, and is the frequent fear-inspiring comparison to today as the "granddaddy of them all" that people are afraid of, there's sense in addressing it.

By that standard, unless the coronavirus is orders of magnitude more contagious and deadly than the 1918 flu, right now we are sitting at about half to one-third the duration and one one-thousandth the death count, despite triple the population. Barring a complete and wild departure from all of those trends, it is going to come nowhere close. Yes, I am aware of the CONSTANTLY repeated maxim of overwhelming the health care system, ("flatten the curve!") and the reasoning behind that. It does not mean I have not considered it, rather that I have considered it and wondered how in the fuck you can get those numbers even if the hospitals were all overrun tomorrow.

Right now we have something that is, ignoring the hospital-overwhelming theory, on the order of one-thousandth as deadly as the big bad 1918 pandemic. What happens if, starting tomorrow, no one else can get into a hospital at all? Does it become 1,000 times more deadly? That's a bit of a stretch, because the numbers so far are more like just shy of 3% of detected cases end up going on a ventilator, and the survival rate from there is about 50% anyway. So that would seem to indicate even completely overwhelming the health care system would not come even close to increasing the danger 1,000-fold. To a complete dumbass like me, it looks like that would roughly double it, and even allowing for another 10x greater effect just because I'm a dumbass, it's still not even in the ballpark.

This is the part where you are supposed to shake your head and go, "why wont he just listen to the experts," but no really - has anyone even addressed that? Is there an explanation of how we actually get from Point A to Point B, or do we just talk about overwhelming the hospitals and leave our imaginations to fill in the difference?

The one very interesting piece of data from the 1918 study is that it would appear overwhelming the medical system and local resources resulted in about double the risk of dying (coincidentally very similar to what the percentages would suggest among those needing acute treatment today). If there is something special that would throw that off by 500 times or more if and only if the worst cases don't get treatment, why is that not patently obvious and being trumpeted everywhere.

I don't understand why it is heresy to even ask these things. A fundamental tenet of science is that it gladly accepts inquiry from all directions and meets the challenges or adjusts the hypothesis. It does not say "How dare you." Yet that is all I see in the public discourse. It is much closer to a religious argument than a scientific one.

I'm not going to Google for you. You are capable of doing that all on your own. I, for one, have never said it is heresy to question any of this, but I do strongly question the fundamental variables and projections you are using to throw a bunch of numbers around. I don't think all of the assumptions and "math" you are using are actually valid. Again, this is the static vs dynamic argument.

Here is a recent comparative article I found that makes some intriguing points about differential responses: https://foreignpolicy.com/2020/04/02...ng-quarantine/

[steelreserve]

Also, flattening the curve means stretching the number “in the hospital” at any one time. It’s not solely about the numbers over the course of the pandemic.

But, let’s assume it is about total numbers of deaths. If I am reading what you wrote correctly, the difference would reduce the number of deaths by 350 for every 100,000 people... quick math says that that would save a total of 1,155,000 people. Maybe I’m missing something...

I think you're missing a couple of things. It's correct that you'd arrive at 1.1 million instead of about 550,000 using that set of assumptions. But that is assuming the level of care from a century ago. I'd be willing to bet that if this were 1918, virtually all of the people who needed critical care would just die in the hospital anyway because that didn't exist, and so would a lot of people who didn't need it. So the baseline would probably be higher. Maybe not - just a mere fan making a guess - but it wouldn't be surprising.

The other thing is that the 0.35% was the difference between reasonable precautions and fucking up entirely. We are talking about the difference between going from draconian measures to reasonable ones, not going from draconian measures to just saying fuck it. In other words, the difference between this and the St. Louis model. As we are seeing, it is impossible to drop the death rate all the way to zero no matter what you do, so you would expect the here-to-St. Louis effect to be much less than the from-St.-Louis-to-ignore effect. One would think you'd end up with the St. Louis death rate minus whatever difference modern technology makes, which is probably a lot. Of course, adjusting for all the differences and variables that nobody knows for sure.

[steelreserve]

I'm not going to Google for you. You are capable of doing that all on your own. I, for one, have never said it is heresy to question any of this, but I do strongly question the fundamental variables and projections you are using to throw a bunch of numbers around. I don't think all of the assumptions and "math" you are using are actually valid. Again, this is the static vs dynamic argument.

Here is a recent comparative article I found that makes some intriguing points about differential responses: https://foreignpolicy.com/2020/04/02...ng-quarantine/

Like I told our quack doctor friend, what in particular are you taking issue with? My general outlook is likely appalling, but that doesn't kill or cure a single person. Some assumptions are wrong, so which ones?

Those are the kinds of things worth debating and considering, which is a hell of a lot more useful than "shut up and don't question." The kind of stuff that's actually interesting.

Like, I probably read most of the same shit that you do. The fundamental difference at the center of everything seems to be that I just don't see the evidence that filling up the hospital system would be quite the catacylsmic disaster that's advertised. I can easily see the logic of why it's not ideal, but when we are making such a big leap in severity, I'm hesitant to take it on faith.

[Mojouw]

Like I told our quack doctor friend, what in particular are you taking issue with? My general outlook is likely appalling, but that doesn't kill or cure a single person. Some assumptions are wrong, so which ones?

Those are the kinds of things worth debating and considering, which is a hell of a lot more useful than "shut up and don't question." The kind of stuff that's actually interesting.

Like, I probably read most of the same shit that you do. The fundamental difference at the center of everything seems to be that I just don't see the evidence that filling up the hospital system would be quite the catacylsmic disaster that's advertised. I can easily see the logic of why it's not ideal, but when we are making such a big leap in severity, I'm hesitant to take it on faith.

I am kinda out of explanation words today. But what I am trying to communicate is that you are assuming that the rate stats you are basing most of your questions and perspectives around stay constant whether it be outbreak day 1, 100, 1,000, or whatever. My reading of the "logic" of all this is that those rate stats are incredibly dynamic and are dependent on a ton of other variables. So discussing this all in a static way "death rate is this and that" is most likely a flawed assumption. I am not certain, but I suspect based on my readings, that death rates, transmission rates, spread, etc. are dynamic variables that can move wildly during the entire duration of a given outbreak. Something like for days 1-100, the death rate is X. Then since some benchmark number of "stress" on health care systems is encountered, the death rate spikes to X+Y on days 100-150. Then if the "curve doesn't flatten" it becomes X+y+Z for every day after. Dynamic and fluctuating multi-variate math like what I am outlining does not really lend itself to this rate/counting stat will stay like this from start to finish.

[teegre]

I think you're missing a couple of things. It's correct that you'd arrive at 1.1 million instead of about 550,000 using that set of assumptions. But that is assuming the level of care from a century ago. I'd be willing to bet that if this were 1918, virtually all of the people who needed critical care would just die in the hospital anyway because that didn't exist, and so would a lot of people who didn't need it. So the baseline would probably be higher. Maybe not - just a mere fan making a guess - but it wouldn't be surprising.

The other thing is that the 0.35% was the difference between reasonable precautions and fucking up entirely. We are talking about the difference between going from draconian measures to reasonable ones, not going from draconian measures to just saying fuck it. In other words, the difference between this and the St. Louis model. As we are seeing, it is impossible to drop the death rate all the way to zero no matter what you do, so you would expect the here-to-St. Louis effect to be much less than the from-St.-Louis-to-ignore effect. One would think you'd end up with the St. Louis death rate minus whatever difference modern technology makes, which is probably a lot. Of course, adjusting for all the differences and variables that nobody knows for sure.

Clarification:
1,115,000 would be the reduced rate... down from 2,230,000 deaths (which would occur with the most minimal measures taken).

I understand that our modern medicines will help with the second wave (I hope). But, but for this first wave, almost nothing can help those who get it. Again, I understand that respirators will help a few (that is indeed something that’s better than 1918), but many people are simply going to die no matter what.

But, let’s say that respirators do indeed help with 100% effectiveness.

Back to flattening the curve, the reason it’s important is this. Let’s assume Hospital X has 350 respirators. If 350 people are hospitalized at once, all of the respirators are taken up. Now, steelreserve is watching Teen Wolf, and he decides to car surf. Boom!!!... he falls, hits his head, and needs a respirator. Oh well, they’re all taken up. Good bye, steelreserve. Imagine further if 400 cases hit at once... or 500 cases... Simply, it’s what is currently happening in New York.

Let’s use 600 as a total (for easy math). Now, spread those cases over three months; that is 200 per month, with 150 respirators left over for car surfers. The odds of people surviving goes way up not only for COVID sufferers, but also for people admitted for other reasons (due to having more resources and a staff that’s not overwhelmed).

Once again, if we had simply taken reasonable precautions, we could easily have spread these 600 cases out over three months. Alas, people flocked in droves to supermarkets creating (ironic) group gatherings. Other people flat-out refused to “change” anything about their daily life. In turn, the government was forced into mandating “quarantines”.

[silver & black]

I'm not saying a word for or against anyone's position/opinion on this. Just watch it.

https://youtu.be/4J0d59dd-qM

[steelreserve]

I am kinda out of explanation words today. But what I am trying to communicate is that you are assuming that the rate stats you are basing most of your questions and perspectives around stay constant whether it be outbreak day 1, 100, 1,000, or whatever. My reading of the "logic" of all this is that those rate stats are incredibly dynamic and are dependent on a ton of other variables. So discussing this all in a static way "death rate is this and that" is most likely a flawed assumption. I am not certain, but I suspect based on my readings, that death rates, transmission rates, spread, etc. are dynamic variables that can move wildly during the entire duration of a given outbreak. Something like for days 1-100, the death rate is X. Then since some benchmark number of "stress" on health care systems is encountered, the death rate spikes to X+Y on days 100-150. Then if the "curve doesn't flatten" it becomes X+y+Z for every day after. Dynamic and fluctuating multi-variate math like what I am outlining does not really lend itself to this rate/counting stat will stay like this from start to finish.

Yeah, we're basically talking about the same thing, it's not rocket science. To greatly simplify, X being the death rate if everyone who needs it gets treatment, Y the additional burden of people who can't get treatment once the system is full, and Z the backlog of people who keep piling up as long as the number of new infections exceeds the recovery rate. (Plus the death rate, but since that is low in any case, might as well just call it the recovery rate). If you want, Z acting more as a multiplier on Y.

That looks as if it can spiral out of control really badly, but the big BUT - what is the absolute maximum? Say it's all Z, no one at all gets any treatment. From what data is currently available, that's about 3% of cases that need critical care, the rest recover on their own. Critical care being about 50% effective, so the spread between X (1.5%) and Z (3%) is about double. The fact that nearly everyone recovers with less than that level of treatment, or none at all, is a huge backstop on the worst case. It's not going to get up to 50% of people dying no matter what you do. Then adjust downward by some degree, which is open for debate, for factors such as everyone is not going to be sick at the same time; the entire population is not going to be exposed at all (25-30% was more like it for bad pandemics of this type in the past); and the actual fatality rate could be anywhere from 2x-100x lower (both extremes) based on how many people with the virus are undetected because they never get tested.

If there is one thing about the 1918 data that compares to this, it's probably that places like St. Louis were closer to X and places like Philadelphia were closer to the X-Y-Z, and remarkably, it followed a similar pattern of about doubling even if you completely fucked up. More importantly, it proved that you can stay at level X without going to nearly the extremes we are today.

The thing about having a population of 330 million is that 0.3% is a million. 0.03% is a hundred thousand. The absolute number freaks people out, and while it certainly does suck, at some point you have to admit you do not have control over every fraction of a fraction of a percent, do your best, and figure out a plan that works in the real world, not just the medical one.

[tom444]

Well, we certainly wouldn't want this virus to inconvenience anybody.

[Craic]

A simpler way of putting it is, I don't believe a nationwide quarantine, let alone a global one, is remotely practical under any circumstances. It had damn well better be the Black Death if you are going to try, and this sure isn't it.

Meanwhile, the neighbors are texting that the alarm on their side door went off at 3 a.m. and there has been - you guessed it - another rash of car break-ins in the neighborhood. So I get to make decisions like, should I get the revolver out of storage despite having children in the house, including one with some fairly serious issues.

Yet idiots like you think that if anyone questions the unprecedented destructive and draconian measures in place, it's all "muh economy, oh no the stock market" or "poor me, I'm bored from staying at home." Talk about a privileged point of view, if that's all you can see.

SR,

The problem here is, you're letting your anecdotal experience stand as the common experience. Crime has gone down in most areas during the pandemic. Cities like Chicago, New York, Los Angeles (source); Philadelphia (source); San Jose (Santa Clara county, source); Burlington (source); Kansas City (source); Memphis (source); Los Vegas (source); Toronto (source); Atlanta (source); Toledo (source); and so on.

As for the number of deaths, we haven't even seen the start of it yet. Since March 15, there's been an average 12-13 percent increase in deaths every day. The total number of deaths have doubled approximately every four to seven days since January 23rd. As of the last five days, the average death rate for this virus is 4,461 people per day.

Yes, it's affecting the elderly more. Yes, it's affecting those who already have health issues more. But that doesn't mean anything. Why? I have asthma and am still a bit overweight. I am considered high risk if I get sick. Yet, I'm a fully-functional member of society with over 25 years left of production and earning potential.

And, all of this is predicated on the unrealistic numbers coming out of China. To be honest, there are many now who are arguing China probably underreported their deaths by almost 66 percent. Everything from the thousands of burial urns being stacked outside funeral homes to the constant use and capacity of those homes for cremation. There's also serious questions about numbers coming out of Iran, Russia, Indonesia, North Korea (they report 0, yeah, right!), Saudi Arabia, and Egypt.

And, think about this. The numbers being this low so far, is because of the quarantine.

[Mojouw]

Yeah, we're basically talking about the same thing, it's not rocket science. To greatly simplify, X being the death rate if everyone who needs it gets treatment, Y the additional burden of people who can't get treatment once the system is full, and Z the backlog of people who keep piling up as long as the number of new infections exceeds the recovery rate. (Plus the death rate, but since that is low in any case, might as well just call it the recovery rate). If you want, Z acting more as a multiplier on Y.

That looks as if it can spiral out of control really badly, but the big BUT - what is the absolute maximum? Say it's all Z, no one at all gets any treatment. From what data is currently available, that's about 3% of cases that need critical care, the rest recover on their own. Critical care being about 50% effective, so the spread between X (1.5%) and Z (3%) is about double. The fact that nearly everyone recovers with less than that level of treatment, or none at all, is a huge backstop on the worst case. It's not going to get up to 50% of people dying no matter what you do. Then adjust downward by some degree, which is open for debate, for factors such as everyone is not going to be sick at the same time; the entire population is not going to be exposed at all (25-30% was more like it for bad pandemics of this type in the past); and the actual fatality rate could be anywhere from 2x-100x lower (both extremes) based on how many people with the virus are undetected because they never get tested.

If there is one thing about the 1918 data that compares to this, it's probably that places like St. Louis were closer to X and places like Philadelphia were closer to the X-Y-Z, and remarkably, it followed a similar pattern of about doubling even if you completely fucked up. More importantly, it proved that you can stay at level X without going to nearly the extremes we are today.

The thing about having a population of 330 million is that 0.3% is a million. 0.03% is a hundred thousand. The absolute number freaks people out, and while it certainly does suck, at some point you have to admit you do not have control over every fraction of a fraction of a percent, do your best, and figure out a plan that works in the real world, not just the medical one.

Again, your not accounting for change in almost any of your variables. Look up sources on dependent versus independent variables and then go down the rabbit hole of single variate versus multivariate statistics. The fundamental assumption your making (and through no fault of your own) and your sources are making is that the variables hold constant over time. In the context of a vital outbreak, that just isn't true. Therefore if TODAY the mortality rate is X that has no relevance on the mortality rate tomorrow or next week or next month and on and on. Sure it can provide a floor, but it has almost no bearing on the ceiling. In this setting, the ceiling is the relevant measure.

It's a modern version of the old riddle about tricking a ruler to agreeing to double the payment from one grain on the first square of a chessboard and then 2 on the next and then 4 and so on. By the time you complete the board, the number is almost incalculable.

[tom444]

Dr. Fauci says the entire US should be under stay at home orders. For the neanderthals, that doesn't include essential workers.

The novel coronavirus has a strong grip in the United States and the nation's top infectious disease expert says the whole country should already be under orders to stay at home.

"I don't understand why that's not happening," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Thursday on CNN's Global Town Hall, "Coronavirus: Facts and Fears."

"If you look at what's going on in this country, I just don't understand why we're not doing that," Fauci added. "We really should be."

More than 90% of the US population will be under a local or state order this week but Fauci and other officials have said stricter measures are needed to slow down the spread of the virus.


https://www.cnn.com/2020/04/02/healt...day/index.html

[AtlantaDan]

The lack of testing drove ALL of this. It was the central failure that formed a pivot point for every subsequent decision and action.

Fortunately that problem is now in the rear view mirror

Health experts say they now believe nearly one in three patients who are infected are nevertheless getting a negative test result. They caution that only limited data is available, and their estimates are based on their own experience in the absence of hard science.

That picture is troubling, many doctors say, as it casts doubt on the reliability of a wave of new tests developed by manufacturers, lab companies and the U.S. Centers for Disease Control and Prevention.

https://www.wsj.com/articles/questio...ry-11585836001
https://www.msn.com/en-us/news/us/qu...KXh?li=BBnb7Kz

[Mojouw]

Fortunately that problem is now in the rear view mirror

Health experts say they now believe nearly one in three patients who are infected are nevertheless getting a negative test result. They caution that only limited data is available, and their estimates are based on their own experience in the absence of hard science.

That picture is troubling, many doctors say, as it casts doubt on the reliability of a wave of new tests developed by manufacturers, lab companies and the U.S. Centers for Disease Control and Prevention.

https://www.wsj.com/articles/questio...ry-11585836001
https://www.msn.com/en-us/news/us/qu...KXh?li=BBnb7Kz

We have all the best doctors and really beautiful tests from the greatest labs. So sad that other countries won't be able to have access to all our wonderful health care. AMERICA!

This is just an unforgivable sin, in my opinion. Viable and reliable tests were readily available on the international marketplace. Could have been readily purchased. But no....we had to invent/develop our own. On top of that, when officials asked to go to China during he initial stages of this outbreak so they could learn about the disease they were denied by the government.

We entered this with both hands tied behind our back, one leg tied to the other, and wearing a blindfold.

[tom444]

I don't like what I'm hearing from those who study these things. They are saying this is going to be a long fight and we are in the earliest rounds. I'm not just talking about here in America, I mean global also.

[Mojouw]

So perhaps these are some new baseline numbers to work with: https://www.nbcnews.com/health/healt...-news-n1172706

"As many as 240,000 people in the U.S. could die from COVID-19 — and that’s only with strict social distancing measures in place, one of the government’s top doctors warned Tuesday.Dr. Deborah Birx, Vice President Mike Pence’s coronavirus response coordinator, said that between 1.5 and 2.2 million could die without the intervention.


Quick math says that intervention is cutting the death toll somewhere between 6-10 times less. This is the first time I've seen numbers from a public health official covered that laid out with and without intervention.

- - - Updated - - -

I don't like what I'm hearing from those who study these things. They are saying this is going to be a long fight and we are in the earliest rounds. I'm not just talking about here in America, I mean global also.

I'm hearing through the end of the calendar year at the earliest. Most universities and school districts are beginning planning now for staying online at least that long.

[Born2Steel]

We have all the best doctors and really beautiful tests from the greatest labs. So sad that other countries won't be able to have access to all our wonderful health care. AMERICA!

This is just an unforgivable sin, in my opinion. Viable and reliable tests were readily available on the international marketplace. Could have been readily purchased. But no....we had to invent/develop our own. On top of that, when officials asked to go to China during he initial stages of this outbreak so they could learn about the disease they were denied by the government.

We entered this with both hands tied behind our back, one leg tied to the other, and wearing a blindfold.

Just an amendment really. The 'blindfold' was made in China. We have no actual idea how long they let the spread go on until they finally let the rest of us know about it. It was not done by political channels but rather by medical ones. People getting sick after leaving China around the world became a common thread to the world medical community first. Governments were notified but communicating with China is somewhat problematic as it has always been. No government had the whole truth behind the pandemic until it was a pandemic. From what I understand there are still cruise ships loaded with passengers that have no port to go to? The travel ban was a first response.

[Mojouw]

Just an amendment really. The 'blindfold' was made in China. We have no actual idea how long they let the spread go on until they finally let the rest of us know about it. It was not done by political channels but rather by medical ones. People getting sick after leaving China around the world became a common thread to the world medical community first. Governments were notified but communicating with China is somewhat problematic as it has always been. No government had the whole truth behind the pandemic until it was a pandemic. From what I understand there are still cruise ships loaded with passengers that have no port to go to? The travel ban was a first response.

Sure. But the blame doesn't rest there alone. Read about countries right next to China. They knew something was happening. They suspected China was playing games with the truth. The stockpiled tests. Started testing 10s of thousands a day. Stopped this thing in its tracks. Taiwan and S. Korea have been successful enough at dealing with this that they have resumed EXPORTING masks, gloves, and respirators.

What did the US do? Basically we did fuck all. That's the bottom line. States are literally bidding AGAINST each other in morbid auction for personal protection equipment for health workers. There are not enough of anything. And we have NO IDEA the true spread of this virus because not only did we not make enough tests but the ones we did make may not work.

There was enough time to get the testing situation sorted out. There are "third world" countries (remember "shithole" countries?) that are testing thousands and thousands of their people per day, some with results in hours. Meanwhile, we can't even reliably test people that are visibly sick with this thing.

I am not saying this because of what administration is in control. I would say this no matter who was in charge. There was more than enough information, knowledge, money, and know how to ensure that a large scale testing program was ready to go. Our leaders just decided not to make sure it happened. Every other debate is massively influenced by the lack of reliable and large scale testing. Should we lift a lockdown here? Put a proactive one in place over there? No one knows. No one can know because we have almost no reliable data. It is a failure of leadership on an incredible scale.

[steelreserve]

SR,

The problem here is, you're letting your anecdotal experience stand as the common experience. Crime has gone down in most areas during the pandemic. Cities like Chicago, New York, Los Angeles (source); Philadelphia (source); San Jose (Santa Clara county, source); Burlington (source); Kansas City (source); Memphis (source); Los Vegas (source); Toronto (source); Atlanta (source); Toledo (source); and so on.

As for the number of deaths, we haven't even seen the start of it yet. Since March 15, there's been an average 12-13 percent increase in deaths every day. The total number of deaths have doubled approximately every four to seven days since January 23rd. As of the last five days, the average death rate for this virus is 4,461 people per day.

Yes, it's affecting the elderly more. Yes, it's affecting those who already have health issues more. But that doesn't mean anything. Why? I have asthma and am still a bit overweight. I am considered high risk if I get sick. Yet, I'm a fully-functional member of society with over 25 years left of production and earning potential.

And, all of this is predicated on the unrealistic numbers coming out of China. To be honest, there are many now who are arguing China probably underreported their deaths by almost 66 percent. Everything from the thousands of burial urns being stacked outside funeral homes to the constant use and capacity of those homes for cremation. There's also serious questions about numbers coming out of Iran, Russia, Indonesia, North Korea (they report 0, yeah, right!), Saudi Arabia, and Egypt.

And, think about this. The numbers being this low so far, is because of the quarantine.

Look at it this way, if someone wrote a headline saying, "PANDEMIC COULD RAVAGE 0.03% OF POPULATION," are you frightened to death yet?

"DEATH TOLL COULD RISE AS HIGH AS 0.3% UNLESS MARTIAL LAW DECLARED, EXPERTS WARN" - do you declare martial law?

"GLOBAL DEATH RATE INCREASES BY 1%, CRISIS DECLARED" is this the worst crisis of our times? Is it even "unprecedented?"

But these are the actual numbers people are freaked the fuck out over. Absolute numbers sound terrible. Concept of scale, though.

Again, your not accounting for change in almost any of your variables. Look up sources on dependent versus independent variables and then go down the rabbit hole of single variate versus multivariate statistics. The fundamental assumption your making (and through no fault of your own) and your sources are making is that the variables hold constant over time. In the context of a vital outbreak, that just isn't true. Therefore if TODAY the mortality rate is X that has no relevance on the mortality rate tomorrow or next week or next month and on and on. Sure it can provide a floor, but it has almost no bearing on the ceiling. In this setting, the ceiling is the relevant measure.

It's a modern version of the old riddle about tricking a ruler to agreeing to double the payment from one grain on the first square of a chessboard and then 2 on the next and then 4 and so on. By the time you complete the board, the number is almost incalculable.

If that is the reasoning, then the issue is that it takes as many assumptions to arrive at your worst-case catastrophe as it takes for me to project zero deaths in a week. Where those assumptions fall apart for me is when it requires fundamental changes to the nature of the disease that already has a fairly well-established mortality rate (which mathematically is extremely likely to go down even further, not up, the more testing is done - lots of expert articles on that). Sure, auxiliary issues like you and teegre pointed out could have spillover effects that make things somewhat worse, and that's totally believable. But declaring "it's open-ended and could go as high as the sky, because reasons" is just writing a blank check in the currency of fear, and you can't make decisions that way.

It was Alexis de Tocqueville who once said, "Show me a policy based on 'modeling,' and I'll show you a rat-brained clusterfuck." Or maybe that was some guy at a gas station. But more to the point, one of the best analogies I have seen is that the fire department could come out and tell you every single way imaginable that your house could burn down, from the real and tangible dangers to the ludicrously far-fetched, and be completely correct about all of them. But you would not want them setting policy based on that. You would want to take it into account and figure out a practical way to implement the most useful of it while still allowing people to, you know ... live. Similarly, if you put an epidemiologist in charge of the economy and personal freedom, and his one and only focus is on the absolute minimum number of deaths, then he will tell you to shut down the whole world without doing a cost/benefit analysis, which he isn't even capable of doing in the first place.

What we have here is unique in history, in that it is a total shutdown of the economy which is essentially based on a crisis of conscience and of ethics. (Please do not confuse "economy" with corporate profitability or the stock market - I am talking about mass unemployment and barely being able to keep the country fed.) Does it suck if a million people die? Of course. Can you always stop a million people from dying? Not by a longshot. You can try, but if you are rushing ahead blindly without any consideration of the consequences, you are in for a rough landing. The hell of it is, even if these measures "save" something like half a million lives, 90% of them will probably still be dead by next Christmas.

I am well aware that by this point the die has been cast and we are pretty much just along for the ride, and few if any minds will be changed from here on out. But god damn, is it something to watch the whole world gone mad.

[Born2Steel]

Sure. But the blame doesn't rest there alone. Read about countries right next to China. They knew something was happening. They suspected China was playing games with the truth. The stockpiled tests. Started testing 10s of thousands a day. Stopped this thing in its tracks. Taiwan and S. Korea have been successful enough at dealing with this that they have resumed EXPORTING masks, gloves, and respirators.

What did the US do? Basically we did fuck all. That's the bottom line. States are literally bidding AGAINST each other in morbid auction for personal protection equipment for health workers. There are not enough of anything. And we have NO IDEA the true spread of this virus because not only did we not make enough tests but the ones we did make may not work.

There was enough time to get the testing situation sorted out. There are "third world" countries (remember "shithole" countries?) that are testing thousands and thousands of their people per day, some with results in hours. Meanwhile, we can't even reliably test people that are visibly sick with this thing.

I am not saying this because of what administration is in control. I would say this no matter who was in charge. There was more than enough information, knowledge, money, and know how to ensure that a large scale testing program was ready to go. Our leaders just decided not to make sure it happened. Every other debate is massively influenced by the lack of reliable and large scale testing. Should we lift a lockdown here? Put a proactive one in place over there? No one knows. No one can know because we have almost no reliable data. It is a failure of leadership on an incredible scale.

As I said, just an amendment, not a rebuttal by any means. A variable that can't be measured at this time is how do we know the actual spread before reports escaped China, Taiwan, or Korea? Think back to Indonesia refusing world-wide aid after the tsunami in 2018. We still don't have an accurate death toll from that. This was big before it was BIG, if I make any sense with that statement. When the world medical community says this is coming and China reports it's contained and under control, that handcuffs response by itself. Was there foot dragging even after that? Hell YES! That is why I called it an amendment to the US did nothing angle.

[Mojouw]

Look at it this way, if someone wrote a headline saying, "PANDEMIC COULD RAVAGE 0.03% OF POPULATION," are you frightened to death yet?

"DEATH TOLL COULD RISE AS HIGH AS 0.3% UNLESS MARTIAL LAW DECLARED, EXPERTS WARN" - do you declare martial law?

"GLOBAL DEATH RATE INCREASES BY 1%, CRISIS DECLARED" is this the worst crisis of our times? Is it even "unprecedented?"

But these are the actual numbers people are freaked the fuck out over. Absolute numbers sound terrible. Concept of scale, though.




If that is the reasoning, then the issue is that it takes as many assumptions to arrive at your worst-case catastrophe as it takes for me to project zero deaths in a week. Where those assumptions fall apart for me is when it requires fundamental changes to the nature of the disease that already has a fairly well-established mortality rate (which mathematically is extremely likely to go down even further, not up, the more testing is done - lots of expert articles on that). Sure, auxiliary issues like you and teegre pointed out could have spillover effects that make things somewhat worse, and that's totally believable. But declaring "it's open-ended and could go as high as the sky, because reasons" is just writing a blank check in the currency of fear, and you can't make decisions that way.

It was Alexis de Tocqueville who once said, "Show me a policy based on 'modeling,' and I'll show you a rat-brained clusterfuck." Or maybe that was some guy at a gas station. But more to the point, one of the best analogies I have seen is that the fire department could come out and tell you every single way imaginable that your house could burn down, from the real and tangible dangers to the ludicrously far-fetched, and be completely correct about all of them. But you would not want them setting policy based on that. You would want to take it into account and figure out a practical way to implement the most useful of it while still allowing people to, you know ... live. Similarly, if you put an epidemiologist in charge of the economy and personal freedom, and his one and only focus is on the absolute minimum number of deaths, then he will tell you to shut down the whole world without doing a cost/benefit analysis, which he isn't even capable of doing in the first place.

What we have here is unique in history, in that it is a total shutdown of the economy which is essentially based on a crisis of conscience and of ethics. (Please do not confuse "economy" with corporate profitability or the stock market - I am talking about mass unemployment and barely being able to keep the country fed.) Does it suck if a million people die? Of course. Can you always stop a million people from dying? Not by a longshot. You can try, but if you are rushing ahead blindly without any consideration of the consequences, you are in for a rough landing. The hell of it is, even if these measures "save" something like half a million lives, 90% of them will probably still be dead by next Christmas.

I am well aware that by this point the die has been cast and we are pretty much just along for the ride, and few if any minds will be changed from here on out. But god damn, is it something to watch the whole world gone mad.

OK. So turn it on its head. What are the mathematical benchmarks and metrics that would have to be in operation for you to feel that the current response level was appropriate? At what level do you stop asking questions and would just say "Yeah. This is what needs to happen."

Killing double digit percentage? Start killing prime aged adults at an increased rate? If so what is that rate? Don't worry about what is or actually will happen. That is not what I am asking. What would trigger a massive response if you were in charge of it all?

[silver & black]

Well, we certainly wouldn't want this virus to inconvenience anybody.

Too late.

[Mojouw]

As I said, just an amendment, not a rebuttal by any means. A variable that can't be measured at this time is how do we know the actual spread before reports escaped China, Taiwan, or Korea? Think back to Indonesia refusing world-wide aid after the tsunami in 2018. We still don't have an accurate death toll from that. This was big before it was BIG, if I make any sense with that statement. When the world medical community says this is coming and China reports it's contained and under control, that handcuffs response by itself. Was there foot dragging even after that? Hell YES! That is why I called it an amendment to the US did nothing angle.

Ah. I see what you are getting at now.

Sadly, some of this is/was tragically far too predictable. China lying about an outbreak? That never happens! Except about every 3 years...

I'm just extra grumpy today...might need to take a break and play some video games.

[Born2Steel]

Ah. I see what you are getting at now.

Sadly, some of this is/was tragically far too predictable. China lying about an outbreak? That never happens! Except about every 3 years...

I'm just extra grumpy today...might need to take a break and play some video games.