shoshin

It's still slightly in the news. We need to get back our economy priority 1, but there will be a new normal in a lot of ways, and one of those ways is taking steps to make sure this shutdown is a one time thing and we don't get spikes in cases that overwhelm health systems.

What SK did was test like crazy and contact trace, lessons learned when they had the SARS outbreak. Testing of course helped them get on top of this quickly. To think otherwise is just wrong. We couldn't get ahead of the outbreak because we lacked testing and testing protocol, and also didn't do very much in February to monitor the outbreak. That's not blaming Trump, but our response at the federal and state level. Not once you get ahead of the virus. Testing is a leading indicator to control outbreaks. The man you're arguing with is made of straw.

Rounding up by 60% is an interesting way to round. I'm not sure what you think I think, but testing identifies areas of outbreak and particularly severity BEFORE the outbreak gets out of control. Testing and contract tracing lets us stay ahead of this once we get it to some semblance of control for health care workers. So testing is pretty damn important.

Not true. 17,000/1M vs 12,000/1M. More but not double, and they don't need to do as many tests now because they got on top of it early, so it's not really a meaningful data point. They had 10 positive cases yesterday in SK. I'd take their cases and deaths per population if we can trade our test totals.

What Birx said is that we need a testing breakthrough and antibody tests are so far too scarce. We definitely are undertested since not everyone who is even symptomatic is still getting tested, though that's getting better. Testing asymptomatic people is really the big breakthrough we need but serology tests are not available AND not accurate yet. A tough 1-2 punch. I hear rumblings of tracing talk at Trump press conferences but little detail from the states that are reopening. How is Georgia tracking? Florida? Texas? Are they following the Trump guidelines on a tracing regimen? I can't follow all the states but I've not heard much on these and I know other states like NY are working on that part of their plan to reopen.

If you need more information next time, let me know and I’ll provide the links to the stories if you can’t find them.

Not what Birx and Fauci said this weekend. Trump continues to put out mixed messages. Also the serology testing is having serious reliability issues. I hope that gets wrapped up soon.

NY to follow the CDC plan. NJ using some other version but sounds similar. CT as yet unknown. PA doing some extreme plan.

Meant to get this into the article linked earlier. Plays into the numerator on mortality.

The UK approach was to try this, then their healthcare system got mobbed quickly and they went to lockdown. Sweden has half the population of Pennsylvania and one city the size of Jacksonville, spread across an area the size of California. Sweden has many other differences too. It's a nice lab but it does not extrapolate well to the US.

Controlling the questions sounds pretty fascist. I don't think the media comes off well right now in many of these but locking them out is the wrong way to go. If Pepcid cures this thing, we're all going to have a "get the f### outta here moment." (Studies are very preliminary in NYC hospitals but noting it for amusement.)

He is still smarting from his sarcasm not going over well / gaffe. The Covid posse would be so welcome each day. It would get the guy off stage who knows the least about this and also take away the bug-zapper that the press flies can't resist flying into. If only they would do this!

Just wore out my keyboard pasting this into texts. Fantastic.

Under 55s spread the disease for sure but even in hospitalizations, they lag the rest by a lot. Given the correlation between other conditions and hospitalizations, it makes a lot of sense that this is so.

No. It shows how much sicker a lot of people are getting for lack of adequate care. And it shows how many other people who have orthopedic injuries are just sitting in pain, ENT people are just getting bathed in ABX, and so many other band aids. The system is not working well at all right now. Trust me, the last thing you want to do right this moment is have a soft tissue injury that requires surgical repair, because not only are you not getting it now, but there will be a long line of people ahead of you when practices reopen. You say that like you won't get hospitalized and also like you won't spread it. We are getting ahead of things now, and hopefully can stay ahead of it with more testing and tracking, though it looks like we will be trying to get ahead of this without adequate testing or tracking in most places.

As Magox and I have discussed, deaths from lack of other care are no doubt up too. Still, that’s a big spike in “other deaths” for them all to be non Covid. The uncategorized deaths are a mix of undiagnosed Covid and non-Covid neglect.

There were some calls here to see mortality numbers compared to historical average when you take out Covid deaths. Article on it here. This shows deaths not counted as Covid are significantly increased over the historical average (mostly probably uncounted Covid cases but I’m sure others dying for lack of care for other conditions). These numbers cast a skeptical eye on the argument that Covid deaths are massively inflated. NYC proved they were not in many ways but this makes the point that not only are they undercounted, they are undercounted by a lot. “Today’s rise in all-cause mortality takes place under conditions of extraordinary measures, such as social distancing, lockdowns, closed borders and increased medical care, at least some which have positive impacts,” said Vladimir Shkolnikov, a demographer at the Max Planck Institute for Demographic Research. “It is likely that without these measures, the current death toll would be even higher.”

Disagree. The media is critical to a functioning Democracy AND they can ask questions the administration does not want to answer. Further, the room has a nice contingent of admin-friendly press so they can always go to OAN of Fox when they need a lifeline. The real thing that should happen is Trump should get off the stage so we can get actual information. Just because Trump embarrassed himself does not excuse him from dealing with a free press, though this latest temper tantrum of shutting down the briefings is an astounding reaction to him screwing up (or being sarcastic when he asked about the injections--ha!). Some of the media questioners have been embarrassing but you can't shut them down. That is absolutely the wrong approach. The briefings already have a high viewership as Trump keeps telling everyone. The R leadership has concerns about the briefings being too much of a "ME" show already, so maybe the better tack is to get Trump off the stage and get the information out from the experts and the guy who is in charge of the task force, Pence.

Umm, yeah they are but I enjoy the thread for the covid discussion so good luck with that.

New York will follow the Trump/CDC guidelines. First state to do so I think.

Fauci earlier this week noted that we are massively under testing for what is needed to safely control this and now Birx as well. Maybe we can stop focusing on lab capacity as a critical data point now? A different type of coronavirus test is required to screen the U.S. population on the necessary scale, Dr. Deborah Birx, the White House coronavirus response coordinator, said in an interview on Sunday, saying that it will take “a huge technology breakthrough” to get there. What’s needed, she said on the NBC program “Meet the Press,” is a screening test that detects antigens, like the screening tests used for flu, strep and other diseases. Antigens stimulate the body to produce antibodies, and are essentially evidence of an immune response. “We have to be able to detect the antigen, rather than constantly trying to detect the actual live virus or the viral particles itself, and to really move into antigen testing,” she said. The current RNA tests, which are more precise but more laborious, would then be used to confirm diagnoses.

For sure, which is why regional approaches make the most sense. What is stranger about PA's approach to reopening based on cases/population is that the Philadelphia area has the best hospitals in the world but will be the last to open. There is hardly a nursing home that will be spared in this once it gets going unless we make DRASTIC changes to how to support their residents.

We have both made this point on hospitalization/health care suffering for many others who are not covid patients. That's why overall hospital capacity is the best metric for phased reopening. We know that covid patients mob the health care system and that continued spread will take up resources. So it makes sense to look at hospitalization as the limiting resource to reopening. If hospitals in a region are at or near capacity, total shutdown is needed. As that wanes, reopening should happen. By the way, the Trump guidelines kind of work like this. The first step in reopening is that "all patients" can be treated by their hospitals without "crisis care." Only then do you start phase 1 (along with other metrics). And after establishing that cases are declining and hospitals are still operating without crisis care, you can move to the next step. So this is not a new idea--it's right there in the Open Up America guidelines that no state is following(!!). We can really get ahead of this issue and stamp this out for good with widespread testing and contact tracing. Some states are starting to put together more comprehensive plans around this.