Sundancer

The Gates interview (which will be available for replay) is really good. He's not saying things that Hapless and others haven't covered, but he's a voice people listen to (unlike Hapless!).

A few things. I agree with Trump's Tweet yesterday about the cure and the disease. Assuming he has any control over lifting state-mandated quarantines, he is in a tough position, as are all world leaders. Crush economy vs screw the doctors and people who will die. There are some ways to split the difference but getting to that will take some more time and I believe, CENTRAL planning to make it happen. Nationally directed plans of how to test and track, and national authority over who needs what kind of quarantine. I agree with you that the experts can make the informed decisions. I hope it is them who are doing so AS A GROUP, listening to doctors AND economists. As to your comments about other diseases, I suspect you're trying to make a point that this disease hasn't yet killed that many people. Take a look at the exponential growth. A couple weeks ago, people were saying, "Big deal...500 people in the US have coronavirus. I had 500 people in my high school." Now we are at 40,000. This may taper off in a week but that's only because of quarantine. It will pop right back if we are not ready with testing and tracking, along with facilities and equipment for dealing with cases. When hospitals get swamped by these cases, many of which are treatable under normal conditions, they will not be treatable when swamped, so of those 50% of 18-49 year olds who are mostly living but ending up in hospitals, they may not live. And then there are the other issues of swamping a medical system. When you have an allergy attack to a bee sting while the hospitals are bogged down, you're dead. And when you get an infection from a cut that just won't cure up, you're dead. And when your sibling who needs his regular treatment can't get to the clinic. And when the pregnant mother needs some attention because her birth is not working smoothly. Etc. Bogging down the doctors with CV-19 has more effect than just killing off the CV-19 people and their healthcare workers.

We need the capability to test, and the capability (and will) to track and allow tracking of cases to put a lid on breakouts. The former (testing) requires getting tests and labs ready. We are working on that. It's not centralized that I can see but at least there is some gearing up in many places. The later (tracking) I've not seen anything on. An app would seem to be the least invasive way to do this with the least training. Korea had teams of people interviewing patients and tracking, which seems impractical here as no one has been trained to do this. Americans who want to party on spring break and don't trust big data (whether it's government or private) will blanche at the tracking. Anecdotally, I mentioned an installed COVID-19 tracking app to a neighbor the other day (socially distant...we were out walking our dogs and came across each other), and he said, "No way. I'm not installing any app." And I'm anti-government too but this is a time to temporarily centralize some things. If the government takes advantage of a virus and we turn from COVID-19 tracking to Stalinist Russia, that would be horrible, but I don't see that happening. It's a peak because of the distancing. Meaningful to show how distancing works, meaningless for coming back to normal without testing and tracking deeply part of life. I've not heard that Italy has any system in place to re-open safely without just restarting the problem.

The stadiums will likely be empty but could they do it. America will want it, if only for morale boost, and the NFL will want it for $$. Would it be financially possible to take all the people involved in playing, reffing, showing, training, etc and quarantine them in two phases. Self quarantine for 2 weeks. Group quarantine for two weeks. Then those groups all stay together in contained units like mini-prisons almost for the duration of the season? It would have to be voluntary, and it would be really hard, but if you kind of "flag and country"-d the idea, I think people would sign up. Maybe just do a 14 game schedule, no pre-season? Lots of holes in this plan (doctor visits being the most glaring...anyone who leaves the island can't get back for two weeks) but this is a football board and I would love to have football this fall to cheer us up in a down time.

I know Hapless's feelings (!) but just as an FYI, TED's Chris Anderson is hosting a TED Talk with Bill Gates today at 12pm on Facebook. In 2015, Gates gave a TED Talk about our preparedness (or lack thereof) for a pandemic, and being an eternal optimist, will likely have some positive thoughts on the situation right now. Yes, he's a business leader and not a doctor, but he's had a lot of conversations about pandemics with a lot of people, and donated to a lot of causes that he is mode deeply involved in than just writing checks. He also has an appreciation for the economic issues. I will be interested to hear his take. #draftBillGates

Italy cases and fatalities drop again. Social distancing working after 2 weeks. How they lift distancing and manage cases coming out of this will be huge to ensure they don’t just get another spike up. My mistake at 7am est. this is still yesterday’s data to be clear. Updates in a bit for today. Fingers crossed for more progress. Scouring the Internet for good news is fun!

That episode kind of sucked. Very little plot movement forward. Zzzz fest.

Can we at least stay quarantined until our healthcare workers have enough masks, gowns, and tests...as well as a plan to address the tsunami of cases that will come if we lift the ban without testing and Aggressive tracking? They need all the sick buildings ready so patients don’t just walk into every ER where there won’t be enough room. No matter what drug you have, there won’t be enough now. So If you lift the ban (not sure how the admin would do this), you’re telling doctors to go to war against a tank with A bow and no arrows. Forget the deaths for a second. The hospitalization rate for 18-49 year olds is something like 40% of known cases. Those people will not have beds and treatments available, and they will infect their caregivers. All the other people who need doctors won’t get treatment or they will get crappy treatment. My neighbor’s infant daughter who needs open heart surgery in April? Guess she’s ***** because the doctors won’t have time for her. Letting it run its course starting on Friday is not a plan. We don’t have the drugs (even if the anti malarials and zpac’s work). We don’t have the protective equipment. We don’t have one of the most important treatment equipments (ventilators). And we don’t have beds and doctors. The way to thread the needle is with a shut down for long enough to set up massive testing and you set up a plan for tracking every case rigorously, along with all the prep. That will be awful for medical staff and the economy too but at least it’s a plan.

Good but that’s just the quarantine at work. Quarantine can get it to 0 if everyone complies but this doesn’t solve the problem without huge testing and tracking. The collapse of the healthcare system dealing with this would have so many other consequences.

No one is going back to school this year, and maybe not this calendar year unless summer burns this off and we can get our treatment, testing, and tracking together by a possible fall resurgence.

Lots of people would be pretty happy to be working right now (unless they are doctors or nurses). What do you do?

I'll take any ray of sunshine. Question for you or anyone who might know. What is the mass availability of some of these? Let's assume just here in the US of A (ignoring the worldwide cases), we are soon at a rate of tens of thousands of people needing treatment a day, over a course of days, is there anything on hand to meet that demand? Assuming the answer is "no" as I assume it will be, do you have insight into when it would be available to keep up with such demand? I've looked online about the malaria meds and those can come fast but not in huge quantities for several weeks. These I imagine would take more time but I am not sure.

My wife works for a local hospital. They are offering $5000 if she can refer someone who will come fill any one of many healthcare positions. That's how freaked out they are over the impact of the bodies coming and the impact on their staff getting sick.

Like Hapless mentioned, if we are going to punt on test and track, the least we can do is make sure we don't re-open until docs and nurses have masks, gowns, and more ventilator options, and there's a clear plan for where sick people should report to when they need medical help (CV wards). Re-opening now is saying to millions of Americans who will die, "Oh well" and it's saying to healthcare workers, "Good luck with your underwear masks." Reopening when we are a little more prepared is just about saying the same but at least we can give the healthcare workers a little protection.

I'm not saying hydroxychloroquine won't end up helping, but this is irresponsible: Florida man with coronavirus says drug touted by Trump saved his life (NYPost) I've taken it before when traveling to malaria zones and it has VERY SERIOUS side effects. This is a dangerous drug that has to be carefully administered, if it even works. Oh yeah I get it (on paper). I just see no ability for us to bite off what needs to be done on testing and tracking...followed by a nearly national lockdown of 3 weeks. This current shutdown is a joke. I'll just keep saying it: Boston is STILL mostly open.

That's how I'm reading it too. I also hope I'm wrong. The 15-day thing was not national and not enforced, so of course it is having only an arbitrary effect. But there is a balancing act with the economy here...if we'd had a really severe lockdown from day 1 of this, 2 (more likely 3) weeks might have worked if we were ready with testing and tracking coming out of it (both of these are VITAL to prevent more outbreaks). But we have sort of got nothing. The administration may have little choice but to re-open and sacrifice the healthcare system and deaths from CV and others whose care gets blocked by CV patients. Given the choice between a "now-informed" public choosing between: (1) shutdown with no testing/tracking, and (2) no shutdown, we might as well do #2 could well be the administration's decision. It doesn't seem like we have the capability for testing or the national will for tracking (see this NYT opinion, which reflects what a neighbor told me the other day, "I ain't installing an app to let people see where I go.").

Went to a local nature area with hiking. More people than normal for sure but plenty of space for all. We all smiled and gave wide births when crossing paths. I hope they keep the parks open. Very good for my mental health. I expect they may be closed though as they get lumped in with “public spaces” to avoid like playgrounds and basketball courts (kids continue to play ball at my local park, which is baffling).

Maybe a national plan in 8 days. This would be a week from tomorrow. That's an arbitrary wait time. It'd be nice to know which way to go now, since we can see other countries who are ahead of us on the timeline and how it's going. But it's something.

The model couldn't be clearer. Massive testing and tracking. We can't do the first. The later isn't even being discussed. And regional closure left to local or state governments(or not) has been the approach here. So while NYC is being crushed, Boson biz (not restaurants) are still open. This needs to centralized at a national level to get back to any nomral. It seems we are not willing to do this nationally yet.

I see Italy had fewer deaths today than yesterday. Before I take comfort in that, I wonder if they changed their counting to resemble Germany and others and now are starting to disregard deaths of people with Co-morbidities (those who were already dying from something else should not be listed as dead from Covid-19). [Edit: Thanks for the source challenge Hapless...some part of me thought this was a bigger story but you are right taht it's not.] How Italy counts Then there's Germany's way. It's subtle but real. I found another article criticizing Italy about this but now can't find it. In any event, there is some sourcing on how they count deaths.

Unreliable source but curious issue. I wonder if Americans who are out of work can be trained to do this. I bet not fast enough.

That stuff is coming. But it re-emphasizes the need for quarantine everywhere at some degree. If you’re in a healthy area stay that way, please. Other areas need the resources you don’t. Must be centrally organized. Another day passes without that and Boston is still open.

I hope we reverse this trend as more supplies of gowns and tests become available. We cannot afford to take a no test and no track path.

The fact that New York has given up on widespread testing is an absolute worst case. People focusing on the death rates are often ignoring the hospitalization rates. Cuomo gets it. Social distancing now only works in conjunction with massive testing and tracking organized centrally but... Boston is Still open.

Still hearing nothing from the admistration about the need to track and isolate cases coming out of this. “As the number of global coronavirus cases surpassed 300,000 and the death toll rose to more than 13,000, the World Health Organization’s top emergency expert said on Sunday that countries could not simply lock down their societies to defeat coronavirus without public health measures to avoid a resurgence of the virus down the road. “What we really need to focus on is finding those who are sick, those who have the virus, and isolate them, find their contacts and isolate them,” the expert, Mike Ryan, said in an interview on the BBC’s “Andrew Marr Show.” “If we don’t put in place the strong public health measures now,” he said, “when those movement restrictions and lockdowns are lifted, the danger is the disease will jump back up.””