CountDorkula Posted March 12, 2020 Posted March 12, 2020 45 minutes ago, teef said: anyone who thinks this isn't a big deal at this point either doesn't understand what's happening or refuses to even try to understand what's happening. I have a feeling things are going to change for me drastically over the next two weeks. Here is what baffles/angers me. This virus is affecting the entire world, drastically, but for some reason people in America believe that this virus will just skip this country because America? Ive told jokes about it, but that's because you still have to try and live life, but to act like "This ain't no thing" is incredibly selfish. People are blaming the NBA for overreacting for suspending the season. 2
The Wiz Posted March 12, 2020 Posted March 12, 2020 2 hours ago, teef said: And now it’s confirmed in the Rochester area. Nice. And I'll likely be working from home for the remainder of the semester now that RIT announced they are switching to online only. Waiting to see what's going to happen with my kids in grade school still though.
teef Posted March 12, 2020 Posted March 12, 2020 24 minutes ago, SlimShady'sGhost said: I hope things go well for you. Can you do "dental checkups" via Skype? i can't do implants and veneers on skype, that's for sure. i'm legit concerned here. 80 yr old parents. i have employees to look out for, payroll to meet, a new building mortgage. there's no way this virus doesn't stagger me a bit. i'm being selfish knowing that medically my family will be ok...i'm just worried about everything else. 15 minutes ago, CountDorkula said: Here is what baffles/angers me. This virus is affecting the entire world, drastically, but for some reason people in America believe that this virus will just skip this country because America? Ive told jokes about it, but that's because you still have to try and live life, but to act like "This ain't no thing" is incredibly selfish. People are blaming the NBA for overreacting for suspending the season. i think a lot of that is due to this having such a political slant to it. my father in law is a hard core fox news guy. we know if he's been at our house because it's literally always on tv. two days ago he was telling my wife this was a nothing. i think he's now changed his tune. i'm not making a comment to any political affiliation leaning one way or another, but i have seen it personally on some level. 15 minutes ago, The Wiz said: And I'll likely be working from home for the remainder of the semester now that RIT announced they are switching to online only. Waiting to see what's going to happen with my kids in grade school still though. i think that's good. my brother works downtown at m and t, and he's waiting to see what happens. both my kids are in doodlebugs daycare, so we're waiting to see if that closes too. then we have to figure out care. 2
DCOrange Posted March 12, 2020 Posted March 12, 2020 2 hours ago, teef said: And now it’s confirmed in the Rochester area. Nice. It’s probably safest to assume it’s everywhere now since we didn’t even start looking for it until it had been here for a month and didn’t start doing anything about it for much longer. It’s far more widespread than we currently know. 5
CountDorkula Posted March 12, 2020 Posted March 12, 2020 2 minutes ago, DCOrange said: It’s probably safest to assume it’s everywhere now since we didn’t even start looking for it until it had been here for a month and didn’t start doing anything about it for much longer. It’s far more widespread than we currently know. To be fair America is doing very little currently to stop it, because 'Murica. 2
Halloween Land Posted March 12, 2020 Posted March 12, 2020 Faith and Trust in the Lord is the best way to deal with the concern and panic of this virus.
Pine Barrens Mafia Posted March 12, 2020 Posted March 12, 2020 2 minutes ago, CountDorkula said: To be fair America is doing very little currently to stop it, because 'Murica. Such bitterness. Can you really blame anyone for being cynical? H1N1, SARS, bird flu, Ebola, etc etc etc
CountDorkula Posted March 12, 2020 Posted March 12, 2020 6 minutes ago, Joe in Winslow said: Such bitterness. Can you really blame anyone for being cynical? H1N1, SARS, bird flu, Ebola, etc etc etc Yes, I can blame people for not listening to top Health officials and scientists. I'm not bitter, I'm baffled that people are just that ignorant that people are still continuing with "Its just a cold" 3
teef Posted March 12, 2020 Posted March 12, 2020 9 minutes ago, Halloween Land said: Faith and Trust in the Lord is the best way to deal with the concern and panic of this virus. on your knees!
May Day 10 Posted March 12, 2020 Posted March 12, 2020 1 hour ago, teef said: anyone who thinks this isn't a big deal at this point either doesn't understand what's happening or refuses to even try to understand what's happening. I have a feeling things are going to change for me drastically over the next two weeks. months. This is bad. No politics to it. People need to please check that at the door. It is coming to every corner, many will get sick, many wont, many will die. Things are going to be disrupted and sideways and the economy is going to get ugly. This is completely different than those other outbreak scares. It is here, it is very contagious, and will be deadly. 3 1
teef Posted March 12, 2020 Posted March 12, 2020 Just now, May Day 10 said: months. This is bad. No politics to it. People need to please check that at the door. It is coming to every corner, many will get sick, many wont, many will die. Things are going to be disrupted and sideways and the economy is going to get ugly. This is completely different than those other outbreak scares. It is here, it is very contagious, and will be deadly. i'm with ya. there's no reason not to take it seriously at this point. we don't need public panic, but everyone needs to be aware medical, social and economic impact this thing is going to have. my biggest hope is that people stop being so concerned about the individual and we all work together to manage this. 2
DrDawkinstein Posted March 12, 2020 Posted March 12, 2020 16 minutes ago, Halloween Land said: Faith and Trust in the Lord is the best way to deal with the concern and panic of this virus. T's an P's, broooo!
row_33 Posted March 12, 2020 Posted March 12, 2020 (edited) 15 minutes ago, Joe in Winslow said: Such bitterness. Can you really blame anyone for being cynical? H1N1, SARS, bird flu, Ebola, etc etc etc of course “they” will use any excuse to gripe and complain you probably have put them on ignore because everything they think and do has already been proven repulsive on here? Edited March 12, 2020 by row_33
Pine Barrens Mafia Posted March 12, 2020 Posted March 12, 2020 7 minutes ago, CountDorkula said: Yes, I can blame people for not listening to top Health officials and scientists. You do you.
DrDawkinstein Posted March 12, 2020 Posted March 12, 2020 (edited) This is long but a great read on the very real issues we're facing... (link to original post) Quote Well I think the algebra is 6th grade math, right? To keep the numbers simple, assume 1000 confirmed cases. In all likelihood the real number is much higher because weeks (or months) of inadequate testing Empiric, reported data from dozens of credible independent sources OBSERVE (not estimate) a doubling rate of 5-7 days. Call it a week. This makes sense because 1 sick person likely infects at least 1 more person each week they're walking around, right? Before they even start coughing or shitting virus everywhere & take precautions, get help. Hence R0 of 2+ or say 2.5 nominal (reported 10+ in early outbreaks in Wuhan pre-lockdown, and that appears consistent with Iran for example). Our policy goal thus needs to be squashing 10 down towards 2, ideally below 2, which will stop the pandemic over time eventually. In the meantime, we have to assume infections/cases double weekly. That may be way low. It can't be way high. Meaning the problem could be much worse than my math suggests, thus my math is conservative. So make today week zero, 1k cases. Can't be fewer, may be 10-1000x higher already. (We'll figure out which over time, as people start dying. That's an objective measurement and as n gets larger, error bars get smaller.) Empirically, the mortality rate ("Case Fatality Rate") is conservatively 1%. Globally CFR apparently over 2%, cumulatively, but again the world is probably massively under-testing, which is sorta OK (at least understandable) because MOST infected people don't get sick. We're only testing sick people and close contacts here in US. OK, so to understand what's going on we have to look at the data we have, and use it to inform (estimate) the parameters we don't have. For example we have to look at only the "1000" confirmed cases we are SURE of by testing or clinical presentation acute viral pneumonia (with progressive respiratory failure and death by cardiac arrest with or without cytokine storm). If 1k today, it will be 2k in a week. So by week, new cases expected: 2k 4k 8k 16k 32k 64k 128k 256k By mid-May we expect 1/4M new cases per week. As won't have yet infected enough people to deny the virus 1 new host per current host. And won't have a vaccine etc. Quarantine and STRICT social distancing can delay that math by denying the virus trivially easy hops from one sick person to the next. Most of us will get it & most of us will be OK. But not the old/sick/vulnerable. The important thing rapidly becomes >100M Americans will contract the virus this year; but are competing for only 500k hospital beds. That's a 20:1 supply-demand problem. (Assuming only 10% of infected people go to the hospital... 200:1 if hypothetically we had magic testing and KNEW.) In practice it's better than that because many people won't go to the hospital (because won't be infected, or sick, or tested etc) and those who do will be load balanced over time, spread out over months. But that's the end of the good news. The bad news includes the cohort dynamic where the load/utilization rate of hospital beds will grow exponentially not linearly. As you can see above, exponential growth starts slow, then compounds in counter intuitive ways. For example if we have 1k confirmed cases today (min) then we can easily do the math backwards. Patient 0... Arrives WHEN to US from Wuhan? We can solve for that with only the doubling rate and current snapshot of confirmed cases. 1k 500 250 125 60 30 15 8 4 2 Ten weeks ago. Which hey presto is roughly the Lunar New Year holiday, when many folks here on west coast flew home to visit family in Asia. Came back to Seattle or SF sick. Let's assume that's true. That would require we have only 1 "patient zero" and the doubling rate has been constant, and we're just now starting to see 10% of infected people show up at the hospital, and 10% of them die, ie 1% of the total population of infected people. That would mean 10 people per day are dying in America directly from this bug. Watch the news, and do your own math. Is that happening, or not? If more, then timeline started earlier; or R0 higher; or CFR higher; or any combo. Because while some sick person (any one of the notional 1000 confirmed cases) who got treatment MAY have spread the virus faster or slower than average R0 predicts, that's basically irrelevant. Secondary. Because the reality is more new "local zero" patients got off the plane from China. A lot. Every day. For weeks. EACH local zero could stack their own bloom... in different regional clusters. That may or may not be what happened. Probably is. That would imply we already have WAY more than 1000 cases nationally, we just don't know because testing. Now. Back to bad news. Of the ~500k (550k roughly) hospital beds in USA circa 2015 (see 'Society of Critical Care Medicine: SCCM' online via Google or whatever) fewer than 100k are ICU beds. Suitable for this. So we have 1000 sick patients this week and 100k ICU beds for them. No problem, right? Except no, because baseline demand. Strokes. Cancer. Trauma, accidents, emphysema, GSW, whatever. MOST ICU beds are already in use for something else. In reality only ~10% of our 100k ICU beds are free. That's 10k. So in reality this week we have to accommodate 1000 confirmed cases in only 10k empty ICU beds spread around the country. Problem is the cases are not spread. They're clustered. For now. Wait a month and they will be everywhere, in every hospital. Which is a kind of better, because there will be ZERO idle ICU docs anywhere in the country. So efficient utilization. But the problem is by then the 1000 cases has bloomed exponentially (2,4,8,16) so many hospitals will be overwhelmed by local demand. The same hospitals (the ones already busy, for example, in silicon valley, Seattle, and NYC etc) will also be exhausted and increasingly understaffed. Because their docs and nurses and even janitors will have been working harder than they ever have in their lives, for weeks on end... not sleeping much, and getting sick themselves. This has already happened in every city globally that's "ahead" of us on timeline (weeks since first case) which hasn't clamped down on work/school/travel etc. So, Italy. Iran. They're *****. Swamped. Today. And it's just beginning to get bad there. It will get much worse. Inevitably. Conversely South Korea, Japan, Singapore, did much better with demobilizing civilian spread and surging paramilitary testing and intervention. For example compare un-protected American first responders carrying infected people off Oakland cruise liner... they've all been exposed now... with South Korea media with all pros in full PPE and most civs already social distancing. Going on a cruise AFTER the pandemic started is the opposite of social distancing. Most Americans are still doing the opposite of what we should all be doing, today. Because the way the math works is it's super hard to increase peak capacity at the hospital. To increase supply of trained doctors, nurses, ICU beds, ventilators, oxygen etc. Those are finite, in practice. While as I hope I established above the demand from patients is growing exponentially. That won't stop. It can slow. Quarantine helps. Not going to work or school helps. No more eating out. No more church. No more bars. Those are all KILLING people now, offset to the right into the near future. Because we still only have 10k free ICU beds. By the end of the month zero. By the end of the month we will be evicting regular people from regular hospital beds and frantically converting the entire hospital into temporary intensive care units. That's 500k beds today. Say we buy another 500k or use every gurney or couch etc. Double that. 1M peak capacity. That's doable. Well, problem is again, in 8 weeks we have 256k new cases PER WEEK. In 9 weeks that's 500k, in 10 weeks it's a million new cases weekly. Dying takes about a week. Recovering and going home takes longer. But all the beds, even the crappy temporary beds, will be full. And half the docs and nurses will be offline from fatigue, stress, dehydration (hard to drink in a suit) or the disease itself. This is already happening in Italy. https://threadreaderapp.com/thread/1237142891077697538.html This already happened in Wuhan. It won't stop happening until the virus can't find a new person to hop to, each week. There's only two ways to do that. Stay home, with your family etc. For 30+ days. Or die. Anything else you do is just gifting the virus another host to replicate in. We will achieve herd immunity one way or the other. (Or worse, we won't, and this is the new flu, like... forever, but it's 10x worse than the regular flu in the same way the flu is 10x worse than banal cold. This might be a new normal. We can't know yet.) Of course a vaccine or mutation would be a miracle. We ought to hope. But not expect that. The only things we can control our individual actions now. Not the government. Not the supply chains. Not the hospitals. Those are actually relatively small and powerless institutions, like, a few million people. Conversely there are 300+ million regular people in America who have to now decide whether they will make this problem worse today, or better. It's up to us. Edited March 12, 2020 by DrDawkinstein 1
DrDawkinstein Posted March 12, 2020 Posted March 12, 2020 (edited) and back to some "humor"... cue Curb Your Enthusiasm theme music. Edited March 12, 2020 by DrDawkinstein
plenzmd1 Posted March 12, 2020 Posted March 12, 2020 (edited) 40 minutes ago, Halloween Land said: Faith and Trust in the Lord is the best way to deal with the concern and panic of this virus. science and planning and doing what it takes to get the virus under control is the best way to deal with the panic. BTW, players is on TV for those of us who need a break Edited March 12, 2020 by plenzmd1 1
SlimShady'sSpaceForce Posted March 12, 2020 Posted March 12, 2020 (edited) 1 hour ago, CountDorkula said: Here is what baffles/angers me. This virus is affecting the entire world, drastically, but for some reason people in America believe that this virus will just skip this country because America? Ive told jokes about it, but that's because you still have to try and live life, but to act like "This ain't no thing" is incredibly selfish. People are blaming the NBA for overreacting for suspending the season. Funny when I offered to give these types of people first hand evidence I'm accused of wanting to spread the disease. 1 hour ago, teef said: i can't do implants and veneers on skype, that's for sure. i'm legit concerned here. 80 yr old parents. i have employees to look out for, payroll to meet, a new building mortgage. there's no way this virus doesn't stagger me a bit. i'm being selfish knowing that medically my family will be ok...i'm just worried about everything else. I know. I just had a crown put on. sorry trying as little levity For my company All it took was one outsourced IT guy. Edited March 12, 2020 by SlimShady'sGhost 2
Hapless Bills Fan Posted March 12, 2020 Author Posted March 12, 2020 18 hours ago, Jauronimo said: The handwashers have nothing to worry about. 100% of COVID cases have been linked to people who routinely do not wash their hands. This might be a good place to put this new research article. It is not good news. Covid may stay suspended in air for 3 hrs and live on hard surfaces for a day. New England Journal of Medicine Study from NIH and Princeton "We found that viable virus could be detected in aerosols up to 3 hours post aerosolization, up to 4 hours on copper, up to 24 hours on cardboard and up to 2-3 days on plastic and stainless steel. HCoV-19 and SARS-CoV-1 exhibited similar half-lives in aerosols, with median estimates around 2.7 hours. Both viruses show relatively long viability on stainless steel and polypropylene compared to copper or cardboard: the median half-life estimate for HCoV-19 is around 13 hours on steel and around 16 hours on polypropylene. Our results indicate that aerosol and fomite transmission of HCoV-19 is plausible, as the virus can remain viable in aerosols for multiple hours and on surfaces up to days." This directly contradicts information from some public health officials that the virus requires close contact (within feet) for hours for transmission. but these are solid researchers and it seems to be a good article. Also note that virus lives up to 4 hrs on copper, so don't buy your $69 copper nose-picker and expect results. https://www.medrxiv.org/content/10.1101/2020.03.09.20033217v1.full.pdf?fbclid=IwAR13hLFn38qUlbDRiNK5QnuMz-V8hzlNmzJz_kTO0O0Z82T5rDLBJUAu4FU 2
Hapless Bills Fan Posted March 12, 2020 Author Posted March 12, 2020 1 hour ago, DrDawkinstein said: This is long but a great read on the very real issues we're facing... (link to original post) Dawkinstein, the logic train of that link is fine, but I'd just like to note that there are links to far more vetted articles which rely upon the mathmatics of professional epidemiologists here (it's a bit beyond algebra). Thanks. But I think the point is very valid: what some of the epidemiologists are saying can be independently confirmed by a person able to do algebra and wield a pencil, the details may be off a bit but the conclusions are the same.
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