Covid-19 discussion and humor thread [Was: CDC says don't touch your face to avoid Covid19...Vets to the rescue!

[K-9]

7 minutes ago, Sundancer said:

The Commerce Clause thinks the Tenth Amendment is cute. 

So does the General Welfare Clause. 

[Miyagi-Do Karate]

2 hours ago, May Day 10 said:

The problem is, everyone cant go back to normal because then we are either right back here again.... or we just try to ignore it and the worst case scenario is realized.  Without a vaccine, or some sort of hammer treatment for the symptoms, we are pretty screwed.

 

They need to be finalizing a plan for testing, tracking, and containment

that had been my concern for a while. By doing what we are doing now, once we go back to normal, aren’t we just going to push the spike to that point (likely during regular cold and flu season in the winter)?

 

my only hope on this is that the modeling is wrong, and I’m pretty sure it will be. I don’t believe the modeling can account for the likely vast majority of people who got the COVID19 with mild symptoms, were never tested, and have long since recovered. That number has to be through the roof.  

[Gray Beard]

2 hours ago, May Day 10 said:

The problem is, everyone cant go back to normal because then we are either right back here again.... or we just try to ignore it and the worst case scenario is realized.  Without a vaccine, or some sort of hammer treatment for the symptoms, we are pretty screwed.

 

They need to be finalizing a plan for testing, tracking, and containment

Agree.  They should open things up in stages.  Schools, but not restaurants, or vice versa.  Parks and beaches, but not stadiums. Stores, but not movies.  Offices can be opened with guidelines to avoid crowded meetings.  Forehead thermometers can be used where possible to monitor for fevers.  The wearing of masks should be encouraged.  Etc.   Then the nature of the rebound spike can be assessed before more things are open.

[Sundancer]

13 minutes ago, Gray Beard said:

Agree.  They should open things up in stages.  Schools, but not restaurants, or vice versa.  Parks and beaches, but not stadiums. Stores, but not movies.  Offices can be opened with guidelines to avoid crowded meetings.  Forehead thermometers can be used where possible to monitor for fevers.  The wearing of masks should be encouraged.  Etc.   Then the nature of the rebound spike can be assessed before more things are open.

 

We will reopen in the reverse that we closed I hope.

 

rural to metro

car transport to public

businesses where distancing is possible in part to those where its not

local schools to national universities

restaurants to conventions

local travel to regional to world

limited seating sports to full stadium

 

Or something like the above. Of course, without any guidance, this will be left up to every state. So if Iowa wants its huge state fair, they have it. 

 

I do not know how they reopen New York. It only works one way. Lots of crowds everywhere. 

 

Edited April 7, 2020 by Sundancer

[Miyagi-Do Karate]

13 minutes ago, Gray Beard said:

Agree.  They should open things up in stages.  Schools, but not restaurants, or vice versa.  Parks and beaches, but not stadiums. Stores, but not movies.  Offices can be opened with guidelines to avoid crowded meetings.  Forehead thermometers can be used where possible to monitor for fevers.  The wearing of masks should be encouraged.  Etc.   Then the nature of the rebound spike can be assessed before more things are open.

 

one thing that has been bothering me

is that it seems everyone is now recommending against testing if you can self-treat at home. In PA, the advice is: “don’t get tested; self-quarantine and operate under the assumption you have it.” Isn’t the ability to get back to work And life dependent on having the data to understand who already got the virus? 

[Sundancer]

1 minute ago, JR in Pittsburgh said:

 

one thing that has been bothering me

is that it seems everyone is now recommending against testing if you can self-treat at home. In PA, the advice is: “don’t get tested; self-quarantine and operate under the assumption you have it.” Isn’t the ability to get back to work And life dependent on having the data to understand who already got the virus? 

 

That's the advice because we lack the ability to test, going to the hospital is more dangerous now, and PPE for testers is so limited. 

 

In getting back to work, we should have so many tests lying around, they should be like breath mints. 

[Miyagi-Do Karate]

Just now, Sundancer said:

 

That's the advice because we lack the ability to test, going to the hospital is more dangerous now, and PPE for testers is so limited. 

 

In getting back to work, we should have so many tests lying around, they should be like breath mints. 

I think the key may also be those antibody tests that are hopefully being developed. if you had it, then you go back into society without limitation. 

[Gray Beard]

1 minute ago, JR in Pittsburgh said:

 

one thing that has been bothering me

is that it seems everyone is now recommending against testing if you can self-treat at home. In PA, the advice is: “don’t get tested; self-quarantine and operate under the assumption you have it.” Isn’t the ability to get back to work And life dependent on having the data to understand who already got the virus? 

Yup.

I think the blood test for antibodies is key. That lets you know if you’ve had it already.  The test exists and is just starting to be used. 
 

My son is a nurse in a smallish Upstate NY hospital.  He’s pretty mad that they don’t have the antibody test available so that people who’ve already had it can work the covid floor, and people who haven’t had it can work the regular floor.  

[ALF]

A $40 oxygen-measuring device can tell at-home coronavirus patients if they need to go to the ER

 

device known as a pulse oximeter, which can measure the oxygen levels in one's blood within seconds after being clipped to one's finger or another body part, is becoming a hot new commodity during the coronavirus pandemic.

 

Oximeters measure blood oxygen levels by sending photons of a specific wavelength through the skin and observing the measurements. They are most commonly used by people with respiratory issues, or by individuals in professions where monitoring oxygen levels is a paramount concern, such as athletes and pilots. In medicine, of course, they are in many different cases including for routine check-ups.

 

Because COVID-19 can lead to a drop in a patient's blood oxygen levels, the coronavirus era has brought on a minor oximeter craze. 

 

https://www.salon.com/2020/04/06/a-40-oxygen-measuring-device-can-tell-at-home-coronavirus-patients-if-they-need-to-go-to-the-er/

 

I've had this device that also takes your pulse on fingertip for a heart condition. 

 

Another quick temperature check is a ear thermometer . 

 

 Normal oxygen reading would be about 95% ,  below 90  start to check more often.

[SlimShady'sSpaceForce]

New York virus deaths hit new daily high, but hospitalizations slow

 

 

  https://www.msn.com/en-us/news/us/ny-virus-deaths-hit-new-high-but-hospitalizations-slow-live-updates/ar-BB12gExd?OCID=ansmsnnews11

[Hapless Bills Fan]

6 hours ago, John in Jax said:

Seems that there’s light at the end of the tunnel! Hopefully by mid May we can get back to some semblance of normal. And maybe after all is said and done the “modelers” at IHME will get pink slips.

 

To date, I still haven’t seen/heard of a single case in all of the USA where someone needed a ventilator, but wasn’t able to get one. Yet every day on my TV, I continue to be told that the sky is falling.

 

So because you haven't personally seen or heard, you think everything is hunky dunky?  Unless you are a critical care physician or nurse or RT,

 

Cuomo has said that they're splitting ventilators, they're using anesthesia machines as ventilators, they're using CPAP/BIPAPs as ventilators.  Two of those 3 things are distinctly sub-optimal practices for patient recovery.   They aren't doing these things because they're not critically short.

Personally, if I'm a hospital that's running short, I'm not jabbering to the news media, I'm using all my time and energy to solve the problem.

Now I'm going off to kowtow to my spouse, I was told that if we averted catastrophy by stringent social distancing, instead of being all "yea!  the social distancing and stuff worked" people would be all blame-y about the models fortelling the need being incorrect.   I poo-poo'd that.  You're exhibit A of my need for heartfelt apology.

 

 

[John in Jax]

From a story on The NY Times website, which I just read, and was just updated 33 minutes ago (talking about NY city, the hottest spot in the country):

 

“The number of virus patients in hospitals increased 4 percent since Monday, the fourth straight day that it had grown 7 percent or less after growing at least 20 percent a day for weeks.

The number of patients on ventilators in intensive-care units increased, too, but at the smallest one-day rate in weeks, up 2 percent since Monday.

As of Tuesday, there were nearly 4,600 patients on ventilators in New York, far fewer than pessimistic projections in recent weeks said there might be. That has helped keep the state from exhausting its supply of ventilators.“

 

The link: https://www.nytimes.com/2020/04/07/nyregion/coronavirus-new-york-update.html

Edited April 7, 2020 by John in Jax

[Figster]

On 4/5/2020 at 6:38 PM, SDS said:

Does anyone know who’s set of predictions seem to portray the numbers? Also, it’s not apparent to me we are on track for the 100 - 240k fatality point. I am not following those numbers closely, it just feels like with the passage of time these things would have grown substantially.

https://www.yahoo.com/gma/cdc-director-downplays-coronavirus-models-says-death-toll-033800213.html

 

 

[K-9]

11 minutes ago, Hapless Bills Fan said:

 

So because you haven't personally seen or heard, you think everything is hunky dunky?  Unless you are a critical care physician or nurse or RT,

 

Cuomo has said that they're splitting ventilators, they're using anesthesia machines as ventilators, they're using CPAP/BIPAPs as ventilators.  Two of those 3 things are distinctly sub-optimal practices for patient recovery.   They aren't doing these things because they're not critically short.

Personally, if I'm a hospital that's running short, I'm not jabbering to the news media, I'm using all my time and energy to solve the problem.

Now I'm going off to kowtow to my spouse, I was told that if we averted catastrophy by stringent social distancing, instead of being all "yea!  the social distancing and stuff worked" people would be all blame-y about the models fortelling the need being incorrect.   I poo-poo'd that.  You're exhibit A of my need for heartfelt apology.

 

 

God bless the modelers. I can’t think of a more thankless job. They are tasked with forecasting futures based on current data sets and their primary job is to forecast ranges, including worst case scenarios in order to maximize preparedness. And for good reason.

 

I’d think it was plainly obvious to their biggest critics that it’s always best to prepare for a worst case scenario and end up not needing that level of preparation vs. under preparing and being caught short. It’s like insurance is a foreign concept or something. 
 

I’d rather be informed by models based on data sets than a bunch of yes-man sycophants too afraid to tell me I have no clothes on.

[K-9]

Distressing to read that Japanese PM Abe will propose declaring a month long state of emergency in seven districts, including Tokyo and Osaka after a RENEWED surge of the virus in the country’s biggest cities. 
 

This underscores my concerns that in our haste to open things up, we make things worse. 

[SlimShady'sSpaceForce]

Some humor 

 

 

 

 

 

 

 

The STRAIN in Spain falls mainly on the plain 
 

Edited April 7, 2020 by SlimShady'sSpaceForce

[BillsFan4]

1 hour ago, Hapless Bills Fan said:

 

So because you haven't personally seen or heard, you think everything is hunky dunky?  Unless you are a critical care physician or nurse or RT,

 

Cuomo has said that they're splitting ventilators, they're using anesthesia machines as ventilators, they're using CPAP/BIPAPs as ventilators.  Two of those 3 things are distinctly sub-optimal practices for patient recovery.   They aren't doing these things because they're not critically short.

Personally, if I'm a hospital that's running short, I'm not jabbering to the news media, I'm using all my time and energy to solve the problem.

 

 

Yep, Just read the IG report on the our hospitals experience responding to the covid pandemic. Here’s the link:

https://oig.hhs.gov/oei/reports/oei-06-20-00300.pdf

 

Quote

This information is based on brief telephone interviews (“pulse surveys”) conducted March 23–27, 2020, with hospital administrators from 323 hospitals across 46 States, the District of Columbia, and Puerto Rico, that were part of our random sample.

 

There are staff shortages, overcrowding/bed shortages, PPE shortages, shortages on all sorts of other medical equipment, cleaning equipment, food, etc. I’ve read doctors and nurses in NYC saying that they are so overcrowded that have patients dying in the hallways before they can even be moved to a room.

 

Quote

Findings at a Glance: Hospital Challenges:

-Severe Shortages of Testing Supplies and Extended Waits for Results

-Widespread Shortages of PPE

-Difficulty Maintaining Adequate Staffing and Supporting Staff

-Difficulty Maintaining and Expanding Hospital Capacity to Treat Patients

-Shortages of Critical Supplies, Materials, and Logistic Support

 

 

 

Just because they may not be totally out of 1 specific piece of medical equipment yet doesn’t mean that they won’t be soon (many of those 323 hospitals said that they anticipate running out of ventilators soon and don’t know how/where to get more) or that they aren’t facing very difficult problems from shortages in many other areas of need.

 

NYS had to get 1000 from China to keep from running out this coming week.

Other hospitals are reporting acquiring ventilators by unusual means or converting other less than ideal equipment to use as ventilators (as you mentioned) and can potentially spread covid19 (by aerosolizing it). It’s not like there’s an abundance of them or something. They’re taking drastic measures to ensure they have enough.

 

Quote

Anticipated Shortages of Ventilators

Anticipated shortages of ventilators were identified as a big challenge for hospitals. Hospitals reported an uncertain supply of standard, full-feature ventilators and in some cases used alternatives to support patients, including adapting anesthesia machines and using single-use emergency transport ventilators. Hospitals anticipated that ventilator shortages would pose difficult decisions about ethical allocation and liability, although at the time of our survey no hospital reported limiting ventilator use.
 

 

Secure Ventilators and Alternative Equipment to Support Patients

In anticipation of increased needs for ventilators, hospitals tried to obtain additional machines by renting ventilators, buying single-use emergency transport ventilators, or getting ventilators through an affiliated facility. Some hospitals reported converting other equipment, such as anesthesia machines, to use as ventilators.

 

Quote

To secure the necessary PPE, equipment, and supplies, hospitals reported turning to new, sometimes un-vetted, and non-traditional sources of supplies and medical equipment. To try to make existing supplies of PPE last, hospitals reported conserving and reusing single-use/disposable PPE, including using or exploring ultra-violet (UV) sterilization of masks or bypassing some sanitation processes by having staff place surgical masks over N95 masks. Hospitals also reported turning to non-medical-grade PPE, such as construction masks or handmade masks and gowns, which they worried may put staff at risk.

 

 

 

 

Interview with Doctors at NY Presbyterian hospital:

https://www.buzzfeednews.com/article/kadiagoba/ventilator-shortage-new-york-hospitals-coronavirus

 

Quote

There’s a list about six [types of] patients that do not get put on a vent. ‘It makes no sense, they’re going to die soon anyway, so let them die’ — like that’s the crazy thought process. This **** hurts,” they said.

 

Quote

During the coronavirus crisis, the steady tone of a heart monitor that signals health officials need to intervene immediately might go unanswered. Somehow that sound, which most of us recognize only from episodes of Grey’s Anatomy, is now the backdrop for health care officials navigating a hospital’s intensive care unit.

 

“Normally in the real world, you never let that happen so you never really see that. That’s how it was on Saturday. You saw the heart rate go down, the blood pressure go down, the oxygen go down and then everything just flatlines and stops. Literally, we looked at each other and said ‘what else can we do? Nothing,’” the doctor recalled.

 

“And then guess what? We’re so morbid. We’re so jaded. Guess what’s the first thing we think of [when a patient dies]? ‘Oh ****, we got a new ventilator, let’s get somebody on the ventilator!’”

 

“I’ve never seen anything like this in my life. ... Never.”

That part about “we got a new ventilator, let’s get somebody on it” implies that they’d have already been on it if they had more.

 

Quote

“It’s scary and it’s tough,” the doctor said. “I think what’s scary is that the resources are missing. This is the richest country in the world and they’re out here talking about recycling masks. ... Now we’re using the same one all day. We’re using the same gown all day. You don’t really have the time to change, you’re just running from one patient to the next, one patient to the next, one patient to the next.”

 

And then there’s the pace at which the disease ravages each victim.

 

“Literally, I went out to the visiting area — because visitors aren’t allowed — to talk to the daughter. [The] mom is doing fine, her numbers are OK, we’re just going to watch her and we’re going to see,” they said. Within six minutes of the update, the doctor had to provide another update: “I had to intubate your mother.”

 

It’s “that fast. That fast,” thye said.

 

It happened a second time, to a different patient, on the same day.

 

“I go out to tell the husband ‘OK, everything looks good.’ I go back in, oxygen levels drop, we have to intubate her. ... The crazy thing is how fast people go down and die. Literally, like you walk out and go to the bathroom and pee and come back and you’re running around and your patient is dying.”

 

 

“The other day I felt defeated. The patient came in on a code. We looked at each other. The patient had to die. There was nothing we could do.” Any feelings of guilt were upended by the next patient to come through the doors when they had to tell EMS they had no ventilators. EMS said they had nowhere else to go. The patient died.

 

 

Read this survey of 250 healthcare workers and all the shortages they’re facing:

 

https://www.nbcnews.com/news/us-news/system-doomed-doctors-nurses-sound-nbc-news-coronavirus-survey-n1164841

 

 

NYC’s morgues are also over capacity. They had to set up something like 50+ new mobile morgues (and those are reportedly already almost at capacity too). They’re talking about soon having to temporarily bury people who died from covid in the local parks. And They say this next next week is probably going to be the toughest yet. I’m hopeful things are trending in the right direction but we have a long way to go before we are out of the woods.

[LeGOATski]

7 hours ago, Sundancer said:

 

Not easy to model something that has never happened, with data from one dubious source. 

 

I hope the modelers can get the part where we lessen distancing right and also predict second wave right and make good recommendations. 

We've had models since the SARS outbreak. Since the first US case in January, the government should've operated under worst case scenario until better numbers came in, adjusting accordingly as time went on.

 

When they were initially trying to downplay it, they took best case models and told themselves it would only kill 5000 people. Lol

 

I'd like to think the next time this happens we'll operate under worst case scenarios initially. But its always a political/economic question more than it is a death count question.

 

 

[Hapless Bills Fan]

6 hours ago, JR in Pittsburgh said:

that had been my concern for a while. By doing what we are doing now, once we go back to normal, aren’t we just going to push the spike to that point (likely during regular cold and flu season in the winter)?

 

my only hope on this is that the modeling is wrong, and I’m pretty sure it will be. I don’t believe the modeling can account for the likely vast majority of people who got the COVID19 with mild symptoms, were never tested, and have long since recovered. That number has to be through the roof.  

 

Is it through the roof, or isn't it?   

 

That's really the unknown question, and it makes a HUGE difference to accurately forecasting what will happen when social distancing is relaxed.

 

China early on said 1-2% asymptomatic.  Now they're saying more.  S. Korea, which I believe most people place more faith in than in China, says 20% asymptomatic.  Iceland says 50%.  Town of Vo, Italy, more like 30-50% asymptomatic or presymptomatic.

 

We badly need widespread serology testing to determine this.

 

[Hapless Bills Fan]

2 hours ago, K-9 said:

God bless the modelers. I can’t think of a more thankless job. They are tasked with forecasting futures based on current data sets and their primary job is to forecast ranges, including worst case scenarios in order to maximize preparedness. And for good reason.

 

I’d think it was plainly obvious to their biggest critics that it’s always best to prepare for a worst case scenario and end up not needing that level of preparation vs. under preparing and being caught short. It’s like insurance is a foreign concept or something. 
 

I’d rather be informed by models based on data sets than a bunch of yes-man sycophants too afraid to tell me I have no clothes on.

 

What has to be understood, is that the people doing the modeling are asked to consider a number of different inputs and assumptions.

 

They make their models accordingly, stating the assumptions that go into each model clearly.

 

Then leaders and politicians choose which model they wish to publicize, but don't always state the assumptions upon which the model is based, clearly.

 

So, for example, if the model publicized assumes a 50% reduction in transmission due to social distancing, but people take it so seriously that we actually achieve a 75% reduction in transmission due to social distancing, the model is seen as "wrong" - but there is probably a model out there which started with different assumptions, and would match what actually happened much better.