There should be a national dialogue in getting back to work

[Magox]

3 hours ago, B-Man said:

 

 

 

"We Can Safely Restart the Economy in June... Get tough now. Test widely to isolate those infected, and slowly revive businesses with workers and customers who have developed immunity."

 

Writes Ezekiel J. Emanuel in the NYT. 

 

Excerpt:

President Trump’s wish to open up the country by Easter and avoid a nationwide shelter-at-home policy is understandable. After all, a Covid-19-induced recession will cause its own serious health problems — depression; suicides; the damage stress will cause to those with heart disease, diabetes and other conditions, not to mention the effects of growing poverty....

A nationwide shelter-in-place or quarantine should take place for the next eight to 10 weeks.... During the eight weeks of shelter-in-place, the federal government needs to produce and distribute enough tests so state and local health officials can check as many people as possible.... State and local health department then need to deploy thousands of teams to trace contacts of all new Covid-19 cases.  The national quarantine would give hospitals time to stock up on supplies and equipment... States should use blood tests to certify people who have had Covid-19 are immune and no longer contagious...

 

Slowly open the economy and social activities...Lifting restrictions could start with children and young adults....Parents should be allowed to assess the risk that their children could become infected with the corona virus and bring it back home...If the initial opening works, we should allow people in offices to go back to work in places where Covid-19 infections have died down. Businesses need to require workers to follow rules on physical distancing with fellow workers and customers.... We would then open museums and other venues to small numbers of people

 

This is vey helpful. This is the kind of talk we need right now. By contrast, I've heard quite a few commentators interpret Tump's idea of opening things up by Easter to mean that he wants to crowd the pews of churches on Easter !  That's not the idea. The reopening will be done slowly and carefully, and it will not be a sudden return to the old way of living.

 

 

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I wouldn’t be opposed to this

[B-Man]

 

Trending:

 

#WhenCoronaVirusIsOver 

 

#futurefocused

 

 

Others are spending their time arguing about graphs when the dataset isn’t even strictly accurate

 

We should be trying to look around the corner at what comes next for us

 

And that is Green Zones / Red Zones

 

 

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[Doc Brown]

Interesting results of a herd immunity approach that has been floated as an alternative to the approach implemented here where we've essentially temporarily shut down our economy.  Makes me somewhat more confident that these extreme measures taken to "flatten the curve" has been the correct course with the information we've had at our disposal.

Caught Between Herd Immunity And National Lockdown, Holland Hit Hard By Covid-19 (Update)

In a national address to the Dutch nation on Monday, March 16^th, Prime Minister Mark Rutte said his country would aim to develop immunity to the novel coronavirus among its population by allowing large numbers to contract the illness at a controlled pace.

Initially, creating herd immunity for the novel coronavirus was one of two main objectives of Dutch government policy: Controlling spread of the virus while protecting vulnerable groups, including the elderly and people with underlying health conditions. By striking this balance rather than instituting a national lockdown, the thought was the nation could avoid a situation in which post lockdown - when society returns to normal - it would be exposed to the danger of a new outbreak as too few people would have become infected and therefore immune.

 

Faced with a pandemic as potent as Covid-19, a major problem with the herd immunity approach is that the disease has killed or made seriously ill a number of people under 60, some of whom had no serious underlying health conditions. Additionally, the approach suffers from a logistical near impossibility - the ability to separate older adults from potentially contagious younger people. Moreover, there’s the problem of not knowing whether immunity occurs after infection with the novel coronavirus, and the duration of that immunity.

 

In the past week, Rutte has since walked back the herd immunity policy line by introducing what could be characterized as lockdown light. The Dutch government says it is imposing similar restrictions to the ones its neighbors and other European countries have instituted. It has closed schools and universities, ordered bars and restaurants to mostly shut and told people to work from home as much as possible. The country has not issued a shelter in place order to citizens and residents, or imposed travel restrictions within the country.

 

The country’s pragmatic balancing act doesn’t appear to be working as well as intended. The numbers released by the Dutch RIVM (National Institute for Public Health and the Environment) are not especially encouraging. As of Sunday, March 29^th the country has a total of 10,886 confirmed cases, with 1,104 new cases in the past 24 hours; 771 total deaths, with 132 new deaths in the past 24 hours. There are at least 972 patients in intensive care, with thousands more hospitalized. RIVM is reporting that numbers of new patients admitted to hospital and intensive care are rising less rapidly than previously this week, but they’re still increasing.

 

While Covid-19 hasn’t wreaked nearly as much havoc in the Netherlands as in Italy and Spain, it’s still conspicuous that a healthcare system as finely tuned and well coordinated as the Dutch system would have such alarming numbers in terms of mortality and morbidity.

The confirmed case fatality rate in the Netherlands of approximately 7% stands in stark contrast to its neighbor Germany’s 0.7%. The Netherlands, with a younger overall population and one that is almost 5 times smaller than Germany’s, has 60% more deaths. And, unlike Germany, the Dutch haven’t done widespread testing, so it’s likely its number of confirmed cases significantly underestimates the actual number of infections.

 

While the number of confirmed cases in Germany is large, partly due to its testing campaign, the case fatality rate and overall death toll have been relatively small, compared not only to Holland, but also almost all other European nations. Similarly, the numbers of patients in serious or critical condition have remained very low.

 

Both the German and Dutch healthcare systems are relatively well-funded, and score well internationally on population health indicators, such as life expectancy and morbidity. Yet, thus far, the impact from Covid-19 in Holland has been worse. It has led to a situation in which the Netherlands now faces the real possibility of an impending shortage of intensive care units. Germany officials have said they’re prepared to accept Dutch Covid-19 patients. And, in fact, this weekend two Dutch intensive care patients were transported to a hospital in Munster, Germany.

 

The German city of Aachen’s University Clinic, which has strong ties with the medical center affiliated with the University of Maastricht in the Netherlands, has also pledged to cooperate should the need arise for more intensive care patients to be transported from Holland to Germany. Aachen’s University Clinic has made similar arrangements for a number of severely ill French and Italian patients.

 

 

[B-Man]

 

 

National coronavirus response: A road map to reopening

by Scott Gottlieb & Caitlin Rivers

 

Original Article

 

This report provides a road map for navigating through the current COVID-19 pandemic in the United States. It outlines specific directions for adapting our public-health approach away from sweeping mitigation strategies as we limit the epidemic spread of COVID-19, such that we can transition to new tools and approaches to prevent further spread of the disease. The authors outline the steps that can be taken as epidemic transmission is brought under control in different regions. They also suggest measurable milestones for identifying when we can make these transitions and start reopening America for businesses and families.

 

 

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[B-Man]

 

 

 It’s Not a Choice Between Lives or the Economy.

 

 

 

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[Taro T]

If they try to open things back up as Germany has proposed, by letting those who've had the virus and survived it be the 1st people released, when does the next and significantly larger group of people that didn't contract the virus get "permission" to resume their lives?

[Deranged Rhino]

2 minutes ago, Taro T said:

If they try to open things back up as Germany has proposed, by letting those who've had the virus and survived it be the 1st people released, when does the next and significantly larger group of people that didn't contract the virus get "permission" to resume their lives?

 

When the "instant" test becomes available en mass. People will have to take it to go back to work (JMO, not citing a concrete plan) -- and from what I've gathered we're still at least 4 weeks from those tests being widely available. Maybe 3. 

Edited March 30, 2020 by Deranged Rhino

[Taro T]

8 minutes ago, Deranged Rhino said:

 

When the "instant" test becomes available en mass. People will have to take it to go back to work (JMO, not citing a concrete plan) -- and from what I've gathered we're still at least 4 weeks from those tests being widely available. Maybe 3. 

 

So, people that haven't had it would have to wait until they've been tested before being allowed back to work?  2 q's as to how that would actually be implemented: Under what conditions would they have to retest? And more importantly, who decides and how, who gets that test?

 

(And a 3rd related q too:  would the test keep / collect individuals' DNA so that we'd now effectively have a national DNA registry?)

Edited March 30, 2020 by Taro T

[123719bwiqrb]

Just now, Taro T said:

 

So, people that haven't had it would have to wait until they've been tested before being allowed back to work?  2 q's as yo how that would actually be implemented: Under what conditions would they have to retest? And more importantly, who decides and how, who gets that test?

 

(And a 3rd related q too:  would the test keep / collect individuals' DNA so that we'd now effectively have a national DNA registry?)

 

This will be great - we'll have two classes of people.  Maybe we can subjugate one of them!  If you don't have your proper papers, you get gulag'd.  Think of all the fun we can have with this idea.

[Foxx]

9 minutes ago, Taro T said:

 

So, people that haven't had it would have to wait until they've been tested before being allowed back to work?  2 q's as to how that would actually be implemented: Under what conditions would they have to retest? And more importantly, who decides and how, who gets that test?

 

(And a 3rd related q too:  would the test keep / collect individuals' DNA so that we'd now effectively have a national DNA registry?)

since you could become infected at any point... we may be talking daily here.

[Taro T]

28 minutes ago, Foxx said:

since you could become infected at any point... we may be talking daily here.

 

How does that work for say 150,000,000 people or so in actual practice?

[Deranged Rhino]

44 minutes ago, Taro T said:

 

So, people that haven't had it would have to wait until they've been tested before being allowed back to work?  2 q's as to how that would actually be implemented: Under what conditions would they have to retest? And more importantly, who decides and how, who gets that test?

 

(And a 3rd related q too:  would the test keep / collect individuals' DNA so that we'd now effectively have a national DNA registry?)

 

All good questions I don't have answers to.  

[Magox]

We most likely won't completely follow Germany's model.   Ezekiel Manuel and Scott Gotlieb both have similar plans and I'm guessing anytime now Trump will setup some sort of task force to begin looking at this.  

 

The idea of just having those who have tested positive to begin I don't think will be model.  I think they will be included but I just don't see that as the model.   It's too restrictive, specially for a country as free as the U.S

[Foxx]

1 hour ago, Taro T said:

 

How does that work for say 150,000,000 people or so in actual practice?

much like DR said, i don't know. admittedly not very practical, just speculating.

[Magox]

So I found this Twitter thread by Nate Silver to be very interesting on the possible mortality rates.

 

And here is an article on it from Allahpundit, who is an analytical guy who delves into these things.

 

Basically, there are two studies that they are looking at and both the studies are in regards to the possible true rates of infections which of course alters the mortality rates.

 

Looking at the mortality rates right now is not an accurate gauge because it doesn't take into account all the people who haven't been tested, and there are a lot of them.

 

There is a chance that some countries are beginning to build a "herd immunity".  Of course that means they are suffering more so now than other countries but potentially puts them in better shape over the course of the next 12-18 months.

 

Quote

 

The Imperial College, whose projections have been dire, published a new study today that includes this data on estimated infection rates. Check out the numbers for Italy and especially Spain.

The first number is their best guess at the infection (or “attack”) rate in each country and the numbers that follow represent the proverbial margin of error. In Spain the actual rate could be as little as 3.7 percent or as high as 41 percent, which would be approaching herd immunity. In Italy almost 10 percent of the population is expected to be infected right now, although it could be as high as a quarter. What does this mean for the fatality rate?

In Italy there are 11,591 COVID-19 deaths as I write this out of a population of 60.48 million people. If 9.8 percent of the population is infected, that’s 5.9 million cases. That’s a fatality rate of 0.2 percent, lower than the estimates of one to two percent (or higher) that are based on Chinese data.

In Spain there are 7,340 deaths as of today in a population of 46.66 million. Assuming 15 percent are infected, that’s just about seven million infections. Case fatality rate: 0.1 percent.

One more. The Imperial College estimates an infection rate in the United Kingdom of 2.7 percent. Among a population of 66.44 million, that should mean about 1.8 million infections. They’ve had 1,408 deaths so far. That’s a case fatality rate of 0.08 percent.

If you assume that actual infection rates run towards the higher end of the Imperial College’s statistical range, the fatality rate shrinks further. As for our own country, if we assume, say, a two percent infection rate (in line with most of the estimates in the table above), that would mean 6.5 million total infections in the U.S. against 2,945 deaths as of this afternoon. That would be a fatality rate of just .045 percent. If that’s true, then if all 327.2 million Americans were infected, we would expect the total number of deaths to be 147,240 — which, not coincidentally, is smack dab in the middle of the range given by Deborah Birx this morning.

Two things can simultaneously be true, then. One is that the average American’s odds of dying may be very small, something like one in 2,200. (Smaller, actually, for younger age groups.) And two is that a lot of Americans are going to die, whatever the odds may be. Many more than would die in a flu outbreak.

 

 

 

There are a number of qualifiers and it is certainly not definitive in any shape or form.  But the more data that we are learning the more accurate these studies are becoming.  

 

I've said all along, I believe by the time this is all said and over with, the true mortality rate will be between .2-.3%    And that for those that are under the age of 60 and/or without any respiratory and some other diseases that the mortality rate will be in line with the regular flu  But for those that have these risks, it will be considerably higher.

[Foxx]

47 minutes ago, Magox said:

There is a chance that some countries are beginning to build a "herd immunity".  Of course that means they are suffering more so now than other countries but potentially puts them in better shape over the course of the next 12-18 months.

of course, the herd immunity relies on a static virus.  i don't think that is a reasonable approach to take as all virus mutate.

[Magox]

3 minutes ago, Foxx said:

of course, the herd immunity relies on a static virus.  i don't think that is a reasonable approach to take as all virus mutate.

 

From my understanding all viruses or virtually all viruses mutate and that the pattern of mutations that this one has taken are not out of line with others.  That "herd immunity" as the shape it is appearing it will take would be affected by herd immunity

[Foxx]

16 minutes ago, Magox said:

 

From my understanding all viruses or virtually all viruses mutate and that the pattern of mutations that this one has taken are not out of line with others.  That "herd immunity" as the shape it is appearing it will take would be affected by herd immunity

every year we see a new flu vaccine because the previous years won't work against the new strain. strains are variations on the current mutation. if herd mentality worked we wouldn't need a new vaccine every year to protect us from the latest strain of the flu. herd mentality only works in the current season and sometimes not even then.

Edited March 31, 2020 by Foxx

[Magox]

1 minute ago, Foxx said:

every year we see a new flu vaccine because the previous years won't work against the new strain.strains are variations on the current mutation. if herd mentality worked we wouldn't need a new vaccine every year to protect us from the latest strain of the flu. herd mentality only works in the current season and sometimes not even then.

 

You could be right but that isn't what they are anticipating for this one.  Read the two studies that are linked in that article.

[B-Man]

We’re Following A One-Size-Fits-All Coronavirus Strategy Right Into A Great Depression

While this shutdown has already done enormous damage, it is the uncertainty about when and how it will reopen that could prove far more destructive in the long run.