Coronavirus

[emtee]

Looks like the scientists expect this to be an a annual occurrence. Ugh!

Nobody answered my earlier question concerning how a vaccine would help if we can become re-infected. To me that indicates that the antibodies don't sufficiecty build a strong enough immunity.

[Northern Lion]

I think the numbers regarding infections and deaths related to Covid-19 will be fuzzy perhaps even years after this is all over.

We still aren't completely certain about the numbers related to the 1918-1919 flu pandemic.  I read a great book on it a few years ago and it quoted an estimate between 50 and 100 million dead.  That's a large margin for error!  Granted we have better tracking methods now then we did back then, but still...

When all is said and done, we will be able to easily review the death rates of other diseases compared to previous years with those attributed to Covid-19.  And if there is a discrepency found, then the numbers can be "fixed" to be more realistic at that time.

[Dublagent66]

Looks like the scientists expect this to be an a annual occurrence. Ugh!

Nobody answered my earlier question concerning how a vaccine would help if we can become re-infected. To me that indicates that the antibodies don't sufficiecty build a strong enough immunity.

That's what viruses do.  They occur and re-occur.  Vaccines have to be developed and continuously updated to keep up with new strains.  It is literally a race between humans and viruses.

[hunnus2000]

Looks like the scientists expect this to be an a annual occurrence. Ugh!

Nobody answered my earlier question concerning how a vaccine would help if we can become re-infected. To me that indicates that the antibodies don't sufficiecty build a strong enough immunity.

I'll try and answer this even thought I am not remotely an expert. We get a flu shot every year but it only addresses the strains of flu that we know of and we may get the flu that's of another strain. It very well could be that we have to develop a separate vaccine for this strain of virus and it could be that we would have to get a shot every year depending on if the corona mutates. Again, we're still in the 1st quarter with this virus.

[emtee]

I'm pretty well educated on flu vaccines since I sold them for 28 years. I know that a fair amount of guesswork, along with historical data and a few other factors is part of the process. They have to be made in advance of the flu season. I just wondered if this was going to be a different beast.

Along this line of thought, we never get data on people who get the flu despite getting vaccinated. I submit it's  a higher number than we would be comfortable with. This flu season I work with 4 people who were sick. Very sick. My daughter and son in law also. I would like to know the number to see just how successful the vaccine is.

[Luoto]

Finland has significantly increased testing capacity for the virus, but there hasn't been a matching increase in the amount of tests made. The reason is simple: no demand. Prevention measures have been so effective that prediction models have overestimated progression of the epidemic, and the peak under current restrictions was on April 7th. It seems to have come to an almost complete halt everywhere except the capital province, which should make tracing of future contagion chains easier again.

[ZKX-2099]

Looks like the scientists expect this to be an a annual occurrence. Ugh!

Are these the same scientists that said the death count would be over a million at this point? 

[Chino]

Looks like the scientists expect this to be an a annual occurrence. Ugh!

Are these the same scientists that said the death count would be over a million at this point? 

The very same.

Had we not heeded their warnings and took the measures we did, that would have happened without the virus breaking a sweat. Can we please not act like that scientists are somehow the bad guys here?

[Harmony]

Looks like the scientists expect this to be an a annual occurrence. Ugh!

Are these the same scientists that said the death count would be over a million at this point? 

The very same.

Had we not heeded their warnings and took the measures we did, that would have happened without the virus breaking a sweat. Can we please not act like that scientists are somehow the bad guys here?

Exactly.  Scientists and public health officials and the hard work of everyone staying the fuck home is EXACTLY why the death count isn't what was predicted.  This is not a difficult concept to grasp.

[ZKX-2099]

Why are you responding like you're personally offended?

[Harmony]

Personally offended? No.  I'm just tired of this "blame the people who are actually doing the hard work" mode that people seem to be shifting into.  We should be jumping for joy that the curve was flattened.  It means we were successful!

Edit to add that there are many people grieving losses who wouldn't see us as being successful.  I don't mean to minimize their pain.  I'm just saying it could've been so much worse with many more lost had we not all sacrificed and paid attention to the scientists and experts.

[ZKX-2099]

Flattening the curve means spreading out the deaths.

I prefer the ripping off a band aid approach.

[Harmony]

Flattening the curve means having more time to get prepared.  Making sure our hospitals are getting all the PPE we need and staff are not working themselves to death.  I won't speak for other countries, but the US was not prepared.  We still aren't fully prepared but flattening the curve bought us more time to get there.

Ripping off the band aid would've collapsed the health care system.

[Chino]

Flattening the curve means spreading out the deaths.

No it doesn't. You're implying that the total death count would be the same whether it was a gradual bell curve or a Everest-like spike of a mountain. That's just flat out wrong.

[ZKX-2099]

If the virus spreads as much as they say the deaths would be the same

[Chino]

I haven't a clue what you're trying to say.

[Adami]

If the virus spreads as much as they say the deaths would be the same

But that's the point, the stay at home measures helped limit the spread.

[Orbert]

If the virus spreads as much as they say the deaths would be the same

That's the whole point of flattening the curve.  The deaths will not be the same because preventative action has been taken.

Seriously, what is it you don't understand about this?

[Stadler]

I don't blame the scientists at all, but I'm not going to lie.  I'm a numbers/data/analysis kind of guy - I have the World Meter up on my desk top most days - and I'm struggling with the "certainty" of the efficacy of some of the measures.   

I deal in risk management every single day, so I understand that there is benefit to "less bad", but there still has to be some attributable causal connection between the constraints and the benefits.  Too many of the articles I've read simply make the statement prima facie, and it's sort of begging the question if you ask me.   I'm fine so far with what we've done, primarily (and selfishly) since the only hardship I've really endured is the postponing of The Musical Box show.   But that's not enough. 

The real test for me is if the time is spent ACTUALLY PREPARING.  We got it from Europe, not China, so there was a lot more going on than just "bad lab procedures" and careless containment.

[ZKX-2099]

I'm factoring in the recent reports of there being a massive amount of symptomless carriers into my thinking.

[Chino]

If the virus spreads as much as they say the deaths would be the same

That's the whole point of flattening the curve.  The deaths will not be the same because preventative action has been taken.

Seriously, what is it you don't understand about this?

I'm guessing the concept of exponential growth.

[bosk1]

If the virus spreads as much as they say the deaths would be the same

That's the whole point of flattening the curve.  The deaths will not be the same because preventative action has been taken.

Seriously, what is it you don't understand about this?

Not only that--that's only really a small part of it. The bigger factor is, even if we were to get an identical spread with identical numbers, just spread over more time, that in and of itself results in less deaths by preventing the health care system from being overwhelmed.  If there are more cases in a short window than there are hospital staff/beds/ventillators/PPE/etc., people will get less effective care, and more die as a result (both of Covid-19 and for other things that should be treatable, but, again, the system is overwhelmed, so people die that shouldn't).  We have already seen this.  Italy is a prime example.  But it occurred on a lesser scale in the U.S. as well. 

It isn't about "ripping off the bandaid."  That is a poor analogy for this.  It's more like, give me a month to spread it out, and I can drink 50 gallons of water easily.  Give it to me pressurized all at once in 30 seconds, I would be overwhelmed and it would kill me. 

[ZKX-2099]

If the virus spreads as much as they say the deaths would be the same

That's the whole point of flattening the curve.  The deaths will not be the same because preventative action has been taken.

Seriously, what is it you don't understand about this?

I'm guessing the concept of exponential growth.

I still don't get why you're responding like I'm making personal attacks

[Northern Lion]

Looks like the scientists expect this to be an a annual occurrence. Ugh!

Are these the same scientists that said the death count would be over a million at this point? 

The very same.

Had we not heeded their warnings and took the measures we did, that would have happened without the virus breaking a sweat. Can we please not act like that scientists are somehow the bad guys here?

I agree, the scientists are certainly not the bad guys.  I imagine that modeling this sort of thing is complex.  It also is based on the data that is available at the time of the modeling, and if the data is incomplete (which it was and is), and if the situation is new (which it is) then mistakes are bound to be made.

But that doesn't mean that the models aren't useful.  I'm very grateful that science was able to so quickly prepare us so we could potentially dodge a much larger bullet.

Nobody knows what could have happened, all we know is what has and is happening.  And it's not over yet either.  And as I mentioned earlier, we aren't going to know the full scope of this thing until probably years after it's all over.

In short, science is awesome!  And thanks

[Chino]

If the virus spreads as much as they say the deaths would be the same

That's the whole point of flattening the curve.  The deaths will not be the same because preventative action has been taken.

Seriously, what is it you don't understand about this?

I'm guessing the concept of exponential growth.

I still don't get why you're responding like I'm making personal attacks

Because that's how I respond to things. Not my fault if you're assuming I feel attacked.

[Stadler]

I'm not saying I agree with him, but his point of view isn't that far out of bounds.  "Exponential growth" can happen over a short time t or a long time t.  Capacity of hospitals are a time-dependent variable, total number of deaths may or may not be (see caveat below).   Think of it this way:

Assume every person gives it to four others.  Assume the capacity of my local hospital is 300.  Assume 5% die who get it.

No controls.

I get it.   I give it to four people today.  They each spread it today.  Those people spread it tomorrow. The new people spread it tomorrow.  We're now at 1+4+ (4x4)+(4x4x4)+(4x4x4x4) = 341.  Fourteen days later, we all get symptoms, hospitals maxed out.  Problems ensue, 17 (roughly) die, but still more than 300 need care.

We flatten the curve, we social distance.
I get it.  On day 13, I give it to four people.   On day 13, they give it to four people.  After 26 days, flat curve, but we have 21 people still sick.  On that 13th day, they all give it to four people, which is another 64 people, but of the 21, 1 dies and the remainder get well.  So there's only 64 sick at this point (39 days), not 85.   More capacity. Those 64 give it to 4 more each after 13 days, so we have 256 more sick, but 3 die and 61 get better after 52 days.  Still under capacity.   The 256 spread it on day 13; that 256 are still going to lose about 13 people, so we're still at 17 deaths, but after 65 days, the burden on the healthcare system is far lower.   

Now, I get it; the "flaw" is - or the theory is, depending on how you look at it - is the social distancing means that the "four infect four each" doesn't hold.  And that's the real key, isn't it?   Is that really true?   Are the letters they're mailing, the packages their sending/receiving, the Door Dash they're ordering, really making that assumption hold?   I don't know.  "Common sense" says yes, but that's an equally flawed methodology.

[Stadler]

By all this, then, the only metric that really matters is hospital capacity (as measured by beds, ventilators and PPE).  Why are we not measuring that then? 

[Harmony]

But a potential collapse of the health care system due to an overwhelming influx of covid patients isn't the entire picture we need to consider.  If every ventilator in a hospital is being used for covid patients then where do the trauma cases go?  Where do the heart attacks go?  Where do the strokes go?

We have a finite amount of beds, staff, resources.  Covid may have temporarily decreased admissions because there are less car accidents and gun shot wounds, but those are going to come back when we release the hounds.

[Chino]

By all this, then, the only metric that really matters is hospital capacity (as measured by beds, ventilators and PPE).  Why are we not measuring that then?

You're thinking too small. That's just one variable to consider when looking at medical related metrics.

You also need to consider the entire supply chain:
- Number of whatever pieces of equipment you need (beds, ventilators, linens, etc..)
- Pieces of infrastructure in place that allow hospitals the world over to accurately report and relay findings and needs to the proper government channels and inventory managers. 
- Number of staff
- Amount of deliveries each hospital can accept a day
- Number of healthy drivers at the distribution centers that deliver the goods
- Number of healthy people at the manufacturing centers that make the goods to be delivered
- Number of healthy people at the raw resources facilities preparing materials for the manufacturing centers who make the goods to be delivered.

You could have a hospital with 1000 open beds, but if there's a shortage of doctors and/or equipment, how much good are they? We have to look at the whole chain. Not just the hospitals themselves.

[Stadler]

Well, I think it's less "thinking small" than "not covering any and all variables".  You build that into the analysis.  My copy is obsolete now, but I used to use a software called "Extend" to model processes, and analyze for critical path functionality.  If it's not just beds, but ventilators and doctors, factor it in.  When we build a bridge, we don't just account for the weight of the materials in the bridge, we estimate the amount of traffic, with a safety factor.  We estimate the percentage of freight vehicles.  We factor in snow, wind, and rain.  Maybe earthquakes if we're at a certain location.  We estimate resonance frequency of the materials, and slap a safety factor on there, to boot. We can do that with hospital load. 

The point really was, it's not about "number dead" or "number of cases" - so when Brook Baldwin breathless with gravitas says "deaths in the United, States will soon top seventy.  Four.  THOUSAND.  <Pause>." it's really not meaningful news in the sense of being an indicator, but something else.

(Don't know why I thought of this, but this is an interesting article on the library at my school.  The entire time I was there the building was draped in netting due to falling bricks, largely caused by a failure to account for the weight of the books during the design and construction phases.)

[bosk1]

Chino and Harmony:  Didn't I just say exactly what you said here?

If the virus spreads as much as they say the deaths would be the same

That's the whole point of flattening the curve.  The deaths will not be the same because preventative action has been taken.

Seriously, what is it you don't understand about this?

Not only that--that's only really a small part of it. The bigger factor is, even if we were to get an identical spread with identical numbers, just spread over more time, that in and of itself results in less deaths by preventing the health care system from being overwhelmed.  If there are more cases in a short window than there are hospital staff/beds/ventillators/PPE/etc., people will get less effective care, and more die as a result (both of Covid-19 and for other things that should be treatable, but, again, the system is overwhelmed, so people die that shouldn't).  We have already seen this.  Italy is a prime example.  But it occurred on a lesser scale in the U.S. as well. 

It isn't about "ripping off the bandaid."  That is a poor analogy for this.  It's more like, give me a month to spread it out, and I can drink 50 gallons of water easily.  Give it to me pressurized all at once in 30 seconds, I would be overwhelmed and it would kill me. 

[Chino]

Well, I think it's less "thinking small" than "not covering any and all variables".  You build that into the analysis.  My copy is obsolete now, but I used to use a software called "Extend" to model processes, and analyze for critical path functionality.  If it's not just beds, but ventilators and doctors, factor it in.  When we build a bridge, we don't just account for the weight of the materials in the bridge, we estimate the amount of traffic, with a safety factor.  We estimate the percentage of freight vehicles.  We factor in snow, wind, and rain.  Maybe earthquakes if we're at a certain location.  We estimate resonance frequency of the materials, and slap a safety factor on there, to boot. We can do that with hospital load. 

I kind of want to really dig deep into this discussion because I think there's a lot of cool stuff to talk about. But looking back at your reply that I responded to, I completely misread what you were asking, so my bad if the response seemed off.

It's going to be interesting to see what evolves and how over the next few years. I don't think greatly increasing hospital capacity going forward is going to solve a whole lot (that's kind of where I thought you were heading). 

The point really was, it's not about "number dead" or "number of cases" - so when Brook Baldwin breathless with gravitas says "deaths in the United, States will soon top seventy.  Four.  THOUSAND.  <Pause>." it's really not meaningful news in the sense of being an indicator, but something else.

Agreed.

Though I don't think "number dead" should be discouraged from being discussed (not implying you were). Have you seen this: https://www.sheltonherald.com/news/article/Shelton-nursing-home-coronavirus-deaths-rise-again-15223490.php?

I'll tell you how my mentality has changed during all this.... I've been looking at my 401K as a means to enjoy my final years, but now I look at it was a way to prevent myself from being in a place like that.

[Harmony]

Chino and Harmony:  Didn't I just say exactly what you said here?

Yes.  I'm pretty sure these points have been made many times in this 80 page thread.

[Chino]

Chino and Harmony:  Didn't I just say exactly what you said here?

Yeah. Spot on. I missed your post.

[Harmony]

It's going to be interesting to see what evolves and how over the next few years. I don't think greatly increasing hospital capacity going forward is going to solve a whole lot (that's kind of where I thought you were heading). 

Not sure if you are touching on this particular point - and I agree it is going to be VERY interesting to see how the medical model of healthcare delivery is going to change.  I predict a LOT more telehealth which impacts almost every facet of healthcare as we know it.  Now of course, people are still going to need arms set and stitches and EKGs.  But at the very least triage is going to change dramatically. 

I'll tell you how my mentality has changed during all this.... I've been looking at my 401K as a means to enjoy my final years, but now I look at it was a way to prevent myself from being in a place like that.

Excellent point.  Could it mean that home health is going to be even more of a factor going forward?  I think probably so.