[Texased]

Originally Posted by OrangeBlossomBaby

Just make sure to write your obit before locking yourself in a school gym with all your pals who are willing to sacrifice themselves for the sake of humanity.

I for one would prefer not to get sick in the first place, than to get sick and risk death while hoping to recover and become immune.

Exactly

[dcurrie947]

Why hasn't anyone suggested everyone wear something over their face? If the virus enters thru the nose or mouth doesn't it make sense if everyone was covered when they left the house this thing would be gone in a short period of time?

[MandoMan]

Originally Posted by skarra

Where is the more recent data for an order of magnitude (10 times) less? Please provide a reference as I'd like to see that. Dr Birx gave a 2.2M number just last week so I'd like to know who disputes that and what their credentials are (certainly not as good as Dr Birx who is the most reputable person in that field)

The choice is between being able to treat people in hospitals, and being overwhelmed and letting people die who ordinarily would have had a good chance of surviving. Flatten the curve and we can save many more lives. It's a fallacy to believe that the economy would continue as normal as people were dying around us.

There are lessons to be learned from the 1918-1920 epidemic. This is probably going to last a while unless we are fortunate and develop a vaccine quickly. Anything we do to buy time is helpful. Data will also help.

The TV commercial was a bad analogy. The choice is get it now with limited medical resources and little data, or later with ample medical care and plenty of data. I'd chose the later in a heartbeat and I'm not in the "vulnerable" risk group.

There was no vaccine for the 1918 epidemic. It just eventually burned itself out and went away.

I’ve read a report by a doctor in New Orleans that says that about 80% of the people out on respirators there die on them. Only about 20% get well enough to breathe on their own again, and some of them will have brain damage. (Before people are put onto respirators, they are given anesthesia and their muscles are relaxed so they don’t fight the endotracheal tube, and they are kept that way for the duration, so if they die on the respirator, they don’t even know it.) The ones most likely to die are those with pre-existing conditions. If we had the guts, we could make it nation-wide policy that those with pre-existent conditions who need a respirator get only palliative care in a special unit (like a gymnasium). Then there would be no shortage of respirators for those who might survive, and a much larger percentage of those put on a respirator would survive it.

Sorry to be morbid.

[huange@verizon.net]

I don’t disagree with your post. The social distancing was always intended to not overwhelm our limited medical resources and facilities. There was no mention that flattening the curve would drastically reduce the death count. However, that’ll never be proven. The measures taken now will provide the needed time to develop both a vaccine and cure. Hopefully, both will be available or the cycle starts again.

[ts12755]

Of course our govt doesnt have a plan...Niether does the rest of the world. No one alive today has ever seen a worldwide pandemic like this. The last one was in 1918.

[Drdoug49]

I live in south east Asia for part of the winter, almost everybody wears a mask because of air pollution. But it also was a way for countries like Korea, Singapore, Taiwan to stop the virus. Maybe we TV could learn from them, they live longer than us and are certainly a lot slimmer than the cart riding TV person

[Cheiro]

Originally Posted by C. C. Rider

I know there are many threads on the coronavirus problem, but please allow me to start one to discuss just one specific aspect of this. I recently read in another thread here a comment to the effect that if we will just stick rigorously to our social distancing practices and practice good handwashing and the like, that we will be over this problem quicker.

While that may sound logical and correct, I don't believe that it is. In fact, if you will recall, the whole idea behind shutting things down and maintaining social distancing was to drag this process out for many months so as not to have too many cases at one time which would overwhelm our hospital resources. In other words, we wanted to "flatten" the curve, not have a short, sharp, high curve.

The quickest way to be rid of the CV problem would be to make no changes in our everyday habits, let people catch the virus, and then have about 99% of them recover and thereby build herd immunity rather quickly. The problem with this approach is that fatalities would likely be higher in the near term because the number of seriously ill patients would overwhelm our hospital system.

So, the powers that be chose the approach that would drag this situation out for a much longer period of time. While this approach would likely be easier to handle from a healthcare perspective, it will undoubtedly extend the time that we are dealing with the disease to a much, much longer period of time.

The drawback to this approach is that the disease doesn't really go away, it just spreads at a much slower rate and therefore takes a much longer period of time for our country to build a sizeable herd immunity. If we were able to go about our ordinary lives while slowing down the spread of the virus, that would be great, but unfortunately we can't.

So, I don't mean to be the bearer of bad news, but I'm concerned that this "social distancing" and shutting down of all non-essential businesses may be with us a LOT longer than many people think. In fact, the better we are at self distancing, the longer the situation will likely last.

So it appears that we either stay the course for many months or resume life as usual in a few weeks and see a rapid return of many sick people. The only bright light that I can see in the "slow" approach that was chosen is that it may buy us some time in the hopes that a cure may be found quickly. I certainly hope so.

There is one other alternative, but it's not popular in many circles... and that is to isolate the most vulnerable (the aged, the immune compromised, etc) and let the rest of the country go back to work. Personally, that's the approach that I think should have been taken from the start, but many people think otherwise.

I hope everyone stays well. I just wanted to present the choices as I see them.

Thanks

During the Great Flu of 1918, there was no such thing as social distancing or even a vaccine. So, the disease was free to infect virtually everyone in the world and everyone got sick. The result was the death of 50 million people which amounted to 1/5 of the population. Today that statistic would translate to 1,400,000,000 (1.4 Billion) deaths. Do I hear any volunteers?

[CoachKandSportsguy]

I find the original post has several flaws, including lack of secondary and tertiary effects analysis, theoretical assumptions which may not prove out in reality, and reactive only vs proactive behavior with a lack of responsibility to the outcome.

The first theoretical assumption I challenge is that “herd immunity” only results from unrestrained R0, or infection rate. “Herd immunity” can also be gained over time with a lower R0 as the total population infected rate converges to the same percentage, just to a different future date.

The second omission I challenge is the lack of secondary effect on the current healthcare system design. An unrestrained R0 can overwhelm a healthcare system, in more than one way: financially and staffing. Very similar to a bank run, the system can collapse and create extreme chaos for more than the infected, but for the healthy as well as standard healthcare evaporates. In that scenario, current curable or manageable illnesses turn deadly, as maintenance care is no longer available and the indirect death rate rises as well.

Third, studying human behavior and having a wife work along side doctors in the medical field, I find that most of the medical field in hospitals and primary care are in a reactive situation only. They react to what walks in the door, they have prescribed methods to deal in their situation in front of them. And like a teacher, they are the expert but have little control over what comes in, and some control over the outcome. But once out the door, they have much less control on the eventual outcome. This reactive position struggles with strategy and proactive behaviors. In my field of finance, I try to quantify risk, a concept of uncertainty, and be proactive to minimize the risk across the organization. That’s where my wife works, dealing with data, the risk and the outcomes to the total organization. Most, not all, primary care or emergency room doctor lacks that perspective, the strategic long term perspective of the entire organization, and the secondary and tierary effects which risks must be mitigated. I see the same blind spot in other people and professions.

Finally, I see and hear the differences with “older” doctors to whom I have had appointments, who have tough time with data analytics, with large systems, which collects more data for better outcome analysis, and don’t understand the trade off between time and cost to clean data, and the improvement in outcome, to the point that I hear about doctors who shun medical systems in favor of a blackboard with a single number. Again, from personal experience watching and studying questions of process or strategy, outcome or process, reactive versus proactive risk behavioral adjustment.

In my risk analysis, the choice before us is one of balance between economic damage, human damage, and healthcare system damage. As society progresses with medical advances, there is more emphasis on the value of life, and minimizing human damage. Having just bought a retirement home and a year or two away from retirement and joining the villages life, I am doing everything I can to survive to be able to enjoy the outdoor and active lifestyle I enjoy. Wanting to risk that with an outcome I can’t control, not sure I agree with the assumption of “herd” immunity by unrestrained R0 versus a constrained R0 which will give the healthcare industry time to prepare for a scenario that is rarely seen.

A comparison could be made between corona virus and H1N1 virus, in which little proactive behavior was initiated with H1N1 and the death rate will probably be higher with H1N1 (a prediction which is not yet proven nor disproven). The economic damage will be much higher, but again temporary, and recoverable in the medium term. There are ways to recover from temporary economic dislocations, not so with healthcare dislocations. Doctors, nurses take years to educate and prepare.

We have not read the MIT article, but we have had lots of discussions after being well prepared as I saw this coming in January. I asked a life long nurse with 10 letters after her name, about the virus in January. She said she wasn’t worried. Now both she and her husband have it, and we are hoping they survive. The person they got it from is on a ventilator.

Sportsguy and CoachK

[Topspinmo]

Originally Posted by Drdoug49

I live in south east Asia for part of the winter, almost everybody wears a mask because of air pollution. But it also was a way for countries like Korea, Singapore, Taiwan to stop the virus. Maybe we TV could learn from them, they live longer than us and are certainly a lot slimmer than the cart riding TV person

They wear masks cause the live in over populated ____ hole. They are slimmer cause they have little to eat after they ravaged land and sea. Riding around is carts HAS NOTHING to do with it. Majority of population NOT part of the elite like you, they are surviving. But, you probably live in the 1% area right?

[Topspinmo]

Originally Posted by ts12755

Of course our govt doesnt have a plan...Niether does the rest of the world. No one alive today has ever seen a worldwide pandemic like this. The last one was in 1918.

The government of any country are not the saviors, they are the taker’s

[dlb8159@yahoo.com]

So which one are you? Isolated or out and about.

[HelenLCSW]

Originally Posted by skarra

I like to listen to the experts ... Dr Fauci and Dr Birx, plus Bill Gates - all seem to be in agreement that the path we're on is the right one (just wish we could successfully implement it nationwide).

I think over time we will get more data which will enable us to make better decisions. And let us hope it doesn't last 2 years which is what happened in 1918-1920.

We have to support our hospital staff right now. They are the soldiers in this war and are the real heroes. I am in awe of what they are dealing with - many of them are dying as a result. They want us to stay home, so let's support our "troops" as they fight this war.

You are right —if we had all listened to those experts and immediately self isolated, we would be ahead of the curve, not behind it😔

[huange@verizon.net]

CDC Data for the U.S -2017
Leading Causes of Death:
Heart disease: 647,457.
Cancer: 599,108.
Accidents (unintentional injuries): 169,936.
Chronic lower respiratory diseases: 160,201.
Stroke (cerebrovascular diseases): 146,383.
Alzheimer's disease: 121,404.
Diabetes: 83,564.
Influenza and pneumonia: 55,672.
More items...
Centers for Disease Control and Prevention › nchs › fastats

The reason the above deaths did not get the mass hysteria is because the deaths were spread out over an entire year (2017). I speculate that Covid-19 deaths will be less than from influenza and pneumonia, but because of the condensed time frame of the virus outbreak, there’s a need to spread out the cases.

[Klatu]

Being quarantined is frustrating to many people. One of its byproducts is suggesting other methods of dealing with the virus that won't confine people. One of those is the herd immunity strategy.

For it to work, we would have to, as a society, decide we will let lots of people die (including the young since they are not completely immune) and isolate the elderly in their homes for as long as it takes to develop a vaccine.

We can put as smooth a gloss on it as we think is needed, but that is a cruel method of dealing with the problem. I think it goes against our instincts to protect the most vulnerable among us. It says to the young (anyone under 65): "Go about your business. Some of you will die, from the virus or from not being able to get into a hospital, but the rest of us will develop immunity." And to the old: "Stay indoors, because there will be no room for you at the hospitals if you catch the virus."

That is an approach that looks attractive to anyone that thinks they are unlikely to either be locked up or unfortunate enough to catch it and die.

[Jimbo120]

I think your article was great, but a dumb question... if herd immunity is the answer, why has it not worked for the flu? Many people contract it and die each year.

Also, I think our political news system will make it very hard for any politician to vote for the quick approach.