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  #201  
Old 05-05-2020, 02:26 PM
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Originally Posted by Kearsen1 View Post
1500 in a population as big as the US? No, it would be noise, not data.

If you polled 150,000, from across the country with different demographics maybe. But the point was, they were testing people , precisely because they thought they had contact with a positive test. That isn't random.

Another reason to not believe the data inherently available in the right now. The CDC has roughly halved the deaths caused by Covid19 in the US since their initial number.

Representative? Sure with a margin of error (of 50%)
You clearly do not understand sampling theory.
Here is a simple sample size calculator. To get a 5% margin of error at a 95% confidence level for a population of 300 million, you only need 384 samples. A 99% confidence level requires 666. A 2% confidence interval at 95% only requires 2400.
Many people think sample size rises linearly with population. That's not true. Reduce the population to 30 million and you get the same sample size.
Getting a sample that isn't biased in some way is much harder and more important.
  #202  
Old 05-05-2020, 02:33 PM
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You clearly do not understand sampling theory.
Here is a simple sample size calculator. To get a 5% margin of error at a 95% confidence level for a population of 300 million, you only need 384 samples. A 99% confidence level requires 666. A 2% confidence interval at 95% only requires 2400.
Many people think sample size rises linearly with population. That's not true. Reduce the population to 30 million and you get the same sample size.
Getting a sample that isn't biased in some way is much harder and more important.
Because the virus has hot spots, dead spots and light spots would this make unbiased sampling more difficult. Would the extra difficulty mean more sampling was needed??
  #203  
Old 05-05-2020, 02:34 PM
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Because the virus has hot spots, dead spots and light spots would this make unbiased sampling more difficult. Would the extra difficulty mean more sampling was needed??
Again, tossing more uncertainty into the mix is not friendly to your position.
  #204  
Old 05-05-2020, 02:35 PM
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Here are the reasons:
* Many conservatives and Republican fundamentally view liberals and Democrats as evil, corrupt, social justice warrioring, communists who want to take from the successful to give to lazy and incompetent criminals and destroy America.
Something like this one.

I don't think it's so ideological; it's just "Something bad is happening...I should be angry at those people again".
I think the conservative right has struggled to think of where our rage is supposed to be directed. It obviously can't be at the federal government.
You can't call it a hoax because it's clearly not.
Antifa?

Erm...The bad guy is the one making you stay at home! They're not letting meat factories produce delicious meat! Stay angry, and that might...help...I guess?
  #205  
Old 05-05-2020, 02:45 PM
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Originally Posted by GIGObuster View Post
Again, tossing more uncertainty into the mix is not friendly to your position.
It has nothing to do with having a position. The position should be flexible as more info come in. My position is just based on what I see now. There does seem to be some pretty solid patterns developing.
  #206  
Old 05-05-2020, 02:48 PM
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Originally Posted by Kearsen1 View Post
1500 in a population as big as the US? No, it would be noise, not data.

If you polled 150,000, from across the country with different demographics maybe. But the point was, they were testing people , precisely because they thought they had contact with a positive test. That isn't random.

Another reason to not believe the data inherently available in the right now. The CDC has roughly halved the deaths caused by Covid19 in the US since their initial number.

Representative? Sure with a margin of error (of 50%)
Generally, a 1,500 sample is going to give you an error of +/- 2% in the population of the US. Here is the first article I pulled on sample size. So to take the South Korea numbers at face value (not quite a random sample but if anything biased to having a higher percentage than the general population) and they have about .1% +/- 1% of their population infected so their number of infected could range from 1.1-0.02% or 564K people infected down to 10,800. The their death rate is probably between 0.04% and 2%.

That isn't the narrowest of ranges but it’s got a decent amount of confidence around it. So to revisit my initial point after actually doing the math (though only a single day not the series that could narrow the range)

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What are the consequences of reopening and dropping all restrictions? Worst case scenario about 1 in every 1000 Americans would die. Best case scenario about 1 in every 3,000 Americans would die.
Worst-case scenario is 2 in every 100 die and best-case scenario is 3 in 6,000 die. His best case actually wasn’t far off but the worst case doesn’t match the data. As I said earlier due to the ROK not having random outbreaks I think they are catching most of the people in their testing and so the worst case number is much more likely than the best case number.

Last edited by Oredigger77; 05-05-2020 at 02:49 PM.
  #207  
Old 05-05-2020, 02:53 PM
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Another issue I have is when they talk about flattening the curve. I have no idea what the capacity of hospitals in Ca has for example but lets suppose we say we would like to get 60% through this in one year. We project that California has the potential for a 1000 per million death rate and 10 times that many will wind up in the hospital for 30 days. That would come out to about 20,000 people in the hospital at any given time. Could California handle 20,000 patients?? 10,000??. What is our capacity? What ever that is shouldn't we strive to stay open enough to at least be reasonably close to those numbers?
  #208  
Old 05-05-2020, 03:05 PM
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It has nothing to do with having a position. The position should be flexible as more info come in. My position is just based on what I see now. There does seem to be some pretty solid patterns developing.
What I have seen is that after the uncertainty, better data is telling the modelers that opening the economy with few masks, little to no contact tracing or little testing will lead to more deaths, once again, it is more likely that the increase in deaths will shoot down the confidence from the people, that confidence that is needed to open the economy more will not be there when less restrictions are demanded.

https://www.nytimes.com/2020/05/04/u...e-updates.html
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As President Trump presses for states to reopen their economies, his administration is privately projecting a steady rise in the number of coronavirus cases and deaths over the next several weeks. The daily death toll will reach about 3,000 on June 1, according to an internal document obtained by The New York Times, a 70 percent increase from the current number of about 1,750.

The projections, based on government modeling pulled together by the Federal Emergency Management Agency, forecast about 200,000 new cases each day by the end of the month, up from about 25,000 cases a day currently.

The numbers underscore a sobering reality: The United States has been hunkered down for the past seven weeks to try slowing the spread of the virus, but reopening the economy will make matters worse.

“There remains a large number of counties whose burden continues to grow,” the Centers for Disease Control and Prevention warned.

As the administration privately predicted a sharp increase in deaths, a public model that has been frequently cited by the White House revised its own estimates, doubling its projected death toll.

The Institute for Health Metrics and Evaluation at the University of Washington is now estimating that there will be nearly 135,000 deaths in the United States through the beginning of August — more than double what it forecast on April 17, when it estimated 60,308 deaths by Aug. 4. (The country has already had more than 68,000 deaths.)

The institute wrote that the revisions reflected “rising mobility in most U.S. states as well as the easing of social distancing measures expected in 31 states by May 11, indicating that growing contacts among people will promote transmission of the coronavirus.”

The projections confirm the primary fear of public health experts: that a reopening of the economy will put the nation back where it was in mid-March, when cases were rising so rapidly in some parts of the country that patients were dying on gurneys in hospital hallways.

Last edited by GIGObuster; 05-05-2020 at 03:06 PM.
  #209  
Old 05-05-2020, 03:13 PM
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I think many of us see this as a natural disaster like an earthquake or giant storm. The only difference is that it is slower and we have time to react. Will our fear prevent us from acting rationally or will it simply force us to keep pushing it back while absorbing more damages until we can no longer hold it back at which time it will take off on its own anyway. Now that they have us scared shitless how can they unscare us so we can go back to living at at least some semblance of normalcy.
  #210  
Old 05-05-2020, 03:29 PM
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Another issue I have is when they talk about flattening the curve. I have no idea what the capacity of hospitals in Ca has for example but lets suppose we say we would like to get 60% through this in one year. We project that California has the potential for a 1000 per million death rate and 10 times that many will wind up in the hospital for 30 days. That would come out to about 20,000 people in the hospital at any given time. Could California handle 20,000 patients?? 10,000??. What is our capacity? What ever that is shouldn't we strive to stay open enough to at least be reasonably close to those numbers?
It appears that the State of California has 27K hospital beds and ~2,000 ICU beds. What percentage is in normal use by non-COVID patients I'm not certain but I'm sure you could dig up utilization rates.
  #211  
Old 05-05-2020, 03:34 PM
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Another issue I have is when they talk about flattening the curve. I have no idea what the capacity of hospitals in Ca has for example but lets suppose we say we would like to get 60% through this in one year. We project that California has the potential for a 1000 per million death rate and 10 times that many will wind up in the hospital for 30 days. That would come out to about 20,000 people in the hospital at any given time. Could California handle 20,000 patients?? 10,000??. What is our capacity? What ever that is shouldn't we strive to stay open enough to at least be reasonably close to those numbers?
IHME, the tool mentioned in the site referenced by GIGOBuster, has a listing for ICU beds available. For California it is listed as just under 2000. Total hospital beds around 27,000.

I've been down this path on this board and it was pointed out that trying to maintain a certain percentage occupancy rate of hospital beds is a dangerous game. It wouldn't take much to overwhelm the system when there are only 2000 to start. And that is in all of California.
  #212  
Old 05-05-2020, 03:43 PM
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From what I can find as of march 20th we had 88,000 beds with many more being added on so by now we should have close to 100,000 if you figure in areas not normally used for hospital beds but can be utilized. Not sure how many the medical professionals could handle but it looks like 20,000 beds could be doable in a pinch. As for being a dangerous game, it is certainly dangerous but it is not playing a game.
  #213  
Old 05-05-2020, 04:08 PM
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Originally Posted by GIGObuster View Post
Again, tossing more uncertainty into the mix is not friendly to your position.
Surely there is a geographic aspect. If one did all the testing in Claredon, AR you would have a very different result than if your data come from NY, NY.
  #214  
Old 05-05-2020, 04:45 PM
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From what I can find as of march 20th we had 88,000 beds with many more being added on so by now we should have close to 100,000 if you figure in areas not normally used for hospital beds but can be utilized. Not sure how many the medical professionals could handle but it looks like 20,000 beds could be doable in a pinch. As for being a dangerous game, it is certainly dangerous but it is not playing a game.
Indeed, it is not just beds, but enough medicines, medical equipment, besides the usual shortages of nurses and doctors reported even before the pandemic.
  #215  
Old 05-05-2020, 06:40 PM
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Originally Posted by HoneyBadgerDC View Post
From what I can find as of march 20th we had 88,000 beds with many more being added on so by now we should have close to 100,000 if you figure in areas not normally used for hospital beds but can be utilized. Not sure how many the medical professionals could handle but it looks like 20,000 beds could be doable in a pinch. As for being a dangerous game, it is certainly dangerous but it is not playing a game.
I don't care what you want to call it. There isn't going to be a lot certainty to it. You are likely to get a lot of pushback around here for those types of opinions.
  #216  
Old 05-05-2020, 10:45 PM
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Something I am curious about that maybe only a Dr. could answer. If a person is nearing the end of their life and they catch the flu and die will they be labeled a flu death? If 20 patients were in a nursing home and nearing the end of their life and the flu finished them off would they be labeled as flu victims? I know the corona virus it is being used pretty liberally.
  #217  
Old 05-05-2020, 11:57 PM
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Something I am curious about that maybe only a Dr. could answer. If a person is nearing the end of their life and they catch the flu and die will they be labeled a flu death? If 20 patients were in a nursing home and nearing the end of their life and the flu finished them off would they be labeled as flu victims?
Is there a pathologist or coroner in the house?

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I know the corona virus it is being used pretty liberally.
You "know" - from where? If anything, COVID isn't blamed enough; search news on covid deaths undercounted for many reports. The US population isn't being tested (because political folly) and all corpses aren't tested or autopsied so we don't really know who dies of COVID directly, or indirectly as from secondary infections, or from lack of medical care. When excess death rates for the COVID era are calculated, we'll have a better picture of its impact. Till then, listen to immunologists and epidemiologists, not to self-serving political hacks.
  #218  
Old 05-06-2020, 02:19 AM
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Originally Posted by HoneyBadgerDC View Post
Because the virus has hot spots, dead spots and light spots would this make unbiased sampling more difficult. Would the extra difficulty mean more sampling was needed??
No, better sampling.
The classic example is the Literary Digest fiasco in 1936. The did a poll for each election, and in 36 predicted that Landon would win. They had 2.2 million responses, way more than needed. Way, way more. But their sample was based on subscribers, car owners and telephone owners, all of whom were richer than average and thus more likely to vote Republican. Especially against FDR.
  #219  
Old 05-06-2020, 02:27 AM
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Another issue I have is when they talk about flattening the curve. I have no idea what the capacity of hospitals in Ca has for example but lets suppose we say we would like to get 60% through this in one year. We project that California has the potential for a 1000 per million death rate and 10 times that many will wind up in the hospital for 30 days. That would come out to about 20,000 people in the hospital at any given time. Could California handle 20,000 patients?? 10,000??. What is our capacity? What ever that is shouldn't we strive to stay open enough to at least be reasonably close to those numbers?
Besides the bed question, I don't think it is possible to tune the opening to the number of cases. Geographically, perhaps. If you open one restaurant you have to open all of them, or else give that one restaurant a big advantage.
Do you think anyone can tune the reopening to not potentially overwhelm the system?
  #220  
Old 05-06-2020, 02:33 AM
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I think many of us see this as a natural disaster like an earthquake or giant storm. The only difference is that it is slower and we have time to react. Will our fear prevent us from acting rationally or will it simply force us to keep pushing it back while absorbing more damages until we can no longer hold it back at which time it will take off on its own anyway. Now that they have us scared shitless how can they unscare us so we can go back to living at at least some semblance of normalcy.
I agree it is basically a natural disaster. People in hurricane territory board up their windows. Only idiots would object that it it hurts their constitutional right to look outside.
I lived in tornado country once. I never heard an alert, but I knew where the basement was. If tornadoes came one after another you'd stay in the damn cellar way longer than you would want to. That's more or less what we're doing.
And thanks to people around here obeying the rules, I don't feel scared shitless when I go to the grocery once a week, even though I'm over 65. If I was in one of the states that are opening before they should, I'd be a lot more worried.
  #221  
Old 05-06-2020, 04:56 AM
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Besides the bed question, I don't think it is possible to tune the opening to the number of cases. Geographically, perhaps. If you open one restaurant you have to open all of them, or else give that one restaurant a big advantage.
Do you think anyone can tune the reopening to not potentially overwhelm the system?
A better question is to ask how can a restaurant stay in business while being safe? Most places around here switched to being takeout or delivery only. I've read where some are reopening inside seating service but with HUGE restrictions.

So its not trying to keep them closed. Its finding ways they can reopen and stay in business.
  #222  
Old 05-06-2020, 08:50 AM
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If a person is nearing the end of their life and they catch the flu and die will they be labeled a flu death? If 20 patients were in a nursing home and nearing the end of their life and the flu finished them off would they be labeled as flu victims?
I am reminded of Charles Guiteau's argument "The doctors killed Garfield, I just shot him."
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  #223  
Old 05-06-2020, 09:34 AM
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I know the corona virus it is being used pretty liberally.
Well I know the exact opposite is true. And I am not wrong. Where do you even GET this wrong "knowledge"??? I know it from primary sources and first principles. Where does the wrong knowledge come from?


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Originally Posted by HoneyBadgerDC View Post
Something I am curious about that maybe only a Dr. could answer. If a person is nearing the end of their life and they catch the flu and die will they be labeled a flu death? If 20 patients were in a nursing home and nearing the end of their life and the flu finished them off would they be labeled as flu victims?
I am not a Dr but I know enough from basic knowledge. Plus I think actual Dr.s have posted in other threads confirming this.

In my country at least, there are laws and regulations about determining cause of death. And these are followed strictly.

For every death, there must be a doctor who identifies the primary cause of death, and contributing causes. This is the doctor who treated the person while alive, or the resident doctor of the care home, etc. The primary cause of death is recorded on the official death certificate.

My country uses international WHO standards for classifying causes of death, currently ICD-10.

Inflenza deaths here are recorded as J09-J11, link here.

Influenza cannot be uniquely identified from symptoms. There are large ranges of causes that present with broadly similar symptoms.

Both J09 and J10 call for identifying an influenza virus. This is an expensive test and is rarely done for routine influenza symptoms.

J11 is an allowed cause when the virus is not identified. This is typically done when a person has influenza symptoms during an influenza outbreak and then dies. Because of this, we see a clear rise in influenza deaths during the usual recurring influenza epidemics. It is just an artefact of reporting conventions, not a reliable measurement of influenza as a cause of death.

Clearly, influenza is underreported as a cause of death.

And that's just the normal, seasonal influenza.

Initially COVID-19 was also reported as a cause of death only after positive identification of the virus through PCR. This was (still is) a very expensive test with limited availability. It was certainly not performed on old people who had already died in a care home. Therefore, it is absolutely plain that it is underreported as a cause of death, just like normal influenza outside of an outbreak is.

Some countries have changed the criteria for reporting COVID-19 as a cause of death and you see this as large spikes in the stats. Again, these are artefacts of diagnosing and reporting.

A different subject is the EUROMOMO project that attempts to discern influenza deaths from overall excess death statistics. Such projects invariably show higher influenza deaths. "Official" influenza deaths are still reported by counting death certificates as I explained earlier.

Maybe an actual Dr can correct me if I'm wrong.

Last edited by Frankenstein Monster; 05-06-2020 at 09:36 AM.
  #224  
Old 05-06-2020, 10:05 AM
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If 20 patients were in a nursing home and nearing the end of their life and the flu finished them off would they be labeled as flu victims?
Just in case I wasn't clear, they will be labeled as flu victims if they didn't die of another identifiable cause and their doctor thinks they had the flu.

Most (old) people do die of another identifiable cause, which rapidly worsens due to the flu. In these cases the doctor records that other cause as the primary cause.

And the doctor can practically never know for certain if they had the flu.
  #225  
Old 05-06-2020, 01:36 PM
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I'm not a Republican and don't know many, but I'm about ready to endorse opening up. Here's why:

1. Allowing businesses to open doesn't mean they have to. And it doesn't mean people have to go to them. It's not compulsory. Companies and employees can make the best decisions for themselves. If you want a haircut, you can choose to go get one at a salon or cut it at home. If you're at-risk (at-promise?), I suggest you cut it yourself.

2. Perhaps more important than 1, opening up doesn't mean the end of countermeasures. It doesn't mean the end of mask wearing, hand washing, contactless delivery and payment, physical distancing, and the rest. Restaurants can move seats outdoors, close the bar area, mask up, limit contemporary diner numbers, and other things. We can still Lysol everything in sight.

3. We can open up but give people the option of still collecting unemployment if they choose not to work, even if their businesses have recalled them. So if the machine shop says come back to work, and the employee says no thanks I'm diabetic (or whatever), let them get their $900/week for a couple more months.

4. Our hospitals have the capacity (except where they don't), the virus isn't going to burn itself out. We need a certain number of people getting sick every week, so they can end up on the healthy side again when others are getting ill. We need a bottleneck to the viral spread, not a complete stop, or else it'll just flare up in July or August and exceed our hospital capacity. The only way to avoid an eventual overwhelming is to get a certain transmission rate, because that means immunity later. We cannot flatten the curve too much now or it'll be too high later. Hopefully that made sense.

5. A sizeable chunk of the population can keep on working from home for the summer. Their life is altered, but not disrupted. If we open up, we should ask that those businesses who CAN stay home TO keep staying home. That's how we'll keep the curve low and flat while at least some people are getting sick.

6. We don't have to open up today. We can plan this for May 22 or something, depending on where you are and what your state's statistics are like. 2 or 3 weeks is a long time for COVID. Things can change in that amount of time.

7. If we plan ahead, we can always shut down again for a week or two here and there. Just because it's complicated and difficult doesn't mean it's a bad plan. Good strategies are often intricate and complicated. Bad ones are often blunt, unsophisticated, and non-specific.


So those are my reasons. We're better prepared now, we're over the hump, and we don't have to go from 100 mph to 0, so to speak. We can ease off the gas a little bit, and if necessary, step on it again later.
  #226  
Old 05-06-2020, 01:59 PM
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How can we know if we've reached the hump, or over the hump, when our testing capacity is so small? We need to up our testing massively before we can open up even a little bit, at least so we'll know quickly if something's changed and we need to shut it down again.
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Old 05-06-2020, 02:07 PM
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Well I know the exact opposite is true. And I am not wrong. Where do you even GET this wrong "knowledge"??? I know it from primary sources and first principles. Where does the wrong knowledge come from?
...

Maybe an actual Dr can correct me if I'm wrong.
There is a new Kremlin/GOP canard out there, that the covid deaths are inflated as people who die in a auto accident (for example) are classed as Covid deaths. This is being done to scare the populace and get them to vote trump out.

Having worked for a year in the Coroners office (hence my nickname), altho cause of death wasnt my thing (elder fraud was), they are careful to actually determine it. It's a big deal.

Since the rest of the usual causes of deaths roll on like normal* - it is not true that covid deaths are being deliberately inflated and misclassified.

* auto accident deaths will likely be significantly less this year however.
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Old 05-06-2020, 02:27 PM
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Having worked for a year in the Coroners office (hence my nickname), altho cause of death wasnt my thing (elder fraud was), they are careful to actually determine it. It's a big deal.
Thanks...I always wondered.
  #229  
Old 05-06-2020, 02:56 PM
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I'm not a Republican and don't know many, but I'm about ready to endorse opening up. Here's why:
First of all, let me express my appreciation for your organized points, which allow for actual discussion/debate.

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Originally Posted by Chessic Sense View Post
1. Allowing businesses to open doesn't mean they have to. And it doesn't mean people have to go to them. It's not compulsory. Companies and employees can make the best decisions for themselves. If you want a haircut, you can choose to go get one at a salon or cut it at home. If you're at-risk (at-promise?), I suggest you cut it yourself.
I agree with the broad outline of this, however, there is are consequences as to whether a business is closed to external reasons (hurricane, governor imposed shut-down, etc.) vs. internal decisions. This can range from insurance coverage (which typically pays out ONLY for external business stoppage) to whether or not aid of various sorts is available to businesses struggling with the economic side effects of the pandemic. Some business owners will favor a declared shut-down because it enables them to collect on insurance or aid that they otherwise would not have. Given how rationally and thoughtfully you laid out your post I'm sure you will be able to see the pragmatic roots of their viewpoint even if you disagree with it.

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2. Perhaps more important than 1, opening up doesn't mean the end of countermeasures. It doesn't mean the end of mask wearing, hand washing, contactless delivery and payment, physical distancing, and the rest. Restaurants can move seats outdoors, close the bar area, mask up, limit contemporary diner numbers, and other things. We can still Lysol everything in sight.
We can - but will we?

I fear that all too many people see "open up" as the cue to discard all those other measures and precautions. Fortunately, in at least my state (I have not exhaustively reviewed all the current permutations), what is meant by "open up", or perhaps better put "loosening of restrictions", is separated into phases with defined measures and recommendations.

A lot depends on being able to deliver a useful message to the masses.

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3. We can open up but give people the option of still collecting unemployment if they choose not to work, even if their businesses have recalled them. So if the machine shop says come back to work, and the employee says no thanks I'm diabetic (or whatever), let them get their $900/week for a couple more months.
We could - but will we?

I believe that in some cases the cry to "open up!" comes from people seeking to limit (if not entirely eliminate) social spending.

So... what are you doing to communicate this point to your representatives in government?

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4. Our hospitals have the capacity (except where they don't), the virus isn't going to burn itself out. We need a certain number of people getting sick every week, so they can end up on the healthy side again when others are getting ill. We need a bottleneck to the viral spread, not a complete stop, or else it'll just flare up in July or August and exceed our hospital capacity. The only way to avoid an eventual overwhelming is to get a certain transmission rate, because that means immunity later. We cannot flatten the curve too much now or it'll be too high later. Hopefully that made sense.
It does, but it is a difficult balancing act given that there are still so many unknowns and uncertainties about this disease.

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5. A sizeable chunk of the population can keep on working from home for the summer. Their life is altered, but not disrupted. If we open up, we should ask that those businesses who CAN stay home TO keep staying home. That's how we'll keep the curve low and flat while at least some people are getting sick.
I'd argue that's not a bad thing to encourage even in normal times - there are benefits to encouraging people to work from home, from reduced wear and tear on roads, changes in energy consumption, and so forth. Of course, not every job can be done from home (that is the case with myself) but it's a good option where feasible.

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6. We don't have to open up today. We can plan this for May 22 or something, depending on where you are and what your state's statistics are like. 2 or 3 weeks is a long time for COVID. Things can change in that amount of time.
Again, a phased approach has merits. In my state all but three counties moved from one phase to a less restrictive one last Monday - the remaining three will do so next Monday. This decision was made mostly on the basis of where the virus is most present. As long as such a schedule is seen as a plan and not a mandate I think that can work.

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7. If we plan ahead, we can always shut down again for a week or two here and there. Just because it's complicated and difficult doesn't mean it's a bad plan. Good strategies are often intricate and complicated. Bad ones are often blunt, unsophisticated, and non-specific.
One problem is that the Federal level seems to be seeking "blunt, unsophisticated, and non-specific". Thank Og the governors (at least most of them) seem to be stepping up to the plate. My state is making decisions county-by-county. Illinois has divided the state into five different regions for planning/phasing purposes. Given the differences between dense urban and spare rural populations that sort of thing likely makes for a more nuanced approach.

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So those are my reasons. We're better prepared now, we're over the hump, and we don't have to go from 100 mph to 0, so to speak. We can ease off the gas a little bit, and if necessary, step on it again later.
I disagree with your assumption that we are, in fact "over the hump". I say we don't know whether or not most areas are "over the hump" or still driving up the initial slope or not.
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Old 05-06-2020, 03:31 PM
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I'm not a Republican and don't know many, but I'm about ready to endorse opening up. Here's why:




So those are my reasons. We're better prepared now, we're over the hump, and we don't have to go from 100 mph to 0, so to speak. We can ease off the gas a little bit, and if necessary, step on it again later.
Except that we're emphatically NOT OVER THE HUMP. The country, taken as a whole, is pretty clearly only very slightly declining (although, as jshore points out, Rachel Maddow pointed out last night that, if you exclude New York City, the number of cases in the country is still rising). Compare us to countries like Spain and even COVID-ravaged Italy, and we're clearly nowhere near ready to re-open:

https://coronavirus.jhu.edu/data/new-cases

https://www.nytimes.com/2020/05/05/u...ed-states.html
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  #231  
Old 05-06-2020, 03:53 PM
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https://www.vox.com/2020/5/6/2124907...ew-coronavirus

Shows that trump is clueless and useless still as far as Covid goes.
  #232  
Old 05-06-2020, 04:12 PM
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There is a new Kremlin/GOP canard out there, that the covid deaths are inflated as people who die in a auto accident (for example) are classed as Covid deaths. This is being done to scare the populace and get them to vote trump out.

Having worked for a year in the Coroners office (hence my nickname), altho cause of death wasnt my thing (elder fraud was), they are careful to actually determine it. It's a big deal.

Since the rest of the usual causes of deaths roll on like normal* - it is not true that covid deaths are being deliberately inflated and misclassified.

* auto accident deaths will likely be significantly less this year however.
Not that I believe that conspiracy theory but how many deaths came off the CDC board for Covid deaths? And why were they up there without knowledge that they were in fact Covid 19 deaths?
  #233  
Old 05-06-2020, 05:18 PM
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How can we know if we've reached the hump, or over the hump, when our testing capacity is so small? We need to up our testing massively before we can open up even a little bit, at least so we'll know quickly if something's changed and we need to shut it down again.
For the purposes of measuring the virus's effects vs. our hospital capacity, we don't need testing, we just need hospital utilization rates. We can just ask hospitals what their current rates are, then have a need for a buffer.

Consider that we don't technically care if a patient is intubated because of COVID, or flu, or any other reason. A bed is a bed, a vent is a vent. Suppose a chemical plant exploded and 600 people had caustic burns to their lungs, and they were all sent to the ICU and intubated. We'd have to shut down again (in that area) because the hospital would be overwhelmed, and so COVID patients couldn't be cared for.

So all we need to know is how much space we have in ICUs in each particular county. Open if we can, shut down if and when we need to, regardless of reason.

Now that's not to say we don't need testing; we do. We just don't need it for reopening planning.


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First of all, let me express my appreciation for your organized points, which allow for actual discussion/debate.


I agree with the broad outline of this, however, there is are consequences as to whether a business is closed to external reasons (hurricane, governor imposed shut-down, etc.) vs. internal decisions. This can range from insurance coverage (which typically pays out ONLY for external business stoppage) to whether or not aid of various sorts is available to businesses struggling with the economic side effects of the pandemic. Some business owners will favor a declared shut-down because it enables them to collect on insurance or aid that they otherwise would not have. Given how rationally and thoughtfully you laid out your post I'm sure you will be able to see the pragmatic roots of their viewpoint even if you disagree with it.
I feel any of those contingencies can be covered the same way we caused them in the first place - with appropriate legislation and executive orders. I'm no lawyer, but I'm confident there's some way to allow restaurants to open while not violating their insurance policies if they need to be closed. Call it an automatic health inspection failure or something. I don't know the specifics, but it's a matter of law, not science, and legislatures are very good at that sort of thing.


Quote:
We can - but will we?

I fear that all too many people see "open up" as the cue to discard all those other measures and precautions. Fortunately, in at least my state (I have not exhaustively reviewed all the current permutations), what is meant by "open up", or perhaps better put "loosening of restrictions", is separated into phases with defined measures and recommendations.

A lot depends on being able to deliver a useful message to the masses.
When I go out, I see masks on most people. So somehow, people got the message that we needed masks, and from the stats I've seen around the world, I'm of the belief that masks are the #1 best way to stop this thing. I think that's 80%-90% of a solution all by itself.

So if we got the message out the first time, I have faith we can get that message out again. And when I wear a mask, I visually encourage others to as well. "If we all do it, everyone else will too" - Yogi Berra, probably. .


Quote:
We could - but will we?

I believe that in some cases the cry to "open up!" comes from people seeking to limit (if not entirely eliminate) social spending.

So... what are you doing to communicate this point to your representatives in government?
I don't feel responsible for other people's motivations. I can't speak to what they think.

Quote:
I disagree with your assumption that we are, in fact "over the hump". I say we don't know whether or not most areas are "over the hump" or still driving up the initial slope or not.
Well, by we, I guess I mean my area. The east and west coasts are a little further ahead of the central time zone. We built up hospital capacity and turned a few outlying buildings into care facilities, so I think we're ready to take on a few more sick people. Last I heard, the ERs and ICUs were no busier than usual. If that changes, my opinion changes.
  #234  
Old 05-07-2020, 12:28 AM
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For the purposes of measuring the virus's effects vs. our hospital capacity, we don't need testing, we just need hospital utilization rates. We can just ask hospitals what their current rates are, then have a need for a buffer.
IANA epidemiologist, but I don't think it's that simple. Hospitalization rates are an indicator of whether you made the right call a few weeks ago, and if the answer is "no", well, you're screwed.

And, because of the exponential nature of a spreading virus, I am skeptical that we could even make an inference like, say, "Since the hospitalization rate now is less than little-n, we can be confident that it won't exceed big-N if we open up". We don't know that.

Quote:
I feel any of those contingencies can be covered the same way we caused them in the first place - with appropriate legislation and executive orders.
Let's first see if the government can implement adequate testing, contact tracing and, heck, medical supplies. This is not an unreasonable dream, plenty of countries implemented all within weeks. Then we might have confidence the government will legislate and handle the reopening correctly.

Otherwise we're just saying it's all going to shit thanks to the trump admin, but let's reopen anyway because maybe the trump admin might start doing the right things.

Last edited by Mijin; 05-07-2020 at 12:30 AM.
  #235  
Old 05-07-2020, 10:14 AM
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I am starting to think that most testing and contact tracing are complete wastes of time. The only useful test at this point is antibody testing to gauge how far along we are. Social distancing, and strictly guarding nursing homes from infection should slow down the hospitalizations enough to just let the virus run its course. The media as well as the health organizations are deliberately not giving the public enough information as to who exactly would be at high risk. Those individuals simply sheltering in place with a good support system would allow us to get through this quickly with no interruption to the economy.
  #236  
Old 05-07-2020, 10:23 AM
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The media as well as the health organizations are deliberately not giving the public enough information as to who exactly would be at high risk.
This is false. No matter how many times you're allowed to repeat this across different threads, it's still false.
  #237  
Old 05-07-2020, 10:37 AM
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Except that we're emphatically NOT OVER THE HUMP. The country, taken as a whole, is pretty clearly only very slightly declining (although, as jshore points out, Rachel Maddow pointed out last night that, if you exclude New York City, the number of cases in the country is still rising). Compare us to countries like Spain and even COVID-ravaged Italy, and we're clearly nowhere near ready to re-open:

https://coronavirus.jhu.edu/data/new-cases

https://www.nytimes.com/2020/05/05/u...ed-states.html
But I'm not advocating opening this very instant. I'm saying I think we're ready for opening in about two weeks. From today's numbers, it looks like two more weeks will be enough time. Happy to change that date as it draws closer if I'm wrong.

And as for excluding NYC...why? Do New Yorkers not count in this discussion? Does NYC not need to reopen? Do NYC hospitals not have PPE and equipment that can be sent elsewhere once their wave has passed?

I get that you're trying to say the numbers are still rising elsewhere, but again...two weeks more.

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IANA epidemiologist, but I don't think it's that simple. Hospitalization rates are an indicator of whether you made the right call a few weeks ago, and if the answer is "no", well, you're screwed.

And, because of the exponential nature of a spreading virus, I am skeptical that we could even make an inference like, say, "Since the hospitalization rate now is less than little-n, we can be confident that it won't exceed big-N if we open up". We don't know that.
I think we can, though. I think we know enough science and math to say "If we're little-n today, then we'll at most be big-N in two weeks, which is less than max-N by 10%, so we're fine." I've seen the studies and the charts. I've seen how experts in this field can say "We have X dead today, so there are Y infected in a Z-mile radius, so there's something between A and B future infections starting right now." I'm optimistic we have the brain power.



Quote:
Let's first see if the government can implement adequate testing, contact tracing and, heck, medical supplies. This is not an unreasonable dream, plenty of countries implemented all within weeks. Then we might have confidence the government will legislate and handle the reopening correctly.

Otherwise we're just saying it's all going to shit thanks to the trump admin, but let's reopen anyway because maybe the trump admin might start doing the right things.
I never said the Federal government, though. I'm talking about the same people locking us down in the first place. And they seem to have a handle on it, acting where the Feds refused to do so. I'm not suggesting that we open all 50 states at once on the same day. That's foolishness. Again, the hallmark of a bad plan is when it's blunt, nonspecific, and simple. "Everyone open up on May 20th and go back to normal life" would be such a plan. But something like "Cook county apparel stores may open May 20th. Restaurants may open May 22nd with no more than 5 customers per room..." would be appropriate. Nuanced, specific, and fact-based. And that wouldn't come from the Trump administration, but rather the government of Illinois and the Chicago city council.

That's what I support.
  #238  
Old 05-07-2020, 10:50 AM
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This is false. No matter how many times you're allowed to repeat this across different threads, it's still false.
No this is true! Using the term underlying conditions might cover 75% of those over 65 and maybe 25% of the general public. Not anywhere near that number of people is at high risk. They need to be much more specific to help alleviate anxiety and fear instead of stoking it.
  #239  
Old 05-07-2020, 11:07 AM
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Originally Posted by Chessic Sense View Post

And as for excluding NYC...why? Do New Yorkers not count in this discussion? Does NYC not need to reopen? Do NYC hospitals not have PPE and equipment that can be sent elsewhere once their wave has passed?

I get that you're trying to say the numbers are still rising elsewhere, but again...two weeks more.



.
You're missing the point. Of course New Yorkers count. The point is that if you exclude New York City, then there's no sign of the US having "made it over the hump". The cases in the rest of the country are still rising. It's not clear when the country as a whole will pass that hump, but nothing indicates that it's going to be in another two weeks.


The point of excluding New York is that their examplary efforts at containing the spread of CoVID-19 (they are the epicenter of the disease in this country, after all) is distorting the trend of the disease in the rest of the country. Lump in New York City and its environs and it looks as if we're just passing over that hump. Exclude it and you can see that the country as a whole is not.
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  #240  
Old 05-07-2020, 11:35 AM
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No this is true! Using the term underlying conditions might cover 75% of those over 65 and maybe 25% of the general public. Not anywhere near that number of people is at high risk. They need to be much more specific to help alleviate anxiety and fear instead of stoking it.
Even if the above was true, it does not make the following true

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The media as well as the health organizations are deliberately not giving the public enough information as to who exactly would be at high risk.
  #241  
Old 05-07-2020, 11:43 AM
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Even if the above was true, it does not make the following true
They have a motive, even if the motive is not something evil. Politicians have incentives to create drama, especially when it is almost sure to make them look good. They get plenty of free publicity and get to look all presidential on a daily basis. They make dire predictions based on bad models and then when they beat those predictions they come out looking like heroes. I wish they would keep people with motives out of public health issues.
  #242  
Old 05-07-2020, 12:33 PM
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They get plenty of free publicity and get to look all presidential on a daily basis.
BWHAHAHAHAHAHAHAHAHAHAHAHAHAHA


gasp!


BWHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHA!
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  #243  
Old 05-07-2020, 01:09 PM
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You're missing the point. Of course New Yorkers count. The point is that if you exclude New York City, then there's no sign of the US having "made it over the hump". The cases in the rest of the country are still rising. It's not clear when the country as a whole will pass that hump, but nothing indicates that it's going to be in another two weeks.


The point of excluding New York is that their examplary efforts at containing the spread of CoVID-19 (they are the epicenter of the disease in this country, after all) is distorting the trend of the disease in the rest of the country. Lump in New York City and its environs and it looks as if we're just passing over that hump. Exclude it and you can see that the country as a whole is not.
I think you're missing my point. I'm asking you why "the country as a whole" is a relevant issue. New York doesn't need to care about Oklahoma's numbers when New York is deciding whether or not to reopen.

And my further point is that when you start excluding places like New York, you reduce "We shouldn't reopen" to "we shouldn't reopen, if you ignore all the places that should." As I clarified earlier, when I said "we" are over the hump, I was referring to Virginia. Other states should be viewed separately.
  #244  
Old 05-07-2020, 01:13 PM
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Here's what I'm basing this on.

Look at the yellow line on the bar chart. It's the 7-day moving average. It's been flat for a week. The peak day was two weeks ago. You know how people were screaming about how others don't understand exponential growth and how fast it is? Well, the right side of a bell curve drops just as fast as the left side goes up. I think some people, perhaps here, are underestimating how long two weeks is in terms of cases dropping off.

Now if in a week, that yellow line is still flat or starts rising, I'll change my mind, but from the looks of it today, and the data available to me today, it looks like VA is over the hump and can plan to reopen in two weeks or so.
  #245  
Old 05-07-2020, 01:26 PM
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...The media as well as the health organizations are deliberately not giving the public enough information as to who exactly would be at high risk. T....
This is the sort of disinformation the kremlin is trying to spread- make us not trust our health orgs, etc. And it's not true.


https://www.businessinsider.com/trol...YRXNM_dySGuIOk
  #246  
Old 05-07-2020, 01:26 PM
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Here's what I'm basing this on.

Look at the yellow line on the bar chart. It's the 7-day moving average. It's been flat for a week. The peak day was two weeks ago. You know how people were screaming about how others don't understand exponential growth and how fast it is? Well, the right side of a bell curve drops just as fast as the left side goes up. I think some people, perhaps here, are underestimating how long two weeks is in terms of cases dropping off.

Now if in a week, that yellow line is still flat or starts rising, I'll change my mind, but from the looks of it today, and the data available to me today, it looks like VA is over the hump and can plan to reopen in two weeks or so.
Do you think that just looking at the death per millions we have been experiencing might be the best current indicator (even though not accurate) of when we are over the hump?
  #247  
Old 05-07-2020, 01:30 PM
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I think we can, though. I think we know enough science and math to say "If we're little-n today, then we'll at most be big-N in two weeks, which is less than max-N by 10%, so we're fine." I've seen the studies and the charts. I've seen how experts in this field can say "We have X dead today, so there are Y infected in a Z-mile radius, so there's something between A and B future infections starting right now." I'm optimistic we have the brain power.
It's not about brain power it's about the quality of the data that we have to base our decisions on.
Let's take one confounding factor: that there is an incubation period before (some) people have onset of symptoms. That alone means that the conclusion we can draw from hospitalizations alone becomes equivocal: because a scenario where the virus has only recently entered a high population area might look the same as a scenario where the virus has been successfully contained.
And there are many more confounding factors.

Or, to put it another way: cite for a scientist who believes we can make confident predictions of releasing the lockdown based only on the hospitalization rates?

Quote:
I never said the Federal government, though. I'm talking about the same people locking us down in the first place. And they seem to have a handle on it, acting where the Feds refused to do so. I'm not suggesting that we open all 50 states at once on the same day. That's foolishness. Again, the hallmark of a bad plan is when it's blunt, nonspecific, and simple. "Everyone open up on May 20th and go back to normal life" would be such a plan. But something like "Cook county apparel stores may open May 20th. Restaurants may open May 22nd with no more than 5 customers per room..." would be appropriate. Nuanced, specific, and fact-based. And that wouldn't come from the Trump administration, but rather the government of Illinois and the Chicago city council.

That's what I support.
OK, but IMHO the reason the US is handling this outbreak comparatively poorly is because a pandemic response needs more coordination than this. The municipal governments have done a good job, and that's not enough.
So sure, many of the specifics of when and how a state opens up can and should be handled by local governments. But at the same time we should have guidance from the top, informed by teams of epidemiologists and other scientists on what exactly is safe, and what indicators we're looking for.

That's why I am personally hesitant to just suggest we all separately open up gradually: in the absence of a top-level battle plan, such arbitrary decisions may be very wrong in some cases and will prolong the crisis for everyone.

Last edited by Mijin; 05-07-2020 at 01:32 PM.
  #248  
Old 05-07-2020, 01:34 PM
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Another big falsehood by the press and the Democrats. South Korea and China as being showcased and compared to America as models for how this virus should have been managed with the shutdowns and quarantines. I think South Korea is something like 5 deaths per million and China a bit less. No country in South Asia showing death rates higher than 3 per million and many of them are below 1 per million deaths. When it is suggested that there is a reason for what appears to be resistance or immunity to suffering the affects of this disease it is squashed. They make no suggestion that New York, Europe and the U.S. might just possibly have other factors involved that would be easily identifiable causing us much higher Death rates. Instead they choose to continue to make comparisons to the way they managed and to how the U.S. was managed.
  #249  
Old 05-07-2020, 01:45 PM
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{...} When it is suggested that there is a reason for what appears to be resistance or immunity to suffering the affects of this disease it is squashed. They make no suggestion that New York, Europe and the U.S. might just possibly have other factors involved that would be easily identifiable causing us much higher Death rates. Instead they choose to continue to make comparisons to the way they managed and to how the U.S. was managed.
You've yet to present a single thing that backs this notion that "'asians' don't get it as bad because they're asians".

Meanwhile the actual science, IIUC, says Europe and North America got hit with a more virulent stain of the disease.

CMC fnord!
  #250  
Old 05-07-2020, 01:51 PM
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It's not about brain power it's about the quality of the data that we have to base our decisions on.
Let's take one confounding factor: that there is an incubation period before (some) people have onset of symptoms. That alone means that the conclusion we can draw from hospitalizations alone becomes equivocal: because a scenario where the virus has only recently entered a high population area might look the same as a scenario where the virus has been successfully contained.
And there are many more confounding factors.
But we'd know what yesterday's numbers were, and the day before that. We'd know if we had fewer or more cases than previously. I don't understand how it's confounding.

Quote:
Or, to put it another way: cite for a scientist who believes we can make confident predictions of releasing the lockdown based only on the hospitalization rates?
How about the fact that scientists urged the lockdown in the first place specifically to reduce hospitalizations? That's what flattening the curve is all about - hospitalizations. It was never to reduce the overall number of cases.

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OK, but IMHO the reason the US is handling this outbreak comparatively poorly is because a pandemic response needs more coordination than this. The municipal governments have done a good job, and that's not enough.
So sure, many of the specifics of when and how a state opens up can and should be handled by local governments. But at the same time we should have guidance from the top, informed by teams of epidemiologists and other scientists on what exactly is safe, and what indicators we're looking for.

That's why I am personally hesitant to just suggest we all separately open up gradually: in the absence of a top-level battle plan, such arbitrary decisions may be very wrong in some cases and will prolong the crisis for everyone.
I don't disagree, but we don't have a competent federal government and we aren't going to suddenly get one. I don't see how that desire for top-down leadership changes anything.

But even if we did have top-down leadership, we'd still have separate openings at different times and degrees. That's already the plan. The only question is when.
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