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Old 03-07-2020, 01:32 PM
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Is the US doing enough to slow the spread of Covid-19? (public health)


Your thoughts on the steps being taken to reduce the spread of the virus in the United States?

Here's a March 5th article about a man returning from China, dismayed at the lack of screening at the San Francisco airport (he said he felt safer in China).

Here's an article about how Americans are divided along partisan lines over the virus (yep, folks, even with something like this).

The partisan dysfunction is especially concerning. ISTM there's quite a conflict of interest with this administration in light of the upcoming elections, and a desire to downplay the economic risks. The potential mistake here is not taking strong enough steps soon enough, because of untoward sensitivity to how it looks for the leadership re the economic picture, creating a larger disease spread problem down the road. If there's any silver lining, I suppose some optimism is warranted in light of the warmer weather potentially slowing the spread, but that's far from certain.

And here's a March 5th article from the Independent, which is critical of the administration's response--to summarize, words from the administration are not necessarily in sync with the CDC et al. (Be warned, The Independent has a left-center bias.)

This is intended as a debate thread on public health measures, not economic policy.
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Old 03-07-2020, 02:36 PM
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Originally Posted by Settimo View Post
Your thoughts on the steps being taken to reduce the spread of the virus in the United States?
Aside from funding research, and perhaps some stockpiling of medical supplies, too much is being done.

At the beginning, travel restrictions were worth trying on the grounds that maybe they would work. Now that it's reasonably clear people can't contain it (due to too many mild cases, so you'll never know who to quarantine), and while it remains an uncommon disease compared to seasonal flu, there is no point in quarantine.

If, in some particular U.S.city, it gets close to the point where the hospitals are overwhelmed, the local health department should try to slow down the spread by asking many businesses to close. But shutting down economic activity, at a national or even state level, to slow down transmission by an unknown degree, for unknown benefit, doesn't make sense to me.

Politicians can't follow my advice and expect to the re-elected. But if you ask what SHOULD be done -- take only those steps for which scientific evidence of benefit is strong.

Research is mostly needed on details of spread, and any seasonality, and treatment. Vaccine development is worthwhile, but, it may have the best chance of helping those not yet born.

Last edited by PhillyGuy; 03-07-2020 at 02:38 PM.
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Old 03-07-2020, 03:37 PM
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If it gets to the point where hospitals are overwhelmed, it's too late to try to control the spread.

You're correct that keeping it contained is out of the question at this point, it's here and will grow exponentially. The goal at this point is to keep the exponent as small as possible.

Let's say 20% of the population is going to end up infected at some point. If this infections happen over the course of 6-8 months, that's a whole lot more manageable than if they occur over the course of 6-8 weeks.

Those numbers are completely made up, but the point is that it's well worth attempting to slow the spread, even if the totals are the same in the end.
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Old 03-07-2020, 04:32 PM
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>> Is the US doing enough to slow the spread of Covid-19? (public health)

No. The White House is in denial, responding with propaganda. I'm tempted to say the US isn't amenable to the level of control necessary for such a pandemic but that's not true; political courage and unsuppressed science are needed, not faith-healers* and spin.

* A fundamentalist who thinks prayer is the best treatment for AIDS is not a suitable health-crisis czar.
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Old 03-07-2020, 04:39 PM
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For a view into Trump’s priorities go to 8:50 in the below video. I’m shocked this isn’t bigger news. He’s such a psychopath he doesn’t even realize how this comes off.

https://youtu.be/Ow5bhEi6EdY
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Old 03-07-2020, 04:42 PM
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Aside from funding research, and perhaps some stockpiling of medical supplies, too much is being done.
But there's a lot of fieldspace between economy-crushing measures and what's being done now: actions such as getting people prepared for what to expect, coordinating state and local level responses with some kind of federal level oversight, and mass increases in testing (see South Korea with some potential good news on the death rate). The article in the OP on the San Francisco man does raise concerns over how we're handling our borders (eg isolating people with obvious symptoms), as well as what we might need to do at local levels (eg temperature guns, social distancing, and, yes, facemasks). Also, anticipating / preventing price gouging, runs on stores, and other selfish behavior.

From an article in The Hill (note The Hill has a slight right-of-center bias):

Quote:
Some public health experts said the virus is putting a new focus on state and local health departments, the front-line responders who must both confront the virus and also make significant decisions about what elements of everyday life get shut down... Public health entities have not been in the situation to make large-scale population-level decisions for about 100 years.
And I'm no public health official, but I kind of agree with this (from the same The Hill article):

Quote:
Katz said she was concerned that Americans have not yet fully grasped just how drastic the disruption might be, in part because the federal government has not offered strong guidance about the path ahead. “The challenge here is the administration has taken a posture of keep calm and carry on, particularly if it influences the economy, and I am deeply concerned that we are not doing everything we need to do,” Katz said. “For weeks, we’ve been talking about don’t panic but prepare. And I think a lot of people in the U.S. have taken prepare as meaning go out and buy a lot of toilet paper.”
It seems this is SOP for the governmental machinery: at the state, local, and corporate levels, entities are trying to do what needs to get done, while POTUS sends messages woven between keeping everyone calm (good), tossing out a few hunches (which may or may not pan out; let's do hope the death rate is lower as more are tested), and finds ways to get hisself in the media spotlight by striking partisan nerves (bad for the American immune system).

Again, the The Hill article:

Quote:
"The challenge in the United States is magnified, in part, because of constant tensions in the political system and a broad lack of trust in government institutions. That puts a premium on local governments, which are generally seen in a more positive light than a federal government riven by partisanship."
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Old 03-07-2020, 04:56 PM
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If this infections happen over the course of 6-8 months, that's a whole lot more manageable than if they occur over the course of 6-8 weeks.

Those numbers are completely made up, but the point is that it's well worth attempting to slow the spread, even if the totals are the same in the end.
It is only worth attempting if there is some good reason to think that the attempt will do some good.

Suppose schools are closed. Then children go visit their friends. Or, if in poverty, perhaps they go to a church for a free lunch. The politicians attempted something, yes. But maybe they made it worse.

This is from the Department of Public Health of the City of Philadelphia:

Quote:
At this point, the Health Department is unlikely to recommend school closure unless information were to become available showing that children play a significant role in community transmission and that school closure would have a substantial benefit in protecting residents.
If it gets bad enough, the politicians will feel they have no choice but to take unsupported measures like closing the schools. Residents will demand it. But I support those leaders brave enough to, for as long as possible, do little when they have no evidence but a gut feeling as to what to do.

At one time, it seemed obvious that bleeding would help almost any illness by getting rid of the bad blood. It seemed just as obvious as stopping travel might seem today. Doesn't mean either one helps.
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Old 03-07-2020, 05:08 PM
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It is only worth attempting if there is some good reason to think that the attempt will do some good.

Suppose schools are closed. Then children go visit their friends. Or, if in poverty, perhaps they go to a church for a free lunch. The politicians attempted something, yes. But maybe they made it worse.

This is from the Department of Public Health of the City of Philadelphia:



If it gets bad enough, the politicians will feel they have no choice but to take unsupported measures like closing the schools. Residents will demand it. But I support those leaders brave enough to, for as long as possible, do little when they have no evidence but a gut feeling as to what to do.

At one time, it seemed obvious that bleeding would help almost any illness by getting rid of the bad blood. It seemed just as obvious as stopping travel might seem today. Doesn't mean either one helps.
Yes, but in reality a lot of the ignorance on how many are infected does not lead anyone to do what it should be the proper thing. And this situation also painfully demonstrates why not having access to care means that a lot will be missed thanks to many being uninsured or not being able to afford care.

https://www.statnews.com/2020/03/02/...n-be-stronger/
Quote:
The Trump administration’s mistakes have been symptomatic of this larger problem. Officials eliminated White House-level positions aimed at preventing pandemics two years ago, and sought to scale back work to deal with disease outbreaks elsewhere from 49 countries to 10. The administration bungled the roll-out of diagnostic tests. And the Centers for Disease Control and Prevention and the Food and Drug Administration were too slow to adopt a suggestion made by former FDA Commissioner Scott Gottlieb: loop in major academic medical centers so more tests can be run. Only now is testing capacity for coronavirus starting to ramp up.

There is still a chance that cases that have been missed can be identified and controlled with measures like isolation or quarantine. Yet even if that can be done, the question is what happens next when the novel coronavirus comes into widespread contact with our health care system.

To contain the virus, people will need to call health care providers as soon as they develop any flu-like symptoms. But will they do so if it means losing money? Not only do 26 million Americans lack health insurance, but nearly half of those with private insurance — another 60 million people — have high-deductible plans in which they can be on the hook for thousands of dollars. Already, the Miami Herald has reported on a man who was charged $3,270 for getting checked out at a hospital, and the New York Times profiled a man who is facing nearly $4,000 in bills after he and his daughter were quarantined following their return from China.
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Old 03-07-2020, 05:34 PM
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To contain the virus, people will need to call health care providers as soon as they develop any flu-like symptoms.
This is the kind of made-up wish-fulfillment statements I am reading about this new disease.

the World Health Organization (WHO) estimates that the flu kills 290,000 to 650,000 people per year.

Suppose everyone last year called their health care provider as soon as they developed any flu-like symptoms. And then they were tested for flu. Would flu have been contained, preventing this tragic loss of life? Why are people so in favor of mass testing for the one but not the other? At least, if caught with a very early test, you can take Tamiflu. There is no COVID-19 equivalent reason to test.

COVID-19, like the flu, sheds virus even though the patient is hardly ill yet, and maybe never will get very ill. This is why neither one is rationally subject to quarantine measures.

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Originally Posted by Settimo View Post
But there's a lot of fieldspace between economy-crushing measures and what's being done now: actions such as getting people prepared for what to expect, coordinating state and local level responses with some kind of federal level oversight, and mass increases in testing (see South Korea with some potential good news on the death rate).
I don't totally disagree.

But we don't know what to expect. I support public libraries lending medical history books. I'm not a doctor, but I do read history. In large measure, those books tell us to expect the unexpected.

As far as the death rate good news, comparison is to the People's Republic of China, whose government-released statistics have long had big issues.

Treatment of people seriously ill with COVID-19 is vital. But that only addresses symptoms. The disease itself can't yet be treated. Testing may help society, but it won't help the sick person.

Testing does help with research, and therefore should be free.

Last edited by PhillyGuy; 03-07-2020 at 05:34 PM.
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Old 03-07-2020, 05:54 PM
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Originally Posted by PhillyGuy View Post
This is the kind of made-up wish-fulfillment statements I am reading about this new disease.

the World Health Organization (WHO) estimates that the flu kills 290,000 to 650,000 people per year.

Suppose everyone last year called their health care provider as soon as they developed any flu-like symptoms. And then they were tested for flu. Would flu have been contained, preventing this tragic loss of life? Why are people so in favor of mass testing for the one but not the other? At least, if caught with a very early test, you can take Tamiflu. There is no COVID-19 equivalent reason to test.

COVID-19, like the flu, sheds virus even though the patient is hardly ill yet, and maybe never will get very ill. This is why neither one is rationally subject to quarantine measures.
Sorry, but this is just like demanding that being ignorant is better than knowing. Finding why a lot of the infections are not reported (and that goes BTW to the flu too) is just remarking about the inefiencies of the current system that we have.
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Old 03-07-2020, 06:29 PM
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Sorry, but this is just like demanding that being ignorant is better than knowing. Finding why a lot of the infections are not reported (and that goes BTW to the flu too) is just remarking about the inefiencies of the current system that we have.
I have no idea if I ever had the flu. It's because when I have cold-like symptoms, I never call my family doctor's office to ask if I should be tested.

And I have good insurance that usually has zero co-pay for tests (although I would have to pay an office visit co-pay if the doc wanted to see me first). And I have a good continuing relationship with my doctor.

The government probably has some way to make the tests free. The government conceivably has a way to make testing locations nearby for most Americans (any pharmacy?), But the government has no way to get people with typical mild cold-like disease stand in line for testing that benefits society but not themselves personally. Now, if a big sample of people were tested, that would lead to good research papers. But it is not in nature of this that most people who get it will be tested.

Our youngest son lived for years in Taiwan under their single-payer system. Despite trivial co-pays he could pay with zero financial stress, he didn't go to the doc for a cold either. Now, Taiwanese are known for going to the doctor a lot, but we Americans are not Taiwanese, and even they don't to go every time cold symptoms hit.

There is a panic going on here that is leading to unrealistic expectations as to what is possible.

This influenced my thinking:

Philly vaccine pioneer: We can’t rush a coronavirus vaccine
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Old 03-07-2020, 08:07 PM
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That is not fine, Taiwan has no access to a vaccine either, and what are they doing? This is what I look at when I point at the inadequate response we have, based on your mentioning of Taiwan:

https://jamanetwork.com/journals/jam...rticle/2762689
Quote:
In 2004, the year after the SARS outbreak, the Taiwan government established the National Health Command Center (NHCC). The NHCC is part of a disaster management center that focuses on large-outbreak response and acts as the operational command point for direct communications among central, regional, and local authorities. The NHCC unified a central command system that includes the Central Epidemic Command Center (CECC), the Biological Pathogen Disaster Command Center, the Counter-Bioterrorism Command Center, and the Central Medical Emergency Operations Center.5

On December 31, 2019, when the World Health Organization was notified of pneumonia of unknown cause in Wuhan, China, Taiwanese officials began to board planes and assess passengers on direct flights from Wuhan for fever and pneumonia symptoms before passengers could deplane. As early as January 5, 2020, notification was expanded to include any individual who had traveled to Wuhan in the past 14 days and had a fever or symptoms of upper respiratory tract infection at the point of entry; suspected cases were screened for 26 viruses including SARS and Middle East respiratory syndrome (MERS). Passengers displaying symptoms of fever and coughing were quarantined at home and assessed whether medical attention at a hospital was necessary. On January 20, while sporadic cases were reported from China, the Taiwan Centers for Disease Control (CDC) officially activated the CECC for severe special infectious pneumonia under NHCC, with the minister of health and welfare as the designated commander. The CECC coordinated efforts by various ministries, including the ministries of transportation, economics, labor, and education and the Environmental Protection Administration, among others, in a comprehensive effort to counteract the emerging public health crisis.
Managing the Crisis

For the past 5 weeks (January 20-February 24), the CECC has rapidly produced and implemented a list of at least 124 action items (eTable in the Supplement) including border control from the air and sea, case identification (using new data and technology), quarantine of suspicious cases, proactive case finding, resource allocation (assessing and managing capacity), reassurance and education of the public while fighting misinformation, negotiation with other countries and regions, formulation of policies toward schools and childcare, and relief to businesses.
Quote:
Moreover, Taiwan enhanced COVID-19 case finding by proactively seeking out patients with severe respiratory symptoms (based on information from the National Health Insurance [NHI] database) who had tested negative for influenza and retested them for COVID-19; 1 was found of 113 cases. The toll-free number 1922 served as a hotline for citizens to report suspicious symptoms or cases in themselves or others; as the disease progressed, this hotline has reached full capacity, so each major city was asked to create its own hotline as an alternative. It is not known how often this hotline has been used. The government addressed the issue of disease stigma and compassion for those affected by providing food, frequent health checks, and encouragement for those under quarantine. This rapid response included hundreds of action items (eTable in the Supplement).
As for this bit:

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Originally Posted by PhillyGuy View Post
I have no idea if I ever had the flu. It's because when I have cold-like symptoms, I never call my family doctor's office to ask if I should be tested.
You are really then depending on an argument from ignorance, made worse by the reality that what the current administration did was to set us up into avoiding preventive measures like other developed nations are doing.

https://www.snopes.com/fact-check/tr...pandemic-team/
Quote:
Legum outlined a series of cost-cutting decisions made by the Trump administration in preceding years that had gutted the nation’s infectious disease defense infrastructure. The “pandemic response team” firing claim referred to news accounts from Spring 2018 reporting that White House officials tasked with directing a national response to a pandemic had been ousted.
Rear Adm. Timothy Ziemer abruptly departed from his post leading the global health security team on the National Security Council in May 2018 amid a reorganization of the council by then-National Security Advisor John Bolton, and Ziemer’s team was disbanded. Tom Bossert, whom the Washington Post reported “had called for a comprehensive biodefense strategy against pandemics and biological attacks,” had been fired one month prior.
It’s thus true that the Trump administration axed the executive branch team responsible for coordinating a response to a pandemic and did not replace it, eliminating Ziemer’s position and reassigning others, although Bolton was the executive at the top of the National Security Council chain of command at the time.

Last edited by GIGObuster; 03-07-2020 at 08:08 PM.
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Old 03-07-2020, 08:25 PM
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You'd probably know if you'd had the flu. It's not like a bad cold, but more like praying for a quick death.

People mocking others for buying water in bottles in other threads should consider that with a flu-like illness, lifting a gallon water jug to pour a glass might be beyond one's ability, and going to the store for more food or toilet paper completely impossible (quite aside from any considerations about contagion).

My mother tells a story about both of my parents having the flu at around age 27 and being unable to get out of bed, and of me (3-4 years old) bringing them cups of water and saving my little sister by throwing handfuls of Cheerios into her crib. I vividly remember that the first time I had the flu, it would take several hours to work up the strength to get to a toilet that was 10' away because I wasn't sure I could crawl there, and having to rest on the floor for at least an hour on the way back to bed. I hallucinated for several days. In terms of infrastructure, I have seen a local flu outbreak jeopardize the staffing of our water treatment plant.

For natural disasters, I've been trapped in the house without electricity for days because the road up my hill doesn't get plowed. I've bundled up and hiked to the only nearby grocery to find it empty because no trucks were getting through. My local earthquake recommendations call for weeks of supplies because if the bridges across the rivers fall, the estimate for repairing them is over two years.

While it's not useful to panic, I'd argue that it's very useful to be prepared to shelter in place for a few weeks no matter what the reason. If nothing else, the cat litter is going to smell terrible if it can't be replaced, and you're going to be really sick of cold canned pinto beans after a few days.
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Old 03-07-2020, 09:34 PM
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It would be one thing if the "downplaying" crowd were coming from a place of expertise and learnedness. But the "evidence" they have is the cold comfort kind.


"It's just a flu!" OK, but the flu is scary. Like susan, I know what the flu is like and I'm really NOT comforted knowing that I might get some weird, untreatable version of it. I get the flu shot every year for a reason. At any rate, there is plenty of evidence that this isn't like the flu. There are estimates that some 20% of people who get the infection require hospitalization. This is much higher than what we find with the flu.

"It only kills old people!" OK, but "old people" are still people. My parents are old. My grandmother is old. Some of my coworkers are old. And many of these old people that I like and respect have chronic illnesses. My mother has asthma. I have a coworker in his 60s who is a heavy smoker and is still in a fragile state after the heart attack and testicular cancer he had a few years back. If just 1% of all these "old people" die, most of us will be mourning multiple loved ones.

"The fatality rate is lower than what's reported!" OK, but we don't know by how much, since this would require widespread testing. Which is not happening in the US right now.

"Lookit South Korea! The fatality rate there is only 0.5%". OK, but let's also look at Italy, where the mortality rate is 4.25%. Now, we can surmise that the age distribution is skewed older in Italy than it is in other places. And of course SK is doing a bang-up job with testing. But there are still too many unknown variables to know for sure if we are going to be more like Italy or more like SK.

"Lookit China! The infection rate is decreasing! All is well!" OK, but China has quarantined entire towns and cities. It has also set up extra hospitals, which has no doubt prevented non-affected patients from being exposed to the virus. The US isn't doing anything like this and probably never will.

If you point out these things to people, you risk getting labeled a "panic-monger". Simply expressing any skepticism of the doublespeak coming from the White House means you hate Trump and thus America. This disturbs me more than anything else.
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Old 03-08-2020, 08:04 AM
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You'd probably know if you'd had the flu.
If you had MERS, you wouldn't probably know. You could almost certainly know. That's why MERS could be controlled (but not totally wiped out) by quarantines, and the flu cannot.

A month ago, we didn't know how COVID-19 fell on this spectrum.

If the virus is just the right kind, a good health system can be the difference between breakout into the general population, and not. And it looks like this one isn't the right kind.

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Simply expressing any skepticism of the doublespeak coming from the White House means you hate Trump and thus America.
Evidence is lacking that COVID-19 can be substantially delayed by quarantine. Just as evidence is lacking that anyone in this thread likes Donald Trump.

Trump/Pence statements on COVID-19 are sufficiently varied that everyone in this thread could charge everyone else with being a partial administration stooge. If you want to accuse me of this, that's allowed under the Straight Dope rules. But then I could accuse back

If viruses are, by some chance, conscious and intelligent, this one has nothing to fear from world leaders, whether competent or buffoons. That's because it frequently sheds virus before or without severe symptoms.
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Old 03-08-2020, 08:24 AM
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Originally Posted by PhillyGuy View Post
If it gets bad enough, the politicians will feel they have no choice but to take unsupported measures like closing the schools. Residents will demand it. But I support those leaders brave enough to, for as long as possible, do little when they have no evidence but a gut feeling as to what to do.

At one time, it seemed obvious that bleeding would help almost any illness by getting rid of the bad blood. It seemed just as obvious as stopping travel might seem today. Doesn't mean either one helps.
Outright travel bans are counterproductive because of the effect: the encourage countries to manipulate the statistics and not share information, which in turn makes the problem worse - I agree with that point.

However, closing schools, teleworking, and cancellation of public gatherings that aren't essential is common sense. You slow the rate of transmission that way. No, you don't completely stop the transmissions entirely, and you're correct that some people will ignore requests to stay at home, but certain measures can slow transmission rates.
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Old 03-08-2020, 08:30 AM
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Suppose everyone last year called their health care provider as soon as they developed any flu-like symptoms. And then they were tested for flu. Would flu have been contained, preventing this tragic loss of life? Why are people so in favor of mass testing for the one but not the other? At least, if caught with a very early test, you can take Tamiflu. There is no COVID-19 equivalent reason to test.

COVID-19, like the flu, sheds virus even though the patient is hardly ill yet, and maybe never will get very ill. This is why neither one is rationally subject to quarantine measures.
COVID-19's fatality rate is markedly higher than that of flu, meaning anyone who tests positive is about 10-20 times more likely to die from it. And if you're older, the fatality rate is extremely high. Moreover, even if you don't die, a substantial number of people who present with symptoms require hospitalization, which includes mechanical ventilation, and that ain't cheap. There's real reason to be concerned about this virus. It's true that flu has a lot more disease vectors, but the more time that we spend not taking this seriously, the more likely it is that this will change.
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Old 03-08-2020, 08:41 AM
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Originally Posted by PhillyGuy
Just as evidence is lacking that anyone in this thread likes Donald Trump.
This isn't the only thread on the SDMB about COVID-19.
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Old 03-08-2020, 12:13 PM
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Your thoughts on the steps being taken to reduce the spread of the virus in the United States?
I think that the CDC is on top of this. Which doesn't mean that it couldn't break out and spread rapidly, because it certainly cool. But what can be done has been, IMHO and based on what I've read from the calmer experts in the field. I've also been involved in several emergency exercises and what-if scenarios at the state and local level in the past 3 weeks, and while I could wish for more (I always wish for that) I'd say we are in fair shape to weather this thing.

Basically, IF this thing was going to be contained, China and the CCP fucked that up. Perhaps even if THEY had taken it serious right from the start and not tried (and are still trying) to cover it up and cover their asses after that failed, MAYBE it could have been contained. But we have burned that bridge at this point so have to deal with reality.

Quote:
Here's a March 5th article about a man returning from China, dismayed at the lack of screening at the San Francisco airport (he said he felt safer in China).
Either the man is an idiot, doesn't know what he's talking about concerning how things are actually transpiring in China, or he's a paid mouthpiece. From any perspective (even if you are a CCP elite) it's MUCH more dangerous to be in China at moment, so anyone who thinks they are safer is a fool.

Quote:
Here's an article about how Americans are divided along partisan lines over the virus (yep, folks, even with something like this).
Didn't read the article, but it's pretty apparent that both sides are trying to use this outbreak for political gain. There is so much misinformation and horseshit out about this thing that the mind boggles. For my part, the anger I feel at China not only not being called out for their continuing role in this cluster fuck but being praised and touted really highlights the divide world wide. The WHO response especially is sickening wrt China and the CCP, though most seem to be unaware and just nodding along.

In the US we have an idiotic President who is clueless and his party who seem to be handwaving away the issues and on the other side we see a party trying to fix blame on the US President and fan the flames of fear...and all for political gain. It is nearly as sickening as the China/CCP situation.

Myself, I think people should fucking take a deep breath, calm the fuck down, be watchful and wary but not panic, and listen the fuck to what the CDC is saying. They are putting out almost daily updates along with all kinds of good information about the risks and steps that can be taken to mitigate your chances of getting this thing, and what to do if you do have it. People are freaking listening to politicians and talking heads instead of the experts.
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Old 03-08-2020, 01:14 PM
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Originally Posted by XT View Post
I think that the CDC is on top of this.
Note: I'm only singling you out since you're the only one who has express satisfaction with the CDC.

I'm curious what your take is of Gov. Cuomo's claim that the CDC isn't allowing private testing.

There's another report that the CDC's recommendations are being overridden by the White House.

Personally, I am torn. I have always had enormous respect for the CDC. I know the vast majority of the folks who work there are excellent scientists. But I believe the CDC is under a lot of political pressure right now. It looks like the pressure is impeding them from really being on "top of this".
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Old 03-08-2020, 01:26 PM
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You'd probably know if you'd had the flu. It's not like a bad cold, but more like praying for a quick death.

People mocking others for buying water in bottles in other threads should consider that with a flu-like illness, lifting a gallon water jug to pour a glass might be beyond one's ability, and going to the store for more food or toilet paper completely impossible (quite aside from any considerations about contagion).

My mother tells a story about both of my parents having the flu at around age 27 and being unable to get out of bed, and of me (3-4 years old) bringing them cups of water and saving my little sister by throwing handfuls of Cheerios into her crib. I vividly remember that the first time I had the flu, it would take several hours to work up the strength to get to a toilet that was 10' away because I wasn't sure I could crawl there, and having to rest on the floor for at least an hour on the way back to bed. I hallucinated for several days. In terms of infrastructure, I have seen a local flu outbreak jeopardize the staffing of our water treatment plant.
Exactly. Which is why I am surprised that people are taking it so light. Almost all of us have had flu and multiple times and we know that its a horrid experience. You are bedridden, weak as fuck and useless. And by all accounts, COVID19 has worse symptoms. And longer duration.

If a significant amount of people are down sick, even if most recover, how will that affect the workforce and the economy.
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Old 03-08-2020, 01:39 PM
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Either the man is an idiot, doesn't know what he's talking about concerning how things are actually transpiring in China, or he's a paid mouthpiece. From any perspective (even if you are a CCP elite) it's MUCH more dangerous to be in China at moment, so anyone who thinks they are safer is a fool.
China has taken extreme measures to test populations and to isolate people. The numbers show that the numbers of new infections has dropped markedly in recent days. Of course, it is possible that they're just making shit up, and whole cities are now dead zones.
On the other hand, the US government seems to be handling this by pretending it does not exist, or is a hoax by Democrats.
This is the scary part.

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People are freaking listening to politicians and talking heads instead of the experts.
Absolutely correct. The politicians are fuckwits. Unfortunately, in this Trump era, the politicians are muzzling the experts.
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Old 03-08-2020, 03:11 PM
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Evidence is lacking that COVID-19 can be substantially delayed by quarantine. Just as evidence is lacking that anyone in this thread likes Donald Trump.

Trump/Pence statements on COVID-19 are sufficiently varied that everyone in this thread could charge everyone else with being a partial administration stooge. If you want to accuse me of this, that's allowed under the Straight Dope rules. But then I could accuse back
I certainly wouldn't accuse you of that, and I think it would be grossly unfair for others here to do so.

What monstro was probably getting at is the frustration around such partisan tactics, especially the weaponization of the false dichotomy: if you dare be critical of anything I, as a political leader, am doing, then it's automatically a vicious attack against my party's ideology (and, in the extreme, America itself). That is very bad for fluid, critical, public thought, and bad for clear-eyed views of what's going on.

Hopefully, those posting here are flexible enough to see that cautions over partisan tactics can be safely made without giving in to total inter-party animus in tearing down Trump, or unfairly binning anyone on the "we're doing OK" side of this debate with such a negative-partisan verdict on the administration.
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Old 03-08-2020, 04:51 PM
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The overall CFR is likely less than 1% assuming that the healthcare system is good quality and is not overwhelmed. But, if too many people are infected at once our healthcare system will likely not be able to cope with the stress and the CFR might skyrocket to 3-5 percent.
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Old 03-08-2020, 07:16 PM
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‘Unclean! Unclean!’: The Questionable History of Quarantines - From the Black Death to Coronavirus, we’ve tried to separate sick people from the rest of society for centuries—to mixed results.
Quote:
At one point in human history, quarantines served a valuable role in stopping the spread of communicable diseases. But with the advent of modern medicine, they’re no longer a solution for any health benefit—just a way to allay panic in the general population.
Quashing panic is a good idea. But are quarantines now political moves, not medical necessities?
  #26  
Old 03-08-2020, 08:14 PM
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Is the US doing enough to slow the spread of Covid-19? (public health)
Considering that the US, in practical terms as of right now, isn't actually doing anything to stop the spread of COVID-19, I'm gonna go with "no".

Last edited by Snowboarder Bo; 03-08-2020 at 08:15 PM.
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Old 03-08-2020, 08:23 PM
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I think that the CDC is on top of this.
They're just now beginning to wake up, but a larger problem is that the highest levels of the administration is putting political pressure on the scientists - and that's bad news. That's exactly the same mistake that China's CCP made. They didn't want to spook people, didn't want to scare off investors and companies whose supply chain was in China - and it backfired spectacularly. And we're making the same mistake.

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Originally Posted by XT View Post
Which doesn't mean that it couldn't break out and spread rapidly, because it certainly cool.
Day late, dollar short - it's already spreading well beyond what we know. That's what happens when you don't have testing.

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Basically, IF this thing was going to be contained, China and the CCP fucked that up. Perhaps even if THEY had taken it serious right from the start and not tried (and are still trying) to cover it up and cover their asses after that failed, MAYBE it could have been contained. But we have burned that bridge at this point so have to deal with reality.
No question the CCP screwed the pooch, but there are health systems like South Korea, Singapore, and Germany which are prepared to deal with this, and then there's ours, in which people are afraid to spend the money it takes to get seen by a doctor, tested, and potentially hospitalized, and potentially take time off of work. All of the ills of "socialism" are exactly what separate our system from the rest of the industrialized world, and there's a reason why our death rate is going to be inevitably - unavoidably - higher.

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Myself, I think people should fucking take a deep breath, calm the fuck down, be watchful and wary but not panic, and listen the fuck to what the CDC is saying. They are putting out almost daily updates along with all kinds of good information about the risks and steps that can be taken to mitigate your chances of getting this thing, and what to do if you do have it. People are freaking listening to politicians and talking heads instead of the experts.
Dude, we're about to have March Madness. We're about to enter marathon season. We're not going to cancel events because our lack of testing indicates that there's nothing to worry about - not enough known disease vectors. Let's come back to this time next month. I bet it's a different story then. A lot of people are about to die from COVID-19, and you can absolutely bet your ass off that markets are about to experience shocked shit.
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Old 03-08-2020, 08:28 PM
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Two words: "Spring break."
  #29  
Old 03-08-2020, 10:46 PM
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Evidence is lacking that COVID-19 can be substantially delayed by quarantine.
Yeah, evidence is lacking, except in the 33 non-Hubei provinces of China that had 5 million Hubei residents filter through them before the lockdown started and all of them managed to get the virus under control. In the meantime, a few hundred to thousand Chinese people maybe travelled to Iran or Italy and they both have more cases than any non-Hubei province.

You can talk about how impractical a China style quarantine is for anywhere else in the world all you want but you shouldn't continue denying that it works.

Last edited by Shalmanese; 03-08-2020 at 10:46 PM.
  #30  
Old 03-09-2020, 01:53 AM
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Dude, we're about to have March Madness. We're about to enter marathon season. We're not going to cancel events because our lack of testing indicates that there's nothing to worry about - not enough known disease vectors.
BILLBOARD says event promoters are waiting for local emergency declarations to shut them down so they can collect cancellation insurance - which one insurer says will exceed 9/11 claims. Without a force majeure ruling, they're ruined. Admission-charging events will close to avoid civil liability and/or so promoters can file bankruptcy i.e. take the up-front money and run. But that leaves free fun.

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Two words: "Spring break."
Free fun. A good time for us old farts to avoid the hottest party towns a.k.a. viral petri dishes. MrsRico and I hadn't planned to snag kids at Santa Cruz or Cancun anyway. Easter features huge Holy Week gatherings; I think we'll skip Antigua Guatemala and Valencia Spain, too. Are Easter Parades still scheduled for US cities?

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Originally Posted by asahi View Post
Let's come back to this time next month. I bet it's a different story then. A lot of people are about to die from COVID-19, and you can absolutely bet your ass off that markets are about to experience shocked shit.
It's happening right now. Glance at business news: Oil prices in free-fall. Asian markets crashing. Cryptocurrencies crashing. US Treasury yields crashing to below 1% - first time in history. China exports crashing. Travel crashing.

Wall Street opens in a few hours. It won't be pretty. Sure, "buy when there's blood in the streets." This assumes you have some idea when the bleeding will stop. Good luck.
  #31  
Old 03-09-2020, 08:04 AM
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Myself, I think people should fucking take a deep breath, calm the fuck down, be watchful and wary but not panic, and listen the fuck to what the CDC is saying. They are putting out almost daily updates along with all kinds of good information about the risks and steps that can be taken to mitigate your chances of getting this thing, and what to do if you do have it.
I'd be a hell of a lot more trusting of the CDC if they weren't required to filter all their communications with the public through Mike Pence, who's loyalty is to Trump, oligarchs, and the Republican party and not the American public in general.
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Old 03-09-2020, 08:13 AM
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Personally, I am torn. I have always had enormous respect for the CDC. I know the vast majority of the folks who work there are excellent scientists. But I believe the CDC is under a lot of political pressure right now. It looks like the pressure is impeding them from really being on "top of this".
Political pressure after years of funding cuts.

When I worked in the insurance industry I had contact with people at the CDC. They're hardworking people dedicated to medicine and science. But I think they've been hamstrung by an administration more concerned with their personal welfare than the welfare of the people they were elected to represent.
  #33  
Old 03-10-2020, 05:03 PM
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Quashing panic is a good idea. But are quarantines now political moves, not medical necessities?
In this case, I don't think they're just political moves. I'd divide countries dealing with this virus roughly into "pay now" or "pay later." Pay now include Singapore and Hong Kong. Pay later include China (Hubei) and Italy.

Hong Kong is a good example. They credit widespread adoption of personal hygiene measures, including washing hands and wearing face masks, and measures to minimize contact between people (social distancing). From a Financial Times article:

Quote:
Hong Kong has instituted a partial lockdown. Schools and universities have been closed since the middle of January; employees have been encouraged to work from home; public sports facilities and museums have been shut; and residents told to avoid large gatherings.

The territory has also closed most of its border crossings with mainland China and ordered arrivals from the mainland to self-quarantine for 14 days.
The same source remarks that Hong Kong's flu season has ended significantly early.

And an NPR article:
Quote:
The centerpiece of Hong Kong's containment strategy is aggressively tracking down suspected cases and quickly quarantining anyone who's potentially been exposed. At one point in February, the city had nearly 12,000 people in various forms of quarantine. Some are held in what used to be summer camps, others in a just-completed complex of public housing towers. Some are electronically monitored at home.

I think [Hong Kong] is a really good example where I believe that we're seeing [that] social distancing measures, personal hygiene measures really, really work.
The same article debates whether Hong Kong's measures are too much.

Anyone see the US adopting such measures?

Just for my own reference, I've been watching the diagnosed case counts on the John Hopkins "dashboard" site. Here's the US numbers, starting March 2nd (through to 3/10/20): {102, 107, 148, 213, 260, 401, 497, 605, 808}

We can't post images here, but you can plug the logarithms of the values yourself into this linear regression calculator. The linear fit (on log scale) looks like a textbook example of exponential growth. The daily growth rate is around 32%, using the least-squares fit. So the number of US cases in days (d) since March 2nd goes like 102*(1.32)^d. An unpleasant curve to look at, but I suspect we'll see stronger and stronger containment measures as the cases keep climbing. (The Hong Kong case count is almost flat.)
  #34  
Old 03-11-2020, 11:54 AM
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Suppose everyone last year called their health care provider as soon as they developed any flu-like symptoms. And then they were tested for flu. Would flu have been contained, preventing this tragic loss of life? Why are people so in favor of mass testing for the one but not the other? At least, if caught with a very early test, you can take Tamiflu. There is no COVID-19 equivalent reason to test.
Like you say, there are treatments. And it's good for statistical analysis of the flu.

But the question I have to ask is, how often do people get ACTUAL flu-like symptoms that aren't the flu? I don't mean the poorly-named "Stomach flu", which is gastroenteritis.

I mean real, honest to God influenza symptoms. Because for me, they're pretty unmistakable- relatively high fever, cough, body aches, generally feeling like crap. I typically don't run a fever with other upper respiratory infections, and nor do I feel quite so atrocious as I do with the flu.

I would think that if you were suffering those symptoms, it would be worthwhile to report it to your doctor, if for no other reason, than for tracking and data gathering purposes. That stuff does come in handy later for epidemiologists and public health specialists.
  #35  
Old 03-11-2020, 04:38 PM
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IMO, there were two available options at the start:

#1 Completely shutdown all US borders and remove a large number of freedoms related to citizen travel and congregation then wait it out for a couple years until the vaccine was ready.

#2 Don't.

Any choice in-between was a farce as only extreme measures could have stopped the virus from breaking containment. The government chose #2 and I think it was the right choice.

At this point I'd rather the government focus on a realistic goal like protecting the elderly from covid-19.
  #36  
Old 03-11-2020, 06:29 PM
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I just hope they get this under control before tick season starts up-I'm not a big fan of Corona with Lyme.
  #37  
Old 03-11-2020, 07:13 PM
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I just hope they get this under control before tick season starts up-I'm not a big fan of Corona with Lyme.
¡Ay carumba! Top it off with cheap aguardiente rum to disinfect. A jalapeño squirt couldn't hurt, too.

There's a sure procedure. Top-off all suspected COVID infected with rum. Count the survivors. Tally those who died smiling. Wait, this POTUS is a teetotaller. He's doomed.

Last edited by RioRico; 03-11-2020 at 07:16 PM.
  #38  
Old 03-11-2020, 07:52 PM
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My university just shut down in-person final exams and all gatherings of 50 or more people, and moved to online-only for the first 3 weeks of spring term. In addition, they've cancelled university-sanctioned travel indefinitely and urge us not to travel over break. Residence halls remain open.
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Old 03-11-2020, 08:38 PM
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Zomg! Tom hanks, rita wilson!!!! Zomg!!!!
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Old 03-12-2020, 12:28 AM
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Ex-CDC director predicts up to 1.6 million US deaths over 2-3 years. (cite) But POTUS has it under control.
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Old 03-12-2020, 12:47 AM
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Ex-CDC director predicts up to 1.6 million US deaths over 2-3 years. (cite) But POTUS has it under control.
That assume a mortality rate of no more than 1%.

Assuming the worst, that somehow we suck so bad at healthinating that we hit the current WHO estimate of 3.4%, we'd be looking at 5,610,000 deaths if half the population was infected.

ETA: "Plan for the worst; hope for the best" doesn't work as a strategy if you lie to yourself about what the worst could be.

Last edited by Snowboarder Bo; 03-12-2020 at 12:52 AM.
  #42  
Old 03-12-2020, 02:02 AM
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My university just shut down in-person final exams and all gatherings of 50 or more people, and moved to online-only for the first 3 weeks of spring term. In addition, they've cancelled university-sanctioned travel indefinitely and urge us not to travel over break. Residence halls remain open.
At my university, they've just sent out a message (about an hour ago) saying that this week is the last week of face-to-face instruction, and that all classes will be taught online for the remainder of the Spring semester, which is another 7 weeks of classes.

All domestic and international travel for university business is cancelled, and all university-sponsored events between now and April 30 are cancelled. They are still planning and hoping to have the Commencement ceremony in late May, but we'll see how that goes.

Part of the library will remain open to students who need access to study spaces or technology resources like computers. Students living in campus housing are going to get a separate message about how that will be handled.

This all happened pretty quickly. At a meeting with faculty at lunchtime today, our university president was leaning towards trying to keep the campus open for face-to-face classes until our Spring Break week, which is just over two weeks away, but some people at the meeting were not happy with that decision and were pushing her to close the campus earlier, especially since other universities in the San Diego County area had already announced their move to online instruction.

I'm facing a bit of a personal dilemma. My university is in California, but my wife and I live in Connecticut. I've just been renting a place out here for the semester. I'd like to get back home and spend the rest of the semester (and then the summer) with my wife, but I'm also conscious that it's better to limit non-essential travel. I'm tossing up what to do.

Last edited by mhendo; 03-12-2020 at 02:05 AM.
  #43  
Old 03-12-2020, 05:38 AM
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Does this travel ban make sense? I am trying really really hard not to let my distaste for Trump lead me to be outraged by anything he does, but it seems stupid. We know CORVID-19 is here, in 38 states. Domestic travel is as likely to move it from one place to another as is international travel. But even if we decide we need to take draconian measures to prevent any additional points of infection from entering the country, I can't see any reason to allow travel from the UK.

What am I missing?
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Old 03-12-2020, 06:35 AM
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Does this travel ban make sense? I am trying really really hard not to let my distaste for Trump lead me to be outraged by anything he does, but it seems stupid. We know CORVID-19 is here, in 38 states. Domestic travel is as likely to move it from one place to another as is international travel. But even if we decide we need to take draconian measures to prevent any additional points of infection from entering the country, I can't see any reason to allow travel from the UK.

What am I missing?
I think it is something. An imperfect containment plan is better than no plan. For instance, Italy has just shut down all businesses except grocery stores and pharmacies. The virus is still going to spread in these places, but at least it isn't going to be spread around in all the other places at the same time.

I might be confabulating this so don't be mad at me if it turns out I'm wrong, but I believe people coming from the listed countries will not be able to bypass the ban just by flying from the UK.
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Old 03-12-2020, 07:41 AM
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I think it is something. An imperfect containment plan is better than no plan. For instance, Italy has just shut down all businesses except grocery stores and pharmacies. The virus is still going to spread in these places, but at least it isn't going to be spread around in all the other places at the same time.

I might be confabulating this so don't be mad at me if it turns out I'm wrong, but I believe people coming from the listed countries will not be able to bypass the ban just by flying from the UK.
We are stuck in Florence, Italy until next Wednesday :. it’s a bloody ghost town. Only allow three people in the grocery stores at a time. We’re flying out to the UK then home. They said what Italy did was draconian. But it might be helping. The medical has been playing catch-up.
  #46  
Old 03-12-2020, 01:21 PM
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Ex-CDC director predicts up to 1.6 million US deaths over 2-3 years. (cite) But POTUS has it under control.
He did not predict 1.6 million deaths, that was just the worst case estimate he threw out there. He just did a little calculation and ended up with the truly massive range of 327 dead to 1.6 million. It was a mildly interesting thought experiment at best and predicts exactly nothing.

Basically a few people are going to die, some people are going to die or a lot of people are going to die. Not a shocker.
  #47  
Old 03-12-2020, 05:32 PM
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The whole point of these "draconian" methods is to keep it from BEING a total epidemic, like the Bubonic Plague, or the Spanish Flu. You know what they say about the best defense being a good offense?


Quote:
Originally Posted by RioRico View Post
‘Unclean! Unclean!’: The Questionable History of Quarantines - From the Black Death to Coronavirus, we’ve tried to separate sick people from the rest of society for centuries—to mixed results.

Quashing panic is a good idea. But are quarantines now political moves, not medical necessities?
Not necessarily. Perhaps not out right quarantine, but cancelling big events, and encouraging people to stay home and not go out unless absolutely necessary? History seems to show that's a good idea.
  #48  
Old 03-12-2020, 05:56 PM
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The CDC tested only 77 people this week.
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Old 03-12-2020, 06:46 PM
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IMO, there were two available options at the start:
That’s not true. Your post reminds me of the statement attributed to Henry Kissinger about how he advised Nixon on every foreign policy crisis, that the first two options were (1) total thermonuclear war with the Soviets, or (2) complete surrender.

The third option would be his preferred policy. In this case, We could have been testing for fever or diverting passengers from certain areas to a quarantine, for example. I learned yesterday that at at least one major US airport, people were arriving from Italy like normal, no screening or questions asked.
  #50  
Old 03-12-2020, 06:49 PM
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This is just un-fucking-real.

It's so bad that people who suspect they have corona can't even get tested. Medical professionals have to ration testing to people who are highly suspected to have the virus, which means only people with direct contact of someone known to be infected or having returned from an area with high incidence.

What does this really mean? It means that community-spread COVID is going undetected -- by the thousands and maybe the tens of thousands.

What you're going to see - perhaps in just a matter of days - is people flooding emergency rooms, crushing the health system in some places. Take a good look at Italy: this is going to be us, in about 2-4 weeks. Get the coffins ready.
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