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  #201  
Old 03-20-2020, 08:38 AM
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I'm sure that within a few weeks all the skeptics will be convinced, though too late.

The situation in the US is shaping up to be far worse than Italy.
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Old 03-20-2020, 08:46 AM
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I'm sure that within a few weeks all the skeptics will be convinced, though too late.

The situation in the US is shaping up to be far worse than Italy.
I could not agree more. The cultivation of deliberate willful ignorance in the populace, the utter incompetence of leadership, and the culture of blind selfish greed, is going to create hardships the like of which few living have ever seen in the United States. And it will be sudden.

The question is not, will they be convinced, it is who they will blame.
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Old 03-20-2020, 09:45 AM
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The question is not, will they be convinced, it is who they will blame.
Obama and Hillary. Any maybe Matt Damon.

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  #204  
Old 03-20-2020, 12:01 PM
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I could not agree more. The cultivation of deliberate willful ignorance in the populace, the utter incompetence of leadership, and the culture of blind selfish greed, is going to create hardships the like of which few living have ever seen in the United States. And it will be sudden.

The question is not, will they be convinced, it is who they will blame.

I disagree. Only because the USA is 32x the land mass of Italy with only 5x the population. As a population, we tend to be a lot more spread out than European countries and cities. That helps.

The exception is in highly dense urban areas like New York City or Hudson Country, NJ just over the river (where I live). We don't seem to be fucking around with the "social isolation". For the past week in both NY and NJ, schools have closed, everyone who is able is working from home, bars and restaurants are closed to all but takeout and delivery and most non-essential businesses are closed.


As of 3/20, there are 55 positive cases of COVID-19 in Hudson County:.
25 in Jersey City (pop 270,000)
13 in Hoboken (pop 55,000)
2 in West New York (pop 54,000)
2 North Bergen (pop 63,000)
2 Kearny (pop 42,000 )
1 Bayonne (pop 67,000)
1 Secaucus (pop 20,000)
9 don't know

Plus you have around 4,000 in New York City (pop 8.5 million)


Within my apartment building they have shut down all public areas (gym, playroom, lounge). The management office is closed to in-person visits and the concierge's desk has a fancy rope marking off around a six foot perimeter.


Still, it's very difficult to maintain complete quarantine with a family of four. We still have our nanny come in to watch the kids and help with my son's schoolwork while my wife and I work from home. About once every two days I venture out for supplies (the grocery store stocks have more or less normalized at this point). Lots of hand washing and Clorox wiping.

Fortunately we also live on the water with a number of large green spaces around us. So there are places to go out and walk around with the kids where we can also keep our distance from other people.



So to be honest, I can't really understand people who live in suburban houses bitching about "working from home" or "social distancing". In NYC and Hoboken, we practically live in our local bars, restaurants and coffee shops. The people I feel bad for are those who work for those bars and restaurants and small businesses whose jobs are affected by this virus.
  #205  
Old 03-20-2020, 01:16 PM
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So to be honest, I can't really understand people who live in suburban houses bitching about "working from home" or "social distancing".
I don't live in a big city like NYC, but I was thinking the same thing this morning while I was walking through the park and my neighborhood. There was hardly anyone around. It would be much harder to maintain outdoor social distancing while walking around in a place like NYC, but in most places it's pretty dang easy.
  #206  
Old 03-20-2020, 01:29 PM
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Plus you have around 4,000 in New York City (pop 8.5 million)
Currently 5,151 in NYC, and 7,845 in New York State, up from 5,367 yesterday.

Exponential growth is a thing.

Certainly population density is a big factor, but...

Quote:
Dr. Neil M. Ferguson, a British epidemiologist who is regarded as one of the best disease modelers in the world, produced a sophisticated model with a worst case of 2.2 million deaths in the United States.

I asked Ferguson for his best case. “About 1.1 million deaths,” he said.
...

The United States may already have 100,000 infected citizens — nobody knows. That’s too many to trace. Indeed, one can argue that the U.S. is not only on the same path as Italy but is also less prepared, for America has fewer doctors and hospital beds per capita than Italy does — and a shorter life expectancy even in the best of times.

Mitre, a nonprofit that does work on health care, calculated that coronavirus cases are doubling more quickly in the United States than in any other country it examined, including Italy and Iran.

Last edited by GreenWyvern; 03-20-2020 at 01:31 PM.
  #207  
Old 03-20-2020, 01:58 PM
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I don't live in a big city like NYC, but I was thinking the same thing this morning while I was walking through the park and my neighborhood. There was hardly anyone around. It would be much harder to maintain outdoor social distancing while walking around in a place like NYC, but in most places it's pretty dang easy.
This. The sister of a friend lives in NYC. She doesn't own a car, but she does own a dog. Public transportation is too risky, she feels (she's over 60), but she can't even maintain much distance from others while walking her dog. I can walk my dog around here without coming closer to anyone than half a block.
  #208  
Old 03-20-2020, 04:39 PM
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I don't live in a big city like NYC, but I was thinking the same thing this morning while I was walking through the park and my neighborhood. There was hardly anyone around. It would be much harder to maintain outdoor social distancing while walking around in a place like NYC, but in most places it's pretty dang easy.

Except for the millions of us even out here in "flyover country" who live in apartment buildings that don't allow us to get outside without being funneled through narrow common areas.
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  #209  
Old 03-21-2020, 06:16 PM
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How seriously are you taking the recommendations to socially isolate?

I'm not suggesting that people simply continue living their lives as normal. I certainly understand the benefit of avoiding large crowds and vulnerable populations.

But I'm wondering what aspects of "normal living" ought to be avoided? For example, this evening I am planning on going to a friend's house where 3 of us will play music. Hearing people talk, I'm wondering if I should ask my 2 friends if they think we should cancel. But I really question whether the risk to us - or society - is more than infinitesimally negligible.

I don't want to suggest that the loss of live from this will be traumatic to many people. But we don't have a good idea exactly what the mortality rate is. And if avoiding crowds/excessive contact, washing hands eliminates the vast majority of risk, how far should we go trying to eliminate the remaining portion?

If we are supposed to avoid crowds exceeding 10 (or 50, or 100), then why hasn't air travel and public transportation been shut down?

I find myself drawing comparisons to 9/11, where IMO we grossly over-reacted to the threat. Feel free to call me irresponsible or whatever if you wish, but I'm really trying to figure out what is a reasonable and responsible approach, balancing between living life as normal, or hoarding and hunkering down like survivalists.

What made the response to 9/11 a dangerous overreaction is that it led to more driving. Fear of (relatively safe) flying led us to go by car instead -- and there were many more deaths in car accidents than there were in the terrorist attacks. There are about as many deaths in car accidents in the U.S. in the average month as there have been deaths in terrorist attacks in all of U.S. history.


The reaction to the virus has been to stay home, or at least go somewhere close or in the middle of the day. At what are normally peak commuting times, the roads are as empty as they are at those times on a weekend. The decreased use of the roads will save lives. We don't know how many virus deaths would have happened if everyone went to school or work and will be prevented by staying home -- but we know that there are about 100 car accidents on the average day of a normal day, and those won't happen if we stay home.
  #210  
Old 03-21-2020, 06:23 PM
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Except for the millions of us even out here in "flyover country" who live in apartment buildings that don't allow us to get outside without being funneled through narrow common areas.
So wear food service gloves to avoid touching door handles, railings, etc.
  #211  
Old 03-21-2020, 07:03 PM
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As someone who really loves outdoor recreation, this hits me in the gut.

Lombardy region bans outdoor recreation, even individual activities

During this whole week of social distancing, I've been so grateful that the weather has been nice enough for walking and riding around on my electric scooter. Doing these things has helped me to feel grounded during this crazy times.

I hope the things we're doing now are flattening the curve enough so that we don't have to face such a draconian measure. I fear they aren't.
  #212  
Old 03-21-2020, 08:18 PM
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Honestly, given that the lockdown in Italy doesn't seem to be bending the curve at all so far ... what if this just doesn't work? Like, what if this disease mostly spreads through some means other than casual social contact, and doubling down on stricter and stricter lockdown rules doesn't actually do a damn thing to stop it? How long would it take us to figure that out?
  #213  
Old 03-21-2020, 08:21 PM
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what if this just doesn't work? Like, what if this disease mostly spreads through some means other than casual social contact, and doubling down on stricter and stricter lockdown rules doesn't actually do a damn thing to stop it? How long would it take us to figure that out?
Honestly, I've wondered about that myself.
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Old 03-21-2020, 08:22 PM
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Honestly, given that the lockdown in Italy doesn't seem to be bending the curve at all so far ...
We really don't know that. They instituted these measures so very late that it was going to be bad in any event. It could well have been even worse. It's the kind of thing you can't tell until after the fact.
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Old 03-21-2020, 08:31 PM
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Honestly, given that the lockdown in Italy doesn't seem to be bending the curve at all so far ... what if this just doesn't work? Like, what if this disease mostly spreads through some means other than casual social contact, and doubling down on stricter and stricter lockdown rules doesn't actually do a damn thing to stop it? How long would it take us to figure that out?
Then you will win the Nobel Prize.
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Old 03-21-2020, 08:56 PM
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Honestly, given that the lockdown in Italy doesn't seem to be bending the curve at all so far ... what if this just doesn't work? Like, what if this disease mostly spreads through some means other than casual social contact, and doubling down on stricter and stricter lockdown rules doesn't actually do a damn thing to stop it? How long would it take us to figure that out?
I think lockdown rules only work if people have been following them. According to what I have read, a lot of Italians have been ignoring the rules. So I'm worried that people will assume that social distancing isn't effective when really the problem is poor compliance with social distancing.

I think the super big question is to what extreme are we willing to enforce lockdown rules. We're just at week 1 of this thing. Right now we are satisfied with just talking shit about those spring break kids partying on the beach. By week 10 of this thing, will we just be talking shit? Or will we be OK with state-sanctioned violence being directed towards anyone who doesn't follow the rules, since flouters will be blamed not just for deaths but for the continuation of the lockdown?

There's a kneejerk tendency to say this wouldn't happen here in the US. But that's what I said two weeks ago about lockdowns. Two weeks ago I had no idea we'd be where we are now. So ten weeks from now, who the fuck knows where we will be psychologically and thus politically.
  #217  
Old 03-21-2020, 09:02 PM
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We really don't know that. They instituted these measures so very late that it was going to be bad in any event. It could well have been even worse. It's the kind of thing you can't tell until after the fact.
Yeah, but shouldn't the number of deaths and new infections be starting to flatten at least a little bit by now, ten days or so after lockdown, instead of going up and up and up? I know some of the lack-of-bend in the infection one might be due to increased testing, but it's worrying me that there doesn't seem to be any sort of difference in the trend line at all (and there have been more new infections and more deaths today, not yet reflected in these graphs, than on any day so far).

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  #218  
Old 03-21-2020, 09:26 PM
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Admittedly, I'm doing this very imprecisely, just clicking through the days until I reach a day that is equal to or greater than double the number from a specific previous date, but it appears that Italy's lock down slowed their doubling rate from every 4 days to every 5 days. Greater compliance might make that better.

Plus, lockdown was March 9. The results of it won't really be seen until 5 days later. So, March 14. We are barely at the beginning of seeing the effects of it.

A podcast I listened to suggested that perhaps even more than the lockdowns in China and South Korea, a big difference may have been made by some drastic measures that were taken in separating the infected (or even suspected) from their households so that every time one person was infected it did not automatically mean the infection of their whole family. Vigilance, fever clinics, rapid diagnosis (often based on CT-scans of lungs rather than PCR tests, and separation of anyone referred for testing until they were cleared.

Last edited by eschrodinger; 03-21-2020 at 09:29 PM.
  #219  
Old 03-21-2020, 09:39 PM
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Yeah, but shouldn't the number of deaths and new infections be starting to flatten at least a little bit by now, ten days or so after lockdown, instead of going up and up and up?
No. The SARS-CoV-2 seems to have a long latency period—maybe as long as 7-10 days—prior to expression, and it appears that many people may be asymptomatic or marginally symptomatic, so even with social distancing, people may be living with asymptomatic carriers. And the lack of effective testing means that we actually have do not have a good basis to make a qualified statistical estimate of how widespread the contagion may be, although the number of asymptomatic people who have tested positive indicates that the current estimates of the R0 value are probably way too low.

FWIW, I build a very simple dynamical system model of the virus distribution based upon the publicly available data as of last Saturday, and even using the most conservative assumptions about transmission and dispersion, I got an R0 of at minimum 4, and possibly higher than 6. Now, I’m not a virologist or epidemiologist so I could have made some unlikely assumptions that a professional would dispute, but as I’ve been watching the R0 estimates creep up I get the feeling that people were trying to make optimistic projections rather than realistic ones.

At this point, there is a minimum of a two week lag between the institution of distancing and isolation measures and seeing any measurable effects; realistically it might even be three weeks given the potential latency of onset of COVID-19 and undiagnosed asymptomatic carriers. We will almost certainly have the same type of situation that Italy has had except with a larger population and an even more fragile medical system, combined with the reluctance that uninsured people and undocumented immigrants may have in reporting early symptoms and seeking treatment.

And by all measures this is a love tap in comparison to an aggressive influenza or viral hemorrhagic fever pandemic could be in terms of lethality. While it is not correct to say that only the elderly and immunocompromised are experiencing critical illness, it is disproportionally affecting the elderly and not exhibiting the kind of effects like meningitis or cytokine release syndrome that would affect old and young alike. An occurrence of a InfA/H1N1 pandemic similar to the 1918 Spanish Flu could run through the population like a hot knife through butter with mortality rates exceeding 20% across all age groups. And by the way, we are particularly vulnerable to a co-incident influenza pandemic, so even if distancing is too late to directly affect the distribution of SARS-CoV-2 throughout the population it is still valuable in preventing a secondary epidemic that might dwarf this one.

The short answer is that right now we shouldn’t assume that we have the full picture on anything, and that the most ‘extreme measures’ (of which this is not) should be on the table in order to forestall even worse outcomes than what we are already facing. And after this is over—which won’t be for at least a few months—there should be some hard questions asked about how the nation was not better prepared for this (as epidemiologists have been warning for decades), why we do not have an organization with as much power and authority as the Department of Defense which has the mission to fight global pandemics, and why our economic and health system is so fragile that we can’t even weather what is really just a bad cold epidemic much less a major influenza or other epidemic that is coming as sure as spring follows winter.

PBS NewsHour: ”Why another flu pandemic is a likely just a matter of when”

Stranger
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Old 03-21-2020, 09:43 PM
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Thanks for the detailed answers, Stranger and eschroedinger! I don't know if that's comforting or ... very very not.
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Old 03-21-2020, 09:57 PM
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I don't think you can really use China as a reference for how to control the spread of corona, considering the fact that it was the government's lies that allowed it to fester in Wuhan and eventually spread worldwide. When they say that there haven't been any new cases, you know it's probably a lie: the CCP is feeling the heat and their propaganda efforts are intended to wipe everyone's memory clear of Wuhan and to fixate on how bad their home-cooked crisis is for everyone outside of China. I don't trust a fucking thing that comes out of China.

South Korea is the model. They are the standard that everyone else has to live up to, and unlike China, which barbarically left some people to die in the streets, tyranically imposed martial law, threatened to throw doctors and their families in jail merely for telling people that there was a serious health crisis...South Korea did everything with transparency. When South Korea says that their number of new infections is going down, believe that.

As for the American response, much has already been said about the lack of testing and the efforts at social distancing - we're catching up slowly but surely in that regard. But there is still an inexcusable amount of misinformation about the disease. All I keep seeing is "Wash your hands! And stay six feet apart."

No, you don't get it, but read this and read this carefully because it might just save your life: all the evidence points to the primary mode of transmission being through the air, not by touching doorknobs and failing to wash hands. Don't get me wrong, you can get it by touching infected surfaces. And you do need to wash your hands. But the thing you absolutely must remember about this virus is that it stays airborne, and that's how it is typically transmitted. ANd it can stay airborne a lot longer than people realize. If you're in a room, or even in a hallway, and someone coughs, those droplets can stay in the air for 10-30 minutes, and in some cases, they can remain airborne for hours.

Don't think you can just go on shopping, walking, jogging, living your normal life and then come home and wash it away. You will DIE if you believe that.
  #222  
Old 03-21-2020, 10:18 PM
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You will DIE if you believe that.
Come on now. This thing is bad, but the melodrama is not necessary.
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Old 03-21-2020, 10:39 PM
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I'm sure that within a few weeks all the skeptics will be convinced, though too late.

The situation in the US is shaping up to be far worse than Italy.
How so? I thought we moved faster than Italy by like a week.
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Old 03-21-2020, 10:47 PM
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No, that is group 2. People that will survive if and only if they can get medical treatment.

We cannot flatten the curve enough to make enough capacity.

The question is and continues to be, at what point do we need say the cost is too high to save these lives?

This really is not that complicated.
The reason I separated it out was because there's the set of people with coronavirus who WOULD survive, with adequate medical care. That's Group 2.

Then Group 4 was the set of people who have OTHER conditions who would survive with adequate medical care. The people who say... a month ago, would have been treated without any capacity issue questions.

So the goal is to flatten the curve as much as we can, even if we can't totally flatten it. Even if we drop it only a little bit and 5% more people could be treated than otherwise, on a national scale that translates into a non-trivial number of lives saved.
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Old 03-21-2020, 11:46 PM
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The success Asian countries have had in flattening the curve shows that social distancing does work, it just needs to be strictly followed.


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So wear food service gloves to avoid touching door handles, railings, etc.

We are doing that, but it is looking increasingly likely that the virus spreads through the air, and lingers in the air for anywhere from a half hour to three hours. So a narrow hallway to outside, with no ventilation, is going to collect a lot of people's exhalations in an apartment building with hundreds of residents and only two exits (other than for the ground floor residents, who can just walk out their sliding glass doors, whereas for us on higher floors those go to a balcony).


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I don't think you can really use China as a reference for how to control the spread of corona, considering the fact that it was the government's lies that allowed it to fester in Wuhan and eventually spread worldwide. When they say that there haven't been any new cases, you know it's probably a lie: the CCP is feeling the heat and their propaganda efforts are intended to wipe everyone's memory clear of Wuhan and to fixate on how bad their home-cooked crisis is for everyone outside of China. I don't trust a fucking thing that comes out of China.

South Korea is the model. They are the standard that everyone else has to live up to, and unlike China, which barbarically left some people to die in the streets, tyranically imposed martial law, threatened to throw doctors and their families in jail merely for telling people that there was a serious health crisis...South Korea did everything with transparency. When South Korea says that their number of new infections is going down, believe that.

As for the American response, much has already been said about the lack of testing and the efforts at social distancing - we're catching up slowly but surely in that regard. But there is still an inexcusable amount of misinformation about the disease. All I keep seeing is "Wash your hands! And stay six feet apart."

No, you don't get it, but read this and read this carefully because it might just save your life: all the evidence points to the primary mode of transmission being through the air, not by touching doorknobs and failing to wash hands. Don't get me wrong, you can get it by touching infected surfaces. And you do need to wash your hands. But the thing you absolutely must remember about this virus is that it stays airborne, and that's how it is typically transmitted. ANd it can stay airborne a lot longer than people realize. If you're in a room, or even in a hallway, and someone coughs, those droplets can stay in the air for 10-30 minutes, and in some cases, they can remain airborne for hours.

Don't think you can just go on shopping, walking, jogging, living your normal life and then come home and wash it away. You will DIE if you believe that.

THIS.
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  #226  
Old 03-22-2020, 01:30 AM
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FWIW, I build a very simple dynamical system model of the virus distribution based upon the publicly available data as of last Saturday, and even using the most conservative assumptions about transmission and dispersion, I got an R0 of at minimum 4, and possibly higher than 6. Now, I’m not a virologist or epidemiologist so I could have made some unlikely assumptions that a professional would dispute, but as I’ve been watching the R0 estimates creep up I get the feeling that people were trying to make optimistic projections rather than realistic ones.
Did you have (or need) any particular assumptions about the ratio of actual cases to official cases in those models? Scott Alexander at slatestarcodex reviewed a number of different estimates in the 5x to 20x range of ratios and at some point it's going to make a big difference to in the infection rate.
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Old 03-22-2020, 01:58 AM
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The reason I separated it out was because there's the set of people with coronavirus who WOULD survive, with adequate medical care. That's Group 2.

Then Group 4 was the set of people who have OTHER conditions who would survive with adequate medical care. The people who say... a month ago, would have been treated without any capacity issue questions.

So the goal is to flatten the curve as much as we can, even if we can't totally flatten it. Even if we drop it only a little bit and 5% more people could be treated than otherwise, on a national scale that translates into a non-trivial number of lives saved.
Yah.. I knew why you were splitting it out and trying to create a group 4. I consider those part of group 2, but call it group 2a if you want. In the end, as a result of this wave we are staring at, there will be a WHOLE bunch of people who will need medical care to survive who aren't going to get it. Whether that be because of COVID-19 or something else, they are going to die. 5% of a huge number is significant and hopefully we can get it that high.

I truly hope we are able to save huge numbers that otherwise would died had we not done all these things to flatten the curve. I just hope in the long run, months or years from now, this saves more than it kills.

Last edited by cmosdes; 03-22-2020 at 01:59 AM.
  #228  
Old 03-22-2020, 05:28 AM
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No. The SARS-CoV-2 seems to have a long latency period—maybe as long as 7-10 days—prior to expression, and it appears that many people may be asymptomatic or marginally symptomatic, so even with social distancing, people may be living with asymptomatic carriers. And the lack of effective testing means that we actually have do not have a good basis to make a qualified statistical estimate of how widespread the contagion may be, although the number of asymptomatic people who have tested positive indicates that the current estimates of the R0 value are probably way too low.

FWIW, I build a very simple dynamical system model of the virus distribution based upon the publicly available data as of last Saturday, and even using the most conservative assumptions about transmission and dispersion, I got an R0 of at minimum 4, and possibly higher than 6. Now, I’m not a virologist or epidemiologist so I could have made some unlikely assumptions that a professional would dispute, but as I’ve been watching the R0 estimates creep up I get the feeling that people were trying to make optimistic projections rather than realistic ones.

<snip>....
To help other English majors like myself understand Stranger's excellent post(s):
Quote:
What Is R0?: Gauging Contagious Infections

Understanding the possibilities

R0 is pronounced “R naught.” It’s a mathematical term that indicates how contagious an infectious disease is. It’s also referred to as the reproduction number. As an infection spreads to new people, it reproduces itself.

R0 tells you the average number of people who will catch a disease from one contagious person. It specifically applies to a population of people who were previously free of infection and haven’t been vaccinated. If a disease has an R0 of 18, a person who has the disease will transmit it to an average of 18 other people, as long as no one has been vaccinated against it or is already immune to it in their community.

What do R0 values mean?

Three possibilities exist for the potential spread or decline of a disease, depending on its R0 value:
  • If R0 is less than 1, each existing infection causes less than one new infection. In this case, the disease will decline and eventually die out.
  • If R0 equals 1, each existing infection causes one new infection. The disease will stay alive and stable, but there won’t be an outbreak or an epidemic.
  • If R0 is more than 1, each existing infection causes more than one new infection. The disease will spread between people, and there may be an outbreak or epidemic.
....
More at the link.
  #229  
Old 03-22-2020, 07:28 AM
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Come on now. This thing is bad, but the melodrama is not necessary.
If you think it's melodrama, then carry on. You'll end up in an ICU pretty soon.

Another thing people ought to be aware of is that the currently reported number of cases 25,000-ish...is way, way, low. We're still catching up, and these numbers mostly reflect the past. The real number of infected is already in the hundreds of thousands. COVID-19 is much, much closer to you than you realize.

Let's put numbers into perspective.

For the average person, the death rate is about 1 in 100. The problematic word here, though, is "average." The average death rate for someone who is in their 20s and in good health is quite low - perhaps as low or even lower than for seasonal flu (the data are not completely in). But that "average" number gets worse as you age, and as you collect conditions over the course of your life. If you're over the age of 70 or 75, there's a good chance you have decreased immunity, decreased liver function, and increased high blood pressure. Consequently, the "average" fatality rate for such patients is more like 1 in 10.

But another problem that doesn't get talked about nearly enough is that this is a devastating and rough affliction even if you don't die. You could live, but end up in the ICU and in a hospital bed for weeks - do you have that kind of money? I don't. Most people I know would have their savings and retirement significantly depleted by this illness. Don't expect to just stay home and fight it off with orange juice. You could have severe lung tissue scarring, and consequently, permanent lung injury. How'd you like to walk around leashed to an oxygen machine?

There's no melodrama here. There will be many, many people of all ages who will live, but they will require immediate emergency hospitalization -that's quite different from seasonal flu, which the health system already takes into account and prepares for. COVID-19 was unexpected. It's extra. It throws everything out of balance. That's exactly why healthcare workers in major cities are sounding the alarm about running out of beds and equipment.
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Old 03-22-2020, 07:36 AM
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  #231  
Old 03-22-2020, 07:43 AM
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If you think it's melodrama, then carry on. You'll end up in an ICU pretty soon.
Telling all of us that we're gonna die if we contract COVID-19 is blatantly wrong. And telling me that I'm gonna end up in the ICU for believing as much is blatantly stupid.

You can make your point without relying on wrongness and stupidity. It detracts from your otherwise cogent arguments.
  #232  
Old 03-22-2020, 07:53 AM
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First of all, it should be understood that all of the guidelines about washing hands, keeping a 6 foot/2 meter distance, avoiding gatherings of more than an arbitrary number of people, et cetera, are just general guidance based upon prior experience with public health measures and will in no way guarantee to improve your odds of not being infected. In fact, there are no really good estimates of the behavior and transmissibility of the virus because of the significant delay in some patients between being exposed to SARS-CoV-2 (the coronavirus) and the onset of COVID-19 (the medical nomenclature for the disease that some people suffer). The media and general public continue to conflate the two but in fact there appear to be a substantial number of people who have tested positively for antibodies to the SARS-CoV-2 virus (indicating that they have had a significant viral load) but have exhibited no signs or symptoms of COVID-19. Given how limited testing has been and continues to be, and that it has been restricted to people either exhibiting signs and symptoms or have been in the immediate proximity of COVID-19 sufferers, there is a strong possibility of asymptomatic transmission, and that the incidence in the population of anyone in or near a major population center could be far greater than suggested by public health numbers. It also seems apparent that the virus can be transmitted by aerosol vector as the original SARS-CoV virus responsible for the 2003 Hong Kong outbreak.

Second, while you may not be concerned about the consequences of being exposed to SARS-CoV-2 or contracting the COVID-19 illness, and the people you gather with may be equally indifferent, the reality is that by engaging in unnecessary social contact you may transmit or receive the virus and then transmit it to other people by incidental contact. Even though it is likely that you will eventually come into contact with the virus, the fewer paths it has to spread, the lower overall rate of effective spread (as measured by the R-0 value you have been hearing the talking heads yammering on about in the past few days). Even reducing transmission rates by a factor of two will have a significant impact upon the overall rate of infection which gives more time for people who may have severe reactions to the virus to be distributed in time and thus not overloading our increasingly fragile critical health care systems and underequipped facilities and requiring critical patient triage as has been seen in China, Iran, and Italy. Even shifting the average rate of infection by a week or two across a significant amount of the population allows freeing up beds and respirators for patients in critical need and reducing the case fatality rate due to an avoidable lack of respiration support or other care measures.

Third, you should be concerned about contracting the illness right now because while you may not be in a high risk demographic, it is simply not possible to be assured that some aspect of the viral interaction does not provoke a strong response in you. Respiratory infections can progress from benign to lift-threatening in a matter of hours depending on cofactors, including the presence of previously weakly pathogenic bacteria. There is also the reality that coronaviruses as a class are particularly prone to mutation, and there have in fact been reports of researchers in China reporting evidence of mutation. Since the CDC only started growing the virus in their labs in early February (and it is unclear to the extent they have been able to cultivate multiple samples) the variability that this novel coronavirus, which is previously uncharacterized and strongly suspected to be recently zoonotic (transferred from animal host to human, and therefore has not evolved to co-exist in a human host without reaction as thousands of existing viruses do in every person) is unknown, as is the effectiveness of antibodies developed against one strain in fighting off another. In other words it is possible that you could be infected and develop a resistance to one strain of SARS-CoV-2 only to be infected with a different strain for which you have little or no inherent resistance, as it is with the various families of enteroviruses, coronaviruses, adenoviruses, parainfluenza viruses, and other viruses that cause seasonal colds, or the families of influenza A and B viruses that cause 'the flu'.

And again, the goal of social distancing and isolation is to slow the spread of these viruses. This has a critical effect in addition to blunting the peak rates of COVID-19 illness; it also allows the virus to adapt to be more benign within the population, as well as developing better care measures and (maybe) an effective vaccine. As more virulent strains burn out, more benign strains may become predominate and offer at least some protection to build up immunity even if someone is exposed to a more virulent strain. By participating in the recommended public hygiene and social distancing measures you are helping to blunt the rate of infection giving people with a potentially higher likelihood of contracting a severe case of COVID-19 a better chance, even if in just the aggregate. Or, you can ignore these guidelines and contribute to a situation like that in Italy, where people are dying while waiting just to get into a hospital, or Iran, where satellite images show the excavation of mass grave sites. But realize that by doing this, you are putting people like ThelmaLou at greater risk. The impact may be lost in the aggregation, but the effects are very real and personal to people at high risk for contracting the disease.

By the way, everyone should be absolutely outraged about the public health response to this pandemic and going right up to the top. It is certain that the unwillingness of the Chinese to share information about the extent of the outbreak and their inability to control it has had significant effects on allowing the disease to get a foothold outside of Wuhan (and I'm not convinced that their most recent response to reopen businesses and schools will not result in a mass flareup) but the United States, Japan, and Europe had plenty of warning to at least start a public health informational campaign. In retrospect, completely containing the virus was probably never possible given the long latency period and likelihood of asymptomatic and aerosol transmission, but starting an education campaign about the need for social distancing back in January, giving lead time for businesses and institutions to make plans for remote work and interaction, and otherwise educating and indoctrinating the public in the need for public hygiene measures could have gone a long way toward limiting the rate of spread, and could have been done in a way to minimize public panic. Instead–and in the interests of not making this political I won't name any names, but I think everyone is aware of the biggest and absolute best perpetrators–certain leading figures have spoken to the public in manner and word dismissive of the potential hazard, spreading factually untrue information about how the virus may be spread, and seemingly intentionally undermining the efforts of public health officials to inform the public. This is absolutely criminal negligence of the most absurd kind.

This is not some unexpected threat that came out of nowhere to blindside officials; epidemiologists have been warning about this very type of pandemic for decades as the degree and rate of zoonosis has been better understood. A major motion picture starring all those pretty people you see at the Oscars every year was made by Steven Soderbergh back in 2011 which presented this threat in a very realistic fashion, and popular science books from Richard Preston's The Hot Zone to David Quammen's Spillover have warned about the potential for unconfined zoonotic viruses to emerge into pandemic status in a world in which an infected patient can travel from Singapore to Amsterdam (or Sri Lanka to San Francisco) in a matter of hours with no controls, no truly global medical information network, and health systems that are fragile to these kinds of major health epidemics. There should have been existing plans in place for dealing with a public epidemic which are shared with educations institutions, businesses, and other impacted parties instead of the mad panic of post-equine-barn-door-closing 'directives' which sequentially contradict each other or will have little-to-no effect, and in the case of travel bans and trade restrictions may have a negative effect on the ability of the epidemiological community to effectively communicate. By the point that your pandemic has reached New Zealand there is exactly no point in a blanket travel ban or shutting borders down except to be seen doing something, anything, just make it look like we're not as clueless as the bureaucrats in that Scottish zombie movie with Discount Kate Beckinsale.

As for the o.p., you are presumably an adult and will do as you please, but consider that your actions do have consequences even if they are not personally apparent to you. The guidelines for social distancing aren't crafted just to ensure that you do not get to have a good time; they are the best if belated measures that you can personally take to help retard the spread of an infectious pathogen you can neither see nor restrain. You may not get a medal or public adoration for making a few sacrifices now in your social life, but the decisions that you make in this regard and at this time matter, even if they don't seem meaningful to you.

Stranger
I think I'll go look in the mirror - and hold up Stranger's avatar in front of my face.

A truly awesome post, Stranger.
  #233  
Old 03-22-2020, 07:59 AM
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Telling all of us that we're gonna die if we contract COVID-19 is blatantly wrong. And telling me that I'm gonna end up in the ICU for believing as much is blatantly stupid.

You can make your point without relying on wrongness and stupidity. It detracts from your otherwise cogent arguments.
Okay, you MAY die.

Is that better? Does that make you sleep easier at night?

We are waaaay too relaxed about this contagion, and I'm seeing a lot of feel-good bullshit on TV, which unfortunately is being reinforced by the highest levels of government.

Hand washing is good, but there's hardly any emphasis at all on how the virus is most likely to infect people, and the fact is, the data show, that you are much more likely to get it through respiratory droplets than by touching a doorknob and rubbing your eyes. As I said, you absolutely should wash your hands, but my point is that people aren't social distancing nearly enough because the wrong kind of information - or maybe not enough of the right kind of information - is getting out.

People are hearing "social distancing" and stay 3-6 feet apart. But unless they really hear more information about the actual mode of transmission, this will mean nothing to them. The virus is airborne through millions of droplets that you cannot see, droplets that will circulate up, down, sideways, and all around, riding air currents for seconds, minutes, or hours. If you come into contact with those droplets, you're in trouble.
  #234  
Old 03-22-2020, 08:23 AM
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...
People are hearing "social distancing" and stay 3-6 feet apart. But unless they really hear more information about the actual mode of transmission, this will mean nothing to them. The virus is airborne through millions of droplets that you cannot see, droplets that will circulate up, down, sideways, and all around, riding air currents for seconds, minutes, or hours. If you come into contact with those droplets, you're in trouble.
Here are some qualifications on that:
Quote:
...
"The current scientific consensus is that most transmission via respiratory secretions happens in the form of large respiratory droplets ... rather than small aerosols," he said. "Droplets, fortunately, are heavy enough that they don't travel very far" and instead fall from the air after traveling only a few feet.

Aerosols, by contrast, can potentially travel across far greater distances; the virus that causes chickenpox, for example, can travel tens of yards from an infected person and incite secondary infections elsewhere in the environment, and can remain in an area even after the person who emitted them has left.
....
Source
Not meant to make people complacent, so read the entire article to be as well-informed as possible right now. This has NOT been thoroughly studied yet-- too new, but it looks like this virus does not travel far or spread through a whole room and hang there for days.

Another cite:
Quote:
...And, finally, the good news. While Covid-19 spreads through the air on respiratory droplets, there is one fact limiting how far the virus can travel: its weight. Coronaviruses are physically larger and heavier than other known respiratory viruses. So while Covid-19 infects hosts via mucus droplets, its infectious range is lower relative to other viruses because its mass limits how far it can travel before succumbing to gravity. Case in point, coronaviruses can only travel about one to two meters, less than seven feet, before they start falling to the ground. Compare that to much more infectious viruses like measles or chickenpox, both of which are much lighter and able to remain airborne on tiny dust particles.
Source
IOW you probably don't need to worry about breathing the air in a room half an hour after a COVID-infected person has left. The SURFACES-- yes, those might still have the virus on them. Hand-washing! No face-touching!

It's better to take more precautions than you think necessary until we (as a population) know more. But still keep our wits about us as much as possible.
  #235  
Old 03-22-2020, 08:29 AM
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Okay, you MAY die.

Is that better? Does that make you sleep easier at night?

We are waaaay too relaxed about this contagion, and I'm seeing a lot of feel-good bullshit on TV, which unfortunately is being reinforced by the highest levels of government.
Bro, just because I'm not screaming on the internets "WE'RE ALL GONNA DIE!!!!" doesn't mean I'm relaxed about this. I've been on edge about this thing for the past 3-4 weeks. I've been fighting feel-good bullshit on the SDMB for that entire duration. But that doesn't mean I'm going to let unnecessarily doom-and-gloom shit slide either. Yes, we are truly fucked right now, and a lot of people will end up in the ICU and die. But a lot of the ones who do will be folks who followed the CDC recommendations as best as they could.

You are setting up the groundwork for blaming people for their own victimization. If I get sick and end up in the ICU, it won't be my fault because I haven't broken any of the "rules" or best practices. If I do get sick, it certainly won't be because I disagreed with a faceless entity on the internet.

I'm not gonna tell you to calm the fuck down because I hate when people say that to me. But like I said, you don't have to give incorrect information to make your point. It detracts away from what you're saying when you do this.
  #236  
Old 03-22-2020, 09:44 AM
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Here are some qualifications on that:
Not meant to make people complacent, so read the entire article to be as well-informed as possible right now. This has NOT been thoroughly studied yet-- too new, but it looks like this virus does not travel far or spread through a whole room and hang there for days.
The virus doesn't hang in the air for days, but it can hang in the air for minutes and hours. If you're in a very large, spacious, well-ventilated room with one or two other people, the risk of infection is low.

But let's consider a more realistic scenario: "small" gatherings of people over for a small dinner or cocktail gathering, or maybe three or four people riding in an apartment complex elevator or in a community laundry room. Nobody's showing visible signs of infection. One of the people standing close by is infected - not showing visible signs of infection but breathing through the mouth or talking. The longer you're even within 3-6 feet of that person, the more likely you are to get infected. You can get infected by breathing in the air of an infected jogger who exhales as you inhale while passing you on the sidewalk.

Obviously the greatest risk is to healthcare workers in a healthcare setting because they're working in an enclosed environment and working with equipment that COVID-19 more easily aerosolized, but it's wrong to assume that it requires a cough or a sneeze to infect. That's a potentially fatal assumption to make.
  #237  
Old 03-23-2020, 01:45 PM
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It is true that some research has shown that this virus can be truly airborne -- not just spread via large droplets from a cough or sneeze, and can hang in the air for hours as an aerosol. So, no, hand washing and staying 6 feet away won't necessarily cover it. That is a big part, I think, of why the shelter in place orders have been happening. It isn't enough to just do those things. You also have to stay out of space that others have recently occupied. There is other evidence though, to suggest that it is not primarily being spread by aerosols -- it doesn't probably become highly aerosolized that easily.

https://www.npr.org/2020/03/13/81530...ir-on-surfaces
https://www.statnews.com/2020/03/16/...t-mean-doomed/

No one should be getting blamed for catching it unless they actively set out to do so, in my opinion. There is misinformation coming from the President and entire "news" networks -- even the CDC in some limited instances*. In addition, people are generally terrible at understanding risk, lots of people don't understand the details of this risk, and lots of people still have to worry about who's watching their kids and how they are going to get enough food to eat, so they don't have time or mental bandwidth to read up on the latest research. People will get it who took all reasonable precautions, and people will get it who did not follow recommendations,. And some who don't follow recommendations won't get it. This is a time for thinking and acting collectively, not individually. I'm being as cautious as I reasonably can, because I'm able to, and that helps the people who can't.

* There's already a thread discussing the "masks don't work" line, and now the CDC has told healthcare workers who are running out of proper masks that they should use bandanas or other cloth masks "as a last resort." But those could literally do more harm than good. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420971/

Last edited by eschrodinger; 03-23-2020 at 01:48 PM.
  #238  
Old 03-23-2020, 02:25 PM
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There's already a thread discussing the "masks don't work" line, and now the CDC has told healthcare workers who are running out of proper masks that they should use bandanas or other cloth masks "as a last resort." But those could literally do more harm than good. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420971/
I can't sew, but I can hot glue. You think nurses and doctors will take hot glued masks?

I want to do something to help this horrible situation.

Last edited by monstro; 03-23-2020 at 02:26 PM.
  #239  
Old 03-23-2020, 06:49 PM
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I can't sew, but I can hot glue. You think nurses and doctors will take hot glued masks?
They likely will pass them on to visitors, not use them themselves.

Quote:
I want to do something to help this horrible situation.
Put kitteh to work.

Relief agencies need donations of money and blood. Food delivery drivers are needed. See this Marketwatch piece 6 ways to help others during the coronavirus outbreak — ‘Everyone is a responder in this crisis’
Quote:
How to help others during the coronavirus pandemic.

First, wash your hands properly and practice social distancing. then:
  • Get medical supplies shipped to where they're needed most.
  • Volunteer with Meals on Wheels.
  • Donate money to reputable nonprofits.
  • Support your local food bank.
  • Give blood.
  • Help people experiencing homelessness.
  #240  
Old 03-23-2020, 07:30 PM
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The situation in the US is shaping up to be far worse than Italy.
I hope not.

There will be days when the U.S. caseload is growing greater than any other country, and days when it isn't.

Also, different places in Italy, and in the U.S. will have different experiences.

Now, if we are lucky, American health care leaders have learned from the Northern Italy situation what not to do. I'm not totally confident this is happening.

One lesson is to designate health care facilities as either for infectious and non-infectious cases, to reduce sick people in the hospital, for something else, from catching it. In 1918-19, at least that was done. Has anyone heard of it yet in the U.S.?

I have heard of an infectious hospital wing. I'm not sure if that is isolation enough.

Also, there need to be infectious and non-infectious ambulances. Is that being done?

Re social distancing, I feel my family is doing it. Seeing the grandkids on screens only
  #241  
Old 03-23-2020, 07:57 PM
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I just talked to my parents. On one hand, I do think they are taking this seriously. But on another, I still don't think they are taking it seriously enough. My mother just came back from shopping. I demanded to know what the hell she'd been shopping for.

Toilet paper.

I asked my mother if they were out of toilet paper. No, they have enough. But she wants to get some more since everyone is hoarding it. And of course, none of the stores has any.

She's been to driving around to multiple places today, looking for got-damn toilet paper and god-knows-what else she doesn't need!!!

I yelled at her. I started to cry. She laughed like she always does when her kids are in pain (she can't help it), and I yelled at her again to let her know I'm fucking serious. She grew quiet and eventually promised she'd be more careful. I told her that all she has to do is tell me what she wants and I will order it online for her. She poo-pooed that idea ("You don't know what brands I like!!") but I insisted. Thing is, I have never ordered groceries online. I don't even know if that's an option in her area. But I'm going to figure out something. Apparently it is too hard for her to write up a fucking shopping list and buy enough groceries to last a week. No, she's still think it's perfectly fine to go to the store (or multiple stores) whenever she gets a wild hare to go shopping. Which is every freakin' day.

People like my mother need a shelter-in-place order. When left to their own devices, they will revert to deeply engrained habits and bullshit rationalizations ("I'm going to wash my hands when I get home! I'm safe!")
  #242  
Old 03-23-2020, 08:51 PM
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I just talked to my parents. On one hand, I do think they are taking this seriously. But on another, I still don't think they are taking it seriously enough. My mother just came back from shopping. I demanded to know what the hell she'd been shopping for.

Toilet paper.

I asked my mother if they were out of toilet paper. No, they have enough. But she wants to get some more since everyone is hoarding it. And of course, none of the stores has any.

She's been to driving around to multiple places today, looking for got-damn toilet paper and god-knows-what else she doesn't need!!!

I yelled at her. I started to cry. She laughed like she always does when her kids are in pain (she can't help it), and I yelled at her again to let her know I'm fucking serious. She grew quiet and eventually promised she'd be more careful. I told her that all she has to do is tell me what she wants and I will order it online for her. She poo-pooed that idea ("You don't know what brands I like!!") but I insisted. Thing is, I have never ordered groceries online. I don't even know if that's an option in her area. But I'm going to figure out something. Apparently it is too hard for her to write up a fucking shopping list and buy enough groceries to last a week. No, she's still think it's perfectly fine to go to the store (or multiple stores) whenever she gets a wild hare to go shopping. Which is every freakin' day.

People like my mother need a shelter-in-place order. When left to their own devices, they will revert to deeply engrained habits and bullshit rationalizations ("I'm going to wash my hands when I get home! I'm safe!")
I wish your mother were a rare case. She's not. I don't know why people don't get this. It reminds me of the time I was in the pre-surgical unit at a California hospital. They settled a new patient into the next bed. "And you've had nothing to eat or drink since midnight, right?" they asked.

"Nothing," she said firmly. "Only a few bites of a breakfast burrito." They had to cancel her surgery.

I don't get it. I don't know what we have to do so THEY get it. Sorry you're having such a hard time with your mom.
  #243  
Old 03-23-2020, 09:09 PM
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I can't sew, but I can hot glue. You think nurses and doctors will take hot glued masks?

I want to do something to help this horrible situation.
Did you read the link? The study indicates that cloth masks may increase the chance of infection.

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They likely will pass them on to visitors, not use them themselves.
No really, the CDC told healthcare workers to use them as a last resort. There are some drives happening. Some may be with appropriate materials. Some are not, and it is unclear what the plans for those masks are.
  #244  
Old 03-23-2020, 09:27 PM
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To be fair, nelliebly, I have to remind myself that COVID-19 has altered my life a lot more than it has my parents, who are retired. I've been telecommuting for the past week--something I would have never imagined I'd ever do just a few weeks ago. All the public meetings I had scheduled through the next two months have been canceled. I'm thinking it will be weeks, maybe months, when I get to sit in face-to-face staff meeting again. In contrast, my parents have only had to give up their casino habit and figure out how to do Sunday School online. They also aren't news junkies like me. For the past month, I've been living and breathing COVID-19. My parents watch the news, but the news about the virus didn't really hit them until a couple of weeks ago. They don't know how high the death toll is in Italy. They don't even know how many Americans have died. So this thing is abstract to them in a way it isn't for me. And it is abstract for me.

So I can't really blame them for not really getting it. I know they are trying their best with what they do know. So I'm going to try to be more patient with them.
  #245  
Old 03-23-2020, 09:28 PM
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Did you read the link? The study indicates that cloth masks may increase the chance of infection.
Do you not know what hot glue is? Hint: It has nothing to do with cloth.
  #246  
Old 03-23-2020, 11:08 PM
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Excellent OP. I am not sure either. We have a night planned with friends this Saturday for dinner at someone's home - there will be 8 people. It was planned a long time ago. I don't wont to go, my wife definitely wants to go, and it is important to her. Not sure what to do. I also work in an office of 4 people, and don't know if there is any real benefit to working from home. We are all washing our hands, have plenty of space, and are wiping down surfaces, not coming in if sick.
And what are your friends and co-workers doing when you're not around. How many little get-togethers are they attending?
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  #247  
Old 03-23-2020, 11:30 PM
Tastes of Chocolate is offline
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Join Date: Aug 2003
Location: slightly north of center
Posts: 4,777
I'm beyond frustrated with companies responses. I work with several dozen vendors, and all but one of them has convinced themselves that they are essential and so are ok to ignore shelter in place orders. Look, I know you have bills and employees to pay. I know that closing things down for weeks if not months will cause lots of problems, up to causing your business to fail. But no, Company that Sells a Variety of Screw and Bolts, you are not essential. Wisconsin's shelter in place order should apply to you. And no, Company that makes specialty fittings, you are also no essential, and the California bay area orders apply to you too. Thank you for sending me letters explaining how you are all concerned for the well being of your employees, and you will be washing hard surfaces 3 times a day.

Gah... Keeping your offices and warehouses and manufacturing plants full of employees is going to spread this disease, and if you are lucky, no one will have more than a case similar to the flu. I hope you are all lucky.
I'd tell all you CEOs to go give your kids a hug, but seriously, I hope you don't. They don't need to catch this from you.
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  #248  
Old 03-23-2020, 11:37 PM
Absolute is offline
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Join Date: Apr 2000
Location: In flight
Posts: 4,115
Quote:
Originally Posted by Tastes of Chocolate View Post
I'm beyond frustrated with companies responses. I work with several dozen vendors, and all but one of them has convinced themselves that they are essential and so are ok to ignore shelter in place orders. Look, I know you have bills and employees to pay. I know that closing things down for weeks if not months will cause lots of problems, up to causing your business to fail. But no, Company that Sells a Variety of Screw and Bolts, you are not essential. Wisconsin's shelter in place order should apply to you. And no, Company that makes specialty fittings, you are also no essential, and the California bay area orders apply to you too.
Are those screws and bolts used to keep the nation's trains and trucks running? What about farm equipment? Are the specialty fittings used in sewage treatment plants? What about drug manufacturing?
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  #249  
Old 03-24-2020, 12:33 AM
China Guy is offline
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Join Date: Mar 2001
Location: Pacific Northwest
Posts: 11,931
Quote:
Originally Posted by asahi View Post
I don't think you can really use China as a reference for how to control the spread of corona, considering the fact that it was the government's lies that allowed it to fester in Wuhan and eventually spread worldwide. When they say that there haven't been any new cases, you know it's probably a lie: the CCP is feeling the heat and their propaganda efforts are intended to wipe everyone's memory clear of Wuhan and to fixate on how bad their home-cooked crisis is for everyone outside of China. I don't trust a fucking thing that comes out of China.
Asahi, we get you fucking hate China and the Chinese Communist Party.

Could you puh-leese set that aside this for the time being and focus on what might actually be productive in the US of A to stop Covid-19? It's obvious from your posts that you take the threat seriously. There is plenty to learn from China, and there is plenty for the US to gain from cooperating with China in this time of global crisis versus exasperating xenophobic right wing talking points.

Honestly, I'm not trying to bust your balls. Let's be a Americans, let's be a global village, and pull together.
  #250  
Old 03-24-2020, 12:55 AM
Aspidistra is offline
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Join Date: Feb 2001
Location: Melbourne, Australia
Posts: 6,160
Are China saying that they haven't been having any new cases at all?

Because I downloaded an official Corona-cases datafile from the ECDC and that says infection is still puttering along at a low rate like the other successfully-suppressing Asian countries - a hundred or so a day at the moment, so a little bit up from earlier this month. Well-controlled, but not gone.
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