I was definitely playing fast and loose there and that’s a fair cop. We don’t really know what the chance will be, and we also have different appetites for risk. So, some people will be more willing to go out than others.
Presumably in a month or two we’ll have better information in the form of serological tests and some examples of places that opened up on May 1 and either did or didn’t have a wave of deaths follow.
I’m still going to say that I’ll think we’re ready to “open up” when I don’t have to pay a scalper for basic cleaning and hygiene products.
Gotta agree. One would imagine that after a month the supply chain would have caught up but instead whatever gets to the shelves is still swiftly cleaned out. Meaning a large part of the population is still panic-buying.
However, I think CarnalK’s later comment may have a different angle to it as well. It may well be that once a reopening seems to be under way, a lot of the Freaked-Out-American community will react by finally stopping their attempt to hoard all the supplies for all time, so the shelves can be restocked at some rational pace.
But the problem there is that some of those same people in turn will be the ones who will want to believe we can go back to the full normal of NOT taking precautions at all, FAST. My fear is that wherever some state goes into Phase One and then fails to go on to Phase Two on the 15th day because all the criteria aren’t met, those people will be marching in the streets demanding Normality Now, No Turning Back!
As to whether extensive testing is feasible, well, we definitely need far more than is being done. There is then another concern of mine – that the pressure to reopen and renormalize (even if at a “new normal”) will lead to the Powers That Be saying, “ehhh, good enough” far short of where we need to get on testing. ***And ***that a large proportion of the population will get to the point of saying “OK so we will not run out of food and TP and I won’t have to shoot looters? Good enough! Oh, you’d be afraid to ever hug your mother again lest you be a carrier of her death? What a snowflake!”
So to put a range on it - IF the numbers get to a point of documented about the same on going risk for the behavior in question as going out during influenza season would you be willing to go out?
I enjoy how you casually toss off my expertise on this issue while resorting to “it can’t be done” as the strongest argument for you position that you can be bothered to come up with. Bravo.
Nor, it should be noted, am I suggesting that we wait for a vaccine - that would be completely stupid. What we do need is a actual ability to test people so we can figure out who/what/where/when when the pandemic flares again.
If you choose to continue with the drive-by “can’t be done” type of argument than than substantive discussion, I politely suggest you bugger off.
(NB: Quote function keeps barfing on this for some reason)
Quoted from DSeid: “SuperAbe no question that we should “choose to try and mitigate the effects of the pandemic” - your confident declaration of what such requires is however meritless. Maybe instead of listening to you we should listen to what the disease tells us by its response to changes in policy in real time and to the critical data as it finally comes in?”
Meritless? Really? I’d accept “overly cautious” or even “possibly too dogmatic” from you but meritless? Is your position that any area of the US has sufficient epi and/or testing capability right now to trial any of the proposed options with any sort of reasonable safety margin? If there is I certainly haven’t heard so.
And as for “listening to the disease”, that’s pretty much all I do now, brother, now that I’m reassigned. Perhaps we hear different things, eh?
(Meritless? <sigh>)
Look! More dogmatic posting without any factual content! Amazing! And he even tosses in a derogatory aside at “Science”.
Dude, you’re getting boring. At least be more interesting in your banality.
We have a vaccine for influenza. And some antivirals that are (modestly) effective. And a long history of what to expect in most cases. None of which we have here.
Apples and water buffalo.
Yes. Meritless. A declaration without any substance behind it. Without merit.
Not “overly cautious”, that does not describe it. “Too dogmatic” maybe but dogma is often meritless declaration, so not too different.
It is in fact worse than “meritless”. It is the sort of argument that declares that anyone who questions “Plan A”, who points out why “Plan A” is unworkable and, well, stupid, is wanting to “let hundreds of thousands to millions of people die”. That is not only “meritless”, it is vile.
No “brother” you are not listening to the disease. You are listening to what you think you know about the disease rather than understanding how much is not known and being able manage uncertainty.
To claim that 1-3% of their population every week is literally the only safety valve we have is LITERALLY ignorance of major proportions.
You need to be able to prove in real time that rates in the population (of syndromic cases, of confirmed cases, of asymptomatic case, ideally of hospitalizations and ICU admissions) are staying within acceptable parameters. You make predictions on what would do that by having the data that we do not yet have to plug into the models, and you monitor rates in real time, only advancing when the disease response proves those changes were tolerated, and pulling back on the change if it goes the other way to some predetermined metric.
That is the safety valve that matters, making the change that the science as informed by the best information of the moment (which will be more than we have this moment) suggests is safe to make, and then monitoring closely before making a next move, not testing 6.6 million Americans every week. That’s not how surveillance monitoring is done. (Shit. Let’s say they get the cost down from $50 per to $10. That is still spending $3.4 trillion in the year on testing alone.)
As to apples … Yes we have a vaccine for influenza. And antivirals that do something anyway. And the result of having those things is a range of quantifiable risk each year on a weekly basis during flu season of getting influenza and dying from it, such that in a bad year, like 2017-18, some 80K die from influenza spread over a few months.
So the question remains: if the quantifiable measured consistent risk of death from COVID19 is at that same bad flu season level or below, say a death rate of 3K/week across the country, with certain behaviors like going to coffee shops or what ever it ends as allowed, would “you” (it wasn’t actually asked of “you” but sure chime in) be comfortable doing those behaviors again? Or only if 2% of the population was tested every week?
People think of tests as being a bigger shield than they are. If the disease rate is low then a great test will be falsely telling a large number they have disease. If the disease rate is high a great test will be falsely telling a large number they do not have the disease. Surveillance testing with trend monitoring of populations is vital. Testing everyone (or even 2%) gives individuals false and potentially harmful information way too often.
“It can’t be done” because you are making fantasy world benchmarks for moving forward. Adequate testing can certainly be done. And the person I was replying to, who “QFT”'d you, quite literally said that we are doomed until we get a vaccine.
I am cautiously optimistic that (based on news reports I saw yesterday) about 70-75% of the country believes that COVID-19 is a real crisis and that we need to take the scientists seriously. Perhaps this could be the middle finger moment this country needs to reject the “know nothings” that populate Fox News and Facebook.
It’s still surreal that 1/4 to 1/3 of people are so estranged from reality. If you had 25-30% of people in a movie denying a pandemic, it might be dismissed as unrealistic that people would be in so much denial.
Apart from the observable fact that 1/4 to 1/3 of people ARE estranged from reality (going by the metric of ‘views on the current President’), there is also the factor introduced by certain features of this particular virus. Namely: the very long incubation period, and the wide variation in reactions to infection.
If we were dealing with classic Ebola–in which you know fairly quickly if you’ve got it, and if you get it you are highly likely to die–then we’d see less pandemic-denialism. Because you can’t argue with a corpse lying in its own expelled fluids. Death that is vivid and certain and quick carries with it a certain credibility.
But the astro-turfed “no more lockdown” protesters, for example, may not get sick for two or three weeks after their adventure in microbial interchange. And of those who get sick, some will have only mild symptoms. In those conditions, denialism thrives.
Sure. However, I and everyone in my household old enough gets a flu vaccine every year, which makes my risk of getting the flu lower than average and the risk of someone in my family getting the flu from me much lower than my risk of someone in my family getting covid from me. And, of course, in the average year my risk of dying from the flu is semi-independent of my risk of getting it. My risk of dying of covid is highly correlated with my risk of getting it, because if I get it, probably so have a lot of other people who need to use the closest ICU to me.
I still don’t understand how people can think that this thing is about as deadly as the average flu.
South Korea is measuring a ~1% Case Fatality Rate, and they did extensive testing, even of asymptomatic people, based on contact tracing. And they’re getting hardly any new cases. For covid to have a ~0.1% actual fatality rate, you have to believe that South Korea is missing 90% of their cases… but also that those 90% of infections aren’t leading to infections in other people who go on to develop severe illness.
What’s not great? Saying “Plan A sucks. My plan is to assume we’re all ready for this rodeo now, so, here goes!”
Faith in a system is no plan at all.
As I said - perhaps we hear different things. I hear that prudence is better than cavalierly assuming that we’re suddenly prepared enough to deal with the pandemic problems that it’s time to start relaxing the societal restrictions that have - so far - “only” caused 39,014 deaths.
And it’s your opinion that, by relaxing *now *that we won’t end up with “hundreds of thousands to millions” of deaths? How does that work?
Excellent! I agree with all of this wholeheartedly! And, again I ask, where in the country are we anywhere close to being able to test, monitor, and adequately evaluate these parameters? Or even close?
In addition, are you under the misapprehension that I care a rat’s ass about the exact numbers of people we need to test in the end? If testing 0.1% of asymptomatic people gives us the data we need - great! While I don’t think that will turn out to be true, I would be thrilled to death to have that few samples to deal with. But if we fail to have the testing and monitoring and treatment infrastructure ready…there are going to be a lot of NYCs around the country.
So…you want to have a safety valve - that we don’t have ready yet - to respond to a demonstrably fast-moving pandemic…by…not monitoring? How it that suppose to work?
Also, there’s nothing about the testing strategy that says every state must test 1-3% of their population every week until a vaccine comes out - yes, that’s absurd. Nor have I said anyone has to do that.
We have to test enough asymptomatic people to get an actual handle on where cases prevalence is high in a given state/area, then drill down hard in the high case load places. **Then you have to have enough testing capacity to rapidly ramp up to thousands of tests/day when you find a new outbreak. **Otherwise you’re back to where we were at the start of this mess.
Again, with the generally aggressive social isolation we’ve done we’ve still had ~40k people die from this pandemic in…5 weeks. And your solution is to stop doing what’s been working before we have any good fall back options ready?
Ah - you’re one of the “it’s just like a bad flu season” people. The problem is the influenza comparison is the “best case scenario” (vaccine + drugs + partial immunity) while this is pretty much the opposite of that. Sadly the data doesn’t agree with you - and, I know, you’re going insist it does. That’s fine, too - it’s a popular opinion. And I really, really hope you’re right, because the way I see the data scares the crap out of me.
And when will I be going back to coffee shops and such? It’ll be a long, long time - maybe in a year.
Testing should never exist in a vacuum - that’s nearly axiomatic despite what some clin chem folks would say. And all the points in this paragraph are reasonable. But I still can’t figure out where you think the testing capacity to even adeqautely answer some of the basic questions - how many people are completely asymptomatic? who actually spreads the disease? how good is our true/false positive/negative matrix - where it is ready?
Again, I don’t care how many people we test, as long as we test enough to answer these questions and figure out how to protect people from this shitty disease. But I don’t know of any Epi/ID/Testing folks who think we’re anywhere even close to relaxing our guard without very, very Bad Things happening.
SuperAbe do have fun arguing against positions no one here is taking.
Meanwhile the actual plan released, the subject of the thread, as discussed, has some pretty strict gating criteria, inclusive of testing capacity adequate to monitor for disease response to the changes by a variety of measures, and documented fourteen day improvements in those measures. The actual plan (not what Trump yammers) is not: “Yeeha! Let’s ride!”
Since you now state you “don’t care how many people we test, as long as we test enough to answer these questions” I’ll ignore your declaration that testing 1 to 3% of the population every is “is literally the only safety valve we have until an effective vaccine is available” or else “hundreds of thousands to millions of people die”.
You are one of those who remain ignorant of how nightmarishly bad a bad influenza season event compressed into weeks instead of months would be, dismissing those numbers as “just” … and that is by this point pathetic.
Ah, the rhetorical technique in which one sidesteps all the questions posed and resorts to limpid and sad strawmen (if it was unclear: I do think it will take testing 1% or more of the population; I don’t think you have to test 1% every week for a year; I would be thrilled if we can get awaya with testing less - how are these positions unclear?)
I get it - you’re pissed that not everyone is as sanguine about the situation as you are. That’s okay.
But could you please humor me before you go and actually answer, I don’t know, any of the questions I’ve posed to you multiple times? You know, an actual discussion? On the merits rather than the vitriol?
Or, if you could even answer just one: where in the country you think we are anywhere close to having adequate testing capacity, acceptable hospital surge capacity, and effective epidemiological tracking?
Because without those things the document in question is a complete fantasy. And we’ve got enough real problems to solve right now.