We should end the general lock-downs. Now

The Quarantine Zone
81

(CONT)

I hate to go on about this, but our lives here have essentially gotten back to normal now. I went out for coffee yesterday with a friend and we hugged. I queued in a line and we didn’t keep a metre apart. I bought a pie from a bakery and I used a tong to get it from the pie warmer myself.

We locked down with a plan for about two months. We all played our part. All I had to do was sit on my damn ass. America won’t be able to stamp out Covid-19 like we have here. But you can certainly do a hell of a lot better than what you’ve done now. And it starts with doing the work.

82

What are you, some kind of communist? Like Rush has been saying for decades, government is the problem, government is evil, and Americans don’t need it. That great patriot Mitch McConnell has already assured us that no more money will be given to the states. Anyway, why should the president do anything for those ungrateful blue states? It’s not like they’re gonna vote for him.

Seriously, as a non-American, do you really understand the political philosophy in play here, and how much raw power it holds in state and federal government, all voted in enthusiastically by literal millions of people for decades on end?

83

…yep. My point stands. You are asking a different question to the one I was answering.

84

It’s a confusing message, which is just as bad. If you want us to find nuance, avoid saying “We should end the general lock-downs. Now.” Yes, if you read the entire post, you can see that he’s saying open it all up, unless you’re old or have preexisting conditions – in which we, the more fortunate ones will go out and earn a livelihood and not worry about coronavirus, and just leave your sorry asses behind. Or, as Broomstick said, we’ll force you to risk your future health or even your life even if you’re afraid. Sucks for y’all, I guess.

Everyone talks about how we can’t keep shutting down - fine, then think of a fucking solution then. But since nobody is, don’t tell us to accept that we have to get sick and that this is just going to have to run its course.

It’s this mixed messaging and misinformation that is making what could be a situation we could manage into something that is threatening to explode out of control, and posts like the OP (and frankly yours, DSeid) are not helping.

Here again – another post that appears to minimize the severity of the situation. Yet you yourself acknowledge that the per capita hospitalization rates will likely change, considering how there’s a lag between new cases and new hospitalizations. So why even point that out, DSeid? What’s your point in doing this?

85

Not picking on you as such, but you said something very key in the snippet I quoted.

Lots of people (and agencies) seem to assume COVID has a “course” to “run”. We just brace ourselves, hunker down, prepare to accept some number of casualties and it will simply all go away some day. Helped along by medical research, vast clinical effort, and huge amounts of money.

As far as I (a well-read non-expert) can tell, there is little evidence for that future.

It looks to me like COVID will be with us for years, if not millenia. It looks like vaccines will be marginally effective and only for short periods, a la flu vaccines. It looks like individuals’ own post-infection immunity will be of short duration (weeks, not a lifetime), a la the common cold. So herd immunity will be a weak, fluid, and fleeting local thing, not a planetary scale outcome.

That means there will always be reservoirs of disease in the US and certainly in the poorest least “civilized” parts of the world. between the reservoirs, the incubation period, and the asymptomatic transmission, we have the makings of a long term major planet-scale problem.

The treatment regimes are much better today than they were in e.g. February when the medics were groping into the dark based on analogy to other diseases and intuition. The regimes will continue to improve marginally as enough good quality, high headcount, unhurried research begins to emerge.

ISTM we have a societal choice to make and we’ll be making it over teh next 12-18 months. We can choose “freedom”, no masks, the NFL, and 500K dying every year, or we can choose to live as if we’re in a giant petri dish, wear masks, avoid crowds, minimize exposure of the most vulnerable, and kill 100K year.

I choose the 100K option. It’s not a good choice. But it’s the least bad choice.

Blithely assuming a magic wand will appear and save the other 400K is foolish.

86

It also includes the provision that everyone wears a mask. To me, that’s looking about as reasonable as “we don’t need to provide BC if everyone will just agree not to fuck”. It’s not happening. The OP is acting like the roadblock to his plan is that people are unwilling to re-open, and handwaving away the way all these other people won’t wear masks.

In Texas, it felt like all the rules and things they put in to make reopening “safe” were empty promises. EVERYONE knew they were toothless guidelines, given with a wink and a nod. Everyone knew they HAD to be flouted if businesses were to be able to make enough revenue to cover costs. But they sounded reasonable, and made it look like the people objecting were just wusses. Stupid haircut lady having her ass kissed by senator and governor sealed the narrative.

And here we are, breaking records every day, 12% positivity rate even as we test more, and Houston hospitals officially over capacity.

So I am cynical about “reasonable” plans.

87

Serious question: are the treatments THAT much better? I know, for example, there’s not a rush to put people on ventilators like there was at the beginning. But are there other current treatment regimens that are “much better”?

88

I don’t necessarily disagree; however, there are measures we can take - that some nations are taking - that can buy people time. Even if we don’t have a vaccine, we can buy time for drug cocktails. We can buy time for more effective treatment. Time gives us a chance to reduce the degree of danger associated with this disease.

This is a good summation, but I’d add that we might be able to sacrifice a little bit of short-term economic output and perhaps invest more in responding to the current situation, plus all of the things you mention above, and possibly lower the fatality rate over time.

To some extent, we’re already too late. Our lack of preparedness and investment in public health and a viable healthcare system is already on display. What concerns me most is that we still can’t agree on a response. We’re politically divided and badly misinformed on how to move forward.

Our ability to get this response right will have profound consequences beyond the question or whether we have 100K or 500K deaths per year. Failure to respond adequately will lead to more economic inequality and more political instability. We will look back at this moment a key turning point in America’s status as a unified and strong political entity, not unlike the destabilizing events that took place in the late Roman Republic.

89

IANA medic. But between not prematurely ventilating, not high pressure ventilating, transitioning from immune system support in the early stages to immune system suppression in the later stages, and simply earlier diagnosis as a result of better citizen awareness and more / better testing, the gross dead / infected ratio is better than it was.

Digging up specific numbers is hard, but the professional press I’ve been following tells a general tale of improvement. Start your own voyage of discovery here: Novel Coronavirus (COVID-19) News & Resources | Medscape

As I said though, absent some SARS-CoV-2 specific anti-viral, we’ve squeezed most of that low-hanging fruit out of the early uninformed treatment procedures.

IOW, I’d much rather catch COVID this week than back in February. But as between this week and 6 months from now I predict there wouldn’t be much difference in my treatment plan or my outcome.

Understanding also that some of that improvement is the result of getting out of crisis mode in the most overwhelmed hospitals / ICUs. Which progress can be rapidly undone, at least locally, if enough yahoos refuse to take COVID seriously. As I predict we are about to see graphically demonstrated in several states.

90

We’re long past the point where we could bargain for 80% normalcy by everyone wearing masks, acting normally, and putting Grandma in bubble wrap.

In the US, part of it is just the bad luck of having New York City being ground zero early in the pandemic. There was huge media saturation because New York was so much in the public eye, and then they got it under control. The rest of the country shrugged and said “that wasn’t so bad. Nothing happened to anybody I know. Obviously this was an overreaction for our state.” They’ve now dug in their heels and it will take many thousands of deaths to dislodge that attitude.

The other part of the equation is that the CDC messed up so badly in some of their initial public guidance. I still remember all the takes circulating about “actually the CDC says masks are bad” (masks are actually good) and “flatten the curve” (we should have been eradicating it while we had political capital to make quarantines stick).

Of course, in assigning blame, we can’t escape the fact that the fish rots from the head, and Trump and the Republicans have done everything in their power to persuade everyone to keep shopping and showing up to work, health be damned, because the economy needs to be turning around by November.

But still… we messed up. We all did, as a country, and it’s no longer possible to buy partial normalcy with partial behavior modification. We should accept serious sacrifices right now so the pain doesn’t last longer than it needs to.

There won’t be a vaccine next year. There are reports of people being reinfected with COVID after initial infection, which makes a coronavirus harder. AFAIK nobody has ever marketed a working vaccine for a coronavirus. Many viral diseases never got a vaccine at all. There may never be a coronavirus vaccine.

It’s time to give up on partial sequestration and “flattening the curve”. We need to be moving toward eradication through isolation and contact right now. That’s the fastest way out of this.

91

@asahi

I agree fully with your points and can’t say it any better than you did.

IIRC you live in Broward County. Or at least did when I was last active at SDMB. I live in Broward and locally we are seeing all the dysfunction you and Manda_JO discuss. Despite this being the retirement capital of the USA with so many elderly, the Public. Simply. Doesn’t. Care. Despite the fact that, locally at least, they vote reliably D not R.

As you so clearly say, decades of underinvestment in social capital of all forms is a gigantic obstacle to us becoming anything but a disease-ridden basket case for years if not decades. Having il Douche in charge is just a giant shit-cherry on top of our long term shit sundae.

92

Definitely this.

93

I’d add - wanted to add - that even though it’s already too late in many respects, it’s not too late to change, to start an awakening, to start wearing masks, to demand that we hire competent people in an administration, particularly where national emergency responses are at stake.

After 9/11, we had bipartisan agreement that something needed to change, that we needed more investment in national security. There was little disagreement that we needed something, even though we debated and still do debate the degree to which we need investment and where that investment should go.

What will be the legacy of COVID-19? Will we still have major news outlets saying that we should ignore science? Will we still debate the efficacy of masks in the face of science? Will the senate block funding or laws that invest more in terms of pandemic preparedness? Will angry second amendment activists threaten public health officials and force them to resign, likely costing hundreds of lives by virtue of that alone in every city where this occurs?

We can’t change the past, but what matters is now and going forward. If people want to throw up their hands and accept 120,000 deaths, yeah, I get that - we can’t change that. But we can change going forward, and we can start by changing our attitude. This is why I reject the OP and a lot of other posts like this.

94

Pointing out that hospitalization rates have not yet skyrocketed in those states is not minimizing. It is responding to the statements that Texas systems are already “fucking scary right now” followed by the statement that “[c]ities that have hospital systems near capacity should have imposed more draconian measures like 7-10 days ago”

Yes, if taking a step back waited until health systems were near capacity then the actions would be 7 to 10 days too late. OTOH responding to increases other metrics that can reasonably be expected to result in higher hospitalization rates in 7 to 10 days may not be too late.

Note: I completely agree that pulling back is the prudent course, and that opening freaking bars as an early step was dumb. But it is also true that the demographics of the jumps in new infections in Texas and Florida are within presumptively lower risk groups, who will get significantly ill (inclusive of needing hospital and ICU resources) at much lower rates. Those rates increasing does not invalidate the argument of the op. Those at higher risk NOT taking reasonable precautions, not even wearing masks, let alone staying “the fuck home” (as the op would suggest be the plan, along with everyone else wearing masks) does not invalidate the argument of the op either.

As to LSLGuy preference to get it this week rather than back in Feburary but not thinking that 6 months from now will make much of a difference. Well there MAY be some major treatment improvements by then. But OTOH six months from now hospitals and ICU bed capacity will be stressed dealing with influenza cases. Better treatment options and protocols won’t help if there is no room at the inn for those with either disease.

95

But what we got was security theater and a couple of generational wars.

I know you didn’t mean it this way, but your example makes me more pessimistic about our ability to overcome this virus.

96

Rapper Scarface is on dialysis after suffering from COVID-19 complications

Broadway actor on temporary pacemaker after having leg amputed due to COVID complications

97

Excellent point. When I said “6 months” I was thinking the rhetorical medium term future. I totally overlooked where that falls in the annual seasonality of infectious disease.

Funny enough, during the time the US was as closed as it got and everyone around me was taking this stuff real seriously I commented to all and sundry that IF we can keep this level of public disease awareness up, and IF we can persuade people to not go to work sick, THEN next winter’s cold / flu season might be a non-event even if everything is opened back up.

IOW we could learn that losing 30-80K Americans every year to flu was mostly optional, not inevitable; all we need to do is take not being infectious in public seriously.

Sadly now 3 months later it seems more likely that the upcoming winter will have uncontrolled flu and uncontrolled COVID both rather than neither.

As k9bfriender almost said to asahi just above: “We have met the enemy and he is us.”

98

That is likely true, but the fact remains that we’re dealing with a disease that is: 1) highly contagious, 2) deadly, 3) capable of causing long-term deterioration of health. And before you say, “Yeah, but the flu,” it’s increasingly clear that this is a disease that is remarkably different than the flu in many regards, so it’s not in any way a valid comparison.

But there’s an even bigger problem, which is that young people inevitably come into contact with older people. Those with lower risk inevitably come into contact with those who have a higher risk, and many times, this happens even when people in the higher risk groups are doing all or most of the things that we’re telling them to do. What happened in Sweden is not some fluke - that’s what happens in a contagion, DSeid. This has been pointed out to you numerous times, I believe. And the reason it happens is because people are getting mixed messages.

99

FMLA has generally been unpaid leave, but it’s now FMLEA, and it includes PAID leave for many Covid-19 related reasons. One of the biggest is for parents who have to take time off to care for kids whose schools were closed. There are also provisions related to having to self-isolate. Basically, no one should wave off using FMLEA based on an understanding of how FMLA has worked. If you need to take leave, you need to look into it. And if an employer is balking at letting you work from home, pointing out that they could instead be paying for your leave time might cause some loosening up.

As far as the OP, it’s hard to say what exactly we should be doing now, because there is no one coherent plan or policy. I can understand impatience to reopen, because the economy is being harmed but there’s no clear explanation of how it fits into a plan to reopen later. Not much has changed, so there’s little reason to reopen now rather than later, but there’s also no established plan with targets to hit for reopening, and explanations about why it will make sense to reopen under those conditions, but not now. If the stay home time had been used to set up the conditions for reopening, it would make sense to be reopening. On the other hand, because there is no coherent plan, and little chance of one appearing and being executed before, say, next January, people are realizing that there may be no economy left to reopen.

I’m not for reopening without a plan, but I’m also not for staying closed without a plan.

100

It looks to me like COVID will be with us for years, if not millenia. It looks like vaccines will be marginally effective and only for short periods, a la flu vaccines. It looks like individuals’ own post-infection immunity will be of short duration (weeks, not a lifetime), a la the common cold.

First of all, so far there doesn’t seem to be much evidence for either of these claims. If immunity only lasted for weeks, we would be already seeing significant numbers of people get it twice, which isn’t happening. (Yes, I know there have been reports of reinfection, but most, possibly all, of them seem to be “people testing positive for an extended period of time” rather than “people actually getting sick twice.”) And there are several promising vaccine candidates, one of which may be ready as soon as this fall. Most public health authorities seem cautiously optimistic, which pretty much translates to “very optimistic” since these are people who are normally very cautious about everything.

But in any case, if true, this doesn’t seem to me to be a good argument for living as if we’re in a giant petri dish indefinitely. Indeed, I’d say it’s the opposite – extended shutdowns and social distancing are considered reasonable options because and only because there’s a plausible end in sight in the near term. If we’re working on the assumption that there won’t be, the costs of living like this pretty quickly start to outweigh the anticipated benefits.