[Rondec]

I do think the worst is behind us, but simply because social distancing and quarantines have worked. The problem is that you could easily have a second wave. In the hardest hit part of the country -- New York City -- slightly over 20 percent of folks tested positive for antibodies to covid. That could easily mean that there 75 percent of the population that is still susceptible. That's good enough reason to take things slow.

The rest of the country has had significantly fewer cases and surely has even more people who could catch this if it came back around.

[timb64]

Over the past few days I've been fielding an increasing number of comments from family and friends on other social media who have clearly decided that they've had enough of lockdown and are just looking for excuses to abandon it. These are not stupid people; these are intelligent, educated, thoughtful folk who can usually be relied on to support their opinions with strong reasoning and evidence. But right now they are all seemingly determined to convince themselves that Covid hasn't really been so bad and that it's okay to forget about it. After all, they say, they're all still alive, and the few people who they know personally who have been infected have all made it through. So for now their desire to return to the privileges of their normal lives has overwhelmed their capacity to think rationally about the long term.

Sadly, I've resigned myself to the thought that a second wave is inevitable. People in my part of the world are starting to vote with their feet, and by the time the death rate has climbed high enough again for them to realise what they've done, it'll be too late.

Dave I’m not one for conspiracy theories but I do wonder to what extent the UK media is being “sat on” regarding reporting public displays of dissent/unruly behaviour/looting etc in any form.

[beholder3]

After all, they say, they're all still alive, and the few people who they know personally who have been infected have all made it through.

Sadly, people are not smart enough for this type of situation. They only react once things hit them personally and flat in the face.

[sarcasm on]
I guess we should start storing land mines in kindergartens. I do not visit kindergartens often, so I personally am not at risk and lets say a thousand or so stupid kids die, we can rightfully say "the flu kills more, so what".
We should also stop having any police or military. No need at all. We are still alive.
[sarcasm off]

[nonpigliounoshoot]

For some days I have not been through the forum and I have seen that this topic has had difficult moments but that with common sense has not been closed. I thank the forum for this. In other forums there was practically no game and the topics were closed. In fact, I find it absurd that in the face of this historical event, the usefulness of exchanging information will not be understood. In Italy at the moment the situation is improving slowly. Everything is still closed and small openings have been announced from next week to reach the complete reopening only in June. In reality, the rules of production activities are still unclear, which are still too general. Timing is crucial. As the virus prevention interventions were late, no country can afford to miss the times for reopening and the modalities of lower risk (risk 0 does not exist). The problem is that the economic consequences will soon be truly devastating. Hello everybody.

[aslyfox]

an individual with impressive initials behind his name and undoubtedly more experience than I have seems to admit that unproven herd immunity cannot be counted on to save us but yet it will ?

logic it ain't

Opinion
Doug Iliff: It’s time to re-evaluate COVID-19 strategy

In the April 23 paper, we had an editorial cartoon of Pandora’s Box with a key on the floor, labeled “Reopening Soon.” And then CDC director Dr. Robert Redfield warned that a second COVID wave in the fall may be worse than the first.

Protests against the lockdown are a preview of the coming class/generational warfare we’re facing as governors struggle to find the political balance between the tragedy of job loss and fear of COVID-19. Everyone working with this mysterious new virus is missing important puzzle pieces, awaiting future research.

In general comparison to influenza, which itself varies widely from year to year, COVID is maybe twice as dangerous (death rate of 0.2% instead of 0.1%), and three times as likely to have no symptoms at all (60% to 20%). Nobody has any immunity from past infection or vaccination. Throw in the lack of testing for infection or recovery, and you can see why this pandemic is a nightmare for the health care system.

How do our yearly epidemics end? With influenza, “herd immunity” develops when 50%-60% of the population is protected by immunization, cross-immunity from past epidemics, or recovery from infection. COVID will resolve itself when we achieve herd immunity, find an effective treatment, or develop and distribute a vaccine.

The current strategy is to “flatten the curve” of infection to avoid overwhelming our ICUs, then play quarantine whack-a-mole as adequate testing allows teams of public health workers to identify cells of infection.

The Achilles heel of this approach is that herd immunity will not develop. The hope is to simply hold the line until we get a vaccine. The problem is that it took five years to develop an Ebola vaccine, and only time will tell with COVID.

If, as emerging data seems to indicate, the true death rate for infected individuals turns out to be closer to 0.2% than 2%, and CDC statistics continue to show that 7% of deaths occur in the under-55 age group, the risk of death in that group will approximate 1.4 per 10,000.

Furthermore, since it only takes infection in 60% of the population to achieve herd immunity, that rate drops to 1 in 10,000. If we have 100,000 citizens in Shawnee County under age 55, that’s just 10 deaths.

At that point it becomes clear that the Swedish strategy, perhaps with more aggressive isolation of older, sicker, unemployed citizens, would have allowed the economy to pretty much go on as usual. And we still would have had March Madness to amuse ourselves as we practiced modest social isolation to “flatten the curve” of hospital admissions.

This hypothetical scenario, now past, makes the current “debate” about re-opening the economy look pretty silly. Just admit we made a mistake, with inadequate information and the best of intentions, isolate the high-risk population until herd immunity emerges, and let people go back to work.

Admitting honest mistakes is admirable and defensible, although difficult for politicians.

Under the present strategy, COVID will do an encore in August. Are we again going to close schools, restaurants, theaters and sports events?

As the economy opens up in the next month or two, it’s time for a discussion about our COVID strategy. There are well-respected epidemiologists who think rolling lockdowns are not the answer. In military terms, no strategy survives first contact with the enemy.

Let’s re-evaluate the battle plan.

Doug Iliff, MD, FAAFP, has been a family physician in Topeka for 34 years.

Doug Iliff: It’s time to re-evaluate COVID-19 strategy - Opinion - The Topeka Capital-Journal - Topeka, KS

**** let those who will die, die and the rest of us will survive **** seems to be his argument, at least to me

[beholder3]

**** let those who will die, die and the rest of us will survive **** seems to be his argument, at least to me

Humanity.

I assume most armchair experts would frown upon native civilizations from a thousand years ago who made human sacrifices (say 50 killed per year. maybe take the first born kids of some families) to their gods of sun, harvest, earth and weather, deep in the jungle.

Now: where exactly is (any) difference today in such thinking that it is ok to sacrifice "a couple of tens of thousands" of ("hopefully") anonymous citizens to the god of economy?

I bet the native mother of the child Maria to be sacrificed in the jungle a thousand years ago didnt like the concept either. And all the non-chosen ones were literally banging the drums during the execution. I bet they told the mother of the sacrificial child that "more people die of the leopard each year". I bet they told her that "the religion of Yadda-Yadda allows us to sacrifice children and this is the law. It is unlawful to not sacrifce the baby.". They certainly told her that much more people will commit suicide if the tribe is hit by famine. They told her that life for the tribe is so much more than just a single babies life. Maria's life. And the other 49 lives. They must balance a few lifes versus this year's crop. Bow down and cut the throats of the babies.

We are so much better.

[Serkevan]

Humanity.

I assume most armchair experts would frown upon native civilizations from a thousand years ago who made human sacrifices (say 50 killed per year. maybe take the first born kids of some families) to their gods of sun, harvest, earth and weather, deep in the jungle.

Now: where exactly is (any) difference today in such thinking that it is ok to sacrifice "a couple of tens of thousands" of ("hopefully") anonymous citizens to the god of economy?

I bet the native mother of the child Maria to be sacrificed in the jungle a thousand years ago didnt like the concept either. And all the non-chosen ones were literally banging the drums during the execution. I bet they told the mother of the sacrificial child that "more people die of the leopard each year". I bet they told her that "the religion of Yadda-Yadda allows us to sacrifice children and this is the law. It is unlawful to not sacrifce the baby.". They certainly told her that much more people will commit suicide if the tribe is hit by famine. They told her that life for the tribe is so much more than just a single babies life. Maria's life. And the other 49 lives. They must balance a few lifes versus this year's crop. Bow down and cut the throats of the babies.

We are so much better.

If Kukulkan had a majority stake in Pemex I can bet some people would have rallied to defend the sacrifices.

---------- Post added 04-29-20 at 04:42 AM ----------

an individual with impressive initials behind his name and undoubtedly more experience than I have seems to admit that unproven herd immunity cannot be counted on to save us but yet it will ?

logic it ain't



Doug Iliff: It’s time to re-evaluate COVID-19 strategy - Opinion - The Topeka Capital-Journal - Topeka, KS

**** let those who will die, die and the rest of us will survive **** seems to be his argument, at least to me

That's a compelling argument if you basically don't care about the elderly. Or for the fact that we don't even know whether herd immunity is effective: antibodies don't necessarily mean you won't catch the disease again in a month.

[Dartmoor Dave]

Dave I’m not one for conspiracy theories but I do wonder to what extent the UK media is being “sat on” regarding reporting public displays of dissent/unruly behaviour/looting etc in any form.

I think it's a fair question and it doesn't make you a conspiracy theorist at all. At some point almost every day I'm finding myself wondering what else might be going on in the world that just isn't being reported at the moment. I guess there will be quite a few times later this year that I'll find out about something that has gone on during this strange period and I'll say: "Huh? I didn't know THAT had happened!"

[Riggomatic]

I'm scheduled to return to work this coming Monday

Not at all excited about that. I have my masks, hand sanitizer, and spray bottle of isopropyl and water already to go.

A positive: it is highly automated so everyone is very spread out. I'll get to maintain my social distancing at work.

I'll setup a spot in my garage to change and disinfect before entering the house when I get home.

I'm still taking this very seriously even though I'm starting back to work.

[Dartmoor Dave]

I assume most armchair experts would frown upon native civilizations from a thousand years ago who made human sacrifices (say 50 killed per year. maybe take the first born kids of some families) to their gods of sun, harvest, earth and weather, deep in the jungle.

In the past I've occasionally joked that we Dartmoor folk still make a human sacrifice or two at those special times of the year. But I'm not joking about it now, because I'm starting to think that there might actually be a few people in my neighbourhood willing to give it a try.

[Sandy Hancock]

Australia has called itself "The Lucky Country" for generations, but I am becoming more and more convinced that (to some extent at least) we make our own luck.

I have never been happier that I live in the antipodes (yes, I include New Zealand here). Where we (more or less) trust that our government is committed to doing the right thing by its constituency. Where the population (more or less) accepts the advice of the experts and does what is recommended. Where we (more or less) are willing to sacrifice a few freedoms in the short term for the common good.

It's been a full week now since South Australia has had even a single new diagnosis of CoViD-19. There are now only 14 known active cases in the whole state, despite one of the highest testing rates in the world. We have one patient in ICU and only another three in hospital, with a statewide case fatality rate of less than 1%

I despair when I see what is happening elsewhere.

[Fogel70]

The isolation of elderly and sick seems to have failed in most places. With lots of death coming from this group, but only death from hospitals may be included in the official statistics.

People working in nursing homes may not have equipment or training for handling something like this, and rhey have not been prioritized for getting PPE and testing.

Inside UK care homes: why the system is failing its coronavirus test | Financial Times

Saw some eye opening, and sad statistics about mortality rate on Swedish covid-19 cases.

Of all the death in Sweden, 85% are in the age group of 70+.
In the 70+ age group the moratlity rate are in average 30%, at least 100x higher than in the age group of 30 and younger.

So successful protection of the elderly can make a huge difference.

[aslyfox]

I'm scheduled to return to work this coming Monday . . . I'll setup a spot in my garage to change and disinfect before entering the house when I get home. . . . .

good luck to you and yours

[photoptimist]

an individual with impressive initials behind his name and undoubtedly more experience than I have seems to admit that unproven herd immunity cannot be counted on to save us but yet it will ?

logic it ain't



Doug Iliff: It’s time to re-evaluate COVID-19 strategy - Opinion - The Topeka Capital-Journal - Topeka, KS

**** let those who will die, die and the rest of us will survive **** seems to be his argument, at least to me

The IFR (infection fatality rate) seems to be more in the range of 0.4% (German data that tested 80% of the entire population of one town) to 0.5%-0.8% (a New York study which likely under-estimates due to biased sampling). Also, now we are learning that overall death rates have surged in conjuction with COVID-19, thousands have died at home, in nursing homes, etc. and never tested for COVID-19. Thus, the fatality side of the equation is worse than Iliff thinks.

Illiff estimates only 10 people would die in Shawnee County but apparently citizens over 55 don't count as people in his book. The 130 "aged units" (as President Reagan call them) culled from the population don't matter to Iliff but probably do matter to their friends, relatives, and community.

We also don't know the true percentage required for herd immunity maybe it's 60%, maybe it's higher. In fact, we don't even know if herd immunity works with COVID-19 or how long it lasts. We do know that viruses can mutate and that the greater the total virus population, the greater the chance that some mutation happens somewhere that lets the virus reinfect all those that had it (sparking another global pandemic!).

We also do know that if the infection rate gets high enough, the death rate surges. And we do know that without social distancing, the case rate doubling time of the virus makes it easy to exceed the allowable infection rate. We only get the lower IFR values that Iliff hopes for if the hospitals have capacity. But that requires social distancing. Ergo, Iliff's low death rate projections are incompatible with Iliff's economic reopening strategy.


TL;DNR: Iliff underestimates the death rate, recommends a strategy that will increase the death rate, and pins his hopes on an unproven "herd immunity" and the virus not mutating.

[Unregistered User 8]

I'm scheduled to return to work this coming Monday

Not at all excited about that. I have my masks, hand sanitizer, and spray bottle of isopropyl and water already to go.

A positive: it is highly automated so everyone is very spread out. I'll get to maintain my social distancing at work.

I'll setup a spot in my garage to change and disinfect before entering the house when I get home.

I'm still taking this very seriously even though I'm starting back to work.

Stay safe David. The precautions you are taking, especially at home, are wise.