Roth, Zags plan for season of uncertainty

[LTownZag]

Nobody seems to recall my postings from February and March. I warned everyone here about the seriousness of this pandemic (including my medical colleague friends on this board who were making frivolous flu comparisons), and very sadly bailed myself on attending the WCC tournament because of the data.

Here's the relevant thread/discussion including Caduceus' posts from early March, there weren't any COVID-related posts from Caduceus in February. It's really interesting to see a time capsule from 3 months ago.

http://guboards.spokesmanreview.com/...CAA-tournament

Another related thread worth a time capsule revisit from 3 months ago, and I learned an excellent new word from Caduceus:
"Recrudescence"
the recurrence of an undesirable condition.
"recrudescence of the disease is a real possibility"

[Zags11]

Lets see how MLB works. Then NFL season until november. Then we will see.

[caduceus]

So never. That's when you get a vaccine for corona viruses like MERS and the common cold. Outside of curing the common cold, you never get a vaccine.

There is one plan and there has always been one plan. It spreads enough to gain some semblance of herd immunity without overloading the hospitals. You can draw it out or you can rip off the band-aid but the defense is dealing with the spread, not stopping the spread.

At the core of coming up with the solution is politics. Politics is going to creep into every offering of a solution because the solution depends on one's belief. Do you believe that the government is a benevolent force concerned with your well being or people working in their own self-interest and the interest of those in powerful positions. Wherever you are on the spectrum, it influences your opinion.

Deciding to return to normalcy has a cost. Deciding to stay shut down and infringe on liberties has a cost. It depends on what types of prices one is willing to pay.

Based on the governor's current position, it doesn't look like we'll have a 20-21 season at GU.

My friend, tinfoil, I have to completely disagree with the first half of your post, from a medical/scientific/epidemiological perspective.

First off, coronavirus comprises a small amount of "common colds." Most colds are rhinoviruses, and second are adenoviruses. Of the dangerous coronaviruses, MERS was too deadly and so there wasn't enough community spread to do a clinical trial. Similarly, SARS petered out before Oxford and others could trial their (nearly ready) vaccines. The other coronaviruses weren't worth the time since they only gave you sniffles.

Herd immunity through nCov-19 "spreading over the population," by some studies suggest 5-7 years before we reach that (without a vaccine), and recent studies suggest antibody protection may only last a matter of a few months. If so, you'll probably NEVER reach herd immunity.

Dealing with the spread (i.e. flattening the curve) is beneficial to prevent overload of the hospital system (which nearly every layperson thinks is the only reason due to the news), but there are a host of other benefits (increasing PPD availability, giving time for better treatments/vaccine, enabling more robust testing [which requires more kits and PPD], hiring contact tracers, establishing more efficient protocols based on region, establishing and training the public and businesses how to operate safely, etc.,etc.). Many other things as well, but it would require an epidemiology course to cover them all. Authorities try to keep it simple so people will hopefully comply, but if you try to explain all these reasons to the public, eyes start to glaze over.

Stopping the spread is something you add onto largely AFTER flattening the curve. Without a vaccine, it's the way you STOP. THE. VIRUS. IN. ITS. TRACKS. It's been known for every serious infectious disease, and is a tried and true public health measure. Once you punch the virus in the mouth by slowing transmission (flattening the curve), you ease restrictions gently, test expansively, isolate the positives, and find their recent contacts (contact tracing) and isolate them as well. It's highly effective when applied properly (see just about every other country that's done better than the U.S.). Some call it the Hammer and the Dance. Lockdown is the hammer. Opening up, and test, isolate and contact trace is the dance. If things get worse, you apply the hammer again. If things get better, you gently apply the dance.

The problem is is that people want the light switch approach. Off/On. There are nuances to this. You HAVE to take that into consideration, and you have to apply them regionally. The big problem is that the population won't adhere to restrictions if they're applied all at once. The CDC has known this since the 50s, so even their protocols call for gentle introduction to the public of measures that are anathema to typical everyday life. Unfortunately, people use this as an argument that they're not consistent, or that they're moving the goalposts. Add to that the changing conditions on the ground, and you end up with even bigger problems. IT'S NOT EASY!

Your second half of the post regards politics. I won't get into that as that's not for this board, and not a topic I'm interested in discussing. I advocate following the science. I understand there are societal, economic, whatever issues. But, if the science was listened to early on, we'd be over this largely and college basketball would not be having nearly the issues that they are facing. A sad truth.

We applied the hammer, and it worked. Nobody wanted to deal with the dance, and thought it was all over. Fauci is right. We're going to be dealing with this for a good long while. It all starts with TESTING.

Pray for a vaccine sooner rather than later, and enough doses to distribute it.

[MDABE80]

So where have you been Cad??? The lab? Good to see you posting again and in such clear terms.

[caduceus]

So where have you been Cad??? The lab? Good to see you posting again and in such clear terms.

Hey, partner. I'm sort of allergic to the off-season. I get too wrapped up during the on-season! I lurk (often) from Apr-Oct, just don't post unless my britches are burning. I generally avoid the recruiting stuff because it's often toxic, but it's like opening a present on Christmas Day when the season starts!

[Birddog]

Lets see how MLB works. Then NFL season until november. Then we will see.

I heard that spitting and sunflower seeds will be banned but the players will still be allowed to scratch their balls and rearrange their package.

[kitzbuel]

Lets see how MLB works. Then NFL season until november. Then we will see.

There is a top level league playing now, the German Bundesliga. They are playing behind closed doors, players are tested at least twice a week, there are tight controls on players living spaces (homes and hotels), no use of team facilities like locker rooms and showers.

The Bundesliga is being studied closely by other leagues across the world.

I think all College sports conferences would be wise to look at this model.


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[MDABE80]

Kitz love the Korean pro leagues. Look in sometime. They are very very good. They seem to get a lot out of their fastballs.90=95 mph. from such smallish frames. It's a great league.

[kitzbuel]

Kitz love the Korean pro leagues. Look in sometime. They are very very good. They seem to get a lot out of their fastballs.90=95 mph. from such smallish frames. It's a great league.

It’s a sport, it’s on TV, so I’m watching it!


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[tinfoilzag]

My friend, tinfoil, I have to completely disagree with the first half of your post, from a medical/scientific/epidemiological perspective.

First off, coronavirus comprises a small amount of "common colds." Most colds are rhinoviruses, and second are adenoviruses. Of the dangerous coronaviruses, MERS was too deadly and so there wasn't enough community spread to do a clinical trial. Similarly, SARS petered out before Oxford and others could trial their (nearly ready) vaccines. The other coronaviruses weren't worth the time since they only gave you sniffles.

Herd immunity through nCov-19 "spreading over the population," by some studies suggest 5-7 years before we reach that (without a vaccine), and recent studies suggest antibody protection may only last a matter of a few months. If so, you'll probably NEVER reach herd immunity.

Dealing with the spread (i.e. flattening the curve) is beneficial to prevent overload of the hospital system (which nearly every layperson thinks is the only reason due to the news), but there are a host of other benefits (increasing PPD availability, giving time for better treatments/vaccine, enabling more robust testing [which requires more kits and PPD], hiring contact tracers, establishing more efficient protocols based on region, establishing and training the public and businesses how to operate safely, etc.,etc.). Many other things as well, but it would require an epidemiology course to cover them all. Authorities try to keep it simple so people will hopefully comply, but if you try to explain all these reasons to the public, eyes start to glaze over.

Stopping the spread is something you add onto largely AFTER flattening the curve. Without a vaccine, it's the way you STOP. THE. VIRUS. IN. ITS. TRACKS. It's been known for every serious infectious disease, and is a tried and true public health measure. Once you punch the virus in the mouth by slowing transmission (flattening the curve), you ease restrictions gently, test expansively, isolate the positives, and find their recent contacts (contact tracing) and isolate them as well. It's highly effective when applied properly (see just about every other country that's done better than the U.S.). Some call it the Hammer and the Dance. Lockdown is the hammer. Opening up, and test, isolate and contact trace is the dance. If things get worse, you apply the hammer again. If things get better, you gently apply the dance.

The problem is is that people want the light switch approach. Off/On. There are nuances to this. You HAVE to take that into consideration, and you have to apply them regionally. The big problem is that the population won't adhere to restrictions if they're applied all at once. The CDC has known this since the 50s, so even their protocols call for gentle introduction to the public of measures that are anathema to typical everyday life. Unfortunately, people use this as an argument that they're not consistent, or that they're moving the goalposts. Add to that the changing conditions on the ground, and you end up with even bigger problems. IT'S NOT EASY!

Your second half of the post regards politics. I won't get into that as that's not for this board, and not a topic I'm interested in discussing. I advocate following the science. I understand there are societal, economic, whatever issues. But, if the science was listened to early on, we'd be over this largely and college basketball would not be having nearly the issues that they are facing. A sad truth.

We applied the hammer, and it worked. Nobody wanted to deal with the dance, and thought it was all over. Fauci is right. We're going to be dealing with this for a good long while. It all starts with TESTING.

Pray for a vaccine sooner rather than later, and enough doses to distribute it.

Everything you state is reasonable with some issues that make this situation different:

- We don't have vaccines for the Corona version of the common cold. Corona-type viruses are extremely difficult to vaccinate for. I don't think we can plan for "temporary" restrictions that last years while we wait for something that never comes. On top of that, Covid-19 also can infect several types of tissue and there seems to be a viral load component which leads to the next point....

- Covid-19 is different because it was given properties that are outside of a naturally evolving virus that jumps species. As you know, when a virus jumps species, it is very damaging to the host because the host has no defenses against something new (Novel) but it is difficult for the virus to reproduce as it hasn't evolved to shed from the new species. Covid-19 is novel AND highly contagious, so that natural controls that help control something like SARS are not present with Covid-19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996883/

- Our elected officials chose politics over safety when they didn't condemn the riots to control the spread of the disease. This has caused them to lose moral authority and now people will not comply with health orders because they see it as political struggle instead of a health struggle.

- US citizens don't deal well with being tracked and being told what to do. And when I say they don't deal well with it, I mean they won't in big enough numbers over months/years for a nationwide quarantine to succeed.

- I believe in the scientific method as well. Believing in "science" though, it starts to make it sound like science is defined and settled when it is constantly evolving with our understanding.

- The quarantine (hammer) did not work. It worked as a triage but could not be sustained. The lock down was a key factor in the riots. It created a tinderbox that just needed a spark. People's immune systems are being degraded to stress, lack of exercise, and lack of sunshine (vitamin D).

I respect your posts and think we just differ in approach. You appear to be approaching this from the standpoint that we can "cure the patient" where I see it as a quality of life as we "treat the patient" with a chronic illness. IMO This isn't about the eliminating the disease, it's about us living with the disease from my point of view.

[BurgessEraZag]

Thank you Caduecus for a measured and informing post relying on science and your obvious extensive medical and academic expertise.
As an 81-year-old retired attorney I have the advantage of "staying home", social distancing, wearing a mask when necessary and using "personal responsibility" to not take unwise risks so I am "Dancing" as you say to help prevent the spread of virus. Not all of our community's citizens, state's citizens or America's citizens have the privilege or advantages I have to help with the dance. More about that later.
I have no complaint or quibble with your analysis scientifically and I hope my post will not sound political but there is indeed a "human" issue for many of our fellow citizens which has not been considered.
First let's look at Washington.gov statistics reported on 6/22. In WA counties that day there were 29386 coronavirus cases reported, 1284 deaths, 4067 hospitalizations and 487059 total cases reported. The WA website opines accurately that the deaths were 4.4% of the cases and total positive tests were 6%.
The site did not report what percentage of the deaths were "caused" by corona or just the deaths occurred "with" corona. Suspect at least a significant number were elderly and compromised persons sadly who were in the end stages of life. The hospitalizations of the reported cases was 14% which sounds scarey until you note that 86% of the cases were either positive but asymptomatic or did not need inpatient care (and we assume will recover). 86% is a good number.
When 6% of the tested cases are positive that means 94% were negative. Again 94% is a very good number. I hope I've used my math skills to report correctly. In Washington where the governor decides what happens (and obviously that effects all of us GU fans, and myself a 1961 graduate)
Based on the numbers above but reading the media reports or listening to many TV and Radio reporters they never mention the 86% asymptomatic and non-inpatient persons tested nor the 94% of tested people who were negative.
So as I reported above I will be a complient patient (who is negative tested) but a little worried about the people in our state who don't have the benefit of Mediccare, Social Secuirty and Retirement benefits who now are unemployed, maybe with no medical insurance and trying to raise 1, 2 or maybe 3 kids. From a science evaluation basis I guess we want them to wear masks, social distance and stay home. How in the hell are they going to survive?
That's my proposition now. This is not only a medical science issue but a human issue which needs to be considered. Please help me. I practiced for 35 years looking at issues, evidence and tried to serve my clients to a fair and reasonable result. I like Dr. Fauci and I liked your analysis but can you help me understand how we deal with all the other "non-political issues" on a human, caring and loving way?

[DZ]

Remarkably, it is very difficult to find another First World Nation where the cases are rising, except for us, and they're going way up.

Cases are at all time highs where I live. Houston is now putting adults in peds hospitals, almost out of ICU space, Florida is right at the edge of the same cliff.

Unless something huge changes in the next 90 days I don't see any possible way to have a season.

My daughter asked me when things might be "normal again" and I said (guessing) "next summer at the earliest" and I think that's right.

[Bogozags]

I went to an electrician the other day and asked him about my in-grown-toe-nail...he looked at me as if I was crazy. He told me he is an electrician and that I should go ask the doctor as MD's have the answer to medical issues. I thought this was just crazy, I mean if the TOP medical minds in the country say wear masks then that is the direction we should go!!! No matter if "leaders" chose not to wear them because they don't look good or not you should wear them AND "IF" everyone wore them and kept social distancing and wash their hands regularly, then maybe, just maybe this virus could be controlled BUT since there are "leaders" out there that don't want to wear them, so then others won't wear them so whose liberties are being tested?

I live in South Carolina and the governor says maintain social distancing BUT it is ok for two none family members to SHARE THE SAME GOLF CART!!! This is As-a-nine so it is apparent that some "leaders" are not following the guide lines set forth by highly respected medical doctors and still go do their own thing. The CDC says stay away from large groups of more than 10 so there were over 10K partying in Tulsa and another large group smoozing in Phoenix??? And we wonder why the virus numbers continue to go up???

As Caduceus stated, the virus can and will dampen our hopes for a season if COVID19 continues to flourish.

[kitzbuel]

Thank you Caduecus for a measured and informing post relying on science and your obvious extensive medical and academic expertise.
As an 81-year-old retired attorney I have the advantage of "staying home", social distancing, wearing a mask when necessary and using "personal responsibility" to not take unwise risks so I am "Dancing" as you say to help prevent the spread of virus. Not all of our community's citizens, state's citizens or America's citizens have the privilege or advantages I have to help with the dance. More about that later.
I have no complaint or quibble with your analysis scientifically and I hope my post will not sound political but there is indeed a "human" issue for many of our fellow citizens which has not been considered.
First let's look at Washington.gov statistics reported on 6/22. In WA counties that day there were 29386 coronavirus cases reported, 1284 deaths, 4067 hospitalizations and 487059 total cases reported. The WA website opines accurately that the deaths were 4.4% of the cases and total positive tests were 6%.
The site did not report what percentage of the deaths were "caused" by corona or just the deaths occurred "with" corona. Suspect at least a significant number were elderly and compromised persons sadly who were in the end stages of life. The hospitalizations of the reported cases was 14% which sounds scarey until you note that 86% of the cases were either positive but asymptomatic or did not need inpatient care (and we assume will recover). 86% is a good number.
When 6% of the tested cases are positive that means 94% were negative. Again 94% is a very good number. I hope I've used my math skills to report correctly. In Washington where the governor decides what happens (and obviously that effects all of us GU fans, and myself a 1961 graduate)
Based on the numbers above but reading the media reports or listening to many TV and Radio reporters they never mention the 86% asymptomatic and non-inpatient persons tested nor the 94% of tested people who were negative.
So as I reported above I will be a complient patient (who is negative tested) but a little worried about the people in our state who don't have the benefit of Mediccare, Social Secuirty and Retirement benefits who now are unemployed, maybe with no medical insurance and trying to raise 1, 2 or maybe 3 kids. From a science evaluation basis I guess we want them to wear masks, social distance and stay home. How in the hell are they going to survive?
That's my proposition now. This is not only a medical science issue but a human issue which needs to be considered. Please help me. I practiced for 35 years looking at issues, evidence and tried to serve my clients to a fair and reasonable result. I like Dr. Fauci and I liked your analysis but can you help me understand how we deal with all the other "non-political issues" on a human, caring and loving way?

Burg

The targeted test percentage standard is less than 5% positive. You want to have enough widespread testing so that your positive is less than 5%.

1. You are testing significantly enough to over the built in bias of testing those that we know have it. The sample test population has to be be broad enough to show the true scope of transmission and if we are biased towards those that latest positive we don’t get a true representative population sample.

2. If infection rates grow enough to where positive results are greater than 5% with large scale testing then it is an indicator that the infection rate is out of control.


Sent from my iPhone using Tapatalk

[caduceus]

Everything you state is reasonable with some issues that make this situation different:

- We don't have vaccines for the Corona version of the common cold. Corona-type viruses are extremely difficult to vaccinate for. I don't think we can plan for "temporary" restrictions that last years while we wait for something that never comes. On top of that, Covid-19 also can infect several types of tissue and there seems to be a viral load component which leads to the next point....

We don't have vaccines for corona-cold viruses mainly because there hasn't been a focus, funding or need, relative to other infectious diseases. Uncommon, self-limiting, very, very low mortality. Priorities.

Your second sentence is untrue. We don't know that. Prior phase 3 clinical trials had to be halted before endpoints could be reached (community spread ended of these diseases, thus effectiveness in vivo couldn't be discerned). We have other successful RNA viral vaccines. Will we have a COVID-19 vaccine? Perhaps. We don't know yet. That is why we have multiple concurrent clinical trials going, at-risk pre-production of doses, and more money spent on it than any other vaccine, ever.

Your third sentence is an opinion, and I get it, respect it. Many people feel the same. But I'd just offer: be careful that your feelings don't overlook the biology. All you have to look at is the influenza pandemic of 1918. Killed maybe 100 million, in four waves over three years. The first wave (spring-summer 1918) took an estimated 10-20,000 U.S. lives. Our current coronavirus visitor has killed at least 10 times that many Americans over less time, and that's WITH a lockdown (there was none in 1918). If COVID-19 roars back in the fall (like H1N1 in 1918 did), you may not have a choice about "temporary restrictions" no matter what your feelings. Kids and teachers won't go to school. Many, many people won't venture out, regardless of whether the law says they can. I don't mean that with any disrespect, just a word of precaution. My advice is hope for the best, but prepare for the worst. We have just a couple of months. Remember, less than 5% of the population has been exposed.

- Covid-19 is different because it was given properties that are outside of a naturally evolving virus that jumps species. As you know, when a virus jumps species, it is very damaging to the host because the host has no defenses against something new (Novel) but it is difficult for the virus to reproduce as it hasn't evolved to shed from the new species. Covid-19 is novel AND highly contagious, so that natural controls that help control something like SARS are not present with Covid-19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996883/

I won't get into complicated details, but your assumptions here are largely incorrect. Yes, it's novel to humans and came from xenotropic transmission. There are millions, probably billions of different viruses on this planet. Only a very, very small portion of those infect humans, or even animals. Aside from that, your posted article seems to be pointing toward some eerie plot. Numerous studies, including highly regarded geneticists right here in our state, have unequivocally determined that the genome of nCOV19 is by natural occurrence. Not going to entertain wacky conspiracy theories.

- Our elected officials chose politics over safety when they didn't condemn the riots to control the spread of the disease. This has caused them to lose moral authority and now people will not comply with health orders because they see it as political struggle instead of a health struggle.

- US citizens don't deal well with being tracked and being told what to do. And when I say they don't deal well with it, I mean they won't in big enough numbers over months/years for a nationwide quarantine to succeed.

This is mostly politics (not going there), but I'll agree that there's enough anti-science people that will take this pandemic at their peril and the peril of their loved ones.

- I believe in the scientific method as well. Believing in "science" though, it starts to make it sound like science is defined and settled when it is constantly evolving with our understanding.

No one should care what it sounds like. It's irrelevant. Yes, there is very little in science that's "settled." We learn new things every day, good or bad. Science doesn't have an agenda. Another reason why these pandemic guidelines change. We learn something new, we change our approach. And hopefully we win.

- The quarantine (hammer) did not work.

Absolutely it did. Likely saved thousands of lives (early studies are strongly indicative at this point). The "dance" isn't working because people don't want to play that game, and there was no coordinated effort to test, trace, isolate. Now we are going back to early April which is no surprise to me. Except now we have 18,000 active cases roaming Washington State instead of 9,000 when everyone was scared.

I respect your posts and think we just differ in approach. You appear to be approaching this from the standpoint that we can "cure the patient" where I see it as a quality of life as we "treat the patient" with a chronic illness. IMO This isn't about the eliminating the disease, it's about us living with the disease from my point of view.

I appreciate that. I've spent most of my life treating the patient directly at the bedside (and teaching doctors and residents, med students, and other HC professionals, and doing medical research, and so on). Will we move from pandemic -> endemic? Probably. Eventually. I don't think we've reached halftime in the pandemic game. Hope for a vaccine. In the meantime, we MUST approach this like those countries that are winning the battle. We are losing, badly.

I'll probably go back to lurking if this discussion devolves into more politics and conspiracy. I'm on GUBoards "vacation" after all.

Cheers.

[caduceus]

Burg

The targeted test percentage standard is less than 5% positive. You want to have enough widespread testing so that your positive is less than 5%.

1. You are testing significantly enough to over the built in bias of testing those that we know have it. The sample test population has to be be broad enough to show the true scope of transmission and if we are biased towards those that latest positive we don’t get a true representative population sample.

2. If infection rates grow enough to where positive results are greater than 5% with large scale testing then it is an indicator that the infection rate is out of control.


Sent from my iPhone using Tapatalk

What he said.

[sylean]

before the Vegas tournament I posted about my fear that the vegas tourney would be cancelled....I was scoffed at....glad we went though.....great time.....

the lockdown was wrong headed....the vulnerable should have been asked to isolate.....what we did was just prolong the virus's course.....

people say they follow science until it doesn't agree with them....science tells us that there will always be virus's around , even after covid....science tells us that a virus runs its course, and it weakens....science tells us that the sickliest, and oldest will always be more susceptible to any disease...

there is no vaccine for the common cold, another corona virus....I wouldn't bet that covid will have a completely effective vaccine ....many people get the flu after getting the flu shot...

testing is showing more people have or had the virus because we are testing so many more.....the death rate however is low....

people want 100% safety and the truth is there is no such thing....

[tinfoilzag]

We don't have corona-cold viruses mainly because there hasn't been a focus, funding or need, relative to other infectious diseases. Uncommon, self-limiting, very, very low mortality. Priorities.

Your second sentence is untrue. We don't know that. Prior phase 3 clinical trials had to be halted before endpoints could be reached (community spread ended of these diseases, thus effectiveness in vivo couldn't be discerned). We have other successful RNA viral vaccines. Will we have a COVID-19 vaccine? Perhaps. We don't know yet. That is why we have multiple concurrent clinical trials going, at-risk pre-production of doses, and more money spent on it than any other vaccine, ever.

Your third sentence is an opinion, and I get it, respect it. Many people feel the same. But I'd just offer: be careful that your feelings don't overlook the biology. All you have to look at is the influenza pandemic of 1918. Killed maybe 100 million, in four waves over three years. The first wave (spring-summer 1918) took an estimated 10-20,000 U.S. lives. Our current coronavirus visitor has killed at least 10 times that many Americans over less time, and that's WITH a lockdown (there was none in 1918). If COVID-19 roars back in the fall (like H1N1 in 1918 did), you may not have a choice about "temporary restrictions" no matter what your feelings. Kids and teachers won't go to school. Many, many people won't venture out, regardless of whether the law says they can. I don't mean that with any disrespect, just a word of precaution. My advice is hope for the best, but prepare for the worst. We have just a couple of months. Remember, less than 5% of the population has been exposed.




I won't get into complicated details, but your assumptions here are largely incorrect. Yes, it's novel to humans and came from xenotropic transmission. There are millions, probably billions of different viruses on this planet. Only a very, very small portion of those infect humans, or even animals. Aside from that, your posted article seems to be pointing toward some eerie plot. Numerous studies, including highly regarded geneticists right here in our state, have unequivocally determined that the genome of nCOV19 is by natural occurrence. Not going to entertain wacky conspiracy theories.




This is mostly politics (not going there), but I'll agree that there's enough anti-science people that will take this pandemic at their peril and the peril of their loved ones.



No one should care what it sounds like. It's irrelevant. Yes, there is very little in science that's "settled." We learn new things every day, good or bad. Science doesn't have an agenda. Another reason why these pandemic guidelines change. We learn something new, we change our approach. And hopefully we win.



Absolutely it did. Likely saved thousands of lives (early studies are strongly indicative at this point). The "dance" isn't working because people don't want to play that game, and there was no coordinated effort to test, trace, isolate. Now we are going back to early April which is no surprise to me. Except now we have 18,000 active cases roaming Washington State instead of 9,000 when everyone was scared.



I appreciate that. I've spent most of my life treating the patient directly at the bedside (and teaching doctors and residents, med students, and other HC professionals, and doing medical research, and so on). Will we move from pandemic -> endemic? Probably. Eventually. I don't think we've reached halftime in the pandemic game. Hope for a vaccine. In the meantime, we MUST approach this like those countries that are winning the battle. We are losing, badly.

I'll probably go back to lurking if this discussion devolves into more politics and conspiracy. I'm on GUBoards "vacation" after all.

Cheers.

Good points.

I hope that resources and urgency were the things holding back vaccines for corona viruses.

There's a level 4 bio-safety lab in Wuhan specializing in bat-borne viruses and it's a coincidence that that's where it started? I won't push it because it seems a non-starter for you but we should consider all possibilities if we want to combat this new virus.

When an infected populous feels like they have been mislead to the point where they disregard guidance, that's not a political issue, it's a trust issue. Behavior is key in preventing the spread and behavioral controls have been compromised. This is in part due to lies (saying that masks didn't work early to avoid a run), selective enforcement (supporting protests that would lead to super spreader events to save face) and overstating the threat (misrepresenting death count and sensational models). Our media and experts have been very wrong recently and there is no faith in them or their data.

Try to get grant money for research and tell me that science doesn't have an agenda. Taking on risk doesn't make you anti-science.

Some people value their business, freedom, and even basketball careers as much as they value their lives (let alone the life of a stranger). With the extremes in value systems, behavior will also vary wildly. Without uniform behavior, quarantines are not going to work in the mid to long-term. If the solution to any problem is "if everyone would just do x", it's not going to work.

[willandi]

before the Vegas tournament I posted about my fear that the vegas tourney would be cancelled....I was scoffed at....glad we went though.....great time.....

the lockdown was wrong headed....the vulnerable should have been asked to isolate.....what we did was just prolong the virus's course.....

people say they follow science until it doesn't agree with them....science tells us that there will always be virus's around , even after covid....science tells us that a virus runs its course, and it weakens....science tells us that the sickliest, and oldest will always be more susceptible to any disease...

there is no vaccine for the common cold, another corona virus....I wouldn't bet that covid will have a completely effective vaccine ....many people get the flu after getting the flu shot...

testing is showing more people have or had the virus because we are testing so many more.....the death rate however is low....

people want 100% safety and the truth is there is no such thing....

We didn't have a lock down. We had a half assed try at sometimes quarantine. Many states didn't participate and, in the states that did, many people didn't.
If we had had a hard and virtually total lockdown, we would be just about over this.

[DZ]

Some people value their business, freedom, and even basketball careers as much as they value their lives (let alone the life of a stranger). With the extremes in value systems, behavior will also vary wildly. Without uniform behavior, quarantines are not going to work in the mid to long-term. If the solution to any problem is "if everyone would just do x", it's not going to work.

I don't want to get into how many ways I disagree with the other aspects of what you posted but it's just a disagreement.

All I wanted to point out is that from my point of view the news/experts have been right every step of the way, within reason and it continues right on through today.

We have the highest recorded total positives today, and anyone who says it is "just more testing" should explain that to the doctors in Houston and Miami where they are running out of ICU beds (Houston at 98%), which will be increasingly apparent this coming week.

But as to your last point I suppose people in Europe don't value their business, freedom, or basketball careers near as much as the value their lives (And strangers' lives, as I suspect I'm even more respectful of others' lives over mine).

A quarantine does work. Whether we in the U.S. are a mature enough as a people to do it or not, is certainly up in the air, we haven't yet. The solution isn't that different to the solution to drunk driving: "If everyone would just get a designated driver …" and deaths went down, people changed knowing they could hurt others.


Here is a chart of day to day positives, Euro numbers align pretty well with ours in total cases, and then how we've done over the months versus them. I guess they're just more disciplined, and that's why they're opening their economies while Texas and Florida are about to shut theirs.

[MDABE80]

Dixie nobody is disputing that FL, TX and AZ are having spikes in the disease.....I do think much of it is due to not using the protection guidlines.
Imprtantly as the younger set gets infected, the survival rate is better. I do not know how Cad or Tin feels about attenuation.but it looks like thats happening as the older hosts in general seem to be doing better ( Maybe most vulnerable of them passed already) except in NY, NJ where management is just stupid due to incompetent governors.

In my life, I've always worried about doing the best thing...in my case I worry after treatment... that maybe the best thing wasn't done.........I know this much: I'm tired of this COVID 19 virus and the recurrent discussions about it when few, if any, really can put their fingers on the facts and then make something work properly.

We do have principles of management though.and they usually work. Distance, masking, and common sense measures.......should continue.

[tinfoilzag]

A quarantine does work. Whether we in the U.S. are a mature enough as a people to do it or not, is certainly up in the air, we haven't yet. The solution isn't that different to the solution to drunk driving: "If everyone would just get a designated driver …" and deaths went down, people changed knowing they could hurt others.

All countries are too different to compare (culture, climate, diet, geography, etc.). Apples to oranges comparison.

You're making my point when you say 'not mature enough' in the US for quarantine. That means the quarantine won't work over time because you don't have compliance. People's behavior is a key component of quarantine. To your drunk driving analogy, we have to have drunk driving patrols and over-serving rules and education campaigns and huge penalties and they are still happening. All this stuff to stop drunk driving and you can't eliminate it. Reduced but not eliminated. You have many more people that are going to ignore lock down orders than drunk driver laws by percentage.

It's another case of "the system to save the people would work if it wasn't for the people."

I'm not saying quarantine doesn't work, i'm saying it doesn't work without people changing their behavior. If US citizens by in large aren't willing to change, then there needs to be a different plan because right now we are destroying businesses and lives at the same time we are spreading the disease.

[willandi]

All countries are too different to compare (culture, climate, diet, geography, etc.). Apples to oranges comparison.

You're making my point when you say 'not mature enough' in the US for quarantine. That means the quarantine won't work over time because you don't have compliance. People's behavior is a key component of quarantine. To your drunk driving analogy, we have to have drunk driving patrols and over-serving rules and education campaigns and huge penalties and they are still happening. All this stuff to stop drunk driving and you can't eliminate it. Reduced but not eliminated. You have many more people that are going to ignore lock down orders than drunk driver laws by percentage.

It's another case of "the system to save the people would work if it wasn't for the people."

I'm not saying quarantine doesn't work, i'm saying it doesn't work without people changing their behavior. If US citizens by in large aren't willing to change, then there needs to be a different plan because right now we are destroying businesses and lives at the same time we are spreading the disease.

If we had HAD a lock down, virtually complete, for 6 weeks, we would be over this. The virus transfers from person to person. If no people are interacting, there would be no transmission.

I posted this on Facebook today and thought I had already posted it here, but apparently not.

"Hindsight is, indeed 20/20.

In my opinion, what needed to be done in mid March was for there to be a single entity, at the head of this country, that mandated a 6 week quarantine. Health care workers, grocery store and pharmacy workers, to put your online or phoned in orders into the trunk of your car, truck drivers for delivery of products for the groceries, utility workers, on a rotating/skeletal staff, and the same for package delivery of medical necessities should be the ONLY essential workers. All others quarantined in home excepting to get food and medicine.
Strict monitoring and fines, graduated for repeat offenders up to, and including, incarcerations for those unwilling.
Rent and bills are held in abeyance. A single time check to ALL eligible individual workers should be paid...no companies and no corporations. Make the check large enough that no person or family is hurting (and having Amazon etc unavailable means the money WILL go to necessities.) The essential workers get this money plus their wages. Maybe $5000/person. Still less than the largesse shown to the corporations and the rich.
Had this been done in March, we would be over this coronavirus now.

The question is, could it be done now?"

[DZ]

All countries are too different to compare (culture, climate, diet, geography, etc.). Apples to oranges comparison.

You're making my point when you say 'not mature enough' in the US for quarantine. That means the quarantine won't work over time because you don't have compliance. People's behavior is a key component of quarantine. To your drunk driving analogy, we have to have drunk driving patrols and over-serving rules and education campaigns and huge penalties and they are still happening. All this stuff to stop drunk driving and you can't eliminate it. Reduced but not eliminated. You have many more people that are going to ignore lock down orders than drunk driver laws by percentage.

It's another case of "the system to save the people would work if it wasn't for the people."

I'm not saying quarantine doesn't work, i'm saying it doesn't work without people changing their behavior. If US citizens by in large aren't willing to change, then there needs to be a different plan because right now we are destroying businesses and lives at the same time we are spreading the disease.

So in the entire world, we are the one country unable to do it. They're apples, we're oranges.

I don't agree with anything you've said, so I'll stop now and just leave a link with the rest of the world's performance versus ours, and you're argument is that we're the one nation unwilling or unable to do it. (And we can't include the whole nation bc the Northeast now looks like the rest of the world's graphs.

[tinfoilzag]

So in the entire world, we are the one country unable to do it. They're apples, we're oranges.

I think this is well stated. We are so fundamentally different, we'll need our own solution.