A Doubtful 2020-2021 Season vs COVID19

[caduceus]

So is this the next basketball forum thread destined for closure ?

Inevitable. I've given up. Informative posts that educate? Relegated to the dungeon (while we are in the off season discussing whether we will even have a season). Personal opinions based on nothing? Business as usual. I haven't had more private messages asking for medical information than in the last ten years. Nearly all of my medical colleagues have given up on informing the public, due to the crazy uninformed whackadoodle backlash. Whatever happened to making informed decisions? I can't tell you how much despair is happening among the medical community. As one smart poster said...it's collective stupidity. My friend, BobZag used to say, "we're doomed." So weird how fantasy becomes reality.

Stay safe, RZ.

Edit:

[JPtheBeasta]

One big factor in reducing infections among children was keeping them from school, but children also adhere to social distancing better. They don’t shop, drive, go to bars, etc. They have their distancing enforced by their parents. That is a difference.

We thought that 20-35 group also had similar low transmission rates, but find that is not true now.

This is a very important article from NPR, in my opinion, that everyone should read. It doesn’t march your theory and may challenge your paradigm on this. For whatever reason, kids just don’t contract the disease as well as adults. 0.16% of children contracted the virus, and there was close to zero child-to-adult transmission of the virus in childcare centers that stayed open during this pandemic— and these were kids of essential workers.

Article: https://www.npr.org/2020/06/24/88231...ring-lockdowns

[kitzbuel]

Inevitable. I've given up. Informative posts that educate? Relegated to the dungeon (while we are in the off season discussing whether we will even have a season). Personal opinions based on nothing? Business as usual. I haven't had more private messages asking for medical information than in the last ten years. Nearly all of my medical colleagues have given up on informing the public, due to the crazy uninformed whackadoodle backlash. Whatever happened to making informed decisions? I can't tell you how much despair is happening among the medical community. As one smart poster said...it's collective stupidity. My friend, BobZag used to say, "we're doomed." So weird how fantasy becomes reality.

Stay safe, RZ.

Edit:

I do appreciate the insight you have from a professional viewpoint. There are a lot of people who may not post but read and act accordingly. Valid information is valuable.

[willandi]

I said it before and I'll say it again.

Lock down, everybody and every thing for 6 weeks. Only essentials. Health care, grocery and pharmacy to put you online or phone orders in the trunk. Truck drivers to deliver to food and prescripts to those places, Skeletal staff for utilities, for prescription delivery through the mail, and Law Enforcement to pick up those idiots that just refuse to obey. They will serve the 6 weeks (or until they are up) in jail, extended to 14 days after the lock down is over.
Every worker gets $5000, including landlords and bosses, but no corporations or companies. NO RENT for 2 months, but no payments to the banks by the landlords for two months. Utilities, cable tv, cell phone, credit cards etc get paid.
When the 6 weeks are up, people will burst out ready to spend that money. The economy will rebound.

We lose this season of MLB, Nascar etc, but we get ALL the college sports, the NFL and all fall, winter and spring sports. The NBA can go ahead because of their bubble/campus plan.
All tests go to health care, people that are transported and those they live with. Their quarantine lasts until they are proven clean.

I have proposed a plan to get a grip on COVID-19.
Is it draconian? Yes it is. Is it unconstitutional? I am not an attorney, so really can't say, but against the backdrop of requiring ALL men, at age 18 to register for the military draft, and, in the event of need, be called to report for duty, to go where and when this government decides, to risk life and limb, I would think not. By the time it got to court, the 6 weeks would be over.

I don't want to bog down in the discussion of legality. I would like to know what other ideas people have to get a grip on this virus. Whether a 4-6 week almost absolute lockdown would do the job?

Masking, washing hands and sanitizing and social distancing helped to flatten the curve, while they were in place, but were not actually intended to defeat the virus, just to slow the spread. Is there something else that will knock this puppy to it's knees until a viable vaccine is developed?

[MDABE80]

I could be wrong but looking at the data does that dictate that those states who opened are the same ones contributing to increased numbers of infections. Deaths are down still (for. NOw) but if we dont mask up, distance, and use common sense measures, bad things will happen. Worse though, deaths will soar. It’s just a matter of time. Honestly I never thought reopening states would bring this virus back so quickly. Remembering what safeguards brought the virus down, I’m not sure why the states reopenedwhen they had the results going their way. More to learn..

[caduceus]

I could be wrong but looking at the data does that dictate that those states who opened are the same ones contributing to increased numbers of infections. Deaths are down still (for. NOw) but if we dont mask up, distance, and use common sense measures, bad things will happen. Worse though, deaths will soar. It’s just a matter of time. Honestly I never thought reopening states would bring this virus back so quickly. Remembering what safeguards brought the virus down, I’m not sure why the states reopenedwhen they had the results going their way. More to learn..

High transmissibility and particularly exponential growth will do that. Looking at all the curves, opening up in combination with large masses of people on Memorial day was clearly a major contributor. June 10-16 is when the logistic curve went from linear to exponential in all the hard hit states (and others, like Washington State are teetering in that direction). Rush week at the UW fraternity system last week has brought 105 positive cases already. I don't see how we'll get younger people to take this seriously. It will be our downfall, minus a vaccine.

I fear for what July 4 will bring.

[caduceus]

I do appreciate the insight you have from a professional viewpoint. There are a lot of people who may not post but read and act accordingly. Valid information is valuable.

Thank you.

[zagamatic]

I would be interested to find out how many people would test positive for covid19 antibodies but never showed any symptoms? My logical side says that it is likely at least 4 times as many people who are currently being counted as having covid19, and I'm guessing that is pretty low. I'm not a medical expert, nor do I have any studies to point to (there haven't been any). But my point is, if it were really shown that millions of people (perhaps over a billion worldwide) didn't even know that they had beaten the covid19 virus just like billions of people don't even know that they had the seasonal flu and beat it, would we really be doing all of this half hearted lock down? I mean seriously, we had our chance to do a real lock down when this first hit. Nobody out and about except emergency personnel and military.....period for 3 weeks. Take those infected to quarantine. Absolutely no air travel, grocery shopping, etc. But it wasn't necessary then and it isn't necessary now. I know that no one wants to hear this but, with few exceptions as there are with any disease, this virus isn't taking out anybody who isn't living on borrowed time anyway such as cancer, heart disease, etc.

[JPtheBeasta]

I would be interested to find out how many people would test positive for covid19 antibodies but never showed any symptoms? My logical side says that it is likely at least 4 times as many people who are currently being counted as having covid19, and I'm guessing that is pretty low. I'm not a medical expert, nor do I have any studies to point to (there haven't been any). But my point is, if it were really shown that millions of people (perhaps over a billion worldwide) didn't even know that they had beaten the covid19 virus just like billions of people don't even know that they had the seasonal flu and beat it, would we really be doing all of this half hearted lock down? I mean seriously, we had our chance to do a real lock down when this first hit. Nobody out and about except emergency personnel and military.....period for 3 weeks. Take those infected to quarantine. Absolutely no air travel, grocery shopping, etc. But it wasn't necessary then and it isn't necessary now. I know that no one wants to hear this but, with few exceptions as there are with any disease, this virus isn't taking out anybody who isn't living on borrowed time anyway such as cancer, heart disease, etc.

The CDC estimates, using antibody serum/blood data, that 10 times as many persons who have been diagnosed with Covid -19 via nasal swab have been infected.

https://apple.news/AKpBWXXTuRkeVh8qUkY0G0Q

[MDABE80]

Key article JP . Dry good post and info. The younger ones have light if any symptoms in general despite being positive. This is a mess!. Hard to have accurate sensitivity or specificity with testing. Seeing asymptomatic kids and adults who are positive generates confusion.

[caduceus]

I would be interested to find out how many people would test positive for covid19 antibodies but never showed any symptoms? My logical side says that it is likely at least 4 times as many people who are currently being counted as having covid19, and I'm guessing that is pretty low. I'm not a medical expert, nor do I have any studies to point to (there haven't been any). But my point is, if it were really shown that millions of people (perhaps over a billion worldwide) didn't even know that they had beaten the covid19 virus just like billions of people don't even know that they had the seasonal flu and beat it, would we really be doing all of this half hearted lock down? I mean seriously, we had our chance to do a real lock down when this first hit. Nobody out and about except emergency personnel and military.....period for 3 weeks. Take those infected to quarantine. Absolutely no air travel, grocery shopping, etc. But it wasn't necessary then and it isn't necessary now. I know that no one wants to hear this but, with few exceptions as there are with any disease, this virus isn't taking out anybody who isn't living on borrowed time anyway such as cancer, heart disease, etc.

Your antibody guesstimate is probably not that far off. Couple of things. First, some studies have shown that not all infected people (particularly asymptomatics) generate a detectable antibody response. There are other immunity pathways the body has to fight off the virus, such as cellular immunity, when the white blood cells take on the virus directly (and form a "memory" of the virus in case they get exposed in the future). The antibody tests are actually pretty horrible compared to the PCR (nasal swab) tests, and there are LOTS of false positives. From the FDA:

Based on the underlying scientific principles of antibody tests, we do not expect that an antibody test can be shown to definitively diagnose or exclude COVID-19 infection.

That doesn't just mean active infection, but also past infection!

[A] serology test can yield a negative test result even in infected patients (e.g., if antibody has not yet developed in response to the virus) or may be falsely positive (e.g., if antibody to a coronavirus type other than the current pandemic novel strain is present).

Second, there has been a lot of pushback by scientists in regards to the CDC statement that JP referred to. The largest and most comprehensive antibody study was performed in May in Spain, with about 45,000 people tested (and they were compelled which reduces selection bias). That study found that 5% of their population tested positive, and they were hit harder per capita at their peak than the U.S. This aligns with most of the modeling done in the U.S. (and is within the range that the CDC stated, but not the top range that the press are pushing). The consensus at this point is that roughly 4 to 10 times the number of Americans that have tested positive have been infected, and it's probably closer to 5x than 10x.

The most historically accurate model currently estimates that 6.0% of the U.S. population (range 4.5 - 7.7) has been infected, although they admit their model may be slightly underestimating with regards to this category.

The Red Cross is now surveying blood donations for nCov-19 antibodies. This may give us a more accurate picture in a bit (although selecting blood donors only may introduce some bias into the numbers. It could skew the results either way due to people wanting to get tested if they think they had it, or due to generally healthy people being donors).

With regards to your last sentence:

I know that no one wants to hear this but, with few exceptions as there are with any disease, this virus isn't taking out anybody who isn't living on borrowed time anyway such as cancer, heart disease, etc.

This is where things go wrong. Half of Texas' hospital admissions are under 50. A third of their ICU patients are under 50. Many, many are previously healthy. There are tons of anecdotal stories in the recent press now about health nuts, bodybuilders, healthy pregnant women, etc., dying.




Any young person should see this video from the front lines in Texas. It may change their attitude toward this virus:

[Zagceo]

“Flatten the curve” remember that mantra?

Does science weigh the unintended consequences of lockdowns?

[JPtheBeasta]

The thing with the idea that not all people who are infected create serum antibodies is that it implies that there have been even more infections than we have detected-- not less. I saw a study that suggested only the most severe infections resulted in detectable serum antibodies. Given that 80% of cases are mild, the CDC number-- or whatever number one accepts-- might need to be multiplied by 5.

Antibody tests can be bad, but there are also good ones. And with any test, the more real positives that are out there the more representative they are of the actual population.

[JPtheBeasta]

“Flatten the curve” remember that mantra?

Does science weigh the unintended consequences of lockdowns?

The Uncommon Knowledge podcast, episode 327, "The Doctor is In: Scott Atlas and the Efficacy of Lockdowns, Social Distancing, and Closings" discusses an article which discusses the concept of life years, which is used by actuaries and economists to try to quantify the impact of someone dying at age 20, say, vs 90; the 20 year old would lose more life years than the 90 year old. They used empirical methods which show how many life years are lost due to economic impacts, persons not going to the hospital for strokes or heart attacks, missed cancer screenings, missed childhood vaccines, and such. They found that more life years were lost from the lockdowns than from Covid deaths.

[sittingon50]

“Flatten the curve” remember that mantra?

Does science weigh the unintended consequences of lockdowns?

Really good point ceo. Had an interesting conversation with an RN that I work with. He stated that medical Drs. were/are the ones making the call but there are other types of Drs. (mental health) that should also be involved. My co-worker said his 16 yr. old son had a mental break last week due to his month's of isolation ( and we know suicides are up). While speculative, certainly plausible. But how do you choose? If the fire department rolls do they try to knock down the fire 1st or rush in looking for people? Chicken or egg? I personally think you needed to try to knock down the virus 1st, but 20/20 says ?

[caduceus]

The Uncommon Knowledge podcast, episode 327, "The Doctor is In: Scott Atlas and the Efficacy of Lockdowns, Social Distancing, and Closings" discusses an article which discusses the concept of life years, which is used by actuaries and economists to try to quantify the impact of someone dying at age 20, say, vs 90; the 20 year old would lose more life years than the 90 year old. They used empirical methods which show how many life years are lost due to economic impacts, persons not going to the hospital for strokes or heart attacks, missed cancer screenings, missed childhood vaccines, and such. They found that more life years were lost from the lockdowns than from Covid deaths.

And here we are again. Are you still denying climate change? On one day you're lamenting the unborn babies while 132,000+ living, breathing people have choked to death from a virus that's congested their lungs to the point of asphyxiation. Pro Life people should be very concerned. That's 22 full MacCarthy Center capacities. Or 44 Nine-Elevens. If you weren't dismayed by 9/11, then would 44 of them make you react??? I just. cant. believe. this... F*cking economists. Money before lives. Do you have grandparents? Money should never, ever, ever, be considered over lives. Seventy percent of the population says we should lockdown over opening up. Go stand in the corner. Your opinions are among the weakest in our society. As long as it's not YOUR LIFE, it's OK then? Your podcast might make you happy, but when the virus invades your epithelium, you'll have another opinion. Stay safe, and wear a mask (doubtful). What happens when your last post is about your cough and fever. Hmmm...

[JPtheBeasta]

And here we are again. Are you still denying climate change? On one day you're lamenting the unborn babies while 132,000+ living, breathing people have choked to death from a virus that's congested their lungs to the point of asphyxiation. Pro Life people should be very concerned. That's 22 full MacCarthy Center capacities. Or 44 Nine-Elevens. If you weren't dismayed by 9/11, then would 44 of them make you react??? I just. cant. believe. this... F*cking economists. Money before lives. Do you have grandparents? Money should never, ever, ever, be considered over lives. Seventy percent of the population says we should lockdown over opening up. Go stand in the corner. Your opinions are among the weakest in our society. As long as it's not YOUR LIFE, it's OK then? Your podcast might make you happy, but when the virus invades your epithelium, you'll have another opinion. Stay safe, and wear a mask (doubtful). What happens when your last post is about your cough and fever. Hmmm...

I think that you have completely missed the point. Poverty, delayed cancer diagnoses, missed vaccinations, not going to the hospital for a stroke and such result in measurable loss of life. Surely as a doctor you know this. My post was only about money in as much as poverty results in less human flourishing.

Dr. Scott Atlas in the podcast is an MD, by the way. Q

I have been seeing patients every day and could have taken an optional furlough. I wear a mask in clinic and in my personal life. I think the world is round. Your insults are not very becoming. Why the ad hominem?