OT: On this episode of Days of the OT..

[Dubi Doo]

Good stuff from my homie!

The thing is, we've had a bit more time to react to this then other countries, and we're still testing at an extremely low rates, which is absurd, imo, because that the best way to combat this virus outside of shutting down cities.

You're right, tho. We cant test everyone. We need to focus on highly dense areas, because that's where this virus can have catastrophic effects. Drive through stations should be readily available in every major city. We've had a month to start preparing for this. Hell, it could've been a nice stimulus bill for the economy, haha.

Also, I'm not really concerned about catching the people with negative results. I want to find the people with positive results. The real scare of this virus is a lot of people show no symptoms or similar symptoms to the common cold. These are the people we need to catch, and have measures taken to keep quarantined. This would drastically reduce the spreading, which is vital during the early stages of breakout since vaccines aren't readily available.

Once testing kits become more widely available, it is much more likely that we see that this virus is more widespread and the mortality rate is way lower.

The number one reason for concern for this is the higher mortality rate. But, if that is being overstated currently due to a lack of testing, then that gets to people saying that a lot of the panic to this virus is overstated.

I do believe that we have enough data to reinforce that people take basic respiratory infection precautions.

Wash your hands, you filthy animals!

Cover your cough.

If you have a fever and/or a persistent cough, go see your PCP and stay home from work.

And other, basic, common sense stuff like that.

But, creating panic behaviors among society at large that leads to behaviors like hoarding medical masks and hand sanitizer isn't a good way to respond to this virus. Shutting down all sorts of things like university campuses and any events with 100+ spectators also falls into this realm, to me.

There is plenty of disinformation being spread about this virus and a reasoned, commonsense approach to this has been in short supply, IMO.

I agree that the mortality rate is likely way lower than the 3-4% being reported. I'm assuming it'll be under 1%. I'm more concerned about overcrowding in hospitals due to lack of knowledge, lack of vaccines, and how rapidly this virus is spreading.

I also agree we need to educate the population and stress to use good personal hygiene. The issue is- a lot of younger people see they aren't in the group that gets hit heavily by this virus- and are acting nonchalant about it, which is concerning.

I've talked to nurses who literally will be the first line of defense if this spreads rapidly here, and they dont seem to be phased by this at all- some of them have the ' it wont kill me, so who cares?' Attitude.

The thing that separates this from other viruses is we dont know much about it yet, we dont have any vaccines or symptom suppressors in place, and it is spreading rapidly. It's causing overcrowding in ICUs, which will have a terrible ripple effect.

We'll know a lot more about the effect this virus will have on our country in the coming weeks. Luckily, we arent nearly as dense as Italy and our elderly population per capita is much lower, so it shouldn't hit us as hard. I'm concerned about the dense cities and how this will hit our extremely high obese population.

 

[Jim Bob]

I agree that the mortality rate is likely way lower than the 3-4% being reported. I'm assuming it'll be under 1%. I'm more concerned about overcrowding in hospitals due to lack of knowledge, lack of vaccines, and how rapidly this virus is spreading.

I also agree we need to educate the population and stress to use good personal hygiene. The issue is- a lot of younger people see they aren't in the group that gets hit heavily by this virus- and are acting nonchalant about it, which is concerning.

I've talked to nurses who literally will be the first line of defense if this spreads rapidly here, and they dont seem to be phased by this at all- some of them have the ' it wont kill me, so who cares?' Attitude.

The thing that separates this from other viruses is we dont know much about it yet, we dont have any vaccines or symptom suppressors in place, and it is spreading rapidly. It's causing overcrowding in ICUs, which will have a terrible ripple effect.

We'll know a lot more about the effect this virus will have on our country in the coming weeks. Luckily, we arent nearly as dense as Italy and our elderly population per capita is much lower, so it shouldn't hit us as hard. I'm concerned about the dense cities and how this will hit our extremely high obese population.

I am the child of two nurses. One of which worked in a large urban ED for over three decades. It takes a lot more than the exotic virus of the year to rattle them, especially my dad who is the former ED nurse.

The fact that nurses aren't panicking about this one is a good sign and not a sign that they aren't taking it seriously.

They are using their past experience with similar situations and they are taking a reasonable, measured approach to this one.

And as far as a vaccine goes, it will be many months before one is widely available in the US due to all the testing that needs to be done to validate it's safety and effectiveness. Just look at the development cycle for the flu shot every year.

Another factor that makes this less likely to hit the US like it has Italy and China is that those countries have higher levels of cigarette smokers. Anyone who has damaged lungs due to smoking will be at a higher risk for a bad outcome when they contract any sort of respiratory illness like COVID-19.

But again, that is just common sense for any respiratory illness.

 

[Jim Bob]

Comparing COVID-19 to the flu is the first bit of misinformation that needs to stop. It's downright stupid and dangerous.

I find the people telling me not to panic (Trump, Musk) are those who need a strong market/economy to save their hides. I find the people telling me to be very cautious and to take this very seriously are health care and infectious disease specialists who prioritize public health over short term economic interests. I'll stick with the latter.

I think the issue is that people tend not to take the flu serious enough.

People should not panic over COVID-19 and just take the normal precautions and steps that people should already be taking during cold and flu season.

There is no reason to horde medical masks, disinfectant wipes, and hand sanitizer, let alone toilet paper. And by hording things like masks that the population that is most likely to be impacted (namely the elderly, the immune compromised, and people with cardio-respiratory issues) can't get them.

Like a lot of things, people are landing too far one way or the other when the answer tends to lie in the common sense middle.

 

[Dubi Doo]

I think the issue is that people tend not to take the flu serious enough.

People should not panic over COVID-19 and just take the normal precautions and steps that people should already be taking during cold and flu season.

There is no reason to horde medical masks, disinfectant wipes, and hand sanitizer, let alone toilet paper. And by hording things like masks that the population that is most likely to be impacted (namely the elderly, the immune compromised, and people with cardio-respiratory issues) can't get them.

Like a lot of things, people are landing too far one way or the other when the answer tends to lie in the common sense middle.

That'd be incredible if they got a vaccine in a few months. I'd say it's a year away at the least. More than likely a couple of years away.

This link has some good info on how far away we are from a vaccine:

How Long Will It Take to Develop a Coronavirus Vaccine?

People already dont take the normal precautions. We really need to emphasize that this isn't the same circumstances as the flu. How big of an impact it will have here is still unknown, but there's a very real possibility this runs rampant through NYC, Chicago, etc...very dense cities.

Oh, and my ICU is taking this very seriously. I share my office with nurse managers, and they're listening to reports regarding the Coronavirus as I type, haha.

Good point regarding lung damage in Italy and China. It's going to be interesting to see how this affects the US.

As far as where I lean- if leaning left is nonchalant and leaning right is OMG we're f***ed! I'm middle-right. I'm not going to alter my social life yet. I live in Rochester, and doubt it hits too hard here, but I am aware this could escalate and precautions need to be put in place.

 

[Jim Carr's Rug]

Though perhaps slightly alarmist, this a pretty good conversation to listen to regarding COVID-19 and the spread through the US:

Making Sense Podcast #190 - How Should We Respond to Coronavirus? | Sam Harris

 

[slip]

I think the issue is that people tend not to take the flu serious enough.

People should not panic over COVID-19 and just take the normal precautions and steps that people should already be taking during cold and flu season.

There is no reason to horde medical masks, disinfectant wipes, and hand sanitizer, let alone toilet paper. And by hording things like masks that the population that is most likely to be impacted (namely the elderly, the immune compromised, and people with cardio-respiratory issues) can't get them.

Like a lot of things, people are landing too far one way or the other when the answer tends to lie in the common sense middle.

What's common sense here? Why is the entire nation of Italy on full quarantine? Why has travel collapsed? Why has Cuomo deployed the National Guard to New Rochelle? When has any of this ever happened in the context of a mere flu outbreak?

The battle now is to limit contact between people to lessen the impact given that it spreads faster and is far more deadly than any flu. COVID-19 is airborne and easily infects people occupying the same enclosed space as the infected. You could wash your hands all day, never touch your face, and practice good overall sanitation and you'll still likely catch it if you're around someone infected (and probably asymptomatic) who is literally just breathing.

There's a time in life to be calm, cool and collected. And then there's a time to be maximally paranoid.

 

[tsujimoto74]

My school (in NYC) is doing all of its classes for the rest of the month virtually. Wild.

 

[tsujimoto74]

What's common sense here? Why is the entire nation of Italy on full quarantine? Why has travel collapsed? Why has Cuomo deployed the National Guard to New Rochelle? When has any of this ever happened in the context of a mere flu outbreak?

The battle now is to limit contact between people to lessen the impact given that it spreads faster and is far more deadly than any flu. COVID-19 is airborne and easily infects people occupying the same enclosed space as the infected. You could wash your hands all day, never touch your face, and practice good overall sanitation and you'll still likely catch it if you're around someone infected (and probably asymptomatic) who is literally just breathing.

There's a time in life to be calm, cool and collected. And then there's a time to be maximally paranoid.

Isn't the mortality rate for the Coronavirus ~1-2%, depending on the quality of the health care in the region? And, unlike the flu, it so far doesn't seem to be more dangerous for the young, only the elderly. I'm not sure what the mortality rate among those afflicted by prior flu pandemics was, but my suspicion is that the % was definitely higher.

 

[slip]

Isn't the mortality rate for the Coronavirus ~1-2%, depending on the quality of the health care in the region? And, unlike the flu, it so far doesn't seem to be more dangerous for the young, only the elderly. I'm not sure what the mortality rate among those afflicted by prior flu pandemics was, but my suspicion is that the % was definitely higher.

So it's maybe only 20X more deadly than the flu, kills predominately old people, and is potentially not as dangerous as other historical pandemics.

Let's assume all of that is true.

I'm still paranoid as f***.

Joe Rogan had infectious disease specialist Michael Osterholm on the other day. Very informative interview:

 

[brian_griffin]

Isn't the mortality rate for the Coronavirus ~1-2%, depending on the quality of the health care in the region? And, unlike the flu, it so far doesn't seem to be more dangerous for the young, only the elderly. I'm not sure what the mortality rate among those afflicted by prior flu pandemics was, but my suspicion is that the % was definitely higher.

There are affliction rates and there are mortality rates. My understanding is the mortality rates for Corona virus in the elderly sub-groups is ~2x that for the flu. E.g., I think the over-age-80 mortality rates are ~8% flu and 15% corona.

 

[Jim Bob]

What's common sense here? Why is the entire nation of Italy on full quarantine? Why has travel collapsed? Why has Cuomo deployed the National Guard to New Rochelle? When has any of this ever happened in the context of a mere flu outbreak?

The battle now is to limit contact between people to lessen the impact given that it spreads faster and is far more deadly than any flu. COVID-19 is airborne and easily infects people occupying the same enclosed space as the infected. You could wash your hands all day, never touch your face, and practice good overall sanitation and you'll still likely catch it if you're around someone infected (and probably asymptomatic) who is literally just breathing.

There's a time in life to be calm, cool and collected. And then there's a time to be maximally paranoid.

Influenza (Seasonal)

Coronavirus

If you look at how to protect yourself against seasonal influenza and COVID-19, it is basically the same exact stuff.

Coronavirus Disease 2019 (COVID-19)

Coronavirus Disease 2019 (COVID-19) – Prevention & Treatment

The CDC is saying the same sorts of things.

And there is zero evidence that someone breathing who is asymptomatic can get you sick unless they are a creepily close breather and you are ingesting their respiratory droplets.

This is like the panic around other diseases in the past and people throwing out ideas like how you could contract an STD from sitting on a toilet seat.

 

[brian_griffin]

What's common sense here? Why is the entire nation of Italy on full quarantine? Why has travel collapsed? Why has Cuomo deployed the National Guard to New Rochelle? When has any of this ever happened in the context of a mere flu outbreak?

The battle now is to limit contact between people to lessen the impact given that it spreads faster and is far more deadly than any flu. COVID-19 is airborne and easily infects people occupying the same enclosed space as the infected. You could wash your hands all day, never touch your face, and practice good overall sanitation and you'll still likely catch it if you're around someone infected (and probably asymptomatic) who is literally just breathing.

There's a time in life to be calm, cool and collected. And then there's a time to be maximally paranoid.

PM me if you honestly can't figure that out yourself. Hint: It's the same reason manufacturing "NYS Clean" hand sanitizer in prisons required a professionally produced press conference and media release / coverage by dozens of print and broadcast media outlets.

 

[Jim Bob]

That'd be incredible if they got a vaccine in a few months. I'd say it's a year away at the least. More than likely a couple of years away.

This link has some good info on how far away we are from a vaccine:

How Long Will It Take to Develop a Coronavirus Vaccine?

I went with months after listening to this and figuring that it has a chance to get expedited if this extends into 4Q2020. Especially if other countries with less stringent testing gets one shortly before the election.

But, it won't shock me if it takes a couple of years and this scare has long since run it's course like SARS, etc.

 

[Jim Bob]

I feel bad for those players, especially the seniors who are probably seeing their college careers come to a premature end.

 

[SnuggaRUDE]

This "Scare" has already run well past SARS and H1N1. Don't look at the mortality rates, look at the hospitalization rates. Italy didn't lock down THEIR ENTIRE POPULATION because of the flu.

The complete lack of preventative measures being taken nationally is insane. You know what has never done a good job of fighting respiratory infections? Tax cuts! tax cuts are not an evidence based epidemiological response.

 

[HaNotsri]

My company basically has to go full digital in a week due to corona. If anyone knows a good collaborative software (preferably a web app) for business modeling it would be super appreciated. Might end up with some "let's paint together app" to solve it.

 

[Jim Bob]

Ivy League to Cancel All Athletic Events Through the Remainder of the Spring

I feel bad for the athletes who may be seeing their college careers end like this.

 

[SnuggaRUDE]

My company basically has to go full digital in a week due to corona. If anyone knows a good collaborative software (preferably a web app) for business modeling it would be super appreciated. Might end up with some "let's paint together app" to solve it.

Slack is super popular in programming circles.

 

[Chainshot]

Ivy League to Cancel All Athletic Events Through the Remainder of the Spring

I feel bad for the athletes who may be seeing their college careers end like this.

Sometimes public health supersedes all.

 

[Buffaloed]

Restrictions are necessary because the health care system will be overwhelmed if the spread of the disease isn't slowed. The population most severely affected, the elderly, and those with chronic disease is large. We know that many of those people will require hospitalization and the bed capacity isn't there if Covid-19 is allowed to spread unchecked. They found that out in China the hard way and had to build 2 temporary hospitals. We don't want MASH units in Delaware Park. The true mortality rate, which I expect to be less than 1%, really isn't the issue. The fact is we already know a lot of people will require hospitalization. The authorities are acting appropriately to mitigate the impact of that. I'd say it's vitally important.

Think of the people you know in that vulnerable population before complaining about cancellations and restrictions. Delaying the spread could save their lives. We can't lose RJ to no stinkin' virus!

If that doesn't do it for you, think about yourself or a loved one having a medical emergency and the hospitals are full.

Expect a vaccine for Covid-19 in record time. For the people involved it's a race to get it done before containment of the disease is lost. This is their Stanley Cup Playoffs.
COVID-19 Vaccine Shipped, and Drug Trials Start
Covid-19 vaccine development close by Israeli researchers

We have a vaccine for the flu. Over 60% of children are vaccinated, and 45% of adults. That has a significant impact on checking its spread. While it doesn't completely prevent infection in all cases, it does lessen the symptoms.

 

[Chainshot]

This "Scare" has already run well past SARS and H1N1. Don't look at the mortality rates, look at the hospitalization rates. Italy didn't lock down THEIR ENTIRE POPULATION because of the flu.

The complete lack of preventative measures being taken nationally is insane. You know what has never done a good job of fighting respiratory infections? Tax cuts! tax cuts are not an evidence based epidemiological response.

Coronavirus: COVID-19 Is Now Officially A Pandemic, WHO Says

 

[Dubi Doo]

This "Scare" has already run well past SARS and H1N1. Don't look at the mortality rates, look at the hospitalization rates. Italy didn't lock down THEIR ENTIRE POPULATION because of the flu.

The complete lack of preventative measures being taken nationally is insane. You know what has never done a good job of fighting respiratory infections? Tax cuts! tax cuts are not an evidence based epidemiological response.

I agree, but I do take solace in the fact that Italy and Wuhan are the absolute worst case scenarios given their circumstances. Italy is way more densely populated than the US and has about 10% more elderely people. Wuhan is more dense than NYC and has live stock in their street markets, which is where the disease originated from.

So, in theory, the virus should spread much slower throughout the US giving us more time to react. Of course, this puts faith in our president to react to such an epidemic effectively, which I have my doubts, but I'm going to avoid politics.

 

[Jim Bob]

Sometimes public health supersedes all.

I don't believe this move was made for public health reasons.

 

[Buffaloed]

My company basically has to go full digital in a week due to corona. If anyone knows a good collaborative software (preferably a web app) for business modeling it would be super appreciated. Might end up with some "let's paint together app" to solve it.

We use Slack. It's pretty ubiquitous.

 

[SnuggaRUDE]

I don't believe this move was made for public health reasons.

That's like.. your opinion man.