GatewayRedbirds.com

I guess I'm getting a little confused by the shelter in place stuff. We aren't doing it, yet. But say I stay home for three weeks. Then I go out and the disease is still out there. What good did it really do? Slow the spread maybe? But it seems that it would explode all over again. I suppose we are trying to save the hospitals from one big overwhelming situation.
Maybe I'll ask Gupta.

BottenFieldofDreams wrote: ↑

March 25 20, 11:02 am

Portland has two alt-weeklys that were already struggling. One had gone to bi-weekly. But because everything's cancelled: shows, bars, food: they have no revenue. It all came from those ads. I hope at least one of them makes it. I don't have real big problems with The Oregonian (it definitely sucks a lot more in the current state of clickbait media), but I think the counter culture voice is important. However, it's also a voice that will find a way out one way or another.

Interesting impact of COVID.

St Louis' own Riverfront Times has also laid off all its staff (I think?) but they're still posting stuff on the social media feed, and put out what will probably be their final issue for a while yesterday.

Leroy wrote: ↑

March 26 20, 8:29 am

I guess I'm getting a little confused by the shelter in place stuff. We aren't doing it, yet. But say I stay home for three weeks. Then I go out and the disease is still out there. What good did it really do? Slow the spread maybe? But it seems that it would explode all over again. I suppose we are trying to save the hospitals from one big overwhelming situation.
Maybe I'll ask Gupta.

Basically yes,save the hospitals from being overwhelmed. That's what all the "flatten the curve" stuff is about. In areas where healthcare isn't overwhelmed, the death rate is 1-2% ish (lots of conflicting info that changes daily, but in that neighborhood). Basically 2-4x higher than the normal flu. So bad, yes, but not catastrophic.

For areas where the healthcare system is overwhelmed, the death rate is far higher. I've seen 5-10%. If you only compare deaths vs recoveries, (taking out current cases that haven't been resolved as recovered/dead) its more like 15-20% death rate where overwhelmed. (I haven't looked at the data for a couple of days so that may have changed a percentage point or two in either direction)

These stay at home measures help spread out the rate of infection, and also buy time to hopefully develop a cure/vaccine/something. Its a special issue because its so damn easy to spread, and the incubation time is so long.

Leroy wrote: ↑

March 26 20, 8:29 am

I guess I'm getting a little confused by the shelter in place stuff. We aren't doing it, yet. But say I stay home for three weeks. Then I go out and the disease is still out there. What good did it really do? Slow the spread maybe? But it seems that it would explode all over again. I suppose we are trying to save the hospitals from one big overwhelming situation.
Maybe I'll ask Gupta.

We’re in a shelter in place in ft worth; and it won’t be just a few weeks (even though the “end” date is in April)...from everything I’ve been told/heard in healthcare where I work is this will be in place for months and months (most say at least through summer)...basically until the new cases reported have diminished to a negligible amount (and we haven’t even begun to peak yet).

So even though these shelter in place orders say a few weeks, they’re really not. If this doesn’t start to peak and then slow down significantly very soon, then it’s more like 4-5 months of shelter in place.

(And yes, the economy will be destroyed if that turns out to be true)

The DJIA is up like 4% despite 3.3M new jobless claims, a claim that makes previous claims in a recession look like childs play (3.3M compared to 0.5M in 2008 let's say)

One thing that's going to be interesting to unfold, and jc kind of alluded to it, is what is the death rate? And, it's not a meaningless or easy question.

Leroy wrote: ↑

March 26 20, 8:29 am

I guess I'm getting a little confused by the shelter in place stuff. We aren't doing it, yet. But say I stay home for three weeks. Then I go out and the disease is still out there. What good did it really do? Slow the spread maybe? But it seems that it would explode all over again. I suppose we are trying to save the hospitals from one big overwhelming situation.
Maybe I'll ask Gupta.

You've got it.

The same way our grocery stores are optimized to have just enough surplus on hand to meet normal demand with a little, but not too much, extra, our hospitals are the same. They have budgets just like everyone and the future of healthcare is both rapidly changing from a treatment and technology standpoint and very uncertain from a compensation standpoint (too many uninsured, medicare is dysfunctional, and costs are too high). Because of that, they all optimize their expenditure to ensure a balance between meeting normal demand for treatment with being able to survive as a business well into the future.

If we don't "flatten the curve" by staying home, hospitals will be just like grocery stores with toilet paper and lysol, except the things they run out of will be ventilators, PPE (masks, gowns, etc), quarantine spaces/equipment, and also people. Hospital staff will go down from infection, exhaustion, stress, etc.. When that happens, they will be forced to triage incoming patients via defacto death panels, deciding who is worth investing a precious ventilator mask on (a young, relatively healthy person) or an old person who is less likely to survive and has already lived a longer life.

Much like toilet paper and lysol, there will be a gap between supply meeting demand and because this is a pandemic and literally every country on earth is facing the same supply shortages, well, it ain't good.

Here is the perfect example of the importance of social distancing:
https://talksport.com/football/687311/a ... amo-mayor/

EVERY, SINGLE ATTENDEE AT THIS SOCCER GAME WAS INFECTED. COVID literally batted 1.000 and infected 40,000 out of 40,000 attendees. This virus is unprecedented in it's ability to infect.

This match was the inciting incident that lead to the devastation in northern Italy. It created an exponential surge of infections that overwhelmed a health system that is superior to ours in many ways.

I think it's fair to say that shelter in place orders are more important in Manhattan than South Dakota because of population density, but I'd also caution you as someone who works with outlying and sometimes rural healthcare networks in Illinois, Michigan and Idaho that while places like NYC may have way more cases, they also have better capacity for treating than areas like S. Dakota. They have more of the aforementioned equipment and more capacity of beds and medical staff than rural areas. Crucially, they also have more pull politically and culturally to be at the front of the line when supplies and reinforcements are available. Because of that, conditions will be relatively similar when it comes to shortages and inability to treat everyone with the same degree of care regardless of where you live or when the outbreak really hits hard in your area.


Also, anecdotally from what I've read, this thing sucks to experience, even for those who survive. It has a way longer symptomatic period than the flu and I don't relish the idea of being feverish, achy, and coughing for 10-14 days. That sounds absolutely miserable.



Edit - I left out the most crucial part of the equation. Testing. Testing has proven to be the most important factor in containing the outbreak. Rural places will be far down the food chain for testing capacity. Places like West Virginia and Mexico were touting their lack of infections as recently as a week ago and it turned out that they just weren't testing and now they're beginning to be overwhelmed just like everywhere else.

That's a pretty good explanation. Thanks.
I do think that maybe there is a lack of testing out here, but it's also much easier to trace people that have it or the people they may have contacted. I mean, I come in contact with maybe 5 people a day right now in an area of 120,000 people. Obviously way more if I go to a store or something.
I can't imagine tracing the steps of someone who was on a subway in NYC or something.
I hate to sound cold, but the disasters every where else made even us dumb rubes do what we need to before it blows up here too.

Welp, two people who work in my building tested positive. They don't work on my floor, and apparently the last time either of them were in the office was March 13. Not sure why we're only finding out today. Our firm went to WFH two days ago, and I wish we had sooner.

Also, sounds like the new hyped/promised advance is taking antibodies from ppl who have had COVID-19 and got healthy and injecting them into those who are ill. Supposedly it's a promising development.

Btw, the last hyped/promised advance - chloroquine, which our dear President touted as a miracle cure - was based on a completely fabricated study by a guy who publishes a few hundred bogus studies a year.