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Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


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8 minutes ago, PenelopeWitherspoon said:
10 hours ago, ChiTownDoc said:
I'm guessing on this one like everyone else...how long do we need to be quarantined...shelter in place etc?  I'm saying 2 months from March 14 when much of the lockdown started.  And I'm fully willing to admit that's wishful thinking so I have the green light to go be a degenerate on our annual vegas MDW trip...

I don't think folks will stand for 2 months. Govt needs to act quicker because I think the shelf life of this "quarantine" is 4-5 weeks (i.e. early May). Thwy have to get shit in place then move to more measured actions.

Besides Memorial Day will be here, and I wanna be able to wear my whites out in public.

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20 minutes ago, PenelopeWitherspoon said:
10 hours ago, ChiTownDoc said:
I'm guessing on this one like everyone else...how long do we need to be quarantined...shelter in place etc?  I'm saying 2 months from March 14 when much of the lockdown started.  And I'm fully willing to admit that's wishful thinking so I have the green light to go be a degenerate on our annual vegas MDW trip...

I don't think folks will stand for 2 months. Govt needs to act quicker because I think the shelf life of this "quarantine" is 4-5 weeks (i.e. early May). Thwy have to get shit in place then move to more measured actions.

Reminder:

Anne Frank and 7 others hid in a 450 sq/ft attic apartment for three years during WWII.

No tv, no video games, etc.

 

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2 hours ago, Buzzrock said:

How long before a segment of America backlashes on this? I’m already sensing a bit of “fuck this” attitude from some who are looking at 260 deaths in a country of 300M but also watching the destruction of the economy.

For me, it's more of a "prove it" attitude.  How many of those 260 were "unexpected?" A 90 year old is gonna die of SOMETHING, right?  IDK what that number is directly attributable to CV, but many of us suspect it is not remotely a significant percentage of the deaths; and it's hardly the reason to obliterate our way of life as a nation for a handful of deaths.

There is also a hint of underlying current from people who seem to want things to get more fucked up, economically and socially.  Fuck them.

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11 minutes ago, Onboard 2.0 said:

Fucking S.K, Japan, Singapore, HK....... splitters !!!

 

How in the hell is India not leading the world wide pack with their population density, and lack of widespread healthcare ?

Just guessing? Because the vast majority of Indians don’t travel and don’t come into contact with people who travel.  It’s spreading from a tiny subset of the managerial class and hospitality workers. 

My guess is that will also be true of most impoverished nations.  Once it takes off, though, it will spread like absolute wildfire.

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2 minutes ago, Iceman said:

For me, it's more of a "prove it" attitude.  How many of those 260 were "unexpected?" A 90 year old is gonna die of SOMETHING, right?  IDK what that number is, but many of us suspect it is not remotely a significant percentage of them; and it's hardly the reason to obliterate our way of life as a nation for a handful of deaths.

There is also a hint of underlying current from people who seem to want things to get more fucked up, economically and socially.  Fuck them.

y9kc7H.gif

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9 hours ago, triplehorn said:

 

(tl;dr)  About 3 weeks ago I registered with the Oregon Health Authority for email updates after the first covid case was diagnosed here.  A few days later when we were still at about 4-6 cases after the Vets in that nursing home got diagnosed down in the valley, I got an OHA email about a conference call with the press you could dial into to listen.  I joined the conference which had a panel of several state level medical officials and other govt policy types.  The 15-20min briefing was calm and reassuring and went on about the great length efforts that would be made to ensure the greatest protection and care would be provided to our cherished elderly Vets.  Then on the call they said you could enter a code on your phone to ask a question. 

I got patched in after hitting the buttons as the first question for the panel.  I identified myself and after acknowledging the effort to care for our nursing home elderly, I asked "considering this has a case doubling rate of 4 days with exponential spread, and that two weeks ago Italy was tranquil, and that right now our neighbors in Washington are under fire as I speak, what aggressive steps are are you considering to prevent spread such as social distancing or school closures when every day matters?"  The moderator then asks, "what news outlet are you with? Oh, this is only for press reporters *click*."  I stayed on to listen and there was a looong pause.  The reporters were freaked and the whole discourse in the room shifted.  The next day Gov. Kate Brown and some same panelists did a live webstream from PSU with a very different message speaking to urgency and laying out anticipated soon to be defined measures, making particular note of the predicament facing "our neighbors in Washington."  

Much rep for the thoughtful question. My hand hovered over the keyboard, however, for you not pulling a Hugh Grant but substituting "The Surly Horner" for news outlet in lieu of "Horse and Hound."

8 hours ago, Beau Vine said:

That must be some special bowl movement if you can strap a bayonet to it.

If we can mobilize a turd army within the next two weeks, we can retake DC (no CR).

6 hours ago, Hook1997 said:

The local sheriff in my county is still calling out On Facebook  the media for a ploy vs the republicans for this whole thing and it’s demo disease....   Someone else setup a meetup to do drink at a local restaurant tonight before they got shut down..  I have a feeling small town Texas with their mentality (a case was already confirmed) will be just as effected as big cities % wise soon due to stupidity. 

Another mom called me this week complaining about some other parents. The students on athletic teams are unhappy about their sports being cancelled (understandable) and are meeting up and having practices at the parent's homes/nearby parks and then gathering afterwards for meals. Her son knows and is friends with the students and was at work when one of the moms went through the drive through and picked up a very  large call ahead order that was to feed the crowd that was at her home. The customer was chatting with him and asking him about what precautions his employer was taking to make sure her order wasn't contaminated with the virus and the son was thinking, "?????"

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14 minutes ago, Bateshorn said:

Just guessing? Because the vast majority of Indians don’t travel and don’t come into contact with people who travel.  It’s spreading from a tiny subset of the managerial class and hospitality workers. 

My guess is that will also be true of most impoverished nations.  Once it takes off, though, it will spread like absolute wildfire.

That's been my thought as well. It seems like this virus rides on the back of folks with a bit more economic prosperity (foreign travel, or in that world of contact with foreign travelers).

Second point, yeah if it starts spreading in India, it's gonna be really ugly.  I don't even know what measures they've taken to even shut down their borders, 

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13 minutes ago, Onboard 2.0 said:

That's been my thought as well. It seems like this virus rides on the back of folks with a bit more economic prosperity (foreign travel, or in that world of contact with foreign travelers).

Second point, yeah if it starts spreading in India, it's gonna be really ugly.  I don't even know what measures they've taken to even shut down their borders, 

road-block-or-roadblock-concept-as-a-clo

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46 minutes ago, Onboard 2.0 said:

How in the hell is India not leading the world wide pack with their population density, and lack of widespread healthcare ?

They don’t go anywhere?   I mean when was the last time you were trampled at Westminster Abbey by Indian tourists?

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Just now, ClubWhatever said:

They don’t go anywhere?   I mean when was the last time you were trampled at Westminster Abbey by Indian tourists?

Well, besides being a very significant portion of our American hotel and convenience store industries, that'd be a good guess.  

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I have a neighbor that sounded like they hosted a small dinner party last night. A couple of cars in the driveway, cooking out back. What dont people get about social distancing. It’s not about whether the other people are nice, and probably are healthy.

and no I’m not mad that I didn’t get an invite.

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Listened to a bit of Dallas press conference regarding a drive-through testing center for 65+ year olds with symptoms.  It said they will get test results back in 3-5 days?  Seriously?  3-5 days for a test result is the best we can do?  Fucking pathetic.

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I have a neighbor that sounded like they hosted a small dinner party last night. A couple of cars in the driveway, cooking out back. What dont people get about social distancing. It’s not about whether the other people are nice, and probably are healthy.
and no I’m not mad that I didn’t get an invite.

Our new neighbors across the street hosted a party in front of their house yesterday afternoon. Counted 7 adults and 9 kids. Playing basketball and throwing a football.

Fucking idiots.
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1 minute ago, Skipper said:

Listened to a bit of Dallas press conference regarding a drive-through testing center for 65+ year olds with symptoms.  It said they will get test results back in 3-5 days?  Seriously?  3-5 days for a test result is the best we can do?  Fucking pathetic.

Anyone with symptoms should just assume they have it until testing shows otherwise. And if the symptoms get bad, call your health provider or hospital to see what you should do.

unfortunately formally knowing you have it doesn’t produce a cure for you.

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3 minutes ago, DDD Dad said:


Our new neighbors across the street hosted a party in front of their house yesterday afternoon. Counted 7 adults and 9 kids. Playing basketball and throwing a football.

Fucking idiots.

"Honey this might be your last birthday, so let's raise some hell tonight..."

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Our new neighbors across the street hosted a party in front of their house yesterday afternoon. Counted 7 adults and 9 kids. Playing basketball and throwing a football.

Fucking idiots.
People aren't going to change their behavior unless forced.
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1 minute ago, Nice Guy Eddie said:

You’re right, you can only catch and spread coronavirus if there are more than 10 people in the room.

 

I'm finding myself having to be the voice of reason/borderline asshole amongst my friends re: social gatherings. We're talking about a group of neighbors, married couples, most of whom are in their early 60s (I'm 50). Most have known one another for close to 10 years, have had lots of BBQs together, hung out at the neighborhood pubs, traveled together, etc. 

They were all gung ho last weekend for a St Paddy's day celebration & went out. We stayed in (hey, I was smoking a brisket). I kept getting texts from them, pics of the gang in large groups of strangers reveling. This was just a week after many of them had gone to the McGuire's 5K fun run in Pensacola along with several thousand runners.

I caved a bit & went to a house gathering on Thursday. There were 8 of us total. They sat around the kitchen table drinking beer. I drank mine while playing with their dogs in the living room. They want a traveling happy hour 2-3X a week with each of us hosting. I've told them they're going to have to proceed without me unless the weather is nice enough we can do it in a backyard. 

The worst part is that three of them would be extremely high risk due to their age & pre-existing respiratory issues. They know it's a serious situation, but they feel like getting together & talking about what a mess this is somehow is worthwhile.

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4 minutes ago, Hank_Hill said:

Well, no. But there’s data and a reason for why small gatherings are still permitted. 

why have unnecessary parties at this moment? If one person there is sick, the other 9 could easily be sick at the end of next week. I find it hard to believe that a dinner party, people are also meeting the guideline of 6 ft apart. 

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1 minute ago, Nice Guy Eddie said:

why have unnecessary parties at this moment? If one person there is sick, the other 9 could easily be sick at the end of next week. I find it hard to believe that a dinner party, people are also meeting the guideline of 6 ft apart. 

Well, parties with people you hate sounds like a good idea right.. almost the perfect crime...

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The Frontline in Louisiana - https://www.propublica.org/article/a-medical-worker-describes--terrifying-lung-failure-from-covid19-even-in-his-young-patients?utm_medium=twitter&utm_source=social&utm_campaign=publishtweet#179875

A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients

“It first struck me how different it was when I saw my first coronavirus patient go bad. I was like, Holy shit, this is not the flu. Watching this relatively young guy, gasping for air, pink frothy secretions coming out of his tube.”

Spoiler

A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients

“It first struck me how different it was when I saw my first coronavirus patient go bad. I was like, Holy shit, this is not the flu. Watching this relatively young guy, gasping for air, pink frothy secretions coming out of his tube.”

by Lizzie Presser

March 21, 5 a.m. EDT
20200320-Ventilator-3x2.jpg
A medical worker treats a COVID-19 patient in an intensive care unit in Italy. Across the globe, health care providers are using ventilators to treat COVID-19 patients. (Flavio Lo Scalzo/Reuters)

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

As of Friday, Louisiana was reporting 479 confirmed cases of COVID-19, one of the highest numbers in the country. Ten people had died. The majority of cases are in New Orleans, which now has one confirmed case for every 1,000 residents. New Orleans had held Mardi Gras celebrations just two weeks before its first patient, with more than a million revelers on its streets.

I spoke to a respiratory therapist there, whose job is to ensure that patients are breathing well. He works in a medium-sized city hospital’s intensive care unit. (We are withholding his name and employer, as he fears retaliation.) Before the virus came to New Orleans, his days were pretty relaxed, nebulizing patients with asthma, adjusting oxygen tubes that run through the nose or, in the most severe cases, setting up and managing ventilators. His patients were usually older, with chronic health conditions and bad lungs.

Since last week, he’s been running ventilators for the sickest COVID-19 patients. Many are relatively young, in their 40s and 50s, and have minimal, if any, preexisting conditions in their charts. He is overwhelmed, stunned by the manifestation of the infection, both its speed and intensity. The ICU where he works has essentially become a coronavirus unit. He estimates that his hospital has admitted dozens of confirmed or presumptive coronavirus patients. About a third have ended up on ventilators.

His hospital had not prepared for this volume before the virus first appeared. One physician had tried to raise alarms, asking about negative pressure rooms and ventilators. Most staff concluded that he was overreacting. “They thought the media was overhyping it,” the respiratory therapist told me. “In retrospect, he was right to be concerned.”

He spoke to me by phone on Thursday about why, exactly, he has been so alarmed. His account has been condensed and edited for clarity.

“Reading about it in the news, I knew it was going to be bad, but we deal with the flu every year so I was thinking: Well, it’s probably not that much worse than the flu. But seeing patients with COVID-19 completely changed my perspective, and it’s a lot more frightening.”

This is knocking out what should be perfectly fit, healthy people.

“I have patients in their early 40s and, yeah, I was kind of shocked. I’m seeing people who look relatively healthy with a minimal health history, and they are completely wiped out, like they’ve been hit by a truck. This is knocking out what should be perfectly fit, healthy people. Patients will be on minimal support, on a little bit of oxygen, and then all of a sudden, they go into complete respiratory arrest, shut down and can’t breathe at all.”

They suddenly become unresponsive or go into respiratory failure.

“We have an observation unit in the hospital, and we have been admitting patients that had tested positive or are presumptive positive — these are patients that had been in contact with people who were positive. We go and check vitals on patients every four hours, and some are on a continuous cardiac monitor, so we see that their heart rate has a sudden increase or decrease, or someone goes in and sees that the patient is struggling to breathe or is unresponsive. That seems to be what happens to a lot of these patients: They suddenly become unresponsive or go into respiratory failure.”

The lung is filled with so much fluid, displacing where the air would normally be.

“It’s called acute respiratory distress syndrome, ARDS. That means the lungs are filled with fluid. And it’s notable for the way the X-ray looks: The entire lung is basically whited out from fluid. Patients with ARDS are extremely difficult to oxygenate. It has a really high mortality rate, about 40%. The way to manage it is to put a patient on a ventilator. The additional pressure helps the oxygen go into the bloodstream.

“Normally, ARDS is something that happens over time as the lungs get more and more inflamed. But with this virus, it seems like it happens overnight. When you’re healthy, your lung is made up of little balloons. Like a tree is made out of a bunch of little leaves, the lung is made of little air sacs that are called the alveoli. When you breathe in, all of those little air sacs inflate, and they have capillaries in the walls, little blood vessels. The oxygen gets from the air in the lung into the blood so it can be carried around the body.

“Typically with ARDS, the lungs become inflamed. It’s like inflammation anywhere: If you have a burn on your arm, the skin around it turns red from additional blood flow. The body is sending it additional nutrients to heal. The problem is, when that happens in your lungs, fluid and extra blood starts going to the lungs. Viruses can injure cells in the walls of the alveoli, so the fluid leaks into the alveoli. A telltale sign of ARDS in an X-ray is what’s called ‘ground glass opacity,’ like an old-fashioned ground glass privacy window in a shower. And lungs look that way because fluid is white on an X-ray, so the lung looks like white ground glass, or sometimes pure white, because the lung is filled with so much fluid, displacing where the air would normally be.”

20200321-lungs-inline-1.jpeg A screenshot of chest radiographs of a man suspected to have COVID-19. (Obtained by ProPublica via the Radiological Society of North America, cited in the paper “Severe Acute Respiratory Disease in a Huanan Seafood Market Worker: Images of an Early Casualty” by Lijuan Qian, Jie Yu and Heshui Shi.)

This severity ... is usually more typical of someone who has a near drowning experience ... or people who inhale caustic gas.

“With our coronavirus patients, once they’re on ventilators, most need about the highest settings that we can do. About 90% oxygen, and 16 of PEEP, positive end-expiratory pressure, which keeps the lung inflated. This is nearly as high as I’ve ever seen. The level we’re at means we are running out of options.

“In my experience, this severity of ARDS is usually more typical of someone who has a near drowning experience — they have a bunch of dirty water in their lungs — or people who inhale caustic gas. Especially for it to have such an acute onset like that. I’ve never seen a microorganism or an infectious process cause such acute damage to the lungs so rapidly. That was what really shocked me.”

You’ll try to rip the breathing tube out because you feel it is choking you ...

“It first struck me how different it was when I saw my first coronavirus patient go bad. I was like, Holy shit, this is not the flu. Watching this relatively young guy, gasping for air, pink frothy secretions coming out of his tube and out of his mouth. The ventilator should have been doing the work of breathing but he was still gasping for air, moving his mouth, moving his body, struggling. We had to restrain him. With all the coronavirus patients, we’ve had to restrain them. They really hyperventilate, really struggle to breathe. When you’re in that mindstate of struggling to breathe and delirious with fever, you don’t know when someone is trying to help you, so you’ll try to rip the breathing tube out because you feel it is choking you, but you are drowning.

“When someone has an infection, I’m used to seeing the normal colors you’d associate with it: greens and yellows. The coronavirus patients with ARDS have been having a lot of secretions that are actually pink because they’re filled with blood cells that are leaking into their airways. They are essentially drowning in their own blood and fluids because their lungs are so full. So we’re constantly having to suction out the secretions every time we go into their rooms.”

I do not want to catch this.

“Before this, we were all joking. It’s grim humor. If you are exposed to the virus and test positive and go on quarantine, you get paid. We were all joking: I want to get the coronavirus because then I get a paid vacation from work. And once I saw these patients with it, I was like, Holy shit, I do not want to catch this and I don’t want anyone I know to catch this.

“I worked a long stretch of days last week, and I watched it go from this novelty to a serious issue. We had one or two patients at our hospital, and then five to 10 patients, and then 20 patients. Every day, the intensity kept ratcheting up. More patients, and the patients themselves are starting to get sicker and sicker. When it first started, we all had tons of equipment, tons of supplies, and as we started getting more patients, we started to run out. They had to ration supplies. At first we were trying to use one mask per patient. Then it was just: You get one mask for positive patients, another mask for everyone else. And now it’s just: You get one mask.

“I work 12-hour shifts. Right now, we are running about four times the number of ventilators than we normally have going. We have such a large volume of patients, but it’s really hard to find enough people to fill all the shifts. The caregiver-to-patient ratio has gone down, and you can’t spend as much time with each patient, you can’t adjust the vent settings as aggressively because you’re not going into the room as often. And we’re also trying to avoid going into the room as much as possible to reduce infection risk of staff and to conserve personal protective equipment.”

Even if you survive ... it can also do long-lasting damage.

“But we are trying to wean down the settings on the ventilator as much as possible, because you don’t want someone to be on the ventilator longer than they need to be. Your risk of mortality increases every day that you spend on a ventilator. The high pressures from high vent settings is pushing air into the lung and can overinflate those little balloons. They can pop. It can destroy the alveoli. Even if you survive ARDS, although some damage can heal, it can also do long-lasting damage to the lungs. They can get filled up with scar tissue. ARDS can lead to cognitive decline. Some people’s muscles waste away, and it takes them a long time to recover once they come off the ventilator.

“There is a very real possibility that we might run out of ICU beds and at that point I don’t know what happens if patients get sick and need to be intubated and put on a ventilator. Is that person going to die because we don’t have the equipment to keep them alive? What if it goes on for months and dozens of people die because we don’t have the ventilators?

“Hopefully we don’t get there, but if you only have one ventilator, and you have two patients, you’re going to have to go with the one who has a higher likelihood of surviving. And I’m afraid we’ll get to that point. I’ve heard that’s happening in Italy.”

 

 

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58 minutes ago, Iceman said:

For me, it's more of a "prove it" attitude.  How many of those 260 were "unexpected?" A 90 year old is gonna die of SOMETHING, right?  IDK what that number is directly attributable to CV, but many of us suspect it is not remotely a significant percentage of the deaths; and it's hardly the reason to obliterate our way of life as a nation for a handful of deaths.

I don't think you get it.  First of all, death trails symptom onset by about 20 days.  So people dying today were infected in late February.  But you are right you may very well survive even a severe case (even if you need to be on a respirator for weeks).  But what happens to our healthcare infrastructure while each hospital is fighting to keep more and more people alive (while more and more healthcare workers and first responders become infected and are out of the game)?  Do you want to die of a heart attack you would otherwise survive except for the fact that the ambulance takes 45 minutes to arrive instead of 8 and then you can't get the treatment you would otherwise receive because the hospital is overwhelmed?  That heart attack death will never be attributed to Covid but it's going to happen if we can't manage it.  

If you really want to try to understand instead of looking at a snapshot in time and rolling your eyes at "a handful of deaths", this is one of the better articles I've come across:  https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56

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why have unnecessary parties at this moment? If one person there is sick, the other 9 could easily be sick at the end of next week. I find it hard to believe that a dinner party, people are also meeting the guideline of 6 ft apart. 


What about necessary parties?
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15 minutes ago, Nice Guy Eddie said:

Anyone with symptoms should just assume they have it until testing shows otherwise. And if the symptoms get bad, call your health provider or hospital to see what you should do.

unfortunately formally knowing you have it doesn’t produce a cure for you.

I agree with this.   It's just ridiculous from a macro perspective.  Even when we finally ramp up testing this next week, data is still going to be trailing 3-5 days which isn't helpful for city leaders monitoring the rate of spread and what (if any) additional measures are warranted. Further, I think it's well established people are fucking idiots.  No doubt some of those with mild cases will start feeling better during that 5 day period, assume it was just a cold, and go back out in public while still shedding the virus.   I just don't understand how as a state (or as a city) we still haven't managed to put ourselves in a better position to fight this.   

If the eventual goal is to slow the spread down enough we can open things back up and get the economy going, a key component to that is mass testing and contract tracing.  3-5 days  and a few thousand tests per week isn't going to cut it.  We've got to start getting our shit together or we're going to all be stuck at home a lot longer than potentially necessary. 

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11 minutes ago, Skipper said:

I don't think you get it.  First of all, death trails symptom onset by about 20 days.  So people dying today were infected in late February.  But you are right you may very well survive even a severe case (even if you need to be on a respirator for weeks).  But what happens to our healthcare infrastructure while each hospital is fighting to keep more and more people alive (while more and more healthcare workers and first responders become infected and are out of the game)?  Do you want to die of a heart attack you would otherwise survive except for the fact that the ambulance takes 45 minutes to arrive instead of 8 and then you can't get the treatment you would otherwise receive because the hospital is overwhelmed?  That heart attack death will never be attributed to Covid but it's going to happen if we can't manage it.  

If you really want to try to understand instead of looking at a snapshot in time and rolling your eyes at "a handful of deaths", this is one of the better articles I've come across:  https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56

I get all that.I COMPLETELY get that the health system will/ could be inundated with folks that it otherwise would not be treating.  That's an absolute function of our society in general- see TP hoarders and then apply mentality to seeking medical care that might not be necessary.

FTR, I have been abiding by the guidelines and "suggestions" recommended by the 'experts.'  I was just describing how the mindset might waver in the face of less than convincing results.  The dichotomy of "Not enough people are dying, so let's discard the precautions" could be very real.  If America gets to recovery mode, how do we quell popups or hotspots created by international travel? At what point do we try to achieve some semblance of normalcy with regard to economic and social activity so that 'life' does in fact go on?

There is nor script or precedent for this whole situation.  It's gonna be interesting to see where and how it goes, to say the least. How do we as a society determine what the proper risk/ reward might be?

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  • hayden_horn changed the title to Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


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