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


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1 minute ago, GRHorn said:

One thing that I find very curious is, the ihme model has been overestimating pretty badly  hospitalizations and deaths the whole time, but not that it’s flipped and says we’ve past the peak, it’s underestimating the impact. 

Today’s projected hospitalizations 1,312

Actual 1,471

hmm

the hospitalizations number, IMO, is likely very unreliable.  no one was really tracking it well.  Cuomo/NY seemed to be the only one really charting it consistently. 

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And on the testing I have no idea how anyone can make blanket statements just saying 'testing'.  Testing what?  Who?  Which type of test, antibody vs PCR?  Just broadly saying there's enough testing is asinine and flat our false.

Nursing homes / long term centers now are being told, treat every admit like a positive.  So in many buildings, where it's possible, you isolate admits for 14 days, and if they show no signs move them to a regular floor.  The truth is if there was enough testing, we'd literally be blanketing long term care with testing - as in the entire population of workers and residents.  This has happened but in very few places. That's for any city with serious spread - like all of Chicagoland and some areas in Texas. 

Also, as many physicians define 'enough', it's can I, specifically, test a patient that comes in my ER.  That's gotten MUCH better, and it may be enough.  But overall testing includes a shitload more than that.  One - most experts would agree accurate antibody testing is more important to truly open up the economy vs PCR C19 testing.  Also current PCR C19 testing takes a long time to get results, like several days. If we want to re-open on a broad scale you need rapid point of care testing - Abbott has the lab but they can't produce the machines fast enough...the technology is there.   And the antibody testing is of horrible quality - either too many false positives as the testing is sensitive for any Coronavirus or not sensitive enough and missing patients who we verified multiple times as having had C19.  

I'll screenshot a doc on the frontlines in Lubbock and his thoughts on testing currently.  

But yelling at eachother about 'enough testing' without specifying is moronic. 

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4 minutes ago, GRHorn said:

San Antonio metro was 118 on Friday. 
 

Warmer weather and people more spread out I think are huge factors. 

Less density for sure - and I'm REALLY hoping warmer weather is a factor...means I can use my damn condo in Miami and get into some Vegas tits this summer.  Please God...

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7 minutes ago, ChiTownDoc said:

And on the testing I have no idea how anyone can make blanket statements just saying 'testing'.  Testing what?  Who?  Which type of test, antibody vs PCR?  Just broadly saying there's enough testing is asinine and flat our false.

Nursing homes / long term centers now are being told, treat every admit like a positive.  So in many buildings, where it's possible, you isolate admits for 14 days, and if they show no signs move them to a regular floor.  The truth is if there was enough testing, we'd literally be blanketing long term care with testing - as in the entire population of workers and residents.  This has happened but in very few places. That's for any city with serious spread - like all of Chicagoland and some areas in Texas. 

Also, as many physicians define 'enough', it's can I, specifically, test a patient that comes in my ER.  That's gotten MUCH better, and it may be enough.  But overall testing includes a shitload more than that.  One - most experts would agree accurate antibody testing is more important to truly open up the economy vs PCR C19 testing.  Also current PCR C19 testing takes a long time to get results, like several days. If we want to re-open on a broad scale you need rapid point of care testing - Abbott has the lab but they can't produce the machines fast enough...the technology is there.   And the antibody testing is of horrible quality - either too many false positives as the testing is sensitive for any Coronavirus or not sensitive enough and missing patients who we verified multiple times as having had C19.  

I'll screenshot a doc on the frontlines in Lubbock and his thoughts on testing currently.  

But yelling at eachother about 'enough testing' without specifying is moronic. 

what type of testing is Fauci talking about when he says we are good to get safely through phase 1?

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Just now, dcar00 said:

what type of testing is Fauci talking about when he says we are good to get safely through phase 1?

I'm assuming PCR testing for sure...and he would never admit there's enough point of care testing - we all know those are very rare right now.  Antibody testing is not nearly as widespread and what's out there is garbage.  He's not talking about those,  I'm pretty sure.  I'm definitely not a fire Fauci guy but he's not a God that knows it all, he's definitely doing his best like we all are.  And I'm glad he's there for the country.  I would give him and B.  It's a tough as hell job especially with all the nutters, on both sides, that want to politicize shit.  

Also phase 1 includes gyms, lol.  I mean, every doc I've discussed this with is like WTF on that one.  

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4 hours ago, aggie08 said:

Sorry, didn't mean to imply that forgery was what you were suggesting. I don't agree with all of what you say, but you at least come at it from a mostly rational...unlike that stork642 troll.

I was responding to modesitt's anecdote about his grandma's sister's daughter telling him that doctors and/or the state told her that they were certain the death wasn't COVID-related, but they were going to mark it that way anyway because money. That's the definition of forgery. I believe modesitt that that's what he was told, but I don't buy it all at the doctor/coroner/hospital level.

I’m definitely not a troll but I guess you can’t really deal with people who don’t echo your viewpoints.  I will however wear with pride the troll label when it comes from an aggy.  Thanks 

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24 minutes ago, ChiTownDoc said:

And on the testing I have no idea how anyone can make blanket statements just saying 'testing'.  Testing what?  Who?  Which type of test, antibody vs PCR?  Just broadly saying there's enough testing is asinine and flat our false.

Nursing homes / long term centers now are being told, treat every admit like a positive.  So in many buildings, where it's possible, you isolate admits for 14 days, and if they show no signs move them to a regular floor.  The truth is if there was enough testing, we'd literally be blanketing long term care with testing - as in the entire population of workers and residents.  This has happened but in very few places. That's for any city with serious spread - like all of Chicagoland and some areas in Texas. 

This is the secret DeSantis was trying to keep from the public.  Facing a lawsuit from the Herald he finally released the information.   I hope other states are doing a much better job than Florida.

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11 minutes ago, stork642 said:

I’m definitely not a troll but I guess you can’t really deal with people who don’t echo your viewpoints.  I will however wear with pride the troll label when it comes from an aggy.  Thanks 

That's awesome. The quote that you chose to tailor that response to is literally me showing appreciation to a poster who has radically different viewpoints than me. You're not too bright, are ya?

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2 minutes ago, aggie08 said:

That's awesome. The quote that you chose to tailor that response to is literally me showing appreciation to a poster who has radically different viewpoints than me. You're not too bright, are ya?

We could do this all day.  You calling me a troll is you implying I can’t legitimately have my viewpoint I’m just here to start shit.  At least be consistent in “praising” different opinions and stop patting yourself on the back.  

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One thing that I find very curious is, the ihme model has been overestimating pretty badly  hospitalizations and deaths the whole time, but not that it’s flipped and says we’ve past the peak, it’s underestimating the impact. 
Today’s projected hospitalizations 1,312
Actual 1,471
hmm

That site gives itself incredible wiggle range. Range was probably 500-5,827
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35 minutes ago, BradInATX said:

 

Yeah, nobody on this thread is saying that the testing is where it needs to be right now. In fact, that's sort of the point, that we need to make it better. 

I'm just patiently waiting for him to post any sort of evidence that backs up his assertion that it is impossible to ramp up our testing infrastructure to more adequate levels. (Narrator: he won't)

Because for about the eighth time, I said rt-PCR is not meant for testing the general public. It is expensive, time-consuming, and requires specific expertise. Currently, antibody tests are inaccurate and of limited utility because of their poor predictive value. So specific to rt-PCR tests, I said they will never be ramped up to the level that we can test the entire US population, and that holds even more true when we are talking about ongoing testing. Because if you are negative today, there is no guarantee that you will be negative tomorrow.

Anyway, a common thermal cycler like the ABI 7500 Fast Dx or QuantStudio costs over $50,000. Commercial assays cost about $40 per test. Tests take between 4 and 8 hours. A million tests can be made in a week so 300 million tests would take 300 weeks to make. Now also remember that it requires expertise to collect samples and run the tests and that there are a limited number of thermal cyclers in clinical use and a limited number of people who can collect samples and a limited number of people who can run the tests and a limited number of reagent quickmixes and perhaps you will see the problem.

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58 minutes ago, ChiTownDoc said:

I'm assuming PCR testing for sure...and he would never admit there's enough point of care testing - we all know those are very rare right now.  Antibody testing is not nearly as widespread and what's out there is garbage.  He's not talking about those,  I'm pretty sure.  I'm definitely not a fire Fauci guy but he's not a God that knows it all, he's definitely doing his best like we all are.  And I'm glad he's there for the country.  I would give him and B.  It's a tough as hell job especially with all the nutters, on both sides, that want to politicize shit.  

Also phase 1 includes gyms, lol.  I mean, every doc I've discussed this with is like WTF on that one.  

agree gyms is going to be interesting. time for some folks to just run around the neighborhood and do some push ups.  didn't know the gym lobby was so powerful.

Also, I like Fauci.  I think the guy is a pretty straight shooter.  I do think he was being fed shitty data from IHME.

Edited by dcar00
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33 minutes ago, stork642 said:

We could do this all day.  You calling me a troll is you implying I can’t legitimately have my viewpoint I’m just here to start shit.  At least be consistent in “praising” different opinions and stop patting yourself on the back.  

dude, putting it on the wall is the ultimate back patting...

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33 minutes ago, MNLonghornFUKM said:


That site gives itself incredible wiggle range. Range was probably 500-5,827

if people actually looked at how this shit happens they would be amazed but they want to yell at clouds mostly.

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29 minutes ago, Bevo said:

Because for about the eighth time, I said rt-PCR is not meant for testing the general public. It is expensive, time-consuming, and requires specific expertise. Currently, antibody tests are inaccurate and of limited utility because of their poor predictive value. So specific to rt-PCR tests, I said they will never be ramped up to the level that we can test the entire US population, and that holds even more true when we are talking about ongoing testing. Because if you are negative today, there is no guarantee that you will be negative tomorrow.

Anyway, a common thermal cycler like the ABI 7500 Fast Dx or QuantStudio costs over $50,000. Commercial assays cost about $40 per test. Tests take between 4 and 8 hours. A million tests can be made in a week so 300 million tests would take 300 weeks to make. Now also remember that it requires expertise to collect samples and run the tests and that there are a limited number of thermal cyclers in clinical use and a limited number of people who can collect samples and a limited number of people who can run the tests and a limited number of reagent quickmixes and perhaps you will see the problem.

Still waiting for you to cite a credible source that backs up your earlier claim that it's literally impossible to ramp testing up to more adequate levels.

Waiting-Skeleton.jpg

 

Edited by BradInATX
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7 minutes ago, BradInATX said:

Still waiting for you to cite a credible source that backs up your earlier claim that it's literally impossible to ramp testing up to more adequate levels.

Waiting-Skeleton.jpg

 

first it was 2M will die

then it was 500K will die

then it was we don't have enough beds

then it was we don't have enough vents

then it was we don't have tests

then it was we aren't ramping to have adequate tests

all in 7 weeks

oh what may come May(I'm guessing why the don't have antibody tests everywhere for 300M people)

 

Edited by dcar00
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Just now, dcar00 said:

first it was 2M will die

then it was 500K will die

then it was we don't have enough beds

then it was we don't have enough vents

then it was we don't have tests

then it was we aren't ramping to have adequate tests

all in 7 weeks

oh what may come May(I'm guessing why the don't we have antibody tests everywhere for 300M people)

 

Who are you talking to?

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7 hours ago, ChiTownDoc said:

I'll answer in more detail in a bit.  The antibody testing is very inaccurate right now.  That's why many feel people are getting 'reinfected'...they never really had antibodies in the first place. 

And testing is the first step - totally agree you need to trace after that.  1. Test 2. Trace 3. Open shit back up before we kill ourselves

Question for you Or other doctors on the “reinfected”.  Were those identified as reinfected tested for anti-bodies or just to see if they were testing negative for Coronavirus?  My guess is that anti-body testing is or was too new or inaccurate to be used and it was just testing negative for Covid-19.

If this is correct is it unusual for people infected with a virus to get “better” but not retain anti-bodies?

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3 minutes ago, Bevo said:

You gonna email me a copy of this $3,000 report? Or am I supposed to just take your word for it that it supports your position?

Good grief... the gymnastics here.  I'll be waiting if you want to actually be serious.

Edited by BradInATX
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13 minutes ago, dcar00 said:

first it was 2M will die

then it was 500K will die

then it was we don't have enough beds

then it was we don't have enough vents

then it was we don't have tests

then it was we aren't ramping to have adequate tests

all in 7 weeks

oh what may come May(I'm guessing why the don't have antibody tests everywhere for 300M people)

 

Who said 2 million or even 500k would die if we shutdown? Who are you talking about? 

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33 minutes ago, stork642 said:

We could do this all day.  You calling me a troll is you implying I can’t legitimately have my viewpoint I’m just here to start shit.  At least be consistent in “praising” different opinions and stop patting yourself on the back.  

Fine.  I'll bite.  So your contention, as I understand it, is that state governments--namely in NY and Michigan--are pressuring their hospitals to churn out higher death numbers, so they can get a bigger cut of stimulus money.  Meaning doctors, coroners, hospital officials, etc. are in the loop to try to push as many "maybes" as they can towards "COVID" and assigning "maybes" to the slightest of symptoms, thus intentionally going against what the CDC stipulates.

Couldn't I just as easily say that there's heavy incentive for the more quarantine-impatient states to fudge and suppress the numbers in the opposite direction?  You don't think the governor of Alabama, for instance, would love to say, "Look at these low numbers! We've got this under control, so we're going to open back up!"  Isn't that just as logical (or illogical in this case)?  There's a ton of money on the table in my example too.  But I'd sound pretty fucking stupid parroting that over and and over and over without anything but speculation to back it up.*

If you're going to throw around pretty substantial conspiracy theories and allegations of corruption, how about providing something resembling facts?  It wouldn't take much: the normally expected deaths--given time of year and population growth--are out there.  If you could show me that expected deaths for the first two weeks of April in NY are, say, 2000, and they're at 3000 this year, but they're claiming 1500 COVID deaths for that time period, then you might be onto something.  But those numbers don't exist (if they did, they'd make up every 3rd post on this thread).  Instead, the numbers show that deaths above expectation are outpacing the COVID deaths, suggesting that there may even be a slight under-count.

 

*No, I do not believe that this is happening either.  I shouldn't have to clarify this, but this thread can get batty at times.

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12 minutes ago, ABSR said:

Question for you Or other doctors on the “reinfected”.  Were those identified as reinfected tested for anti-bodies or just to see if they were testing negative for Coronavirus?  My guess is that anti-body testing is or was too new or inaccurate to be used and it was just testing negative for Covid-19.

If this is correct is it unusual for people infected with a virus to get “better” but not retain anti-bodies?

It's very likely shoddy testing.  No reason to believe this virus acts different from all others.  If you legit have antibodies and are not immunocompromised, you should not get it again. 

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17 minutes ago, BradInATX said:

You gonna email me a copy of this $3,000 report? Or am I supposed to just take your word for it that it supports your position?

Good grief... the gymnastics here.  I'll be waiting if you want to actually be serious.

I think you need to take my word for it. Or better yet, read what I have written about it. Otherwise, buy the reports or talk to others or do the research and realize the limitations of rt-PCR for testing the general population for active COVID-19 infections. If you think that $100K machines and $40 tests that require expertise can currently be done on 300 million people on an ongoing basis, I personally think you are unwilling to learn. But if I am wrong and you are willing to learn, look up the information or ask others. Below is the type of article you will need to read and understand:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC387602/

 

 

Edited by Bevo
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2 minutes ago, aggie08 said:

Fine.  I'll bite.  So your contention, as I understand it, is that state governments--namely in NY and Michigan--are pressuring their hospitals to churn out higher death numbers, so they can get a bigger cut of stimulus money.  Meaning doctors, coroners, hospital officials, etc. are in the loop to try to push as many "maybes" as they can towards "COVID" and assigning "maybes" to the slightest of symptoms, thus intentionally going against what the CDC stipulates.

Couldn't I just as easily say that there's heavy incentive for the more quarantine-impatient states to fudge and suppress the numbers in the opposite direction?  You don't think the governor of Alabama, for instance, would love to say, "Look at these low numbers! We've got this under control, so we're going to open back up!"  Isn't that just as logical (or illogical in this case)?  There's a ton of money on the table in my example too.  But I'd sound pretty fucking stupid parroting that over and and over and over without anything but speculation to back it up.*

If you're going to throw around pretty substantial conspiracy theories and allegations of corruption, how about providing something resembling facts?  It wouldn't take much: the normally expected deaths--given time of year and population growth--are out there.  If you could show me that expected deaths for the first two weeks of April in NY are, say, 2000, and they're at 3000 this year, but they're claiming 1500 COVID deaths for that time period, then you might be onto something.  But those numbers don't exist (if they did, they'd make up every 3rd post on this thread).  Instead, the numbers show that deaths above expectation are outpacing the COVID deaths, suggesting that there may even be a slight under-count.

 

*No, I do not believe that this is happening either.  I shouldn't have to clarify this, but this thread can get batty at times.

I don't think the phases has anything to do with deaths.  but I certainly didn't read through all of it so it may.

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5 hours ago, Johnny Sack said:

I thought Birx and Fauci did a really good job addressing the “testing, testing, testing” argument last week, but it really hasn’t been discussed here.  Did anyone but me see it?

Basic argument is that testing is over rated.  I get tested today and get a negative result.  Fine, that’s good for all of 15 minutes or the next time I leave the house.  The idea that you could do 100mm tests/day is ludicrous and everyone knows it.  Scott Gottlieb said we needed 750k test/wk.  We’re now doing 1MM/week.

The real solution is to monitor hospital visits and anomalies in flu symptom reports which we already have in place county by county.  Then, you go to those areas and do random and targeted testing.  They theorize we have enough testing to do this for phase 1 and will need to ramp up more for phase 2.

Thoughts?  Anyone for team apocalypse (Or team nothing but the sniffles) still think we need hundreds of millions of tests or a vaccine before this national nightmare ends?

Finding out who has antibodies is the big need on testing now since social distancing has worked to slow the spread.  Getting a reliable/accurate antibody test is very important.  The medical people need to know our progress toward 'herd immunity' to guide where things go from here.

Edited by ShaggyBevo RIP
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18 minutes ago, Bevo said:

I think you need to take my word for it. Or better yet, read what I have written about it. Otherwise, buy the reports or talk to others or do the research and realize the limitations of rt-PCR for testing the general population for active COVID-19 infections. If you think that $100K machines and $40 tests that require expertise can currently be done on 300 million people on an ongoing basis, I personally think you are unwilling to learn. But if I am wrong and you are willing to learn, look up the information or ask others. Below is the type of article you will need to read and understand:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC387602/

 

 

😂😂

 

This is a paper from 2004 - what does this have anything to do with COVID 19 in 2020? Not only that but it concluded that there were cost effective and accurate ways to test for coronaviruses back in 2004, which actually weakens your already stupid point.

Still waiting for you to post anything that corroborates your initial assertion that it is literally impossible to build out a more adequate testing infrastructure. You can just admit that you can't find anything. It's okay to own up to being completely full of shit. This is Surly, we all are. You're in the trust tree.

 

 

Edited by BradInATX
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11 minutes ago, dcar00 said:

well well look what we have here...

I feel like you are fundamentally misconstruing or misunderstanding the purpose of the early modeling. For instance, the 2 million number comes from the imperial college report. But, the whole point of the report was to determine what type of actions were necessary to deal with the pandemic (e.g., nothing vs mitigation vs suppression). The 2 million number comes from the do nothing scenario, which is why the paper advocated for suppression efforts, (i.e., shutdown). It did not say 2 million would die even after a shutdown. No one has to my knowledge.

Edited by Dahobbs
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5 minutes ago, Dahobbs said:

I feel like you are fundamentally misconstruing or misunderstanding the purpose of the early modeling. For instance, the 2 million number comes from the imperial college report. But, the whole point of the report was to determine what type of actions were necessary to deal with the pandemic (e.g., nothing vs mitigation vs suppression). The 2 million number comes from the do nothing scenario, which is why the paper advocated for suppression efforts, (i.e., shutdown). It did not say 2 million would die even after a shutdown. No one has to my knowledge.

I can tell you I am not misuderstanding anything...

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2 minutes ago, dcar00 said:

I can tell you I am not misuderstanding anything...

Your post seemed to be suggesting that the 2 million number was meant to be a prediction of what would happen under current circumstances and that as a result it was gross exaggeration. If that is not what you meant, then I misunderstood your post. It's why I asked what you were referring to. 

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Who said 2 million or even 500k would die if we shutdown? Who are you talking about? 

First it was we need more tests, PPE’s, and ventilators. And its still that a month later. Social distancing has flattened the curve but we’re in the same place we were a month ago. Perhaps the hot weather will help us out. Perhaps more people wash hands. Perhaps 15% have already had it and there’s some immunity. We’re still flying blind, experts are still guessing, and there’s a lot of confusion and misinformation.
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2 hours ago, bluto said:


Don’t wanna rain on the socially distanced parade but I’ve gotten my hopes up based on weekend case numbers/reports a few times already and find myself disappointed come Tuesday.

Yep, Hays has been set at 109 since Thursday. We shall see Tuesday. 

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17 minutes ago, Eskimohorn said:


First it was we need more tests, PPE’s, and ventilators. And its still that a month later. Social distancing has flattened the curve but we’re in the same place we were a month ago. Perhaps the hot weather will help us out. Perhaps more people wash hands. Perhaps 15% have already had it and there’s some immunity. We’re still flying blind, experts are still guessing, and there’s a lot of confusion and misinformation.

I agree, like 4000 and counting "maybes."  so far I haven't heard of any hospitals being completely overrun(yes they were getting pushed hard and props to those on the front lines) , save possibly NYC where the governor didn't shut down until 3/20.

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33 minutes ago, Dahobbs said:

Your post seemed to be suggesting that the 2 million number was meant to be a prediction of what would happen under current circumstances and that as a result it was gross exaggeration. If that is not what you meant, then I misunderstood your post. It's why I asked what you were referring to. 

hopefully people don't project models in the future that have no basis in reality.

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Chitown, are you pretty satisfied with standard IMV ventilators for this virus? I was bringing up NIV and oxygen concentrators and I was told that even standard ventilators were of limited utility and many people aren't gasping for breath but still have inadequate blood oxygen levels. And by using IMV, you are creating new issues that increase mortality. Just curious with what you are seeing in practice once patients require ventilation.

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Oh, so you think costs have come down from $40 per test and $100K per machine? They haven't. Why would you think prices would decline? You probably don't have any clue. You just want to argue. How do you think market research is done? It is either collected from available resources (I use to have paid subscriptions of epidemiology data but I don't have any need now, and I would get in significant trouble for posting the info on the web anyway) or primary research needs to be collected through surveys and analysis.
Anyway, you have $40 test reagents and VOX states "One of the lower-end benchmarks estimates the US will need 750,000 tests per week. The high-end proposal, from Nobel laureate economist Paul Romer, starts at 22 million tests per day and goes up. And not just one test per person, but repeated testing over time". So $22 million tests a day at $40 per test comes to costs of $880 million a day or $320 billion per year just on testing and not including the cost of finding, developing, and training personnel, the cost of creating facilities, and the time to scale-up to these numbers.
The bottom-line is that good antibody tests will be the only viable option. But you want proof from who exactly to confirm what I am saying or Chitowndoc is saying? This board? Dr. Fauci? And why should I care whether you, a dumbass politics poster, believes me or anyone else? You really should just go away and realize that you are out of your element and a detriment to humanity.
 

Damn.. zero chill
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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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