CR: COVID-19 --Political Talk

[triplehorn 2664]

@Anastasis

"Yes, I have not been in the clinic for quite some time, but your sense is wrong my friend."

- stay frosty.

 

"Once again, you fail to acknowledge the basic concepts underlying evidence based medicine, and how the various levels of evidence should translate to clinical practice." 

- Sounds like an EMAW "circumstantial evidence isn't admissible as evidence in a court of law" moment.  When you have to make a definitive move, never settling with not knowing everything will paralyze you, then eat you alive.  An OCD type can only carry you for so long in the red zone.

 

"This is quackery."

It's hard to conceive of day when I've been asked a clinical question where I didn't say "I don't know" at least once to something where knowing the answer would impact decision making, and yet decisions were made.  There's an unknowable granularity to every complex decision.  That's what I'm speaking to.  But quackery?  You're coming at me from someplace else.

[elfenix 34161]

14 hours ago, HenryJames said:

 

 

 

 

Edited June 11, 2020 by elfenix
fixing screwup

[safe sex 11628]

Can't speak for other hospitals in town, but Austin's downtown COVID ICU is now full. I know this because I helped intubate and stabilize a trauma stat stabbing, and was in the OR with them when we got the test results back. Welp.

[Horn Under a Bad Sign 20332]

 

[Bama Llama 1441]

Mucho mojo sympathy to you, sister BamaChick.  Breathe deep and keep moving forward.  The gloom may be gathering now but we will get through this swamp of merde as long as places like Surly exist and people like you communicate their ideas.  I don't know what's worse, a deadly virus or a nation of meatheads disregarding it.

[Mo Horn 8779]

Over 2 million cases now, and death predictions have been revised up to 200k.

[wildcat09 29146]

48 minutes ago, Mo Horn said:

Over 2 million cases now, and death predictions have been revised up to 200k.

How the fuck is this gonna stop at 200k? Are they expecting that every state will shut down again once things get bad enough?

[Anastasis 23328]

8 hours ago, triplehorn said:

There's an unknowable granularity to every complex decision.  That's what I'm speaking to.  But quackery?

Wrap yourself up in a cloak of clinical mysticism if it makes you feel better, but the reality is that there is no strong evidence supporting use of HCQ as a COVID treatment in any phase of the illness. To the extent that we have solid evidence, the results are negative. The gaps in knowledge will not be filled with mystical thinking on the unknowable granularity of clinical decision making. They will be filled by clinical research. That is the only role for HCQ at the moment, use in trials addressing the remaining gaps in knowledge. Anything else is simply quackery at this point. 

Edited June 11, 2020 by Anastasis

[Anastasis 23328]

9 hours ago, cactusflinthead said:

Hey, while y'all are arguing about HCQ you think we can find out which communities are getting hit in this spike?

H-town taking the hit at the moment in terms of hospitalizations, driving the state numbers and trend.  ATX taking the length in terms of new cases at the moment.  ATX case counts appear to be associated in time with the recent mass gathering related to protests. 

[Mrs Whiggins 13049]

Question for you re: Austin spikes. Number of people I've listened to in casual convo that are mentioning having gone to the usual water spots to tube, party etc or the beach either for the recent holiday or as a graduation/reopening getaway. How much do you think that is contributing in comparison? One of my kiddos is a Buccee's fan practically as an experience all its own. (A little odd, but supplied with a drink and kolache it seems to satisfy the odd fascination). I'm not going anywhere near there but I remember how crowded they are whenever we would stop on our way back from the various SPs. What are your thoughts?

[BradInATX 9208]

8 minutes ago, Anastasis said:

ATX case counts appear to be associated in time with the recent mass gathering related to protests. 

Come on dude. Even Austin Public Health has said they've not traced it to the protests, but to the general re-opening.

There's probably some protest in there, but making the above statement definitively is crazy talk.

[Anastasis 23328]

13 minutes ago, BradInATX said:

Come on dude. Even Austin Public Health has said they've not traced it to the protests, but to the general re-opening.

There's probably some protest in there, but making the above statement definitively is crazy talk.

There is nothing crazy at all with the statement "ATX case counts appear to be associated in time with the recent mass gatherings related to protests." The temporal relationship is pretty clear cut and right in the window.  Have you seen details related to APH's tracing results?

[safe sex 11628]

20 minutes ago, Mrs Whiggins said:

Question for you re: Austin spikes. Number of people I've listened to in casual convo that are mentioning having gone to the usual water spots to tube, party etc or the beach either for the recent holiday or as a graduation/reopening getaway. How much do you think that is contributing in comparison? One of my kiddos is a Buccee's fan practically as an experience all its own. (A little odd, but supplied with a drink and kolache it seems to satisfy the odd fascination). I'm not going anywhere near there but I remember how crowded they are whenever we would stop on our way back from the various SPs. What are your thoughts?

I won't be setting foot in a Buccee's for the next year, easily.

[BradInATX 9208]

2 minutes ago, Anastasis said:

There is nothing crazy at all with the statement "ATX case counts appear to be associated in time with the recent mass gatherings related to protests." The temporal relationship is pretty clear cut and right in the window.  Have you seen details related to APH's tracing results?

Appear, based on what? You're passing your own speculation off as some sort of correlation.

And no, I obviously have not seen APH's tracing results, but I'll take their word for it over your speculation with what we know today.

[BradInATX 9208]

29 minutes ago, Mrs Whiggins said:

Question for you re: Austin spikes. Number of people I've listened to in casual convo that are mentioning having gone to the usual water spots to tube, party etc or the beach either for the recent holiday or as a graduation/reopening getaway. How much do you think that is contributing in comparison? One of my kiddos is a Buccee's fan practically as an experience all its own. (A little odd, but supplied with a drink and kolache it seems to satisfy the odd fascination). I'm not going anywhere near there but I remember how crowded they are whenever we would stop on our way back from the various SPs. What are your thoughts?

There's not a lot of evidence of big spreading events from outdoor events. So far the only big one I can recall is the anti-mask protests in Wisconsin. That was also in cooler weather. Last I heard, they had zero new cases traced to theOzark parties that everyone was up in arms about. I fully expect to see some new cases from the protests because you're talking millions of people in total; which is a lot less than people floating the river, much more packed in.

I'm reluctant to make any fact statements because I don't want to give anyone bad advice. I have read from reputable sources that you are 12-20x more likely to catch it indoors than out. My family has erred on the cautious side, and we'll be at the beach in about a month. We won't be eating at any restaurants, though. Ultimately we have not been provided a lot of great information, so it's frustratingly tough to make decisions for our families. 

Edited June 11, 2020 by BradInATX

[Mrs Whiggins 13049]

6 minutes ago, trauma babe said:

I won't be setting foot in a Buccee's for the next year, easily.

I'm in a similar mindset. Like a lot of people, we've had to rearrange plans. We had a trip scheduled for some personal business with family out of state but have postponed it until we see how the reopenings are going. Yeeeeeeah, not great at the moment, but really don't want to put it off until fall, either.

[Anastasis 23328]

3 minutes ago, BradInATX said:

Appear, based on what? You're passing your own speculation off as some sort of correlation.

And no, I obviously have not seen APH's tracing results, but I'll take their word for it over your speculation with what we know today.

Median time to onset of symptoms, 4 days. Delay to take test 2-3 days, time to get results 2-3 days.  Eight to ten days from contact to test result is probably right for the leading end. I would expect a march up over the rest of the week and into the next. 

As I have shared in exchanges across other threads, the last few days of data are probably a mix of baseline reopening trend, memorial day tail end, and protest leading end. I sure as shit hope that protest related cases are already showing up in the counts. If transmission related to the protests is not associated with the last few days of results, buckle the fuck up, because shit is going to hit the fan if the sudden spike this week is solely related to re-opening and memorial day gatherings. 

[BradInATX 9208]

1 minute ago, Anastasis said:

 probably a mix of baseline reopening trend, memorial day tail end, and protest leading end. I sure as shit hope that protest related cases are already showing up in the counts. If transmission related to the protests is not associated with the last few days of results, buckle the fuck up, because shit is going to hit the fan if the sudden spike this week is solely related to re-opening and memorial day gatherings. 

Yep - I agree with this. that's not how you framed it earlier. All good.

Edited June 11, 2020 by BradInATX

[Dark Horse 2257]

How the fuck is this gonna stop at 200k? Are they expecting that every state will shut down again once things get bad enough?

I’m pretty sure that’s just where their models end. Previously, the models were predicting X deaths by August, they’re now extending through October.

[cactusflinthead 27588]

50 minutes ago, Anastasis said:

H-town taking the hit at the moment in terms of hospitalizations, driving the state numbers and trend.  ATX taking the length in terms of new cases at the moment.  ATX case counts appear to be associated in time with the recent mass gathering related to protests. 

Dallas ain't looking real good either. I don't know if it's better testing access or if it's an uptick from re-opening. Some places are still mask wearers and others are not. 

[Mrs Whiggins 13049]

Bernie telling it like it is.

 

[Dnaguy 11704]

4 minutes ago, cactusflinthead said:

Dallas ain't looking real good either. I don't know if it's better testing access or if it's an uptick from re-opening. Some places are still mask wearers and others are not. 

Father in Dallas area had a confirmed case at work.

if the way he’s handling it / the policy of his plant is any indication on how we go forward ... we’re all fucked.

It amazes me how ignorant of the actual disease people still are.

Things I’ve heard that somehow negate the need for testing:

1.) I don’t know where to get tested

2.) If I come back positive then I’d have to quarantine 

3.) I don’t have the time / I have too much work to be out of commission

4.) This doesn’t affect you

5.) I don’t have any symptoms so i probably don’t have it anyway

6.) It takes over a week to get back the results so what am I supposed to do during that time?

 

[Beantown Express 2.0 6531]

Good friend of mine lost his brother in law to Covid last week.  The guy was 50 years old with no health conditions or medications.  He lived in Baton Rouge.  Shit like this is what scares me even though I know its rare for someone in that demographic to die.  The wife is really wanting to go on a vacation somewhere just to get out of the house but I have no desire to go drive somewhere in TX just to say we went on a vacation and risk being around a bunch of people.

[Mrs Whiggins 13049]

8 minutes ago, Beantown Express 2.0 said:

Good friend of mine lost his brother in law to Covid last week.  The guy was 50 years old with no health conditions or medications.  He lived in Baton Rouge.  Shit like this is what scares me even though I know its rare for someone in that demographic to die.  The wife is really wanting to go on a vacation somewhere just to get out of the house but I have no desire to go drive somewhere in TX just to say we went on a vacation and risk being around a bunch of people.

That's really sad. Looking back, hard to believe that the first CDC telecalls by Nancy Messonier (remember her?) were about four months ago. Seems like years ago.

 

 

Someone call Jared K and whoever that lead task force guy and tell them to get on this. Who was that lead guy again? Oh yeah, the Vice President. I'm sure when he's done photo-opping w/o a mask he'll be right there:

 

[Chuckie Finster 22571]

7 minutes ago, Mrs Whiggins said:

That's really sad. Looking back, hard to believe that the first CDC telecalls by Nancy Messonier (remember her?) were about four months ago. Seems like years ago.

 

 

Someone call Jared K and whoever that lead task force guy and tell them to get on this. Who was that lead guy again? Oh yeah, the Vice President. I'm sure when he's done photo-opping w/o a mask he'll be right there:

 

It's a shame that this even matters, but the Democrats really need to get on the Republicans level when it comes to messaging.  A single incident like this in a Democratic administration would be a top story on Fox News for months.  It's insane what this administration is getting away with.

Edited June 11, 2020 by Chuckie Finster

[NameAlreadyInUse 5102]

3 hours ago, wildcat09 said:

How the fuck is this gonna stop at 200k? Are they expecting that every state will shut down again once things get bad enough?

That 200k number is not total, its by end of summer.

[Jive Turkey 12546]

 

[NameAlreadyInUse 5102]

How can it be jaw dropping when they told us up front they were going to ignore the transparency part of the bill?

[RPM 26167]

7 minutes ago, Jive Turkey said:

 

Making America Great Again!

[Pig Bellmont 8664]

6 minutes ago, NameAlreadyInUse said:

How can it be jaw dropping when they told us up front they were going to ignore the transparency part of the bill?

Then fired the IG and put a White House attorney with no prior IG experience in the oversight role

[Chet Steadman 940]

I so badly want Bolton's books to have some major bombshells but I'm afraid ti will be more of the same -digesting , everyday acts by the president which unfortunately barely move the needle.

[hayden_horn 11358]

welp, pretty fucking obvious that governor abbott got us in a goddamn hurry to open up. well done, shithead.

https://www.kvue.com/article/news/health/coronavirus/austin-coronavirus-updates-cases-spike/269-5e7306b0-244e-481c-bf40-1f20e798bbed

 

please note that phase one began on may fucking first. we hit a small plateau, and governor abbott decided it was all over. this is why we can't have nice things when republicans are in charge. 

also, how did covid become so partisan?

[jimmyjazz 45428]

Austin Public Health noted in a teleconference this morning that the % positive numbers have doubled to over 9 positive results per 100 tests.

New hospitalizations in the city hit an all-time high yesterday at 24, breaking the previous record of 18.  I have heard and seen multiple people saying that's just because of more testing.  News flash:  they hospitalize for disease severity, not test results, geniuses.

[DDD Dad 14144]

Restaurants opening to 75 percent this week?  Seems like a bad idea.

[DDD Dad 14144]

2 minutes ago, jimmyjazz said:

New hospitalizations in the city hit an all-time high yesterday at 24, breaking the previous record of 18.  I have heard and seen multiple people saying that's just because of more testing.  News flash:  they hospitalize for disease severity, not test results, geniuses.

Apparently you haven't visited the DT thread lately.

[jimmyjazz 45428]

7 minutes ago, DDD Dad said:

Apparently you haven't visited the DT thread lately.

I also haven't placed my balls on an end table and repeatedly smashed them with a crescent wrench.

What have I missed?

[Pig Bellmont 8664]

27 minutes ago, hayden_horn said:

welp, pretty fucking obvious that governor abbott got us in a goddamn hurry to open up. well done, shithead.

https://www.kvue.com/article/news/health/coronavirus/austin-coronavirus-updates-cases-spike/269-5e7306b0-244e-481c-bf40-1f20e798bbed

 

please note that phase one began on may fucking first. we hit a small plateau, and governor abbott decided it was all over. this is why we can't have nice things when republicans are in charge. 

also, how did covid become so partisan?

Don’t worry, there are plenty of hospital beds in El Paso if Austin or Houston becomes a hot spot. Why change any policy or mandate mask wearing? 

[Anastasis 23328]

16 minutes ago, hayden_horn said:

welp, pretty fucking obvious that governor abbott got us in a goddamn hurry to open up. well done, shithead.

https://www.kvue.com/article/news/health/coronavirus/austin-coronavirus-updates-cases-spike/269-5e7306b0-244e-481c-bf40-1f20e798bbed

please note that phase one began on may fucking first. we hit a small plateau, and governor abbott decided it was all over. this is why we can't have nice things when republicans are in charge. 

also, how did covid become so partisan?

 

What states serve as the best examples of navigating re-opening?  We are seeing spikes in states that have taken very different approaches to re-opening, and haven't see jumps in some others where re-opening has proceeded quickly. Washington, Oregon, California, Vermont, PR, etc. 

[MC Fresh Breath 4074]

An interesting read, imo.  

 

https://www.theatlantic.com/science/archive/2020/06/america-giving-up-on-pandemic/612796/

[jimmyjazz 45428]

Just now, Anastasis said:

 

What states serve as the best examples of navigating re-opening?  We are seeing spikes in states that have taken very different approaches to re-opening, and haven't see jumps in some others where re-opening has proceeded quickly. Washington, Oregon, California, Vermont, PR, etc. 

I am highly skeptical of case counts, not only because of less than optimal testing and changes in test coverage, but because of the policy variations on testing that exist from state to state.

[BradInATX 9208]

Yeah, we need to stay with hospitalizations. @Anastasis' infographic uses cases which I think most everyone agrees is not a good metric. California's hospitalizations have been steady for the last couple of months. Basically flat.

I don't really care about other states. We're seeing what looks like the beginning of a trend showing that the relaxation of societal norms is leading to an uptick. And yeah, the protests probably contribute as well. I don't think it much matters because as a society we seem to be mostly "over it", and because the re-opening train is not going to stop.

What scenario do you envision needed to happen to re-tighten restrictions? I don't see it happening in Texas barring doomsday, overwhelmed hospitals type stuff. And even then, I think there'd be a significant portion of the population that wouldn't even abide by them.

Edited June 11, 2020 by BradInATX

[Anastasis 23328]

Just now, jimmyjazz said:

I am highly skeptical of case counts, not only because of less than optimal testing and changes in test coverage, but because of the policy variations on testing that exist from state to state.

I tend to agree. FWIW, Oregon and Washington's case count increase is also associated with an increase in their positivity rates, similar to Texas.  California's positivity rate appears flat at just under 5%. 

[Anastasis 23328]

5 minutes ago, BradInATX said:

Yeah, we need to stay with hospitalizations.

The shutdown were based on the correct notion that we must prevent overwhelming of the healthcare system.  I agree that that should be the key measure to track. Cases are a useful leading indicator. 

6 minutes ago, BradInATX said:

What scenario do you envision needed to happen to re-tighten restrictions? I don't see it happening in Texas barring doomsday, overwhelmed hospitals type stuff. And even then, I think there'd be a significant portion of the population that wouldn't even abide by them.

We are not shutting back down under any circumstances, imo. We'll just let it burn out and rack up the body count. The genie ain't going back in the bottle. 

[BradInATX 9208]

4 minutes ago, Anastasis said:

We are not shutting back down under any circumstances, imo. We'll just let it burn out and rack up the body count. The genie ain't going back in the bottle. 

Yeah, I think that's where we're at too. Our Covid strategy is #YOLO.

Edited June 11, 2020 by BradInATX

[Radical Larry 28498]

 

Don’t forget all those unemployed people can live for 8-10 weeks on $1,200.

[hayden_horn 11358]

33 minutes ago, Pig Bellmont said:

Don’t worry, there are plenty of hospital beds in El Paso if Austin or Houston becomes a hot spot. Why change any policy or mandate mask wearing? 

it's somewhat mind-blowing that people won't take the most minor of precautions. my father in law offered to buy us tickets to a cap city comedy club show. that sounds like a terrible idea. bunch of people eating and drinking and laughing germs all over the place? no thanks.

26 minutes ago, Anastasis said:

 

What states serve as the best examples of navigating re-opening?  We are seeing spikes in states that have taken very different approaches to re-opening, and haven't see jumps in some others where re-opening has proceeded quickly. Washington, Oregon, California, Vermont, PR, etc. 

i would say that after bungling the beginning, the uk's curve seems like it doesn't suck:

part of the reason that we struggle state by state is because we have utterly no national covid-19 leadership. i would argue that abbott opening up texas on may 1, despite a two day increase in cases, and only a slight plateau, not a clear downward indication is due to the president's approach to the pandemic. abbott wanted to show trump that texas was standing with him on covid-19. 

edit: and i realize the graph is deaths, so here is data on hospitalizations 

Edited June 11, 2020 by hayden_horn

[6th Street 6329]

11 minutes ago, Anastasis said:

The shutdown were based on the correct notion that we must prevent overwhelming of the healthcare system.  I agree that that should be the key measure to track. Cases are a useful leading indicator. 

We are not shutting back down under any circumstances, imo. We'll just let it burn out and rack up the body count. The genie ain't going back in the bottle. 

Unless people start dying en masse and hospitals fill up, things are slowly progressing to a full re-opening by 4Q 

[otisdog 365]

24 minutes ago, jimmyjazz said:

I am highly skeptical of case counts, not only because of less than optimal testing and changes in test coverage, but because of the policy variations on testing that exist from state to state.

Well, that was always the plan. The larger the sample, the more accurate statistical information results. So if there were national testing standards, the whole nation would be the sample. But we're lucky if every test in a county is handled appropriately in a standardized fashion. So we have hundreds  of smaller sample sizes with zero correlation amongst them. Another words, we don't know what the hell is going on.

[jimmyjazz 45428]

That UK curve is interesting -- the weekends are obvious.  I wonder how the rolling average would look if they had 7-day full reporting?  Not much different, I imagine, but the standard deviation would be better.

EDIT:  actually, the 7-day rolling average probably wouldn't be any different, unless it were weighted to favor more recent days.  Otherwise, it's just moving data from bucket to bucket.  A 3-day average would suffer more.

I think there's a decent chance that a good percentage of Austinites will self-isolate if and when mortality spikes.  The causation would be irrefutable to anyone with a brain and without an agenda.  

Edited June 11, 2020 by jimmyjazz

[Wanker Bob 379]

1 hour ago, DDD Dad said:

Restaurants opening to 75 percent this week?  Seems like a bad idea.

Almost all of them are already 100 percent full go ahead by now. I've seen very little precautions other than employees wearing surgical masks.