DoraBora
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Posts posted by DoraBora
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President Trump just announced extending "Slow the Spread" to April 30th.
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Praying right now.
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Definitely queso. (Texas)
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1 hour ago, katilac said:
She's really close! This is so helpful y'all, thanks so much!
Well, if she needs more, I'm sure lots of us know people who are at home tonight and have time to help. 😉
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17 minutes ago, square_25 said:
They had, however, slowly ramped up it up over the week before (schools were shut on that Monday the 16th, for instance.) So I'm hoping it takes a bit less time than that :-/.
I do wish they hadn't dithered.
Yeah, but all such decisions require public buy-in, and public buy-in requires emotional readiness, particularly when the situation doesn't appear to be that serious. Can you imagine if any of our leaders had called a press conference three weeks ago to announce shelter in place and closing non-essential businesses? The panic would have been terrible, and so dangerous.
People weren't ready. (They're still not ready if they are fleeing New York and failing to self-isolate when they get where they're going to make sure they aren't taking the virus with them. Grrr Did I see that someone posted about New Yorkers sightseeing in PA? What????)
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Done! I hope it all goes well.
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15 minutes ago, Jean in Newcastle said:
Our Safeway grocery store has screens at checkout counters to protect the cashiers. Some have masks and gloves and some don't. I don't know if that is by choice or not. (ie. I don't know if the masks and gloves are provided by the grocery store if they bring them from home.)
Our Safeway has the screens, too. They also have large stickers on the floor to remind people to stay six feet apart. (The reminders only work if people are paying attention, though. There was a woman behind me this morning who was talking on her phone and getting rather too close to me, backing into other customers, etc. She only had two items. I had to ask her several times to please go ahead of me (because she was busy with her phone call). I would normally do that anyway, to be kind, but I'll confess that I really just wanted her GONE.
I need to be patient. 😐
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13 minutes ago, square_25 said:
I was wondering this yesterday. Link?
From the Wall Street Journal:
WASHINGTON— President Trump ordered General Motors Co. to sharply ramp up the production of ventilators to treat coronavirus patients, turning to a wartime presidential power that he had been reluctant to use.
Mr. Trump on Friday invoked the Defense Production Act, or DPA, which dates back to the Korean War and gives the president powers to require businesses to produce goods tied to national defense. For weeks he had said that the threat of invoking the DPA was sufficient. Previously he likened using the DPA to nationalizing American business. He reversed course Friday, saying GM was “wasting time” in negotiations with the federal government.
https://www.wsj.com/articles/trump-lashes-out-at-general-motors-over-ventilators-11585327749
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1 hour ago, square_25 said:
So... I have a question. Does anyone have any theories about WHY New York wound up as such a hot spot? 2 weeks ago, we weren't first in deaths or cases or anything in the US. I know this is a dense place, but some place (like South Korea) are also dense. We weren't particularly late to shut schools, compared to numbers of cases and deaths. So what gives?
I don't know. I wonder how on earth Italy become one. Dr. Fauci theorizes it was because of the very large number of Chinese tourists, who seeded the virus in multiple spots in that country.
I think the epicenter in SK was Daegu, which is quite a bit smaller than NYC. Your city has large airports, people coming in from all over the world, tons of wonderful (and crowded) sights to see.
It's so hard to predict how things will play out. Even as recently as ten days ago(!), Gov Cuomo didn't think NY would get to a state-wide shelter in place order.
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9 minutes ago, Pen said:
Also though there have been reports of people dying in before they could get seen or get a bed, so I guess that helps decrease new hospitalization numbers.
Yes, there have been reports. I kind of wonder why Gov Cuomo hasn't touched on that -- or at least I haven't been able to find a comment on it.
He tweeted just a couple of hours ago that New York hospitals will not force any woman to give birth alone. "Not now. Not ever."
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From a Forbes article about current situation in NY: (Savoring small blessings is good for the weary soul.)
Surprising fact: Though the rate of infection in New York is still doubling, it is doing so at a slower pace, Cuomo said again on Saturday. The number of ICU admissions fell slightly, as did the number of new hospitalizations. ICU admissions were down to 172 yesterday—the lowest level since earlier this week and down from 374 a day before. Patients who have been newly hospitalized also decreased to 847, down from over 1,000 during the two days previously. “I wouldn’t put too much stock in any one number—the overall trend is still up, but you could argue that the trend is slowing,” Cuomo said of the data.
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48 minutes ago, Corraleno said:
I don't doubt that the real number of CV19 deaths in China is higher than reported, but keep in mind that mortuaries there have been closed for three months or so, so those urns are for everyone who died of CV19 plus all the other deaths that would naturally have occurred in that area during those 3 months plus all the extra deaths caused by people not being able to get access to healthcare when hospitals were overwhelmed. So the number of urns would represent the number of deaths directly attributable to CV19 + deaths indirectly caused by CV19 + the normal 25-30% of annual deaths in that area.
Thank you. Incidentally, Wuhan, though I had not ever heard of it before January, has a larger population that NYC (11+ million).
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1 minute ago, square_25 said:
Probably sooner :-). Either the ventilators will arrive where needed or they will not. I think we won't know exactly what happened with GM negotiations for a good long while, if ever. (I am very glad the Act is being used, by the way.)
The DPA is good news... 😊
I read that message between Elon Musk and Mayor De Blasio to mean that there are other vents that are held up in warehouses because of red tape. Cuomo said today that they are storing them until they need them, down the road.
You're likely right about the GM thing -- it will probably be he said/she said. Whatever.
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2 minutes ago, square_25 said:
Awesome :-). But I meant about the logistical issues.
I guess we'll know when the dust settles. 😉
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11 minutes ago, BusyMom5 said:
I wonder if he realizes that you cant just start making ventilators overnight? Its going to take a few weeks at least to get parts organized, people trained, evt.
I live way off in the country. Our hospital will probably get nothing extra. There are 12 ICU beds with ventilators. It serves about 4 counties worth of people. There are going to be hard decisions made once it gets here. Our population skews elderly, lots of pre-existing conditions. We still dont have any official orders, but cities (think small towns) have started making their own. In the last few weeks some elderly have chosen (or been ordered by their kids) to stay home. Most have not. Every time I've been out, the stores are just as full, no one in a masj or gloves (except me!). No one was social distancing. We are in an area where people just aren't taking it seriously. Last week an 80+ year old woman in line behind me was getting hair dye, Cheetos and a can of air freshener. There is a sense that these things are just happening in the city- bc the news focuses on cities. I do hope that when the time comes, there will be help for rural areas- we are going to need it!
A little more than an hour after Trump’s first tweet, GM and Ventec announced they’ll build ventilators at the automaker’s parts plant in Kokomo, Indiana, which they’ve been working around-the-clock for a week to convert into a medical-device facility.
GM said in a statement that it will be “donating its resources at cost.” It’s also beginning to make surgical masks at a manufacturing facility in Warren, Michigan, north of its Detroit headquarters. Output will start next week, ramp up to 50,000 a day within two weeks and may eventually get to 100,000.
“This pandemic is unprecedented and so is the response, with incredible support from GM and their suppliers,” Chris Kiple, Ventec’s CEO, said in the statement.
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Just now, Ausmumof3 said:
53 people aboard the Zaandam cruise ship off Panama are sick, including 2 who have tested positive for coronavirus. 4 older passengers have died, according to Holland America Line
feel so sorry for the crew trapped on that ship.
Is this the ship that was denied entrance to Panama? Are they planning to stay there?
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President Trump on Friday invoked the Defense Production Act to order ventilators from General Motors needed to treat coronavirus patients, after initially declining to do so.
“Our negotiations with GM regarding its ability to supply ventilators have been productive, but our fight against the virus is too urgent to allow the give-and-take of the contracting process to continue to run its normal course” Trump said in a statement. “GM was wasting time.”
Trump had criticized GM and Ford earlier on Friday, accusing the automakers of failing to meet demand for ventilators.
“[GM] said they were going to give us 40,000 much needed Ventilators, ‘very quickly.’ Now they are saying it will only be 6000, in late April, and they want top dollar,” Trump wrote on Twitter. “General Motors MUST immediately open their stupidly abandoned Lordstown plant in Ohio, or some other plant, and START MAKING VENTILATORS, NOW!!!!!! FORD, GET GOING ON VENTILATORS, FAST!!!!!!”
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1 hour ago, square_25 said:
@DoraBora -- Cuomo said in his briefing that his "ICU" numbers are vent numbers. He could be misstating, of course, but that's what he says.
They are up to 1500, by the way. So only a factor of 20 off from the projected need.
The Times says most of them are on ventilators, without offering specific numbers.
As of Friday morning, nearly 1,600 Covid-19 patients in New York State were in intensive care units, most of them on ventilators, a 22 percent increase from Thursday morning. The state has projected that the growth of coronavirus cases will continue to accelerate for several more weeks.
The president is expressing, in his colorful way, his frustration with GM, and says there will be an announcement today about additional ventilators the feds have purchased.
I'm spending time today calling and emailing the WH and my representatives.
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26 minutes ago, square_25 said:
Well, I'm afraid to leave the house, because the NYC hospitals are already getting overwhelmed, and I'm pretty sure if I get sick or hurt in any way, I won't get good medical care.
Do you want to tell me about how I'm overreacting, though?
(Gently) Is there anything more can you do than what you are already doing (to stay safe)? Why not step away from the daily briefings and mathematical models, just for a while? They will still be there when you come back. You wrote earlier that you can't even sleep, that you are running on adrenaline. The constant barrage of negative information -- and dwelling on that information -- is bad for your health and your spirit.
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6 minutes ago, square_25 said:
First of all, they are up to 1300 ICU beds (I think), and secondly, they stated that their ICU bed count was the ventilator count. That's how he was treating the numbers at the briefing today. So I think your starting number is too low.
The problem is that it really depends how fast thing double. If you listened to Cuomo yesterday, he said that the estimates of doubling times kept changing. Yesterday was the longest possible estimate, at 4.7 days, but it may very well be 3 days. If it's doubling every 3 days, then in 21 days it doubles 7 times, giving us an estimate of 2^7*1300, which is unreasonably large -- 5 times more than 30000, in fact.
As you can see, small changes in the numbers make a huge difference. That's why I'm not feeling all that willing to take the more optimistic estimates... it seems imprudent.
I did just listen to most of Cuomo's briefing from earlier today, but I disagree that he is certain that the ICU bed count is the vent count. That didn't seem definitive.
Yes, even though I am not a mathematician, I do understand that small changes in the numbers in such scenarios make a huge difference. As I wrote in my reply to Dot, I should have softened my earlier statement about your leader overreacting. I didn't mean to upset you.
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4 hours ago, square_25 said:
Two of the doctors advising the nation :-P. There are lots of doctors. I get the sense that Cuomo has his own doctors who are telling him their own estimates.
You should try running the numbers yourself :-). See what you think the expected numbers of vents should be. You can start with 1,000 vents right now and work with the current rate of increase. See what you think is a reasonable estimate. Try it and tell me what you think. Argument by authority is never as convincing as being able to actually test people's prediction! (Of course, sometimes the models are too complicated to run yourself, but we are in the strange situation here that the models in the short term boil down to a simple exponential growth model.)
Well, the starting number is important, of course. Yesterday's New York Times ran an article in which it listed ICU numbers at 888 and the current doubling rate at 4.7 days.
https://www.nytimes.com/2020/03/25/nyregion/coronavirus-new-york-update.html
I'm still looking for the JAMA article I read in which it estimated a 71% rate of ventilator use among Coronavirus ICU patients, but how 'bout I inflate that to 75%?
I think I remember you saying that you are a mathematician. I am not, so I had to keep this calculation simple (for me). 75% of 888 is 666. (Ahem.) Even if I double 666 five times instead of 4.7 times (taking us beyond the peak, which is supposed to be three weeks from yesterday), I still only get 21,312. Needing 21,312 ventilators at the peak assumes that the mitigation strategies already in place don't result in further slowing of the doubling rate and that no one ever gets off a ventilator to free it up for another patient. (I think I read that the average time on a vent is 11 days, but I've read so much lately, I couldn't begin to tell you where.)
Btw, I am aware there are other doctors (sigh), and lots of opinions, but your governor evidently speaks to Dr. Fauci about this stuff. It's a difficult time. I hope the numbers end up being much, much better than Mr. Cuomo fears they will be, and I wish you and all of your fellow New Yorkers the very best.
ETA: Here's some interesting info, but it's from Wuhan, so it will probably be quickly dismissed: (from https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19?source=history_widget)
In one study of 138 patients hospitalized in Wuhan for pneumonia due to SARS-CoV-2, dyspnea developed after a median of five days since the onset of symptoms, and hospital admission occurred after a median of seven days of symptoms [36]. In another study, the median time to dyspnea was eight days [34].
Acute respiratory distress syndrome (ARDS) is a major complication in patients with severe disease. In the study of 138 patients described above, ARDS developed in 20 percent after a median of eight days, and mechanical ventilation was implemented in 12.3 percent [36]. In another study of 201 hospitalized patients with COVID-19 in Wuhan, 41 percent developed ARDS; age greater than 65 years, diabetes mellitus, and hypertension were each associated with ARDS [58].
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15 minutes ago, square_25 said:
I think there's pressure on them to be as positive as possible. Cuomo said that the way they are currently using the language, any bed he calls an ICU bed is a bed with a vent. I don't think that's usually true.
I don't trust people in general, lol -- I need to be able to check their information. I just ran the numbers myself, didn't I? What's wrong with my calculations, if they are wrong?
Yes, NY is up to something like 14,000 ventilators and they are also talking about converting anesthesia machines to ventilators and splitting ventilators. And I'm really really hoping you're right and that's actually plenty to meet the need, but I can't stress this enough: I commend Governor Cuomo for working with the pessimistic estimates (and actually, I'm not sure they are pessimistic -- he said 40,000 was the pessimistic estimate he's seen.) Doing anything else has a good chance of leading to serious loss of life.
Well, it won't be me being right (or wrong), it will be the doctors advising the nation. I hope they are right, too.
The two week lag is hard -- waiting for improvement resulting from current mitigation efforts.
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50 minutes ago, square_25 said:
It's very hard for me to believe that someone who isn't local and who's working for an administration that is extremely eager to reassure people is going to be more reliable than the governor of the state. I know NY has actually bought 7,000 ventilators on top of the 3,000 it has, so it's at least putting its money where its mouth is.
There are currently 1,290 ICU patients in NY state <snip>
NY will also have 4k vents from the federal government's stockpile.
I don't think all Covid ICU patients are on ventilators(?). In a JAMA article (that I can't find right now), I read that 71% have needed them. Some are on oxygen, but not on ventilators.
I am amazed that you would distrust someone with Deborah Birx's credentials and service record. I haven't noticed her or Dr. Fauci toeing an optimistic party line for anyone.
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wuhan - coronavirus
in The Chat Board
Posted
I reported something the president said. He is extending the "Stop the Spread" campaign through the end of April. I posted it because people were worried about his hopes that we could open things up by Easter.
Somehow I doubt my post broke any rules.