Flattening the curve, masks etc. rant

[Teaching3bears]

We were in the single digits for most of June and now we have had big spikes and cases are way up. we flattened the curve but what is the point of flattening if it's just going to go up again? In the meantime, everything has opened, including bars and masks have become mandatory. Masks are good but they are not enough. They do not blame the spike on the openings but on young people getting together. Meanwhile, there have been outbreaks in day cares, gyms and more in nursing homes. So, not just young people even if there were one or two parties. A lot of our news cases are children.

We are opening for the economy but if the numbers go up more people will stay home and businesses won't do well. If we had waited 3 more months and gotten it down to a stable zero we could have gone back to a normal life. How long can restaurants and other businesses go at half capacity because they have to distance customers?

Public health officials are not worried because hospitals are doing okay. They say we will just have to live with covid for 2 years.

There is such a focus on cleaning too, which is good, but you can't clean the air and that's how most people catch it.

[SKL]

Another view ... maybe in some places we went too far beyond flattening the curve.  If more people had been exposed since last March while all the schools were shut, we'd have a lot more people immune in time for school to start.  Seems March-August would be the perfect time for "well" kids to get it and gain immunity without forcing at-risk people to breathe their germs.  I understand not wanting to overwhelm hospitals, but where I live, they actually laid medical people off because we "flattened the curve" so well.

I believe it's always been well understood that we could not stop the spread in time for the school year to start.  So why are we going into a school year with most kids still unexposed?

Frankly I am hoping my kids and others get exposed during pre-season sports over the summer (if they haven't already had this thing).  I think it will reduce the likelihood of school shutdowns over the school year.  Also I am sick of walking around assuming I probably have an unsymptomatic case, hiding from at-risk loved ones etc.  This is taking an invisible toll that needs to be recognized.

[SKL]

Also - cases were expected/intended to go up once they opened.  Plus there are more tests, so cases may not actually be going up as much as being diagnosed more.  (It's probably a combination.)

[Ottakee]

Since there are so many more tests we will find more cases.  The big question is how many of these cases are asymptomatic or with only very mild symptoms....all cases that early one would have never warranted a test or even a doctor's visit.

Are you deaths and hospitalizations going way up?  In our area, they are staying very low, despite the increase in number of positive test results.

 

[kokotg]

16 minutes ago, Ottakee said:

Since there are so many more tests we will find more cases.  The big question is how many of these cases are asymptomatic or with only very mild symptoms....all cases that early one would have never warranted a test or even a doctor's visit.

Are you deaths and hospitalizations going way up?  In our area, they are staying very low, despite the increase in number of positive test results.

 

In my area deaths and hospitalizations stayed low for awhile as cases rose, but now hospitalizations are at record levels and deaths are rising steadily. Hospitalizations and especially deaths are lagging indicators. Deaths not only because it takes awhile for people to die of covid, but because deaths often aren't reported in real time. Cases are rising at a much faster rate than testing in much of the country. In some areas the increase in testing can explain much/most of the rise in cases, but it's easy to see that that's not true in many other areas. ETA I'm skeptical of the "cases are only going up because of testing" argument because we saw people say that about places like Florida long past the point when it was clearly untrue.

Edited July 26, 2020 by kokotg

[marbel]

It seems obvious to me that cases were going to go up once people came out of quarantine, lockdown, shelter-in-place, whatever you choose to call it. If the object was to flatten the curve by shutting down, of course there would be more cases once things opened up and when testing was more widespread. No one believed (to my  knowledge) that the virus was just going to go away and we would have zero cases.  Maybe (probably) there were better ways to open up, I don't pretend to have answers to that. But I don't find it surprising at all that case #s are increasing.

[KungFuPanda]

24 minutes ago, Ottakee said:

Since there are so many more tests we will find more cases.  The big question is how many of these cases are asymptomatic or with only very mild symptoms....all cases that early one would have never warranted a test or even a doctor's visit.

Are you deaths and hospitalizations going way up?  In our area, they are staying very low, despite the increase in number of positive test results.

 

That’s true. It’s also true that a LOT of people catch it and treat at home without becoming part of the official headcount. I think as long as people can manage their symptoms nobody is in a hurry to get near a hospital. There is no treatment; only symptom management until your body recovers. 

[Teaching3bears]

In my area, there are more hospitalizations but no new deaths. Still, given that there are many new cases in nursing homes, that might not last. They say the new cases are not caused by increased testing.

I would rather a longer period of closures than having to live with this another 2 years.

[Ottakee]

3 minutes ago, Teaching3bears said:

In my area, there are more hospitalizations but no new deaths. Still, given that there are many new cases in nursing homes, that might not last. They say the new cases are not caused by increased testing.

I would rather a longer period of closures than having to live with this another 2 years.

Hopefully your state is not doing what Michigan did (possibly still does) is putting COVID positive patients into the nursing homes....discharging them from hospital and into nursing homes.   That made our nursing home residents be at such higher risk.

[J-rap]

In our state, everything has been slowly opening up (though not as much as other areas), yet, our curve has remained steady because people are actually masking.  Even protesters and homeless people mask.  Stores are careful, restaurants are careful.  Masks are required.  I do think that makes a difference.

Edited July 27, 2020 by J-rap

[KathyBC]

1 hour ago, Teaching3bears said:

I would rather a longer period of closures than having to live with this another 2 years.

Is that scenario scientifically possible?

For reputable information about the likely course of this pandemic, maybe try Michael Osterholm.
Edited: rushing

Edited July 27, 2020 by KathyBC

[Ausmumof3]

I’m sorry.  It’s so depressing to watch.

[Ausmumof3]

15 hours ago, Ottakee said:

Since there are so many more tests we will find more cases.  The big question is how many of these cases are asymptomatic or with only very mild symptoms....all cases that early one would have never warranted a test or even a doctor's visit.

Are you deaths and hospitalizations going way up?  In our area, they are staying very low, despite the increase in number of positive test results.

 

What’s your percentage positive like?  If it stays steady it’s probably more testing.  If that starts going up it’s probably laggy data/delay till deaths? 

[Ausmumof3]

16 hours ago, SKL said:

Another view ... maybe in some places we went too far beyond flattening the curve.  If more people had been exposed since last March while all the schools were shut, we'd have a lot more people immune in time for school to start.  Seems March-August would be the perfect time for "well" kids to get it and gain immunity without forcing at-risk people to breathe their germs.  I understand not wanting to overwhelm hospitals, but where I live, they actually laid medical people off because we "flattened the curve" so well.

I believe it's always been well understood that we could not stop the spread in time for the school year to start.  So why are we going into a school year with most kids still unexposed?

Frankly I am hoping my kids and others get exposed during pre-season sports over the summer (if they haven't already had this thing).  I think it will reduce the likelihood of school shutdowns over the school year.  Also I am sick of walking around assuming I probably have an unsymptomatic case, hiding from at-risk loved ones etc.  This is taking an invisible toll that needs to be recognized.

NY and NJ have had over 1,600 deaths per million people.  There’s no evidence they have herd immunity but they might.   If that’s the rate of deaths needed for herd immunity it would take around 530,000 deaths for the US to get there.

[Ottakee]

1 hour ago, Ausmumof3 said:

What’s your percentage positive like?  If it stays steady it’s probably more testing.  If that starts going up it’s probably laggy data/delay till deaths? 

In my state the percent positive is dropping.

[Ausmumof3]

6 minutes ago, Ottakee said:

In my state the percent positive is dropping.

That’s good!  Sounds like you are staying on top of it.

[SKL]

2 hours ago, Ausmumof3 said:

NY and NJ have had over 1,600 deaths per million people.  There’s no evidence they have herd immunity but they might.   If that’s the rate of deaths needed for herd immunity it would take around 530,000 deaths for the US to get there.

The reported death rate in NY and NJ is not representative at all.  There are multiple reasons why it is so high that do not apply across the board, and especially don't apply to discussions about exposing children over the summer.

[BlsdMama]

19 hours ago, Ottakee said:

Since there are so many more tests we will find more cases.  The big question is how many of these cases are asymptomatic or with only very mild symptoms....all cases that early one would have never warranted a test or even a doctor's visit.

Are you deaths and hospitalizations going way up?  In our area, they are staying very low, despite the increase in number of positive test results.

 

I think it's fascinating how every state is so markedly different.  Yesterday marked the first 24 hour period in which no one died here.  We had almost 400 new cases (and another 600+ on Fri/Sat) but after a high couple of weeks, there are fewer than 300 patients in the hospital and 29 on vents. 

I think the increase in tests made more readily available allowed us to test more of the less ill people.  The statistics are now more fully representative of the disease - because the increase in the testing - nearly symptomless people or just exposed people can be tested and we will get a more accurate idea of how many get seriously or deathly ill.

[ktgrok]

19 hours ago, Teaching3bears said:

We were in the single digits for most of June and now we have had big spikes and cases are way up. we flattened the curve but what is the point of flattening if it's just going to go up again? In the meantime, everything has opened, including bars and masks have become mandatory. Masks are good but they are not enough. They do not blame the spike on the openings but on young people getting together. Meanwhile, there have been outbreaks in day cares, gyms and more in nursing homes. So, not just young people even if there were one or two parties. A lot of our news cases are children.

We are opening for the economy but if the numbers go up more people will stay home and businesses won't do well. If we had waited 3 more months and gotten it down to a stable zero we could have gone back to a normal life. How long can restaurants and other businesses go at half capacity because they have to distance customers?

Public health officials are not worried because hospitals are doing okay. They say we will just have to live with covid for 2 years.

There is such a focus on cleaning too, which is good, but you can't clean the air and that's how most people catch it.

Well, the good news and one reason for flattening was that catching it now, versus months ago, has a bit better outcome because we know a bit more about how to treat it. So delaying does help. And people who can delay even longer will likely get even better treatments. 

But yeah, opening bars if cases/positivity are up is just dumb. They need to be the last places. Gyms too. Sounds like you are following our trajectory. I'm sorry. 

And yup, they said that about hospitals here too. It took a while for those younger people to pass it to older people who were more likely to be hospitalized or die. And by then, it was too late. 

19 hours ago, SKL said:

Another view ... maybe in some places we went too far beyond flattening the curve.  If more people had been exposed since last March while all the schools were shut, we'd have a lot more people immune in time for school to start.  Seems March-August would be the perfect time for "well" kids to get it and gain immunity without forcing at-risk people to breathe their germs. 

HOW do you have kids spread it and get it, without the rest of the population being exposed? I mean, they will obviously expose their parents, who then expose other adults, who expose the vulnerable. Saying kids should get it is the same as saying we should just let it rip through the population. Ask Texas and Florida how well that works. 

19 hours ago, Ottakee said:

Since there are so many more tests we will find more cases.  The big question is how many of these cases are asymptomatic or with only very mild symptoms....all cases that early one would have never warranted a test or even a doctor's visit.

Are you deaths and hospitalizations going way up?  In our area, they are staying very low, despite the increase in number of positive test results.

 

Deaths and hospitalizations take TIME. By the time those are going up, it is too late. Better to look at both positivity and case numbers. 

[Ausmumof3]

1 hour ago, SKL said:

The reported death rate in NY and NJ is not representative at all.  There are multiple reasons why it is so high that do not apply across the board, and especially don't apply to discussions about exposing children over the summer.

True but they also don’t necessarily even have herd immunity it’s just a possibility.  I get angsty about that concept because we have sheep and we had a disease go through once and it was pretty awful to watch the suffering going on.  The vaccine was pretty expensive but so worth it to not watch sheep rolling around dying with bloated stomachs and nothing to do but end the suffering.  Herd immunity is not a pretty process and even in livestock we don’t aim for it without a vaccine.  

[shawthorne44]

By the time the WHO admitted that there was a disease, it was too late.   At that point there was no scenario where we eradicated the disease.   Look at smallpox.  We've had a vaccine for forever.   We thought we had it beat.   But, the U.S. still has outbreaks.   H1N1 is still around.    The Spanish Flu is still around.    SARS1, (this disease is officially SARS2) was handled well at the source and isn't a worry.   

So, now your choices are to get it and get the antibodies, get the vaccine and get the antibodies, or get lucky.    I've heard the thing about antibodies may not work.   But, unless we have convincing evidence to the contrary, I'll think that this virus is like others.  Just depends on how much it mutates.  

One thought to ponder.   How many cases of asymptomatic flu are there every year?   We have no idea.   Including asymptomatic cases in the total cases is ridiculous.  

In hindsight, what we should have done in the beginning was to have households put themselves into two groups, those in danger if they get it, and those that likely aren't.    The households in danger should have TOTALLY locked down.   We could have given those households extra money to pay for food delivery, etc.    Then everyone else should have actively socialized for the first two weeks.   Square dancing in town squares, etc..   Those not in danger that got it, then would stay home totally until two weeks after they got better.  We could have protected those that needed protecting, AND developed the herd immunity.  
 

[Ausmumof3]

3 minutes ago, shawthorne44 said:

By the time the WHO admitted that there was a disease, it was too late.   At that point there was no scenario where we eradicated the disease.   Look at smallpox.  We've had a vaccine for forever.   We thought we had it beat.   But, the U.S. still has outbreaks.   H1N1 is still around.    The Spanish Flu is still around.    SARS1, (this disease is officially SARS2) was handled well at the source and isn't a worry.   

So, now your choices are to get it and get the antibodies, get the vaccine and get the antibodies, or get lucky.    I've heard the thing about antibodies may not work.   But, unless we have convincing evidence to the contrary, I'll think that this virus is like others.  Just depends on how much it mutates.  

One thought to ponder.   How many cases of asymptomatic flu are there every year?   We have no idea.   Including asymptomatic cases in the total cases is ridiculous.  

In hindsight, what we should have done in the beginning was to have households put themselves into two groups, those in danger if they get it, and those that likely aren't.    The households in danger should have TOTALLY locked down.   We could have given those households extra money to pay for food delivery, etc.    Then everyone else should have actively socialized for the first two weeks.   Square dancing in town squares, etc..   Those not in danger that got it, then would stay home totally until two weeks after they got better.  We could have protected those that needed protecting, AND developed the herd immunity.  
 

This sounds good in theory.  However there’s three things it doesn’t account for.  we don’t know for sure who is in danger.  We know definitely about older ages and we know about some pre existing conditions.  However there are also some people without any of that who get really sick.  Second follow ups show that for a high percentage of even younger healthy people who get it the recovery is not exactly like having the cold.  For some it is only two weeks but for others they are struggling to walk to the letter box four months on.  Third, lung damage shows up on scans even in the “not sick” group and we don’t know what the long term implications are.  It appears to improve over time.  But we don’t know if the scarring etc ever fully goes away.  Some viruses etc cause cancer or other bad stuff years later (think chicken pox, HPV etc). Fourth - someone has to deliver those groceries and the more community spread the more chance the person doing the delivery has something nasty that gets picked up by the high risk person putting the cold stuff away.   And fifth we don’t know how long it takes to go through meaning we may be asking high risk people to remain indoors in complete isolation for an extremely long period of time.  
 

anyway that’s just my thoughts.  In theory isolating the at risk sounds good.  I just don’t know if it’s as practical in reality.  

[PerfectFifth]

2 hours ago, BlsdMama said:

I think the increase in tests made more readily available allowed us to test more of the less ill people.  The statistics are now more fully representative of the disease - because the increase in the testing - nearly symptomless people or just exposed people can be tested and we will get a more accurate idea of how many get seriously or deathly ill.

Based on what is happening in So. Cal, we are no where near this. In many areas around me, you can only be tested if you have symptoms and that is after you wait in line for 4-6 hours. There is no way they are catching people with early/mild symptoms. No one wants to wait in line for a test when your symptoms are manageable and there is the possibility they will run out of tests before you get there or they will refuse to test due to insufficient test kits and you may not be sick enough to warrant use of a kit.  Plus as of 2 weeks ago, it was taking 9 days to get results back.  So the sick person may stay home until results return, but the asymptomatic or healthy  family members can't wait. They need to work to pay the rent. 

It's a mess. California was starting to stabilize last week, but LA is not. Haven't looked at numbers today....need more coffee before I can tackle that.

Edited July 27, 2020 by PerfectFifth

[wathe]

12 hours ago, Ottakee said:

Hopefully your state is not doing what Michigan did (possibly still does) is putting COVID positive patients into the nursing homes....discharging them from hospital and into nursing homes.   That made our nursing home residents be at such higher risk.

Where else can you discharge them to?  Occupying an acute-care hospital bed is not a solution for otherwise stable patients who are ready for discharge.  Those beds are needed for acute care.  Especially when hospitals are already overwhelmed or nearing capacity during a pandemic.   Cohorting in nursing homes is what most jurisdictions are currently doing, I think. 

[shawthorne44]

2 hours ago, square_25 said:

Except how in the world do we know who's vulnerable? Everyone over 50? Everyone with diabetes? What about people who have jobs that put them in contact with vulnerable people? I think you would find very few people would be square dancing in the town square by the end of it. 

 

We knew that from the beginning.   

https://www.npr.org/2020/04/13/833010438/who-is-most-vulnerable-to-covid-19-and-other-questions-answered

There are a great many people who aren't vulnerable  and don't work with those are are.     

DH had it in Feb, DD likely had it then and I might have too.    For DH, he was miserable for abut 12 hours, and stayed in bed for a day.   DD spent an afternoon in bed.  Around that time, I had what I thought was a sinus infection, but the symptoms are expanding, so maybe I had it too.   We know DH had it, but neither DD nor I have been tested for antibodies yet.  Every flu I've had was worse than this.  But, then we aren't in the population that needs to worry.  

[Suzanne in ABQ]

As I understood, back in March/April, the reason we were flattening the curve was because hospitals weren't able to cope with a sudden influx of COVID patients. They didn't have the resources (PPE, beds, ventilators), and they didn't know anything about how to treat the disease. Testing wasn't available, so there was no way to know who had the disease. The bar was set at the number of patients the hospitals could handle, and our goal was to "flatten the curve" to keep it under that line. The original intent of flattening the curve was not to keep everyone from getting the disease, forever and ever. It was to keep the hospitals from being overwhelmed.

Since then, the bar has been raised. The supply of PPE has been beefed up. Hospitals have fitted out COVID wards, and have created a cooperative structure to share ventilators and other equipment, and something like 40,000 ventilators have been built. Doctors are learning more every day about how to treat the disease in all its stages. Testing (at least in my state) is available to everyone, and they have some level of tracking happening. 

Simultaneously, though, the original intent of the campaign to flatten the curve has been forgotten, and it's morphed into a different idea for every individual, and the government hasn't been clear about the goals. I think that's why there is so much discord and judgement between people. What, exactly, are we trying to do? Are we trying to keep every single person from getting it? Are we still just trying to prevent hospitalizations and deaths? Should we be focused on trying to protect the vulnerable? Should we be trying to just wait it out, with everyone isolated until it just goes away? If so, who will feed and house those who are now at the end of their reserves, and are in danger of losing their homes? Are we trying to bankrupt the government? If we do, then who will be taxed next? How can people pay income tax if they don't have any income? What about the businesses that will *never* be considered essential? The questions go on and on. 

 

[kokotg]

 

 

14 minutes ago, Suzanne in ABQ said:

 

Simultaneously, though, the original intent of the campaign to flatten the curve has been forgotten, and it's morphed into a different idea for every individual, and the government hasn't been clear about the goals. I think that's why there is so much discord and judgement between people. What, exactly, are we trying to do? Are we trying to keep every single person from getting it? Are we still just trying to prevent hospitalizations and deaths? Should we be focused on trying to protect the vulnerable? Should we be trying to just wait it out, with everyone isolated until it just goes away? If so, who will feed and house those who are now at the end of their reserves, and are in danger of losing their homes? Are we trying to bankrupt the government? If we do, then who will be taxed next? How can people pay income tax if they don't have any income? What about the businesses that will *never* be considered essential? The questions go on and on. 

 

I think the goal should be to do what pretty much every other wealthy country in the world has been able to do: get transmission rates low enough that it's reasonable to stop new outbreaks before they get out of control, so that we can maintain a careful new version of normal until there's a vaccine and/or more effective treatments. It's clearly not impossible, because most countries have done it already. 

[TCB]

On 7/26/2020 at 12:38 PM, KungFuPanda said:

That’s true. It’s also true that a LOT of people catch it and treat at home without becoming part of the official headcount. I think as long as people can manage their symptoms nobody is in a hurry to get near a hospital. There is no treatment; only symptom management until your body recovers. 

Just wanted to say that there are some treatments with some encouraging data to show they work. There isn’t a cure or anything like that yet, but wanted to point out that there are medications and therapies that seem to be reducing length of illness and reducing mortality.

[Corraleno]

I have to wonder if the people who think the solution is for everyone to get it and achieve "herd immunity" ASAP actually understand the math involved. In order to get 70% of the country infected, we need 230,000,000 people to get it. Let's say that the 4 million reported cases so far represent 30 million actual infections. So in order to achieve "herd immunity" within one year, we need to get another 200 million people infected: 200,000,000 divided by 365 is ~ 548,000. So we would need 548,000 new cases every single day for the next year in order to achieve herd immunity by July 27, 2021. And with an IFR of around 1% (and it's likely to be much higher considering the levels of hospital overwhelm), that's another 2,000,000 deaths. 

Who thinks the US healthcare system can handle that? Who thinks that level of illness and death will have no effect on the economy? Who has a feasible plan for "protecting the vulnerable" when 40% of American adults have underlying conditions that make them high risk? Do people really think that 330 million Americans will happily gamble with their lives and go back to "normal" life while the virus blasts through the population killing 2 million people? And after all that suffering, and all those deaths, there is no guarantee that the immunity would even last. 

Edited July 27, 2020 by Corraleno

[kokotg]

2 minutes ago, square_25 said:

To be honest, I’d guess Europe will have problems again when people get inside. 

Asia and Oceania seem to have done a better job, though.

But do you think they'll ever get to the same point we're at? I think that especially in places that have already been hit hard, people don't want to go there again and will do what they have to do to keep it from happening. I don't think a New Zealand like scenario where there's no more coronavirus and everyone can have a big party to celebrate is realistic most places, but I do think we know enough now to keep things from exploding by keeping a certain level of precautions in place and stomping out fires when they pop up. I hope. But, yeah, winter will be rough. But I'd much rather be going into winter looking like Europe than looking like the US. 

[kokotg]

Just now, Corraleno said:

I have to wonder if the people who think the solution is for everyone to get it and achieve "herd immunity" ASAP actually understand the math involved. In order to get 70% of the country infected, we need 230,000,000 million people to get it. Let's say that the 4 million reported cases so far represent 30 million actual infections. So in order to achieve "herd immunity" within one year, we need to get another 200 million people infected: 200,000,000 divided by 365 is ~ 548,000. So we would need 548,000 new cases every single day for the next year in order to achieve herd immunity by July 27, 2021. And with an IFR of around 1% (and it's likely to be much higher considering the levels of hospital overwhelm), that's another 2,000,000 deaths. 

Who thinks the US healthcare system can handle that? Who thinks that level of illness and death will have no effect on the economy? Who has a feasible plan for "protecting the vulnerable" when 40% of American adults have underlying conditions that make them high risk? Do people really think that 330 million Americans will happily gamble with their lives and go back to "normal" life while the virus blasts through the population killing 2 million people? And after all that suffering, and all those deaths, there is no guarantee that the immunity would even last. 

yes. the math is staggering. 

[Pronghorn]

My brother, who is big on herd immunity as the right approach, believes that fifty percent of people are naturally immune.  I believe that figure is based on how many people got it on closed systems like boats. So, he thinks just twenty percent of people need to get it. Add the twenty and fifty and you have herd immunity. He thinks that has probably been achieved in the New York area.

[Corraleno]

1 minute ago, square_25 said:

To be fair, if the T-cell results are correct, the IFR may be 0.5 percent and not 1 percent.

It’s still far too much, especially with hospital overwhelm which would raise it, but I did want to point that out.

Even at 0.5%, which is the best possible scenario in an ideal world where everyone gets the treatment they need, we'd be looking at another 1,000,000 deaths. But there is no way the US healthcare system could handle more than half a million new cases every single day for a year, so the IFR would likely be far higher than 1%.  It's just insane that anyone is suggesting this is a good idea, let alone a viable solution.

[kokotg]

8 minutes ago, Pronghorn said:

My brother, who is big on herd immunity as the right approach, believes that fifty percent of people are naturally immune.  I believe that figure is based on how many people got it on closed systems like boats. So, he thinks just twenty percent of people need to get it. Add the twenty and fifty and you have herd immunity. He thinks that has probably been achieved in the New York area.

Even if that were true, if the US as a whole had the same death rate as NYC had, we'd be looking at almost 900,000 deaths in the US before we're finished.

ETA: someone should probably check my math

Edited July 27, 2020 by kokotg

[KungFuPanda]

3 hours ago, TCB said:

Just wanted to say that there are some treatments with some encouraging data to show they work. There isn’t a cure or anything like that yet, but wanted to point out that there are medications and therapies that seem to be reducing length of illness and reducing mortality.

I'll admit I'm probably behind on the latest, best practices. Do these treatments attack the virus directly? Or do they shore up your systems so your body can fight more efficiently and heal faster?

[TCB]

15 minutes ago, KungFuPanda said:

I'll admit I'm probably behind on the latest, best practices. Do these treatments attack the virus directly? Or do they shore up your systems so your body can fight more efficiently and heal faster?

Well one of them, Remdesivir, is an anti viral. Dexamethasone, a steroid, helps stop the overactivity of the immune system that causes a cytokine storm so I guess that is not acting on the virus itself. There are other supportive measures too, that stop some of the dangerous symptoms, like anti-coagulants, and measures like lying prone which help improve oxygenation. 
 

ETA: Those are some of the things we are using at work, there are others I haven’t had personal experience with and know less about.

Edited July 27, 2020 by TCB

On 7/26/2020 at 1:11 PM, Ottakee said:

Since there are so many more tests we will find more cases.  The big question is how many of these cases are asymptomatic or with only very mild symptoms....all cases that early one would have never warranted a test or even a doctor's visit.

Are you deaths and hospitalizations going way up?  In our area, they are staying very low, despite the increase in number of positive test results.

 

Here on my side of the state they keep talking about “spikes”, but the hospitals are all advertising for people to please come back and schedule all the stuff they put off back in March/April.

Flattening the curve was never elimination, but postponement.  Some people seem confused and want to change the definition.

[kokotg]

3 minutes ago, Happymomof1 said:

But see that is what I do not understand and if someone can find the stupid John Hopkins map.  I only see it when I get linked there by CNN sometimes.  But they had a chart with total number of cases, number of deaths by state. We don't have the death rate that NYC did.  Florida had almost reached them in number of cases but had 5,000 deaths  as opposed to 50,000.  ( Yes, I'm making up numbers.  If someone can link the chart I cannot find, I would appreciate it.  But the death level was SO SO much worse for New York than Texas or Florida.  I didn't understand why. 

That's because Florida is doing more testing than New York was when things were bad and finding a higher percentage of cases. It might also be partially because treatments are better now, but I think it's mostly about testing. The positivity rate suggests Florida still isn't doing enough testing (you want it under 5%), but its outbreak happening when tests are more available means they can do way more testing. But my math is looking at the death rate compared to the entire population of NYC. Somewhere around .25% of ALL NEW YORKERS died (I'm not doing math again to find the precise number). I.e. it has nothing to do with the death rate for verified cases, because I was responding to the idea that NYC has herd immunity now. If they do, it took about .25% of the population dying to get there. 

 

[KungFuPanda]

A local hospital just lost the doctor in charge of their critical care division to Covid.  He was healthy, 56, and knew how to take every precaution. It's so sad. 

[KungFuPanda]

33 minutes ago, TCB said:

Well one of them, Remdesivir, is an anti viral. Dexamethasone, a steroid, helps stop the overactivity of the immune system that causes a cytokine storm so I guess that is not acting on the virus itself. There are other supportive measures too, that stop some of the dangerous symptoms, like anti-coagulants, and measures like lying prone which help improve oxygenation. 
 

ETA: Those are some of the things we are using at work, there are others I haven’t had personal experience with and know less about.

That is encouraging.  The anti-viral wasn't even on my radar.  I don't know how I even missed that one.  

[kokotg]

8 minutes ago, Happymomof1 said:

Right, ok to be honest math and science are not my thing, but they are doing more testing and more cases but .25 aren't dying???  I'm not getting it.   And someone do simple math for me.  A lot of times people give some sciency explanation and I don't understand it at all. 

If you're identifying more cases, the death rate will look lower than if a bigger percentage of cases goes undiagnosed. Florida is testing something like 7x as many people right now as NYC was at its peak (peak of cases, not testing). When you're doing less testing, it's the very serious cases that you're more likely to find, and those are the people who are more likely to die, so it will look like the death rate is higher than if you're catching a big percentage of less severe and asymptomatic cases. We can't know the true mortality rate unless we find every single case (and correctly identify every single death). 

[TravelingChris]

Only 1.1 % of my county has been tested and did have Covid as of today.  Within the last 14 days, we have had 12% of tests come back positive.  I am glad we have a mask order in my state.

[Corraleno]

43 minutes ago, Happymomof1 said:

We don't have the death rate that NYC did.  Florida had almost reached them in number of cases but had 5,000 deaths  as opposed to 50,000.  ( Yes, I'm making up numbers.  If someone can link the chart I cannot find, I would appreciate it.  But the death level was SO SO much worse for New York than Texas or Florida.  I didn't understand why. 

Keep in mind that the explosion in cases in FL is very recent. The vast majority of NY's death toll happened several months ago, so the deaths associated with their peak have already been recorded. Florida's cases only started to go up about 6 weeks ago, and since there is a lag between diagnoses and deaths, deaths only started to go up about 3 weeks ago. If you look at this chart from Worldometer, the deaths we have recorded for FL in the last 3 weeks most likely relate to the cases in the blue area, from the previous 3 weeks, and we have probably not seen the deaths that are (or will be) associated with the cases in the red area. And that red area holds more than half of the total CV cases in FL — just under 225,000.

So you are really looking at 6K deaths in FL out of the 210K cases that were recorded up to about 3 weeks ago. Let's say that, due to how bad the testing issues were in March, NY was only catching half as many cases as FL is, and that if they had the same level of testing that FL currently has, they might have recorded twice as many cases — 880K, not 440K. That would work  out to 3.75 deaths per 1000 cases for NY and around 3 deaths per 1000 cases for FL. So not that far off.

[Corraleno]

Just now, Happymomof1 said:

Ok, I think I get what you are saying, but that doesn't match the numbers on John Hopkins as far as deaths per 100,000.  So that is because of the lag?

More than half of the total cases for FL have only been recorded in the last 3 weeks, so the people in that cohort who may eventually die most likely haven't died yet. You can't really compare "deaths per cases" between states if one of them had the vast majority of their cases months ago, with nearly all "potential" deaths already accounted for, and one of them is at the beginning of an outbreak that is still increasing, and we have no idea how many of the most recent 225,000 cases are going to die.

[kokotg]

29 minutes ago, Happymomof1 said:

Ok, once again just making up numbers to see if I am understanding.  So New York tested 100,000 people and 10,000 had it but they were only the sick ones, so really 100,000 people had it..  But then what was their positivity rate? I know we didn't catch all of the cases, but were their positivity rates higher than Florida's are now because according to Florida's numbers they are not testing nearly enough so there are many more people that actually have it, which would then make their death rate even lower...  What am I missing.  ( I know I probably am.  I used to be good at math, but since menopause my whole thinking seems slow and fuzzy.  )

New York's positivity rate was MUCH higher at its peak. Florida's is, what, a little under 20% lately? New York state's was 50% in April (I imagine higher in NYC--I'm just looking up numbers quickly to get a rough idea)

[ktgrok]

39 minutes ago, Corraleno said:

Keep in mind that the explosion in cases in FL is very recent. The vast majority of NY's death toll happened several months ago, so the deaths associated with their peak have already been recorded. Florida's cases only started to go up about 6 weeks ago, and since there is a lag between diagnoses and deaths, deaths only started to go up about 3 weeks ago. If you look at this chart from Worldometer, the deaths we have recorded for FL in the last 3 weeks most likely relate to the cases in the blue area, from the previous 3 weeks, and we have probably not seen the deaths that are (or will be) associated with the cases in the red area. And that red area holds more than half of the total CV cases in FL — just under 225,000.

So you are really looking at 6K deaths in FL out of the 210K cases that were recorded up to about 3 weeks ago. Let's say that, due to how bad the testing issues were in March, NY was only catching half as many cases as FL is, and that if they had the same level of testing that FL currently has, they might have recorded twice as many cases — 880K, not 440K. That would work  out to 3.75 deaths per 1000 cases for NY and around 3 deaths per 1000 cases for FL. So not that far off.

Yes! It takes up to 8 weeks from time of death to being reported, according to the CDC. So you have people catch it, then get sick enough to get tested, then sick enough to die, then the lag in reporting. And that doesn't take into account that at first, our big spike was college age people, who are unlikely to die, but then they started spreading it to others, and now the age is going back up again, so we will see more deaths in that latter round of cases but...it's going to be a while before we know. 

Which is why it is so frustrating when places seeing the beginnings of a spike say, "but deaths are not up". Not yet. But they will be. 

[Ausmumof3]

39 minutes ago, Happymomof1 said:

Ok, once again just making up numbers to see if I am understanding.  So New York tested 100,000 people and 10,000 had it but they were only the sick ones, so really 100,000 people had it..  But then what was their positivity rate? I know we didn't catch all of the cases, but were their positivity rates higher than Florida's are now because according to Florida's numbers they are not testing nearly enough so there are many more people that actually have it, which would then make their death rate even lower...  What am I missing.  ( I know I probably am.  I used to be good at math, but since menopause my whole thinking seems slow and fuzzy.  )

I don’t know for sure but I have seen some people say at some points it was 50pc so still much higher I’ll see if I can find the source for that 

[kokotg]

3 minutes ago, Ausmumof3 said:

I don’t know for sure but I have seen some people say at some points it was 50pc so still much higher I’ll see if I can find the source for that 

I found it on Johns Hopkins site: https://coronavirus.jhu.edu/testing/individual-states/new-york

[Reefgazer]

On 7/26/2020 at 12:21 PM, Teaching3bears said:

We were in the single digits for most of June and now we have had big spikes and cases are way up. we flattened the curve but what is the point of flattening if it's just going to go up again? In the meantime, everything has opened, including bars and masks have become mandatory. Masks are good but they are not enough. They do not blame the spike on the openings but on young people getting together. Meanwhile, there have been outbreaks in day cares, gyms and more in nursing homes. So, not just young people even if there were one or two parties. A lot of our news cases are children.

We are opening for the economy but if the numbers go up more people will stay home and businesses won't do well. If we had waited 3 more months and gotten it down to a stable zero we could have gone back to a normal life. How long can restaurants and other businesses go at half capacity because they have to distance customers?

Public health officials are not worried because hospitals are doing okay. They say we will just have to live with covid for 2 years.

There is such a focus on cleaning too, which is good, but you can't clean the air and that's how most people catch it.

I think the bolded is true; we're going to be playing whack-a-mole for several years (not just 2) until most of us have been infected and develop some immune memory response.  I don't believe we will see a safe and effective vaccine ready for the average Joe's arm within a year or 2.

[Reefgazer]

19 hours ago, square_25 said:

The whole point of playing whack-a-mole is that most of us are not supposed to get infected. 

I don't really understand the fatalism here. There are lots and lots and lots of viruses which we do not want to go through the population, even if we disregard the people who die (which I see no reason to do), because they have so many side effects. We don't realistically know what the effects of this virus are long term. As I've mentioned before, a lot of the people we know personally who've had it seem to still have residual effects, and those are the things they feel themselves... realistically, we have no clue if most people who've had it are now likely to develop an autoimmune disease or now have heart damage (which is being indicated by some studies, I believe.) 

Having everyone get it seems like an experiment you may very well not want to do on your population, assuming you want the optimally functional and healthy population. 

I don't mean to be fatalistic, or to promote getting the virus intentionally.  Sorry if it came off that way.  But I do not see it playing out any other way, given that a vaccine (if one can be found that is safe and effective) is longer away than a year.