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Are things getting worse?


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7 minutes ago, Bootsie said:

Time for what?  Parts of the US are seeing large outbreaks now.  I am not hearing of hospital overruns, lack of ICU beds, and other issues that were occurring earlier this year.  Does that mean that those areas took the time to address those issues and that even though there are increased numbers of COVID cases the lockdown was successful in addressing the supplies needed for medical care?  How can we measure the effectiveness (or lack thereof) of lockdowns?  

We definitly have more PPE. I'm remembering last spring,  nurses being told to keep their one mask and drives to try to get people to donate masks they may have purchased at the store.

 

My state currently has beds where I live but not enough nurses. We usually hire traveling nurses for the winter and the competition is stiff and we simply don't have enough. It's not like you just convert over a factory and viola with in months out come highly trained nurses capable of ICU care. Training nurses takes years.

Edited by frogger
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1 hour ago, Ottakee said:

Hones question.  Cases are going up here but the severity of illness appears to be much less than last spring.  Our hospitalizations and ICU beds are way way down and no covid in ICU in our county.

Is that true most places?   In our are the 10 people I know that tested positive over the past week either had no or mild cold symptoms.  

That is not true in my area - midwest. The patients we are getting in the ICU are sicker and we have lost many more than we did in the spring. Our area did not have a hard lock-down and over the summer many people just went back to life as normal - in fact the local businesses had their best season financially ever! It seems that more people came here because we had so few restrictions.  Rates of infection have been increasing and now we have many patients in the hospital. 

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9 minutes ago, Bootsie said:

Time for what?  Parts of the US are seeing large outbreaks now.  I am not hearing of hospital overruns, lack of ICU beds, and other issues that were occurring earlier this year.  Does that mean that those areas took the time to address those issues and that even though there are increased numbers of COVID cases the lockdown was successful in addressing the supplies needed for medical care?  How can we measure the effectiveness (or lack thereof) of lockdowns?  

We have that in Wisconsin.  Hospitals are filled.  They opened a field hospital for covid outside of Milwaukee last week and have patients there. I think in spring they either set up one and never used it or they just had plans for a field hospital if needed. 

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Quoted in WaPo: "The next six to 12 weeks are going to be the darkest of the entire pandemic," Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told NBC's"Meet the Press" on Sunday.

Any idea why he would say 6-12 weeks? I don't understand why public health officials are still implying that the curve will tail off, as we saw in almost every model in the first few months of the pandemic. My guess is we're going to have a rough winter, November through March, at least in areas like mine where winter weather prevents most outdoor gatherings. And the pattern may be reversed in southern states, where people start spending more time outside around now.

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13 minutes ago, Bootsie said:

Time for what?  Parts of the US are seeing large outbreaks now.  I am not hearing of hospital overruns, lack of ICU beds, and other issues that were occurring earlier this year.  Does that mean that those areas took the time to address those issues and that even though there are increased numbers of COVID cases the lockdown was successful in addressing the supplies needed for medical care?  How can we measure the effectiveness (or lack thereof) of lockdowns?  

Hospitals are being overwhelmed https://www.politico.com/news/2020/10/16/pandemic-states-virus-rebound-429753

Areas like New York that had issues earlier this year are doing better. I think anecdotally that shows that what they have done worked. But was it the lockdowns or mask wearing or contact tracing or the combination of everything? Or was it just the virus burning out in that population and they will have another surge no matter what they do?

Susan in TX

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re medical sector constraints

11 minutes ago, frogger said:

We definitly have more PPE. I'm remembering last spring,  nurses being told to keep their one mask and drives to try to get people to donate masks they may have purchased at the store.

 

My state currently has beds where I live but not enough nurses. We usually hire traveling nurses for the winter and the competition is stiff and we simply don't have enough. It's not like you just convert over a factory and viola with in months out come highly trained nurses capable of ICU care. Training nurses takes years.

Yeah, it's the TRAINED PEOPLE constraint that is, and will continue to be, the hardest to fill.

There really were severe PPE constraints in the worst days of the NYC/surrounding area crisis, and that issue has been largely resolved.

With reasonable leadership, overflow sites can be found/built and beds can be brought in from civilian or military sites.  There are new portable/specialized HVAC capacities that emerged out of the NE crisis to allow for rapid and effective conversion of non-specialized spaces to hospital purposes.

But you can't just create trained medical workers.  That is the most difficult capacity constraint to deal with.

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33 minutes ago, Bootsie said:

Parts of the US are seeing large outbreaks now.  I am not hearing of hospital overruns, lack of ICU beds, and other issues that were occurring earlier this year.

Locally rural beds are full and people from rural areas are being transported into the metro area.  The metro area is starting to get full but says it isn't a problem yet.  

I would say -- it isn't happening here yet, but I am concerned about where things will be a month from now.  

This is the first time that people have been transported this way, because the rural areas (with 1-2 exceptions) basically weren't having any cases before.  

Edit:  This is newly happening here, here is an article: https://oklahoman.com/article/5674045/opinion-cramped-icus-another-reminder-of-need-to-help-curb-virus/amp

"Heather Yazdanipour, a regional director of the Regional Medical Response System, told the city council Tuesday that ICU beds were not available that day. A nursing shortage is contributing to the problem, Yazdanipour said, along with patients being transferred from rural areas."

 

Here is another newspaper article:  https://oklahoman.com/article/5673827/as-mask-ordinance-is-extended-covid-19-surges-and-okc-has-no-icu-beds-available

 

Edited by Lecka
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1 hour ago, PeterPan said:

Exactly. That's what is happening here. Deaths way down, treatments working.

You've got Tr*mp out saying this is going to end soon, and he usually seems to be on the forward end with his claims. Maybe he's got data on where this is going.

Without going into politics here are a couple of facts:

Trump used the Regeneron product made from stem cells (derived from babies) in order to get better. I am 100% certain that any of the ordinary Americans who are led to believe that this virus is easy to beat will not have access to this treatment in their local hospitals at this time - not to mention the horror with which stem cell research is regarded by certain lobbies and segments of American population.

Trump was making promises of vaccines for everyone by Nov 1st in August. We saw what happened on that.

No, he has no data on where this virus is going, there is no data on how Russians are doing with their vaccines, nobody can predict when this will end.
 

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2 hours ago, Ottakee said:

Hones question.  Cases are going up here but the severity of illness appears to be much less than last spring.  Our hospitalizations and ICU beds are way way down and no covid in ICU in our county.

Is that true most places?   In our are the 10 people I know that tested positive over the past week either had no or mild cold symptoms.  

I just checked my county (single digits of positive tests per day, but now 6-9 compared to 3 or 4) and we only have one hospitalized COVID patient.  That sounds terrific.
But we only have 5 ICU beds and 30 medical/surgical open, so I feel pretty invested in keeping cases at or below where they are now.

This is after we already experienced numbers high enough to be making plans for a field hospital.

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Yep I expect to get worse.  Here locally it was already bad until the mask mandate. We've been trending down since July until recently.  For the last 4 weeks we have stayed relatively flat but not low enough to meet any of the targets.  Positivity is ~7% and cases are 120/100k.  Not terrible but not great.   We have been allowed to move up a phase and open a bunch of indoor dining and restaurants.  Also both school districts are going ahead and starting hybrid elementary school even though they had originally said we need to be at 75/100k for two weeks.

Everyone is definitely acting like we had our spike and everything is over now.  

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1 hour ago, Bootsie said:

Time for what?  Parts of the US are seeing large outbreaks now.  I am not hearing of hospital overruns, lack of ICU beds, and other issues that were occurring earlier this year.  Does that mean that those areas took the time to address those issues and that even though there are increased numbers of COVID cases the lockdown was successful in addressing the supplies needed for medical care?  How can we measure the effectiveness (or lack thereof) of lockdowns?  

Hospitals are filling up rapidly: In general - https://www.politico.com/news/2020/10/16/pandemic-states-virus-rebound-429753

Wisconsin - https://www.postcrescent.com/story/news/2020/10/01/wisconsin-coronavirus-fox-valley-hospitals-serious-danger-being-overwhelmed-coronavirus-patients-off/5879574002/

South Dakota - https://news.yahoo.com/rural-midwest-hospitals-struggling-handle-130829745.html

These were just the first articles I found regarding the issue. 

In my area, we have had positivity increases for the last 14 days. 10 days of that has been over 8% (which is my state's limit before they roll back openings). The county is now at a solid 11% positivity. I expect our deaths to start inching up since it's been 2 weeks of increasing case positivity. 

Edited by historically accurate
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1 hour ago, Lecka said:

I would say -- it isn't happening here yet, but I am concerned about where things will be a month from now.  

Quoting myself -- with reading other posters' comments, now I am wondering if there is a state official saying "but we have some beds available" and not looking at the availability of nursing staff.  Because that would explain why things are being said differently by different officials!  

I was not aware of the nursing staff issue.    

Edit:  because it's like -- some officials are saying it's already a problem, and others are saying it's not a problem yet.  

Edited by Lecka
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1 hour ago, Pam in CT said:

re medical sector constraints

Yeah, it's the TRAINED PEOPLE constraint that is, and will continue to be, the hardest to fill.

There really were severe PPE constraints in the worst days of the NYC/surrounding area crisis, and that issue has been largely resolved.

With reasonable leadership, overflow sites can be found/built and beds can be brought in from civilian or military sites.  There are new portable/specialized HVAC capacities that emerged out of the NE crisis to allow for rapid and effective conversion of non-specialized spaces to hospital purposes.

But you can't just create trained medical workers.  That is the most difficult capacity constraint to deal with.

We have set up an extra critical care area but finding staff is very difficult.

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re difficulties in finding trained personnel to staff COVID and ICU beds / staff trained for particular pulmonary procedures

5 minutes ago, Lecka said:

Quoting myself -- with reading other posters' comments, now I am wondering if there is a state official saying "but we have some beds available" and not looking at the availability of nursing staff.  Because that would explain why things are being said differently by different officials!  

I was not aware of the nursing staff issue.    

Edit:  because it's like -- some officials are saying it's already a problem, and others are saying it's not a problem yet.  

 

4 minutes ago, TCB said:

We have set up an extra critical care area but finding staff is very difficult.

What happened during the Northeast crisis showed multiple layers of the staffing crisis -- not just getting enough doctors / nurses / technicians to the facilities, but also housing them (people from out-of-area did volunteer to take on extended shifts... but they needed to be he housed in order to do so) and getting their basic food/ laundry needs taken care of, and also, over the long haul, how to ensure they weren't by volunteering to support the needs of the sick, infecting their own family members.

This was all taking place while medical PPE was severely constrained, so the latter issue is less worrisome now than it was then. But the other issues remain -- even to the extent that there is "excess" nursing and other medical sector capacity in less-badly hit areas, and even to the extent that medical workers are willing to pick up and travel to other regions to serve in times of excess overflow capacity, there are real logistical issues and substantial extra costs associated with that. 

 

Let 'er rip is extremely bad public policy.

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10 minutes ago, Margaret in CO said:

Things are MUCH better here. We've only had 3 positive cases since Sept 3rd. Two were from out-of-town. Schools and the college are open. It looks like rodeo weekend here, with so many tourists Because of our nice weather (usually we have had more than one major snowfall but it's still in the 60's) the snowbirds have not left. The hunters have arrived. 2nd home owners (close to 60% of our homes) have come and are staying here. 

How is the state of Colorado doing?  Wasn't there a huge spike over summer?

People in Florida, Arizona, and California how is it going?

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1 hour ago, mommyoffive said:

We have that in Wisconsin.  Hospitals are filled.  They opened a field hospital for covid outside of Milwaukee last week and have patients there. I think in spring they either set up one and never used it or they just had plans for a field hospital if needed. 

Wisconsin was specifically mentioned in the article I read

Question for everyone - am I allowed to post the link to the article? I only know how to copy and paste.

I am wondering, with my general lack of science understanding and very limited covid knowledge if I my interpretation is correct

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In Florida, hospitalizations are increasing, as are deaths. For the past six weeks there were almost 100 deaths per day. Our positivity rate has been fluctuating between just over 3% to almost 8%. As of Friday it was 5.21%.

Sources:

https://www.tampabay.com/news/health/2020/10/16/florida-coronavirus-cases-rise-again-as-death-toll-continues-its-climb/

The first county listed at the end of this article is where I live (they're in alphabetical order, nothing to do with numbers).

https://www.clickorlando.com/news/local/2020/10/17/florida-health-officials-report-4000-new-cases-87-new-deaths-related-to-covid-19/

 

Edited by Lady Florida.
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In Indiana, and in my local area, we first had younger people driving the increased spread, so we didn't see hospital and deaths rise with the positivity increases. Then the virus then started affecting all age groups again. At that point, our hospitalizations started rising exponentially, but deaths stayed steady for a bit longer. Now our deaths are rising exponentially too. At the current rate, the state is on track to be nearly to our previous high deaths (in April), by the end of this month. 

My local area is absolutely "on fire."  We are far worse than we were at any time previous. Health authorities and hospitals in my town have been "sounding the alarm" for the last few weeks. I am seeing a little bit more mask usage over-all just in the last week or so, but still lots of people who gather as normal, without masks or social distancing. I personally know many people who think this virus is "no big deal for nearly everyone"  and refuse masks and any precautions. 

I'm worried about where we are headed. And sad. I think it's going to be very dark this fall for lots of us. 

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3 hours ago, Bootsie said:

Time for what?  Parts of the US are seeing large outbreaks now.  I am not hearing of hospital overruns, lack of ICU beds, and other issues that were occurring earlier this year.  Does that mean that those areas took the time to address those issues and that even though there are increased numbers of COVID cases the lockdown was successful in addressing the supplies needed for medical care?  How can we measure the effectiveness (or lack thereof) of lockdowns?  

There are parts of my state where ICU's are full and medical personnel are having to work extra shifts to cover surge requirements. That isn't sustainable long-term and the rate of infection among medical personnel has increased.

Edited by maize
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I saw my asthma doc this morning in her office. She called to see if I could come in before flu season for an in-person visit because I have severe asthma. Then she said we'd do a telemedicine visit in late January or February. 

All of her sources say that it's going the wrong direction. She asked about my schedule and made several comments about continuing to mask. My church is heading towards not requiring masks and only social distancing in a small, old building (my state no longer requires that for churches), and she got very emphatic that I shouldn't go if that happens. I figured. 

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Just now, G5052 said:

I saw my asthma doc this morning in her office. She called to see if I could come in before flu season for an in-person visit because I have severe asthma. Then she said we'd do a telemedicine visit in late January or February. 

All of her sources say that it's going the wrong direction. She asked about my schedule and made several comments about continuing to mask. My church is heading towards not requiring masks and only social distancing in a small, old building (my state no longer requires that for churches), and she got very emphatic that I shouldn't go if that happens. I figured. 

I'm seeing people do stupid stuff here, too. Our homeschooling center has restarted small classes in a tiny, unventilated space... I don't think that's a good idea 😕 

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For us, April-June were really high numbers.  Now we are a faction of those numbers, but it goes up and down daily.  The one positive thing I have seen (looking at our numbers) is while positive cases are up and down sometimes drastically, the daily death rates and hospital rates are down into the single digits.  September and October, our overall deaths whether from Covid or other reasons is right around the average for this time of year.  I do know there have been asymptomatic people in my community that were tested due to school, work, etc. (vs just going on their own) but they never developed any symptoms nor those they came in contact which is another reason people around me have relaxed.

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6 hours ago, Pam in CT said:

re medical sector constraints

Yeah, it's the TRAINED PEOPLE constraint that is, and will continue to be, the hardest to fill.

There really were severe PPE constraints in the worst days of the NYC/surrounding area crisis, and that issue has been largely resolved.

With reasonable leadership, overflow sites can be found/built and beds can be brought in from civilian or military sites.  There are new portable/specialized HVAC capacities that emerged out of the NE crisis to allow for rapid and effective conversion of non-specialized spaces to hospital purposes.

But you can't just create trained medical workers.  That is the most difficult capacity constraint to deal with.

And many of those who travelled across the country to help in worse hit areas are getting burned out and exhausted.

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You can look at your state on the john's hopkins positivity chart to see if it is getting worse where you are, or better, etc. That way you can look at the percentage positive, rather than cases, since more testing can mean more cases, even without the virus being more widespread. 

Click on the drop down menu to choose your state. The blue line is the weekly average. https://coronavirus.jhu.edu/testing/individual-states

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Just now, ktgrok said:

You can look at your state on the john's hopkins positivity chart to see if it is getting worse where you are, or better, etc. That way you can look at the percentage positive, rather than cases, since more testing can mean more cases, even without the virus being more widespread. 

Click on the drop down menu to choose your state. The blue line is the weekly average. https://coronavirus.jhu.edu/testing/individual-states

Yep. That's the right thing to track. Thanks for linking. 

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I really hate feeling like we have to read the tea leaves.

I feel like with the US Presidential election so close, that is where news is focused.  I don’t think that’s all of the problem, but I think it’s part of the problem.

Then I think it is just surprisingly hard to find out accurate information and to get a clear message about what it means.

For any statistic, there is always someone to say “but look at this other statistic, it shows that everything is okay.”

I am trying to make good decisions about risk mitigation and it’s just confusing.  
 

Thanks for linking that website. 

Edited by Lecka
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The cases will go up as things open up, the weather cools, and people are inside more.  But I think more is known about covid now- what meds and supplements work, what to look out for, new treatments are coming out, vaccines will be out ...  so I think it’ll be different this time around if people are smart about it.

also, many businesses and schools are able to switch to virtual if they see a need.  I’d rather see more local/individual control ongoing as hot spots pop up.

 

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3 minutes ago, matrips said:

The cases will go up as things open up, the weather cools, and people are inside more.  But I think more is known about covid now- what meds and supplements work, what to look out for, new treatments are coming out, vaccines will be out ...  so I think it’ll be different this time around if people are smart about it.

also, many businesses and schools are able to switch to virtual if they see a need.  I’d rather see more local/individual control ongoing as hot spots pop up.

 

We do have local control, which I agree is a good thing.

There aren't really drugs that are known to be great.

Vaccines are going to take a long time to get to everyone.

Our numbers are bumping up school will be starting anyway because it will take a long time to get through this and school is important too.

I doubt it will be pretty. 

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Things are getting worse where I live.  It started slowly at the end if summer and got much worse a couple of weeks ago.  Everyone has been wearing masks in all public places.  They say most of transmission is happening in people’s homes. There hasn’t been transmission in schools.  
At first it was mostly young people and then it moved into nursing homes again and we got more deaths.  It makes me so sad.  People in nursing homes can’t do anything to protect themselves. People are sick of isolating.  I was in Michael’s the other day and it was busier than before Christmas prepandemic.  I think treatment is somewhat better.  

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12 hours ago, Amethyst said:

My crystal ball says it will get a lit worse before it gets better. 
 

Quarantine fatigue and winter months not a good combination. No governors want to shutdown again - the political pressure (not to mention threats on their lives) is too great. 
 

 

Just thinking out loud...  At least here, people are used to staying home during the frigid winter, so possibly winter months + quarantine fatigue will not be quite so horrible as expected??  I don't know.   (I'm sure getting antsy though!)

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One other thing I’ve noticed from outside the country is that here in this forum it’s gone from a handful of people knowing someone who has it or having it themselves to quite a number.  Of course some of that is probably just passage of time/cumulative but seems like there has been more in the last two or three weeks.

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Things are definitely picking up here.  That is, hospitalizations and deaths are increasing.  Not yet in the high numbers of May and June, but possibly heading that way.  I'm still hopeful that after a perhaps bad winter, things will start looking up come late spring.  

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2 hours ago, ktgrok said:

You can look at your state on the john's hopkins positivity chart to see if it is getting worse where you are, or better, etc. That way you can look at the percentage positive, rather than cases, since more testing can mean more cases, even without the virus being more widespread. 

Click on the drop down menu to choose your state. The blue line is the weekly average. https://coronavirus.jhu.edu/testing/individual-states

State means nothing really.  We have areas that are really bad and areas that are really good and areas that are moderate.  

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As my dh keeps saying- we don't know hardly anything about this virus.  Lots of speculations.  For example, a nursing home in our area that had 62 patients had about half die of it.  But they were doing what they should have been doing- all staff had N95, lots of cleaning, separation, etc.  I assume that the staff member who did have it first was a super spreader and maybe those people have a much higher virus count???? Who knows?    And I haven't heard of any genetic studies of the super spreaders so we have zero idea how to protect anyone.  Normal covid patients spread to 1 or 2 others.  Super spreaders spread to 20 or more. 

It seems to me that a good thing to do is figure out how to determine who will be super spreaders and have them stay home with full salaries (by the govt).  

But, for example, my county- it was moderate than high than moderate than low and now back to high.  Nothing has happened here noticeable.  We are all wearing masks, restaurants have spacing and some have shielding too,  and I have no idea why the number went from low to high in one week and neither does any health scientist either. Presumably one or two super spreaders who were also running around everywhere.

But I am also unclear how the stats are done.  Like my county has three hospitals and these hospitals pull in from other areas too.  We are the big city in the Northern part of Al.  Is our county looking bad because of what we are doing or because of what other counties are doing --- they never reached low and I am wondering if there people are now in our county's hospitals and being counted as our problem.

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12 hours ago, Ottakee said:

Hones question.  Cases are going up here but the severity of illness appears to be much less than last spring.  Our hospitalizations and ICU beds are way way down and no covid in ICU in our county.

Is that true most places?   In our are the 10 people I know that tested positive over the past week either had no or mild cold symptoms.  

Not in WI where my mom lives. Many hospitals there are at capacity. In my state deaths are still pretty steady, really no decrease, so it doesn’t seem less severe in that sense. I do think they have made progress on treatments, but lots of people are still dying every day in the US. I know one of the doctors on these boards actually treating patients didn’t agree recently with the idea that illnesses were less severe now. 

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11 hours ago, PeterPan said:

I don't keep a running list of your posts/opinions, lol. What's wild to me is that people in CA seem so FAVORABLE of his approach. I read these Disney blogs, etc. and they just seem to totally drink the koolaid. I had a trip planned to there for next year that is getting killed by his insanity. Total bummer, as it would have been great. 

Speaking of drinking the koolaid, some are just choosing a different flavor. 😜

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47 minutes ago, TravelingChris said:

As my dh keeps saying- we don't know hardly anything about this virus.  Lots of speculations.  For example, a nursing home in our area that had 62 patients had about half die of it.  But they were doing what they should have been doing- all staff had N95, lots of cleaning, separation, etc.  I assume that the staff member who did have it first was a super spreader and maybe those people have a much higher virus count???? Who knows?    And I haven't heard of any genetic studies of the super spreaders so we have zero idea how to protect anyone.  Normal covid patients spread to 1 or 2 others.  Super spreaders spread to 20 or more. 

It seems to me that a good thing to do is figure out how to determine who will be super spreaders and have them stay home with full salaries (by the govt).  

But, for example, my county- it was moderate than high than moderate than low and now back to high.  Nothing has happened here noticeable.  We are all wearing masks, restaurants have spacing and some have shielding too,  and I have no idea why the number went from low to high in one week and neither does any health scientist either. Presumably one or two super spreaders who were also running around everywhere.

But I am also unclear how the stats are done.  Like my county has three hospitals and these hospitals pull in from other areas too.  We are the big city in the Northern part of Al.  Is our county looking bad because of what we are doing or because of what other counties are doing --- they never reached low and I am wondering if there people are now in our county's hospitals and being counted as our problem.

I think the issue is we don’t actually know that super spreaders are superspreaders because of something specific about that particular person.  The thought is that it’s more likely just any person who happens to be in a “superspreadable” environment at the right time for the peak infection.  Or just to do with some people being more social and more connected than others.  

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20 hours ago, mommyoffive said:

How is the state of Colorado doing?  Wasn't there a huge spike over summer?

People in Florida, Arizona, and California how is it going?

Much improved in Ca. New cases are flat, hovering around 3k a day, which is where we were in early June for a very short time before we spiked to 10-12k a day. Deaths are trending down and sitting in the 60's, which is also where we were in June. 

My county looks good. Really, outside of the prison outbreak and some serious nursing home outbreaks, our community spread has been good all along. 

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