Pretty interesting op-ed saying what we all intuitively knew -- so far, this is very much a NY and NYC problem. The answer really may be to keep NYC shut down all summer, restrict tourism, and start trying to slowly reopen the rest of the country. It is stark to see some of the numbers.

https://www.nytimes.com/2020/04/24/opinion/coronavirus-lockdown.html

 

Quote

 

In 1976, the artist Saul Steinberg drew a cover for The New Yorker — "View of the World from Ninth Avenue” — that became an instant classic. You know the one: Manhattan heavily in the foreground, the Hudson River, a brownish strip called "Jersey,” the rest of the America vaguely in the distance.

 

It could almost be a map of the coronavirus epidemic in the United States.

Even now, it is stunning to contemplate the extent to which the country’s Covid-19 crisis is a New York crisis — by which I mean the city itself along with its wider metropolitan area.

 

As of Friday, there have been more Covid-19 fatalities on Long Island’s Nassau County (population 1.4 million) than in all of California (population 40 million). There have been more fatalities in Westchester County (989) than in Texas (611). The number of Covid deaths per 100,000 residents in New York City (132) is more than 16 times what it is in America’s next largest city, Los Angeles (8). If New York City proper were a state, it would have suffered more fatalities than 41 other states combined.

It isn’t hard to guess why. New York has, by far, the highest population density in the U.S. among cities of 100,000 or more. Commuters crowd trains, office workers crowd elevators, diners crowd restaurants. No other American city has the same kind of jammed pedestrian life as New York — Times Square alone gets 40 million visitors a year — or as many residents packed into high-rises. The city even has a neighborhood called Corona, which, it turns out, has among the highest rates of coronavirus infections.

Consider a thought experiment in which metropolitan New York weren’t just its own state, but its own country. What would the crisis for what remained of America look like, then? In this slightly smaller nation of a little more than 300 million people, the death toll would amount to about 7.5 per 100,000, slightly above Germany’s levels.

 

No wonder so much of America has dwindling sympathy with the idea of prolonging lockdown conditions much further. The curves are flattening; hospital systems haven’t come close to being overwhelmed; Americans have adapted to new etiquettes of social distancing. Many of the worst Covid outbreaks outside New York (such as at Chicago’s Cook County Jail or the Smithfield Foods processing plant in Sioux Falls, S.D.) have specific causes that can be addressed without population-wide lockdowns.

 

 

Yet Americans are being told they must still play by New York rules — with all the hardships they entail — despite having neither New York’s living conditions nor New York’s health outcomes. This is bad medicine, misguided public policy, and horrible politics.

 

On Friday, I spoke with Tomislav Mihaljevic, C.E.O. of the widely admired Cleveland Clinic, and an advocate of the need to use "tailored and discriminating solutions” that also recognize regional differences. At the moment, he says, "We’re using the methodology from the 14th century to combat the biggest pandemic of the 21st century.” It can’t go on.

Dr. Mihaljevic acknowledges the necessity of the lockdowns to contain the virus, along with the urgent need for ramped-up testing and ongoing monitoring. But, he adds, "we cannot hold our breath forever.” The U.S. will not soon be able to test 330 million people. Effective therapies or vaccines may be long in coming. Covid-19 will be "a disease we have to learn to live with.”

 

That means accepting that the immediate goal of public policy cannot be to eliminate the risk of Covid-19. It is to mitigate, manage and frame expectations for it — while not losing sight of other priorities. In Ohio Dr. Mihaljevic says that Covid patients take up just 2 percent of hospital capacity, and the curve of new infections has been flat for more than two weeks. Yet there has been a dramatic decline in people seeking care for heart attacks, strokes, or new cancers, presumably out of fear of going to hospital.

 

"The public conversation needs to be about the value of human life in its totality,” Dr. Mihaljevic says. That includes fewer restrictions on activity for people at the low end of the risk spectrum, while taking additional care of those on the high end.

 

Right now, there’s a lot of commentary coming from talking heads (many of them in New York) about the danger of lifting lockdowns in places like Tennessee. Perhaps the commentary needs to move in the opposite direction. Tennesseeans are within their rights to return to a semblance of normal life while demanding longer restrictions on New Yorkers.

 

I write this from New York, so it’s an argument against my personal interest. But I don’t see why people living in a Nashville suburb should not be allowed to return to their jobs because people like me choose to live, travel and work in urban sardine cans.

 

Gina Raimondo, the Rhode Island governor, was on to something when, a few weeks ago, she wanted to quarantine drivers arriving from New York. The rest of America needs to get back to life. We New Yorkers prefer our own company, anyway.

 

 

 

Leader of ReOpen NC tests positive for coronavirus: Report

 

Quote

"I have been told not to participate in public or private accommodations as requested by the government, and therefore denied my 1st amendment right of freedom of religion," she reportedly wrote.

"It has been insinuated by others that if I go out, I could be arrested for denying a quarantine order," she is said to have written.

 

A restaurant in florida closed down today after 17 years because of complications from corona. They need to start opening things back up, this was a very popular place I can only imagine what smaller  restaurants are feeling. Costing people their livelihoods for no reason

15 minutes ago, devpool said:

A restaurant in florida closed down today after 17 years because of complications from corona. They need to start opening things back up, this was a very popular place I can only imagine what smaller  restaurants are feeling. Costing people their livelihoods for no reason

Wait, a Restaurant caught Corona??  I heard a couple cats got it and some animals in the zoo, but now buildings are catching it?

Just now, NYEagle said:

Wait, a Restaurant caught Corona??  I heard a couple cats got it and some animals in the zoo, but now buildings are catching it?

yeah...for no reason.

2 minutes ago, mr_hunt said:

yeah...for no reason.

Maybe the building next to it had it and because they weren't six feet apart the restaurant got it?

3 minutes ago, NYEagle said:

Wait, a Restaurant caught Corona??  I heard a couple cats got it and some animals in the zoo, but now buildings are catching it?

It’s Florida.

Maybe the restaurant was too old or had underlying conditions leading the the complications from Corona?

and, did the restaurant have PPE or wear a mask?

and wait, is this about a person named Restaurant dying or an actual building dying from complications?

and does it matter, it's Florida where everything goes to die right? 😁

1 hour ago, vikas83 said:

Pretty interesting op-ed saying what we all intuitively knew -- so far, this is very much a NY and NYC problem. The answer really may be to keep NYC shut down all summer, restrict tourism, and start trying to slowly reopen the rest of the country. It is stark to see some of the numbers.

https://www.nytimes.com/2020/04/24/opinion/coronavirus-lockdown.html

 

 

 

At this point for as much as it's probably skirting the Constitution it might be a good idea to block interstate travel in at least the tri-state area if not the Northeast as a whole.

Maybe a little dystopian but maybe look further at restricting travel from below Poughkeepsie to upstate.

CNN Headline:

Local restaurant that exploded from a gas leak is forced to file for bankruptcy due to the coronavirus

1 hour ago, mikemack8 said:

CNN Headline:

Local restaurant that exploded from a gas leak is forced to file for bankruptcy due to the coronavirus

Goddamnit, I knew I finally got the coronavirus!!  I've been leaking gas all day!!  

Just need a Sixers and Flyers mask. 

3 hours ago, Toastrel said:

Could they speed this crap up 

https://www.nothingbutthetruthmd.com/2020/04/42720-covid-19-update.html

Good Evening:

 

I want to start off tonight with a little recap of recent history.  I am inclined to do this partly to assuage my anxieties and because so much has been transpiring at such a rapid pace and we are fast approaching a critical decision point in our struggle with Covid-19 infections.  The decisions regarding the process we will utilize in re-opening our country are critical.   We need to get  it right.  Starting off with one or two infected individuals is far different from starting off with 200,000 infected individuals.  Three weeks of bad process could make the US look quite different if we get it wrong.

 

In previous posts, I have written about the experiences of South Korea and Japan.  On 4-22-20, I wrote about the experiences of Taiwan, and on 4-19-20, I wrote about the experiences of Iceland.  I selected these countries because of their success in combating the Covid-19 infection.  The common thread amongst these countries was the high compliance demonstrated with wearing masks.

 

On 4-18-20 I provided references to articles related to the efficacy of wearing masks.

 

1.  Dr. Jessica Reubens from John Hopkins wrote a letter to the editor in the NEJM,  "Covid-19 is not transmitted to healthcare workers who are wearing masks" 

 

2. Dr. Kevin Schwartz, from Toronto Public Health, wrote about the efficacy of surgical masks

 

3. Dr. Emil Lecho, from Rochester University, cited articles investigating the efficacy of regular masks in preventing influenza transmission.

 

In addition there are three randomized controlled studies from Canada and Australia that demonstrated that regular surgical masks were not statistically inferior to the much talked about N95 mask in protecting healthcare workers from respiratory diseases.  In addition there is a trial from Australia that demonstrated that regular surgical masks worn by parents decreased the transmission of influenza from children to parents by 60% to 80%.   Influenza and covid-19 are about the same size. 

 

I write nightly letters to our Governor and State Senators about the benefits of wearing surgical masks, to the point, I am sure, they wish I would move to another state. 

 

I have written about changes on the frontline which have allowed over 10 million healthcare workers to work carefully with patients simply by wearing masks, physical distancing when possible and good hand hygiene.  I am aware, and I do not trivialize the losses among our ranks, but I attribute much of this to the early days when we did not know what we were dealing with, the lack of a mandate of masks for all, shortages of PPE ,and occasional bad technique.  In an article entitled "Transmission of Covid-19 to Healthcare Personnel During Exposure to a Hospitalized Patient - Solano County, California, February 2020, published in the Weekly Morbidity and Mortality Report, April 17 ,transmission of covid-19 to healthcare workers is examined.  Ninety four staff had high or medium contact with an index patient.  Three subsequently developed RT-PCR positive tests.  We can assume hand hygiene was practiced, since universal precautions have been in existence for decades.  Two workers wore no masks or eye protection, one wore a mask intermittently., This represents 3.195 % of the workforce. If that infection percentage was extrapolated to the healthcare workforce of approximately 12 million, we would expect 382,000 covid positive healthcare workers.  Thank God for masks and goggles.

 

It is this last paragraph, which so clearly demonstrates the need for, and the benefit of, masks for all, which should inform our leadership, the decision makers, of what needs to be done, while relaxing/reversing the mandates that have been necessary, given the circumstances, that were so costly, physically, emotionally and economically, to all of us.  The evidence for the efficacy of masks in preventing transmission of covid-19 to healthcare workers is irrefutable.  Masks for all has allowed the large healthcare workforce to care for patients in an environment where transmission of Covid-19 is far more likely than any other workplace we are asking the workforce to go. We have been practicing good hand hygiene for decades and we frequently can't utilize physical distancing. I do not understand the hesitancy to mandate masks for all and ensure compliance to protect our workforce and allow them to become functional and productive again.  Since properly protecting our workforce is so easy, I cannot understand the reluctance to permit our workers to return to work now.  It is vital to all of society.

 

We should clearly remember that we did not get ourselves into this muddle by wearing masks! Three relatively simple practices that were ignored did.  The lack of masks, the lack of good hand hygiene, and physical distancing when possible.   

 

Just give me a mask and some soap.  I don't want to be tested unless I am sick, and if I have never been sick, I don't want to have serology unless it may benefit an ill covid patient. Don't tell me about the covid status of my patient at times like this, I just assume they all have it, and act appropriately.

 

Where are the luminaries, the star athletes, the models, the big name entertainers who could lend so much influence to this vital cause?  I know there have been some advertisements, but not nearly enough, and I thank all who have taken part in these efforts already!  

 

 

Getting to know that virus that many of us are playing host to. (you didn't realize you were entertaining?)

 

SARS-CoV-2 = Severe acute respiratory syndrome, coronavirus 2

 

There are two groups of Coronavirus, alpha and beta.  It is a single strand RNA virus that has has a plasma envelope, which can be disrupted fairly easily rendering the virus noninfectious.

 

Coronavirus causes about 10% to 30% of the common colds.  An unusual feature of coronavirus  is that it easily hops between mammalian species,  such as camels, cows, rats, civets and bats.

 

MERS (middle eastern respiratory syndrome) and SARS, are both coronavirus diseases which  were caused by transmission from camels and civets.

 

There are 5 sequences in the life cycle of Covid-19

1.  binds to the host cell (that would be one of our cells)

2.  magical steps result in the release of the virus inside the host cell

3.  the virus builds material for replication inside the cell

4.  the full length RNA strand is created

5.  fully functional virus is release from the cell

 

Phases of the disease:

1. incubation period lasts about 7 to 10 days

2. symptomatic phase - probably 95% of infected individuals have a self limited disease.  Fifty to sixty percent may be totally asymptomatic, but this depends on the knowledge of symptoms and how hard you look for them.  Viral shedding probably begins three days before symptoms and can last for two weeks after symptoms abate.  RT-PCR can be negative at low viral levels leading up to the symptomatic phase.

3.  severe phase which will involve five to ten percent of the population.  A small percentage will progress to respiratory insufficiency severe enough to require mechanical ventilation.

 

There is a steep dependence of mortality on age.

 

SARS is probably 10 times more lethal than SARS-CoV-2

 

Transmission is caused by either respiratory secretions by the way of aerosol or droplets contaminated by the virus, which are effectively prohibited by wearing MASKS.  This is called direct transmission.

 

Indirect transmission occurs when an infected individual touches a common object and deposits virus on that common object which is then touched by another individual who facilitates transmission by contaminating his mouth, eyes or nose, difficult to do while wearing a mask and goggles.

 

 

Numbers:

 

Tonight I am adding California to our numbers at the request of some readers in the far West.

 

California is our most populated state. (it is coming in at around fourth or fifth in total number of caes for the states)  On March 4, 2020 there were 53 cases of Covid-19.  Until about 4/2/20 the number of cases was doubling every three or four days.  On 4/2/20 , the number of cases did not double again until 4-9-20.

 

Looking at case fatality rates ( the number of fatalities divided into the number of covid positive cases that have come to medical attention, and I assume if you have been tested you have come to medical attention)

 

USA -5.26%

California -5.6%

Maryland -4.89%

New Jersey -5.4%

New York -5.89%

Pennsylvania -3.76%

South Carolina -3.19%

Texas -2.63%

 

The infected fatality rate is the number of  fatalities divided into the number of those infected.  If we assume that for every infected symptomatic patient there was one infected asymptomatic patient, just divide the numbers above by 2. (for the most part we only tested symptomatic patients)

 

Tests - 5,593,495 (152,416 tests in the last 24 hours)

 

USA - 983,843 (up 2.27%, down from 3.35%,  10, 365 fewer cases then the day before)

 

New York - 299,996 (up 4.41%, up from 2.09% the day before)

 

New Jersey - 111,188 ( up 1.97%, down from 3.35% the day before, 1390 fewer new cases than the day before)

 

Pennsylvania - 43,256 ( up 1.47% down from 3.75% the day before , 895 fewer new cases then the day before)

 

Maryland - 19487 (up 4.87%, up from 4.57% the day before)

 

California - 43,853

 

South Carolina - 5498 (up 4.66%, up from 2.81% the day before)

 

Texas - 25,292 (up 2.18%, down from 3.39% the day before, 270 fewer new cases than the day before)

 

World - 3,029,915 (up 2.23%, down from 2.82% the day before, 15,012 new cases than the day before)

 

Not quite as good as yesterday but overall a good day.

 

 

Projections

 

Projected fatalities for this day were lower for New Jersey, Pennsylvania, Maryland South Carolina and Texas.  Only New York exceeded projections by a little (26)

 

Hospital bed utilization for this day was lower only for Maryland.  New York for the first time came below surge capacity in quite some time.  California is quite a bit above projected bed utilization at this time.  Pennsylvania was 409 beds above projected but has plenty of capacity.

 

We need to convince people that as we relax restrictions continuing to wear masks, wash hands and physically distance when possible so please take a minute to send this message to new readers tonight.

 

Live Safely

Be Well

 

Thank you

3 hours ago, devpool said:

A restaurant in florida closed down today after 17 years because of complications from corona. They need to start opening things back up, this was a very popular place I can only imagine what smaller  restaurants are feeling. Costing people their livelihoods for no reason

Only the oldest and weakest restaurants and businesses will die from the closure of the economy anyway. More restaurants and businesses die each year from litigation. Why is everyone making such a big deal about them being closed? 

32 minutes ago, BirdsFanBill said:

Only the oldest and weakest restaurants and businesses will die from the closure of the economy anyway. More restaurants and businesses die each year from litigation. Why is everyone making such a big deal about them being closed? 

Agreed the ones that can't survive this were most likely holding on by a thread anyways

9 hours ago, vikas83 said:

Pretty interesting op-ed saying what we all intuitively knew -- so far, this is very much a NY and NYC problem. The answer really may be to keep NYC shut down all summer, restrict tourism, and start trying to slowly reopen the rest of the country. It is stark to see some of the numbers.

https://www.nytimes.com/2020/04/24/opinion/coronavirus-lockdown.html

 

 

 

Rational thought. Nice to see. 

9 hours ago, BirdsFanBill said:

Only the oldest and weakest restaurants and businesses will die from the closure of the economy anyway. More restaurants and businesses die each year from litigation. Why is everyone making such a big deal about them being closed? 

Because they wouldn't have had an issue had they not been forced to close for an entire month. This isn't a restaurant closing because they mismanaged it, they were forced to go under because people would rather live in fear than wash themselves and keep distance from others.

I would rather die of this virus than live in fear like they're making us do

I think fear of the unknown really had me on board for putting Shelter at Home orders in, closing everything, etc.......but when I look at Sweden, they basically just said f it......people are going to get it....let 'em and deal with it.  Herd immunity, etc.  They basically felt their Healthcare System could handle a massive peek where as ours couldn't.  

46 minutes ago, NYEagle said:

I think fear of the unknown really had me on board for putting Shelter at Home orders in, closing everything, etc.......but when I look at Sweden, they basically just said f it......people are going to get it....let 'em and deal with it.  Herd immunity, etc.  They basically felt their Healthcare System could handle a massive peek where as ours couldn't.  

Things can certainly open up now IF people wear masks, keep physical distance where possible, and practice good hand hygiene.  This only works though if EVERYONE does it.  The most important thing is everyone wearing masks. 

 

1 hour ago, NYEagle said:

I think fear of the unknown really had me on board for putting Shelter at Home orders in, closing everything, etc.......but when I look at Sweden, they basically just said f it......people are going to get it....let 'em and deal with it.  Herd immunity, etc.  They basically felt their Healthcare System could handle a massive peek where as ours couldn't.  

Sweden also has over 200 deaths per million, more than 6x that of its neighbors Finland and Norway.

2 hours ago, devpool said:

Because they wouldn't have had an issue had they not been forced to close for an entire month. This isn't a restaurant closing because they mismanaged it, they were forced to go under because people would rather live in fear than wash themselves and keep distance from others.

I would rather die of this virus than live in fear like they're making us do

You want us to go to restaurants to keep them making money...and yet keep distance from others to avoid spreading a virus?

You dying from the virus is fine. Problem is, you'd take some of us down with you by either spreading it or clogging up the healthcare system with the other "fearless" ones. 

Look, the government bungled this 8 ways to Friday......the fact is, and I called for it, was that they should have done a mandatory Shelter at Home nationwide at the first signs of this.  But Trump was too busy saying they had it under control while working on his short game on the golf course.  Now...because millions have already been exposed, might as well open back up and deal with the consequences of that rather than an even worse economy.