Time to open up America immediately for a huge spike so we can close back down!!

America is great again! 

5 hours ago, Toastrel said:

When a quarter of a million Americans are dead will some of you still be saying it is just the flu?

When most of that number is comprised of people over 60+ years old, it's not something for most people be afraid of. Is it serious, yes. For people over that age and those who are immuno suppressed. For everyone else, it'll be like the flu.

It is obviously sad that so many people have died and will die because of this illness. It is serious. But it isn't Spanish flu serious. The Spanish flu was almost the opposite of this virus. The main demographic being killed was 20-40 years old and that was the biggest question back then.

Call it F'ed up, call it dark, call me an a-hole, call it whatever you want. We shouldn't be on lockdown for an extended period for 2% of the population. Quarantine the most vulnerable, and don't penalize people who want to play it safe by staying home.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734171/

1 hour ago, devpool said:

don't penalize people who want to play it safe by staying home

I wonder what this would mean. Would their employers have to pay them? Would their employers be allowed to fire them for staying home? Would they be subject to evictions and foreclosures if they don't make rent or mortgage payments? Would their other bills be subsidized? 

I'm asking all this because it seems like we either have to give ordinary working people cash or we have to let/force them to go to work regardless of the danger. 

I don't know what the answer is -- other than, of course, very extensive testing and tracking to the point that we can actually quarantine everyone who might have been exposed to the virus. And then we can open back up completely.  

 

1 hour ago, devpool said:

We shouldn't be on lockdown for an extended period for 2% of the population.

I wonder about this too. Do you know and love anyone over 65? You're saying you're willing to look them in the eyes and tell them that if their death is the price of you living your normal life, you're fine with that. 

I have a lot of 65+ relatives, and I don't even get along with all of them very well, but I can't say anything like that to them. 

8 hours ago, DBW said:

The last projection I heard was that estimated deaths would be 100k and something like 70% of those were people with underlying conditions, elderly. Nursing homes, etc.  Not "just the flu” a worse virus but one that is not as bad as what they want you to believe. 

If there's 80K dead now, 100K is a ludicrous figure. Since we are not being smart. Not testing everybody and tracing contacts, it is going to keep spreading an killing everyone it can kill. That's how it works.

 

Either you have a vaccine or you gain herd immunity once the susceptible are all dead. If you test, quarantine and contact trace, you can slow this timeline down to give you people a chance at a vaccine.

Otherwise a quarter of a million will be dead by Halloween. From the looks of things, my estimate is very low.

Daily update from the Doc

https://www.nothingbutthetruthmd.com/2020/05/51720-covid-19-update.html?m=1

Good evening,

How do I find reliable information:

 

Since January, the speed of transmission and volume of information concerning the Covid-19 Pandemic has increased at a mind numbing pace. This phenomena has necessitated a change in what was my routine for many years. Authoring this email has also had an effect on my habits.   I read the lay press selectively, always subscribed to two Anesthesia Journals, the Weekly Morbidity and Mortality Report, and New England Journal of Medicine Journal Watch (a monthly, brief synopsis of 10 to 15 article in the World Wide Medical Literature that the Editors feel important to the practice of medicine) 

 

There is a difference between producing news and reporting news.  I think the lay press frequently producess.  As of February, the daily articles in lay press have increased many fold and new products geared towards physicians have suddenly appeared.  There is a plethora of online review presentations covering recently released literature, chat rooms in most of the specialties, and a few of the most reputable American Medical Journals have begun weekly live streams with Nationally and Internationally recognized experts.  In addition, some of these same Journals have begun offering their articles on Covid-19 free to anyone wishing to read them.  I added to my normal reading material, JAMA and New England Journal of Medicine, which you may have suspected, as many of the source materials that I reference come from these two Journal sources.

 

In addition there was always a background exchange of  "hey have you seen this article" which has also increased.

 

It isn't hard to imagine that there is insufficient time to read and digest it all, sleep, eat, and work.

 

After building a knowledge base it has actually become somewhat easier.  I don't need to read review articles and how many times can I read about ventilator management, or the increased risk of clotting?

 

I have stopped reading the lay press and I do not read  journal articles that are not peer reviewed.  Relying on mistaken or misinformation in my clinical practice or forwarding in my emails (which some of the readers actually depend on ) is just unacceptable.

Lay press articles which contain misinformation generally carry no consequences for the author.   Such occurrences in reputable medical journals however have significant consequences.  Editors are suddenly unemployed.  Purposeful misrepresentation by authors are generally career ending and frequently have significant financial penalties.  In a time when there is a wealth of material to choose from, I choose the material that will be, by logic, the most accurate and helpful to me, my patients and individuals who read this email.  

 

As restrictions are eased, how many businesses will have more common sense than leadership and mandate wearing mask while at work?  The more the merrier, and we might succeed despite leadership.

 

Tidbits

 

This morning I looked at  case statistics from 16 states: Alabama, California, Connecticut, Florida, Iowa, Illinois, Louisiana, Maryland, Michigan, Mississippi, New Jersey, New York, Ohio, Pennsylvania, South Carolina and Texas.  I looked at the increase in cases from May 10 to May 16 and May 3 to May 9.

 

Four states had increasing new cases in the May 10 to May 16 interval.  Florida, Louisiana, Michigan and Texas.  All the rest had declining numbers.  The increase in Texas is especially large.  After what I witnessed yesterday at the Jersey Shore, I would expect that the numbers will start to increase in New Jersey in the next week or two. The problem with that scene however is, many of those individuals will be going back to neighboring states and taking their little newly acquired viral friend with them.

 

Interview with Dr. Anne Schuchat, Principal Deputy Director of the CDC

 

The next phase of attempting to control the disease will involve tracking and tracing contacts.  One infective individual is queried as to known contacts in the last three days, who are then quickly (hopefully within 48 hours) contacted, tested and quarantined.  The problem I see arising in this country, as opposed to countries that have successfully employed this protocol is getting individuals to comply with quarantine for 14 days.  We are struggling to get people to wear masks, I am not optimistic about compliance with quarantine.

 

It is now clear that the vast majority of spread is respiratory in origin and the most effective control to this spread (other than isolation) is wearing a mask.  Fomites are of lesser importance but we should remain vigilant about hand hygiene and reasonable surface cleaning. (do not poison yourself or your family in attempting to clean surfaces)

 

Joining society again after a positive RT-PCR:  The newest CDC guidelines - - 10 days after symptom onset with at least three days being symptom free, allows you to rejoin society without further testing.

 

As is consistent with data from South Korea and Taiwan, it appears that it is difficult, if not impossible, to culture virus after 9 days of symptoms.  This does not mean that a RT-PCR will be negative, it does mean that you are likely no longer infectious.

 

If you are looking to catch the virus, join a gathering of unmasked individuals, maybe a packed elevator going up 50 floors.  It appears that various gatherings around the Country in March were responsible for the amplification of the disease that was witnessed that month.

 

 

Numbers:  1800 from the Hopkins website

 

Tests - 11,499,203 (422024 new tests in the last 24 hours)

 

USA - 1,484,804 (up 1.41% down from 1.70%, 3919 fewer new cases than the day before)

 

New York - 348,232 (up 0.54%, down from 0.69%, 530 fewer new cases)

 

New Jersey - 146,504 ( up 0.97%, up from 0.76%)

 

Pennsylvania - 65,700 (up 0.79%, down from 1.63%, 536 fewer new cases than the day before)

 

Maryland - 38,804 (up 2.20%, down from 22.65%, 146 fewer new cases than the day before)

 

California - 79,210 (up 2.18%, up from 1.52%)

 

South Carolina - 8661 ( up 3.02%)

 

Texas - 48,057 -(up 2.01%, down from 4.20%, 949 fewer new cases than the day before)

 

World - 4,702,603 (up 1.75%, down from 2.15%, 16,135 fewer new cases than the day before)

 

Please pass this message along

 

Thank you

 

Live Safely as restrictions are eased

Be Well

 

7 hours ago, DBW said:

Again I was comparing the media propaganda of the viruses.   Not the virus itself.  But if you choose to only read parts of my posts, then just skip them.  

And I’m saying the reason the coverage in the media is different is because Zika and H1N1 didn’t pose anywhere close to the risk of loss of life as this virus.
So the comparison is pointless.   Why would the media coverage be similar between a virus that has so far killed over 80,000 people in 2 and a half months, and H1N1 and Zika which resulted in the deaths of a fraction of that amount over an entire year?  Come on man....

2 hours ago, wyote said:

I wonder what this would mean. Would their employers have to pay them? Would their employers be allowed to fire them for staying home? Would they be subject to evictions and foreclosures if they don't make rent or mortgage payments? Would their other bills be subsidized? 

I'm asking all this because it seems like we either have to give ordinary working people cash or we have to let/force them to go to work regardless of the danger. 

I don't know what the answer is -- other than, of course, very extensive testing and tracking to the point that we can actually quarantine everyone who might have been exposed to the virus. And then we can open back up completely.  

 

Their employers would do what they're doing now. Whether that's paying them or not depends on the business.

2 hours ago, wyote said:

I wonder about this too. Do you know and love anyone over 65? You're saying you're willing to look them in the eyes and tell them that if their death is the price of you living your normal life, you're fine with that. 

I have a lot of 65+ relatives, and I don't even get along with all of them very well, but I can't say anything like that to them. 

Of course I do. Idk why you assume I think their life is worth my freedom, I would be devastated. But the people over 65 that I know are not going out in public currently because they know they're among the most susceptible. Do they like it? Obviously not. My grandparents' first great grandchild was recently born and they haven't seen him (in person) since the lockdown started. You complete ignored what I said to make a strawman. I'll say again, those people who are most vulnerable should be quarantined. I value their lives, so they should stay quarantined while those who are not as vulnerable should be allowed to work and go out while maintaining social distancing/masks etc. This isn't the first time I've said this.

3 hours ago, devpool said:

When most of that number is comprised of people over 60+ years old, it's not something for most people be afraid of. Is it serious, yes. For people over that age and those who are immuno suppressed. For everyone else, it'll be like the flu.

No, for everyone else it will NOT be just like the flu.  This virus has a significantly higher mortality rate compared to the flu for all age ranges of adults.  Not to mention a significantly higher risk of causing critical illness.  
 

3 minutes ago, devpool said:

Their employers would do what they're doing now. Whether that's paying them or not depends on the business.

Of course I do. Idk why you assume I think their life is worth my freedom, I would be devastated. But the people over 65 that I know are not going out in public currently because they know they're among the most susceptible. Do they like it? Obviously not. My grandparents' first great grandchild was recently born and they haven't seen him (in person) since the lockdown started. You complete ignored what I said to make a strawman. I'll say again, those people who are most vulnerable should be quarantined. I value their lives, so they should stay quarantined while those who are not as vulnerable should be allowed to work and go out while maintaining social distancing/masks etc. This isn't the first time I've said this.

You can have your freedom if you sign a waiver saying you refuse treatment for COVID. Sound good?

1 minute ago, Toastrel said:

You can have your freedom if you sign a waiver saying you refuse treatment for COVID. Sound good?

Me personally? Sure. That .002% death rate for my age is really scary. If that's how I go, that's how I go. I currently do all the suggested measures. Masks, social distance etc. If I still get it, it is what it is.

2 minutes ago, devpool said:

Me personally? Sure. That .002% death rate for my age is really scary. If that's how I go, that's how I go. I currently do all the suggested measures. Masks, social distance etc. If I still get it, it is what it is.

This is what is wrong with the world. "I'm fine, F you."

9 minutes ago, Phillyterp85 said:

No, for everyone else it will NOT be just like the flu.  This virus has a significantly higher mortality rate compared to the flu for all age ranges of adults.  Not to mention a significantly higher risk of causing critics illness.  
 

The mortality rate for healthy  20-40 year olds is less than 1% based on everything I have read. And I've only known 2 people in that age range that had it, but both recovered fine. One said it was like a cold, the other said it was having a bad hangover for a week.

I feel like everyone here thinks I'm ok with people dying. I obviously don't want people to die. But the risk for healthy people under 60 is low.

2 minutes ago, Toastrel said:

This is what is wrong with the world. "I'm fine, F you."

Yea the same can be said for those who think we can stay closed forever. "Well I'm doing fine, my job is paying me and I can pay my bills. F you."

How's that sound? Get off your high horse guy

 

Edit: also, you literally were mentioning me specifically and that is how I answered . If you want to ask something different maybe rephrase your question.

1 minute ago, devpool said:

The mortality rate for healthy  20-40 year olds is less than 1% based on everything I have read. And I've only known 2 people in that age range that had it, but both recovered fine. One said it was like a cold, the other said it was having a bad hangover for a week.

I feel like everyone here thinks I'm ok with people dying. I obviously don't want people to die. But the risk for healthy people under 60 is low.

Yea the same can be said for those who think we can stay closed forever. "Well I'm doing fine, my job is paying me and I can pay my Bill's. F you."

How's that sound? Get off your high horse guy

That's the only option? Stay closed forever?

The problem is that healthy young people are awesome carriers and can spread the disease all over. Most people have no idea what cross-contamination is or what to do about it. So you wear gloves and mask while you use your phone and touch your face and scratch your nose and touch your steering wheel and spread the disease to every surface before you throw your gloves in the trash (if we're lucky)

People take the infected gloves off and stick them in their pocket to wear later.

Just now, Toastrel said:

That's the only option? Stay closed forever?

The problem is that healthy young people are awesome carriers and can spread the disease all over. Most people have no idea what cross-contamination is or what to do about it. So you wear gloves and mask while you use your phone and touch your face and scratch your nose and touch your steering wheel and spread the disease to every surface before you throw your gloves in the trash (if we're lucky)

People take the infected gloves off and stick them in their pocket to wear later.

How long do you want to stay closed? Until your job stops paying? Until you have to start paying rent/mortgage? Almost 2 months in and not everyone has landlords willing to forgo rent for that long. Healthy young carriers can pass to other healthy young people with a much higher rate of survival, which is why I said keep everyone else quarantined. 

I'm on deployment. I don't wear gloves because anywhere I go, is probably where my crew has already been. If any of us gets it, we are screwed. Everything I touch is touched by a ton of other people. And I touch stuff touched by a ton of other people. We probably practice and adhere to these measures better than anyone. No one likes it. It's a giant pain in the arse but we do it anyway. 

7 minutes ago, devpool said:

The mortality rate for healthy  20-40 year olds is less than 1% based on everything I have read. And I've only known 2 people in that age range that had it, but both recovered fine. One said it was like a cold, the other said it was having a bad hangover for a week.

I feel like everyone here thinks I'm ok with people dying. I obviously don't want people to die. But the risk for healthy people under 60 is low.

Yes, the mortality rate for 20-40 year olds is low, it’s still significantly higher than the flu.  You said for everyone under 65, it will be just like the flu, and I replied saying that for all age range of adults the risk of death and critical illness are significantly higher than the flu. 
I’m glad that the 2 people you who had it recovered and all was well.  
My dad has had to put multiple young COVID patients on ventilators.   
Again, is the overall risk low?  Yes.  Is it the same level of risk as the flu?  No, it is significantly higher.

Just now, Phillyterp85 said:

Yes, the mortality rate for 20-40 year olds is low, it’s still significantly higher than the flu.  You said for everyone under 65, it will be just like the flu, and I replied saying that for all age range of adults the risk of death and critical illness are significantly higher than the flu. 
I’m glad that the 2 people you who had it recovered and all was well.  
My dad has had to put multiple young COVID patients on ventilators.   
Again, is the overall risk low?  Yes.  Is it the same level of risk as the flu?  No, it is significantly higher.

Alright, I'll go ahead and concede it isn't the flu. But I'm glad you agree overall risk is low for that age group. So can you reasonably assess that it should be allowed for that age group to return to work and go out in public while adhering to current social distancing and mask guidelines?

44 minutes ago, devpool said:

Alright, I'll go ahead and concede it isn't the flu. But I'm glad you agree overall risk is low for that age group. So can you reasonably assess that it should be allowed for that age group to return to work and go out in public while adhering to current social distancing and mask guidelines?

Yes as I’ve been saying for weeks, the economy should be opened back up provided that the tasks being done can be accomplished while wearing a mask and/or while maintaining physical distances from others.  
In the end, it will be up to the people to reduce the spread of this virus by taking the proper precautions, which will have ramifications on the economy.

If the spread isn’t significantly reduced, then it won’t matter what the government does in terms of opening things up, people will voluntarily choose to stay home and not take part in economic activity.  
So wear a mask in crowds, maintain physical distance wear practical, and practice good hand hygiene.  

42 minutes ago, devpool said:

How long do you want to stay closed? Until your job stops paying? Until you have to start paying rent/mortgage? Almost 2 months in and not everyone has landlords willing to forgo rent for that long. Healthy young carriers can pass to other healthy young people with a much higher rate of survival, which is why I said keep everyone else quarantined. 

I'm on deployment. I don't wear gloves because anywhere I go, is probably where my crew has already been. If any of us gets it, we are screwed. Everything I touch is touched by a ton of other people. And I touch stuff touched by a ton of other people. We probably practice and adhere to these measures better than anyone. No one likes it. It's a giant pain in the arse but we do it anyway. 

How long do I want to be quarantined?

Zero nanoseconds.

No, the problem is YOU probably aren't screwed. However, you will spread it to others.

If the doctors and nurses get overloaded the death toll will be a lot higher and might include people like you, because there are no treatments left to give.

19 minutes ago, Phillyterp85 said:

Yes as I’ve been saying for weeks, the economy should be opened back up provided that the tasks being done can be accomplished while wearing a mask and/or while maintaining physical distances from others.  
In the end, it will be up to the people to reduce the spread of this virus by taking the proper precautions, which will have ramifications on the economy.

If the spread isn’t significantly reduced, then it won’t matter what the government does in terms of opening things up, people will voluntarily choose to stay home and not take part in economic activity.  
So wear a mask in crowds, maintain physical distance wear practical, and practical good hand hygiene.  

Then we are of the same opinion. Opening is fine as long as there are social distancing and mask mandates in place

2 minutes ago, Toastrel said:

How long do I want to be quarantined?

Zero nanoseconds.

No, the problem is YOU probably aren't screwed. However, you will spread it to others.

If the doctors and nurses get overloaded the death toll will be a lot higher and might include people like you, because there are no treatments left to give.

If we're spreading it to people who aren't vulnerable, because vulnerable shod be quarantining, the hospitals won't be overloaded because those people are very unlikely to need hospitalization 

ordered takeout over the weekend for only the 2nd time since the stay at home order...a locally owned mexican place we really like.  no mask on the girl working the counter...there was a guy at one of the tables...i'm not sure if he works there or not...no mask on him either.   we won't be back. 

and the other local mexican place we like seems to have gone out of business.    

3 hours ago, wyote said:

I wonder what this would mean. Would their employers have to pay them? Would their employers be allowed to fire them for staying home? Would they be subject to evictions and foreclosures if they don't make rent or mortgage payments? Would their other bills be subsidized? 

I'm asking all this because it seems like we either have to give ordinary working people cash or we have to let/force them to go to work regardless of the danger. 

I don't know what the answer is -- other than, of course, very extensive testing and tracking to the point that we can actually quarantine everyone who might have been exposed to the virus. And then we can open back up completely.  

 

We let our employees stay home without punishment but, they also will not get paid. 

 

2 hours ago, devpool said:

Their employers would do what they're doing now. Whether that's paying them or not depends on the business.

Of course I do. Idk why you assume I think their life is worth my freedom, I would be devastated. But the people over 65 that I know are not going out in public currently because they know they're among the most susceptible. Do they like it? Obviously not. My grandparents' first great grandchild was recently born and they haven't seen him (in person) since the lockdown started. You complete ignored what I said to make a strawman. I'll say again, those people who are most vulnerable should be quarantined. I value their lives, so they should stay quarantined while those who are not as vulnerable should be allowed to work and go out while maintaining social distancing/masks etc. This isn't the first time I've said this.

I see. I was assuming that, as in my family, 65+ people often live with their younger relatives (children and grandchildren). You're apparently assuming that they live somewhere separate so that it's possible to absolutely quarantine them while others go out.  

Of course they don't always live somewhere separate. I suppose that people in your scheme will have to choose between being able to go out in public and being able to live with 65+ people, immunocompromised people, or other vulnerable people.