I’m in Texas and there are hospitals here where nurses have said they don’t have enough PPE for what has so far been a pretty limited outbreak. Is Texas not red enough?
Donnie's Delay
- Thread starter astonmartin708
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The federal governments role is to supplement supplies where needed. They obviously can’t meet the needed supplies of all the states. The interview I link was conducted after your article. Gov Newsome “ Trump has filled every request for supplies which he was capable of for the state of California”. Listen to the interview conducted on Friday. California is a blue state last I checked.
Oklahoma purchased its needed PPE from a private supplier. No red state favoritism just good state government. No clue what’s going on in New Mexico and why they aren’t able to duplicate Oklahoma’s efforts.
Good thing this didn’t happen under Obama. Nobody would be getting any PPE.
https://www.usatoday.com/story/news...ation-deplete-n-95-mask-stockpile/5114319002/
https://www.usatoday.com/story/news...ation-deplete-n-95-mask-stockpile/5114319002/
Nation state. 49 smaller? Alaska and Texas? Defy the Federal Government. South Carolina tried that. Sherman’s March to Malibu.
He is like all politicians who say something one place and something else in another. For a long time you could get by with that. Then, later, you couldn’t but now you can get by with it again because people listen to or read different sources. Few watch MSNBC and Fox News.
He is like all politicians who say something one place and something else in another. For a long time you could get by with that. Then, later, you couldn’t but now you can get by with it again because people listen to or read different sources. Few watch MSNBC and Fox News.
Some of the PPE issues are on the state level and involve distribution and not supply. States have a central storage location for their PPE supplies. Larger states may have several. States have very little experience in the mass distribution of millions of supplies to the hundreds of locations across the state. Oklahoma has done a nice job but there has still been some oversights with supplies not getting to a certain location prior to said location running short. It’s a huge task.
Governors like to deflect blame and when the Pres is of the opposition party politics play a role. Not saying some blame isn’t warranted btw. However, when almost all the complaints come from one particular party it’s pretty obvious that politics play a part...which is to be expected.
Governors like to deflect blame and when the Pres is of the opposition party politics play a role. Not saying some blame isn’t warranted btw. However, when almost all the complaints come from one particular party it’s pretty obvious that politics play a part...which is to be expected.
Some of you make some good points, and I am forced to admit that I am not, and probably cannot be, entirely objective here.
My wife is an ICU nurse, as you know. She doesn't feel it is safe to continue living at home, so she is staying in a casita until this is over. Which leaves me the father of a 2 and 4 year old home alone, still obligated to try and fulfill my professional obligations and somehow balance that with not being a terrible father to impressionable young children and somehow being available to go deliver food and do laundry for my wife. Oh, and my father in law just had a heart attack, so she's a wreck.
All this is not to try and garner sympathy for my point of view, but to illustrate that I am in one of the hardest positions I have ever been in and my ability to process news rationally instead of emotionally is definitely diminished, and so I am probably going off too aggressively. This was always going to be hard. I don't see any way we could have completely avoided this. But I do see a whole slew of botched chances and missed opportunities that could have made this at least somewhat better, and I see Trump refusing to take any responsibility at all and insisting that he is doing the best job ever. Sorry, but no. He was downplaying this until mid-March, and again, he refused to institute the DPA to begin the mass manufacturing of lifesaving vents and PPE until April. He gave away half our stockpile in the early stages of the pandemic (which I actually have no issue with), but then neglected to place any federal orders to replenish it. There's no point of view that I can see and conclude that he didn't make this worse than it had to be, even if many of the same problems still may have come up.
I've said my peace.
My wife is an ICU nurse, as you know. She doesn't feel it is safe to continue living at home, so she is staying in a casita until this is over. Which leaves me the father of a 2 and 4 year old home alone, still obligated to try and fulfill my professional obligations and somehow balance that with not being a terrible father to impressionable young children and somehow being available to go deliver food and do laundry for my wife. Oh, and my father in law just had a heart attack, so she's a wreck.
All this is not to try and garner sympathy for my point of view, but to illustrate that I am in one of the hardest positions I have ever been in and my ability to process news rationally instead of emotionally is definitely diminished, and so I am probably going off too aggressively. This was always going to be hard. I don't see any way we could have completely avoided this. But I do see a whole slew of botched chances and missed opportunities that could have made this at least somewhat better, and I see Trump refusing to take any responsibility at all and insisting that he is doing the best job ever. Sorry, but no. He was downplaying this until mid-March, and again, he refused to institute the DPA to begin the mass manufacturing of lifesaving vents and PPE until April. He gave away half our stockpile in the early stages of the pandemic (which I actually have no issue with), but then neglected to place any federal orders to replenish it. There's no point of view that I can see and conclude that he didn't make this worse than it had to be, even if many of the same problems still may have come up.
I've said my peace.
Prayers sent to you and your family Clong. Stay safe buddy.
My niece is an ICU nurse and has three kids still at home. Fortunately they are older 15 year old twins and 17 yo. ICU has its advantages (they are already decontaminated when they come there) and down sides like seeing more people pass away and families with drama over ventilator or not for ancient patients. Then you come home to regular stuff. Happy Easter.
I’ve mentioned before that my daughter is an RN at St Francis. I feel weird texting every other day asking about her health. Can’t help it though.
I am checking in here for the first time in a long time. It will be my last. The amount of myopia on all sides of this is absolutely stunning. Quit self selecting your news. Look around. There is so much more going on.
Though your predictions were off (like everyone else's), it seemed like you had a fair amount of medical knowledge/first hand experience to share. It'd be nice to hear from someone in the field that has a lot more knowledge than the rest of us on here, so I hope you aren't gone for good.
There are so many more people and organizations involved than what Trump did or didn’t do. But you know what, in the end people believe what they want. Because we can select the viewpoint of news that supports our presuppositions. Confirmation bias is alive and well.
So I apologize for my previous post. I just reacted emotionally. I shouldn’t have done that.
So I apologize for my previous post. I just reacted emotionally. I shouldn’t have done that.
That makes two of us (at least) who have done that in this thread. And I agree this is bigger than any one man doing a good/bad job. I simply can’t get behind any sort of rally behind him right now because I don’t think he is being part of the solution.
To lawpoke: thank you.
To TuME: your niece is lucky. They typically show up more or less bathed and wearing masks if not intubated, but they don’t always stay that way. My wife has been treating someone in their 80s with dementia who rips off her mask and oxygen line every so often. Oxygen levels drop to the 70s and she has to go back in there with the patient hacking and coughing without any sense of what is going on and wrangle them back to bed and get it all set back up again. And the way her hospital works, literally only the nurse and doctor go in Covid rooms, so she is on her own to do that stuff, as well as food, cleaning, respiratory therapy, etc, etc.
My niece is at St. Francis. I said that they come to ICU decontaminated. I didn't say it was easy to keep them that way. And again, you have high 80s in age in a coma and a family wants them put on a vent. She has about 15 years and next month gets her DNP. I'm sure she is sparing some of the worse details in front of her kids.
There’s plenty of blame to go around. At all levels. And there will be no changing of minds, whoever you think is to blame, that’s who you blame. Good for you.
Let’s start with a real basic question I have seen no one ask: Of the 20k people who have died, why haven’t their charts been audited to not only list and enumerate any comorbidities, but more importantly to survey them for what treatments were attempted? A vent is not a treatment. That would be some useful information.
Let’s start with a real basic question I have seen no one ask: Of the 20k people who have died, why haven’t their charts been audited to not only list and enumerate any comorbidities, but more importantly to survey them for what treatments were attempted? A vent is not a treatment. That would be some useful information.
I've heard that coroners would like some of the test kits to detect whether or not deaths were attributed to COVID-19 presence but the test kits are still in short supply and the higher priority is testing the living. Still a shortage?
We had a nursing home locally have 2 folks diagnosed with COVID-19 and are now in the ICU. The rest of the nursing home patients and staff are being tested, but they say it could be 3 days or more for results. What happened to the 5 minute tests that we heard were available?
Don't worry, our idiot Texas Governor Hot Wheels is going to unveil a plan this week to reopen the state. For business, or increasing the COVID cases. Your choice.
I have always assumed that some medical researcher somewhere (or several) is doing just that. I'm not generally privy to ongoing medical research projects, but if nobody is doing anything like that, then they absolutely should.
So, it’s OK that 23K have died because that number is below projections?
Whatever the number ends up being, it could have been significantly lower had we taken action and prepared equipment and a response when we first heard about in Dec, or were told again it would get bad in Jan, or in Feb when if was obvious it would get bad.
Defend Trump all you want but the absolute worse thing he did wasn’t inaction, it was minimizing and politicizing the virus which resulted in a lot of people not taking the medical community seriously.
It’s easy to say, “he did a good job because deaths were below projections” when you haven’t had a family or friend die. I haven’t known anyone who was even sick and while I’m happy the numbers are below projections, I’m sad that so many needlessly died as a result of misinformation and lack of action from POTUS.
Seems you’re better than this LP. I’m honestly surprised at your reaction and defense of leadership.
I have a cousin that works in a Tulsa hospital.
The QT worker who died had a kid born in the hospital before he had symptoms. 3 NICU nurses are now positive.
They are also using their masks for 5 days and they’re being sterilized via UV. Both of which are not recommended according to their packaging.
WD, no death is to be minimized. The first confirmed case in the US was January 21. It was likely here well before that, but again the first confirmed case was January 21. The Chinese travel ban was January 31 I believe.
Even into February, there were still questions about the communicability of the virus. At that point it was thought to be low. That was likely due to the complete disinformation from the Chinese. Which was then picked up by the WHO, who was saying even in February that the human to human transmissibility seemed low.
Dr Fauci was saying all the way to February 29, that the risk to the great majority of Americans was extremely low and he did not recommend any change in behavior. The director of public health for New York City was even saying it was safe to go to their festivals in early March.
I’m not saying the president is blameless. But you have Communist China, the WHO, Dr Fauci and the NIH, governors and mayors and local health departments, and a bunch of ordinary citizens who don’t like being told what to do. Not to mention models that were, and continue to be, incorrect by orders of magnitude.
Again, I don’t expect to change anyone’s mind on here. But there is a whole lot more to this, and the timeline simply is being rewritten.
Even into February, there were still questions about the communicability of the virus. At that point it was thought to be low. That was likely due to the complete disinformation from the Chinese. Which was then picked up by the WHO, who was saying even in February that the human to human transmissibility seemed low.
Dr Fauci was saying all the way to February 29, that the risk to the great majority of Americans was extremely low and he did not recommend any change in behavior. The director of public health for New York City was even saying it was safe to go to their festivals in early March.
I’m not saying the president is blameless. But you have Communist China, the WHO, Dr Fauci and the NIH, governors and mayors and local health departments, and a bunch of ordinary citizens who don’t like being told what to do. Not to mention models that were, and continue to be, incorrect by orders of magnitude.
Again, I don’t expect to change anyone’s mind on here. But there is a whole lot more to this, and the timeline simply is being rewritten.
I've never said we couldn't and should have done better. I've said the objective standard is the response of our piers in western Europe who had the same intelligence and reports as the US. I don't believe those leaders are all incompetent or all dropped the ball. The ending to this story has yet to be written. I'll make my judgment when the final numbers are in and will compare them to those of our piers. I can't think of a more fair way to judge the response of the American people.
And while all of this goes on, we are inching toward 60,000 influenza deaths this year. But those don’t count, because that’s not the sexy disease this season.
My guess, without looking it up, is that if you added the populations of Spain, Italy, France, and the UK it would probably end up with about the population of the US. Those four countries have 67k deaths, we are at 23k.
Here is something else to consider: India, a country with well over 1 billion people, reports less than 350 deaths. It seems pretty inconceivable that they are able to have the quarantine and social distancing standards that more developed countries have, with the squalid conditions of many of their slums. How is their number so low? Maybe just non-reporting, but it is interesting.
Also worth noting, there were tens of thousands of cremation urns being sent to funeral homes weekly in the Wuhan province about a month ago. Photographs showed long lines of people lined up at funeral homes to pick up remains.
Here is something else to consider: India, a country with well over 1 billion people, reports less than 350 deaths. It seems pretty inconceivable that they are able to have the quarantine and social distancing standards that more developed countries have, with the squalid conditions of many of their slums. How is their number so low? Maybe just non-reporting, but it is interesting.
Also worth noting, there were tens of thousands of cremation urns being sent to funeral homes weekly in the Wuhan province about a month ago. Photographs showed long lines of people lined up at funeral homes to pick up remains.
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Oh, and the CFR that was projected by the WHO to be 3.4% initially, is now down to 0.37% and going lower every day. Just a few ticks above influenza. Just like I predicted.
Again, extremely bad modeling.
Again, extremely bad modeling.
You're not wrong, and I hope that if anything, all of this causes more people to get vaccinated for the flu every year. The flu is a terrible killer as well, taking mostly elderly. We could do a much better job at limiting its spread if everyone got simply got vaccinated and stayed out of public when they get sick. I truly hope that happens.
But I'd be remiss to not point out that we might be able to keep American deaths from COVID under 60k by closing down everything and telling everyone to stay at home for weeks at a time. If we treated Covid like the flu (basically do nothing), there would likely be hundreds of thousands of dead by the time this is all done. I don't believe that is a controversial statement, and I don't think anyone serious has disputed that. Shortages are bad now, but if concerts and travel and other large events were still ongoing, virtually everywhere would be completely overwhelmed all at once.
That is absolutely incorrect. It has appeared that low in some places, but overall it is clearly much higher.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7104689/
https://jidc.org/index.php/journal/article/view/32146445
https://www.medrxiv.org/content/10.1101/2020.03.09.20033357v1
https://www.medrxiv.org/content/10.1101/2020.03.05.20031773v2
All of the above academic papers suggest a rate of at least 1%. It's not 5% like was feared in the early stages, but errors with limited data are expected. It has shrunk, and the range has generally tightened to somewhere around 1-3%, which is an order of magnitude more deadly than the flu.
EDIT:
There's also this one, which actually argues that 2-3% may be an underestimation:
https://jglobalbiosecurity.com/arti...rggKwdcKGlH4nbl79O4WbvWrNqLoyyDgrXITEP8djYkEg
You could argue that many of the above articles (but not all) are from mid-March, and are out of date. That's the thing about real academic work. To get something through peer review and actually published doesn't happen overnight, and so we have a lack of academic knowledge about this disease. That said, I will weight a medical academician's analysis of the CFR over some guy on an internet forum. No offense intended. And while the numbers being thrown around still have a fairly broad range, I could find no peer-reviewed study that suggested the likely CFR was below 1%. Maybe in the error bars, sure, but not as a likely figure.
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One of the largest scale studies as a German study which also takes into account asymptomatic patients. Sorry for the German, this one is at 0.37%.
https://www.tagesschau.de/regional/nordrheinwestfalen/corona-studie-heinsberg-101.htm
Something else worth noting: this virus kills absolutely no one. It creates conditions where other diseases kill the person. So yeah, we have a bunch of people in this country who are too fat and diabetic and smoke too much. Plus old people. But the virus killed none of them.
https://www.tagesschau.de/regional/nordrheinwestfalen/corona-studie-heinsberg-101.htm
Something else worth noting: this virus kills absolutely no one. It creates conditions where other diseases kill the person. So yeah, we have a bunch of people in this country who are too fat and diabetic and smoke too much. Plus old people. But the virus killed none of them.
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But whatever, I know you’ve been through a lot lately and I’m very sorry to hear it. Best of health to you and yours and everyone else in the Hurricane family.
Yes, Germany appears that low. Germany is listed in the first paper I linked to. It appears to be an outlier, and the paper discusses what the actual CFR might be and why it seems to vary from country to country.
All things considered, it is not likely that the single best result from many nation's apparent death rates is accurate on the whole.
EDIT: Spoiler alert: The literature suggests that the virus may eventually mutate into a less lethal form with a CFR close to that of the regular flu, like what Germany experienced. It is certainly not the case that every strain out in the wild currently is anywhere close to that.
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I don't need your pity as a way of dismissing an academic argument that is no longer about politics. But thanks anyway. BTW, your link goes to some sort of article (in German) about an academic article. Try linking to primary sources if you really want to get into the weeds of the likely CFR.
Throw in Germany, and it is about the same.
Spain, Italy, France, UK, and Germany: Pop 323M Deaths 70k
US: Pop 328 Deaths 23k
But they are probably at least 3 or 4 weeks ahead of us in dealing with the outbreak. Germany dealt with it better, and Italy and Spain were harder hit. So I don't think this is an unfair comparison.
Just to put this in perspective. 7300 people have died thus far from COVID in New York City. If the CFR is 0.37%, than that means that at least 1.9 million people have contracted it in New York City and progressed with the disease far enough to have possibly died from it.
7300/.0037 = 1,972,973
That's more people than have been confirmed to have Covid in the entire world so far. Are you asserting that New York City has a 25% infection rate and that simply nobody has noticed?
Mass transit is bigger in Europe overall. The majority of people not having a car over there, while better for the environment, is not better for an outbreak like this. I know you all realize this. I just think any mention of Europe as a comparison, should always have this mentioned as a caveat.(Just like the culture being different in SK and Japan should eliminate them from a comparison.)
There's one more thing I'd like to point out on this CFR front. There is CFR and IFR, and it is important not to confuse or conflate them.
CFR referes to the Case Fatality Rate. That is, the number of fatalities per clinically diagnosed cases. IFR refers to Infection Fatality Rate, or the number of fatalities per total number of people infected. This number is always more speculative, since we have to guess at the number of infected people that never got diagnosed or sought treatment. That's true for any disease. In countries with massive amounts of testing, the IFR and the CFR will approach the same number, since there are fewer undiagnosed cases.
This is one of the reasons you see such a large difference in death rate between some countries, in addition to somewhat different strains and the demographics of the population that it ends up circulating through. Some countries do much much more testing than others, and end up diagnosing people that otherwise never would have been. And if you do a better job of testing the public at large, you can also help to keep the disease out of at-risk communities like nursing homes by knowing who the asymptomatic carriers are, which can further help to lower the CFR. This is likely what has happened in South Korea. A country achieving a CFR of 0.4% or so does not necessarily mean that the disease is not all that deadly. It may simply mean that the country did a very good job of testing and of protecting at-risk populations. It's instructive, but needs to be taken in context with data from other sources as well to get a picture of the disease as a whole, as well as the demographics of those it infected. If it somehow primarily infected 80 year olds in Italy and gave a CFR of 9%, that is obviously skewed. And if it infected very few elderly or infirm people in Korea and showed a CFR of 0.4%, that is skewed too. Obviously neither of those is the right answer to the question of "How deadly is this disease?" It also highlights in general how hard it is to find a single number that really represents the severity of the disease very well.
Anyhow, although some countries have achieved a CFR for COVID as low as 0.37, it is very likely going to be higher than 1% overall. Likely around 2% or so. To be clear, that is different than the IFR number. The IFR of COVID is likely around 1-1.5%, and it is admittedly possibly as low as 0.6% or so. Some sources:
https://www.eurosurveillance.org/co...2HYtfYfviWdLt0B0.i-0b3d9850f4681504f-ecdclive
https://www.medrxiv.org/content/10.1101/2020.03.05.20031773v2
So not much worse than the flu, right? After all, the flu usually has a CFR of about 0.3%, depending on the year and the strain. 0.6% and 0.3% aren't hugely different, and would arguably be not much worse than a very bad flu strain. So, that's it then, right? Not quite. The flu has an estimated IFR of about 0.1%. Last year, 34000 people died out of an estimated 35000000 cases.
So, we have a situation where the Covid is 5-10x deadlier than the flu by a head to head comparison of both metrics. More than "a tick".
I am trying to argue with just data to make this point. I feel that allowing the notion that this disease is not much worse than the flu to proliferate is very dangerous, and again, I have seen no data from any peer-reviewed study that suggests this is the case.
CFR referes to the Case Fatality Rate. That is, the number of fatalities per clinically diagnosed cases. IFR refers to Infection Fatality Rate, or the number of fatalities per total number of people infected. This number is always more speculative, since we have to guess at the number of infected people that never got diagnosed or sought treatment. That's true for any disease. In countries with massive amounts of testing, the IFR and the CFR will approach the same number, since there are fewer undiagnosed cases.
This is one of the reasons you see such a large difference in death rate between some countries, in addition to somewhat different strains and the demographics of the population that it ends up circulating through. Some countries do much much more testing than others, and end up diagnosing people that otherwise never would have been. And if you do a better job of testing the public at large, you can also help to keep the disease out of at-risk communities like nursing homes by knowing who the asymptomatic carriers are, which can further help to lower the CFR. This is likely what has happened in South Korea. A country achieving a CFR of 0.4% or so does not necessarily mean that the disease is not all that deadly. It may simply mean that the country did a very good job of testing and of protecting at-risk populations. It's instructive, but needs to be taken in context with data from other sources as well to get a picture of the disease as a whole, as well as the demographics of those it infected. If it somehow primarily infected 80 year olds in Italy and gave a CFR of 9%, that is obviously skewed. And if it infected very few elderly or infirm people in Korea and showed a CFR of 0.4%, that is skewed too. Obviously neither of those is the right answer to the question of "How deadly is this disease?" It also highlights in general how hard it is to find a single number that really represents the severity of the disease very well.
Anyhow, although some countries have achieved a CFR for COVID as low as 0.37, it is very likely going to be higher than 1% overall. Likely around 2% or so. To be clear, that is different than the IFR number. The IFR of COVID is likely around 1-1.5%, and it is admittedly possibly as low as 0.6% or so. Some sources:
https://www.eurosurveillance.org/co...2HYtfYfviWdLt0B0.i-0b3d9850f4681504f-ecdclive
https://www.medrxiv.org/content/10.1101/2020.03.05.20031773v2
So not much worse than the flu, right? After all, the flu usually has a CFR of about 0.3%, depending on the year and the strain. 0.6% and 0.3% aren't hugely different, and would arguably be not much worse than a very bad flu strain. So, that's it then, right? Not quite. The flu has an estimated IFR of about 0.1%. Last year, 34000 people died out of an estimated 35000000 cases.
So, we have a situation where the Covid is 5-10x deadlier than the flu by a head to head comparison of both metrics. More than "a tick".
I am trying to argue with just data to make this point. I feel that allowing the notion that this disease is not much worse than the flu to proliferate is very dangerous, and again, I have seen no data from any peer-reviewed study that suggests this is the case.
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