How long should the lock down last?

  • Thread starter Thread starter deleted836128
  • Start date Start date
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Status
Not open for further replies.
turkeyjerky said:
But but but Heart disease and Cancer kill more than flu and 'rona combined. We don't shut down society for those
Click to expand...

Why would we shut down society for diseases that aren't contagious?

Potential for growth, especially exponential growth is more important than the current absolute mortality number in cost-benefit analysis. And corona's current mortality figures are partly a result of unprecedented mitigation efforts.

I'm not saying we should shutdown society, in fact I don't think what's going on in America could be considered a "shutdown".
 
Birdstrike said:
I overheard someone who is obviously an anti-science, right-wing conspiracy-theorist nut, implying the shutdown was for naught. He claimed we told people to go home and isolate and destroyed the economy to keep people safe. Then he said, what actually happened is they they went home, isolated and still got COVID and died. His name is Andrew Cuomo:

"'Overwhelmingly, the people were at home,' he added. 'We thought maybe they were taking public transportation, and we’ve taken special precautions on public transportation, but actually no, because these people were literally at home.'
Cuomo said nearly 84% of the hospitalized cases were people who were not commuting to work through car services, personal cars, public transit or walking."
Click to expand...

Yes, this is why a strategy of socially isolating only the most vulnerable segments of the population is destined to fail. You can't completely isolate them. That's the point.

Do you honestly think that the current M&M of this pandemic would not be worse without the lockdown?
 
turkeyjerky said:
Yes, this is why a strategy of socially isolating only the most vulnerable segments of the population is destined to fail. You can't completely isolate them. That's the point.

Do you honestly think that the current M&M of this pandemic would not be worse without the lockdown?
Click to expand...
Yes and no. We would have had a much more rapid spike in deaths, but conversely a rapid decline. Now we are destined for a slow smolder of hundreds of deaths a day for the foreseeable future. Likely overall deaths would be unchanged. Again we will see once we have long term numbers from Sweden.
 
GeneralVeers said:
This guy sums up the actual science and data perfectly:

www.drjohnm.org

Can We Discuss Flatten-the-Curve in COVID19? My Eight Assertions

On Telehealth, an older couple asked me a tough question about COVID19. They asked whether this virus would either be gone or less dangerous in 6 months to a year. It was a curious question. I repl…
www.drjohnm.org
Click to expand...

I like that guy. Generally agree with the post, but I do have qualms with the assertion about hospitals having adequate surge capacity. Many systems now seem to be preparing to demobilize their surge capacity they put into place a few weeks ago and resume elective procedures (which further decreases hospital capacity).

With the current socioeconomic restrictions we have managed to keep it to a slow burn. However, once they're let up, there remains a real risk of massive rapid spike.
 
I disagree with the continued premise that flattening the curve has done nothing to reduce the AUC. Reducing the R0 via social distancing has allowed us time to learn (somewhat) how to manage this b*$!#, taught us that early intubation probably isn't the best idea, let us learn that prolonging our QTc's wasn't a good way to cure it, self proning, time for remdesivir to show some promise, recognize and hopefully manage some of the thrombotic complications we're seeing in this population...I think without a doubt we will see a significant reduction in the AUC, but of course this can't be proved.
 
turkeyjerky said:
Yes, this is why a strategy of socially isolating only the most vulnerable segments of the population is destined to fail. You can't completely isolate them. That's the point.

Do you honestly think that the current M&M of this pandemic would not be worse without the lockdown?
Click to expand...
I don't have any opinion on it at all. I was simply telling you what your Governor Cuomo said, that your shutdown to quarantine the well, to keep them well, didn't work. He said it, not me.
 
MediMike said:
I disagree with the continued premise that flattening the curve has done nothing to reduce the AUC. Reducing the R0 via social distancing has allowed us time to learn (somewhat) how to manage this b*$!#, taught us that early intubation probably isn't the best idea, let us learn that prolonging our QTc's wasn't a good way to cure it, self proning, time for remdesivir to show some promise, recognize and hopefully manage some of the thrombotic complications we're seeing in this population...I think without a doubt we will see a significant reduction in the AUC, but of course this can't be proved.
Click to expand...

100% agree
 
MediMike said:
I disagree with the continued premise that flattening the curve has done nothing to reduce the AUC. Reducing the R0 via social distancing has allowed us time to learn (somewhat) how to manage this b*$!#, taught us that early intubation probably isn't the best idea, let us learn that prolonging our QTc's wasn't a good way to cure it, self proning, time for remdesivir to show some promise, recognize and hopefully manage some of the thrombotic complications we're seeing in this population...I think without a doubt we will see a significant reduction in the AUC, but of course this can't be proved.
Click to expand...

Too bad that's largely untestable unless we could see a parallel universe.
 
turkeyjerky said:
Yes, this is why a strategy of socially isolating only the most vulnerable segments of the population is destined to fail. You can't completely isolate them. That's the point.

Do you honestly think that the current M&M of this pandemic would not be worse without the lockdown?
Click to expand...

I suspect that we will soon be testing that commitment to the “most vulnerable” segments of the population if the lockdown goes on for more than another month or so. Just one example - we’ve already strained our food supply lines with this initial response. A second wave in the next 8 months or so before we can recover will make for some interesting social Darwinism discussions ahead of the November election.
 
In a landmark 2006 paper by epidemiologists, including the man who eradicated smallpox D.A. Henderson, "lockdowns" were determined to be ineffective and destructive for pandemic viruses like Coronaviruses (SARS) and influenza, and that life should go on with as little disruption and anxiety, as possible.


"There are no historical observations or scientific studies that support the confinement by quarantine of groups of possibly infected people for extended periods in order to slow the spread"

Screen Shot 2020-05-17 at 7.40.52 PM.png
 
Last edited:
Large scale quarantines cause more harm than benefit, should not be done.

"negative consequences of large-scale quarantine are so extreme (forced confinement of sick people with the well; complete restriction of movement of large populations; difficulty in getting critical supplies, medicines, and food to people inside the quarantine zone) that this mitigation measure should be eliminated from serious consideration."

Screen Shot 2020-05-17 at 7.45.01 PM.png


 
Last edited:
How does this article trashing lockdowns, from 2006, have any further relevance? China has rewritten the book on the efficacy of lockdowns while we in America continue to squabble with no coherent policy and watch bodies and economic casualties mount.

And 6 posts with enlarged print? What point are you trying to make?
 
Last edited:
That Article just makes assumptions and uses past history even though the only good data we have on a mass pandemic is 1918. Also I don’t understand how hospital use is ok with masks but everywhere else isn’t.
 
Fantastic point. Because as we've proven time and time again, CV19 is exactly the same as the flu and as such should be treated and managed in a similar fashion. Therefore this article has high relevance to the discussion at hand?

🙄
 
I read part of it. Then I fell asleep.

The first impression I had from it, from the first paragraph, is there might be an underlying assumption we can get a vaccine in 6 months. Because with a variant of the flu, we have so much infrastructure and medical experience already set up to make and test an influenza vaccine, that we can likely come up with one for 6 months.

We have no such vaccine, nor infrastructure, nor experience for a betacoronavirus vaccine.

I wonder if the authors had to consider not being able to make a vaccine, perhaps ever, if the conclusion of their paper might change.

I wanted to read more of it but again, I fell asleep.
 
GeneralVeers said:
A sane epidemiologist explains exactly why our governments were mostly wrong:

www.spiked-online.com

‘We could open up again and forget the whole thing’

Epidemiologist Knut Wittkowski on the deadly consequences of lockdown.
www.spiked-online.com www.spiked-online.com
Click to expand...

I read most of the article and the guy is a frucking idiot. He is spewing so much falsehood that it's like Mount Vesuvius. Pretty impressive this isn't published at the same time as getting an unexpected kick in the balls because that's about how much that article and his opinion is worth.
 
GeneralVeers said:
A sane epidemiologist explains exactly why our governments were mostly wrong:

www.spiked-online.com

‘We could open up again and forget the whole thing’

Epidemiologist Knut Wittkowski on the deadly consequences of lockdown.
www.spiked-online.com www.spiked-online.com
Click to expand...

spiked: Are we on the way to reaching herd immunity?
Wittkowski: All the studies that have been done have shown that we already have at least 25 per cent of the population who are immune.

- Where is even one study that shows we have 25 percent of the population who is already immune?
 
thegenius said:
I read most of the article and the guy is a frucking idiot. He is spewing so much falsehood that it's like Mount Vesuvius. Pretty impressive this isn't published at the same time as getting an unexpected kick in the balls because that's about how much that article and his opinion is worth.
Click to expand...

How much better is Fauci for spouting claims about Remdesivir or his back and forth flip/flopping on masks? The truth is most of these guys don't know what they are talking about.....which makes sense given a novel virus with poorly researched behavior.
 
GeneralVeers said:
I caught that too. Only one I know is NYC.
Click to expand...

But it's not 25%. It's about 20%. And most of the rest of the state is 2% - 5%.
And even with 20%, so many people died in NYC that the infection fatality rate (not case fatality rate, which is always higher) is > 1%.

Coronavirus Death Rate (COVID-19) - Worldometer

New York State conducted an antibody testing study [source], showing that 12.3% of the population in the state had COVID-19 antibodies as of May 1, 2020. The survey developed a baseline infection rate by testing 15,103 people at grocery stores and community centers across the state over the preceding two weeks. The study provides a breakdown by county, race (White 7%, Asian 11.1%, multi/none/other 14.4%, Black 17.4%, Latino/Hispanic 25.4%), and age, among other variables. 19.9% of the population of New York City had COVID-19 antibodies. With a population of 8,398,748 people in NYC [source], this percentage would indicate that 1,671,351 people had been infected with SARS-CoV-2 and had recovered as of May 1 in New York City. The number of confirmed cases reported as of May 1 by New York City was 166,883 [source], more than 10 times less.

As of May 1, New York City reported 13,156 confirmed deaths and 5,126 probable deaths (deaths with COVID-19 on the death certificate but no laboratory test performed), for a total of 18,282 deaths [source]. The CDC on May 11 released its "Preliminary Estimate of Excess Mortality During the COVID-19 Outbreak — New York City, March 11–May 2, 2020" [source] in which it calculated an estimate of actual COVID-19 deaths in NYC by analyzing the "excess deaths" (defined as "the number of deaths above expected seasonal baseline levels, regardless of the reported cause of death") and found that, in addition to the confirmed and probable deaths reported by the city, there were an estimated 5,293 more deaths to be attributed. After adjusting for the previous day (May 1), we get 5,148 additional deaths, for a total of actual deaths of 13,156 confirmed + 5,126 probable + 5,148 additional excess deaths calculated by CDC = 23,430 actual COVID-19 deaths as of May 1, 2020 in New York City.

Actual Cases with an outcome as of May 1 = estimated actual recovered (1,671,351) + estimated actual deaths (23,430) = 1,694,781.

Infection Fatality Rate (IFR) = Deaths / Cases = 23,430 / 1,694,781 = 1.4% (1.4% of people infected with SARS-CoV-2 have a fatal outcome, while 98.6% recover).
Click to expand...
(bold emphasis NOT mine)

Amid Ongoing COVID-19 Pandemic, Governor Cuomo Announces Results of Completed Antibody Testing Study of 15,000 People Showing 12.3 Percent of Population Has COVID-19 Antibodies

The above link shows the % infected by antibodies, per county, in NY State. Three are > 10%, the rest are < 10%.


I don't know why people think that getting herd immunity in a population of 300+ million is the right way to eradicate this virus.

Terrible idea:

Without A Vaccine, Herd Immunity Won’t Save Us




I don't believe you that you say you would rather die from the 'rona than endure a Wuhan style lockdown. I believe your frustration though.
 
thegenius said:
But it's not 25%. It's about 20%. And most of the rest of the state is 2% - 5%.
And even with 20%, so many people died in NYC that the infection fatality rate (not case fatality rate, which is always higher) is > 1%.

Coronavirus Death Rate (COVID-19) - Worldometer


(bold emphasis NOT mine)

Amid Ongoing COVID-19 Pandemic, Governor Cuomo Announces Results of Completed Antibody Testing Study of 15,000 People Showing 12.3 Percent of Population Has COVID-19 Antibodies

The above link shows the % infected by antibodies, per county, in NY State. Three are > 10%, the rest are < 10%.


I don't know why people think that getting herd immunity in a population of 300+ million is the right way to eradicate this virus.

Terrible idea:

Without A Vaccine, Herd Immunity Won’t Save Us




I don't believe you that you say you would rather die from the 'rona than endure a Wuhan style lockdown. I believe your frustration though.
Click to expand...
Maybe a more complete statement might be, “Our society can continue to function long term better by enduring a 1-3% fatality risk than it can endure months/years of shutdown that don’t actually change fatality risk and just delay (not permanently lower) infection risk. It’s also important to note the long term risk of accepting govt power to implement the second”
 
Things are getting back to normal here. Lots of UV light every day to kill the virus.
 
MediMike said:
Fantastic point. Because as we've proven time and time again, CV19 is exactly the same as the flu and as such should be treated and managed in a similar fashion. Therefore this article has high relevance to the discussion at hand?

🙄
Click to expand...
You obviously didn't read it or the parts that discuss a previous Coronavirus pandemic. Feel free to trash it though, based on your preconceived biases.
 
Last edited:
Brigade4Radiant said:
That Article just makes assumptions and uses past history even though the only good data we have on a mass pandemic is 1918. Also I don’t understand how hospital use is ok with masks but everywhere else isn’t.
Click to expand...
"We must listen to the experts, because they're smarter than us!"

"But just not that guy that eradicated smallpox! Because I'm obviously right, because his view point disagrees with my preconceived bias."
 
Last edited:
veaselhaufen said:
And 6 posts with enlarged print?
Click to expand...
They are screen shots that upload how SDNs software wants them to upload. I have no control over that. But obviously, you're right, the way SDN uploaded the print obviously makes the conclusions of the article wrong.

veaselhaufen said:
What point are you trying to make?
Click to expand...
My point is, that it's an interesting article by a guy who eradicated a disease that killed 500 million people in history, and might be worth reading. Try it. Or focus on the print size. Either way, I'm cool with it.
 
thegenius said:
Should have shown that article to Fauci and Trump back on Jan 15.
Click to expand...
I wish I had. But even if I did, I doubt it would have been enough to stem the tide of hysteria created by the media's panic porn, which is ongoing.
 
Birdstrike said:
They are screen shots that upload how SDNs software wants them to upload. I have no control over that. But obviously, you're right, the way SDN uploaded the print obviously makes the conclusions of the article wrong.

My point is, that it's an interesting article by a guy who eradicated a disease that killed 500 million people in history, and might be worth reading. Try it. Or focus on the print size. Either way, I'm cool with it.
Click to expand...
The epidemiology behind mass vaccination isn't exactly the same as the epidemiology behind an infectious disease outbreak so the appeal to authority doesn't really translate well.
 
My state has now been off lock-down for 2-3 times the average COVID-19 incubation period. Tourists have been flocking here in droves from the COVID hotbeds of NY and NJ. Restaurants have been open. They are block parties in the streets. Beaches have been packed. Life is back to normal and has been for a while.

Despite the continued existence of the virus, cases and deaths have been trending down far after we'd have seen a spike in cases if it was going to happen. I initially supported the lockdown measures, but I'm now convinced the lock-downs didn't do a thing to suppress the virus. That's my opinion, based on what I've seen.
 
Last edited:
Birdstrike said:
My state has now been off lock-down for 2-3 times the average COVID-19 incubation period. Tourists have been flocking here in droves from the COVID hotbeds of NY and NJ. Restaurants have been open. They are block parties in the streets. Beaches have been packed. Life is pretty much back to normal and has been for a while.

Our COVID-19 cases and deaths have not gone up. In fact, despite the continued existence of the virus, they've been trending down and continue to do so far after we'd have seen a spike in cases, if it was going to happen.

I'm convinced the lock-downs didn't do a thing.
Click to expand...
I won't lie, I was enjoying the lack of traffic. Cut my commute almost in half.

We're heading to Hilton Head in right at a month so I'm keeping a sharp eye on the Myrtle Beach area to see how things are likely to go.
 
Interesting article in the NYT about how the lockdowns have affected hospital bottom lines:

Hospitals Knew How to Make Money. Then Coronavirus Happened.

The crystal palace shops like Mayo and Hopkins are especially impacted since their operations were geared toward lucrative concierge care, international referrals, etc. and now they are having to adjust to increased Medicare and self-pay. While painful, those places have deep enough pockets to weather the storm for several years. Small, independent systems could be in big, big trouble since they were living on the edge with 1-2% margins before the pandemic. That could set off a self-sustaining chain reaction of closures.
 
Birdstrike said:
You obviously didn't read it or the parts that discuss a previous Coronavirus pandemic. Feel free to trash it though, based on your preconceived biases.
Click to expand...

Thanks! I willfully concede that there were around two (2) mentions of SARS in the article, buried amongst the influenza was mentioned.

Just want to make sure we are on the same page here in following the authors' guidance for navigating this pandemic.

Quarantine- Voluntary quarantine of the ill may work but it's really hard to explain to people why it's important so we shouldn't do it..
But on the next page it's important to do it so hospitals can concentrate on the critically ill...but no we changed our minds again on the last page. Their sources note that quarantining known infectious individuals and those that have contact with them is the best approach. We aren't/weren't able to test for this disease.

Travel- There is no need to screen any individuals traveling to the United States as it does no good. Here is the quote from the original literature they cite:

"In spite of intensive screening, no SARS cases were detected. SARS has an extremely low prevalence, and the positive predictive value of screening is essentially zero. Canadian screening results raise questions about the effectiveness of available screening measures for SARS at international borders."

"In the case of SARS, interventions at a country's borders should not detract from efforts to identify and isolate infected persons within the country, monitor or quarantine their contacts, and strengthen infection control in healthcare settings.

(Emphasis mine)

Masks- Masks don't work because they get clogged with moisture. No point in wearing them. Their own source notes that surgical masks protect the environment from the wearer rather than the other way around.

So I guess my question to you is did YOU (critically) read this paper or did you just interpret it in the context of your own biases? Not picking a fight, just trying to get a point across.
 
Birdstrike said:
Handwashing helps everywhere it's done. Mask wearing outside healthcare settings doesn't help, and only depletes in hospital supply.

"There are few data available to support the efficacy of N95 or surgical masks outside a healthcare setting."

View attachment 306619

Click to expand...

The mask situation is ridiculous.

Lay people using N95s to go grocery shopping or walk outside. I see it on a regular basis.

Unfortunately valuable hospital supplies are getting used up by people who don't need them and are wearing then incorrectly as well.
 
MediMike said:
did you just interpret it in the context of your own biases? Not picking a fight, just trying to get a point across.
Click to expand...
We all have biases. Some are more willing to change them based on new information, than others. I'm not sure I'm any better at it than anyone else, but I do try.

Here's my current "bias." I think these two things can coexist:

1) Coronavirus is a serious matter.

2) Life must go on.

I don't think it has to be one or the other. I think it's both. Feel free to disagree with or without explanation. Fear an anxiety about Coronavirus serves no purpose for me at this point. I wash my hands, I wear a mask at work and in Costo. Other than that, I'm moving on with life.
 
The older I get, the more I come to believe that intellectual flexibility, by which I mean the ability to adroitly change one's beliefs or thought processes in response to changing evidence or conditions, is both critically important and severely lacking. This is true both amongst ourselves, in terms of medical decision making and among the general population, in terms of pretty much everything.

Take the mask thing, for example. How hard is it to understand that in the midst of a supply chain failure, when healthcare workers are literally dying due to a lack of PPE, it would be irresponsible and counterproductive to encourage mask usage among the general population (many of whom were already hoarding N95s), even though there is a small decrease in the rate of transmission when one wears a mask.

This wasn't 'flip-flopping' by the CDC. It was a responsible evolution in in recommendations.

IMHO, one of the most valuable results of the lockdown was that it allowed many of our anxiety-prone colleagues to realize that this isn't a zombie-apocalypse and that you'll most likely be fine, even if you're in the room w/ a patient while not wearing level 4 protective attire.
 
turkeyjerky said:
IMHO, one of the most valuable results of the lockdown was that it allowed many of our anxiety-prone colleagues to realize that this isn't a zombie-apocalypse and that you'll most likely be fine, even if you're in the room w/ a patient while not wearing level 4 protective attire.
Click to expand...

Pretty much this. Back in February we had no idea how the virus would behave in our population and the images from Italy and China were not encouraging. We needed that 2-3 month lockdown to size up the threat and our capacity to respond even if it didn’t impact the initial spike (I think it did).

Now, I think that economic necessity requires that we begin to open up while hardening our PPE infrastructure, analyzing the efficacy of therapeutics (to the extent they exist), deploying vaccine protocols, and most importantly - deciding now what our response will be in 6-8 months if this virus returns with a vengeance. That is to say, how much of this do we want to repeat in order to spare septua and octogenarians as well as the non-working chronically ill who are being warehoused in nursing homes.

If we don’t start thinking about that last difficult question now as a society, things will get ugly if this virus spikes again in the Winter and people are blindsided by rationing.
 
Status
Not open for further replies.

Similar threads

alpinism
Resident ITE scores have plummeted 25% in the last 5 years
2
Replies
94
Views
6K
HemorrhagicShock
HemorrhagicShock
Bro Jenkins
How was the job market in 08 recession
Replies
15
Views
2K
gamerEMdoc
gamerEMdoc
miamidoc101
  • Question Question
How much do yall work?
2 3
Replies
144
Views
8K
doitalldoc
D
T
Should I Quit?
2 3
Replies
128
Views
15K
Old_Mil
Old_Mil
W
Dogs in the ED
Replies
15
Views
1K
WorkNoteEmergency
W
Top