How long should the lock down last?

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I think his point was number of total cases can only increase. It's impossible to ever decrease. The only way it will ever not increase is if it is totally eliminated smallpox style. The better metric would look at something else like number of new cases and the trajectory of rate of change of the new cases.

Yea that makes sense. Can't look at total numbers. But daily confirmed cases, especially if done and resulted quickly, is an excellent marker of disease control.

It's hard to do regional or even municipal lockdowns or viral control if it takes >= 24 hours to get a test back.
 
Meanwhile, in the U.K.:

"CANCER deaths caused by the indirect effects of Covid-19 on the NHS will outstrip the number predicted to die from the virus, experts have warned. The eventual figure will be far higher than the 20,000 projected UK fatalities caused by coronavirus, researchers said...They believe the findings will show an urgent need to rethink the current pandemic health policy, citing major disruptions to cancer services and care. "

 
Meanwhile, in the U.K.:

"CANCER deaths caused by the indirect effects of Covid-19 on the NHS will outstrip the number predicted to die from the virus, experts have warned. The eventual figure will be far higher than the 20,000 projected UK fatalities caused by coronavirus, researchers said...They believe the findings will show an urgent need to rethink the current pandemic health policy, citing major disruptions to cancer services and care. "


That's hard to reconcile with my clinical experience. I work with a cancer center and our patients are still getting chemo, radiation treatments and resections. It's elective cases that are being cancelled. So people are waiting for new knees but not diverting colostomies.
 
That's hard to reconcile with my clinical experience. I work with a cancer center and our patients are still getting chemo, radiation treatments and resections. It's elective cases that are being cancelled. So people are waiting for new knees but not diverting colostomies.
I literally just saw a guy who's getting his nephrectomy for cancer this time next week
 
That's hard to reconcile with my clinical experience. I work with a cancer center and our patients are still getting chemo, radiation treatments and resections. It's elective cases that are being cancelled. So people are waiting for new knees but not diverting colostomies.

Yeah, I don't what what the NHS is doing, but we're basically full speed for heme/onc. The screening is an interesting take, but I can't imagine a few months mammo / c-scope etc delays is going to be more impactful than COVID-related morbidity/mortality
 
Yeah, I don't what what the NHS is doing, but we're basically full speed for heme/onc. The screening is an interesting take, but I can't imagine a few months mammo / c-scope etc delays is going to be more impactful than COVID-related morbidity/mortality
Getting a bit off topic, but I've been pushing cologuard much harder the last month since that is still getting done
 
New York vs Everybody Else




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Source: "Deborah Birx: Graphs (data) of US Coronavirus cases from states and top 25 metro areas"

NY Daily News summary: What happened here? Independent epidemiologists must do a deep dive into what made NYC the coronavirus epicenter
 

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Governor/Czar Andy Cuomo does a daily update. Today was the first time I watched in the entirety. He started by introducing the other 4 people, two of whom (I'm sure of 1) had PhDs, and referred to the state health commissioner as the only "real" doctor on the panel. Ouch! (Even if true)

Well, at the end, he opens for questions, and I had two observations: first is that the Gov is kinda condescending to the press. However, the second is more sanguine: "erudite" is a word that will NEVER be applied to any member of the press. Serious as a heart attack, some of those reporters are borderline dumb.
 
It’s not silly, it’s the right thing to do. Wuhan didn’t open up until they had a week of no cases. You don’t open up when cases are increasing. That’s daft.

What do you mean? Cases will always go up, even if it's 1 or 2 per day. I think you mean the rate at which cases are increasing. My understanding is that for most of the country case rates are declining. In NYC ICU beds occupied, and new admissions are both declining.

My biggest problem with this whole thing (besides implementing a lockdown) is that no one has set a goal for when we can go off this nonsense. How much does the new infection rate have to decline? We aren't told. To listen to the epidemiologists and the CNN journalists, we would have total economic lockdown forever.

We can't keep everything locked down forever based on a theoretical "second spike" in infections. Likely a second spike would be less severe, and the vast majority of the country's health systems could handle it. We aren't saving any lives at this point by continuing the lockdown madness.
 
We can't keep everything locked down forever based on a theoretical "second spike" in infections. Likely a second spike would be less severe, and the vast majority of the country's health systems could handle it. We aren't saving any lives at this point by continuing the lockdown madness.

Aside from a few urban hot-spots where prolonged shutdowns might be beneficial, there are ulterior motives driving the desire for shutdowns with no end that have little to do with beating a virus, at this point. Certain people want the country to be a steaming, ash covered, post-apocalyptic mess by November 3rd, for selfish purposes. Then November 4th they plan on suddenly declaring, "It's Time To Reopen, Hope Is Alive, Celebration Day!" Power hungry people won't hesitate to use a pandemic crisis to destroy our economy and lifestyle if that's what's needed to achieve their political goals. There is no political party I would put past using this type of tactic.
 
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Good for the governors of Florida, Texas, and SC who are re-opening things in a stepwise manner this week. I think history will prove that they took the correct actions to save the lives and livelihoods of their constituents despite the media's irrational consternation.

Also plaudits to Austria and Sweden, and Germany.
 
In other news, US oil prices are less than $0 per barrel! I don't even understand how that is possible! Does that mean you get paid to take the oil lol
 
What do you mean? Cases will always go up, even if it's 1 or 2 per day. I think you mean the rate at which cases are increasing. My understanding is that for most of the country case rates are declining. In NYC ICU beds occupied, and new admissions are both declining.

My biggest problem with this whole thing (besides implementing a lockdown) is that no one has set a goal for when we can go off this nonsense. How much does the new infection rate have to decline? We aren't told. To listen to the epidemiologists and the CNN journalists, we would have total economic lockdown forever.

We can't keep everything locked down forever based on a theoretical "second spike" in infections. Likely a second spike would be less severe, and the vast majority of the country's health systems could handle it. We aren't saving any lives at this point by continuing the lockdown madness.

I'm not sure why you think a 2nd spike will be less severe. We're not likely to emerge from this initial lockdown w/ any element of herd immunity. Maybe something along the lines of 4-5% of the population will have been infected (assuming we're currently half-way through the initial wave, w/ 10% of cases identified), which I doubt will be enough to significantly impact the rate of viral spread. The DHS and FEMA pojections leaked a few weeks ago actually projected a more severe 2nd wave in the event of a 30 day shutdown than if nothing had been done at all.

I don't see any indication that the government is developing capacity for suppression through a test/trace/isolate strategy. Rather, it seems that the only real prep being made is to modestly increase surge capacity through field hospitals, temp housing facilities and increased vent/mask production. These preparations seem a little half-assed though, imho.
 
Our neck of the woods is forbidding large crowds till the fall. Wonder when sports will ever come back.

Our hospital admin is going HAM about social distancing. They yelled at staff walking to the cafeteria and not being 6 feet away. In the ED they got upset that the stations were too close. And will run like the wind if you say hi in passing in the halls

I want to be safe and want people to do the right things but sometimes things can get carried away.
 
Our neck of the woods is forbidding large crowds till the fall. Wonder when sports will ever come back.

Our hospital admin is going HAM about social distancing. They yelled at staff walking to the cafeteria and not being 6 feet away. In the ED they got upset that the stations were too close. And will run like the wind if you say hi in passing in the halls

I want to be safe and want people to do the right things but sometimes things can get carried away.

True dat. I imagine just wearing a mask and maybe gloves would reduce this stupid virus to a R0 just above 1.0. Like 1.05 or 1.1
 
I'm not sure why you think a 2nd spike will be less severe. We're not likely to emerge from this initial lockdown w/ any element of herd immunity. Maybe something along the lines of 4-5% of the population will have been infected (assuming we're currently half-way through the initial wave, w/ 10% of cases identified), which I doubt will be enough to significantly impact the rate of viral spread. The DHS and FEMA pojections leaked a few weeks ago actually projected a more severe 2nd wave in the event of a 30 day shutdown than if nothing had been done at all.

I don't see any indication that the government is developing capacity for suppression through a test/trace/isolate strategy. Rather, it seems that the only real prep being made is to modestly increase surge capacity through field hospitals, temp housing facilities and increased vent/mask production. These preparations seem a little half-assed though, imho.

It doesn't matter. We can't be closed until fall. We are past the peak in most areas of the country. Let's get things moving again with reasonable precautions, and whatever will be, will be. It's simply stupid that with empty hospitals we continue destroying our economy.
 
It doesn't matter. We can't be closed until fall. We are past the peak in most areas of the country. Let's get things moving again with reasonable precautions, and whatever will be, will be. It's simply stupid that with empty hospitals we continue destroying our economy.
And it helps that we know more about this thing now than we did a month ago.

I live in SC, and my hope is that when we start opening stuff again if we see significant increases in cases we can always back off again.

But admittedly these is no reason why we should all follow the NYC playbook as each state is different.
 
And it helps that we know more about this thing now than we did a month ago.

I live in SC, and my hope is that when we start opening stuff again if we see significant increases in cases we can always back off again.

But admittedly these is no reason why we should all follow the NYC playbook as each state is different.
My county in SC had one new case yesterday. ONE.
 
Aside from a few urban hot-spots where prolonged shutdowns might be beneficial, there are ulterior motives driving the desire for shutdowns with no end that have little to do with beating a virus, at this point. Certain people want the country to be a steaming, ash covered, post-apocalyptic mess by November 3rd, for selfish purposes. Then November 4th they plan on suddenly declaring, "It's Time To Reopen, Hope Is Alive, Celebration Day!" Power hungry people won't hesitate to use a pandemic crisis to destroy our economy and lifestyle if that's what's needed to achieve their political goals. There is no political party I would put past using this type of tactic.

The election cycle effect is just going to get worse as this drags out, sadly.
 
Right. And this is my problem with the one-size-fits-all lockdowns. Counties and states with low density and low infection rate could at least have some sort of economy. Why lock down Montana???

Hell let's build a fence and a moat around Montana! Let's do severe lockdown mode and saran-wrap every Montanan into a cocoon.
 
My county in SC had one new case yesterday. ONE.
We led the state yesterday with 7/

Interestingly, turns out the state's hospitals are running at like 55% capacity at the moment. Should help if the re-opening goes poorly.
 
The biggest problem with the idea of simply closing things at a second spike is that most businesses can't handle it. A good portion of business (especially in the service industry) are already toast, but a large proportion of the rest of the business can only afford to reopen once. Likewise, some of the rural areas are not immune as well, as one of the biggest clusters in Sioux Falls, SD from the Smithville Plant, and more hits like that would be repeated supply side shock on the economy.

Nonetheless, some places are likely ready to reopen based on regional information, and it is fortunate that a lot of states are starting to coordinate regionally on the plan, as the decisions is really regional, instead of letting an idiot on the wrong side of the Dunning-Kruger curve dictate what we should do. I think for my region we most likely open up slowly in May, although I suspect a lot of our mass events will be done until 2021.
 
I see that a complete shutdown of all immigration has been announced to block COVID-19 entry. I've already started to see people who previously were arguing for a never ending shutdown for Americans, arguing that an immigration shutdown is racist, unnecessary and that immigration should continue unchecked.

Which is it:

Are we all shutting down for science and safety, and without regard to politics?

Or do only Americans need to shutdown for 'science,' while immigration continues unchecked to advance political goals?
 
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I see that a complete shutdown of all immigration has been announced to block COVID-19 entry. I've already started to see people who previously were arguing for a never ending shutdown for Americans, arguing that an immigration shutdown is racist, unnecessary and that immigration should continue unchecked.

Which is it:

Are we all shutting down for science and safety, and without regard to politics?

Or do only Americans need to shutdown for 'science,' while immigration continues unchecked to advance political goals?

It's the same as "China flight bans are racist!" but "Trump did nothing to stop this". You can't have it both ways.

How about we come off of lockdowns so we can end "racist and xenophobic" immigration bans? There, everyone is happy.
 
It’s not silly, it’s the right thing to do. Wuhan didn’t open up until they had a week of no cases. You don’t open up when cases are increasing. That’s daft.

You're right, they were on ultimate lock down. People who were tested positive and broke quarantine were dragged by their feet kicking and screaming to isolation. No one was allowed outside. Drones were used to shame people who broken the rules. They tracked everyone via app. They monitored everyone's temperatures that were going in and out of communities and neighborhoods.

What I'm trying to say is that the more serious we take this virus, the better our chances and I feel like we aren't really taking this thing that seriously.
 
You're right, they were on ultimate lock down. People who were tested positive and broke quarantine were dragged by their feet kicking and screaming to isolation. No one was allowed outside. Drones were used to shame people who broken the rules. They tracked everyone via app. They monitored everyone's temperatures that were going in and out of communities and neighborhoods.

What I'm trying to say is that the more serious we take this virus, the better our chances and I feel like we aren't really taking this thing that seriously.

Yea I generally agree with that.

But the ultimate question is why not allow people to do more if our hospitals are at 50% capacity?

The general notion is that the death rate is more-or-less fixed at some number (reported to be 1% CFR, probably more like 0.1% in real life, maybe even less) and then starts to rise as hospitals get overwhelmed.

It's not like the death rate goes from 1% to 1.5% if our health care resources go from 50% to 75%. I imagine that our death rate is relatively uniform and flat until we exceed health care resources and then it can go dramatically up.

Or so I think.
 
It's not like the death rate goes from 1% to 1.5% if our health care resources go from 50% to 75%. I imagine that our death rate is relatively uniform and flat until we exceed health care resources and then it can go dramatically up.

Or so I think.


The problem is that the media and elites are all based in NYC where they were skirting the edge of over-capacity. They don't understand flyover country or that it even exists. Interesting perspective:

 
Latest CDC COVID-19 data:

Only 3 under age 15 have died out of 60,885,444. That's 0.000005% or 1 in 20 million.

Under age 55, there's been 1,453 COVID-19 deaths in the US, out of 232,463,605. That's 0.0006% or 1 in 159,988 people. 99.9994% have not died.


Screen Shot 2020-04-21 at 5.10.48 PM.png
 
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The problem is that the media and elites are all based in NYC where they were skirting the edge of over-capacity. They don't understand flyover country or that it even exists. Interesting perspective:


Yea what if. God how many times have I said what if?

What if David Tyree fumbled and bumbled that one catch during SB XLVI?
What if Trump actually did catch that superbug venereal disease?
What if I just didn't say that one word in this girls ear while we were hooking up in college?
LOL
 
Latest CDC data:

Under age 55, there's been 1,453 COVID-19 deaths in the US, out of 232,463,605. That's 0.0006% of Americans < 55 that have died of COVID-19, or 1 in 159,988. More than twice as many, 3,274, have died of pneumonia, or 0.0014%.

99.9994% of Americans under age 55 have NOT died of COVID.

Only 3 people under age 15 have died from COVID-19, out of 60,885,444 kids under 15 in the country. That's 0.000005% or only 1 in 20 million.


View attachment 303036

In your stats you gotta make sure you include all of the fetuses currently brewing in the womb, and for good measure include some hominids. Everything possible to buff the denominator. And maybe include all the people that have lived over the last 5 years, and then you can write "over the last 5 years, only 0.0000000000012123% of the population died from COVID-19"

"Son, about 500,000 people each year die from a heart attack. There is a 0.15% chance you will die this year from a heart attack."
"But dad, I'm 5 years old. Do I have CAD?"
"Dammit son, don't argue with me. 0.15% is THE PERCENTAGE. NOW GO BRUSH YOUR TEETH."
 
In your stats you gotta make sure you include all of the fetuses currently brewing in the womb, and for good measure include some hominids. Everything possible to buff the denominator. And maybe include all the people that have lived over the last 5 years, and then you can write "over the last 5 years, only 0.0000000000012123% of the population died from COVID-19"

"Son, about 500,000 people each year die from a heart attack. There is a 0.15% chance you will die this year from a heart attack."
"But dad, I'm 5 years old. Do I have CAD?"
"Dammit son, don't argue with me. 0.15% is THE PERCENTAGE. NOW GO BRUSH YOUR TEETH."
😆
 
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At this point the continued lockdown is political. My state’s governor has no plan other than to just keep extending the lockdown. People who were following social distancing isolation orders and hospital workers wearing masks all day were still getting the virus, putting into question how much it all works. My hospitals volume is down significantly but luckily we are still getting great cases so my training is not being affected. Based on how the governor has handled this, I don’t plan on staying in this state post residency, and many business owners feel the same way.
My state’s one of the early re-openers, thank God. We’ll see how it goes.
 
I see that a complete shutdown of all immigration has been announced to block COVID-19 entry. I've already started to see people who previously were arguing for a never ending shutdown for Americans, arguing that an immigration shutdown is racist, unnecessary and that immigration should continue unchecked.

Which is it:

Are we all shutting down for science and safety, and without regard to politics?

Or do only Americans need to shutdown for 'science,' while immigration continues unchecked to advance political goals?

It’s the same as “TRUMP IS DOING NOTHING TO HELP NURSES GET PROPER PPE... NURSES ARE WORKING WITHOUT MASKS... TRUMP SUCKS!” Yet then they say “Good on 3M for sending out masks to other countries instead of supporting us here. Glad they stood up to Trump! Trump is a selfish a-hole to ask that the masks be directed to the US at the expense of other countries!” I can’t do the liberal logic. I can’t. It’s not logic actually - it’s pure, rabid irrationality.
 
Latest CDC COVID-19 data:

Only 3 under age 15 have died out of 60,885,444. That's 0.000005% or 1 in 20 million.

Under age 55, there's been 1,453 COVID-19 deaths in the US, out of 232,463,605. That's 0.0006% or 1 in 159,988 people. 99.9994% have not died.


View attachment 303036

I'm not making an argument to blindly extend lockdowns, but your percentages are guaranteed to be extremely low if you use the total population in these age groups as the denominator, which doesn't seem particularly useful seeing as how the entire country hasn't been infected.
 
seeing as how the entire country hasn't been infected.
That's the whole point. Six weeks ago it was, "THE WHOLE COUNTRY INCLUDING YOU WILL BE AFFECT LIKE ITALY SHUTDOWN! HOSPITALS COLLAPSING! 2.2 MILLION AMERICANS DEAD EVEN IF WE ACT NOW! OMG OMG OMG!"

Now it's, "Even though nothing near that happened and the 'entire country hasn't been infected' I'm going to imply we blindly extend lockdowns, while claiming to not favor blindly extending lockdowns"?

And even survival odds of 99.999% (or greater if you're not in NY/NJ) isn't enough for people to start gradually even peek out from hiding?

My advice for people of that mindset is to stay in hiding for a whole year. Cash out your 401K. Quit your job. Don't work. Pull your kids out of school. Do nothing but order delivered groceries for a whole year or longer, if needed. Do whatever it takes. "Stay safe" and in hiding forever, if you want. But let the people who want to be able to pay their mortgage, avoid bankruptcy, and hunger, do it. You don't have to leave your bedroom and get their germs. Ever.

Just because a mandatory lockdown ends doesn't take away your right to merrily stay quarantined, virus free, forever.
 
That's the whole point. Six weeks ago it was, "THE WHOLE COUNTRY INCLUDING YOU WILL BE AFFECT LIKE ITALY SHUTDOWN! HOSPITALS COLLAPSING! 2.2 MILLION AMERICANS DEAD EVEN IF WE ACT NOW! OMG OMG OMG!"

Now it's, "Even though nothing near that happened and the 'entire country hasn't been infected' I'm going to imply we blindly extend lockdowns, while claiming to not favor blindly extending lockdowns"?

And even survival odds of 99.999% (or greater if you're not in NY/NJ) isn't enough for people to start gradually even peek out from hiding?

My advice for people of that mindset is to stay in hiding for a whole year. Cash out your 401K. Quit your job. Don't work. Pull your kids out of school. Do nothing but order delivered groceries for a whole year or longer, if needed. Do whatever it takes. "Stay safe" and in hiding forever, if you want. But let the people who want to be able to pay their mortgage, avoid bankruptcy, and hunger, do it. You don't have to leave your bedroom and get their germs. Ever.

Just because a mandatory lockdown ends doesn't take away your right to merrily stay quarantined, virus free, forever.

I agree that the whole country likely doesn't need to be under total lockdown; my point was that it's not as minor a problem as you imply by using the whole population as the denominator. I think the far more frustrating aspect of this situation is that, in the weeks since this whole crisis started, there's hardly been any talk as to how we are going to move beyond lockdown/shelter-in-place, as if talking about such things will jinx the whole operation. As if the government thinks the general population will flock right back to doing things as if this had never happened without threat of legal action. Additionally, at least where I live, we've gone from "don't buy masks" to "shutdown nonessential business" to "shelter in place" to "have to wear masks in hospital" to "everyone has to wear a mask in public" over the span of 2 weeks, so I think the fear on the government's part is if they give even an inch that the whole operation is going to be undone; the public is already frustrated with the contradictory messages. I'm not saying it's right, but it's where we are right now.

Problem is, how many people does it take to not care about social distancing to undo what we've already done to this point? Have the past few weeks been one giant example of sunken-cost fallacy?
 
Problem is, how many people does it take to not care about social distancing to undo what we've already done to this point? Have the past few weeks been one giant example of sunken-cost fallacy?

Not that many...
LA just saw a huge spike in new cases over the past two reporting days.
I did read that some of those came from a backlog of tests that finally resulted.
We were seeing daily new cases in CA go slightly on the decline for the past week (indicating SIP orders working), but now these last two days makes me wonder. Hopefully it's a blip and not a trend.
 
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