How long should the lock down last?

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Renaissance Man said:
Hopefully you can last longer with her than your career did in Emergency Medicine.
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I see you have "Saving The World" under your profile pic, "Renaissance Man." I have to admit it's pretty cool to be able to chat with a real superhero and all. Which are you going to do first, save the world or pass the boards?
 
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I apologize for my low blow comment. I was pissed about being accused of "welcoming" all other forms of death, and the insinuation about my mother (who I haven't been able to see for almost 2 months because of my job). It had me seeing red. I will think before hitting "post". Sorry.
 
Renaissance Man said:
I apologize for my low blow comment. I was pissed about being accused of "welcoming" all other forms of death, and the insinuation about my mother (who I haven't been able to see for almost 2 months because of my job). It had me seeing red. I will think before hitting "post". Sorry.
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It's all good, man. We're family here. I shouldn't have brought out mom jokes. My bad.

I don't consider comments about my EM career length a "low blow." I've been open about it since my first, "I'm done!" post 10 years ago. You'd be surprised how many DMs I get from people saying, "I finally get you, bro. Help." And I do try to help. Technically, I'm still going to say I'm still "in" EM as long as ABEM keeps charging me $2,000 to stay certified so I can have the pleasure of paying $2,000 to stay sub-specialty certified 😆 .
 
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Not only does Detroit currently have enough ICU beds to fight COVID-19, they have more empty ICU beds than they've ever had in a normal non-COVID year. The mayor is begging Governor Whitmer to reopen elective hospital services and she's refusing, despite armed protestors storming the capital building demanding the state reopen.

"'The one thing I’m really calling on our governor and our hospitals and our doctors to work on is opening up the rest of the medical system,' [Mayor] Duggan said. 'Having 700 empty beds is something we never saw in this city in a normal year.'"
www.freep.com

Detroit mayor calls for governor and hospitals to allow more medical procedures

Detroit Mayor Mike Duggan urged the governor to let hospitals resume more medical procedures because he says people are missing out on care they need.
www.freep.com www.freep.com
 
Was getting a Trebek/Connery vibe from you two.



Birdstrike said:
It's all good, man. We're family here. I shouldn't have brought out mom jokes. My bad.

I don't consider comments about my EM career length a "low blow." I've been open about it since my first, "I'm done!" post 10 years ago. You'd be surprised how many DMs I get from people saying, "I finally get you, bro. Help." And I do try to help. Technically, I'm still going to say I'm still "in" EM as long as ABEM keeps charging me $2,000 to stay certified so I can have the pleasure of paying $2,000 to stay sub-specialty certified 😆 .
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Birdstrike said:
Not only does Detroit currently have enough ICU beds to fight COVID-19, they have more empty ICU beds than they've ever had in a normal non-COVID year. The mayor is begging Governor Whitmer to reopen elective hospital services and she's refusing, despite armed protestors storming the capital building demanding the state reopen.

"'The one thing I’m really calling on our governor and our hospitals and our doctors to work on is opening up the rest of the medical system,' [Mayor] Duggan said. 'Having 700 empty beds is something we never saw in this city in a normal year.'"
www.freep.com

Detroit mayor calls for governor and hospitals to allow more medical procedures

Detroit Mayor Mike Duggan urged the governor to let hospitals resume more medical procedures because he says people are missing out on care they need.
www.freep.com www.freep.com
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But... what if we didn't actually NEED those 700 empty beds?
I'm willing to bet that a good portion of those beds are occupied by "rocks" (Think: "House of God") that have now finally died.
 
RustedFox said:
But... what if we didn't actually NEED those 700 empty beds?
I'm willing to bet that a good portion of those beds are occupied by "rocks" (Think: "House of God") that have now finally died.
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Those greedy doctors killed 'em off just to make money.
 
Birdstrike said:
Not only does Detroit currently have enough ICU beds to fight COVID-19, they have more empty ICU beds than they've ever had in a normal non-COVID year. The mayor is begging Governor Whitmer to reopen elective hospital services and she's refusing, despite armed protestors storming the capital building demanding the state reopen.

"'The one thing I’m really calling on our governor and our hospitals and our doctors to work on is opening up the rest of the medical system,' [Mayor] Duggan said. 'Having 700 empty beds is something we never saw in this city in a normal year.'"
www.freep.com

Detroit mayor calls for governor and hospitals to allow more medical procedures

Detroit Mayor Mike Duggan urged the governor to let hospitals resume more medical procedures because he says people are missing out on care they need.
www.freep.com www.freep.com
Click to expand...

In the interest of accuracy there aren't 700 empty ICU beds, there are 700 empty hospital beds. There are 100 empty ICU beds per the article.
 
Maybe this isn't the right place for this, but I honestly hope that this COVID-crisis spurs America to "get lean".

No, you can't eat every meal out.
Yes, you can cook for your family using simple things.
No, "frozen dinners" do not count as "cooking for your family".

In a nation with an obesity (not overweight, mind you, but OBESITY) rate of 35%+
Change needs to happen.

Breakfast can be oatmeal.
Lunch can be a simple, home-made sandwich and a pickle or two.
Dinner can be a pork-chop and a salad. You'll wake up hungry enough to eat breakfast.

I just hate "fat and dumb".

"RustedFox Rants" in 5.... 4.... 3.... 2.... 1....
 
Restaurant with outdoor seating open in my state, bitchezzzzzz! So ready for a big, fat, juicy steak-a-layka!

Beaches, parks open, "work or home order" gone!

(Hotels open to NY/NJ tourists, too. :scared:, Lol)
 
Birdstrike said:
Restaurant with outdoor seating open in my state, bitchezzzzzz! So ready for a big, fat, juicy steak-a-layka!

Beaches, parks open, "work or home order" gone!

(Hotels open to NY/NJ tourists, too. :scared:, Lol)
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Not sure I love that hotel reopening part...
 
Been following this thread and other human med COVID threads for awhile because I think hearing from physicians on this matter is valuable. Meanwhile WA seems to want to kill any economy we had left. Guy didn't even have an inkling of how to try and reopen as of 2 weeks ago and still needed to create a task force. Released a "plan" today. No parameters for how we should determine to move from one phase to the other. Guy says we haven't "won this fight against the virus yet"... So basically perpetual "stay at home". Thank goodness I live within driving distance to ID they at least have a solid plan in place even if it ends up being a disaster.
 
RustedFox said:
Maybe this isn't the right place for this, but I honestly hope that this COVID-crisis spurs America to "get lean".

No, you can't eat every meal out.
Yes, you can cook for your family using simple things.
No, "frozen dinners" do not count as "cooking for your family".

In a nation with an obesity (not overweight, mind you, but OBESITY) rate of 35%+
Change needs to happen.

Breakfast can be oatmeal.
Lunch can be a simple, home-made sandwich and a pickle or two.
Dinner can be a pork-chop and a salad. You'll wake up hungry enough to eat breakfast.

I just hate "fat and dumb".

"RustedFox Rants" in 5.... 4.... 3.... 2.... 1....
Click to expand...

Unfortunately my friend, gluttony and debauchery will come back FULL FORCE after people feel safe.
Fatty Frank and Jumbo Jim will be coming out of their hoarding just in time to slop back greasy pork chicharrones.
 
MixedAnimals77 said:
Been following this thread and other human med COVID threads for awhile because I think hearing from physicians on this matter is valuable. Meanwhile WA seems to want to kill any economy we had left. Guy didn't even have an inkling of how to try and reopen as of 2 weeks ago and still needed to create a task force. Released a "plan" today. No parameters for how we should determine to move from one phase to the other. Guy says we haven't "won this fight against the virus yet"... So basically perpetual "stay at home". Thank goodness I live within driving distance to ID they at least have a solid plan in place even if it ends up being a disaster.
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Did you see the study I just posted from Iran?
 
MixedAnimals77 said:
Been following this thread and other human med COVID threads for awhile because I think hearing from physicians on this matter is valuable. Meanwhile WA seems to want to kill any economy we had left. Guy didn't even have an inkling of how to try and reopen as of 2 weeks ago and still needed to create a task force. Released a "plan" today. No parameters for how we should determine to move from one phase to the other. Guy says we haven't "won this fight against the virus yet"... So basically perpetual "stay at home". Thank goodness I live within driving distance to ID they at least have a solid plan in place even if it ends up being a disaster.
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Wash state is below avg in deaths and cases per capita. You should open.
 
Screen Shot 2020-05-02 at 10.23.29 AM.png


 
Birdstrike said:
View attachment 304923

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Ahh yes, because i also like to get my public health recommendations from Oceanographers. From the author's bio:

"I study mesoscale and submesoscale oceanic processes. I am particularly interested in the formation and evolution of coherent and recurrent vortices and their impact on other oceanic structures. This includes their interactions with coastal currents, basin-scale transports of heat and salt, and small scale tracer variance production. My work is both observational and numerical."

Birdstrike said:
May 1, 2020, CDC: "For people 65 years and older, current COVID-19 hospitalization rates are similar to those observed during comparable time points* during recent high severity influenza seasons."

View attachment 304927

www.cdc.gov

COVID Data Tracker Weekly Review

The week’s key data, narrative interpretations, & visualizations.
www.cdc.gov www.cdc.gov
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Yup, the lockdown was unnecessary. All this hubbub for basically a 2nd season of the flu. Nothing to see here folks.
 
turkeyjerky said:
Ahh yes, because i also like to get my public health recommendations from Oceanographers. From the author's bio:

"I study mesoscale and submesoscale oceanic processes. I am particularly interested in the formation and evolution of coherent and recurrent vortices and their impact on other oceanic structures. This includes their interactions with coastal currents, basin-scale transports of heat and salt, and small scale tracer variance production. My work is both observational and numerical."



Yup, the lockdown was unnecessary. All this hubbub for basically a 2nd season of the flu. Nothing to see here folks.
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In the first example, you’ve ad hominem attacked the authors and not their methods, facts or conclusions, which I presented without comment. By that logic any consultant you ever call can say, “Nothing you say can be right because you’re an ER doctor and not specialist in _____.”

In the second example you’ve put words in the mouth of the CDC, claiming they said in the announcement that their own recommendations for a shutdown were not needed. They never said that in their announcement which I posted without comment.
 
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I think I'm pretty centrist on the competing ideologies of this pandemic. I think the lockdown was initially necessary for the healthcare system to get its feet under itself, for industry to develop capacity to churn out adequate PPE, ventilators, and test kits, and for federal and state governments to develop some semblance of a plan to move forward. Now, I believe the time has arrived to begin slowly opening back up to avert any further economic damage done to our country. I think this is a reasonable perspective.

What I don't find reasonable is the cavalier attitude expressed by several healthcare professionals on this board. No matter what the R0 is or what the true infection fatality rate is, 60,000 or so Americans have died of this virus in a little over one month's time. It should be glaringly obvious that this health threat is significantly worse than even the most severe seasonal influenza despite whatever cherry picked statistics there are out there.
 
Torsion said:
What I don't find reasonable is the cavalier attitude expressed by several healthcare professionals on this board. No matter what the R0 is or what the true infection fatality rate is, 60,000 or so Americans have died of this virus in a little over one month's time. It should be glaringly obvious that this health threat is significantly worse than even the most severe seasonal influenza despite whatever cherry picked statistics there are out there.
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If you're saying this in response to the CDC release above, none of that is said in their update, at all. I don't know where you got that from.
 
Birdstrike said:
If you're saying this in response to the CDC release above, none of that is said in their update, at all. I don't know where you got that from.
Click to expand...

You highlighted a specific line comparing the hospitalization rate for 65+ being comparable to severe seasonal flu. Am I wrong to infer the purpose of this was to support an argument comparing COVID to seasonal flu? I don't think its a stretch to say that your postings, in aggregate, are written in support of a belief that this pandemic is not all its cracked up to be. If I'm wrong then I'm sorry for misinterpreting you.

I would agree that certain fear mongering in the national media has people more fearful than they should be, but the gravity of the situation should be obvious in the body count. From the guys in Bakersfield to members of this board, I've seen people use questionable data and questionable methodology to claim that this crisis is blown out of proportion and not much worse than the flu. 65,000+ American lives in a matter of a few weeks time would say otherwise.
 
Torsion said:
You highlighted a specific line comparing the hospitalization rate for 65+ being comparable to severe seasonal flu. Am I wrong to infer the purpose of this was to support an argument comparing COVID to seasonal flu? I don't think its a stretch to say that your postings, in aggregate, are written in support of a belief that this pandemic is not all its cracked up to be. If I'm wrong then I'm sorry for misinterpreting you.

I would agree that certain fear mongering in the national media has people more fearful than they should be, but the gravity of the situation should be obvious in the body count. From the guys in Bakersfield to members of this board, I've seen people use questionable data and questionable methodology to claim that this crisis is blown out of proportion and not much worse than the flu. 65,000+ American lives in a matter of a few weeks time would say otherwise.
Click to expand...

I don't think it's cavalier. We know this virus disproportionally kills people > 80 and those who have medical problems. It would have been far simpler to divert resources to protect and isolate the proportion of the population at risk, than to attempt to quarantine 100% of the population while destroying the economy. Nursing homes (where this virus kills the most) should have been forced adopt stringent employee testing/tracing and quarantine measures. All other elderly, obese, and sick people should have been advised to self isolate indefinitely. We could have set up programs for meals/essential delivery as well as economic assistance for the elderly who needed it.

Would some elderly or sick people not listen to guidelines and go out and get infected? Yes of course, but it is their right to do that once given the data.

Americans have been so willing to give up basic rights and freedoms it's shocking.
 
Torsion said:
You highlighted a specific line comparing the hospitalization rate for 65+ being comparable to severe seasonal flu. Am I wrong to infer the purpose of this was to support an argument comparing COVID to seasonal flu?
Click to expand...
There was no purpose or intended inference. I simply posted the information without comment. Do with it, what you will.
 
CDC 5/1/20 : "For children (0-17 years), COVID-19 hospitalization rates are much lower than influenza hospitalization rates during recent influenza seasons."

Screen Shot 2020-05-02 at 2.51.56 PM.png


www.cdc.gov

COVID Data Tracker Weekly Review

The week’s key data, narrative interpretations, & visualizations.
www.cdc.gov www.cdc.gov
 
GeneralVeers said:
I don't think it's cavalier. We know this virus disproportionally kills people > 80 and those who have medical problems. It would have been far simpler to divert resources to protect and isolate the proportion of the population at risk, than to attempt to quarantine 100% of the population while destroying the economy. Nursing homes (where this virus kills the most) should have been forced adopt stringent employee testing/tracing and quarantine measures. All other elderly, obese, and sick people should have been advised to self isolate indefinitely. We could have set up programs for meals/essential delivery as well as economic assistance for the eld
Would some elderly or sick people not listen to guidelines and go out and get infected? Yes of course, but it is their right to do that once given the data.

Americans have been so willing to give up basic rights and freedoms it's shocking.
Click to expand...

I really do respect your attitude towards this (and tend to agree that this would have been an ideal approach), however I don't think it's feasible, for a few reasons:
--we're not equipped with, and disinclined to create, the type of social-support network necessary to allow for targeted quarantining of those affected and at risk
--we lacked the necessary equipment (testing, PPE) to allow for stringent healthcare and nursing home testing/tracing/isolation.
--As a populace, we would cumulatively freak out about the overall case and fatality numbers and quickly switch gears. There would be plenty of sob stories about peoples parents/grandparents dying and the rare cases of younger people dying would garner quite a bit of news coverage
--Old people are a politically powerful demographic and politicians would get skewered for abandoning them. Moreover, the elderly are (despite anecdotes disputing it) overall more fearful of their health and anxious about this than younger generations

I highly doubt we'll ever be able to institute a containment based strategy here. The more interesting question is whether we'll make the necessary arrangements to allow for a mitigation-based approach or whether we'll just default to intermittent lockdowns. Since it appears the curve has flattened across the country (eg new cases numbers are steady), and, in my opinion, containment measures are not going to be created, it's unnecessary to wait until cases get to zero to begin lifting the current restrictions.
 
"And what America needs most right now, she said, isn’t this drumbeat of testing, testing, testing, because there will never be enough superfast, super-reliable tests to determine on the spot who can safely enter a crowded workplace or venue, which is the scenario that some people seem to have in mind. America needs good information, from many rigorously designed studies, about the prevalence and deadliness of coronavirus infections in given subsets of people, so that governors and mayors can develop rules for social distancing and reopening that are sensible, sustainable and tailored to the situation at hand."

Opinion | She Predicted the Coronavirus. What Does She Foresee Next?
 
GeneralVeers said:
I don't think it's cavalier. We know this virus disproportionally kills people > 80 and those who have medical problems. It would have been far simpler to divert resources to protect and isolate the proportion of the population at risk, than to attempt to quarantine 100% of the population while destroying the economy. Nursing homes (where this virus kills the most) should have been forced adopt stringent employee testing/tracing and quarantine measures. All other elderly, obese, and sick people should have been advised to self isolate indefinitely. We could have set up programs for meals/essential delivery as well as economic assistance for the elderly who needed it.

Would some elderly or sick people not listen to guidelines and go out and get infected? Yes of course, but it is their right to do that once given the data.

Americans have been so willing to give up basic rights and freedoms it's shocking.
Click to expand...


How exactly do these old and sick people self isolate? Where do they do this? Many of them were already very isolated in nursing homes and we know how that went. It’s not like they were going to Disneyland and bars and Costco.
 
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The Democratic governors have no incentive to re-open anything. Benefits for them to keep things closed as long as possible:

1. They can't be accused of "not doing everything to save lives"
2. They won't be blamed for a second spike in infections
3. The more ego-maniacal ones get to exercise broad control over people
4. It's an excuse to push through other pet projects, like environmental and welfare programs that are unrelated
5. A bad economy makes it less likely for Trump to win

They will only open things up when there is so much public pressure and discontent that the situation is untenable.
 
GeneralVeers said:
The Democratic governors have no incentive to re-open anything. Benefits for them to keep things closed as long as possible:

1. They can't be accused of "not doing everything to save lives"
2. They won't be blamed for a second spike in infections
3. The more ego-maniacal ones get to exercise broad control over people
4. It's an excuse to push through other pet projects, like environmental and welfare programs that are unrelated
5. A bad economy makes it less likely for Trump to win

They will only open things up when there is so much public pressure and discontent that the situation is untenable.
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???

Sometimes I don't know what to make of your posts either.
 
GeneralVeers said:
This article perfectly sums up the situation and how we get out of it:

thehill.com

How to reopen society using medical science and logic

Total isolation must now end to limit the enormous harms accumulating from sacrificing vital health care and imposing economic lockdown.
thehill.com thehill.com
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I think that dude who wrote that article was saying a few months ago that this isn't all that harmful of a virus. At least he's consistent.

I agree with some of the article, however opening schools is an area of concern. We are not keeping them home because of risk of disease to kids; rather we keep them home because they spread the disease like wildfire spreads through dry chaparral in California and Arizona. Plus the end of the school year is just about over anyway. I would rather keep them home now, and open school 4-6 weeks earlier to make up for lost time. Like in mid July.
 
thegenius said:
I think that dude who wrote that article was saying a few months ago that this isn't all that harmful of a virus. At least he's consistent.

I agree with some of the article, however opening schools is an area of concern. We are not keeping them home because of risk of disease to kids; rather we keep them home because they spread the disease like wildfire spreads through dry chaparral in California and Arizona. Plus the end of the school year is just about over anyway. I would rather keep them home now, and open school 4-6 weeks earlier to make up for lost time. Like in mid July.
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There's talk in my state about doing just that
 
VA Hopeful Dr said:
There's talk in my state about doing just that
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That might not be bad, as I recall July 2006, when there were 18 days over 100. I had a season's pass to an amusement park, and couldn't do it. The kids in the AC might be just right.

Unless the AC is off, so as to not propagate the 'Rona.
 
thegenius said:
Interesting in their "bad models" that actual deaths >> modeled deaths. Birdstrike, why can't they get their modeling correct?!?! LOL
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Let's face it. None of these cats trying to predict anything about this thing, have right about anything. Next time, let's put some numbers up on a wall and while blindfolded throw a cat turd at the wall and see where it sticks. We might get closer that way.
 
Dude just look at these:

projected cases 5-1.jpg


projected deaths 5-1.jpg


Projected cases they seemed to do alright, the projected deaths is all over the place.

For some reason I don't believe that relatively steep death curve off to the right is actually going to happen. I expect it to be flat for the next 6-12 months.
 
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