How long should the lock down last?

[EBME Tech]

---

Members do not see this ad.

Correct!

Also the UK did not enforce lockdown in its entirety, unlike many other European countries where police would send people home if they where out in public for any other reason than essential travel or walking a dog, in the UK many people still met up.

 

[EBME Tech]

you do gloss over some finer points

Being from the UK i can tell you they ran a horse racing festival with 60k people just as things really were kicking off. It was a cess pit and likely the cause of lots of their deaths. Also Liverpool played Ath Madrid at home and allowed 1000s of fans to travel to it from Spain on March 22nd again just at exactly the wrong time.

So their lockdown wasnt really the longest and hardest of countries.
Didnt the chinese did send the army into wuhan? That sounds pretty hard to me

Correct!

Also the UK did not enforce lockdown in its entirety, unlike many other European countries where police would send people home if they where out in public for any other reason than essential travel or walking a dog, in the UK many people still met up.

 

[Birdstrike]

Here is the other thing. Even if lockdowns did work, the fact that covid is only as deadly as a seasonal flu still means lockdowns are not worth it. Look at the data: https://pbs.twimg.com/media/EccBlJ3WAAAo3Ql?format=png&name=900x900

I'm sympathetic to your point. But I typed in the link address on your chart and there is no data after 2017 and none since COVID-19 came into existence, for comparison. NCHS Data Visualization Gallery - Mortality Trends in the United States

 

[Birdstrike]

culture is also to blame. ...hard to focus on losing weight if ...

I know a thing or two about working 70 hrs per week at minimum wage. I also know a thing or two about being overweight/obese. By the end of residency I was up to a BMI of 32. The reason was simple: I rarely exercised, and I ate and drank as much of whatever I wanted, whenever I wanted. My BMI is now 20 and last week ran my best 5K time ever (19:47), placed 11 out of 265 and #1 Masters division (all runners over 40). Why? I finally decided to commit to limiting what I eat and drink, and exercising daily. It wasn't easy to do. In fact, it was hard to get and is hard to keep, like most things worth having. It took commitment, hard work and dedication. But it was a very, very simple thing to do. Move little, eat much, be fat. Move much, eat little, be thin.

Find out what it costs to get what you want and pay the cost. Some are willing to do it. Some aren't. And no, life isn't fair.

 

[wamcp]

I'm sympathetic to your point. But I typed in the link address on your chart and there is no data after 2017 and none since COVID-19 came into existence, for comparison. NCHS Data Visualization Gallery - Mortality Trends in the United States

Other examples of flu killing more than covid, as recent as 2017-2018, yet no one even thought of proposing lockdowns to contain the flu:


France - deaths per months 1980-2020
In January 2017 more people died than in April 2020.

https://pbs.twimg.com/media/EcqsxcNWAAE6vPY?format=png&name=large

Germany - deaths per months 1990-2020
In 2017/18, Germany was faced with the deadliest flu season of the last 30 years with more deaNobody took notice. Nobody cared the way do with covid.

https://pbs.twimg.com/media/EcqtEh2XoAAUe0Y?format=png&name=large

 

[wamcp]

Correct!

Also the UK did not enforce lockdown in its entirety, unlike many other European countries where police would send people home if they where out in public for any other reason than essential travel or walking a dog, in the UK many people still met up.

So why still, is the UK worse off than sweden with no lockdown? Because of one mass gathering event? Why is Belgium worse than sweden?
Or maybe the correct answer is that people’s behavior with mask wearing and distancing remain the same whether or not businesses shutdown?

I mean....What mental gymnastics shall you propose to explain Chile vs Brazil then....the best lockdown failure example...

Brazil had no real lockdown.

Chile meanwhile has THE HARSHEST lockdown measures implemented of anyone, with penalties of up to 5 YEARS IN PRISON for violating curfew or quarantine.

Chile deaths per million: 354
Brazil deaths per million: 331

Chile continues to perform WORSE than Brazil, especially considering the fact that their economy is in even worse shape for forcing businesses to collapse and shortages of even food occurred.

I thought lockdowns work though?

COVID-19 Data Explorer

Explore global data on COVID-19.

ourworldindata.org

Chile tightens lockdowns as coronavirus cases surpass 200,000

New measures include increased policing, and penalties of up to 5 years in prison for violating curfew or quarantine.

www.aljazeera.com

Protests Over Food Shortages Erupt in Chile Amid Virus Lockdown

Chile risks the return of the social unrest that wracked the nation late last year following protests against food shortages in the capital Santiago amid a tight lockdown aimed at slowing the spread of the coronavirus.

www.bloomberg.com

 

[thegenius]

Correct!

Also the UK did not enforce lockdown in its entirety, unlike many other European countries where police would send people home if they where out in public for any other reason than essential travel or walking a dog, in the UK many people still met up.

And that’s why their daily new infection rate didn’t go down as quickly as other countries. But.....it is still going down.

 

[Siggy]

Remember when this thread was all, "Whar deaths, whar?"

Here's the current 7 day trend line for the US, Florida, and Texas... looks like we've found them. Looks like the people who were saying, "They're coming, but deaths are weeks delayed because that's how this virus worked" ended up being right. But brews before bros....

 

[Siggy]

Yup, that's what happens when people to go parties and the beach and don't care about disease transmission.

Why do you hate freedom? /s

 

[xaelia]

Not just “deaths lag hospitalizations lag cases”, but also reporting.

There are likely hundreds of unreported deaths from COVID from the last couple weeks in AZ alone.

Those who have refused to acknowledge the seriousness of rising case counts, or trying to explain away the positive tests as incidental or clinically unimportant, are contributing to its spead.

 

[carbonizedeyesockets]

Brazil had no real lockdown.

Chile meanwhile has THE HARSHEST lockdown measures implemented of anyone, with penalties of up to 5 YEARS IN PRISON for violating curfew or quarantine.

Chile deaths per million: 354
Brazil deaths per million: 331

Chile continues to perform WORSE than Brazil, especially considering the fact that their economy is in even worse shape for forcing businesses to collapse and shortages of even food occurred.

I thought lockdowns work though?

I I'd trust Chile's numbers much more than Brazil's. Chile is much wealthier and probably better able to devote resources and track cases than Brazil. Chile is also less corrupt and probably much more likely to accurately report their actual case numbers. My assumption is that Brazil's numbers are far worse than reported. It is not an apples to apples comparison.

 

[Birdstrike]

Remember when this thread was all, "Whar deaths, whar?"

Here's the current 7 day trend line for the US, Florida, and Texas... looks like we've found them. Looks like the people who were saying, "They're coming, but deaths are weeks delayed because that's how this virus worked" ended up being right. But brews before bros....

Not just “deaths lag hospitalizations lag cases”, but also reporting.

Yes, unfortunately, the death curves are finally starting to trend up (somewhat) along with the case curves. Now what?

 

[GeneralVeers]

Yes, unfortunately, the death curves are finally starting to trend up (somewhat) along with the case curves. Now what?

Nothing. We expected this. Surprise, surprise locking down for 8 weeks didn't get rid of the virus. I'm glad the numbers are going back up now, instead of in Oct/Nov. The first wave took out the most vulnerable so it's doubtful deaths can match the peaks in early April/May.

 

[GeneralVeers]

So why still, is the UK worse off than sweden with no lockdown? Because of one mass gathering event? Why is Belgium worse than sweden?
Or maybe the correct answer is that people’s behavior with mask wearing and distancing remain the same whether or not businesses shutdown?

I mean....What mental gymnastics shall you propose to explain Chile vs Brazil then....the best lockdown failure example...

Brazil had no real lockdown.

Chile meanwhile has THE HARSHEST lockdown measures implemented of anyone, with penalties of up to 5 YEARS IN PRISON for violating curfew or quarantine.

Chile deaths per million: 354
Brazil deaths per million: 331

Chile continues to perform WORSE than Brazil, especially considering the fact that their economy is in even worse shape for forcing businesses to collapse and shortages of even food occurred.

I thought lockdowns work though?

COVID-19 Data Explorer

Explore global data on COVID-19.

ourworldindata.org

Chile tightens lockdowns as coronavirus cases surpass 200,000

New measures include increased policing, and penalties of up to 5 years in prison for violating curfew or quarantine.

www.aljazeera.com

Protests Over Food Shortages Erupt in Chile Amid Virus Lockdown

Chile risks the return of the social unrest that wracked the nation late last year following protests against food shortages in the capital Santiago amid a tight lockdown aimed at slowing the spread of the coronavirus.

www.bloomberg.com

It's interesting that there is no consistent correlation with countries (and US States) who did varying degrees of lockdowns and the death rate. If lockdowns really worked, there should be a clear correlation between the length/strictness of the lockdowns and the death reate.

 

[xaelia]

It's interesting that there is no consistent correlation with countries (and US States) who did varying degrees of lockdowns and the death rate.

It’s almost like the local prevalence of infection wasn’t homogeneously distributed at the time of lockdown.

 

[GeneralVeers]

It’s almost like the local prevalence of infection wasn’t homogeneously distributed at the time of lockdown.

Right. But we had to do one-size-fits-all.

 

[xaelia]

Right. But we had to do one-size-fits-all.

Yes - that was an error on the side of greater caution, for sure. Lack of testing really hamstrung the ability to determine the true prevalence around the country. For example, right now, should we lock down Rhode Island because there is a flare up in Arizona? Or lock down rural northern CA because of the flare up in southern CA? Obviously not. But those places where the population are a threat to each other definitely need substantially curtailed movement and contact.

 

[Siggy]

Nothing. We expected this. Surprise, surprise locking down for 8 weeks didn't get rid of the virus. I'm glad the numbers are going back up now, instead of in Oct/Nov. The first wave took out the most vulnerable so it's doubtful deaths can match the peaks in early April/May.

A week ago this thread was celebrating the fact that the number of cases were going up and the mortality rate was staying low while discounting the people in the units saying, "People linger for a few weeks on vents before they die." I can go back and get some links if you'd like.

 

[Siggy]

Right. But we had to do one-size-fits-all.

Yes.. because the Government put its head in the sand and said that SARS-CoV-2 was going to magically go away... and didn't ramp up testing on a per capita basis. Hence why it's longer than a week to get results back, which defeats the purpose of test and trace. The government was decrying testing because it was going to make the numbers look bad.

It's really hard to target lockdowns and resources if you don't know where the hot spots are because we (the US via our government) didn't want to invest in the 'military intelligence' to help us fight this 'war.' The lockdown was meant to ramp up testing, tracing, and be able to localize further restrictions. We, as a country, refused to do that part, refused to open in a controlled manner, and now we get to pay the piper for it.

 

[GeneralVeers]

A week ago this thread was celebrating the fact that the number of cases were going up and the mortality rate was staying low while discounting the people in the units saying, "People linger for a few weeks on vents before they die." I can go back and get some links if you'd like.

I think i was on record saying we'd have more infections whenever we re-opened.

 

[VA Hopeful Dr]

Yes.. because the Government put its head in the sand and said that SARS-CoV-2 was going to magically go away... and didn't ramp up testing on a per capita basis. Hence why it's longer than a week to get results back, which defeats the purpose of test and trace. The government was decrying testing because it was going to make the numbers look bad.

It's really hard to target lockdowns and resources if you don't know where the hot spots are because we (the US via our government) didn't want to invest in the 'military intelligence' to help us fight this 'war.' The lockdown was meant to ramp up testing, tracing, and be able to localize further restrictions. We, as a country, refused to do that part, refused to open in a controlled manner, and now we get to pay the piper for it.

I don't get this part. I'm in SC which is a great combo of hot spot and very bare bones public health.

Despite that, our testing is coming back in about 36 hours. If my bass-ackwards state can do that I don't understand why everyone can't.

 

[Siggy]

I don't get this part. I'm in SC which is a great combo of hot spot and very bare bones public health.

Despite that, our testing is coming back in about 36 hours. If my bass-ackwards state can do that I don't understand why everyone can't.

In my hospital, it's a few days. I'm hearing week plus for the public testing locations. Hospitals should be prioritized over public testing, however for test and trace programs to be useful then public testing needs a useful timeline for test results to be returned.

 

[thegenius]

Yes, unfortunately, the death curves are finally starting to trend up (somewhat) along with the case curves. Now what?

We wait.

And we hope that ‘Mericans at some point decide to take this virus more seriously and do some relatively simple things to mitigate its spread. Similar to whats being done in just about every other country who also had an initial wave....and now are dealing with small daily case counts.

we cannot prevent all morbidity and mortality. And we can do a better job by doing some simple things.

 

[thegenius]

Nothing. We expected this. Surprise, surprise locking down for 8 weeks didn't get rid of the virus. I'm glad the numbers are going back up now, instead of in Oct/Nov. The first wave took out the most vulnerable so it's doubtful deaths can match the peaks in early April/May.

Man....you are a sick human being. I’m surprised you find enjoyment helping sick people.

 

[Siggy]

I think i was on record saying we'd have more infections whenever we re-opened.

I'm not going to mention names, just quote posts and links that lead back to this thread.

I personally don't care about the number of infected except more infected will lead to more deaths until we have an effective treatment protocol (seeing the results of high dose steroids in severe SARS-CoV-2 which resulted in rapid improvement in a patient with an almost competely whited out chest x-ray and fall in CRP over the following 48 hours as backed up from a couple of published case series makes me hopeful) and making sure that the number of deaths doesn't lead to overwhelmed ICUs. My ICU is supposed to be 22 beds between 2 units. We're at 40-50 patients. ~15 of those are COVID, but they're the straw breaking the camels back. The floors are worse... which makes it hard to safely move people out of the ICU. There are definitely patients that I would have liked to T-Piece, but they're in a med/surg room on a vent hooked to a portable monitor with no central monitoring station. That makes it hard to move patients along.

I'll also admit that I have observation bias. I'm simply not seeing the patients who are sent home from the ED or from the floor because, thankfully, they don't need me.


At least we're finally staffed with 2 attendings. My first post fellowship shift was 50 patients with 2 novice NPs. Every note I write now has an addendum that we're over 200% ICU capacity and provided care in line with crisis surge capacity and citing the ACCP critical care surge capacity paper from 2014.

"-U.S. COVID deaths are down
-Unemployment is plummeting
-CHOP has been dismantled
-Jefferey Epstein's pimp has been arrested "
7/2/20 How long should the lock down last?

" It says that on June 26 some states reported probable deaths which is why there looks like theres an increase in death rates starting june 26. What does this even mean? Either way, deaths are currently decreasing. I'm well aware that this could change though "
6/29/20 How long should the lock down last?

"That's interesting. It was relevant to share the U.S. death curve in March to induce mass panic when it was going up, but when it's trending down it's "ridiculous" to discuss and irrelevant. If we get a vaccine and the death curve goes to zero, will that be ridiculous to mention, too?

Remember everybody, you can't say anything about COVID-19 unless it's panic inducing, even if true. Only panic porn is allowed. "

6/29/2020 How long should the lock down last?''

Link to declining US death rates on World -o-meters as of 7/6/20 (well into the spike of cases)

How long should the lock down last?

interesting studies immunologically but hard to say what they mean clinically. Does having heterologous immunity to covid make you immune? Give you a less severe course? Make you more reactive with a more ARDSy picture? Hard to say. I agree, it's "Hard to say." Although, if I had to battle a...

forums.studentdoctor.net

A response to the picture of declining death rates despite the spiking cases on 7/6/20
" Exactly. Our graph mirrors the graphs of every other Western country, including ones that shut down more things, ones that shut down less. I've posted data repeatedly about Sweden, and non-lockdown U.S. states, but it's always ignored, or drowned out be a sea of anecdotal evidence. "

How long should the lock down last?

interesting studies immunologically but hard to say what they mean clinically. Does having heterologous immunity to covid make you immune? Give you a less severe course? Make you more reactive with a more ARDSy picture? Hard to say. I agree, it's "Hard to say." Although, if I had to battle a...

forums.studentdoctor.net

 

[Birdstrike]

Man....you are a sick human being. I’m surprised you find enjoyment helping sick people.

I don't think he was saying it was good that the virus took out the most vulnerable, but that since it did, that fact may drive the cases fatality rate down since a higher proportion of those remaining are more able to fight it off.

 

[GeneralVeers]

Thrgenius...you need to chill a bit.

 

[Birdstrike]

I'm not going to mention names, just quote posts and links that lead back to this thread.

I personally don't care about the number of infected except more infected will lead to more deaths until we have an effective treatment protocol (seeing the results of high dose steroids in severe SARS-CoV-2 which resulted in rapid improvement in a patient with an almost competely whited out chest x-ray and fall in CRP over the following 48 hours as backed up from a couple of published case series makes me hopeful) and making sure that the number of deaths doesn't lead to overwhelmed ICUs. My ICU is supposed to be 22 beds between 2 units. We're at 40-50 patients. ~15 of those are COVID, but they're the straw breaking the camels back. The floors are worse... which makes it hard to safely move people out of the ICU. There are definitely patients that I would have liked to T-Piece, but they're in a med/surg room on a vent hooked to a portable monitor with no central monitoring station. That makes it hard to move patients along.

I'll also admit that I have observation bias. I'm simply not seeing the patients who are sent home from the ED or from the floor because, thankfully, they don't need me.


At least we're finally staffed with 2 attendings. My first post fellowship shift was 50 patients with 2 novice NPs. Every note I write now has an addendum that we're over 200% ICU capacity and provided care in line with crisis surge capacity and citing the ACCP critical care surge capacity paper from 2014.

"-U.S. COVID deaths are down
-Unemployment is plummeting
-CHOP has been dismantled
-Jefferey Epstein's pimp has been arrested "
7/2/20 How long should the lock down last?

" It says that on June 26 some states reported probable deaths which is why there looks like theres an increase in death rates starting june 26. What does this even mean? Either way, deaths are currently decreasing. I'm well aware that this could change though "
6/29/20 How long should the lock down last?

"That's interesting. It was relevant to share the U.S. death curve in March to induce mass panic when it was going up, but when it's trending down it's "ridiculous" to discuss and irrelevant. If we get a vaccine and the death curve goes to zero, will that be ridiculous to mention, too?

Remember everybody, you can't say anything about COVID-19 unless it's panic inducing, even if true. Only panic porn is allowed. "

6/29/2020 How long should the lock down last?''

Link to declining US death rates on World -o-meters as of 7/6/20 (well into the spike of cases)

How long should the lock down last?

interesting studies immunologically but hard to say what they mean clinically. Does having heterologous immunity to covid make you immune? Give you a less severe course? Make you more reactive with a more ARDSy picture? Hard to say. I agree, it's "Hard to say." Although, if I had to battle a...

forums.studentdoctor.net

A response to the picture of declining death rates despite the spiking cases on 7/6/20
" Exactly. Our graph mirrors the graphs of every other Western country, including ones that shut down more things, ones that shut down less. I've posted data repeatedly about Sweden, and non-lockdown U.S. states, but it's always ignored, or drowned out be a sea of anecdotal evidence. "

How long should the lock down last?

interesting studies immunologically but hard to say what they mean clinically. Does having heterologous immunity to covid make you immune? Give you a less severe course? Make you more reactive with a more ARDSy picture? Hard to say. I agree, it's "Hard to say." Although, if I had to battle a...

forums.studentdoctor.net

Of these quotes that are mine, all are correct reflections of the stats at the time, and remain so. Maybe you'd prefer I post fake statistics, or alter them? I don't know. Or maybe you thought a snapshot in time predicts the future? Hmm...I don't know.

You know you can check these statistics yourself, right? You don't have to go back and stalk my post history to see what the stats were on any day😆 , but you can. I'm okay with it.

But, you're right. COVID sucks, and it’s going to suck real bad for a while. I don’t think us quoting-jousting each other is going to change that. But it's all good.

 

[MediMike]

Thank you for being such a dedicated reader of my content. I'm flattered. And thank you for quoting stats that were correct reflections of the stats at the time, and remain so. Maybe you'd prefer I post fake statistics, or alter them? I don't know. Or maybe you though a snapshot in time predicts the future? Hmm...I don't know.

You know you can check these statistics yourself, right? You don't have to go back and stalk my post history to see what the stats were on any day. But I'm happy to be there for ya.

C'mon man. Whether it's a worthwhile point or not the poster was demonstrating the condescending attitude demonstrated by others on this board when people brought up their concerns about death rates rising in the near future.

 

[AMEHigh]

I still don't understand how educated people think that letting the virus run through everyone without any attempts to curtail it's spread is good for the health and economy of this country. Thousands of people are going to be left unable to work temporarily and possibly permanently. And we all know that companies are going to be quick to let people go if they're sick, then those people are going to be unemployed. We do not see these prolonged symptoms with the flu or other respiratory viruses in general.

"Nearly 88% of patients reported persistent intense fatigue, while almost three out of four had continued shortness of breath. Other enduring symptoms included, among other things, chest pressure (45% of patients), headache and muscle ache (40% and 36%, respectively), elevated pulse (30%), and dizziness (29%). Perhaps the most startling finding was that 85% of the surveyed patients considered themselves healthy prior to getting Covid-19. One or more months after getting the disease, only 6% consider themselves healthy."

"Regardless of the possible reasons for some “mildly” ill patients being symptomatic long-term, the Dutch study confirms what has been known anecdotally about long-haulers. For this group, recovery is a grueling process. Globally, as the the numbers of people infected with the novel coronavirus increases, so will the number of people with (temporary) disabilities, in spite of their “mildly symptomatic” status."

Report Suggests Some ‘Mildly Symptomatic’ Covid-19 Patients Endure Serious Long-Term Effects

 

[Siggy]

C'mon man. Whether it's a worthwhile point or not the poster was demonstrating the condescending attitude demonstrated by others on this board when people brought up their concerns about death rates rising in the near future.

That's the entire point. A few of us were going, "Yes, the death rates aren't going up... but they lag behind cases. The deaths lagged behind the first part of wave one... they're going to lag behind the second part of wave one, this is the nature of the current natural course of SARS-CoV-2.

...and what we got in response was, "no deaths yet, so open everything up!"

 

[Birdstrike]

C'mon man. Whether it's a worthwhile point or not the poster was demonstrating the condescending attitude demonstrated by others on this board when people brought up their concerns about death rates rising in the near future.

Let's be honest. This is the internet. The tone is not going to change.

Cases are going to go up and down. Deaths are going to go up and down, repeat, repeat, repeat, until there's a vaccine or most people have had it. No amount of moral preening is going to change that.

Being the most "pro-social distancing" on the Internet isn’t going to change that. Someone doing a celebration dance because they got the deaths they wanted so they could win the internet for the day, isn’t going to change that.

If it makes people feel better, fine. But the CDC has made their recommendations. States and cities are making adjustments based on current situations.

You and I can choose to where a mask and follow other precautions. What else is there to do at this point?

 

[Birdstrike]

That's the entire point. A few of us were going, "Yes, the death rates aren't going up... but they lag behind cases. The deaths lagged behind the first part of wave one... they're going to lag behind the second part of wave one, this is the nature of the current natural course of SARS-CoV-2.

...and what we got in response was, "no deaths yet, so open everything up!"

Congrats, deaths going up allowed you to win the internet for the day. Meanwhile, that hasn't prevented them from continuing to go up. I hope they don't, but they might. Or they might not. Maybe...wear a mask and wash your hands?

I mean, seriously. "Deaths up, deaths down....cases up, cases down" repeat. What difference does all of us sparring on SDN about it make?

 

[VA Hopeful Dr]

I'm not going to mention names, just quote posts and links that lead back to this thread.

I personally don't care about the number of infected except more infected will lead to more deaths until we have an effective treatment protocol (seeing the results of high dose steroids in severe SARS-CoV-2 which resulted in rapid improvement in a patient with an almost competely whited out chest x-ray and fall in CRP over the following 48 hours as backed up from a couple of published case series makes me hopeful) and making sure that the number of deaths doesn't lead to overwhelmed ICUs. My ICU is supposed to be 22 beds between 2 units. We're at 40-50 patients. ~15 of those are COVID, but they're the straw breaking the camels back. The floors are worse... which makes it hard to safely move people out of the ICU. There are definitely patients that I would have liked to T-Piece, but they're in a med/surg room on a vent hooked to a portable monitor with no central monitoring station. That makes it hard to move patients along.

I'll also admit that I have observation bias. I'm simply not seeing the patients who are sent home from the ED or from the floor because, thankfully, they don't need me.


At least we're finally staffed with 2 attendings. My first post fellowship shift was 50 patients with 2 novice NPs. Every note I write now has an addendum that we're over 200% ICU capacity and provided care in line with crisis surge capacity and citing the ACCP critical care surge capacity paper from 2014.

"-U.S. COVID deaths are down
-Unemployment is plummeting
-CHOP has been dismantled
-Jefferey Epstein's pimp has been arrested "
7/2/20 How long should the lock down last?

" It says that on June 26 some states reported probable deaths which is why there looks like theres an increase in death rates starting june 26. What does this even mean? Either way, deaths are currently decreasing. I'm well aware that this could change though "
6/29/20 How long should the lock down last?

"That's interesting. It was relevant to share the U.S. death curve in March to induce mass panic when it was going up, but when it's trending down it's "ridiculous" to discuss and irrelevant. If we get a vaccine and the death curve goes to zero, will that be ridiculous to mention, too?

Remember everybody, you can't say anything about COVID-19 unless it's panic inducing, even if true. Only panic porn is allowed. "

6/29/2020 How long should the lock down last?''

Link to declining US death rates on World -o-meters as of 7/6/20 (well into the spike of cases)

How long should the lock down last?

interesting studies immunologically but hard to say what they mean clinically. Does having heterologous immunity to covid make you immune? Give you a less severe course? Make you more reactive with a more ARDSy picture? Hard to say. I agree, it's "Hard to say." Although, if I had to battle a...

forums.studentdoctor.net

A response to the picture of declining death rates despite the spiking cases on 7/6/20
" Exactly. Our graph mirrors the graphs of every other Western country, including ones that shut down more things, ones that shut down less. I've posted data repeatedly about Sweden, and non-lockdown U.S. states, but it's always ignored, or drowned out be a sea of anecdotal evidence. "

How long should the lock down last?

interesting studies immunologically but hard to say what they mean clinically. Does having heterologous immunity to covid make you immune? Give you a less severe course? Make you more reactive with a more ARDSy picture? Hard to say. I agree, it's "Hard to say." Although, if I had to battle a...

forums.studentdoctor.net

So you have noticed that decaron helps in the ICU setting?

 

[Birdstrike]

I still don't understand how educated people think that letting the virus run through everyone without any attempts to curtail it's spread is good for the health and economy of this country.

I don’t think the majority of educated people think this is good. However, I sense that same majority feels that taking some precautions, while avoiding drastic shutdowns, is least crappy of options, at this point.

 

[WilcoWorld]

In my hospital, it's a few days. I'm hearing week plus for the public testing locations. Hospitals should be prioritized over public testing, however for test and trace programs to be useful then public testing needs a useful timeline for test results to be returned.

WTF? We're as fast as 6 hours round these parts.

 

[Siggy]

So you have noticed that decaron helps in the ICU setting?

It's hard to say with decadron because my fellowship program has been using Decadron 4mg IV q8 since March as recommended from EMCrit/IBCC. So we don't really have a control to compare it to. The mechanism (cytokine storm) makes sense to use of steroids in the critical care population and decadron specifically for the lack of mineralcorticoid activity. I've used the solumedrol 125 q6 x 4 doses after intubation followed by 60 mg BID (See The Combination of Tocilizumab and Methylprednisolone Along ... : Critical Care Explorations. The other case report with higher doses here, Error - Cookies Turned Off) twice. One with good results, the other had been intubated and hypoxic for several days and unfortunately passed about 24 hours later. Both patients <60, but obese and African American.

I get why steroids were dismissed early on in the sense that most patients aren't in the ICU, but if you're nearing intubation, that isn't the population that we're concerned with viral spreading.

 

[WilcoWorld]

Man....you are a sick human being. I’m surprised you find enjoyment helping sick people.

Thrgenius...you need to chill a bit.

Personal attacks are not helpful, you're right about that.

I also think you are on record as saying that you do not practice medicine because you find enjoyment in helping sick people - probably not in those exact words, but not too far off either. If I am wrong and you are practicing medicine because you like helping people, then please correct me and I'll rescind my assertion.

 

[Birdstrike]

Personal attacks are not helpful, you're right about that.

I also think you are on record as saying that you do not find enjoyment in helping sick people. If I am wrong and you are practicing medicine because you like helping people, then please correct me and I'll rescind my assertion.

This is a thinly veiled personal attack in my opinion. I'm not saying Veers is burned out, but "loss of enjoyment in helping sick people," is a classic symptom of burnout and not a personal failing. Implying so, would be in my opinion, a personal attack of sorts.

 

[AMEHigh]

The majority of people do not think this is good. However, that same majority feels some precautions while avoiding drastic shutdowns is least crappy of options, at this point.

I guess we'll never know if it's the true majority or not but the fact is there are people in this country protesting masks. I've seen business signs that encourage people to NOT wear masks. People on this forum have said they won't wear a mask and are going about their daily lives. From pictures I've seen lots of people going to crowded small bars and restaurants indoors. There was a post within this discussion about someone going to a party and happy that no one was wearing masks. Friends have told me about being invited to weddings with the guest count of 200. And the lists goes on. So yeah it seems like a lot of people are disregarding the advice about masks and avoiding large indoor crowds. Disneyworld is open in a state with a very large number of cases, attracting people to go and then travel back to their state. But yes you are correct that it might not exactly be the majority, but it does seem like more people than should be when we're in a pandemic that seems to be affecting a lot of people.

It seems like the priority should be to not overwhelm health care systems, make sure essential businesses are going and make sure schools can open where teachers and students feel safe. But instead people are yelling about masks and not wanting to mitigate their behaviors at all during a pandemic even though it has negative affects on a lot people's health and economics and not just over age 65.

 

[Birdstrike]

I guess we'll never know if it's the true majority or not but the fact is there are people in this country protesting masks. I've seen business signs that encourage people to NOT wear masks. People on this forum have said they won't wear a mask and are going about their daily lives. From pictures I've seen lots of people going to crowded small bars and restaurants indoors. There was a post within this discussion about someone going to a party and happy that no one was wearing masks. Friends have told me about being invited to weddings with the guest count of 200. And the lists goes on. So yeah it seems like a lot of people are disregarding the advice about masks and avoiding large indoor crowds. Disneyworld is open in a state with a very large number of cases, attracting people to go and then travel back to their state. But yes you are correct that it might not exactly be the majority, but it does seem like more people than should be when we're in a pandemic that seems to be affecting a lot of people.

It seems like the priority should be to not overwhelm health care systems, make sure essential businesses are going and make sure schools can open where teachers and students feel safe. But instead people are yelling about masks and not wanting to mitigate their behaviors at all during a pandemic even though it has negative affects on a lot people's health and economics and not just over age 65.

I generally agree with this. I just think many, if not most, people are emotionally worn down by this virus and want to go on with their lives, even if they know it's not the best thing epidemiologically, and even if it involves some risk. I'm not saying that's good or that it won't have consequences. But that's what I'm hearing from friends, family and patients.

 

[wamcp]

...and what we got in response was, "no deaths yet, so open everything up!"

Wait. Full stop. What are people who are supporters of lockdowns seriously proposing?

have I not shown enough data points over and over and over and over and over and over

that there is no convincing data that lockdowns work?

I will repeat this again.

Initial contact tracing and localized containment WORKS. We saw this in Germany, SK, Taiwan, New zealand.

if you fail to do that early on, shutting an entire state or country down DOES NOT stop the eventual total spread and deaths destined to occur. The area under the curve does not change.

The reason is that the ONLY thing that works is mask wearing and avoiding sick contacts.

Viruses do not TELEPORT to others just because a non essential business is kept open.

You all KNOW this. You do this at work EVERYDAY when you wear a simple mask and you don’t get sick seeing multiple covid patients a day.

I sincerely ask in good faith. WHAT are lockdown people proposing? Should we arrest anyone and imprison then for five years who violate a national curfew, like Chile is doing? Except even draconian measures like that ISN’t working there, cases continue to explode up!! Because laws from politicians do not force anyone to change their usage of masks! Telling people to stay indoors doesn’t work- NO ONE wears masks at home or when visiting a family /friend’s home!
Lockdowns destroy the economy without changing the final trajectory of the virus. Why does anyone here disagree, can someone please explain for real?

 

[WilcoWorld]

The thing is that we all basically want the same thing - as quickly as possible we want to be able to interact with people in public settings, we want our kids back in school, and we want unemployment to go down. Most (all?) of us would like to achieve this in a way that doesn't cause thousands of people to die unnecessarily.

I personally don't like the terms "lockdown" or "reopen the country". I do not want to lock anyone in their home or lock anything down and I don't think the country is closed - I can fly, buy groceries, get a rifle or a new car, and as long as I wear a mask on my way from the front door to the patio I can go out for appetizers and drinks. I took my kids on a road trip across 5 states last week & we had a blast. You can't do that when the country is "closed" due to "lockdowns".

Somehow, we are so politically divided in this country right now that we can all want essentially the same thing but be incapable of working towards it because we're so busy seeing each other as horrible people.

 

[thegenius]

You make some good points. I don’t think that it’s absolutely better that the virus run through everyone, more so that I don’t think we can stop it. The cat is out of the bag, and I think the vast majority of the world’s population will likely catch it. I think the true number of positive cases may be even a degree of magnitude higher than the estimated 10x the current case count.

I’m thinking it might be less because we have been testing so much more recently. Let’s say before there was 10x true infectivity, it might now be 7x or 5x now.

all we really need to do look at the seemingly mythically generated number R0. Is it higher now than what it was in March/April before the effective lockdowns?

 

[thegenius]

The thing is that we all basically want the same thing - as quickly as possible we want to be able to interact with people in public settings, we want our kids back in school, and we want unemployment to go down. Most (all?) of us would like to achieve this in a way that doesn't cause thousands of people to die unnecessarily.

I personally don't like the terms "lockdown" or "reopen the country". I do not want to lock anyone in their home or lock anything down and I don't think the country is closed - I can fly, buy groceries, get a rifle or a new car, and as long as I wear a mask on my way from the front door to the patio I can go out for appetizers and drinks. I took my kids on a road trip across 5 states last week & we had a blast. You can't do that when the country is "closed" due to "lockdowns".

Somehow, we are so politically divided in this country right now that we can all want essentially the same thing but be incapable of working towards it because we're so busy seeing each other as horrible people.

well written, I agree.

 

[Siggy]

Wait. Full stop. What are people who are supporters of lockdowns seriously proposing?

have I not shown enough data points over and over and over and over and over and over

that there is no convincing data that lockdowns work?

I will repeat this again.

Initial contact tracing and localized containment WORKS. We saw this in Germany, SK, Taiwan, New zealand.

if you fail to do that early on, shutting an entire state or country down DOES NOT stop the eventual total spread and deaths destined to occur. The area under the curve does not change.

The reason is that the ONLY thing that works is mask wearing and avoiding sick contacts.

Viruses do not TELEPORT to others just because a non essential business is kept open.

You all KNOW this. You do this at work EVERYDAY when you wear a simple mask and you don’t get sick seeing multiple covid patients a day.

I sincerely ask in good faith. WHAT are lockdown people proposing? Should we arrest anyone and imprison then for five years who violate a national curfew, like Chile is doing? Except even draconian measures like that ISN’t working there, cases continue to explode up!! Because laws from politicians do not force anyone to change their usage of masks! Telling people to stay indoors doesn’t work- NO ONE wears masks at home or when visiting a family /friend’s home!
Lockdowns destroy the economy without changing the final trajectory of the virus. Why does anyone here disagree, can someone please explain for real?

So if the Houston Astros had a game right now with 40,000 fans who were free to mask at their own will or not (because people will take the mask off at some point if only to eat a hot dog) you'd be lining up to get tickets?

You can't say that local containment works and argue against lock downs because that's what local containment is. It's just on the regional or local level and not on a national level. I agree that, provided we have contact tracing and control, we should open up. However we can't even get people to wear masks. We can't process tests fast enough for contact tracing. When it's taking 4-6 days for test results ('Pushing the frontiers': Long lines for COVID tests, stressed labs delay results as demand spikes) there virus is already too far away from that case.

The goal for the lockdown was to build that infrastructure out. Taiwan, New Zealand, and South Korea (practically speaking) are islands. Taiwan and South Korea have played the test and trace game for a long time. Germany is headed by a literal scientist. We have a business man who inherited a fortune and then managed to fail at selling gambling, steaks, and wine while lying about the size of his buildings and perving on young women.

We locked down in order to put infrastructure in place... and then refused to actually put infrastructure in place. Never mind the people who scream about their rights to infect other people when they refuse to mask or assist with information to contact trace.

 

[AMEHigh]

The thing is that we all basically want the same thing - as quickly as possible we want to be able to interact with people in public settings, we want our kids back in school, and we want unemployment to go down. Most (all?) of us would like to achieve this in a way that doesn't cause thousands of people to die unnecessarily.

I personally don't like the terms "lockdown" or "reopen the country". I do not want to lock anyone in their home or lock anything down and I don't think the country is closed - I can fly, buy groceries, get a rifle or a new car, and as long as I wear a mask on my way from the front door to the patio I can go out for appetizers and drinks. I took my kids on a road trip across 5 states last week & we had a blast. You can't do that when the country is "closed" due to "lockdowns".

Somehow, we are so politically divided in this country right now that we can all want essentially the same thing but be incapable of working towards it because we're so busy seeing each other as horrible people.

Yep.
I mean to be honest though I do see trump as a horrible person lol.
He just decided to wear a mask today. Why wasn't he wearing a mask from the beginning?
Have you seen some of his quotes? Did you watch his press conferences in the beginning? I remember he talked about making the biggest and best website so everyone could get testing, lol. And now more recently he's talked about we're testing too much and that's what's causing the increase cases.

It's just very very frustrating that the federal government's response has been pathetic causing even more unnecessary harm and I think that set a precedent for how the rest of the country responded. There's certainly a middle ground between throwing people in jail for leaving their house and opening up Disneyworld. It seems we have no leadership at the federal level to help us find that middle ground. He's threatened that schools need to open, yet they don't even have money for paper let alone hand sanitizer and teachers are rightfully scared to go back in a classroom with 30 unmasked 15 year olds.

Yes we have high rates of obesity, but there's no reason that things couldn't be on a better trajectory here like they are in other countries, since apparently america is the best country in the world.

There's no reason that this whole mess needed to be political with essentially people on the right calling this a hoax and yelling about their freedom. This country could've responded with better leadership, guidance and assistance.

 

[GeneralVeers]

Not sure why we are still talking about contact tracing. IT...WILL ...NEVER...HAPPEN....IN....THIS...COUNTRY!

The cat is out of the bag. Lockdown or no lockdown. Masks or no masks. Its going to continue to infect everyone and will kill the people it wants to kill. #futility

 

[wamcp]

So if the Houston Astros had a game right now with 40,000 fans who were free to mask at their own will or not (because people will take the mask off at some point if only to eat a hot dog) you'd be lining up to get tickets?

You can't say that local containment works and argue against lock downs because that's what local containment is. It's just on the regional or local level and not on a national level. I agree that, provided we have contact tracing and control, we should open up. However we can't even get people to wear masks. We can't process tests fast enough for contact tracing. When it's taking 4-6 days for test results ('Pushing the frontiers': Long lines for COVID tests, stressed labs delay results as demand spikes) there virus is already too far away from that case.

The goal for the lockdown was to build that infrastructure out. Taiwan, New Zealand, and South Korea (practically speaking) are islands. Taiwan and South Korea have played the test and trace game for a long time. Germany is headed by a literal scientist. We have a business man who inherited a fortune and then managed to fail at selling gambling, steaks, and wine while lying about the size of his buildings and perving on young women.

We locked down in order to put infrastructure in place... and then refused to actually put infrastructure in place. Never mind the people who scream about their rights to infect other people when they refuse to mask or assist with information to contact trace.

You aren’t making the right case here. Pointing to extreme examples isn’t helping- lockdowns refer to blanket closure of non essential businesses. I’m not advocating mass gathering events should reopen. I’m talking about “non essential” small businesses like clothing stores being shutdown. Can you explain why you think closing those help? Why would you support forced unemployment and bankruptcy when that doesn’t stop any spread? Again, mask wearing is the only thing that works now for us. People will do it or they don’t. Closing the economy doesn’t change that.

 

[wamcp]

Not sure why we are still talking about contact tracing. IT...WILL ...NEVER...HAPPEN....IN....THIS...COUNTRY!

The cat is out of the bag. Lockdown or no lockdown. Masks or no masks. Its going to continue to infect everyone and will kill the people it wants to kill. #futility

exactly the point i’m making

Closing the economy doesn’t change the fact that spread will still happen