Life disrupted... thanks to Covid-19

Discussion in 'The OT' started by Mark Holtz, Mar 14, 2020.

  1. Mar 25, 2020 #81 of 104
    inkahauts

    inkahauts Well-Known Member

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    Oh overall look at China. Close to three to four months till their basketball league started back up. It may sound silly but when you see sports come back that’s when we will really be coming out of this thing imho.
     
  2. Mar 25, 2020 #82 of 104
    Mark Holtz

    Mark Holtz New Texan

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    so-there-was-5528967653.jpg
     
  3. Mar 25, 2020 #83 of 104
    James Long

    James Long Ready for Uplink! Staff Member Super Moderator

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    The times are certainly changing.
     
  4. Mar 25, 2020 #84 of 104
    Rich

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    Not sure how long it took China once they figured out what to do, four months? If that's true we are looking at summertime. Agree about sports. Sure would like to see a ballgame.

    Rich
     
  5. Mar 25, 2020 #85 of 104
    cpalmer2k

    cpalmer2k New Member

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    I would be curious to see a comparison of places with "Shelter in Place" orders vs. none. Most of them last between 14-21 days, but because of those "essential" activities people are still going to have contact with each other. If Bob begins sheltering in place on April 1st, but on April 5th needs to go to the grocery store he could come in contact with someone with the virus. He takes it back home, but doesn't have symptoms until sometime between April 7th and 19th. By that point in time most shelter in place orders have expired, but now Bob has the virus and has exposed his family whom he has been stuck with in close quarters the entire time. They could potentially go out and infect others for the same time frame. Some would say do a month of Shelter in Place, but the same pattern could repeat. Unless you're going to do as you suggest and have a long term order in place it doesn't seem like they're going to make a huge difference.

    I think a bigger problem is in the "wait to see what happens" approach we're taking. I've ready many articles that highlight the success of administering the malaria drug, a z-pack, and vitamin supplements at the time of diagnosis/positive test results. Some surveys have found improvement within three days. The problem is most of our states are doing this only for their most critical patients. They're sending the average patient home and telling them to rest and come back if it gets bad. By the time they're back they are in awful shape and require oxygen/hospitalization. I think we need to be gambling more by treating, or at least offering, those drugs to those patients we're sending home. If it keeps 25% of them from developing complications we'd "flatten the curve" more than we are now.
     
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  6. Mar 25, 2020 #86 of 104
    inkahauts

    inkahauts Well-Known Member

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    While you are right about shelter in place not stopping ability to be infected it does severely slow down the spread, which is the entire point and goal at this point. We are way past trying to simply stop it.
     
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  7. Mar 25, 2020 #87 of 104
    phrelin

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    The single and sole purpose of "shelter in place" is to slow down the spread so that hospitals are not completely overwhelmed. There are 74% fewer hospital beds per capita in the United States than there were in 1960. Our system no longer has the capacity to deal with pandemics.

    [​IMG]

    And yes, I along with everyone else who is older than the Millennials, allowed this to happen.

    On a less self-critical note I was looking at the following newspaper front page today and thinking of other historical front pages:
    [​IMG]
     
  8. Mar 25, 2020 #88 of 104
    James Long

    James Long Ready for Uplink! Staff Member Super Moderator

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    The focus of health care is to keep people OUT of the hospital. Outpatient surgery with recovery at home has replaced most overnight stay surgery. Every additional night in the hospital is a failure of the system.. The only thing worse than a long stay is readmission to the hospital. Recover at home. That hospital room is the most expensive bed in town - with only an emergency room bed being more expensive. There are hospitals with no beds. That is the modern vision for healthcare.

    The goal is "don't get sick". Health insurance has changed from reimbursements for when a person gets sick to paying to keep that person well. Good insurance includes regular checkups and preventative medicine. Keep people healthy so they don't need a hospital. The challenge is to get people who are "not sick" to participate.
     
  9. Mar 26, 2020 #89 of 104
    dmspen

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    I remember my Dad kept the headline newspaper (SF Chronicle), "NIXON RESIGNS"
     
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  10. Mar 26, 2020 #90 of 104
    cpalmer2k

    cpalmer2k New Member

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    I understand the "Shelter in Place" argument, but I'm a data person and I think this "flatten the curve" line is nonsense based on the way we are currently tracking data. Every day we're told how many "cases" there are, and how many deaths there are because that draws attention. The cases isn't even close to accurate though because some places are testing thousands per day (NY) and some are testing only hundreds per day. Most states are turning away people who come in with symptoms of COVID-19 and telling them just to go home, take cold medicine and isolate. We have no clue how many people have already been exposed and could be a threat to the population, or who are no longer a threat because they are now immune.

    The curve we need to be tracking is the # of hospital admissions and ventilator patients per day. Those are all that actually matter in our current setting. When those numbers normalize, or start to decline, we're getting somewhere. The total # of cases tells us nothing though. If we suddenly increase testing capability in every state like we are now the "curve" is never going down simply because we're now testing more people who were "undocumented" cases before and therefore skewing our data.

    If a state gets 100 new cases per day people freak out. But if 75 of them are people aged between Infant and 40 it isn't going to increase their hospitalization "curve" dramatically because those aren't as risky as older patients. On the other hand if a state gets 100 cases and 70 of those are from a retirement community zip code then we need to worry. We're tracking the wrong data.

    I'm not usually a conspiracy theorist but there is a lot of misinformation out there being posted by doctors, nurses, etc. too. There was a post my wife's relative shared on Facebook this morning for example. It was supposedly written by a "friend" of hers who works in a COVID-19 unit at a hospital here warning people to stay home because of all the horrible things she saw the previous day and the patient who died she wishes she could have saved. The only problem with that is the region in question has very few cases, and based on percentages couldn't have more than a hand full of hospitalization qualifying cases. The post was written days ago, but there have been no deaths reported in that county or region of the state either. So either the state and county both are lying in their numbers or more likely the person on Facebook is stretching the truth.
     
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  11. Mar 26, 2020 #91 of 104
    trh

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    All the flatten the curve graphs I've seen don't have a number tied to the hospital capacity line. That's because it is a generic chart and capacity will vary based on local hospitals.
    Yes, we don't know the total numbers. And yes, something like 80% of those infected won't require medical treatment. And the numbers and percentages won't be known until after the dust has settled and all the data can be analysized.

    But keep in mind. When our numbers requiring emergency care exceed our capacity, doctors have to determine who to save and who to let die. Won't be based on their abilities or skill, but equipment availability.
     
  12. Mar 26, 2020 #92 of 104
    James Long

    James Long Ready for Uplink! Staff Member Super Moderator

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    Here is the comparison:

    In 1918, the city of Philadelphia threw a parade that killed thousands of people. Ignoring warnings of influenza among soldiers preparing for World War I, the march to support the war effort drew 200,000 people who crammed together to watch the procession. Three days later, every bed in Philadelphia’s 31 hospitals was filled with sick and dying patients, infected by the Spanish flu.

    By the end of the week, more than 4,500 were dead in an outbreak that would claim as many as 100 million people worldwide. By the time Philadelphia’s politicians closed down the city, it was too late.
    [​IMG]
    A different story played out in St. Louis, just 900 miles away. Within two days of detecting its first cases among civilians, the city closed schools, playgrounds, libraries, courtrooms, and even churches. Work shifts were staggered and streetcar ridership was strictly limited. Public gatherings of more than 20 people were banned.

    The extreme measures—now known as social distancing, which is being called for by global health agencies to mitigate the spread of the novel coronavirus—kept per capita flu-related deaths in St. Louis to less than half of those in Philadelphia, according to a 2007 paper in the Proceedings of the National Academy of Sciences.

    The concept of “flattening the curve” is now a textbook public health response to epidemics, including the spread of Covid-19.
    (source)​


    102 years later what have we learned?
    Stay safe.
     
  13. Mar 28, 2020 #93 of 104
  14. Apr 9, 2020 #94 of 104
    inkahauts

    inkahauts Well-Known Member

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    I get all your points and do not disagree the curve most important to flatten is the hospitalizations, but that is likely directly tied to number of overall new cases in general. I know here in Los Angeles we seem to be doing well as they are now testing more people daily than ever and the number of deaths and such has not significantly increased, so social distancing is working.

    If they are testing more people daily and your cases aren’t growing exponentially like they where in the beginning, then that does show progress in slowing the spread down.

    It’s just hard to tell how big a difference it’s making based on the numbers they post, as you note. However, I have a feeling it’s making a bigger impact than can be seen on the numbers they post, but are to worried people won’t understand the nuances of the more detailed yet smaller numbers, so they go with the bigger numbers so people are more likely to see this as wide spread as it is.

    I also think the total cases is to point out that this thing has spread a lot and everyone is at risk to get it and transmit it to others. The transmitting to others is the thing I think people do not understand the most, and how dangerous that is. I’m looking at you Florida when I say this...
     
  15. Apr 9, 2020 #95 of 104
    James Long

    James Long Ready for Uplink! Staff Member Super Moderator

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    They (the authorities) need to find a way to balance letting people know how serious the pandemic is vs scaring them so much that they feel hopeless. I'd like to see the "survival" rates posted - people once infected who are now testing clear (although the definition of recovered includes a waiting period after testing). The number of negative tests are also not widely reported.

    Active cases: 1,138,343 (416,008 US)
    Recovered cases: 346,780 (24,775 US)
    Fatal cases: 94,567 (16,252 US)

    I believe they lowered the expected death estimate for the US yesterday - which is good for the people who were losing hope, not so good for the people who think the risk is over and go back to less distanced behavior.
     
  16. Apr 9, 2020 #96 of 104
    billsharpe

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    The problem is there are still a lot of people who think coronavirus is not a problem.
     
  17. Apr 9, 2020 #97 of 104
    scooper

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    And then there are all the conspiracy theory people who take what may be correct facts, but completely misintrepting them. We have a few of them on another forum I hangout on, and regularly have to reign them back.
     
  18. Apr 24, 2020 #98 of 104
    Mark Holtz

    Mark Holtz New Texan

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    This came out this afternoon.
    62a8351acc5e6c060e8eb5a3b85f6791.jpg.max800.jpg
     
  19. Apr 24, 2020 #99 of 104
    James Long

    James Long Ready for Uplink! Staff Member Super Moderator

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    Trash collection never stopped in my area - although the trash services were asking people to slow down on what they were throwing out. People sitting at home with nothing to do but stare at their junk and no way to have a garbage sale increased the use of trash services. One local city stopped picking up extra bags (contact free containers only).
     
  20. billsharpe

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    No disruption in trash collection here. Some neighbors in alley had overflowing bins but apparently trucks picked up everything.

    I put a big thank you note on my back wall for the collectors and on my front door for the mail carriers.
     
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