Coronavirus thread

[Maple Syrup Actual]

I agree, it is an interesting situation from academic standpoint, as is their decision. Now, their deaths doubled overnight and since their last official gov position statement so they may not be able to stick with the plan just because of the emotions and public sentiment. I bet a six-pack of Guinness (bought yesterday, may have COVID19 on the packaging) that they will end up with conventional response sooner than six weeks.

I think you're probably right about this - they will change course more likely in six days than six weeks.

But whether that will turn out to have been the right decision I think is difficult to say. I expect a massive surge in confirmed cases, but that's going to be from expanded testing. Will it translate into an overwhelmed system? I wonder. Dangerous guessing game, I think, no matter what you do.

I'm currently in self-imposed isolation from everyone because I'm pretty sure I have a chest cold and I don't want my kid to get it. Isolation is about as proven a technique as I can think of and it's hard to imagine rejecting it. But then, failures of imagination are common; maybe I'm experiencing one. If it's just a cold, maybe I should want him to get it. Maybe exposure to whatever I have will improve his immune system. Maybe I have a different coronavirus that will confer some kind of partial immunity as I have seen theorized a lot recently. Who knows?

Anyway, really interested to see how it plays out.

[Nephrology]

When taking juvenile offenders to ER's, I observed that in every instance a long wait was required. I saw an overwhelmed medical system. My opinion is that the new crisis will wreck emergency care. I fear that stressed and harried doctors and nurses will say screw it, drop out, and walk off--not all at once, of course, but over time. Human resources bosses will be faced with an increasing shortage of qualified people. They will notice that newly hired replacements can't cut the mustard. Intelligent ones among them will question the 20 year trend of having adopted a system using temporary and part time workers. They might wish that a cadre of full time professionals had been staffing their facilities.

We(I) are quick to criticize government. I predicted Bush's Katrina fiasco. I was negatively harsh. With this threat I intend to use my ability to generate ways to help. Yes, I will still bitch but not nearly as much. I will not indulge. Instead, I want to assist in maintaining community stability. There will be ample opportunities to step up and contribute. I can set a good example, or volunteer for Salvation Army charity initiatives, or serve as a volunteer in other organizations. Assisted living facilities and nursing homes are filled with lonely and neglected citizens who would welcome attention. This is my chance to saddle up one last time and do something worthwhile. I have no doubt that other forum members will do the same.

NYU's School of Medicine has supposedly put 3rd/4th year medical students on standby. I will definitely volunteer to help if things become that dire.

[the Schwartz]

Question for the LE here: Any signs of looting or like activity?

None in my neck of the woods.

Just got back from the grocery store where I picked up a couple of filet mignon and a six pack of Budweiser (if this is really TEOTW, then I am gonna enjoy myself ) Other than a moderate increase in shoppers and a correspondingly moderate depletion of items on the shelves, everyone here is behaving themselves. No panicky stuff, fights, or other poor behavior, just a moderate run on groceries. I'd describe the overall atmosphere here as being friendly, even jovial in some instances, as most folks seem to think that anyone running in full panic mode is just overreacting.

[deflave]

There will be a huge surge in confirmed cases.

And the vast majority of those cases are going to say "I've had worse."

And then everything will return to normal, the media will look like the incompetent dipshits that they are, and all the alarmists will make excuses for their hysterics.

Book it.

[Half Moon]

I fear that stressed and harried doctors and nurses will say screw it, drop out, and walk off--not all at once, of course, but over time.

Maybe. Historically though, for instance during the Spanish influenza, far more folks stepped up than stepped out. I hope we are not lesser people than of old.

Tangential but a poem in my head the last week:

Epitaph on an Army of Mercenaries
BY A. E. HOUSMAN

These, in the days when heaven was falling,
The hour when earth's foundations fled,
Followed their mercenary calling
And took their wages and are dead.

Their shoulders held the sky suspended;
They stood, and the earth's foundations stay;
What God abandoned, these defended,
And saved the sum of things for pay.

[Maple Syrup Actual]

I'd give it less than 6 days. If you look at Italy's numbers, they went from where we are right now to utterly swamped quasi-overnight.

The lengthy asymptomatic incubation period + indolent course of the disease is what is making this so dangerous. It's effectively an average of 2 weeks lag from exposure to intubation for those who end up with severe disease (~5 day incubation, ~7-9 days of mild Sx). All of those time bombs are out there, fuses lit. It's a matter of days and hours before they start to present in large numbers.

I think this is very likely true, for sure.

I know a couple older medical professionals (namely my GF's mother who is a hospice RN) that are seriously downplaying this risk. It blows my mind. There is unanimous consensus from effectively every prominent expert whose opinion matters that this is going to be very bad. The only debate is exactly how bad, and even the most optimistic numbers I've read are extremely chilling.

Of the people I know in the field (and I'll just mention that my wife worked on communicable diseases for on-reserve health here and we're friends with a whole group of pandemic and CD people) it's fairly split. I would say half are bracing for serious disaster, and half are expecting what I'd call "H1N1 times two".

But Canada doesn't have many ICU beds and our sytem is running at or over capacity when nothing is wrong, so it won't take much to start experiencing shortages here, I don't think.

Part of the blase attitude some of them have, I think, is that they are very adapted to the idea of triaging critical cases, and letting people die is not something they overtly talk about, but is accepted practise already. So I think in some cases they're looking at this and thinking, "I'll probably just be getting a little quicker to call it."

[Arbninftry]

None in my neck of the woods.

Just got back from the grocery store where I picked up a couple of filet mignon and a six pack of Budweiser (if this is really TEOTW, then I am gonna enjoy myself ) Other than a moderate increase in shoppers and a correspondingly moderate depletion of items on the shelves, everyone here is behaving themselves. No panicky stuff, fights, or other poor behavior, just a moderate run on groceries. I'd describe the overall atmosphere here as being friendly, even jovial in some instances, as most folks seem to think that anyone running in full panic mode is just overreacting.

I picked up some Corona's and Angels Envy bourbon, we always keep food for a week or so. Lots of electric outages in my area every year. If we got to hunker down, I will do it with a nice glass of bourbon.

[scjbash]

As bad as I worry things may get here in 1-2 weeks especially in Seattle/SF/NYC, it’s mind boggling to me that the UK is appearing to try and reach “herd immunity” levels of infection on purpose, instead of mitigating/flatting the curve. Lots of assumptions for that to go right...

The cynic in me says it's a political move. You can't fail to slow the spread and flatten the curve if it wasn't your goal to begin with.

I try not to listen to my cynical side though.

[Nephrology]

I'd describe the overall atmosphere here as being friendly, even jovial in some instances, as most folks seem to think that anyone running in full panic mode is just overreacting.

Good. I encourage all of you to adopt the same attitude. If shit gets really ugly, we have to come together and not devolve into chaos.

I am really encouraged by the scenes out of Italy today. That kind of solidarity is what we need.

I would say half are bracing for serious disaster, and half are expecting what I'd call "H1N1 times two".

Even H1N1 times two would be a crisis for our system, albeit less horrifying than what may come.

Part of the blase attitude some of them have, I think, is that they are very adapted to the idea of triaging critical cases, and letting people die is not something they overtly talk about, but is accepted practise already. So I think in some cases they're looking at this and thinking, "I'll probably just be getting a little quicker to call it."

The kind of triaging I am talking about is going to be extreme and unlikely anything we've seen in recent memory.

Something I heard out of Italy still haunts me; apparently, in some hospitals, patients >65 y/o and/or with comorbidites (diabetes, cancer, heart or kidney disease, etc) were not even being evaluated by an ICU physician and instead given mask O2 and comfort care. The idea of being put in the position of having to make that call is just nauseating to me.

[blues]

...and now for something completely different...





(If we can't laugh, we are doomed.)