https://www.academia.edu/42242357/Re...erventions..._Originally Posted by Caballoflaco
And the critique, which you may or may not find persuasive. I’m kind of shocked how abrasive Nassim Taleb is on Twitter, but whatever.
https://www.academia.edu/42242357/Re...erventions..._
And the critique, which you may or may not find persuasive. I’m kind of shocked how abrasive Nassim Taleb is on Twitter, but whatever.
The homeless are exempt from the shelter in place order. That is not a typo. We are being redeployed to the field to support operations there, and I'm hearing some magnificently crazy rumors about the mayor and chiefs plans for this friday, in response to an apparent lack of public interest in the order. Total shitstorm if it turns out to be true.
Thanks for posting that. My understanding is that the paper hasn’t been peer reviewed in a journal and alternate info is always welcome. I’ll let somebody with more brain and less sand in their head comment on the details of the original paper and the criticism on a public forum.
That’s the problem with flattening the curve. Both curves start in the same place and they both contain the same area underneath. One is a spike, one is a spike that is stretched out on the time (x) axis.
To my mind there are three broad goals with curve flattening for this outbreak.
1) Reduce peak load on healthcare with particular emphasis on ICU load.
2) Slow infection rate to allow adequate testing and monitoring measures to be put into place.
3) Slow infection rate to potentially allow a vaccine and/or high quality anti-viral treatments to be developed and able to be implemented. Thus reducing death rate.
Flattening the curve, importantly, does not reduce the total number of infections; merely how quickly that total number arrives at. It can reduce case fatality rate, like we see in Italy, by not overwhelming an entire system forcing everyone onto triage.
I don’t think their models are particularly wrong, unfortunately.
If we had taken this threat and other epidemiological threats as seriously in the past, we could well not have to take as drastic measures right now to mitigate. An ounce of prevention pound of cure thing. But it is what it is. At this point mitigation is our best tool to save lives, even if it means periods of isolation with bursts of reactivity for a while.
I concur that China will be the place to watch.
I am pleased that we already seeing some development of anti-viral treatments. I hope we’re able to streamline the process a bit and get things out there soon.
That’s very interesting, as well as disconcerting.
Unfortunately, I’m gong to spend just under 14 hrs on the ground in Santa Clara tomorrow night for work. I’ll be interested to see how much “shelter in place” is going on.
Any suggestions?
Discussion of the day (one of many) at work is how we do the CPR on COVID19 patients or strongly suspected ones.
Background: CPR is a high risk procedure from a transmission standpoint due to aerosolization. There's a massive shortage of N95 masks. We can't run in them at all times because we'll use them up. Cardiac arrests usually come unannounced. If we have some level of anticipation, we plan on using N95s and PAPRs ahead of the time. If we don't have correct PPE on when arrest happens, then things might become interesting.
The take-home point for all of you: if you're ACLS trained and see yourself as a bystander CPR-capable and willing, you might wanna have a properly fit N95 with you.
Doesn't read posts longer than two paragraphs.
Do you have access to mechanical CPR devices? We have the Lucas on our ambulances and I love them. If you did, you could just place the device and that would give the code team time to PPE up. Not ideal, but less risk to the staff than diving in and a better chance for the patient than waiting to gear up first.
'Nobody ever called the fire department because they did something intelligent'
My brother in law that is an infectious disease doctor just texted the family this afternoon and said that despite putting 2 patients to a ventilator, he’s close to running out of ventilators.
#RESIST
Is the 1 month survival rate of those administered CPR still only 5%?
I know decades ago CHP taught petite female officers to use their foot to apply sufficient force for chest compressions - perhaps we should bring that back?
Nevada's governor has ordered the closing of all non-essential businesses as of noon Wednesday, lasting for 30 days. Not the more typical two weeks: a whole month. https://www.kolotv.com/content/news/...568789201.html .
From the linked story: "The closures will take effect Wednesday, March 18 at noon and will be in place for at least the next 30 days.
The closures include bars and restaurants, though restaurants are encouraged to offer curbside delivery, home delivery, and takeout.
"Non-essential businesses have two options," he said. "Find other ways to serve your customers, or close your doors."
Essential services will remain open including fire, police, transit, and healthcare, in addition to businesses that provide food, shelter, and social services for disadvantaged populations.
Pharmacies, grocery stores, banks, hardware stores, and gas stations will also stay open, as well as truck stops to allow the delivery of supplies."
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