Coronavirus Discussion Thread

Carlos Danger

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An aspect of COVID that gets relatively little publicity is disability. I haven't been able to find any studies -- too soon, I guess -- but I've read dozens of reports of ongoing disability secondary to the disease. I doubt such outcomes were considered by the President when he claimed 99% of cases are "totally harmless" (and I doubt most symptomatic COVID sufferers would describe their experiences as harmless).

Looking at COVID outcomes merely as binary -- i.e., alive or dead -- and thinking of herd immunity as a largely inconsequential process are mistakes, I believe.
So what is the alternative? Keep the economy half closed and allow businesses to keep failing and unemployment to keep rising and keep vulnerable people isolated for however long as it takes for the virus to mutate itself away, or a vaccine is developed, and just hope that one of those things happens sooner rather than later?

I've never heard a single person suggest that the process of achieving herd immunity is inconsequential, yet I also have very rarely heard any of the alarmists acknowledge the many consequences of higher rates of unemployment and significant contraction of the economy.
 

mgr22

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So what is the alternative? Keep the economy half closed and allow businesses to keep failing and unemployment to keep rising and keep vulnerable people isolated for however long as it takes for the virus to mutate itself away, or a vaccine is developed, and just hope that one of those things happens sooner rather than later?

I've never heard a single person suggest that the process of achieving herd immunity is inconsequential, yet I also have very rarely heard any of the alarmists acknowledge the many consequences of higher rates of unemployment and significant contraction of the economy.

Not sure where you are, but where I live, herd immunity is on the table. So is the belief that doctors are all pessimists, science is part of a deep-state conspiracy, and the President speaks the truth.

An alternative to relying on herd immunity? I'd start with clear, consistent, science-based, top-down policy originating from the White House. We've seen that delegating responsibility for a COVID response to thousands of local officials produces a mix of good and bad decisions. I think there's a workable middle ground between closing the country and partying like it's 1999, but people need to be lead there. Centralized virus avoidance guidelines, while not laws, would at least produce a consistent message and leave room for folks to weigh compliance against one consistent set of realistic consequences.
 

Summit

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According to a poster the #1 way to stop/prevent Corona is washing your hands. If this is true why isn't washing hands mandatory in public? Mask ordinance/law is a thing
Washing your hands is the #1 way to stop the spread of contagious diseases in general because the most common contagions are most commonly spread by contact.

(Fomite transmission example is someone with rhinovirus wipes their nose with their hand, touches the doornob, you touch the doornob and then start eating chips).

Not the case for COVID-19. Droplet spread is the predominant mode of community transmission.

Universal masking, physical distancing, and staying home if ill are the primary ways to prevent the community spread of COVID-19.

Wash your hands too. Fomite transmission is a concern.
 
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E tank

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Not sure where you are, but where I live, herd immunity is on the table. So is the belief that doctors are all pessimists, science is part of a deep-state conspiracy, and the President speaks the truth.

An alternative to relying on herd immunity? I'd start with clear, consistent, science-based, top-down policy originating from the White House. We've seen that delegating responsibility for a COVID response to thousands of local officials produces a mix of good and bad decisions. I think there's a workable middle ground between closing the country and partying like it's 1999, but people need to be lead there. Centralized virus avoidance guidelines, while not laws, would at least produce a consistent message and leave room for folks to weigh compliance against one consistent set of realistic consequences.

Ban the sale of alcohol...done....you're welcome....
 

Summit

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Are they saying covid isn't airborne anymore?
We’ve suspected it was airborne since January and known it was airborne since February. However, we know that the predominant mode of transmission in community spread is droplet.

Healthcare transmission is potentially different because of cumulative exposure, the patients are sicker and we do stuff to patients that either generates aerosols, or makes airborne indistinguishable from droplet (extended close contact with high densities of fine droplets).
 

Summit

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There are several of reasons to not want to wear a mask that don't involve being a "science denier", not the least of which is that the overall strategy of trying to stop the spread of the virus through social distancing and mask wearing among the general public is itself questionable.

Please expand on your reasoning. I need some clarity on your point... I'll front load by saying:

1. We have good evidence that universal masking functions as source control to reduce transmission rates, which allows us to relax other economically and socially painful mitigation measures.

2. I don't want to put words in your mouth, but many of the antimask posts I've seen on the internet (from the ones that are blatanly antiscience and denying COVID exists or that masks will kill you by hypoxia) relate to the deside to get to community immunity faster. If not, disregard. IF you are of the camp that slowing transmission is undesirable because it "delays herd immunity," then how exactly do you propose to achieve the optimal prevalence rate and hold it there? For herd immunity, can you state: target seroprevalence results that indicate community immunity, current seroprevalence rates, and duration of immunity?
 
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ffemt8978

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The questions in my mind are:
1 is masking among the general public really necessary;
2 "cost benefit of masks"
3 what about individual autonomy (always a foremost concern in my mind);
1. You admit that its effective. We have evidence it is. We need to control transmission. Masks seem the least costly, easiest, yet effective techniques to cut transmission.
2. Yes, in fact, there have been a few analyses that show they both save lives and money. AND what would the consequences of the alternative methods of control?
3. Temporarily having to mask in social situations is only slightly more intrusive than laws requiring a certain amount of clothing.

We have similar levels of libertarian outlook, except in a public health crisis it would appear. What you keep missing here: What is the alternative?

Without masks, controlling transmission rates requires more draconian action like further increasing contract tracing, isolation orders, and societal/economic restrictions.

Masks are the lesser of temporary evils.

lastly, is trying to stop the spread really the best strategy to begin with, vs. instead focusing on protecting the minority of the population who is likely to develop severe disease

Communities full of multigenerational households, health workers, diabetics, old people, obese people.... the minority with significant risk factors is large.

You understand public use of masks is source control, then in the next breath imply we can end universal masking while still protecting the most susceptible? We have a disease with significant cryptic transmission and long incubation... so how do you keep all the people who interact with the huge "minority of the population" from being infected? Or the people who interact with them? And on and on?

and allowing those who are at very little risk to be exposed naturally and develop herd immunity?
See my post above. We are nowhere near it, we don't even know how durable immunity is, and we cannot hope to isolate the more vulnerable part of the population while infection burns through the rest.

Especially considering that the more we learn about it, the less deadly we are finding out it is on a per-case basis.
Maybe IFR is not the 5% that initial Chinese data shows, but the morbidity, mortality, disability, and cost of disease is vastly higher than seasonal influenza.

The officials have been wrong about pretty much everything they've told us since day 1. They've changed most of their recommendations at least once, been inconsistent and self-contradictory in their messaging in general,
No, not everything. Yea, there has been some **** messaging, some of it even disingenuous (CDC on public masking, WHO on a lot).

Other things change as we know more, as you would expect with a novel pathogen driven pandemic that arose in a communist nation that suppresses and alters information to save face.

and every prediction has failed to come true.
While there were some wild models out there, the predicted outcomes were the motivation to take action. Actions avoided many of the predicted the outcomes. You cast that as a failure of prognostication rather than a success of mitigation.

We HAVE managed, however, to beat the hell out of our economy, massively increase our federal debt, create record unemployment, destroy many, many businesses, force the cancellation of countless weddings, graduations, family vacations, and funerals, seen a huge spike in suicides, a huge spike in mortgage defaults, etc, etc.
Yes. And it is tragic. The cost is real and atrocious. If only we had acted earlier and with more determination and coordination, and been better prepared on the whole, some or much could have been avoided.

All that, and it isn't even clear that any of the lockdown and social distancing orders were really necessary or all that effective.
You can place your personal valuation of cost vs benefit in here, and you can compare not doing the draconian things to countries where the fire burned much hotter and see... but to argue that it was not effective is a mind boggling claim that I'd love to see you defend... unless you mean the haphazard, political stunted way in which we executed it piecemeal caused a dilution in effectiveness.
 
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VFlutter

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I am fairly libertarian in most regards however with masks I do not disagree to the point of contention. I rather wear a mask to avoid the social confrontations of those who are fearful and not medically inclined. However, I can agree that masks can reduce transmission from droplets and still contend that they are redundant to social distancing and with asymptomatic persons.
 
OP
Akulahawk

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We’ve suspected it was airborne since January and known it was airborne since February. However, we know that the predominant mode of transmission in community spread is droplet.

Healthcare transmission is potentially different because of cumulative exposure, the patients are sicker and we do stuff to patients that either generates aerosols, or makes airborne indistinguishable from droplet (extended close contact with high densities of fine droplets).
I'm one of the few that go straight from surgical mask to PAPR at work. I rarely will wear an N95 mask, and that's only when a PAPR blower isn't available. When I'm wearing a mask, I don't spend much time close-in with a patient. One of the other ways that I try to help others out at work is because I do have the helmet is that I'll do the aerosol-producing procedures for some of my colleagues so their exposure is more limited.

I'm not exactly expecting this to go completely away for quite a while... even if it appears to go "quiet" for a few months. Once flu season rolls around again, I actually expect this to come back either by itself or as a co-infection with influenza and if that happens, it ain't gonna be pretty...
 

RedBlanketRunner

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So what is the alternative? Keep the economy half closed and allow businesses to keep failing and unemployment to keep rising and keep vulnerable people isolated for however long as it takes for the virus to mutate itself away, or a vaccine is developed, and just hope that one of those things happens sooner rather than later?
Do what Thailand did? Government jumped on it, masks and social distancing mandatory the first of March, with people being arrested for non compliance. Almost all businesses shuttered, Stay at home order in effect. Near 100% compliance. Customers at the stores that were opened were turned away if they didn't wear masks and use the mandatory alcohol hand scrubs out in front of every one of those businesses.

March 29 had the worst number of new infections per day at 143. The second week of April the new infection rate started tapering off. By May 1st new infection rate was under 10 per day and the curve was nearly flat. The government kept full lockdown in place until June 1st then with only re-entires from foreign countries infected they allowed small businesses to cautiously open back up, masks and social distancing still enforced.
And at present the curve remains flat. The government is considering allowing large venues such as shopping malls and schools to reopen in August. Present new infection rate per week, >10, all repatriations. Lockdown will only be eased off further in accordance with the infection rate.

Everyone felt the hurt, and per capita about the same number of jobs have been lost as in the US. But here they played hardball and did it right the first time. Waffling, misleading and gaslighting only serves to prolong the agony.
 

mgr22

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I am fairly libertarian in most regards however with masks I do not disagree to the point of contention. I rather wear a mask to avoid the social confrontations of those who are fearful and not medically inclined. However, I can agree that masks can reduce transmission from droplets and still contend that they are redundant to social distancing and with asymptomatic persons.

That's pretty much how I feel. I started wearing a mask in public a few days ago.
 

RedBlanketRunner

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Economies can recover. Dead bodies, not so much.
 

ffemt8978

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Economies can recover. Dead bodies, not so much.
Are we now disregarding the effects a broken economy has on things like suicide and crime rates? Bad economies can be just as deadly as the disease in some cases.
 

SandpitMedic

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Are we now disregarding the effects a broken economy has on things like suicide and crime rates? Bad economies can be just as deadly as the disease in some cases.
More lives will be touched by an economic depression (and for far longer) than will be by COVID19.
 

ffemt8978

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More lives will be touched by an economic depression (and for far longer) than will be by COVID19.
Exactly. Look at just some of the side effects of an economic depression: personal depression, suicide, crime, starvation/hunger, lack of medical care, homelessness, reduction in education. Everything on that list at one time or another has been proclaimed to be the most severe thing we face and we must fix it for the benefit of society and to help people.

There is ALWAYS a risk vs benefit factor involved in everything we do as a society and as an individual. Focusing on one risk (the pandemic) to the detriment of the other risks doesn't help solve the problem. It would be like killing Peter to save Paul. The same goes for the benefit side of the equation.

Unfortunately, I'm beginning to believe that our governments and health organizations blew it with their COVID-19 response. Not enough common sense and effective response in the early stages appears to have led to more draconian responses in the later stages. The next time we face a global pandemic, people may be less likely to adhere to government regulations and guidelines, because they will remember how badly it hurt them this time.

Chicken Little or the boy who cried wolf ring a bell to anyone?
 

RocketMedic

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Exactly. Look at just some of the side effects of an economic depression: personal depression, suicide, crime, starvation/hunger, lack of medical care, homelessness, reduction in education. Everything on that list at one time or another has been proclaimed to be the most severe thing we face and we must fix it for the benefit of society and to help people.

There is ALWAYS a risk vs benefit factor involved in everything we do as a society and as an individual. Focusing on one risk (the pandemic) to the detriment of the other risks doesn't help solve the problem. It would be like killing Peter to save Paul. The same goes for the benefit side of the equation.

Unfortunately, I'm beginning to believe that our governments and health organizations blew it with their COVID-19 response. Not enough common sense and effective response in the early stages appears to have led to more draconian responses in the later stages. The next time we face a global pandemic, people may be less likely to adhere to government regulations and guidelines, because they will remember how badly it hurt them this time.

Chicken Little or the boy who cried wolf ring a bell to anyone?
Yes, there are life challenges posed by public-health measures. Doesn’t justify someone willfully engaging in behavior that poses a public health hazard.
A very direct question for you: have you ever treated a COVID patient?
 

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