Coronavirus (COVID-19)

[-Hope-]

3 minutes ago, mission27 said:

I'm not talking about rationing care. I'm talking about what level of public health response is justified to prevent what number of deaths/cases. That is a cost benefit and we have to be honest about the facts - i.e. how many people and which people are dying, what is the prevalence and severity of ongoing complications, etc.? 

you were very explicitly talking about rationing care lol

Quote

1. Completely disagree. A 20 year old on a ventilator for the rest of their life is a far greater tragedy than an 85 year old in the same position. Quality and years of life remaining matter. It is why when rationing care, the 20 year old would get the care over the 85 year old. As it absolutely should be.

but anyway, yes, you obviously have to be honest about who is getting hit harder and who is more at risk when weighing reopening plans. that doesn't mean you don't minimize risk and that doesn't mean you throw vulnerable populations to the dogs because it's "less of a tragedy."

[mission27]

2 minutes ago, Deadpulse said:

All triage discussion is cold hearted. That doesn't mean it is not necessary. Some level of disease and death is inevitable, even in an ideal response to the pandemic. On the flip side, it is near impossible to measure how the societal and economic relief measures add to the death and disease. If that was possible, we could have that discussion, but I don't think you can empirically sit there and say, well if we reopen movie theaters it will revitalize hollywood and a large industry and add X amount of jobs back to the economy but it will cost us X amount of cases and X amount of deaths if we do it.

 

Yeah its not an exact science. Its directional.

For example, if we got to a point with the first partially effective vaccine where we could open up our economy further and only have 10 deaths a day in the United States, almost all very elderly and sick people, rather than 1000 deaths a day including many younger people... then certainly that would justify opening up more than can be justified under 1000 deaths a day, right? Its not that those 10 people don't matter, but the pandemic will be much less serious at that point and the same level of social cost from public health response will no longer be justified. 

[mission27]

1 minute ago, -Hope- said:

you were very explicitly talking about rationing care lol

but anyway, yes, you obviously have to be honest about who is getting hit harder and who is more at risk when weighing reopening plans. that doesn't mean you don't minimize risk and that doesn't mean you throw vulnerable populations to the dogs because it's "less of a tragedy."

I was using the rationing of care to demonstrate that these same cost benefit discussions do happen and there is nothing wrong with thinking in those terms, when put in that position. 

We are in that position right now on a larger scale, in that we have a tradeoff between the social cost and health benefits of various shutdown measures. Ignoring things like death rate and age demographics of those impacted makes no sense.

[Deadpulse]

1 minute ago, mission27 said:

Yeah its not an exact science. Its directional.

For example, if we got to a point with the first partially effective vaccine where we could open up our economy further and only have 10 deaths a day in the United States, almost all very elderly and sick people, rather than 1000 deaths a day including many younger people... then certainly that would justify opening up more than can be justified under 1000 deaths a day, right? Its not that those 10 people don't matter, but the pandemic will be much less serious at that point and the same level of social cost from public health response will no longer be justified. 

You can't predict that reduction however. I think you need to play the long game. When a vaccine is released we 1) have to wait for a large vaccination population number (ideally 90% or more but that might be overly optimistic) and B) to see its effects on the number of cases/deaths and death/recovery rates while maintaining pre-vaccine prevention measures. I do believe with both in effect, we could see daily deaths hit 0 almost consistently. At that point I think you can begin to slowly return to normalcy. Give it a few weeks to a month to track cases and deaths and see if it increases. If it doesn't move the needle much, move to another step of reopening and so on. 

[mission27]

3 minutes ago, Deadpulse said:

You can't predict that reduction however. I think you need to play the long game. When a vaccine is released we 1) have to wait for a large vaccination population number (ideally 90% or more but that might be overly optimistic) and B) to see its effects on the number of cases/deaths and death/recovery rates while maintaining pre-vaccine prevention measures. I do believe with both in effect, we could see daily deaths hit 0 almost consistently. At that point I think you can begin to slowly return to normalcy. Give it a few weeks to a month to track cases and deaths and see if it increases. If it doesn't move the needle much, move to another step of reopening and so on. 

I don't disagree. You need to ease into all of these changes.

My point is, this is the sort of cost benefit discussions we need to have, and while GSU is a troll I don't think he's fundamentally wrong that there is a certain level of preventable disease and death we would accept and move on with our lives, just like we all live our lives despite a 10s of thousands dying of flu every year, car accidents, lung cancer, and on and on. Pretending otherwise just feeds the troll tbh. His mistake is in thinking COVID is anywhere near comparable to that level right now, with the current suite of therapeutics, etc., as if we aren't potentially a month away from all our hospitals being overrun again. 

IMO we've learned enough about slowing the spread and made enough progress that we do not need quite the same extreme measures employed in March, but clearly we are far from out of the woods.

[ramssuperbowl99]

7 hours ago, mission27 said:

I don't disagree. You need to ease into all of these changes.

My point is, this is the sort of cost benefit discussions we need to have, and while GSU is a troll I don't think he's fundamentally wrong that there is a certain level of preventable disease and death we would accept and move on with our lives, just like we all live our lives despite a 10s of thousands dying of flu every year, car accidents, lung cancer, and on and on. Pretending otherwise just feeds the troll tbh. His mistake is in thinking COVID is anywhere near comparable to that level right now, with the current suite of therapeutics, etc., as if we aren't potentially a month away from all our hospitals being overrun again. 

IMO we've learned enough about slowing the spread and made enough progress that we do not need quite the same extreme measures employed in March, but clearly we are far from out of the woods.

I don't think anyone sincerely discussing this would disagree with what you mean.

Since viral spreads are exponential, the diminishing returns on each successive quarantining-type measure become very painful. If we're starting from 50k new cases daily, it's going to take as much work to go from 50k to 5k as it will to go from 5k to 500. So the question is finding the right balance in the months before a vaccine. But on the flip side, at 50k we're as close to 500k/daily as we are to 5k/daily, so we should recognize there is very little breathing room at this point, and right now that balance is out of whack even with things being partially closed.

One of the silver linings of the total failure on our part to actually lockdown and stop the spread is that we've seen which things really need to stay shut, and which things don't. I'll put my hand up and say I was wrong on sports coming back; generally, bubbles seem to work. Cool, let's keep that going. CFB is the exception given that they are still masquerading as students, but that's just one example of how we can have our cake and eat it too. 

 

All of that said, the only part of your post that I object to is the "certain level of preventable disease and death we should accept and move on with our lives" quote. I don't disagree that there is going to be preventable death, COVID related or otherwise. And every single one of them is a tragedy, so we should always be evaluating the cost:benefit and trying to save as many lives as possible, and if that lines up with a small number of preventable COVID deaths, then that's the best crappy option we have. But that's very different than "accept and move on".

Edited October 28, 2020 by ramssuperbowl99

[WizeGuy]

45 faculty and staff have tested positive in the past few weeks at our hospital due to socializing with friends outside of work and eating lunch together at work.

 

I'm keeping my circle incredibly tight this winter. My wife and I have two couples we made a pact with to be extra safe and only hangout with each other. We're also going to hangout with those couples one on one so we can socially distance easier. My dad and I are going to watch football outside with at least 6 feet of distance between us. We like to drink brews, so we're going maskless but extra diligent in socially distancing. If we're indoors we mask up. I'm masking up with all my family if we're indoors (and outdoors if we can't socially distance) and we're all going to avoid bigger family get-togethers. 

[acowboys62]

15 hours ago, Xenos said:

Given the circumstances that we’re in, absolutely! Unless you’re in the wrong thread. We are talking about a pandemic here that more easily spreads the more people there are, especially indoors. And given that it’s flu season as well....

So just going to tack on the flu to this as well?  Let's tack on everything then, including car accidents. 

My point being no politician NEEDS to be telling me or my family what to do on holidays, let alone any day.  We are just having a disagreement on word choice here really.  

[TVScout]

Not free:

With proper measures flying can be safer than eating at a restaurant during the pandemic, study says

Quote

The risk of catching the coronavirus on an airplane can be significantly reduced if travelers wash their hands frequently, wear masks at all times, and if airlines clean and sanitize planes thoroughly and ensure there is a constant flow of air throughout the cabin — even when the plane is parked, according to a study released Tuesday.

 

Using these and other measures as part of a layered approach could push the risk of catching the virus on a plane below that of other activities, including grocery shopping and eating at a restaurant, researchers at the Harvard T.H. Chan School of Public Health concluded.

Caveat: "It is being funded by airlines, airports and aircraft manufacturers."

https://www.washingtonpost.com/local/trafficandcommuting/with-proper-measures-flying-can-be-safer-than-eating-at-a-restaurant-during-the-pandemic-study-says/2020/10/27/01d6d248-17d1-11eb-aeec-b93bcc29a01b_story.html

[acowboys62]

15 hours ago, Xenos said:

Some of these, like the sanitation, is what I already practice. But assuming that we get a viable vaccine and we build normal immunity to this thing, I will forgo the masks unless the doctors and scientists tell us to keep wearing them. We do need a certain amount of “normal” germs in our body so that we don’t weaken against the common cold.

Wouldn't having a vaccine mean we are not building a normal immunity towards this thing?  I could just be 100% dumb here in not understanding how the vaccine process works which I am sure has been stated 1,000 times.  If that is the case ignore me.  I just always assumed vaccines were for things our bodies were not able to "normally" become immune to. 

[acowboys62]

13 hours ago, Deadpulse said:

Simple math really. If we continue to see record number of cases, the death rate is negligible. If we have more cases than ever than the same amount of people die despite a lower death rate. Besides, the goal is to prevent cases/spread so that there is NO death. Sure, its good that less people are dying by case, but people are still dying and they shouldnt be. Don't comfort yourself with the idea that less people are dying, because people are still dying. 

The death rate is not negligible.  I 100% get what you are saying and its just a slower burn to get to the same higher total.  But the rate still matters as does the ever improving theraputics treatment until we ultimately get to where we need to be. 

[Deadpulse]

Just now, acowboys62 said:

The death rate is not negligible.  I 100% get what you are saying and its just a slower burn to get to the same higher total.  But the rate still matters as does the ever improving theraputics treatment until we ultimately get to where we need to be. 

It doesn't matter under the circumstance that cases are increasing at this rate. Same amount of people will die. It will matter if we can stop the spread. It can't be just one, case rate and death rate need to both go down. One is no good without the other. Sure its nice that we got one down, but we need to not rest on that laurel. 

[Xenos]

6 minutes ago, acowboys62 said:

So just going to tack on the flu to this as well?  Let's tack on everything then, including car accidents. 

My point being no politician NEEDS to be telling me or my family what to do on holidays, let alone any day.  We are just having a disagreement on word choice here really.  

I tacked on the flu because you can get both now. And in general, I would agree with you about the no politician statement except these are different times. The public created a problem during the summer when Newsom let the states decided what to do. And it led to a huge surge even with mitigating factors like seasonality and having the ability to be outside more. Now without those things and without these strict restrictions, more people will die and spread Covid.

[acowboys62]

13 hours ago, Deadpulse said:

Not when it is preventable. No one needs to be. If we stop downplaying this thing and take all the precautions neccessary, then this discussion is irrelevent. Why wouldnt you want that? Why wouldnt you want this topic to not matter because NO ONE is suffering?

 

https://www.foxnews.com/health/1-in-5-hospitalized-youths-need-icu-ongoing-care-research-says

Do you believe deaths related to alcohol, cigarettes', obesity are preventable? If so, do you put the same type of energy into those things as you do COVID?  If not, is it because those things will not impact your life if you do not partake in them? 

[Deadpulse]

Just now, acowboys62 said:

Do you believe deaths related to alcohol, cigarettes', obesity are preventable? If so, do you put the same type of energy into those things as you do COVID?  If not, is it because those things will not impact your life if you do not partake in them? 

This is a logical fallacy, sorry.