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Thread: COVID-19: A bloody battle or a long war?

  1. #61
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    Default Re: COVID-19: A bloody battle or a long war?

    The 'normal' ratio is 5 patients per qualified carer, even if doubled it's unlikely that enough qualified staff will be available. Which means crash courses and an acceptance of fatalities due to human error. If it would come to that stage then it will be preferable over fatalities caused by no respiration at all.
    The fact will remain that the number of 'operational' ventilators will be limited and most likely dropping over time when the trained stuff will be reduced by necessary quarantine.
    The 'normal' ratio for invasive ventilation is 1:1. (at least in most developed countries I know of- & if there are some 'backward' countries that use 1:5 ratios -I would run immediately- as you truly cannot provide appropriate patient care (when it comes to invasive ventilation) with anything other than 1:1 ratios.
    Fatalities/injuries due to Human error are unacceptable- you get sued (in today's 'sue/compensation culture'), you loose your registration & with it your livelihood. So good luck training 'tens of thousand staff' for your 'tens of thousands ventilators" in the next year let alone 5-6 months (by then this will most likely be over as the virus burns itself out + we'll probably have some kind of a vaccine).
    Last edited by Stario; March 25, 2020 at 12:17 PM.

  2. #62
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    Default Re: COVID-19: A bloody battle or a long war?

    Quote Originally Posted by Stario View Post
    if there are some 'backward' countries that use 1:5 ratios -I would run immediately
    Stop saying nonsense, armchair doctor. Please, run...
    ICU nurse-to-patient ratio of 1:6 recommended for covid-19 crisis, up from 1:1. Normally, intensive care units work under guidelines of one registered nurse to one patient.

    -----
    -----
    [QUOTE=mishkin;15889444] Whats your point exactly Ludicus?
    We are all in this together, we will get through it together. We are Latins, mishkin...Spain has a great a great national health care system, but Spain's government struggled to convince citizens of coronavirus crisis. Apart from that, Spain has declared state of emergence on Mar 14,after infections soared to 4,209 with 120 dead.

    Edit for funny bit: On the same day, March 8, the alt-right/fascist party Vox held a congress in an auditorium (9000 people). At least their leader and one of its top members were infected.
    Vox, Trump, Bolsonaro...according to those execrable idiots, national media is trying to stoke nationwide hysteria. Bolsonaro,65-year-old: "in my particular case, with my history as an athlete, if I were infected by the virus, I wouldn’t need to worry,I wouldn’t feel anything or, if very affected, it would be like a little flu or little cold."
    They don't care at all. Why are we surprised?

    Quote Originally Posted by antaeus View Post
    Like concerts around the world, a march wouldn't be a great vector for a virus. .
    Nope, 5.3 million women across Spain marched in Madrid, Barcelona, Bilbao, Valencia and a number of other cities, in 200 Spanish locations.

    --------
    Food for thought. From Medscape, four articles,
    1- COVID-19 and PPE: Some of Us Will Die Because of the

    I have to remind the American doctor that life is changing.… It's not a normal life. It's a #COVID19 life. It's a pandemic life."
    With these words, spoken March 18, during a joint webinar of the Chinese Cardiac Society and the American College of Cardiology, Professor Bin Cao, MD, from China, jolted healthcare workers across the world.

    ....I've heard and sensed that many nurses and docs are ready for the challenge. But the new fear is the shortage of personal protective equipment (PPE).
    The analogy of a coming storm is apt. It's as if we can now feel the winds and see the dark clouds. But even as we begin to see patients with COVID-19, and some hospitals in hot spots feel the surge, we won't be fully protected against the contagious virus.

    Numerous colleagues have direct messaged (DM) me on Twitter that their hospital is rationing PPE and supplies are running short. C. Michael Gibson, MD, tweeted that he has received 10 DMs about shortages of masks. In a Twitter poll with more than 300 votes, a third of respondents said their hospital had no masks, and nearly half said they were allowed only one mask.
    Another chilling message received through the privacy of direct messaging: many doctors have been expressly told by their administration not to speak publicly about conditions. And few will go against their employer out of fear of being fired. That means the stories about PPE shortages likely underestimate the problem.
    Adding to the shortages of PPE and the muzzling of frontline clinicians is the lack of testing. We simply don't know who is infected. And if you don't know that, you don't know who to isolate.
    Perhaps the most dire message came when Gibson tweeted a screenshot from the Centers for Disease Control and Prevention with recommendations for use of homemade masks if a facility runs out of masks: "HCP [health care provider] might use homemade masks, such as a bandana or scarf, for the care of patients with COVID19. However homemade masks are not considered PPE."
    Bandanas? Are they serious? In the richest country in the world?

    To be clear, hospital administrators did not cause PPE shortages. Leadership at my hospital has not told me to shut up.
    On an e-group with colleagues, most of whom are young and healthy, a friend wrote, "Every time I read about a person with no comorbidities on a ventilator, my heart sinks."
    I remember these sensations from the 1990s, when we placed lines in patients with HIV. But at least then we could identify infected patients; we can't do that with COVID-19.
    And this week, the New England Journal of Medicine reports the virus can be passed through the air.
    It's weird: the feeling that your job could take your life. Now, nurses and doctors report to work knowing that we will likely become infected.
    While we don't know the exact virulence of this disease, the evidence is clear that some of us will become ill and die. It's a numbers game.

    Be safe and be lucky, colleagues. Respect to you all.
    2- Two Emergency Physicians Remain in Critical Condition
    Both are members of the American College of Emergency Physicians (ACEP).
    The emergency physician with COVID-19 in New Jersey is James Pruden, MD, age 70, director of emergency preparedness for St. Joseph's University Medical Center in Paterson.

    The other case involves an emergency medicine physician in his 40s who works for EvergreenHealth, the hospital system in Kirkland, Washington,

    3- Coronavirus Stays in Aerosols for Hours, on Surfaces for Days


    Air: less than 3 hours.



    Lack of protective gear.

    4-Colleagues Mourn Italian 'Hero' Physician Killed by COVID-19
    Colleagues and others are mourning the coronavirus-related death earlier this week of Italian physician Roberto Stella, 67, leader of the medical association in Italy's northern Varese region, who continued to treat patients even after protective gear ran out.
    Stella, president of the Medical Guild of Varese, died of respiratory failure after contracting SARS-CoV-2 Tuesday in a Como hospital, according to news reports.

    A colleague of Stella's at a health service training academy in the region, Alessandro Colombo, was quoted by the Italian news service ANSA as saying that Stella told him a few days ago, "We have run out of masks. But we don't stop. We are careful and we go on."
    Last edited by Ludicus; March 25, 2020 at 01:46 PM.
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  3. #63
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    Default Re: COVID-19: A bloody battle or a long war?

    Quote Originally Posted by Ludicus
    Stop saying nonsense, armchair doctor. Please, run...
    ICU nurse-to-patient ratio of 1:6 recommended for covid-19 crisis, up from 1:1.
    This is unsafe & just plain bad practice & will only contribute to more patients dying. w(°o°)w
    We are running 1:1 (when in comes to invasive-ventilation).



    Edit:

    NWM I found the article you [FAILED] to reference- first hit on google.

    Well here is the article ICU nurse-to-patient ratio of 1:6 recommended for covid-19 crisis, up from 1:1.

    From the article:
    "HSJ understands acute trusts in London have been told to base their staffing models for ICU on having one critical care nurse for every six patients, supported by two non-specialist nurses and two healthcare assistants."

    So it seems you get x5 nursing staff to 6 patients NOT exactly 1:6 ratio (and we aren't told how many patient in such a scenario require invasive ventilation as opposed to non-invasive ventilation etc.)

    Still not great skill mix -sounds dodgy IMO- if all 6 patients happen to require invasive ventilation you're still potentially focked (as most likely then all 6 MV patients will be the responsibility of the one critical care nurse as the support staff will not have the skills/knowledge & most importantly certification/qualifications to care for invasive ventilated patients) (•̥̥̥д•̥̥̥)

    If i was that one Critical Care nurse I would resign and run (I am sure most will as they would have been in the business for long enough to know better- it simply will not be worth the risk loosing ones registration & the many years worth of study to get your qualification). Good luck then running the ICU with mostly non-specialist staff + health care assistants.
    Again your '10's of thousands ventilators'- even if they were available- would be of no use here because when you loose most of your experienced/senior staff (if such BS was ever implemented)- you will be left with even less staff that have the certification/qualification to use these '10s of thousands of ventilators'.

    It's one thing for a bunch of non-clinical pencil pushers to recommend 1:6 nurse-to-patient ratios & to then implementing such BS ratios & then being able to keep your 'on-the floor' staff.
    Take it how ever you want but I've been in this business over 20 years (in management for over 10+ years) & know what I am talking about.
    Last edited by Stario; March 26, 2020 at 12:02 PM.

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    Default Re: COVID-19: A bloody battle or a long war?

    Stario, you are literally an antivaxxer. Why do you think you have any kind of knowledge or authority on anything related to medicine?

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  5. #65
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    Default Re: COVID-19: A bloody battle or a long war?

    Quote Originally Posted by Stario View Post
    This is unsafe & just plain bad practice & will only contribute to more patients dying.
    Stario, 15 years ago, around the world, 18% of intensive care units were characterized by a nurse:patient ratio >1:3
    In war times (coronavirus) the ratio 1:6 works. Ask the Italians.There is a shortage of ventilators and highly specialized nurses.
    Il y a quelque chose de pire que d'avoir une âme perverse. C’est d'avoir une âme habituée
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    Default Re: COVID-19: A bloody battle or a long war?

    Update.
    Dr Fauci. A lots of questions, listen attentively.

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    Every human society must justify its inequalities: reasons must be found because, without them, the whole political and social edifice is in danger of collapsing”.
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    Default Re: COVID-19: A bloody battle or a long war?

    Update. Published March 23
    Time Kinetics of Viral Clearance and Resolution of Symptoms in Novel Coronavirus Infection,"
    Our study provides initial insights into the viral clearance kinetics and the ability of the virus to persist even after the resolution of the for as long as 8 days, which may pose a significant challenge in controlling the spread of the disease. However, further studies are needed to investigate if the real-time PCR-detected virus is capable of transmission at the later stage of the disease
    Il y a quelque chose de pire que d'avoir une âme perverse. C’est d'avoir une âme habituée
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    Every human society must justify its inequalities: reasons must be found because, without them, the whole political and social edifice is in danger of collapsing”.
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  8. #68

    Default Re: COVID-19: A bloody battle or a long war?

    Quote Originally Posted by sumskilz View Post
    If so, you'all evidently weren't paying much attention. From March 1st to March 8th, the number of confirmed cases in Spain grew from 82 to 625. There had already been 17 deaths.
    Sure. There was COVID. But was there coronavirus fear in early march as mishkin describes?
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  9. #69

    Default Re: COVID-19: A bloody battle or a long war?

    Quote Originally Posted by Garbarsardar View Post
    First, I hope you are all well and you take good care of yourself and yours.

    I am aware there is a thread in the mudpit about COVID-19, but I would like, here, to discuss response options as informed by current science and steer away from political recriminations and bickering.

    The incentive for posting this is this excellent paper.

    It's rather short and a good read but I will briefly summarize it here.

    There is a number of NPIs (non-pharmaceutical interventions) which are presently available:



    The first three (CI, HQ, SDO) aim at mitigation, or the "long war" of the thread's title. With the addition of the last two (SD, PC) we have suppression, that is the "bloody battle".

    For example China used suppression while Taiwan uses something akin to mitigation (akin, in the sense that SDO is not mandatory).

    The argument is that most countries do not have the necessary means (an all encompassing regime with near totalitarian powers) to implement suppression especially for an extended period of time. Therefore suppression efforts are eventually bound to fail, after they have placed a horrendous strain on our existing resources.

    On the other hand, mitigation will tax society less, at the cost of a considerable death toll now and in the near future, but will stave off the collapse of our health systems.

    You can see below the chart with the availability of hospital beds in each scenario



    Your thoughts.

    I wonder how effective these closure procedures are. Given the long period of time (up to 14, even 24 days) where you can be infected and infect others but still not show any symptoms, by the time the first symptoms showed up, it may be too late and everyone might already have been exposed and have the disease. So far, the stringent measures don't seem to have worked in the US. The states with thr most stringent measures also have the largest number of cases of coronovius. Texas has been taking less stringent measures than Michigan bu Michigan has far more cases.

    The US is at a disadvantage in that if there was a Typhoid Mary like carrier, who could spread the disease but shows not sysmptoms, they could spread the disease far and wide before the first symptoms even showed up in the US. Korea and China had an advantage in that is he first symptoms showed up earlier, meaning they could justify implementing the drastis quarantine actionsmuch sooner.

    It would be exceptionally hard to close all the schools and restaurants, bars, movie theaters, etc., before the first symptom showed up, when you don't even know if you had the coronovirus, and by the first sysmptoms did show up it might be too late.
    Last edited by Common Soldier; March 28, 2020 at 12:02 PM.

  10. #70

    Default Re: COVID-19: A bloody battle or a long war?

    Quote Originally Posted by Garbarsardar View Post
    First, I hope you are all well and you take good care of yourself and yours.

    I am aware there is a thread in the mudpit about COVID-19, but I would like, here, to discuss response options as informed by current science and steer away from political recriminations and bickering.

    The incentive for posting this is this excellent paper.

    It's rather short and a good read but I will briefly summarize it here.

    There is a number of NPIs (non-pharmaceutical interventions) which are presently available:



    The first three (CI, HQ, SDO) aim at mitigation, or the "long war" of the thread's title. With the addition of the last two (SD, PC) we have suppression, that is the "bloody battle".

    For example China used suppression while Taiwan uses something akin to mitigation (akin, in the sense that SDO is not mandatory).

    The argument is that most countries do not have the necessary means (an all encompassing regime with near totalitarian powers) to implement suppression especially for an extended period of time. Therefore suppression efforts are eventually bound to fail, after they have placed a horrendous strain on our existing resources.

    On the other hand, mitigation will tax society less, at the cost of a considerable death toll now and in the near future, but will stave off the collapse of our health systems.

    You can see below the chart with the availability of hospital beds in each scenario



    Your thoughts.
    One thing I did notice is that while Texas doesn't have the statewide shutdowns as states lime Michigan and Illinois have, it does have a county by county shutdown, where one county might decide to shutdown all the he restaursnts and bars, while othet counties might notm. Given that the vast majority of csses in Michigan are centered in the counties around Detroit, that might make more sense than shutting down the whole state, where some cunties only have a couple cases.

    Oh, one big difference between Korea and the US, maybe Italy, is that Koreans all wear face mask, in the US only health care workers for the most part. Health care professionals discourage ordinary people from wearing mask, likely because they are afraid there won't be enough mask for health care workers if everyone wore a mask.
    Last edited by Common Soldier; March 28, 2020 at 12:40 PM.

  11. #71

    Default Re: COVID-19: A bloody battle or a long war?

    Quote Originally Posted by Gaidin View Post
    Sure. There was COVID. But was there coronavirus fear in early march as mishkin describes?
    Mishkin would know better than I would regarding the general mood of the population, but the outcome was already entirely predictable by that time. By March 13th, they had declared a national emergency. All the relevant characteristics of the virus were known well enough by late January to be able to predict the infection growth rate, that is if one is capable of doing some very simple algebra, which Spain's expert epidemiologist Fernando Simón apparently is not:

    “Spain will only have a handful of cases,” said Dr Fernando Simón, the head of medical emergencies in Madrid, on 9 February. Six weeks later he gives out daily figures of hundreds of deaths.
    I don't know enough about Spain to be able to judge this article, but maybe it's insightful:

    Cinta Moro, a doctor in the southern city of Seville, believes the lack of foresight and planning doomed Spain from the start. “With tests, we would’ve stopped a lot of the problems we have now,” she told me.

    But it wasn’t just a testing failure, it was a cultural and political failure, too.

    Those I spoke with noted two aspects of the Spanish lifestyle that complicated the public’s own response. First, the country has a deeply embedded late-night culture, with everyone staying out late to hang out at bars or simply eat dinner. Second, a paranoia stemming back to Spain’s decades-long dictatorship created a palpable friction between the public and law enforcement.

    The result was that few in Spain felt compelled to change their ways despite signs of chaos. “The Spanish character is not to believe a crisis is coming,” Moro said. “Once you see people die, that’s when you react — but by then it’s too late.”

    Government inaction didn’t help. As mentioned above, Prime Minister Sánchez refused to stop large gatherings like soccer matches and political rallies from proceeding. Some experts I spoke to said that allowing so many people to congregate almost surely spurred a larger outbreak. But Martich, the health policy expert at the University of Carlos III, cautioned that it’s too early to know if that’s truly the case.
    Quote Originally Posted by Enros View Post
    You don't seem to be familiar with how the burden of proof works in when discussing social justice. It's not like science where it lies on the one making the claim. If someone claims to be oppressed, they don't have to prove it.


  12. #72
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    Default Re: COVID-19: A bloody battle or a long war?

    Quite right. In fact, the average patient infects at least 2 persons (2-3).Viruses grow exponentially,not in a linear way. The average incubation period is +-5 days. So....
    ------
    First Case of 2019 Novel Coronavirus in the United States New England Journal of Medicine
    On January 19, 2020, a 35-year-old man presented to an urgent care clinic in Snohomish County, Washington...He disclosed that he had returned to Washington State on January 15 after traveling to visit family in Wuhan, China...Given the patient’s travel history, the local and state health departments were immediately notified...On January 20, 2020, the CDC confirmed that the patient’s nasopharyngeal and oropharyngeals wabs tested positive
    -----
    Quote Originally Posted by sumskilz View Post
    Mishkin would know better than I would regarding the general mood of the population
    Well,yes, but we are not here to blame anybody.March,16.


    Despite COVID-19 Warnings, Many Americans Continue to Party

    Last edited by Ludicus; March 28, 2020 at 02:48 PM.
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  13. #73
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    Default Re: COVID-19: A bloody battle or a long war?

    Quote Originally Posted by Akar View Post
    Stario, you are literally an antivaxxer.
    Ye, I think I might have said that somewhere, but not precisely- i think people should pick & choose as there will be side-effects (I am pretty sure I also said that somewhere) i.e. I would definitely recommend the Hep vaccines (albeit I don't personally put much trust into the effectiveness of such vaccines so I always go with the PPE when treating Hep patients as if i wasn't immunised etc).
    Flu vaccines etc. I don't bother -they not very effective anyways (its false security- which is the worst kind of security IMO).

    I also let my children (just as I was) get exposed to chicken pox, measles + rubella & thus acquire natural immunity. We had a bit of an outbreak of chicken pox about a month ago- my two kids were pretty much the only ones not affected at all- while all the other kids were- despite all the other parents claiming their kids were immunised (in fact my kids were exposed to multiple outbreaks at school over the years- so this is not first time) -I see this scenario all the time -natural immunity > chemical immunity in most cases.
    Make of it what you want- I am really not here to convince anyone just my opinion. Do your own research & decide whats best for you.

    Why do you think you have any kind of knowledge or authority on anything related to medicine?
    Maybe because this is my field of work.

    Quote Originally Posted by Ludicus
    Ask the Italians.There is a shortage ....highly specialized nurses.
    Ye if they are running 1:6 ratios- that would explain why they have one of the highest (if not the highest) CFR in the world (1:6 ratios would be impossible to manage safely- patient would simply die-when it comes to invasive ventilation as there are so many complications with invasive ventilation in the best of times). Also, I said you can have all the ventilators in the world- they are of no use if you ain't got the staff that know how to use them.
    Last edited by Stario; March 28, 2020 at 08:35 PM.

  14. #74

    Default Re: COVID-19: A bloody battle or a long war?

    I've been lurking around the alt-right media for some time and a lot of the commentary has taken a drastic and disturbing turn towards "it's just a flu"/"herd immunity yass
    !!"/"gotta prep for RAHOWA"
    It's almost like their paymasters have decided to opt for mass deaths rather than allow the economy to go to , because it will go to .

    we're dealing with a novel coronavirus against which we have yet to invent a vaccine; trials may take 8-18 months; no matter how you slice it, the world in autumn of 2021 is going to be a vastly different place to january 2020.

  15. #75
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    Default Re: COVID-19: A bloody battle or a long war?

    Quote Originally Posted by Stario View Post
    Maybe because this is my field of work.
    I seriously doubt. Please elaborate. Doctors are not anti-vaxxer activists, and I have never heard a physician say" Annual flu epidemics are responsible for +600K deaths, are we all frightened now!? this is all a media hype to scare the commoners".
    On the March 9 edition of Primetime, Trish Regan claimed Democrats were causing "mass hysteria to encourage a market sell-off" and also "sparking fear and panic about the virus". She was fired.

    Quote Originally Posted by Stario View Post
    1:6 ratios would be impossible to manage safely
    Not exactly. I it can be done, with one specialized nurse leader, additional trained/training staff that contribute to the care of patients, involving anaesthetists and others to provide ICU medical care - and non specialized nurses from elsewhere in the hospital to work as ICU staff. That's the reality. Even in normal times there are ICUs reporting 1 specialized nurse: more than 3 patients.
    ---------

    Update.
    Non- controlled,observational study with 80 patients, treated with hydroxychloroquine +azithromycin.
    Coronavirus : une nouvelle étude de Didier Raoult sur la ...
    ...porté sur 80 patients. Nous confirmons l'efficacité de l'hydroxychloroquine (dérivé de la chloroquine, un médicament contre le paludisme, NDLR) associée à l'azithromycine (un antibiotique, NDLR) dans le traitement du Covid-19
    In English,
    https://mediterranee-infection.com/wp-content/uploads/2020/03/COVID-IHU-2-1.pdf




    Debate Ends Over Chloroquine as France Officially Sanctions

    The Minister of Health, Olivier Véran, further said on Thursday that doctors can now prescribe chloroquine both in hospital and for home usage
    In UK the government has prohibited its use outside of trial, but that position is probably untenable now as they have to explain why they are not treating patients as France is doing.
    CDC
    There are no currently available data from Randomized Clinical Trials (RCTs) to inform clinical guidance on the use, dosing, or duration of hydroxychloroquine for prophylaxis or treatment of SARS-CoV-2 infection. Although optimal dosing and duration of hydroxychloroquine for treatment of COVID-19 are unknown, some U.S. clinicians have reported anecdotally different hydroxychloroquine dosing such as: 400mg BID on day one, then daily for 5 days; 400 mg BID on day one, then 200mg BID for 4 days; 600 mg BID on day one, then 400mg daily on days 2-5.
    Last edited by Ludicus; March 29, 2020 at 10:53 AM.
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    Every human society must justify its inequalities: reasons must be found because, without them, the whole political and social edifice is in danger of collapsing”.
    Thomas Piketty

  16. #76
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    Default Re: COVID-19: A bloody battle or a long war?

    Away from the arguments about which medicines are effective or not, and back to the main topic:

    Nobel prizewinner Paul Romer has issued a grave warning about the economic impact of lockdown. It seems that the economic crisis it has triggered (even if, as seems likely to me, it was already going to happen anyway - the genie is out of the bottle now) may pose a bigger risk than the virus itself. We're looking at a financial crisis of a level larger than 2008. His proposed solution is a massive investment in testing and PPE, as well as mass subsidising of employers to keep employees on and measures to deal with debt and cash liquidity on the part of banks, companies and individuals.

    It seems to me we simply don't have enough information yet to tell what the long-term effectiveness of lockdowns will be, even if it is probably saving thousands lives in the short term. Meanwhile the economic crisis may prove to be a much bigger issue than the virus body count. In general, we need a long term strategy which maximises our ability to make good decisions (this means gathering information in the form of mass testing), and this may then allow us to phase in a return to normal economic life. But even then it certainly won't be a short-term thing, as the economic crisis has already been unleashed and until we get a vaccine the virus will continue to spread.

    By the way I think the whole premise of this thread is flawed - it was never possible to make this into a short battle. The structural vulnerabilities of the health system and the economy have meant that even if we let the virus run its course unabated, it would lead to lasting chaos. Contrary to the claims of some people in this thread, scaling back globalisation is unlikely to be a good idea - it was globalisation which allowed us to recover from the 2008 crisis through Chinese economic growth propping up that of the rest of the world. Meanwhile the current escalating conflicts between countries (e.g. European nations within the EU, and the oil price war between Russia and KSA) which are a large part of the problem. These things will only get worse.
    A new mobile phone tower went up in a town in the USA, and the local newspaper asked a number of people what they thought of it. Some said they noticed their cellphone reception was better. Some said they noticed the tower was affecting their health.

    A local administrator was asked to comment. He nodded sagely, and said simply: "Wow. And think about how much more pronounced these effects will be once the tower is actually operational."

  17. #77
    Ludicus's Avatar Vicarius Provinciae
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    Default Re: COVID-19: A bloody battle or a long war?

    Quote Originally Posted by Copperknickers II View Post
    lIt seems to me we simply don't have enough information yet to tell what the long-term effectiveness of lockdowns will be, even if it is probably saving thousands lives in the short term.
    Well, we are buying time. Quarantine works (see Chinese experience), but in the western, democratic world, there is a conflict between quarantine and legal rights. In the US,
    Covid-19 — The Law and Limits of Quarantine | NEJM

    Quote Originally Posted by Copperknickers II View Post
    massive investment in testing and PPE,
    Yep.And antibody tests, the next frontier.

    --------
    Here, we are ready to use hidroxicloroquine as a preventive medication for high-risk population. Just waiting for a final decision/consensus in a couple of days.
    Il y a quelque chose de pire que d'avoir une âme perverse. C’est d'avoir une âme habituée
    Charles Péguy

    Every human society must justify its inequalities: reasons must be found because, without them, the whole political and social edifice is in danger of collapsing”.
    Thomas Piketty

  18. #78
    Copperknickers II's Avatar quaeri, si sapis
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    Default Re: COVID-19: A bloody battle or a long war?

    Quote Originally Posted by Ludicus View Post
    Well, we are buying time. Quarantine works (see Chinese experience), but in the western, democratic world, there is a conflict between quarantine and legal rights.
    Fortunately, less so in Europe than in the US. We don't yet know if China's quarantine has worked, it may be that they'll have a renewed outbreak now that people are out and about again. The PPE, mass testing and closed borders probably will help mitigate against that, however.
    A new mobile phone tower went up in a town in the USA, and the local newspaper asked a number of people what they thought of it. Some said they noticed their cellphone reception was better. Some said they noticed the tower was affecting their health.

    A local administrator was asked to comment. He nodded sagely, and said simply: "Wow. And think about how much more pronounced these effects will be once the tower is actually operational."

  19. #79
    Stario's Avatar Campidoctor
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    Default Re: COVID-19: A bloody battle or a long war?

    Quote Originally Posted by Copperknickers II View Post
    Away from the arguments about which medicines are effective or not, and back to the main topic:

    Nobel prizewinner Paul Romer has issued a grave warning about the economic impact of lockdown. It seems that the economic crisis it has triggered (even if, as seems likely to me, it was already going to happen anyway - the genie is out of the bottle now) may pose a bigger risk than the virus itself. We're looking at a financial crisis of a level larger than 2008. His proposed solution is a massive investment in testing and PPE, as well as mass subsidising of employers to keep employees on and measures to deal with debt and cash liquidity on the part of banks, companies and individuals.

    It seems to me we simply don't have enough information yet to tell what the long-term effectiveness of lockdowns will be, even if it is probably saving thousands lives in the short term. Meanwhile the economic crisis may prove to be a much bigger issue than the virus body count. In general, we need a long term strategy which maximises our ability to make good decisions (this means gathering information in the form of mass testing), and this may then allow us to phase in a return to normal economic life. But even then it certainly won't be a short-term thing, as the economic crisis has already been unleashed and until we get a vaccine the virus will continue to spread.
    Ye I suspect depression, mental health, suicide rates, domestic violence (already seeing a HUGE surge over the last few weeks) etc. will go through the roof as people loose their employment, loose the 'roof over their heads', loose their business, face bankruptcy & personal/family relationships deteriorate as a result of the economic pressure.
    I personally don't think the economic fallout is worth a virus that has a CFR of 1% (that's about the same odds as dying as a result of injuries sustained in an automobile accident in the US).
    Last edited by Stario; March 29, 2020 at 09:21 PM.

  20. #80
    Kyriakos's Avatar Praeses
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    Default Re: COVID-19: A bloody battle or a long war?

    I think the angle is about hospitals not being able to deal with even 1% of the population being sick and sent there at the same time. Also, obviously other people are sick, without the coronavirus. So if everyone got infected, a lot more would die than just 1%, and hospitals would simply stop being functional.
    Λέων μεν ὄνυξι κρατεῖ, κέρασι δε βούς, ἄνθρωπος δε νῷι
    "While the lion prevails with its claws, and the ox through its horns, man does by his thinking"
    Anaxagoras of Klazomenae, 5th century BC










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