Light at the end of the tunnel ?

[Bijan]

7 minutes ago, porkchop said:

If you are older than 75 and determined to remain above ground, that is awesome (and also entirely on you). It is a completely selfish pursuit - an entire country does not need to shutdown so you can achieve that goal.

Seems odd when you think the government is there to protect life, liberty and the pursuit of happiness to think of life itself as a selfish pursuit.

Obviously government has to balance life and liberty in this case.

[El Presidente]

I can hear the anti vaccers screaming blue murder once countries/airlines/cruise ships designate no entry/boarding without proof of the vaccine. 

[Cairo]

6 minutes ago, El Presidente said:

anti vaccers

I want everybody to take the vaccine--except me.    They take the risk, I get the reward.  Win, win!   ?

[SigmundChurchill]

1 hour ago, porkchop said:

If you are older than 75 and determined to remain above ground, that is awesome (and also entirely on you). It is a completely selfish pursuit - an entire country does not need to shutdown so you can achieve that goal.

Hospitals have 100% been able to cope in the US. When the virus first hit, many field hospitals were constructed and staffed, at great expense to the taxpayer - only to go unused. The 1,000 bed hospital ship that docked in NYC took on 182 patients and departed within a month. All the arguments for stricter lockdowns are emotional pleas. America is not about one individual (or their suffering), it is about a system that allows individuals to flourish. To blow a hole in that system, to put people out of work, unless there are other political machinations, is not wise. We have not even begun to pay for the damage done back in the spring. 

As for protecting the vulnerable, the idea is not for the government to decree them into isolation. The vulnerable can protect themselves by whatever means they deem appropriate.

Those field hospitals you mentioned, were made available so non-covid patients would have somewhere to go because the actual hospitals were filled with covid patients.  The actual hospitals were overwhelmed.  People died because we couldn't get to them fast enough because we were dealing with too many people dying at the same time, and that is something that will haunt many medical professionals for the rest of their lives.  In a previous post, I said it was like being in a war zone, and that was no exaggeration.  We had to turn people away that didn't meet the criteria, knowing that they would be back soon, meeting the criteria.  Our morgues were overwhelmed with all of the dead.  At one point we had 6 refrigerated cargo holds in our back parking lots, filled with bodies.  

The biggest mistake our governors made was to send covid positive patients back to their nursing homes.  One of those field hospitals should have been designated for covid patients that did not meet hospital criteria to keep them out of nursing homes and other places where they could infect other vulnerable people.

Here is a bit of reality for you.  One day on my way into the parking lot, they were loading bodies into these cargo holds.  I snapped a couple of pictures.

[Nino]

 

15 minutes ago, Cairo said:

I want everybody to take the vaccine--except me.    They take the risk, I get the reward.  Win, win!   ?

I see the risk of a good vaccine way lower compared to the risk of contracting Covid, so to me it's a well defined decision, a no-brainer.

 

[mprach024]

1 hour ago, porkchop said:

 

If you are older than 75 and determined to remain above ground, that is awesome (and also entirely on you). It is a completely selfish pursuit - an entire country does not need to shutdown so you can achieve that goal.

 

I understand your view point, and can see you are emotional about this subject.  It’s not my place to guess or determine how you or your loved ones have been impacted by this in comparison to myself.  This is unprecedented, and I’m not defending the steps or actions taken as I’m sure there were many mistakes.  I do applaud action though, I’d rather try something and adjust accordingly than sit back and watch because the outcome is tbd.  As for this not being a real concern for all of us, my brother is the CMO of major health system in the Midwest, and as he said to me last week, “you can fake positive cases, you can fabricate stats, but you can’t fake the overloaded ICU we have and the hallways full of patients waiting for rooms.”  Again that might be a regional issue, but where I’m at this is very real, and it’s not just old people filling those halls.  

[Ken Gargett]

4 hours ago, porkchop said:

Covid, for the well connected, is big $$$$ - would expect one more national scare to warrant another huge spending bill.

 

57% of Covid deaths in the US have been individuals 75 or older (124,826/217,348). Life expectancy in the US is 78, give or take. 

79% of Covid deaths in the US have been individuals 65 or older (171,814/217,348). Retirement age in the US is 65, give or take. 

*Stats from CDC as of Nov. 4th.

Why not simply take extra precautions for those that are vulnerable and allow everyone else to continue on? Appears the vulnerable are mostly out of the flow of the economy already.

using your figures and leaving aside the extraordinary callousness of abandoning anyone over 65 (and also leaving aside the debate about those people being out of the 'flow of the economy'), that still means 21% of deaths are of those under 65. if 247,000 have died so far, that is still over 50,000 americans in their prime. dead.

at the beginning of the year, if anyone had suggested we just let everything "continue on" while a virus killed more than 50,000 in their prime, i think most people (obviously not all), would have been beyond horrified. toss in all those you consider to be surplus to requirements and we have the nightmare that is the world today. 

[vhampl03]

In my view, humility and grace is required on this subject, since it can be argued no one state, country, NGO performed flawlessly in response to this thing.  Our politicians have to analyze multiple variables - public health, the ability to provide for one’s family, property rights,  personal freedom, etc as they craft the policy response to this novel pandemic.

I am a huge fan of federalism and the ability of US states to determine the approach that best fits their populace (ie, not the same for North Dakota as New York, and I would argue, not the same for NYC as for upstate).  I predict the states that performed better in their response to this thing will see positive inflows (and I at least know which states I would avoid).

Anyway - my view only.  Thanks to @SigmundChurchill and all the health and public safety folks out there for your work - crazy times.

Vance

[porkchop]

We "let" people die from disease, accidents, poverty, poor decisions, etc. every minute of every day. The language used in this thread evokes civil rights abuses of the past when in reality the precautions equate to avoiding large crowds and washing your hands. 

On the subject of "overrun" hospitals - I do not doubt there was a busy hospital in the NYC area. I do not doubt people died and they put the bodies in shipping containers. That said, why would a 1,000 bed hospital ship go essentially unused? That does not align with a picture of chaos. 

Tone is hard to convey online - every person who has worked tirelessly to stem the tide of Covid should be commended. Losing a loved one is heartbreaking. Any skepticism or anger is placed squarely at the feet of the politicians who have used this pandemic for their own gain. It is possible, in twenty years, Covid will be mentioned in the same breath as "Saddam has WMDs." 

[Ken Gargett]

10 minutes ago, porkchop said:

We "let" people die from disease, accidents, poverty, poor decisions, etc. every minute of every day. The language used in this thread evokes civil rights abuses of the past when in reality the precautions equate to avoiding large crowds and washing your hands. 

On the subject of "overrun" hospitals - I do not doubt there was a busy hospital in the NYC area. I do not doubt people died and they put the bodies in shipping containers. That said, why would a 1,000 bed hospital ship go essentially unused? That does not align with a picture of chaos. 

Tone is hard to convey online - every person who has worked tirelessly to stem the tide of Covid should be commended. Losing a loved one is heartbreaking. Any skepticism or anger is placed squarely at the feet of the politicians who have used this pandemic for their own gain. It is possible, in twenty years, Covid will be mentioned in the same breath as "Saddam has WMDs." 

sorry but i do not buy that comment about saddam and the WMDs at all. current worldwide death toll is approaching 1.3 million. this is real. it is not some political concoction. saddam's WMDs killed how many as opposed to 1.3 million? they could hardly be further apart.

i suspect that in 20 years, or hopefully much sooner, it will be mentioned in the same breath as getting an annual flu injection. 

as for 'letting' people die, i'd agree that a great many die unnecessarily and much more could be done. but i think you might need to define 'let'. in this case, you have quoted 'poor decisions' as a factor. i agree with that. in the case of the US (and elsewhere), some unforgivably poor decisions by politicians has cost many thousands their lives. 

i'm not in a position to comment on the hospital situation in the states but i completely agree that every person who has worked to save lives and stem covid, wherever they are, deserves commendation. 

when the first of these threads started on FoH, there was an immediate divide between those who seemed to place the economy/life as we know it ahead of making the necessary changes to limit the virus no matter what the cost (within reason, which was itself a matter for debate). it seems little has changed. 

one point, when this started, the idea of more than a few thousand dying seemed beyond comprehension to both sides of the debate, i believe. that it has reached levels that seemed inconceivable at that time does not seem to have changed some opinions. i wonder how many deaths that will take? 

[Bijan]

15 minutes ago, Ken Gargett said:

i wonder how many deaths that will take?

To be pretty morbid, probably an order of magnitude more. Annual death rate is about 1.1% in the US, or 2.8 million. Covid deaths are a tenth of that. Possibly somewhere between covid being the leading cause of death, and covid being greater than all other causes of death combined would be the tipping point for those least inclined to care about it.

[Ken Gargett]

Just now, Bijan said:

To be pretty morbid, probably an order of magnitude more. Annual death rate is about 1.1% in the US, or 2.8 million. Covid deaths are a tenth of that. Possibly somewhere between covid being the leading cause of death, and covid being greater than all other causes of death combined would be the tipping point for those least inclined to care about it.

depressing thought. 

[porkchop]

The lie always has elements of truth. Terrorism is/was real - attacks happen(ed) in the US and Europe. That, along with the WMD lie, was used by those in our government as a cover to start a full-scale 20 year war which coincidentally put hundreds of billions of dollars in the pockets of the politically well connected. Covid has similar elements where death is used to stoke the flames of fear which allows the politicians to implement bad policy. 

 

[Bijan]

@porkchop

I don't disagree that it is a calculus between protecting the vulnerable population from covid and economic (unemployment, and small businesses going under), psychological and social harm (drug and alcohol abuse increasing, as well as suicides) to the entire population.

I agree with you in that I don't think that it was always a fair trade.

The only thing that complicates it are the large cities where if left unchecked hospitals would definitely have been overrun causing even more chaos. In more remote areas with less density I think a more relaxed approach would have been fine.

Edit: What I don't agree with is the sentiment that this generally hits older people, and that their rights are less important.

[Ken Gargett]

3 minutes ago, porkchop said:

The lie always has elements of truth. Terrorism is/was real - attacks happen(ed) in the US and Europe. That, along with the WMD lie, was used by those in our government as a cover to start a full-scale 20 year war which coincidentally put hundreds of billions of dollars in the pockets of the politically well connected. Covid has similar elements where death is used to stoke the flames of fear which allows the politicians to implement bad policy. 

 

i understand the situation as it relates to the WMDs and the matters related to it. but that has absolutely nothing to do with covid. utterly irrelevant. 

you keep coming back to lies. can you be more specific? as far as i can see, the lies have come from those politicians who have sought to diminish the danger of this. if we keep to the states for the moment, almost a quarter of a million deaths (unless you dispute that - and most times when i see those figures disputed, it tends to be by those who believe that the figures are worse). are you suggesting that is a lie? 

stoking the flames of fear? i'm not sure scientists, doctors and experts pointing out the dangers and the figures is stoking fear. given that it seems record levels of deaths and infections in the states seem to be increasing almost every day, perhaps stoking a bit of fear might be wise. 

[SigmundChurchill]

39 minutes ago, porkchop said:

We "let" people die from disease, accidents, poverty, poor decisions, etc. every minute of every day. The language used in this thread evokes civil rights abuses of the past when in reality the precautions equate to avoiding large crowds and washing your hands. 

On the subject of "overrun" hospitals - I do not doubt there was a busy hospital in the NYC area. I do not doubt people died and they put the bodies in shipping containers. That said, why would a 1,000 bed hospital ship go essentially unused? That does not align with a picture of chaos. 

Tone is hard to convey online - every person who has worked tirelessly to stem the tide of Covid should be commended. Losing a loved one is heartbreaking. Any skepticism or anger is placed squarely at the feet of the politicians who have used this pandemic for their own gain. It is possible, in twenty years, Covid will be mentioned in the same breath as "Saddam has WMDs." 

As I said, the ship was for non covid patients.  After we converted all of our ICU's to covid ICU's, we started converting most of our 22 operating rooms into covid ICUs as well.  We saved a few operating rooms for emergency surgeries only.  Most of our surgeons closed up shop and took a 3 month vacation.  During that 3 months, we fixed a couple of fractures every day, fixed ruptured aneurisms and other life threatening issues here and there, but that's about it.  If we did 5 surgeries a day, it was a lot.  When it was all said and done, we were all scratching our heads wondering, "What happened to all the appendixes." " What happened to all the gall bladders?"  All these surgeries we used to do urgently in the middle of the night, were no longer necessary?  It was just bizarre.  And they weren't going to other nearby hospitals, because ALL the area hospitals were going through the same thing we were going through.  Maybe these things we do urgently are not so urgent as we think they are.  Most inflamed appendixes, it turns out, can be treated medically.  Most people with gall bladder pain can live with it for a while.  

People were avoiding hospitals at all costs.  And in NYC, everybody who didn't have covid, left the city.  NYC was a ghost town.  We rented out one of our beach houses from April through June, at summer rates.  When we went out to our other beach house in April, the place was as busy as any July or August, all filled with NYC people escaping covid in the city.  It was no surprise to me that the ship and the Javits Center went largely unused.

[mprach024]

Can always make more money, can’t get a lossed love one back no matter what you do.  If we error, and we will as we are human, we error on the side of life not on a bank account or political agenda.  

If you prefer stats, here’s some others.  

9/11 - 2977 deaths

Pearl Harbor - 2403 deaths

Nov 10 Covid (USA) - 1420 deaths

We are having a 9/11 every 2 days, in April (2600) we were having it nearly every day, just some perspective.  

[SigmundChurchill]

I remember reading tweets and seeing pictures of relatively empty hospital parking lots, "So how could they be overrun if there are so few cars in the parking lots?" 

Our hospital was overrun at the time, so I walked to the window and looked out at the parking lot.  Sure enough, it was pretty empty compared to before COVID.  Then I realized, we have no same day patients, no visitors are allowed in the hospital, 3/4 of the doctors are gone, the administrative people are all gone, the physical therapists are gone, most of the x ray department is gone.  Of course the freaking parking lot is empty!

I have read so many dumb theories on the internet at that time, I just had to stop reading all together.

[Bijan]

33 minutes ago, Ken Gargett said:

depressing thought. 

It's probably even worse than that. Since it would be mainly people after their child-bearing years, it would have little direct effect on births/population growth (only difference would be that US population would go down in a year, possibly for the first time in a long while or ever really, which is not nothing). Those who don't care about the elderly, would only notice the economic effects of whatever percentage of the workforce disappeared.

[porkchop]

In the US, the "one death is too many" attitude falls overwhelmingly into two categories. Limousine liberals who are chiefly concerned with winning the morality d-measuring contest during cocktail parties. Or, government employees whose aim is to do as little as possible while fattening their taxpayer subsidized salaries/benefits. The middle-class is already leveraged to the gills and cannot afford another shutdown. Not all of us want to subsist on the supposed generosity of the government.

Scientists and doctors are not infallible and certainly not beyond stupidity in the name of bureaucracy. Dr. Fauci flip-flopped on masks at least once and certain predictions had us at 2 million deaths in May. Hell, Italy was second on the WHO healthcare rankings and they got slaughtered by Covid. 

Appreciate the info on NYC. As mentioned before, tone is tough online and nobody is saying that Covid is not real.

There is definitely a trade-off. Any death is a tragedy. Hopefully a vaccine comes quickly.

 

[Bijan]

18 minutes ago, porkchop said:

Italy was second on the WHO healthcare rankings and they got slaughtered by Covid.

Deaths per million are a bit lower in Italy than the US (711 vs 746). An older population hurt them and overran hospital capacity (over 75 population is 11.7% in Italy vs 6.3% in the US, 22.8% over 65 vs 15%).

[mprach024]

7 minutes ago, Bijan said:

Deaths per million are a bit lower in Italy than the US (711 vs 746). An older population hurt them and overran hospital capacity (over 75 population is 11.7% in Italy vs 6.3% in the US, 22.8% over 65 vs 15%).

Bijan, I’ve been reading a lot of your posts, you work with numbers for your profession don’t you?

[El Presidente]

1 hour ago, Ken Gargett said:

i'm not in a position to comment on the hospital situation in the states but i completely agree that every person who has worked to save lives and stem covid, wherever they are, deserves commendation. 

 

I recall the zoom sessions in March and April where several of us  slowly watched the good doctor SC go from "worried" to a mental and physical wreck over a 6-8 week period.  replicate that by tens (hundreds) of thousands of front line medical personnel worldwide. 

They didn't know what they were dealing with. What they thought would work didn't and what seemed left field treatment made a difference (sometimes). 

Initially some members thought it was no worse than a flu. Well that went out the window come end March.  

We can kick the definitive method(s) of handling this from a medical/economic/political standpoint for another 12-18 months down the road.  The jury is still out and a lot of how this will be determined is seeing how politicians fare at the polls/elections (internationally) based on the positions they have taken. 

 

 

 

 

[BTWheezy]

10 minutes ago, El Presidente said:

I recall the zoom sessions in March and April where several of us  slowly watched the good doctor SC go from "worried" to a mental and physical wreck over a 6-8 week period.  replicate that by tens (hundreds) of thousands of front line medical personnel worldwide. 

They didn't know what they were dealing with. What they thought would work didn't and what seemed left field treatment made a difference (sometimes). 

Initially some members thought it was no worse than a flu. Well that went out the window come end March.  

We can kick the definitive method(s) of handling this from a medical/economic/political standpoint for another 12-18 months down the road.  The jury is still out and a lot of how this will be determined is seeing how politicians fare at the polls/elections (internationally) based on the positions they have taken. 

 

 

 

 

And then on top of that, @SigmundChurchill had to deal with me, @rcarlson and @ElJavi76 on Zoom. The man is truly a saint.

My sincere hope is we can all collectively put common sense and science (as best we can) in front, and politics on the sidelines. We’re all in this together.

[Fugu]

A lot that could be said in response to your posting @porkchop but getting to the gist - what you are proposing simply ins’t in any way a solution. “Letting all go“ and only protect those at high risk will lead to a rapid spread among the rest of the population. And there will then be still “enough” serious cases, which will eventually demand triage. In fact, infection rates are going down in the older age group now in my country compared to young, as those folks have already understood and ARE quite strictly protecting themselves. Your idea has been tried in a number of countries and shown to fail brutally!

There really is nothing to be won by letting go. A fact. Fact is also, those countries that implemented strict measures at an early stage are faring best, and in particular economically.