Restarting America Means People Will Die. So When Should We Do It?

badlatitude

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From New York Times Magazine today. A very interesting read, especially after President Trump, said that he can override the Governors and that "I have great authority if I want to use it." He doesn't have that authority, but it is indicative of problems on the horizon.

"The politics of the coronavirus have made it seem indecent to talk about the future. As President Trump has flirted with reopening America quickly — saying in late March that he’d like to see “packed churches” on Easter and returning to the theme days ago with “we cannot let this continue” — public-health experts have felt compelled to call out the dangers. Many Americans have responded by rejecting as monstrous the whole idea of any trade-off between saving lives and saving the economy. And in the near term, it’s true that those two goals align: For the sake of both, it’s imperative to keep businesses shuttered and people in their homes as much as possible.

In the longer run, though, it’s important to acknowledge that a trade-off will emerge — and become more urgent in the coming months, as the economy slides deeper into recession. The staggering toll of unemployment has reached more than 16 million in just the last three weeks. There will be difficult compromises between doing everything possible to save lives from Covid-19 and preventing other life-threatening, or -altering, harms.

When can we ethically bring people back to work and school and begin to resume the usual rhythms of American life? We brought together by video conference five different kinds of experts to talk about the principles and values that will determine the choices we make at that future point. One of them, the bioethicist Zeke Emanuel, led a group from the Center for American Progress that earlier this month presented a plan to end the coronavirus crisis. First, the group said, the country needs a national stay-at-home policy through mid-May. (Eight governors still haven’t issued such orders statewide.) In the intervening weeks, testing would have to ramp up to test everyone who has a fever, or lives with someone who tests positive for Covid-19. Contact-tracing — identifying and notifying people who have been in proximity to someone infected — would become comprehensive. People who have the virus or a fever, or those in proximity to them, would be isolated. There would also be testing of a representative sample in every county, to determine the rate of infection in the population, as well as mapping and alerts to inform the public about the location of Covid-19 cases.

If these efforts are successfully put in place, Emanuel hopes the current restrictions could begin to ease in June. At that point — or later, if the necessary steps have not been taken — we will need to rethink how we manage risk, recognizing trade-offs among various harms and benefits. That’s what the panel discussed."

https://www.nytimes.com/2020/04/10/magazine/coronavirus-economy-debate.html

 

Grrr...

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The sooner the restrictions are relaxed the sooner the second wave begins.  They need to do the math on when the hospitals will be able to handle it.

People are going to die no matter what we do and no one has a crystal ball.  Do the math and pick what appears to be the best option.

Michigan has a bigger infection than most. Our curve is flattening but our hospitals are on the edge.  Field hospitals are starting to fill.

Curves show we might be on top of this by the second week of May. In Michigan.

 
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badlatitude

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The sooner the restrictions are relaxed the sooner the second wave begins.  They need to do the math on when the hospitals will be able to handle it.

People are going to die no matter what we do and no one has a crystal ball.  Do the math and pick what appears to be the best option.
What bothers me is that Trump is discouraging testing. We can't really move forward until we can safely mix again. The only thing that I can come up with for this reticence, is his fear of a large number of deaths that would affect his approval rating. If we don't test, and start the economy too early, it will be like we did nothing about this at all.

 

Grrr...

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What bothers me is that Trump is discouraging testing. We can't really move forward until we can safely mix again. The only thing that I can come up with for this reticence, is his fear of a large number of deaths that would affect his approval rating. If we don't test, and start the economy too early, it will be like we did nothing about this at all.
I think that you're wrong.  We can't stop this virus.  It will never be safe.  I think pragmatically we have to move forward assuming everyone is going to get it.  Our task is to keep the curve flat enough that the hospitals can treat people.

 

badlatitude

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I think that you're wrong.  We can't stop this virus.  It will never be safe.  I think pragmatically we have to move forward assuming everyone is going to get it.  Our task is to keep the curve flat enough that the hospitals can treat people.
Opening the economy without testing will just create a rolling crisis where there will be multiple lockdowns, more hoarding, and violence. We can stop this virus, it's just the terms of doing that are unacceptable to some.

 

Cal20sailor

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I think that you're wrong.  We can't stop this virus.  It will never be safe.  I think pragmatically we have to move forward assuming everyone is going to get it.  Our task is to keep the curve flat enough that the hospitals can treat people.
I agree with this to a large extent, my GF has a 21yo son who has Type 1 diabetes.  If he gets it, it could be a struggle.  With the hospitals where they are today, if he takes 3x the resources of a 'normal' patient with COVID-19, will he get the care he needs.  In a month or two, the answer might be absolutely, today, that's not clear.  

 

Grrr...

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I agree with this to a large extent, my GF has a 21yo son who has Type 1 diabetes.  If he gets it, it could be a struggle.  With the hospitals where they are today, if he takes 3x the resources of a 'normal' patient with COVID-19, will he get the care he needs.  In a month or two, the answer might be absolutely, today, that's not clear.  
No.  In a world of triage, he will not.  That's what is happening in Italy.  That's exactly why we need to stay home until our hospitals catch a breather and can make room for more cases.

Now I'm talking Michigan specific.  We're further along than most places.

 

Fakenews

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I agree with this to a large extent, my GF has a 21yo son who has Type 1 diabetes.  If he gets it, it could be a struggle.  With the hospitals where they are today, if he takes 3x the resources of a 'normal' patient with COVID-19, will he get the care he needs.  In a month or two, the answer might be absolutely, today, that's not clear.  
Hey, I assume you did not in fact get Coronavirus?  Good news.  We don’t need to be losing good posters. Malarkey, Mikey and Bravo Bravo are a different story..

 

Raz'r

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I think that you're wrong.  We can't stop this virus.  It will never be safe.  I think pragmatically we have to move forward assuming everyone is going to get it.  Our task is to keep the curve flat enough that the hospitals can treat people.
Sadly this

 

Cal20sailor

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Now I'm talking Michigan specific.  We're further along than most places.
An ex-GF is a Hospital Chaplain (St Marys, Livonia) and we traded texts today and she said it is absolute madness right now.  I'm optimistically thinking maybe 6wks for hospitals here to be reasonably normal.  

 

phillysailor

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No, I did, and that's why my GF is leaving care packages and we're not seeing each other.
Good luck to you. I will be hoping you do well.

Monitor your symptoms carefully, and know that it can be a bit of a roller coaster with dramatic reversals possible. Do not become sanguine: if you get short of breath, get into a hospital quickly.

 

badlatitude

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An ex-GF is a Hospital Chaplain (St Marys, Livonia) and we traded texts today and she said it is absolute madness right now.  I'm optimistically thinking maybe 6wks for hospitals here to be reasonably normal.  
Los Angeles extended the quarantine today until May 15th.

Edit: I wish you well also

 
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Cal20sailor

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Good luck. I'm assuming if you're posting here then you aren't doing too horribly.
From everything I've read, I showed minimal affects.  No significant respiratory or coughing issues.  Several days of bad fever and associated aches.  For me, just a bad case of the flu. 

 

AJ Oliver

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The sooner the restrictions are relaxed the sooner the second wave begins.  They need to do the math on when the hospitals will be able to handle it.

People are going to die no matter what we do and no one has a crystal ball.  Do the math and pick what appears to be the best option.
Respectfully disagree - periodic random sampling can tell us what we need to know. 

So fa, doing it are Iceland, Norway, Finland, Ohio, Germany that I know of . .  

It is a total no-brainer. 

For Jeebus & Gawd's sake, even the Naional Review gets it. 

 
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