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

[Fah Kiew Tu]

Why wait for a disease? Especially one that doesn't take much to overwhelm our healthcare systems - which is the big problem - hospital full then everything non covid is going to fight for the right to get treated. Heart Attack and it takes a half hour for EMS to arrive? It's already happened in NYC. Need surgery? Better hope you don't get infected as a bonus.

So a better solution would be to build some camps and ovens and be efficient.  National Slogan "Gramps went to live on that farm in the country".

That's me, sunshine - I'm a grandfather. I already live in the country. Good luck with your plan around these parts.

What I find surprising is just how many of you are in such denial that you'll attack gissie for stating basically the bleeding obvious. It makes me wonder just where your heads are because you're waaaay closer to that nutcase Mikey than you might feel comfortable being.

Unless & until we have fast, cheap *and* reliable testing any relaxation of movement restrictions is *going* to cause further outbreaks, which will result in sick people and the older sick people will more likely die than the younger ones. Sure - hopefully, in a better world, we'll stamp on the outbreaks a lot faster, but given the incubation period, it'll still be stamping out small brushfires to prevent a major raging conflagration. And people will die that otherwise wouldn't for some indeterminate longer time.

OTOH the cost of keeping movements heavily restricted also isn't zero so - shrug. You pays your money and you takes your choices. We can argue about the merits, likely death rates and costs, sure, but attacking gissie and attributing to him a position he hasn't articulated just makes you part of the problem (and a fucking idiot) in my book. Just like Mikey.

FKT

 

[Grrr...]

What is your point?

Do you have an opinion about the cost vs benefit of restarting human activity over time?

His point is that he thinks this is all a total over reaction, and he thinks we should throw out all the preventive measures like social distancing and should go back to work.  He just doesn't dare elaborate on it because he's already been bitch slapped once recently for essentially spreading false info.  Get used to it.  It's what he does.

Hell, it wasn't to long ago that he was claiming to be an auto mechanic as well and was trying to contradict me on something that I have to do regular legal reviews on.

He is a blowhard and a liar.

 

[mikewof]

Ahh - there are a lot of statements there without attribution or support.

• viral pneumonia is far from rare https://thorax.bmj.com/content/63/1/42 "Conclusions: Virus-associated CAP is common in adults". Sure, by the time someone dies in hospital, they will likely have a bacterial infection as well. (Plus their liver will be fucked, heart barely functioning etc). One paper I read had influenza type A as the cause of 45% of pneumonia, which was what I based the 'bacterial and viral causes are about equal' from.
  
• You are correct to pull me up on saying influenza is a corona virus. I should have said a virus which affects the respiratory system and is transferred via the same mechanism as COVID 19
  
• You graph shows approximately 40000 deaths from Pneumonia on average and 25k currently. That's about a 30% drop. Where are you getting the 90% figure from?
  
• You do realise that 'CAP' is just used to differentiate from 'hospital aquired'? Streptococcus is a pretty common bacteria, which rarely causes pneumonia, again I have not seen any evidence that the primary cause of pneumonia is Strep? Total bacterial pneumonia I have seen in the 45% range.
  
• We are in agreement on the total deaths reduction, except once again I have seen no evidence that lowered air pollution is having the instantaneous effect you assume. Do you have some support for this claim?
  

Overall, this seems like a bunch of pointless nit pickery when I still don't actually understand what the argument is on this topic? To me, it seems obvious that the measures in place have reduced the spread of all contageous diseases (and hence deaths) exactly as expected (plus reduced deaths by various misadventures). Do you disagree with this?

What is your point?

Do you have an opinion about the cost vs benefit of restarting human activity over time?

CAP is primarily bacterial. Do you know the percentage of CAP that is viral? The one statistic I remember is that over 75% of the CAPs are caused by strep, I don't remember viral CAP being any more than about 10%, but I'm happy to be corrected if you have the data. Non CAP, that can be anything I guess, from physical infiltrations to virus, etc.. But that's not communicable.

My limited understanding of viruses is that flu virus is built to handle the specific "environmental" conditions of the alveolar region (high shear stress, modified osmotic gradient), where Rhinovirus and Coronavirus are built for the really tough conditions of the "twilight" area that flutters between hot from the body and cold from the air. That is supposedly one of the reasons why coronas and rhinos are so hard to treat and inoculate. Flu is hard enough, but because of the conditions where it lives, it doesn't make as many sub-strains. It's supposedly the sub-strains and fast mutations that make rhinos and coronas so hard to manage. There was a good SciAmerican article about it, link.

Our average deaths from Pneumonia are 50k/year in USA, and we're currently at about 25k, but the chart shows an abrupt drop right when the SARS-CoV-2 started, like, close to nada. This pneumonia season started slow, the curve to me looked like it was headed to about 2013 levels, which was a little higher than average. My original contention is that the year's SARS + pneumonia deaths will add to somewhere a bit north of the average, say 2014 levels, about 60k because this new SARS virus seems to e similar to H1N1, MERS and the first SARS. So right now, at 25k-some SARS deaths, and 25k-some pneumonia deaths, we will likely beat the average, but the CDC has already raised their flu burden, because the SARS testing is showing all kinds of previously undiagnosed flu and pneumonia estimates.

But the real point here, is that the pneumonia should likely not have fallen off the cliff that fast if they were happening independently from SARS. The argument I've seen is "hey quarantine stopped pneumonia." Okay, then why didn't it stop SARS? They're both vectored similarly, why would the quarantine be a raging success against one but not the other?

As for the air pollution, the death toll from that is bigger than flu, bigger than pneumonia, almost as big as hospital error. Air pollution is attributed to 200,000 deaths per year in the USA. The typical connection is with asthma, emphysema, COPD. These deaths are some of the fastest in the industry, hours in some cases, directly tied to extreme ozone pollution events.

And of course, there is also the connection between air pollution and SARS-CoV-2, which sort of creates the triple whammy of a viral/bacterial coinfectioin, but the infiltration from Particulate Matter and Ozone. https://projects.iq.harvard.edu/covid-pm

Your last question first ... the old saying, "a boat is perfectly safe in the harbor, but that's not where boats are designed to stay." We have to restart this rat race and fix our problems the old-fashioned way, but plugging away at them while people go to work. We can lower our air pollution through good policy and low-entropy. We can lower traffic fatalities the way we've already been doing it. Hospitals will get a ton of data from this thing on how to lower accidental hospital deaths and prevent superspreaders. For instance, it's nuts that even in this day and age, an orderly or a housekeeping staff has open run of the hospital, the HVAC systems are often co-mingled between wards, and contagions travel widely. Everyone freaks out over MRSA, but when it comes to common exhaled bacteria, it's still common to shove a patient in a ward with similar contagions. I think this will change, superspreaders time has come. And not that long ago surgeons used to wear the same blood-soaked smock between surgeries.

So what's my point you ask? That we're collectively taking a child's view on this thing. We're wringing hands over SARS-CoV-2, but we're essentially ignoring its function as a bellwether, as a canary-in-coal-mine about deep and expansive underlying lung weaknesses from vaping, PM2.5, ozone, infiltrations, and of course coinfections. When someone has clean air, clean water, and clean food, they seem to be able to shrug off illnesses. Yeah, discussing these things isn't as exciting as running in terror from the viral boogyman, and dragging a guy off a bus because he didn't want to wear his Mouth-hole Bacterial Incubator. But complexity is life, and it's ridiculous for idiots like me, and super-smart guys like you and journalists and Presidents to essentially build public health policy, to the point that guys are being dragged off buses, and ER Doctor mothers are having their children taken away from them.

But even more, it's silly to let physicians set this policy either. They clearly fuck up more than anyone else, with some 200,000 deaths per year due to their mistakes. But also because just as air pollution fizzicists like me don't understand the complexity of microbial function, microbiologists don't understand the complexity of particulate matter and aerosols in the lungs. This is a multidisciplinary effort, or at least it should be, but physicians are notoriously resistant to letting non-medical people feed them data and results. Is that an ego thing, or the due to the confines of academia in hospitals, I don't know.

So now I went through the details, the next step is for Raz'r, or one of those guys to insult me for having a reasonably informed opinion, or Meli to proclaim that I clearly must be mentally ill for thinking about things that don't relate to nonsensical crap.

And that's really the main issue, isn't it? Idiocracy. We revere our stupidity. We revere our stupidity to the point in this country that we will spend all day hating The President while the idiot next to us will spend all day loving The President. Neither of these actually produce anything.

If the average global citizen cared as much about science and critical thought as they do about the politics of the day, this would be a very different kind of world. And it couldn't possibly be any more harsh than it currently is.

 

[mikewof]

Suggestion - if you are bored enough to carry on with Mikey do the rest of us a YUGE favor and don't quote him - he responds to anybody and anything so you don't even have to address him. 

Thanks,

Miss Management.

You see Se7en, case in point here ... never a shortage of 2-cents to add to the politics of the day, but things that require critical thought are looked as something not-to-be-trusted, and not-to-be-examined.

If you bring up science that agrees with their politics, they'll welcome you with open arms. But science doesn't give a rat's ass about politics, it only cares about finding the least wrong answers. And that's not something which the scientifically-illiterate can handle too well.

 

[PHIRKIN]

1) 1st post. Reason even I have account is site went quasi tits up while following (lurking?) commentary on last VOR, and registering let me continue to follow boards. 

2) No tit pix now. Not a sock. Have followed for many years. 

3) THE POINT:  You should carefully consider what you wish for. A consumer self-administered Covid-19 test employed regularly as "personal hygiene" as quoted in post #409 (I can't be arsed to learn how to quote posts to make this one point)   due to governmental, employer, or social pressure is a multi-chambered Pandora's box. For biotech-pharma this could be the realization of a wet dream with chocolate and a cherry on top. I  was under the impression that reducing profiteering by pharma was a current societal goal.  The concept of the employee being responsible for the testing, unlike the now pervasive drug testing, the cost of which is borne by the employer, digs a new channel for flood up as opposed to trickle down. The price of a test is a lot more than the razor blade and squirt of deodorant required to prepare for a workday.  What illness is next for this concept?

4) I waited for someone else to make this point, didn't happen, so I stuck my snout in. 

 

[mikewof]

Se7en, there should be one more thing that should bug the living shit out of you about that pneumonia drop-off, if you really think about it.

It seems that the definitions of the infections are sufficiently fluid that deaths can be shuttled between modes with sufficiently little effort to take 20,000-some deaths from the pneumonia season and stick them into the SARS-CoV-2, whether or not the deceased actually died from the SARS virus or not. (As you know, pneumonia strep does a fine job of killing people all by itself, or it used to, before that statistical cliff appeared.)

Mortality should be a kind of science, with the actual definitions not impacted or influenced by the politics of the day. But that's not the way medicine works at this point. Someone can be put into the box as a SARS-CoV-2 having never actually been tested for the virus antibodies, their cause of death can be based entirely on symptoms.

How are we supposed to make effective policy if we can't trust the repeatability of the data?

 

[roundthebuoys]

My stupid graph shows that we were above the weekly death toll the last 12 months until almost exactly the week everyone stayed home and now we are below it by far.  BECAUSE NO ONE IS DOING ANYTHING THAT KILLS THEM.

 

[mikewof]

1) 1st post. Reason even I have account is site went quasi tits up while following (lurking?) commentary on last VOR, and registering let me continue to follow boards. 

2) No tit pix now. Not a sock. Have followed for many years. 

3) THE POINT:  You should carefully consider what you wish for. A consumer self-administered Covid-19 test employed regularly as "personal hygiene" as quoted in post #409 (I can't be arsed to learn how to quote posts to make this one point)   due to governmental, employer, or social pressure is a multi-chambered Pandora's box. For biotech-pharma this could be the realization of a wet dream with chocolate and a cherry on top. I  was under the impression that reducing profiteering by pharma was a current societal goal.  The concept of the employee being responsible for the testing, unlike the now pervasive drug testing, the cost of which is borne by the employer, digs a new channel for flood up as opposed to trickle down. The price of a test is a lot more than the razor blade and squirt of deodorant required to prepare for a workday.  What illness is next for this concept?

4) I waited for someone else to make this point, didn't happen, so I stuck my snout in. 

It was the societal goal before fear became the order of the day. And the irony is that it's not pharma that will take this one in the shorts, but the hospitals. They are now operating with lots and lots of empty beds, profits are flying out the windows, and the death rate is falling all over the country. People talk about the "other side" of this thing, and I am reasonably confident that unlike Dentists, hospitals will not work to put themselves out of business. But that justification to keep stable patients in hospital beds until their insurance runs out is going to be skating on some thin ice until we forget about this whole thing.

When that guy was dragged off the bus, the people could be heard cheering inside. That's scary to me. When the ER Doctor has her child taken away from her, it seems the most obvious thing to do.

How many people on this board would protest if people deemed to be "high risk" for superspreading were packed into cattle cars and sent off to re-education camps?

 

[mikewof]

I edit people's words without noting that I did so.

Yeah, and?

 

[roundthebuoys]

Yeah, and?

I did so.  Bye Felicia.

 

[wal']

Has anyone asked Bruce yet?

He'll know.....

 

[Amati]

Nice change of direction there AM. To answer, old enough to be hitting the age having a better chance of not surviving an attack.

As for owning a sail boat, nah. Used to, then spent years getting paid to be on them. As for the demographics of who is in the sport, maybe the question I was answering would be the best outcome for the future of the sport.

Millions of old boomers die, leaving house, investments and boats to a younger crowd. Some of those inheriting a boat will like it and go sailing, more room at the club bar now the old dicks at the end gave shuffled off. Some that don't inherit will have always wanted a boat but could never afford it will buy one.

So your silly jibe at how the sport is suffering has an answer. Just not a very acceptable one for most.

Change of direction from what?  Enduring another diatribe? Oh!   My apologies, how stupid of me not to immediately glean that you were inquiring about my thinking on your modest proposal,mand not merely venting your spleen on whoever might have the pleasure of your random attentions.  If that is the case my answers would be:  

1 No

2 you’re brutally greedy and looking forward to somebody dying and leaving you money, right?   

3 yes, for a year or so, and then inflation will tick up, and the usual people will rake in even more.  I hope it’s you Gissie, I Really do.  I think it would make you happy and you could buy a big ranch house on a river in the Redoubt (I’m thinking Kellogg Idaho) buy 30 or 40 guns and have lots of friends just like you.  You could fight, and afterwards enjoy a brew, Rocky Mountain Oysters, sweet potato fries and a good midnight ride on I- 90 on your baggers to State Line without the government telling you to wear one of those Goddamned helmets.  

4 Yes

5 why not?

6 hell no!

7 right.  So right. Really!  Right!

8  Finally I have to offer you my compliments on consistently presenting your finally honed thoughts with such a witheringly dripping and foaming snarl-  it’s not easy, and yet you pull it off with such careless aplomb!  The tightness in your chest must close to excruciating as you wind up your epinephrine spring and release it, to devastating effect!  It’s an edgy superpower you’ve got going there!  I doubt if I’m alone in saying it!  
 

If I have missed anything, please let me know, and I will block you.  It’s the least I can do!  For both of us!
 

 

[Amati]

There seems to be an overlap between the Council to re-open America and the Council that fucked things up.

And they (the ubiquitous pluralism) said that Trump isn’t consistent  ^_^

 

[Amati]

Gissie has grandkids, he’s in the “should die” bracket. Like jeffreaux saying the world needs fewer people, I vote those arguing for deaths go first. You and yours first fuckers.

In North Idaho he could be 36.  Or 30.     oh!  I get your point!  
 

Does Idaho have Legal Assisted Suicide? 

edit- looked it up, and no.    So Idaho is perfect for Gissie!  
 

Yay!

 

[Se7en]

Our average deaths from Pneumonia are 50k/year in USA, and we're currently at about 25k, but the chart shows an abrupt drop right when the SARS-CoV-2 started, like, close to nada.

Mike - please go to this link https://gis.cdc.gov/grasp/fluview/mortality.html 

The CDC site is where you got the data / graphs you have been sharing from.

It shows;

Week 11 pneumonia deaths: 3445

Week 12 pneumonia deaths: 3697

Week 13 pneumonia deaths: 4135

This abrupt drop you are talking about doesn't exist in the data.

(My guess is that the graph you showed with the drop off in the last week was drawn from a dataset taken before the week was finished / or data updated. )

As for the rest - I agree with you that better air, food and water quality will make people healthier. But that comes at a cost which society so far has elected to not pay. But I think that discussion is somewhat seperate to one specific to restarting society from a covid 19 induced lockdown.

 

[Se7en]

It seems that the definitions of the infections are sufficiently fluid that deaths can be shuttled between modes with sufficiently little effort to take 20,000-some deaths from the pneumonia season and stick them into the SARS-CoV-2, whether or not the deceased actually died from the SARS virus or not. (As you know, pneumonia strep does a fine job of killing people all by itself, or it used to, before that statistical cliff appeared.)

I'm sure that there are some cases in the US where people have pneumonia from a non covid 19 infection, but are being recorded as covid 19 deaths. But the number is likely to be small (and is non existant in AU - all our recorded covid 19 deaths, at 1.5% of infections, have tested positive to covid 19).

As per previous - the data from the CDC doesn't seem to support your idea of a statistical cliff.

 

[mikewof]

I'm sure that there are some cases in the US where people have pneumonia from a non covid 19 infection, but are being recorded as covid 19 deaths. But the number is likely to be small (and is non existant in AU - all our recorded covid 19 deaths, at 1.5% of infections, have tested positive to covid 19).

As per previous - the data from the CDC doesn't seem to support your idea of a statistical cliff.

Based on that data from the CDC, I see no way that you can conclude that.

Again, the research from China, and increasingly from the USA shows viral/bacterial coinfections. For all we know at this point, pneumonia could be key component.

And the research I linked earlier that links it to air pollution was discounted here in PA, now it's shown to be significant.

The moral of the story here Seven, is that horse sense doesn't apply here. But what verges on nonsense is your suggestion that the "statistical cliff" is my idea. It's not my opinion, it's right in the data. As long as we have measured pneumonia and deaths, there has never been anything like this. Ignoring what is right in front of us is essentially impossible.

 

[mikewof]

Mike - please go to this link https://gis.cdc.gov/grasp/fluview/mortality.html 

The CDC site is where you got the data / graphs you have been sharing from.

It shows;

Week 11 pneumonia deaths: 3445

Week 12 pneumonia deaths: 3697

Week 13 pneumonia deaths: 4135

This abrupt drop you are talking about doesn't exist in the data.

(My guess is that the graph you showed with the drop off in the last week was drawn from a dataset taken before the week was finished / or data updated. )

As for the rest - I agree with you that better air, food and water quality will make people healthier. But that comes at a cost which society so far has elected to not pay. But I think that discussion is somewhat seperate to one specific to restarting society from a covid 19 induced lockdown.

You got there late. They supposedly retracted the data a couple days ago.. Why? Trumpain politics? Error? I don't know. The Trump supporters claim a conspiracy by the Dems to withhold data that would vindicate their man. The rest seem to claim a conspiracy by Trump to quash the truth. I don't know, I don't care, but I suspect it's just the CDC rechecking that data until they can be sure.

I'm confident that the CDC would not publish bad data, but putting an embargo on data for various reason? It happens all the time. But that chart has been independently created by several people, the data was there.

I'm not a tin-foil hatter, so I'm happy for them to reissue the data when they're ready. For all we know at this point, the anomaly will simply disappear, or else it may just pop up again. But I'm patient enough not to jump to the kind of conclusions that you seem to be happy jumping.

 

[roundthebuoys]

words... Yes I did this.

 

[Gissie]

Gissie has grandkids, he’s in the “should die” bracket. Like jeffreaux saying the world needs fewer people, I vote those arguing for deaths go first. You and yours first fuckers.

What a real bunch of useless cretins you are. The question was asked - what would happen to the US economy if hundreds of thousands died. My response was the economy would be booming. That is all. No suggestion people should be put out to die, just my thoughts if the events proposed did occur.

You inbred, mindless mongrels immediately read something completely different into it and fire off shit balls. No reasoned debate, just piles of shit. At no point have I argued for any one to die, but that doesn't stop your solitary brain cell from de iding that must be what I said.

Look in a mirror and you will see some of the reasons Trump got in looking back at you. Fucking idiots.