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Expert report predicts up to two more years of pandemic misery

Ken555

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Yup.

Lipsitch and Osterholm both said they are surprised by the decisions many states are making to lift restrictions aimed at controlling the spread of the virus.

"I think it's an experiment. It's an experiment that likely will cost lives, especially in places that do it without careful controls to try to figure out when to try to slow things down again," Lipsitch said.
Plus, he said, some states are choosing to lift restrictions when they have more new infections than they had when they decided to impose the restrictions.

"It is hard to even understand the rationale," Lipsitch said.
 

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Now the World Health Organization is saying that Sweden may be a model to be followed in the future and we should learn from their experience

 

Luanne

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DannyTS

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DannyTS

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I would like to add that it seems difficult to make a clear comparison between countries and states, a lot seems to be based on luck rather than on the measures taken. Canada has had a rather uniform approach. Yet, Ontario is doing a lot better than Quebec despite the larger Asian population and the higher number of travelers.
 

MrockStar

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Some of this differences can be attributed to population density per square mile, public transportation Busses (Detroit, New York, New Orleans) and Subways/Trains ( New York, Chicago) and population makeup, minorities, elderlyand heath risks.
 

PigsDad

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Copying Ken's quoted text from his post above:
Lipsitch and Osterholm both said they are surprised by the decisions many states are making to lift restrictions aimed at controlling the spread of the virus.

"I think it's an experiment. It's an experiment that likely will cost lives, especially in places that do it without careful controls to try to figure out when to try to slow things down again," Lipsitch said.
Plus, he said, some states are choosing to lift restrictions when they have more new infections than they had when they decided to impose the restrictions.

"It is hard to even understand the rationale," Lipsitch said.
It still baffles me as to why people are surprised that states are lifting restrictions. Think back a couple of months: what was the main reason for putting in the SIP restrictions in the first place? It was to "flatten the curve" so that medical facilities would not be overwhelmed, and the states that are lifting some restrictions have now accomplished that. There has not been any cases in the US where medical service was denied to a CV-19 patient due to facilities being overwhelmed.

Flattening the curve does not change the area under the curve (i.e., the number of people who are exposed to the virus). It simply lengthens out the curve. To put it another way, it just changes the date of when one will get exposed. For those who really don't want any chance of being exposed, then they can certainly lock themselves in their home and close off all contact with the outside world until a vaccine or cure is found. But for anyone else, it makes no sense to continue strict SIP policies since eventually, we will all be exposed one way or another. CV-19 is here, and it doesn't magically go away if we SIP forever. People need to work to pay rent, put food on the table, etc. We can be smart and take precautions, but restricting people from making a living cannot go on forever.

Kurt
 

stmartinfan

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Osterholm is from my state and he's a real expert with lots of history in public health issues. He has been saying from the beginning that we will be facing the virus likely for years, until a vaccine is found or enough people are exposed to have the transmission stop. If he's concerned about lifting restrictions it's likely because of the risk still of surging so high in a short time to overwhelm health care the lack of testing to try to control surges.
 

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There has not been any cases in the US where medical service was denied to a CV-19 patient due to facilities being overwhelmed.

The flaw in your logic is that it omits the fact that SIP "is" the reason that our healthcare system was not overwhelmed. Had we not instituted these practices, we'd be in the same position as Spain and Italy. Don't get me wrong. I'm all for opening things up. I just want to make sure we have the healthcare infrastructure in place ,and do it in a safe and cautious manner. If you think things are bad now, watch what happens if we open up prematurely. If we screw this up, there are no "do-overs".
 

PigsDad

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The flaw in your logic is that it omits the fact that SIP "is" the reason that our healthcare system was not overwhelmed. Had we not instituted these practices, we'd be in the same position as Spain and Italy. Don't get me wrong. I'm all for opening things up. I just want to make sure we have the healthcare infrastructure in place and do it in a safe and cautious manner. If you think things are bad now, watch what happens if we open up prematurely.
But the states that are opening up are doing so in small ways; they're not removing all restrictions at once. Doing it this way allows them to reevaluate if they do start to see a rise in cases and adjust to that. Denmark started opening schools two weeks ago and their cases are still declining, so there is precedence for relaxing restrictions after the cases have peaked out.

Most of the hospitals and medical facilities were nowhere near being overwhelmed in the states starting to relax the restrictions. Even the states that delayed and were some of the last to put in restrictions did not have any issues with facilities being overwhelmed, so your logic that SIP was the only reason our healthcare system was not overwhelmed in those states is suspect, to say the least. At some point, SIP will cost more lives than it will save, due to economic and mental effects -- it is not viable as a long-term "solution".

Kurt
 

WVBaker

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I just want to make sure we have the healthcare infrastructure in place ,and do it in a safe and cautious manner.

I doubt we can ever have the healthcare infrastructure in place to meet the need, whatever that may be. Even prior to this virus you would be surprised at the number of emergency rooms and trauma centers, on any given day, that are on by-pass and patients need to be transported to the next available facility, no matter how far away. It would take a great amount of construction to have that needed healthcare infrastructure available.

Also, who is to decide what defines, "a safe and cautious manner"? You have 50 states that can't agree on that now.
 

Luanne

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But the states that are opening up are doing so in small ways; they're not removing all restrictions at once. Doing it this way allows them to reevaluate if they do start to see a rise in cases and adjust to that. Denmark started opening schools two weeks ago and their cases are still declining, so there is precedence for relaxing restrictions after the cases have peaked out.

Most of the hospitals and medical facilities were nowhere near being overwhelmed in the states starting to relax the restrictions. Even the states that delayed and were some of the last to put in restrictions did not have any issues with facilities being overwhelmed, so your logic that SIP was the only reason our healthcare system was not overwhelmed in those states is suspect, to say the least. At some point, SIP will cost more lives than it will save, due to economic and mental effects -- it is not viable as a long-term "solution".

Kurt
I'm assuming by medical facilities not being overwhelmed you mean there were sufficient beds to handle patients? I'm wondering about the reports of insufficient PPE and ventilators. I know there was talk of needing to "split" the ventilators. Did that ever come to pass, or was it a "just in case". Even if there were enough beds the lack of PPE and other things needed to treat people would, to me at least, mean facilities were overwhelmed.
 

Pathways

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The flaw in your logic is that it omits the fact that SIP "is" the reason that our healthcare system was not overwhelmed

Not a flaw in his logic at all - that is precisely what he said. SIP was to reduce stress on our healthcare. It worked. Now open things up. Yes, you can do it in stages. and yes, subject to change if cases/deaths spike so much they could overwhelm hospitals.
 

Pathways

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I know there was talk of needing to "split" the ventilators. Did that ever come to pass, or was it a "just in case".
Splitting a vent in two has always been taught. During this crisis, they taught how to use one vent for four. And I'm not aware of any cases where they even needed to put two on a vent.
 

cbyrne1174

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I always thought the whole point of the lock down was to prevent as many people from dying as possible before the drug trials could finish. Now that the trials are coming to an end, they're probably just going to open things up, keep the rate from being exponential (flatten the curve) and let people get infected until herd immunity is reached. If they can find a drug that they can prescribe BEFORE hospitalization occurs that drastically lowers the hospitalization rate, only those who are already close to dying anyways will die from the infection.

People need to prepare themselves to be infected. If you are "obese", but not "morbidly obese", you have plenty of time to drop enough pounds safely to land in the "overweight" category and improve your chances to fight it off.
 

Pathways

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reports of insufficient PPE

This was an issue in certain areas. (Millions of masks in storage were found to have rotten elastic that broke.)

The vast % of masks are manufactured in China. When the virus hit there, the Chinese government would not allow them to be shipped as they needed them for domestic facilities. (Just like we do). The 30% made here (mostly by 3M) was just not enough, even with 3M putting backup equipment into service and running shifts 24/7.

No place in the four states around me had any issues with PPE. They were still conserving though, as they never knew when the next shipment was going to arrive.
 

isisdave

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At some point, SIP will cost more lives than it will save, due to economic and mental effects -.
That's a guess. There have been some economic projections that show the opposite, although I think the inputs and assumpptions to all these models are too speculative to believe.

Flattening the curve doesn't guarantee that the area under it [the number of cases] stays the same. It could be bigger, it could be smaller.

There are other reasons for flattening, besides avoiding overload of the health system. These are largely matters of increased time, including giving more time for researchers to study the disease and its victims, possibly coming up with new or improved treatment modalities that will reduce the risk of death or serious complications; more time to come up with one or more vaccines; more time to graduate or train more health care workers; even more time for mortuaries in NYC to arrange more storage, if you saw the news yesterday. Health care workers not having to work so intensely will probably keep them healthier and less likely to catch the disease themselves.

We don't know how or even if herd immunity will work, because we don't yet have a good understanding of whether a person is immune once recovered or not. We don't know if it depends on how high an antibody level you get, and whether, on a scale of 1-100, you need a 95 or just a 12. We don't know how long any such immunity would last, and whether it depends on the antibody count. We don't know if the virus will mutate, and whether, if it does, any immunity you have will apply to the new version. Extra time will help researchers answer these questions, and consider how to go forward if it turns out badly: that there is little immunity, or it doesn't last long, or the virus mutates into a worse version.

Some old or unhealthy folks will die of other, more ordinary, quicker, gentler, less terrifying problems, many at home with their familes, and not alone in a hospital.

Even if the number of deaths is inevitably the same, there's more time for grandbabies to meet their grandparents; more time to right old wrongs and settle feuds and misunderstanding. I'll bet others are making good use of this extra time.

Herd immunity without a vaccine is not a solution for Covid-19, any more than it is for mumps. There's an explanation here, but generally the summary is that would still be WAY too many people sick and dead.

I too am anxious to get out and resume having fun. I think those of us who are 70 have at least as much wish not to waste time as those half our age. But just because Solution A is not great, doesn't mean that Solution B has to be better. Solution C, as yet unimagined, might be. Any safe way forward before an effective vaccine involves much more testing, and a contact tracing plan. We all should be asking our leaders why, five months into this, we're not awash in testing materials, kits, and results. And PPE -- where the hell is it?
 
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Some of this differences can be attributed to population density per square mile, public transportation Busses (Detroit, New York, New Orleans) and Subways/Trains ( New York, Chicago) and population makeup, minorities, elderlyand heath risks.
and industries.
 

Pathways

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I always thought the whole point of the lock down was to prevent as many people from dying as possible before the drug trials could finish

This is the first time I have ever heard of this. They said from the beginning, 70% of the population WILL be exposed, and the SIP was just to slow the rate of infection to not overwhelm the hospitals. The assumption has always been no magic treatment, and no vaccine until two years out at a minimum.

COULD there be a treatment? COULD there be a vaccine in 1 year? Anythings possible, but if either one happens, it will be a historic first against a virus like this.

Politicians always tout the 'to keep them from dying' mantra to help justify what they were doing. The medical experts never used it that way. For them, it was to keep the hospitals from being overwhelmed to give the medical staff the best odds on saving lives.

Turns out, even in NY they never were overwhelmed with the need for vents. Of course, the shortage of medical staff has been literally a 'killer' in some hospitals. Medical residents who had never before seen a vent, used youtube to try to learn how to operate them. The stories some of them are telling about how they set them up wrong with no supervision which literally caused the deaths of some patients. So sad. And these heroes are having nightmares from guilt.
 
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isisdave

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That was my point. In the beginning all we had was "try to slow it down while we think a little." Of course there will be new and better treatment. And Oxford has been tinkering with a generic coronavirus vaccine "for decades," so it might take a lot less than 2 years to tweak it to this one. They've said they're about to start manufacturing it, even before end of tests, as they have a high degree of confidence and hope to have 100 million doses ready when it is approved. (This sounds pretty risky to me, but it illustrates that we haven't yet heard every good idea or encouraging bit of news.)

Off topic, but one of the reasons I like TUG so much is that no one shouts over your ideas. We have time to read and consider them before replying.
 

Pathways

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There are other reasons for flattening, besides avoiding overload of the health system. These are largely matters of increased time, including giving more time for researchers to study the disease and its victims, possibly coming up with new or improved treatment modalities that will reduce the risk of death or serious complications; more time to come up with one or more vaccines; more time to graduate or train more health care workers;

You are SPOT ON!. These are all great additional reasons to 'flatten the curve'

We all should be asking our leaders why, five months into this, we're not awash in testing materials, kits, and results. And PPE -- where the hell is it?

Actually, a little searching about the industries, (and specifically the companies doing this work) and the answers are pretty easy to find. And the answers are generally pretty straight forward. These companies are working around the clock, but it still takes times. Just remember, for the past 30+ years the #1 complaint in our country was the cost of healthcare. So every company out there has been operating as lean as possible.

(Remember, no politician would ever actually say 'they are doing the best they can'. Only lay blame.)
 
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Pathways

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They've said they're about to start manufacturing it, even before end of tests, as they have a high degree of confidence and hope to have 100 million doses ready when it is approved. (This sounds pretty risky to me, but it illustrates that we haven't yet heard every good idea or encouraging bit of news.)

There are actually three that I am aware of (probably more) that are already gearing up to manufacture. But FOLLOW THE MONEY! You better believe they are counting on a pot of gold if they are successful, and I'm willing to bet even if they fail they will be fully reimbursed.
 
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