Since there's quite a bit of confusion, even here, I wanted to consolidate some existing covid-19 material on Hubski, and add some more. I might do this every few weeks or every month-ish. Other people are also encouraged to make round-up posts, of course. I'm sorry that this content has to be political, it's not my fault.
3Blue1Brown just put out a very nice video discussing the mathematics of epidemics, which resembles an exponential during the early phase of explosive growth:
He nails it with his last spoken sentence: "But if there's no one worried, that's when you should worry". It is my belief that we aren't yet collectively worried enough here in the 'States, as we haven't seen concern translated into taking the actions required to face this disease, both personal and political. In a large hunk of the general public, there seems to be almost a grave misunderstanding of what we need to be doing. I think we need to be taking drastic action at a federal level if we are to even begin this process of "flattening the curve", i.e. hastening the "inflection point" in the transition from an exponential to a logistic curve. I can see that China appears to have reached an inflection point in their covid-19 spread 1 month ago, as seen in the data from this Covid-19 map, but it took a large-scale and very invasive government response. Here's a related concept, showing why it's important to minimize and slow covid-19's growth while we develop a vaccine: Yes, wasoxygen, containment was likely impossible, which of course contradicts relatively recent claims from the Trump administration. My own father has more or less dismissed covid as media hype, and is upset that my mother has insisted on canceling (this is the weirdest part) two cruises they had scheduled for this year. Somehow, this man has whittled his information sphere into somewhere that taking not one, but two cruises this year is a good idea. I think there's about a 100% chance that the ships never sail. Clearly, at a personal level, large swaths of the public can't be trusted yet to even ATTEMPT to behave in any significantly risk-adverse behavior. Community-scale stuff and businesses telling employees to work from home is all fine and dandy, but ideally, we need an essentially endless supply of test kits distributed everywhere in the United States. Well over a month ago, experts had begun recommending that the United States majorly ramp up covid-19 testing capabilities. Because of the complexity and cost of this, it should probably happen at the federal level. Obviously, the Trump administration hasn't and isn't ramping test production up fast enough. It's plain that Trump calls all the shots, but he doesn't understand a goddamn thing about pretty much any of the requisite source material here, and usually manages to gag those in the government who do. Seems like half of America now gets most info from F-book.com, and welp, we know how that's going: According to accounts from several social media platforms, the State Department has been reluctant to share evidence of disinformation, making it difficult for Americans to know what to look out for. As the novel coronavirus outbreak has grown in recent weeks, the State Department has informed the press of conspiracy theories about the outbreak that are being spread on social media platforms such as Twitter, Facebook, and Instagram. Many of the accounts spreading these theories appear to be from Russia, the State Department says. Strange. And just to spam this in one more place, yes, the Trump administration fired the pandemic response team a couple years back. We can argue CDC, NIH, or whatever funding, but it doesn't much matter if you've fired some experts and then ignore and contradict the ones you haven't, using a buffer of loyalists headed by the VP between federal scientists and the public. ========= Trump's To-Do List: (in my fantasies) 0. Changing the rhetoric and educating the public, which includes telling America that some models are currently predicting several hundred thousand American fatalities from covid-19: Here, you can model covid-19 spread with your own parameters. 1. Working towards testing literally everyone as often as we can possibly afford to. 2. Building new emergency hospitalization facilities. 3. Beginning negotiations to contract and train shittons of people how to be nurses or even doctors at these facilities. 4. Federally subsidizing immediate mass production of medical supplies, and then maybe we'll avoid more price gouging from idiots depleting equipment (although this is the first time I'm almost OK with gouging, if it's primarily idiots being gouged). ========= Some version of all of those things already undeniably needs to be done. If hospital facilities are already commonly near capacity each influenza season (they are), the numbers say we need, like, ten times as many facilities. Note: that does NOT mean 10x as many hospitals as we have currently, because most hospitals do many other things besides care for influenza patients. But still, arranging for State Department officials are claiming that disinformation related to the coronavirus — including some pushed by Russia — is rampant across popular social media platforms. But the government seems cagey about reporting the details to the companies involved.
The above paragraph is facts. After that, then we can debate exactly how stupid a payroll tax cut is when it's the elderly and retired who will overwhelmingly be most impacted by covid-19. Trump has been thinking about short-term economic stimulus plans (almost 100% assuredly to help his re-election chances) instead of taking sufficient steps to slow covid. Every day is precious. "Precious" in a comedic and farcical sense, too. Today was "I'm self-quarantining, but everything's absolutely fine" day. Who knows what tomorrow will hold.
Know that things will get worse, but don't panic. Educate yourself and others, and practice better hygiene than normal. Call your representatives.
Took a pandemic to get me to post here again, huh? I was in Spain briefly before the country started to take things seriously. The first few consumer tells had begun to register in supermarkets: shelves mysteriously empty of hand santiser, a shortage of antibacterial wipes (really?). Fortunately there was no sign of TPSDS (toilet paper shortage delusion syndrome). The news was on televisions in local bars; Italy was already happening; yet still the older generation were still shrugging and wondering what the fuss was. Schools remained open. Event closures were being discussed but nothing enacted. A right wing political rally and a march for International Women's Day both went ahead. When I left, the airport was a little quiet. Many Asian passengers were wearing masks. I improvised one for the flight. I won't lie, I modelled a low risk seat in the cabin and sat in it. (Yes, I isolated once I got back to the UK, for the good of the species. No symptoms thus far.) Then, things happened very quickly. The Spanish goverment shut schools, then brought in a state of emergency (only the second since 1978). They have now shut everything but supermarkets, petrol stations and pharmacies. People are being asked to stay indoors except for urgent travel. Meanwhile, back here in the UK, everything continued as if nothing were happening. Restaurants full, concerts ongoing, just the odd mask wearer on public transport. Here in the UK, there have been panic buys, starting with toilet paper and now moving on to pasta. The epidemiology of nervous middle class shoppers' actions is surely a field for study. I think this is partly due to the timid messaging from the government which leaves a vacuum that social media is starting to fill. The UK is enacting a very strange strategy, quite at odds with the rest of Europe (of course) but also seemingly at odds with WHO recommendations. (Offered by the same team who fought and learned from Ebola.) Instead of a heavy-handed total lockdown, or even focused messaging on establishing a cordon sanitaire in a coordinated way following a South Korean model, the conservative government here has decided it wants to allow as many people to become infected as possible before restricting movement. I know, to the untrained layman, or one who might dabble in global epidemiology, that might sound fucking insane, but hear them out. One explanation they have given is apparently to achieve herd immunity. Now, my understanding of herd immunity is that it results prophylactically from innoculations, rather than letting a disease with a 2-4% CFR ... you know, kill people. But, please, continue... Part of the justification is that they feel the British public will tire of being in lockdown and, just as transmission begins to decline, will start back up with their lives and cascade another wave. We are quite clearly in the second phase of their plan, on from Containment (we did not) to Delay. As part of this plan, the new guidance for testing suspected cases is not to do so unless admitted to hospital. And generally you are not admitted unless you are in the 20% of severe cases. I know, that does sound a little like it would make tracking accurate infection rates, how you say? impossible. But maybe we can extrapolate it. Obviously it would be spectacular if we put in the same kind of open data effort Singapore has, which might help the rest of world too, but why bother, eh? So, yes, we are in the Delay phase and yet we have not officially asked people to enact NPIs like social isolation etc. This is because it is all part of the UK's plan to allow lots of people to become infected. Remind me why this is a good idea, again? Another explanation is to suggest that this will allow us to "time" the stress upon the health services, in order to allow it to reach 95% capacity, then control further intake by restricting movement. Presumably this will also balance damage to the economy by keeping things ticking over, rather than slamming on the brakes as in other more sternly responding countries. It is certainly a tricky and vital balancing act. It does look a little like trying to control the behavour of mulitple, intertwined, self-modulating feedback loops with a fucking dimmer switch but let's give it a go, eh? The trouble is, none of these explanations are really clear since the government messaging and communications has been typically Nanny-state British. The public doesn't need to know, just let us get on with it as we know best. The government hasn't revealed the modelling that led them to this decision either, although it has been pressured into doing so and apparently will comply this coming week. Into this hazy space flows conspiracy theories about a greedy right wing having already squeezed the country financially through austerity hoping to kill off its older population so it doesn't need to pay their pensions. Whatever the justification, the action is going ahead. Unless it doesn't. Because, you know, they're not exactly engendering faith in their steady-handed control of the situation. Considering the UK's per capita hospital bed ranking is below that of both Spain and the USA (it's 35 of 40 just above Canada) this is a very interesting strategy which I urge you all to keep your eyes on. And by interesting I mean that ancient curse "may you live in interesting times" interesting. I am getting quite tired of hearing expert scientists repeat variations of the phrase "We can avert X, as long as we act urgently and with determination and coordination" about every single species threatening crisis, only for our goverments to fuckorate it all sideways through the usual cocktail of incompetence, ignorance and greed. Anyway, Vitamin D is indicated in reducing pulmonary infection rates by 30%, zinc ionosphores like chloroquine might be a cheap, easily accessible tool in fighting viral replication, you can control infection rates without lockdowns as South Korea has demonstrated and getting lots of sleep, eating well and not stressing too much is great for your immune system. How are you all doing?
Currently in Glencoe. Wednesday we'll be back in urban society again, with our Eurostar booked for Sunday. Thursday eve we will be in London, which will definitely not go as planned, but we'll see how it will go down. The Netherlands is in public life lockdown mode starting today. Trains are still going thankfully. We've been doing a ton of hikes, so we're pretty fit, but it's also hard not to be exposed to much when you're traveling out and about. I'm very much looking forward to being home, that's for sure.
Well, good weather forecast for Saturday and all my school teaching gigs have been cancelled. If you want a socially distanced meet up in one of the nicer parks, hit me up. (But feel free to sit out London indoors, too. Everyone else is taking things faaaaar too laid back here.) The recent governmental announcements have the pubilc furious. They "urged" people not to go to pubs, theatres, cinemas etc but despite admitting they had the powers to do so, they did not legally compel them to close. Which means they carefully sidestepped legal responsibility for insurance claims. Certainly not surprising for this government.
I'm just going to put this here. "It was hard to breathe," Reed says. "Even walking to the bathroom, I felt like I was running out of air. My ears hurt from it, I lost my balance at times. It started to get scary, like the worst flu I've ever had." Reed ended up in hospital and, after a full day of testing, he says doctors told him he had a "new kind of pneumonia". Fortunately, he was fit and healthy: his life didn't appear to be in danger. Steroid inhalers helped reduce inflammation in his lungs and, more than a month after that first sniffle, Reed recovered. When he called the hospital in early January to ask more about his test results, they told him what was about to hit headlines around the world in just a matter of days – a new kind of coronavirus had been identified in humans. Reed was one of the earliest suspected cases. That description is what led me to inquire with my insurance about getting this thing tested despite the fact that I haven't had a fever in weeks. My experience has been milder, but the time frame matches. For the record: I probably had a fever Feb24-25. As my wife had had a "cold" three days previously, I didn't check. I did check on March 1 and did not have a fever and have not had a fever since. I started to experience malaise, weakness and exhaustion Feb 24 which persisted through March 15 (today). I have had a persistent cough since March 2 or March 3, and I have had an ear infection that has responded slowly to augmentin since March 8. I have never before had an ear infection that didn't clear up within two days of augmentin. I have had a sore throat off and on since about March 1, minimal nasal symptoms, and occasional back ache and other pains since March 2 or 3. I was on a flight from Seattle to Anchorage on February 16, was constrained to a single location from February 16 to February 23, visited a museum in Anchorage on February 23, then traveled from Anchorage to Seattle on February 23. I visited one restaurant on February 24, one yoga class on February 25 and one restaurant on March 5 but have otherwise been self-quarantined. I went shopping at three stores yesterday. My wife's clinic gained access to Quest's COVID-19 test on Wednesday, March 11. On Friday March 13 I called my insurance company to see if they would cover it. They will not. Its projected cost is $1500 minimum. They suggested I call my primary care provider. My primary care provider advised me that they will not cover COVID-19 testing unless I have fever, chills and a cough and can document exposure to a known COVID-19 positive-testing patient, but they would pass a message to my doctor. I have not heard back yet. EDIT: My wife reminded me that our daughter was feeling shitty enough that we almost didn't send her to school on Thursday, February 13 but not so shitty that she didn't come home a bubbling bundle of energy. So. At first, Reed seemed to just have a cold. A week on, then early December, he was already feeling better when a fever hit, and a cough. His whole body started to ache. Another week went by. He thought he was on the mend until the cough became deeper, seeming to settle at the bottom of his lungs.
A Snohomish County man, 35, the nation’s first coronavirus case, was admitted to Providence Regional Medical Center Everett on Jan. 20. He became ill five days after returning from a trip to Wuhan, China, and was treated in a special isolation unit devised for the Ebola outbreak five years ago. After two weeks at Providence, he was monitored at home and fully recovered.
I’m more and more sure that this thing came through my social circle and work circle in early to mid January, though in a milder form. Multiple bouts of sickness with a brief “healthy” period, a cough that couldn’t be shaken and went deeper into my lungs on the second round (to the point where there was a rattling sensation in my chest). Hmmmm. And now we get to see what happens when we rely on private lab testing on a large scale.
I would wonder if it went through all my in-laws and my work starting in mid February except that nobody except that I don't think a single one out of a few dozen have had symptoms worse than 'cold with a lingering cough'. And that includes some heavy smokers who don't exercise pushing 70.
Yeah I felt pretty shitty when my mother-in-law went down about the same time. She's still got laryngitis. Except I didn't so much as go into the house and she's got like eight students (all in their 60s-70s-80s) who have been dealing with said-same. This is the part where the CDC goes "well duh that's why we've stopped community testing. When we say 'endemic to the region' this is what we're talking about."
Hopefully fewer than if I'd gone "it's just a cold, I do what I want" but let's run with it. Best guess is COVID-19 has a median incubation period of 5 days. So. My wife started feeling sniffly Wednesday evening to Thursday morning; we were on a fully-packed 737-900 with 225 people, two pilots and four crew. Did everyone get sick? No, because I didn't get sick until five days after my wife got sick (and my daughter has yet to get sick) so all three of us were likely shedding viruses on three sets of rental gear, shedding viruses in two restaurants a day, shedding viruses at a museum, shedding viruses at an airport, shedding viruses on a fully-packed 737-900 with 225 people, two pilots and four crew (again). Nobody at my wife's work has felt sick yet, despite the likelihood that I caught it from her, despite the fact that viral shedding persists from 8 to 37 days past contraction according to what data we can find. If nothing else that means that our procedures at the birth center are working but it also means that we've had hundreds of patients and relatives exposed in the three weeks we've been back. Let's say I pay for that test. I'm out $1500 and if it comes back negative, I know I don't have coronavirus right now. Let's say it comes back positive. Five families are out of work and an entire clinic caseload of screened low-risk patients gets launched onto the public health system. This is probably about where I mention we've got four acute-care patients coming in tomorrow with symptoms of coronavirus, who were not tested for coronavirus at the emergency room but were instead told to follow up with their primary care provider. In other words, "we don't have the wherewithal to deal with you, go infect your family doctor on Monday." What we've been dealing with is "what can we fob off on telemedicine" and "what do we have to do in person" and suppose I've dropped $1500 to shut my business down. From a public health standpoint do we tell our staff and all our patients to self-isolate and seek testing? Can they get testing considering my test is a self-report? I mean, we've had zero infectious disease communication; I suppose we report to the Department of Health but at this point they've demonstrated they'd rather we keep our patients out of their system. And really, if the test is telling me what I already know, is my moral duty to shut everything down and fob it off on a system that has far more crucial patients than a bunch of pregnant women in their late '20s or is my moral duty to go "you know what we're all going to have CV sooner or later so let's soldier on?" Perhaps most importantly, now that enough time has passed that my wife is no longer symptomatic and I'm on the mend, If I've traced my exposure back to "an airline flight a full calendar month ago" how deep in the shit are we already? Alaska has one (1) confirmed case of COVID-19. How much testing do you think they're doing?
Uhm. I’m gonna share this. It’s an email from an Italian citizen that has been making its way around my work emails so I sincerely hope none of my coworkers googles any specific phrases in the contents but even then, hey, they probably can’t specifically doxx me. It feels worthy of sharing here in a megathread. Again, this is an email from an Italian citizen that lives in Italy that, in a very circuitous roundabout way, ended up in my inbox. Frankly I thought that most of this had been covered on the ‘ski already and admittedly mostly by kleinbl00, but this thread makes me think it’s worth sharing. > Thank you for checking in. Around here we are mostly fine so far, but the overall situation is evolving rapidly and not in a reassuring way. One of the main effects of this contagion is not necessarily about an individual person to be infected and develop life-threatening symptoms but that, considering the population as a whole, the number of people infected and in need of hospitalization and of intensive care (mainly because they need assisted ventilation) is increasing quickly, putting a heavy strain on the health care system. We have come very fast, in a couple of weeks actually, from a scenario where nobody was taking this issue as a serious one (“it’s like the flu”) to the point today where the effects of the infection have mostly wiped out all the spare capacity in intensive care units in many areas of Nothern Italy (sudden higher-than-usual number with critical pneumonia conditions, mostly elderly people or people already weakened by other concurrent illnesses). All of a sudden the number of people in need of ICU has started increasing well above both the seasonal and the long term standards used to determine how many ICU beds are needed for a given area. This created a dire scarcity of beds both for the infected people in critical conditions, and also for people who normally would have needed ICUs, putting everyone infected or not at higher risk of not being capable to get the proper care. Consider that Northern Italy's healthcare system is among the best of the world for standards, personnel, and equipment, so it’s not a local organizational or structural issue, but something that can easily happen in other western countries. The big effort at a nation’s level right now is to try and slow down the contagion rate as much as possible. The target is to spread the number of critical cases as much as possible over time, to dilute over time the strain put on the ICUs. The idea is that, considering that as of now a widespread contagion is inevitable, if the critical cases don’t happen all at once but spread over the next months, the healthcare system can cope with them gradually without clogging the hospital ICUs. For this reason, you are probably seeing stories talking of lockdown of the most affected areas and of a general effort to encourage and enforce so-called social distancing: schools, museums, universities, libraries, gyms, swimming pools are closed, all gatherings are either prohibited or discouraged, depending on the kind. Shops and restaurants are open but the general prescription is to avoid going out as much as possible. The authorities are trying to limit interactions between persons as much as possible to slow down the contagion, without at the same time grinding to a halt the country and the economy. It may seem from the outside that these measures are excessive in some regards, I ensure you that they looked like that to many people here not earlier than ten days ago, but the situation in hospitals has deteriorated so quickly that, in retrospect, probably, harsher measures should have been put in place already starting from two-three weeks ago. Sorry, I elaborated a bit on this, but looking at international news it seems that other countries are not grasping the issue, as we weren’t here until recently, so I thought that a bit of first-hand testimony from the “hot” zone would help to clarify the scenario. Italy is probably just the first western country to be hit by this, but the situation is evolving quickly in other countries and the pattern everywhere is identical to ours, with a first moment of underestimation and then a quick realization of how critical the situation is. Ciao,
Yes, thank you. Anything to help reinforce the seriousness of what we’re facing. Here’s another one out of Italy:
Edit: there are many different people converging on the same set of concerns independently. That’s not a priori proof of fact, but it usually increases the likelihood. I'd remove the accidental censoring I've done in my original post, way above, when I discuss the data out of China, but editing long posts with embedded tweets is a haaaaaard "no", and there's something oddly excellent about accidentally censoring a discussion of Chinese data. Hey, here's some, uh, generational [OC] for everyone: Another boomerang, and I blocked their number. Finally, C3P0 called, and ya know what he said??Boomerang. I hit ignore.
I was seeing stuff out of Italy last night saying that people presenting at the ITU over 65 weren't put on ventilators because there were no ventilators to put them on. Italy is at triage. The Atlantic has a wildly speculative piece suggesting Iran has somewhere between 600,000 and 2 million cases. Iran has one advantage over the rest of the world: everyone of fighting age was wiped out in the Iran/Iraq war so their average age is like 30.
A lady in Fremont, Nebraska tested positive for COVID-19 after attending the Special fucking Olympics and a VFW dinner, showing all the symptoms you'd expect, and thinking "Yeah, it's totally fine for me to go hang out with these vulnerable citizens!" Nebraskans have a placid attitude about this whole infection, trusting our biocontainment unit to contain, and assuming that this is just a "coastal" problem. As far as I'm concerned, though, it's not a question of whether this lady infected anyone outside her family, it's how many, and we won't know that until it's too late. Her family is sick now, too. We're not fucking prepared for this.
Yeah my wife asked if I was going to yoga today. (1) no, my ear feels like it has an aquarium in it downward facing dog is not my idea of a good time (2) there's like 10 people in there in their 70s and I sweat profusely at the best of times so fuck no I feel bad enough maybe exposing them to whatever two weeks ago. I'm told that we can get chlorox wipes for our medical clinic if we order online from the grocery store the night before because the store opens at 6am and between the sprinters waiting at the door every morning and the online shoppers, it's all gone by 6:15am. Thing is? Eventually everyone who needs fuckin' Chlorox wipes will have fuckin' Chlorox wipes. They're hella easier to manufacture than blood oxygenators.
I'd appreciate updates on how things look on the ground in Seattle over the next few days. Kentucky is up to four cases now, one in Louisville that we know of. I'm thinking we're about twenty days behind Seattle, and given that I'm on the front lines, I'd like to know what I'll be up against. My immediate hunch is that our hospital is woefully unprepared for the next two months. Getting a little anxious.
If I had greater insight into the hospitals I'd give it to you. What I can tell you is that everyone has clamped down on the number of acquaintances you can bring into labor and delivery. I can also tell you that this has caused an uptick in calls to us from women who want to transfer their care from hospitals to our birth center. On the one hand, I'm conflicted: we've got carpet FFS and have to buy our disinfection products retail. On the other hand, I see the thinking: sick people aren't coming to birth centers to find out how sick they are. Our naturopaths, who see patients for reasons other than "checking on your pregnancy", have been masked up for two weeks now and wipe down all surfaces in the exam room between patients. We're doing what we can but one of our employees went home today with a sore throat. She's been through some shit lately so I'm more inclined to believe she caught it somewhere else. Whatever I got? I got from a flight from Seattle to Alaska on February 16th. One of my colleges shut down for a few days and then until the 20th because their nursing program was in and out of Life Care Center on the reg - they had like 60 exposures. The other one shut down for a day for deep cleaning and then reopened. They have, however, closed their food bank. I've heard it suggested that Seattle Public Schools has not closed yet because 13,000 of their 55,000 students are on SNAP and they're worried that those 13,000 students won't get any food if they don't come to school. I've heard it further suggested that NYC public schools aren't closing because fully 113,000 of their students are legit homeless so the whole "your college food bank is unavailable because of pestilence" is just the tip of the Dickensian spear here. Amusingly enough, North Seattle keeps saying "no Seattle Colleges campus has yet shut down because of Coronavirus" because despite the fact that LWTech is a college in Seattle, it's not a "Seattle Colleges" college. Fuckin' ridiculous. UW has gone remote, and has drive-through testing for their own medical employees. We haven't tried rounding up a CV19 test since we looked into it Wednesday. My understanding is they're easier to get ahold of now for a number of reasons but we haven't tested that hypothesis. There are no issues buying food whatsoever. Fred Meyer is limiting cold- and flu-related purchases to 5 per customer. I've heard from a Costco employee and a Fred Meyer employee that things like bleach and hand sanitizer and disinfecting wipes are available every morning or every other morning at 6am but there are always people lined up and waiting who purchase to the limit. What's left is taken by online shoppers. Italy is totally shut down but life goes on, which seems kinda like where this thing is gonna go. I got an email this morning from an Italian manufacturer of machine tools saying From this morning the Italian Government has declared the whole Italian territory as a "Red Zone", that means at risk of infection, thus limiting the movement of people throughout the territory, but with the same provision the Italian Government has kept the possibility for people to go to work, and the goods to move freely, in order not to block production activities. HSD has also taken extraordinary measures to deal with this situation and minimize the risks for its employees and consequently to give continuity to the supplies for its customers, consequently from today until 3 April 2020 included, the whole company will observe a timetable continued from 07:00 AM until 07:00 PM by dividing the coverage of this schedule with two groups of employees, the first in the morning (07:00 AM - 01:00 PM) and the second in the afternoon (01:00 PM - 07:00 PM). These two groups of employees will alternate weekly, in order to give continuity to the company activity and to the service to its customers. We also confirm that our 4 branches HSD Deutschland, HSD Mechatronics Shanghai, HSD USA and HSD Korea are fully operational at regular times, to support and possibly support our customers also in other areas of the world. Thanks to these actions, HSD has kept constant production levels and order management continues with normality: supplies and shipments of goods are regular. HSD continues to monitor the development of the situation while the HSD staff remains available for any request.Considering the most recent instructions concerning the spread of Coronavirus COVID-19, HSD Group has enacted a series of measures to guarantee the safety of employees, customers and anyone who interacts with the company, both at the Headquarters and at the Subsidiaries around the world.
When I think about it, this waaay more sad than funny? But gaddamn if I didn't laugh out loud. Which I've found myself doing at all the least appropriate moments in the last two weeks. Like all that's left for us is to dance in front of the fire. I'm not worried about supply shortages or the logistics of tele-educating. The JCPS system is such a shitshow that my kids' school could burn down tomorrow and we wouldn't see a blip in either direction in their MAP scoring. Might go up, seems like they learn more on the weekends anyway. I am absolutely worried about the fact that three weeks ago, our hospitals had no tele beds available, no ICU/CCU beds available, and we were boarding septic shock patients in ER overflow. That was BEFORE all this tomfuckery. I'm worried about the fact that our ER's plan for how to deal with COVID19 patients is to slap a mask on them and move them into one of our negative pressure rooms. Of which we have two. I'm worried that respiratory therapy's best estimate on how many vents our hospital has approaches 80, which is a far cry from, you know, building an entirely new hospital for COVID19 patients in a matter of a few days. I'm worried about the reports from medical staff in Italy which amount to "hey guys, so woah, we are way over our heads here and it's just spooling up for us, so y'all best pucker your butts." Meanwhile, Louisville is essentially a straight split between newlyweds and nearly-deads. We got old people for days. And I'm wondering what'll happen to all the really, really sick people we see NOW when our cup overfloweth with ARDS patients.I've heard it further suggested that NYC public schools aren't closing because fully 113,000 of their students are legit homeless so the whole "your college food bank is unavailable because of pestilence" is just the tip of the Dickensian spear here.
The new measures, announced by Prime Minister Giuseppe Conte, amount to an unprecedented commercial shutdown. They come in response to pressure from politicians in northern Italy, the center of the coronavirus outbreak, who had said more dramatic measures were needed to slow the virus’s spread. This story will be updated. ...well that lasted about 36 hours.BREAKING: Italy announces it will stop almost all commercial activity aside from supermarkets and pharmacies, ramping up national lockdown
All the smooth transitions hospitals are advocating any maternity patient not comfortable birthing alone "reach out to the community" to investigate the possibility of out-of-hospital birth. Effectively, everyone but Swedish is saying "we think our 94% marketshare belongs in a 6% place." We've heard Prov Everett isn't necessarily locking down to the "separate COVID-19 moms from their babies for 14 days" CDC recommendation but they haven't ruled it out. We've gone from "holy shit we had six client interviews this week woo hoo" to "holy shit we had six client interviews today..." and I've started discussions with the landlord about renting additional office space upstairs so we can separate our peds from our maternity. We're about to buy a Butterfly IQ and get someone to locum for us so that we don't have to bump our moms out anywhere for basic ultrasound. We've got six boxes of masks. On the plus side, Frontline came to visit and it looks like Seattle is doing substantially better than NY, but you never know: Trump took our hospital ship because someone reminded him that Jay Inslee criticized him on Twitter.
This is exactly what my wife heard from her old work cohort. This feels like a waking nightmare. We're not yet out of surgical masks or respirators, but with conservative use we'll still be out by next week, just before the shit is really projected to hit the fan. The president of our ED physician's group has told us not to bother soliciting the community to sew masks, as there's essentially no evidence to suggest that they're at all effective. CDC, as I'm sure you know, is recommending bandanas. It's like if we sent our soldiers to war without body armor. And then recommended that when they ran out of bullets they should just point their finger at the enemy and make a shooty sound. The first cases are trickling into our hospital. Had one guy last week in a serious way and his chest CT was sobering. He's now on a vent and people are saying critical but stable, but given that average stay in ICU before death was something like 19-21 days in China, I'm betting his ticket comes pre-punched. Then two days ago we had two more like him. I'm off until Tuesday, and I have no idea what I'll go back to. I'm a hundred percent gonna get it at some point in the following months. 35 is not young enough to feel like I'm gonna glide through. And I'm relatively healthy? But I've also had a chronic cough since I was about 15 and I'm betting my cilia are beaten all to hell. I've had at least one major panic attack per day, but I'm back on my anxiety meds so I got that going for me. But until they kick into full effect, I feel like I'm constantly progressing through finer and finer striations of dread. The dread of what work will be like when I go back. Dread of whether I'll be the one assigned to the COVID-heavy pod. Dread of what my PPE will be like. The dread of waiting for symptoms to kick in. When they inevitably do, eight to twelve days of dread waiting for my breath to get shorter and shorter until I can't talk in full sentences.
It's irresponsible of your ED's group to suggest that community produced masks are ineffective. Providence isn't going that way. We've even seen equivalency tests of like t-shirts and viral load up on Pub Med and NIH. Mine currently has inserts carved out of an MERV13 furnace filter which looks to be about an n65 equivalent. The odds are it won't hit you hard. The odds are if it does hit you hard, it won't hit you hard enough to need a ventilator. They are not odds I like but they beat the shit out of Ebola. Stay safe. And ask mk about baicalin powder. I think it made a difference for me.
Thanks for posting this. It's a really interesting line to walk: I've got people on my teams getting nervous. Colorado declared "a state of emergency" which sound cataclysmic... but really it's about freeing up dollars and cutting red tape... but based on some people's reactions around the office, you'd think we just got word of a Russian nuclear launch. I really like it... it resonates with me, so I'll quote you again:Know that things will get worse, but don't panic. Educate yourself and others, and practice better hygiene than normal. Call your representatives.
Know that things will get worse, but don't panic. Educate yourself and others, and practice better hygiene than normal.
You're gonna be alright, man. Statistically, everyone reading this will mostly be fine, considering the site's demographics. It isn't us that I worry for. It's more like trying to protect the 'Boomers-and-up demographic from themselves. Pretty self-righteous bullshit, but that's generally how I feel. Maybe this is all just me trying to justify my anti-boomer memes. I do wish I had better news to give everyone, but we need to all get real, here, because the federal gov't isn't. Times are gonna be rough for a while, but we'll resume to kinda-normal in a couple years, looks like. We're about to build some national character, but the character in the white house has to get out of the way first. And buckle up, 'cuz he's eventually gonna come at us with some absolutely insane conspiracies to pin the entire coronavirus outbreak on Biden before the election. That'll be fun. Sorry I'm so angry. It's not u, bruh
My institute, university and school where I'm TAing closed until mid-April. Same goes for nurseries, kindergartens and primary/secondary schools in Warsaw, Crakov, Poznań, Łódź and a bunch of other cities. Poland only has 22 confirmed cases as of the time of writing, and I hope it'll dampen the spread.
Because America is the only country that matters in the world (HUGE fan of American Exceptionalism, myself), you've probably heard we just hit 1,000 infections. We're undoubtedly way behind in assessing and tracking the true number, despite a growth rate matching the rest of the non-China world closely (b ~ 1.2). Alotta this comment is for posterity, not Devac. If we have identified 1k+ cases, and we have reportedly used perhaps, optimistically 8k testing kits to this day. Let's say there's a two-day test delay for specimen handling, testing, and reporting (again, pretty optimistic, I think). We might infer that somewhere around 1 in 5 people that get tested are testing positive, but this invests an unwise amount of faith into our testing and reporting system. Because, OHhh, that's right, we don't even fucking know for sure that the other 4 out of 5 aren't positive yet (per theAtlantic.com article above), or if the tests even always work. We can't infer a damn thing because of the botched response, which obviously needed to include accurate statistical reporting. You want good statistics? The feds and states should've talked about how they would coordinate testing and coordination in like January. We knew this was more contagious than SARS or Ebola because of China's (relatively) swift and massive response, and then their transparency. We talk shit about China, and maybe for good reason sometimes (sorry), but they deferred to scientists, and now, the source country of the outbreak is on track to have less cases than the U.S. within a month or two. Thank goodness covid-19 didn't originate here in the U.S. under Trump, the rest of the entire world would be 10x more clueless about it. Not-America saved our asses by generating the statistics we need. This time, it's not just another instance of U.S. disregard of science on the world's stage, our naive response negatively impacts health at a global scale. An international organization may investigate Trump and his genius squad for criminal conduct in their response to covid-19. Or, at least, one may try. K, back to strict math. Let's play nice for almost a few contiguous paragraphs, and assume that U.S. measurements are going OK. Here they are: I'mma fit an exponential function, f(x, A) = A*(b)^x, to data between Feb. 23 to now. I'm just using A=50, and x={0, 17}, and I get a b value somewhere between 1.19 and 1.2 that satisfies f(x=17) = 1,000. That actually agrees with what is currently being observed in the larger dataset of all the non-China's right now (source: the YouTube video in my post far above, by 3Blue1Brown). Fitting an exponential to this larger dataset (which has muuuuuuch better statistics) over roughly the same time interval as before also gives me b ~ 1.2. Pretty cool, but not necessarily indicative of accurate measurements in the 'States. Using the covid-19 tracking map and basic knowledge of population sizes, a comparison of population percentage diagnosed with covid shows that the United States is shockingly low compared to e.g. Europe (don't use the circles to do this, use the raw numbers in the sidebar). Perhaps it came to the U.S. last, or some initial quarantine efforts were not in vain, but we cannot make any statements with a high confidence when only a very small subset of folks presenting with symptoms are being tested. For whatever reason. The cloud of uncertainty regarding wtf is going on inside the Trump administration doesn't help, and casts further doubt on the veracity of the numbers they offer (or don't). Ok, angry me, again, sorry not sorry. This absolute shit job of almost zero covid-19 testing preparation means we will, FOR A LONG TIME, continue to have much worse statistics compared to almost every other developed country. We have missed an opportunity to respond intelligently to this. It frankly doesn't much matter how many little hotspots you quarantine if you're not tracking the spread of the virus through the population. That's like simply ignoring a flaming bag o' poo on your doorstep, but your porch is wooden, and your house burns down. Shoulda sprung for a fire extinguisher. I have yet to see any documentation or explanation regarding why the Trump admin. refused testing kits offered to the U.S. from the WHO (probably not the band, in this instance): Again, the theme: You need good science, president dipshit. Good science needs data. You've ensured that we won't get it in time to help choke this thing early, and compared to the rest of the developed world, we're fucked. You've endangered the entire world. Great job. Prediction: The U.S. will lead the developed world in covid-19 cases within a month or two, surpassing China. Italy's condition is unfortunate, and a reminder that luck is always on the playing field during an epidemic.
But neither the CDC nor the coronavirus task force chaired by Vice President Mike Pence would say who made the decision to forgo the W[orld] H[ealth] O[rganization] test and instead begin a protracted process of producing an American test, one that got delayed by manufacturing problems, possible lab contamination and logistical delays.
Our city finally got our first case, and second one soon after. A father and his son, the son goes to a local high school in the same class as the daughter of one of our professors so they are all at home now. It's actually affecting us, wow. I had just been watching my retirement/first house fund sink but now it's here.
WelpTherefore, CDC, in accordance with its guidance for large events and mass gatherings, recommends that for the next 8 weeks, organizers (whether groups or individuals) cancel or postpone in-person events that consist of 50 people or more throughout the United States.
Great call, and my apologies to ‘bl00. I had only linked one-way, from that thread back this way, and that wasn’t nice, in hindsight.