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Monday, April 6. 2020
What is the purpose of all of these virus recommendations? The masks, the distancing, the stay-at-home, the hospital and nursing home rules?
The purpose is to lower the curve. Not to reduce cases of those made very ill, but to flatten the burden to make medical care more manageable over time: longer, but less intense at the moment.
This particular covid is sneaky - almost always mild-to-nothing, but sometimes lethal for the frail or unlucky. The unlucky part is what makes it scarey. There is no effective protection, in my view, because viruses go viral. Their RNA is their reason for existing.
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Flattening the curve also means more time to get cures while there are fewer cases overall.
With viruses there really are no "cures", there are treatments. These can help to keep you alive until your immune system can take out the virus.
With bacteria, there is a foreign cell type that can be targeted with chemicals that attack the different materials and metabolic pathways that they use. With a virus, the cells and metabolic pathways are the same as healthy cells, so targeting infected cells without harming healthy cells is not really possible at out level of technology. My understanding is that what many of the anti-viral drugs do is not attack the virus but rather preferentially bind to infected cells, making easier for the immune system to recognize them and attack. In military parlance, they aren't the warhead, they're target designators.
This is why we have to develop vaccines against them rather than drugs to treat them. And the logistics of vaccine production are such that it's going to be 18 months to 2 years before they're available in quantity. With the annual flu shot, they are just tinkering with known and understood processes and they can formulate in 6 months or so, but this is a novel case and they're starting pretty much from scratch.
This was made for Nebraska, but a lot of people will find it interesting.
It's a 13 minute video that passes fairly quickly.
Coronavirus update, should I wear a mask or shelter in place?
It is most interesting and actually a sane way to protect yourself. The panic masters on TV, whether media, politicians or medical staff would do well to watch this piece.
Mo effective protection except for better sanitation and chemical intervention.
from onhealth.com : "Different kinds of antiviral medications may be used to treat chickenpox, shingles, herpes simplex virus-1 (HSV-1), herpes simplex virus-2 (HSV-2), HIV, hepatitis B, hepatitis C, and influenza."
Getting more time is a very valuable blessing. We need time far more than we need hundreds of thousands more ventilators, but time will help us get more ventilators. We only have so many people who have the training and expertise to put ventilators to good use. If we could instantly conjure a million ventilators we couldn't use them because that requires not only people with particular expertise but a long logistical tail of additional expertise and STUFF.
Time gets us:
- not so exhausted medical staff expertise who can take a few moments here and there to communicate with other not so exhausted expertise to compare notes and ideas about what is and isn't working well.
- the logistical tail a chance bring up PPE, drugs, tubing, oxygen, configure properly equipped facilities, figure out how to move people where they are needed when they are needed there.
- gather data, usefully analyse data, distribute data about what we are actually facing
- absolutely no end of other things we need done now
I agree with the distancing, masks, washing hands, nursing homes, etc.
Stay at home and shuttering of businesses? Not so much. This is where we've reached a point of absurdity. The logic would point to the fact that flattening the curve also EXTENDS the time line for the disease to spread. And increases the opportunity for a second and third round (as the Spanish Flu had).
So keeping people in their jobs? Probably a good idea. Otherwise extended timelines will have....starvation and excessive need.
https://thedailycoin.org/2020/04/06/food-banks-warn-they-will-soon-run-out-of-food-as-economic-suffering-explodes-all-over-america/?utm_source=rss&utm_medium=rss&utm_campaign=food-banks-warn-they-will-soon-run-out-of-food-as-economic-suffering-explodes-all-over-america Yes, it's a bit of a conspiracy blog, the Economic Collapse blog, but on this point I know he's right as our local food bank (in a region with relatively little need for one, but still we give...) has already begun out reach for more food.
My sister contacted me. She's an essential worker (manages EMS for an over-50 community in FL), but she is concerned because so many of her friends have lost their jobs.
2 friends of mine have been laid off. No furloughed, laid off.
2 other friends have, between them, furloughed or laid off 10 other people.
My wife is concerned her job will be gone in a month.
I'm less concerned...but a month? I may not have a job, either.
I am lucky. I have an emergency fund. Assuming the banks don't run out of cash...(the Fed says no...but even the Fed is fallible). My wife was concerned. Her mother has gone to the ATM several times...only to find it empty. They are in Florida.
Shutting down the businesses created a separate problem which doesn't help with flattening the curve, but also creates a separate problem of despair. I suspect we'll see increases in suicides, domestic violence, and a rise in some drug use if we haven't already.
Abundance of caution, yes. I was cautious. When we shut down, I followed 'the rules'. I still got it. But I'm healthy...
I haven't seen my father or mother in 2 months because we all agreed it's not a good idea. That's an abundance of caution.
Other folks have waxed eloquently regarding proper distancing, etc.
I'm going to posit.....it's social conditioning. If the rubes will follow these guidelines......what else will they do?
Define the y-axis.
The graph that Dr Birx showed uses "number of deaths" as the y-axis, not number of infections.
If number of infections is used, what you have said is plausible - assuming we have time to come up with an intervention that allows us to reduce fatality rate.
If number of deaths is used, the proposal implies that the same number of deaths will occur, but they will occur over a more protracted time interval.
If you can flatten the curve enough to get the reinfection rate below 1.0, the disease dies out, without any cure being necessary. This doesn't mean infecting nobody, but infecting less than one person on the average.
The reinfection rate is lowered by social distancing, and by existing herd immunity, which is slowly growing.
It is a little bit about being unlucky, But the pattern I am seeing is that in addition to hijacking the ACE2 receptor the virus is also downregulating the RAS, reducing angiotensionII production, which probably causes an upregulation in ACE2 receptors.
Bad thing about messing with the RAS is that many blood pressure meds target this system. Infection with the virus might be managed by stopping your HBP meds, increasing water intake, along with NaCl, and watching your BP as well as O2 sats. This may also explain the encephalopathy a few people are exhibiting.
There's only two ways we get past this extreme quarantine: a vaccine or we gradually creep out and get exposed.
Yeah, this thing will be a "thing" till it slips into the background with the common flu and cold viruses and that will a couple years. Faster if a vaccine proves possible. Therapeutics will shift the virus out of the news and political attention.
The talk of beating the virus is happy talk. Similarly, public venues are going to be slow to reopen to a crowd. Restaurants should be planning for operation without dense, crowded dining rooms. Industry will be slow to open as well since they'll have to acquire backfill for the PPE that has been shifted to the response.
Speaking of gradual exposure, ama #11, that has an obvious downside that few people are willing to compare to the even more obvious downside of remaining in lockdown: widespread economic ruin.
The irony here is that the argument that we must take extreme measures — like “stay home” lockdown orders even for the vast numbers of people who are virtually at zero risk, because it is somehow obviously the more moral choice — completely ignores the downside of that policy.
Nobody in government even brought up that throwing millions of people out of work, shutting them in their homes for months, under force of law, just might have some health-related downsides. Right? Even if they mentioned it once, that was it. No big deal.
Even worse, those who advocate for it accuse those who opppose it of “trading lives for dollars”, without realizing they are explicitly trading dollars for lives without ever even considering the downsides.
We should have started that discussion immediately in early March when this all started.
All moral arguments are complicated and people of goodwill can disagree, but you need to at least make an effort to address good faith counter-arguments.
I get that this is an uncomfortable topic. And yet here we are. This discussion is MUCH needed, as uncomfortable as it is. Pretending the question does not exist does not make it go away and in fact breeds contempt those who take another view — and what do you think policy experts from the health and economic domains are arguing about every day behind closed doors? Of course they are discussing this, they have to. We don’t have any choice.
The more effective we are at flattening the curve and social distancing, the larger the pool of remaining potential victims of the virus which means the measures must remain in place for long periods of time to avoid the dreaded second (and third) wave. Until there is an effective treatment or vaccine we may be locked into lock down.
And it seems to be working. Yesterday I spoke to my neighbor, an emergency room PA. He said: Work is slow. All the hospitals are slow. Everyone is getting their hours cut.
Now, that might just reflect the emergency room departments due to reduced car accidents, but my impression was that he was talking about entire hospitals. He works for a level I trauma center that is treating Wuhan Virus patients.
It’s the flu. The stats show it’s the flu and have from the very beginning. Keep repeating to yourself, and quit waiting for the debunking after each ‘body count’.
I know this fact is scarier than an pandemic, but time to make up your mind and quit waffling here, folks.
For a start, watch Amazing Polly vids. Who benefits?