OtherGround Forums OG doc. AMA on COVID-19

4/3/20 10:53 PM
6/2/11
Posts: 1557
mataleo1 -
REALLYBIGRHINO - 

Mataleon, just wondering how many of your colleagues have got the virus? Apologies if this has been asked before. 


A fucking ton.

More than 20 docs, a few of them were in bad shape.

Plenty of nurses.

Damn, I'm sorry to hear that. I appreciate your support in the front lines. and here...

4/3/20 11:21 PM
1/9/02
Posts: 51351
46and2 -
NoNeed4aScreenName -

Italy on the downward 

 

 

Some people sure are happy at how things are going in the USA.  Just another example of how disgusting political tribalism has become   

yeah wtf john burn-murdoch

 

go fuck yourself

Edited: 4/3/20 11:54 PM
9/5/17
Posts: 41

Perhaps this inquiry has been posited before, but I'm wondering for any high level medical personnel/physicians here: what timeframe would you estimate before we have efficacious and widespread treatments that significantly improve symptomology and/or mortality in response to this virus. Maybe this is just my nursing mind wondering, but I'm not as afraid of my loved ones catching this thing (as it seems almost inevitable either this spring or next fall) as I am of them not having a fighting chance because we are struggling to treat this disease. Thank you for what you do and thanks in advance for any speculative information you can provide.

Edited: 4/4/20 12:26 AM
1/9/02
Posts: 51361

vaccine is over a yr out at least, so were going to probably have 2 waves in that time maybe 3 at which point well have herd immunity anyway. we got vaccinated the hard way.

November is supposed to be bad but their epidemiologic models have been off with this thing so who knows

 

the serum thing is looking the most promising in the meantime. the hcq and azi drug cocktail doesn't seem to be super effective and would have a large cardiac risk in the patient population that would tend to need it.

i havent seen any covid pateints yet though i just talked to an ER doc and he said they have 2 in the ICU right now.

4/4/20 3:36 AM
11/23/10
Posts: 174
pidgey -

@JobSecurity:

 

first stats coming out on mortality in Italy in 2020 compared to 2015-2019

 

https://translate.google.com/translate?hl=it&sl=it&tl=en&u=https%3A%2F%2Fwww.youtrend.it%2F2020%2F04%2F03%2Fcoronavirus-dopo-codogno-in-italia-si-e-iniziato-a-morire-molto-di-piu%2F

Thank you!

That’s a very important statistic. Seems to support the other two sources suggesting a similar effect on overall mortality.

Condolences, I hope the worst is over for you down there!

4/4/20 7:50 AM
1/1/01
Posts: 26885
gregbrady -

vaccine is over a yr out at least, so were going to probably have 2 waves in that time maybe 3 at which point well have herd immunity anyway. we got vaccinated the hard way.

November is supposed to be bad but their epidemiologic models have been off with this thing so who knows

 

the serum thing is looking the most promising in the meantime. the hcq and azi drug cocktail doesn't seem to be super effective and would have a large cardiac risk in the patient population that would tend to need it.

i havent seen any covid pateints yet though i just talked to an ER doc and he said they have 2 in the ICU right now.

i think any model that includes china will always be off. 

4/4/20 8:20 AM
10/23/05
Posts: 3238
Crazycracker - 

Perhaps this inquiry has been posited before, but I'm wondering for any high level medical personnel/physicians here: what timeframe would you estimate before we have efficacious and widespread treatments that significantly improve symptomology and/or mortality in response to this virus. Maybe this is just my nursing mind wondering, but I'm not as afraid of my loved ones catching this thing (as it seems almost inevitable either this spring or next fall) as I am of them not having a fighting chance because we are struggling to treat this disease. Thank you for what you do and thanks in advance for any speculative information you can provide.


Pretty much what gregbrady said.

Having experienced the tamiflu bonanza, I don't have much hopes for antivirals.

Plasma and vaccines will be, IMO, the game changers.

Thank you for being on the front line.

4/4/20 8:26 AM
10/23/05
Posts: 3239
Mica Kizbig - 

Mataleo1, thank you and the rest of the professionals providing information here.

What are your thoughts on BC? The numbers are a far cry from Ontario and Quebec which lends some comfort that we may be doing well.

Yesterday's update from the province had noted that over the past few days they have been testing just over 1300 people a day, down from 3-4k per day a few days prior. This was due to the saturation of tests as they focused on healthcare workers. They also noted a reduction in hospitalizations today.

I find it hard to believe that we can get in front of this thing with only testing 1300 people a day but our hospitals dont even appear to be very burdened at all.

Seeing the Ontario and Quebec numbers make me wonder how it could possibly be so different here.

 

Still plenty of people out and about though less than 2 weeks ago.

I do hope we are doing that well but I cant help the skepticism.


There's been a big issue with Ontario vs Quebec.

Ontario has tested less and has more faulty kits (or faulty techniques) it seems.

My wife is actually doing a ID locum in Vancouver now. BC is simply better organized (I'm a kidney guy and I wish we had 50% of your resources). ID/microbiology protocols (as she says) are way better implemented.

Cases in Quebec are on the upswing. COVID patients are becoming the largest % of ICU patients right now. Hopefully we can turn this around soon.

4/4/20 8:29 AM
10/23/05
Posts: 3240
Easters - 
NoNeed4aScreenName -

Italy on the downward 

 

 

Nice to see.  The thing with the US is we’re, what...10x bigger than Italy?  So even if NY acts like Italy and turns the corner in a month, doesn’t really have much to do with other areas of the country.  California might not hit a peak til summer.  I just pray to god all this shut down actually makes a difference, because we can’t do this forever 


I'm positive the shutdowns have had a marked effect at flattening the curve already. Models have shown this time and again. And it also explains why certain countries have fared a lot better than others. In France for example despite the army being in the streets, they permitted open air markets. Absolutely crazy.

4/4/20 8:35 AM
10/23/05
Posts: 3241
Matrix - 

Mata, thanks for doing this. Information is king and you’re passing on great info. I had this stuff btw and I understand why it’s a killer for the elderly and those who have weaker immune systems. Keep up the good fight brother.


Thx. I'm happy so many are also contributing. Please share your experience as a patient.

Between the naysayers, the conspiracy lunatics, the "COVID=mild flu" crowds, ones who want to politicize the issue, and those that think that HCQ will solve everything, I think it's important to give some perspective.

We don't have many answers but we can offer our experience on the battlefield and can share our ability to dissect and interpret medical papers.

4/4/20 10:12 AM
11/10/18
Posts: 6931
yusul -
gregbrady -

vaccine is over a yr out at least, so were going to probably have 2 waves in that time maybe 3 at which point well have herd immunity anyway. we got vaccinated the hard way.

November is supposed to be bad but their epidemiologic models have been off with this thing so who knows

 

the serum thing is looking the most promising in the meantime. the hcq and azi drug cocktail doesn't seem to be super effective and would have a large cardiac risk in the patient population that would tend to need it.

i havent seen any covid pateints yet though i just talked to an ER doc and he said they have 2 in the ICU right now.

i think any model that includes china will always be off. 

The problem isn’t China. We are using a model entirely based off Italy and New York. The model predicted New York would need 52,000 beds yesterday. They needed 13,000 in reality. This will all be quite interesting to watch play out and reflect upon. I’ve taken a lot of heat here for consistently saying our response is too heavy handed. I stand by that and I think my position will look far more reasonable in a year, especially when we still have a 30% or higher unemployment rate. That’s when the medical community will really be overwhelmed and have zero resources. There are no easy solutions to what is a horrible situation. 

4/4/20 10:17 AM
3/6/06
Posts: 31073
Eskimo -
yusul -
gregbrady -

vaccine is over a yr out at least, so were going to probably have 2 waves in that time maybe 3 at which point well have herd immunity anyway. we got vaccinated the hard way.

November is supposed to be bad but their epidemiologic models have been off with this thing so who knows

 

the serum thing is looking the most promising in the meantime. the hcq and azi drug cocktail doesn't seem to be super effective and would have a large cardiac risk in the patient population that would tend to need it.

i havent seen any covid pateints yet though i just talked to an ER doc and he said they have 2 in the ICU right now.

i think any model that includes china will always be off. 

The problem isn’t China. We are using a model entirely based off Italy and New York. The model predicted New York would need 52,000 beds yesterday. They needed 13,000 in reality. This will all be quite interesting to watch play out and reflect upon. I’ve taken a lot of heat here for consistently saying our response is too heavy handed. I stand by that and I think my position will look far more reasonable in a year, especially when we still have a 30% or higher unemployment rate. That’s when the medical community will really be overwhelmed and have zero resources. There are no easy solutions to what is a horrible situation. 

I don't think you will be able to use hindsight that way, because there will be no saying what would have happenned without the heavy-handed response.  Plus there will be no knowing just what would have happened to the economy without the heavy-handed response.

4/4/20 10:23 AM
2/4/09
Posts: 10795
Pura Vida -
Eskimo -
yusul -
gregbrady -

vaccine is over a yr out at least, so were going to probably have 2 waves in that time maybe 3 at which point well have herd immunity anyway. we got vaccinated the hard way.

November is supposed to be bad but their epidemiologic models have been off with this thing so who knows

 

the serum thing is looking the most promising in the meantime. the hcq and azi drug cocktail doesn't seem to be super effective and would have a large cardiac risk in the patient population that would tend to need it.

i havent seen any covid pateints yet though i just talked to an ER doc and he said they have 2 in the ICU right now.

i think any model that includes china will always be off. 

The problem isn’t China. We are using a model entirely based off Italy and New York. The model predicted New York would need 52,000 beds yesterday. They needed 13,000 in reality. This will all be quite interesting to watch play out and reflect upon. I’ve taken a lot of heat here for consistently saying our response is too heavy handed. I stand by that and I think my position will look far more reasonable in a year, especially when we still have a 30% or higher unemployment rate. That’s when the medical community will really be overwhelmed and have zero resources. There are no easy solutions to what is a horrible situation. 

I don't think you will be able to use hindsight that way, because there will be no saying what would have happenned without the heavy-handed response.  Plus there will be no knowing just what would have happened to the economy without the heavy-handed response.

We can at least make some inferences based on flu rates this year 

4/4/20 10:28 AM
10/23/05
Posts: 3242
Eskimo - 
yusul -
gregbrady -

vaccine is over a yr out at least, so were going to probably have 2 waves in that time maybe 3 at which point well have herd immunity anyway. we got vaccinated the hard way.

November is supposed to be bad but their epidemiologic models have been off with this thing so who knows

 

the serum thing is looking the most promising in the meantime. the hcq and azi drug cocktail doesn't seem to be super effective and would have a large cardiac risk in the patient population that would tend to need it.

i havent seen any covid pateints yet though i just talked to an ER doc and he said they have 2 in the ICU right now.

i think any model that includes china will always be off. 

The problem isn’t China. We are using a model entirely based off Italy and New York. The model predicted New York would need 52,000 beds yesterday. They needed 13,000 in reality. This will all be quite interesting to watch play out and reflect upon. I’ve taken a lot of heat here for consistently saying our response is too heavy handed. I stand by that and I think my position will look far more reasonable in a year, especially when we still have a 30% or higher unemployment rate. That’s when the medical community will really be overwhelmed and have zero resources. There are no easy solutions to what is a horrible situation. 


I've seen models from different countries with different resources.

Undoubtedly, Italy (Lombardy especially) has had the worst of it. But South Korea and Singapore also show what can happen when testing and masks are available.

I respect your position. I just don't know or understand how we could have managed if some of the restrictions you find too strict were waved off. It's already a disaster zone in various NYC hospitals. Assume we hadn't closed up restaurants or other businesses. You'd have at least double the population requiring a hospital bed. Then you'd have to factor in certain transmission to other US cities.

If anything, whatever the outcomes, I hope we can learn from this and make better preparations, forecasts, and decisions in the future. I also hope that big data combines with AI neural net / deep learning can have a bigger role in predictions. This is destructive.

4/4/20 10:30 AM
3/6/06
Posts: 31074
NoNeed4aScreenName -
Pura Vida -
Eskimo -
yusul -
gregbrady -

vaccine is over a yr out at least, so were going to probably have 2 waves in that time maybe 3 at which point well have herd immunity anyway. we got vaccinated the hard way.

November is supposed to be bad but their epidemiologic models have been off with this thing so who knows

 

the serum thing is looking the most promising in the meantime. the hcq and azi drug cocktail doesn't seem to be super effective and would have a large cardiac risk in the patient population that would tend to need it.

i havent seen any covid pateints yet though i just talked to an ER doc and he said they have 2 in the ICU right now.

i think any model that includes china will always be off. 

The problem isn’t China. We are using a model entirely based off Italy and New York. The model predicted New York would need 52,000 beds yesterday. They needed 13,000 in reality. This will all be quite interesting to watch play out and reflect upon. I’ve taken a lot of heat here for consistently saying our response is too heavy handed. I stand by that and I think my position will look far more reasonable in a year, especially when we still have a 30% or higher unemployment rate. That’s when the medical community will really be overwhelmed and have zero resources. There are no easy solutions to what is a horrible situation. 

I don't think you will be able to use hindsight that way, because there will be no saying what would have happenned without the heavy-handed response.  Plus there will be no knowing just what would have happened to the economy without the heavy-handed response.

We can at least make some inferences based on flu rates this year 

The seasonal flu?  The numbers being killed by COVID19 are so much higher that seasonal flu numbers are meaningless.

 

COVID19 killed about as many Americans last week as the flu has in all of 2020 and it will likely kill twice as many this week as it did last week.  

Edited: 4/4/20 10:40 AM
2/4/09
Posts: 10797
Pura Vida -
NoNeed4aScreenName -
Pura Vida -
Eskimo -
yusul -
gregbrady -

vaccine is over a yr out at least, so were going to probably have 2 waves in that time maybe 3 at which point well have herd immunity anyway. we got vaccinated the hard way.

November is supposed to be bad but their epidemiologic models have been off with this thing so who knows

 

the serum thing is looking the most promising in the meantime. the hcq and azi drug cocktail doesn't seem to be super effective and would have a large cardiac risk in the patient population that would tend to need it.

i havent seen any covid pateints yet though i just talked to an ER doc and he said they have 2 in the ICU right now.

i think any model that includes china will always be off. 

The problem isn’t China. We are using a model entirely based off Italy and New York. The model predicted New York would need 52,000 beds yesterday. They needed 13,000 in reality. This will all be quite interesting to watch play out and reflect upon. I’ve taken a lot of heat here for consistently saying our response is too heavy handed. I stand by that and I think my position will look far more reasonable in a year, especially when we still have a 30% or higher unemployment rate. That’s when the medical community will really be overwhelmed and have zero resources. There are no easy solutions to what is a horrible situation. 

I don't think you will be able to use hindsight that way, because there will be no saying what would have happenned without the heavy-handed response.  Plus there will be no knowing just what would have happened to the economy without the heavy-handed response.

We can at least make some inferences based on flu rates this year 

The seasonal flu?  The numbers being killed by COVID19 are so much higher that seasonal flu numbers are meaningless.

 

COVID19 killed about as many Americans last week as the flu has in all of 2020 and it will likely kill twice as many this week as it did last week.  

No, you can see if social distancing had the desired effect by observing flu case rates. 

 

If flu rates continued to increase during social distancing one can assume it wasnt as beneficial as claimed. 

 

We should see rates of both go down

4/4/20 10:51 AM
10/23/05
Posts: 3243
NoNeed4aScreenName - 
Pura Vida -
NoNeed4aScreenName -
Pura Vida -
Eskimo -
yusul -
gregbrady -

vaccine is over a yr out at least, so were going to probably have 2 waves in that time maybe 3 at which point well have herd immunity anyway. we got vaccinated the hard way.

November is supposed to be bad but their epidemiologic models have been off with this thing so who knows

 

the serum thing is looking the most promising in the meantime. the hcq and azi drug cocktail doesn't seem to be super effective and would have a large cardiac risk in the patient population that would tend to need it.

i havent seen any covid pateints yet though i just talked to an ER doc and he said they have 2 in the ICU right now.

i think any model that includes china will always be off. 

The problem isn’t China. We are using a model entirely based off Italy and New York. The model predicted New York would need 52,000 beds yesterday. They needed 13,000 in reality. This will all be quite interesting to watch play out and reflect upon. I’ve taken a lot of heat here for consistently saying our response is too heavy handed. I stand by that and I think my position will look far more reasonable in a year, especially when we still have a 30% or higher unemployment rate. That’s when the medical community will really be overwhelmed and have zero resources. There are no easy solutions to what is a horrible situation. 

I don't think you will be able to use hindsight that way, because there will be no saying what would have happenned without the heavy-handed response.  Plus there will be no knowing just what would have happened to the economy without the heavy-handed response.

We can at least make some inferences based on flu rates this year 

The seasonal flu?  The numbers being killed by COVID19 are so much higher that seasonal flu numbers are meaningless.

 

COVID19 killed about as many Americans last week as the flu has in all of 2020 and it will likely kill twice as many this week as it did last week.  

No, you can see if social distancing had the desired effect by observing flu case rates. 

 

If flu rates continued to increase during social distancing one can assume it wasnt as beneficial as claimed. 

 

We should see rates of both go down


I get your point but transmission (and distance) are a little different with COVID: more aerosolized and larger distance of contagion. And you'd have to compare flu rates from this year compared to last year, which is another can of worms because of vaccination effect.

Also, I think that mathematically it's not simply looking at rates (up or down) but how you modify it (the slope), say you decrease the slope from 2 to 1.5 (assuming linearity).

This is actually super interesting. I'd love to see models.

4/4/20 11:01 AM
2/4/09
Posts: 10801
mataleo1 -
NoNeed4aScreenName - 
Pura Vida -
NoNeed4aScreenName -
Pura Vida -
Eskimo -
yusul -
gregbrady -

vaccine is over a yr out at least, so were going to probably have 2 waves in that time maybe 3 at which point well have herd immunity anyway. we got vaccinated the hard way.

November is supposed to be bad but their epidemiologic models have been off with this thing so who knows

 

the serum thing is looking the most promising in the meantime. the hcq and azi drug cocktail doesn't seem to be super effective and would have a large cardiac risk in the patient population that would tend to need it.

i havent seen any covid pateints yet though i just talked to an ER doc and he said they have 2 in the ICU right now.

i think any model that includes china will always be off. 

The problem isn’t China. We are using a model entirely based off Italy and New York. The model predicted New York would need 52,000 beds yesterday. They needed 13,000 in reality. This will all be quite interesting to watch play out and reflect upon. I’ve taken a lot of heat here for consistently saying our response is too heavy handed. I stand by that and I think my position will look far more reasonable in a year, especially when we still have a 30% or higher unemployment rate. That’s when the medical community will really be overwhelmed and have zero resources. There are no easy solutions to what is a horrible situation. 

I don't think you will be able to use hindsight that way, because there will be no saying what would have happenned without the heavy-handed response.  Plus there will be no knowing just what would have happened to the economy without the heavy-handed response.

We can at least make some inferences based on flu rates this year 

The seasonal flu?  The numbers being killed by COVID19 are so much higher that seasonal flu numbers are meaningless.

 

COVID19 killed about as many Americans last week as the flu has in all of 2020 and it will likely kill twice as many this week as it did last week.  

No, you can see if social distancing had the desired effect by observing flu case rates. 

 

If flu rates continued to increase during social distancing one can assume it wasnt as beneficial as claimed. 

 

We should see rates of both go down


I get your point but transmission (and distance) are a little different with COVID: more aerosolized and larger distance of contagion. And you'd have to compare flu rates from this year compared to last year, which is another can of worms because of vaccination effect.

Also, I think that mathematically it's not simply looking at rates (up or down) but how you modify it (the slope), say you decrease the slope from 2 to 1.5 (assuming linearity).

This is actually super interesting. I'd love to see models.

If the social distancing worked for the 1918 spanish flu I would assume it should have an effect on flu in this instance as well

4/4/20 11:03 AM
2/4/09
Posts: 10802
NoNeed4aScreenName -
mataleo1 -
NoNeed4aScreenName - 
Pura Vida -
NoNeed4aScreenName -
Pura Vida -
Eskimo -
yusul -
gregbrady -

vaccine is over a yr out at least, so were going to probably have 2 waves in that time maybe 3 at which point well have herd immunity anyway. we got vaccinated the hard way.

November is supposed to be bad but their epidemiologic models have been off with this thing so who knows

 

the serum thing is looking the most promising in the meantime. the hcq and azi drug cocktail doesn't seem to be super effective and would have a large cardiac risk in the patient population that would tend to need it.

i havent seen any covid pateints yet though i just talked to an ER doc and he said they have 2 in the ICU right now.

i think any model that includes china will always be off. 

The problem isn’t China. We are using a model entirely based off Italy and New York. The model predicted New York would need 52,000 beds yesterday. They needed 13,000 in reality. This will all be quite interesting to watch play out and reflect upon. I’ve taken a lot of heat here for consistently saying our response is too heavy handed. I stand by that and I think my position will look far more reasonable in a year, especially when we still have a 30% or higher unemployment rate. That’s when the medical community will really be overwhelmed and have zero resources. There are no easy solutions to what is a horrible situation. 

I don't think you will be able to use hindsight that way, because there will be no saying what would have happenned without the heavy-handed response.  Plus there will be no knowing just what would have happened to the economy without the heavy-handed response.

We can at least make some inferences based on flu rates this year 

The seasonal flu?  The numbers being killed by COVID19 are so much higher that seasonal flu numbers are meaningless.

 

COVID19 killed about as many Americans last week as the flu has in all of 2020 and it will likely kill twice as many this week as it did last week.  

No, you can see if social distancing had the desired effect by observing flu case rates. 

 

If flu rates continued to increase during social distancing one can assume it wasnt as beneficial as claimed. 

 

We should see rates of both go down


I get your point but transmission (and distance) are a little different with COVID: more aerosolized and larger distance of contagion. And you'd have to compare flu rates from this year compared to last year, which is another can of worms because of vaccination effect.

Also, I think that mathematically it's not simply looking at rates (up or down) but how you modify it (the slope), say you decrease the slope from 2 to 1.5 (assuming linearity).

This is actually super interesting. I'd love to see models.

If the social distancing worked for the 1918 spanish flu I would assume it should have an effect on flu in this instance as well

But I understand what you mean. The distribution curve would be flatter. 

 

Based on previous years growth of flu we can make a model. That's out of my field though. 

 

I'll see if I come across anything later in terms of models

4/4/20 11:13 AM
3/6/06
Posts: 31077
NoNeed4aScreenName -
Pura Vida -
NoNeed4aScreenName -
Pura Vida -
Eskimo -
yusul -
gregbrady -

vaccine is over a yr out at least, so were going to probably have 2 waves in that time maybe 3 at which point well have herd immunity anyway. we got vaccinated the hard way.

November is supposed to be bad but their epidemiologic models have been off with this thing so who knows

 

the serum thing is looking the most promising in the meantime. the hcq and azi drug cocktail doesn't seem to be super effective and would have a large cardiac risk in the patient population that would tend to need it.

i havent seen any covid pateints yet though i just talked to an ER doc and he said they have 2 in the ICU right now.

i think any model that includes china will always be off. 

The problem isn’t China. We are using a model entirely based off Italy and New York. The model predicted New York would need 52,000 beds yesterday. They needed 13,000 in reality. This will all be quite interesting to watch play out and reflect upon. I’ve taken a lot of heat here for consistently saying our response is too heavy handed. I stand by that and I think my position will look far more reasonable in a year, especially when we still have a 30% or higher unemployment rate. That’s when the medical community will really be overwhelmed and have zero resources. There are no easy solutions to what is a horrible situation. 

I don't think you will be able to use hindsight that way, because there will be no saying what would have happenned without the heavy-handed response.  Plus there will be no knowing just what would have happened to the economy without the heavy-handed response.

We can at least make some inferences based on flu rates this year 

The seasonal flu?  The numbers being killed by COVID19 are so much higher that seasonal flu numbers are meaningless.

 

COVID19 killed about as many Americans last week as the flu has in all of 2020 and it will likely kill twice as many this week as it did last week.  

No, you can see if social distancing had the desired effect by observing flu case rates. 

 

If flu rates continued to increase during social distancing one can assume it wasnt as beneficial as claimed. 

 

We should see rates of both go down

That makes sense, but aren't we at the end of seasonal flu season anyway?  

4/4/20 11:16 AM
10/23/05
Posts: 3244
Pura Vida - 
NoNeed4aScreenName -
Pura Vida -
NoNeed4aScreenName -
Pura Vida -
Eskimo -
yusul -
gregbrady -

vaccine is over a yr out at least, so were going to probably have 2 waves in that time maybe 3 at which point well have herd immunity anyway. we got vaccinated the hard way.

November is supposed to be bad but their epidemiologic models have been off with this thing so who knows

 

the serum thing is looking the most promising in the meantime. the hcq and azi drug cocktail doesn't seem to be super effective and would have a large cardiac risk in the patient population that would tend to need it.

i havent seen any covid pateints yet though i just talked to an ER doc and he said they have 2 in the ICU right now.

i think any model that includes china will always be off. 

The problem isn’t China. We are using a model entirely based off Italy and New York. The model predicted New York would need 52,000 beds yesterday. They needed 13,000 in reality. This will all be quite interesting to watch play out and reflect upon. I’ve taken a lot of heat here for consistently saying our response is too heavy handed. I stand by that and I think my position will look far more reasonable in a year, especially when we still have a 30% or higher unemployment rate. That’s when the medical community will really be overwhelmed and have zero resources. There are no easy solutions to what is a horrible situation. 

I don't think you will be able to use hindsight that way, because there will be no saying what would have happenned without the heavy-handed response.  Plus there will be no knowing just what would have happened to the economy without the heavy-handed response.

We can at least make some inferences based on flu rates this year 

The seasonal flu?  The numbers being killed by COVID19 are so much higher that seasonal flu numbers are meaningless.

 

COVID19 killed about as many Americans last week as the flu has in all of 2020 and it will likely kill twice as many this week as it did last week.  

No, you can see if social distancing had the desired effect by observing flu case rates. 

 

If flu rates continued to increase during social distancing one can assume it wasnt as beneficial as claimed. 

 

We should see rates of both go down

That makes sense, but aren't we at the end of seasonal flu season anyway?  


Exactly. Another confounder.

4/4/20 11:17 AM
2/4/09
Posts: 10804
Pura Vida -
NoNeed4aScreenName -
Pura Vida -
NoNeed4aScreenName -
Pura Vida -
Eskimo -
yusul -
gregbrady -

vaccine is over a yr out at least, so were going to probably have 2 waves in that time maybe 3 at which point well have herd immunity anyway. we got vaccinated the hard way.

November is supposed to be bad but their epidemiologic models have been off with this thing so who knows

 

the serum thing is looking the most promising in the meantime. the hcq and azi drug cocktail doesn't seem to be super effective and would have a large cardiac risk in the patient population that would tend to need it.

i havent seen any covid pateints yet though i just talked to an ER doc and he said they have 2 in the ICU right now.

i think any model that includes china will always be off. 

The problem isn’t China. We are using a model entirely based off Italy and New York. The model predicted New York would need 52,000 beds yesterday. They needed 13,000 in reality. This will all be quite interesting to watch play out and reflect upon. I’ve taken a lot of heat here for consistently saying our response is too heavy handed. I stand by that and I think my position will look far more reasonable in a year, especially when we still have a 30% or higher unemployment rate. That’s when the medical community will really be overwhelmed and have zero resources. There are no easy solutions to what is a horrible situation. 

I don't think you will be able to use hindsight that way, because there will be no saying what would have happenned without the heavy-handed response.  Plus there will be no knowing just what would have happened to the economy without the heavy-handed response.

We can at least make some inferences based on flu rates this year 

The seasonal flu?  The numbers being killed by COVID19 are so much higher that seasonal flu numbers are meaningless.

 

COVID19 killed about as many Americans last week as the flu has in all of 2020 and it will likely kill twice as many this week as it did last week.  

No, you can see if social distancing had the desired effect by observing flu case rates. 

 

If flu rates continued to increase during social distancing one can assume it wasnt as beneficial as claimed. 

 

We should see rates of both go down

That makes sense, but aren't we at the end of seasonal flu season anyway?  

Definitely approaching the end. As mataleo mentioned I guess it could be more reasonable to observe the slope.

 

Should be a fairly drastic cut in new cases after the commencement of social distancing

4/4/20 11:27 AM
3/6/06
Posts: 31079
NoNeed4aScreenName -
Pura Vida -
NoNeed4aScreenName -
Pura Vida -
NoNeed4aScreenName -
Pura Vida -
Eskimo -
yusul -
gregbrady -

vaccine is over a yr out at least, so were going to probably have 2 waves in that time maybe 3 at which point well have herd immunity anyway. we got vaccinated the hard way.

November is supposed to be bad but their epidemiologic models have been off with this thing so who knows

 

the serum thing is looking the most promising in the meantime. the hcq and azi drug cocktail doesn't seem to be super effective and would have a large cardiac risk in the patient population that would tend to need it.

i havent seen any covid pateints yet though i just talked to an ER doc and he said they have 2 in the ICU right now.

i think any model that includes china will always be off. 

The problem isn’t China. We are using a model entirely based off Italy and New York. The model predicted New York would need 52,000 beds yesterday. They needed 13,000 in reality. This will all be quite interesting to watch play out and reflect upon. I’ve taken a lot of heat here for consistently saying our response is too heavy handed. I stand by that and I think my position will look far more reasonable in a year, especially when we still have a 30% or higher unemployment rate. That’s when the medical community will really be overwhelmed and have zero resources. There are no easy solutions to what is a horrible situation. 

I don't think you will be able to use hindsight that way, because there will be no saying what would have happenned without the heavy-handed response.  Plus there will be no knowing just what would have happened to the economy without the heavy-handed response.

We can at least make some inferences based on flu rates this year 

The seasonal flu?  The numbers being killed by COVID19 are so much higher that seasonal flu numbers are meaningless.

 

COVID19 killed about as many Americans last week as the flu has in all of 2020 and it will likely kill twice as many this week as it did last week.  

No, you can see if social distancing had the desired effect by observing flu case rates. 

 

If flu rates continued to increase during social distancing one can assume it wasnt as beneficial as claimed. 

 

We should see rates of both go down

That makes sense, but aren't we at the end of seasonal flu season anyway?  

Definitely approaching the end. As mataleo mentioned I guess it could be more reasonable to observe the slope.

 

Should be a fairly drastic cut in new cases after the commencement of social distancing

I'm not trying to be contrarian, just asking questions because this is interesting.

On the slope, isn't it reasonable to think the flu slope would be impacted by people thinking they have COVID19?  Meaning, last year if I had a fever and sore throat I might think "that sucks, I have the flu."  This year I might think "I have the COVID19, I'm going to get checked right away," leading to a confirmed case of the flu that would not have been confirmed in other years.

4/4/20 11:27 AM
11/10/18
Posts: 6934
mataleo1 -
Eskimo - 
yusul -
gregbrady -

vaccine is over a yr out at least, so were going to probably have 2 waves in that time maybe 3 at which point well have herd immunity anyway. we got vaccinated the hard way.

November is supposed to be bad but their epidemiologic models have been off with this thing so who knows

 

the serum thing is looking the most promising in the meantime. the hcq and azi drug cocktail doesn't seem to be super effective and would have a large cardiac risk in the patient population that would tend to need it.

i havent seen any covid pateints yet though i just talked to an ER doc and he said they have 2 in the ICU right now.

i think any model that includes china will always be off. 

The problem isn’t China. We are using a model entirely based off Italy and New York. The model predicted New York would need 52,000 beds yesterday. They needed 13,000 in reality. This will all be quite interesting to watch play out and reflect upon. I’ve taken a lot of heat here for consistently saying our response is too heavy handed. I stand by that and I think my position will look far more reasonable in a year, especially when we still have a 30% or higher unemployment rate. That’s when the medical community will really be overwhelmed and have zero resources. There are no easy solutions to what is a horrible situation. 


I've seen models from different countries with different resources.

Undoubtedly, Italy (Lombardy especially) has had the worst of it. But South Korea and Singapore also show what can happen when testing and masks are available.

I respect your position. I just don't know or understand how we could have managed if some of the restrictions you find too strict were waved off. It's already a disaster zone in various NYC hospitals. Assume we hadn't closed up restaurants or other businesses. You'd have at least double the population requiring a hospital bed. Then you'd have to factor in certain transmission to other US cities.

If anything, whatever the outcomes, I hope we can learn from this and make better preparations, forecasts, and decisions in the future. I also hope that big data combines with AI neural net / deep learning can have a bigger role in predictions. This is destructive.

I respect your position as well and I wouldn’t think you were a good doctor if you didn’t have that position. I ultimately think we should have used a birthday triage system that started with people over 85 not getting care and being taken off ventilators as the system was overwhelmed. Then adjusted down in age as needed to keep the system working. That’s extremely harsh and I’m fully aware it would be awful. My position is that we have no idea what awful can really be as everyone living has only known good economic times. I think we’ve fundamentally changed the world with our approach to this and we’ll never go back to the way things were. I hope I’m wrong, but I genuinely believe we’ve made a terrible situation far worse. 

4/4/20 1:37 PM
11/1/03
Posts: 21696

I suspect if we took social distancing more seriously earlier and used masks and gloves more we could have cut this down so the drastic decisions werent needed. The S. Koreans were more used to this, apparently they learned from sars, mers and swine fly episodes.