COVID-19 Thread

[homer]

Pretty sure the order does say no elective procedures etc...that being said I think the one that will go into effect will allow that stuff again.

 

 

https://evers.wi.gov/Documents/COVID19/EMO12-SaferAtHome.pdf

 

I didn't read it word for word but I could not find anything. Maybe I missed it.

 

This is from Aurora Health. You'd think they'd mention the Stay at Home order if that was indeed what drove this:

In response to COVID-19, we’re limiting nonurgent outpatient appointments and certain elective surgeries/procedures for the health and safety of our patients and team members. If you have a nonurgent appointment or elective surgery/procedure scheduled on or before April 24, your physician will determine the best approach.

[Outlander]

Personally, I'd like to see the drive-ins get an exemption. I understand New York is considering it. It would at least be something to do with a change of scenery. Maybe you'd have to do some e-ticketing and shut down the concession stand, but it seems feasible.

I was thinking about that too but so much of their revenue is concessions but maybe they could figure out carside service. Also, not sure what they would be able to show that would bring in people.

[igor67]

Based on what I've seen in MN I'm guessing a big hurdle for 'elective' procedures is PPE. Initially it was a combination of prevent spread and trying to keep all hands on deck.

 

I got rather excited by that antibody study, but between it being in California and a non-random sample I'm hesitant to get that excited that the actual infection rate is that much north of the previous estimate of 50% asymptomatic. We are just about to 0.5% of the population if you take the official count and double it, which isn't much but it wouldn't take a lot of bias in the study to push the apparent rate into the range they calculated.

[PeaveyFury]

Completely unsurprizingly, Wuhan completely revised their COVID numbers today, dramatically increasing both numbers of deaths and cases.

[Fear The Chorizo]

Whether people totally buy into them or not, the same models utilized to initiate the stay at home orders in the first place point to us rapidly approaching a point of diminished returns from a Covid-19 public health standpoint for extending the orders for everyone well into May/June or even beyond - that doesn't even factor the likely issue of us already being well beyond the point of economic hardship that is going to lead to longterm struggles for tens of millions of Americans and the state & local units of government representing them, and if we aren't careful we will see a worse public health crisis evolve from extended lapses with all the other comorbidities and conditions that aren't being treated routinely right now.

 

The MN state modeling indicated its estimated overall death total across the full arc of the pandemic response would be almost unchanged had stay at home measures started getting lifted a week ago versus extending their current stay at home order for everyone into early May - the difference was the peak hospitalization rate would have occurred by early June compared to mid July, so the governor's primary reasoning for extending the order a few weeks ago was to buy hospitals more time to have ICU bed surge capacity in the state.

 

If states/local units of government have enough hospital capacity and ICU surge capability to manage the anticipated surges in hospitalizations, they need to start allowing things to reopen much sooner than late May for the majority of working and school-aged people who aren't immunocompromised or have cormorbidities that make them more vulnerable for symptoms leading to hospitalization - not saying open up everything instantly, but much more than what the stay at home orders and exceptions currently allow. Keep in mind that these models could be revised further down in terms of death and hospitalization totals should improved/increased testing and effective contract tracing actually happen, which is a critical element to diminish and isolate future infection spikes along with figuring out improved treatments/therapies. I'm guessing the next round of modeling will start coming out soon from many different sources, and my hope is that if the data continues to revise estimates lower for certain states, current stay at home orders can be lifted before they expire just as easily as they were extended if they are determined to be excessive.

 

Keep the vulnerable isolated longer, stay the current course in population centers that have been hardest hit a bit longer than other minimally impacted areas, but get everyone else moving forward to the next stage in dealing with coronavirus - which is living with it as a society. The sooner we get away from a one size fits all approach, the better off we will be overall. The hospitalization/death estimates coming from China are still garbage even after today's revisions, but I think the reason they are able to say they have very limited new cases happening in Wuhan right now is that a huge chunk of that population was infected with the virus after it was allowed to run rampant for almost two months once it started spreading. Wuhan may be the one spot on earth that has built up a herd immunity - my guess is that came at the expense of a huge amount of deaths because letting Covid-19 burn through a population unchecked is not the solution, either. It stinks we will never get decent data from there on what the percentage of people who currently have antibodies in their system actually is.

[homer]

It'd be helpful if you linked to the things you reference.

[pacopete4]

Some rogue local county governments down here in the Milwaukee area. I’ve seen Racine and Washington County lash out against Evers and are now opening golf courses (among other things) tomorrow instead of waiting for the 24th.

[stalton]

Enivitably when this thread gets split because of the size, can we name the new thread Covid-20 or Covid-19 2 the electric boogaloo?

[homer]

Evivitably when this thread gets split because of the size, can we name the new thread Covid-20 or Covid-19 2 the electric boogaloo?

 

I support this

[FVBrewerFan]

Enivitably when this thread gets split because of the size, can we name the new thread Covid-20 or Covid-19 2 the electric boogaloo?

 

Hopefully new thread will be called "covved 19 WHOAA SOLVDD"

[superfly]

Some rogue local county governments down here in the Milwaukee area. I’ve seen Racine and Washington County lash out against Evers and are now opening golf courses (among other things) tomorrow instead of waiting for the 24th.

 

 

I predict this is going to be a nationwide trend in short order, along with increasing protests.

[dpapo]

Even a deadly pandemic is now being used for political purposes. I know we can't get into politics here, but it is really frustrating and depressing to see how this is now being turned into a way for political activists and politicians to serve their political purposes at the cost of the health and lives of the people they claim they are doing their actions for. And the health and lives of people who are trying to do the right thing but will now get the virus because of all of these mass protests and States lifting restrictions too soon.

And when it does occur they will blame everyone but themselves.

There is a debate to be had about the best course of action going forward, but that is not what this is.

Follow the science and what the experts in this field are saying. Don't follow what TV doctors who have their own shows on TV are saying. Or what the people on political shows are saying. Overall, I think what is being reported on the tv news channels has been responsible. It's not hard to figure out when it becomes political, but there is no shortage of legit or non political sources that anyone can easily find on this virus.

I myself don't get my news from one channel or just TV. Since I now live overseas, I also watch the news here which is less political in general. I read what is being reported in newspapers. I read up about studies being done. I now have the time and hope anyone who decides to go out and protest or supports protests and getting ride of restrictions are doing the same. Even if I disagreed with the restrictions I definitely would not go to mass protests rally where I know I could end up getting the virus and passing it on to my family or people I don't even know. I don't have the right to end up causing the illness and death of other people by doing actions which are going to lead to the death of others.

If politicians really wanted to work out a compromise, they would talk everyday till they finally came to some sort of agreement. But, since they can't do the responsible and grown up thing, they call on people to risk their lives and the lives of other people to get what they want.

It's really not that difficult to see what other countries that have had greater success have done. There are various things they have done, but I think there are two common actions in successfully limiting the spread of the virus. Putting in measures and dealing with the virus early on. And wide spread testing. The US was late in dealing with the virus and still doesn't have wide spread testing available. So, the only actions left are to do restrictions and try to catch up on testing and possible treatments and vaccines.

Asian countries that successfully dealt in greatly limiting the number of virus cases and eased restrictions have now had to increase restrictions again. European countries are now starting to ease restrictions, so will soon see how that turns out.

Didn't mean to write a long message, just frustrating to see all that is going on in my home country. In my home state which has become a laughing stock around the world. People in the US may not follow what is going on in other parts of the world, but people in other people parts of the world see what is going on in US.

I have to deal the same restrictions and in some cases even greater restrictions. The UK was also late in dealing with the virus and putting in restrictions which has resulted in a great deal of lost of life. I would love for things to go back to normal, to be able to go out and do the things I want. But, here I think there is a stronger sense of trying to what we can to stop the spread of the virus, first and foremost. Pressure the politicians to do what is right to support the people financially. And do what is best for the country even if it means having to make sacrifices.

There are no easy answers or solutions right now. It's going to take time and patience to get through all of this.

[nodakfan17]

Brown County is now considered a hot spot, having increased 4-fold in the last 10 days. We’re at 180 cases. Representatives from the CDC are coming to investigate next week. For a community that didn’t have a confirmed case until several days into the Safer at Home order, I don’t know how we biffed this so bad. The lack of transparency from county officials is also frustrating.

[homer]

Unfortunately it's probably gonna take re-opening to show what a bad idea re-opening is.

[Fear The Chorizo]

It'd be helpful if you linked to the things you reference.

 

https://mn.gov/covid19/assets/MNmodel_PPT_tcm1148-427787.pdf

 

Slides 13-16 pretty much show key modeled estimates. For reference, "Scenario 1" was MN's initial projections assuming nothing was done social distance-wide in mid-February. "Scenario 2" was basically that same model with a revised increase in available ICU beds AND the initial virus parameter changes that significantly downgraded Covid-19's lethality and hospitalization rate back in early April. That initial mortality reduction between Scenario 1 and 2 had little to do with sheltering in place, it was all about having increased ICU capacity and changes to the virus parameters as data was becoming more available that wasn't skewed from China or from targeted vulnerable populations in Italy. "Scenario 3" would have been ending the statewide stay at home order about a week ago in April for people not considered to be vulnerable populations. "Scenario 4" is the current approach - which is the stay at home order through early May and staged reopenings. "Scenarios 3.1 and 3.2" would have been ending the initial stay at home order a week ago, but extending other measures to vulnerable populations even longer. The difference between modeled deaths and hospitalizations between any of Scenarios 3, 4, 3.1, and 3.2 are statistically negligible - particularly considering the ranges those estimates are based on.

 

The graphs of peak hospitalizations are the most telling, however - as shown, no matter how long a stay at home order is extended, there will be a significant peak in infections/hospitalizations after those orders are lifted.

 

These models use parameter from available data in early April - I still think those inputs overestimate hospitalizations/deaths, and they don't factor in improvements in treatment or effective contract tracing testing (if that ever happens), but the models are still valuable in showing how their projected peak hospitalizations/peak death dates are determined.

[Ron Robinsons Beard]

Brown County is now considered a hot spot, having increased 4-fold in the last 10 days. We’re at 180 cases. Representatives from the CDC are coming to investigate next week. For a community that didn’t have a confirmed case until several days into the Safer at Home order, I don’t know how we biffed this so bad. The lack of transparency from county officials is also frustrating.

 

I know that the county is denying that it had anything to do with the live election, but the timelines do match up.

[reillymcshane]

I believe more people are going to die during this extended stay at home due to loss of medical care and mental issues than would have died if Evers would have waited and possibly opened up May 1st instead of automatically pushing it out. My wife is waiting on a biopsy that was scheduled. The appointment was cancelled and she was told that they could not re-schedule at this time. My mother in law was supposed to have double knee replacements done next week, they were also cancelled and she was told no re-scheduling at this point. She is basically bed ridden. I run a small business and most of my sales are done at trade shows. I ordered product in January like I always do in preparation for the spring show season. I am now sitting on $50,000 worth of product that I cannot sell and yet I have to still continue to make payments on. I am just one person and was on board with the initial stay at home order, but as you can see it has effected me directly in many negative ways. I am strongly against the premature timing of this extension and feel it will cause far more harm than good.

 

Can someone explain how the stay at home order prevents hospitals from performing certain procedures or services? I'm pretty sure that's up to the hospitals.

My wife is an executive for a health care system, and she said the biggest reason for this is the lack of testing. And let's be clear - this is not the ability to test - most everyone can now do testing and turn around those tests quickly (a couple of hours). The issue is the lack of supplies to actually conduct the tests.

 

What the hospitals and clinics need is the ability for a doctor/nurse/worker come into the office, get a test, and once cleared - go to work. They then need the patients to come in and get tested as well. And once they are cleared, they get their physical or have their surgery done, etc.

 

But healthcare facilities are simply lacking in supplies (swabs for instance). So they save those supplies for critical situations and for active healthcare workers. By the way, in the past - with SARS - the number one way to transmit the illness was through the health care setting. So you have to be really diligent about keeping your workers healthy.

 

My wife's organization would love to do more stuff (see patients and do surgeries, etc.). They are getting killed financially by COVID. But until they get more testing capacity - they can't open things up.

 

This is a huge frustration on their part. They just don't know when they are going to get stuff. They'll get an order for supplies - and then have those supplies taken by the federal government and diverted somewhere else.

[reillymcshane]

With regard to the stay-at-home orders and so forth, the main issue that we face is the lack of testing for the COVID virus.

 

As I noted in my previous post, the healthcare systems are simply not getting enough supplies to conduct testing. If we want to open back up the economy, the first thing we need to do is provide our healthcare systems with the ability to actually conduct the tests to see if a person has COVID.

 

Once we have the ability to test, we can start to reopen things in a (relatively) safe manner.

 

This means a barber could go to a designated spot, get a test, be told in a short time (let's say less than an hour) that they are not infected, and then head into work. He or she then goes back and does it the next day. Ideally, the barber's customers go and do the same thing - getting a test every time they want to go out.

 

This doesn't have to go on forever, but what you need is a person being able to get themselves designated as free of COVID, and this allows them to do wherever they need. Go to the doctor, dentist, hair salon, etc., etc.

 

That's your ideal situation. And I realize not everyone would get a test. But it would be foolish to go to barber or doctor or dentist not feeling relatively sure they are COVID free.

 

What needs to happen is testing capacity needs to increase. As it does, you can start giving certain businesses and industries more leeway to open back up (with COVID testing requirements a part of the deal). Just starting with hospitals and clinics would be a great first step.

 

Unfortunately, the healthcare systems have no idea when this will happen. Everything is being done haphazardly - and mostly left to the states - meaning no one can predict when this will be a reality.

[DuWayne Steurer]

Reilly, thanks for the in depth explanation of how and why Covid is impacting the ability of healthcare facilities to provide care.

 

I recently had a neurology appointment and it was cancelled. I had another neurology appointment and it was made into a "by phone" appointment.

 

I had a minor heart procedure (ok, not really minor, but common), a heart catheter, and the day before, I had to go to a Covid testing site, get "cleared" and then I could go to the hospital and get the procedure. The only reason the heart procedure wasn't cancelled or delayed was because it was considered necessary and needed to be done ASAP. (and it did need to be done ASAP, based on what was found, thank goodness we got in when we did). There were extra hoops to jump through, and I don't mind that I had to do it. I understand why it was.

 

I have to do cardio rehab starting this week, and for the foreseeable future, most of my rehab appointments are going to be via phone or some sort of video chat or conferencing. That's just how it is, and I'm ok with that.

[MrTPlush]

I doubt Brown county had an explosion of cases due to the election. Mainly because no other place is seeing such an exponential increase. Unless there was a rogue poll worker licking each ballot it doesn’t really make a ton of sense.

[LouisEly]

That's an interesting idea. Back during the Spanish Flu, Chicago opened things up neighborhood by neighborhood. Of course that was before cars made it easier to move from Englewood to Lincoln Park. I wonder if every zip code has a decent grocery store?

Grocery stores are already open so there would be no change. It's to the other businesses that aren't open (restaurants, etc.).

[reillymcshane]

Reilly, thanks for the in depth explanation of how and why Covid is impacting the ability of healthcare facilities to provide care.

 

I recently had a neurology appointment and it was cancelled. I had another neurology appointment and it was made into a "by phone" appointment.

 

I had a minor heart procedure (ok, not really minor, but common), a heart catheter, and the day before, I had to go to a Covid testing site, get "cleared" and then I could go to the hospital and get the procedure. The only reason the heart procedure wasn't cancelled or delayed was because it was considered necessary and needed to be done ASAP. (and it did need to be done ASAP, based on what was found, thank goodness we got in when we did). There were extra hoops to jump through, and I don't mind that I had to do it. I understand why it was.

 

I have to do cardio rehab starting this week, and for the foreseeable future, most of my rehab appointments are going to be via phone or some sort of video chat or conferencing. That's just how it is, and I'm ok with that.

You are welcome, and please take care at this time.

 

I hear about this stuff from my wife everyday. It has been brutally hard - and immensely frustrating for them. They have a million people telling them how to do stuff or saying they're doing this or that wrong - when they are hamstrung by the lack of testing capability.

 

To be honest - that (the lack of testing) is the #1 issue right now with the pandemic. This is, unlike the seasonal flu or SARS or MERS or whatever, a virus that can be transmitted by people who don't show any symptoms. That's huge. For all these other viruses, if a person shows signs of being sick (cough, fever, etc.), you can quickly isolate them and limit the threat they pose. But not with COVID-19. That's why we need testing so badly.

 

Healthcare systems desperately want to start doing all the 'normal' stuff they do -- surgeries, checkups, etc. But they have to be very careful. As I said in my previous post, healthcare locations are usually the #1 place where sicknesses like the flu get passed around. More testing is the only way to prevent that.

[nodakfan17]

Brown County is now considered a hot spot, having increased 4-fold in the last 10 days. We’re at 180 cases. Representatives from the CDC are coming to investigate next week. For a community that didn’t have a confirmed case until several days into the Safer at Home order, I don’t know how we biffed this so bad. The lack of transparency from county officials is also frustrating.

 

I know that the county is denying that it had anything to do with the live election, but the timelines do match up.

I’ve heard from a friend at a local hospital that 60% of the Brown County cases have been traced to a single facility. I won’t name the facility because I don’t want to harm the reputation of this business until the report is verified, but it was apparently communicated in a hospital memo. The Green Bay area was tracking well below average for the last 6 weeks, so to see such an explosion now is disheartening (especially after we’ve all been so careful).

[PeaveyFury]

I know that the county is denying that it had anything to do with the live election, but the timelines do match up.

I’ve heard from a friend at a local hospital that 60% of the Brown County cases have been traced to a single facility. I won’t name the facility because I don’t want to harm the reputation of this business until the report is verified, but it was apparently communicated in a hospital memo. The Green Bay area was tracking well below average for the last 6 weeks, so to see such an explosion now is disheartening (especially after we’ve all been so careful).

 

I've heard something similar, completely unofficially. I think this is what makes a whole-scale 'reopening' of everything so problematic: all it takes is a case or two to cause things to grow exponentially in a short period of time. If it's happening now, how much worse will it be when 'non-essential' businesses re-open?

[OldSchoolSnapper]

The JBS beef plant source has been reported by Fox 11 so there is no real need to 'protect them', it's out there. They are bringing in hospital staff from Madison to work the facility in some capacity.