COVID-19 Thread [V2.0]

[OldSchoolSnapper]

Not sure, but Washington/Dodge were ground zero for a little bit and nothing was closed. It has less to do with infection rates and more to do with who's in charge.

[homer]

If people are going to go to bars or go party with large groups of people right now that's their choice. I'm not gonna be doing that but I'm also not going to get upset about it any more than I would about people that live generally unhealthy lives.

 

I really don't understand how there can continue to be a lack of understanding that this has far, far less about people going out and putting themselves at risk by choosing to go to bars as it does the fact that they go to those bars and then go to work, go to church, etc. and literally spread the virus to people who aren't choosing to engage in that risky behavior. That is literally nothing like someone choosing to drink themselves to death or over eating. It's astounding that 7+ months into this thing, there are still so many people who don't get that.

 

I have sympathy for people who have no choice but to, I don't know the word, cross-pollinate with every group of people, like cashiers, teachers, etc. But for people not in those lines of work it would seem really easy to mitigate your risks if you're really that worried about it. If you have a bunch of health problems, are in a risk group, or are just a nervous person, a lot of the onus is on you. This is something that doesn't really get mentioned much, but how many of the dead made risky choices?

 

In Chicago, 2 out of 3 people infected knew the person that infected them. 3 out of 4 took place at home. So people are going out and catching the virus and then spreading it to their families in the majority of cases. This isn't a "I'm gonna live my life and if I die it's on me" thing. It's a "I'm gonna put my family in danger" thing.

 

https://blockclubchicago.org/2020/10/19/we-are-in-the-second-surge-lightfoot-says-we-could-return-to-phase-3-as-coronavirus-cases-soar/

[OldSchoolSnapper]

The majority of cases would be contracted at home since that is where all the close contact is. I don't know many families that get flu/cold and not have it run through the house but I understand someone has to bring it in. But the other issue I have with that is figuring out how it got there. If I got sick tomorrow I would not know where to begin if forced to backtrack 2 weeks.

 

I am highly skeptical of contact tracing data though. There are huge swaths of people not bothering with it at all who will never be accounted for, people lying to the tracers, people withholding information because they did something bad, people spreading it around at routine places without knowing they were sick. I have a hard time wrapping my head around how sloppy this entire effort has been but then putting stock into something so incredibly hard to reliably track like that. It's the single part of this that has most felt like busy ants to me, like an illusion that we're "doing something" without it really achieving much at all.

[tmwiese55]

Yes, at this point it's too widespread for any reliable contact tracing, which is also why its tough to say there is nothing knowingly tied to xyz so that's fine, at this point its almost impossible to know where someone would have gotten it.

 

To the other big topic. It's just not logical to use the argument that its my choice my risk etc when this is something that's contagious. It's the equivalent logic (not activity)of saying what's the big deal if I drink and drive, my choice. Snappers point is also correct that it's very likely many of the folks who've passed probably did some kind of behaviour to be at risk. After all, we can't sit at home forever. But that's where the greater good comes if everyone would collectively do it it goes down for everyone. Plus, then the people being more compliant could actually do stuff again sooner safely (everyone could). It would reduce the numbers cycling around so people going to needed works like schools, groceries, etc are at less risk, and of course the medical workers who eventually have to work on them. Believe it or not, there still is a lot of people complying and taking it seriously. And yea I'm with you on things like schools and certain works that just have to be done in person and I don't blame anyone for trying to make school happens. the idea would be to reduce the things outside of those essential activities to keep the numbers/risk as low as is reasonably feasible. Instead we're trying to take the leap of 'well we're doing these essential type things, so who cares might as well do everything.

 

The big one to be skeptical throughout all this is bars/restaurants, that's not something that's needed. It's absolutely brutal for the owners and people who worked there though, so I feel for the industry and I get why the pressure to get it going again. So many are going to go out of business, and many more would have if not for opening up. And I'm one that likes sitting and BSing in the bar, especially with sports going on, as much as anybody. But this is what should've been addressed in the stimulus bills, these small businesses are the ones who should've been taken care of.

[OldSchoolSnapper]

It's the equivalent of saying what's the big deal if I drink and drive, my choice.

 

I've seen this a lot and it just isn't quite right. The risks aren't the same for all people engaging in activity. A young, healthy couple in their 30s living alone on 5 acres in Mukwonago could probably fly to Disney World this weekend and endanger nobody. Once you get past the initial "OMG traveling" aspect and think about it there is just not much about it that's terribly risky.

 

You could probably make the case that staying home and visiting 6 stores over the weekend is riskier. A high school teacher getting drunk with 3 friends at poker night is probably worse.

 

The risk profile of every household is different. If you are just acting normally right now and diabetic grandpa lives in the spare bedroom then you are stupid. There are all kind of variables that make these "everyone should be doing this" policies ill-fitting. And they'll never be adhered to anyway.

 

I have believed for some time that the problem isn't that nobody is taking this seriously. It's that there's huge imbalance among who should and shouldn't. You have low-risk profile people doing all the right stuff and people who really need to be following protocol following none of it.

[PeaveyFury]

I am highly skeptical of contact tracing data though. There are huge swaths of people not bothering with it at all who will never be accounted for, people lying to the tracers, people withholding information because they did something bad, people spreading it around at routine places without knowing they were sick. I have a hard time wrapping my head around how sloppy this entire effort has been but then putting stock into something so incredibly hard to reliably track like that. It's the single part of this that has most felt like busy ants to me, like an illusion that we're "doing something" without it really achieving much at all.

 

This is an 'us' problem, unfortunately. The countries like Japan and New Zealand that have basically squashed the virus all had robust, dynamic contract tracing protocols.

[tmwiese55]

 

It's the equivalent of saying what's the big deal if I drink and drive, my choice.

 

I've seen this a lot and it just isn't quite right. The risks aren't the same for all people engaging in activity. A young, healthy couple in their 30s living alone on 5 acres in Mukwonago could probably fly to Disney World this weekend and endanger nobody. Once you get past the initial "OMG traveling" aspect and think about it there is just not much about it that's terribly risky.

 

You could probably make the case that staying home and visiting 6 stores over the weekend is riskier. A high school teacher getting drunk with 3 friends at poker night is probably worse.

 

The risk profile of every household is different. If you are just acting normally right now and diabetic grandpa lives in the spare bedroom then you are stupid. There are all kind of variables that make these "everyone should be doing this" policies ill-fitting. And they'll never be adhered to anyway.

 

I have believed for some time that the problem isn't that nobody is taking this seriously. It's that there's huge imbalance among who should and shouldn't. You have low-risk profile people doing all the right stuff and people who really need to be following protocol following none of it.

 

 

I actually just came back to edit my post and to say the logic of the argument. Not the act itself. So yea, I agree with what you're saying. The fact that this act affects others is the key point. Just like DD affects others. Eating a bunch of bad food to get unhealthy only affects you.

[igor67]

Some nice informational reporting on how the vaccine trials are being reviewed.

https://www.propublica.org/article/who-decides-when-vaccine-studies-are-done-internal-documents-show-fauci-plays-a-key-role

 

A really long look at the unknowns about Sturgis https://www.washingtonpost.com/health/2020/10/17/sturgis-rally-spread/?utm_campaign=wp_main&utm_medium=social&utm_source=twitter

[JosephC]

I'm a big fan of contact tracing and frankly felt the government fell flat early on. Especially in the Milwaukee area where the JS reported that people who tested positive were not getting any follow up calls to find out where they had been so they could get word to people/places that may be affected. IMO, this still seems like the best and most effective way to handle the spread of the disease.

 

But the longer we go into this, the more obvious it becomes that HIPAA laws makes this just about impossible. I work for a large corporation. If someone gets sick at work (a building with about 100 people), no one knows about it unless the sick person contacts someone else at work to spread the news. So we had someone who went out last Thursday, not because she was sick but someone else in her family is COVID-19 positive, and not a word was said to any of the other people in the office by the employer because of privacy concerns. She mailed friends about it on Friday and told those people to spread the word but I only heard about this yesterday. If I would have been informed immediately I could have skipped my Friday trip to the grocery store, avoided using the elevator in my apartment building (no air circulation in there!) and altered my movements as to not put anyone else at risk. But due to privacy concerns, I had no idea until 5 days later.

 

I am all for privacy laws. But in this case, should COVID-19 be exempted from HIPAA for obvious reasons? I think it's a discussion worth having.

[igor67]

I'm not 100% sure that HIPAA is the biggest stumbling block, but certainly the contract tracing for Covid is less invasive to an individual than the contract tracing for STDs and I would agree an exemption should be up for discussion. I do wonder after reading the article as well if melding cell phone data with over the phone interviews could improve efficiency? Now is rather late in the game almost, but some exemptions to try and use that data might help a great deal as well.

[Fear The Chorizo]

I am highly skeptical of contact tracing data though. There are huge swaths of people not bothering with it at all who will never be accounted for, people lying to the tracers, people withholding information because they did something bad, people spreading it around at routine places without knowing they were sick. I have a hard time wrapping my head around how sloppy this entire effort has been but then putting stock into something so incredibly hard to reliably track like that. It's the single part of this that has most felt like busy ants to me, like an illusion that we're "doing something" without it really achieving much at all.

 

This is an 'us' problem, unfortunately. The countries like Japan and New Zealand that have basically squashed the virus all had robust, dynamic contract tracing protocols.

 

If only the US was an isolated stretch of islands next to nobody routinely traveled to for commerce like New Zealand to give contact tracing a realistic chance. More people live in WI than in all of New Zealand and the state is roughly 1/2 the land size of a country bordered by nothing but water. And even with that contact tracing wasn't the reason their numbers have remained low until this point - they just pretty much closed their country down for months and really don't have a good way of reopening things to the rest of the world despite being reliant on them for tourism, which drives their economic existence as a country. They're in the midst of their worst 3Q GDP decline since tracking started in the mid 1980s.

 

Japan didn't have dynamic contact tracing protocols - they attempted to do so on the people who were most impacted early on and had some success with that in the spring, but since then they've just dealt with asymptomatic community transmission without even chasing after it via testing because they just didn't have that many people display significant symptomatic responses to the virus. MN has tested more people than Japan.

[PeaveyFury]

They're in the midst of their worst 3Q GDP decline since tracking started in the mid 1980s.

 

Yep. Because they did what they needed to do to contain the virus and save lives. I'd imagine their populace will deal with the short-term recession as a trade off for the quick bounce-back they're expected to experience relative to the rest of the world:

 

But economists say New Zealand will bounce back faster, while other nations are still struggling to contain the coronavirus.

 

https://www.reuters.com/article/newzealand-economy-gdp/new-zealand-economy-in-deepest-recession-as-second-quarter-gdp-shrinks-idUSKBN26804K

 

MN has tested more people than Japan.

 

.... because Japan tested the people most likely to be exposed based on their robust contact tracing protocols.

 

Just curious.... you've been one of the biggest down-players and naysayers here on the board since the start of this, despite identifying yourself as 'having a medical background.' At what point do you look at the situation that is unfolding and state that this is an absolute disaster, and the we are, in fact, worse off than other countries who have found a way to handle this better? Based on nearly everyone else I know 'in the medical industry' right now, they're overwhelmed and fed-up. Why have you continued to stick with your 'down-play' stance?

[Machu Peach]

I really don't understand how there can continue to be a lack of understanding that this has far, far less about people going out and putting themselves at risk by choosing to go to bars as it does the fact that they go to those bars and then go to work, go to church, etc. and literally spread the virus to people who aren't choosing to engage in that risky behavior. That is literally nothing like someone choosing to drink themselves to death or over eating.

I've listed second hand smoke and vaccine non-compliance as examples of tolerated behaviors which harm the health of others who don't engage in 'risky behavior'. Those behaviors might make for a better comparison.

 

...despite identifying yourself as 'having a medical background'... ...Based on nearly everyone else I know 'in the medical industry' right now, they're overwhelmed and fed-up.

I'm also 'in the medical industry' (though mostly unrelated to infectious diseases these days) and my best friend is an internal medicine MD in a MICU in a formerly major hotspot. There is a significant amount of discussion regarding the relative and absolute efficacy of various mitigation strategies among my and her circles. There is no consensus.

[PeaveyFury]

I've listed second hand smoke and vaccine non-compliance as examples of tolerated behaviors which harm the health of others who don't engage in 'risky behavior'. Those behaviors might make for a better comparison.

 

If you read the post that was being responded to, you'll note that the examples cited were specifically mentioned in the original post as examples of things people 'do to themselves':

They smoke, they drink to excess, they're overweight, they have a crap diet full of sugar and processed food, they get no physical activity, they avoid sleep and live on energy drinks.If people are going to go to bars or go party with large groups of people right now that's their choice. I'm not gonna be doing that but I'm also not going to get upset about it any more than I would about people that live generally unhealthy lives.

 

You cite accurate examples of things that people do to themselves that are also dangerous to others, but I think it's very fair to note that this isn't something that can equate to people choosing to "live on energy drinks."

 

 

I'm also 'in the medical industry' (though mostly unrelated to infectious diseases these days) and my best friend is an internal medicine MD in a MICU in a formerly major hotspot. There is a significant amount of discussion regarding the relative and absolute efficacy of various mitigation strategies among my and her circles. There is no consensus.

 

Indeed. Hopefully things are calmer in your friend's MICU now and that his life is more normal than it presumably was earlier. I'm interested to know if based on his experience and discussions, whether there's a diminished concern or worry about the severity of the situation, and whether there's an acknowledgement that other countries/governments HAVE had more success at containing this. Discussion about how to handle this going forward is good and very fair. The issue is that some decided back in March that this wasn't a serious event, and continue to try to downplay it today while society continues to struggle with the pandemic, IMO, which leads to an ineffective response and an unnecessary loss of life.

[Machu Peach]

I'm interested to know if based on his experience and discussions, whether there's a diminished concern or worry about the severity of the situation, and whether there's an acknowledgement that other countries/governments HAVE had more success at containing this.

"Her" not "his." Women can be MDs too.

 

"I'm interested to know... ...whether there's an acknowledgement that other countries/governments HAVE had more success at containing this."

I'd be happy to answer a less leading inquiry.

[PeaveyFury]

"Her" not "his."

 

My apologies.

 

I'd be happy to answer a less leading inquiry.

 

How about the first part of the inquiry, if you wish: I'm interested to know if based on her experience and discussions, whether there's a diminished concern or worry about the severity of the situation?

[reillymcshane]

I've listed second hand smoke and vaccine non-compliance as examples of tolerated behaviors which harm the health of others who don't engage in 'risky behavior'. Those behaviors might make for a better comparison.

 

Second hand smoke isn't a great example as it is NOT tolerated in many places. You can't smoke in most public indoor places (and often outside of these places). The place it is tolerated is in the homes of smokers - where children and spouses and roommates get subjected to second hand smoke. To try and police people's homes is, frankly, a logistical impossibility, and runs into government overreach questions.

 

Vaccine non-compliance is a better example (to a degree), but still an iffy comparison. Many places do require vaccines - such as for kids to attend school. The US military requires many vaccinations. Many hospitals and so forth require their staff to be vaccinated. Immigrants are required to have many vaccinations - including measles, mumps, rubella, hepetitis, etc.

[Machu Peach]

There is absolutely 'a diminished concern or worry about the severity'. I hate to speak for others, but I think that's true for just about everyone.

 

Back in March and April... The media were predicating a 1-3% (even higher in some cases) mortality rate. There were models that had millions dying. You had health directors claiming that 1% of people were actively infected at that time. There was an idea that a 14 day incubation period was typical. NYC had roughly 2000 deaths per million and some thought that would occur everywhere. There was an idea that the virus could live on surfaces for days, making the delivery of food and other essential items very risky. There was a great deal of worry about hospitals running out of beds and ventilators. There were worries about widespread PPE shortages... I'm sure there are other things I'm forgetting.

 

Most of those worries have proven to be wrong or overexaggerated, but they were real worries at the time. Combine that with the fact that much much more is known about the pathology and transmission of COVID and I think most people are less worried.

[PeaveyFury]

Back in March and April... The media were predicating a 1-3% (even higher in some cases) mortality rate.

 

Isn't the current U.S. case fatality rate ~2.65%? EDIT: Obviously, we don't know how many of us will end up actually getting this before a vaccine and proper immunity is obtained so who knows what the final mortality rate will actually look like. I agree, though, that 3% was clearly an overestimate.

 

There was a great deal of worry about hospitals running out of beds and ventilators. There were worries about widespread PPE shortages... I'm sure there are other things I'm forgetting.

 

Unfortunately, these concerns may have abated where you/your friend are, but this situation is playing out currently in Wisconsin. News reports this morning are that in some places hospital staff are given one N95 mask per week, and patients are being admitted to a field hospital setup in West Allis.

 

Very fair points about surface contact, etc., though. It is indeed good news that some items have played out better than anticipated. What we'll never truly know, however, is how much the results of the past 7 months were positively influenced by the measures that were taken, many of which were (and still are) being fought tooth-and-nail by various groups, nor will we know how much better the results may have been if those measures had been adhered to on a wider basis.

 

In the end, other places have managed to virtually eliminate the virus, and some continue to act and, sometimes outright claim as though nothing that they did, no policies that were put in place, nor societal behavioral differences had any effect on that result. Which, IMO, is absurd.

[Machu Peach]

I've listed second hand smoke and vaccine non-compliance as examples of tolerated behaviors which harm the health of others who don't engage in 'risky behavior'. Those behaviors might make for a better comparison.

 

Second hand smoke isn't a great example as it is NOT tolerated in many places. You can't smoke in most public indoor places (and often outside of these places). The place it is tolerated is in the homes of smokers - where children and spouses and roommates get subjected to second hand smoke. To try and police people's homes is, frankly, a logistical impossibility, and runs into government overreach questions.

"In Chicago, 2 out of 3 people infected knew the person that infected them. 3 out of 4 took place at home. So people are going out and catching the virus and then spreading it to their families in the majority of cases. This isn't a "I'm gonna live my life and if I die it's on me" thing. It's a "I'm gonna put my family in danger" thing."

 

Given that people are most likely to infect their family members, it seems like second hand smoke is a good comparison. It kills an estimated 40,000 people per year so it's still a major public health problem that gets little attention anymore.

 

Vaccine non-compliance is a better example (to a degree), but still an iffy comparison. Many places do require vaccines - such as for kids to attend school. The US military requires many vaccinations. Many hospitals and so forth require their staff to be vaccinated. Immigrants are required to have many vaccinations - including measles, mumps, rubella, hepetitis, etc.

Vaccine non-compliance is largely tolerated in our culture. Vaccination rates have been decreasing for a while now. Waivers are very easy to get in many areas. There are mainstream politicians promoting vaccine skepticism with almost no pushback. There are even people this board that have stated their vaccine skepticism, again with little pushback.

 

Your argument that 'schools, the military, and hospitals require it' (pardon the paraphrasing) doesn't hold water. Schools, the military, and hospitals require COVID compliance too. Those facts strengthen the comparison.

 

There are important differences between second hand smoke, vaccines, and COVID and I am not arguing that they are identical. However, they're not bad comparisons for many purposes and they are better comparisons than obesity.

[Machu Peach]

Isn't the current U.S. case fatality rate ~2.65%? EDIT: Obviously, we don't know how many of us will end up actually getting this before a vaccine and proper immunity is obtained so who knows what the final mortality rate will actually look like. I agree, though, that 3% was clearly an overestimate.

227,000 deaths / 8,585,000 confirmed infections = 2.64% I'm not aware of anyone that thinks the confirmed infection count accurately reflects the actual number of infections. However if you do we'll have to agree to disagree, and yes using that logic the initial estimates were correct.

 

Unfortunately, these concerns may have abated where you/your friend are, but this situation is playing out currently in Wisconsin.

I'm not 100% sure, but I believe no one in the US has been denied treatment because of a shortage of PPE, hospital beds, or ventilators. Please correct me if you have a citation that that's incorrect. That was a significant concern, particularly the PPE and ventilators, among many on this message board, if I remember correctly.

 

Even with those caveats, I think the overall point "everyone is less worried" remains.

[reillymcshane]

227,000 deaths / 8,585,000 confirmed infections = 2.64% I'm not aware of anyone that thinks the confirmed infection count accurately reflects the actual number of infections. However if you do we'll have to agree to disagree, and yes using that logic the initial estimates were correct.

I think it's pretty obvious - and acknowledged - that the death rate is lower than 2.64%. Many, many symptomatic people aren't tested, and - especially early on - people with COVID were simply told not to get tested unless absolutely necessary. This was due to the fact there were testing shortages. And some people just ignore symptoms - and don't get tested. They just think it's a little cold or allergies - or are afraid of getting tested. A positive test, for instance, can force a person out of work for two weeks. Many people can't afford that. So they rough it for a few days, the symptoms fade (hopefully), and they go on with their lives (sometimes spreading the virus to others - sometimes not).

[FVBrewerFan]

They smoke, they drink to excess, they're overweight, they have a crap diet full of sugar and processed food, they get no physical activity, they avoid sleep and live on energy drinks.

 

Ironic this was used as part of another debate, but it's also a large part of the reason Covid deaths are higher in the US than other countries.

 

There's no proof stricter or longer lockdowns would have mattered. Or contact tracing, or masks. Virus is spreading here just as everywhere else. Every country, and state, is just bending the curve differently but we're all ending up at the same place. Only significant difference is the general health, and we are a fat, fat country.

[reillymcshane]

I'm not 100% sure, but I believe no one in the US has been denied treatment because of a shortage of PPE, hospital beds, or ventilators. Please correct me if you have a citation that that's incorrect. That was a significant concern, particularly the PPE and ventilators, among many on this message board, if I remember correctly.

 

Even with those caveats, I think the overall point "everyone is less worried" remains.

I think there are some truths to this. On a personal level - we know a lot more than last March. The death rate is lower than many feared. We know how to treat the virus better and how to recognize it as well. Testing is much more robust. Most experts think a vaccine is coming next year. And we have best practices that we can follow to help avoid infection.

 

In those ways, I think we are all less worried. However, many people believe that the overall effect of COVID will continue and only get worse in the coming months. And it could mean shortages. How this manifests itself remains to be seen. PPE and ventilators probably aren't that big of a deal as supply chains gets better every day. But beds are growing more scarce each day in Wisconsin. A few weeks ago, all the hospitals in Duluth were diverting all patients from their facilities. That's just one example.

 

Another thing is that the healthcare professionals to handle all of these people could be strained due to doctors and nurses and other hospital staff getting sick themselves, or getting out of this kind of care due to stress/hours. I think we've seen this same thing with teachers.

 

Also, it's important to understand that 'beds' don't matter that much if you don't have the staff to care for those people in the beds. Burnout is growing with many of these people - and will only get worse.

 

The other issue popping up is that healthcare systems are increasingly having to put more resources into handling COVID patients. This takes resources from other areas of care. This can mean people put off going to the doctor - which happened a lot this past summer. This means they often come in later - and sicker. It also hurts healthcare systems financially - simply because they have to increasingly put off elective surgeries - which is a big money maker for them. Not a huge thing in the grand scheme of things - but still a factor.

 

So, while many people are less worried - many are not. But I understand the statement, even if I don't necessarily agree with parts of it.

[Machu Peach]

I think it's pretty obvious - and acknowledged - that the death rate is lower than 2.64%. Many, many symptomatic people aren't tested, and - especially early on - people with COVID were simply told not to get tested unless absolutely necessary. This was due to the fact there were testing shortages. And some people just ignore symptoms - and don't get tested. They just think it's a little cold or allergies - or are afraid of getting tested. A positive test, for instance, can force a person out of work for two weeks. Many people can't afford that. So they rough it for a few days, the symptoms fade (hopefully), and they go on with their lives (sometimes spreading the virus to others - sometimes not).

While this is all true to some extent or another, one would have think that the majority of underreporting is due to asymptomatic people who don't even suspect they're infected, right?

 

However, many people believe that the overall effect of COVID will continue and only get worse in the coming months.

 

And it could mean shortages.

 

Another thing is that the healthcare professionals to handle all of these people could be strained due to doctors and nurses and other hospital staff getting sick themselves.

 

Burnout is growing with many of these people - and will only get worse.

 

The other issue popping up is that healthcare systems are increasingly having to put more resources into handling COVID patients.

These factors were all true in hotspots in March and April too. People knew it was going to spread and get worse. Roughly half the residents in the MICU at my friend's hospital got COVID early on. They had to shorten shifts because of the emotional burden. Almost all non-COVID, non emergency resources were redirected. Are you saying these are new factors in Wisconsin?