COVID-19 Thread [V2.0]

[PeaveyFury]

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.

 

Except, as previously noted, that's simply factually incorrect. Australia, Japan, New Zealand have successfully managed the virus without the second spike. Attributing the entirety of the current spike to 'the health of the population' is pretty serious spin, IMO. A factor in the death/complication rate? Undeniably. But at some point people have to take responsibility for their own actions and our poor behavior as a society and stop trying to minimize our culpability how this is unfolding.

 

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.

 

I too didn't research to see if this was accurate, but even if it is, does it warrant a 'yet' caveat based on the current trend? (Wisconsin data)

 

[Machu Peach]

(Wisconsin data)

I'm guessing this is a key difference. I'm looking at the entire US, including areas with much higher viral spread, whereas people here are understandably focused in on WI alone.

 

 

Edit: I feel I should add, that I'm also concerned about an increase as fall progresses. However, that's not a new worry. People were worried about increases in the March/April too.

 

I'm quite surprised this is an area of disagreement. So much more is known about almost every aspect. There's so much less panic and fearmongering in the media. A lot of worries remain, but the most of the more outlandish fears haven't occurred and there's good reason to think they won't occur.

[PeaveyFury]

WI Hospitalizations, to further illustrate the current situation:

 

[PeaveyFury]

I'm quite surprised this is an area of disagreement.

 

I suppose I am too. This exchange started with a question regarding the current feeling/climate among medical professionals, which was a bit leading considering I know how the medical professionals friends/family of my own feel right now. They're just as concerned about the current situation as they were back in March/April, even perhaps more so considering back then most people actually cared and tried to help. As the populace willing to help continues to dwindle seemingly week by week, I think things look quite bleak in the healthcare industry right now.

 

As you note, perhaps that perspective is different in Wisconsin now. But numbers are spiking in many states and countries, and the situation is still very much ongoing.

[Machu Peach]

Maybe the medical professionals in WI didn't realize how bad the situations were in the initial hotspots? One would have hoped that they would have had the foresight to understand what was happening elsewhere.

 

The mortality rate (~3000 per million in NYC and ~300 per million in WI) are an order of magitude different.

...and that's not even getting to the fact that there was very little known about the virus, both the pathology and epidemiology, at the time of NYC's outbreak.

 

I'm guessing this is a case of seeing the effects firsthand. One can hear that 1000 people are dying per day in NYC, but it doesn't have the same emotional impact as 40 people dying per day in your area.

 

"I think things look quite bleak in the healthcare industry right now."

In NYC 4th year med students were pulled out of their programs to help with the pandemic. Retired MDs, nurses, and technicians were recalled to work. Volunteers were flown in from across the country. Two of my colleagues, MDs doing research who hadn't seen a patient in years, were called in to volunteer at their university's emergency dept and granted admitting privileges. They had ~40 people dying per day just at their hospital alone. That is what bleak looks like.

 

...anyways, I've said my piece and don't have any more to add.

[PeaveyFury]

That is what bleak looks like.

 

Perhaps they (and I) don't share the confidence that you seem to have that those situations that you note from earlier in the year are actually behind us. I think it's odd to assume that with the current trajectory of cases that an overwhelming of the healthcare system similar to NYC in March is impossible to occur again, possibly in areas of the country where the facility capacity and healthcare workers available to help relieve the strain are much lower.

[Machu Peach]

That is what bleak looks like.

 

Perhaps they (and I) don't share the confidence that you seem to have that those situations that you note from earlier in the year are actually behind us.

I feel I should add, that I'm also concerned about an increase as fall progresses. However, that's not a new worry. People were worried about increases in the March/April too.

[PeaveyFury]

Then why the posts pointing out the death rates etc. and noting the overwhelming of the system/PPE shortages back in March, while seemingly dismissing the trend that is LITERALLY HAPPENING RIGHT NOW? PPE shortages are happening in Wisconsin. Hospitals have reached capacity.

 

The virus hasn't run its course. Implying that what happened back in March/April can't happen again is patently false, and dismissive of the plight of actual front-line healthcare workers. They're scared and overwhelmed, and the signs point to it only getting worse. But, feel free to dismiss that if you wish.

[homer]

There are varying degrees of "bad". People were talking about the healthcare system potentially "breaking" and I think an argument could be made that it did break, or at least fracture, in NYC. To me if ICU beds in a region are full from a single disease source that's pretty bad since people are still going to have strokes, heart attacks, falls, and accidents, etc.

 

And as for staff issues...they are beginning to happen in Wisconsin.

 

From CEO of Prevea Health in Green Bay:

"More and more staff are being exposed and falling ill and having to isolate. Some are coming back from isolation. At Prevea and HSHS, we have traveling nurses coming in. They’re arriving this week from throughout the country. We’ve asked for over two dozen to come and help right now.

 

“The additional help is for two reasons: number one, our own health care people are getting sick; and secondly, the sheer volume. Obviously, we’re not designed to take care of an extra 140 patients in this city on top of what we normally take care of. So you do need more health care staff. It’s not just nurses. It’s respiratory therapists. People in the lab. People who clean the room. All of which need specialized training. And that doesn’t happen overnight.”

 

From Bellin Health in Green Bay:

Bellin Health redeployed 138 staff members to help in various areas of the organization and brought temporary staff in to help.

 

Having said all that, I don't expect things to go south like they did in April in NYC, Detroit, New Orleans, etc. A lot of reasons for that but some of it is due to a big chunk of people wearing masks and being responsible, governmental restrictions, improved treatments, and possibly the virus itself becoming less deadly. But that doesn't mean it won't be extraordinarily bad.

[Machu Peach]

Implying that what happened back in March/April can't happen again is patently false,

Didn't state or imply that.

 

In fact, I state my worry about the upcoming 'fall surge.' ...which I actually am extremely concerned about. I was concerned about it March/April too. I'm pretty sure it was even discussed here at the time.

 

and dismissive of the plight of actual front-line healthcare workers. They're scared and overwhelmed, and the signs point to it only getting worse. But, feel free to dismiss that if you wish.

Didn't state or imply that either. ...and I know one 'front line healthcare worker' quite intimately

 

(I guess I'm sorta a front line worker too? I deal with cancer patients not COVID, but I haven't been furloughed or WFH a single day as our trial was deemed lifesaving, thus essential.)

[PeaveyFury]

Implying that what happened back in March/April can't happen again is patently false,

Didn't state or imply that. If you're reading that much into what I wrote, that's on you.

 

Curious what point you're actually trying to make here, then:

 

Back in March and April... There was a great deal of worry about hospitals running out of beds and ventilators. There were worries about widespread PPE shortages...

 

Maybe the medical professionals in WI didn't realize how bad the situations were in the initial hotspots? One would have hoped that they would have had the foresight to understand what was happening elsewhere.

 

In NYC 4th year med students were pulled out of their programs to help with the pandemic. Retired MDs, nurses, and technicians were recalled to work. Volunteers were flown in from across the country. Two of my colleagues, MDs doing research who hadn't seen a patient in years, were called in to volunteer at their university's emergency dept and granted admitting privileges. They had ~40 people dying per day just at their hospital alone. That is what bleak looks like.

 

Many of the items you cite to paint a picture of the 'bleakness' of the situation back in March/April are starting to happen again. In view of that, what, in particular, is the point you're trying to make? Just for clarity sake.

[reillymcshane]

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?

That's a good assumption, but there have been a lot of other people who have symptoms but don't get tested. This was especially true early one, when testing resources were scarce. But yes, I'm guessing the majority of underreporting is the asymptomatic people.

[reillymcshane]

 

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?

 

They are new for certain parts of the state. In the north and north central the hospitals weren't overwhelmed with COVID - even while they prepared for it. And while many shut down non emergency surgeries and so forth, they started to open back up within 6-8 weeks. Getting more testing capabilities was a key for many healthcare locations.

 

Now many places are experiencing - for the first time - what you describe. It may not be 'new' to the world, but it certainly is to many hospitals and healthcare facilities.

 

And the longterm affects on staff is new. It grinds at people mentally, physically and emotionally. Many people can work under a lot of stress for months - but it's now more than 1/2 a year. Those effects are new (if predictable).

[Machu Peach]

Curious what point you're actually trying to make here, then:

In March/April in NYC

1000 people per day were dying. There was very little know about the virus. The hospital system was actively overwhelmed. There was worries that everywhere in the US was going to end up as bad as NYC. There were worries it was going to continue to get worse and worries of a fall surge.

 

In Oct in WI

40 people per day are dying. There is a lot more known about the virus. There are worries that the hospital system is getting overwhelmed. There is little worry that WI going to end up as bad as NYC. There are worries it is going to continue to get worse and worries of a fall surge.

 

It's not binary. I don't see it as an either/or situation. One can simultaneously acknowledge that 1) the situation in NYC was far more dire by any objective measure 2) there are fewer unknowns now than in March/April and 3) the potential for further increases and a 'fall surge' were/are real concern(s), both in March/April and now.

 

I don't know how to state it any more plainly and have little interest in continuing this discussion.

 

If you disagree that's fine, but stating that I'm dismissive of "the plight of actual front-line healthcare workers" is inappropriate. ...particularly, as I am (arguably) one and my wife is inarguably one.

[PeaveyFury]

[ One can simultaneously acknowledge that 1) the situation in NYC was far more dire by any objective measure 2) there are fewer unknowns now than in March/April and 3) the potential for further increases and a 'fall surge' were/are real concern(s), both in March/April and now.

 

I think where the continued disconnect is comes from the fact that the initial question that was posed to someone else was 'is there a diminished concern about the severity of the situation?' Your response was basically to the effect of 'things were really bad back in March/April, so of course the concern is less', with supporting points regarding hospital capacity, PPE, etc., that are starting to become issues again. Perhaps there is less concern in your geographic area right now, but there certainly isn't here.

 

Yes, at this moment in time, the situation is still better than it was in March/April. But it takes very little time in looking at the current data to speculate that the situation COULD reach those levels in the next month or two. Will it? Who knows.

 

I... have little interest in continuing this discussion.

 

Probably a fair course of action on both of our parts to save the rest of the board.

[Machu Peach]

Your response was basically to the effect of 'things were really bad back in March/April, so of course the concern is less',

This is not true. My actual response.

 

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.

[PeaveyFury]

Your response was basically to the effect of 'things were really bad back in March/April, so of course the concern is less',

This is not true. My actual response.

 

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.

 

My full sentence, including after where you cut it off:

 

Your response was basically to the effect of 'things were really bad back in March/April, so of course the concern is less', with supporting points regarding hospital capacity, PPE, etc., that are starting to become issues again.

 

Implying that what happened back in March/April can't happen again is patently false,

Didn't state or imply that.

 

And yet:

 

There is little worry that WI going to end up as bad as NYC.

 

You can dismiss the notion if you choose, but it seems that you've spent the better part of the last two pages of this thread diminishing the current situation and downplaying the seriousness of the trend right now. Perhaps it is indeed less concerning to you, but to imply that 'most' people share that view is, again, patently false. As that is apparently where we'll disagree, I can agree to the 'no need to discuss it further' notion that you've suggested twice now. Regardless, I do appreciate the discussion.

[Machu Peach]

I can agree to the 'no need to discuss it further' notion that you've suggested twice now.

I am going to correct when I'm being incompletely quoted or misquoted.

 

My full sentence, including after where you cut it off:Your response was basically to the effect of 'things were really bad back in March/April, so of course the concern is less', with supporting points regarding hospital capacity, PPE, etc., that are starting to become issues again.

In that response I list

1)Bad estimates of morality rate

2)Bad models

3)Bad estimates of infection rate

4)Bad understanding of incubation time

5)Numbers of deaths per million

6)Bad understanding of transmission

7)Hospital Capacity

8)"Widespread" PPE shortages.

[RobertR]

I'm just going to butt in and say, maybe "Not as bad as NYC in March" isn't actually a benchmark that describes success.

[Machu Peach]

I'm just going to butt in and say, maybe "Not as bad as NYC in March" isn't actually a benchmark that describes success.

Is anyone making that claim?

[RobertR]

I'm just going to butt in and say, maybe "Not as bad as NYC in March" isn't actually a benchmark that describes success.

Is anyone making that claim?

 

It sure seems like you are when you describe NYC in March as "this is what bleak looks like". Maybe that wasn't the intention, but it sure seems like the bar is being set awfully low.

 

But, let's turn it around, what does a successful response in Wisconsin look like given the trends we're looking at now? With winter setting in and families wanting to gather, how do we tamp the curve back down?

[Machu Peach]

I'm just going to butt in and say, maybe "Not as bad as NYC in March" isn't actually a benchmark that describes success.

Is anyone making that claim?

 

It sure seems like you are when you describe NYC in March as "this is what bleak looks like". Maybe that wasn't the intention, but it sure seems like the bar is being set awfully low.

There's a nasty trend on this board where people are comfortable telling me what it "seems like" I'm writing. It's unfair and it should stop.

 

Instead focus on what I actually write. If anyone is confused by what I write, please ask questions. It's fair more likely to further the discussion than this "seems like"/"seemingly" stuff. If one attempts to make me defend a position I haven't taken, I'm simply going to point out that I haven't taken that position.

 

If you think I've declared the WI a "success" that's on you; I haven't used that word or any of it synonyms.

 

But, let's turn it around, what does a successful response in Wisconsin look like given the trends we're looking at now?

I don't know what a successful response would look like. There are so many variables at play that I would have trouble even measuring success. Obviously one wants the death rate to be as low as possible. How low is possible? I can't predict with any confidence.

[LouisEly]

To me it seems like Machu Peach is looking at things at a national level and Peavey is looking at thing at a Wisconsin level.

 

That, I believe, is the disconnect. (Not everyone on this board lives in WI )

 

Considering NY has 3.3x the population of WI, and the most WI has seen in deaths in a day is 48 (21/day on the seven-day moving average), NY was worse back in March/April (up to 1,000 deaths/day) than WI is today.

 

WI is by far the worst that it has ever been, getting worse by the day, and is on the brink of being overrun, that is not disputable.

 

Both of you are correct.

[RobertR]

 

Instead focus on what I actually write. If anyone is confused by what I write, please ask questions. It's fair more likely to further the discussion than this "seems like"/"seemingly" stuff. If one attempts to make me defend a position I haven't taken, I'm simply going to point out that I haven't taken that position.

 

 

I'm just going to quote what you actually wrote.

 

In NYC 4th year med students were pulled out of their programs to help with the pandemic. Retired MDs, nurses, and technicians were recalled to work. Volunteers were flown in from across the country. Two of my colleagues, MDs doing research who hadn't seen a patient in years, were called in to volunteer at their university's emergency dept and granted admitting privileges. They had ~40 people dying per day just at their hospital alone. That is what bleak looks like.

 

That to me reads like NYC in March is the bar for bleak. But, my apologies for misinterpreting. Frankly, I do value the medical perspective and more nuanced arguments than we get from the news.

 

I think it's clear, that it's Wisconsin's turn to deal with the outbreak that's spreading throughout the state at a scary growth rate now. And, yeah, I don't think it will get quite that bleak. But, I'm not optimistic that it's not going to get a lot worse in Wisconsin.

 

I kind of think that mixing the pandemic with an election year just made everything worse. I'll leave it at that since I know this isn't the political forum, but the mistrust across the political spectrum certainly did not help matters. And, frankly, I don't understand it as I think the mixed messages have only prolonged and deepened the economic and public health suffering.

[Machu Peach]

Two people discussing a bad dinner.

 

Person A "Wow this chicken is awful."

Person B "The beef is even worse."

Person A "It seems like you're saying the chicken is good."