(COVID/ETC CONTENT HERE) China Locks Down 11 Million in Wuhan,

[tb-av]

Can any of you insiders figure where this guy was? He was NDA. I wonder if this may have been been when the "press" was getting on Trump for 'have you been tested"

https://www.prosoundnetwork.com/live...-from-covid-19

[AKDoug]

Can any of you insiders figure where this guy was? He was NDA. I wonder if this may have been been when the "press" was getting on Trump for 'have you been tested"

https://www.prosoundnetwork.com/live...-from-covid-19

CPAC in late February? https://www.politico.com/news/2020/0...tendees-124808 They have confirmed cases from there. I have a friend that attended CPAC then came to visit me shortly after and spent two weeks at my house. He had no symptoms and still does not.

[ramairthree]

I'm no scientist, but as an Architect, if I gave you a set of drawings and said it was for a 4,000SF home, then when it's built it ends up a 160sf shed, I would lose my license. Yet somehow we let "scientists" slide with this crap all the time, just look at the wildly wrong predictions of climatologists; hockey stick graph et al. If you want to do crap science, fine, but if your crap science effects the lives of millions or in this case, billions of people, and you are wrong, you should be in prison for a long long time.

The media crap fest over incorrect reports like these caused a panic which really screwed over a lot of people. I just don't see any defense to what this dude said/did/wrote/published. Maybe instead of wanting to be the first one out with your chicken little theory, you wait for some more data before making such predictions?

I detest irresponsible and in accurate Science, especially when done to drive an agenda.

But to be fair, you practice a Newtonian profession, lacking the artistic talent to be a true artist, and the math ability to be an engineer...
(Ok, just parroting some jokes, back to the point)

A Newtonian profession has an answer that is reproducible and repeatable. Your square footage will always be the same.

The human body and its management are a quantum profession.
Based on probability clouds.
The same dose of the same medicine for the same thing in the same type of patient might not work, might work, might inexplicability make things worse.

I agree 100% regarding the sensationalism and agendas and the harm of fanning the flames of panic.

[pinzgauer]

Didn’t know standing up for the constitution was grand standing. The last few weeks have confirmed that no one gives a damn about the constitution.

I'm a big fan of the Constitution. What exactly was passed that was unconstitutional? Specifically what Massey was standing up against?

To be clear, I have mixed feelings about the bill.

Edit after reading his tweet:
Fair point on the constitution requiring them to vote on bills. Not sure its specific enough to say you must meet by X hours, etc.

But the rest of his commentary, while I agree with it, is not a constitutional issue.

The bill should be focused on clear emergency measures. It's not, and both Republicans and Democrats are to blame for that.

The root cause is lobbyists and special interest groups. they would argue they represent constituents. And in that aspect the Democrats might have a little bit of high ground over the Republicans listening to industry lobbyists. At the least the special interest groups do sort of represent some constituents, maybe not the majority though.

Likewise I could see some industry focused relief for airlines and hotels. But I'm not sure it should be the leading item in a bill like this. And I'm a hundred percent in alignment with Trump that it should not be used for things like stock BuyBacks and others. The industries and big business are complicit and that kind of behavior.

[pinzgauer]

I completely agree with you. I think scientists often fail with responsibly communicating their findings to the media and, in this case, interacting with policymakers. Any work around modeling is particularly suspect and needs to be reinforced as just that- a model with a wide variability of inputs and outputs and one that needs to be updated regularly as new data emerge. And, after all of that, it's still a model. It seems like many focused on the numbers with this particular work rather than the authors conclusions that were primarily focused on epidemic suppression through interventions to flatten the curve.

I would think the architect/scientist analogy in this case would be more akin to drafting scaleable set of plans for a structure between x and y square footage (or volume), with inputs and outputs of varying electrical demand, HVAC, plumbing, sewage, etc. Maybe that's a poor analogy?

At any rate, this type of work and the resulting uncertainty is one of the reasons I'm an epidemiologist working in oncology rather than infectious disease.

Ask an architect (or engineer) to predict exactly what the energy use of a building will be and the answer will be "it depends". As it does, on many factors in the model, local weather, people load, movement working hours, etc.

It's a model with a number of disparate inputs. All you can do is make assumptions and or calculate high and low ranges. The aggregate of those inputs will lead to very large swings in potential answer.

For stuff like the yield stress of a beam the answer still varies but by practice the specs go with the low end to be very conservative. Rightfully so.

I say this as a EE, that impacts our world too. Because of variability we answer very conservatively. So what's a medical expert or an epidemiologist going to do when faced with the extreme variability? They're going to give the high range which is the conservative answer.

The other thing is that structural beams don't mutate. The virus is a living changing thing that's intersecting with a wide range of individual biologies who relocate, etc.

[pinzgauer]

Henry Ford Health officials confirm letter outlining life and death protocols for COVID-19


Patients who have the best chance of getting better are our first priority. Patients will be evaluated for the best plan of care and dying patients will be provided comfort care.

What this means for you and your family:
1. Alert staff during triage of any current medical conditions or if you have a Do Not Resuscitate (DNR)/Do Not Attempt Resuscitation (DNAR) or other important medical information.

Anyone starting to 2nd guess their "advanced directive" DNR order?

Surely they would differentiate between someone who needs a ventilator as a short term measure to allow recovery (like from covid-19) vs someone who will likely not recover.

[ABNAK]

Well our first officially confirmed COVID-19 patient circled the drain and was intubated a couple of days ago. Late 60's, shit-ton of co-morbidities. I know the guy, he's quite the character. His vent settings weren't too bad compared to what I've read about others needing. I think it was +8 PEEP and FiO2 of 0.60 (60% oxygen). Certainly not "low" per se but not bad for COVID. Well he requested to be extubated, was told he likely wouldn't make it without the vent but he said he didn't care. They extubated him yesterday afternoon and put him on a 100% non-rebreather mask with comfort measures. Sumbitch is still kickin' as of this morning! Damn, I hope he pulls through. That would be sooo encouraging to everyone. Considering what his vent settings were he just might pull it off.

FWIW he was being given Hydroxychloroquine and Azithromycin, so there's that. I asked our head Pulmonary doc about that and he said they are using it on a case-by-case basis. I told him "Well if God forbid I'm laying there one day I'm putting my request in now!" He just kind of laughed.

I also asked him about the Lisinopril (ACE inhibitor) thing. He takes it too so when I mentioned it last week it got his attention and he told me he was going to look into it. I asked him yesterday if he'd had a chance to check on it. He kind of winced and said "Yeah, there's some conflicting data but I'm thinking about taking myself off of it for now but might wait until I talk to one of the infectious disease guys first". I asked him to please keep me informed as I am on the max dose of it (40mg).

[ABNAK]

Anyone starting to 2nd guess their "advanced directive" DNR order?

Surely they would differentiate between someone who needs a ventilator as a short term measure to allow recovery (like from covid-19) vs someone who will likely not recover.

Don't count on it. Generally speaking a DNR means no endotracheal tube for you period. Especially if resources are tight like in NYC or NO.

[pinzgauer]

For what it's worth, SpO2 ("sats") can not go above 100%; it's basically "what percent of the available seats have a passenger" with the seats being the parts of our blood that can transport oxygen (hemoglobin) and the passengers being a molecule (oxygen in the sense of "satting"- however, for the sake of being accurate, it can be other molecules like CO)

Not at all associated with medical fields and no med training, but my understanding of "saturation" in the chemistry sense aligns with your explanation.

So it makes me wonder is there some potential for supersaturation where atoms temporarily bind in some unstable relationship above the saturation point.

[pinzgauer]

Don't count on it. Generally speaking a DNR means no endotracheal tube for you period. Especially if resources are tight like in NYC or NO.

Ouch. I guess here's the ultimate question, with COVID-19, by the time you reach the point if you have to go on a respirator, is there much likelihood of recovery?

If some are recovering then I'm tearing up my DNR! Or at least having my wife keep quiet about it initially.

The wording of advance directives typically used in Georgia is more focused on medical procedures solely used to sustain life where recovery is not expected or likely. And less about resuscitation.

But I think I'm going to dig that out and check :-)

In general I think advance directives are a good thing and you young turks should get them as well. Ours is combined with medical power of attorney, which is critical when you're over 18. EVERYONE needs to have someone with medical power of attorney so you don't get stuck in a situation without a directive.