Covid 19 Sci/med discussions only

[WillBrink]

The interviewer is, well, you know, but another worthy interview:

[VARIABLE9]

This Dr was interviewed about this for a BBC podcast and explained the benefit of monitoring the oxygen levels in a little more detail than this article. The BBC podcast was aired on Saturday 04/25/2020.

https://boston.cbslocal.com/2020/04/...chard-levitan/

[WillBrink]

That YT would be removing a vid from qualified people who have a different view using the data that exists is irresponsible too. That's very different than some conspiracy wack job ranting about hoe the virus was created by Gates and the illumanate to control the population, yada yada. This is discourse by med pros and they have every right and reason to be heard. Some of what they say may not be 100% accurate, but censorship of this is bad science. They are getting some kickbck as expected:

https://calmatters.org/health/2020/0...d-conclusions/

Also, their own med org not too happy with them:

https://www.acep.org/corona/COVID-19...isinformation/

[Adrenaline_6]

The interviewer is, well, you know, but another worthy interview:

This is what I suggested doing early on. Logically, this just made sense. Total lockdown was, from a logic standpoint, extremely stupid.

[chuckman]

This is what I suggested doing early on. Logically, this just made sense. Total lockdown was, from a logic standpoint, extremely stupid.

Lockdown isn't stupid, you just have to do it at the right time (isolation and containment). That ship sailed at the end of March, so yeah, NOW lockdown is stupid because it's out there. Social engineering and risk mitigation is what we need to be doing, and I think time for the lockdowns is past. Part of the problem was trying handle this from an emergency management vice public health strategy since they are not both parallel.

[Adrenaline_6]

Lockdown isn't stupid, you just have to do it at the right time (isolation and containment). That ship sailed at the end of March, so yeah, NOW lockdown is stupid because it's out there. Social engineering and risk mitigation is what we need to be doing, and I think time for the lockdowns is past. Part of the problem was trying handle this from an emergency management vice public health strategy since they are not both parallel.

So you are saying locking down a portion of the population (the major portion of it) that has almost no risk of death was logically sound? If so, in what way?

[ramairthree]

Our institution's Big Hat ID doc Cameron Wolfe is not a doomsdayer or alarmist, and his (with our internal epidemiologists) models have been the most accurate for my area. So I take what he says with a high degree of fidelity. On young people getting it, he is seeing a lot of young people with clotting disorders. He does not know if these disorders will be time-limited, or part of their life. But they are bad enough whereby these folks get exertional SOB. He also thinks until there is a vaccine, which won't be anytime soon, we will continue to see variations of social distancing and a resurgence of COVID. He thinks this is a long-haul scenario and we'll be dealing with it for many months.

It’s definitely here.
I actually think much of the public thought it was going to be gone or we would have a vaccine or a cure in a few weeks.

As far as the coagulations issues. Yes, they are real. But I want to iterate, these coagulation issues are not new. They are not specific to COVID. They are seen in multiple other overwhelming bacterial and viral infections. This is important, because the way the news has spun things, people get the impression that COVID uniquely results in-
ERs and ICUs are at capacity
Young healthy people got it and died
Bleeding and clotting disorders
Lung injury
Myocarditis
Etc.

When these are all things that are ongoing all the time, they are not new, they are not unique, many other viruses do this.
They are only new and unique to much of the public.


An ID physician will be a consultant to the ICU doctor managing severe cases in the ICU or the hospitalists with less severe cases not in the ICU. While not a hands on intubater, vent manager, etc. he will likely have Been consulted on all the cases, so will have a good overhead view on all the facility’s admitted COVID patients, their complications, etc.


I actually finally found a graph of another thing I have been trying to convey. It takes the peak NYC impact time frame, and compares it to the same time frame in 2019.



You can see how the majority of the COVID impact is on a pre-existing background of deaths from the conditions of those numbers already dying from those conditions. With a bump from the next months period. My opinion all along has been the key to capacity for the outliers was to shift from futile, end of life care- with an end result being essentially the same number of deaths we were going to have this year, without the societal and financial impact.

It’s a nation outlook vs individual outlook. As an individual I would rather grandpa got to see his great grandson graduate this spring, go to another Memorial Day parade, and die of his metastatic lung cancer in June. As a nation it doesn’t matter if he dies of COVID in April, May, or June and we didn’t have to add trillions in debt and make things horrible for tens of millions of people.

Shift back to individual view. What happens to your son that was supposed to get his big look for his baseball scholarship this spring and then go off to college? Your nephews rescinded job offer from when he gets his engineering degree next month? Your daughters cancelled internship where she hoped to get her comp Sci job next year? Your uncles shattered retirement plans? Your best friends failed business and financial ruin after two decades of blood, sweat, and tears? This has happened to a magnitude more people than a few hundred thousand potential COVID deaths. And a far more significant impact to the nation.

[chuckman]

So you are saying locking down a portion of the population (the major portion of it) that has almost no risk of death was logically sound? If so, in what way?

If you know a R0 (little zero) and how long it is transmittable, the higher the population of lockdown, the faster it burns itself out. Given we 'probably' had cases as far back as the fall, and post-mortems are showing people having had it far early than we first thought, by the time we did a lockdown, it probably would not have its' desired effect. The risk of death is only part of it; the risk of disability is also part of it (in that if you get it and recover, can you have sequelae for life?).

So the answer to the question of can you hold your nose and support a lockdown depends on if you are approaching it from the risk of death/disability, or the risk to the economy (or the risk of anything else). Everyone needs to answer that based on their own values.

[WillBrink]

So you are saying locking down a portion of the population (the major portion of it) that has almost no risk of death was logically sound? If so, in what way?

he didn't say that at all. Nothing comes without risk, but at the time, the models suggesting the medical system could be severely overwhelmed leading to considerably more deaths, and being they were already well behind the curve with the virus, it made some logical and medical sense. Why we were so behind the curve is another issue of course to be debated another day, but in the context of where we where and so forth, one can understand why that route was chosen.

Had we been better prepared and had a full plan in place of testing, tracking, plenty of PPE, etc, say more similar to S. Korea, such drastic measures could have been avoided, but one also has to take into account things like the size, culture, demographics of the US compared to others.

I tend to think the S. Korean model more applicable to the US than say the Swiss, but I'm not an infectious disease expert either.

Once this crazy chit is done with, there will be a lot of really interesting and useful papers that will get published as the medical/sci equiv of an AAR and lessons learned

Whether we use them to better prepare for the next event is another matter...

[Adrenaline_6]

If you know a R0 (little zero) and how long it is transmittable, the higher the population of lockdown, the faster it burns itself out. Given we 'probably' had cases as far back as the fall, and post-mortems are showing people having had it far early than we first thought, by the time we did a lockdown, it probably would not have its' desired effect. The risk of death is only part of it; the risk of disability is also part of it (in that if you get it and recover, can you have sequelae for life?).

So the answer to the question of can you hold your nose and support a lockdown depends on if you are approaching it from the risk of death/disability, or the risk to the economy (or the risk of anything else). Everyone needs to answer that based on their own values.

Gotcha. My logic usually is from the 100,000' level, so it will take both factors into account. By the time we did a lockdown we had some data. Enough to see that most of the population would be unaffected. To me, when both are taken in, totally locking down the healthy population with almost zero risk and in doing so, hurting the economy, employment, peoples livelihood, and mental health along with so many other hurtful factors, in the end, was tremendously shortsighted and stupid.