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SEC targets late July for COVID-19 decision-making


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3 hours ago, AU_Tiger_88 said:

I don't look at the negativity rate for just that and getting counted each time a person is negative is correct.  It isn't about the number of people who test negative.  It is more about the positive rate and how long they have had it.

 

 

isn't  positive rate the total positive tests/ total number of tests.   If you have two people and one has covid,  and you test them both the positive  rate would be 50%.  But if you tested the negative person over and over the positivity rate would drop.  

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3 hours ago, AU_Tiger_88 said:

And this is another reason that I don't think we have good reporting on the actual numbers when they count this as a COVID death...

https://www.fox35orlando.com/news/fox-35-investigates-questions-raised-after-fatal-motorcycle-crash-listed-as-covid-19-death?fbclid=IwAR2EV6EeGk8qqQI-YV3tot-nF441DMRp1w8gmUwMWM8fMf1aGsTMdNiQ6GU

 

Honestly, looking at COVID deaths is somewhat of the wrong way to judge this.  The key is hospitalization rate.  If hospitals are being overstressed because of COVID, that means there are fewer resources to devote to victims of car accidents, heart attacks, etc, etc.  You can't stress the healthcare system to that degree and expect solid results overall.

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2 minutes ago, Brad_ATX said:

Honestly, looking at COVID deaths is somewhat of the wrong way to judge this.  The key is hospitalization rate.  If hospitals are being overstressed because of COVID, that means there are fewer resources to devote to victims of car accidents, heart attacks, etc, etc.  You can't stress the healthcare system to that degree and expect solid results overall.

Thank you for pointing this out. People typically forget the middle area of treating and hopefully discharging. It takes a lot of resources and major effort. Mental health among nurses is very compromised. 

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1 hour ago, Quietmaninthecorner said:

isn't  positive rate the total positive tests/ total number of tests.   If you have two people and one has covid,  and you test them both the positive  rate would be 50%.  But if you tested the negative person over and over the positivity rate would drop.  

I guess I misstated what I was trying to say.  I don't really care about the rate of positivity.  I just want to know the number of cases, are the hospitals being overrun?  And it not then it isn't that bad as the media is putting it out there.

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38 minutes ago, AU_Tiger_88 said:

I guess I misstated what I was trying to say.  I don't really care about the rate of positivity.  I just want to know the number of cases, are the hospitals being overrun?  And it not then it isn't that bad as the media is putting it out there.

Well you have hospital people here who have told you guys that yes it is bad. Yes and some parts of the country, the hospital is being overrun and it seems it goes by the wayside because “the media.” Majority of healthcare workers and providers have all been in support of masks, social distancing and hand hygiene. It is not to take away rights or scare tactics. I am sure you can find an article from a physician or health official who opposes this thought but I find the majority agrees with these premises due to what we say when there were state wide lockdowns and now the results from free for alls. 

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12 hours ago, DAG said:

Well you have hospital people here who have told you guys that yes it is bad. Yes and some parts of the country, the hospital is being overrun and it seems it goes by the wayside because “the media.” Majority of healthcare workers and providers have all been in support of masks, social distancing and hand hygiene. It is not to take away rights or scare tactics. I am sure you can find an article from a physician or health official who opposes this thought but I find the majority agrees with these premises due to what we say when there were state wide lockdowns and now the results from free for alls. 

I also have friends that work in hospitals here tell me the opposite about here in Florida.  So I guess our perspective is shaped on where we live.  I can see the support of the masks & social distancing.  Hygiene should be a given but unfortunately it isn't.  There is truly no way we will ever know how many have actually had COVID.  However, I also don't think we should cancel our lives over it either.  This has been to politicized and that has been the main problem. 

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13 hours ago, DAG said:

Well you have hospital people here who have told you guys that yes it is bad. Yes and some parts of the country, the hospital is being overrun and it seems it goes by the wayside because “the media.” Majority of healthcare workers and providers have all been in support of masks, social distancing and hand hygiene. It is not to take away rights or scare tactics. I am sure you can find an article from a physician or health official who opposes this thought but I find the majority agrees with these premises due to what we say when there were state wide lockdowns and now the results from free for alls. 

What about that group of virologists who said it was ok to dispense with all of that during the BLM protests? I believe that was the point when all the young people said ok we can do what we want now. We reap what we sow.

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2 hours ago, ChltteTiger said:

What about that group of virologists who said it was ok to dispense with all of that during the BLM protests? I believe that was the point when all the young people said ok we can do what we want now. We reap what we sow.

What group said that? From what I read there was no change in the standard protocol. It has always been standing six feet apart, mask on and hand hygiene. If people didn’t follow that then you are right , it is reap what you sow. No different then the people who refuse to wear mask now , who attend bars and beaches , etc. However, protest was hardly the start where people had an ambivalent attitude. Prior to the protest here in Milwaukee , people were already fighting the stay at home order. 

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20 hours ago, Brad_ATX said:

Honestly, looking at COVID deaths is somewhat of the wrong way to judge this.  The key is hospitalization rate.  If hospitals are being overstressed because of COVID, that means there are fewer resources to devote to victims of car accidents, heart attacks, etc, etc.  You can't stress the healthcare system to that degree and expect solid results overall.

Well, for four months all we have been concerned about is deaths and now we are going to change the metric?  The original goal was to flatten the curve so we would not overwhelm the medical system.  We did that.  We now are allowing elective surgeries that are contributing to the ICUs percentage to be higher.   The solution then, is to limit the elective surgeries to accommodate the virus patients if the system is being overwhelmed again.

As the virus is being transmitted to younger folks and older, more vulnerable folks are protecting themselves, the death rate is still a viable way to judge how we are doing.

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1 hour ago, I_M4_AU said:

Well, for four months all we have been concerned about is deaths and now we are going to change the metric?  The original goal was to flatten the curve so we would not overwhelm the medical system.  We did that.  We now are allowing elective surgeries that are contributing to the ICUs percentage to be higher.   The solution then, is to limit the elective surgeries to accommodate the virus patients if the system is being overwhelmed again.

As the virus is being transmitted to younger folks and older, more vulnerable folks are protecting themselves, the death rate is still a viable way to judge how we are doing.

It's never been all about the death rate.  Death rate matters, but having the entire medical system inundated with cases has been the main driver behind shutting things down.  More cases = fewer beds in hospitals.  And the curve hasn't been flattened nationally at all.  There are spots (like here in Texas) where the curve is very much worse.

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20 hours ago, AU_Tiger_88 said:

I guess I misstated what I was trying to say.  I don't really care about the rate of positivity.  I just want to know the number of cases, are the hospitals being overrun?  And it not then it isn't that bad as the media is putting it out there.

I don't normally talk much about myself, but: I work for the CDC. I specifically work on this issue. Speaking only for myself and not in an official capacity in any way or on behalf of the agency: It is not only as bad as what the media is saying, it could reasonably be considered to be actually worse.

 

1 hour ago, I_M4_AU said:

Well, for four months all we have been concerned about is deaths and now we are going to change the metric?  The original goal was to flatten the curve so we would not overwhelm the medical system.  We did that.  We now are allowing elective surgeries that are contributing to the ICUs percentage to be higher.   The solution then, is to limit the elective surgeries to accommodate the virus patients if the system is being overwhelmed again.

As the virus is being transmitted to younger folks and older, more vulnerable folks are protecting themselves, the death rate is still a viable way to judge how we are doing.

First, that's not "all" we've been concerned about, (edit) at least from the public health side - although, admittedly, it is the most easily grasped and communicated concept, which is why media started using it. The case fatality rate is a function of a lot of things - biology and individual treatment, yes, but also being able to provide care. As you said yourself, one of the objects of the March-May period this year was to flatten the curve to reduce the strain on the system, but it was also a time-out to figure out how to re open, how to ramp up testing, how to secure PPE, what infection control measures hospitals and doctors and dentists and grocery stores and schools would need to take. A pause so that we could handle the period between then and when a vaccine would hopefully be available. Among other things.

The issue with your stance is that this is a novel virus, and we're learning at a rapid rate. In March, we thought this was just a bad respiratory virus, and we didn't have the tools to fight it. As more and more is learned, we've moved towards the understanding that it is a blood vessel disease (which is why you see such a strange constellation of symptoms). The treatments are getting better because they're getting more targeted. However, that doesn't mean that the hospitalization rate is going down, nor does it mean that people aren't getting as sick. A SITREP I saw yesterday had about 2/3 of the jurisdictions experiencing plateaued or rising infections.

The focus on the death rate has been wrong from the start, as DAG and Brad pointed out. For one thing, the way that we count deaths in an official way is not conducive to being done in real time. It's a lagging indicator - it takes time for people to die, yes, but it also takes time to make the determination and report it all the way up and compile and release. Add that to the fact that morgues are full and that (i'm not kidding) hospitals and municipalities and counties all over the south and west have created a run on refrigerated and freezer trucks, and that will get even harder to use it as a valuable metric. Normally death rates are accounted after the fact, retrospectively, and the system is not set up at all for what we are trying to use it for.

Death is just one possible endpoint, and it takes time before you get to that endpoint, and the period between becoming sick and becoming well is an extended period of time and that period matters, whether or not they're sick enough to need hospitalization or not. Someone in that state eats up a ton of resources, in terms of supplies, personnel, space, and time (not just at a hospital - if someone in your household is sick, that means they can't go to work, and you shouldn't either because you should be quarantined, and you're pretty damn likely to get sick yourself. That's a financial and productivity hit, but it's also deeply damaging on the psyche). That said, despite this narrative that we are counting non-virus deaths in the total, we're likely drastically UNDER-COUNTING deaths. The excess deaths for the time period at the beginning of this are about 30% higher than can be accounted for in just case counts, by some accounting. (Edit - to be clear, the entirety of this is likely not because they themselves had coronavirus, but in a disaster - any disaster - it is standard to count deaths associated with it.)

Regarding the elective surgeries thing - part of the strain on the healthcare system is that it is depending on those "elective" surgeries. Many hospital systems are hundreds of millions of dollars in the hole, and spent the time between April and now furloughing staff and cutting fat that wasn't much there to begin with. From an infection control and public health standpoint, yes, limiting the kinds of elective treatments is a viable way to increase hospital system capacity and reserve valuable personal protective equipment, but there are other issues to take into consideration. Staffing levels are abysmal (we were already in a nursing shortage before this, and many hospitals were relying on horrifyingly expensive travel nurses and overtime that systems can't pay now), and what's more, they've been functioning at a high stress level since March. The burnout is real. The last figure I saw (which was Wednesday) had about 1/4 of the hospitals in the country with less than 20% of their capacity available. That's a problem, especially considering that that count includes the states not hotbeds of the current spike. It's much worse in those areas.

This is not an easy problem to fix. If it were, we would have by now. Just remember, at the end of April and early March, public health practitioners said that if we didn't reopen the right way that we'd erase all of the gains that we made by a month and a half of shutdown. We didn't, and it has played out exactly like it was predicted to. To a person, if you ask someone in public health what's going to happen next, we will tell you that what is coming is not good - I just hope that people listen this time.

Edited by Auctoritas
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All of that said: wear your @#!$&#@ masks. Even if it sucks. Even if you think it doesn't work. Even if you think it is a hoax. Have some @#%&%^*&^ compassion or sense of civic duty. Even if we are wrong about it (trust me, we aren't), it's a small sacrifice to make. Even if we weren't sure about it, or there was a 50/50 chance, it still is a concrete thing you could at least try to do, just in case it does. It's not about keeping you from getting sick, it's about - just in case you are and didn't know it - giving other people a chance not to be sick.

Drives me nuts. American exceptionalism used to mean that we were set above the rest of the world, that we were special and could do anything if we set our minds to it. Somewhere along the way, the idea switched from "America is exceptional" to "I am an American, and therefore I, personally, am more special than you are."

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13 minutes ago, Brad_ATX said:

It's never been all about the death rate.  Death rate matters, but having the entire medical system inundated with cases has been the main driver behind shutting things down.  More cases = fewer beds in hospitals.  And the curve hasn't been flattened nationally at all.  There are spots (like here in Texas) where the curve is very much worse.

It is to the point that the virus is manageable and we are learning as we go.  We have enough knowledge to adapt as conditions change and enough experience to know how to adapt.  The Texas, Florida, Cali etc are really just now seeing an increase in cases that NY, NJ, etc saw earlier.  How the former states react will determine how to proceed.  That is where the death rate is a good indicator as we work through this thing.  JMO.

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4 minutes ago, Auctoritas said:

All of that said: wear your @#!$&#@ masks. Even if it sucks. Even if you think it doesn't work. Even if you think it is a hoax. Have some @#%&%^*&^ compassion or sense of civic duty. Even if we are wrong about it (trust me, we aren't), it's a small sacrifice to make. Even if we weren't sure about it, or there was a 50/50 chance, it still is a concrete thing you could at least try to do, just in case it does. It's not about keeping you from getting sick, it's about - just in case you are and didn't know it - giving other people a chance not to be sick.

Drives me nuts. American exceptionalism used to mean that we were set above the rest of the world, that we were special and could do anything if we set our minds to it. Somewhere along the way, the idea switched from "America is exceptional" to "I am an American, and therefore I, personally, am more special than you are."

I’m not wearing a mask now because of this post. 

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11 minutes ago, Auctoritas said:

First, that's not "all" we've been concerned about.

The “all” I was referring to was the media and laymen, not specifically to the CDC.  I can imagine you have had your hands full and thank you for your service.

Thanks, also, for the information you have provided.  We still have a long way to go.  Hoping for the best.

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Just now, I_M4_AU said:

The “all” I was referring to was the media and laymen, not specifically to the CDC.  I can imagine you have had your hands full and thank you for your service.

Thanks, also, for the information you have provided.  We still have a long way to go.  Hoping for the best.

Yeah, I should go back and make an edit - that's a fair point, and it came off more snarkily than I intended it to.

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Everyone please panic! This virus has only a 99.5% survival rate! Run! Hide! Stay in your homes! Ruin your lives! Civilization as we know it is done!  Use a cheap cloth mask that you will constantly remove and touch your face and touch other objects! Wear a mask but also distance!  Or distance but also wear a mask!  Or, stay home! Wait, no go out but don’t breathe!  If you get this virus you will die immediately! In a motorcycle wreck...or wait no you will die by shooting...urrr no wait you won’t die but you will be asymmetrical I mean asymptomatic !  Or your blood vessels will pop! No, wait you will kill your grandmother!  
 

You are unAmerican if you don’t do exactly as your government tells you!  
 

 

 

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1 minute ago, Auctoritas said:

Yeah, I should go back and make an edit - that's a fair point, and it came off more snarkily than I intended it to.

No problem, I just wanted to clarify for the other posters.  You are seeing the problem from a difference perspective than the rest of us.

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Just now, nixtosanders94 said:

Everyone please panic! This virus has only a 99.5% survival rate! Run! Hide! Stay in your homes! Ruin your lives! Civilization as we know it is done!  Use a cheap cloth mask that you will constantly remove and touch your face and touch other objects! Wear a mask but also distance!  Or distance but also wear a mask!  Or, stay home! Wait, no go out but don’t breathe!  If you get this virus you will die immediately! In a motorcycle wreck...or wait no you will die by shooting...urrr no wait you won’t die but you will be asymmetrical I mean asymptomatic !  Or your blood vessels will pop! No, wait you will kill your grandmother!  
 

You are unAmerican if you don’t do exactly as your government tells you!  
 

 

 

1 minute ago, nixtosanders94 said:

 

I’m not wearing a mask now because of this post. 

Then you're just an a-hole and should be ashamed of yourself as a human being. If that's what makes you not want to wear a mask, then I'd say you deserve whatever karma is coming to you. Of course, then again, you're probably going to end up killing a family member or a friend, so it's a shame your abject selfishness is going to affect other people.

You. You are what is wrong with America. Good riddance to you.

Unfortunately, you're the kind of person that has made it so that the season will likely be cancelled. Maybe since you can't see past your own self-interest, maybe that'll get your attention.

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2 minutes ago, Auctoritas said:

Then you're just an a-hole and should be ashamed of yourself as a human being. If that's what makes you not want to wear a mask, then I'd say you deserve whatever karma is coming to you. Of course, then again, you're probably going to end up killing a family member or a friend, so it's a shame your abject selfishness is going to affect other people.

You. You are what is wrong with America. Good riddance to you.

Unfortunately, you're the kind of person that has made it so that the season will likely be cancelled. Maybe since you can't see past your own self-interest, maybe that'll get your attention.

Wow lol. Now I know what kind of person you are. Thanks. Enjoy your day in Mad Max world. I’m gonna head outside and breathe in the fresh air. 

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