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Covid 19 virus inpacts sports, NHL,Season Tix other impacts

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Our ancestors dealt with the potential for catching the plague, small pox, dysentery, consumption, yellow fever, leprosy and all manner of pestilence.  If they’d have locked themselves up until it was over, we’d probably still be playing hockey with wooden sticks... 😜

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The word "quarantine" comes from the Italian word for "40-day time period", as they would stop all commercial traffic during the Black Plague until the sailors had been shown to be healthy for 40 days.

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12 hours ago, Red_Storm said:

Our ancestors dealt with the potential for catching the plague, small pox, dysentery, consumption, yellow fever, leprosy and all manner of pestilence.

With all due respect Red, no, they didn't. They merely died from those things until they ran their course, and only because they did. There is no indication whatever that this virus has a fixed course to run--all indications are that it will be become endemic: an ongoing threat, until a vaccine is in place.

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1 hour ago, top-shelf-1 said:

With all due respect Red, no, they didn't. They merely died from those things until they ran their course, and only because they did. There is no indication whatever that this virus has a fixed course to run--all indications are that it will be become endemic: an ongoing threat, until a vaccine is in place.

While true top, oddly this virus' cousins, MERS and SARS seem to have petered out for unknown reasons?

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1 hour ago, KJUNKANE said:

While true top, oddly this virus' cousins, MERS and SARS seem to have petered out for unknown reasons?

SARS patients were not infectious during the incubation period.

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18 minutes ago, legend-1 said:

SARS patients were not infectious during the incubation period.

That and many died before passing it on. SARS reportedly had a 55% mortality in patients over 60, and a 10-15% mortality overall. 

 

Ebola had a 50% mortality overall not age adjusted.

 

Luckily from a pandemic point of view the really deadly viruses tend not to spread as far both because people get sick fast and the response to contain tends to be massive.

 

Covid 19 has sort of straddled that line in a way as to create maximum havoc for the amount of actual death. The case fatality rate will still (IMO) end up under 1% and not that far from a bad flu year. But the WAY it has hit is the thing. Being far more contagious, but also the people who are dying and HOW they're dying is scary as hell. That combined with the novelty of it and the massive media and social media echo chamber amping every thing up has created this unique moment. 

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Building on my lat paragraph.

 

This is an unprecedented situation in several key ways. But one of them is that Covid 19 is a tale of at least two totally different processes (really probably 4 or more, but for simplicity sake...) the huge majority of people will get the non lethal form of Covid, and the massive majority of people under 30. This ranges from no symptoms to a pretty nasty pneumonia. But then there are those whose bodies overreact to the virus and the combination of the direct viral effects and a massive immune overreaction create a storm of nastiness that can kill you a number of different ways, sometimes all at once. But the other thing, especially for people of older age, is that this thing can get you seemingly randomly. That this is so new (many things that intensivists knew to do for patients that looked sort of like this did not work) and insanely difficulty to treat (multi system issues), scares the crap out of doctors. 

 

One thing that gives doctors some sense of an ability to go fight disease, is at least a pretty decent understanding of the disease and what to do and not to do for it. This is particularly true for the bad things since massive amounts of research is done on those things. But remember, that's done over many years. And over many years, many things we just KNEW were right, turned out to be wrong years later. That's the dirty little secret of medical science. About 40-50% of things that a new study "proves" turn out to be wrong. But that process takes years. We've had this thing for months. 

 

So, while those really really sick patients are very few as a percentage, they are everything in absolute terms, and they are scary as hell to everyone from providers to the general public. The pathophysiology of this is just being worked out, but we know it is different than anything we've seen before in those really sick patients. I mentioned that if you're young, this is basically the flu, and it is. But if you're the person on a ventilator in that full cytokine storm, then for you this is ebola, if not worse.

 

And that combination of a subset of "really sick in a scary way" people, with the fairly high contagiousness run through the non stop media hype machine has created the maximal fear/risk ratio. And that has driven a lot of policy to this point. And that is not even unreasonable. It probably IS reasonable. Most of the decisions on this have been ones that needed to be made at the time (though they may look wrong in retrospect). But that was then. Things are changing so incredibly fast on this thing. The intervals of meaningful changes in the science and epidemiology is weeks, not months. And the current information, that we didn't even know 2 weeks ago, is that the curve has flattened, and there are massive numbers of asymptomatic people that tested positive for this. We will NOT overload the medical system, which was the rationale for the lockdown. We now know that. 

 

Since I'm dumb enough to keep couching this in predictions, I'll predict this. If we stay in total lockdown more than a few more weeks, the fear of Covid will giveaway to the fear of economic calamity. For politicians, especially at the national level, the real risk moving forward will be the economic fallout of staying locked down too long. Hard to see that in the fire of the covid fear, but that's the prediction thing, looking past that. But my prediction is that we won't see the full brunt of it, because we won't stay locked down much longer than that. However, there will still be a price to pay economically, and it will not be small. The longer we wait to open, the worse that will be. Personally, I'd wait another week or 10 days or so in NC, but quicker or slower in other places depending on their curves.

 

BTW Arkansas, Iowa, North and South Dakota, Oklahoma, Nebraska, Utah and Wyoming never shut down. They have not suffered calamity. Sure they are not NYC, but they do have some cities in there. 

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18 hours ago, KJUNKANE said:

Okay rem, and I'm only quoting this most recent statement because the others would take up too much space reposting them. But, I'm wandering back out on that "island" that you were so famous for years ago, and I hung on WITH YOU UNTIL THE BITTER END.While your reasoning and logic thru all this, combined with the "facts" you brought forward are sound, what I believe at this still neophyte point in understanding this disease, is that NONE of us know jack squat? Not the mensaas, geneticists, virologists, infectious disease experts, electron microbiologists, xray diffraction specialists, pulmonologists, cardiologists, gastroenterologists, statisticians, or our learned politicians. Problem is, in this day and age of rampant mass media coverage, now everyone is an expert!! This becomes the main problem as now there's a mishmash of truth, half-truth, myths and just plain lies, all making the man on the street an expert?

The neophyte thing is true, and the media coverage issue is even more true. We didn't now much. I would suggest that we do know more than we did, but admit that the knowledge is evolving rapidly still. But on media coverage? If that's the only place one is getting their opinions from, well, not great. When I read media pieces about things I feel the need to bang my head on the wall. The most obvious contradictions are blown past, the most obvious questions are ignored. Partly out of space limitations, partly because journalistic standards are weaker than ever, and partly because there is always spin now (usually to create the most sensationalized version of the story).

 

Right now there is a story on Yahoo about it not helping if people wear gloves to the market because Covid isn't really that much of a fomite (can't really get it from touching things) . The same exact story says that doing so could actually be bad. Why? Because people don't know the proper method for taking them off and disposing of them and the gloves might infect someone else. 

 

OK, first, we've been told for months that the virus can last on things for days and now they're saying, "yeah, not really." BUT THEN they say that the gloves could give it to someone else. So, I really can't get it by touching something. But someone could get it from touching the gloves that touched something. 

 

This contradiction is not even mentioned. This is a national piece. (They did the same thing with masks for the public. First, you have to be an idiot to wear a mask in public. Then, you're a criminal if you don't. First, you can't get it from the air. Now, you can't really get it from a surface). 

 

A story on the "rise of pediatric Covid at a Boston Children's hospital",  makes no mention of how sick the kids were, or the presumed percentage of the total. Don't recall a big issue in NYC on that. But here, someone decided to write an article in Boston. Odds that they have some new angle on deadly Covid in kids? Pretty low. 

 

 

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Now, undoubtedly, and this is coming from my field of expertise, the most critical fly in the ointment so to speak, early on, was being unable to critically test for this viral scourge. At least, even though viral origin, specifics of the virion structure and the disease it causes, understanding of the autoimmune component ("cytokine storm"), treatments to attack it, etc, would likely have been lacking earlier, had we had at least a way to detect the damn thing, we likely would have been able to avoid complete financial gridlock? In the early days of testing, not only were the very primitive methodologies wanting and components to perform them often in short supply or completely lacking, but a "turn around time" of days to a week, was a joke. Apparently, the infectivity of this virus, still not completely understood, but likely not quite so rapid as measles, as well as what you keep reminding us of, those either asymptomatic or sub-clinical, together with now known "early infectious viral shedding" combine to make it paramount to have a test with rapid TAT (turn around time).

 

To make matters even worse, with the mounting pressures to give us that critical data, now you get a plethora of poorly verified "tests" in most cases, whose results further propagate misunderstanding, rather than clarify conclusions. And from the point of view of my small place in the universe, tests that are reliable are sold to be used on Rolls Royce machines that we here cannot afford. Not only that, but the critical reagent(s) to run those expensive machines are relegated/rationed to "hot spots".

 I would utterly yield to a pathologist on testing characteristics of a test. So I trust you on that one. I do know that false negatives for some of these tests are pretty high. But there is no doubt that early testing was lacking. At the start we could only test people who had been to China. Then Italy, Washington State, California, then NYC, or known exposure to covid patient, then finally, we could test on the symptoms without exposure history. At the start the only people being tested were people with high risk exposures OR the very sick. This is why it was obvious that the death rate would be adjusted down: only testing the sickest people. 

 

It's also why it was likely we were missing a big subset of patients, possibly a massive one. We were not only testing only the sickest, but we were testing essentially no one who was minimally symptomatic or asymptomatic. There had to be some of them. Turns out there might be a LOT of them.

 

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Now, I see your angst and agree with the apparent overkill of medical resources diverted to what now is appearing to be a true viral "bogeyman", but I ask you, based on the horror which APPEARED to be associated with this COVID 19 disease in the Far East and Europe, and the relative ignorance of it in this country, how could we have prepared in a responsible way any differently? One other factor here if one paid attention to the rhetoric, was unfortunately this disease arose DURING AN ELECTION YEAR, and God forbid we put the welfare of this country ahead of which party is in office? 

No. I have mentioned it several times buried in all my prose, that I don't blame us for what we did. As hard as it is to look forward past the weight of bias that's brought us to the present, it's even harder to look back and place ourselves in that time again rather than Monday morning QB'ing. At that time, the information being given to us was based on false models. But we didn't really know how false they were. As a clinician on the front line of this thing, especially listening to my overrun colleagues in NYC and NJ, the fear of being in a mass casualty situation and picking who lives and dies based on having too few ventilators, I was all in on this lockdown. This doesn't mean though, that I was right. Just that I can't imagine seeing past that fear given the information we had at the time. 

 

And yet, 8 governors did, and the Swedes did. And so far, they are looking less wrong than all of us, though time will tell for sure.

 

So my point now isn't, nor has it been, that we screwed up (though that has also not been disproven) my point is that that was then, and this is now. We now know for almost certain, that the peak will not exceed capacity. Since there is no vaccine in the near future, that capacity issue was the only thing even arguably worth the cost of a shutdown. It is no longer an issue. I'm still in favor of some caution with opening though. In NC: Wait 10 days. Then open in phases. 

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And, I'll make one last statement and be quiet, MY UNBRIDLED HOPE from this pandemic, despite the financial strain this country and world has experienced, is that this event is a trial run preparing humankind for waves of possibly more lethal disease we are being warned about. Please let's learn from it and prepare ourselves should we have to face it again.   

I hesitate to go here because even mentioning his name will get both sides fired up. But on this one issue it is a stark example of the press and what you just said there. Last night the president was touting all of the ventilators we'd built (as he is want to do). A reporter asked incredulously, that since this was winding down, why would we keep making these ventilators. The response? For next time. 

 

Brilliant. The very same people harshly criticizing that we didn't have enough ventilators planned ahead for this pandemic, were already forgetting about planning for the next one. 

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1 hour ago, cc said:

In other words, like the current flu which does which not stop and wont end even though a vaccine is in place for it.  So why are we treating it so differently now that we know more about it?  

 

Looking at just one statistic, and without going into the differences between the diseases: The flu kills between 20k and 60k US citizens a year.  Covid-19 has killed 48k in less than 2 months despite extreme mitigation attempts. I don't know what estimated deaths countrywide would be without mitigation, but I think most would agree it would be a heck of a lot higher than 48k.  And as far as I know, there's no indication yet that covid-19 might subside with warm weather (as does the flu).   I don't mean to be disrespectful, but does that start to answer what I assume is your serious question?      

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1 hour ago, cc said:

I have no clue as the mutation factor cannot be assessed or cumulative immunity. Way too early to tell. That’s exactly my point.  

Indeed...the Spanish Flu basically disappeared very shortly after peak deaths in its second wave In many areas.  Mystery still surrounds this disappearance, but rapid mutation is a common theory.  

 

Even though it mostly disappeared, the Spanish Flu did linger beyond 1918, even into March and April 1919 when it killed “Bad Joe” Hall, defenseman for the Canadiens, and hospitalized most of the team and some of the Seattle Metropolitans were sickened too.  The Stanley Cup finals were cancelled mid-series and no Cup awarded.  Actually in a great show of sportsmanship, the Canadians manager said he was forfeiting the Cup to Seattle, but the Seattle manager said he could not accept the Cup under such circumstances and the series was cancelled instead.

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3 hours ago, cc said:

In other words, like the current flu which does which not stop and wont end even though a vaccine is in place for it.  So why are we treating it so differently now that we know more about it?  

cc, I'm not sure what your question is here so forgive me if I've misunderstood, but I believe we (the medical and scientific experts) are "treating it so differently now" precisely because we don't "know more about it". I guess that statement needs to be qualified though because even though likely some strides have been made in understanding this particular disease, SARS-COV-2 burst so quickly onto the scene, appearing to quickly overwhelm medical supplies and personnel in its path, that the depth of knowledge related to it has significantly lagged. To me, this NOVEL (and again I emphasize that term as I have tried to in past writings) virus has challenged medical science, not only with elements previously little studied or frankly unique to it. For instance, what appears to be the range of organs affected by it? Make no mistake, I don't pretend to be an Infectious Disease expert, but in my perhaps naive thoughts about the viral organism, I'd always believed that a virus (virion is the infective particle) has very specific receptors on cells with which it attaches, And those cells are in specific organs. Thus, a "respiratory virus" caused respiratory tissue disease, "gastrointestinal virus" caused GI problems, etc. We are seeing with this coronavirus though, respiratory, then GI symptoms, liver problems and cranial nerve problems?  Thus apparently this virus's receptor is shared by cells in many organs, UNLESS these other symptoms are indirect rather than primary damage?

 

Then, you've got this ever popularized "cytokine storm". Now that is not a previously unknown condition, having been seen in relationship to other autoimmune problems, but its imposition in a disease state where a person appears by folklore to be "improving", only to suddenly and significantly crash, is at the least unusual. 

 

Add to those, the questions of this virus's origin (true zoonotic vs somehow in part already partially embedded in a human's DNA), shedding of infectious particles after recovery, permanence (or not) of immunity, its mutational and infectivity chacteristics, and even now, its ability to recross species and infect our pets, and I'd say medical science is just beginning to scratch the surface of understanding this virus.

 

So, finally in conclusion, given that medical science has basically ignored, or possibly been denied the funding for critical research to understand possibility of future pandemics, in a world with  increasing globalization, animal food sources and potential for more zoonotic transmission, it is critical that we thoroughly understand this disease as a possible harbinger of things to come.    

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6 hours ago, legend-1 said:

SARS patients were not infectious during the incubation period.

You are correct legend, only during IT WOULD APPEAR, the symptomatic phase does it appear infectious. This is a very unique characteristic and I just wonder if it holds up after more thorough scientific scrutiny, but you are absolutely right in suggesting that if true, and the other fact that rem has mentioned, its high mortality rate, that could stem the spread? BTW, there have been more isolated cases of it I've read so not completely extinct.

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I will be interested to see how the epidemiologists begin to factor in what appears to be a pretty big to massive number of people who have been exposed and didn't even know it, or had very mild disease. As the few people still on here know, I've been curious about this since the beginning, and now it's turning out to be true. I recent recalculation of the death rate using a projection of the percentage of people around NYC found to be positive, but never sought medical care puts the actual death rate of this at 0.5%. This is still only one guess (though it is pretty close to my guess from the start). Aside from the death rate though, is the notion of naturally slowing this disease. I've heard different numbers on herd immunity from 40%-60% need to get it. Supposedly around 4.5% of people in hot spots (NYC, LA) have been exposed and have reported immunity. 

 

OK, we need at least 40% or more to be immune to stop the disease, but what about to slow it? 

 

So, NYC is tapering down along with most of the country. So that's the massive success of the lockdowns right? Makes sense. But in science, it's amazing how many things that make sense are wrong. If the lockdowns limit the spread so much, why did the non lockdown states fair as well as similar lockdown states? Could there be an offset? If massive numbers of people achieve immunity with little or no disease, then not locking down would get you there faster. Or maybe equal to the lock down effect. I am not claiming to know. Just asking questions that people tend not to ask when a thing seems so obvious. That's years of watching obvious things turn out to be wrong as well as seeing how long it takes to turn that ship around after the wrongness is proven. Better to stay open to the possibilities early on than to "lockdown" your opinion, in my experience because once that opinion is locked in, it's really hard to pry it open again.

 

I remain fascinated with Sweden for several reasons. This is a country running counter to many instincts, including many that normally point to Sweden as an example for us, who seem to be ignoring it quite a bit suddenly. Sweden has moved much farther away from it's socialist experiment than most know. And this is an example. The socialists tend to favor lockdown, but Sweden left her open canceling only large events. Restaurants, hair salons, bars...open. And now, they're minister of health claims that they are close to herd immunity. I don't know if that's true, but what if it is? Sweden will have come through this thing and out the other side fast and with little economic damage. Worth at least watching? 

 

Numbers on the Hopkins map for Sweden are hard to square. Ireland, for instance, is a country of half the population of Sweden. Dublin is a bit more populated than Stockholm, and it's not a perfect comparison, but Norway, about the population of Ireland is putting out unusual numbers, so it's really hard to compare them. But Ireland's cases/100K is 361. Sweden's is 175. Ireland locked down and has extended that to May 5. But Sweden's case fatality rate per case is unrealistically high at 12.5%. Why unrealistic? That's Italy territory. That clearly did not happen. The only thing that makes sense to me is that Sweden didn't test that much and remained testing only the sickest people. If one extrapolates Ireland's case fatality rate, but adds twice as many tests to Sweden the rates become about the same. 

 

There is no doubt that the raw numbers make it look like Sweden blew it by not locking down. But, there can be a lot of mitigating factors to the numbers that will have to be worked out. What we do know is that their ICU system was not overwhelmed. It will be interesting to see how the numbers settle out over time in terms of their actual fatality rate now, as well as this. The number that will matter is deaths in the end. If their curve is over quicker and they do get to herd immunity then their cases and deaths will stop sharp while those of other countries will keep coming. 

 

I don't know the answer, but it is worth watching. 

 

Bill Gates, who seems to be in the know on vaccines, hinted that a vaccine could be ready on the "short" side of the 12-16 month estimate. And that hope is still out there, but this thing will hit some sort of herd immunity or at least herd shut down way before that, so waiting on that to make these moves won't work.

 

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One personal note of observation. Neuse Correctional's outbreak is starting to peak. The sickest people tend to show up in the ED about 7 days after they first get symptoms. They've had 460 Covid positives so far. (Durham has 500 total). All of the sick ones come to our ED. We've seen some sick patients, even very sick. But we are so far, so far from being overwhelmed it's not even funny. So cases per 100K, Wayne County stands out among the entire region including Virginia and SC. We have the highest concentration pointed right at our ED/Hospital. And we are still managing while sending 2 providers home per day from our usual. 

 

We'll see how the next week plays out on this, but given this, TBH we should be opening up the state in a first phase sooner than later. If we see a bump in cases? The system is ready for it. 

 

Here's another thought: if we think we are destined for more Covid cases in the future, since there will not be a vaccine soon enough. Personally, I'd rather see it now, while we're in full ready mode. But also, now when there is no flu. If we stay locked down all summer, then open up in the fall, then the second wave could come right along with flu, which presents a much trickier proposition, not to mention co infections with flu plus covid being dangerous. 

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18 hours ago, KJUNKANE said:

So, finally in conclusion, given that medical science has basically ignored, or possibly been denied the funding for critical research to understand possibility of future pandemics, in a world with  increasing globalization, animal food sources and potential for more zoonotic transmission, it is critical that we thoroughly understand this disease as a possible harbinger of things to come. 

Not possibly, totally.

 

Now, if you'll excuse me, I must go inject some disinfectant. Elections have consequences, alright...

 

Edit to add: this is top-shelf-1. I set this up temporarily during a site issue many months back and just merged the two accounts. (It's great to be a rookie again!)

Edited by top-shelf-2

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1 hour ago, remkin said:

Bill Gates, who seems to be in the know on vaccines, hinted that a vaccine could be ready on the "short" side of the 12-16 month estimate. And that hope is still out there, but this thing will hit some sort of herd immunity or at least herd shut down way before that, so waiting on that to make these moves won't work.

Two things here rem. 1st concerning this vaccine, I've been expecting a shorter time period for it's availability from the time it was originally announced as 12-18 months and have posted so. My reasoning is the worldwide scrutiny on this disease SHOULD bring more minds to bear on the problem than have ever worked on any single vaccine. Not only the basic science of the virus, but my guess, and that's all it is, is that shortcuts will emerge that do not compromise the vaccine's safety, but will also decrease that usual time period?

 

The other thing which occurred to me in your thoughts on Sweden vs other countries, I just wonder if genetics are at play here? Along those lines, I predict that when all is said and done with scientific investigation of this one virus, that our knowledge regarding immunity as well as genetic components related to immunity will grow exponentially such that many of these mysteries will be solved? We're "tip of the iceberg" stage presently of our understanding of zoonotics as well as coronaviruses, IMHO.

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Rem: I'm not going to quote your posts in order to save space, lol. (not a complaint ;))

 

Leo Tolstoy had an interesting quote related to one of your points:  "I know that most men, including those at ease with problems of the greatest complexity, can seldom accept even the simplest and most obvious truth if it be such as would oblige them to admit the falsity of conclusions which they have delighted in explaining to colleagues, which they have proudly taught to others, and which they have woven, thread by thread, into the fabric of their lives."    --Tolstoy

 

Just a couple days ago I heard some interesting stats on current death rates in some of the "Nordic" countries.  Sweden came in at 150/million people, Denmark was 60/m, Norway was 30/m, and Finland was 16/m.  I'm thinking we won't know the implications of that until this thing dies down one way or another.  If the total deaths eventually even out, just under different curves, and Sweden reaches herd immunity quicker, and without the economic hit their neighbors took, that will be proven to be a better course.  If her neighbors end up with a lower total death ratio, then it becomes a cost (deaths) / benefit (economy) calculation that ultimately determines which was the better strategy.  I imagine less total deaths for Sweden's neighbors could occur due to reasons such as a seasonal aspect (I know that's not too promising right now), modifications based on what is learned in the interim that the other countries were shut down, or an effective available treatment prior to herd immunity. If, say, interim results from remdesivir or other currently approved antiviral trials show good enough efficacy I could see the drug being approved for covid-19 on an emergency basis.  Or, maybe they discover that they can kill the virus by injecting disinfectants or using uv light inside the lungs, which would solve all our problems? :P     

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He's got a lot of NHL friends, while it might not happen I wouldn't be surprised if it's the current running plan whether smart or idiotic.

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8 hours ago, legend-1 said:

 

He's got a lot of NHL friends, while it might not happen I wouldn't be surprised if it's the current running plan whether smart or idiotic.

Is restriction for people from European Union to enter US already expired/lifted? What about 2 week quarantine period for people coming from abroad? Regular flights from Europe to US? I think not all NHL players can easily rent a jet to fly back to US/Canada.

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Hey crew. Been a long time since I’ve hopped on here. Hope everyone is doing well and staying healthy-physically and mentally 👍🏽
 

Any rumor or chatter when when we’re going to be seeing NHL face masks/coverings? The NFL and NBA already have them on their respective online shop sites. 

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11 hours ago, LakeLivin said:

Just a couple days ago I heard some interesting stats on current death rates in some of the "Nordic" countries.  Sweden came in at 150/million people, Denmark was 60/m, Norway was 30/m, and Finland was 16/m.  I'm thinking we won't know the implications of that until this thing dies down one way or another.  If the total deaths eventually even out, just under different curves, and Sweden reaches herd immunity quicker, and without the economic hit their neighbors took, that will be proven to be a better course.  If her neighbors end up with a lower total death ratio, then it becomes a cost (deaths) / benefit (economy) calculation that ultimately determines which was the better strategy.  I imagine less total deaths for Sweden's neighbors could occur due to reasons such as a seasonal aspect (I know that's not too promising right now), modifications based on what is learned in the interim that the other countries were shut down, or an effective available treatment prior to herd immunity. If, say, interim results from remdesivir or other currently approved antiviral trials show good enough efficacy I could see the drug being approved for covid-19 on an emergency basis.  Or, maybe they discover that they can kill the virus by injecting disinfectants or using uv light inside the lungs, which would solve all our problems? :P     

 

Yes. The thing about this that is both fascinating and frustrating on this is that it is moving faster than good science moves, by a lot. It's fascinating because this is definitely a novel virus. While the young do very well, the thing that happens to the really sick is totally unheard of in the way it happens and is devastating. Take that novelty together with the massive impact across medical, social, political, and economic worlds. Then you have just about everyone in the world chiming in on this thing. I mean doctors, scientists, of course politicians, and put those sparks on the accelerant of a social media and traditional media that are omnipresent and have constantly try to come up with new stories, and make them stand out, and you get data points and "facts" coming in all the time. Some of it will turn out to be right on, and a lot of it will turn out to be garbage. Then fold in a political bent, and suddenly it's very hard to know which end is up. It's kind of a pretty good analogy of our current media and social media situation: so much information coming in fast and constant, but impossibly difficult to place value on each new "fact". 

 

Just about the only thing I know for certain is that a lot of things we think we're sure of will certainly turn out to be wrong in the end. But we don't know which things. 

 

This is why I also think that Sweden will be an interesting study in the end. But to say now? Impossible IMO. There are so many variables that we don't have a firm handle on that we just can't really know. Why has Sweden's death rate been so high? Outliers should have some explanation. In Italy we saw the coffins lined up. We heard the doctors and everyone else tell the stories of letting people die because they outstripped capacity. Now it could be that there's more to their story (maybe a more virulent strain of the virus, definitely a much older population), but at least we know that their peak went above their capacity. But I don't recall ever hearing of that in Sweden. The case fatality rate being higher is easy to explain if they only tested the sickest people. But the fatality per 100K people in the population would not be affected by testing so long as all of the deaths were tested. That could be higher if they counted too many non covid cases (had covid when you got hit by a bus and counted it as a covid death), but not that much higher, I wouldn't think.

 

So, it would seem, and I stress seem, because I have not deep-dived this, or heard a good explanation, but it would seem that they just had WAY more cases because they just let it happen, and at the same time they didn't bother testing non sick patients or even mild/moderately sick, so all of those cases didn't show up in the "confirmed cases". That would explain a higher case fatality and the higher fatality per 100K people also. 

 

IF that's true, then the question will remain: did they essentially front load their deaths? As you mention, will we all catch up eventually? If so, then they did it right IMO. If not, OR if we develop a truly effective treatment or vaccine very quickly (like in the next month) then the lockdown areas might have done it right. Time will tell, as well as a rigorous and thorough analysis of the data.

 

And finally this will also have to include the full economic fallout of locking down. Fascinating again, because we really don't know that for sure either since a lockdown like this one has never been done. I think there will be a big price to pay and the longer we stay locked down the bigger. But who knows? I thought deficits mattered, but till now they don't seem to, so why not print another $3 trillion, even if it doesn't bring any infrastructure or anything new really? But maybe there is a limit on that. Let's hope not.

 

From a medical vantage in the US (outside of NYC and surrounding areas), we know is that the lockdowns that we did overshot the stated intention of them: flatten the curve, don't overrun the healthcare system. And missing on that will have a cost to the people not getting their tumors biopsied or cancers detected by colonoscopy or gallbladders out before they get inflamed, etc. And it has definitely cost the health care system with empty OR's and half empty ERs. And despite this being clear, we have just extended to May 8th in NC, which outside of my county is a very much non hotspot. 

 

I don't have a huge problem with that. I get the caution. I get the fear of the governor to being blamed if there is a second wave. And we are seeing sick Covid patients right now as much as we ever have (though far far from overwhelming us). IMO the hospitalizations are peaking right now. But much past that? Barring another spike up, my opinion is that to stay locked down past that would be a mistake. That's my opinion anyways. 

 

I would also vote no on pouring surface disinfectants into one's mouth. That is with the exception of 70% ethyl alcohol of course! 🤪

 

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OK things have boiled over on the politics. This is a very emotional and heated topic, but we're trying not to be twitter on here. It is impossible not to let political leanings creep into posts on this topic, but it IS possible not to take blatant swipes and naked attacks on a political figure or viewpoint. 

 

So, I've hidden everything related to attacking Trump or any other political figure for the last few pages. I was slow to the draw. 

 

Resorting to blatant political attacks is intellectually lazy IMO. Everyone on here is smart enough to make their points without going there. Please do that. 

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Finally, we have a PM system. We don't moderate it. If people want to have a rabid twitter-like political rage fest on there? Have at it.

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53 minutes ago, remkin said:

OK things have boiled over on the politics. This is a very emotional and heated topic, but we're trying not to be twitter on here. It is impossible not to let political leanings creep into posts on this topic, but it IS possible not to take blatant swipes and naked attacks on a political figure or viewpoint. 

 

So, I've hidden everything related to attacking Trump or any other political figure for the last few pages. I was slow to the draw. 

 

Resorting to blatant political attacks is intellectually lazy IMO. Everyone on here is smart enough to make their points without going there. Please do that. 

Can’t all this be solved over a Zoom ice cream 🍦  “social”? 🤷🏻‍♂️😎

 

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