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

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Thanks for the post romansperson. You make excellent points. When they end up putting down the numbers by age and certain other risk factors I think it will be apparent that while the overall death rate is going to be at or below what I predicted way back near the start of this thread, it is going not going to be a minuscule risk for all age groups and medical problem groups. There is no question that the older the riskier, and the more one has certain medical problems (particularly hypertension, cardiac disease, diabetes, obesity) the more the risk. 

 

IMO the science bears out that the risk to very healthy people under 35 (especially under 30) is indeed very small, the risk for a 70 overweight, diabetic hypertensive with a previous MI is anything but miniscule. In fact, that the death rate will be so low is because the young healthy people pull the rate down. Thus, mathematically, the death rate grows with age and the wrong comorbidities. So, while covid is probably safer than flu for a healthy 16 year old, Covid is substantially more dangerous than flu for a 68 year old with cardiovascular disease. I suspect the numbers will bear out that the difference is massive in relative terms. 

 

So, IMO again, for a healthy 25 year old hockey player? Very small risk. This is the basis along with an extensive testing regime to limit exposure, for my thinking, playing games in empty arenas can and will be done. This is dramatically different though from restarting regular games with fans. That, will be one of the very last things to come back. 

 

I think we must and will open society back up. But that is a totally different question precisely because of the heterogeneity of the general population vs hockey professionals. I totally get the concern, and agree that particularly older people and or those with health issues might and often should be more cautious about getting back into more public spaces. And the older and more vulnerable one is, the more one should continue to lock down. That will naturally be part of the way it works out as younger people will probably be the first movers on going back to restaurants etc. But even then, people will distance, wear masks, etc. And I don't expect concerts or sporting events to resume with fans in attendance until the very last phase, likely when we are at least approaching herd immunity, or get an effective vaccine. 

 

I am 57. I took care of two people with Covid today. I have a PA that probably has it but is still working and presenting patient's cases to me because she has no cough or fever. I completely get that even if one doesn't get the full on "cytokine storm" that getting this can be miserable, and scary indeed, and I don't want to get it either. I'll go back slow too.  

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BTW the case of my PA is interesting. She had complete loss of smell and most loss of taste. This is not from congestion, as she had almost no congestion. Further she's had seasonal allergies and colds and even then can at least smell a little and this was completely different. To be a bit blunt, she could not smell her dog's sculpture from a foot away. So how do I know this is covid? Well, besides the incredibly odd and specific symptom of lack of smell. Her husband worked at Neuse Correctional and was Covid positive and had full symptoms including coughing all over the place while she cared for him.

 

But while he had a flu like illness and was miserable. She has had no symptoms besides the lack of smell, and even that is resolving. She never got tested. In about 2 weeks she'll get the antibody test. I'll let you know, but I'd bet a lot that it will be positive and she'll not have missed a day of work.

 

And there are lots of other people like her out there. Continuing to work. They are at Costco's and Harris Teeter and the ABC store and lots of places we are all still going. 

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3 hours ago, remkin said:

So, IMO again, for a healthy 25 year old hockey player? Very small risk. This is the basis along with an extensive testing regime to limit exposure, for my thinking, playing games in empty arenas can and will be done. 

Yes, I get this. And I think that's fine, if the league considers things carefully and decides it's safe to have games - just remember not everyone involved in the playing of games is 25 and robustly healthy. Coaches, maintenance and supply and other support people may not be, and players can't play without those people.

 

That's also not going to bring back full revenue, which is so tied up with all this. Yes, they'll get TV money again (and TV crews are another group that have to work on these things). My husband is a multi-sport fan and he'd be delighted to have something, anything to watch again! But no fans in seats means local arenas get nothing. There's no ticket revenue, no food and beverage revenue, no people coming in from out of town and spending at hotels and restaurants. This is all going to be a really hard nut to crack. 

 

I'm sorry your PA and her husband were sick. I hope they were able to isolate. I know there are a lot of folks out there who probably didn't or couldn't. Which just makes things harder for us older folk. I do hope she'll be able to donate plasma, though, if she does end up positive. Amazing that we have to resort to a 100-year-old treatment method right now, but it's better than nothing I guess. 

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I've been listening to XM every morning while working on a long project, and every day there are snippets of rumors.  Over the last week we've progressed like this:

- 4 arenas to finish the season, including Raleigh!

- Scratch Raleigh, their practice facility sucks.

- Oh, look at the NFL, they are adjusting their schedule!

- We can too, maybe.  Maybe things will start (empty arenas, maybe more than four) around mid June after the logistics of getting everyone back are worked out

- Finish the season, then do the playoffs.  Again, some arenas may not be available due to local restrictions.  Doesn't matter, no fans.

- 19-20 season, including playoffs, ends by Sept 30.

- 2 month break, then season starts Dec 1, with high compression.  20-21 season ends by July 31.

 

Then this morning the latest is... Whoa there on those rumors!  Heart patients are dying in Toronto because just about all surgeries consider elective (which is surprisingly wide) are stopped.   We gotta get the hospitals back first.  All you talking about Sports go to the back of the line!  Don't worry about hockey.

 

I'm paraphrasing what was said.   In a nutshell, it is all rumor.  What is coming out of it is this:

- The NHL really wants to try to get the season finished along with playoffs to make a complete, real season.  Whether that happens or not is unknown.

- It is unknown because the start date is unknown.  As the elective surgery thing sends home, focus on other things is going to happen first.

- They want next season to happen in total, and they are prepared to make significant schedule changes.

- Don't rule out things like radical schedule changes... like not intra-conference play.

- There's a realization disruption will likely be multi-year.

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On 4/29/2020 at 9:16 PM, romansperson said:

Yes, I get this. And I think that's fine, if the league considers things carefully and decides it's safe to have games - just remember not everyone involved in the playing of games is 25 and robustly healthy. Coaches, maintenance and supply and other support people may not be, and players can't play without those people.

 

That's also not going to bring back full revenue, which is so tied up with all this. Yes, they'll get TV money again (and TV crews are another group that have to work on these things). My husband is a multi-sport fan and he'd be delighted to have something, anything to watch again! But no fans in seats means local arenas get nothing. There's no ticket revenue, no food and beverage revenue, no people coming in from out of town and spending at hotels and restaurants. This is all going to be a really hard nut to crack. 

 

No doubt the coaches and especially other staff are at higher risk. The coaches though, could wear n95 masks, and even other PPE. Maybe hook up some sort of microphone and speaker so the players can hear them. But again, the players will be the most tested people on Earth with serial negative tests. There was talk about announcers calling the game from a remote site. That seems unnecessary to me, but possibly the play by play guy and color guy in different booths. At this point they'd just need one neutral set of announcers. 

 

Other personnel could also wear a robust set of PPE, maybe even N100 respirators that let nothing but air in. But I can tell you that, especially if they go with the full NHL arenas, that the risk to a guy driving the zamboni is pretty close to zero even without PPE. But this is where I stop and realize that our understandable zeal for safety goes off the common sense rails. That Zamboni driver, is socially distanced by about 100 yards and several walls from players in their dressing rooms, and about 50 feet from the nearest person on the ice and is basically outside in a massive, empty arena. That same guy has a much much higher risk at Costco's or the local grocery store. Let alone once states start opening up, which is happening now and will be probably complete by then. Plus their risk is from other workers, not the players who have been tested up and down. Even people shoveling ice can wear masks and stay 6 feet apart.

 

The risk will, IMO be places where people congregate off ice. But really, the locker room is the only one that could break tricky at that. Still, players can wear N95 masks in the locker rooms, and shower in shifts, or even shower at home. Outside the box thinking is needed. 

 

But outside the box thinking is also what could make this relatively interesting. Presenting the games in a made for TV format for instance with features that take advantage of that focus. Another thing could be just taking 16 playoff teams and ranking them 1-16. The whole East - West thing is largely about travel anyways. Things like that. 

 

My prediction was based on where I thought things would be, not where they were at the time, or even are now. And indeed states are opening and people are starting to rise up against lockdowns that are going on too long. Even in NC, which is slated to open things to a new phase in one week, there is a protest today. So as states open up and people are going back to some sort of life, a lot of the concerns on this thing will lessen IMO. 

 

BTW when I look at articles online about this, the comment sections seem to favor not doing this, and just focus on next season by at least 4/5. So, I seem to be in the minority on this. I completely understand that reasonable people disagree on this thing.

 

But as always, we shall see. 

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25 minutes ago, remkin said:

No doubt the coaches and especially other staff are at higher risk. The coaches though, could wear n95 masks, and even other PPE. Maybe hook up some sort of microphone and speaker so the players can hear them. But again, the players will be the most tested people on Earth with serial negative tests. There was talk about announcers calling the game from a remote site. That seems unnecessary to me, but possibly the play by play guy and color guy in different booths. At this point they'd just need one neutral set of announcers. 

 

Other personnel could also wear a robust set of PPE, maybe even N100 respirators that let nothing but air in. But I can tell you that, especially if they go with the full NHL arenas, that the risk to a guy driving the zamboni is pretty close to zero even without PPE. But this is where I stop and realize that our understandable zeal for safety goes off the common sense rails. That Zamboni driver, is socially distanced by about 100 yards and several walls from players in their dressing rooms, and about 50 feet from the nearest person on the ice and is basically outside in a massive, empty arena. That same guy has a much much higher risk at Costco's or the local grocery store. Let alone once states start opening up, which is happening now and will be probably complete by then. Plus their risk is from other workers, not the players who have been tested up and down. Even people shoveling ice can wear masks and stay 6 feet apart.

 

The risk will, IMO be places where people congregate off ice. But really, the locker room is the only one that could break tricky at that. Still, players can wear N95 masks in the locker rooms, and shower in shifts, or even shower at home. Outside the box thinking is needed. 

 

But outside the box thinking is also what could make this relatively interesting. Presenting the games in a made for TV format for instance with features that take advantage of that focus. Another thing could be just taking 16 playoff teams and ranking them 1-16. The whole East - West thing is largely about travel anyways. Things like that. 

 

My prediction was based on where I thought things would be, not where they were at the time, or even are now. And indeed states are opening and people are starting to rise up against lockdowns that are going on too long. Even in NC, which is slated to open things to a new phase in one week, there is a protest today. So as states open up and people are going back to some sort of life, a lot of the concerns on this thing will lessen IMO. 

 

BTW when I look at articles online about this, the comment sections seem to favor not doing this, and just focus on next season by at least 4/5. So, I seem to be in the minority on this. I completely understand that reasonable people disagree on this thing.

 

But as always, we shall see. 

 

If they start up again players would be together unprotected on the ice and on the bench, so why worry about them being together in the locker room or showers?  

 

But I do think there would need to be some novel, perhaps outside the box procedures implemented.  E.g., let's face it, while treating covid-19 with disinfectants or light was an outright stupid thing to suggest, I wonder if they could use UV light or some type of disinfectant mist to frequently and thoroughly disinfect areas like locker rooms, showers, and benches?  

 

Which raises a question in my mind: I wonder if there's currently much of an effort on advancing technology to make mass disinfection cheap, thorough, and easy?  

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On 4/27/2020 at 5:06 PM, remkin said:

If you think anyone who's making these play or no play, open up the society or not decisions is reading my opinions to make those decisions on here you can feel safe in knowing that they're certainly not.

Rem, I understand why you'd feel that way, because back in the day it was true. But today, thanks to social media, anyone who says they have some credential is being held out by at least some people as "an expert," and fueling what are often those peoples' extremely bad decisions. With credentials come responsibility, and despite this disclaimer...

On 4/28/2020 at 2:01 PM, remkin said:

No one is going to live or die based on anything any of us write on here. 

...others are listening to you. I know you think your scribblings here are only an opinion, but what matters is not how you see them, but how others do. And when your comments are couched in "the experience" of your day job, they can absolutely persuade some people that this thing is not as serious as the experts say.

 

Less than a week ago you wrote, "The patients never showed up." Well, yesterday saw NC's highest reported number of new laboratory-confirmed infections, and the number is still climbing--exactly as the experts said it would. And we are still not testing enough people to get a full picture of the spread: Of the total tests performed in NC, 8 percent have been positive, a number far higher than is being reported in regions with higher tests-performed-to-confirmed-cases ratios.

 

The known facts around this pandemic are scary, but what we still don't know is scarier still. Anyone who believes we already know enough to resume business as usual is not only fooling him or herself, but is advocating for something that has an even-money chance of putting themselves and those they love at grave risk.

Edited by top-shelf-1

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The more we test, the more cases we'll find. It's not a brilliant point, but I did predict it. And the new cases we find from more testing will be minor cases (since we've been testing the sickest people at nearly 100% for a long time now) further sending the true case fatality rate pretty close to my initial predictions. Again, despite ignoring this over and over in posts, the fundamental issue short of a vaccine is not outstripping the medical capacity. That was the stated reason for the lockdowns, not keeping anyone from getting this. On that I've been more correct than many experts by a lot, and continue to be, and I think will be. My vantage on that is on the ground directly in the line of fire in the highest density covid county in the state. The vast numbers of intubated patients is what I said aren't coming. And they aren't. 

 

If we could eradicate the disease by locking down, that would be different. But if we could, then how are the cases still going up after weeks of lockdown?  The disease is still spreading. 

 

There may be an uptick with opening. If not then the lockdown was even less effective. But it there is, it will not outstrip capacity of the system to care for the sick. And that was the point. 

 

Here's irony. The WHO is now saying that Sweden is the model that most countries should follow. Those who want to follow the experts find themselves in an odd spot. Following the World's experts now means abandoning the tight lockdown mode in favor of one of the most open models on Earth. 

 

Top, I'm not responding to your unqualified sly attempts to disqualify my opinions. I'm not planning on having a continuing debate with you. People have made it clear that they don't want to read it. Post your opinions so long as you stop attacking personally and don't get political, and I'll post mine. 

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NC is finally, finally getting testing ramped up, and are rightly mass testing congregate facilities like prisons and group living facilities.   And we're seeing what was feared, a lot of cases in those close-quarter facilities.

 

I'm following what our government is following: the trend of positive tests versus total tests.  This key metric has finally flattened and may be downtrending.  Read it for yourself:

https://www.ncdhhs.gov/divisions/public-health/covid19/covid-19-nc-case-count

 

Quote

Is North Carolina seeing a 14-day downward trajectory of positive tests as a percentage of total tests?

As we ramp up testing, there will be more laboratory-confirmed cases. Looking at what percent of total tests are positive helps us understand whether laboratory-confirmed cases are increasing in comparison to the number of tests conducted. 

To calculate this, North Carolina uses positive tests and total test numbers from labs that reported both positive and negative tests electronically into the NC Electronic Disease Surveillance System (NC EDSS). This ensures that the positive and total tests were conducted on the same day to calculate a more accurate daily percent positive. 
Limitation: While most labs report negative results, we do not get this data from all labs. The labs used in the percent positive calculation represent the majority of total tests reported to the state. 

Positive Tests as a Percent of Total Cases

 

 

 

 

 

 

 

 

 

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38 minutes ago, remkin said:

Here's irony. The WHO is now saying that Sweden is the model that most countries should follow. Those who want to follow the experts find themselves in an odd spot. Following the World's experts now means abandoning the tight lockdown mode in favor of one of the most open models on Earth. 

 

Hi rem, and thanks for the plug for testing, as that is what I've contended in like forever since this thing emerged. Of course that's what my profession is based upon. Saying that though, I doubt the average man/woman in general, and I know that many physicians seem not to realize(thus how can the general population be expected) the efforts of QUALITY CONTROL that laboratorians breath, eat and sleep  to assure quality work. Hearing for instance that plans are underfoot to allow "giant pharmacies" to undertake antibody testing sent shivers thru me, UNLESS they bring on board qualified laboratorians to oversee, thus to assure reproducible, quality work. Too often, I've observed physician offices swayed by skillful salesmen concerning POC (point of care) tests, with their spiel that their product is xyz% sensitive and xyz% accurate. Never mind that those figures have been rigidly controlled, and this has to be similarly done to get them? One doesn't just plug the test into their super duper machine and VOILA theres your unquestionable, unassailable answer? Anyway, enough of my soapbox, but you see where this is going, unqualified or barely qualified people conducting unvalidated tests certainly will not result in better understanding of SARS-CoV-2?

 

As to Sweden's approach, I ask you why not follow it because we've seen amply demonstrated in numerous locales about this country as well as this state, that our citizens will not allow their "unassailable right" of personal choice be challenged, even if it benefits our society? Demonstrations throughout this country, public flaunting of decrees to self-isolate like beach gatherings, etc are examples that fly in the face of medical opinion, so why not just open the whole thing up, spend all the funny money being printed as economic stimulus and lets attain rapid "herd immunity" while the refrigerated trucks accommodate those either lacking immunity or at the opposite end of the spectrum, that have overactive immunity? As David Farragut so famously phrased it, "damn the torpedoes, full speed ahead"? 

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I'm not really saying Sweden was right, I just find it ironic that the people most likely to say we must obey the WHO experts also tend to be the people who tend to favor strict lockdowns and that it must put them in a tough spot given that WHO now says, follow Sweden 

 

But TBH so far I think NC's overall government approach has been pretty good. It is looking at the right things IMO. The problem is that the data they list is a week old, and with the massive ramp up in testing, a week is important when it comes to new cases. Still, hospitalizations in NC have held steady. Some of that is because hospitalizations lag as people tend to stay in the hospital 1-2 weeks, but it is a meaningful metric in terms of making sure that capacity is not exceeded.

 

IMO another week of lockdown here is not unreasonable. I'm guessing that by then some things can be opened with very little chance that any surge will come close to exceeding capacity. 

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Kjun, I'd be curious about the sensitivity and specificity of the test we are now running. Oddly, that information is not easily provided to us by the lab. I guess I should call them.

 

But I can tell you that the ability to test has ramped up exponentially. Initially tests were very limited in quantity and had to be approved through UNC. I could only test very sick AND contact with covid or travel to or from China. Then other places were added and only the admissions, etc. Further the turnaround time was about 5 days, down to 3 days, down to 2, then 24hours. Available hospital tests went from 20 total, to now over 900. And starting yesterday I can now order a Covid test that I get back in 45 minutes like a regular lab. 

 

It should not be surprising that we are going to see an increase in "confirmed" cases. (In fact, early on it took 2 different positive tests to "confirm"). 

 

Here's a question for you or anyone who has the data? How long after a know exposure does it take for the test to turn consistently positive?

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2 hours ago, wxray1 said:

NC is finally, finally getting testing ramped up, and are rightly mass testing congregate facilities like prisons and group living facilities.   And we're seeing what was feared, a lot of cases in those close-quarter facilities.

 

I'm following what our government is following: the trend of positive tests versus total tests.  This key metric has finally flattened and may be downtrending.  Read it for yourself:

https://www.ncdhhs.gov/divisions/public-health/covid19/covid-19-nc-case-count

 

I saw that graph too wxray. The thing too is that testing has ramped up just recently. It will take at least a week to really set the trend. The state is using a trailing 14 days, but if you take the line down from 4/17 on, as testing has increased the trend is forming pretty clearly.

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34 minutes ago, remkin said:

Here's a question for you or anyone who has the data? How long after a know exposure does it take for the test to turn consistently positive?

Very good question rem, and as a disclaimer right off the bat, I don't personally know as to me there are as yet to be understood 'variables". This is what I think.

 

1st, the expertise of those administering tests for "viral recovery" comes into question, namely the nasopharyngeal vs oropharygeal swab, as the former CAN be tricky. Then there is now evidence of better recovery of virus from a sputum or oral gargle, but I think there's some discussion of the virus progressively moving more distant in the respiratory tract as the infection progresses, and if that's proven true, then it would seem that recovery of it would depend at which stage of the disease the patient presenting is in?

 

The next consideration I'd suggest in regards to "known exposure", as you are aware, relates to viral shedding and the number of virions necessary to cause a disease? If for instance, the contact is with an infected person shedding very little of this virus, then that would reduce the chance that the exposed person would become ill? If on the other hand this virus is highly contagious, like Hep C for instance, than very few viral particles are necessary for disease to commence? It's being said that SARS-CoV-2 is "highly infectious", thus I'm supposing that the "viral load" must be on the smaller side to result in disease?

 

Then, not only are characteristics of virus influential in "infection", but those of the "host" also affect whether disease occurs, thus affecting testing results?

 

Finally, by "the test", the above discussion presumed you were asking about RT-PCR test, thus not antibody, because antibody testing involves blood sampling, with its own set of unknowns? An equally perplexing question I had posed me from a friend who owns/runs a local restaurant that apparently she has been unable to have answered (and local health departments are to be in charge of contact notification??), but how long after suffering this disease are people infectious, i.e. When is it safe for an infected, recovered individual to resume work? The question this involves to me is, Is the viral particle being shed in the recovered person infectious?

 

All of these questions, with answers, hopefully will be better understood as there's more experience with this coronavirus, but as you have frequently communicated in your discussions, even the so-called experts can err. A humbling experience no doubt, but eventually we learn.     

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Some of the testing makes me nervous - primarily the emerging antibody tests.  Anyone read about the Elizabeth Holmes and her company Theranos  ?  It was a great story -- until it wasn't.   In short, she said she had a way to do all kinds of tests with just a drop of blood versus the vials need by the competitors.  It was a fake, and she is currently going through some serious legal processes.

 

Reading about some of these tests, and the fact that the FDA has waived any scrutiny has me a bit nervous.  The field has a checkered history, and there is room for some bad actors to get involved.  Hopefully not this time...

Edited by wxray1

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From the perspective of managing the disease / restrictions, I don't see total infections as the primary metric we should be considering right now.  I'm more interested in serious cases (deaths and hospitalizations) and the effect that easing mitigation will have on serious cases.   

 

Extreme (and unrealistic) examples to illustrate the point.  We ease restrictions and:

  1. the infection rate skyrockets, but none of the cases are serious. That could actually be a good thing (herd immunity).  
  2. the infection rate is relatively low, but all of the cases are deaths. Not so good. 

 

One other nit I'll pick; there's not enough distinction between raw numbers and rates in much of the reporting.  How meaningful is, say, a comparison of how many tests South Korea has administered compared to the US if you don't factor in relative populations?  And same with total deaths.

 

edit: I do recognize that there is likely a high correlation between overall infection rates and serious cases.  But I see us as much more accurately tracking serious cases than estimating overall infection rates, especially given the difficulties with testing the larger population.

Edited by LakeLivin

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57 minutes ago, cc said:

Does anyone else find it interesting for lack of a better term that state governors appear to unilaterally be removing our rights.  They are not above the bill of rights and have no power to make law by executive decree . Are you ok with this?  This is just a question. Not attacking anyone or picking a side here. 

 

 

I think what's happening fits under temporary emergency powers; as far as I'm aware, no governors are making new laws.

 

One may disagree about the actions governors are taking, but I don't think you'll find many who disagree that the pandemic is an emergency.  If you're concerned about executive overreach and abuse of power I think you're looking in the wrong place.  I'd start with the money Congress authorized for the military that was diverted to pay for a border wall. There are other examples, but going there definitely gets us into politics.  

Edited by LakeLivin

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I don’t necessarily disagree. But who defines how far the powers extend and for how long? It’s really unprecedented. This is more of a philosophical not a political question in my mind. 

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14 minutes ago, cc said:

I don’t necessarily disagree. But who defines how far the powers extend and for how long? It’s really unprecedented. This is more of a philosophical not a political question in my mind. 

 

Unprecedented at least for the last century.  I'm not well enough steeped in history to know what happened during the Spanish flu 100 years ago, but I believe there were quarantines imposed. I guess the obvious answer is that the emergency powers extend as long as the emergency exists, but that leads to another philosophical question: what defines an emergency?

 

One can think about the question from a philosophical perspective but unfortunately, given how bifurcated our country has become, I don't see it not becoming political in practice.  I mean, our president was tweeting "liberate certain states" at the same time those states were acting under the guidance put forward by his administration. 

 

For years I've had the opinion that hyper-partisanship is the biggest threat to our country, and while the US has initially more or less come together during this pandemic, I'm wondering how long that will last.  

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6 hours ago, LakeLivin said:

... I guess the obvious answer is that the emergency powers extend as long as the emergency exists, but that leads to another philosophical question: what defines an emergency?

 

Hopefully future tyrants have not learned a lesson at how easily the populace gave up their most cherished freedoms, either completely or in a limited way, with this so-called “invisible enemy”, the right to assemble, the right to free speech, the right to vote, the right to bear arms, the right to practice religion, the right to hockey... After this, it is not difficult to imagine—is it?—a future ‘public health’ or similar crisis, real or created, leading to totalitarianism here or in other western democracies.  Patriots beware!

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Just an opinion, but so often in the face of an emergency the easier and more obvious thing is to see the immediate threat and react strongly to it. In this case, people are dying and this can be spread from person to person (even though WHO initially said it couldn't be spread that way, oops, pretty big miss for the world's experts). The initial response is usually legit, and IMO was legit this time too. But by legit, I mean truly well-intentioned and aimed at the right target, (preventing a mass casualty beyond the system's ability to provide the best care available) and not an authoritarian overreach. 

 

It is always much harder to see or predict the price of the response though. And it's harder for authority to give that new found power back. There definitely is another side to this pendulum. Are we there yet? I think history will tell. My personal opinion is that the pendulum is just swinging though the bottom of it's arc, or fairly neutral. Yes there are blatant examples of overreach, but they are still mostly the exceptions. The real question will be what happens in the next month or so. 

 

IMO the key question is whether our leaders act in good faith and will adapt to the changing conditions. It is also key that they are aware that there is a downside to lockdowns, and that the price of that will be felt more in the future than we now think. The price of lockdown is economic pain that can grow bigger and bigger, potentially into something devastating like a depression. And another price is the aforementioned loss of freedoms. Ultimately if the U.S. one day loses it's democracy it would probably be something like this. My opinion is that it won't actually be this one though. 

 

The loss of freedom is almost always in the name of safety. There is a slope there. What if this disease was as bad as it looked to some initially? There are still journalists quoting a 6% fatality rate for this. That's nuts, but what if next time it's true? That would be 1/17 people. At this degree of contagiousness? That would be insanely disastrous. That would overrun the system for certain. It would be pandemonium. That would be plague. The government would have to do whatever it could. And it would be legit. But in the face of that much fear? Bad actors could take it over and we might let them and lose our democracy. But this isn't that (despite many early reports and at least one recently that it was the rate).  I don't think this will rise to that level. We do see some inklings of that and how some in charge could go there, but not this time. 

 

 

This does have a smaller, but real element of that fear. But lest I leave the impression that I'm saying this is a nothing-burger, it is not. It is killing a lot of people. And especially devastating is the "younger" middle age and relatively young older people who can just seemingly randomly get hit with the full force of it. And that is horrible. Those people who get the bad pneumonia and immune overreaction, and clotting are getting a disease that medicine has literally not seen before, and with a very very high mortality rate. Though young people have a very small risk, others have a higher risk, and when a thing infects millions of people, there are always exceptions. So this thing has a very bad side, that while relatively uncommon is deadly, and even an uncommon thing seems common when so many people catch it and have to spin that roulette wheel. I've said before, if you're under say 30 this is flu or even better for the vast majority, but if you get the full brunt of the bad side, it is on the order of ebola or worse for you. 

 

But over time, even though there is a very ugly side to this, it is increasingly known that the system can now handle the spike, and that the actual mortality rate is relatively low, and that we will not have a vaccine for 9 months (shortest estimate by the experts). And even in lockdown this is spreading. In 9 months? On March 15th (about 1.5. months ago) there were an estimated 1200 new cases/day in the US as the curve just started to ramp up. Since April 1 there have been around 30,000 new cases daily (that are confirmed but probably hugely more). Even as that number of new cases/day is trending down, it's still in that neighborhood. and a lot of people. Again, that's confirmed cases. There are up to 100X that many actual cases potentially. And that's with lockdown. 

 

What I'm saying is what I've typed about 10X now: The point of the lockdown and it's potentially calamitous price was always to assure that the medical system was not overwhelmed leaving people to die in waiting rooms, and causing there to be no doctors or nurses left to care for anyone. That is not going to happen. If there were a vaccine on the verge of being out there, and or this was deadlier, lockdown continuation could make sense. Since neither are true, it doesn't (or soon won't). 

 

Again, my own opinion is that we are on the verge of this new paradigm in thinking on lockdowns. It is just starting to catch. There are places where staying for a short period more in lockdown makes sense (I favor another week in NC, and despite being the guy who will get hit, I'm on the side of opening up soon). There are places that should open up now. 

 

Our federalist system is coming into play here. The ying and yang of this will play out differently in different states, probably eventually showing the way forward as well as allowing the way forward as some more cautious politicians get cover by not moving first. At some point, if opening is the right way, the states that don't will face revolt of their citizens because IMO the death of most American's drive for freedom is greatly exaggerated. As more and more people realize that, bad as this is, it's not the plague, they will want their lives back and then demand it. I predicted this a while ago, and it's already starting to happen. 

 

I suggest from personal experience, that one of the least protected classes in this country is the small business owner. There is really no powerful lobby looking out for them. Chamber of Commerce? Yeah right. Both sides protect the big guys, but the small business owner, has almost no political power unless he or she is very successful and is really dialed into local politics. So take the barber. The government shuts him down. Threatens to wreck him if he opens. But he still has to pay his landlord (usually a huge corporation), he still has to pay his utility bills, and irony of all, he still has to pay his taxes. Even while the bailout money somehow misses him but makes it's way to large corporations. This can't stand for very long since the vast majority of businesses are small businesses. That's where the revolt will eventually come from if things improve but governments don't ease. 

 

OK this is finally long enough. I think it will work out. I think that most state governments will ease. Some will be slow, but they will be pushed to come along. We will get some semblance of life back. And when we do, any bump in new cases will be manageable and would have mostly come almost as soon anyways. BTW if there is a massive bump, shutting back down is not the end of the world. That is a false argument. In fact it will be easier than keeping things shut down because the huge rise will be there for all to see the logic of shutting back down. We will open, and will stay open in the vast majority of places. There will be a few outbreaks and the media will point to them jumping up and down, but it won't change anything. Only if there is renewed and realistic fear of a medical system collapse would we think of locking back down, and that is very unlikely IMO. 

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Just throwing a thought against the wall. As testing ramped up, the new cases found obviously ramped up, even in the face of actual cases falling. It is possible that behind closed doors that is coming into play. They want to let the effect of those millions of new tests get into the actual graph so that when the fall comes there is less contamination by testing more people. THEN open when the actual numbers start falling in spite of increasing testing (just starting to happen). I doubt any leaders are making that the sole consideration, but it is true. 

 

If you go to the number of new cases in the U.S. it looks like a very uneven, very slow decline. But that's an illusion because we began increasing testing at a very big rate of incline during that period. If you go back and pad the numbers for the initial peak to what you'd expect by testing the same number of people, you get a much bigger peak with a much bigger decline over the next few weeks. But trying to explain that rather than just putting up a graph that's falling off? Well it's like trying to account for magic beans in hockey season. Easier to just have the graph tell the story as it is. 

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17 hours ago, LakeLivin said:

From the perspective of managing the disease / restrictions, I don't see total infections as the primary metric we should be considering right now.  I'm more interested in serious cases (deaths and hospitalizations) and the effect that easing mitigation will have on serious cases.   

 

Extreme (and unrealistic) examples to illustrate the point.  We ease restrictions and:

  1. the infection rate skyrockets, but none of the cases are serious. That could actually be a good thing (herd immunity).  
  2. the infection rate is relatively low, but all of the cases are deaths. Not so good. 

 

One other nit I'll pick; there's not enough distinction between raw numbers and rates in much of the reporting.  How meaningful is, say, a comparison of how many tests South Korea has administered compared to the US if you don't factor in relative populations?  And same with total deaths.

 

edit: I do recognize that there is likely a high correlation between overall infection rates and serious cases.  But I see us as much more accurately tracking serious cases than estimating overall infection rates, especially given the difficulties with testing the larger population.

 

Exactly right IMO. This is a tale of two diseases (probably more like 4). People who get the flu or better, and people who get really sick and might die (likely less than 1%). This is also not distributed equally in the population. Kids don't die from this (always outliers, but close to zero. People over 85 with lots of vascular disease do. Day care? No problem. Nursing home? Massive problem. Clearly it is the later that could overwhelm the system, while the former just get us to herd immunity quicker. Sure there's an in between, probably where a lot of us are. But as you mention, it is the sick people that are the issue medically. Almost the entire issue. 

 

When we are sent a patient for rule out covid, but they are generally well and low risk, the answer has been, go back home and recover. 

 

So, the fact that there appears to be a large number of asymptomatic people, if true would turn out to be a game changer. The more of them the better. (Someone wrote that at the very beginning of this thread before even the experts were saying it). Unless the current antibody tests contain a large contingent of false positives, or unless the antibodies prove unprotective (very unlikely), then there is a large number of asymptomatic, now immune people. That is a huge silent majority. That leads to the estimates of 60-100 immune patients for every positive test. 

 

But it also affects the open the lockdown calculation because as we open up, this group will grow exponentially fast. 

 

I would be keenly interested in a modeler looking at that. IF there is a massive subpopulation with immunity, and thus as the disease spreads it is really 100X more prevalent than testing has suggested, how fast to some degree of herd immunity? Has Sweden really already achieved it? WHO seems to think so. If so, then there is no question what the right way forward is. I'd think we'd want to know this. I haven't seen it yet: If the US opened up to Sweden levels, how long to herd immunity both with and without all of those apparently asymptomatic but immune people? And how many total deaths that way vs letting it play out slowly?

 

BTW, Sweden did not just throw open the gates. There were restrictions still. Since nursing homes and elderly are most vulnerable, plans to protect them make sense. Also, some degree of social distancing, no concerts or mass events, etc. 

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2 hours ago, remkin said:

. . .

 

IMO the key question is whether our leaders act in good faith and will adapt to the changing conditions. It is also key that they are aware that there is a downside to lockdowns, and that the price of that will be felt more in the future than we now think. The price of lockdown is economic pain that can grow bigger and bigger, potentially into something devastating like a depression. And another price is the aforementioned loss of freedoms. Ultimately if the U.S. one day loses it's democracy it would probably be something like this. My opinion is that it won't actually be this one though. 

 

. . .

 

Rem, gotta disagree with your thought above.  If the U.S. ultimately loses it's democracy it won't likely be due to an "emergency powers" power grab (although I could see that as a tool utilized in certain circumstances). It will be a much more subtle and insidious process.  Take a look at recent examples of countries that have actually seen a significant deterioration in democracy in favor of populist authoritarian regimes.  Russia, Venezuala, Turkey, and Hungary are some good examples.. Democracy was eaten out from within, not taken over.

 

Common techniques included leveraging anti-establishment sentiment and fostering "us vs. them" mentalities. Attacks on and eventual suppression of the free press. Installation of loyalists in positions of power.  A gradual usurping of power that neutralized or bypassed checks and balances built into the system,  If it happens in the US it won't be a takeover; the population would't stand for that. It will be more analogous to putting a lobster into the pot and gradually turning up the heat so it won't notice it's being cooked.

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