Coronavirus pandemic

[SEWIGuy]

https://bfi.uchicago.edu/working-paper/2020-80/

Loss in consumer traffic due much more to people not feeling safe and not the lockdowns.

IOW, even for long-term economic reasons, opening carefuly with limitations in place was a much better alternative than the one many state chose.  Their short shutdowns, with quick reopenings, is not only a bad decision health wise, but a bad decision for economic reasons as well.

[Brandon]

https://www.khou.com/article/news/health/coronavirus/houston-hospitals-ceo-provide-update-on-bed-capacity-amid-surge-in-covid-19-cases/285-a5178aa2-a710-49db-a107-1fd36cdf4cf3

Looks like flattening the curve didn't work very well in Texas...

Remember when the lt. gov said he'd take the risk of death over keeping the doors closed?

One way or another, people will die from it.  Either we had it early (as in some northern states) or later (as we see in parts of Texas).  I think we need to accept that fact.  It may sound a bit cold to some, but we do need to face facts, people will perish from it, and most of them will have underlying illnesses (approximately 0.3-0.4% mortality overall).  This isn't the Black Death (1348 - 30% mortality) nor does it even rate up with the Spanish Flu (1918 - 5% mortality).  Yes, it's bad (3x worse than seasonal flu - 0.1% mortality), but it could be worse (see the Black Death and Spanish Flu for more).

Anyway, no one gets out of life alive.

[US 89]

The insanity has reached Utah:

Hang on friends, it won't be long before you are required to do the Sieg Heil salute to Herbert. Welcome to Utah now extend your right arm straight at 45 degrees keeping your hand parallel to your arm and offer your "Heil Herbert"  @GovHerbert #utah #nazi #masks #utpol

Yes, a county commissioner tweeted this. He did eventually take the tweet down but was apparently surprised that everyone was finding it offensive. And the best part? He wasn't even affected. He tweeted this in response to the governor allowing a mandatory mask order for Salt Lake and Summit Counties, both of which are still at the yellow or orange risk levels. Piute was lowered to green weeks ago.

Unrelated, we had 676 new cases today in Utah, the largest single-day increase yet and pushing us over 20,000 total cases. Our state epidemiologist has been pushing for a statewide mask requirement for a while now, but the governor won't do it. Every time there's a press conference he'll strongly state that everyone needs to be wearing a mask, but he refuses to sign an order because he seems to think the entire state's population will mask up on their own for the good of society. Clearly that is not happening.

[hbelkins]

Also, I cannot find any indication that Kentucky requires masks even in the locations described by bandit957.

The governor basically admitted that his "wear masks" order was a paper tiger and not enforceable for general retail establishments.

But it's different in businesses that are licensed by the state -- barber shops, hair and nail salons, medical offices, etc. Masks are pretty much required by the various licensure boards and such an establishment can lose its license if it doesn't enforce the requirement.

As for going barefoot, you're a braver man than I am if you go barefoot in public, especially at Walmart.

[tradephoric]

It's starting to bother me that the media is hyper focused on the rise in daily cases.  Today over 600k Americans are being tested for coronavirus compared to about 130k in early April during the initial peak.  If only 130k people were being tested today, there would be around 10k new cases as opposed to the 40k being reported.  Also daily deaths from Covid is 1/4th of what it was back in April yet we hardly hear a mention of that.

[Max Rockatansky]

It's starting to bother me that the media is hyper focused on the rise in daily cases.  Today over 600k Americans are being tested for coronavirus compared to about 130k in early April during the initial peak.  If only 130k people were being tested today, there would be around 10k new cases as opposed to the 40k being reported.  Also daily deaths from Covid is 1/4th of what it was back in April yet we hardly hear a mention of that.

Because that statistic doesn't make for as good of a headline.  I'm not saying the news is good with case increases but it shouldn't be a shock with large scale reopening and far more tests that the confirmed case numbers are going way up. 

[corco]

It's starting to bother me that the media is hyper focused on the rise in daily cases.  Today over 600k Americans are being tested for coronavirus compared to about 130k in early April during the initial peak.  If only 130k people were being tested today, there would be around 10k new cases as opposed to the 40k being reported.  Also daily deaths from Covid is 1/4th of what it was back in April yet we hardly hear a mention of that.

That's because it's not just the case numbers if you look beyond the headlines - the percentage of positive tests is also going up in most places, which suggests that it's spreading more quickly than it was before.

[Alps]

It's starting to bother me that the media is hyper focused on the rise in daily cases.  Today over 600k Americans are being tested for coronavirus compared to about 130k in early April during the initial peak.  If only 130k people were being tested today, there would be around 10k new cases as opposed to the 40k being reported.  Also daily deaths from Covid is 1/4th of what it was back in April yet we hardly hear a mention of that.

That's because it's not just the case numbers if you look beyond the headlines - the percentage of positive tests is also going up in most places, which suggests that it's spreading more quickly than it was before.

And ICU occupancy is getting maxed out, which means that the serious cases are rising, which is exactly what we need to be concerned about.

[cl94]

And ICU occupancy is getting maxed out, which means that the serious cases are rising, which is exactly what we need to be concerned about.

Ding ding ding! THIS is what should concern people. ICU cases going up is bad, because that's what causes problems. Sure, we're testing more, but ICU occupancy isn't dependent on testing.

[SEWIGuy]

It's starting to bother me that the media is hyper focused on the rise in daily cases.  Today over 600k Americans are being tested for coronavirus compared to about 130k in early April during the initial peak.  If only 130k people were being tested today, there would be around 10k new cases as opposed to the 40k being reported.  Also daily deaths from Covid is 1/4th of what it was back in April yet we hardly hear a mention of that.

More people are being tested because the virus is more widespread.  New cases is just one of a number of stats that look terrible right now.  We have utterly failed as a nation.

[SEWIGuy]

Read this thread. An avoidable disaster. Failed leadership.

https://twitter.com/drtomfrieden/status/1276681496624070657?s=21

[oscar]

Every time there's a press conference he'll strongly state that everyone needs to be wearing a mask, but he refuses to sign an order because he seems to think the entire state's population will mask up on their own for the good of society. Clearly that is not happening.

I am in southern Utah right now. Mask-wearing here isn't as consistent as it should be, but it seems similar to New Mexico and what little I saw of Colorado. And it's much better than the pathetic levels (with the striking exception, aside from the elderly, of black people) I saw in all the states between Virginia (mask requrement) and New Mexico I passed through on my way out west.

That last bothers me. I'm consistently wearing my mask where I can't completely avoid other people, which offers me some protection. But I would be better protected if more of the other people around me also wore masks. I hope the situation improves on the return trip, which will take a more northerly route (TBD).

[webny99]

I am in southern Utah right now. Mask-wearing here isn't as consistent as it should be, but it seems similar to New Mexico and what little I saw of Colorado. And it's much better than the pathetic levels (with the striking exception, aside from the elderly, of black people) I saw in all the states between Virginia (mask requrement) and New Mexico I passed through on my way out west.

Which states? And is any distinct type of urban vs. rural divide noticeable?

I hope the situation improves on the return trip, which will take a more northerly route (TBD).

Fortunately, all current signs point to the bolded pairs going hand-in-hand with one another, while heading south is associated with things getting worse.

[tradephoric]

More people are being tested because the virus is more widespread.  New cases is just one of a number of stats that look terrible right now.  We have utterly failed as a nation.

They are reporting record daily cases yet deaths have dropped by roughly 75% since April.  The reality is testing capacity has substantially increased and with more testing comes more positive tests.  At this point comparing the number of daily cases today to the number of daily cases back in April is almost meaningless.  I just wish the media would do a better job at putting these numbers in context and lay off the fear mongering just a tiny bit.

[Duke87]

I am in southern Utah right now. Mask-wearing here isn't as consistent as it should be, but it seems similar to New Mexico and what little I saw of Colorado. And it's much better than the pathetic levels (with the striking exception, aside from the elderly, of black people) I saw in all the states between Virginia (mask requrement) and New Mexico I passed through on my way out west.

That last bothers me. I'm consistently wearing my mask where I can't completely avoid other people, which offers me some protection. But I would be better protected if more of the other people around me also wore masks. I hope the situation improves on the return trip, which will take a more northerly route (TBD).

I have in the past week been in Missouri, Kansas, Colorado, Utah, Nevada, California, Oregon, Wyoming, Nebaska, South Dakota, and now Iowa.

Of these, the best mask wearing rate I've seen has been in California. The rest... all equally bad.

It's probably a safe bet that if you want to be somewhere where the majority of people are wearing masks you're best off sticking to the northeast and maybe also urban areas on the west coast. Anywhere else, you're likely to be the only customer wearing one, and even for employees it's hit or miss unless you're in a chain where corporate HQ has sufficient control over operations to mandate and enforce it.

[oscar]

I am in southern Utah right now. Mask-wearing here isn't as consistent as it should be, but it seems similar to New Mexico and what little I saw of Colorado. And it's much better than the pathetic levels (with the striking exception, aside from the elderly, of black people) I saw in all the states between Virginia (mask requrement) and New Mexico I passed through on my way out west.

Which states? And is any distinct type of urban vs. rural divide noticeable?

I took a southern route, though not including Florida or Louisiana. So far, little overlap with Duke87's trip.

I generally avoided urban areas, and the ones I couldn't avoid, I usually didn't even get out of my car. So I can't speak to any urban vs. rural divide.

[webny99]

It's probably a safe bet that if you want to be somewhere where the majority of people are wearing masks you're best off sticking to the northeast and maybe also urban areas on the west coast. Anywhere else, you're likely to be the only customer wearing one ...

Possibly also the Midwest?

[wxfree]

https://www.khou.com/article/news/health/coronavirus/houston-hospitals-ceo-provide-update-on-bed-capacity-amid-surge-in-covid-19-cases/285-a5178aa2-a710-49db-a107-1fd36cdf4cf3

Looks like flattening the curve didn't work very well in Texas...

Remember when the lt. gov said he'd take the risk of death over keeping the doors closed?

One way or another, people will die from it.  Either we had it early (as in some northern states) or later (as we see in parts of Texas).  I think we need to accept that fact.  It may sound a bit cold to some, but we do need to face facts, people will perish from it, and most of them will have underlying illnesses (approximately 0.3-0.4% mortality overall).  This isn't the Black Death (1348 - 30% mortality) nor does it even rate up with the Spanish Flu (1918 - 5% mortality).  Yes, it's bad (3x worse than seasonal flu - 0.1% mortality), but it could be worse (see the Black Death and Spanish Flu for more).

Anyway, no one gets out of life alive.

I don't know what the fatality rate would be without remediation, but it would be higher if we all caught it at once and most of us couldn't get life-saving help.  Besides that, accepting the inevitability of mass death, justified by the universal inevitability of death, should be our last resort, not our first choice.  Just about every wealthy and advanced nation in the world has brought the numbers way down, by responding strongly to the smallest outbreaks instead of waiting for a disaster to be imminent before making small course changes.  They're also getting back to a more normal life faster and have less economic loss.  It seems to be a uniquely American predilection that we're eager to thin the herd even though we already know it isn't going to get us back to normal faster, but will make it take longer.  In Black Death and 1918 flu days, they may have had no choice, but we have the ability to quickly identify and put down outbreaks and have a high likelihood of soon having effective treatments.  There's no reason to jump right into the mass death option just because it's easier for everyone who doesn't die (or survive with organ damage).

[LM117]

Every time there's a press conference he'll strongly state that everyone needs to be wearing a mask, but he refuses to sign an order because he seems to think the entire state's population will mask up on their own for the good of society. Clearly that is not happening.

I am in southern Utah right now. Mask-wearing here isn't as consistent as it should be, but it seems similar to New Mexico and what little I saw of Colorado. And it's much better than the pathetic levels (with the striking exception, aside from the elderly, of black people) I saw in all the states between Virginia (mask requrement) and New Mexico I passed through on my way out west.

That last bothers me. I'm consistently wearing my mask where I can't completely avoid other people, which offers me some protection. But I would be better protected if more of the other people around me also wore masks. I hope the situation improves on the return trip, which will take a more northerly route (TBD).

Hardly anybody here in Danville/Pittsylvania County is wearing masks and they're sure as hell not social distancing for shit. The stores aren't enforcing the mask requirement, either. My mom (who is high risk) recently went in Family Dollar, which had a sign on the door telling people that masks were required. Of course, nobody paid it any attention, including the employees. When she mentioned the sign to them, they laughed at her.

Every time there's an article in the local newspaper on the virus or Northam, the Facebook comments make me weep for humanity.

[hotdogPi]

Mask wearing is pretty good where I live.

[SEWIGuy]

More people are being tested because the virus is more widespread.  New cases is just one of a number of stats that look terrible right now.  We have utterly failed as a nation.

They are reporting record daily cases yet deaths have dropped by roughly 75% since April.  The reality is testing capacity has substantially increased and with more testing comes more positive tests.  At this point comparing the number of daily cases today to the number of daily cases back in April is almost meaningless.  I just wish the media would do a better job at putting these numbers in context and lay off the fear mongering just a tiny bit.

Yeah.  100,000 dead.   Positive testing has gone UP after weeks of decreasing.  (And decreasing substantially in Europe.)  Hospitalizations rising in a number of areas.

But it's just the media "fear mongering." Seriously some people just don't get it.

But anyway, my point is lack of proper controls is increasing cases across the country - which will mean both hospitalizations and deaths eventually - yet the economy still stinks.

Failure of leadership. 

[Brandon]

And ICU occupancy is getting maxed out, which means that the serious cases are rising, which is exactly what we need to be concerned about.

Ding ding ding! THIS is what should concern people. ICU cases going up is bad, because that's what causes problems. Sure, we're testing more, but ICU occupancy isn't dependent on testing.

But the ICUs aren't actually all that full.

100 percent of regular ICU beds in Texas Medical Center occupied, but hospitals have space for surge

All regular ICU beds in the Texas Medical Center are now being used, according to numbers just released on the TMC website, but officials say they can add more.

Hospitals in Houston's Medical Center will now move some ICU patients to beds not normally used for critical care.

Twenty-eight percent of the ICU patients are being treated for COVID-19.

The average ICU occupancy rate at the world's largest medical center is 70 to 80 percent, but higher rates aren't unheard of.

"It is completely normal for us to have ICU capacities that run in the 80s and 90s," Methodist Hospital CEO Dr. Marc Boom said. "That's how all hospitals operate."

"The spread is increasing and it's very concerning. However, our hospitals are okay and ready to manage this surge effectively and appropriately," said Dr. Doug Lawson, CEO of CHI St. Luke's Health, CHI. "The reality is our capacity to care for those patients significantly exceeds what we're staffing on any given day."

[wxfree]

And ICU occupancy is getting maxed out, which means that the serious cases are rising, which is exactly what we need to be concerned about.

Ding ding ding! THIS is what should concern people. ICU cases going up is bad, because that's what causes problems. Sure, we're testing more, but ICU occupancy isn't dependent on testing.

But the ICUs aren't actually all that full.

100 percent of regular ICU beds in Texas Medical Center occupied, but hospitals have space for surge

All regular ICU beds in the Texas Medical Center are now being used, according to numbers just released on the TMC website, but officials say they can add more.

Hospitals in Houston's Medical Center will now move some ICU patients to beds not normally used for critical care.

Twenty-eight percent of the ICU patients are being treated for COVID-19.

The average ICU occupancy rate at the world's largest medical center is 70 to 80 percent, but higher rates aren't unheard of.

"It is completely normal for us to have ICU capacities that run in the 80s and 90s," Methodist Hospital CEO Dr. Marc Boom said. "That's how all hospitals operate."

"The spread is increasing and it's very concerning. However, our hospitals are okay and ready to manage this surge effectively and appropriately," said Dr. Doug Lawson, CEO of CHI St. Luke's Health, CHI. "The reality is our capacity to care for those patients significantly exceeds what we're staffing on any given day."

The regular ICU capacity is kept on standby and ready to go.  The capacity is expandable.  The covid dashboard has the numbers.  Right now in Texas there are 1,284 ICU beds available, ready to be used today.  There are 5,807 ventilators available.  Some of those are ready to use on those ICU beds, and others are stored for surges.  ICU capacity can be increased by setting up ventilators and other equipment and bringing in more staff to monitor the patients.  There are field hospitals that were set up in some places to house these units.  I don't know if they were taken down after the initial surge in other places, but I assumed they would be maintained because it's entirely foreseeable that they'll be needed eventually.

In Trauma Service Area E (DFW, the most populous area with 8 million), there are 419 ICU beds and 1,323 ventilators available, and there are 1,180 covid patients hospitalized.  It isn't too bad here.  Area Q, Houston (6.7 million) has 159 ICU beds and 1,252 ventilators available, with 1,606 covid patients.  The worst area is R, Beaumont (1.3 million).  They have 9 ICU beds (it's been as low as 3) and 194 ventilators available, and they have 271 covid patients (30 times the ICU capacity available).  I would assume they're setting up extra ICU capacity since availability is so low.

I'm just learning about it this week, but the way I understand it is that the published ICU availability is what's set up and staffed and can be used now, and that can be increased by hooking up the equipment and bringing in more staff.

[kalvado]

I'm just learning about it this week, but the way I understand it is that the published ICU availability is what's set up and staffed and can be used now, and that can be increased by hooking up the equipment and bringing in more staff.

IF that equipment and stuff exist. NYC was gathering equipment and people from wherever they could - but that was just one sour spot at that point.
If Houston, Dallas, LA, and Phoenix go into a peak mode at the same time, there may only be only that much to go around. "Flatten the curve" is not a buzz word any more, but still the name of the game.

People forget that while death rates are going down - and sounds like a better understanding of care principles is a big part of it - at this point recovery is just a synonym of survival. Post-effects may be a big issue...

[wxfree]

I'm just learning about it this week, but the way I understand it is that the published ICU availability is what's set up and staffed and can be used now, and that can be increased by hooking up the equipment and bringing in more staff.

IF that equipment and stuff exist. NYC was gathering equipment and people from wherever they could - but that was just one sour spot at that point.
If Houston, Dallas, LA, and Phoenix go into a peak mode at the same time, there may only be only that much to go around. "Flatten the curve" is not a buzz word any more, but still the name of the game.

People forget that while death rates are going down - and sounds like a better understanding of care principles is a big part of it - at this point recovery is just a synonym of survival. Post-effects may be a big issue...

It bothers me that we use the term "recovery," because it's rather presumptive.  One local government uses the term "released," meaning that the person is no longer under a quarantine order because he appears to no longer have the virus and be capable of spreading it.  That's an important thing to know, but it doesn't mean that the person is recovered.