The ultimate COVID thread

[chocomorsel]

Hold up a second are you saying you agree with no testing?

And also are you saying your stay home measures and distancing were sufficient or even heeded by much of the population?

I guess he’s forgetting about these people termed “essential workers” who had to go to work and possibly infected their coworkers.

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[Lawpy]

Thoughts on dexamethasone so far?

 

[deleted697535]

I’m not saying either one of those things.

I’m saying I think it’s a stretch to say more lives would have been saved with more testing.

fair enough. not much of a stretch tho. in fairness i would say testing definitely saves lives but again just my 2c

 

[pgg]

I don't know if this is true. I think there's a widespread misconception that social distancing and other mitigating strategies only cause a right-shift, when in fact they're probably also reducing the total area under the curve if enough people are doing it to push down the R0 (After all, if the R0 becomes less < 1 the virus eventually totally dies out). If this weren't the case then all the revised models coming out wouldn't have lowered the total projected figures for people who will have died specifically from the disease.

I don't think COVID-19 will get an R0 less than 1 absent a vaccine (or herd immunity because >60% of the planet actually caught it).

Treatments also get a little better with time (e.g. we're not screwing around with hyrdoxychloroquine any more), so later infections are likely to have lower morbidity and mortality. So flattening probably reduces the area under the death curve, at least.

Maybe next pandemic we can try an early crash program for massive testing and see how much better that works out.

 

[DoctwoB]

We may be less then a year away from aN approved vaccine. “Pushing the curve to the right” may mean fewer deaths since fewer people will get it before combo of limited herd immunity and vaccine crushes R0.

 

[nimbus]

fair enough. not much of a stretch tho. in fairness i would say testing definitely saves lives but again just my 2c

It only saves lives if people who test positive are able and willing to self isolate. That is not a given in freedom loving ‘murica. After 120,000 deaths we still have people who believe it’s a hoax.

 

[vector2]

I don't think COVID-19 will get an R0 less than 1 absent a vaccine (or herd immunity because >60% of the planet actually caught it).

Treatments also get a little better with time (e.g. we're not screwing around with hyrdoxychloroquine any more), so later infections are likely to have lower morbidity and mortality. So flattening probably reduces the area under the death curve, at least.

Maybe next pandemic we can try an early crash program for massive testing and see how much better that works out.

Overall, maybe not, but I'm sure regionally around the country there are many places where the R0 is getting to less than 1. It doesn't make sense to me how models can go from 1 million deaths to 200k deaths in the absence of a vaccine without the actual area under the curve getting reduced. I mean, it could be a right shift but that means the pandemic is lasting like 10 years to get to a million...

 

[AMEHigh]

I’m not saying either one of those things.

I’m saying I think it’s a stretch to say more lives would have been saved with more testing.

Obviously we’ll never know. Epidemiologists are saying that testing and tracing is a good strategy to help reduce morbidity and mortality, but maybe they’re wrong? I think in general the slow response to testing was a flaw in this country but you are correct in that we’ll never know if deaths could’ve been reduced, but looking at death numbers in other countries who had more robust testing it seems plausible that it is helpful.

 

[AMEHigh]

It only saves lives if people who test positive are able and willing to self isolate. That is not a given in freedom loving ‘murica. After 120,000 deaths we still have people who believe it’s a hoax.

That is true. But I do believe that in my city specifically people would’ve avoided the subway and work if they were known to be positive. Living in a densely populated area makes it easy to spread. The vast majority of people here took and still are taking the virus seriously and I do think testing would’ve made a difference in the beginning. But we’ll never know! You only get one shot to respond to a pandemic.

 

[vector2]

Obviously we’ll never know. Epidemiologists are saying that testing and tracing is a good strategy to help reduce morbidity and mortality, but maybe they’re wrong? I think in general the slow response to testing was a flaw in this country but you are correct in that we’ll never know if deaths could’ve been reduced, but looking at death numbers in other countries who had more robust testing it seems plausible that it is helpful.

It beggars belief to think that this kind of testing/tracing infrastructure had nothing to do with how quickly they flattened their curve and brought their daily death toll down to ~0

 

[vector2]

Is our 'pts who are getting a test' selection changing (and thus pre-test probability going up) or is the true incidence really on the up and up?



" This graph shows the total daily number of virus tests conducted in each state and of those tests, how many were positive each day. The trend line in blue shows the average percentage of tests that were positive over the last 7 days. The rate of positivity is an important indicator because it can provide insights into whether a community is conducting enough testing to find cases. If a community’s positivity is high, it suggests that that community may largely be testing the sickest patients and possibly missing milder or asymptomatic cases. A lower positivity may indicate that a community is including in its testing patients with milder or no symptoms. The WHO has said that in countries that have conducted extensive testing for COVID-19, should remain at 5% or lower for at least 14 days. "

Daily Testing Trends in the US - Johns Hopkins

See daily changes in tests performed and positivity rates in the US

coronavirus.jhu.edu

 

[deleted59964]

I’m no Trump fan, but how exactly did lack of testing lead to loss of life?

because people dont know they've got it, and then they don't isolate, and so they give it to other people ... and a fraction of those people die

 

[Southpaw]

Regardless of my feels about testing, the idea that we did amazing on testing (because of Trump) and tested too many, and then having Trump use it as a rally cry during a stump speech says so much about Trump and the people willing to show up for his speeches.

 

[vector2]

I’m sure it was planted by some very fine people who only fly the confederate flag for “cultural” reasons

NASCAR says noose found in Wallace's garage

NASCAR is investigating and will reportedly work with law enforcement after a noose was found in the garage of Bubba Wallace, the Cup series' only black driver, on Sunday at Talladega.

www.espn.com

 

[deleted162650]

Well, patients who are or mildly asymptomatic passing the disease on the other people unknowingly instead of isolating themselves and the other people end up ill and dying?
Or you don’t know you are infected and you think you have a cold and are the so-called happy hypoxic and go to sleep and die?

First off, everyone was under lockdown and forced social distancing anyways. If someone is "mildly asymptomatic" , what's going to prompt them to get tested in the first place? At my shop, if you showed up with symptoms and needed to be admitted - you got tested. If you didn't require admission you did not get tested, but were told you likely have the disease and you should go home and self quarantine for 2+ weeks. Testing them doesn't change any outcomes there. Are you proposing that we forcibly test everyone by going door to door - because that just is not possible in this country.

As for the happy hypoxemic. Again if symptoms were so mild that they don't seek medical attention, how are they going to get tested?? If you do seek medical attention, a COVID test won't save your life. We already have a test that will save that person's life, and it's widely available - it's called pulse oximetry.

I guess he’s forgetting about these people termed “essential workers” who had to go to work and possibly infected their coworkers.

So what exactly are you proposing here? Mandatory testing of all "essential workers". If so how often do you plan to do it, 'cuz if you aren't doing repeat serial testing every few days there's no point in doing it at all. If you have symptoms and show up to work anyways you're a D-bag, and no test is gonna change that fact.

 

[deleted162650]

because people dont know they've got it, and then they don't isolate, and so they give it to other people ... and a fraction of those people die

Again, so is your plan to go door to door forcibly testing everyone??

I'm not sure what you have in mind here as far as testing all these asymptomatic people.

 

[deleted162650]

If we want to hold Trump criminally negligent for anything during this pandemic, it should be for gutting/defunding the CDC/WHO.

 

[vector2]

First off, everyone was under lockdown and forced social distancing anyways.

Yea, not really. There were a number of places that didn’t lock down until welllllll into the pandemic, and even in all the places that did the number and types of businesses deemed essential and full of non socially distanced foot traffic was laughable.

Again, so is your plan to go door to door forcibly testing everyone??

The ratio between the number of people who you think we’d have to force a test on vs the number of people who wanted a test but couldn’t get one is hilariously, absurdly low.

 

[deleted162650]

Yea, not really. There were a number of places that didn’t lock down until welllllll into the pandemic, and even in all the places that did the number and types of businesses deemed essential and full of non socially distanced foot traffic was laughable.




The ratio between the number of people who you think we’d have to force a test on vs the number of people who wanted a test but couldn’t get one is hilariously, absurdly low.

I don't necessarily disagree with either of your points here.

But, increased testing doesn't change #1.

As for the people that wanted a test but couldn't get one, you think those people actually said to themselves "Well, I'm concerned I might have it, but I couldn't get tested - so F it - I'm goin' out!"

Additionally, actual % positive rate (especially through the first 1/2 of the pandemic) was very low - and continues to be so in most places. I think a negative result is more likely to give one a false sense of security than not getting tested at all.

The bottom line is that a test (like a monitor) does not change outcomes - interventions do. Unless you have an effective intervention that you can employ based on the test result, the test doesn't do anything to affect outcomes.

 

[vector2]

As for the people that wanted a test but couldn't get one, you think those people actually said to themselves "Well, I'm concerned I might have it, but I couldn't get tested - so F it - I'm goin' out!"

This is precisely what I think, although people come to that conclusion mostly subconsciously. My bro in law mid-pandemic was stopping by my in laws 2-3 times a week in the absence of testing. Less than a month ago his work started mass testing everyone and he was was Ab positive (not sure which one) and PCR negative and was super embarrassed about it. Of course not as embarrassing as if he had killed my father in law who has a couple preexisting conditions, but you get the point. Ignorance is bliss.

The bottom line is that a test (like a monitor) does not change outcomes - interventions do. Unless you have an effective intervention that you can employ based on the test result, the test doesn't do anything to affect outcomes.

No argument there. Unless people are on board with isolation (either by choice or by force) after a positive test then the only rational (not necessarily moral) options are let it burn like wildfire or lockdown everyone hard. We’ve half-assed it and thus have done exactly what this guy warned us about

 

[Southpaw]

If we want to hold Trump criminally negligent for anything during this pandemic, it should be for gutting/defunding the CDC/WHO.

holding up HCQ like it was holy water before it was proven was a buzzkill also. As was Trump and Navarro arguing and yelling w Fauci behind closed doors because Fauci asked the president to wait for evidence. Now - who was right? Do Trump voters care? No. Again - says a lot about what we need to know of Trump and his supporters.

 

[deleted162650]

holding up HCQ like it was holy water before it was proven was a buzzkill also. As was Trump and Navarro arguing and yelling w Fauci behind closed doors because Fauci asked the president to wait for evidence. Now - who was right? Do Trump voters care? No. Again - says a lot about what we need to know of Trump and his supporters.

Agree with you.

Then on the other side you have people roasting him for the rally while encouraging BLM protests at the same time.

MF’ing lying hypocrites who don’t give 2 sh**s about this country or anyone aside from themselves on all sides.

Sometimes I wish emigrating to NZ or Aus was easier for us yanks.

 

[Lawpy]

If we want to hold Trump criminally negligent for anything during this pandemic, it should be for gutting/defunding the CDC/WHO.

The WHO is terrible but i agree Trump unnecessarily harmed the CDC

 

[Lawpy]

I’m sure it was planted by some very fine people who only fly the confederate flag for “cultural” reasons

NASCAR says noose found in Wallace's garage

NASCAR is investigating and will reportedly work with law enforcement after a noose was found in the garage of Bubba Wallace, the Cup series' only black driver, on Sunday at Talladega.

www.espn.com

I'm pushing for every single Confederate statue and flag to be destroyed. And every single Confederate street, town and base renamed.

 

[crash2500]

Then on the other side you have people roasting him for the rally while encouraging BLM protests at the same time.

False equivalency.

 

[deleted162650]

False equivalency.

Please elaborate.

 

[chocomorsel]

I'm pushing for every single Confederate statue and flag to be destroyed. And every single Confederate street, town and base renamed.

Come on, they are historical monuments. We can't forget about how this great country came to be.

 

[deleted162650]

Come on, they are historical monuments. We can't forget about how this great country came to be.

Can someone please explain to me why they are now toppling statues that have nothing to do with slavery/the confederacy?

What did Teddy Roosevelt and Ulysses S. Grant do to piss these people off??

 

[chocomorsel]

Can someone please explain to me why they are now toppling statues that have nothing to do with slavery/the confederacy?

What did Teddy Roosevelt and Ulysses S. Grant do to piss these people off??

“The American Museum of Natural History has asked to remove the Theodore Roosevelt statue because it explicitly depicts Black and Indigenous people as subjugated and racially inferior,” de Blasio said in a written statement. “The City supports the Museum’s request. It is the right decision and the right time to remove this problematic statue.”
You might want to ask your wife what she thinks of the native American next to the president. Maybe she doesn't have a problem. Maybe she does.

 

[deleted162650]

“The American Museum of Natural History has asked to remove the Theodore Roosevelt statue because it explicitly depicts Black and Indigenous people as subjugated and racially inferior,” de Blasio said in a written statement. “The City supports the Museum’s request. It is the right decision and the right time to remove this problematic statue.”
You might want to ask your wife what she thinks of the native American next to the president. Maybe she doesn't have a problem. Maybe she does.

My wife is Hispanic, not Native American.

I dunno. I think that one is a stretch.

How ‘bout Grant? He was on the right side of the Civil War.

 

[chocomorsel]

My wife is Hispanic, not Native American.

I dunno. I think that one is a stretch.

How ‘bout Grant? He was on the right side of the Civil War.

If your wife is Hispanic of the Latin kind, she has Native American, or Native South American ancestry no? I mean, they were all colonized by white people right? Maybe she wouldn't care.

 

[VA Hopeful Dr]

My wife is Hispanic, not Native American.

I dunno. I think that one is a stretch.

How ‘bout Grant? He was on the right side of the Civil War.

He owned slaves before the war

 

[chocomorsel]

Please elaborate.

I am just embarrassed to see the black faces of supporters at his rallies considering that he has shown that he is a racist who cares only about constantly being the center of attention whether in bad light or goo but mostly bad.

 

[deleted162650]

If your wife is Hispanic of the Latin kind, she has Native American, or Native South American ancestry no? I mean, they were all colonized by white people right? Maybe she wouldn't care.

While that is technically correct, I don’t think many Hispanics identify as Native Americans. Anywho, I think we are getting a little sidetracked with my wife’s lineage. It sounds like in this case the problem was with the particular statue, not the man. That answers my question.

 

[deleted162650]

He owned slaves before the war

So did all our founding fathers. Do we have to change the heads on our currency now?

 

[chocomorsel]

So did all our founding fathers. Do we have to change the heads on our currency now?

Maybe we should.

 

[deleted162650]

he is a racist who cares only about constantly being the center of attention whether in bad light or goo but mostly bad.

No argument from me there.

 

[deleted162650]

Maybe we should.

Are you serious???

If you truly feel offended by currency depicting slave owners, then please send all your 1/2/10/20/50/100$ bills to me, and I will be happy to dispose of them for you.

 

[Angus Avagadro]

holding up HCQ like it was holy water before it was proven was a buzzkill also. As was Trump and Navarro arguing and yelling w Fauci behind closed doors because Fauci asked the president to wait for evidence. Now - who was right? Do Trump voters care? No. Again - says a lot about what we need to know of Trump and his supporters.

My friend just got back from working at. the Javitz Center. He said every Doc there was on HCQ. Guess there arent any atheists in a foxhole. DBRT or not.

 

[vector2]

Are you serious???

If you truly feel offended by currency depicting slave owners, then please send all your 1/2/10/20/50/100$ bills to me, and I will be happy to dispose of them for you.

At the very least that's a more complex question than whether we should have streets named after Jefferson Fcking Davis.

Maybe keep the statue of George Washington up but put a sign next to his face says:

"Teeth not actually made of wood.*"

"*Made from teeth sourced** from other human teeth."

"**Involuntarily***"




"***aka from live slaves"

 

[Goro]

He owned slaves before the war

Well, that was due to his wife's family owning them. And it was a single slave, actually. Like a lot of things in life, there's nuance in the story:

Myths & Misunderstandings | Grant as a slaveholder Archives- American Civil War Museum

Did Ulysses S. Grant own slaves during the Civil War? No, but it will come as a surprise to many people, that …

acwm.org

 

[chocomorsel]

My friend just got back from working at. the Javitz Center. He said every Doc there was on HCQ. Guess there arent any atheists in a foxhole. DBRT or not.

That place is still open? Is he or she a New Yorker?

 

[Angus Avagadro]

1 not sure
2 no

I think he got home within the last few weeks. Not sure of the dates. He was there later in the pandemic rather than early on. That much I'm sure.

 

[crash2500]

Please elaborate.

Protesting for equal human rights in the wake of a brutal police murder is very different than holding a rally as the leader of the free world to boost your own ego.

They're almost the exact opposite.

 

[deleted162650]

Protesting for equal human rights in the wake of a brutal police murder is very different than holding a rally as the leader of the free world to boost your own ego.

They're almost the exact opposite.

You're missing the point. COVID-19 doesn't give 2 sh**s what your cause is. You can't say it's okay to hold mass gatherings for one issue, but not another and cite COVID-19 as your reason. Either large gatherings of people are okay in the face of Corona, or they're not. It's a science/public health thing - not a political thing.

 

[crash2500]

You're missing the point. COVID-19 doesn't give 2 sh**s what your cause is. You can't say it's okay to hold mass gatherings for one issue, but not another and cite COVID-19 as your reason. Either large gatherings of people are okay in the face of Corona, or they're not. It's a science/public health thing - not a political thing.

I'm not saying it's 'ok' for either one.

But there's still a difference in motivation and risk/benefit.

It's like taking a patient to the OR with severe AS for a knee replacement vs a cold leg.

 

[vector2]

You're missing the point. COVID-19 doesn't give 2 sh**s what your cause is. You can't say it's okay to hold mass gatherings for one issue, but not another and cite COVID-19 as your reason. Either large gatherings of people are okay in the face of Corona, or they're not. It's a science/public health thing - not a political thing.

I think you're missing the point. Whether or not you believe in their cause, people out in the streets believe they are protesting about a literal life and death matter while being cognizant that what they're doing may very well be worse from a pandemic standpoint. It's the same reason why all those thousands of people in Wisconsin broke social distancing because the GOP monsters in that state wouldn't delay the vote or allow mass mail-in voting.

It's not black and white- it's a fighting for life vs putting life in danger, risks vs benefits issue. That's quite different than holding a white supremacy rally indoors for 6000 f_ckwits not wearing masks.

 

[crash2500]

I think you're missing the point. Whether or not you believe in their cause, people out in the streets believe they are protesting about a literal life and death matter while being cognizant that what they're doing may very well be worse from a pandemic standpoint. It's not black and white- it's a fighting for life vs putting life in danger, risks vs benefits issue. That's quite different than holding a white supremacy rally indoors for 6000 f_ckwits not wearing masks.

My man.

It's literally what we're paid to do every day as anesthesiologists.

What's the risk/benefit?

 

[deleted162650]

That's some hardcore rationalizing you guys undertaking there.

You wanna talk risk benefit - even if the end result of the protests was that unjustified police shootings went to zero (which is impossible), how many hundreds of lives were saved versus how many thousands were just exposed to Corona?

Any way you slice it, 10’s of thousands of people running amok in the streets is a much greater public health risk than 6000 screened MAGA buffoons in an arena.

 

[Lawpy]

This is good media