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Old 21 March 2020, 03:28 AM   #3001
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Contrarian perspective. Carry on as normal, do nothing, let it pass through the population as quickly as possible. Short term disruption. But, back to normal as soon as possible. And, the economy keeps on rolling with only a minor hiccup.

Whatís currently going on feels like death by a thousand cuts ...
This is part of my struggle.

I see the logic behind this. Itís not very warm and fuzzy, but neither is the potential global economic depression.
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Old 21 March 2020, 03:30 AM   #3002
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Exactly! Not at all palatable, but we’ll end up here eventually. The short, sharp shock may be better than long drawn out chaos.
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Old 21 March 2020, 03:35 AM   #3003
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If they shut down the US for 2 weeks

What about people like me that have to get drugs for diabetes, high BP and heart medications? Im running out in several days and worried sick over getting refills....my doctor office is closed. WTH I left 2 messages and nobody returns my calls.....
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Old 21 March 2020, 03:38 AM   #3004
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How long do you think the entire country should stay in lockdown? Lockdown meeting absolutely no one goes to work?
I really have no idea. It will depend on the course of the disease. China and South Korea are reporting drastically reduced numbers of new cases. But other pandemics in history have gone on for years.

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With your medical background I'd be curious to hear your thoughts if you think #5 is possible. From my knowledge, the below are the 7 Coronaviruses that infect humans. I'm not familiar with a reliable vaccine for any of these though, so very curious how we will develop one effective against SARS-COV-2. I'm not an epidemiologist though, so perhaps virus coding is different and more targetable with this compared to others. Though it doesn't seem much progress has been made with the 3 below that potentially cause acute respiratory syndrome. Perhaps there have not been enough cases prior though to justify full research of the ARS causing infections?

Common Cold Causing Coronaviruses:
Serotype HUK1
Serotype NL63
Serotype OC43
Serotype 229E

The more serious Coronaviruses that more often result in respiratory issues compared to the prior:

SARS-COV-1
MERS
SARS-COV-2

I imagine we can make some solid progress towards treating symptoms at the very least though.
I don’t know enough about immunology or ID to make a guess. I know, like everyone else does, that we’ve been told a vaccine is 12-18 months out. Is that realistic, or is that statement made to reduce panic and placate us? I don’t know.
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Old 21 March 2020, 03:39 AM   #3005
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What about people like me that have to get drugs for diabetes, high BP and heart medications? Im running out in several days and worried sick over getting refills....my doctor office is closed. WTH I left 2 messages and nobody returns my calls.....
That is unacceptable. Of all the places that should be open pharmacies and doctors offices should never close. I know you said you donít have any family out there to help you but maybe a forum member can pick up your prescriptions for you and bring them to you.
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Old 21 March 2020, 03:41 AM   #3006
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If youíre talking about the report about Lewisham Hospital I have it from the mouth of one of the consultant physicians there that itís fake news. Having said that it sounds like things could get very bad very quickly.

BoJo did though just announce that pubs and restaurants in London are being shut down.

Hopefully was fake, think it was Harrow?! Iím not familiar with London so could be wrong.


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Old 21 March 2020, 03:42 AM   #3007
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What about people like me that have to get drugs for diabetes, high BP and heart medications? Im running out in several days and worried sick over getting refills....my doctor office is closed. WTH I left 2 messages and nobody returns my calls.....

I feel your pain, in the U.K. itís similar, huge queues and prescriptions not fulfilled.


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Old 21 March 2020, 03:42 AM   #3008
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Contrarian perspective. Carry on as normal, do nothing, let it pass through the population as quickly as possible. Short term disruption. But, back to normal as soon as possible. And, the economy keeps on rolling with only a minor hiccup.

Whatís currently going on feels like death by a thousand cuts ...
That actually is a sixth option I should have included in my post about the course of a pandemic. But it goes against human nature and good politics to let that happen. Only time will tell if that option would have resulted in less death and disruption.
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Old 21 March 2020, 03:44 AM   #3009
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What about people like me that have to get drugs for diabetes, high BP and heart medications? Im running out in several days and worried sick over getting refills....my doctor office is closed. WTH I left 2 messages and nobody returns my calls.....
I would call your pharmacy. I think they will make sure you have a supply of meds. They may have a way to contact your provider, or at least someone taking his/her calls, or they may give you your meds and deal with the formalities later.
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Old 21 March 2020, 03:45 AM   #3010
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Contrarian perspective. Carry on as normal, do nothing, let it pass through the population as quickly as possible. Short term disruption. But, back to normal as soon as possible. And, the economy keeps on rolling with only a minor hiccup.

Whatís currently going on feels like death by a thousand cuts ...
You are making a good point. Half measures don't seem to be helping here. You either take the bull by the horns as China has done or perhaps consider a carry on as normal approach.

This does seem to be getting totally out of hand in Italy. Almost 6000 new cases and 627 deaths in one day.
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Old 21 March 2020, 03:46 AM   #3011
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I feel your pain, in the U.K. it’s similar, huge queues and prescriptions not fulfilled.
Have you got more on this? I have many prescriptions and have not heard anything about it. I normally collect mine but will get the Boots Chemist delivery service.

You have me worried now. Where did you get this info please?
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Old 21 March 2020, 04:01 AM   #3012
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When a virologist who identified the virus that causes HIV tells you to be cautious about using hydroxychloroquine without knowing more about how to use it, and a construction contractor refutes by him by saying he's got a good feeling about this drug, listen to the virologist.
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Old 21 March 2020, 04:21 AM   #3013
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Precisely! Hence my recommendation of the do-nothing scenario. Let nature take it’s course. But, at least we’d be through the worst in the shortest time.

The end of the current scenario doesn’t bear thinking about. No working economy and a completely crippled government ...
The thing is it’s very hard to commit to a course of action that you know will cause certain death to maybe a quarter of a million (conservatively). I understand that economic Armageddon might ultimately be even worse, but the numbers are intangible. It feels like the difference between actively killing someone versus letting them die slowly and painfully: the former might be more humane but how many people could bring themselves to actually do it?
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Old 21 March 2020, 04:26 AM   #3014
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When a virologist who identified the virus that causes HIV tells you to be cautious about using hydroxychloroquine without knowing more about how to use it, and a construction contractor refutes by him by saying he's got a good feeling about this drug, listen to the virologist.
You don’t have an agenda and that’s not political at all
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Old 21 March 2020, 04:30 AM   #3015
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The thing is itís very hard to commit to a course of action that you know will cause certain death to maybe a quarter of a million (conservatively). I understand that economic Armageddon might ultimately be even worse, but the numbers are intangible. It feels like the difference between actively killing someone versus letting them die slowly and painfully: the former might be more humane but how many people could bring themselves to actually do it?

Yes, I understand exactly what you mean. But death by a thousand cuts likely to end in a quarter of a million deaths anyway, albeit over a longer time frame. Even worse would be the total destruction of the economy in the process. The objective perspective might be to concentrate on ďpost-CoronavirusĒ and minimise the destruction to get there ...

Either way, dreadful choices to have to make ... but thatís what Bojo should be considering. Iím sure he is. Somewhat more stressful than the trifling issue of Brexit!
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Old 21 March 2020, 04:30 AM   #3016
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Thought I would share this here, it was a good read for sure and worth taking a look at

https://www.statnews.com/2020/03/17/...reliable-data/
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Old 21 March 2020, 04:36 AM   #3017
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That is unacceptable. Of all the places that should be open pharmacies and doctors offices should never close. I know you said you donít have any family out there to help you but maybe a forum member can pick up your prescriptions for you and bring them to you.
Well it's a free country and pharmacies and doctors' offices are typically private entities. I'm not aware of any law on the books mandating that a business stay open when it's taking financial losses and incurring risk to staff by staying open. It is in the best interest of patients and providers to do everything possibly remotely at this point.

It would be nice if there was some form of safety net or system in place for folks who can't safely get meds refilled, rather than needing to rely on personal relationships developed over the internet. Any ideas or solutions?
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Old 21 March 2020, 04:39 AM   #3018
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Exactly! Not at all palatable, but weíll end up here eventually. The short, sharp shock may be better than long drawn out chaos.
This is the "herd immunity" thought. Where we abandon thinking and knowledge and behave like a "herd" of cows. 100% penetrance at once for 330 million people. 16% of those will require hospitalization: oxygen support, ventilators, etc. That's 52 million people. The number of staffed hospital beds in the United States is less than 1 million. At that point the medical system collapses. Law and order could collapse right behind it.

There's already a post reporting difficulty reaching standard medical care. That would get worse adding to the mortality. I am not an economist, but it would seem to me that using science and communication has got to be better for the economy than acting like cows.
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Old 21 March 2020, 04:40 AM   #3019
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To anyone who says you can't put a price on human life, why did we just start thinking that in March 2020? We price human lives any time we build a new highway. Companies price out human lives when they decide whether to do a recall (e.g. 100 projected dead at 5 million tort liability per death, versus cost of recall).

This coronavirus response is pricing lives higher than we ever have before. If it costs 10 trillion to save a million lives, that's 10 million per life.

To clarify, I don't support putting a price on life. It sounds wrong and it is wrong. I'm observing that 1) society already puts a price on life, and 2) that price seems to skyrocket within the specific context of COVID-19
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Old 21 March 2020, 04:46 AM   #3020
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You donít have an agenda and thatís not political at all
Read the rules before you post!
My agenda is to save lives. That is done by listening to a virologist during a pandemic.
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Old 21 March 2020, 04:50 AM   #3021
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You are making a good point. Half measures don't seem to be helping here. You either take the bull by the horns as China has done or perhaps consider a carry on as normal approach.

This does seem to be getting totally out of hand in Italy. Almost 6000 new cases and 627 deaths in one day.
It feels as if weíre already at the do-nothing baseline for Europe and the U.S. considering the escalation in the number of cases. Hold tight and let it run itís course, rather than try to stifle. Then, within 12 weeks weíd be though the worst. If we try to stifle now, it simply drags it all out. And, wrecks the economy. Fairly brutal, perhaps, but we minimise ongoing disruption.
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Old 21 March 2020, 04:53 AM   #3022
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The number is US cases is doubling every 3-4 days. In weeks, not months, it will flatten or we will be in the total saturation scenario, whether we like it or not. I suspect we better prepare (which I believe the government is doing).

But, with two parents 83 years old (one with diabetes, the other a cancer survivor or), a brother with high blood pressure and COPD, an obese sister and a MIL who is 85 with lungs ravaged by 70 years of West Texas dust, I’d like to give flattening the curve a try.
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Old 21 March 2020, 04:55 AM   #3023
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It feels as if weíre already at the do-nothing baseline for Europe and the U.S. considering the escalation in the number of cases. Hold tight and let it run itís course, rather than try to stifle. Then, within 12 weeks weíd be though the worst. If we try to stifle now, it simply drags it all out. And, wrecks the economy. Fairly brutal, perhaps, but we minimise ongoing disruption.
Tough words. Are you going to watch this from your sofa, or hold a couple hands of the people you are dooming?
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Old 21 March 2020, 04:56 AM   #3024
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It feels as if weíre already at the do-nothing baseline for Europe and the U.S. considering the escalation in the number of cases. Hold tight and let it run itís course, rather than try to stifle. Then, within 12 weeks weíd be though the worst. If we try to stifle now, it simply drags it all out. And, wrecks the economy. Fairly brutal, perhaps, but we minimise ongoing disruption.
You need to remember that in situations where we are only testing symptomatic and hospitalized patients, the current numbers reflect the state of play 1-2 weeks ago, and are not a current snapshot. If we were blindly testing large numbers of people regardless of symptoms, we would have a better handle on current numbers of asymptomatically infected people. We will see in another 2 weeks if the efforts of social distancing and such have paid dividends.
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Old 21 March 2020, 04:59 AM   #3025
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Number of confirmed cases means nothing. It is more reflective of increase capacity to conduct testing.
A more accurate number is count of similar influenza cases ( confirmed not to be influenza) reported by hospitals. Same symptoms as influenza but tested negative for influenza A and B, those are more likely COVID19 patients.
It seems based on this approach baseline scenario is worse and it will overwhelm hospital in the next few days.
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Old 21 March 2020, 05:01 AM   #3026
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This is the "herd immunity" thought. Where we abandon thinking and knowledge and behave like a "herd" of cows. 100% penetrance at once for 330 million people. 16% of those will require hospitalization: oxygen support, ventilators, etc. That's 52 million people. The number of staffed hospital beds in the United States is less than 1 million. At that point the medical system collapses. Law and order could collapse right behind it.

There's already a post reporting difficulty reaching standard medical care. That would get worse adding to the mortality. I am not an economist, but it would seem to me that using science and communication has got to be better for the economy than acting like cows.
Well, itís more an understanding that the high level of casualties will happen either way. Perhaps it may be better to concentrate that into a tighter timeframe, to minimise economic destruction, rather than to drag out?

I agree, this is not very pleasant, certainly not humane.

However, it might be appreciated more by those left afterwards! The current approach will see our grandchildren still paying for this ...

Iím not saying I particularly favour one or the other, just pointing out an alternate viewpoint. The options facing our various governments are diabolical either way.
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Old 21 March 2020, 05:05 AM   #3027
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Diabolical is the name indeed.
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Old 21 March 2020, 05:13 AM   #3028
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As we discuss the options with this pandemic, it might be worthwhile to set reasonable expectations. The choice of flattening the curve versus accepting a glut of new infections has an assumption that we will have a vaccine in 12-18 months. But there is also experience when vaccines are not forthcoming.

Please consider the last coronavirus borne respiratory disease: MERS.

The first known cases of MERS occurred in April 2012.

There is currently no vaccine to protect people against MERS. But scientists are working to develop one. It has been 8 years since the initial outbreak.

MERS can affect anyone. MERS patients have ranged in age from younger than 1 to 99 years old.

Most MERS patients developed severe respiratory illness with symptoms of fever, cough and shortness of breath.

There is no specific antiviral treatment recommended for MERS-CoV infection.

For severe cases, treatment includes care to support vital organ functions.

About 3 or 4 out of every 10 patients reported with MERS have died. A mortality rate of approximately 35%.

Some chilling parallels and some differences, donít you think?

Public policy choices for MERS were prevention, isolation and similar hygiene protocols that we hear today for COVID-19. Fortunately the Arabian peninsula isnít as densely populated as China.

Why mention MERS? It may have been a dress rehearsal for humankind to tackle our current play. Because as we debate flattening the curve vs acquiring ďherd immunityĒ, we shouldnít lose sight of history.

We may not get a vaccine. We may need to protect and isolate for much longer than forecasted.




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Old 21 March 2020, 05:14 AM   #3029
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3M has announced that it has doubled production of N95 masks to 100 million per month and expects to produce 1.1 billlion annually up from 400 million. I think this is a tangible example of how reducing the load on the healthcare system (in this case through lockdowns) gives the market a chance to catch up.
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Old 21 March 2020, 05:15 AM   #3030
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This is what a "lock down" looks like. This image from just a few minutes ago, flights coming and going from all over the world.

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