Reopening America ?

pbojanoski

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I live in the uk and work as paramedic
I believe we need to keep the lockdown

There are still people dying everyday, we all have a responsibility to stop the silent killer, I know it’s a tuff time for everyone, but we only have 1 life and we need to make sure we are here to live it

I don’t see Covid going anywhere in the short term

I for one want to be around to enjoy my new ER RWD, i’am willing to wait a bit longer to get it
And how many will lose their lives and livelihoods with a failed economy while you are waiting?

https://www.cnn.com/2020/04/22/africa/coronavirus-famine-un-warning-intl/index.html

I really didn't want to post the above article, but this is what many will be facing going forward. How long should we keep the economy of the world shutdown?
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pbojanoski

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In one last attempt to inject useful, on topic discussion, I thought I'd share the results of a national opinion survey just conducted on this very topic. While it addresses "gatherings" it speaks volumes on confidence of people to go out into stores, restaurants, etc., all of which are part of reopening the economy. While some will be ready to go out in May, most say June, July, or even later.

imrs.php.jpeg


Survey reported in:
https://www.washingtonpost.com/poli...436dda-833b-11ea-a3eb-e9fc93160703_story.html
While interesting, as are most polls, this isn't worth much. People will feel comfortable going out when they see others going out and not getting sick or dying as a result. Asking someone when they think that will happen isn't very useful information, IMO.

The quicker we allow people to live their lives (WITH MITIGATION!!), the quicker all of us will get back into society.
 

pbojanoski

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I think the fact that so many don't or simply won't consider, are the additional deaths that will occur if we don't open soon. There is absolute factual evidence that as this lockdown continues there will be many additional deaths from drug ODs, suicides, untended to medical conditions and a variety of other things including depression from long term unemployment. These additional deaths can be substantial. This must be weighed against keeping the lockdown going.

Then, as we learn more about the virus, it's becoming very apparent that the actual death rate relative to the those that have already been infected (many totally unaware they were ever infected) is far smaller than first thought. The more random testing we do for antibodies, the more we see people were infected at a greater level than ever believed. Thus the denominator in this equation continues to grow. It will probably wind up much less than 1%...not much different than what would occur with a flu season.
One important factor is that this virus seems to spread easier than the flu, but otherwise I am in agreement with your comments.
 

TheSteelRider

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My apologies, but if that is not a rhetorical question (or even if it is), I do not understand what you are asking, given the context.

To be clear, what I was observing is that there appears to not be a consensus among people about their confidence. E.g., from a statistics point of view (and, from the example numbers I proposed based off the source study's margins of error) people are not converging on a date.

I was not making any scientific statement about COVID-19, nor was I making a statement about epidemiology. I was merely making an observation that, according to this particular study, there appears to not be a consensus among the population.
 

Redundant

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I think you need to state exactly what you think can be done before you call something a failing. How exactly do you think we can do millions of COVID-19 tests everyday when there is no installed base of testing to do that kind of thing? Nowhere in the world have they been able to test a large portion of their citizens on a daily basis. How many do you think can be tested and how effective do you think that level of testing will be? Why can't Governors get a large portion of their citizens tested if the President is failing?

If we focus more on preventing getting infected, something we can do, mass testing will be less of a requirement. Obviously, we can continue to expand testing, but we need to have a reasonable and attainable goal.
I will say that like almost all complex problems, it requires a multi-pronged approach. Absolutely, we should focus on preventing infection. But, part of that strategy should be testing, Every single back to work plan calls for testing, including the White Houses.

That is why I mention the National Defense Act. I just did a quick search and cannot find evidence of it being used other than securing 60K tests in March. To me, that is a failing big time. We should be signing mutilple companies, I don't know who makes these kits, to make millions of them, absolutely. Why not? GM built bombers in WWII. Without testing, this is just going to be a sin wave of cases and deaths, shut down, flatten, reopen, ad nauseam. This is a unique power of the federal government to enact, to get testing going and for that matter, manufacturing of vents, which they did do with GM, masks, gowns, etc. Due to the lack of action on the part of the feds, has 50 Governors competing on the open market against each other for scarce resources. It should be a national plan. That is what the NDA is for, enlist our manufacturing base to resolve a national problem. If I am wrong, I would love to be wrong. I am hoping the virus will slow down this summer, no evidence that is the case, and that we can use our countries tremendous resources to get testing in place for the fall. Do you not agree that would be a good course of action?
 


SyNRG

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BTW, previous very depressing last post of mine notwithstanding, I am really open to hearing from others on their thoughts on scenarios. I understand the balance of having to go about life vs. combating the virus, but I'm getting more and more depressed at what this means for society going forward. I've switched from being optimistic we could get a hold of it within a couple of months to thinking, it will be 18 months from now and 1 million dead in America before we really have a handle. Sorry to be so depressing. Can anyone cheer me up?
Hey Steel - I've been in the same place just a few weeks ago, I just "unplugged" from all news, daily briefings, COVID-19 and political BS stuff. Now I just go about life and check local news and statistics when I'm free. I've replaced that "noise" with some of the things I used to love doing before the pandemic. Also my wife was recently furloughed, so she keeps me busy (my son and dog as well) with all of the home/gardening projects on the weekends! I work in healthcare, thus still going to work M-F.

Here's some encouraging news, here in Orange County, CA, our numbers appears to be in the peak. The social distancing and shelter in place works, it has helped with flattening the curve.
https://occovid19.ochealthinfo.com/coronavirus-in-oc

The LA County numbers, although still too early to say with confidence, but they may be entering the peak as well.

My thoughts on "reopening America, going forward as some states begin to loosen the restrictions and "reopen", rest assured, it will be a step-by-step process with proper mitigation plans in place. The "new norm" may include: recommendations to those vulnerable to stay home as much possible, everyone going out in public will be required to wear proper facial protection (masks), practicing proper hand hygiene, temp checks before entering work place, social distancing within work spaces (companies ensuring their staff are 6ft apart, etc). Sporting events, theme parks, concerts, not sure how that will be handled at this point, too much of a big risk.

These steps will be a necessity since we don't have a vaccine available. Is there a chance that cases could spike again? Absolutely, but hopefully by taking these steps and if EVERYONE abides by them we minimize it, if not, I can see states and local official reinstating the restrictions.
 

ChasingCoral

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Your "reopen" posts are very recent. You've been decidedly against any reopen discussion for weeks.

All I've been saying for weeks is to reopen in a thoughtful and prudent way, but received push back and ridicule (from some) for even thinking about it.

I'm also not asking you to leave any discussion. I am asking for each of us to really think about the HARD questions we all face and to answer them honestly and constructively. I won't wither in the face of hard questions. I hope you won't either.
Sure, the reopen posts didn't start until after the shutdown happened. Follow the White House plan and that's the whole point. Have you looked at it? You have to stop the spread from getting worse. Then you slowly reopen when and where it makes sense. Then you finish solving the problem. I've only been against reopening too soon. I think you missed that part of it.

And no, I'm not running away from hard questions. I'm just uninterested in digging through the politically charged personal attacks that have now filled this thread. I'm already spending too much time on these fora and definitely don't have time to spend sorting through political arguments that go no where and spend hours getting there.
 

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Hey Steel - I've been in the same place just a few weeks ago, I just "unplugged" from all news, daily briefings, COVID-19 and political BS stuff. Now I just go about life and check local news and statistics when I'm free. I've replaced that "noise" with some of the things I used to love doing before the pandemic. Also my wife was recently furloughed, so she keeps me busy (my son and dog as well) with all of the home/gardening projects on the weekends! I work in healthcare, thus still going to work M-F.

Here's some encouraging news, here in Orange County, CA, our numbers appears to be in the peak. The social distancing and shelter in place works, it has helped with flattening the curve.
https://occovid19.ochealthinfo.com/coronavirus-in-oc

The LA County numbers, although still too early to say with confidence, but they may be entering the peak as well.

My thoughts on "reopening America, going forward as some states begin to loosen the restrictions and "reopen", rest assured, it will be a step-by-step process with proper mitigation plans in place. The "new norm" may include: recommendations to those vulnerable to stay home as much possible, everyone going out in public will be required to wear proper facial protection (masks), practicing proper hand hygiene, temp checks before entering work place, social distancing within work spaces (companies ensuring their staff are 6ft apart, etc). Sporting events, theme parks, concerts, not sure how that will be handled at this point, too much of a big risk.

These steps will be a necessity since we don't have a vaccine available. Is there a chance that cases could spike again? Absolutely, but hopefully by taking these steps and if EVERYONE abides by them we minimize it, if not, I can see states and local official reinstating the restrictions.
I get down quite a bit too, especially as it affects my young adult children, one still in college and one just graduating. I particularly feel for them, as life is difficult enough without this facing them as they are just going into adulthood and trying to make a life for themselves. But, despite that, I try not to loose sight of how fortunate we are compared to so many during this time, many without financial resources, laid off and lacking health care. I am trying to flatten my curve and not cycle my moods depending on the days news. Sometimes, avoiding the news for me is key.

That said, while the vaccine could be a ways away, I am being optimistic that in the short term we will develop treatments for those who do get sick. That is where flattening the curve is important, the longer we can keep people from getting sick, the better chance we have of better treatment. This is a weird virus, and they find patients with super low oxogen, 50, rather than 90 to 100, but they are still texting. They are literally close to death and untreated would crash pretty quickly. They think it is because they are still able to exhale CO2. Rather than intubating, they are putting them on their stomachs or sides, and can get O2 up with machine. Much to learn.

Finally, I hope drugs can be repurposed and treatments from antibodies of survivors will provide critical help as we wait for a vaccine. Glass is half full.
 

Ken7

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I will say that like almost all complex problems, it requires a multi-pronged approach. Absolutely, we should focus on preventing infection. But, part of that strategy should be testing, Every single back to work plan calls for testing, including the White Houses.

That is why I mention the National Defense Act. I just did a quick search and cannot find evidence of it being used other than securing 60K tests in March. To me, that is a failing big time. We should be signing mutilple companies, I don't know who makes these kits, to make millions of them, absolutely. Why not? GM built bombers in WWII. Without testing, this is just going to be a sin wave of cases and deaths, shut down, flatten, reopen, ad nauseam. This is a unique power of the federal government to enact, to get testing going and for that matter, manufacturing of vents, which they did do with GM, masks, gowns, etc. Due to the lack of action on the part of the feds, has 50 Governors competing on the open market against each other for scarce resources. It should be a national plan. That is what the NDA is for, enlist our manufacturing base to resolve a national problem. If I am wrong, I would love to be wrong. I am hoping the virus will slow down this summer, no evidence that is the case, and that we can use our countries tremendous resources to get testing in place for the fall. Do you not agree that would be a good course of action?
Actually there have been far more than 60,000 tests conducted. The National Defense Act was utilized more for the procuring of ventilators than testing kits. I believe the last number I saw for testing was well over a million. There are multiple companies that have submitted applications to produce these tests, but as usual it must cut through the bureaucratic red tape. I don't recall if this is a function of the FDA or CDC, but either way the administration has been seeking the help of private industry. The President is most certainly an advocate of harnessing the power of private industry. The government certainly can't do it in the numbers required.
 

pbojanoski

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I will say that like almost all complex problems, it requires a multi-pronged approach. Absolutely, we should focus on preventing infection. But, part of that strategy should be testing, Every single back to work plan calls for testing, including the White Houses.

That is why I mention the National Defense Act. I just did a quick search and cannot find evidence of it being used other than securing 60K tests in March. To me, that is a failing big time. We should be signing mutilple companies, I don't know who makes these kits, to make millions of them, absolutely. Why not? GM built bombers in WWII. Without testing, this is just going to be a sin wave of cases and deaths, shut down, flatten, reopen, ad nauseam. This is a unique power of the federal government to enact, to get testing going and for that matter, manufacturing of vents, which they did do with GM, masks, gowns, etc. Due to the lack of action on the part of the feds, has 50 Governors competing on the open market against each other for scarce resources. It should be a national plan. That is what the NDA is for, enlist our manufacturing base to resolve a national problem. If I am wrong, I would love to be wrong. I am hoping the virus will slow down this summer, no evidence that is the case, and that we can use our countries tremendous resources to get testing in place for the fall. Do you not agree that would be a good course of action?
I ask again, how long will it take to make and do millions of tests per day. You can use the "defense act" or anything you want, but it doesn't mean it will just happen. This kind of request could take months or years to accomplish. Can we wait that long? What is the rate of false positives or false negatives? How quickly must the tests be done?

There are plenty of testing labs out there that would love to make a ton of money on this virus. Why aren't they doing it? Or maybe they are, but it just isn't that simple to do.

Am I wrong? If so, how long do you think it will take to have that kind of testing base? I'm talking about getting out of the current lockdown, not the fall. Things will be better by the fall, but I'm more concerned about today than I am about four or five months from now. New tests are being approved as we move forward, but getting millions per day is not going to come quickly for the current problem we face, if ever.

I'm now hearing the virus is mutating into varied strains which will make vaccines and tests even more difficult to accomplish. How do we do it?
 
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virus is mutating into varied strains: Great --- Just F____ Great.
 

SyNRG

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Correct, essentially the strain seen here along the West Coast is more similar to the originating one in Wuhan, while the NYC strain are similar to the ones in EU.

See here for info: https://nextstrain.org/ncov/global
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