Global Pandemic Part II: Sequel Escalation

[DaveC]

https://tvtropes.org/pmwiki/pmwiki.php/Main/SequelEscalation

 

[DaveC]

reposting this from the last thread because it's excellent and should be widely read: https://www.theatlantic.com/health/archive/2020/03/how-will-coronavirus-end/608719/?linkId=85439737

 

[anitram]

I read it and it's very well written and IMO, realistic.

Once the vaccine is available, they need to not only mass produce it but figure out a way to administer it very quickly to very large numbers of people. Start with the elderly + high-risk, then work your way down. Large employers should set up their own administration like they often do with the flu vaccine, schools should be doing it and so on.

And yes, tons will change in the aftermath. Many of us already worked at home occasionally but now employers will come to realize that we can largely be productive that way and so why spend millions on very valuable real estate (particularly in the most expensive cities) when you maybe need 1/3 of the employees actually present in person. Personal real estate will change as well - I think the suburbs and exurbs will be the main beneficiaries. Who wants to be trapped in 450 square feet for weeks/months at a time, in a building that's like an incubator for disease where you can't help but interact with others. Not to mention the lack of outdoor space and so on. People with young kids will be particularly prone to bailing from "cool" downtown areas. I don't live in the suburbs, but I am in Toronto's west end, in a nice area with large lots and that has been a lifesaver for us. I'd have gone mental with the kids and dog in a condo by now.

Global travel will also be impacted. Again, employers will see just how much business travel is totally frivolous and unnecessary. And people will be less likely to return to their pre-COVID travel patterns for a long time. Some because of financial reasons, some will just be hesitant, and some will decide to stay more local/regional.

 

[LemonMelon]

Fuck paywalls in a global pandemic when public information is so essential. Here is an article from LA Times explaining how social distancing is impacting epidemiological models in California and New York.

https://www.latimes.com/california/...stancing-west-coast-california-new-york-covid

MILLBRAE, Calif. —* For California and Washington, the coronavirus triggers came early. They pushed the two Western states to social distancing measures earlier than the rest of the country.

In the San Francisco Bay Area, the warning came while the Grand Princess cruise ship, carrying infected crew and passengers, lurked outside the Golden Gate. As the coronavirus cases spread in Silicon Valley, health officers as early as March 5 urged employers to consider allowing more employees to work from home, and companies to cancel large gatherings and nonessential travel.

By the time the ship docked in Oakland on March 9, the BART transit system had seen a 24% drop in ridership compared with a typical Monday in February. Ridership was down 75% a week later, the same day the Bay Area issued the nation’s first coronavirus shelter-in-place order.

In Seattle, the early deaths at a suburban nursing home at the end of February shocked many into action. By the first week of March, major tech companies were telling employees to work from home and local officials urged them to do so.

The coronavirus continues to spread rapidly in both places, but so far at a rate slower than in the country’s other hot spots such as New York, New Jersey, Michigan and Louisiana.

To be sure, the epidemic still could get dramatically worse on the West Coast. A San Francisco nursing home with more than 700 beds is contending with an outbreak that has infected two patients and nine staff members. There are signs of the contagion at 11 Los Angeles County nursing homes, too.

But experts are looking to California and Washington for signs that social distancing is making a difference.

With all eyes on the sharply rising curves showing the dramatic rise in cases, “if and when it flattens, you’ll see it here first,” said Dr. George Rutherford, an epidemiologist and infectious disease expert at UC San Francisco.

*

The implementation of the shelter-in-place orders in the Bay Area “happened closer to the introduction of the virus, so you haven’t had as many generations of transmission. So there are fewer cases per capita in the population,” Rutherford said.

While cautioning that there’s no way to predict the future, it’s plausible the Bay Area’s early action will allow it to avoid a New York-style surge in cases, he added.

Dr. Robert Kim-Farley, an epidemiologist at UCLA, said the numbers of hospitalizations and deaths provide a more accurate indicator of the outbreak’s trajectory than the number of cases identified through uneven testing. On Thursday, the total number of deaths in L.A. County nearly doubled in a single day.

“I will anticipate that we will continue to see increased in hospitalizations and deaths, but I think we should be able to see some leveling off of those numbers in a couple of weeks because of the physical distancing measures,” Kim-Farley said.

Indeed, Gov. Gavin Newsom said Monday that the number of patients hospitalized with COVID-19 had doubled over the course of four days — and the number in intensive care units had nearly tripled.

After a person is infected with the coronavirus, it can take two to 14 days for symptoms — commonly fever, cough and shortness of breath — to appear. Then, in cases where the illness becomes severe, it usually takes an additional eight to 15 days for a patient to require treatment in an intensive care unit.

That means it can take weeks for the effects of stay-at-home orders become evident.

And there are a number of things that can still go wrong for California.

The state does not know how many people are flouting the order to stay at home as much as possible and keep at least six feet away from others, said Dr. Otto Yang, an infectious disease expert at UCLA Medical Center, where coronavirus cases have climbed sharply in the last couple of weeks.

A few news accounts suggest that some Californians are skeptical about the threat from the virus and the need for physical distancing.

The lack of widespread testing can also mask how many people are actually infected and passing the virus around, Yang said. The true number “is going to determine how much hospital resources are going to be needed,” he said.

The Bay Area stunned the nation on March 16 when health officers in six counties jointly ordered residents to shelter in place to curb the spread of the coronavirus, officially known as SARS-CoV-2. Eleven other California counties soon joined the order, and on March 19 it was expanded statewide by Newsom.

New York state, by contrast, issued a stay-at-home order on March 20, and made it effective on March 22.

California’s earlier, aggressive stay-at-home order is one reason why a model published by the University of Washington’s Institute of Health Metrics and Evaluation suggests that New York state will see its worst day of the epidemic in early April, and that it will be dramatically worse than California’s worst day.

The report projects the peak of hospitalizations and deaths in California to come in late April.

“Given what we’ve been seeing in California, we are expecting the peak of the epidemic — the intensity of it — to be lower than in New York,” said Dr. Chris Murray, professor and director of the Institute for Health Metrics and Evaluation and the author of the report. “That means the surge in the hospitals will be smaller.”

Officials advising President Trump said their model of the pandemic mirrors the University of Washington projections. But other experts have raised doubts about the conclusions.

Nicholas Jewell, a biostatistics researcher at UC Berkeley, said he is “very skeptical” about the work. He said it makes a number of assumptions that remain to be proved — including about the death rate in Wuhan, China, where the disease originated, and in one region of Italy hard hit by the coronavirus.

The University of Washington projections changed from Friday to Monday, as the researchers fed new data into their computer simulation. On Monday, it showed that California would most likely be hit with 4,306 deaths, compared with the 6,109 forecast last week. For New York, the projected death total rose considerably — from 10,243 to 15,546.

Those sharp shifts were another factor giving Jewell pause.

“I am not saying their answer is wrong,” Jewell said. “I am just saying we shouldn’t put too much confidence in it yet.”

 

[iron yuppie]

Personal real estate will change as well - I think the suburbs and exurbs will be the main beneficiaries. Who wants to be trapped in 450 square feet for weeks/months at a time, in a building that's like an incubator for disease where you can't help but interact with others. Not to mention the lack of outdoor space and so on. People with young kids will be particularly prone to bailing from "cool" downtown areas. I don't live in the suburbs, but I am in Toronto's west end, in a nice area with large lots and that has been a lifesaver for us. I'd have gone mental with the kids and dog in a condo by now.

Suburbs of major US cities are hellishly expensive as it is. If this comes true, the flight will be short-lived because no one can afford it.

 

[anitram]

Fuck paywalls in a global pandemic when public information is so essential. Here is an article from LA Times explaining how social distancing is impacting epidemiological models in California and New York.

California's testing is ABYSMAL. Last I checked today they were 48th out of 50 states in per capita testing. It's an absolute disaster and their numbers should not be viewed with any kind of certainty.

 

[LemonMelon]

California's testing is ABYSMAL. Last I checked today they were 48th out of 50 states in per capita testing. It's an absolute disaster and their numbers should not be viewed with any kind of certainty.

The epidemiological models towards the end of this article utilize rate of hospitalization/ICU and daily growth rate in fatalities to limit the wide variance involved in testing practices. It's even mentioned halfway through that our raw case figures are to be taken with a grain of salt.

 

[anitram]

The epidemiological models towards the end of this article utilize rate of hospitalization/ICU and daily growth rate in fatalities to limit the wide variance involved in testing practices.

They believe that looking at rates of hospitalization/critical care is a BETTER tool than uneven testing. But that means they are relying on the most severe cases and we still do not have good enough data from a reliable place (no, not China) to know exactly how many asymptomatic cases are, how many mild vs severe. So you just can't project with any kind of accuracy.

What it also means is that California is missing enormous numbers of non-hospitalized people because they are not testing. You can take the view that this is fine, but then comparing them to New York is really apples to oranges.

 

[LemonMelon]

They believe that looking at rates of hospitalization/critical care is a BETTER tool than uneven testing. But that means they are relying on the most severe cases and we still do not have good enough data from a reliable place (no, not China) to know exactly how many asymptomatic cases are, how many mild vs severe. So you just can't project with any kind of accuracy.

What it also means is that California is missing enormous numbers of non-hospitalized people because they are not testing. You can take the view that this is fine, but then comparing them to New York is really apples to oranges.

It's frustrating because, while it's a somewhat peripheral matter right now, we do eventually need to work out a plan for how the local economy will ramp up again, and California will be grossly unprepared for this task if we don't have a realistic number of who is only mildly sick and who may already have immunity. New York is already working out plans for antibody testing and we currently aren't in the ballpark (well, some testing is happening at Dodger Stadium, but anyway).

My primary concern is with our hospitals. Trump isn't looking out for us; we need to do that for each other. There are positive signs that our local health care system may take a less critical hit than many others for reasons outlined above and that is a very positive thing. Despite our flaws, the one thing we did very right can still serve as a model for the states pretending that life can go on as is.

 

[anitram]

Despite our flaws, the one thing we did very right can still serve as a model for the states pretending that life can go on as is.

Yes, Washington and California really paved the way.

The reason it's important to know the total number of infected, including the asymptomatic or very mildly ill, is that if the numbers seem deceptively low - as a state of over 30M people, if you are posting a couple of hundred cases a day and not increasing testing, that will push people to relax the restrictions currently in place. Businesses struggling to keep going, the unemployed, the underemployed, etc. And it's hard to say "we need to stay shut down" while also posting numbers that are per capita (falsely) lower than almost anywhere else.

 

[LemonMelon]

Yes, Washington and California really paved the way.

The reason it's important to know the total number of infected, including the asymptomatic or very mildly ill, is that if the numbers seem deceptively low - as a state of over 30M people, if you are posting a couple of hundred cases a day and not increasing testing, that will push people to relax the restrictions currently in place. Businesses struggling to keep going, the unemployed, the underemployed, etc. And it's hard to say "we need to stay shut down" while also posting numbers that are per capita (falsely) lower than almost anywhere else.

It really does make one wish that a nation-wide lockdown were on the table to prevent that, as we are by no means the only state lagging behind in testing (our problem is more a backlog in results than the tests themselves). From my understanding, that's not something the federal government has authority to do though.

 

[DaveC]

Who wants to be trapped in 450 square feet for weeks/months at a time, in a building that's like an incubator for disease where you can't help but interact with others. Not to mention the lack of outdoor space and so on. People with young kids will be particularly prone to bailing from "cool" downtown areas. I don't live in the suburbs, but I am in Toronto's west end, in a nice area with large lots and that has been a lifesaver for us. I'd have gone mental with the kids and dog in a condo by now.

oh cool i'm in this comment

 

[anitram]

oh cool i'm in this comment

How are you coping? My friends downtown are in varying states of distress.

 

[DaveC]

we have a bit under 400 square feet, but thankfully it's only the two of us and three very needy cats who at the same time are also very angry that we don't leave them alone 9+ hours a day anymore. the building is only an 8-story low-rise so we aren't crammed into a shoebox where there are a dozen other people in the elevators every time we come or go, like some people are. i don't have a balcony and the only outdoor space my building has is a tiny patch of grass out front for the building's dogs to go on. so i'm getting a little stir crazy. if i had kids running around (with the prospect of having to keep them busy for the next month at least too) i don't know how i'd deal with it. i admire the hell out of anyone who is managing it.

i count my blessings that i have a fairly indispensable (to my employer) job that will only really be in jeopardy if the TSX shuts down entirely for a long period of time, and my partner is the only manager remaining in one of the essential businesses at the airport so she's safe as well as long as airplanes are still flying. our incomes are both stable, neither of us is sick and we don't have anyone depending on us or older family close by that we could possibly be putting in danger. so in the grand scheme of things, we are relatively very very lucky at this time.

i am *extremely* jealous of your backyard though. the forecast for the rest of the week is supposed to be sunny and mild so you should have a chance to enjoy it. i plan to make my way down to the shore at ontario place at some point, hoping that it won't be too busy to keep our distance from others.

thanks for checking in hope you and yours are happy and healthy through this. let me know if i can help with anything.

 

[LemonMelon]

I live in a 1 bedroom/1 bathroom apartment with three humans, two dogs and a cat inside. We have no patio and only a shared yard, which is admittedly better than nothing. I love our orange tree.

To keep from going stir crazy, I walk/jog around the neighborhood and the walking paths that remain open 60-90 minutes each day.

 

[the tourist]

I work from home normally anyway, and am kind of a homebody, so aside from not getting out of the house on weekends and having to postpone a haircut, nothing is out of the ordinary for me aside from the fact that I usually see my parents once a week. My wife is a dance instructor for kids, and her work has changed significantly, but she’s adapting. It just changed the hours she’s gone as the teachers are videoing all their classes now, and only one teacher uses the studios at a time now instead of multiple. One upshot is she’s gone less evenings, but for longer, so on the new nights off I’ve had more opportunity to work on the album I’m in the throes of recording.

 

[DaveC]

i've been trying to find the motivation to go for a run at lunch time while i'm working from home. i used to go to the gym in my building once a week or so - nothing serious but enough not to feel like a complete lump. but they closed it down on the 13th and i haven't really done anything besides walks to the store since then. it sucks when long time habits are suddenly broken to have to figure out new ones.

 

[DaveC]

having to postpone a haircut

this is rapidly becoming an issue for me too.

 

[dazzledbylight]

from gump

Thanks. We are all fine and are lucky to have jobs that allow us to work from home. Hope you are doing ok too. I’m in North Brooklyn, not too far from one of the hotspots in South Williamsburg, where there are tons of cases in the Hasidic community. But I barely leave the apartment at all. It just sucks to see the devastation everywhere you look.

Glad to here that you folks can work from home. I lived in Brooklyn for a bunch of years - a few blocks NW of Grand Army Plaza. Now I'm about 3/4 miles south of Fordham Rd in the Bronx not far from the bridge that connects to Manhattan Washington Height's Eastern side not far from the GW Bridge.

Yeah, it's pretty surreal, so many stores closed maybe some for good. Not going out except for food, house hold basics, and pharmacy. Every 2-3 days with masks and gloves. My supermarket seems to has closed early tonight - I hope ONLY that since it was open same a few days ago. Oh, yeah, there's the other big one 2 blocks up a hill. Will go out earlier tomorrow. Luckily I have a lot of art, crafts to keep busy. And WiFi at home only second time with the first a trial grant from the library lending out WiFi hotspots for several months 4 years ago. A few friends and a bunch of cousins to be in contact with (besides the ones I talk on the phone with).

 

[the tourist]

this is rapidly becoming an issue for me too.

Yeah. I already was like a month or two overdue because I was working tons of OT all through the hours that they were open. Will probably be the longest I’ve had it in years by the time I can get it cut again. Whatever though, not a big deal on the grand scheme of things.

 

[dazzledbylight]

Good luck to everyone in your various apts

Dave C Having a friend who ended up "rescuing" a older kitten some years back and regaling me with tales good and bad of life with him - I really now get your cats annoyance at not being "left alone for 9+ hrs".

anitram Sorry to hear your friends downtown are extra stressed.

lm An orange tree?!
Mucho decades ago when my mom was living in California with roommates they had a few trees, maybe an orange tree, but definitely an avocado tree!

 

[LemonMelon]

Yes, an orange tree! When those blossoms pop up in the early spring, it's the greatest scent in the world. Instantly brightens my mood. Orange trees are all over the place here and there's a pomegranate tree near by apartment too. No avocados though.

 

[DaveC]

i bought a pair of binoculars last fall and as the birds are coming out i'm very happy that i purchased those.

there's a big fat cardinal lording over the top branches of the tree in my apartment window. i think the swallows are gathering their numbers down below to fight back.

edit:

 

[Moonlit_Angel]

Cool picture, Dave ! What a pretty bird.

this is rapidly becoming an issue for me too.

LOL, yeah, it may well be for me soon, too. I usually get my hair cut once the weather starts getting warmer, because it's long and thick and that's not always the most comfortable thing to deal with in warmer weather (it actually hasn't been all that warm here lately, mind, but eventually it will be). But now...I may have to deal with the lion's mane look for a while longer.

 

[dazzledbylight]

LM Sounds lovely to have the scent of flowering orange blossoms trees wafting about! My mom was eating pomogrenats years before they became popular! Such a beautiful looking fruit outside (the color) and the amazing set up of ruby like gel around the multitude of seeds.

Dave C I love Cardinals! I learned to recognize their call so I'd hear then often see them in parks, or in my neighborhood.
Most interesting was when in our family apartment, out the back window with the fire escape (my veranda) over looked the apt buildings below, as the back of our building was built up on a steep hill - the big balcony was surrounded by trees on 3 sides. One Spring (w help from small binoculars )I watched a pair of crows flying with branches in their beaks for building their nest. Wildlife in NYC.

 

[Diemen]

Here’s a little bit of cool/good news: so I realized that I had a box of N95 particulate masks in my shop at work that I’d only ever used one of, so we called a couple local hospitals to see if they could use them. Both said that they could only take unopened boxes. One of my wife’s colleagues knows a neurosurgeon who was apparently desperate to find masks for emergency surgeries, and would be willing to take opened boxes, since they simply couldn’t find anything in stock in town.

So my wife drove over to their house to drop them off to his wife, who mentions that, though her husband is a neurosurgeon, the emergency procedures he needs the masks for are stage 4 colon cancer surgeries.

My wife’s dad died when she was 10 from colon cancer, and her older brother got it when he was 26 (and fully recovered). It was a really special bit of synchronicity/grace for her. Obviously we’d be happy if those masks went to help anyone needing surgery, but for it to be that closely connected to her family history was pretty powerful for my wife.

 

[MrsSpringsteen]

It's fun to see guys here talking about hair. Sorry about fun, don't know the right word. My last appointment was March 5th. I just started going to this new salon a few months ago, 15 minute walk down the street. The owner works there by herself and wasn't having luck renting out chairs. She and her husband and kids did most of the renovations, the place is beautiful. I really hope she can survive this shutdown.

I was going there for cut and color, the price was so reasonable and she's so talented. My last day in March appointment was cancelled, I wasn't going anyway in order to be responsible. Governor shut down non essential businesses yesterday until May 4th and I know it will go well beyond that. I've been hiding it under my winter hats when I go out for walks, and other hats if it's warmer. I order groceries and other essentials. I have one prescription that can't be delivered so that's my only essential trip.

Obviously it's completely trivial and unimportant. But I'm seriously considering a wig at this point.I had to grow out my layers to do what I want to do with it, so at least that is mission accomplished.

And major victory for me today, Wal-Mart shipped my 36 rolls of toilet paper Fed Ex arrives tomorrow. I've had multiple orders of toilet paper cancelled. I ordered some more from another site to help out my brother or any neighbors or anyone else needing some, If that order comes through.

From what I've heard you have to be at stores first thing in the morning to get toilet paper, and stores have reserved those hours for seniors and immune compromised. Never thought it would be impossible to get toilet paper in this country, certainly is one lesson among countless others regarding how many things we take for granted.

 

[MrsSpringsteen]

Here’s a little bit of cool/good news: so I realized that I had a box of N95 particulate masks in my shop at work that I’d only ever used one of, so we called a couple local hospitals to see if they could use them. Both said that they could only take unopened boxes. One of my wife’s colleagues knows a neurosurgeon who was apparently desperate to find masks for emergency surgeries, and would be willing to take opened boxes, since they simply couldn’t find anything in stock in town.

So my wife drove over to their house to drop them off to his wife, who mentions that, though her husband is a neurosurgeon, the emergency procedures he needs the masks for are stage 4 colon cancer surgeries.

My wife’s dad died when she was 10 from colon cancer, and her older brother got it when he was 26 (and fully recovered). It was a really special bit of synchronicity/grace for her. Obviously we’d be happy if those masks went to help anyone needing surgery, but for it to be that closely connected to her family history was pretty powerful for my wife.

That's a very special story, and not a coincidence in my world view. The universe works in magical ways sometimes.

 

[Jerry Dunk]

Is Andrew Cuomo still trying to cut Medicaid funding in New York by $400 million during a pandemic that is particularly threatening to those who can't afford health care? Genuine question, a lot is happening and perhaps he has changed his tune.

Also, what is the status of inmates on Rikers Island?

 

[MrsSpringsteen]

This is fascinating, I hope it will turn out to be promising.


Celtics' Marcus Smart donating blood for experimental coronavirus treatment


ESPN
10:42 PM

Boston Celtics guard Marcus Smart, who announced Monday that he is clear of COVID-19 after testing positive two weeks ago, confirmed Tuesday night that he plans to donate blood so it can be studied with the hope of finding a treatment for the coronavirus.


Michael Joyner, an anesthesiologist at the Mayo Clinic, told ABC News that at least four NBA players who have recovered from the infection plan to donate blood for the National COVID-19 Convalescent Plasma Project, an experimental treatment that could help high-risk patients recover from the virus.

Smart confirmed through his agent that he is one of the players who opted in. The identities of the three other players were not revealed.

The NBA league office reached out to team physicians Sunday, encouraging players who have recovered from the virus to consider participating in the experimental treatment, according to a copy of the memo obtained by ABC News.

Joyner said Tuesday that he believes the experimental treatment "can be disease-modifying and reduce duration and severity in some patients." The therapy utilizes the antibodies in blood from recovered patients to potentially curb the virus in sick patients.

Joyner said professional athletes could be especially valuable plasma donors.

"These are big men with blood volumes, and as a result [they] have a lot of plasma volume," Joyner said. "Frequently people who are physically trained also have an increase in their plasma volume from what you would expect from them just being regular-sized guys."