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  1. #3861
    Join Date
    Sep 2007
    Location
    Undisclosed

    Cool

    Quote Originally Posted by MChambers View Post
    You think we're facing a mine-shaft gap?
    "I'm not saying we wouldn't get our hair a little mussed."

  2. #3862
    Join Date
    Feb 2007
    We didn't overreact, but even if we did, overreacting every time is better than under-reacting the one time we shouldn't have. Novel viruses are going to continue to pop up, and eventually one of them will have a higher fatality rate than Covid-19 combined with the high transmission rate. Because the data is never going to be good early on when a novel virus pops up (especially if it originates in certain countries), you have to prepare for and react as if it's the worst-case scenario, in case it does turn out to be the Big One.

    At the same time, I certainly support our country restructuring a few things so that if a virus originates in another country, it doesn't impact us as much. Supply chains for PPE and medicines should be moved into the USA, for example.

  3. #3863
    Join Date
    Nov 2007
    Location
    Raleigh, NC
    Quote Originally Posted by Troublemaker View Post
    We didn't overreact, but even if we did, overreacting every time is better than under-reacting the one time we shouldn't have. Novel viruses are going to continue to pop up, and eventually one of them will have a higher fatality rate than Covid-19 combined with the high transmission rate. Because the data is never going to be good early on when a novel virus pops up (especially if it originates in certain countries), you have to prepare for and react as if it's the worst-case scenario, in case it does turn out to be the Big One.

    At the same time, I certainly support our country restructuring a few things so that if a virus originates in another country, it doesn't impact us as much. Supply chains for PPE and medicines should be moved into the USA, for example.
    If we're going to take strong action like this for every new novel virus, we need to restructure the entire country/economy, not just supply chains for PPE and medicine (I know those were just examples and you weren't restricting to just those two things, but if we're going to have an event like this more often than once every 40-50 years we basically need to restructure everything​).

  4. #3864
    Quote Originally Posted by Acymetric View Post
    If we're going to take strong action like this for every new novel virus, we need to restructure the entire country/economy, not just supply chains for PPE and medicine (I know those were just examples and you weren't restricting to just those two things, but if we're going to have an event like this more often than once every 40-50 years we basically need to restructure everything​).
    We didn't do this for SARS. We didn't do it for MERS. We didn't do it for H1N1. We didn't do it for Ebola. We didn't do it for Zika. We didn't do it for HIV.

    I imagine whenever there is a disease that spreads quickly and is this dangerous, we will do that...but evidence suggest these types of outbreaks are the exception not the rule. I would say we need a better playbook on how to handle a shutdown like this. There should be a very clear plan that is being followed instead of the result we have going on now...this is not a political comment. It's that most places in the world are clearly winging it. The Pacific Rim countries who had a big SARS scare 18 years ago were the only ones who made early, effective and decisive actions that saved their economies and countries from having to enact extreme measures. They had a plan and they put it into effect. The results clearly show.

  5. #3865
    Join Date
    Feb 2007
    Location
    NC
    Quote Originally Posted by Acymetric View Post
    If we're going to take strong action like this for every new novel virus, we need to restructure the entire country/economy, not just supply chains for PPE and medicine (I know those were just examples and you weren't restricting to just those two things, but if we're going to have an event like this more often than once every 40-50 years we basically need to restructure everything​).
    To be fair, I'm not sure that we'll be having one of these more than once every 40-50 years. We had a couple of scares with the MERS and SARS, both of which were more severe but neither was transmissible enough to take off. Same with ebola on a more extreme scale (even more severe, even less transmissible). And since we didn't shut down for SARS, MERS, or ebola, it stands to reason that the shutdowns only apply in more extreme circumstances where it becomes clear that the healthcare systems can't manage otherwise. That's why these shutdowns are being done: because the healthcare systems were getting overwhelmed in other parts of the world and the death toll was rising too rapidly, so more extreme measures where necessary.

    This one was pretty problematic in that it was much more transmissible than SARS and MERS but less deadly, but apparently more deadly than the flu. So we haven't seen anything quite like this in about 100 years (when the H1N1 "Spanish flu" killed over 600,000 people in the US). So I don't know that the entire economy needs to be restructured.

    So I think we need to have a better "readiness" plan in place for surveillance as well as healthcare resources. Because the more each of those are readily available (or to which each can be made readily available quickly), the less likely a shutdown is needed. If, for example, we had better surveillance measures in place and were able to prepare the tests and equipment needed more quickly, it's perhaps even possible that this shutdown could have been avoided.

  6. #3866
    Join Date
    Feb 2007
    Location
    Washington, D.C.

    I dunno

    Quote Originally Posted by CDu View Post
    To be fair, I'm not sure that we'll be having one of these more than once every 40-50 years. We had a couple of scares with the MERS and SARS, both of which were more severe but neither was transmissible enough to take off. Same with ebola on a more extreme scale (even more severe, even less transmissible). And since we didn't shut down for SARS, MERS, or ebola, it stands to reason that the shutdowns only apply in more extreme circumstances where it becomes clear that the healthcare systems can't manage otherwise. That's why these shutdowns are being done: because the healthcare systems were getting overwhelmed in other parts of the world and the death toll was rising too rapidly, so more extreme measures where necessary.

    This one was pretty problematic in that it was much more transmissible than SARS and MERS but less deadly, but apparently more deadly than the flu. So we haven't seen anything quite like this in about 100 years (when the H1N1 "Spanish flu" killed over 600,000 people in the US). So I don't know that the entire economy needs to be restructured.

    So I think we need to have a better "readiness" plan in place for surveillance as well as healthcare resources. Because the more each of those are readily available (or to which each can be made readily available quickly), the less likely a shutdown is needed. If, for example, we had better surveillance measures in place and were able to prepare the tests and equipment needed more quickly, it's perhaps even possible that this shutdown could have been avoided.
    I think there is a real risk that we will be having pandemics more frequently, due to human encroachment on wildlife. Experts have been warning about this in recent years. I don't know how to quantify the risk, but I don't the past is necessarily a guide.

  7. #3867
    Join Date
    Feb 2007
    Location
    Tampa
    Quote Originally Posted by Troublemaker View Post
    We didn't overreact, but even if we did, overreacting every time is better than under-reacting the one time we shouldn't have. Novel viruses are going to continue to pop up, and eventually one of them will have a higher fatality rate than Covid-19 combined with the high transmission rate. Because the data is never going to be good early on when a novel virus pops up (especially if it originates in certain countries), you have to prepare for and react as if it's the worst-case scenario, in case it does turn out to be the Big One.

    At the same time, I certainly support our country restructuring a few things so that if a virus originates in another country, it doesn't impact us as much. Supply chains for PPE and medicines should be moved into the USA, for example.
    Even if the measures enacted, particularly in places with few cases, results in local businesses, such as hospitals, clinics, etc., going out of business? Don't get me wrong, I'm not taking a position on whether the measures taken were or were not an overreaction or whether those measures were proper in every community, but in my opinion, FWIW, there is a valid discussion to be had (preferably at the outset). It's not as simple as imposing the most stringent measures in the name of saving lives. The protective measures taken have a very real possibility of costing lives as well.

  8. #3868
    Quote Originally Posted by Troublemaker View Post
    We didn't overreact, but even if we did, overreacting every time is better than under-reacting the one time we shouldn't have.
    In the face of a deadly, easily spread disease (of which I consider COVID-19) it is far better to overreact than under. The problem is, how do you know when a you are facing that situation.

    There have been plenty of outbreaks over the past 20-30 years and so far, we've made the correct call on all of them. We haven't overreacted, imo, to any of them.

    SARS came close to breaking out and was more deadly than COVID-19, but wasn't as easy to transmit.
    Ebola even more deadly, but thankfully even harder to transmit.
    H1N1 was as easy to transmit, but only slightly more dangerous than the flu. A few hundred school districts in the US did close down for a bit because of H1N1.
    MERS, quite deadly but for some reason confined to the middle east, not easy to spread and not seen more than a few hundred cases a year (there were 212 in 2019).

    Again, I don't think we need to overreact as this is doing very really, very long lasting damage to the global economy. What we do need to do is have a plan in place. Hong Kong, Singapore, Taiwan, Japan all had plans in place that worked and have been effective. We need to learn from their experience. Ideally a shutdown like the world is experiencing should be a tool of last resort when the best laid plans don't work. The US unfortunately didn't have a plan.

  9. #3869
    Join Date
    Nov 2007
    Location
    Raleigh, NC
    Quote Originally Posted by PackMan97 View Post
    We didn't do this for SARS. We didn't do it for MERS. We didn't do it for H1N1. We didn't do it for Ebola. We didn't do it for Zika. We didn't do it for HIV.

    I imagine whenever there is a disease that spreads quickly and is this dangerous, we will do that...but evidence suggest these types of outbreaks are the exception not the rule. I would say we need a better playbook on how to handle a shutdown like this. There should be a very clear plan that is being followed instead of the result we have going on now...this is not a political comment. It's that most places in the world are clearly winging it. The Pacific Rim countries who had a big SARS scare 18 years ago were the only ones who made early, effective and decisive actions that saved their economies and countries from having to enact extreme measures. They had a plan and they put it into effect. The results clearly show.
    Quote Originally Posted by CDu View Post
    To be fair, I'm not sure that we'll be having one of these more than once every 40-50 years. We had a couple of scares with the MERS and SARS, both of which were more severe but neither was transmissible enough to take off. Same with ebola on a more extreme scale (even more severe, even less transmissible). And since we didn't shut down for SARS, MERS, or ebola, it stands to reason that the shutdowns only apply in more extreme circumstances where it becomes clear that the healthcare systems can't manage otherwise. That's why these shutdowns are being done: because the healthcare systems were getting overwhelmed in other parts of the world and the death toll was rising too rapidly, so more extreme measures where necessary.

    This one was pretty problematic in that it was much more transmissible than SARS and MERS but less deadly, but apparently more deadly than the flu. So we haven't seen anything quite like this in about 100 years (when the H1N1 "Spanish flu" killed over 600,000 people in the US). So I don't know that the entire economy needs to be restructured.

    So I think we need to have a better "readiness" plan in place for surveillance as well as healthcare resources. Because the more each of those are readily available (or to which each can be made readily available quickly), the less likely a shutdown is needed. If, for example, we had better surveillance measures in place and were able to prepare the tests and equipment needed more quickly, it's perhaps even possible that this shutdown could have been avoided.
    I mostly agree with what you guys are saying, except that I think the COVID-19 experience is going to lower the bar for when extreme measures (like lockdowns) are taken, perhaps significantly so. We didn't lock down for SARS, but we might for a similar virus 5 years from now out of fear that it could turn out like COVID-19. I think this incident makes the trigger finger itchier in the future.

  10. #3870
    Join Date
    Feb 2007
    Location
    NC
    Quote Originally Posted by MChambers View Post
    I think there is a real risk that we will be having pandemics more frequently, due to human encroachment on wildlife. Experts have been warning about this in recent years. I don't know how to quantify the risk, but I don't the past is necessarily a guide.
    It's entirely possible. But if we're at the point of having huge global pandemics more frequently than every ~50 years, then we will have even MORE need for a pandemic disaster preparedness strategy much better than the (absence of) one we had this time around.

    That being said, if we are going to be having pandemics more frequently, that will likely require lifestyle and economic changes regardless of how we handle the responses to the pandemics.

  11. #3871
    Join Date
    Feb 2008
    Location
    Oregon
    Quote Originally Posted by bundabergdevil View Post
    Yeah. It seems inevitable that new hot spot spikes are going to occur as some folks interpret phrase re-openings as all clear. There have already been reports of rural hot spots in areas without stay-at-home order.

    It's tough for me to fully understand the mindset of the protesters chanting "lock her up" in Michigan but, then again, I have some at-risk people in my life and I'm very worried about their situations even while being empathetic to the other folks in my life who are economic casualties.
    I wouldn't defend "lock her up," but I hear from my brother in Michigan that the protests are partly fueled by feelings that the restrictions are too tight and defy common sense. As an example, landscapers are not allowed to work as they are considered non-essential. My brother has three elderly neighbors who now have no landscape service and don't even own lawn mowers. Brother has been doing some extra mowing. Landscapers are the epitome of a social distancing business - they do not interact with the homeowner except by phone. A common sense approach would be to allow services like landscapers (and pool service, etc.) to continue if they can do so with safe social distancing.

    Another example is vegetable gardening. Stores can sell groceries, but if they have a nursery section is must be roped off - no sales. I can hardly think of a better stay-at-home family activity than buying some seeds or starts and working together in the back yard vegetable garden. Selling vegetable seeds would help social distancing while giving families a way to save a little more cash and spend less time in the grocery store later this summer.

    The other main reason for the Michigan protests is suspicion that the Governor isn't motivated only by what's best for the people of her state. I'd detail but that's probably 'nuf said.

  12. #3872
    Join Date
    Feb 2007
    Quote Originally Posted by Acymetric View Post
    If we're going to take strong action like this for every new novel virus, we need to restructure the entire country/economy, not just supply chains for PPE and medicine (I know those were just examples and you weren't restricting to just those two things, but if we're going to have an event like this more often than once every 40-50 years we basically need to restructure everything​).
    I didn't mean we should shut down the economy every time a novel virus pops up. This shutdown is arguably only necessary because we didn't take strong measures sooner when the data on Covid-19 was more unclear. (e.g. The economy would've taken a hit if we had closed our borders to travel on Jan 1st, for example, but not the hit that we're taking now).

    Also, I probably wasn't clear about this, but I was suggesting that there are ways to restructure so that we don't have to react so harshly in the future. In general, the less interconnected we become with the world (with supply chains for PPE and meds being one example), the less harsh the actions we'd have to take for the next pandemic.

  13. #3873
    Join Date
    Feb 2007
    Location
    NC
    Quote Originally Posted by Troublemaker View Post
    I didn't mean we should shut down the economy every time a novel virus pops up. This shutdown is arguably only necessary because we didn't take strong measures sooner when the data on Covid-19 was more unclear. (e.g. The economy would've taken a hit if we had closed our borders to travel on Jan 1st, for example, but not the hit that we're taking now).

    Also, I probably wasn't clear about this, but I was suggesting that there are ways to restructure so that we don't have to react so harshly in the future. In general, the less interconnected we become with the world (with supply chains for PPE and meds being one example), the less harsh the actions we'd have to take for the next pandemic.
    Agree with these thoughts, with the admittedly minor quibble that there was never a chance of closing borders on Jan 1. We didn't hear about it at all until Jan 5 from the WHO, didn't hear it was a novel virus until Jan 7, didn't get any guidance from the WHO until Jan 10, and didn't have a confirmed case outside of China until Jan 13 (Thailand), and didn't have confirmation of human-to-human transmission until Jan 14, and as of Jan 23 there wasn't a consensus that there was a public health emergency of international concern. By that point, the virus was already in the US (first confirmed case was Jan 21 in Washington).

    That being said, your broader point I completely agree with: a better emergency preparedness infrastructure and plan could have prevented the need for a month(s?)-long shutdown of the country. If we had closed our borders to non-US citizens completely as of Feb 1, and tested and quarantined every US citizen returning to the US since, that would likely have prevented the need for a shutdown.

  14. #3874

    Injecting a little levity

    This is funny and tangentially Duke-related due to the mention of RJ Barret:

    THE CORONAVIRUS CRISIS OR THE NEW YORK KNICKS?

    https://www.mcsweeneys.net/articles/...ew-york-knicks (no sub required)

  15. #3875
    Join Date
    Feb 2007
    Location
    Steamboat Springs, CO

    Open Sweden vs. Closed Nordic Countries

    As you may have heard, Sweden is proceeding without major shut-downs and shelter-in-place rules, unlike most other countries, including the other Nordic countries.

    Sweden is paying a price. Here are the stats for the four neighboring Nordic countries

    Sweden (pop. 10.1 M)
    Cases per M: 1,463
    Deaths per M: 156

    Denmark (pop. 5.8 M)
    Cases per M: 1,297
    Deaths per M: 63

    Norway (Pop. 5.4 M)
    Cases per M: 1,314
    Deaths per M: 32

    Finland (Pop. 5.5 M)
    Cases per M: 698
    Deaths per M: 18

    Sweden is experiencing about 100 more deaths per million than its neighboring countries, who have imposed restrictions on travel and business. That's about 1,000 more deaths, given its population of 10.1 million.
    Sage Grouse

    ---------------------------------------
    'When I got on the bus for my first road game at Duke, I saw that every player was carrying textbooks or laptops. I coached in the SEC for 25 years, and I had never seen that before, not even once.' - David Cutcliffe to Duke alumni in Washington, DC, June 2013

  16. #3876
    NC State Senator Jeff Jackson is not my local representative, but seems to have been a reliable source for non-politicized information through this crisis. He's been regularly posting information on Reddit, and today released a short video about what reopening the state will look like. I encourage you to check out both.

    Update: What we know about reopening North Carolina; the wild west of PPE acquisition; major testing bottlenecks [Sen. Jeff Jackson]
    https://redd.it/g3tnky


    We can’t reopen North Carolina today - but we’ve made enough progress that we can start having a realistic conversation about what reopening will look like. Here’s what we know. [Sen. Jeff Jackson]
    https://redd.it/g4v5en

  17. #3877
    Join Date
    Feb 2007
    Location
    Boston area, OK, Newton, right by Heartbreak Hill
    Quote Originally Posted by TampaDuke View Post
    Even if the measures enacted, particularly in places with few cases, results in local businesses, such as hospitals, clinics, etc., going out of business? Don't get me wrong, I'm not taking a position on whether the measures taken were or were not an overreaction or whether those measures were proper in every community, but in my opinion, FWIW, there is a valid discussion to be had (preferably at the outset). It's not as simple as imposing the most stringent measures in the name of saving lives. The protective measures taken have a very real possibility of costing lives as well.
    Yes, there is a valid discussion to be had, but assuming that these local businesses are only going out of business because of the measures we are taking is not an assumption we can make. Even without these measures, some local businesses would be lost. Also -without these measures, there would be no places with few cases. There still might not be. Three of the top 10 counties (last time I checked which was a couple of days ago) with the highest per capital infection rates were rural counties in Georgia.

  18. #3878
    Join Date
    Feb 2007
    Location
    Washington, D.C.

    Yep

    Quote Originally Posted by Bostondevil View Post
    Yes, there is a valid discussion to be had, but assuming that these local businesses are only going out of business because of the measures we are taking is not an assumption we can make. Even without these measures, some local businesses would be lost. Also -without these measures, there would be no places with few cases. There still might not be. Three of the top 10 counties (last time I checked which was a couple of days ago) with the highest per capital infection rates were rural counties in Georgia.
    It’s the virus that’s Primarily causing the economic downturn, not the stay at home measures. And lifting the measures will not revive the economy if it means a second wave of the virus.

    I wish there were a way to revive the economy more quickly, but I don’t see one.

  19. #3879
    Quote Originally Posted by MChambers View Post
    It’s the virus that’s Primarily causing the economic downturn, not the stay at home measures. And lifting the measures will not revive the economy if it means a second wave of the virus.

    I wish there were a way to revive the economy more quickly, but I don’t see one.
    Right! The industries and businesses hardest hit are the ones that would be hardest hit in an unchecked pandemic.

    Let's put ourselves into the height of epidemic in NYC, in Italy, in France, in anywhere in the globe where the healthcare system has been overwhelmed. Ambulance sirens begin to blend into the background noise. Most everyone knows someone who is on a ventilator or dead. Even the healthcare workers, cops, EMTs are being hospitalized and dying.

    Would you, in this environment of COVID-19 at it's peak:
    1) Go to a gym?
    2) Go out to eat?
    3) Go see a movie?
    4) Go to a department store and try on some clothes?
    5) Go to a furniture store and test set in a few dozen couches?
    6) Send your kids to school?
    7) Go on a cruise?
    8) Invite your in-laws to town to stay at a hotel (ok, maybe some of you world)?
    9) Go to the hospital or medical provider for an elective procedure?

    The answer to all of this is NO, you wouldn't not. The end result is pretty much the same with or without a stay-at-home order. The only difference is whether we end up with a manageable case load or we end up with a completely overwhelmed medical system.

  20. #3880
    Join Date
    Feb 2007
    Location
    New Jersey
    Quote Originally Posted by PackMan97 View Post
    Again, I don't think we need to overreact as this is doing very really, very long lasting damage to the global economy. What we do need to do is have a plan in place. Hong Kong, Singapore, Taiwan, Japan all had plans in place that worked and have been effective. We need to learn from their experience. Ideally a shutdown like the world is experiencing should be a tool of last resort when the best laid plans don't work. The US unfortunately didn't have a plan.
    Singapore says "not so fast"

    https://www.nytimes.com/2020/04/20/w...singapore.html

    “The reality is that Americans and Europeans will face the same issues, too,” said Teo Yik Ying, the dean of the Saw Swee Hock School of Public Health at the National University of Singapore. “My economist friends may not like this, but if trade and economic activity are resumed and people start moving without adequate measures, there will be subsequent waves of infection.”
    Rich
    "Failure is Not a Destination"
    Coach K on the Dan Patrick Show, December 22, 2016

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