PlagueWatch 2020-23 - Coronavirus

[freshmanjs]

I don't think it is fair to use hospitalization alone as a marker for severity. It seems to me that a higher percentage of covid patients who end up in the hospital are generally more severely affected, based on ICU numbers. Hospltalization, per se, is inherently a more arbitrary measure of severity than ICU admission or intubation and mechanical ventilation.
For example, many flu patients end up in the hospital because they have myositis, and thus need aggressive hydration and monitoring to keep them from developing kidney failure. Most of these people, although requiring hospitalization, do not require admission to intensive care, and can be discharged within a few days.

I don't remember a flu season ever in which the ICUs became filled up and other parts of the hospital had to be utilized as overflow intensive care, or where extra ventilators had to be acquired, or where the Navy had to send a ship up to the Hudson river to take care of overflow patients. If it has happened, I have not been informed of it.

So, at a minimum, I'd have to say that the rapidity with which this virus spread, and the numbers of extremely severe cases is beyind what we have seen with infuenza in the past 50 years, at least, even if the total hospitalization numbers are similar at this point in time.

For what it's worth, a quick Google search yields a lot of articles about ICU overflow, treating patients in tents, etc. during various flu seasons. Nothing about Navy ships though (However, the Comfort only treated 180 patients when it was in NY, raising the question of whether a Navy ship was a necessary or even a good way to handle the overflow)

I'm not disagreeing with your conclusion. I suspect you are absolutely right that the ICU situation has been worse from Covid, but the shoddy reporting on the topic does not make it easy to evaluate.

[Deslok]

As a teacher who moved into online teaching just before covid emerged in the USA, I’m thankful to be teaching online and not in the Petri dish that is most classrooms. And being in the comprised immunity category, I don’t think you could pay me enough to set foot in a classroom right now, and kind of appalled at some of the publicly proclaimed expectations of schools. Am reminded of proponents of stopping foisting all manner of jobs on policeman(and the idea behind most support of the poorly monikered “defund the police” movement). But let’s not keep foisting extra stuff on schools either.

[swood1000]

There are several differences, including the fact that all of those jobs are taken with the risk being understood. There has never been that risk as part of the equation of being a teacher, so suddenly imposing that risk on teachers and telling them "Accept it or you are fired" seems immoral, to me.

But would "accept it for a pay increase" be immoral? How about "accept the additional risks associated with a vaccine produced under circumstances making the existence of side-effects more likely"?

[budwom]

Saw five noted pediatricians on TV the other night, and they were asked "would you send your kids to school this Fall." Every one of them enthusiastically said yes. OTOH, no one asked them how they'd feel about school if they were a teacher or staff member. That might be an entirely different calculation.

[Phredd3]

But would "accept it for a pay increase" be immoral?

I don't think you've ever answered my question: Where is this hypothetical pay increase coming from? Do you even understand the scale of that question? School budgets in my area are substantially more than half of the entire local city budget, and salaries are more than half of those costs. Extra expenses for the hardware and added cleaning staff and supplies has already added to the budget, as well (although in my area, fortunately, an enormous amount of those costs were defrayed through philanthropic efforts). Unemployment claims are way, way up, as well, both adding to the immediate outflow and reducing the revenue stream. While the latter won't be truly felt until next fiscal year, fortunately, it has to be planned for ASAP.

Moral questions aside, I simply don't see any practical way in which the incentive structure you propose could actually work.

[MChambers]

School and town budgets are already established. I don't know how you would go about changing that, and it would be an incredible challenge to "sell" the changes needed to the public, ESPECIALLY to the non-child having public.

The budgets are established, but it's even worse than that. Most states and localities operate under rules that require them to try to maintain a balanced budget and not borrow money. Because of the financial crisis associated with the pandemic, state and local governments have seen their revenues drop dramatically. Congress provided some aid in the first relief legislation, but not enough, and so state and local governments are going to have to slash their spending for the remainder of the fiscal year and for the next fiscal year. So even if folks wanted to hire additional people in the schools, I don't know where the money would come from.

[Bostondevil]

There are several differences, including the fact that all of those jobs are taken with the risk being understood. There has never been that risk as part of the equation of being a teacher, so suddenly imposing that risk on teachers and telling them "Accept it or you are fired" seems immoral, to me.

We are in a no-win situation. It's not that I disagree with you, but I don't completely agree either. We have told lots of people to keep working because what they do is essential: meat packing plant workers, bus drivers, hospital staff not directly involved in patient care, grocery store cashiers, Amazon warehouse employees, a whole host of professions where risk has never been a part of the equation before. Teachers, like it or not, are essential employees. We cannot sacrifice a generation of children. So, we must find a way to provide education that works for them. Online education will work for some but it will not work for all. The children that cannot effectively learn remotely have to be put first. Our first priority should be towards providing the safest learning environment possible. If it's a hybrid of online for some and in person for others, then so be it. There isn't a one size fits all solution, but merely claiming that we can't keep everybody safe is not a reason give up. We are past the point of no return with containment of this disease, we must move on to mitigation. And part of any mitigation strategy will have to include providing education to those that still need it.

[Tappan Zee Devil]

But would "accept it for a pay increase" be immoral? How about "accept the additional risks associated with a vaccine produced under circumstances making the existence of side-effects more likely"?

Your comment is irrelevant. Teacher unions, which are going to worry about what is best for both teachers and students (as opposed to best for Trump), simply will not accept that.
And the district needs to get the union onboard to change the way things are done.

[sagegrouse]

This thread needs a little good news. Here's an op-ed from the WaPo by a prof at the Harvard school of public health:

1. Therapies will arrive before vaccines (antibodies promising).
2. Rapid low-cost saliva tests on the way and a game-changer.
3. Debate over masks is over -- masks work!
4. Agreement finally that airborne spread occurs.
5. Exposure to common-cold coronaviruses may offer some people protection (early results).
6. Vaccine trials seem to be working -- amazing, given the difficulties.

[budwom]

This thread needs a little good news. Here's an op-ed from the WaPo by a prof at the Harvard school of public health:

1. Therapies will arrive before vaccines (antibodies promising).
2. Rapid low-cost saliva tests on the way and a game-changer.
3. Debate over masks is over -- masks work!
4. Agreement finally that airborne spread occurs.
5. Exposure to common-cold coronaviruses may offer some people protection (early results).
6. Vaccine trials seem to be working -- amazing, given the difficulties.

I wish the debate with masks were really over. Yeah, among scientists it may be, but how about the sizeable number of honyocks in this country who adamantly refuse to wear them? That's not good news at all...

[Jeffrey]

We're getting the same kind of TV reports from docs and nurses we got from NYC months ago...severe despair, overwhelmed, unmanageable situations. (Texas, AZ, FL).

Horrible situation! It’s unfortunately hard to imagine the recent mortality rate will stay relatively low when quality of care decreases.

[budwom]

Horrible situation! It’s unfortunately hard to imagine the recent mortality rate will stay relatively low when quality of care decreases.

Very sad interview with a nurse from AZ (i think) saying she was incredibly sad because never in her career had she seen people die for a lack of resources, and that's what she's seeing now.

[Jeffrey]

Very sad interview with a nurse from AZ (i think) saying she was incredibly sad because never in her career had she seen people die for a lack of resources, and that's what she's seeing now.

Absolutely! I’ve seen interviews with doctors and nurses in AZ, TX, and FL saying the same. Unfortunately, there are not enough available medical workers and resources to simultaneously go to that many different areas. It’s not concentrated like the NYC and surrounding area disaster was in April and May.

[CDu]

This thread needs a little good news. Here's an op-ed from the WaPo by a prof at the Harvard school of public health:

1. Therapies will arrive before vaccines (antibodies promising).
2. Rapid low-cost saliva tests on the way and a game-changer.
3. Debate over masks is over -- masks work!
4. Agreement finally that airborne spread occurs.
5. Exposure to common-cold coronaviruses may offer some people protection (early results).
6. Vaccine trials seem to be working -- amazing, given the difficulties.

Yeah, quite a lot of work being done on the treatment side. Remdesivir has an Emergency Use Authorization, and may well become approved once its Phase 3 trial is complete. Dexamethasone has shown a small but significant effect on death, but isn't yet approved. And several antivirals and immunomodulators and anti-inflammatories are being tested. Hopefully enough of these prove effective at reducing the mortality rate as well as the severity and duration of hospitalizations. If they can become available by the Fall, that will help reduce some of the burden on the healthcare system and the death toll, effectively buying time until (hopefully) some vaccines become available.

There is at least home downstream. In the meantime, hopefully folks can start accepting that you need to wear an effing mask.

[jafarr1]

https://thehill.com/policy/healthcar...data-reporting

[OldPhiKap]

https://thehill.com/policy/healthcar...data-reporting

They couldn’t wait until a late Friday night to announce this?

[cato]

I suspect you are absolutely right that the ICU situation has been worse from Covid, but the shoddy reporting on the topic does not make it easy to evaluate.

At first, I thought “shoddy reporting” referred to the counts that newspapers et al were putting together by gathering all publicly available information, and then reporting it. Then I realized that you might also be including reporting by the government agencies. I imagine we are not holding hospitals responsible for shoddy reporting?

How do you think we develop the information needed to make decisions fact-based?

[Skydog]

A question for the experts: Could one of the reasons for the lower death rates we are currently seeing be due to mutations in the virus? A NYT's podcast was saying that new viruses typically become more communicable and less lethal over time.

[throatybeard]

I think I can pinpoint exactly when Student Health at Duke fell apart, between my sophomore and junior years. In the before time, they offered throat lozenges so saturated with sweet numbing trocaine that you couldn't feel your throat at all for a good hour. Afterwards, they had switched to some cherry OTC garbage from like Dollar General's house brand that was basically Red 40 and plastic. Being immature, we blamed Nan Keohane.

[jv001]

After 2 months of having services in our Church, our pastor has cancelled services for the next two weeks. We've had our first two positive cases of Covid-19. A young couple in their late 20s have tested positive. Our Pastor and Deacons have been very pro-active with the covid guidelines. Seating capacity is 50% with social distancing seating. There are no choir songs, no hugging or hand shaking and masks are required. Disbursing after church is done by row aisle out different doors and keeping social distance. There was an 8:30 service for sections one and two and a 10:00 am service for sections three and four. I really don't believe the couple contracted the virus at church. They have not been to many of our services. However, they did attend a large gathering celebrating high school graduates. I think this may have been where they contracted the virus. I appreciate our pastor's quick response to the positive tests.