Cancel Order? Because of Corona Virus Fallout?
03-22-2020, 03:25 PM
#166
that’s not what that means. Community transmission is cases of unknown origin. After brutally quarantining 60M people, China tested a **** ton of people, including using chest xrays to triage folks. They cranked their already massive surveillance state up a notch and tested people randomly for fevers. They tested or quarantined everyone who came into contact with a victim. If you contact trace nearly 100% of the cases, then vola there’s no community transmission
The early estimates of the disease R0 (contagious-ness) were twice that of the flu. This tweet is a scientist using scientist jargon. It’s poorly phrased.
it’s not some evidence of a grand conspiracy. China didn’t know about the problem in November (this was discovered after the fact), denied the problem for a couple weeks in December, and then was pretty open about things. You can’t put 60M people into quarantine and mobilize for a war economy without other countries noticing. By mid January they had publicly announced they were “going to war” against it.
you might not have noticed, but many people did. This was well understood by our intelligence agencies in January.
so far the early WHO data appears well corroborated by ... 150 other countries. Some imprecision afforded for the “fog of war” in a new catastrophic and rapidly changing situation
The early estimates of the disease R0 (contagious-ness) were twice that of the flu. This tweet is a scientist using scientist jargon. It’s poorly phrased.
it’s not some evidence of a grand conspiracy. China didn’t know about the problem in November (this was discovered after the fact), denied the problem for a couple weeks in December, and then was pretty open about things. You can’t put 60M people into quarantine and mobilize for a war economy without other countries noticing. By mid January they had publicly announced they were “going to war” against it.
you might not have noticed, but many people did. This was well understood by our intelligence agencies in January.
so far the early WHO data appears well corroborated by ... 150 other countries. Some imprecision afforded for the “fog of war” in a new catastrophic and rapidly changing situation
I have the document if you want to see it. It is on the internet. I'm not saying they are not being transparent, I'm just asking why they won't apparently share their treatment data with the world. Why?
03-22-2020, 03:27 PM
#167
I live in Seattle and promise you the number of infections here is many times more than what's being reported.
Two of my friends are RNs and were you exposed to confirmed COVID cases. Both started to feel ill and (obviously) self quarantined and were held out from work. It took the hospital 4 days to get either of them tested, not for lack of trying. There is a huge lack of supplies and direction on what to do.
The reality is most people with symptoms here are being denied tests. Furthermore, Seattle is in full on spring break mode as the weather has been very nice and people are flocking to popular outdoor areas. I'm looking out my window now and the sidewalk is as busy as I've ever seen it this time of day.
Even if China is experiencing a recovery, I don't see anywhere even close to that level of quarantine being enforced in the US.
Two of my friends are RNs and were you exposed to confirmed COVID cases. Both started to feel ill and (obviously) self quarantined and were held out from work. It took the hospital 4 days to get either of them tested, not for lack of trying. There is a huge lack of supplies and direction on what to do.
The reality is most people with symptoms here are being denied tests. Furthermore, Seattle is in full on spring break mode as the weather has been very nice and people are flocking to popular outdoor areas. I'm looking out my window now and the sidewalk is as busy as I've ever seen it this time of day.
Even if China is experiencing a recovery, I don't see anywhere even close to that level of quarantine being enforced in the US.
03-22-2020, 03:28 PM
#168
still not convinced that the Chinese government can control 55 million people to a great degree and I am sure there has been some travel within china before the war was declared I don't know how to explain this , but to me it is not adding up
even if you lock down apartment buildings with chains , what about the couple hundred people living within a building , how did they get food and other services , we are talking about 55 million people Also we are assuming that the rest of the country has zero carriers from Wuhan . All other countries affected at least initially were related to traveler from china.. so we have to assume that more infected people travelled from Wuhan to Italy as compared to Wuhan to the rest of china
unless my second assumption that there is Herd Immunity in china that affected transmission rates
I don't believe in conspiracy theories and not trying to imply that , but just trying to explain things in a more logical way
even if you lock down apartment buildings with chains , what about the couple hundred people living within a building , how did they get food and other services , we are talking about 55 million people Also we are assuming that the rest of the country has zero carriers from Wuhan . All other countries affected at least initially were related to traveler from china.. so we have to assume that more infected people travelled from Wuhan to Italy as compared to Wuhan to the rest of china
unless my second assumption that there is Herd Immunity in china that affected transmission rates
I don't believe in conspiracy theories and not trying to imply that , but just trying to explain things in a more logical way
03-22-2020, 03:31 PM
#169
Rennlist Member
I have used HCQ for 30 years in thousands of patient and I assure you that there is no ! % fatal toxicities ..... I am not advocating use of HCQ in this situation , but lets not trash HCQ because will harm a lot of patients that are on it and now they think that they are taking a dangerous drug
03-22-2020, 03:40 PM
#170
So we let people possibly die from Coronavirus pneumonia by not using a relatively non-toxic therapy, recording our results, while we wait for the trials to announce? If the trials were positive, and 10,000 people died because you waited 6 months for the trial to be done and complete, how would you feel?
Hoarding is stupid and wrong, as is taking these drugs without MD supervision, but there is nowhere near a 1% incidence of fatal toxic side effects from HCQ. HCQ is over the counter in much of the world, in pregnant women, and in children. We MDs would not be putting it COVID 19 pneumonia treatment guidelines with very precise doses and schedules (currently recommended in many US Academic medical centers and in at least 5-10 countries for COVID 19 pneumonia requiring oxygen) if we did not think the possible risk/benefit ratio was currently appropriate.
Not sure what your comments are trying to accomplish here?
Hoarding is stupid and wrong, as is taking these drugs without MD supervision, but there is nowhere near a 1% incidence of fatal toxic side effects from HCQ. HCQ is over the counter in much of the world, in pregnant women, and in children. We MDs would not be putting it COVID 19 pneumonia treatment guidelines with very precise doses and schedules (currently recommended in many US Academic medical centers and in at least 5-10 countries for COVID 19 pneumonia requiring oxygen) if we did not think the possible risk/benefit ratio was currently appropriate.
Not sure what your comments are trying to accomplish here?
people should not be hoping drugs will come to the rescue. Exponential growth means it’s vital to act now with urgency and an overwhelming response. Doctors and scientists around the world are working as fast as they can to determine if these drugs are effective and how to best utilize them. Thousands of experts are on it. And yes, they are skipping safety protocols to the extent that is effective. It’s not really relevant to you and what you can do.
you need to quarantine for weeks, at least, and demand your government test 1000x as many people. We need more masks, ventilators, medical equipment, ad hoc hospitals, and volunteers trained as nurses’ assistants. Tens of millions of people are in the process of becoming unemployed. 2M last week alone. The economy also needs urgent and overwhelming intervention. You should be telling your elected officials that.
South Korea is how you have hope. That’s what we need to do. The drugs are a distraction and a rounding error. They may ultimately save some lives, but it will be insignificant compared to the power of quarantine.
03-22-2020, 04:00 PM
#171
still not convinced that the Chinese government can control 55 million people to a great degree and I am sure there has been some travel within china before the war was declared I don't know how to explain this , but to me it is not adding up
even if you lock down apartment buildings with chains , what about the couple hundred people living within a building , how did they get food and other services , we are talking about 55 million people Also we are assuming that the rest of the country has zero carriers from Wuhan . All other countries affected at least initially were related to traveler from china.. so we have to assume that more infected people travelled from Wuhan to Italy as compared to Wuhan to the rest of china
unless my second assumption that there is Herd Immunity in china that affected transmission rates
I don't believe in conspiracy theories and not trying to imply that , but just trying to explain things in a more logical way
even if you lock down apartment buildings with chains , what about the couple hundred people living within a building , how did they get food and other services , we are talking about 55 million people Also we are assuming that the rest of the country has zero carriers from Wuhan . All other countries affected at least initially were related to traveler from china.. so we have to assume that more infected people travelled from Wuhan to Italy as compared to Wuhan to the rest of china
unless my second assumption that there is Herd Immunity in china that affected transmission rates
I don't believe in conspiracy theories and not trying to imply that , but just trying to explain things in a more logical way
there’s no herd immunity. Quarantines enforced by police are extremely effective. People went to the grocery store just like they do here. One person per household was authorized. China is a vast authoritarian regime and surveillance state, so tracking people wasn’t a big leap for them. Being in public without authorization was ... not good for you. The other regions absolutely got carriers from Wuhan. These outbreaks were small enough to be contained with contact tracing. China tested many more people than we have much more aggressively including creative approaches to triage people with CT scans. If you had fluid in your lungs from a scan, or you had a fever, you were presumed positive. Do not pass go.
China started this when they had 400 cases. The US had 400 cases by March 7th (official tests, probably 4000+ true but it’s the data we have). We still haven’t reacted appropriately. Tens of thousands of additional Americans are going to die because of our governments failure to act. Exponential growth is not to be ****ed with. But we’re still not taking it as seriously as it deserves.
03-22-2020, 04:07 PM
#172
RL Community Team
Rennlist Member
Rennlist Member
03-22-2020, 04:10 PM
#173
futilely attempting to explain why the FDA does NOT endorse this course of action. yet. There are many reasons why these drugs aren’t a great hope, even if their effectiveness is proven. even if these drugs work as well as the initial studies claim (dubious) they are not a cure and do not alter the strategic decision space in any way. So, yes, you don’t understand what you’re talking about, and maybe should consider that better informed experts aren’t evil criminals.
people should not be hoping drugs will come to the rescue. Exponential growth means it’s vital to act now with urgency and an overwhelming response. Doctors and scientists around the world are working as fast as they can to determine if these drugs are effective and how to best utilize them. Thousands of experts are on it. And yes, they are skipping safety protocols to the extent that is effective. It’s not really relevant to you and what you can do.
you need to quarantine for weeks, at least, and demand your government test 1000x as many people. We need more masks, ventilators, medical equipment, ad hoc hospitals, and volunteers trained as nurses’ assistants. Tens of millions of people are in the process of becoming unemployed. 2M last week alone. The economy also needs urgent and overwhelming intervention. You should be telling your elected officials that.
South Korea is how you have hope. That’s what we need to do. The drugs are a distraction and a rounding error. They may ultimately save some lives, but it will be insignificant compared to the power of quarantine.
people should not be hoping drugs will come to the rescue. Exponential growth means it’s vital to act now with urgency and an overwhelming response. Doctors and scientists around the world are working as fast as they can to determine if these drugs are effective and how to best utilize them. Thousands of experts are on it. And yes, they are skipping safety protocols to the extent that is effective. It’s not really relevant to you and what you can do.
you need to quarantine for weeks, at least, and demand your government test 1000x as many people. We need more masks, ventilators, medical equipment, ad hoc hospitals, and volunteers trained as nurses’ assistants. Tens of millions of people are in the process of becoming unemployed. 2M last week alone. The economy also needs urgent and overwhelming intervention. You should be telling your elected officials that.
South Korea is how you have hope. That’s what we need to do. The drugs are a distraction and a rounding error. They may ultimately save some lives, but it will be insignificant compared to the power of quarantine.
Nobody disputes the power of quarantine and testing. Nobody disputes the power of social distancing, no matter how inefficient it may be in the end. Nobody disputes the need for a $1-2 trillion dollar stimulus to prevent a prolonged depression or recession.
You never are prepared for the war you fight. Ever. You are almost always caught with your pants down. The only reason South Korea was more prepared this time is because they botched their SARS response in 2003, and their avian flu response in 2009. Of this there is no dispute. Our government is doing the best they can, and even if they had another 3-4 weeks lead time, it likely would not have made a difference in ramping up supply chains, which in this country were (and still are) entirely controlled by local and state governments. Nobody seriously prepares enough masks and ventilators for a 100 year event in advance. Nobody. Nobody prepares for widespread testing when all testing until two weeks ago was controlled by the CDC (rightfully so, since nobody was ready for a 100 year event).
We will do the best we can, and get through it. Starting a blame game in the middle of this is counterproductive. We all need to be in this together. Politics and blame need to take a back seat. As the late Kenny Rodgers said "they'll be time enough for counting, when the dealins' done."
In terms of HCQ and other antivirals: the models that I have seen suggest that if you can reduce the asymptomatic transmission rate, this epidemic can get under control. Social distance and strict quarantines are one way. Reducing viral load in asymptomatic carriers is another. They can be complementary. A drug that costs pennies to produce, is non-toxic, and possibly could be administered in endemic areas to block community transmission, or at least attenuate it a bit? That isn't hopeful? Even a bit? I wouldn't let my guard down because of it, but that is not hopeful?
Additionally, if we all knew that there was some treatment that could even a bit attenuate the disease for the group of us that were the most seriously affected, wouldn't that help quell some of the panic?
In terms of the FDA, let me say I know quite a bit about how it works and how it administers clinical trials. It is a lot slower than you think. I am in a position to know, and I'll leave it at that. A pragmatic trial, where we give it to people and record the results in persons with COVID 19 and mild to moderate symptoms (like needing supplemental oxygen) and compare it to contemporaneous untreated patients, is the way to go, and the way that is currently being pushed to the coronavirus task force.
This is the part of your comment that amuses me the most: "So, yes, you don’t understand what you’re talking about, and maybe should consider that better informed experts aren’t evil criminals."
How do you know who I even am?
We are all trying to do our part, at all levels of medicine, try to get as much accurate information to the public as we can, as soon as we can, to give people hope and something to look forward to. Will HCQ work? Who knows? It is wrong to hope? No.
I happened to get my 992 last week (as I described earlier in this thread) and I am taking the opportunity to spread as much informed discussion as I can. Is this is right venue? Who knows? Do we know for sure what is going to happen in the next few weeks? No. Will we get through it? Yes. Can we hope for a better outcome, while preparing for the worst? Yes.
I need to go for a ride in my 992...
03-22-2020, 04:31 PM
#174
Some restaurants and coffee shops have started skirting the ban by offering takeout but then mass seating outside/nearby.
03-22-2020, 04:36 PM
#175
Frankly i don’t give a damn about your political affiliation and find the politicizing of a pandemic despicable to the core.
Bloomberg? Seriously, now your accusing Trump of killing people in Nigeria brought to you by the news organization controlled by the guy who hates Trump and has committed hundreds of millions to attack him. You can’t be serious. At least have some intellectual integrity. I know Fox is a partisan news outlet but so are CNN and MSNBC and a good chunk of what unfortunately passes for journalism today,
And your 1% vs .09% is bogus and you should now it. No one ever suggested giving these drugs to those otherwise healthy adults with mild symptoms. Both drugs have been administered only to those patients who are suffering from severe symptoms and appear to be deteriorating toward death. Hope. Do you understand that concept? How many thousands of Italians died without even a chance for these drugs but you want to deny hope to hundreds of thousands because 2 Nigerians OD’d on chloroquine after self medicating.
“Gov. Andrew Cuomo announced Saturday that the U.S. Food and Drug Administration will send 10,000 doses of azithromycin and hydroxychloroquine to New York. Azithromycin is an antibiotic and hydroxychloroquine is used to treat malaria.
Cuomo spoke to President Donald Trump on Friday and expressed interest in conducting trials in New York.
"There is a theory that the drug treatment could be helpful," Cuomo said. "We have people who are in serious condition and (state Health Commissioner Dr. Howard Zucker) feels comfortable, as well as a number of other health professionals, that in a situation where a person is in dire circumstance, try what you can."
THANK YOU PRESIDENT TRUMP and GOVERNOR CUOMO for giving the people in NY stricken with COVID-19 a reason to be hopeful, And to those mean spirited partisan hacks who would throw cold water on a possible treatment and take away hope from human suffering for political gain, SHAME ON YOU!
Bloomberg? Seriously, now your accusing Trump of killing people in Nigeria brought to you by the news organization controlled by the guy who hates Trump and has committed hundreds of millions to attack him. You can’t be serious. At least have some intellectual integrity. I know Fox is a partisan news outlet but so are CNN and MSNBC and a good chunk of what unfortunately passes for journalism today,
And your 1% vs .09% is bogus and you should now it. No one ever suggested giving these drugs to those otherwise healthy adults with mild symptoms. Both drugs have been administered only to those patients who are suffering from severe symptoms and appear to be deteriorating toward death. Hope. Do you understand that concept? How many thousands of Italians died without even a chance for these drugs but you want to deny hope to hundreds of thousands because 2 Nigerians OD’d on chloroquine after self medicating.
“Gov. Andrew Cuomo announced Saturday that the U.S. Food and Drug Administration will send 10,000 doses of azithromycin and hydroxychloroquine to New York. Azithromycin is an antibiotic and hydroxychloroquine is used to treat malaria.
Cuomo spoke to President Donald Trump on Friday and expressed interest in conducting trials in New York.
"There is a theory that the drug treatment could be helpful," Cuomo said. "We have people who are in serious condition and (state Health Commissioner Dr. Howard Zucker) feels comfortable, as well as a number of other health professionals, that in a situation where a person is in dire circumstance, try what you can."
THANK YOU PRESIDENT TRUMP and GOVERNOR CUOMO for giving the people in NY stricken with COVID-19 a reason to be hopeful, And to those mean spirited partisan hacks who would throw cold water on a possible treatment and take away hope from human suffering for political gain, SHAME ON YOU!
this isn’t true in several ways. If the drug treatment has a 1% chance of fatal side effects, but in SK the disease mortality is 0.9% then you’ve just murdered more people than the disease would have killed. At the moment, nobody knows how these drugs will interact with each other, or effect patient recovery. The studies are incomplete. For many people these drugs are likely to be a waste of time and money. We’ve had this problem in past epidemics too. Rushing drug and vaccine treatments is a great way to kill people.
this is what false hope does to desperate people https://www.bloomberg.com/news/artic...p-praised-drug
randomly giving people random doses of drugs ad hoc isn’t science. The drugs have some promise, as a hypothesis, and with a high degree of uncertainty some hope they’ll become a useful treatment protocol soon.
I get a lot of people are scared, but false hopes distract from real solutions. The virus needs a lock down, and the economy needs a vast prop. This was obvious 3 weeks ago and every day we delay is thousands of more infections or worse.
this is what false hope does to desperate people https://www.bloomberg.com/news/artic...p-praised-drug
randomly giving people random doses of drugs ad hoc isn’t science. The drugs have some promise, as a hypothesis, and with a high degree of uncertainty some hope they’ll become a useful treatment protocol soon.
I get a lot of people are scared, but false hopes distract from real solutions. The virus needs a lock down, and the economy needs a vast prop. This was obvious 3 weeks ago and every day we delay is thousands of more infections or worse.
Last edited by Underblu; 03-22-2020 at 04:53 PM.
03-22-2020, 04:38 PM
#176
Instructor
Enjoy your ride..... & thanks for your time and efforts to keep those of us on this forum better informed (and in context) than FOX, CNN, NBC & the rest of the "screamers" on both sides of the political spectrum.
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03-22-2020, 05:08 PM
#177
this has some summarization and references
https://blogs.sciencemag.org/pipelin...cal-trial-data
none of these drugs are cures, and none of them are more effective than quarantine.
03-22-2020, 05:21 PM
#178
Many thanks to our medical professionals on this forum/thread for passionate and expert insight, as well as for what you do, you are our frontline defense/offense IMO.
I’m feel that I’m learning more, and better informed on a Porsche forum...who woulda thought?
Be well, and remain hopeful everyone.
I’m feel that I’m learning more, and better informed on a Porsche forum...who woulda thought?
Be well, and remain hopeful everyone.
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markanth (03-22-2020)
03-22-2020, 05:37 PM
#179
And your 1% vs .09% is bogus and you should now it. No one ever suggested giving these drugs to those otherwise healthy adults with mild symptoms. Both drugs have been administered only to those patients who are suffering from severe symptoms and appear to be deteriorating toward death. Hope. Do you understand that concept? How many thousands of Italians died without even a chance for these drugs but you want to deny hope to hundreds of thousands because 2 Nigerians OD’d on chloroquine after self medicating.
You propose to undertake random unproven actions to give people false hope, when there are many vastly more important actions to take. You propose to basically lie to dying people instead of preventing people from getting sick in the first place. This is not a good way to get people to make effective decisions. I haven’t proposed denying anyone these drugs. I have shared experts analysis, including the official FDA and CDC positions that what you propose in fear and ignorance is unwise. The world might make a little more sense if you honestly listened to more domain experts with an open mind.
A linear response to an exponential problem will fail. Italy’s government failed to act quickly enough, despite a month’s warning. As has America’s despite 3 months warning. NY will be worse than Italy soon, less than 2 weeks. For folks outside NY, now is the time to quarantine.
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hamerans (03-23-2020)
03-22-2020, 05:37 PM
#180
Rennlist Member
I was in China and returned end of January when we started hearing in higher volume about the virus. I have an office in China with 24 Taiwanese and Chinese employees in Dongguan.
When the lock down started the difference between China and here is dramatic. When the China government said "don't do this or that" the Chinese did as instructed. Here we still have people on the beach fondling each other and slathering each other with lotion. Not the same at all. Don't think the free will we have here is the same in China.
By doing complete lock downs they have contained the virus and are now opening restaurants in Dongguan with table distancing guidelines. Try that here.
When the lock down started the difference between China and here is dramatic. When the China government said "don't do this or that" the Chinese did as instructed. Here we still have people on the beach fondling each other and slathering each other with lotion. Not the same at all. Don't think the free will we have here is the same in China.
By doing complete lock downs they have contained the virus and are now opening restaurants in Dongguan with table distancing guidelines. Try that here.
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