Americans cry out: Quarantine the most vulnerable and let the rest get back to work!

[musiclady]

Better to pay attention to the professionals in health care, infectious disease specialists, physicians, virologists, and ignore the “expertise” of the let-em-die crowd.

[libertybele]

All that’s being accomplished is reshaping the bell curve.

IF they manage to flatten that curve, then the number of cases will be contained as opposed to us turning into another Italy (and France and Spain are not far behind).

We have approximately 9 days till we will know if containment was successful.

Keep praying.

[libertybele]

Better to pay attention to the professionals in health care, infectious disease specialists, physicians, virologists, and ignore the “expertise” of the let-em-die crowd.

 

[roamer_1]

What?
It IS happening anyhow. How the heck does it get all the way up here in mere days?

So for all the shutting everything down, it ain't stopped a dang thing.

I know you think I am cold. I ain't. I have just dealt with this kind of thing with cows.
Either you immunize the whole herd, or you let it run through.
That's the options.

You can try to remove the sick ones, but it's too dang late. For every one you know, there's 10 coming on.

There ain't no magic medicine gonna come save the day, And we're gonna take it in the teeth one way or the other. All you're doing shutting down is taking options away.

This is a logistics problem. The health problem is happening one way or the other.
So focus on the logistics. That REQUIRES industry and distribution.
Shutting it off is exactly backwards.

[roamer_1]

Better to pay attention to the professionals in health care, infectious disease specialists, physicians, virologists, and ignore the “expertise” of the let-em-die crowd.

Let em die, my ass. 

[XenaLee]

That's right. And I've got my money where my mouth is. It's here. My mom and sis are sequestered, and my elder son and his wife are working at the hospital. I got skin in this game.

By the same token, IT'S HERE. In a matter of days it has stretched to TimbuckFour Montana.
All y'all ain't stopping a damn thing.

And in the mean time, folks that matter keep on goin. Strappin on their boots and heading out. Truckers, Linemen, Mechanics, County Workers, Road Crews, Farmers, Ranchers, soldiers, LEOs, Firemen... All them thankless bastards that walk out in it regardless.

All y'all are lucky there's a harder breed out there to keep your shit runnin the whole damn while.

Exactly.   Thank God for all of those unsung, unrecognized and unappreciated heroes that keep on keepin on.

 

[HoustonSam]

All that’s being accomplished is reshaping the bell curve.

In the absence of a vaccine, that's all that can be accomplished from a public health point of view.

The virus will be generally controlled when enough people are immune that it cannot spread more quickly than the health care system can respond to those who will need hospitalization.  People will become immune either through (a) vaccination or (b) contracting the virus and recovering from it.  Since (a) is not available, (b) is the only option.  The complication is to allow for (b) without overwhelming the health care system.

The hard reality is that large numbers of people will contract the virus, and in fact *must* contract the virus if it is to come under control; a minority proportion of those people, primarily elderly and those with previously-existing conditions that can weaken respiration, will become seriously ill even to death.  None of these people should be written off but some will be beyond saving.

The purpose of quarantining, i.e. "social distancing", is to allow the best chance for the health care system to provide care for all those who must be hospitalized.  While none of us want to contract the virus, it's false hope to think that quarantining is to prevent us from contracting it.  The purpose of quarantining is to prevent us from *all contracting it at once*.

Do we really have to shut down the entire economy to accomplish that?  I don't know.  In theory if we could perfectly, selectively quarantine only those who would require hospitalization then we could let every one else contract and recover from the virus while continuing with their normal lives.  I hope we will learn in a couple of weeks that we have over-corrected and can ease up on the degree of restriction we're now experiencing.

All of this is a temporary expedient until a vaccine is available, but for a vaccine to be proven, scaled up in production, and made broadly available worldwide (or even nationwide) will likely require months.  Therapeutic medicines will likely be available more quickly but will still take time, and when available will primarily support strategy (b) above.

[Free Vulcan]

As usual, while we need to take it seriously, the libs do what they always do: take advantage and never let a crisis go to waste.

[DB]

In the absence of a vaccine, that's all that can be accomplished from a public health point of view.

The virus will be generally controlled when enough people are immune that it cannot spread more quickly than the health care system can respond to those who will need hospitalization.  People will become immune either through (a) vaccination or (b) contracting the virus and recovering from it.  Since (a) is not available, (b) is the only option.  The complication is to allow for (b) without overwhelming the health care system.

The hard reality is that large numbers of people will contract the virus, and in fact *must* contract the virus if it is to come under control; a minority proportion of those people, primarily elderly and those with previously-existing conditions that can weaken respiration, will become seriously ill even to death.  None of these people should be written off but some will be beyond saving.

The purpose of quarantining, i.e. "social distancing", is to allow the best chance for the health care system to provide care for all those who must be hospitalized.  While none of us want to contract the virus, it's false hope to think that quarantining is to prevent us from contracting it.  The purpose of quarantining is to prevent us from *all contracting it at once*.

Do we really have to shut down the entire economy to accomplish that?  I don't know.  In theory if we could perfectly, selectively quarantine only those who would require hospitalization then we could let every one else contract and recover from the virus while continuing with their normal lives.  I hope we will learn in a couple of weeks that we have over-corrected and can ease up on the degree of restriction we're now experiencing.

All of this is a temporary expedient until a vaccine is available, but for a vaccine to be proven, scaled up in production, and made broadly available worldwide (or even nationwide) will likely require months.  Therapeutic medicines will likely be available more quickly but will still take time, and when available will primarily support strategy (b) above.

Well said. I would think the quarantine quanta could be in much larger increments than one's home. For example a small town that is near a large city could be left free to operate within that town as long as travel in and out of the town was controlled. If no one has the virus in the town it should stay that way for awhile but they can continue to operate and be productive. If someone in the town is infected they'll likely spread it but not to a group larger than the town and not more than the nearby city can handle.

Cities could be divided up into smaller quarantine sections where they could continue to operate near normal within each section.

[roamer_1]

The hard reality is that large numbers of people will contract the virus, and in fact *must* contract the virus if it is to come under control; a minority proportion of those people, primarily elderly and those with previously-existing conditions that can weaken respiration, will become seriously ill even to death.  None of these people should be written off but some will be beyond saving.

The purpose of quarantining, i.e. "social distancing", is to allow the best chance for the health care system to provide care for all those who must be hospitalized.  While none of us want to contract the virus, it's false hope to think that quarantining is to prevent us from contracting it.  The purpose of quarantining is to prevent us from *all contracting it at once*.

Do we really have to shut down the entire economy to accomplish that?  I don't know.  In theory if we could perfectly, selectively quarantine only those who would require hospitalization then we could let every one else contract and recover from the virus while continuing with their normal lives.  I hope we will learn in a couple of weeks that we have over-corrected and can ease up on the degree of restriction we're now experiencing.

That's right - HENCE, this is a logistics problem. More beds, more ventilators, more medicines, more workers. *ALL* of that requires industry and distribution.

Shutting it down is tying both hands behind our backs and creating a finite distribution pie.
That is DOOM.

[roamer_1]

All of this is a temporary expedient until a vaccine is available, but for a vaccine to be proven, scaled up in production, and made broadly available worldwide (or even nationwide) will likely require months.  Therapeutic medicines will likely be available more quickly but will still take time, and when available will primarily support strategy (b) above.

A vaccine is unlikely. It will be long burnt out before one can be fashioned and tested.

[Fishrrman]

Title and premise:
"Americans cry out: Quarantine the most vulnerable and let the rest get back to work!"

Once again, Fishrrman's credo:
Reality is what it is. It is not what we believe it to be.

The title's premise ain't gonna work.
Do that, and "the most vulnerable" will still end up "in contact with" the less-vulnerable anyway.

Kids come home to parents.
Parents contact their parents.

And... if the numbers out of New York are to be believed -- something like 40% or more of the new infections are in those UNDER age 40 or thereabouts.

With a spreading epidemic with something like 30% of the infected being "silent carriers" (or so I've read), there's simply no way to know who's dangerous and who is not.

On the railroad, we had something called "Rule 108":
"When in doubt, the safe course must be taken".

That was it, a lot was left open to interpretation.

But... when ANYONE could be dangerous to your health -- and when there's no way to ascertain who is dangerous and who is not -- the only "safe course" to be taken is to keep EVERYONE separated to the fullest extent possible.

Thus... "social distancing" (I would prefer "physical distancing" as the better term).

I don't think that two weeks is gonna be long enough to tell if such policies are working or not. That's only "one cycle" of infection, so to speak. It will probably take 3 or 4 cycles -- another six to eight weeks -- before we see if there is real progress in reversing the rates of new infections.

Also, I predict it's going to take about that long before doctors really can see if the anti-malarial drug is working across a wide-enough spectrum of different patients.

It "is what it is".
No vaccine (will you take one when it becomes available?).
No historically-proven treatments yet (although pathways are opening towards them).

No toilet paper, either...  (sigh)

[DB]

A vaccine is unlikely. It will be long burnt out before one can be fashioned and tested.

It wouldn't surprise me at all if China is "testing" one right now on the population.

[libertybele]

What?
It IS happening anyhow. How the heck does it get all the way up here in mere days?

So for all the shutting everything down, it ain't stopped a dang thing.

I know you think I am cold. I ain't. I have just dealt with this kind of thing with cows.
Either you immunize the whole herd, or you let it run through.
That's the options.

You can try to remove the sick ones, but it's too dang late. For every one you know, there's 10 coming on.

There ain't no magic medicine gonna come save the day, And we're gonna take it in the teeth one way or the other. All you're doing shutting down is taking options away.

This is a logistics problem. The health problem is happening one way or the other.
So focus on the logistics. That REQUIRES industry and distribution.
Shutting it off is exactly backwards.

Since the virus is now community spread, that person would have had to travel to another part of the country where the virus is present or someone visited the area from an infected area.  Though rare, it is not beyond the realm of possibility that the virus could have come in on a box delivered, fruit, vegetables, etc. and then the person touched their eyes, mouth or nose. 

I hear you about herd immunity but there is also something to be said for social distancing and doing a simple thing like washing your hands, washing produce and sanitizing items. The virus can live on surfaces for hours and some surfaces many days. 

They aren't trying to eradicate the virus by social distancing, they are trying to contain it so that fewer people become ill or die.  We'll know in just a short time, whether or not this is proves successful.

[libertybele]

Title and premise:
"Americans cry out: Quarantine the most vulnerable and let the rest get back to work!"

Once again, Fishrrman's credo:
Reality is what it is. It is not what we believe it to be.

The title's premise ain't gonna work.
Do that, and "the most vulnerable" will still end up "in contact with" the less-vulnerable anyway.

Kids come home to parents.
Parents contact their parents.

And... if the numbers out of New York are to be believed -- something like 40% or more of the new infections are in those UNDER age 40 or thereabouts.

With a spreading epidemic with something like 30% of the infected being "silent carriers" (or so I've read), there's simply no way to know who's dangerous and who is not.

On the railroad, we had something called "Rule 108":
"When in doubt, the safe course must be taken".

That was it, a lot was left open to interpretation.

But... when ANYONE could be dangerous to your health -- and when there's no way to ascertain who is dangerous and who is not -- the only "safe course" to be taken is to keep EVERYONE separated to the fullest extent possible.

Thus... "social distancing" (I would prefer "physical distancing" as the better term).

I don't think that two weeks is gonna be long enough to tell if such policies are working or not. That's only "one cycle" of infection, so to speak. It will probably take 3 or 4 cycles -- another six to eight weeks -- before we see if there is real progress in reversing the rates of new infections.

Also, I predict it's going to take about that long before doctors really can see if the anti-malarial drug is working across a wide-enough spectrum of different patients.

It "is what it is".
No vaccine (will you take one when it becomes available?).
No historically-proven treatments yet (although pathways are opening towards them).

No toilet paper, either...  (sigh)

Not everyone dies of the flu, even the most vulnerable during flu season.  I am hoping that the same will hold true with this virus, otherwise, all of us old farts over 60 with pre-existing conditions (and most of us do) are going to die.  Period.

[roamer_1]

Not everyone dies of the flu, even the most vulnerable during flu season.  I am hoping that the same will hold true with this virus, otherwise, all of us old farts over 60 with pre-existing conditions (and most of us do) are going to die.  Period.

NO, you likely will not. Sure you got a bigger target on your back, but even at that, 15% will die. That's a big number, but not as big as the 85% of elders (nearly all with preexisting conditions) that will live.

[Hoodat]

Better to pay attention to the professionals in health care, infectious disease specialists, physicians, virologists, and ignore the “expertise” of the let-em-die crowd.

Let-em-die crowd?  Seriously?  What health care professionals and infectious disease specialist told schools to close and businesses to shut their doors and lay off all their workers?  The only guidelines I have seen from such professionals are:

• If you're sick, stay at home.
• If you're kids are sick, keep them at home.
• If anyone in your household tests positive, everyone stay home.
• If you are over 65, stay at home.
• If you have an underlying medical condition, stay at home.
• Wash hands frequently for at least 20 seconds.
• Avoid touching your face.

[catfish1957]

Better to pay attention to the professionals in health care, infectious disease specialists, physicians, virologists, and ignore the “expertise” of the let-em-die crowd.

That is offensive, and unfounded   Wonder why the mods don't look at your posts?

[skeeter]

In the absence of a vaccine, that's all that can be accomplished from a public health point of view...
The purpose of quarantining is to prevent us from *all contracting it at once*...

Do we really have to shut down the entire economy to accomplish that?  I don't know.

Thank you for your response. This is the $1000 question.

When all is said and done I hope there will be an accurate way to total up the entire cost in dollars - and lives both saved and lost - of the route we've chosen this time.

[skeeter]

That's right - HENCE, this is a logistics problem. More beds, more ventilators, more medicines, more workers. *ALL* of that requires industry and distribution.

Shutting it down is tying both hands behind our backs and creating a finite distribution pie.
That is DOOM.

I realize its Monday morning quarterbacking, but I can't help but think about how much more easily this virus would've been dealt with  if Barry Obama had responded responsibly to the H1N1 outbreak twelve years ago.

[roamer_1]

I realize its Monday morning quarterbacking, but I can't help but think about how much more easily this virus would've been contained  if Barry Obama had responded responsibly to the H1N1 outbreak twelve years ago.

Shoulda Coulda Woulda... What matters is NOW. Navel gazing comes after.

And what matters now is logistics. Maybe shipping patients. Maybe shipping workers... arranging local quarantine facilities and outfitting them... Seat of the pants manufacturing of parts and assembly thereof... Kickin chem companies into gear making cleaning stuff, materials companies into providing masks gowns, and whatever...

All of that can be done - It's Jumpin Jack Flash, and a thousand critical paths all humming at once. States can't manage that... Industry does... State just needs to plow the way.

[HoustonSam]

When all is said and done I hope there will be an accurate way to total up the entire cost in dollars - and lives both saved and lost - of the route we've chosen this time.

I'm sure there will be estimates, but they will be heavily-laden with premises and assumptions, and consequently of limited inferential significance.

I would be more interested in understanding a way to estimate the necessary length of the restrictions we're now living under.  In theory that bell curve should get lower and broader; do we have a way to estimate what it *would have been* without these restrictions?  I'm not sure we have a good way to know what it is *with* the restrictions, since all we can measure against is those who have been tested; many will have (perhaps already do have) a case of the virus so mild it's indistinguishable from other routine maladies, and they'll never have it confirmed.  And when the restrictions are eased we might expect to see an increase in reported cases, as those who have been isolated and not exposed then become exposed.  Some kind of step-wise return to normalcy might be the way to handle that.

Much of the real kinetics have to come from the transmission rate, and that's where the basic practices of hand washing, surface cleaning, limited numbers of people in groups, and six-feet-apart will come into play, even when we can all go back to work.  And back to school might have to be a separate event.

[HoustonSam]

Kickin chem companies into gear making cleaning stuff

Speaking from one of those chem companies, let me tell you the regulatory burden for anything antimicrobial is huge, and for human or food contact, even "huge-er".  Not saying I disagree with your prescription @roamer_1, but on the chemical side it will take more than just ramping up production of specific products.  The feds keep our hands tied tight, so tight that most of us don't even think about selling anything that would be useful in solving this immediate problem.

Could those regulations be eased temporarily, in a "war time" measure?  Sure, and the current POTUS would be, in my opinion, more likely than most to endorse such an easing.  But I would expect it to get tied up in legal challenges for longer than the lifetime of this crisis.

What *will* be done is the chemical industry supply chain will favor raw materials and transportation to those companies who are already "spec-ed in" on the regulatory burden and manufacturing capacity to ramp up antimicrobials approved for this kind of human-contact use, because our other markets (like mine, the oilfield) have collapsed.

[DB]

I'm sure there will be estimates, but they will be heavily-laden with premises and assumptions, and consequently of limited inferential significance.

I would be more interested in understanding a way to estimate the necessary length of the restrictions we're now living under.  In theory that bell curve should get lower and broader; do we have a way to estimate what it *would have been* without these restrictions?  I'm not sure we have a good way to know what it is *with* the restrictions, since all we can measure against is those who have been tested; many will have (perhaps already do have) a case of the virus so mild it's indistinguishable from other routine maladies, and they'll never have it confirmed.  And when the restrictions are eased we might expect to see an increase in reported cases, as those who have been isolated and not exposed then become exposed.  Some kind of step-wise return to normalcy might be the way to handle that.

Much of the real kinetics have to come from the transmission rate, and that's where the basic practices of hand washing, surface cleaning, limited numbers of people in groups, and six-feet-apart will come into play, even when we can all go back to work.  And back to school might have to be a separate event.

The only meaningful feedback will probably come from states and countries that do things different and then analyzing the results after it is all over to know what worked, what didn't work and everything in between.

[roamer_1]

Speaking from one of those chem companies, let me tell you the regulatory burden for anything antimicrobial is huge, and for human or food contact, even "huge-er".  Not saying I disagree with your prescription @roamer_1, but on the chemical side it will take more than just ramping up production of specific products.  The feds keep our hands tied tight, so tight that most of us don't even think about selling anything that would be useful in solving this immediate problem.

Could those regulations be eased temporarily, in a "war time" measure?  Sure, and the current POTUS would be, in my opinion, more likely than most to endorse such an easing.  But I would expect it to get tied up in legal challenges for longer than the lifetime of this crisis.

What *will* be done is the chemical industry supply chain will favor raw materials and transportation to those companies who are already "spec-ed in" on the regulatory burden and manufacturing capacity to ramp up antimicrobials approved for this kind of human-contact use, because our other markets (like mine, the oilfield) have collapsed.

Yeah I get it @HoustonSam  ... But that is precisely what I mean about the feds plowing the road. Now ain't the time for red tape. Now is when to knock out the chocks.