Trump shifts, says distancing to go to April 30

[roamer_1]

For the 18,346th time.   This was never about the death rate... that’s just an also ran.  This is and has always been about overwhelming the healthcare system and preventing all the OTHER deaths that would result from that.

YES, in fact, it IS about the death rate. Whether, and how mortal it is, because THAT is what is driving the panic. And it IS panic.

Fact: this IS at least 2.5-3 times more transmissible than the seasonal flu.
Fact: (and this is the most important one given the transmissibility referenced above) unlike the seasonal flu, there is no vaccine, there is no cure.

So now, please.... all the naysayers follow me here:
If there is no cure, and there is no vaccine...AND it is much more transmissible than the seasonal flu...how does our healthcare system accommodate that?

Transmittable/contagiousness is only a factor in the light of lethality. The common cold - also a corona virus - is also highly transmittable... No one cares though, because as a rule, the common cold is not lethal. So lethality is still THE factor. And this virus is largely not lethal. Even the elderly and compromised TEND to recover. More so by far than not.

  Answer: without (here’s that phrase) flattening the curve, they absolutely CANNOT do so. Folks will be dying of otherwise very treatable maladies.

Again, not true - What you are saying is right - but what has caused the overwhelming of medical resources is PRECISELY the castle mentality caused by quarantine. Systems are overwhelmed BECAUSE folks are treating this as a health care issue and not a logistics issue. You are right - resources are overwhelmed, IN PLACES. That those places are cut off from replenishment is BECAUSE of the quarantine mentality.

Lockdown castle, circle-the-wagons thinking shut down the very pathways that assets and resources travel by.

Now roll in the fact that this has mutated at least once if not twice and who knows what the next one may bring. And roll in that it APPEARS to be at best 10x more fatal than the season flu...and you’ve got the very real potential for a real shitstorm.

Alright, but not really... Viral mutations tend more often than not (read: always) toward the more benign - The horribly viral and lethal tending to burn hot and die out, having destroyed their path forward by their very mortality. Usually, the virus that infects but does not kill tends to be the one that lasts long enough to reach contagion.

Mutation is to be encouraged and welcomed, as it will tend toward a lessening of lethal symptoms. That's what viruses do. The very thing that makes them 'new' and lethal, makes them short lived. They WILL morph, and that morphing is going to tend toward the benign.

Nothing I’ve said here is contested, I took the low figures across the board.  My sister is a nurse in Chicago...they are ALREADY on the brink of being overwhelmed.  They are virtually out of PPE, re-using some, and she has had one day off since this began.  And every sign they’re seeing is that it’s only in the beginning stages of spooling up.

Right. Because assets are not being managed. because logistics. It's logistics.
Ship nurses in from unaffected areas when the regulars get sick. six to ten days later the original regulars are well again, and immune. That means eventually, that human assets are hardened and reliable... you just have to get over that logistical hump.

It;s ALL about logistics. Stop letting doctors tell you how to handle supply and demand problems - They don't know how.

[Formerly Once-Ler]

Whn my grandfather was young in the 1890s, he was one of seven children. Three died of diptheria in a matter of days.

He headed West to Wyoming and Montana, where he was a real cowboy. He went as far away as Texas, to bring back horses for his employer, the William F. Cody Wild West Show.

In 1917 he registerec for the WWI draft from Green Grass County Montana, and later settled down and married near Cody WY.

Outbreaks like Diptheria killing so many people, later 1918 Spanish flu, gave way to the field of Public Health.

I was in elementary school when were were all innoculated for Polio. There was a kid on my grandparents' block already wearing braces.

Great story @truth_seeker 

When I was young boy I would wake in the morning and get dressed for school.  Before going downstairs for breakfast I would often wash my hands.  In those days we had a sink with two faucets.  When I turned one faucet hot water would come out, and when I turned the other faucet on cold water would come out.  I didn't like washing my hands in either cold or hot water, so I would combine the water in the base of the sink to make warm water.  I would always use soap to make my hands cleaner and by moving my wet hands over the surface of the soap I would create a bunch of wet and soapy bubbles on my hands I called lather.  after my hands were covered in soap lather, I would submerge my hands in the warm water in the bottom of the sink, and this would rinse the soapy lather off my hands.  After that it was simple task to dry my hands by patting them with a dry towel.

[truth_seeker]

Great story @truth_seeker 

When I was young boy I would wake in the morning and get dressed for school.  Before going downstairs for breakfast I would often wash my hands.  In those days we had a sink with two faucets.  When I turned one faucet hot water would come out, and when I turned the other faucet on cold water would come out.  I didn't like washing my hands in either cold or hot water, so I would combine the water in the base of the sink to make warm water.  I would always use soap to make my hands cleaner and by moving my wet hands over the surface of the soap I would create a bunch of wet and soapy bubbles on my hands I called lather.  after my hands were covered in soap lather, I would submerge my hands in the warm water in the bottom of the sink, and this would rinse the soapy lather off my hands.  After that it was simple task to dry my hands by patting them with a dry towel.

You are really putting your amazing sense of humor out there, for all to see.

[Formerly Once-Ler]

You are really putting your amazing sense of humor out there, for all to see.

I was actually making a point with my rambling.

[Axeslinger]

YES, in fact, it IS about the death rate. Whether, and how mortal it is, because THAT is what is driving the panic. And it IS panic.

Only with regards to the general public is panic an issue.  The healthcare system decisions are being based on my points I laid out before.  Panic and sound healthcare solvency decisions are not mutually exclusive

Transmittable/contagiousness is only a factor in the light of lethality. The common cold - also a corona virus - is also highly transmittable... No one cares though, because as a rule, the common cold is not lethal. So lethality is still THE factor. And this virus is largely not lethal. Even the elderly and compromised TEND to recover. More so by far than not.

While what you say is true, you are still ignoring the burden on the system.   From the CDC: “Among U.S. COVID-19 cases with known disposition, the proportion of persons who were hospitalized was 19%.  The proportion of persons with COVID-19 admitted to the intensive care unit (ICU) was 6%”
My friend THAT is not the common cold.  In a population where the transmission is accelerating up the bell curve like a bat outta hell, just these two points alone make this a potentially catastrophic situation. Period. Full stop.

Right. Because assets are not being managed. because logistics. It's logistics.
Ship nurses in from unaffected areas when the regulars get sick. six to ten days later the original regulars are well again, and immune. That means eventually, that human assets are hardened and reliable... you just have to get over that logistical hump.
Really?! And what happens to the patients in the area from which those assets are allocated?  This is not a situation where you can rob Peter to pay Paul. This “logistical” redistribution is exactly what people are talking about when they say the system will be overwhelmed. Pull masks from here, ventilators from there. Doctors from here, nurses from there.   And meanwhile little Johnny dies from an infection due to compound fracture in his leg.   And trucker Bill dies from burns over 30% of his body from that accident he was in. And grandma dies from an otherwise survivable heart attack.

@roamer_1

[jmyrlefuller]

I'll note here, though, that in states with high testing (such as New York), the hospitalization/ICU rates were somewhat lower. As of a few days ago (and I don't follow as closely as I did, for my own mental health) the hospitalization rate was closer to 12% and ICU rate 3%. Those numbers may have gone up since then.

Still higher than the flu but this is not "The Big One."

[massadvj]

I recognize that we are trying to avoid a short-term disastrous overload of the health care system.

My concern is that we have not properly evaluated the benefit of being able to adequately care for all of those who need care against the cost of ruining our economy.  Ruining the economy is going to have disastrous effects on the health care system and all other systems.  These costs may well pale in comparison to the short-term benefit of having enough ventilators.

As Trump pointed out, we make these trade-offs all the time. We don't shut down the interstate highway system because there are 1.25 million deaths from auto accidents every year.  We have made the calculation that having an interstate highway system is worth the cost of 1.25 million lives per year.  The same has been true of the flu.  We do not shut down our economy in flu season in spite of the fact that tens of thousands die each year from the flu.

What is the value of having an airline industry, a hotel industry, a restaurant industry?  If someone says "if it saves one life to lose all of these industries, it's worth it" I think that person needs to be flogged.  The calculation needs to be made, not in terms of dollars, but in terms of lives.  How many human lives are we willing to trade for having an airline industry?  The answer to that question is not zero.  It never has been.

A leader who is willing to make this calculation is not a profile in callousness, but a profile in courage.

I am not saying we should not have taken prudent measures.  I am saying we have not adequately anticipated the cost/benefit to all of this.  We may well be cutting off our right arm when we could have gotten by with losing a few fingers.

Remember that "flattening the curve" does not mean fewer people get the virus.  It means we are going to stretch the period over which people get the virus to a longer period of time. Paradoxically, the flatter the curve the more we intentionally inflict damage to the economy.

If we look like Venezuela a year or two from now, people are not going to feel better knowing a few thousand people had ventilators when they needed them.  The cost to us becoming Venezuela -- including in terms of the loss of human life -- will far surpass the loss of the lives from lack of ventilators.

I think Trump sees this clearly, but the political pressure is just too great.  He cannot buck the medical experts because every subsequent death will be blamed on him.  From a political standpoint, he is doing what he has to for survival.  But his instincts on this are right.

[Formerly Once-Ler]

As Trump pointed out, we make these trade-offs all the time. We don't shut down the interstate highway system because there are 1.25 million deaths from auto accidents every year.  We have made the calculation that having an interstate highway system is worth the cost of 1.25 million lives per year.  The same has been true of the flu.  We do not shut down our economy in flu season in spite of the fact that tens of thousands die each year from the flu.

What is the value of having an airline industry, a hotel industry, a restaurant industry?  If someone says "if it saves one life to lose all of these industries, it's worth it" I think that person needs to be flogged. 

My President, and still your President, did not shut down the cruise industry.  The boat loads of dead bodies did that.  It was the virus that shutdown the theaters, hotels, and restaurants.  President Trump was smart to get out in front of it and claim he was in control, but he is not.  The virus is.

[massadvj]

My President, and still your President, did not shut down the cruise industry.  The boat loads of dead bodies did that.  It was the virus that shutdown the theaters, hotels, and restaurants.  President Trump was smart to get out in front of it and claim he was in control, but he is not.  The virus is.

Agreed.  However, it is one thing for the market to decide not to patronize an industry, it is quite another for the government to require the market not to patronize an industry.

[Formerly Once-Ler]

Agreed.  However, it is one thing for the market to decide not to patronize an industry, it is quite another for the government to require the market not to patronize an industry.

The 15 day pause didn't mandate anyone stay home.  It merely recommended Americans do so to stay alive.  Best I know the new 30 day pause does the same.  Thank you for your response @massadvj

[Smokin Joe]

Monday — we can’t have the cure be worse than the disease.

Wednesday — I’d like to open the country up by Easter.

Sunday — Let’s have a Great Depression!

What do you even say to that?  It’d be funny as hell if the joke weren’t on us.

The part I'm just not seeing is where all those hourly employees now getting fewer than 32 hours a week lose their insurance--in the middle of a pandemic.

[Formerly Once-Ler]

The part I'm just not seeing is where all those hourly employees now getting fewer than 32 hours a week lose their insurance--in the middle of a pandemic.

Phase 4 of stimulus bill should address that, and if Obama could Executive Order parts of Obamacare maybe the President can reinstate those EOs...Of course we could also just let the President lead like they do in Hungry.

[txradioguy]

The part I'm just not seeing is where all those hourly employees now getting fewer than 32 hours a week lose their insurance--in the middle of a pandemic.

Yeah I'm not seeing that either.

On the plus side...my wife works at Amazon (part time) and they are giving away so much overtime right now her paycheck is gonna be nice. 

[musiclady]

Yeah I'm not seeing that either.

On the plus side...my wife works at Amazon (part time) and they are giving away so much overtime right now her paycheck is gonna be nice.

In Ohio, those whose hours are restricted because of the pandemic are NOT losing their insurance.

Other states should follow suit.

[Formerly Once-Ler]

https://twitter.com/realDonaldTrump/status/1245000074167541761

Donald J. Trump @realDonaldTrump

With interest rates for the United States being at ZERO, this is the time to do our decades long awaited Infrastructure Bill. It should be VERY BIG & BOLD, Two Trillion Dollars, and be focused solely on jobs and rebuilding the once great infrastructure of our Country! Phase 4
9:48 AM · Mar 31, 2020

[Cyber Liberty]

https://twitter.com/realDonaldTrump/status/1245000074167541761

I hereby dub Phase 4 as "the Works Progress Administration."

[Formerly Once-Ler]

I hereby dub Phase 4 as "the Works Progress Administration."

Oh ho!  A historian.

[roamer_1]

@Axeslinger

Only with regards to the general public is panic an issue.  The healthcare system decisions are being based on my points I laid out before.  Panic and sound healthcare solvency decisions are not mutually exclusive

No, the health care industry has a different kind of panic - frozen in the headlights. They see it coming, and as a body, refuse to act. They WILL get run over.

While what you say is true, you are still ignoring the burden on the system.   From the CDC: “Among U.S. COVID-19 cases with known disposition, the proportion of persons who were hospitalized was 19%.  The proportion of persons with COVID-19 admitted to the intensive care unit (ICU) was 6%”
My friend THAT is not the common cold.  In a population where the transmission is accelerating up the bell curve like a bat outta hell, just these two points alone make this a potentially catastrophic situation. Period. Full stop.

So do nothing? That's better? Just freeze everything and wait to get hit by the train?
Friggin ridiculous.

Really?! And what happens to the patients in the area from which those assets are allocated?  This is not a situation where you can rob Peter to pay Paul. This “logistical” redistribution is exactly what people are talking about when they say the system will be overwhelmed. Pull masks from here, ventilators from there. Doctors from here, nurses from there.   And meanwhile little Johnny dies from an infection due to compound fracture in his leg.   And trucker Bill dies from burns over 30% of his body from that accident he was in. And grandma dies from an otherwise survivable heart attack.

Oh bullcrap. There are VAST regions of this country that are as yet unaffected by this virus, and more yet where it is under control. If estimates are true, that will not last - two weeks from now, those areas will be taking it in the teeth, just like New York is now (I don't actually buy that, but for the sake of the argument...)

Every one of those areas can spare people and parts right now. They might need to put it all in overdrive to cover the absences, but they CAN do it.
Temporarily easing staffing issues.
Temporarily supplying hard and soft parts, relieving both deficits.
The hat trick is getting em back where they need to be JIT.

But it buys you three to six weeks - and if industry and supply are up and humming, there ain't a damn thing I can't get in three weeks.

And there are likewise benefits to the downstream locations that supplied earlier... Their people come back to them hardened, immune, and can hit the ground running, having standardized effective means and efficiencies, in real-world experience. And not just theirs, but a whole damn army of em, in the nick of time. The same for non-medical support. Whole crews of grips and roadies, used to setting up mash style ICU units, mobile hell-on-wheels supply chains, food systems, showers, crash pads, the whole 9 yards.

Put the damn show on the road and they WILL figure it out. Similar to what we do for forest fire fighters. Whole dang towns just show up all hauled in just in time, highly functional in support as needed, and torn down and disappeared as soon as they are done, moving to the next hotspot.

But no... better, ain't it, to let every one of those locations go through EXACTLY what is happening now, all over again, and again, and again... Everywhere the thing fires up, everybody green, working under theoretical protocols and with limited, fixed resources, sure to be inefficient, sure to be overloaded, with no help coming, and no supply chain because some dumass shut it all down. Yeah, sure... that's the ticket.

That's what castle thinking has already done. It's too late now to swing anything. Precious weeks have gone by, and the pipeline is already empty.

Stupidity at it's finest.