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[#] Tue Nov 17 2020 14:30:33 EST from LoanShark

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on the best after-the-fact treatment; I don't think we've gotten *that*

much better at treating this.

n.b. no matter how much better we've gotten at treatment, that doesn't work if the hospitals are full.

[#] Tue Nov 17 2020 17:52:11 EST from Ragnar Danneskjold

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Depends on the treatment, doesn't it? Not every treatment is going to need an admission to the hospital.

Watch these numbers carefully over the coming weeks.

https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm

Deaths have been fairly flat, even with rising cases for a few months. It'll be interesting to see where this goes.

[#] Tue Nov 17 2020 19:48:35 EST from LoanShark

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Deaths have been flat in NYC because hospitalizations have been flat. I don't think anybody's getting significant outpatient treatment. So I view the case numbers as an artifact.

The numbers I'm watching are here:

https://projects.thecity.nyc/2020_03_covid-19-tracker/

Specifically, the bottom left graph (hospitalizations.) There's a date picker up top. Set it to say, Jun 1-present and you'll see we're getting back into a rapid exponential growth phase. For example, the number is 712 today, it was 545 on the 11th, and it got as low as about 250 in the middle of summer.

[#] Tue Nov 17 2020 19:54:00 EST from LoanShark

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Another issue you run into is that cases lag deaths by some amount of time, probably 2-4 weeks. So we're getting this rapid spike now that is not going to match up with deaths from Jun where cases where falling (the cases would have fallen FIRST-they're always leading.)

[#] Wed Nov 18 2020 08:26:59 EST from LoanShark

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IHME: "We have seen convincing evidence from hospital studies of individual patients and
population-level measurements, that the infection-fatality rate (IFR) has declined 30%
since April due to improved treatment."

All right. That's good news. Not good enough on its own, though.

[#] Wed Nov 18 2020 08:48:50 EST from ParanoidDelusions

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Tue Nov 17 2020 14:30:33 EST from LoanShark
on the best after-the-fact treatment; I don't think we've gotten *that*

much better at treating this.

n.b. no matter how much better we've gotten at treatment, that doesn't work if the hospitals are full.

If we get better at treatment, hospital capacity won't be an issue. Once we get it down to, "Stay at home, get plenty of rest and drink lots of liquids, take this twice a day, if conditions do not improve, call us - if it is an emergency, go to an ER..." then it is just "Cold season". And you don't lock down your economy over cold and flu season or live in fear and wear a mask everywhere you go because of that, right? 





[#] Wed Nov 18 2020 08:49:51 EST from ParanoidDelusions

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Wed Nov 18 2020 08:48:50 EST from ParanoidDelusions

 

Tue Nov 17 2020 14:30:33 EST from LoanShark
on the best after-the-fact treatment; I don't think we've gotten *that*

much better at treating this.

n.b. no matter how much better we've gotten at treatment, that doesn't work if the hospitals are full.

If we get better at treatment, hospital capacity won't be an issue. Once we get it down to, "Stay at home, get plenty of rest and drink lots of liquids, take this twice a day, if conditions do not improve, call us - if it is an emergency, go to an ER..." then it is just "Cold season". And you don't lock down your economy over cold and flu season or live in fear and wear a mask everywhere you go because of that, right? 





CovidX OTC - now available in gel-cap. You know it is the Rona, now treat it without an Rx! 

 



[#] Wed Nov 18 2020 09:24:43 EST from IGnatius T Foobar

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I'm not sure I'd go *that* far. Viruses can be very difficult to fight directly, which is why OTC products work on reducing the symptoms. If that weren't the case we would have exterminated rhinoviruses (the common cold) by now.

[#] Wed Nov 18 2020 09:30:50 EST from LoanShark

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That would be a good world to live in, but yeah.

Remdesivir is approved only for hospitalized patients, and the evidence for its effectiveness is marginal. We only know that it *might* work.
Dexamethasone is only for severe cases.

What does that leave us for outpatients? bamlanivimab was only approved last week. I'm not sure there's anything else.

[#] Wed Nov 18 2020 09:32:53 EST from LoanShark

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Bamlanivimab is only approved for those at high risk: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-monoclonal-antibody-treatment-covid-19

[#] Wed Nov 18 2020 14:15:39 EST from ParanoidDelusions

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Wed Nov 18 2020 08:49:51 EST from ParanoidDelusions

 

 


CovidX OTC - now available in gel-cap. You know it is the Rona, now treat it without an Rx! 

 



I think you guys missed my point. 

It isn't about hospital capacity, as much as it is about being able to effectively triage, diagnose, treat, and dismiss infected. 
The issue has always been ICU beds and respirators. That is what we feared when we talked about cases overwhelming healthcare. 

The flu is a potentially fatal and dangerous viral infection that we mostly treat with symptom management. Stay at home, get plenty of rest and fluids, and manage the symptoms with Tylenol and OTC drugs. 

I'm not afraid of getting Covid - as much as I am afraid of that we don't know how to effectively treat complications FROM Covid yet. 







[#] Wed Nov 18 2020 14:29:51 EST from LoanShark

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It isn't about hospital capacity, as much as it is about being able
to effectively triage, diagnose, treat, and dismiss infected. 
The issue has always been ICU beds and respirators. That is what we
feared when we talked about cases overwhelming healthcare. 

All of this is literally true, but you need to put it in context. Here in NYC, in March when I caught the disease, the city's 311 line and the healthcare systems were all quite explicit in what they said to me: YOU NEED TO STAY HOME, SIR, unless it is absolutely necessary for you to be hospitalized.

That left me in the difficult position of buying a pulse oximeter and tracking my own vital signs throgh a difficult and scary period where I could barely function, where BP was spiking to 170/110, and there were issues with tachycardia that on one occasion could only be controlled with albuterol. This would not be a situation where you want to be stuck with home care under normal circumstances. It would have been far better to have hospital staff to keep an eye on things. EMT's were put in the unusual position of telling people they had to stay home, and the hospitals were still nearly overwhelmed like happened in Italy.

Many people are going to be in the same boat this winter. El Paso and a few other areas are already there, from what I'm hearing. You're starting to see facilities filled to capacity, so they're airlifting patient elsewhere, and the return of the refrigerated morgue trucks.

[#] Wed Nov 18 2020 14:31:51 EST from LoanShark

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To recap, my mom's cousin was sent home with covid, and died suddenly at home.

[#] Wed Nov 18 2020 15:01:02 EST from ParanoidDelusions

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Wed Nov 18 2020 14:29:51 EST from LoanShark
All of this is literally true, but you need to put it in context. Here in NYC, in March when I caught the disease, the city's 311 line and the healthcare systems were all quite explicit in what they said to me: YOU NEED TO STAY HOME, SIR, unless it is absolutely necessary for you to be hospitalized.

That left me in the difficult position of buying a pulse oximeter and tracking my own vital signs throgh a difficult and scary period where I could barely function, where BP was spiking to 170/110, and there were issues with tachycardia that on one occasion could only be controlled with albuterol. This would not be a situation where you want to be stuck with home care under normal circumstances. It would have been far better to have hospital staff to keep an eye on things. EMT's were put in the unusual position of telling people they had to stay home, and the hospitals were still nearly overwhelmed like happened in Italy.

Many people are going to be in the same boat this winter. El Paso and a few other areas are already there, from what I'm hearing. You're starting to see facilities filled to capacity, so they're airlifting patient elsewhere, and the return of the refrigerated morgue trucks.

To recap, my mom's cousin was sent home with covid, and died suddenly at home.

So, I think the context here IS important. 

In MARCH, when you personally caught it, in *New York City* - it was a VERY difficult experience for you, at a far more frightening time in our understanding of the course of the disease. You also are personally connected to someone who died from the disease, or from complications from it or caused by it, in a similar circumstance to your own. 

My personal experience in Arizona has been far different. I know probably a dozen people who have caught it, including several family members, one of whom is clinically overweight and has pre-existing conditions. One guy, who is otherwise a healthy guy, ended up in ICU. Almost everyone else described it ranging from, "I lost my sense of smell and I was REALLY tired," to "It was like the worst cold ever." 


But that is why I'm less worried about CATCHING it than our ability to treat it. I hear and acknowledge stories like yours - but I understand that there is a political machine that finds a tremendous amount of political capital in making it as frightening as possible - and so I have a lot of skepticism about a lot of the "official narrative" about this virus. 

I think there is a seasonal spike going on. I think that we're seeing that viral loads are decreasing - and that may have to do with social isolation - but it may have to do with the life cycle of typical Corona Virus outbreaks, too. It is most likely a combination of both factors, in my opinion. I believe that with the decreased viral loads, while we're seeing an increase in confirmed cases (and this is also the result of better and more available testing) - we're seeing a DECREASE in the death rate. 

And I see a lot of irrational claims about the increasing cases and how we're going to deal with it that mostly come back to the division of a very divisive and partisan election that is currently still contested. 

Even if the Democrat leadership *knows* that Covid-19 won't be meaningfully reduced by Federal Mask Mandates and shutting down the economy - as long as 45 is in office and fighting the results, there is huge political incentive still in pushing the idea that Trump's response is making it worse and that if the Dems were in charge it would be better. 

If they win, and the spike isn't as deadly as they've claimed, they can go, "See, things got better as soon as we took the right actions!" 

The entire situation is terrible - because politics is making the information less trustworthy. 

I am sorry about your mom's cousin, and I'm sorry it was such a difficult illness for you, though. Mostly I am sorry that the election cycle made such a serious illness a political wedge issue exploited by both sides simply to try and win an election. 








[#] Wed Nov 18 2020 15:12:24 EST from LoanShark

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Hmm, yeah, not sure what you're talking about. If mask usages goes to 95%, you're talking >60,000 lives saved. There is no dispute that more people staying home reduces effective R--more lives saved in any given time frame. There is no dispute that we can get effctive R below 1.0 if we try, and if the seasonality cooperates--more lives saved. Everyone needs to be as careful as possible. Q.E.D.

[#] Wed Nov 18 2020 15:50:32 EST from LoanShark

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NYC public schools to close tomorrow.

Don't we owe our kids a little more consideration while we lounge around in indoor restaurants that are still open for some reason?

[#] Wed Nov 18 2020 17:07:13 EST from LoanShark

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Just found out this was a key demand of the teachers' union. In the event the citywide test-positivity rate goes above 3% (which it has), schools have to close.

So the union has the power to shut down schools, and only Cuomo has the power to shut down restaurants. It is what it is.

[#] Wed Nov 18 2020 18:31:54 EST from zooer

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I better get another hair cut, they will close the barber shops soon.



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