Airplane ownership CV19

[Shadrach]

39 minutes ago, bonal said:

All this talk about re opening being dependent on testing seems somewhat misleading. IMHO the only test that really matters is the antibody test. Unless they plan on doing a  daily test for people what good is that. Your given the green light to go to work after your test comes up negative what's to say you won't become infected that day and unless you get another test before your next day out you could be spreading the virus. We might as well just start wearing full hazmat gear if we wait for a proven vaccine the world economy is going to be beyond repair and please don't accuse me of thinking money is more important than health but the long term risk of poverty will be far worse than this stupid Chinese virus.some of you worry about our healthcare facilities being over loaded a real concern for the short term. But if we don't get people back to work and keep businesses open there isn't going to be any revenue to keep those hospitals and practices open they will be forced to close their doors permanently. State and local governments are now feeling great economic pressure because the revenue faucet has been turned off because there is very little commerce no business means no taxes.  Food supplies will begin to fail they already have. None of the political leaders are going to risk their careers by being accused of putting the economy above the possible risks associated with re opening. They are talkIng about not re opening schools even in the fall.  Our economy is the life blood of this country and if it dies there won't be any way to do anything for those that get sick. 

 

Antibody testing is not perfect but it’s a start. I think it’s best use in terms of “clear to work” is for those interacting with high risk communities. This virus does hit some younger people hard but the current data indicates that fatalities are  pretty rare for those under 60 without comorbidities. I would also guess the age correlation is more a proxy for fitness levels but I don’t know to what degree.

[bradp]

19 hours ago, bonal said:

By isolating the population all we have done is prolong the inevitable

The prolonging the inevitable is the only thing keeping your healthcare system from “culling” your wife / mother or grandmother during this health “correction”. 

[bradp]

13 hours ago, bradp said:

The prolonging the inevitable is the only thing keeping your healthcare system from “culling” your wife / mother or grandmother during this health “correction”. 

Sorry @bonal the prolonging the inevitable reply was confusing.  The only way you achieve herd immunity is through vaccination or natural infection with the caveats that the immunity must 1) protect the host from severe disease and 2) prevent or reduce transmission.   This is painted on a  background of mutation rates for the pathogen among a number of other variables.  When the pathogen mutates is can do so in small ways or big ways.  In fact the family tree for COVID is based on sequences and accumulating genetic changes to be able to track where the virus comes from.  These have been small changes (antigen drift).  The changes that allowed the virus to jump from intermediate host to human was presumably a big change (antigen shift). Antigen shifts are what cause pandemic influenza.  Antigen shifts are typically not good for us humans.  
 

We will get to herd immunity if the immune response is protective by Methods 1) and 2), above.  We will start over at square one if significant mutations occur in the virus and previous immune responses don’t confer protection to the latest version of the virus, or if neutralizing antibody and T memory responses don’t protect well enough to prevent clinical disease / transmission or last a sufficient duration (this is the fear coming from early Korean data indicating there are a certain percent of reinfection - the question is did they not clear and are still shedding or was there sampling or did they get re-infected with the same strain or a different strain of the virus). 
 

The social distancing and staying home / making social life not normal aspects are working.  The primary reason we’re doing this “prolonging the inevitable” is to buy your local health system time to process critical care patients and to avoid overwhelming the system.  About 80% of your local hospital administrator’s effort is going into planning for COVID right now.  The hospital is designed to run at 75-105% capacity outside the anomaly of a pandemic.  There are still all those patients with heart attacks strokes and cancer that need to be taken care of.   Currently, as @DXB can probably attest to, hospitals are trying to figure out how safely to do all the “elective” procedures that were deferred for a while, but still need to be done, as they are necessary.  COVID impacts the overall health system and every other patient who needs care.  Overwhelmed system = impact on our loved ones ability to receive care if needed up to and including denial or withdrawal of care.  Nobody wants to go there.  None of my colleagues want to be in the situation to deny or withdraw care where it would otherwise be warranted.   
 

The virus isn’t going to go away - it’s a new reality for us in healthcare, and as a population.  It’s a look back to what medicine was pre antimicrobial / public health and vaccination era.  Pre-COVID it was a rarity to have patients on airborne precautions or to use full PPE for procedures.  A lot of the need for PPE will continue - it will be be akin to having a sprinkling of smallpox or measles in the hospital at all times.  
 

If we went ahead and got this over with, the reality is that COVID care needs would outstrip capacity and we’d be in a shortage for critical care beds,  ventilators, staff etc.   The worst situations in New York, Detroit etc would migrate to suburban and the rural centers.   Rural health capacity is dire at baseline.  Local hospitals have been closing and consolidating across the midwest for years.   There are places that don’t have emergency room physicians / NPs or PAs- only telemedicine coaches.  
 

If we got it over with, we’d be in a situation where we would be caring poorly for everyone.  So far, on a national scale, the critical care bed shortage prospect has been managed because the social distancing tools actually work.  Right now that’s our most effective tool.  I hope that additional tools come online in the near future. 
 

Now the tactic by which you achieve this social distancing strategy can variable and may be best tailored to local circumstances; however the strategy must stay the same and not be less, and preferentially more, effective than it currently is.   I‘m pretty sure someone going to try to combine Murphy’s law, a natural version of a crossover trial, and Koch’s postulate this summer. 

My credentials - 

PhD Molecular Immunology 

MD Pediatric Critical Care Medicine 

[DXB]

2 hours ago, bradp said:

 We will start over at square one if significant mutations occur in the virus and previous immune responses don’t confer protection to the latest version of the virus, or if neutralizing antibody and T memory responses don’t protect well enough to prevent clinical disease / transmission or last a sufficient duration (this is the fear coming from early Korean data indicating there are a certain percent of reinfection - the question is did they not clear and are still shedding or was there sampling or did they get re-infected with the same strain or a different strain of the virus). 

...If we went ahead and got this over with, the reality is that COVID care needs would outstrip capacity and we’d be in a shortage for critical care beds,  ventilators, staff etc.   The worst situations in New York, Detroit etc would migrate to suburban and the rural centers.   Rural health capacity is dire at baseline.  Local hospitals have been closing and consolidating across the midwest for years.   There are places that don’t have emergency room physicians / NPs or PAs- only telemedicine coaches.  

Some related comments on viral mutations, mechanisms of immunity, and  hospital capacity:

-  There is antigenic drift seen here as with any rapidly replicating pathogen, but really not that much in relative terms (e.g. the early days of HIV).  This virus has found a rare adaptive niche in humans in a manner that occurs only every 100 years - i.e. very high transmissibility combined with fairly high pathogenicity.  I suspect this virus won't have much ability to change and still maintain that rare combination of features. Certainly mutations allowing antigenic escape will happen as more of the population gets exposed and/or we widely apply an effective vaccine. But I suspect such changes will also knock this virus out of that special ecological niche.  Mutations hurting transmissibilty will be strongly selected against of course.  So I suspect any such changes will sustain transmission but attenuate pathogenicity, which may prove tantamount to the virus going away.

- The mechanism of protective immunity is not a trivial question, particularly as we roll out all these serologic tests and try to develop a vaccine - the test may directly measure the antibody protective mechanism, strongly correlate with a cell-mediated protective mechanism, or unfortunately correlate poorly with effective T memory.  We're all kinda hoping humoral immunity works here, but really I don't know enough about coronavirus immune responses to say. I don't think the killed whole virus and recombinant spike protein approaches to SARS-CovV were all that effective, which is a little ominous. Maybe the fancy liposomal DNA and RNA-based vaccine techologies will fare better here, but they don't have a proven track record of efficacy.  I worry we will need a very strong driver of cell mediated immunity like the recombinant live VSV-based Ebola vaccine, which worked quite well but had a side effect profile that would make application to the entire population challenging.   I'd love to hear more from vaccine experts on this.

-The flip side of protecting hospitals from being overwhelmed is providing the pressure to expand capacity under a deluge of patients while government steps up to bat to support that effort.  Presently we have tried to expand capacity for COVID19 patients at great cost to normal hospital operations, and  much of that capacity around the country now sits unused. Under these conditions, hospitals are hemmorhaging money, and many patients can't get elective care or choose to delay addressing urgent problems so they don't have to go near a coronavirus-infested hospital.  Unfortunately getting past this unsustainable situation, particularly if a good vaccine is likely to be hard, may be to open the floodgates on transmission more than makes us comfortable. Only then will we see our true ability to handle the deluge, and we will have an economic engine in the country still functioning to help us do it, unlike what we have now.  Remember we are the country that expanded its military from 500k to 12 million in the years following Pearl Harbor out of dire necessity - that would have seemed impossible before that. We can do something similar for ICU care. The care quality may not be on par with that in the MICU at MGH, but it doesn't need to be.  We are saving less than half of ICU admits with this disease at present anyway, and most of that survival can be preserved under the kind of pressure that drives resourcefulness. And the volume of clinical experience will also settle a lot of the questions presently on how to care for these patients (e.g. should it truly be managed like ARDS in some cases) and ultimately improve outcomes. 

 

 

[Shadrach]

18 hours ago, bonal said:

All this talk about re opening being dependent on testing seems somewhat misleading. IMHO the only test that really matters is the antibody test. Unless they plan on doing a  daily test for people what good is that. Your given the green light to go to work after your test comes up negative what's to say you won't become infected that day and unless you get another test before your next day out you could be spreading the virus. We might as well just start wearing full hazmat gear if we wait for a proven vaccine the world economy is going to be beyond repair and please don't accuse me of thinking money is more important than health but the long term risk of poverty will be far worse than this stupid Chinese virus.some of you worry about our healthcare facilities being over loaded a real concern for the short term. But if we don't get people back to work and keep businesses open there isn't going to be any revenue to keep those hospitals and practices open they will be forced to close their doors permanently. State and local governments are now feeling great economic pressure because the revenue faucet has been turned off because there is very little commerce no business means no taxes.  Food supplies will begin to fail they already have. None of the political leaders are going to risk their careers by being accused of putting the economy above the possible risks associated with re opening. They are talkIng about not re opening schools even in the fall.  Our economy is the life blood of this country and if it dies there won't be any way to do anything for those that get sick. 

 

Statistically, I think your chances of being killed by a car while crossing  the street are still far higher then death by COVID. Perhaps add a helmet and chest protector to your HAZMAT suite just to be on the safe side...

[aviatoreb]

21 minutes ago, Shadrach said:

Statistically, I think your chances of being killed by a car while crossing  the street are still far higher then death by COVID. Perhaps add a helmet and chest protector to your HAZMAT suite just to be on the safe side...

That is not correct.  Covid-19 is now the leading cause of death in the usa, on a weekly basis.  In hot spots, it is the leading cause by a wide margin.  If you have counter point data I would love to see.

https://nymag.com/intelligencer/2020/04/the-rapid-increase-of-u-s-coronavirus-deaths-in-one-graphic.html

[DXB]

Here's a  "fun" visualization of the dynamics of COVID19 mortality increases through mid April. Of course the comparison categories for mortality shown are historical averages, not real time data, but it's certainly one useful window into understanding the virus' impact.

.https://public.flourish.studio/visualisation/1712761/?fbclid=IwAR05Gqc3d2F9kd2qdcqv25hVZJI0lnU0LsPcqMRm-jPsiJwpSnJq7kWgRCk

At the risk of sounding callous, it's not the only relevant way to look at mortality here. Another one might be life expectancy years lost from a disease. By this metric,  the accidents and overdoses etc. might still dominate given the strong bias of COVID19 mortality toward older people with medical comorbidities.

[larryb]

5 hours ago, bradp said:

The virus isn’t going to go away - it’s a new reality for us in healthcare, and as a population.  It’s a look back to what medicine was pre antimicrobial / public health and vaccination era. 

My credentials - 

PhD Molecular Immunology 

MD Pediatric Critical Care Medicine 

Brad:

How and when do you predict this is all going to end? Are we all going to get it eventually, just a matter of time? Locked in our house for a year or two? Miracle treatment available this summer?

[Shadrach]

42 minutes ago, aviatoreb said:

That is not correct.  Covid-19 is now the leading cause of death in the usa, on a weekly basis.  In hot spots, it is the leading cause by a wide margin.  If you have counter point data I would love to see.

https://nymag.com/intelligencer/2020/04/the-rapid-increase-of-u-s-coronavirus-deaths-in-one-graphic.html

You've taken a 6 day sliver of mortality data for folks of all ages, regions and various comoridities and are using that to draw conclusions about bonal's chances of contracting and dying from COVID19.  In order to refute your claim with data, I'd have to find a study with a premise as flawed as the one you've put forth.  So I think it's an impossible task.   To be clear my post was tongue and cheek.  Back to your regularly scheduled falling sky...

[GDGR]

Look no further than my home province to see what Social Distancing will do. Calgary, a population of 1.3 Million has 71% of the cases in a province of 4.4M. Why? Primarily because of this:

https://www.cbc.ca/news/canada/calgary/cargill-meat-plant-closed-outbreak-covid-19-1.5538824

Here's a meat packing plant, that primarily has immigrants working there. The majority live in Calgary, and car pool the 40 minute drive to work daily. And when I say "car pool", I mean they stuff 12 bodies into a minivan, and hit Hwy 2 south. I've seen it. I know it for fact. 

Take ONE person in a van having COVID-19. That now means There's 12 potential people infected by the time they hit the plant. They disperse, and say they contact 5 people during the day. 3 were lucky and managed to avoid an infection. 2 weren't. That 12 now becomes 36. Half of them carpool back home with an average of 5 per vehicle (and no, that's not an exaggeration). 45 minutes in close quarters, you have potentially upwards of 180 carriers, now going home to kiss their loved ones, go grocery shopping and spread. 

Doesn't take much. I'm quite glad I live in Central Alberta now, where we've had 33 cases in the city, and only have 2 active. The county around me only has 1 active case. Feeling like I'm in a bubble, and enjoy flying over it knowing I'm safe. 

 

[Shadrach]

Just now, GLJA said:

Look no further than my home province to see what Social Distancing will do. Calgary, a population of 1.3 Million has 71% of the cases in a province of 4.4M. Why? Primarily because of this:

https://www.cbc.ca/news/canada/calgary/cargill-meat-plant-closed-outbreak-covid-19-1.5538824

Here's a meat packing plant, that primarily has immigrants working there. The majority live in Calgary, and car pool the 40 minute drive to work daily. And when I say "car pool", I mean they stuff 12 bodies into a minivan, and hit Hwy 2 south. I've seen it. I know it for fact. 

Take ONE person in a van having COVID-19. That now means There's 12 people infected by the time they hit the plant. The disperse, and say they contact 5 people during the day. 3 were lucky and managed to avoid an infection. 2 weren't. That 12 now becomes 36. Half of them carpool back home with an average of 5 per vehicle (and no, that's not an exaggeration). 45 minutes in close quarters, you have potentially upwards of 180 carriers, now going home to kiss their loved ones, go grocery shopping and spread. 

Doesn't take much. I'm quite glad I live in Central Alberta now, where we've had 33 cases in the city, and only have 2 active. The county around me only has 1 active case. Feeling like I'm in a bubble, and enjoy flying over it knowing I'm safe. 

 

Indeed there also seems to also be a strong correlation in areas where mass transit is the primary means of conveyance .

[GDGR]

Another description of exponential growth, by my Caltech  PhD Sister and Brother in Law:

I think as humans it’s hard to get our heads around the concept of exponential growth. Just a few days ago the total number of COVID-19 deaths in the US was around 3,000 (terrible, for sure, but not devastating) and the projections were for 100,000 to 240,000 (whoa!). How do we get there? The sad answer is – it’s easier than you think.

Chris is a high school chemistry teacher, and I love this joke he used with his classes in April. He’d tell them, “Hey, we’re getting close to the end of the school year, and I know you all want an A+. I’m a practical guy and not above bribes (they don’t pay teachers much!) So here’s the deal… I will give you an A+ in Chemistry if you just do this: Bring me a penny on April 1. Then every day for the month, you just double it – so you owe me 2 cents on April 2, etc. If you hold up your end of the bargain for the 30 days of April, I promise I’ll keep up my side of the deal.” The kids laugh and the enterprising ones get excited for a little bit, but then they do the math…

After two weeks – halfway through the month – you’ve had to pay a cumulative total of just under $164. Say, that’s a pretty good deal for a great grade! Things are looking awesome!! But then it all falls apart. One week later you’ve paid $21,000, and by the end of the month you’re at nearly $11 million. (!!!) [Suffice it to say no student ever took Dr. Dartt up on his offer or we would have retired long ago.]

We’re at the same point in the Coronavirus journey. Early on it was tens of cases, and then hundreds. It’s now about 5,300 deaths in the US. If you’re one of those people who thinks, “Yes, that’s bad for those people, but over the entire US population that’s not a terrible number” you need to prepare for the exponential math that’s coming.

This is the data on COVID deaths by country [from here if you want to track: 91-divoc.com/pages/covid-visualization]. The US remains on a straightline path on a log scale – that means it’s still exponential growth. ☹ Until that curve bends SIGNIFICANTLY flatter we need to prepare to be overwhelmed.

Don’t be lulled into a false sense of security if there are few cases around you. Things always look like this in the early days. Be smart. Stay safe. Stay home. #staythefuckhome

[aviatoreb]

19 minutes ago, Shadrach said:

You've taken a 6 day sliver of mortality data for folks of all ages, regions and various comoridities and are using that to draw conclusions about bonal's chances of contracting and dying from COVID19.  In order to refute your claim with data, I'd have to find a study with a premise as flawed as the one you've put forth.  So I think it's an impossible task.   To be clear my post was tongue and cheek.  Back to your regularly scheduled falling sky...

Please explain how to do it in a more relevant manner?  It is an epidemic, so it is not a stationary process.  It is growing until peak and then it will decrease.  So to compare the tongue and cheek idea it is more dangerous to cross the street as you said, I posted data and you say it was both wrong the data and that anyway it doesn't matter because it was for fun.  Fun in the, nothing to see here folks, move along joke.  Fun like a mass grave on heart island, or a row of refrigerator trucks filled with bodies in front of a hospital.  Yeah noticing that people are dying is just falling sky hoax theories.  People who's names I know.  People whom I have met and had conversations with.  Too bad I will never see them again to tell them their death was just an over anxious "falling sky" hoax.

In any case, in New York City, there is an 11 times greater chance of dying by Covid 19 last week than by the next leading cause of death, heart disease from historical data for a typical week in previous recent years.  And for crossing the street, I do not have that data, but the data posted there says there is a 93 times greater chance of dying by covid 19 than all accidents together including crossing the street.

 

Edited April 21, 2020 by aviatoreb

[PT20J]

I really appreciate the knowledge shared by @DXB and @bradp. Opinions are often interesting, but I think the best posts on MS -- on any topic -- are always the ones where someone knows what they are talking about. Thanks.

Skip

[bradp]

38 minutes ago, larryb said:

Brad:

How and when do you predict this is all going to end? Are we all going to get it eventually, just a matter of time? Locked in our house for a year or two? Miracle treatment available this summer?

Practically speaking we can’t stay hermited out for the next year. It seems like the most practical way to get the economy back and running is the same that we are trying to do in hospitals. I am not an epidemiologist but I have more than lay expertise.  

Test / trace / contain aggressively.  
 

Highly accurate and rapid testing is so important.  The magnitude needs to be log folds higher than the current.  The most important part of our PPE conservation measures in the hospital have been due to rapid testing coming online.  The plan for reopening for elective surgery preliminarily hinges on the ability to perform rapid testing. You want to Fly emirates to Dubai tomorrow? You can but you’ll get a rapid IgM blood test prior to boarding. If humoral immunity is protective antibody testing on a massive scale would allow reentry into the economy/workforce.  
 

Contact tracing.  MA is trying to roll it out on a statewide level.  There is an old fashioned and a technology driven method of contact tracing. The old fashioned is to have a team interview by phone and determine the web of people you might have come in contact with (if you remember), and then recommends self isolation for that node, continues along that path ad Infinitum.  I’m not advocating for this yet, but we need to have a fast and adult conversation about methods to (anonymously?) leverage technology to do contact tracing in real time.  Usually I’d be throwing up in my mouth typing something like that, but we are at a juncture where we need to figure out how to move forward without doing something stupid that will set us back to the current economic blight, potentially repeatedly.   
 

Common sense measures.  You can go out and do your business and support your local economy but you must be in a mask at all times in public, have hand washing/sanitizer availability.  Essential and non essential workers must wear basic PPE provided by the employer.  The large congregations of people will likely have to be minimized for the foreseeable future.   Mandatory PPE for an entire economy seems impossible right now.  We will need WWII era manufacturing to be able to keep up.  It’s not impossible, although it seems that way in the current political climate. 

Containment is key. Once someone is identified as either having the virus or having been exposed to a person with the virus - an enforceable quarantine period of approximately 14 days would be appropriate.  Right now there is “recommended self isolation”.  It doesn’t go far enough and relies on altruism to work.  It also ignores the intense pressure people will face needing to go to work even if exposed or sick.  Many SE Asian countries are essentially placing quarantined people (including newly arrived travelers) under a house arrest like scenario with GPS wrist band tracking.  To be able to truly quarantine under the strict definition, you need to be able to provide social services / basic necessities to that individual for that time.  In America we don’t have the breadth or depth of social safety nets to be able to effectively carry out a quarantine of that magnitude.  The large employer carve out for mandatory sick leave for low page wage workers is a bit of a joke- they are still working and showing up to work sick.  I was checking out of the grocery store line and the cashier was clearly ill / sneezing.  I’m betting she didn’t have paid leave to use.  I’d be very interested to learn about the laws that are or are not on the books for quarantine enforceability - cholera / typhoid / TB and more recently Ebola are diseases that have had mandatory enforcement of quarantine carried out previously.  
 

Wash, rinse, repeat until we 1) understand whether natural immunity is protective and 2) have an effective vaccination strategy.  I’m not  holding my breath that we’ll have an antiviral medication that will change the public health strategy significantly. 

[Shadrach]

Just now, aviatoreb said:

Please explain how to do it in a more relevant manner?  It is an epidemic, so it is not a stationary process.  It is growing until peak and then it will decrease.  So to compare the tongue and cheek idea it is more dangerous to cross the street as you said, I posted data and you say it was both wrong the data and that anyway it doesn't matter because it was for fun.  Fun in the, nothing to see here folks, move along joke.  Fun like a mass grave on heart island, or a row of refrigerator trucks filled with bodies in front of a hospital.  Yeah noticing that people are dying is just falling sky hoax theories.  People who's names I know.  People whom I have met and had conversations with.  Too bad I will never see them again to tell them their death was just an over anxious falling sky hoax.

In any case, in New York City, there is an 11 times greater chance of dying by Covid 19 last week than by the next leading cause of death, heart disease from historical data for a typical week in previous recent years.  And for crossing the street, I do not have that data, but the data posted there says there is a 93 times greater chance of dying by covid 19 than all accidents together including crossing the street.

 

Are you quite done projecting things on to me that I did not say?  There was no malice in my post. I am not calling anything a hoax. Feel free to attribute whatever you wish. I am sorry if I've offended you.  Your statistical reasoning is as flawed.  It would be equally flawed to have taken the number of deaths between March 10th and March 16th and suggest your chances of contracting and dying from COVID19 were essentially zero. 

[AH-1 Cobra Pilot]

35 minutes ago, GLJA said:

Look no further than my home province to see what Social Distancing will do. Calgary, a population of 1.3 Million has 71% of the cases in a province of 4.4M. Why? Primarily because of this:

https://www.cbc.ca/news/canada/calgary/cargill-meat-plant-closed-outbreak-covid-19-1.5538824

Here's a meat packing plant, that primarily has immigrants working there. The majority live in Calgary, and car pool the 40 minute drive to work daily. And when I say "car pool", I mean they stuff 12 bodies into a minivan, and hit Hwy 2 south. I've seen it. I know it for fact. 

 

If it were not for the meat packing plants, Nebraska and South Dakota would have a minuscule number of cases.

https://www.omaha.com/news/state_and_regional/grand-islands-rate-of-covid-19-cases-is-higher-than-michigans-close-to-louisianas/article_0748b81b-471c-55b2-bec1-542d6558001f.html

[aviatoreb]

21 minutes ago, Shadrach said:

Are you quite done projecting things on to me that I did not say?  There was no malice in my post. I am not calling anything a hoax. Feel free to attribute whatever you wish. I am sorry if I've offended you.  Your statistical reasoning is as flawed.  It would be equally flawed to have taken the number of deaths between March 10th and March 16th and suggest your chances of contracting and dying from COVID19 were essentially zero. 

I understand you think you are not saying things you are saying, but ..your so described joke when I asserted data. Then referred to my post as sky is falling.  You are saying what you may think you not saying.  But I appreciate very much you do not intend to.

You asserted that "Statistically, I think your chances of being killed by a car while crossing  the street are still far higher then death by COVID. " I asserted no statistics but I did assert data.  Please explain further how to more correctly to interpret data, which counts 93 times as many people died by covid 19 last week than by accidents the previous year as not relevant, since you say I incorrectly incorporated data.  Please explain how to use that data instead so I can advise my friends in New York City what is really happening.  Note that is not a statistical analysis.  It is raw data.  Your "Statistically, I think " assertion on the other hand is not statistics - its pontificating.  So if you pontificate and someone posts numbers and then you assert the sky is not falling as your defense then accuse projecting, don't be surprised if there is a reaction.

 

Edited April 21, 2020 by aviatoreb

[Marauder]

[DXB]

7 minutes ago, Marauder said:

if she gets sick, her chances are not good - obesity is a major risk factor for mortality.  So keep your social distance Chris - you don't want that "weighing" on your conscience 

[bonal]

We hopped in our Mooney with our pup and made an essential flight today to pick up some doggie supplies at pet smart. Had to cross the street twice and didn't die. Thank God. Even though the air was a bit rough it was great to be out social distancing at 160mph.

[Ross Taylor]

I'd feel better about this situation and our potential to come together, in a positive spirit, to fight a common foe...and about the information we're getting...if there weren't such strong motivations to take advantage of the situation for political/social/environmental/power/economic reasons.   

Note - my comment about motivations does not apply to anyone here nor to any of the prior posts.  There's some great information, good input, and healthy discussion going on here.  My concerns lie elsewhere.

And, @Marauder , I've been a supporting member here for a bit over a year and I've seen numerous text references to your "friends"... and now I understand.  

[bonal]

6 hours ago, PT20J said:

I really appreciate the knowledge shared by @DXB and @bradp. Opinions are often interesting, but I think the best posts on MS -- on any topic -- are always the ones where someone knows what they are talking about. Thanks.

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I enjoy reading informed opinions as much as the next and there are a number of studies that don't agree with the models we have based all the doom and gloom on and they are being provided by people that are equally informed with outstanding credentials as well. Obviously I'm not a scientist nor am I a doctor of any kind. But I am an American citizen and know when my constitutional rights are under attack I don't like what's going on not one stinking bit. We are making a huge reaction to projected outcomes when we still don't have a denominator as to how many people have had this virus suffered minor symptoms if any and moved on. More studies are being done and more conclusions are confirming this to be the case. I also am VERY suspicious of the number of deaths that were strictly due to the virus and not underlying conditions. I don't post much on MS anymore because of attitudes like yours. I guess all the millions of normal hard working people that are in the process of losing everything should just keep their uneducated mouths shut do as their told be thankful for the appreciation of their elected leaders for being good little soldiers 

nothing personal I just get really miffed when I read an insult especially when it's between the lines.

[DXB]

No insult intended at all here and sorry if I came off as patronizing at any point...to keep the discussion going in a productive direction, and to address the key points you raise (we are less far apart here than you might imagine):

"We are making a huge reaction to projected outcomes when we still don't have a denominator as to how many people have had this virus suffered minor symptoms if any and moved on."

That is undoubtedly true - many early estimates of mortality were badly inflated by low testing.  The problem is that at the moment the estimates at the very low end may have an artificial inflation of the denominator.  The reason is that tests in populations that have a low prevalence of the condition that is being tested, be it active infection or protective antibodies indicating prior infection, will produce a very high proportion of false positives. Take the extreme example: a population where no one has truly has had the virus. Let's say you have a serum antibody test with 95% specificity and specificity - that is a pretty good test and on par with the first FDA-approved serology test.  If you test an infection free population, 5% will test positive, but they will all be false positives - sounds pretty close to the numbers in that county in CA right?  There could be other explanations for sure - a less virulent strain, or more immunity than predicted by initially reported cases, but the innate limitation of the test is the first thing that comes to mind.  

"I also am VERY suspicious of the number of deaths that were strictly due to the virus and not underlying conditions"

There is no question that other conditions contributed to the tallied deaths from COVID19. First there are innate imprecisions in reporting, but these errors tend to go both ways (e.g. the false positive COVD19 test in the person actually dying of influenza vs. the old person found dead at home of unknown causes).  It's hard to make out if there is a large net error in one direction or the other.  The people ending up dying in the ICU after a positive test for the virus overwhelmingly are older and have other medical conditions. Some of them have medical conditions so serious that they have very short life expectancies even if they didn't catch the virus.  But lots of others have life expectancies measured in years to a decade or more.  Consider  the 70 year old male whose hypertension and diabetes are under medical management. Even though he takes care of himself and is active in his retirement, he is quite vulnerable to die of the virus despite having years of life expectancy  - should we not count him in the numerator and do all we can to help him?  We would do everything for him if he showed up with heart disease or a treatable cancer, so I have a hard time dismissing him as a illegit COVID19 statistic who was going to die anyway of something else.

"I guess all the millions of normal hard working people that are in the process of losing everything should just keep their uneducated mouths shut"

They should not keep their mouths shut.  The economic impact cannot be ignored.  I am far less qualified to speak to those issues, and neither are most of the people belittling their urges to restart the economy.

[PT20J]

1 hour ago, bonal said:

I enjoy reading informed opinions as much as the next and there are a number of studies that don't agree with the models we have based all the doom and gloom on and they are being provided by people that are equally informed with outstanding credentials as well. Obviously I'm not a scientist nor am I a doctor of any kind. But I am an American citizen and know when my constitutional rights are under attack I don't like what's going on not one stinking bit. We are making a huge reaction to projected outcomes when we still don't have a denominator as to how many people have had this virus suffered minor symptoms if any and moved on. More studies are being done and more conclusions are confirming this to be the case. I also am VERY suspicious of the number of deaths that were strictly due to the virus and not underlying conditions. I don't post much on MS anymore because of attitudes like yours. I guess all the millions of normal hard working people that are in the process of losing everything should just keep their uneducated mouths shut do as their told be thankful for the appreciation of their elected leaders for being good little soldiers 

nothing personal I just get really miffed when I read an insult especially when it's between the lines.

Actually, I wasn’t thinking about you at all when I wrote that and I’m sorry you took it personally.

I mean’t what I said literally. I see a lot of threads where someone asks a straightforward question and lots of interesting opinions are offered and then someone with knowledge and/or experience posts a clear answer, often with supporting documentation. I appreciate that because I learn something from it.

In a situation like we face with COVID-19, I listen to opinions, but I look to those with training and experience in their field for direction and understanding.

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