CoronaBro Meltdown/SARS-Covid-19 Spitballing Thread

[Dugout DickStone]

bqqk, when you tell Mrs. bqqk that you are going to rush over to costco to cancel your family's membership because they are going to require people wear masks to enter, does she tell you that's the most Karen move ever or is she kind of used to this type of lashing out?

[michigancat]

interesting piece.

https://twitter.com/Comparativist/status/1255508259437502467

yeah. for people who don't click. It definitely seems like we're out-thinking ourselves.

The point of this thought experiment is that I see – around the world – an unnecessary reliance on technology to plan and execute a public health strategy to eradicate this virus. There are very smart people trying to plot their way out of this mess in the Philippines, India, the UK, the US, and elsewhere not planning their next move until testing capacity expands to X threshold level. They sit on lockdown waiting for technology to fix this. From where I sit, in a place that has one of the highest testing per capita levels in the world, is akin to people denied Google Maps forced to rely on the old paper type for the first time in recent memory and finding themselves lost without it. Except they forgot the paper maps even exist.

1) Don’t Wait For Mass Testing. In an ideal world, every country would have been prepared for 20k tests/day before the virus reached their shores like Korea. We do not live in that ideal world. The goal of mass testing is both objectively a Good Thing and a cognitive roadblock. The same places that say “we can’t re-open without mass testing” and hoping that phone-based contact tracing are going to get them out of this hole still haven’t thought through what to do with confirmed cases that aren’t sick and close contacts. Clinicians need to asking what a 1990 diagnosis would look like (i.e., a context like now in many places where testing is a luxory).

2) Don’t Rely on Lockdowns. There is reasonable debate about what this term means, but here it means sending >90% of workers home and letting protected delivery drivers take care of most groceries and medicine. In red zones, no one should be going outside much for about three months. When and if they do, it should be considered high risk and masks are mandatory. At the same time, lockdowns need to be reframed as buying time to develop a local eradication policy. There is no evidence that lockdowns alone, however, can drive the R0 below 1.

3) Centralized Quarantine with four groups: confirmed infected, no test result but symptomatic, close contacts, and confirmed COVID19 cases with either mild or no symptoms. The goal is to remove these people not just from the population, but from households to cut every potential transmission chain. Generally, the lower the risk the more comfortable these options (i.e., hotel rooms for close contacts). There is no beating this virus without isolating all potentially infectious carriers and smashing every transmission chain you can uncover. The role of testing here is to bring all those who need it to the right place, release those who test negative as quickly as possible, and move place confirmed cases to sites where they will have better monitoring

4) Travel Restrictions. Look at any COVID19 outbreak map and you’ll see waves of infections moving out from cities into places that now have few, or manageable, caseloads. Generally speaking, (a) those outward waves need to be prevented from spreading any further and (b) places with few, or no, cases need to be protected. As Taiwan and Vietnam show, the best way to contain an epidemic in its infancy is to start with low numbers and keep them low. Just as the ‘fleet sails at the speed of the slowest ship,’ entire polities are at risk from their weakest sub-national governments who can not, will not, or do not contain their outbreaks. Successful suppression efforts must be protected. Generally, travel restrictions work best (or only work) when baseline numbers are small.

5) Think Global, Act Local. What is usually a trite number sticker contains a lot of truth right now in many contexts. The situation looks hopeless at the national level in many countries right now. Focus on getting the area you live in under control and protected from waves spreading out of red zones. Centralized Quarantine looks impossible when you think about the numbers at the national level, but they’re likely a lot more manageable at the local level (how many college dorms, coliseum and gym floor space for cots, and empty hotel rooms does your city have?). Domestic travel restrictions should prevent red zones from exporting cases to other places and county-, city-, and state-level automatic quarantines for new arrivals, close contacts, suspected cases, and non-sick confirmed cases.

[michigancat]

I really like the way Kansas laid out a plan with dates. Hopefully the timeline helps businesses that are closed to prepare for reopening.

to be clear, the dates are "no sooner than dates". Which I agree is very helpful.

[Phil Titola]

I really like the way Kansas laid out a plan with dates. Hopefully the timeline helps businesses that are closed to prepare for reopening.

to be clear, the dates are "no sooner than dates". Which I agree is very helpful.

Yeah I'll be stoked if they hit those phases close to those dates but it's good to give guideposts.

[nicname]

interesting piece.

https://twitter.com/Comparativist/status/1255508259437502467

yeah. for people who don't click. It definitely seems like we're out-thinking ourselves.

The point of this thought experiment is that I see – around the world – an unnecessary reliance on technology to plan and execute a public health strategy to eradicate this virus. There are very smart people trying to plot their way out of this mess in the Philippines, India, the UK, the US, and elsewhere not planning their next move until testing capacity expands to X threshold level. They sit on lockdown waiting for technology to fix this. From where I sit, in a place that has one of the highest testing per capita levels in the world, is akin to people denied Google Maps forced to rely on the old paper type for the first time in recent memory and finding themselves lost without it. Except they forgot the paper maps even exist.

1) Don’t Wait For Mass Testing. In an ideal world, every country would have been prepared for 20k tests/day before the virus reached their shores like Korea. We do not live in that ideal world. The goal of mass testing is both objectively a Good Thing and a cognitive roadblock. The same places that say “we can’t re-open without mass testing” and hoping that phone-based contact tracing are going to get them out of this hole still haven’t thought through what to do with confirmed cases that aren’t sick and close contacts. Clinicians need to asking what a 1990 diagnosis would look like (i.e., a context like now in many places where testing is a luxory).

2) Don’t Rely on Lockdowns. There is reasonable debate about what this term means, but here it means sending >90% of workers home and letting protected delivery drivers take care of most groceries and medicine. In red zones, no one should be going outside much for about three months. When and if they do, it should be considered high risk and masks are mandatory. At the same time, lockdowns need to be reframed as buying time to develop a local eradication policy. There is no evidence that lockdowns alone, however, can drive the R0 below 1.

3) Centralized Quarantine with four groups: confirmed infected, no test result but symptomatic, close contacts, and confirmed COVID19 cases with either mild or no symptoms. The goal is to remove these people not just from the population, but from households to cut every potential transmission chain. Generally, the lower the risk the more comfortable these options (i.e., hotel rooms for close contacts). There is no beating this virus without isolating all potentially infectious carriers and smashing every transmission chain you can uncover. The role of testing here is to bring all those who need it to the right place, release those who test negative as quickly as possible, and move place confirmed cases to sites where they will have better monitoring

4) Travel Restrictions. Look at any COVID19 outbreak map and you’ll see waves of infections moving out from cities into places that now have few, or manageable, caseloads. Generally speaking, (a) those outward waves need to be prevented from spreading any further and (b) places with few, or no, cases need to be protected. As Taiwan and Vietnam show, the best way to contain an epidemic in its infancy is to start with low numbers and keep them low. Just as the ‘fleet sails at the speed of the slowest ship,’ entire polities are at risk from their weakest sub-national governments who can not, will not, or do not contain their outbreaks. Successful suppression efforts must be protected. Generally, travel restrictions work best (or only work) when baseline numbers are small.

5) Think Global, Act Local. What is usually a trite number sticker contains a lot of truth right now in many contexts. The situation looks hopeless at the national level in many countries right now. Focus on getting the area you live in under control and protected from waves spreading out of red zones. Centralized Quarantine looks impossible when you think about the numbers at the national level, but they’re likely a lot more manageable at the local level (how many college dorms, coliseum and gym floor space for cots, and empty hotel rooms does your city have?). Domestic travel restrictions should prevent red zones from exporting cases to other places and county-, city-, and state-level automatic quarantines for new arrivals, close contacts, suspected cases, and non-sick confirmed cases.

I feel like any reasonable person would put their stamp of approval on all of this. I don't like using force to make people do things like self-quarantine, and there would always be some rogues who would refuse, but most should see the benefit.

The eradication angle is something a lot of gE has been pushing since february (earlier?) and has always made the most sense imo.

I mean, if the four groups mentioned above would voluntarily self-quarantine in the ways mentioned the rest of us could basically live normally and we could get rid of this thing and truly be back to normal so much quicker.

The part about using lack of tests and tech tracing etc. as a crutch is so true and the gps vs paper map is both but sadly true. It's interesting to think how things might have went down if this did happen in the 80s or 90s.

[nicname]

I guess I don't really understand the difference between the business/walking around scenarios.  If you're going into a business but not really talking to anyone, what's the difference?

maybe it's different for other people; for me if i'm in a grocery store, i'm probably 6-10 feet from someone 60% of the time, no one within 10 feet 30% of the time and closer than 6 feet 10% of the time.  and we're all touching stuff that everyone is walking by.

if i'm walking my dog or whatever, there's almost never anyone within 100 feet and i don't usually touch stuff.

This is my answer.  Even out running I do see people on the sidewalk so I go to the other one or run in the road.  There is not one known passing of infection this way and only one "outside" at all of two people talking to each other for a long time outside, at least that was the results of the study from China.

This seems a little extreme.

I do the same thing. It's no trouble on my part and I do it as a courtesy as much as anything.

yeah it just seems more like a manners things right now versus trying to squeeze by on KC's too narrow sidewalks.  I'm not at all worried about walking by people and getting 'rona.

Apologies I read it as "crossing the street" for some reason. 

I've been out and about in this thing since late March delivering food and my SOP has basically been. Maintain social distance when at all possible. Keep my hands clean and my surfaces clean as much as possible. Keep my hands away from my face. Limit surface touching as much as possible.

I have 10 or so cheapo clinical masks that I rotate thru daily to hopefully let any virus on the masks die before next use. I worry about people reusing masks a lot and getting themselves sick that way. Not sure if that is a thing. I don't constantly wear the mask in public, but put it on any time im going into a place that is likely to make social distancing difficult.

It warms my heart to see that a lot of restaurant counters/ convenience store clerk areas have put up plexiglass shields between employee and customers there.

This is all in Wichita.

[Phil Titola]

https://covid.ks.gov/wp-content/uploads/2020/04/Reopen-Kansas-Framework-043020.pdf

SIAP Kansas reopening plan. V long

Are gyms phase 2?  The only mention of them is in Phase 1 of not being allowed

[MakeItRain]

Grift idea:  open supermarket where all we sell is vastly over priced fat person food which is maga favorite but you BAN masks then you make them feel like Rosa Parks when they shop there and you make a killing.  You encourage them to wear whatever stupid gun they think makes them look tough too.

What would you do when they all die though? You know 90% of them either are type 2, have COPD, high blood pressure, or cirrhosis of the liver.

[Rage Against the McKee]

Grift idea:  open supermarket where all we sell is vastly over priced fat person food which is maga favorite but you BAN masks then you make them feel like Rosa Parks when they shop there and you make a killing.  You encourage them to wear whatever stupid gun they think makes them look tough too.

What would you do when they all die though? You know 90% of them either are type 2, have COPD, high blood pressure, or cirrhosis of the liver.

I bet like 80% of them would survive.

[MakeItRain]

I expect that once antibody tests become widely available, pretty much everyone will get one in their annual checkup. People fortunate enough to have a doctor will get one, anyway.

Maybe I'm an outlier here, but do people actually get yearly check ups?

The life expectancy for black men is like 30 years old, I've been getting annuals since 20 years old. I have been able to catch some serious crap before it became serious.

[wetwillie]

Why would you not do an annual wellness check?  I’m early 30’s and have been doing them for several years.

[Bqqkie Pimp]

bqqk, when you tell Mrs. bqqk that you are going to rush over to costco to cancel your family's membership because they are going to require people wear masks to enter, does she tell you that's the most Karen move ever or is she kind of used to this type of lashing out?

Trying to avoid the mask talk dug, but she actually suggested it...  She was a step ahead of me this time.  I need to up my game.

[Phil Titola]

I've been getting a physical for like 14 years now.  No real reason other than to baseline my stats for like now and going forward. 

[star seed 7]

Outside of two DOT physicals set up by my employer, I haven't been to a doctor in 20 years. I don't even know how to go about finding one if I needed to. Just seems like a hassle.

[wetwillie]

Check engine lights probably been on for a while

[MakeItRain]

Outside of two DOT physicals set up by my employer, I haven't been to a doctor in 20 years. I don't even know how to go about finding one if I needed to. Just seems like a hassle.

That's not good, bro. It isn't a hassle at all. Go to the website of your provider, find an in-network internist, family doc, or men's health doc, make an appointment. The end.

[nicname]

Yeah, I have Cadillac level health insurance and I don't utilize it nearly enough. I'm 38 now and need to start taking that crap more serious. The check engine light is a good comparison.

Our cars and our bodies would last a lot longer and perform better with regularly scheduled maintenance.

[michigancat]

we are getting off topic but entering the world of health care billing and insurance is extremely intimidating and stressful. Starting with MiR's easy step one of going to the website of your provider. OK, I'll find a doctor listed on their site. Are they REALLY in my network? do I even need an in-network provider? Are they in my network for my level of plan? are they actually taking patients?

And then you start to get bills (maybe). I actually upgraded to a plan that covered out-of-network treatment this year. When I went to the website to figure out how to file an out-of-network claim, I learned you could do it VIA MAIL ONLY. WHAT THE eff. Of course I haven't done it yet, and that's 100% the intended result by requiring you to mail in claims.

[star seed 7]

Exactly, insurance stuff is just so frustrating. I had a pretty severe ear infection a few years ago so I go to an urgentcare type place for a quick prescription (very cheap and easy process not involving insurance). Getting the actual prescription from a pharmacy with insurance was a full rough ridin' day hassle and run around. I'd rather just not deal with them and die early.

[Trim]

ss7, you can schedule a videoconference with me where I can see your screen and I can walk you through how to do all this adult stuff.

Wear a mask while we do this, just to be safe.

[star seed 7]

That sounds even scarier

[Trim]

I recently main administrated the eff out of a DQ12 support ticket all by myself, this will be easy.

[MakeItRain]

we are getting off topic but entering the world of health care billing and insurance is extremely intimidating and stressful. Starting with MiR's easy step one of going to the website of your provider. OK, I'll find a doctor listed on their site. Are they REALLY in my network? do I even need an in-network provider? Are they in my network for my level of plan? are they actually taking patients?

And then you start to get bills (maybe). I actually upgraded to a plan that covered out-of-network treatment this year. When I went to the website to figure out how to file an out-of-network claim, I learned you could do it VIA MAIL ONLY. WHAT THE eff. Of course I haven't done it yet, and that's 100% the intended result by requiring you to mail in claims.

This stuff is shitty but we really shouldn't excuse not having routine heath checks, no matter the hassle. There are a lot of things that you can only find and fix with routine blood work. I now get checked every six months.

The provider websites do suck but after you do it the first time they are a breeze. For most of them, I've had 4 carriers in 7 years, about to get my fifth, so I've had a lot of practice with this. Most of the sites give you the in network provider for your plan after you sign up for an online account. The more advanced sites also tell you which providers are taking new patients. In this era of corporatized health care, nearly every provider will take any plan that an employer would give you. In your given area of residence/employment there aren't going to be hardly any providers who don't belong to a gigantic health conglomo anyway.

Bottom line is your health is way more important to ignore because you don't want to be bothered by the 15-45 minutes it would take to find a doctor. I found out about a liver issue that I had and corrected, and a high triglycerides issue I corrected, that I wouldn't have seen without annual blood work.

[chum1]

https://twitter.com/DonnaCassata/status/1256328267407056896

[Dugout DickStone]

bqqk, when you tell Mrs. bqqk that you are going to rush over to costco to cancel your family's membership because they are going to require people wear masks to enter, does she tell you that's the most Karen move ever or is she kind of used to this type of lashing out?

Trying to avoid the mask talk dug, but she actually suggested it...  She was a step ahead of me this time.  I need to up my game.

If my wife actually came up with idea that I run down to Costco and cancel half a years membership because they will require masks I’d probably take her to the neurologist