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10023 Apr 2, 2021 10:50 PM

Quote:

Originally Posted by homebucket (Post 9237056)
It is interesting that despite lockdowns and restrictions, states like CA and now MI were not immune to experiencing surges. It's almost as if they had the opposite effect. Because cases were so well controlled early on, as pandemic fatigue settled in, coupled with new, even more contagious variants, lackluster contact tracing, and the holidays, the surges were inevitable.

It’s not almost as if they had the opposite effect. They had the opposite effect. Lockdowns merely prolonged the inevitable, as I predicted last spring.

Look at places like Italy and France that had the strictest, earliest lockdowns in the West and now are locking down again.

The unpleasant truth is that, aside from enough suppression to keep the hospitals functioning (which, let’s not forget, was the original justification for lockdowns), this thing just needed to work its way through the population, a small percentage of which were going to die (either the very old or the very unlucky).

Pedestrian Apr 2, 2021 10:51 PM

Quote:

Originally Posted by homebucket (Post 9237056)
It is interesting that despite lockdowns and restrictions, states like CA and now MI were not immune to experiencing surges. It's almost as if they had the opposite effect. Because cases were so well controlled early on, as pandemic fatigue settled in, coupled with new, even more contagious variants, lackluster contact tracing, and the holidays, the surges were inevitable.

You can argue it's more than "pandemic fatigue". As I calculated a few pages back now (and it's not entirely my own calculation--"experts" have made similar ones), nationally it seems like maybe 40% of the population is still vulnerable but in places where the first wave was light or kept well under control, that could easily be 50% of more simply because there are fewer recovered cases with natural immunity.

Even if the new wave is limited to only half the population, with the more virulent/contagious strains (as you said), that could be a lot of people sick at one time. And we do seem to be seeing something that suggests this is what's happening: The demographics of the current "wave" is different with mostly the under 50s who haven't yet been eligible for vaccination (and some oldsters who remain unvaccinated).

Pedestrian Apr 2, 2021 10:58 PM

Quote:

Originally Posted by 10023 (Post 9237082)
It’s not almost as if they had the opposite effect. They had the opposite effect. Lockdowns merely prolonged the inevitable, as I predicted last spring.

Look at places like Italy and France that had the strictest, earliest lockdowns in the West and now are locking down again.

The unpleasant truth is that, aside from enough suppression to keep the hospitals functioning (which, let’s not forget, was the original justification for lockdowns), this thing just needed to work its way through the population, a small percentage of which were going to die (either the very old or the very unlucky).

No place in Europe has yet vaccinated enough people to make a noticeable difference. Instead, look at Israel which had a serious problem last spring/summer and now doesn't because it is really there only country that has vaccinated most of the population.

Locking down did not have the "opposite effect" and was not "pointless", merely inconvenient for YOU.

What it has clearly accomplished is to give time for some effective meds to be developed (the egregiously underused monoclonal antibody cocktails) and vaccines. As the "experts" keep telling us, it is now a race as to whether we can vaccinate enough people to blunt any new wave and emerge with lots of people (hopefully ME) who never got it and never will.

In the current European surge, the death rates are lower not only because the sick are younger but because we know better how to treat it and have the better meds. If we had faced the current variants last Spring it could have been much worse than it was and, because of what science has given us in the interval, much worse than we are likely to see now.

Quote:

New COVID-19 cases drop to lowest weekly level since last June
With economy largely open and most Israelis vaccinated, positive test rate falls to 1%; serious infections hit a three-month low
By TOI STAFF
Today, 11:54 am 0

The number of weekly new coronavirus infections dipped to the lowest level in Israel since June 2020, as serious cases hit a three-month low according to data released Friday.

According to the Health Ministry, only 2,479 new cases were discovered in the past week, compared to 5,011 the week prior, marking the lowest weekly tally in ten months.

The number of COVID-19 patients in Israel in serious condition dropped to 368 as of Friday, the lowest rate since December 2020. The number has been on a steady decline for several weeks, after climbing to an all-time high of 1,201 in mid-January.

The number of active cases further fell to 6,581. Thursday’s results, which came from 35,768 tests, represented a positive infection rate of just 1 percent — amounting to 331 new cases.

The virus’s basic reproduction number was at 0.61. Any figure under 1 means the outbreak is abating. The figure represents the situation as of 10 days ago due to the incubation period.

With no deaths reported overnight, the toll stood at 6,220 on Friday morning.

The pandemic has continued to ebb following Israel’s successful vaccination campaign, which has seen a majority of its citizens get the shots.

Israel has so far vaccinated over 4.8 million people — or over 51.67% of its population — with two coronavirus vaccine shots. About 56.49% of Israelis, more than 5.2 million, have received at least one vaccine shot.

When it comes to vulnerable populations, these numbers are much higher. Over 90% of all Israeli residents over 50 are fully inoculated with two vaccine shots or had recovered from the virus.

https://www.timesofisrael.com/new-co...nce-june-2020/

Pedestrian Apr 2, 2021 11:22 PM

Quote:

Dr. Fauci: US may not need the AstraZeneca vaccine
By REUTERS |
PUBLISHED: April 1, 2021 at 4:44 p.m. | UPDATED: April 2, 2021 at 3:55 a.m.
By Julie Steenhuysen | Reuters

CHICAGO – The United States may not need AstraZeneca’s COVID-19 vaccine, even if it wins U.S. regulatory approval, Anthony Fauci, the nation’s top infectious disease doctor told Reuters on Thursday.

The vaccine, once hailed as another milestone in the fight against the COVID-19 pandemic, has been dogged by questions since late last year, even as it has been authorized for use by dozens of countries, not including United States.

Fauci, director of the National Institute of Allergy and Infectious Diseases and chief medical adviser to the White House, said the United States has enough contracts with other vaccine makers to vaccinate its entire population, and possibly enough for booster shots in the fall.

Asked whether the United States will use the AstraZeneca vaccine doses, he said, “That’s still up in the air. My general feeling is that given the contractual relationships that we have with a number of companies, that we have enough vaccine to fulfill all of our needs without invoking AstraZeneca” . . . .

https://www.mercurynews.com/2021/04/...content=manual

I admit to being a little relieved by this. Yes, I realize that the "issues" other countries have had with the vaccine are pretty insignificant on a statistical level, but still, if we don't need it let's stick with the vaccines that haven't had those issues.

Now what to do about the Astrazeneca vaccine we have or have contracted to buy. We should and probably will donate it to other countries but there could be blow-back over this. I expect complaints that we are dumping our rejects on the poorer countries. Well, offer it to them on a take or leave it basis.

Pedestrian Apr 2, 2021 11:44 PM

For the "It Ain't Over 'till It's Over" file (and keep your masks on):

Quote:

Ontario COVID-19 surge could force doctors to use online calculator to make life-and-death decisions
JEFF GRAY
QUEEN'S PARK REPORTER
PUBLISHED MARCH 28, 2021
UPDATED MARCH 29, 2021

If COVID-19′s surging third wave overwhelms Ontario’s hospitals, doctors could soon be using an emergency triage protocol that includes an online calculator to help decide who gets lifesaving care and who does not.

The website, which prompts physicians to key in a critical patient’s diagnosis in order to estimate their chances of survival, is part of an emergency procedure drafted to help doctors make what would normally be unthinkable decisions. The protocol has been distributed to hospitals. But it has never officially been made public.

The province has loosened some pandemic restrictions in recent weeks, even as daily new infections still shoot upward, with more than 2,448 recorded on Sunday and 19 deaths. Ontario counted 390 COVID-19 patients in its intensive-care units, not far from the peak of 420 hit in the second wave of the virus in January.

While the provincial government says it has added hospital capacity, the Ontario Hospital Association warned last Friday that the province’s critical-care system was reaching its “saturation point” and that soon “hospitals will be under extraordinary pressure to try and ensure equitable access to lifesaving critical care.”

To deal with the onslaught, ICUs have been transferring critical patients from packed facilities to those elsewhere that still have space. Patients are being shipped via ambulance helicopter from Toronto to as far away as Kingston. Field hospitals have also sprung up around several health care facilities, including Toronto’s Sunnybrook Health Sciences Centre.

But more than a year into a pandemic that put hospitals in New York and Italy over the brink, the Ontario government has kept almost all planning for such a worst-case scenario out of the public eye.

Meanwhile, the Ontario Human Rights Commission and disability rights groups have raised objections for months, warning that leaked drafts of the protocol discriminate unfairly against older and disabled people.

Both a January version of the protocol, developed by the group that co-ordinates critical care across the province, and the online calculation tool have only come to light after being obtained by the Accessibility for Ontarians with Disabilities Act Alliance, a disability rights group. The AODAA has also obtained a “framework document,” prepared by the government’s bioethics table, a committee of experts that has been wrestling with the triage issue for the past year.

The province’s Ministry of Health has said only that the triage protocol, known as an “emergency standard of care,” was drafted by the medical profession and not approved by the ministry.

The notion of an online triage aide may sound strange, but nothing about hospitals swamped by COVID-19 would be normal. The “short-term mortality risk” calculator would allow physicians to type data on the severity of a patient’s conditions – cancer, trauma, stroke and so on – to help come up with an estimated chance of survival after 12 months. Those with a higher chance of survival would be given priority for ICU spots. Decisions would be made by two doctors, not one alone . . . .

A spokeswoman for Ontario Health Minister Christine Elliott referred questions about the protocol to Jennifer Gibson, the co-chair of the government’s bioethics table and director of the University of Toronto Joint Centre for Bioethics.

Dr. Gibson said the bioethics table has been in discussions with the Ontario Human Rights Commission on addressing its concerns with the triage protocol. She also said the table has previously recommended an open public consultation on the triage issue – but that the government had so far not acted on this idea . . . .

Michael Warner, the head of critical care at Michael Garron Hospital in Toronto’s east end, said ICU doctors have been familiarized with the emergency triage protocol – even though the government says it remains unapproved – and that committees at hospitals across the province to oversee it have been set up. He held up a paper triage form in a Twitter video on Friday, urging Premier Doug Ford to tighten public-health measures.

He also criticized the government for so far declining to say it would, if needed, issue an order to override Ontario’s health care legislation and allow for the withdrawal of lifesaving care from patients already in the ICU who are unlikely to survive. Under the plan as it stands now, only new patients would face ICU triage.

It’s unclear, Dr. Warner warned, how the plans would roll out in what would be an unprecedented crisis.

“This could be battlefield medicine,” he said. “We may end up having to improvise.”
https://www.theglobeandmail.com/cana...calculator-to/

They have now reintroduced a 4-week "lockdown" to try to step the tide (though, of course, certain participants here will argue it's unnecessary and pointless).

JManc Apr 3, 2021 12:59 AM

Quote:

Originally Posted by Pedestrian (Post 9237128)
For the "It Ain't Over 'till It's Over" file (and keep your masks on):


https://www.theglobeandmail.com/cana...calculator-to/

They have now reintroduced a 4-week "lockdown" to try to step the tide (though, of course, certain participants here will argue it's unnecessary and pointless).

I get that much of the population isn't vaccinated and covid is still spreading but I don't think those who are vaccinated should still be holed up in their houses.

someone123 Apr 3, 2021 1:17 AM

Quote:

Originally Posted by Pedestrian (Post 9237128)
For the "It Ain't Over 'till It's Over" file (and keep your masks on):


https://www.theglobeandmail.com/cana...calculator-to/

They have now reintroduced a 4-week "lockdown" to try to step the tide (though, of course, certain participants here will argue it's unnecessary and pointless).

The stuff about the health care system being strained is somewhat misleading and partly based on speculation about future demand. Right now they're around 400 in ICU out of a population of 14.5 million. Total provincial ICU capacity is in the 2,000 range, with most beds being used by non-covid patients. The net impact of reducing non-covid ICU capacity is unclear.

Ontario publicized plans to add 500 new ICU beds to its capacity at one point, more than they have seen in demand due to covid (with each covid-positive person being considered a net new ICU bed used, an upper bound). Over time we have heard more and more talk about how just about any ICU bed utilization due to covid puts a strain on the system. We hear it here in BC and we're at 79 in ICU out of a population of 5 million.

Ontario produced some hockey stick style models based on assumptions of increased R values of variants but it's unclear how accurate those will be as predictions. The old predictions have not been accurate.

Just over 15% of people in Ontario have received at least one dose of vaccine so far. The highest risk (e.g. care home residents) have generally been first to get vaccinated, so future hospitalization rates due to new infections are likely to be lower. Death rates have already dropped. Our death rate in Canada these days is about 1/6 of what it was at the peak last May.

10023 Apr 3, 2021 1:28 AM

Quote:

Originally Posted by Pedestrian (Post 9237128)
For the "It Ain't Over 'till It's Over" file (and keep your masks on):


https://www.theglobeandmail.com/cana...calculator-to/

They have now reintroduced a 4-week "lockdown" to try to step the tide (though, of course, certain participants here will argue it's unnecessary and pointless).

And when is it fucking over?

There has to be a level of acceptable deaths, and looking at the stats these days in the US, we are there.

Old people die. It’s what they do.

JManc Apr 3, 2021 1:35 AM

Quote:

Originally Posted by 10023 (Post 9237182)
And when is it fucking over?

There has to be a level of acceptable deaths, and looking at the stats these days in the US, we are there.

Old people die. It’s what they do.

I would assume herd immunity. I do see many normalizing masks as part of the 'new normal' and how we all should embrace it (fuck that) and lockdown until every single strain is identified and under control (not going to happen). Still, we're not anywhere close to herd immunity and shouldn't derail things until we get there. Old people don't 'die' and many actually get older. My 70-something parents have plenty of miles left in them.

someone123 Apr 3, 2021 1:46 AM

Quote:

Originally Posted by JManc (Post 9237184)
I would assume herd immunity.

How do we know that there will be herd immunity or covid will go to 0? Many people may elect not to be vaccinated, there could be some immune escape, etc. My guess is we'll see outbreaks for years to come, but the spread and consequences will be much smaller.

I think the public health aspect of this will end when everybody has had the option to get vaccinated. At that point we should move to a regime based on personal choice. If people don't want to get vaccinated and would rather risk covid that's their choice. If they have unusual health requirements they are better dealt with individually rather than locking down all of society. In fact the proper functioning of society is what allows us to have the wealth to have elaborate health care services. I doubt that the current situation is sustainable.

TWAK Apr 3, 2021 1:52 AM

Quote:

Originally Posted by JManc (Post 9237184)
I would assume herd immunity. I do see many normalizing masks as part of the 'new normal' and how we all should embrace it (fuck that) and lockdown until every single strain is identified and under control (not going to happen). Still, we're not anywhere close to herd immunity and shouldn't derail things until we get there. Old people don't 'die' and many actually get older. My 70-something parents have plenty of miles left in them.

That's what I always thought it was going to be, and I figure it will go by county since that's how they have been doing things (at least in CA). Maybe localities hit hard by future season flu outbreaks will adjust, and I bet workplaces are gonna be tougher with people who are sick. It hurts productivity anyway coming into work and coughing up a storm...everybody in the office gets sick.

Pedestrian Apr 3, 2021 2:22 AM

Quote:

Originally Posted by JManc (Post 9237168)
I get that much of the population isn't vaccinated and covid is still spreading but I don't think those who are vaccinated should still be holed up in their houses.

Increasingly they aren't. I'm not. I now do my own grocery shopping and other shopping in uncrowded stores, I go out to eat outdoors, I do pretty much everything I've ever done outdoors. But I wear a mask indoors (in stores etc) always.

Pedestrian Apr 3, 2021 2:38 AM

Quote:

Originally Posted by someone123 (Post 9237191)
How do we know that there will be herd immunity or covid will go to 0? Many people may elect not to be vaccinated, there could be some immune escape, etc. My guess is we'll see outbreaks for years to come, but the spread and consequences will be much smaller.

I think the public health aspect of this will end when everybody has had the option to get vaccinated. At that point we should move to a regime based on personal choice. If people don't want to get vaccinated and would rather risk covid that's their choice. If they have unusual health requirements they are better dealt with individually rather than locking down all of society. In fact the proper functioning of society is what allows us to have the wealth to have elaborate health care services. I doubt that the current situation is sustainable.

It will be like measles, mumps and polio: The diseases will still exist but there won't be a steady stream of cases, only sporadic outbreaks of a size that allows rigorous contact tracing and isolation of the infected.

It will be somewhat like what we are seeing in places like South Korea or New Zealand but a better example is Israel, a place that had a severe epidemic and has brought it under increasing control by vaccinating the majority of the population (in spite of resistance in the Orthodox community) although even there the job isn't finished--they are approaching herd immunity but haven't yet reached it (though as I keep saying, it's a thing with a gradual slope, not a sudden demarcation):

Quote:

New COVID-19 cases drop to lowest weekly level since last June
With economy largely open and most Israelis vaccinated, positive test rate falls to 1%; serious infections hit a three-month low
By TOI STAFF
2 April 2021, 11:54 am 0

The number of weekly new coronavirus infections dipped to the lowest level in Israel since June 2020, as serious cases hit a three-month low according to data released Friday.

According to the Health Ministry, only 2,479 new cases were discovered in the past week, compared to 5,011 the week prior, marking the lowest weekly tally in ten months.

The number of COVID-19 patients in Israel in serious condition dropped to 368 as of Friday, the lowest rate since December 2020. The number has been on a steady decline for several weeks, after climbing to an all-time high of 1,201 in mid-January.

The basic reproduction number, the daily share of positive coronavirus test results, and the number of active cases have all been on a several-week downward trend.

The number of active cases further fell to 6,581. Thursday’s results, which came from 35,768 tests, represented a positive infection rate of just 1 percent — amounting to 331 new cases.

The virus’s basic reproduction number was at 0.61. Any figure under 1 means the outbreak is abating. The figure represents the situation as of 10 days ago due to the incubation period.

With no deaths reported overnight, the toll stood at 6,220 on Friday morning.

Israel has so far vaccinated over 4.8 million people — or over 51.67% of its population — with two coronavirus vaccine shots. About 56.49% of Israelis, more than 5.2 million, have received at least one vaccine shot.

When it comes to vulnerable populations, these numbers are much higher. Over 90% of all Israeli residents over 50 are fully inoculated with two vaccine shots or had recovered from the virus.
https://www.timesofisrael.com/new-co...nce-june-2020/

That reproduction number of .61 is critical. That means every case spreads it to .61 other people. In other words, over time there should be fewer and fewer cases, eventually getting to or near zero except for the occasional imported case or other exceptional incident.

When there are zero regularly occurring cases, then even the unvaccinated will be pretty safe as they are in New Zealand. But as we repeatedly see with measles (a much more infectious virus even than coronavirus), occasional cases pop up from travelers and others and the only way to keep the virus suppressed aside from rigorous contact tracing and quarantine in getting the highest possible percentage of the population vaccinated.

If we take your position that it's simply a matter of personal choice, it's quite likely we will never entirely suppress regular cases meaning people who, for one reason or another can't be vaccinated will remain at risk. That's the point of "herd immunity"--to protect even the "can't be vaccinated". In free democratic societies we will never force people to be vaccinated but we can certain apply tough incentives as we do with children who are not allowed to attend public schools without their "shots" or travelers to places where cholera or Yellow Fever have been endemic who are not allowed entry unless they can demonstrate immunization. As I've said, with COVID, at least for now, I'd go further: No entry to any indoor venues where there are crowds like concert halls, sports arenas and so on. Possibly even restaurants. According to my TV, the Washington DC baseball team was only allowing fans to attend their season opener (before it was cancelled due to an opposing player getting COVID) who can show vaccination. That's what we probably should do for a while at least.

CaliNative Apr 3, 2021 3:10 AM

Quote:

Originally Posted by Pedestrian (Post 9237088)
No place in Europe has yet vaccinated enough people to make a noticeable difference. Instead, look at Israel which had a serious problem last spring/summer and now doesn't because it is really there only country that has vaccinated most of the population.

Locking down did not have the "opposite effect" and was not "pointless", merely inconvenient for YOU.

What it has clearly accomplished is to give time for some effective meds to be developed (the egregiously underused monoclonal antibody cocktails) and vaccines. As the "experts" keep telling us, it is now a race as to whether we can vaccinate enough people to blunt any new wave and emerge with lots of people (hopefully ME) who never got it and never will.

In the current European surge, the death rates are lower not only because the sick are younger but because we know better how to treat it and have the better meds. If we had faced the current variants last Spring it could have been much worse than it wuas and, because of what science has given us in the interval, much worse than we are likely to see now.


https://www.timesofisrael.com/new-co...nce-june-2020/

Why are the monoclonal antibody "cocktails" underused if they are effective at treating covid if administered early enough? Are many doctors ignorant about their effectiveness, or are insurance companies reluctant to pay for them? Any at risk patient with early covid should be given them. Patients need to request them and doctors need to use them. They have lots sitting on the shelf. Like tamiflu for early covid. Monoclonals should be routinely used for people with early covid who are at risk of developing serious disease because of at risk factors (age, prexisting conditions, etc.).

CaliNative Apr 3, 2021 3:28 AM

Pedestrian, are reputable N95 masks now available online? On Amazon they still sell mostly Chinese masks and who knows if they are any good. Can one obtain domestic N95s from companies like 3M or Honeywell? Any advice?

SIGSEGV Apr 3, 2021 3:41 AM

Quote:

Originally Posted by CaliNative (Post 9237239)
Pedestrian, are reputable N95 masks now available online? On Amazon they still sell mostly Chinese masks and who knows if they are any good. Can one obtain domestic N95s from companies like 3M or Honeywell? Any advice?


I got some through my in-laws (who are physicians) who ordered from some medical supplier that I assume is reputable, but have no way to check.

CaliNative Apr 3, 2021 3:54 AM

Quote:

Originally Posted by someone123 (Post 9237191)
How do we know that there will be herd immunity or covid will go to 0? Many people may elect not to be vaccinated, there could be some immune escape, etc. My guess is we'll see outbreaks for years to come, but the spread and consequences will be much smaller.

I think the public health aspect of this will end when everybody has had the option to get vaccinated. At that point we should move to a regime based on personal choice. If people don't want to get vaccinated and would rather risk covid that's their choice. If they have unusual health requirements they are better dealt with individually rather than locking down all of society. In fact the proper functioning of society is what allows us to have the wealth to have elaborate health care services. I doubt that the current situation is sustainable.

Covid may be with us forever, like influenza and the common cold is. In the 3rd world, it may take years to get enough vaccinated to achieve herd immunity, so new variants may keep appearing. I read that some of the animals in India like the wild rhesus monkeys are now infected. More variants. And of couse there are bats practically everywhere who could catch it and be a source of new infections and wicked variants. What if our cats and dogs get it? If this isn't a mess it will do until a mess comes along.

mrnyc Apr 3, 2021 6:11 AM

we walked up to the javits convention center early this morning on the highline and my spouse got the pfizer vaccine. while it sounds like a nice, ideal walk it actually sucked eggs as it was flipping freezing with howling gale winds. we were literally the only people on the highline the whole length of it except for park workers lol. we got off in the empty hudson yards and there was a weird, errie whistling noise around the buildings from the winds.

anyway the javits was the opposite of that. i waited outside and it was quite a scene. old people, young, people of all stripes, cabs, old folks home vans all coming and going. it only took 20mins — and that included the 15min wait afterward.

jtown,man Apr 3, 2021 9:31 AM

Quote:

Originally Posted by Pedestrian (Post 9236994)
Again--the Brazilian variant is apparently more dangerous for younger people and it has already been found in many places in the US. It is NOT speculation.

This doesn't mean "we must hunker down indefinitely" because the vaccines apparently do work against it. But it does mean that young people need to be as careful as older people--especially going forward as the variants become even more prevalent-- and especially get vaccinated. Until 60-70% of the entire US population is vaccinated, precautions like mask wearing and avoiding indoor crowds should be practiced by EVERYBODY (10023 can take his chances with the Brazilian variant--I still want to see his blog about the experience).

Older people are like 55x more likely to die from Covid.

No, we do not have to be as careful as older people.

jtown,man Apr 3, 2021 9:33 AM

Quote:

Originally Posted by iheartthed (Post 9237008)
Gov. Gretchen Whitmer attributes Michigan's recent elevated case counts to pandemic fatigue coupled with the state's early pandemic successes in flattening the curve:

Basically, her rationale is:

I did such a good job and now people aren't following what I want them to do, its their fault and they are stupid lol


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