fineshrine
Active Member
Thats what I'm worried about. If they follow the same rules as Italy, my parents would not get the resources. So that's not reassuring at all. I'm worried about my parents needing care and not getting it.
Covid-19 NON DANCE debate
- Thread starter GGinrhinestones
- Start date
Thats what I'm worried about. If they follow the same rules as Italy, my parents would not get the resources. So that's not reassuring at all. I'm worried about my parents needing care and not getting it.
It's more than that. The USA does not have the volume of testing equipment that SK does, for a bunch of reasons.
How South Korea Scaled Coronavirus Testing While the U.S. Fell Dangerously Behind
By learning from a MERS outbreak in 2015, South Korea was prepared and acted swiftly to ramp up testing when the new coronavirus appeared there. Meanwhile, the U.S., plagued by delay and dysfunction, wasted its advantage.
www.propublica.org
In addition, while both USA and SK have a "symptoms and exposure" standard for testing, USA's lag in developing a test at scale makes that standard ineffective. The CDC requirement for "exposure", until very recently, included travel to China, South Korea, Italy, or similar. This means that any cases of domestic transmission would not be tested, by definition, even if the symptoms were severe and lined up perfectly with COVID-19.
This requirement is finally being relaxed, but the damage is done--our understanding of the spread of COVID-19 within the USA is at least two or three weeks out of date, and we do not have sufficient testing resources to "catch up" to the current state of affairs. Korea's model will not work for us, because we've lost critical time and information.
We've missed our chance to address this solely through contact tracing and containment. Mitigation strategies are what we need now.
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(1) Doctors use the results of tests to decide on appropriate treatment.
(2) A negative COVID result means you can't infect someone with COVID. That may mean you don't eed to be isolated from the rest of the population. (You might infect them with something else. Or nothing. Maybe by you have allergies. Or allergies and food poisoning. )
(3) If we aren't past the time when tracking is possible, a positive result means people tracking can focus on you.
(4) Statisticians get a more accurate number for the transmission rate.
(5) We learn a better value for the mortality rate.
Warren J. Dew
Forum Master
To be honest, with two 87 year old parents, I would be too - but I'd be worried about that with or without Covid-19. The US system works much better for people their age.
Warren J. Dew
Forum Master
Took my daughter to her favorite restaurant today. We always go in the midafternoon, when they are quiet anyway; they seem quieter than usual, but by the time we left, other people were coming in. In addition to food for ourselves, we bought enough extra for dinner for our family.
When we entered, the proprietress said, "you're brave". Uh, she's older than I am, closer to my mom's generation, so who's the brave one? A dance studio proprietress has also said this to me when I went to a practice, so maybe it's just a subtle way of thanking people for the business.
Walking from the parking lot to the restaurant, we saw one person in a mask. It would be good if Americans could get over their mask hangup; that's probably the biggest advantage the Pacific Rim nations have over us in handling this crisis.
Agreed, but masks are not available to the general public at the moment.
Warren J. Dew
Forum Master
There's no evidence for this, nor does your link support it.
The US is about three weeks behind South Korea, in terms of the percentage of population affected, commercial test approval, and actual testing. Three weeks ago, South Korea only did enough testing to identify 169 new cases. Yesterday, the US identified 660 new cases, only a slightly smaller percentage of the population. We appear to be no more testing constrained than they were at the corresponding time in their epidemic.
Your own link contradicts you. From your own link:How South Korea Scaled Coronavirus Testing While the U.S. Fell Dangerously Behind
By learning from a MERS outbreak in 2015, South Korea was prepared and acted swiftly to ramp up testing when the new coronavirus appeared there. Meanwhile, the U.S., plagued by delay and dysfunction, wasted its advantage.
...
This requirement is finally being relaxed, but the damage is done--our understanding of the spread of COVID-19 within the USA is at least two or three weeks out of date, and we do not have sufficient testing resources to "catch up" to the current state of affairs. Korea's model will not work for us, because we've lost critical time and information.
South Korea also failed to address this solely through contact tracing and containment, losing containment in several provinces. They did engage in moderate and tailored mitigation strategies similar to what I advocate. That allowed them to recover, as the US appears to be doing in Washington State.
In the meantime, Italy has seen extreme "lockdown" style mitigation strategies fail, with cases and deaths continuing to rise exponentially. Extreme mitigation is not the solution.
Our local CDC has told us that there are limited supplies for testing. In our area, priority testing is for patients with respiratory symptoms who are hospitalized or likely to be hospitalized, health care workers, residents of long term facilities and people who are exposed to a cluster outbreak. People with mild or no symptoms will not be tested and they are asked to self quarantine for 14 days. That includes people who have travelled recently. Personally, I have recently travelled, have no symptoms and I am self quarantining at home. If people at home do develop severe symptoms, then they should go to the ER, where they would be in the first category and be tested.
Warren J. Dew
Forum Master
I should have asked that guy where he got his.
Did you miss this?
And this?
Lack of test availability is also one of the facts on the ground in my wife's provider network. Obviously, I can't cite an article for that.
I never said testing wouldn't help. I said (paraphrased) that we won't be able to test at sufficient scale to pursue Korea's targeted containment model. Testing is data, and there's no such thing as too much data.
I had assumed, based on past posts, that you would disapprove of the response in Daegu (details here). I'm also surprised to hear you speak well of Washington, which has implemented school closings and blanket bans on large gatherings, which are the two events that kicked off this discussion. I'd be delighted to find I merely misunderstood.
Warren J. Dew
Forum Master
No, I noticed that the doctor was insisting on a CDC test when there are at least three commercial labs providing tests.
Possibly the interview occurred before the commercial tests became available, in which case the doctor has an excuse. Possibly the doctor is just stubborn, in which case she is the problem, not the testing availability.
All three of the cases identified in Somerville appear to have been identified through commercial tests.
I've posted multiple times already that I am okay with the public school closings that have occurred. Given Massachusetts is taking statewide actions, we should be closing schools across the state. Given its effectiveness at preventing the spread of other coronavirus diseases, school closings should be a preferred mitigation measure for Covid-19.
Daegu had a major outbreak with multiple deaths that directly resulted from large gatherings at a church. That's the point where economically and personally disruptive measures like bans on large gatherings become justifiable.
However, economically and personally disruptive measures that are justifiable in the face of a known uncontrolled fatal outbreak are not justified as a preventive or speculative measure absent such an outbreak. For example, a blanket large event ban is not justified in Massachusetts at this time. We ended up with a "ban" that has more exceptions than rules, which I view as more political than practical, though I do think the part that basically bans spectators at major league sports events is justifiable. Note that the MIT competition could have run under this "ban" by limiting spectator tickets, so I continue to view its cancellation as unnecessary.
Connecticut ended up with an blanket large event ban that was clearly unjustifiable.
Washington state had an outbreak with multiple deaths. Most of the deaths were at an elder care facility with a record of poor control of infectious disease; as such, the first indicated response should have been better oversight or control of elder care facilities, which I believe Washington addressed with a visitor ban. School closings made sense at that point since some infections were identified beyond the facility. I don't think a large event ban was necessary, and the existence of protest events there suggest I'm not the only one, but I also understand the political stress and uncertainty caused by the outbreak and consider the ban reasonable in that context.
I think a lot of the personal steps people are trying to feel virtuous about are in fact pointless and economically damaging. Washing hands frequently does make sense, absolutely. Not touching your face if you're one of the mutant humans who doesn't touch their faces involuntarily, sure. Staying home if you're sick and have a cough or sneeze, yes. Skipping one's private lesson is one's own decision, but doesn't justify one's feeling virtuous about it.
If the point of "flattening the curve" is to build herd immunity without overloading the medical system, then we still have to do the building of the herd immunity part. That requires that about half the population get the disease over time. Under that strategy, we shoudn't be trying to shut down disease transmission entirely, because that just maintains a population vulnerable to dangerous outbreaks if somebody slips up.
Strategies other than flattening the curve may also make sense. The UK strategy has been discussed separately. Another strategy that might make a lot of sense would be for the elderly to isolate themselves for a month or two while younger people do their best to get Covid-19 and become immune as fast as possible. I'm willing to live with "flattening the curve" as long as it doesn't become an excuse for "trying to put the inevitable off forever".
Incidentally, there's a very interesting question about South Korea here. Their confirmed case count seems to be leveling off at just under 10,000. That's only about 0.02% of the population, maybe 0.04% of what would be required for herd immunity. Are there another 25,000,000 cases out there that ended up unidentified, which would be over 99.9% of their total cases? Or is something else at work other than herd immunity? Figuring out what's going on there may require an antibody test, which nobody has yet, though at least one is being worked on.
Warren J. Dew
Forum Master
And now I see that Governor Baker is closing schools statewide for three weeks - good for him.
Meanwhile, our mayor is closing all eat in restaurants in the city, which falls under the "unnecessary" category - not that I go to restaurants in my city.
That's a really strange model. I wonder if it has any scientific accuracy at all. It assumes that people are perfectly infectious and that any person has a roughly equal chance of coming into contact with any other person.
I kind of wish that they wouldn't do things like that without backing up their model in some way.
ProgressNotPerfection
Forum Master
But it was COOL! It had different COLORS and ANIMATION! I mean, come on, scientific accuracy pales by comparison.
But seriously, if it helps people understand the general concept of why social distancing works, then it has value.
If by "scientifically accurate" you mean it has predictive power, absolutely not at all. It is the epidemiological equivalent of a physicist's frictionless vacuum.
But that's OK, because its purpose is not to model any specific disease. It is to illustrate a concept to people who aren't already familiar with it. Probabilistic transmission and a more realistic model of human contact networks would only distract from the main idea.