It's been like that in CA for almost 10 days...Costco has long lines to get in, and are letting in few people at a time. The lines are snaking around the building and into parking lots. The entrance has a list of out of stock items, and "essentials" such as toilet rolls, paper towels, milk, bread, water, etc. are limited to 1 per purchase...Forget about cleaning supplies and hand sanitizers, which are always almost out of stock...
I find it fascinating how this is working in SF. If you go to Costco or any big box retailer, that's the situation. If you go to most corner stores, of which there are many in SF, they have everything except masks and hand sanitizer, including everything on the list above.
People are generally taking things seriously here - hopefully we will flatten the curve enough to save lives and be able to get back to some level of normalcy soon.
as the WHO doesn't have a central data bank on real-time testing, it is impossible to know what percentage of patients are presenting with the disease. Is it 100%?, absolutely not. Is it 1%?, absolutely not.
China has been rapidly testing asymptomatic patients for the past six weeks, symptomatic patients don't get swabbed, they get Chest CT immediately (swab is 71-75% sensitive, CT scan 96-97% sensitive)
Their figures suggest that probably around 25% of patients present, if that were the case, then we have currently around 1.6 million people world-wide with Covid. This would be in line with WHO estimates that the true mortality is around 1% (currently 4%)
I have many radiologist-colleagues in China, the stories of CT scanners performing 400+ patients a day EACH are astounding, but in line with the statistics suggesting that over one million CT scans have been performed over the past 10 weeks.
The current epidemiology makes for (medically) fascinating, if somewhat morbid, reading.
Those EU countries with excellent health care, like Germany, have a very low mortality.
Those EU countries with sub-standard health-care, like Italy, France and Spain, have a much higher mortality. Sadly, the English system is not much better, and if warmer weather does not save them, they will soon repeat the figures.
The USA has a decent system, provided you are insured, and as long as the Democrats can convince that idiot to think in terms of lives and not dollars, their system should cope OK.
The real danger, the elephant in the room, and where hundreds of thousands may die, is India. People all nervous about Africa, as they should be, but a serious outbreak in India will cause absolute pandemonium.
felixp21 wrote:
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The real danger, the elephant in the room, and where hundreds of thousands may die, is India. People all nervous about Africa, as they should be, but a serious outbreak in India will cause absolute pandemonium.
I agree felix. That’s what has been bothering me. Although I moved to US many years ago, I am originally from India. It would be absolutely chaotic if the pandemic unfolds over there. India is smaller in size compared to China and has more people than China. And there are quite a few cities in India which are 15 million plus in population. Unlike in China, it’s hard to declare martial law or impose strict lockdown restrictions in India. I don’t know if warm weather plays any role in blunting the Coronavirus, but that’s what we can hope for as I don’t think the healthcare system in India can handle the situation.
stefan wrote:Where do you get your ratings of health care by country, Felix? WHO rates France 1, Italy 2, Spain 7, UK 18, Germany 25, USA 37.
WHO rates countries health care on access and cost, rather meaningless in real terms. If you want to look at health spend as a percentage of GDP, the USA is far and away number one, but again, this system has it's flaws. EU healthcare has always been diabolically bad, the healthcare workers absurdly underpaid, and specialist training not up to the standards set elsewhere.
The proof is in the pudding, sadly, and at the end of the day, there are many countries that will be forced to have a good look at their health care systems after this is finished.
Felix, are you an expert on health care around the world? I know that Danny, David, and Stuart are all doctors and even what are their specialties. I only know that you claim to be an Australian doctor. You also claim to be better able than WHO to rate health systems. It would be helpful to know who you are in real life.
Stephan, it's no problem if you don't believe me. This isn't a pissing contest. I am an experienced medical specialist in Australia, my in-laws are from WuHan in China, so I have been living this nightmare for two months longer than most Western people. My brother in law was a colleague and close personal friend of the so-called "whistle-blower", I have had daily contact with him thru wechat for more than ten weeks since this saga became apparent. What is being reported about this "whistle-blower" in the West is total garbage, to say the very least.
I posted five weeks ago on a medical forum in Aus that EU was a disaster waiting to happen, and got howled down for the comment. (although I since have received apologies there, unlike here... but again, that's ok, I couldn't care less). Like it or not, it is well known in medical circles that many EU countries have sub-standard Health systems for the standard of living currently enjoyed, and this saga is beginning to show which systems are indeed capable.
I'm posting now that India is facing the wall, I dearly hope their curfew will arrest what will otherwise be a catastrophe.
This is my last post on this site, I find many of the members, but certainly not the founder, boorish, ignorant and aggressive. Don't need that, and anyway, the next few months look like being very busy for me!!
Felix:
Please reconsider. I have thoroughly enjoyed your passion, even when I have thought you have gone overboard a few times.
Certainly I have gone overboard, and others here as well.
Honestly, Stefan is as good a man as you will find. He is the soul of BWE. And Alex is an immense person.
If you met both of them in person you would love them like brothers.
Things just don't always translate over the internet.
I really hope I get to meet you in Maine this summer, even if for only 15 minutes.
Better yet, over a glass of fine northern Medoc!
A guy from Quebec named Nicola promises he is going to be here in Maine this summer, perhaps we can tag him along.
When you are in Maine call/text/WhatsApp me at +1-207-754-3900. I also have a WeChat account.
I truly respect what you have said here.
Almost every prediction you have made has come true, even when others, perhaps ME more than anyone, has questioned you.
I have a bunch of more questions of you, like:
Do you think 3 weeks of total in-house confinement will/can work in India?
I have a friend in Beijing, she confirms what we are reading here in the west, that the numbers have gone way down, but they are still in like heavy lockdown with no end in sight. Can you corroborate/add insight on that?
And most importantly, from our perspective: What is your best guess (I won't hold you to it) as to when we might see at least a sembleance of normalcy here in the United States?
Anyway... Let's everyone just take a deep breath.
We'll get through this, and as the kind and benevolent dicator of BWE, I hereby and heretofore order you, FelixP, to continue to post on Bordeaux Wine Enthusiasts... the greatest internet web site in the world.
So it is written. So it shall be done.
It's all going to be ok.
I promise you.
BD
Jim
Provincial authorities in Hubei are now starting to wind down the strict controls over the movement of people. The changes are published daily on xinhuanet.
As of today, migrant workers are already returning home for the province (outside of Wuhan) and the Chinese govt has announced that outbound travel restrictions from Wuhan itself (though not inbound) will be lifted on 8 April.
My wife's family (in Changzhou) also are reporting that whilst some measures are still being enforced, the markets are now re-opening and more people are returning to work.
Wendy's sister has now gone back to work (she's an accountant) but there are still numerous rules on contact, crowds, etc plus disinfection and hygiene.
I DO however hope that the re-opening of markets will be done with more attention to hygiene and safety. And no endangered exotic animals or even street dogs.
Can I address the issue of India and other nations with densely populated slum areas.
For the most part, eastern and SE Asian countries have generally reacted quite quickly (after a few slow starts) to the virus and the new infection rate and death rate are slowing.
That does not apply for every country (and the data from some nations that I will not mention is way under-stated for political reasons).
One enormous threat in highly dense slum areas is that if the virus hit, there would be virtually no rational way of dealing with it.
For example, the greater Manila population is officially 30M (wikipedia) but is likely to be greater. It has the most crowded slums in Asia.
The city itself contains about 13M people in a land mass of only 43 sq klms. Concepts such as social distancing are virtually impossible. Poor areas have terrible hygiene and general safety conditions.
However, there are densely packed shanty towns and slums in many Asian cities, and I have seen plenty.
Greater Mumbai (which includes the outskirts areas which sprawl for miles) is around 25M. There are numerous other Asian megacities and they nearly always have large slum populations.
Jakarta province (the city and remainder of the capital region) has a population of 34M.
And I lived in Indonesia some years ago and have travelled there regularly, and I can vouch for the slum areas.
The Indonesian govt are now planning to move the political capital away from Jakarta (and Java per se) and build it in eastern Kalimantan. This way they can avoid the inconvenience of Jakarta.
Putting any one nation aside, the risk of epidemic in the poor areas is pretty high. And I have even mentioned Africa, Central or South America.
If the number of cases passes the level to which health authorities can cope (and that is pretty limited in many cities) then there is no rational way to quarantine them, provide proper medical care, improve sanitary conditions, impose restrictions on contact, movement and hygiene. Many simply live a hand to mouth existence. Providing enough food for them is hard enough.
In China, the rules on movement, contact, hygiene etc were for the most part strictly enforced after the disease started to spread.
I am trying to imagine how that can rationally be put in place in metro Manila, the slum areas of Jakarta (which is prone to flooding), Mumbai and Delhi, and just about any other big city with large slum areas.
Confinement and other controls are likely to be effective over time in more developed countries, despite the contagion in Italy and to an extent, some other European nations, but if the virus hits slum areas, it will be extremely hard to control.
No I am not a doomsday theorist and never have been, but the issues faced everywhere else will be magnified in high density areas.
I have previously made reference to the Spanish flu (1918) for a few reasons:
A). It hit Europe at a time when it was devastated after the war, with troops returning from the front. With populations in a weakened condition, the Flu killed something like 40-50M. My point is that the C-19 virus has already proven to be many times worse when it reaches people who are old and have co-morbidities. That's why I raise the issue of slums - poor nutrition, sanitation and healthcare.
B). There is considerable evidence to say that the Spanish flu morphed into a more virulent strain in Autumn and/or winter, 1918. There is also evidence (Chinese CDC) that the C-19 virus also has two strains, one (L) being considerably worse. Not sure if it is known which places have which strain (or potentially both).
Great article and it is amazing how quick this analysis came out when you consider the UK article released March 16 a week ago. Thanks for sharing.
The Hammer and Dance makes life palatable if we can accomplish it. We need to build stats and test more widely. We are not testing enough people and presumed Covid patients here are put in self isolation but not confirmed and anyone living with them are not forced to self quarantine thereby placing many at risk. My son has a very bad flu like illness with mild shortness of breath staying at home but his fiancee is a healthcare worker still going to the hospital daily potentially putting everyone she contacts at risk if he truly has the disease and she is an asymptomatic carrier. Public Health refuses to test him because he does not meet their current criteria. This is but one example of the holes that we need to plug with more testing capacity to ensure public safety at large. We are in the phase of social distancing but 1-2 weeks away to see if the current measures will have any impact then start to dance...hopefully!
The information you are quoting on the Chinese experience with CT Chest screening is inaccurate and not supported by the current literature written by the Chinese experts and now shared around the world but being modified and put into perspective that one size dose not fit all. They have shown very poor sensitivity with 50% of patients who are Covid +ve ,respiratory symptoms and negative CT early on. The findings on CT are very non specific overlapping with many other diseases placing patients at risk if the wrong diagnosis is made and wrong treatment initiated. Yes CT has been used widely in China during this outbreak and valuable information has been obtained and you make it sound like CT Chest is first line in the diagnosis but you are very wrong on this one.
This just came in tis evening one of dozens of updates on role of CT and I distributed to some via email last week a very good update based on the Wuhan experience on the utility of CT and it did not reflect what you are suggesting.
Great report, Mark, thanks.
Those images you paint of Manila and Mumbai are very sobering.
I hope Wendy and her family are safe and well.
Another day dawns here in the U.S.
The Maine courts have been running pretty smoothly without us.
Less arrests, more non-violent offenders being released from jail.
Cases being resolved. I resolved an aggravted domestic assault yesterday for two weeks time served on a misdemeanor bail violation plea, the client released. This morning we're going to do a bail hearing for a client charged with manslaughter by telephone conference with the judge.
My Alaska case is continued for the time being, though.
Good read and thanks. Starting to look like James Bond thriller but real message is where is the coordinated world leadership. There is truly a void which is most worrisome. This truly a global problem that developed nations are struggling with. I know a great deal of information is being rapidly being shared in the medical community and medical personal are prepared for the storm to come. Govts around the world aren't showing the leadership that the medical community has and the body language of Fauci when Trump starts to speak tells a lot. God help us!!
Jim can't open the WSJ article without subscription.
Danny, have you already been involved in screening patients for Covid-19? If not, I guess it is just a matter of time. I hope you will share with us your experience to the extent allowed by medical ethics.
During the 2014 Ebola epidemic, the U.S. served as that kind of leader. The U.S. fulfilled a similar role also during the 2008 financial crisis, when it rallied behind it enough countries to prevent global economic meltdown. But in recent years the U.S. has resigned its role as global leader. The current U.S. administration has cut support for international organizations like the World Health Organization, and has made it very clear to the world that the U.S. no longer has any real friends – it has only interests. When the coronavirus crisis erupted, the U.S. stayed on the sidelines, and has so far refrained from taking a leading role. Even if it eventually tries to assume leadership, trust in the current U.S. administration has been eroded to such an extent, that few countries would be willing to follow it. Would you follow a leader whose motto is “Me First”?
greatbxfreak wrote:The question is at which temperature coronavirus doesn't spread.
I heard 27 degrees Celsius and 32 degrees Celcius. I don't think it will spread that much in India, Pakistan, etc. It's too hot there.
Just heard that Champions Legaue match Atalanta-Valencia (both legs) contributed heavily to spreading virus in Spain and Italy.
Maybe medical experts can chime in, but I am seriously hoping that warm weather will play a role in negating the spread of the virus. Summer has arrived in India and parts of it are already seeing temperatures of 100F..We have always cribbed about mercury routinely hitting 115 on most of summer days, and now are hoping that it will do the miracle in containing this invisible bug...
greatbxfreak wrote:The question is at which temperature coronavirus doesn't spread.
I heard 27 degrees Celsius and 32 degrees Celcius. I don't think it will spread that much in India, Pakistan, etc. It's too hot there.
Just heard that Champions Legaue match Atalanta-Valencia (both legs) contributed heavily to spreading virus in Spain and Italy.
Maybe medical experts can chime in, but I am seriously hoping that warm weather will play a role in negating the spread of the virus. Summer has arrived in India and parts of it are already seeing temperatures of 100F..We have always cribbed about mercury routinely hitting 115 on most of summer days, and now are hoping that it will do the miracle in containing this invisible bug...
Many experts do not believe that Covid 19 is "seasonal." MERS, another corona virus which appeared in the Arabian peninsula and where its 110 degrees F, transmits from human to human just fine.
Is the Coronavirus as Deadly as They Say?
Current estimates about the Covid-19 fatality rate may be too high by orders of magnitude.
By Eran Bendavid and Jay Bhattacharya
March 24, 2020 6:21 pm ET
A line at an emergency room in Brooklyn, N.Y., March 19.
If it’s true that the novel coronavirus would kill millions without shelter-in-place orders and quarantines, then the extraordinary measures being carried out in cities and states around the country are surely justified. But there’s little evidence to confirm that premise—and projections of the death toll could plausibly be orders of magnitude too high.
Fear of Covid-19 is based on its high estimated case fatality rate—2% to 4% of people with confirmed Covid-19 have died, according to the World Health Organization and others. So if 100 million Americans ultimately get the disease, two million to four million could die. We believe that estimate is deeply flawed. The true fatality rate is the portion of those infected who die, not the deaths from identified positive cases.
The latter rate is misleading because of selection bias in testing. The degree of bias is uncertain because available data are limited. But it could make the difference between an epidemic that kills 20,000 and one that kills two million. If the number of actual infections is much larger than the number of cases—orders of magnitude larger—then the true fatality rate is much lower as well. That’s not only plausible but likely based on what we know so far.
Population samples from China, Italy, Iceland and the U.S. provide relevant evidence. On or around Jan. 31, countries sent planes to evacuate citizens from Wuhan, China. When those planes landed, the passengers were tested for Covid-19 and quarantined. After 14 days, the percentage who tested positive was 0.9%. If this was the prevalence in the greater Wuhan area on Jan. 31, then, with a population of about 20 million, greater Wuhan had 178,000 infections, about 30-fold more than the number of reported cases. The fatality rate, then, would be at least 10-fold lower than estimates based on reported cases.
Next, the northeastern Italian town of Vò, near the provincial capital of Padua. On March 6, all 3,300 people of Vò were tested, and 90 were positive, a prevalence of 2.7%. Applying that prevalence to the whole province (population 955,000), which had 198 reported cases, suggests there were actually 26,000 infections at that time. That’s more than 130-fold the number of actual reported cases. Since Italy’s case fatality rate of 8% is estimated using the confirmed cases, the real fatality rate could in fact be closer to 0.06%.
In Iceland, deCode Genetics is working with the government to perform widespread testing. In a sample of nearly 2,000 entirely asymptomatic people, researchers estimated disease prevalence of just over 1%. Iceland’s first case was reported on Feb. 28, weeks behind the U.S. It’s plausible that the proportion of the U.S. population that has been infected is double, triple or even 10 times as high as the estimates from Iceland. That also implies a dramatically lower fatality rate.
The best (albeit very weak) evidence in the U.S. comes from the National Basketball Association. Between March 11 and 19, a substantial number of NBA players and teams received testing. By March 19, 10 out of 450 rostered players were positive. Since not everyone was tested, that represents a lower bound on the prevalence of 2.2%. The NBA isn’t a representative population, and contact among players might have facilitated transmission. But if we extend that lower-bound assumption to cities with NBA teams (population 45 million), we get at least 990,000 infections in the U.S. The number of cases reported on March 19 in the U.S. was 13,677, more than 72-fold lower. These numbers imply a fatality rate from Covid-19 orders of magnitude smaller than it appears.
How can we reconcile these estimates with the epidemiological models? First, the test used to identify cases doesn’t catch people who were infected and recovered. Second, testing rates were woefully low for a long time and typically reserved for the severely ill. Together, these facts imply that the confirmed cases are likely orders of magnitude less than the true number of infections. Epidemiological modelers haven’t adequately adapted their estimates to account for these factors.
The epidemic started in China sometime in November or December. The first confirmed U.S. cases included a person who traveled from Wuhan on Jan. 15, and it is likely that the virus entered before that: Tens of thousands of people traveled from Wuhan to the U.S. in December. Existing evidence suggests that the virus is highly transmissible and that the number of infections doubles roughly every three days. An epidemic seed on Jan. 1 implies that by March 9 about six million people in the U.S. would have been infected. As of March 23, according to the Centers for Disease Control and Prevention, there were 499 Covid-19 deaths in the U.S. If our surmise of six million cases is accurate, that’s a mortality rate of 0.01%, assuming a two week lag between infection and death. This is one-tenth of the flu mortality rate of 0.1%. Such a low death rate would be cause for optimism.
This does not make Covid-19 a nonissue. The daily reports from Italy and across the U.S. show real struggles and overwhelmed health systems. But a 20,000- or 40,000-death epidemic is a far less severe problem than one that kills two million. Given the enormous consequences of decisions around Covid-19 response, getting clear data to guide decisions now is critical. We don’t know the true infection rate in the U.S. Antibody testing of representative samples to measure disease prevalence (including the recovered) is crucial. Nearly every day a new lab gets approval for antibody testing, so population testing using this technology is now feasible.
If we’re right about the limited scale of the epidemic, then measures focused on older populations and hospitals are sensible. Elective procedures will need to be rescheduled. Hospital resources will need to be reallocated to care for critically ill patients. Triage will need to improve. And policy makers will need to focus on reducing risks for older adults and people with underlying medical conditions.
A universal quarantine may not be worth the costs it imposes on the economy, community and individual mental and physical health. We should undertake immediate steps to evaluate the empirical basis of the current lockdowns.
Dr. Bendavid and Dr. Bhattacharya are professors of medicine at Stanford. Neeraj Sood contributed to this article.
greatbxfreak wrote:The question is at which temperature coronavirus doesn't spread.
I heard 27 degrees Celsius and 32 degrees Celcius. I don't think it will spread that much in India, Pakistan, etc. It's too hot there.
Just heard that Champions Legaue match Atalanta-Valencia (both legs) contributed heavily to spreading virus in Spain and Italy.
Maybe medical experts can chime in, but I am seriously hoping that warm weather will play a role in negating the spread of the virus. Summer has arrived in India and parts of it are already seeing temperatures of 100F..We have always cribbed about mercury routinely hitting 115 on most of summer days, and now are hoping that it will do the miracle in containing this invisible bug...
Many experts do not believe that Covid 19 is "seasonal." MERS, another corona virus which appeared in the Arabian peninsula and where its 110 degrees F, transmits from human to human just fine.
--Gary Rust
Agree - SARS-CoV-2 may not be as sensitive to temperature as influenza, though there is some suggestion there will be some temperature effect. Too soon to tell...
I know Jay Bhattacharya and have worked with him. Very smart and data-driven guy. He's not an epidemiologist. He's an economist. Bendavid is an ID specialist with an interest in disease modeling. I hope they are right, but the assumptions made in the article are less traditional than those made by most epidemiologists. Theirs is an outlier opinion. They compare a mortality rate based on a denominator that is derived differently than the one used for influenza or other infectious diseases.
As I've posted above, the experts are likely to disagree on a scale of 10-100x. Most are not saying it's going to be 100x less bad than the mainstream estimates - i.e. 10,000-20,000 deaths in the US vs 1-2 million. Hoping the social distancing thing keeps us in the tens of thousands range.
Going from the global to the personal, here's a post an Emory infectious disease epidemiologist made to her community website:
As an infectious disease epidemiologist, at this point I feel morally obligated to provide some information on what we are seeing from a transmission dynamic perspective and how they apply to the social distancing measures. Specifically, I want to make two aspects of these measures very clear and unambiguous.
First, we are in the very infancy of this epidemic’s trajectory. That means even with these measures we will see cases and deaths continue to rise globally, nationally, and in our own communities in the coming weeks. Our hospitals will be overwhelmed, and people will die that didn’t have to. This may lead some people to think that the social distancing measures are not working. They are. They may feel futile. They aren’t. You will feel discouraged. You should. This is normal in chaos. This enemy that we are facing is very good at what it does; we are not failing. We need everyone to hold the line as the epidemic inevitably gets worse. This is not my opinion; this is the unforgiving math of epidemics for which I and my colleagues have dedicated our lives to understanding with great nuance, and this disease is no exception. We know what will happen; I want to help the community brace for this impact. Stay strong and with solidarity knowing with absolute certainty that what you are doing is saving lives, even as people begin getting sick and dying around you. You may feel like giving in. Don’t.
Second, although social distancing measures have been (at least temporarily) well-received, there is an obvious-but-overlooked phenomenon when considering groups (i.e. families) in transmission dynamics. While social distancing decreases contact with members of society, it of course increases your contacts with group (i.e.. family) members. This small and obvious fact has surprisingly profound implications on disease transmission dynamics. Study after study demonstrates that even if there is only a little bit of connection between groups (i.e. social dinners, playdates/playgrounds, etc.), the epidemic trajectory isn’t much different than if there was no measure in place. The same underlying fundamentals of disease transmission apply, and the result is that the community is left with all of the social and economic disruption but very little public health benefit. You should perceive your entire family to function as a single individual unit; if one person puts themselves at risk, everyone in the unit is at risk. Seemingly small social chains get large and complex with alarming speed. If your son visits his girlfriend, and you later sneak over for coffee with a neighbor, your neighbor is now connected to the infected office worker that your son’s girlfriend’s mother shook hands with. This sounds silly, it’s not. This is not a joke or a hypothetical. We as epidemiologists see it borne out in the data time and time again and no one listens. Conversely, any break in that chain breaks disease transmission along that chain.
In contrast to hand-washing and other personal measures, social distancing measures are not about individuals, they are about societies working in unison. These measures also take a long time to see the results.
It is hard (even for me) to conceptualize how ‘one quick little get together’ can undermine the entire framework of a public health intervention, but it does. I promise you it does. I promise. I promise. I promise. You can’t cheat it.. People are already itching to cheat on the social distancing precautions just a “little”- a playdate, a haircut, or picking up a needless item at the store, etc. From a transmission dynamics standpoint, this very quickly recreates a highly connected social network that undermines all of the work the community has done so far.
Until we get a viable vaccine this unprecedented outbreak will not be overcome in grand, sweeping gesture, rather only by the collection of individual choices our community makes in the coming months. This virus is unforgiving to unwise choices. My goal in writing this is to prevent communities from getting ‘sucker-punched’ by what the epidemiological community knows will happen in the coming weeks. It will be easy to be drawn to the idea that what we are doing isn’t working and become paralyzed by fear, or to ‘cheat’ a little bit in the coming weeks. By knowing what to expect, and knowing the importance of maintaining these measures, my hope is to encourage continued community spirit, strategizing, and action to persevere in this time of uncertainty.
Jesus Christ, people from Maine are screaming on their Facebook pages that we need to keep New Yorkers out of the state from their summer homes.
At first I thought it was a joke but upon investigation it is like a real concern.
The world is going fucking insane.
I was in NYC looking at apartments two weekends ago, flew back from a morgue-like LaGuardia two Sundays ago, that would be, what, 10 days ago as of today.
I feel fine, not a sniffle.
Just watched Mayor DiBlazio.
Heard Gov. Cuomo earlier.
Sounds like great progress in New York and New York City.
Still waiting for the images of backed up lines of body bags coming out of New York City hospitals, not seeing it.
Last number I heard was I think yesterday, 29 deaths in NYC in a city of 10 million,
A terrible plague, which requires extraodinary measures, perhaps even that of shutting down a plat of 8 billion people.
I know I'm a Neanderthal, but I hope we attain Orange Head's "aspirational" goal of normalcy by Easter.
I'm not at all opposed to New Yorkers coming to their homes in Maine.
Not one bit.
Not an iota.
There's a lot of hysteria out there.
I LOVE New York.
Come to Maine, New Yorkers, and just follow our governor's guidelines, like everyone else.
Wash your hands, and cough into your elbows.
Humanity needs to make a choice. Will we travel down the route of disunity, or will we adopt the path of global solidarity? If we choose disunity, this will not only prolong the crisis, but will probably result in even worse catastrophes in the future. If we choose global solidarity, it will be a victory not only against the coronavirus, but against all future epidemics and crises that might assail humankind in the 21st century.
This is almost biblical....written thousands of years ago, but still applies today
Emil, Harari in my opinion is one of the great thinkers of our age. Sapiens is one of the best books i've read even if some Israeli intellectuals friends of mine denigrate it as simplistic and poorly written. I highly recommend it. It presents ideas and points of reference I never thought of and was very stimulating.
Jacques, i like the way he thinks....there is certainly a sense of religious concepts in his prose...even though he grew up in a secular family.
the current US administration has abdicated the job of leader. It has made it very clear that it cares about the greatness of America far more than about the future of humanity.
Boy...is that an understatement....i don't think wanting good for your country is so terrible, its the delivery of this message that turns heads...as Herari himself states (and he contradicts himself at times) you could take the same scenario and present it in such a different way "that the wolves should be fed and the sheep kept safe. ”
Thanks for that Emory epidemiologist piece. I must say these people are the unsung heroes of medicine that are given little credit until some shit hits the fan. They critically analyze studies in ways the average clinician doesn't or can't and in times like these they are looked upon for their analytical perspective. People don't like to wait for results in this instant gratification society and don't understand that the simple measures of social distancing, self quarrying/isolation do work with TIME. 2-3 weeks hopefully we see some effect or we may be in trouble but I'm hopeful like her but the wait is hard.
Jim,
Thanks for the WSJ article. These guys think more like me. Think like a clinician in simple terms and use data points that make sense. Back to influenza 35 million people infected and 35k deaths in 2018 and no economy shut down measures. I'm still looking for answers as to why this bug is worse. Maybe it's that epidemiologist factor of the RO (R-Naught) that is 1-1.5 for influenza and 2-2.5 for Covid?? Twice as likely to be transmitted but death rates are all over the place depending on where you are and how overwhelmed healthcare systems become. Right now the system can still cope and death rate low but early in this game and NYC starting to get saturated and scared about what's to come. This is a real life living experiment and epidemiologist thrive in this environment. Clinicians sit back and try to do the best they can as the data points unfold. It's easy to treat patients with accepted standards but this thinking outside the box is tough for most people but in times like these I defer to the experts....Epidemiologists!
Reminds me of the Live Aid set in '85, two weeks before the bar exam, I took the day off from my studying that day to watch Freddie and the boys with my brothers.
Incredibly, we had seen them ten years earlier, in February of '75, at the Lewiston Armory.
Happier, innocent times, indeed. And yet, another germ at that time was lurking, pure evil, ready and genetically geared to destruct and destroy life on the planet....
