[Health] The Infectious Diseases Thread

[Jeff V]

will become as taboo as scratching your butt.

And what is wrong with that, sir?

[Isgrimnur]

[gameoverman]

I read a report yesterday that projects all kinds of things out through 2025, using various assumptions to cover things we don't know about yet. The more I read and absorb, the less I'm confident we'll be going back to what we referred to as "normal" any time soon. Knowing that and how we need to collectively adjust is going to be...painful.

When this pandemic started I didn't think it was going to be anything big, outside of China. Then it became a big deal outside China. When they announced we'd need a couple of weeks of shut down, I thought that was impossible. You can't shut everything down for a couple of weeks. Then they shut everything down. Somewhere along the line they announced it was going to be more than two weeks. It HAS been more than two weeks.

So what I'm saying is that based on what I've seen happen to this point in time, I think whatever report you read was probably telling the truth or something close to it. We are going to do things we'd never thought we'd do, and things are going to take longer than anyone imagined, and things aren't going back to whatever 'normal' was, at least not for a long, long time.

Isn't the best case scenario the development of a vaccine? Realistically, counting research phase, fast tracked testing phase, manufacturing phase, distribution phase, and finally implementation phase, we are talking more than a year right? And that's best case. A year of this is going to alter the landscape like the shimmer in Annihilation.

[Kraken]

I read a report yesterday that projects all kinds of things out through 2025, using various assumptions to cover things we don't know about yet. The more I read and absorb, the less I'm confident we'll be going back to what we referred to as "normal" any time soon. Knowing that and how we need to collectively adjust is going to be...painful.

When this pandemic started I didn't think it was going to be anything big, outside of China. Then it became a big deal outside China. When they announced we'd need a couple of weeks of shut down, I thought that was impossible. You can't shut everything down for a couple of weeks. Then they shut everything down. Somewhere along the line they announced it was going to be more than two weeks. It HAS been more than two weeks.

So what I'm saying is that based on what I've seen happen to this point in time, I think whatever report you read was probably telling the truth or something close to it. We are going to do things we'd never thought we'd do, and things are going to take longer than anyone imagined, and things aren't going back to whatever 'normal' was, at least not for a long, long time.

Isn't the best case scenario the development of a vaccine? Realistically, counting research phase, fast tracked testing phase, manufacturing phase, distribution phase, and finally implementation phase, we are talking more than a year right? And that's best case. A year of this is going to alter the landscape like the shimmer in Annihilation.

We don't have a vaccine for the cold. Flu vaccines are sketchy from year to year. I don't have a lot of hope for a one-and-done Covid knockout vaccine.

Herd immunity is the most likely way out, assuming that infection conveys immunity (which isn't certain). As much as we've all come to fear Covid over the past month, the point of all this distancing is to delay catching it until the medical system can handle you without breaking, and ideally has treatments to minimize symptoms and duration. At that point, the risk to people without co-morbidities becomes reasonable, and we can rejoin society.

As for "back to normal," I hope we can do better than that. For too many people, "normal" wasn't working.

[Anonymous Bosch]

Isn't the best case scenario the development of a vaccine? Realistically, counting research phase, fast tracked testing phase, manufacturing phase, distribution phase, and finally implementation phase, we are talking more than a year right? And that's best case. A year of this is going to alter the landscape like the shimmer in Annihilation.

Not necessarily.

Reliable specific treatment(s) are likely to arrive long before any vacccine is made widely available. Which could also go a long way towards relieving concerns of the virus completely overwhelming our healthcare system.

[Holman]

will become as taboo as scratching your butt.

And what is wrong with that, sir?

Now I'm REALLY never shaking your hand!

[Victoria Raverna]

I don't think herd immunity is the way out. To have herd immunity without vaccine means total failure and a huge casualty.

Instead of waiting for herd immunity, a total lockdown or even a very strict social distancing that is done at national or worldwide level will stop COVID-19.

To do that, we need coordination. It'll not work if a state do it this month and the other state do it next month, etc. Don't play whack a mole. Do it at the same time everywhere. Ideally the whole world but if that not possible at least the whole country.

Do it until the virus is gone which should not take more than 2 months. Then if it is not worldwide but country level, have a very strict border to prevent reinfection from other countries.

[malchior]

There isn't enough political will to do anything approaching that yet. Heck we have agitation for the opposite right now.

[gameoverman]

Even if loss of jobs and loss of income wasn't a factor in this, it would be next to impossible to get people to stay in lockdown for 'as long as it takes'. I think that's why the lockdowns are only extended for a couple of weeks or till the end of the month at a time. Leaders know they have to sound like the end might be in sight. Imagine if someone at the top boldly stated back at the end of March "This shut down is in effect until further notice, stop asking when it'll be over". Haha, that would have been a hell of a thing to see.

Now factor in the financial pressure, keeping this going for much longer is going to be very challenging. There are a lot of people who don't know anyone who has been sick, much less died, from this. Those people will not have much reason to accept financial ruin due to a threat that is abstract to them. It might take a second wave of infections that leads to far more deaths until we get full cooperation on stay at home rules. Only then might we reach the 'shiat just got real' moment for these people.

[hitbyambulance]

There are a lot of people who don't know anyone who has been sick, much less died, from this. Those people will not have much reason to accept financial ruin due to a threat that is abstract to them. It might take a second wave of infections that leads to far more deaths until we get full cooperation on stay at home rules. Only then might we reach the 'shiat just got real' moment for these people.

basically, +1 to this. there are a lot of people who are plenty willing to roll the dice - as you say, getting infected is just too abstract to them to conceive of it. they can't think it will possibly maim/kill them. not a lot you can do with these types until the disease personally impacts them.

[Unagi]

I read a report yesterday that projects all kinds of things out through 2025, using various assumptions to cover things we don't know about yet. The more I read and absorb, the less I'm confident we'll be going back to what we referred to as "normal" any time soon. Knowing that and how we need to collectively adjust is going to be...painful.

When this pandemic started I didn't think it was going to be anything big, outside of China. Then it became a big deal outside China. When they announced we'd need a couple of weeks of shut down, I thought that was impossible. You can't shut everything down for a couple of weeks. Then they shut everything down. Somewhere along the line they announced it was going to be more than two weeks. It HAS been more than two weeks.

So what I'm saying is that based on what I've seen happen to this point in time, I think whatever report you read was probably telling the truth or something close to it. We are going to do things we'd never thought we'd do, and things are going to take longer than anyone imagined, and things aren't going back to whatever 'normal' was, at least not for a long, long time.

Isn't the best case scenario the development of a vaccine? Realistically, counting research phase, fast tracked testing phase, manufacturing phase, distribution phase, and finally implementation phase, we are talking more than a year right? And that's best case. A year of this is going to alter the landscape like the shimmer in Annihilation.

We don't have a vaccine for the cold. Flu vaccines are sketchy from year to year. I don't have a lot of hope for a one-and-done Covid knockout vaccine.

Herd immunity is the most likely way out, assuming that infection conveys immunity (which isn't certain). As much as we've all come to fear Covid over the past month, the point of all this distancing is to delay catching it until the medical system can handle you without breaking, and ideally has treatments to minimize symptoms and duration. At that point, the risk to people without co-morbidities becomes reasonable, and we can rejoin society.

As for "back to normal," I hope we can do better than that. For too many people, "normal" wasn't working.

How can you say that a vaccine ‘wouldn’t stick’ but that somehow a thing like herd immunity will likely be the way out?

If one doesn’t work, the other doesn’t exists.

[stessier]

I found this article on modeling the future to be interesting as it talks about immunity to other viruses (or the lack there of) and what it means for COVID-19.

[Kraken]

I read a report yesterday that projects all kinds of things out through 2025, using various assumptions to cover things we don't know about yet. The more I read and absorb, the less I'm confident we'll be going back to what we referred to as "normal" any time soon. Knowing that and how we need to collectively adjust is going to be...painful.

When this pandemic started I didn't think it was going to be anything big, outside of China. Then it became a big deal outside China. When they announced we'd need a couple of weeks of shut down, I thought that was impossible. You can't shut everything down for a couple of weeks. Then they shut everything down. Somewhere along the line they announced it was going to be more than two weeks. It HAS been more than two weeks.

So what I'm saying is that based on what I've seen happen to this point in time, I think whatever report you read was probably telling the truth or something close to it. We are going to do things we'd never thought we'd do, and things are going to take longer than anyone imagined, and things aren't going back to whatever 'normal' was, at least not for a long, long time.

Isn't the best case scenario the development of a vaccine? Realistically, counting research phase, fast tracked testing phase, manufacturing phase, distribution phase, and finally implementation phase, we are talking more than a year right? And that's best case. A year of this is going to alter the landscape like the shimmer in Annihilation.

We don't have a vaccine for the cold. Flu vaccines are sketchy from year to year. I don't have a lot of hope for a one-and-done Covid knockout vaccine.

Herd immunity is the most likely way out, assuming that infection conveys immunity (which isn't certain). As much as we've all come to fear Covid over the past month, the point of all this distancing is to delay catching it until the medical system can handle you without breaking, and ideally has treatments to minimize symptoms and duration. At that point, the risk to people without co-morbidities becomes reasonable, and we can rejoin society.

As for "back to normal," I hope we can do better than that. For too many people, "normal" wasn't working.

How can you say that a vaccine ‘wouldn’t stick’ but that somehow a thing like herd immunity will likely be the way out?

If one doesn’t work, the other doesn’t exists.

Stessier's link kind of touches on that. Naturally acquired immunity from being infected, even if it's only short-term, evolves along with the virus. That is, people are making antibodies to the strain currently in circulation. Whereas a vaccine is going to be frozen in time and only work against the strain it was designed for -- it would need to be updated regularly to fight a constantly-moving target. But you're right that neither of those avenues is going to make the coronavirus go into hibernation anytime soon, at least based on current knowledge.

[Unagi]

Right. We create a new flu vaccine each year , and also, the herd immunity to last years flu is also just as outdated as last years vaccine.

I mean, I certainly accept the nuances involved and that inside the herd , some are indeed perhaps developing antibodies to the current strain, but that’s just like us keeping on top of Covid vaccines like we do the flu.

IMO

[stessier]

That's not exactly what the Ars article was saying. The modelling they were doing included what if our bodies forget the immune response like they do to the common cold. It's not that the cold is evolving, it's just that our immune response only lasts about a year.

Or at least that is how I understood it.

[raydude]

There are a lot of people who don't know anyone who has been sick, much less died, from this. Those people will not have much reason to accept financial ruin due to a threat that is abstract to them. It might take a second wave of infections that leads to far more deaths until we get full cooperation on stay at home rules. Only then might we reach the 'shiat just got real' moment for these people.

basically, +1 to this. there are a lot of people who are plenty willing to roll the dice - as you say, getting infected is just too abstract to them to conceive of it. they can't think it will possibly maim/kill them. not a lot you can do with these types until the disease personally impacts them.

The other scenario is that enough "influencers" get sick that those who don't think it can hurt them see how it got the influencers and maybe think twice. Imagine if Hannity, all the Fox morning crew, and the Bundy family all got sick and died from it for example.

[Paingod]

it's just that our immune response only lasts about a year.

Must be very disease-specific. I think a number of things are "lifetime vaccinations" (like Chicken Pox or the MMR injection, viral), and know of at least one that's several years (Tetanus, bacterial), with the flu changing yearly it makes sense that we'd need yearly vaccines. Is COVID-19 evolving fast enough that we might need a yearly vaccine? What of the 141 people who tested "positive" for active virus after getting over it (and should have a natural immunity now)?

[Unagi]

I will also say this... Academically speaking, I do not believe there is any difference (technically) between a person that is "immune via herd immunity**" and a person that is "immune via vaccine".
Both people's bodies, in theory, are now producing antibodies. The 'natural' immunity that Person A has achieved through actually getting the 'current virus', is clearly better if 'the current strain' is more prevalent than 'the previous strain'. But the 'vaccine immunity' that Person B has achieved through a shot, is certainly as good as it ever was at protecting against what was the most prevalent strain. They are both 'stuck in time', if you want to put it that way.






** herd immunity is actually the idea that YOU aren't getting the virus because the other members of the herd are immune - and hence you are protected by not being exposed to any carriers (or very few). So if enough airport screeners are immune, they won't pass it to world travelers and the virus wouldn't spread as fast as it does when those airport screeners are spreading it to everyone they see.

[Unagi]

What of the 141 people who tested "positive" for active virus after getting over it (and should have a natural immunity now)?

Most experts think it's unlikely that somebody will be re-infected for the coronavirus soon after recovering. It's possible that issues with testing – or varying amounts of viral RNA in the body, which the tests look for – could explain why people tested positive after testing negative

varying amount of viral RNA in the body.... perhaps they were not negative really, and were still fighting it ?

[stessier]

it's just that our immune response only lasts about a year.

Must be very disease-specific. I think a number of things are "lifetime vaccinations" (like Chicken Pox or the MMR injection, viral), and know of at least one that's several years (Tetanus, bacterial), with the flu changing yearly it makes sense that we'd need yearly vaccines. Is COVID-19 evolving fast enough that we might need a yearly vaccine? What of the 141 people who tested "positive" for active virus after getting over it (and should have a natural immunity now)?

My comment was in the context of the article talking about colds. The article said there are 4 categories of coronaviruses - alpha, beta, gamma, and delta. Covid-19 is in the beta group and some of the common cold viruses are in there. The article said the common cold is seasonal because our immune response to it lasts about a year. I wasn't commenting on all immune responses, just the one to that group of viruses.

[Ralph-Wiggum]

What I haven't seen (and maybe this was already mentioned) is whether the group of people who have been "reinfected" are actually displaying any symptoms. Also, I wonder if it would be possible to test whether the virus they currently have is the same strain as the one they originally had.

[Paingod]

The article said the common cold is seasonal because our immune response to it lasts about a year. I wasn't commenting on all immune responses, just the one to that group of viruses.

Need to do more reading, less multi-tasking.

[gameoverman]

The other scenario is that enough "influencers" get sick that those who don't think it can hurt them see how it got the influencers and maybe think twice. Imagine if Hannity, all the Fox morning crew, and the Bundy family all got sick and died from it for example.

That might work too. I was reading an article about how this pandemic is starting to affect Washington state's rural area and it mentioned how many people there thought this virus was just something being used to make Trump look bad. Then when Trump himself declared it an emergency those people changed their view on it being played up to make him look bad. So yeah, there are influencers who wield that kind of...uh, influence. And that's just from him saying it was a problem. Imagine someone they respect publicly commenting on becoming ill with it, then that person dies. That should get through to people.

[LawBeefaroni]

The other scenario is that enough "influencers" get sick that those who don't think it can hurt them see how it got the influencers and maybe think twice. Imagine if Hannity, all the Fox morning crew, and the Bundy family all got sick and died from it for example.

That might work too. I was reading an article about how this pandemic is starting to affect Washington state's rural area and it mentioned how many people there thought this virus was just something being used to make Trump look bad. Then when Trump himself declared it an emergency those people changed their view on it being played up to make him look bad. So yeah, there are influencers who wield that kind of...uh, influence. And that's just from him saying it was a problem. Imagine someone they respect publicly commenting on becoming ill with it, then that person dies. That should get through to people.

It will hammer home the new narrative that it is the fault of China and their mouthpiece the World Health Organisation. Some might even say it was an intentional release by China and obfuscation by their mouthpiece, the WHO. Having COVID hit home just means China has now attacked them direclty.

If people still need getting through to, they ain't gonna get through ta just because an internet-famous influencer gets sick and/or dies.

[Jeff V]

So Monday we get the sad news that my boss's east coast peer's mother had died from the virus while in a Pennsylvania nursing home. Today his sister went to pick up their dad for the funeral. They had been unable to contact him. He was found dead.

[em2nought]

It will hammer home the new narrative that it is the fault of China and their mouthpiece the World Health Organisation. Some might even say it was an intentional release by China and obfuscation by their mouthpiece, the WHO. Having COVID hit home just means China has now attacked them direclty.

Some might even begin to wonder what stamps are in John Kerry's passport during the last quarter of 2019.

[Alefroth]

It will hammer home the new narrative that it is the fault of China and their mouthpiece the World Health Organisation. Some might even say it was an intentional release by China and obfuscation by their mouthpiece, the WHO. Having COVID hit home just means China has now attacked them direclty.

Some might even begin to wonder what stamps are in John Kerry's passport during the last quarter of 2019.

We have a name for those people.

[Unagi]

Imagine if Hannity, all the Fox morning crew, and the Bundy family all got sick and died from it for example.

Are you flirting with me?

[raydude]

It will hammer home the new narrative that it is the fault of China and their mouthpiece the World Health Organisation. Some might even say it was an intentional release by China and obfuscation by their mouthpiece, the WHO. Having COVID hit home just means China has now attacked them direclty.

Some might even begin to wonder what stamps are in John Kerry's passport during the last quarter of 2019.

We have a name for those people.

First wave volunteers to reopen the economy?

[Kraken]

Tonight my BIL said his wife has a fever, cough, and body aches. But he's a drunk and she's a depressive drama queen who's always sick with one thing or another, so...grain of salt. Even though I don't much like either of them, I don't wish them ill and hope that she's just posturing again.

[Zarathud]

Imagine if Hannity, all the Fox morning crew, and the Bundy family all got sick and died from it for example.

Too bad we’re in the Darkest Timeline, not the Poetic Justice Timeline.

[Anonymous Bosch]

Gird your loins if you work for state, county, or city government...

Far worse to come: COVID-19 collapse of state and local governments

Another sudden and unexpected factor will transform this year’s elections. Many states, cities and counties are about to, suddenly, run out of money. Wages won’t be paid. Services won’t be delivered. Institutions will shut down abruptly. Many state colleges may fold. And yet most state and local political and administrative leaders just sit and watch. Voters will not be pleased.

Millions of American workers filed for unemployment insurance during the past two weeks. That is a record and represents a collapse of our local economies. Across the country, in every state, county and city, businesses have been shut down, and many will not return after the coronavirus crisis is over. Tens of millions have lost jobs, homes, savings and retirement incomes that will never return. Owners of rental property will go under when their loan payments come due and renters can’t pay. Across the country, state and local economies are being badly damaged — many of them permanently.

The result is that state and local tax revenues will plummet. States and localities will burn through any reserves they’ve maintained like wildfire. Since most of our politicians and government managers have been raised during a decade of expanding economies, their first instinct will be to wait and then panic and then raise taxes to cover shortfalls — perhaps a special “coronavirus surtax.” Taxpayers across the country have tolerated various forms of high state and local taxes; the politicians would naturally ask, “Why should now be any different?”

But it is different. The resulting increased tax burden would be a disaster. Businesses that were barely hanging on would go under. Workers and homeowners who were barely surviving would go under. State and local tax bases would collapse even faster. There would be social unrest, possibly requiring martial law. People would migrate from high-tax states toward new jobs, accelerating a downward spiral. These large migrations would make the 2020 census results nonsense.

The only answer for the states, counties and cities that want to survive is to slash budgets now — probably 30 to 50 percent — eliminate all nonessential spending and reduce taxes today. Business leaders know that, in these types of situations, the only way to save a company is to cut costs immediately. There is no other answer, and those who act first and most aggressively are the most successful in saving the company and the greatest number of its employees. In short, “fiscal distancing” — that is, separating politicians from taxpayers’ money by cutting budgets and taxes now — is literally the only useful thing that state and local governments can do to prevent further economic and social catastrophe.

There is actually no other significant role that states and local governments can play in saving their economies, tax bases and quality of life. Only the federal government can provide truly useful, significant financial help to businesses and individuals during this historic disaster because only the federal government can print money in a crisis. Cutting taxes is the only state and local option to help their economies. Spending extra money now is throwing rocks into their own lifeboats.

I've talked to and written to many state and local officials over the past couple of weeks. Their recorded messages say they are all “working nonstop on coronavirus task forces.” Not to be rude, but most of that is a complete waste of time and public resources. With few exceptions, little or nothing useful will come of that. Only private businesses, individuals and the federal government are able to address this problem. For the most part, state and local governments will be in the way, except for critical, essential services such as police forces, fire departments and health care. Nearly everything else must go, now.

[LawBeefaroni]

I know here in Chicago, teachers, public transit, judges, city workers, etc are all getting full pay despite no school, low ridership, cancelled courts, etc. We're getting $1.5B in federal funds to keep paying when no one is going but it's hardly enough and it will dry up.

Meanwhile they were happy to collect my first half property tax installment.

[Blackhawk]

Don't worry. Uncle Sam will help...

Spoiler:

...red states.

[Anonymous Bosch]

Don't worry. Uncle Sam will help...

Spoiler:

...red states.

Bear in mind, Congress controls the power of the purse and they're already screwing the pooch in terms of replenishing the small-business loan program. And even the federal government would be hard-pressed to bail out every state and local municipality that runs out of money.

[Jeff V]

So one of my wife's co-workers tested positive. It's the dude they sent home after he mentioned a friend of his (who he had contact with) tested positive.

It took 7 days to receive the test result.

Do you know how we get mass nursing home deaths like the 22 that just died in Joliet? By not getting results on a timely basis. WTF happened to the 5 minute tests that were supposed to roll out at the beginning of the month? Or was Abbott Labs just playing an April Fool's joke?

Now my wife and the rest of her coworkers are in a panic. So you'd think the nursing home would have everyone tested immediately, right? Nope, not until they start showing symptoms (this guy was asymptomatic for a week before he started coughing and finally got tested). Again, you want to know how the mass deaths are occurring? This is how.

[Paingod]

Now my wife and the rest of her coworkers are in a panic. So you'd think the nursing home would have everyone tested immediately, right? Nope, not until they start showing symptoms (this guy was asymptomatic for a week before he started coughing and finally got tested). Again, you want to know how the mass deaths are occurring? This is how.

Rightfully panicked. I'm so sorry this has hit so close to home now. I hope you're (collectively) doing okay.

[LawBeefaroni]

US testing is currently at around 145K tests per day and has been for a few weeks. I saw a blurb yesterday that LabCorp and Quest say they are sitting on excess capacity meaning we could test more but aren't.


The failure to get tests out and back in to be processed is the fundamental failing in our response right now.

[Blackhawk]

A few weeks ago one of Michelle's co-workers told everyone her boyfriend tested positive. Much drama ensued when Michelle and Friend X reported this to the powers-that-be and the employee in question denied that it had ever happened. Michelle and the other co-worker were accused of lying and generating drama. Two office employees who overheard the exchange walked off the job at the boss's response. The next day the co-worker admitted that she had, in fact, said it. Many loud public apologies were given to Michelle and Friend X by the boss.

Spoiler:

The boyfriend had never been so diagnosed or even tested. She just wanted the attention. The employee was given a 14-day pay-free quarantine, followed by a good, old-fashioned firing.

[Paingod]

Spoiler:

The boyfriend had never been so diagnosed or even tested. She just wanted the attention. The employee was given a 14-day pay-free quarantine, followed by a good, old-fashioned firing.

It's the wrong time to make yourself ineligible for unemployment.