COVID-19 Update; 3/14/2020. A Message From Concerned Physicians

Howard Luks MD ^

[griffin]

Is it time to panic? NO.

This document is trying to help you to understand the situation at hand and not to terrify you. We want to make sure you understand the facts and understand what is at stake. This is a Pearl Harbor moment for our country. We are facing a real threat and we need to face it with all of our resources. When people decry the seriousness of this moment they are steering our country off a cliff, we need everyone to understand that this is important and if we work together to slow the spread we will get through this as we are learning from Singapore, Hong Kong, South Korea, and China.

The effectiveness of our healthcare system to deal with a sudden tsunami of respiratory illness is what is at risk. If our healthcare system buckles under the strain of tens of thousands of patients then we could be looking at a catastrophe.

[Freedom_Is_Not_Free]

You can find much more recent examples in SARS and H1N1 flu. No shutting down the country for those either. Covid-19 is just SARS all over again. I don’t know anybody who got SARS. I can’t point to one relative or friend who got SARS. It was a non-event here in California.

[DoodleBob]

Thank you all for your kind words. Carrying on with the civility...

That's the idea behind flattening the curve.

That may be true, but in practice the 'flattening the curve' mantra is being used to bash the 'it's just the flu, bro' crowd with histrionics. As I said, there is plenty of ignorance and hysteria from that crowd, but the 'it's exponential, bro' lecturers tend to get a pass.

But as I said, it ultimately comes down to being a cost/benefit analysis. Even if people come to realize it's a logistic function - and not flat line or exponential function - and that we'll hit an inflection point, the fact remains that Ripley's approach...

...certainly will flatten the curve. It'll also flatten the economy.

When I went to my local grocery store, a new an pattern to the sold out items emerged: chicken nuggets, fries, and pizzas. Why? Because all the kidz will be home with Mom and Dad, and they usually were fed at skool.

Now, a 'fact-based' social distancing policy would suggest that the youngest amongst us aren't the most susceptible to Coronavirus. Maybe, just maybe, emptying the schools and colleges isn't necessary.

Mind you, I'm not arguing that such a policy isn't riskless or 100% thoughtful: young children are walking germ-factories that leak snot and all that good stuff (btw...I have little DoodleBobs and so I speak from a position of love and experience), and I can guarantee that some children would likely die from Coronavirus if we kept the schools open. But that policy WOULD solve other problems, and cause other problems, and so on.

The Marketplace of Ideas is one of the greatest gifts we have in America. It has given us untold innovation, peace and prosperity. Maybe there IS a third way. But I fear, we're not listening but shouting...and in the end, Ripley has won.

I'm reposting this often, because I believe Wayne Allen Root put it best:

I have many great friends and guests on my national TV and radio shows who are medical experts. Half believe this is the pandemic to end all pandemics. They quote Centers for Disease Control and Prevention models that report as many as 1.7 million Americans could die. So people are rightfully scared out of their minds. American business is shutting down. But the other half of my medical friends and expert guests say this is an overreaction. They predict fewer Americans will die than during the flu season of 2017-18 that killed about 80,000 people. They don't believe we need to close down American business and lock ourselves in our homes. The problem is we won't know who's right until it's over.

If we take the advice of the "it's exponential, bro" types then we run the risk of vaporizing the economy but we won't look like Italy; many frayed nerves will be soothed, but many people may also end their lives due to economic stress. If we take the advice of the "it's just the flu, bro" types then we run the risk of looking like Italy if they're wrong but we save the economy and we have fewer suicides.

I never like dilemmas; both options suck - I want a Door Number 3.

However, since we've clearly chosen Door Number 1, we need to prepare for economic devastation and suicide but at least the virus will be snuffed (we hope).

I will pray today, more than usual, because it's in God's hands now...and I apologize for not treating my brother FReeper with dignity (even when they annoy the crap out of me, but I'm sure I do the same to them): the enemy is the virus, not each other. Agnus Dei, qui tollis peccata mundi, miserere nobis. Agnus Dei, qui tollis peccata mundi, miserere nobis. Agnus Dei, qui tollis peccata mundi, dona nobis pacem.

[Pollard]

Finding grammar mistakes makes me not want to take it serious. This guy’s an MD?

“It is a novel virus, which means that in the world has antibodies to it because no one has ever been infected by it before.”

Should be “no one in the world” maybe?

and then he links to The Atlantic which is a far left outfit.

fail

[FreeReign]

Your numbers are way off if you are in a collapsed health system. You did not read the article.

Did the U.S. hospital system collapse during swine flu? There were 300,000 hospitalizations.

Currently 1% if the COVID-19 cases in this country are currently categorized as serious or critical. The remaining 99% of the cases are categorized as mild. Given that, how many people in this country are currently hospitalized? Does this concerned article even mention that statistic?

Fauci and others are saying that So. Korean may be past peak with their cases of COVID-19. Did there hospital system collapse?

The first case of COVID-19 was diagnosed in this country over 7 weeks ago. We are currently averaging about 7 deaths a day. How is that considered exponential growth?

I'll look for your answers.

[AllAmericanGirl44]

Since the you are clearly using logic and reason, perhaps you can help me understand the position of the alarmists; they yap that it President Trump didn’t act fast enough, allowing carriers of the virus to spread it here, yet out of the other side of their mouths, they are certain it hasn’t taken hold here yet. Color me confused with this weird attempt to have it both ways

[CommieCutter]

Noted.

[Ivan]

You clearly do not understand the problem. Breathing support is REQUIRED in many of the severe cases. In a 1000 bed hospital, I would be surprised if they own 50 respirators. The respirator can be required by a single patient for as long as two weeks. It’s not about the number of doctors or the number of beds available or the availability of medicines. It’s about the number of respirators limiting the number of people that can have their lack of lung function supported. If the rate of spread can be slowed, it means that fewer people need breathing assistance at any one time.

[FreeReign]

Good point. They are nuts.

[gas_dr]

Still awaiting your educated opinion on H1N1 Respirationally.

[FreeReign]

Breathing support is REQUIRED in many of the severe cases.

Looking at the Worldometer stats, I see that 1% of the current U.S. cases are categorized as being serious or critical. The rest are categorized as being mild.

So what is the current number of cases that are using breathing support in hospitals?

Also remember, we had 300,000 hospitalized cases of swine flu in 2009. Were are hospitals able to handle the load back then?

[Vaduz]

LOL true

[P-Marlowe]

This is NOT a Pearl Harbor moment. When Pearl Harbor happened Americans pulled together and went to work and ended the depression. Here we are being told to stay away from each other and don’t go to work. We are not pulling together. We are being pulled apart.

[iontheball]

He said if you catch it again your system defenses will probably adapt faster and it will be less severe
_____________________________________
With shingles you are not “catching” chicken pox a second time. The same virus that infected your system remains in residence for life and reappears to cause shingles and let me tell you it is many times more severe than the initial bout of chicken pox. I would not wish it on my worst enemy.

[iontheball]

Varicella Zoster is NOT a reinfection as you state . . .
____________________________
I never said it was a “reinfection.” I said it is the same virus that you get once and it never leaves your body, which is exactly what you said. Don’t call the virus a “rash” that activates down a nerve, call it what it is the same Varicelal Zoster virus that comes out of its hiding place in the Ganglion, travels down a nerve and in my case permanently destroyed the nerves in my right face. I didn’t catch it a second time and I wasn’t reinfected, it was there all the time. It was the one and only virus that will never leave me til death do us part, much to my chagrin!

[SanchoP]

It’s a tag.

[DoodleBob]

Since I'm a man who believes in not backing down when I think I'm right (or at least on the right path), I am hereby posting my forecast for US Coronavirus Cases, based on the assumption that the logistic profile will be repeated here, and the daily growth rates of confirmed cases will follow that of Hubei from Jan 30 onward. If I develop a new technique (i.e., build my own logistic model) I'll update my forecast, but for now, here is where I see this headed stateside:

Date	Forecast US Coronavirus Cases	Forecast Percent Growth	Actual Cases
3/14/20	2,999	38.0%	2717
3/15/20	3,552	18.4%	3478
3/16/20	4,376	23.2%	.
3/17/20	6,837	56.3%	.
3/18/20	8,271	21.0%	.
3/19/20	10,202	23.3%	.
3/20/20	12,029	17.9%	.
3/21/20	13,526	12.4%	.
3/22/20	15,264	12.8%	.
3/23/20	16,577	8.6%	.
3/24/20	18,125	9.3%	.
3/25/20	19,408	7.1%	.
3/26/20	20,410	5.2%	.
3/27/20	20,410	0.0%	.
3/28/20	29,488	44.5%	.
3/29/20	33,280	12.9%	.
3/30/20	34,408	3.4%	.
3/31/20	35,590	3.4%	.
4/1/20	36,696	3.1%	.
4/2/20	37,731	2.8%	.
4/3/20	37,945	0.6%	.
4/4/20	38,196	0.7%	.
4/5/20	38,331	0.4%	.
4/6/20	39,201	2.3%	.
4/7/20	39,201	0.0%	.
4/8/20	39,325	0.3%	.
4/9/20	39,630	0.8%	.
4/10/20	39,875	0.6%	.
4/11/20	40,125	0.6%	.
4/12/20	40,320	0.5%	.
4/13/20	40,579	0.6%	.
4/14/20	40,927	0.9%	.
4/15/20	41,047	0.3%	.

[aMorePerfectUnion]

Interesting forecast...

I’m guessing we will have an immediate jump up, since testing was not widely available previously.

Also, we seem to be on a similar curve trajectory to Italy.

[DoodleBob]

Thank you. Please keep in mind all I did was project US cases as a function of Hubei's daily case growth starting in 1/31/2020. I picked that date because the US' pre-3/13 and Hubei's pre-1/31 growth rates looked similar. Hubei went into lockdown on 1/23 so perhaps I am off by a week from a "similarity of controls" perspective. However, I chose to be guided by the data more than the news, and the Hubei data may be faked for all I know.

That said the Hubei pattern is logistic which is what we saw with SARS in most nations where this hit in 2003. While there is nothing magical about a virus' spread and a logistic function they seems to reflect one of two things (or both): 1) that a virus MAY infect early the people most susceptible (i.e. The elderly, the infirm) which is the steep portion of the curve but as the quantum of susceptible people shrinks the spread isn't as great and you get the flattening, 2) the virus spreads like wildfire early but then outside controls like hand washing and self-quarantining takes hold and the curve flattens.

Many seem to be betting that #2 will save the nation. I think a combo of 1+2 would do the trick but it needn't be everyone; a risk-based quarantine (i.e. like the VA shutting down visitations and hospitals not allowing visiting hours) would be less economically devastating. But what do I know.

Anyway. I'm not a biostatistician and I do t play one on TV. Your forecast may vary. Be safe and FReep on!

[central_va]

It all designed to "Get Trump".

[aMorePerfectUnion]

You too bro!👊