COVID-19 (f/k/a "the Coronavirus")

[forgetful]

Is there a better way to project acute ICU/vent needs, when said needs are unique to the patient pool? There's some smoothing here, and I agree an assumption that vent needs will occur evenly over time vs all at once is difficult to project. You could run the risk of taxing the system at any one time as you near the apex, but if you're staffed/equipped for the high point, it'd be an outlier.

Seems to me that they assume most acute needs (by volume, vs percentage of cases) will occur at the peak, which is the safest bet.

They have the data in the model. Simply calculate the peak ICU needs, from the peak in the ICU distribution. Then subtract the actual number of ICU beds to determine the maximum shortage. They didn't do that. They calculated the maximum shortage, assuming all the curves peak on the same day. The isn't actually the case in their own models.

As an example for the overall US, they report that the number of ICU beds needed is 34,754, because that is how many are needed right at the peak on April 13th. But the ICU needs peaks on April 9th with 36,076 ICU beds needed. So there is a bigger shortage than they are calculating.

[Jockey]

At least he's focused on what really matters.

Donald J. Trump
@realDonaldTrump
“President Trump is a ratings hit. Since reviving the daily White House briefing Mr. Trump and his coronavirus updates have attracted an average audience of 8.5 million on cable news, roughly the viewership of the season finale of ‘The Bachelor.’ Numbers are continuing to rise..

He is a sick, sick man. Maybe if his priority at the beginning was about the American people rather than himself, things wouldn’t be so dire.

[MU82]

Here's a sobering NYT article about the leadership failure early on that created "The Lost Month" -- a stretch in which we might have been able to keep the virus from growing into the monster it has become:

https://www.nytimes.com/2020/03/28/us/testing-coronavirus-pandemic.html?campaign_id=9&emc=edit_nn_20200329&instance_id=17169&nl=morning-briefing&regi_id=108420427&segment_id=23230&te=1&user_id=d36dcf821462fdd16ec3636710a855fa

WASHINGTON — Early on, the dozen federal officials charged with defending America against the coronavirus gathered day after day in the White House Situation Room, consumed by crises. They grappled with how to evacuate the United States consulate in Wuhan, China, ban Chinese travelers and extract Americans from the Diamond Princess and other cruise ships.

The members of the coronavirus task force typically devoted only five or 10 minutes, often at the end of contentious meetings, to talk about testing, several participants recalled. The Centers for Disease Control and Prevention, its leaders assured the others, had developed a diagnostic model that would be rolled out quickly as a first step.

But as the deadly virus  spread from China with ferocity across the United States between late January and early March, large-scale testing of people who might have been infected did not happen — because of technical flaws, regulatory hurdles, business-as-usual bureaucracies and lack of leadership at multiple levels, according to interviews with more than 50 current and former public health officials, administration officials, senior scientists and company executives.

The result was a lost month, when the world’s richest country — armed with some of the most highly trained scientists and infectious disease specialists — squandered its best chance of containing the virus’s spread. Instead, Americans were left largely blind to the scale of a looming public health catastrophe.

The absence of robust screening until it was “far too late” revealed failures across the government, said Dr. Thomas Frieden, the former C.D.C. director. Jennifer Nuzzo, an epidemiologist at Johns Hopkins, said the Trump administration had “incredibly limited” views of the pathogen’s potential impact. Dr. Margaret Hamburg, the former commissioner of the Food and Drug Administration, said the lapse enabled “exponential growth of cases.”

And Dr. Anthony S. Fauci, a top government scientist involved in the fight against the virus, told members of Congress that the early inability to test was “a failing” of the administration’s response to a deadly, global pandemic.

[GooooMarquette]

Here's a sobering NYT article about the leadership failure early on that created "The Lost Month" -- a stretch in which we might have been able to keep the virus from growing into the monster it has become:

https://www.nytimes.com/2020/03/28/us/testing-coronavirus-pandemic.html?campaign_id=9&emc=edit_nn_20200329&instance_id=17169&nl=morning-briefing&regi_id=108420427&segment_id=23230&te=1&user_id=d36dcf821462fdd16ec3636710a855fa

WASHINGTON — Early on, the dozen federal officials charged with defending America against the coronavirus gathered day after day in the White House Situation Room, consumed by crises. They grappled with how to evacuate the United States consulate in Wuhan, China, ban Chinese travelers and extract Americans from the Diamond Princess and other cruise ships.

The members of the coronavirus task force typically devoted only five or 10 minutes, often at the end of contentious meetings, to talk about testing, several participants recalled. The Centers for Disease Control and Prevention, its leaders assured the others, had developed a diagnostic model that would be rolled out quickly as a first step.

But as the deadly virus  spread from China with ferocity across the United States between late January and early March, large-scale testing of people who might have been infected did not happen — because of technical flaws, regulatory hurdles, business-as-usual bureaucracies and lack of leadership at multiple levels, according to interviews with more than 50 current and former public health officials, administration officials, senior scientists and company executives.

The result was a lost month, when the world’s richest country — armed with some of the most highly trained scientists and infectious disease specialists — squandered its best chance of containing the virus’s spread. Instead, Americans were left largely blind to the scale of a looming public health catastrophe.

The absence of robust screening until it was “far too late” revealed failures across the government, said Dr. Thomas Frieden, the former C.D.C. director. Jennifer Nuzzo, an epidemiologist at Johns Hopkins, said the Trump administration had “incredibly limited” views of the pathogen’s potential impact. Dr. Margaret Hamburg, the former commissioner of the Food and Drug Administration, said the lapse enabled “exponential growth of cases.”

And Dr. Anthony S. Fauci, a top government scientist involved in the fight against the virus, told members of Congress that the early inability to test was “a failing” of the administration’s response to a deadly, global pandemic.

Plenty of mistakes were made, but the most frustrating to me was the FDA's refusal to relax its normal requirements for testing. The University of Washington had a test that was working in a research setting, but the FDA refused to allow its use for clinical testing. I was stunned. The FDA Director can't change the regulations, but he CAN tell researchers that he would exercise his discretion not to pursue violations during the COVID crisis. The info in this article - that the FDA Director was new at the job - helps to explain why he was reluctant to take charge and make the right call.

It also shows the benefit of having some "lifers" in positions of regulatory authority, instead of using the revolving-door method....

[rocky_warrior]

My personal opinion is that a country like ours there is very little one can do without violating the basic freedoms we have as a nation and people.  Too many citizens oppose those tactics as well as leaders at the state and federal level. In my readings of messages here there appear to be a call to action as the Chinese have done to stop the spread, but more than likely even their heavy-handed approach has done very little to stop it.  If the solution as proposed by people here is to shut it all down, go door to door and it isn't working there then that data should be shared.

So you're point is...
 - you THINK china is lying
 - and ASSUMING they are lying their control measures didn't work.
 - So you ASSUME it's not worthwhile for the US to do more than they are

?  Yet, regardless of china lying about #s, we have 2nd hand accounts here - from wuhan - that things are going well there - and returning to normal.   

[LON]

So you're point is...
 - you THINK china is lying
 - and ASSUMING they are lying their control measures didn't work.
 - So you ASSUME it's not worthwhile for the US to do more than they are

?  Yet, regardless of china lying about #s, we have 2nd hand accounts here - from wuhan - that things are going well there - and returning to normal.

Have a client that has a facility that is 100 miles from Wuhan and things back to normal there as well.

[Goose]

rocky

I do not believe that Wuhan, or China in general, is anywhere near back to normal. There still is a great emphasis on social distancing, limits on travel and limited non work life. Our team in China is working and then going home. My guess is this the back to normal we will see in the USA in upcoming months.

China government pivoted from medical emergency to an economic emergency. Within 4-6 weeks much of the products for retail in USA will be completed and they are going to experience a very serious economic aftershock. There is limited demand from the USA and EU and factories are going to run out of orders to produce.

China is going to have to use every tool in their toolbox to navigate a serious economic slowdown come May. Again, if only barometer is factory activity than China is looking normal, but from I hear daily, life is far from normal.

[Jay Bee]

We may be done. Not sure the world can return to 'normal'.

The suicides will be off the charts soon. Probably many on social media. Gone b baaaaaad

[Jockey]

rocky

I do not believe that Wuhan, or China in general, is anywhere near back to normal. There still is a great emphasis on social distancing, limits on travel and limited non work life. Our team in China is working and then going home. My guess is this the back to normal we will see in the USA in upcoming months.

China government pivoted from medical emergency to an economic emergency. Within 4-6 weeks much of the products for retail in USA will be completed and they are going to experience a very serious economic aftershock. There is limited demand from the USA and EU and factories are going to run out of orders to produce.

China is going to have to use every tool in their toolbox to navigate a serious economic slowdown come May. Again, if only barometer is factory activity than China is looking normal, but from I hear daily, life is far from normal.

Great post.

Why can't we have leaders in this country saying exactly what you just said to the American people? We are a strong, resilient group. Instead of preparing us for reality, they are giving us "seashells and balloons".

Instead people are being led to believe things will be better by Easter, when in reality we won't even be near the peak then.

[forgetful]

rocky

I do not believe that Wuhan, or China in general, is anywhere near back to normal. There still is a great emphasis on social distancing, limits on travel and limited non work life. Our team in China is working and then going home. My guess is this the back to normal we will see in the USA in upcoming months.

China government pivoted from medical emergency to an economic emergency. Within 4-6 weeks much of the products for retail in USA will be completed and they are going to experience a very serious economic aftershock. There is limited demand from the USA and EU and factories are going to run out of orders to produce.

China is going to have to use every tool in their toolbox to navigate a serious economic slowdown come May. Again, if only barometer is factory activity than China is looking normal, but from I hear daily, life is far from normal.

Great post. Things are returning to normal, but are not there yet.

[Johnny B]

We may be done. Not sure the world can return to 'normal'.

The suicides will be off the charts soon. Probably many on social media. Gone b baaaaaad

Seriously the suicides? Are you on the trump dont let the cure be worse stuff

[muguru]

Here's a sobering NYT article about the leadership failure early on that created "The Lost Month" -- a stretch in which we might have been able to keep the virus from growing into the monster it has become:

https://www.nytimes.com/2020/03/28/us/testing-coronavirus-pandemic.html?campaign_id=9&emc=edit_nn_20200329&instance_id=17169&nl=morning-briefing&regi_id=108420427&segment_id=23230&te=1&user_id=d36dcf821462fdd16ec3636710a855fa

WASHINGTON — Early on, the dozen federal officials charged with defending America against the coronavirus gathered day after day in the White House Situation Room, consumed by crises. They grappled with how to evacuate the United States consulate in Wuhan, China, ban Chinese travelers and extract Americans from the Diamond Princess and other cruise ships.

The members of the coronavirus task force typically devoted only five or 10 minutes, often at the end of contentious meetings, to talk about testing, several participants recalled. The Centers for Disease Control and Prevention, its leaders assured the others, had developed a diagnostic model that would be rolled out quickly as a first step.

But as the deadly virus  spread from China with ferocity across the United States between late January and early March, large-scale testing of people who might have been infected did not happen — because of technical flaws, regulatory hurdles, business-as-usual bureaucracies and lack of leadership at multiple levels, according to interviews with more than 50 current and former public health officials, administration officials, senior scientists and company executives.

The result was a lost month, when the world’s richest country — armed with some of the most highly trained scientists and infectious disease specialists — squandered its best chance of containing the virus’s spread. Instead, Americans were left largely blind to the scale of a looming public health catastrophe.

The absence of robust screening until it was “far too late” revealed failures across the government, said Dr. Thomas Frieden, the former C.D.C. director. Jennifer Nuzzo, an epidemiologist at Johns Hopkins, said the Trump administration had “incredibly limited” views of the pathogen’s potential impact. Dr. Margaret Hamburg, the former commissioner of the Food and Drug Administration, said the lapse enabled “exponential growth of cases.”

And Dr. Anthony S. Fauci, a top government scientist involved in the fight against the virus, told members of Congress that the early inability to test was “a failing” of the administration’s response to a deadly, global pandemic.

I'm not the least bit surprised you would use the NY Times as a source for anything.

[Jockey]

We may be done. Not sure the world can return to 'normal'.

The suicides will be off the charts soon. Probably many on social media. Gone b baaaaaad

We will get back to normal. People are adjusting. If the national leaders will get out of the way, the governors and mayors will do a much better job. They will be worried about their cities and states. They will do what is best for their people. They won't lie to try to glorify themselves.

I try not to complain. I want for nothing. I don't need to depend on a stimulus check to pay rent or to eat. I miss sports. I miss Fantasy Baseball. Thursday would have been the best sports day of the entire year - opening day and Sweet 16. My wife has marveled at how I am adjusting without my daily sports fix. But it is not about me, so I go on each day doing the best I can just as millions and millions of others are doing.

Just settle in as best you can and relax. By mid-summer things will be a lot better. Not yet back to normal, but on its way.

[BM1090]

We may be done. Not sure the world can return to 'normal'.

The suicides will be off the charts soon. Probably many on social media. Gone b baaaaaad

We'll be fine. I do agree that it's going to take a lot longer than people think, though.

[GooooMarquette]

I'm not the least bit surprised you would use the NY Times as a source for anything.

FWIW...Reason.com (a CONSERVATIVE news outlet), has reported similar things about the testing delays, and even referred to an earlier NTYimes article about this topic (which described "a series of missed chances by the federal government") as "a terrific new article." 

https://reason.com/2020/03/11/how-government-red-tape-stymied-testing-and-made-the-coronavirus-epidemic-worse/

Or is Reason.com too "liberal" for you too?

[The Hippie Satan of Hyperbole]

I'm not the least bit surprised you would use the NY Times as a source for anything.

I’m not the least bit surprised you don’t have a response to the article itself.

[GooooMarquette]

I’m not the least bit surprised you don’t have a response to the article itself.

I'm guessing guru won't have a response to the Reason.com article I posted either...since it essentially says the same thing as the NYT article, and was very complimentary of a previous NYT article on the topic.

The reality is that the FDA really missed an opportunity when the University of Washington dropped a COVID-19 test in its lap, but the new Director (appointed by Trump) declined to allow it to be used. And having worked extensively with the FDA over the years, I know that the FDA can use its enforcement discretion to allow things that don't meet all of its normal requirements.

[4everwarriors]

Legit question to liberal, democratic Scoopers:

What exactly would you want our President to do right now, that you believe is not being done to help all Americans get through the pandemic and its economic fallout?
 

[Galway Eagle]

Legit question to liberal, democratic Scoopers:

What exactly would you want our President to do right now, that you believe is not being done to help all Americans get through the pandemic and its economic fallout?

For me:
Be honest and stop giving false assurances constantly (like the chloroquine thing). Stop polarizing states and people along party lines. Confront the conservative sites he usually quotes giving misinformation such as the federalist article.

[GooooMarquette]

Legit question to liberal, democratic Scoopers:

What exactly would you want our President to do right now, that you believe is not being done to help all Americans get through the pandemic and its economic fallout?

Go watch the speech Angela Merkel gave the other day. I would like him to give a similar message. Essentially: this is going to be very difficult for everybody; we will try our best to get things up and running, but can't make any promises; we are all equal and important in fighting this pandemic. A speech that did not tout herself, did not insult any political opponents, but instead gave hope. Then I would like to see him act that way consistently, day after day, until we get through this.

Scroll down for the speech, with English subtitles:

https://nymag.com/intelligencer/2020/03/angela-merkel-nails-coronavirus-speech-unlike-trump.html

[Goose]

4ever

I am looking forward to the answers.

[keefe]

He is a sick, sick man. Maybe if his priority at the beginning was about the American people rather than himself, things wouldn’t be so dire.

Maybe he just needs a new pair of tight whites

[reinko]

4ever

I am looking forward to the answers.

Honesty, sincerity, and empathy.

[forgetful]

Legit question to liberal, democratic Scoopers:

What exactly would you want our President to do right now, that you believe is not being done to help all Americans get through the pandemic and its economic fallout?

The criticisms are him being way late on everything. Testing, way late. Using the defense production act...way way late. Personally, I'd like to see him (and think he should have done it already).

1. Call in all living presidents to help lead and project a message of unity. In all honesty, maybe bring in Biden when we get closer to the election, as whoever wins needs to carry this thing on, and needs to be ready.

2. Shut down any and all non-essential air-travel. We are spreading this around our nation right now like idiots. (not sure on the legality here though).

3. I agree on the honesty, sincerity, and empathy too.

[keefe]

4ever

I am looking forward to the answers.

Long ass wait, Mother Goose