Fascinating video from some doctors on COVID stats and recommendations

[Lennys Tap]

So in my mind we need to find out how to keep a factory or business open and running.  The only way I see that happening is testing with an intrusive level of tracing that the US citizens haven’t faced before or a vaccine. 

Somehow we need to find a quick way to identify sick people and keep them out of circulation.

Frenns

If 50% or 80% of people with the virus are asymtomatic testing and tracing - unless you can test everyone multiple times - won’t do the job. That’s why I tend to favor keeping the vulnerable as under wraps and protected ar possible while the healthy build a herd immunity.

I acknowledged it’s a gamble. All strategies are. Just eels like the most logical one to me.

[forgetful]

Frenns

If 50% or 80% of people with the virus are asymtomatic testing and tracing - unless you can test everyone multiple times - won’t do the job. That’s why I tend to favor keeping the vulnerable as under wraps and protected ar possible while the healthy build a herd immunity.

I acknowledged it’s a gamble. All strategies are. Just eels like the most logical one to me.

The original plan, I thought, was to go through cycles of open and closed to keep everything below the point of saturating medical facilities.

I think that was nixed as too hard/damaging on an economy. But we can't open it up either if it might overwhelm the system.

It just now feels like we have no real plan.

So do we open now and wing it? Take whatever losses of life that will occur. Do we stay closed indefinitely? Take the economic penalty and call it a reset?

Or can we do a rolling open/close/open/close plan, without massive consequences?

[Frenns Liquor Depot]

Frenns

If 50% or 80% of people with the virus are asymtomatic testing and tracing - unless you can test everyone multiple times - won’t do the job. That’s why I tend to favor keeping the vulnerable as under wraps and protected ar possible while the healthy build a herd immunity.

I acknowledged it’s a gamble. All strategies are. Just eels like the most logical one to me.

Pick a number on asymptomatic. It doesn’t actually matter.  Slaughterhouses and first responders can’t stay healthy and operational.  There is not taking a risk. We are taking it and failing.

[Lennys Tap]

The original plan, I thought, was to go through cycles of open and closed to keep everything below the point of saturating medical facilities.

Yes, 15 days to bend the curve became 45 days. Now in the area where it appeared facilities might be overwhelmed, that has been accomplished. New York/New Jersey is looking for states/other countries that need ventilators. The other initially “hot” areas (Washington and California) never really saw their systems stressed. Neither did Florida, thought to be a potential tinderbox.

It seems as if the curve has been bent in many areas but people now say it’s still not “safe”. True, and it won’t be for a long, long time. Do we wait another 45 days, and another and another - ad infinitum? That’s not a plan either IMO.

[The Hippie Satan of Hyperbole]

Pick a number on asymptomatic. It doesn’t actually matter.  Slaughterhouses and first responders can’t stay healthy and operational.  There is not taking a risk. We are taking it and failing.

The original plan, I thought, was to go through cycles of open and closed to keep everything below the point of saturating medical facilities.

I think that was nixed as too hard/damaging on an economy. But we can't open it up either if it might overwhelm the system.

It just now feels like we have no real plan.

So do we open now and wing it? Take whatever losses of life that will occur. Do we stay closed indefinitely? Take the economic penalty and call it a reset?

Or can we do a rolling open/close/open/close plan, without massive consequences?

That to me is what gives me the most anxiety. What is the plan in late May? I don’t know. No one seems to know. I mean we have to have people working and going about life in proximity to one another right?

So what are we going to do?  Each answer seems wrought with awful consequences.

[Lennys Tap]

Pick a number on asymptomatic. It doesn’t actually matter.  Slaughterhouses and first responders can’t stay healthy and operational.  There is not taking a risk. We are taking it and failing.

I don’t know. Could be 10,000,000, could be 100,000,000. Hope it’s the latter. It would mean the virus is less lethal than believed and we are more than half way to herd immunity.

[WarriorDad]

Dr. Scott Atlas, MD, chief of neuroradiology at Stanford University Medical Center had these comments today. Similar to the doctors yesterday.  I'm inclined to agree with them as more data comes in



The tragedy of the COVID-19 pandemic appears to be entering the containment phase. Tens of thousands of Americans have died, and Americans are now desperate for sensible policymakers who have the courage to ignore the panic and rely on facts. Leaders must examine accumulated data to see what has actually happened, rather than keep emphasizing hypothetical projections; combine that empirical evidence with fundamental principles of biology established for decades; and then thoughtfully restore the country to function.

Five key facts are being ignored by those calling for continuing the near-total lockdown.

Fact 1: The overwhelming majority of people do not have any significant risk of dying from COVID-19.

The recent Stanford University antibody study now estimates that the fatality rate if infected is likely 0.1 to 0.2 percent, a risk far lower than previous World Health Organization estimates that were 20 to 30 times higher and that motivated isolation policies. 

In New York City, an epicenter of the pandemic with more than one-third of all U.S. deaths, the rate of death for people 18 to 45 years old is 0.01 percent, or 10 per 100,000 in the population. On the other hand, people aged 75 and over have a death rate 80 times that. For people under 18 years old, the rate of death is zero per 100,000.

Of all fatal cases in New York state, two-thirds were in patients over 70 years of age; more than 95 percent were over 50 years of age; and about 90 percent of all fatal cases had an underlying illness. Of 6,570 confirmed COVID-19 deaths fully investigated for underlying conditions to date, 6,520, or 99.2 percent, had an underlying illness. If you do not already have an underlying chronic condition, your chances of dying are small, regardless of age. And young adults and children in normal health have almost no risk of any serious illness from COVID-19.

Fact 2: Protecting older, at-risk people eliminates hospital overcrowding.

We can learn about hospital utilization from data from New York City, the hotbed of COVID-19 with more than 34,600 hospitalizations to date. For those under 18 years of age, hospitalization from the virus is 0.01 percent, or 11 per 100,000 people; for those 18 to 44 years old, hospitalization is 0.1 percent. Even for people ages 65 to 74, only 1.7 percent were hospitalized. Of 4,103 confirmed COVID-19 patients with symptoms bad enough to seek medical care, Dr. Leora Horwitz of NYU Medical Center concluded "age is far and away the strongest risk factor for hospitalization." Even early WHO reports noted that 80 percent of all cases were mild, and more recent studies show a far more widespread rate of infection and lower rate of serious illness. Half of all people testing positive for infection have no symptoms at all. The vast majority of younger, otherwise healthy people do not need significant medical care if they catch this infection.


Fact 3: Vital population immunity is prevented by total isolation policies, prolonging the problem.

We know from decades of medical science that infection itself allows people to generate an immune response — antibodies — so that the infection is controlled throughout the population by “herd immunity.” Indeed, that is the main purpose of widespread immunization in other viral diseases — to assist with population immunity. In this virus, we know that medical care is not even necessary for the vast majority of people who are infected. It is so mild that half of infected people are asymptomatic, shown in early data from the Diamond Princess ship, and then in Iceland and Italy. That has been falsely portrayed as a problem requiring mass isolation. In fact, infected people without severe illness are the immediately available vehicle for establishing widespread immunity. By transmitting the virus to others in the low-risk group who then generate antibodies, they block the network of pathways toward the most vulnerable people, ultimately ending the threat. Extending whole-population isolation would directly prevent that widespread immunity from developing.

Fact 4: People are dying because other medical care is not getting done due to hypothetical projections.

Critical health care for millions of Americans is being ignored and people are dying to accommodate “potential” COVID-19 patients and for fear of spreading the disease. Most states and many hospitals abruptly stopped “nonessential” procedures and surgery. That prevented diagnoses of life-threatening diseases, like cancer screening, biopsies of tumors now undiscovered and potentially deadly brain aneurysms. Treatments, including emergency care, for the most serious illnesses were also missed. Cancer patients deferred chemotherapy. An estimated 80 percent of brain surgery cases were skipped. Acute stroke and heart attack patients missed their only chances for treatment, some dying and many now facing permanent disability.

Fact 5: We have a clearly defined population at risk who can be protected with targeted measures.


The overwhelming evidence all over the world consistently shows that a clearly defined group — older people and others with underlying conditions — is more likely to have a serious illness requiring hospitalization and more likely to die from COVID-19. Knowing that, it is a commonsense, achievable goal to target isolation policy to that group, including strictly monitoring those who interact with them. Nursing home residents, the highest risk, should be the most straightforward to systematically protect from infected people, given that they already live in confined places with highly restricted entry.

The appropriate policy, based on fundamental biology and the evidence already in hand, is to institute a more focused strategy like some outlined in the first place: Strictly protect the known vulnerable, self-isolate the mildly sick and open most workplaces and small businesses with some prudent large-group precautions. This would allow the essential socializing to generate immunity among those with minimal risk of serious consequence, while saving lives, preventing overcrowding of hospitals and limiting the enormous harms compounded by continued total isolation. Let’s stop underemphasizing empirical evidence while instead doubling down on hypothetical models. Facts matter.

Scott W. Atlas, MD, is the David and Joan Traitel Senior Fellow at Stanford University’s Hoover Institution and the former chief of neuroradiology at Stanford University Medical Center.

[GooooMarquette]

The concern I have with relying on herd immunity – referred to by the Stanford physician as “population immunity” – is that many experts question whether we will even see it with this virus. If we don’t, we will just see wave after wave of outbreaks.

As for isolating the “high risk“ groups, that may be (relativity) easy to do with the 65+ crowd. But there is a huge number of Americans with diabetes, high blood pressure, cardiac disease, lung disease, and obesity. Do we isolate everyone with those conditions too? And if so, who covers their unemployment until a vaccine is developed?

[Frenns Liquor Depot]

I don’t know. Could be 10,000,000, could be 100,000,000. Hope it’s the latter. It would mean the virus is less lethal than believed and we are more than half way to herd immunity.

Exactly.  You are guessing and so am i because we don’t have a scalable way to tell who has or doesn’t have it.  NYC best guess is 20% based on sampling.  Santa Clara single digits.  It’s maddening because until we know more we are flying blind and so will businesses as they try to keep mfg running, let alone services. 

[The Hippie Satan of Hyperbole]

Dr. Scott Atlas, MD, chief of neuroradiology at Stanford University Medical Center had these comments today. Similar to the doctors yesterday.  I'm inclined to agree with them as more data comes in



The tragedy of the COVID-19 pandemic appears to be entering the containment phase. Tens of thousands of Americans have died, and Americans are now desperate for sensible policymakers who have the courage to ignore the panic and rely on facts. Leaders must examine accumulated data to see what has actually happened, rather than keep emphasizing hypothetical projections; combine that empirical evidence with fundamental principles of biology established for decades; and then thoughtfully restore the country to function.

Five key facts are being ignored by those calling for continuing the near-total lockdown.

Fact 1: The overwhelming majority of people do not have any significant risk of dying from COVID-19.

The recent Stanford University antibody study now estimates that the fatality rate if infected is likely 0.1 to 0.2 percent, a risk far lower than previous World Health Organization estimates that were 20 to 30 times higher and that motivated isolation policies. 

In New York City, an epicenter of the pandemic with more than one-third of all U.S. deaths, the rate of death for people 18 to 45 years old is 0.01 percent, or 10 per 100,000 in the population. On the other hand, people aged 75 and over have a death rate 80 times that. For people under 18 years old, the rate of death is zero per 100,000.

Of all fatal cases in New York state, two-thirds were in patients over 70 years of age; more than 95 percent were over 50 years of age; and about 90 percent of all fatal cases had an underlying illness. Of 6,570 confirmed COVID-19 deaths fully investigated for underlying conditions to date, 6,520, or 99.2 percent, had an underlying illness. If you do not already have an underlying chronic condition, your chances of dying are small, regardless of age. And young adults and children in normal health have almost no risk of any serious illness from COVID-19.

Fact 2: Protecting older, at-risk people eliminates hospital overcrowding.

We can learn about hospital utilization from data from New York City, the hotbed of COVID-19 with more than 34,600 hospitalizations to date. For those under 18 years of age, hospitalization from the virus is 0.01 percent, or 11 per 100,000 people; for those 18 to 44 years old, hospitalization is 0.1 percent. Even for people ages 65 to 74, only 1.7 percent were hospitalized. Of 4,103 confirmed COVID-19 patients with symptoms bad enough to seek medical care, Dr. Leora Horwitz of NYU Medical Center concluded "age is far and away the strongest risk factor for hospitalization." Even early WHO reports noted that 80 percent of all cases were mild, and more recent studies show a far more widespread rate of infection and lower rate of serious illness. Half of all people testing positive for infection have no symptoms at all. The vast majority of younger, otherwise healthy people do not need significant medical care if they catch this infection.


Fact 3: Vital population immunity is prevented by total isolation policies, prolonging the problem.

We know from decades of medical science that infection itself allows people to generate an immune response — antibodies — so that the infection is controlled throughout the population by “herd immunity.” Indeed, that is the main purpose of widespread immunization in other viral diseases — to assist with population immunity. In this virus, we know that medical care is not even necessary for the vast majority of people who are infected. It is so mild that half of infected people are asymptomatic, shown in early data from the Diamond Princess ship, and then in Iceland and Italy. That has been falsely portrayed as a problem requiring mass isolation. In fact, infected people without severe illness are the immediately available vehicle for establishing widespread immunity. By transmitting the virus to others in the low-risk group who then generate antibodies, they block the network of pathways toward the most vulnerable people, ultimately ending the threat. Extending whole-population isolation would directly prevent that widespread immunity from developing.

Fact 4: People are dying because other medical care is not getting done due to hypothetical projections.

Critical health care for millions of Americans is being ignored and people are dying to accommodate “potential” COVID-19 patients and for fear of spreading the disease. Most states and many hospitals abruptly stopped “nonessential” procedures and surgery. That prevented diagnoses of life-threatening diseases, like cancer screening, biopsies of tumors now undiscovered and potentially deadly brain aneurysms. Treatments, including emergency care, for the most serious illnesses were also missed. Cancer patients deferred chemotherapy. An estimated 80 percent of brain surgery cases were skipped. Acute stroke and heart attack patients missed their only chances for treatment, some dying and many now facing permanent disability.

Fact 5: We have a clearly defined population at risk who can be protected with targeted measures.


The overwhelming evidence all over the world consistently shows that a clearly defined group — older people and others with underlying conditions — is more likely to have a serious illness requiring hospitalization and more likely to die from COVID-19. Knowing that, it is a commonsense, achievable goal to target isolation policy to that group, including strictly monitoring those who interact with them. Nursing home residents, the highest risk, should be the most straightforward to systematically protect from infected people, given that they already live in confined places with highly restricted entry.

The appropriate policy, based on fundamental biology and the evidence already in hand, is to institute a more focused strategy like some outlined in the first place: Strictly protect the known vulnerable, self-isolate the mildly sick and open most workplaces and small businesses with some prudent large-group precautions. This would allow the essential socializing to generate immunity among those with minimal risk of serious consequence, while saving lives, preventing overcrowding of hospitals and limiting the enormous harms compounded by continued total isolation. Let’s stop underemphasizing empirical evidence while instead doubling down on hypothetical models. Facts matter.

Scott W. Atlas, MD, is the David and Joan Traitel Senior Fellow at Stanford University’s Hoover Institution and the former chief of neuroradiology at Stanford University Medical Center.

Well eventually we will be opening back up.  It's not like we are staying in this state forever.  Being a couple of weeks on either side of the "perfect" opening date isn't going to matter either way.

[Lennys Tap]

The concern I have with relying on herd immunity – referred to by the Stanford physician as “population immunity” – is that many experts question whether we will even see it with this virus. If we don’t, we will just see wave after wave of outbreaks.

As for isolating the “high risk“ groups, that may be (relativity) easy to do with the 65+ crowd. But there is a huge number of Americans with diabetes, high blood pressure, cardiac disease, lung disease, and obesity. Do we isolate everyone with those conditions too? And if so, who covers their unemployment until a vaccine is developed?

So there’s a chance that herd immunity won’t work. And some younger people (who should know who they are) need to self isolate. It’s still a far better plan than hiding under the bed until a vaccine (maybe never) comes along.

[Frenns Liquor Depot]

It’s still a far better plan than hiding under the bed until a vaccine (maybe never) comes along.

Who is recommending this?

[Pakuni]

So there’s a chance that herd immunity won’t work. And some younger people (who should know who they are) need to self isolate. It’s still a far better plan than hiding under the bed until a vaccine (maybe never) comes along.

Is this anyone's plan? Feels like a false choice dilemma.
But I agree. Spending the next 12-18 months under one's bed is a terrible idea.

[Warriors4ever]

Herd immunity is predicated on the assumption that people who have had it acquire some sort of immunity. They don’t yet know if that is true.

[Pakuni]

Herd immunity is predicated on the assumption that people who have had it acquire some sort of immunity. They don’t yet know if that is true.

Also predicated on a minimum of 70 percent of the population contracting it. That's 231 million Americans. Even with a mortality rate on the low end of current estimates  - let's say .15 percent - that's 345,000 deaths. That's a lot of dead people in a short amount of time, all in hopes of a herd immunity that may never arrive.

[tower912]

And the other thing is that we would all like them to be right.   We all want our lives back.

[Hards Alumni]

Also predicated on a minimum of 70 percent of the population contracting it. That's 231 million Americans. Even with a mortality rate on the low end of current estimates  - let's say .15 percent - that's 345,000 deaths. That's a lot of dead people in a short amount of time, all in hopes of a herd immunity that may never arrive.

Not to mention that the people that recover aren't all going to recover fully.  There are a lot of long term problems.

[Lennys Tap]

Also predicated on a minimum of 70 percent of the population contracting it. That's 231 million Americans. Even with a mortality rate on the low end of current estimates  - let's say .15 percent - that's 345,000 deaths. That's a lot of dead people in a short amount of time, all in hopes of a herd immunity that may never arrive.

Yes, that’s a lot of dead people. Sadly, no matter what steps we take, IMO there will be a lot of dead people. The war metaphor is an apt one. Casualties are inevitable. What plan do you favor and how many casualties over what time period do you suppose your plan will result in? And at what added cost to the economy?

[Pakuni]

Yes, that’s a lot of dead people. Sadly, no matter what steps we take, IMO there will be a lot of dead people. The war metaphor is an apt one. Casualties are inevitable. What plan do you favor and how many casualties over what time period do you suppose your plan will result in? And at what added cost to the economy?

I trust in the expertise of the vast majority of those knowledgeable in the area of communicable diseases and therefore believe the stay-at-home orders implemented in most places are wise measures that are saving lives. I believe that in the coming weeks, if and when the rate of infection slows and treatment options improve, we need to begin a gradual lifting of those restrictions while continuing to increase our testing and tracing capabilities, and leaving open options to reimpose restrictions when and where needed.
I have no idea how many people will die as a result. How would I? It's kind of a dumb question.

Is it your belief that the number of deaths will be the same, regardless of the course of action? Or will some measures save more lives than others? And exactly how many additional people are you willing to let die to reopen* your precious economy sooner than the medical professionals suggest? Just give me a ballpark figure of how many lives aren't worth the effort.

As has already been explained, the war metaphor is not apt, unless you believe wars are fought with no idea of how to kill your enemy or even where your enemy is located.

* = And I really wish we'd stop using this phrase. The economy isn't closed. It is in many ways suppressed, but it's not closed.

[Lennys Tap]

Is it your belief that the number of deaths will be the same, regardless of the course of action? Or will some measures save more lives than others? And exactly how many additional people are you willing to let die to reopen* your precious economy sooner than the medical professionals suggest? Just give me a ballpark figure of how many lives aren't worth the effort.

It is my belief that the Swedish plan will actually save lives. We can quarantine/protect the most vulnerable relatively well for a short period of time (while achieving herd immunity). Over a much longer period (a year, 18 months?) I don’t like our chances. That doesn’t mean the number of weekly deaths won’t increase initially. They will. Long run, I don’t think so. Worse case, I think it’s a push.

Regarding “my precious economy”, I don’t really have any skin in the game. I’m 71, mostly retired - my life won’t change whether this is a V or U shaped recovery or prolonged recession or depression. But dismissing the unnecessary pain, suffering and even death that would be associated with the latter is, again imo, myopic.

You say you are “going with the experts”. I’d say more accurately that you’re going with a consensus. If and when you’re/they’re wrong you’ll have that as a cover. I prefer the plan that the Swedish “experts” (medical and economic) have come up with. It’s more logical to me. Time will tell.

[wadesworld]

There’s nothing showing herd immunity is even possible with this virus.

[jesmu84]

There’s nothing showing herd immunity is even possible with this virus.

This is an important point.

Also, why is everyone focusing on Sweden and not new Zealand?

[Pakuni]

It is my belief that the Swedish plan will actually save lives. We can quarantine/protect the most vulnerable relatively well for a short period of time (while achieving herd immunity). Over a much longer period (a year, 18 months?) I don’t like our chances. That doesn’t mean the number of weekly deaths won’t increase initially. They will. Long run, I don’t think so. Worse case, I think it’s a push.

So you believe that over the next 12-18 months there will be no medical advancements in the understanding and treatment of this disease that will that better one's chances of surviving infection? Like, a person who comes down with COVID-19 in April 2021 is in the same boat as one who contracted it in April 2020?
I'd be very disappointed in the world's medical community if that were the case.

Regarding “my precious economy”, I don’t really have any skin in the game. I’m 71, mostly retired - my life won’t change whether this is a V or U shaped recovery or prolonged recession or depression. But dismissing the unnecessary pain, suffering and even death that would be associated with the latter is, again imo, myopic.

Some might suggest that the economic pain isn't unnecessary if it's saving lives.

[Pakuni]

This is an important point.

Also, why is everyone focusing on Sweden and not new Zealand?

It seems obvious.

[Lennys Tap]

So you believe that over the next 12-18 months there will be no medical advancements in the understanding and treatment of this disease that will that better one's chances of surviving infection? Like, a person who comes down with COVID-19 in April 2021 is in the same boat as one who contracted it in April 2020?
I'd be very disappointed in the world's medical community if that were the case.

Some might suggest that the economic pain isn't unnecessary if it's saving lives.

I believe that there’s a better chance that herd immunity will work than we’ll have a vaccine in 12-18 months. Maybe treatments will be more effective by then but by then I believe more of the vulnerable will become infected, too.

I believe that a 12-18 month lockdown means a depression. That’s more than mere economic pain.

I don’t know if I’m right, you’re right or if we’re both wrong. It doesn’t matter. All that matters is that whatever strategy we employ end up working. That’s my only wish. I’m sure yours too.

Finally, I believe it’s unfair for you to insinuate I’m advocating $$ over lives.