At The Atlantic today two doctors argue that there are more steps to be taken. I don't doubt that Trump and his advisers are already on top of most if not all of their recommendations.
For skeptics, I strongly recommend reading up on the 1918 flu pandemic to get an idea of what can happen with a novel and lethal pandemic. The 1918 flu pandemic was novel and lethal--on a scale few can really grasp. It targeted the young and healthy. We as a people have developed limited immunities to common varieties of the flu, but no vaccine is close to being as effective as we need--which is part of why flu is such a killer still. Covid-19 is also novel--it's a killer, it spreads rapidly, and we have no immunities. A wild card is that we may have some specific treatments in the form of anti-malaria drugs that have anti-viral properties as well.
Below are extensive excerpts from the article--but there's lots more at the link:
This Is How We Can Beat the Coronavirus
Mitigation can buy us time, but only suppression can get us to where we need to be.
.. A recent analysis from Imperial College is now making some Americans, including many experts, panic. The report projects that 2.2 million people could die in the United States. But the analysis also provides reason for hope—suggesting a path forward to avoid the worst outcomes.
We can make things better; it’s not too late. But we have to be willing to act.
Let’s start with the bad news. ... If we do nothing and just let the virus run its course, [the report] estimated that infections would peak in mid-June. We could expect to see about 55,000 deaths, in just one day.
Of course, we are doing something, so this outcome is unlikely to occur. ... the report predicts that a significant number of infections will occur, that more people will need care than we can possibly provide in our hospitals, and that more than 1 million could die.
... we are only engaging in mitigation.
Suppression refers to a campaign to reduce the infectivity of a pandemic, what experts call R0 (R-naught), to less than one. Unchecked, the R0 of COVID-19 is between 2 and 3, meaning that every infected person infects, on average, two to three others. An R0 less than 1 indicates that each infected person results in fewer than one new infection. When this happens, the outbreak will slowly grind to a halt.
To achieve this, we need to test many, many people, even those without symptoms. Testing will allow us to isolate the infected so they can’t infect others. We need to be vigilant, and willing to quarantine people with absolute diligence.
[In a previous post I recounted Dr. Michael Osterholm's experience with SARS in 2003. He discovered that there were "superspreaders" who made a mishmash of all the R0 theory. That's part of why testing is so important. However, at this relatively early stage and with out very limited resources, Osterholm recommends more targeted testing--and that appears to be what is going on. The testing appears to be aimed at insuring the integrity of healthcare facilities and personnel. For the time being.]
Because we failed to set up a testing infrastructure, we can’t check that many people. At the moment, we can’t even test everyone who is sick. Therefore, we’re attempting mitigation—accepting that the epidemic will advance but trying to reduce R0 as much as possible.
Our primary approach is social distancing—asking people to stay away from one another. ...
But these efforts won’t help those who are already infected. It will take up to two weeks for those infected today to show any symptoms, and some people won’t show symptoms at all. Social distancing cannot prevent these infections, as they’ve already happened. ...
But buried in the Imperial College report is reason for optimism. The analysis finds that in the do-nothing scenario, many people die and die quickly. With serious mitigation, though, many of the measures we’re taking now slow things down. By the summer, the report calculates, the number of people who become sick will eventually reduce to a trickle.
On this path, though, the real horror show will begin in the fall and crush us next winter, when COVID-19 comes back with a vengeance.
This is what happened with the flu in 1918. The spring was bad. Over the summer, the numbers of sick dwindled and created a false sense of security. Then, all hell broke loose. In late 1918, tens of millions of people died.
[Tens of millions. Have critics of the measures Trump is taking really internalized that possibility? This is a novel, highly infectious virus, that kills at an unacceptable rate. We can't afford to wait for a vaccine and, anyway, our experience with flu vaccines is not encouraging.]
If a similar pattern holds for COVID-19, then while things are bad now, it may be nothing compared to what we face at the end of the year.
Because of this, some are now declaring that we might be on lockdown for the next 18 months. They see no alternative. ...
But all of that assumes that we can’t change, that the only two choices are millions of deaths or a wrecked society.
That’s not true. We can create a third path. ... We could develop tests that are fast, reliable, and ubiquitous. If we screen everyone, and do so regularly, we can let most people return to a more normal life. We can reopen schools and places where people gather. ...
We will need to massively strengthen our medical infrastructure. We will need to build ventilators and add hospital beds. We will need to train and redistribute physicians, nurses, and respiratory therapists to where they are most needed. We will need to focus our factories on turning out the protective equipment—masks, gloves, gowns, and so forth—to ensure we keep our health-care workforce safe. ...
... We’ll need to build up our stockpiles, create strategies, and get ready.
If we choose the third course, when fall arrives, we will be ahead of a resurgence of the infection. ...
The last time we faced a pandemic with this level of infectivity, that was this dangerous, for which we had no therapy or vaccine, was a 100 years ago, and it led to 50 million deaths. The coronavirus pandemic isn’t unprecedented, but it’s not anything almost anyone alive has experienced before. We, are, however, much more knowledgeable, much more coordinated, and much more capable today.
Some Americans are in denial, and others are feeling despair. Both sentiments are understandable. We all have a choice to make. We can look at the coming fire and let it burn. We can hunker down, and hope to wait it out—or we can work together to get through it with as little damage as possible. This country has faced massive threats before and risen to the challenge; we can do it again. We just need to decide to make it happen.
AARON E. CARROLL is a professor of pediatrics at Indiana University School of Medicine.
ASHISH JHA is the K.T. Li Professor of Global Health at Harvard University, Dean for Global Strategy at Harvard T.H. Chan School of Public Health and the Director of the Harvard Global Health Institute.
I think Trump has figured this out and put the US on the 'third path' - notice the activation of the Defense Production Act of 1950. It was part of a broad civil defense and war mobilization effort in the context of the Cold War.ReplyDelete
With the voluntary actions by the pharmaceucical industry for greatly improved test kits and production rates the CDC and FDC could never hope to achieve, and the medical supply industry ramping up, the DPA can then mobilize everything else necessary for Phase 2. This includes a phase 2 response to the genetic modification of Covid 19 that permits a constant cycle of reinfection.
Good thing we have Trump. I dont see the Democratic team even coming close to realizing the danger or finding real time solutions to current day needs, let alone the needs of next year.
Time to consider the quarantine of China too from the rest of the world. That will be legal, political and military challenges as great as the medical one.
I was very encouraged by the activation of the DPA. A needed step.Delete
They say Trump is tear ass at Kushner, who apparently was recommending the "take our lumps" approach. When Trump found out what that might involve he blew his stack.
It's possible that Trump could have been on this a bit sooner, but the whole world was kept in the dark. Once Trump got a handle on what was involved, he's been on the ball. Even honest liberals realize we're lucky with Trump.
There is a study I saw on line that stated that some of the mortality of the 1918 flu was related to overuse of aspirin.ReplyDelete
Of course we're lucky he won, since HRC would've used this virus, as an opportunity to finish the demographic transformation of the U.S., which the Dems have been working on since Jan. 2010 (if not earlier).ReplyDelete
At that time, campaign guru Tom Edsall laid out the Dems' strategy, of banking on the trend that "Non-Hispanic whites are likely to become a minority", to establish a *permanent* Democratic realignment.
But, DJT must keep the economy afloat into the election, so that the Dems don't get to use the W.H. to deploy the D.S. etc., to finish the job fulfilling Edsall's prophecy.
MOPP up for Extradomiciliary Activity. It's a grave new world.ReplyDelete
"We could develop tests that are fast, reliable, and ubiquitous."ReplyDelete
But so far, according to investigative reporter Jon Rappoport, we have none of the above, see
"the most widely used test is called the PCR. It must be done with tremendous care, because contamination with irrelevant microbes and cellular material can yield a misleading and absurd result.
The PCR, it is claimed, can take a tiny, tiny bit of material from a patient, and blow it up many times, so it can be identified. “This is the coronavirus. This patient is infected.”
Not only that, the test’s proponents assert that, quite easily, the PCR can also determine the AMOUNT of virus in the patient’s body....
re the PCR. Its proponents claim, it can count how much virus is in a patient’s body— how much of a particular virus. But where is the proof, in real-life terms, that the PCR can do that? How was that proof ever established?...
I have seen no wide-ranging proof that the PCR was ever checked properly...."
Maybe someone here knows how accurate the above claims are.
We're close to being able to do that:Delete
New blood tests for antibodies could show true scale of coronavirus pandemicNew blood tests for antibodies could show true scale of coronavirus pandemic
It's nice to know that they're getting close to a good test, but I recall hearing no MSM references (incl. on Fox), to these suspicions of the accuracy of the current testing regimen.
All the buzz I've seen, has treated these tests as Holy Writ.
Elsewhere at this link, and on his site, Rappoport, and many reader/ commenters, rip virtually all aspects, of the virus science which is (at least implicitly) touted as being conclusive.
See e.g. https://blog.nomorefakenews.com/2020/03/10/coronavirus-what-real-science-would-look-like-if-it-existed/#Comment-78201 , and
"The researchers didn’t actually use basic procedures, to purify the tissue sample, from even one patient, and they didn’t see MANY identical viruses, in an electron microscope photograph of the purified sample—if they took such a photograph at all.
They certainly didn’t perform this complete test on several hundred emerging patients— they should have, but they didn’t. And most certainly, other researchers, including INDEPENDENT analysts, didn’t perform the necessary electron microscope test, on hundreds of so-called “epidemic patients.”
So… the CDC and WHO researchers came up with a notion, an idea, an inference about a virus, through these indirect markers. And via a process of continuing inferences, they characterized the virus they never saw...."
Or, maybe researchers "saw a few particles that looked similar to each other, BUT quite possibly these virus-like particles were just passengers, that ordinarily live in the body, and cause no harm.
However, the researchers jump up and down, and say THIS IS IT. THIS IS THE NEW KILLING VIRUS. AND WE WILL NOW ASSEMBLE ITS GENETIC SEQUENCE. AND THEY DO...."
"I recall hearing no MSM references (incl. on Fox), to these suspicions of the accuracy of the current testing regimen."Delete
I have. Repeatedly.
If you can recall names, of experts who did these aspects the most justice, that would help.
Sundance has a post showing a Fauci "love letter" to Hillary, after her 2013 Senate etc. testimony, in which he exclaims "we all love her, and are very proud to know her".ReplyDelete
At the time, he was with the Nat. Institute of Infectious Diseases.
Readers there argue this level of rabid idolatry to be quite rare in "expert" gov't circles, and fear that he is a D.S. Trojan Horse.
There are some who argue Trump made a mistake in ceding power to Fauci and Mnuchin. Trump let Fauci guide him into destroying the whole economy unnecessarily.ReplyDelete
This morning there about 20K cases in the US, with the greatest number by far in NY--8K. Given what we know about Covid-19 I don't believe Trump has had much choice but to act as he has. So far the public agrees. The evidence worldwide is that, unchecked, this virus will overwhelm any health system. An economy without people isn't much of an economy.Delete
An article which presents the other side, arguing that it's all overblown and over-reacted. Forget about the hard case numbers, that's the wrong metric to be looking at, he says.ReplyDelete
Governments simply trying to out-do each other as to who has the most caution.
I can't say I understand it all, but it seems to make sense. For example, near the end he says: "Does it make more sense for us to pay a tax to expand medical capacity quickly or pay the cost to our whole nation of a recession? Take the example of closing schools which will easily cost our economy $50 billion. For that single unanimous totalitarian act, we could have built 50 hospitals with 500+ beds per hospital."
I just did a long post on that article. There's good data in there, but I disagree with his conclusions. For example, do you really think it would make sense to "pay a tax to expand medical capacity quickly"? How much are we talking about, and who would profit off that? Build 50 hospitals? When?Delete