totm april 2020 Coronavirus

[ProtoJeb21]

Connecticut has reached peak panic levels. Just about everything school-related that isn’t being at school (trips, sporting events, conferences, awards ceremonies, etc) have been cancelled or postponed, which is not only excessive, but also ineffective, because my school is so insanely crowded that it’ll be easy for the Coronavirus to spread if someone gets it. 
 

I posted the full list of what’s been going on here. Suffice to say, it’s absolutely ridiculous, and all it’s doing is spreading fear and anger. 

Edited March 11, 2020 by ProtoJeb21

[mikegarrison]

12 minutes ago, ProtoJeb21 said:

Connecticut has reached peak panic levels. Just about everything school-related that isn’t being at school (trips, sporting events, conferences, awards ceremonies, etc) have been cancelled or postponed, which is not only excessive, but also ineffective, because my school is so insanely crowded that it’ll be easy for the Coronavirus to spread if someone gets it. 
 

I posted the full list of what’s been going on here. Suffice to say, it’s absolutely ridiculous, but that’s normal for my school district. They’ve done some really stupid and terrible things in the past. 

Dude, that is *not* "peak panic levels". Where I live (the Seattle area) the schools are being closed entirely and students are being asked to work on things at home. Where I work, we have been asked to work from home if at all possible. I haven't been to the office since last Thursday and have no idea when I'll be there again.

I am told by people who live in China that the quarantine rules there are quite extreme right now.

A little personal anecdote about how fast things have been developing here. When I went in on Thursday, I stopped at the coffee shop / Brazilian market I like to stop at on the way to work. They were out of something I wanted to buy, but said it should be in that afternoon. I said, "that's OK, I'll buy it tomorrow". I was wrong. I have literally not stepped out of my house for six days now.

Edited March 11, 2020 by mikegarrison

[tater]

13 minutes ago, ProtoJeb21 said:

Connecticut has reached peak panic levels. Just about everything school-related that isn’t being at school (trips, sporting events, conferences, awards ceremonies, etc) have been cancelled or postponed, which is not only excessive, but also ineffective, because my school is so insanely crowded that it’ll be easy for the Coronavirus to spread if someone gets it. 
 

I posted the full list of what’s been going on here. Suffice to say, it’s absolutely ridiculous, and all it’s doing is spreading fear and anger. 

"Panic" to me means an irrational response.

That seems like a rational response to me, frankly. Mess with that link for scenarios I posted up thread. See how incredibly important it is to move the dial early via limiting transmission.

It comes down to making each person infected infect as few other people as possible. The observation about conditions IN school is important, though, you are right. It also needs to be clear that anyone who feels ill at all should stay home and quarantine. The incentives here are all all wrong, of course. I know at my kids' school, they don't want to miss school and get too far behind.

This is worth a read:

https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca

 

Yeah, the current toll is way less than seasonal flu, but I don't think we want to be shown it is 20X worse by having 20X seasonal flu deaths. My hope going forward is that more people get vaccinated for flu, and during flu season people are more cognizant of the risks to other people when they are ill. Hopefully this shows some seasonality and we catch a break as it warms up.

[DDE]

55 minutes ago, tater said:

This is worth a read

Welcome to battlefield triage, please enjoy your stay...

[tater]

The more I think about this, the more I think that so much of this could be mitigated by a new set of norms/incentives. Not just coronavirus, but seasonal flu, rotovirus, etc. All the common problems we have that kill hundreds of thousands to millions of people per year.

If we had no data on the specifics of this virus, we'd just think it was a really bad flu season, and no one would change anything. Honestly, that would be better in future—assuming we have a new normal with some small behavioral changes.

1. Get vaccinated for flu. Everyone not medically excluded. This goes without saying, but the % of people deeply panicked about COVID19 who are not even vaccinated for flu is probably quite high.

2. Learn how to cough properly into your elbow so you are not inoculating everything you touch with the hand you coughed into.

3. If you are actually sick (fever, body aches, typical flu symptoms): STAY HOME. This requires that people are allowed to stay home. It also means the responsibility not to abuse it by taking the day after the Superbowl off as a sick day. Sick days are for being sick. It also means employers should NOT require a note from a doc. People with flu should not be going to the doctor unless they have severe symptoms (shortness of breath, persistent high fever, etc). Hospitals and Drs offices are crowded during flu season with people who don't need treatment. There is no flu treatment, or indeed any treatment for viral illness. It's supportive care. If you get a pneumonia, that is often a bacterial secondary infection, and THAT requires treatment. Wasting the doc's time on self-limiting stuff needs to stop. As a "medical family" we only seek care for legit reasons, and suck it up the rest of the time.

4. Proper hand washing. The number of people who don't wash their hands at all when they should is high, and of those that do, many do a lousy job.

5. If you are stuck in some sort of crowded place and you have symptoms like a cough (traveling, for example), maybe wear a surgical mask—they are designed to protect others from the wearer, it's hilarious to see people wearing them thinking they are protective for the wearer. Seeing a mask should imply that the person wearing it thinks they are moderately ill, and have the wellbeing of their fellow humans in mind, not that they are paranoid about everyone else being diseased. Note this mask thing is for people who can't "stay home" at that time. Maybe they are staying home but need to get supplies, or got sick on a business trip, and have to fly home, etc.

Those things alone would substantially mitigate the spread of most communicable disease, including the current one.  If people would get on board with the above at large %s, draconian action like travel bans would not be required.

 

 

Edited March 11, 2020 by tater

[Guest]

21 hours ago, Flavio hc16 said:

Nope, this is the difference: in other European  nations they do the test on those who already have symptoms, we don't,  especially where there have been dozens of cases, we had entire villages of 3-5k people who had been all screened, what I'm  saying is  that probably Italy is the best "test subject" for this virus

How do you explain that the mortality in South Korea is only about 0.5% then? Do you think Italy got a much more lethal strain? I don't think an order of magnitude difference can be accounted for by the different demographics.

I believe South Korea are currently the ones with the highest screening rate.

[DDE]

57 minutes ago, tater said:

This requires that people are allowed to stay home. It also means the responsibility not to abuse it by taking the day after the Superbowl off as a sick day. Sick days are for being sick.
It also means employers should NOT require a note from a doc.

Unfortunately that second bit means you remove the verification mechanism, and open the system up for abuse. Not abusing sick days requires levels of altruism even the most tightly-knit societies of old rarely achieved.

[Wjolcz]

2 hours ago, mikegarrison said:

Dude, that is *not* "peak panic levels". Where I live (the Seattle area) the schools are being closed entirely and students are being asked to work on things at home.

This just happened where I live. I've heard supermarkets are being emptied as I'm posting this. It's madness and media really made great work of fuelling all this.

Edited March 11, 2020 by Wjolcz

[tater]

3 minutes ago, DDE said:

Unfortunately that second bit means you remove the verification mechanism, and open the system up for abuse. Not abusing sick days requires levels of altruism even the most tightly-knit societies of old rarely achieved.

The trouble is that it overwhelms docs offices, and definitionally flu cases (anything viral) are not treatable other than the usual, stay hydrated, take OTC stuff for symptoms, and wait.

This is where a fully market system would win (prices not set by the gov as they are in the US, but whatever the market can bear), because there would be a financial incentive to go only when seriously sick. The Oregon study (they had leftover free insurance from a trial program, and gave them out by lottery) showed that people given insurance used more healthcare, and more emergency room healthcare (the theory was always they'd get better primary care, and avoid the ED). At the very least a copay (the % of people who complain about having to pay even $20 up front is astounding).

Wonder what telemedicine could do?

Almost everyone has a smart phone. What about a bluetooth device that insurance (or Medicaid or Medicare) could give/sell to patients that would take a temp, etc. Patient needing work excuse (or even a dr visit) then does a video call to a midlevel or MA, or nurse. Before opening the call, it has a quick survey of questions for the patient that does the bulk of the patient history for the staff. If you don't fill it out, no chat with nurse. The staff on the vid call then tell the patient to take the temp or whatever, and they can see the device to be sure (they send a signal to make it blink or something), and it takes the temp/etc. If they symptoms match whatever, the note is generated electronically. Patient stays home, not infecting people in the waiting room, employer gets CCed the note. If the patient is making serious complaints, the staff sets up an appt.

[Guest]

16 minutes ago, DDE said:

Unfortunately that second bit means you remove the verification mechanism, and open the system up for abuse. Not abusing sick days requires levels of altruism even the most tightly-knit societies of old rarely achieved.

Where I'm from (a Scandinavian country), people are allowed to stay home sick for up to three days without a doctor's note. It's quite common for employers to extend that to a full week. Under the current exceptional circumstances, most employers have extended that to 14 days.

The system is not abused all that much. Social pressure at the workplace is enough. A few people do abuse it but employers tend to cotton on to that pretty easily and they tend not to last long.

(FWIW my workplace is highly multicultural/multinational, in fact I think ATM I think the majority is only a plurality. ATM I have Chinese, Iranian, Italian, Hungarian, German, and Kosovar colleagues in addition to the majority nationality. We recently sold off a business line, and lost a good many more nationalities with that -- Spanish, Ethiopian, Russian, Nigerian, Nepalese, Vietnamese, and probably a few others I can't bring to mind right now. So I don't buy the "tightly-knit society of old" line either. If it works for us, it ought to work pretty much anywhere.) 

[Kerbart]

Pre-emptive measures are considered unnecessary, panicky and “sheeple-think.”

All that changes once you drop the “pre” prefix; then it’s simply “too little, too late.”

For the past month a lot of people I know online have been dismissing it and pointed to “Y2K panic that proved to be unwarranted.” Personally I think there was no Y2K disaster because a good amount of effort was spent preventing it.

We had a Spanish Flu epidemic a little over a century ago; if I remembered correct it killed more people than WW1. Granted, right now the seasonal flu is a bigger killer than Covid-19 but that’s mainly on the basis of the number of people being infected. While there is some overreacting, the only way to stop the spread right now is “not getting it.”

China has proven that you can stop the epidemic in its tracks by taking rather drastic measures. The question is: what country will be willing to be a showcase for what happens when you don’t?

 

[ProtoJeb21]

2 hours ago, mikegarrison said:

Dude, that is *not* "peak panic levels". Where I live (the Seattle area) the schools are being closed entirely and students are being asked to work on things at home. Where I work, we have been asked to work from home if at all possible. I haven't been to the office since last Thursday and have no idea when I'll be there again.

I am told by people who live in China that the quarantine rules there are quite extreme right now.

A little personal anecdote about how fast things have been developing here. When I went in on Thursday, I stopped at the coffee shop / Brazilian market I like to stop at on the way to work. They were out of something I wanted to buy, but said it should be in that afternoon. I said, "that's OK, I'll buy it tomorrow". I was wrong. I have literally not stepped out of my house for six days now.

 

2 hours ago, tater said:

"Panic" to me means an irrational response.

That seems like a rational response to me, frankly. Mess with that link for scenarios I posted up thread. See how incredibly important it is to move the dial early via limiting transmission.

It comes down to making each person infected infect as few other people as possible. The observation about conditions IN school is important, though, you are right. It also needs to be clear that anyone who feels ill at all should stay home and quarantine. The incentives here are all all wrong, of course. I know at my kids' school, they don't want to miss school and get too far behind.

This is worth a read:

https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca

 

Yeah, the current toll is way less than seasonal flu, but I don't think we want to be shown it is 20X worse by having 20X seasonal flu deaths. My hope going forward is that more people get vaccinated for flu, and during flu season people are more cognizant of the risks to other people when they are ill. Hopefully this shows some seasonality and we catch a break as it warms up.

Okay, I should’ve rephrased that. What I meant was how many precautions were taken despite the few amount of reported cases here, to the point where it seems like they’re taking it too far too soon, and it seems that they’re not focusing on things that could have a greater likelihood of getting people infected. I am well aware of the importance of making sure infected people get less people infected, which is something I agree with, but what has been done is not going to fulfill that. My school is not particularly clean and is extremely crowded, so if someone does get the virus, we’re all totally screwed. The main concern I have about that scenario is all of us getting quarantined and the possibility of the virus spreading to vulnerable family members. 

[tater]

11 minutes ago, ProtoJeb21 said:

 

Okay, I should’ve rephrased that. What I meant was how many precautions were taken despite the few amount of reported cases here, to the point where it seems like they’re taking it too far too soon, and it seems that they’re not focusing on things that could have a greater likelihood of getting people infected. I am well aware of the importance of making sure infected people get less people infected, which is something I agree with, but what has been done is not going to fulfill that. My school is not particularly clean and is extremely crowded, so if someone does get the virus, we’re all totally screwed. The main concern I have about that scenario is all of us getting quarantined and the possibility of the virus spreading to vulnerable family members. 

The full lockdown in China was with 400 cases confirmed.

Quarantine means people who are possibly (but not certainly) infected or at risk staying home.

Isolation would be known cases staying home and away from others even within the house, ideally. Say parent gets it, then whole house quarantine, parent isolated as much as possible.

Kids are at very low risk (either infected less often, or so overwhelmingly mild in them that few have been tested, hard to say), so I'm not super sure schools need to be cancelled right away. Might be better to have a few days at all the schools of really concerted education around the issue. Science classes with sinks could have labs on proper hand washing, etc.

Limiting travel seems entirely sensible, though. That said, sports, etc, that are outside, or done minus spectators seem reasonable. Certain academic stuff (debate, etc) could easily be made safer via distancing, and saying that any cough/etc disqualifying (if you are sick don't go).

[DDE]

1 hour ago, tater said:

The Oregon study (they had leftover free insurance from a trial program, and gave them out by lottery) showed that people given insurance used more healthcare, and more emergency room healthcare (the theory was always they'd get better primary care, and avoid the ED).

Oh, I can testify to that. I avoided the hospital for years while I was on single-payer. Once my employer's insurance kicked in? I became an outright hypochondriac - one hospitalization due to an inflamed lymph node that was initially confused with appendicitis, a recent melanoma scare, and a gum abscess.

At least I do get free dental.

1 hour ago, tater said:

Wonder what telemedicine could do?

The people I see it offered to seem rather skeptical.

But I'm surprised no-one has tried coupling it with fitness bracelets.

1 hour ago, tater said:

If they symptoms match whatever, the note is generated electronically. Patient stays home, not infecting people in the waiting room, employer gets CCed the note.

Well, so far the Moscow government has settled for distributing the sick notes via courier. Not the least because they need to issue one for every person on the 14-day quarantine, which is already on the order of thousands.

Don't blame the employers, blame the hyperregulated HR/accounting/tax complex, they aren't allowed to accept anything short of Form 182n.

Edited March 11, 2020 by DDE

[kerbiloid]

So, it's a pandemy. Now officially.

https://time.com/5791661/who-coronavirus-pandemic-declaration/

So, now it can be treated as force majeure in various contracts.

[tater]

We now have 3 cases in the State as of today.

All older people, 2 had traveled together to Egypt recently. The other woman had just traveled to NYC.

[mikegarrison]

I was frankly shocked to find out that some employers require a "doctor's note" to use a sick day. That's ridiculous.

Where I work they are phasing out "sick days" and "vacation" entirely and just lumping it all together as "paid time off" and trusting people to manage which is which for themselves.

[tater]

9 minutes ago, mikegarrison said:

I was frankly shocked to find out that some employers require a "doctor's note" to use a sick day. That's ridiculous.

Where I work they are phasing out "sick days" and "vacation" entirely and just lumping it all together as "paid time off" and trusting people to manage which is which for themselves.

Yeah, PTO is the norm for many places, but people tend to use it without banking time for actual need I think. One problem from an HR standpoint is if they have it calendar/fiscal year vs anniversary date. In the former case people all have the same timeline, and unused days all get taken at the same time (use it or lose it). Anniversary of hire spreads them around more.

[VoidSquid]

Different countries, different culture, different rules.

"Sick days" are a literally foreign concept for us people living in Europe.

Edited March 11, 2020 by VoidSquid

[Guest]

1 hour ago, Kerbart said:

The question is: what country will be willing to be a showcase for what happens when you don’t?

Italy's doing a fairly good job at that.

I have little doubt that most of the rest of the Western world will follow in short order.

[DDE]

1 hour ago, kerbiloid said:

So, it's a pandemy. Now officially.

https://time.com/5791661/who-coronavirus-pandemic-declaration/

Didn't WHO claim some weeks ago that they'd phased the very term out?

50 minutes ago, mikegarrison said:

I was frankly shocked to find out that some employers require a "doctor's note" to use a sick day. That's ridiculous.

Where I work they are phasing out "sick days" and "vacation" entirely and just lumping it all together as "paid time off" and trusting people to manage which is which for themselves.

The problem is that the pay for sick leave, mandated by law, is computed on a vastly different basis from both ordinary pay and vacation.

[kerbiloid]

1 hour ago, mikegarrison said:

I was frankly shocked to find out that some employers require a "doctor's note" to use a sick day. That's ridiculous.

2+ visits to the doctor here. One to open, another one to close the notice, and probably 1 more on the 3rd sick day to check if you are sick.

Edited March 11, 2020 by kerbiloid

[RCgothic]

Grim.

[DDE]

1 hour ago, kerbiloid said:

2+ visits to the doctor here. One to open, another one to close the notice, and probably 1 more on the 3rd sick day to check if you are sick.

Is that a hidden "three policemen" joke reference?

Anyway, you often end up running up and down the hospital to have the head doctor sign that sick note, too.

[Guest]

Walp, Denmark just got locked down. Schools, daycare centres, universities, bars, and nightclubs closed, all public-sector employees not in essential jobs furloughed with pay for two weeks, seat reservations required on public transport, and so on. Diagnosed cases jumped from 35 to 514 in two days. Will be interesting to see if that has any effect on the curve.