Covid, the "lockdowns" etc.

[Mistwell]

It was reasonably assumed the lockdowns would in fact keep the levels well below the ICU bed numbers we have. And it did. For 9 months. And then massive spike on top of massive spike. Which was not predicted. By anyone.

It was predicted by everyone because that is what happens with infectious disease.

See for example the Spanish Flu and or any season of the normal Flu virus.

No really, it was not. A spike was and is predicted. By definition, a spike then falls. You can have another after that of course. But, it was not modeled or predicted to have a spike and then another before the last one really fell. That did not happen with the Spanish flu either, and it's not happening in most places in the World right now. It's not completely unique to Los Angeles, but it's still pretty rare.

[Mistwell]

If I may ask:
What is the number of homeless people, you know - people who live out on the street - who have died of COVID? Because, wouldn't they be the most susceptible to it's effects? Why aren't we seeing them pulling the dead out from the shanties?

It's a fair question at this point.

The best theory I have seen for this is that vitamin D appears to play a meaningful role in resisting the worst impacts of the disease.

[Mistwell]

Half the world predicted it.

No really, they did not. I get it, you're a fucking expert on all topics and an off-the-cuff answer which sounds good is the best answer? But really, what is happening this week in Los Angeles was not predicted under the models. A spike in cases is predicted. What just happened with a double spike (which may be two different mutations converging) was not.  This is not just a surge. There is a normal second surge happening on many parts of the U.S. right now, but it's not like this particular thing happening here.

And lockdowns have not kept it down. We have plenty of examples around the world of places without a lockdown, and few cases; and places with severe lockdowns, where they're overwhelmed by cases.

Yeah Sweden just surrendered the "no lockdown" theory. It didn't work.

Regardless, it's pretty much the only tool we have to not overwhelm ICU beds when it gets like this. "No lockdown" is guaranteed to make it worse once you get to these levels.  All the rest is just bullshit ideology-driven chest thumping. When you get to this point where Los Angeles is at, and you don't have the humans able to treat the number of people in the hospitals, you have to do something more than throw up your hands and claim lockdowns don't help. Because we're now at the point where bad kidney stones can kill you. We're at the point where a gall bladder that goes bad can kill you. When you cannot admit people to emergency surgery anymore because too many people are in the ICU, "no lockdowns" is not a humane answer ether. And I say that as a small business owner who hates lockdowns.

[Pat]

Half the world predicted it.

No really, they did not. I get it, you're a fucking expert on all topics and an off-the-cuff answer which sounds good is the best answer? But really, what is happening this week in Los Angeles was not predicted under the models. A spike in cases is predicted. What just happened with a double spike (which may be two different mutations converging) was not.  This is not just a surge. There is a normal second surge happening on many parts of the U.S. right now, but it's not like this particular thing happening here.

Let's look at the data:
http://publichealth.lacounty.gov/media/Coronavirus/data/index.htm#

There's a double spike, but only in the number of tests. Deaths and hospitalizations have just been sloping up. Even if there were a double spike, so what? We expect regional variation, and the idea that a surge would die down a bit and then spring back up isn't that novel. There are tons of possible reasons.

And lockdowns have not kept it down. We have plenty of examples around the world of places without a lockdown, and few cases; and places with severe lockdowns, where they're overwhelmed by cases.

Yeah Sweden just surrendered the "no lockdown" theory. It didn't work.

Regardless, it's pretty much the only tool we have to not overwhelm ICU beds when it gets like this. "No lockdown" is guaranteed to make it worse once you get to these levels.  All the rest is just bullshit ideology-driven chest thumping. When you get to this point where Los Angeles is at, and you don't have the humans able to treat the number of people in the hospitals, you have to do something more than throw up your hands and claim lockdowns don't help. Because we're now at the point where bad kidney stones can kill you. We're at the point where a gall bladder that goes bad can kill you. When you cannot admit people to emergency surgery anymore because too many people are in the ICU, "no lockdowns" is not a humane answer ether. And I say that as a small business owner who hates lockdowns.

I didn't mention Sweden. You're just strawmanning.

And no, it's literally not the only tool. Start with identifying where it's happening. Talk to the contact tracers, see where most of the infections are happening. Then target those behaviors and locations. If it's occurring mostly in private gatherings, like it appears to be doing in NYC, then maybe put a limit on that. Though that's tricky, because restrictions on private gatherings can't be justified under the commerce clause, and are protected under the 1st amendment, so it might not pass constitutional muster. And it's almost impossible to enforce anyway. What they really should have done is build up trust in public in health by being honest and upfront, instead of pissing it away by politicizing everything, and then use that trust to talk to the public and persuade them to take measures that seem to work. Like limiting private gatherings, or other general techniques like improving ventilation, hygiene, or physical distancing.

But let's say it is. Let's say a complete lockdown was the only tool in the bag. We still have to determine whether it's worth the trade off. You're making an emotional argument right now, basically a variation on "someone do something!" That's bad policy, because doing something that doesn't help but causes immense damage is not a good idea. Even if it helps a bit, we still have to look at the trade offs.

Overwhelming hospitals is a bad thing, but it's not a justification for widespread, total lockdowns forever everywhere. Those cause immense damage, and mostly hurt the people who are most vulnerable. They also have a limited shelf life. People get tired of not having a life, and losing all social contact, and eventually start ignoring the rules. Thus, they need to targeted, and used sparingly. Note I never said that lockdowns should never be used; I simply agree with the WHO, that they should be a last resort, and need to be limited both in geographical scope and duration.

The other posters are correct, the time in between the spring and fall surges should have been spent building excess capacity. They threw up temporary hospitals in Wuhan and NYC, so it should be possible to do so in LA. You're also right that staffing is more challenging than just bringing in stuff and repurposing space. But again, that should be solvable. The one thing that should be obvious to anyone who lived through the previous surge is that, even during the peak, hospital bed usage actually goes down, when considered at the state or national level. The fear of covid-19 drives people away from hospitals, so elective and preventative visits drop precipitously. More hospitals were struggling to pay their bills because they were empty than were running at 90% capacity. The trick is to repurpose that staff. We already have things like the Medical Reserve Corp, designed to help in situations like this, but we should have expanded it.

[Mistwell]

I didn't mention Sweden. You're just strawmanning.

I didn't say you mentioned Sweden (you strawmanned me, by claiming I strawmanned you - nice one!). Sweden is an example of a nation which used the "no lockdowns" method, and it failed. It's a counter-example.

And no, it's literally not the only tool. Start with identifying where it's happening. Talk to the contact tracers, see where most of the infections are happening. Then target those behaviors and locations.

Oh my God, holy shit. You seriously have no idea what's going on out here.

You know where it's happening? Everywhere. EVERYWHERE. It has saturated every aspect of society.  An overwhelming number of responses to "where did you get it" are now "no idea, I didn't gather with a group at all."  The UK has identified a new strain which is 70% more contagious than the prior one. It's probably that. We've likely gone from "you cannot get it from touching an Amazon box delivered to your front porch" to "oh shit now you can get it from that."

But let's say it is. Let's say a complete lockdown was the only tool in the bag. We still have to determine whether it's worth the trade off. You're making an emotional argument right now, basically a variation on "someone do something!" That's bad policy, because doing something that doesn't help but causes immense damage is not a good idea. Even if it helps a bit, we still have to look at the trade offs.

Overwhelming hospitals is a bad thing, but it's not a justification for widespread, total lockdowns forever everywhere.

Well no, of course not. Thanks for your next strawman. I was arguing a LOCALIZED lockdown for a SHORT PERIOD OF TIME. But we cannot achieve even that when guys like yourself are arguing "But freedom and it's all a fraud anyway!"

The other posters are correct, the time in between the spring and fall surges should have been spent building excess capacity. They threw up temporary hospitals in Wuhan and NYC, so it should be possible to do so in LA.

It was. We did. It's not physical capacity, it's personnel.

[Pat]

I didn't mention Sweden. You're just strawmanning.

I didn't say you mentioned Sweden (you strawmanned me, by claiming I strawmanned you - nice one!). Sweden is an example of a nation which used the "no lockdowns" method, and it failed. It's a counter-example.

You quoted me, didn't address what I said, and only talked about Sweden. The only strawmanning is in your part. Even if you were trying to make a general point (you didn't; you just talked about Sweden), Sweden is an ambiguous case, and you're ignoring most of Asia, South America, and Africa.

And no, it's literally not the only tool. Start with identifying where it's happening. Talk to the contact tracers, see where most of the infections are happening. Then target those behaviors and locations.

Oh my God, holy shit. You seriously have no idea what's going on out here.

You know where it's happening? Everywhere. EVERYWHERE. It has saturated every aspect of society.  An overwhelming number of responses to "where did you get it" are now "no idea, I didn't gather with a group at all."  The UK has identified a new strain which is 70% more contagious than the prior one. It's probably that. We've likely gone from "you cannot get it from touching an Amazon box delivered to your front porch" to "oh shit now you can get it from that."

If you're going to start screaming that the sky is falling, you should at least provide a citation. DNA studies show most of the strains spreading in the US can still be attributed to a divergence in January, not a new strain from the UK. Most West Coast cases can be attributed to a case from Wuhan and another from Europe, who both came in thru Washington. The East Coast includes strains from Washington, as well as others directly from China and Europe. Most new infections now are the result of local transmission, or from long distance travel within the country (inter-state travel is less restricted than international travel). The variants with the D614G substitution, which appears to make them more infectious but also more susceptible to antibodies, have been present in the US since before the pandemic was recognized, and are the majority of cases.
https://nextstrain.org/ncov/global

We've had community spread from the start. Recent evidence suggests sars2 was widespread in the US in December 2019, but while that pushes back the date, we knew community transmission was happening in February (or thereabouts; don't remember the exact date). That's why I've been saying contact tracing is a joke. Because once you have community spread, which is defined as cases that can't be traced to back to a new arrival or a previously known outbreak, then there's no way to contain the disease, despite what the contact tracing proponents have been saying. Once a disease is spreading in invisible networks throughout the wider community, all you can hope for is suppression. The WHO agrees, because in a 2019 study they said contact tracing was "[n]ot recommended under any circumstances". However, while I'm highly critical of the idea that contact tracing will somehow stop the disease, it's still effective as a diagnostic tool, because it provides insight into how the disease is spreading. That's why you talk to the people who are doing the contact tracing, because they can tell you how it's spreading. That allows us to target remedies.

Well no, of course not. Thanks for your next strawman. I was arguing a LOCALIZED lockdown for a SHORT PERIOD OF TIME. But we cannot achieve even that when guys like yourself are arguing "But freedom and it's all a fraud anyway!"

Then why you were raging at my post? Because I never said localized lockdowns were a bad idea. In fact, I explicitly supported them. You flipped out over something I never said, and now you're claiming I'm the one making strawmen?

The other posters are correct, the time in between the spring and fall surges should have been spent building excess capacity. They threw up temporary hospitals in Wuhan and NYC, so it should be possible to do so in LA. You're also right that staffing is more challenging than just bringing in stuff and repurposing space. But again, that should be solvable. The one thing that should be obvious to anyone who lived through the previous surge is that, even during the peak, hospital bed usage actually goes down, when considered at the state or national level. The fear of covid-19 drives people away from hospitals, so elective and preventative visits drop precipitously. More hospitals were struggling to pay their bills because they were empty than were running at 90% capacity. The trick is to repurpose that staff. We already have things like the Medical Reserve Corp, designed to help in situations like this, but we should have expanded it.

It was. We did. It's not physical capacity, it's personnel.

Which I addressed. That was literally the entire point of my paragraph. You just edited out everything except the first two sentences to make it look like I was saying something you could oppose. (The parts I added back in are in italics.)

[consolcwby]

Interesting discussions and replies. So, I'll play THE DEVIL IN THE DETAILS for this posting:
MY NEW HYPOTHESIS: The shutdown and the mask mandates have been based on a virus they cannot even prove exists!
--------------------------------
The same group that established the Federal Reserve Bank in the US also financed the Bolshevik Revolution and Hitler and the CCP and promoted the offshoring of US wealth to China. They are the same group behind the World Bank, the IMF, the World Economic Forum and the UN and its numerous agencies, like the WHO.
Then, there are the big commercial banks and mega corporations who carry out their will, via their controlled CEOs, who all serve on each others' interlocking Boards of Directorates. Below that, are all of their blackmailed politicians and military officers. And then, there are their Anointed Ones, who drop in to strategically throw money and publicity at their special projects, like Michael Bloomberg, George Soros and of course, Bill Gates.

As criminal and civil charges are starting to be filed against the WHO and as Governors are having their lockdown mandates overturned by their state supreme courts, perpetrators higher-up are beginning to backpedal on enforcing their scamdemic.

In a 180º turn from the WHO's pronouncements last March, a few months past, the WHO's COVID-19 special envoy David Nabarro announced, "We in the World Health Organization do not advocate lockdowns as a primary means of control of this virus."
The CDC / FDA is admitting, "no quantified virus isolates of the 2019-nCoV are currently available.":
https://forbiddenknowledgetv.net/making-sense-of-the-madness-globalist-revelations/

Interesting hypothesis, isn't it?

[Kyle Aaron]

I was arguing a LOCALIZED lockdown for a SHORT PERIOD OF TIME.

In Victoria we have a joke: "just two more weeks!" We were always promised a short lockdown, just temporary measures for the duration until we... um... hey we reached that goal, let's move those goalposts now... just two more weeks!

Now, wherever you are may need it, I don't know. My point is simply: it always takes longer and costs more than planned. That's government.

[Shasarak]

You're showing yourself to be a fool. ICUs are not intended to be run at a sustained 100% capacity. But you think it's OK to just move to where the beds are, and that (if possible) creates all sorts of additional stresses to the system. Besides, it's a pandemic...that means that all of those capacities are going to be strained (not that 98% capacity is a normal load--it may not even leave a dedicated code bed in some cases). But, by all means, keep going on about shit you don't understand.

ICUs are not designed to run at 100% of capacity?

I already answered your question. They are not intended to be run at a sustained 100% capacity. When you do that, you don't leave any flex room for OR cases that go bad, ED traumas (they have to go somewhere post-stabilization or else they block up your trauma bay), adverse outcomes in cath labs, etc. Many of these services have a small but significant chance of going bad and you need somewhere for those patients to go immediately in such situations. That place is the ICU, so most ICUs typically run at well below 100% so that the other necessary services can continue with the required safety net in place. Without it, interventions for trauma, cardiac events, and cerebrovascular events, as well as many non-elective surgeries get slowed down. This is also why (along with cost issues) there is such a push to downgrade patients and get them out of the ICU. With COVID-19, there are a great many such patients taking up progressive care/stepdown and medical/surgical beds for > 1 week, leading to a lot of throughput issues.

Yeah right.  In NZ with our wonderful socialist healthcare, during a normal flu season our Hospitals can and do go over 100% capacity.  So please spare me your hysterics about some theoretically incompetent ICU that can not operate at 100% capacity.

Call me back when you have Italy levels of patients piling up in the corridors but I wont be holding my breath.

[HappyDaze]

You're showing yourself to be a fool. ICUs are not intended to be run at a sustained 100% capacity. But you think it's OK to just move to where the beds are, and that (if possible) creates all sorts of additional stresses to the system. Besides, it's a pandemic...that means that all of those capacities are going to be strained (not that 98% capacity is a normal load--it may not even leave a dedicated code bed in some cases). But, by all means, keep going on about shit you don't understand.

ICUs are not designed to run at 100% of capacity?

I already answered your question. They are not intended to be run at a sustained 100% capacity. When you do that, you don't leave any flex room for OR cases that go bad, ED traumas (they have to go somewhere post-stabilization or else they block up your trauma bay), adverse outcomes in cath labs, etc. Many of these services have a small but significant chance of going bad and you need somewhere for those patients to go immediately in such situations. That place is the ICU, so most ICUs typically run at well below 100% so that the other necessary services can continue with the required safety net in place. Without it, interventions for trauma, cardiac events, and cerebrovascular events, as well as many non-elective surgeries get slowed down. This is also why (along with cost issues) there is such a push to downgrade patients and get them out of the ICU. With COVID-19, there are a great many such patients taking up progressive care/stepdown and medical/surgical beds for > 1 week, leading to a lot of throughput issues.

Yeah right.  In NZ with our wonderful socialist healthcare, during a normal flu season our Hospitals can and do go over 100% capacity.  So please spare me your hysterics about some theoretically incompetent ICU that can not operate at 100% capacity.

Call me back when you have Italy levels of patients piling up in the corridors but I wont be holding my breath.

I am telling you how it actually works in the USA (which where most of the examples, such as that of CA, are based), from firsthand experience within the field. I don't know, nor do I really care, how it is done in NZ. More likely than not, what they are telling you is their utilization compared to standard capacity, not maximum capacity (the latter of which cannot exceed 100%). I haven't given you any hysterics, but you have given me some true ignorance.

[Shasarak]

I am telling you how it actually works in the USA (which where most of the examples, such as that of CA, are based), from firsthand experience within the field. I don't know, nor do I really care, how it is done in NZ. More likely than not, what they are telling you is their utilization compared to standard capacity, not maximum capacity (the latter of which cannot exceed 100%). I haven't given you any hysterics, but you have given me some true ignorance.

So you think that a Hospital can not have more Patients in it then it has beds for those patients?

Yeah please tell me how things "work"

[HappyDaze]

I am telling you how it actually works in the USA (which where most of the examples, such as that of CA, are based), from firsthand experience within the field. I don't know, nor do I really care, how it is done in NZ. More likely than not, what they are telling you is their utilization compared to standard capacity, not maximum capacity (the latter of which cannot exceed 100%). I haven't given you any hysterics, but you have given me some true ignorance.

So you think that a Hospital can not have more Patients in it then it has beds for those patients?

Yeah please tell me how things "work"

You don't seem to be seeking to understand, and you keep moving goalposts. A hospital may be able to exceed it's total bed capacity (standard capacity, often limited by licensing before physical beds run out) in emergencies, but we are talking about ICU bed capacities, and that's quite different ("hallway beds" seen in Code Black ED situations are not capable of supporting ICU-level needs, nor are typical nurses ICU-trained).

[Pat]

Interesting study for those interested in how habits changed during the pandemic, from the first reaction to eventual fatigue:

https://www.cleaninginstitute.org/newsroom/releases/2020/american-cleaning-institute-survey-finds-decline-handwashing-practices

14% drop in frequent handwashing between March and September.

[Pat]

If anyone's interested in the new variant that Mistwell mentioned:
https://www.bmj.com/content/371/bmj.m4857

That's the British Medical Journal. It's just a briefing not a peer-reviewed article, but it's more authoritative than the popular press. Short version: Is it deadlier? No, doesn't seem to be. Is it more transmissible? It's correlated with areas with rapid spread, so probably. Has it been detected outside the UK? Not yet. How widespread? More than 1100 detected cases. Most are in SE England, but it's spread across the UK. Will this affect the efficacy of the vaccines? Probably not. What's the mutation? There are 17 mutations, the most significant of which is a change in one of the spike proteins, which could affect transmissibility.

[Ratman_tf]

Interesting study for those interested in how habits changed during the pandemic, from the first reaction to eventual fatigue:

https://www.cleaninginstitute.org/newsroom/releases/2020/american-cleaning-institute-survey-finds-decline-handwashing-practices

14% drop in frequent handwashing between March and September.

In march when the lockdowns were fresh, I used to wear mask and gloves when going out and interacting with the world. Sanitize my wheel/handles/etc in the car with cleaning wipes after coming home, fresh masks and disposable gloves every trip, etc.
As the weeks went on, I slowly stopped. Now I just keep a few masks in my car to wear into the store because they're "required".
Constant vigiliance is just not practical for everyday living.