And presumably with lots of procedures deferred or patients treated in normal beds that would normally be done in ICU ? (unless it is done vastly different in the US, ICU beds are also used after lots of procedures). And you can't switch those beds easily between Covid and non-covid as all those other patients still need urgent attention but also need to be shielded.

And the same problem goes for medical personnel that a) can't really switch back and forth and also Covid needs a lot of personell in the ICU. In some regions in Germany they were stretched extremely thin despite being at less capacity than usual pre-covid. If we get to 60% there would be Trouble in most hospitals ... Partly though because we inflated the number of ICU beds massively without acounting for the chronic lack of nurses and medical technicians (like anaesthesiology technicians) and because it'd mean we got worse at keeping them from progressing to that stage. (Treating early prevents a lot of that)

ACP Journals

While we're learning that Covid may not be as fatal as initially feared, we are learning that we still don't know much about it. We're still in a state of "we don't know what we don't know".

One of the key points for those that don't want to read the article:

So I was out and about today doing a pickup from Walmart (where I got everything but one item, and they still didn't have the TP we normally get) and then we headed across the street to Chick'a'fil to grab lunch from the drive-thru.

Let me tell you they win the "prize" for best organized for the virus. Everyone wearing masks and I think gloves. The drive thru is always very busy-so now they have it extended it to three lanes with people there to direct traffic, take orders,pay (with a plastic container to put money/credit card back and forth, then at the takeout window they have more people to bring your order out in another plastic container and direct you to where you can wait to get out of their parking lot without interfering to much with people coming in. Very efficient and thoughtful.

Yeah, I agree. Chick-Fil-A has done a good job. They also do a good job during their rush hours. I hate the rush hour crowds, but they've found ways to manage the wait time.

I noticed the same at my local Chick-Fil-A. But they've always been very efficient even before this.

Culvers has been great too but not sure if everyone has those.

Wow. If true, congratulations NYC.

NYC reports no new coronavirus deaths for first time since mid-March

I do Curbside at rush hours. You will get through 3x as fast as waiting in the wrapped around the building drive thru line. Pro tip

They don't offer curbside here. I will go in if the line is too long.

What the crap

We in MD are moving along with our re-opening. Celebrating the great progress that we are down to 9% positive tests.

Wait, that's still among the highest in the country and far short of accepted guidelines? Fuck it, we want our haircuts and endless breadsticks.

But, hey, Hogan put a couple of guards around his PPE and did well the first few weeks so it's all good.

SI

If we’re talking about restaurants, nearly every drive thru in my town sucks. Those suicide type drive thrus should be illegal. If I’m dissatisfied with how long it takes, I should be able to leave. Instead of sitting 20-30 minutes, trapped, with my car in idle.

My new business plan.

In hindsight, I have more respect for the states/cities that said "Fuck it, we're reopening" than the ones that said "We are establishing metrics, and criteria, and benchmarks and we will let the science guide us" and then just reopened anyway.

Not meant as a "This Virus is so bad, let's all stay in our room for a year !" Post, but i thought that this warrants mention as we move into the phase where more and more people will wonder if any of the hassle was necessary (in germany more so than the US or even UK, admittedly)

While absolutely a ton less young people get seriously ill or even die, this also has a lot to do with this being the case in general (duh, young people die less frequently) and the risk rises disproportionally with age and/or other health issues no matter what diseases you are adding to the mix.

The US as a whole, despite only a small part being heavily affected before measures were taken in time, in Week 15 of this year had 20% more people aged 25-44 die than in any other week, not merely above an average, since the start of 2015 and 28% more than in any week between 12 and 20 (relevant time frame due to general trend being lower there every year than before or after. Basically definitely post-flu/Winter and pre-heat/summer) since 2015.
And there are 7 weeks already during this pandemic where more people in that age group have died than in any week in the 5 years prior. (and death numbers for 2020 are still not complete for any of those weeks, 15 included)
Might even be higher if one would only take natural causes, but the CDC does not have that easily available in combination with age group.

And of course the total numbers of surplus deaths are still only in the high 100s (young people rarely die)

Other age groups:

45-64 = 14 % / 30%.
65-74 = 24% / 42%
75 - 84 = 21% / 39 %
85+ = 8,5 % / 38 % (bad flu seasons also disproportionally harm the most vulnerable)

* looking at those same increases for NYC is going to ruin your whole day ...

YEEHAW! GO, MY TEXAS HOMELAND!

SI

Meanwhile in Portland we're at like 62 covid deaths all-time and our county hasn't even submitted a plan/date for reopening yet.

https://katu.com/news/local/multnoma...-1-application

Michigan is mostly reopening on the 8th. A lot of social-distancing requirements, restaurants at half capacity, etc. I think we'll survive this summer fine. All bets are off after that.

I had my first patio bar beers yesterday, that was pretty nice.

I think the social awkwardness aspect of going out will keep me from going out much though. Every place has their own rules and if they're not clearly stated on the facebook page, you have to call in. The place yesterday, they wanted people to call in 10-15 minutes before you got there, and then they'd tell you if there were any tables available. But you had to call another time before that to know that was their policy.

Plus there's a dynamic that if there's only a few people there, it's OK and everyone's being responsible, but then if a few more people arrive when you're there (which is not in your control), then suddenly things are "out of control" and you risk being socially shamed.

So for introverts, there's a lot of social capital you have to spend just to patronize these businesses.

We are going to venture out to Tillamook County on the Oregon coast in a few weeks though. I guess they're doing a county-by-county approach in Oregon. I've been closely monitoring the facebook pages of our usual haunts there and they are open and eager for business (and showing off their outdoor patios and takeout options), unlike Portland.

you're missing the 4XB tactical gear though.

For a while there were definitely whole coastal towns that were definitely not eager for the influx of business/tourists, but I think that has changed.

My wife didn't get to go visit her parents over Easter/Spring Break so we're going next week. She's been stuck in endless school, having to show up in person to do remote type work because #clusterfuck

Yup, I've been trying to monitor that general mood as best I can. I know in April there was an understandable anti-tourist sentiment. The Old Oregon Smokehouse in Rockaway Beach for example, opened early, weeks and weeks ago, but then closed again because they didn't realize that so many out-of-towners would be there and they didn't want to encourage that. Of course this was back when the hotels in the area were closed.

May 29 seems to have been a significant day where most of the hotels and dining establishments in Tillamook and Clatsop Counties were opened and soliciting general business, and, when the general sentiment around there seemed to be "let's open up but with restrictions", and where the local businesses and city social media pages seem to be inviting people back.

It could change and I could cancel up to the last minute. (and we're still several weeks out). But, we plan on being responsible and keeping to ourselves as much as possible and I'm inclined to go for it.

Not sure I believe this is accurate.

Any of you wash fruits & vegetables in bleach before eating?

403 Forbidden

Nope. But I also made fun of some dufus who said: "And then I see the disinfectant where it knocks it out in a minute. One minute. And is there a way we can do something like that, by injection inside or almost a cleaning?"

Meanwhile, there were others who were parsing this to say he didn't really mean it like that or it was a misspeak, etc.

SI

That's how you get the disinfectant inside. Duh.

Damn, SI beat me to it. :)

Hope it works out for you! It's lovely out there.

Thanks, I love it there, we've gone somewhere on the coast in that vicinity every year for the last 10 years. Before that I went to law school in Eugene and got out there a bunch, that's when I fell in love with it.

Well, the massive increase in cases needing medical attentionnis definitely true:

Error Page


While this shows people are capable being frightened, dumb or careless (a lot might be kids playing around with new stuff lying around) without any help , it would be nice to have a President tell people to stop being stupid, not egg them on when others have tried to keep people from doing it (there were quite a few big news Outlets putting out warnings in April and also telling people they don't need to go Overboard as that is not how the virus spreads)

This is a new CDC page on hospital capacity by state:

COVID-19 Module Data Dashboard – Patient Impact and Hospital Capacity Pathway | NHSN | CDC

The ICU bed map is really concerning to me living in the South. Looks like Georgia, Alabama, Mississippi and Tennessee have over 70% of ICU beds full. (I do wish they'd say how many of those ICU beds are occupied by Covid patients as they have for all inpatient beds)

I think 70% as such is not unnormally high, but of course 70% pre-covid is not the same as 70% now:
1) because a lot of beds were added, but it is easier to add beds than medical personnel.
2) ICU needs more Staff per Patient by default and covid more than normal for longer per patient.
3) ICU staff needs to be more highly trained than regular staff, so again you have a big problem increasing staff easily.
4) With it being an (highly) infectious disease you have less options to reorganise beds and staff as demands change. So you depend on keeping a decent portion empty for both types of patients and with the average covid patient needing that bed for longer you end up prioritising that by default.
5) There is actually a lower need for ventilators than first thought or rather: You should aim to avoid having to use them by treating as early as you can with non-invasive oxygen therapy (there are, at least as i understand it 2 possible variants before ventilators). But of course those patients also need to be treated seperate from all other groups of patients.

This is mostly from the german POV based on people involved that are making clear that the problem is not solved by adding ICU beds and Equipment. But i figure the basic parameters apply to the US situation as well.

You are correct. My friend who is a hospital administrator indicates that is a major challenge - ICU requires far more training.

Can't argue with this.

An interesting local observation; I have a relative who works in the Traverse City area, which due it's location on Lake Michigan, casinos, etc. is one of the state's biggest tourist hotspots. While they kept it quiet, apparently they were at one point within a ventilator or two of running out during the first of the first outbreak. That's during the quiet season. Now that things are opening up they are getting an influx of tourist travel, some of which are apparently saying brilliant things like 'I'm so glad that we don't have to worry about masks, distancing, etc. up here since nobody in this area has the virus'.

That's not how this works. That's not how any of this works. *facepalm*

Las Vegas is officially back. pic.twitter.com/EI3nXs2e5w

— Arash Markazi (@ArashMarkazi) June 6, 2020

Yup, that's how this works. Virus is canceled.

I live right by one of the opened casinos. Needless to say, I am not happy about this and am staying cloistered.

The comments are, interesting.

An article about Remdesivir and production challenges. The article was US specific and I was wondering how/if other countries were getting the drug?

The second link is from May 12 and essentially Gilead has licensed, royalty free (for now) the production of Remdesivir to 5 generic pharmas for 127 countries.

So that is obvious a class act but (1) there are 195 countries so what about the rest (2) I assume there are some countries that are being hit hard by the coronavirus that won't get as much Remdesivir as they would like because the US is "hogging" it all right now.

Not blaming Gilead as these decisions likely delve into politics and other things beyond their control but still a conundrum.

https://www.cnn.com/2020/06/07/healt...rus/index.html

https://www.cnbc.com/2020/05/12/remd...countries.html

You know there's a forum thread saying 'Why don't people just post about Trump here'?

Re: Remdesivir, yeah I think there's no way we have enough for everyone who needs it or anywhere close, but the more who can get it the better obviously. We won't do this, but I'd favor limiting how much we give out now so we can handle the second wave in the fall better.

You're right, my mistake, will remedy.

I never quite understood on what authority the "no political/Trump talk" in this thread was established, when dealing with the virus has been, well, a political/Trump endeavor. Is it because one non-admin said so?

It's been by general agreement because otherwhise it would have degraded into a political snipe-fest a long time ago. A lot, I would say most aspects of the pandemic aren't inherently political. Obviously some parts are but my opinion is this thread might as well not exist if we're going to turn it into that. I've done a couple posts here I probably shouldn't have as well, but I try to keep political comments out of it since there really is another thread for that.

Interesting

https://www.cnbc.com/2020/06/08/asym...-who-says.html

Because this thread would become a Trump thread otherwise.

And it still serves some value as a place to put non-Trump information about the virus.

It's a fuzzy line, but I like it.

So I've been on the side of "let's responsibly re-open things with guidelines and see how it goes". And, in many places, it was OK through the end of May (some cases were increasing - but hospital/ICU capacity was still good).

I also was on the side of letting everyone protest (safely where possible) because of the importance of the issue. Again, cases will probably increase - but that's OK given the situation at hand.

Now, I see everyone freaking out in Arizona because cases are way up because we had thousands of people protesting the past week across most major cities. There are people on my FB feed who were literally out protesting last Wednesday in a crowd of thousands and are now yelling at people who took their two kids to a restaurant without masks (you'd have better luck wrestling a tiger than keeping a mask on my 7-year old - esp while eating).

So, either you are OK with protesting and people going out to safely resume their lives (and the cost of Covid involved) or you are not. This is more just a rant from my part - but I'm not sure I can handle the redneck "Hey, I can go to the bar with my 40 buddies but you can't be out there wearing a mask with 100 other people protesting 'cause of Covid" or the leftist "I can't believe restaurants and bars are opening up to small crowds, but save a place for me at the town square in our BLM protest tonight with 2,000 other people". We have to have some form of consistency here (or everyone will go crazy).

Yep its nice to be able to talk about everything but Trump and his reaction to the virus.

Speaking of which, got my first haircut since the virus precautions went in place today. My usual spot at Walmart. They took my temp (first time ever) and had the salon area chained off to customers so they could control traffic flow through it. All stylists had masks.

And as a bonus, once I got my haircut, went and checked on TP and Napkins. Slowly getting more TP in stock (though not the Charmin we use), but they finally did have some Bounty Napkins-hooray! :)

Though, the protests this past week probably wouldn't show up in most cases yet. Incubation period is slightly longer than that. I wonder if this is Memorial Day numbers showing up?

Or, hear me out, a lot of people found the protests just as life and death important as protecting themselves from Covid.

I mean if you want to make the case that eating out with a 7 year old = protests in an attempt to generate monumental societal change, then go for it.