Coronavirus / COVID-19

[ReluctantSamurai]

AFAIK it would be even more unusual for such a patient, upon testing positive, to benefit from some early intervention (e.g. oxygen therapy).

It would take some re-education of medical personnel, maybe? Obviously hypoxia can be caused by things other than SARS-2, but if I'm understanding what I'm reading correctly (and quite possibly I'm not), hypoxia is almost as good an indicator of infection as fever or dry cough

Just when I thought I've seen everything about just how stupid, greedy, and completely oblivious some people can be to others of their species, there's this:

https://www.cnn.com/2020/04/23/polit...gas/index.html

It appears as though Goodman is offering up Las Vegas as a petri dish to see what happens when you open a major American city back up amid a pandemic. I'm not sure she has cleared this with the actual people who live in the city

https://www.8newsnow.com/news/local-...ing-las-vegas/

https://abcnews.go.com/US/las-vegas-...ry?id=70306241

"I offered to be a control group, and I was told by our statistician that you can't do that because people from all parts of Southern Nevada come in to work in the city. And I said, 'Oh, that's too bad because I know that when you have a disease, you have a placebo that gets them water and the sugar, and then you get those that actually get the shot. We would love to be that placebo side so you have something to measure against.'"

I do believe there's nothing in the language of humans to describe this

[Montmorency]

It would take some re-education of medical personnel, maybe? Obviously hypoxia can be caused by things other than SARS-2, but if I'm understanding what I'm reading correctly (and quite possibly I'm not), hypoxia is almost as good an indicator of infection as fever or dry cough

What I'm getting that is that by my understanding hospitals haven't been proactive enough about getting people treatment - during this pandemic, or perhaps more generally - before their cases turn critical (as opposed to turning them away or giving them antibiotics and a followup appointment or something). In that light, for oximetry screening to take off as an early warning I assume management would have to change their procedures a fair amount to be more proactive and permissive, even as hospitals are already under strain. Since a warning being actionable means you have to proceed to test, diagnose, and treat. It's certainly a question that demands professional insight into how hospitals are operating right now, which I lack.

I do believe there's nothing in the language of humans to describe this

https://en.wikipedia.org/wiki/Not_even_wrong

[ReluctantSamurai]

https://twitter.com/wcwyt/status/125...442818/photo/1





It's sure to make this list:

https://www.theverge.com/2018/10/29/...ofins-injuries

[ReluctantSamurai]

For those living in the US, this is a pretty cool site for "the resilience of communities when confronted by external stresses on human health":

https://svi.cdc.gov/

[Viking]

Haven't seen a good media example in the last couple of days

Eventually a new example showed up:



Together with the UK, Denmark and Norway are described as having a "lockdown" while Sweden is not. In reality, the measures taken in both Denmark and Norway are much more similar to those taken in Sweden than to those taken in the UK.

You don't need a good reason to leave your house in either Denmark or Norway. I would describe the measures taken here as a partial shutdown; your appointment with the hairdresser might have been cancelled, but you can still go for a hike. You might be urged to not travel more than necessary, but that's also the case in Sweden.

Ultimately, the illustration is misleading.

From the above NBC News link:

The experts and the data suggest the reasons are linked to the patients' home addresses — but also to effects of the virus on the body that have come into better focus only after six weeks of deaths. Many patients probably didn't know how sick they really were.

Overlapping with the content of that article, I read in an article in a national medical journal that one thing that is unusual about this disease is how severe symptoms might not show up before the later stages of the disease.

I've also read how patients can progress rapidly from symptoms that appear to be of low or medium severity to high severity. This combination could explain the videos from China showing people collapsing in public. Those individuals probably did not know how severe their situation was, and their symptoms might have gone from just about manageable to severe or critical in a matter of hours, or maybe even minutes, as their oxygen levels dropped.

[Montmorency]

Man Just Buying One Of Every Cleaning Product In Case Trump Announces It’s Coronavirus Cure

Throwing bottles of bleach, ammonia, and Drano into a cart at his local grocery store, area man Troy Mitchell was reportedly stocking up on one of every cleaning product he could find Wednesday in case President Donald Trump announces it is a coronavirus cure. “I got toilet bowl cleaner, carpet cleaner, Swiffer WetJet refills—you name it—just so me and my family will be ready if the president announces one of these things can treat Chinese virus,” said Mitchell, indiscriminately throwing containers of laundry detergent, Scrubbing Bubbles, grout whitener, steel wool, Febreze, Tilex mold and mildew remover, and laptop screen wipes into the cart, the contents of which rang up to $2,513.67 at checkout. “I’m not getting caught without some oven degreaser should Trump say it’s going to save us, so I better go ahead and grab me a bottle. After this, I’m hitting the hardware store to pick up a 5-gallon bucket of roof sealant to make sure I’m prepared in the event that turns out to be what gets rid of the Wuhan. Could just be 10 or 20 squirts of Windex into each nostril. You never know what might work in a pinch!” At press time, neighbors confirmed Mitchell had been found unresponsive on the floor of his bathroom with several empty aerosol cans of Rust-Oleum wax-and-tar-removing solvent by his head.

3/25/20 2:18PM

Glitch in the matrix.

Ultimately, the illustration is misleading.

The terms "shutdown" and "lockdown" are broad enough to become misleading. The US is not like France and Italy; in addition to those areas where few measures have been taken, anyone anywhere can leave the home at any time for any reason, without the need for authorizing documentation. Depending on various personal characteristics, a dick cop might decide to harass you for not wearing a mask or not, allegedly, adhering to social distancing guidelines, but no more. As Furunc said, one has to be careful not to abstract too much when doing comparative analysis of pandemic responses.

[Furunculus]

"one has to be careful not to abstract too much when doing comparative analysis of pandemic responses."

as an anecdote to support this:

i have been taking my son for a ride up the river path out of town for an hour or two most days.
my wife works in the health service, and I am WFH - so he is left to occupy himself for roughly three days a week.
(oh how I laugh at all the nonsense about chillaxing at home and/or how easy homeschooling is!)

the aim of the game (as he is only five), is to get to a nice pebbly beach up-river where we can have a picnic, he can play with his toys and throw stones and have a paddle.
not exactly within the definition of acceptable exercise - but we are socially distanced so who cares as it is what he [needs].

the police spend most of their time moving people on from the seafront/harbour - sit down and they will wander up to you and have a polite chat - but they don't go much the other way out of town as there is 'nothing' out there.
well, last week, just as we approached the pebbly river beach we saw two coppers walking down on to it to talk to the half dozen parents kids down there, so we carried on riding as we saw no point in having a polite conversation.

when we came back the same way half an hour later, the police were still there having a chat with people on the river, and people were still happily enjoying the pebbly beach with there kids.
so the police weren't demanding everyone move on - they recognised that groups were 20m apart, mainly parents and kids, and that our rural part of the world has very few cases... and they responded appropriately.

frankly - i still think the UK approach is closer to Sweden than the countries that have attempted to crush the outbreak.
stated policy is to "squash the sombrero", and while health service capacity for covid19 has been massively increased the gov't seems extremely comfortable in using that capacity. and quite content to keep using that capacity at 95% for the foreseeable future!

so rather than crushing the outbreak and investing in track-n-trace to squash new outbreaks - the aim [remains] to keep processing the population through to the other side of antibody resistance as fast as that expanded health service capacity allows.
in this vein - i rather suspect that primary schools will reopen outside of urban hotspots after half-term. kids do not seem to 'suffer' much from covid and they do not appear to be very contagious - so they may well be the perfect vector to keep spreading low viral-loads around in the community.

https://www.telegraph.co.uk/news/202...ools-lockdown/

[Viking]

Word of the day: Dugnad



I'm confident predicting that the dictator of Belarus will not prove to have handled his country's crisis well.

Speaking of dugnad and Belarus, Belarus held a national dugnad Saturday last week, perhaps lending the virus a hand as well.

Yet, the precise role of outdoor spaces in the spread of the virus seems most uncertain at this time, so maybe the dugnad did not matter much.

[Montmorency]

Next excess deaths analysis: in 14 countries assessed, up to 60% (120K EDIT: Sorry, that's the total number of excess deaths, so 45K) more excess deaths than expected but not accounted for by confirmed CV19 deaths.
https://www.ft.com/content/6bd88b7d-...9-0d5c6fac846c

Reinfection vs. reactivation/relapse: recovered patients putative lack of immunity probably not a big problem, or at least it isn't in South Korea.
https://www.aljazeera.com/news/2020/...235141488.html

Long article with more on how the West Coast's initial pandemic response was much superior to the East Coast's (i.e. New York). To Cuomo's marginal credit he actually stepped up and improved, which is a rare thing these days.
https://www.newyorker.com/magazine/2...-yorks-did-not

About the more general failure of American government and civilization.
https://www.salon.com/2020/04/27/ame...e-whole-world/

O'Hehir rightly observes that empires inevitably collapse, but America's almost childlike inability to admit it even is an empire, even as it crumbles, may be unique in human history.
[...]
Now the country that sent men to the moon and brought them home again, all the way back in the 1960s, is a fumbling mess, unable to manage the simple logistics of getting supplies from one place to another or coordinating a national set of guidelines in a public health crisis. The vaunted CDC, long thought of as the greatest scientific disease research facility in the world, fumbled in making a test that had already been produced in other countries.
[...]
But it’s not just him, is it? The U.S. government seems to have lost its capacity to act, and the private sector is so invested in short-term profit-making that it’s lost its innovative edge. The result is that the United States of America, formerly the world’s leader in science and technology, now only leads the world in gruesome statistics and body counts.

It’s still unclear exactly why the CDC felt it had to make its own test when another test, created by a German lab, was already available. According to those in the know, Americans just don’t use tests from other countries, ostensibly because our “standards” are so high. Apparently, they aren’t. In this case, the test we created was faulty, causing weeks of delay, and there was some kind of contamination in the lab. How can this be?

The government’s inefficiency and ineptitude in producing, locating and distributing needed medical supplies, combined with Trumpian corrupt patronage toward his favored states, is staggering. Stories of FEMA commandeering shipments of gear that were already paid for by states, and governors having to bid against each other for supplies because the federal government refused to use its power to take control in a global emergency, are simply astonishing. The country that planned the D-Day invasion is incapable of coordinating the delivery of medical supplies to New York City?

Sen. Tom Cotton of Arkansas, a rising Republican leader, evidently wants to ensure that American never attracts any expertise again:

"If Chinese students want to come here and study Shakespeare and the Federalist Papers, that’s what they need to learn from America. They don’t need to learn quantum computing. It is a scandal to me that we have trained so many of the Chinese Communist Party’s brightest minds."

[Spoken like a true troglodyte.]

The rest of the world is moving on without us. This week 20 global leaders held a conference call pledging to “accelerate cooperation on a coronavirus vaccine and to share research, treatment and medicines across the globe.” No one from the United States was among them.

frankly - i still think the UK approach is closer to Sweden than the countries that have attempted to crush the outbreak.

That's debatable, but also subjective in that depends a lot on your value of "close." The UK imposed heavy restrictions on business operations (extended well into May), as did most of continental Europe. Sweden basically didn't at all. I don't know about Germany, but the main difference between France/Spain/Italy and either the UK or Sweden is that the former are much stricter about individual movement.

stated policy is to "squash the sombrero", and while health service capacity for covid19 has been massively increased the gov't seems extremely comfortable in using that capacity. and quite content to keep using that capacity at 95% for the foreseeable future!

Every country almost by definition has the same goal. But the tendency, after a spell, is to seek a less chaotic and lethal approach. These distinctions are measured in thousands of lives. Even in Sweden's example, as I understand it to the extent their strategy would be working (and it's not clear that it is) it is to the extent Swedes are obeying anarchist principles - non-coercion, independent concerted action toward common good - by individually deciding to drastically curtail consumer and commercial activity as a solidarity measure. (Very fascinating that Sweden's pandemic response has become a de facto case study in anarchism; I never would have predicted it.)

If you want a picture of shocking laxity however, look at Japan.

A source for UK healthcare capacity (beds? ventilators?) being used at 95%, please. I can't find anything from more recent than early April (though I did find some articles on UK's difficulty expanding testing).
https://www.nytimes.com/2020/04/16/w...y-test-uk.html
https://www.bbc.com/news/health-51943612
https://news.sky.com/story/coronavir...acity-11977115 [Seriously, how can the UK be testing below-par with a US state with 1/3 the population (with the exception of this past weekend)?]
https://www.wired.co.uk/article/uk-coronavirus-testing

But if true, it would be horrifying, comparable to Soviet shenanigans with the Chernobyl reactor configuration.

so rather than crushing the outbreak and investing in track-n-trace to squash new outbreaks - the aim [remains] to keep processing the population through to the other side of antibody resistance as fast as that expanded health service capacity allows.
in this vein - i rather suspect that primary schools will reopen outside of urban hotspots after half-term.

kids do not seem to 'suffer' much from covid and they do not appear to be very contagious - so they may well be the perfect vector to keep spreading low viral-loads around in the community.

That sounds grossly irresponsible. The whole premise of suppressing the outbreaks to the point of containment is so that we can buy time to establish these guidelines as the new normal:
https://www.propublica.org/article/c...heir-economies [Recommended for Samurai]

1. Contact tracing at scale.
2. Mass testing at scale.
3. Isolation of confirmed and suspected cases AWAY from family.
4. Protect health care workers
5. "Normalcy" is a mirage.
6. Be prepared for future waves.
7. Communicate clearly and truthfully with the public.

Allowing the virus to 'burn' through a population unchecked is national self-harm to a degree not even Johnson's government seems willing to contemplate.

[Furunculus]

"A source for UK healthcare capacity (beds? ventilators?) being used at 95%, please."

That is not intended to be factual statement. :) Merely to convey that available capacity is to be expanded and used, rather than left underutilised because we've squashed it SK stylee.

"That sounds grossly irresponsible. The whole premise of suppressing the outbreaks to the point of containment is so that we can buy time to establish these guidelines as the new normal:
1. Contact tracing at scale.
2. Mass testing at scale.
3. Isolation of confirmed and suspected cases AWAY from family.
4. Protect health care workers
5. "Normalcy" is a mirage.
6. Be prepared for future waves.
7. Communicate clearly and truthfully with the public. "

That's an interesting view, and yet the UK is not doing: #1 and #3.
There is clearly a difference between those countries that have attempted to squash the outbreak vs those those that have attempted to manage the outbreak.
And as you say, there is a continuum along that spectrum from sweden to taiwan, rather than an absolutist binary choice.
I merely suggest that UK sits closer to Sweden than is commonly recognised...
The UK doesn't even want to 'know' if you have Covid19 - merely stating that if during your self-isolation the symptoms become bad enough to require hospitalisation then please "give us a call".
Ringing your GP won't result in an appointment and an official diagnosis based on symptoms; "yeah, sounds like Covid, take a paracetamol and put your feet up."
Ringing 111 won't result in being sent to a testing centre; "please don't call this number unless your are struggling to manage at home, take a paracetamol!"
So from a management perspective the gov't doesn't know or much care about containing the outbreak, it's stats are purely focussed on NHS demand in order to calibrate NHS capacity.

"Allowing the virus to 'burn' through a population unchecked is national self-harm to a degree not even Johnson's government seems willing to contemplate. "

I would agree, but I have not suggested that anyone does or should follow such a policy.
If you presume - as I do - that there is no solution to this beyond a vaccination program that covers the whole population in approximately two years time, then any attempt to squash the outbreak - with massive contact tracing and full carrier isolation - while maintaining 'normal' economic activity is likely to resemble riding-the-clutch with countries lurching into and out of lockdown in a most disruptive manner. i.e. we'll all end up with similar numbers two years down the line (excepting where a health system has been overwhelmed), its just a question of how much damage the economy suffers in the interim.
What i describe 'might' be a smoother process of just managing the progression of the disease so economic activity can achieve a new equilibrium...

[Seamus Fermanagh]

Monty:

Liked your jibe at Cotton. The use of USA universities by many Asian countries has been a brain-drain for those countries. A notable percentage come here, learn, love our comparative freedom and lack-of-graft, and decide to make a future here.

Link

[Strike For The South]

Texas lt. governor on reopening state: 'There are more important things than living'

RIP Strike for the South. Master wants his money.

I am essential. Been at work the whole time.

[Montmorency]

Behold



the Holy American Empire. This is your correspondent from the Regional Advisory Council*.

*Connecticut, Delaware, Massachusetts, New Jersey, New York, Pennsylvania and Rhode Island (and apparently Vermont??)

[ReluctantSamurai]

Kinda looks like this map, no?

https://www.nationalgeographic.org/p...he-confederacy

[Furunculus]

an entertaining look at the malign effect of dominic cummings on uk covid19 policy response:

https://www.bloomberg.com/news/artic...-back-lockdown

#evil
#moreevilthantheorangeman
#theworst

[Greyblades]

Neocons fully believed that the powers exercised by the Bush admin were fully compatible with a reading of the Constitution that permits a unitary executive to make wide spanning decisive actions in many policy areas with only the limitations being what Congress and SCOTUS places on it.

Trump is too much for them because like we have been saying for 4 years now, he indulges in a very basic strongman mentality and bypasses Constitutional arguments with emotional arguments towards fascistic values (outsiders are bad, opposition is unpatriotic, rules undermine strength) to force his position. This is why neoconservative intellectuals have effectively split from the base, the former understand the implication of this new politics and the latter simply see a new type of politician.

The failing of neoconservatism boils down to this: A philosophy which holds character and ethics in politics as unimportant since raw power must be fought (i.e. elections) and argued (i.e. SCOTUS rulings) for within an existing legal framework will inevitably devolve into a philosophy that believes the legal framework itself must be tossed if elections and arguments cannot give them the power they want.

Anti-Trump conservatives are the most poignant in addressing the state of the GOP since they are the ones who felt this transition occur in front of them while mainstream America looked in from the outside in confusion.

The failing of neoconservatism boils down not to character and ethics but to adhiering to thier voters expectations.

I agree in practice they valued raw power over character and ethics. The issue isnt they were impeded from getting raw power by legal frame work, but that when it did get them power they used it against their voters interests in outright hideous ways.

They spend thier elections acting the good right winger: Secure the border, cut taxes, push american interests, uphold the constitution! Only to forget it the rest of the term; encouraging american industrial to be leached away by china, doing jack in the face of overflow from the perpetually failing mexican state (failure that thier drug war maintained, by the by) spending american blood and treasure toppling nations on dubious justification and taking a hatchet to civil liberties in every opportune moment national tradgedy gave.

I do not value their philosophical pandering over their actions, or inactions, thats what I share with the republican base and thats largely why it rejected them in favour of trump.

What gets me is this intellectual class: the people who espoused conservatism's principles found trump unbearable when in practice the neocons they persisted through were worse in nearly every fasion.

And why do they do that? Trump is abrasive and doesnt give them the lip service the neocons did.

It's a sad joke.

[ReluctantSamurai]

Something I thought was going to happen here in the States:

https://www.vox.com/2020/4/28/212395...-rural-america

“The epicenter of this outbreak really has shifted into the smaller rural areas,” said Angela Hewlett, associate professor in infectious disease at the University of Nebraska Medical Center, in a recent Infectious Diseases Society of America briefing. And that’s a major problem, given that the health systems of many of these places are the least equipped to deal with a sudden surge in cases.

Most epidemiology models predict that initial peaks in less-densely populated states may still be weeks away, making understanding these kinds of nuances — and not relaxing social distancing prematurely — critical.

“When you have a large outbreak associated with an industry like the meatpacking industry,” Hewlett says, “then you can have a sustained community transmission.”

And couple that last statement concerning the meat processing industry with this:

https://www.bbc.com/news/world-us-canada-52466502

Without strict adherence to safety guidelines - which are not currently being deemed "mandatory" by the Occupational Safety and Health Administration - it's not hard to picture new outbreaks at factories, or resurgences of the virus in factories that shuttered but reopen prematurely.

It's going to be a long, long summer.......

[Montmorency]

A neat set of graphs from the excess deaths article if you didn't see it.



The joys of being an island, like New Zealand...
('New Zealand anticipates eradication of Covid-19')


EDIT: Furunc should know that Sweden's projected GDP annual contraction is 7%, more than projected for the US. That's what attends mitigation and social distancing of any form. Though in truth, regardless of what measures they do or don't take, every country on the planet can expect to be in recession at least. Sounds like an opportune moment for pursuing unprecedented robust transnational cooperation up to unionism, but what do I know.

[I]That is not intended to be factual statement. :) Merely to convey that available capacity is to be expanded and used, rather than left underutilised because we've squashed it SK stylee.

I hope it's obvious in concept why pricing in stability for a healthcare system operating continuously at near-peak capacity is inadvisable.

That's an interesting view, and yet the UK is not doing: #1 and #3.

1-3 flow into one another. Testing enables tracing enables isolation. Very few are doing 1 and 2, or are prepared do it, to the appropriate extent. I'm not aware of anyone doing 3 other than the well-known East Asian examples. On a very small scale some US localities have offered voluntary isolation quarters for confirmed or suspected cases, and this could certainly be expanded nationally. Even better with financial inducements, but the mere availability of reasonable accommodations (empty hotels abound!) with honest presentation of facts would ensure high voluntary uptake. Ah, this was something that should have been planned out in February.

4-7 are hard to grade, beyond the obvious no-mark countries. Apparently Ecuador of all places is leading on some aspects of 7.

What i describe 'might' be a smoother process of just managing the progression of the disease so economic activity can achieve a new equilibrium...

I can't comment on the UK's current healthcare protocols, but anything that sounds like "take the punch" should have us wary.

Ideally - assuming a worthwhile treatment in 2021 and a vaccine by 2022 - you want to minimize the death toll. That is achieved by limiting transmission to or below R₀ = 1 for an extended period, which itself can be achieved by containing a national epidemic, by minimizing interpersonal contacts. Afterwards restrictions can be relaxed in a graduated fashion. What permits relaxed restrictions is the organization of a mass testing/tracing regime; without one in place containment will rapidly be lost and the country enters a disruptive shutdown cycle as you remark. (If there are tens or hundreds of thousands of concurrent infections, then tracing becomes both out of reach and superfluous.) Most of the world is unfortunately not well-placed to achieve these benchmarks, and even some of those countries that are well-placed are not realizing their advantages.

If we expect neither treatment nor vaccine by any foreseeable timeline, then even with vigilant travel quarantines all but the most successful countries can only stagger the death rates we all slouch toward (adjusted for population age and underlying condition distribution, baseline medical system, etc.). At least the experiences of Italy and others have been an education to individuals around the world.

In a bad scenario, sars-cov-2 dissolves into the viral landscape and merges permanently with the yearly flu season, considerably elevating the costs thereof.

And couple that last statement concerning the meat processing industry with this:

https://www.bbc.com/news/world-us-canada-52466502

Good on you for mentioning what they're doing with OSHA. They've already waived an assortment of environmental regulations on an emergency basis. Their current plan is to limit business liability related to the pandemic (tort reform!).

[a completely inoffensive name]

The failing of neoconservatism boils down not to character and ethics but to adhiering to thier voters expectations.
I agree in practice they valued raw power over character and ethics. The issue isnt they were impeded from getting raw power by legal frame work, but that when it did get them power they used it against their voters interests in outright hideous ways.

I don't think this is true. But I don't blame you for thinking this; right wing media makes conservatives think they lose all the time so that people become more receptive to radicalization.

They spend thier elections acting the good right winger: Secure the border, cut taxes, push american interests, uphold the constitution!

Secure the border: https://en.wikipedia.org/wiki/Secure_Fence_Act_of_2006
Cut taxes: https://en.wikipedia.org/wiki/Bush_tax_cuts
American Interests: https://en.wikipedia.org/wiki/Kyoto_Protocol / https://en.wikipedia.org/wiki/Americ...Protection_Act / https://en.wikipedia.org/wiki/2002_U...s_steel_tariff / https://en.wikipedia.org/wiki/Presid...or_AIDS_Relief

Conservatives never looked to uphold the Constitution.

Only to forget it the rest of the term; encouraging american industrial to be leached away by china, doing jack in the face of overflow from the perpetually failing mexican state (failure that thier drug war maintained, by the by) spending american blood and treasure toppling nations on dubious justification and taking a hatchet to civil liberties in every opportune moment national tradgedy gave.

Half of this I have already shown above is false. The other half is revisionist history. Everyone approved of the War in Afghanistan. Conservatives and moderates approved of the war in Iraq. Everyone approved of the PATRIOT Act when it came out. They agreed with Guantanamo Bay. Public support collapsed for these things years later.

I do not value their philosophical pandering over their actions, or inactions, thats what I share with the republican base and thats largely why it rejected them in favour of trump.

Consider yourself fooled.

What gets me is this intellectual class: the people who espoused conservatism's principles found trump unbearable when in practice the neocons they persisted through were worse in nearly every fasion.

Leftists would disagree, and if that doesn't make you rethink your position you are simply in it for the movement not the meaning.

And why do they do that? Trump is abrasive and doesnt give them the lip service the neocons did.

With the exception of trade, Trump is still giving them everything they would want. Aggressive foreign policy to Iran, tax cuts, devolution of powers to the states, appointment of conservative judges.
There is another reason why they disagree, perhaps you should actually read what they say.

It's a sad joke.

Yeah, its sad how easily recent history is forgotten to continue the victim complex of conservatives.

[Furunculus]

A neat set of graphs from the excess deaths article if you didn't see it.

The joys of being an island, like New Zealand...
('New Zealand anticipates eradication of Covid-19')

good graphs, thank you.

EDIT: Furunc should know that Sweden's projected GDP annual contraction is 7%, more than projected for the US. That's what attends mitigation and social distancing of any form. Though in truth, regardless of what measures they do or don't take, every country on the planet can expect to be in recession at least.

Sounds like an opportune moment for pursuing unprecedented robust transnational cooperation up to unionism, but what do I know.

i'm not sure why you are telling me - but thanks - given my principle argument is that this is a complex system with too many variables for anyone to [know] what the correct macro-strategy is (or for that to be deemed a template for any other country).

"Up to unionism" - would you expand on that?

I hope it's obvious in concept why pricing in stability for a healthcare system operating continuously at near-peak capacity is inadvisable.

no. it is not obvious, given the alternative might increase the likelyhood and impact of second/third peaks.

1-3 flow into one another. Testing enables tracing enables isolation. Very few are doing 1 and 2, or are prepared do it, to the appropriate extent. I'm not aware of anyone doing 3 other than the well-known East Asian examples. On a very small scale some US localities have offered voluntary isolation quarters for confirmed or suspected cases, and this could certainly be expanded nationally. Even better with financial inducements, but the mere availability of reasonable accommodations (empty hotels abound!) with honest presentation of facts would ensure high voluntary uptake. Ah, this was something that should have been planned out in February.

agreed, it is a continuum.

I can't comment on the UK's current healthcare protocols, but anything that sounds like "take the punch" should have us wary.

Ideally - assuming a worthwhile treatment in 2021 and a vaccine by 2022 - you want to minimize the death toll. That is achieved by limiting transmission to or below R₀ = 1 for an extended period, which itself can be achieved by containing a national epidemic, by minimizing interpersonal contacts. Afterwards restrictions can be relaxed in a graduated fashion. What permits relaxed restrictions is the organization of a mass testing/tracing regime; without one in place containment will rapidly be lost and the country enters a disruptive shutdown cycle as you remark. (If there are tens or hundreds of thousands of concurrent infections, then tracing becomes both out of reach and superfluous.) Most of the world is unfortunately not well-placed to achieve these benchmarks, and even some of those countries that are well-placed are not realizing their advantages.

If we expect neither treatment nor vaccine by any foreseeable timeline, then even with vigilant travel quarantines all but the most successful countries can only stagger the death rates we all slouch toward (adjusted for population age and underlying condition distribution, baseline medical system, etc.). At least the experiences of Italy and others have been an education to individuals around the world.

and yet you do. :)

re: minimise the death toll - sure, as a statement of general principles - but this is a complex system with many, many variables:
as you note, NZ has an enviable social isolation (it also has a very low population density).
the UK does not have this advantage, given the following characteristics:
a nation with a very high populations density (england is about fourth densest in europe excluding micro-states)
at the heart of which is a global mega-city of ~15m, i.e. London.
and London is intimately connected to the rest of the world by a major hub airport - heathrow (as well as large international airports - gatwick and stanstead).

so i would suggest again that we need a little humility in recognising just how little we know, and won't know for some time to come, about both the:
1. efficacy of national strategies in minimising the death toll and economic damage over the medium term, and;
2. the portability of those strategies to other nations whose own strategies are deemed to have been less successful
Yes, we can point to a collapsed health system like northern italy, and yes we can point to poor communication like trump, outside of that it is too early to tell much.

WHO lauds lockdown-ignoring Sweden as a ‘model’ for countries going forward:
https://nypost.com/2020/04/29/who-la...irus-lockdown/

Perils of early predictions based on poor assumptions:
https://twitter.com/PhilWMagness/sta...00441985355776

Children may in fact be carrying the same viral load - despite showing less serious symptoms:
https://www.theguardian.com/world/20...pening-schools

[Montmorency]

Dumped potatoes and cars lined up at a food bank.



From my own 'original' calculations, based on crudely comparing preliminary antibody surveys against excess death estimates and confirmed death counts, I have figured the 'true' (i.e. global) IFR of CV19 to be 0.5%, more or less, and not really more than 1%.

This informal meta-analysis of available IFR studies around the world comes to a similar conclusion (though the range arrived at is 0.5-1.0% with a point estimate of 0.75%).
https://medium.com/@gidmk/what-is-th...9-7f58f7c90410

"Up to unionism" - would you expand on that?

Just what's implicated by an economically and ecologically-interdependent world system.

Tangentially, it should be noted that global leadership on the worst pandemic in a hundred years has been vastly worse than that for smallpox, AIDS, SARS, malaria, Ebola, avian flu, swine flu...

no. it is not obvious, given the alternative might increase the likelyhood and impact of second/third peaks.

There is no way to engineer a scenario in which only a certain amount, but close to maximum, of healthcare capacity is committed in a time interval, because disease outbreaks can't be controlled so precisely and because labor and material resources will be depleted over time above replacement in such an intense environment. Trying to price in such a benchmark, which is to say make it doctrinal, would perversely lead to a very high risk of overrun without a lucky break in the qualities of the pathogen. Much better for there to be multiple low peaks, which is the consensus.

Not to mention, even, that the medical sector is not like a physically-abstracted machine; its function is not like a switch, where on one side of some threshold it functions perfectly, and on the other it fails. It is more like a real machine, in that it will be increasingly degraded the more it is abused. The 95% scheme is like planning to drive across the Sahara at 95% of a vehicle's rated top speed without stopping. A good way to get the engine killed in the middle of the desert, leaving you stranded. I guarantee the car fares better, and gets you across faster, if you pace it. Under any circumstances, a medical system fluctuating between 10-33% over a year would expect fewer deaths, fewer adverse outcomes in general, than one somehow constantly at 50%, and 99% is about as catastrophic as 101%.

Should be readily apparent.

and yet you do. :)

I'm not commenting on the facts of the matter about the NHS' current practices.

the UK does not have this advantage, given the following characteristics:

Airports are natural chokepoints if the controlling country has the will to do screenings. It could even throw up its hands and kill travel to buy time.

Density only becomes a problem with rampant community spread. It's possible to head it off in the first place, or, you know, lock down to limit spread, ramp up testing, suppress the outbreak, and staunch transmission below a threshold indefinitely.

The UK could absolutely look like New Zealand here with different choices.

Yes, we can point to a collapsed health system like northern italy, and yes we can point to poor communication like trump, outside of that it is too early to tell much.

There's more to say about Trump than "poor communication."

But I reject your seeming premise that the proof of the pudding must be in the stool. It is not impossible to assess an ongoing public health response, despite all the uncertainties. If that were the case then there would be no discerning how to act between random policies or a basis to make predictions - yet there is. And it is uniquely informative to have a whole region - Nordic - to compare against. That Norway, Denmark, and Finland are all clustered together for deaths per capita, but range from 6-10 times less than Sweden's, is a fact open to interpretation. But it must and can be interpreted. Anything else is deflection.

WHO lauds lockdown-ignoring Sweden as a ‘model’ for countries going forward:
https://nypost.com/2020/04/29/who-la...irus-lockdown/

I think the fellow is being taken out of context a bit. His overall remarks were more balanced, and the locus of the praise came down to cultural exceptionalism (which is, as you say, not portable). The part about ramping up testing is questionable though, as Sweden appears to be below European average, as of now, on tests per capita. Norway and Denmark have, to their great exultation I'm sure, each tested more than Sweden despite being smaller (Iceland has like 3% of Sweden's population btw). The Swedish government has promised a ramp-up to 100K weekly (they've tested a little more than 100K so far); we'll see how they and the UK perform.

Perils of early predictions based on poor assumptions:
https://twitter.com/PhilWMagness/sta...00441985355776

Models in general have underestimated the adjustments made by governments and individuals, as well as the typical fatality of the virus (see above, the pandemic probably can't kill more than 100K Swedes total). In the model linked, a new fact I learned is that 95% of Sweden's workplaces have 1-9 employees, which on top of ~40% single-occupancy households is a shocking sparseness for normal Swedish society. Sweden's low density outside Stockholm, plus the cultural attributes and practices, will also prove to have limited its spread so far.

It would be great though to have hard data on the behavior of Swedish consumers. Something like this (restaurant bookings) for example. I'm not going to look it up, but I do recall seeing a visualization of mobility in Stockholm; the drop from normal movement was similarly-dramatic to New York's.

[Furunculus]

And yet...

... you will note - just as I do - that every single evening briefing from the gov't in the last week when questions of easing the lockdown arise say precisely this:

"our absolute ambition when considering how to ease the lockdown is that the R number must not rise above 1.0!"

Not "must stay below 0.5", or 0.7, or even 0.9!
No, the phrase used is "must not rise above 1.0".

So if the R number in the UK is considered right now (as of last night), to be somewhere between 0.5 and 0.7, then what they are looking to assess in the next week is which social isolation measures can be relaxed and ensure that we go no higher than every person in population right now with covid infects no more than one other person.

Not "with every measure we take we must ensure that the R number drops by X percentage for every X measure of time", or any similar such formula of words.

The wording is quite precise, and quite deliberate: "must not rise above 1.0".

The government seems quite content to cycle the population through the pandemic as quickly as NHS capacity will allow.

Population density map of europe:

[ReluctantSamurai]

This is not going to end well:

https://www.vox.com/policy-and-polit...-at-home-order

At some point, a self-proclaimed Rambo (you've got three of them right there in the lead photo) is going to take issue with something a legislator says, or something a state trooper says, and a blood bath will ensue.

And yet:

As of April 30, Michigan has over 41,300 confirmed cases of the coronavirus and over 3,700 deaths

That's the third highest in the US. I am simply dumbfounded at the sheer stupidity of all this......

[Seamus Fermanagh]

And yet...
The government seems quite content to cycle the population through the pandemic as quickly as NHS capacity will allow.

There are epidemiologists who are asserting that this novel coronavirus, because of its easy communicability, will spread to roughly 2/3 of the global population over the course of the next 18-24 months. Vaccines normally take between 24-48 months to develop, test, and manufacture in quantity.

Presuming your assessment is correct, your government could argue that cycling the population through as quickly as possible is the rational response in a world where we all are going to get this anyway.

[ReluctantSamurai]

It's increasingly frustrating to me to see the continued Don't Tread On My Rights while I continually Tread On Yours mentality occurring on a weekly basis here in the States. So I did a bit of digging and found this:

https://papers.ssrn.com/sol3/papers....act_id=3582626

I have several problems with this study not the least of which is its' limited scope, and the lack of inclusion of minorities. It's also hard to determine whether this study crosses the urban/rural divide so prevalent here. And it is not peer reviewed, as of yet. Having said that, there are some interesting points raised, and I hope there will be more follow-ups to come.

I don't pretend to understand all the statistical jargon, but I think I get the general gist. Read the whole paper if you have the time, or if you don't trust my following Cliff Notes to be unbiased.

Results indicated that gender, health issues others, trust in science, and trust in media were significantly associated with compliance. More specifically, women, people who knew someone with health issues, and people with higher levels of trust in science and media reporting showed greater compliance with COVID-19 mitigation measures. Age and personal health issues were not related to compliance.

Results indicated that specific moral alignment, negative emotions, and impulsivity showed significant associations with compliance; participants who more strongly believed people should follow the COVID-19 mitigation measures, who experienced more negative emotions, and who were less impulsive, showed greater compliance with the COVID-19 mitigation measures.

Results indicated that these measures all showed significant associations with compliance; people that had greater ability to comply, perceived the measures to be clearer, and had less opportunity to violate. All showed greater compliance with the COVID-19 mitigation measures.

the more participants indicated that they only obey the authorities handling the Coronavirus because they are afraid of them, the less they complied.

The results revealed that political orientation was not associated with compliance.

(notsure I agree with this as many polls show that political leanings DO influence compliance---see my following post)

This shows that what really matters for compliance is not whether people think the measures are appropriate or necessary to protect themselves or loved ones, but rather whether they hold the belief that morally people should comply. Overall, it shows that at this time, moral support for the measures does play a role in compliance.

within the American population, there are individual differences in compliance. People who are more impulsive are less likely to follow the measures. This is important knowledge, as it supports measures that make it practically harder to refrain from social distancing, for instance the measures in New York City where basketball hoops were removed.

The more individuals fear the authorities enforcing the measures, the more they disobey the measures, likely in a form of rebellion to authority they deem to be coercive.

And some conclusions:

Social norms and moral views appear to shape compliant behavior more strongly than political orientation. Only time will tell whether this will remain true in light of the recent politically-laden protests in states like Michigan and Arizona. That is, it is possible that the impact of political views on compliance may be changing with time; initially, it may have been strongly associated with compliance during March, weakly associated during early April, and increasingly associated during mid-to-late April, exhibiting a U-shaped curve. For the long run, we speculate that maintaining current levels of social distancing will become increasingly difficult. It is likely that governments, in light of economic and societal demands, will lift some of the restrictions on public spaces, thereby increasing opportunities for people to gather. Unfortunately, opportunity to break rules was consistently associated with non-compliance, and lifting restrictions will inherently create opportunity. As people see the number of infections and deaths decrease as a result of the initial measures, they will likely have less substantive moral support for compliance with the measures. Also, we expect that the longer people have to maintain social distance and stay at home, the higher the costs of compliance will become. At some point, this may undermine their capacity to comply, as they potentially lose income or even housing. We speculate that at that point, the measures themselves may spur negative emotions, which will enable people to cope through offending. Once more people start to offend, social norms will start to shift and non-compliance may normalize.

Non-compliance due to shifting social behavior is the most worrysome part. Risks starting the whole process all over again.

[ReluctantSamurai]

AFAIAC, politics are playing a big part in "anti-lockdown" protests:

https://www.theguardian.com/us-news/...ghtwing-donors

It was a Michigan organization that has landed DeVos in the news over the past two weeks. The Michigan Freedom Fund, which “fights to champion conservative policies on behalf of Michigan taxpayers” – including lower taxes – helped promote a rally in Michigan against the state’s stay-at-home order. The MFF, which is chaired by Betsy and Dick DeVos’ longtime political adviser, Greg McNeilly, helped promote, rather than organize, the Michigan rally. But the MFF exists, in large part, due to the DeVos family’s largesse.

This is certainly no co-incidence coming less than a day after the latest protests in Lansing:

Trump is once again weighing in on the anti-stay-at-home protests that have been popping up across the country, suggesting Michigan governor Gretchen Whitmer should “make a deal” with the demonstrators. “The Governor of Michigan should give a little, and put out the fire,” Trump wrote in a tweet. “These are very good people, but they are angry. They want their lives back again, safely! See them, talk to them, make a deal.” The president’s tweet comes one day after protesters descended on the Michigan capitol in Lansing to rail against Whitmer’s stay-at-home order. A number of the demonstrators were photographed carrying assault rifles, causing alarm among the legislators who were at the Capitol.

Fearless Leader is definitely afraid of losing Michigan come November....

[Montmorency]

The US has reached up to 1.5 million tests weekly. If we can get that to daily I will call it an accomplishment, but it sounds hard with effectively nil federal component. Meanwhile, New York has dropped from its peak of a quarter of daily US tests (and far more cumulative) to 1/7 cumulative and a similar proportion daily.

At first I thought face coverings and surgical masks were hardly useful in a clinical setting, and useless outside it. Then I was embarrassed for thinking so after encountering research touting the effectiveness of face coverings, especially in combination with other measures, at reducing disease transmisson. Soon after reading about this the CDC changed its recommendations to include face coverings in general public settings. Then I read that there is basically no evidence for face coverings reducing transmission of respiratory disease outside of healthcare settings. Now, I'm reading that surgical masks specifically are actually contributing to infection in healthcare workers. AAaahaghghghkghre
https://khn.org/news/widely-used-sur...-serious-risk/

On expanded unemployment insurance and labor consciousness:
https://www.wsj.com/articles/coronav...rk-11588066200

oughly half of all U.S. workers stand to earn more in unemployment benefits than they did at their jobs before the coronavirus pandemic shut down swaths of the U.S. economy, a result of government relief that employers say is complicating plans to reopen businesses. The package of coronavirus stimulus laws Congress passed and President Trump signed in March included a $600 boost to weekly unemployment benefits through July 31. As that support is added to state benefits over the coming weeks, the average weekly payment to a laid-off worker should rise to about $978 from the nearly $378 the Labor Department said was paid on average late last year. Qualified workers will receive the government payout every week through July, and in most cases, the combined $978 weekly payout amounts to better pay than what many workers received before the crisis hit. Labor Department statistics show half of full-time workers earned $957 [median weekly income] or less each week in the first quarter of 2020.

Tracy Jackson, 50, of Nacogdoches, Texas, started receiving unemployment benefits after losing her job as a cook at a college. Her benefits total $1,200 every two weeks, almost twice what she would earn on the job.

She wants to return to work, but being stuck at home has given her time to reflect. The extra money she receives in unemployment benefits has made her conclude she had been underpaid at her previous job, earning $10.30 an hour after five years.

“I like the college, I really do,” she said. “But they’re going to have to come with more money. If they don’t, I’m not going to be there.”

You love to see it. (Of course, UI expansion expires in the summer and in a mass-unemployment environment near-literal beggars can't be choosers - just how employers like it.)

The wording is quite precise, and quite deliberate: "must not rise above 1.0".

The government seems quite content to cycle the population through the pandemic as quickly as NHS capacity will allow.

So, I don't understand - your preferences are not met by this policy, which are closer to my own and the general scientific consensus, because the whole point is that it slows down the incidence (in the proper sense) among the general population.
?????

According to a pre-print study from the London School of Hygiene and Tropical Medicine published at the start of April, the average number of people an individual comes into contact with each day dropped by 73 per cent since the UK’s lockdown began.

“This would be sufficient to reduce R0 from a value from 2.6 before the lockdown to 0.62 during the lockdown, indicating that physical distancing interventions are effective,” the study, which tracked over 1,300 adults and has not yet been peer reviewed, concluded. The government's more recent estimates have since backed up this data.

So if it is working, why are not out of lockdown yet?
The R0 is not the only figure the government is tracking. It is also making sure that the pandemic does not overwhelm the NHS, looking for a "sustained and constant" fall in death rates, ensuring there is enough personal protective equipment (PPE), and finally, being confident that any changes do not risk another peak.

In Germany, where some lockdown measures were lifted once the R value made it to 0.7 - with some shops reopening, for example - R0 has crept back up to around 0.76, the head of the country's Robert Koch Institute on said on Thursday.

As such, its government plans to keep many social distancing measures in place for a longer period than initially expected. It is likely that the UK, too, will have to walk a similar tightrope, lifting some restrictions while keeping a close eye on R0 and cases, and adapting its plan depending on what happens.

Presuming your assessment is correct, your government could argue that cycling the population through as quickly as possible is the rational response in a world where we all are going to get this anyway.

Even in a world with no treatment or vaccine, slow and steady wins the race. Well, "win" isn't the right word.

The UK and Sweden both agree in principle. China agrees. The Jews agree. (Not sure about the Dutch...)

This is not going to end well:

https://www.vox.com/policy-and-polit...-at-home-order

At some point, a self-proclaimed Rambo (you've got three of them right there in the lead photo) is going to take issue with something a legislator says, or something a state trooper says, and a blood bath will ensue.

At some point we need to enforce the understanding that terrorism is not protected speech. We've long been clear on this when it comes to the boogeyman of "radical Islamist terrorism."

AFAIAC, politics are playing a big part in "anti-lockdown" protests

Interesting study in how it dovetails with other work on social trust and lack thereof.

We might make a distinction here between personal compliance with guidelines in practice, and political opinions about the guidelines. There won't necessarily be perfect alignment. And speaking of impulsivity, in Georgia last week:

“I still say stay at home,” said Amanda Jackson, a customer and a nurse at the public hospital downtown. But she made an exception for her birthday — to get a tongue piercing.

I agree with the potential of social deconditioning leading to increasing non-compliance, since much of compliance will follow from that referenced moral intuition, reinforced by perceptions of 'what others people are doing.' It's a general mechanism. A little "cheating" degrades into complacency, and the less positive modeling there is to be observed (or incentivized) the faster the process.

But in principle the overwhelming support for stay-at-home policy is still there. You will be very interested in the following:
https://www.washingtonpost.com/polit...home-measures/





We have almost never been this united as a country. America's closed, and don't let the jackals out front tell you otherwise.

[Montmorency]

Illinois.


Tennessee.


Sounds oddly familiar.

[CrossLOPER]

This is not going to end well:

https://www.vox.com/policy-and-polit...-at-home-order

At some point, a self-proclaimed Rambo (you've got three of them right there in the lead photo) is going to take issue with something a legislator says, or something a state trooper says, and a blood bath will ensue.

And yet:



That's the third highest in the US. I am simply dumbfounded at the sheer stupidity of all this......

I never understood why liberals never just brought their own guns.

[Furunculus]

Uk looks to relax the 2m rule to help with easing lockdown measures (inc schools):
https://www.telegraph.co.uk/politics...ictions-could/

The difference between national 'success' rates:

https://www.telegraph.co.uk/news/202...virus-experts/

Prof Keith Neal, Emeritus Professor of the Epidemiology of Infectious Diseases, University of Nottingham

I believe that comparing epidemics between countries is erroneous. I say epidemics despite, because although it has been called a pandemic, we are seeing essentially lots of epidemics in different nations, and in different regions.

There are a lot of different dynamics, and there is a genuine uniqueness both between counties, within countries. And the number of travellers is important too. Someone pointed out put the other day that the death rate is so much lower in Ireland .

This is partly because Ireland’s population is 1/13 the size of ours with 1/13 the number of international travelers.

The UK is also home to more people than France, or Spain. Germany has been held up as an example of an effective response, with a similar population to the UK. But we must consider that the population of Berlin is 3.8 million, and London is home to nine million.

Add to this the issue of having the busiest airport in Europe right next door at Heathrow, and a more nuanced set of problems begin to defy direct national comparison.

Now to get the global financial centre of London, travellers will enter one of the busiest public transport networks in Europe. And it must be realised that the virus in all probability entered this unaware and particularly vulnerable ecosystem of mass transit and international visitors long before the alarm was raised in China.

New Zealand has been praised, but they are in far greater isolation, and have longer to prepare. There will always be people who say you can go into lockdown a week earlier, or a week earlier than that - then that will be too early!

We will only know how everybody has fared when this is over, and excess mortality rates have been calculated.