[fullmetal]

I'm betting the decreases correlate with the respective government requests to wear masks.  

Just.  Do.  It.

[fullmetal]

I'm betting the decreases correlate with the respective government requests to wear masks.  

Just.  Do.  It.

[chrisk]

If I continue taking precautions to avoid getting Covid-19, I'm not going to get it. The same can be said for the vast majority of people. The only reason more people aren't acting like me is because they are ignorant to how bad it could be to actually get the virus. 

I don't lock myself in my house. I go to stores to get things and wear a mask any time around people in or outside. But I don't hang out with others for a very long time either. Nor am I hopping on an airplane.  Could I get infected even by limiting risk?  Sure I could.  But CT reported 81 Cases Thursday and 41 Friday.  We have done the work and made the effort to mitigate spread in this state and it has worked. So this notion that it is inevitable that we get overrun by the virus is not supported by reality.  You have to actively choose to take risks that promote virus spread for it to spread.

I have heard so much conflicting information.  I have heard the mask is almost entirely for a person not to spread it to others.   But it does very little if anything to prevent someone from getting the virus.  The theory I heard is the virus in itself is so much smaller than the holes between threads of any mask material that there is no protection. 

Be interested to hear if any study has made a definitive conclusion about wearing masks.

Reading this thread has changed my opinion from optimistic to pessimistic about fall sports.  I don't see how when full practice with pads starts that everyone who hasn't had it yet won't get it.

There is an increasing body of evidence that masks are effective, more so in preventing the spread from the wearer.
There are not sufficient by themseleves to prevent transmission. They do not substitute for social distancing or touching; they are incremental. They are important in small meetings of some duration and they are important in casual contacts indoors (shopping, etc.) where 6 feet distance is not always possible.

The authorities discouraged masks initially because of the shortage for health care worksers, who definitely had to have priority. This predisposed people who were not likely to want to wear masks even less likely to be willing to do it.

[chrisk]

If I continue taking precautions to avoid getting Covid-19, I'm not going to get it. The same can be said for the vast majority of people. The only reason more people aren't acting like me is because they are ignorant to how bad it could be to actually get the virus. 

I don't lock myself in my house. I go to stores to get things and wear a mask any time around people in or outside. But I don't hang out with others for a very long time either. Nor am I hopping on an airplane.  Could I get infected even by limiting risk?  Sure I could.  But CT reported 81 Cases Thursday and 41 Friday.  We have done the work and made the effort to mitigate spread in this state and it has worked. So this notion that it is inevitable that we get overrun by the virus is not supported by reality.  You have to actively choose to take risks that promote virus spread for it to spread.

I have heard so much conflicting information.  I have heard the mask is almost entirely for a person not to spread it to others.   But it does very little if anything to prevent someone from getting the virus.  The theory I heard is the virus in itself is so much smaller than the holes between threads of any mask material that there is no protection. 

Be interested to hear if any study has made a definitive conclusion about wearing masks.

Reading this thread has changed my opinion from optimistic to pessimistic about fall sports.  I don't see how when full practice with pads starts that everyone who hasn't had it yet won't get it.

There is an increasing body of evidence that masks are effective, more so in preventing the spread from the wearer.
There are not sufficient by themseleves to prevent transmission. They do not substitute for social distancing or touching; they are incremental. They are important in small meetings of some duration and they are important in casual contacts indoors (shopping, etc.) where 6 feet distance is not always possible.

The authorities discouraged masks initially because of the shortage for health care worksers, who definitely had to have priority. This predisposed people who were not likely to want to wear masks even less likely to be willing to do it.

[OutsiderFan]

Those of you adopting the surrender monkey position of we couldn’t have done anything more and what we asked was too much, are seeing your credibility evaporate in front of my eyes. You are otherwise very smart, so it confounds me how such a blind spot can exist when it comes to Covid-19 containment in the United States.

Maybe New Zealand isn’t the best example. Island nation. Ability to close borders. Whatever. OK, how about Thailand? Similar climate as Florida. Yet look:
https://www.worldometers.info/coronaviru.../thailand/

Florida reported more cases yesterday (third consecutive day of record new cases reported) than Thailand has recorded total. Everyone in Thailand wears a mask and practices distancing. 

Thailand and New Zealand not good enough, how about Japan?
https://www.worldometers.info/coronaviru...try/japan/

Or maybe let’s go to Germany? It is a fellow G7 country that had a big outbreak:
https://www.worldometers.info/coronaviru...y/germany/

Wow, look at that. Need I go on? How about closer to home, like Canada?
https://www.worldometers.info/coronaviru...ry/canada/

Hmm, even Canada - still not bent down the curve enough - did a far better job than the U.S. and it’s active cases are trending down. Not in the USA. Only Brazil is worse. And the fact of the matter is, the only reason the U.S. isn’t way worse than it is can be attributed to the fact the Tri-State area got hit hard and did a great job knocking the virus down. But even we are slipping.

Remember a week ago I reported about being horrified by what I saw when out last Saturday? Well, the following Saturday, after only double digit daily increases for a week, 158 new cases were reported. 

It all starts at the top. The United States should NEVER, EVER be so weak as to be the least competent and most impacted by something Thailand can easily handle. If you think what we are experiencing is unavoidable, you need to massively ratchet up your expectations for everyone in this country and hold them accountable for better performance. Because the simple reality is we can and have no reason not to be way, way better than we are right now.

[OutsiderFan]

Those of you adopting the surrender monkey position of we couldn’t have done anything more and what we asked was too much, are seeing your credibility evaporate in front of my eyes. You are otherwise very smart, so it confounds me how such a blind spot can exist when it comes to Covid-19 containment in the United States.

Maybe New Zealand isn’t the best example. Island nation. Ability to close borders. Whatever. OK, how about Thailand? Similar climate as Florida. Yet look:
https://www.worldometers.info/coronaviru.../thailand/

Florida reported more cases yesterday (third consecutive day of record new cases reported) than Thailand has recorded total. Everyone in Thailand wears a mask and practices distancing. 

Thailand and New Zealand not good enough, how about Japan?
https://www.worldometers.info/coronaviru...try/japan/

Or maybe let’s go to Germany? It is a fellow G7 country that had a big outbreak:
https://www.worldometers.info/coronaviru...y/germany/

Wow, look at that. Need I go on? How about closer to home, like Canada?
https://www.worldometers.info/coronaviru...ry/canada/

Hmm, even Canada - still not bent down the curve enough - did a far better job than the U.S. and it’s active cases are trending down. Not in the USA. Only Brazil is worse. And the fact of the matter is, the only reason the U.S. isn’t way worse than it is can be attributed to the fact the Tri-State area got hit hard and did a great job knocking the virus down. But even we are slipping.

Remember a week ago I reported about being horrified by what I saw when out last Saturday? Well, the following Saturday, after only double digit daily increases for a week, 158 new cases were reported. 

It all starts at the top. The United States should NEVER, EVER be so weak as to be the least competent and most impacted by something Thailand can easily handle. If you think what we are experiencing is unavoidable, you need to massively ratchet up your expectations for everyone in this country and hold them accountable for better performance. Because the simple reality is we can and have no reason not to be way, way better than we are right now.

[Farm93]

Right - The USA could fight this like New Zealand, Taiwan, Thailand, South Korea, Canada or even like USA 1945-2016.

I feel I must strongly point out (yet again) that the USA was in no position to contain this kind of a virus as early as 2008, if not before.

That was a nod to the idea of American exceptionalism solving big problems and trying not to imply the USA, as a country, couldn't meet the standard of other countries with a slightly different set of priorities.

A country that could fight (and win) a multi-front war spanning the globe in 1945 should have been able to do at least as much as Thailand did this year.
A country that took people to the moon should be able to do at least as much as a New Zealand or Taiwan.
And a country that helped the world out of a financial crisis it admittedly created should be able to at least mimic the strategies they are using across the border in Canada.

That is not to say the USA would have been best in class in this pandemic, but at a minimum the USA could have been a global leader in tackling this new challenge much like the USA had done for decades. 

And, for this board, we are likely to see closed campuses (again) and no NCAA sports (again).

LSU has 30 players in isolation or quarantine this weekend.  The reports I saw didn't disclose how many of them have the virus and how many are in quarantine as a precaution, but just imagine that happened on Thursday prior to a game.   I can't imagine any college football team could function with 30 players unable to play, or if both colleges would consent to the game moving forward.

If we have a season there likely will be at least a few games cancelled by forfeit.   There certainly will be cases in many teams during August-November.   Maybe the players on those teams will be more or less OK, but a lot of coaches, trainers, and administrators have existing risk factors that would result in hospitalizations and deaths.   

Sure hope the NCAA and the colleges make the only call available to them, but I fear it may only happen after a prominent coach or two end up in the hospital first.

[Farm93]

Right - The USA could fight this like New Zealand, Taiwan, Thailand, South Korea, Canada or even like USA 1945-2016.

I feel I must strongly point out (yet again) that the USA was in no position to contain this kind of a virus as early as 2008, if not before.

That was a nod to the idea of American exceptionalism solving big problems and trying not to imply the USA, as a country, couldn't meet the standard of other countries with a slightly different set of priorities.

A country that could fight (and win) a multi-front war spanning the globe in 1945 should have been able to do at least as much as Thailand did this year.
A country that took people to the moon should be able to do at least as much as a New Zealand or Taiwan.
And a country that helped the world out of a financial crisis it admittedly created should be able to at least mimic the strategies they are using across the border in Canada.

That is not to say the USA would have been best in class in this pandemic, but at a minimum the USA could have been a global leader in tackling this new challenge much like the USA had done for decades. 

And, for this board, we are likely to see closed campuses (again) and no NCAA sports (again).

LSU has 30 players in isolation or quarantine this weekend.  The reports I saw didn't disclose how many of them have the virus and how many are in quarantine as a precaution, but just imagine that happened on Thursday prior to a game.   I can't imagine any college football team could function with 30 players unable to play, or if both colleges would consent to the game moving forward.

If we have a season there likely will be at least a few games cancelled by forfeit.   There certainly will be cases in many teams during August-November.   Maybe the players on those teams will be more or less OK, but a lot of coaches, trainers, and administrators have existing risk factors that would result in hospitalizations and deaths.   

Sure hope the NCAA and the colleges make the only call available to them, but I fear it may only happen after a prominent coach or two end up in the hospital first.

[Goose]

Right - The USA could fight this like New Zealand, Taiwan, Thailand, South Korea, Canada or even like USA 1945-2016.

I feel I must strongly point out (yet again) that the USA was in no position to contain this kind of a virus as early as 2008, if not before.

That was a nod to the idea of American exceptionalism solving big problems and trying not to imply the USA, as a country, couldn't meet the standard of other countries with a slightly different set of priorities.



A country that could fight (and win) a multi-front war spanning the globe in 1945 should have been able to do at least as much as Thailand did this year.

A country that took people to the moon should be able to do at least as much as a New Zealand or Taiwan.

And a country that helped the world out of a financial crisis it admittedly created should be able to at least mimic the strategies they are using across the border in Canada.



That is not to say the USA would have been best in class in this pandemic, but at a minimum the USA could have been a global leader in tackling this new challenge much like the USA had done for decades. 

Amazingly, we might be converging to something like agreement!  I do believe in "American exceptionalism". We have in the past and should today lead the way in "fixing" this epidemic problem. Your examples are right on the mark, but examine them closely. WW II started with the total decimation of Pac Fleet. Our army was tiny. We were using wooden models as training tanks. In fact we couldn't do what the UK, Germany, Japan and Italy were doing at that moment. We got started, got in the war, and then there was Kasserine Pass. But at the end of the day, we got it done. Race to the moon, same situation. We were way behind Russia and had to go like mad to catch up and pass them.

The current situation with this health emergency is similar in that we were totally woefully unprepared. In the above two examples the fact we were way behind was made particularly obvious by the opponent. It is critical IMHO that we realize that we were not anywhere near up to the mark public health wise. We need a remedial effort, not so much on the scientific front but on the organizational and manning front. We simply couldn't do what Thailand or Taiwan did because we didn't have the people in place to do it. We still don't, as near as I can see. Just like we couldn't attack Japan in 1942. We didn't have the people in place. It was a holding action that didn't go well. See Wake, Bataan, etc.

Our reaction to the epidemic is different than the previous examples. In WW II and the space race, we got going. It wasn't an immediate solution. It took time. However, we as a nation said "never again". I don't see that happening with this epidemic. I see lots of disbelief, the idea that we can't be that messed up, it must be "treachery". While some of that existed in the response to Pearl Harbor, mostly it was determination to fix the problem. We need that type of effort now. The USA has a long history of not anticipating problems real well, but recovering.

Churchill said about the USA "At the end of the day, you can rely on America to do the right thing. That is, after they have tried everything else". He intended it pejoratively. I think it is complimentary. France would have just given up. The UK would have found something really sub-optimal, quit looking, and muddled through. America keeps at it until we get it right (or at least in the past we have).

[Goose]

Right - The USA could fight this like New Zealand, Taiwan, Thailand, South Korea, Canada or even like USA 1945-2016.

I feel I must strongly point out (yet again) that the USA was in no position to contain this kind of a virus as early as 2008, if not before.

That was a nod to the idea of American exceptionalism solving big problems and trying not to imply the USA, as a country, couldn't meet the standard of other countries with a slightly different set of priorities.



A country that could fight (and win) a multi-front war spanning the globe in 1945 should have been able to do at least as much as Thailand did this year.

A country that took people to the moon should be able to do at least as much as a New Zealand or Taiwan.

And a country that helped the world out of a financial crisis it admittedly created should be able to at least mimic the strategies they are using across the border in Canada.



That is not to say the USA would have been best in class in this pandemic, but at a minimum the USA could have been a global leader in tackling this new challenge much like the USA had done for decades. 

Amazingly, we might be converging to something like agreement!  I do believe in "American exceptionalism". We have in the past and should today lead the way in "fixing" this epidemic problem. Your examples are right on the mark, but examine them closely. WW II started with the total decimation of Pac Fleet. Our army was tiny. We were using wooden models as training tanks. In fact we couldn't do what the UK, Germany, Japan and Italy were doing at that moment. We got started, got in the war, and then there was Kasserine Pass. But at the end of the day, we got it done. Race to the moon, same situation. We were way behind Russia and had to go like mad to catch up and pass them.

The current situation with this health emergency is similar in that we were totally woefully unprepared. In the above two examples the fact we were way behind was made particularly obvious by the opponent. It is critical IMHO that we realize that we were not anywhere near up to the mark public health wise. We need a remedial effort, not so much on the scientific front but on the organizational and manning front. We simply couldn't do what Thailand or Taiwan did because we didn't have the people in place to do it. We still don't, as near as I can see. Just like we couldn't attack Japan in 1942. We didn't have the people in place. It was a holding action that didn't go well. See Wake, Bataan, etc.

Our reaction to the epidemic is different than the previous examples. In WW II and the space race, we got going. It wasn't an immediate solution. It took time. However, we as a nation said "never again". I don't see that happening with this epidemic. I see lots of disbelief, the idea that we can't be that messed up, it must be "treachery". While some of that existed in the response to Pearl Harbor, mostly it was determination to fix the problem. We need that type of effort now. The USA has a long history of not anticipating problems real well, but recovering.

Churchill said about the USA "At the end of the day, you can rely on America to do the right thing. That is, after they have tried everything else". He intended it pejoratively. I think it is complimentary. France would have just given up. The UK would have found something really sub-optimal, quit looking, and muddled through. America keeps at it until we get it right (or at least in the past we have).

[Farm93]

Goose,

I have full faith the USA will rebound.   No doubt in my mind.

However, the NCAA college football season looks lost while we wait for the rebound to start.   The 2020-2021 athletic year, and likely academic year, appear to be in the same category.

It is true Pearl Harbor, Sputnik and the financial market crash inspired the American exceptionalism examples I noted.   I would have though 120,000 deaths would be enough of a spark to get the USA to at least wear simple masks, but hopefully the mountain of daily events will shock the USA to action soon.

Waiting for the vaccine seems to be our path now, but that would mean that many things we covet will be cancelled or lost while we wait for that medical quick fix.

[Farm93]

Goose,

I have full faith the USA will rebound.   No doubt in my mind.

However, the NCAA college football season looks lost while we wait for the rebound to start.   The 2020-2021 athletic year, and likely academic year, appear to be in the same category.

It is true Pearl Harbor, Sputnik and the financial market crash inspired the American exceptionalism examples I noted.   I would have though 120,000 deaths would be enough of a spark to get the USA to at least wear simple masks, but hopefully the mountain of daily events will shock the USA to action soon.

Waiting for the vaccine seems to be our path now, but that would mean that many things we covet will be cancelled or lost while we wait for that medical quick fix.

[Goose]

Goose,

I have full faith the USA will rebound.   No doubt in my mind.

However, the NCAA college football season looks lost while we wait for the rebound to start.   The 2020-2021 athletic year, and likely academic year, appear to be in the same category.

It is true Pearl Harbor, Sputnik and the financial market crash inspired the American exceptionalism examples I noted.   I would have though 120,000 deaths would be enough of a spark to get the USA to at least wear simple masks, but hopefully the mountain of daily events will shock the USA to action soon.

Waiting for the vaccine seems to be our path now, but that would mean that many things we covet will be cancelled or lost while we wait for that medical quick fix.

The problem is that a vaccine is not a certainty, and it's effectiveness also isn't a certainty. Even more importantly what happens the next time we are hit by a novel virus? What if it has a 10 day pre-symptomatic contagious period? We need to restore our ability to manage epidemics at the county, state and federal level. We used to have it. It fell into disuse because we didn't get hit by anything "really bad" in recent memory. It will happen again. In today's world, you don't have time to figure it out on the fly. Lots of people travel a lot, or at least pre-COVID they did. Yet not much, if anything is being done, or even discussed.

[Goose]

Goose,

I have full faith the USA will rebound.   No doubt in my mind.

However, the NCAA college football season looks lost while we wait for the rebound to start.   The 2020-2021 athletic year, and likely academic year, appear to be in the same category.

It is true Pearl Harbor, Sputnik and the financial market crash inspired the American exceptionalism examples I noted.   I would have though 120,000 deaths would be enough of a spark to get the USA to at least wear simple masks, but hopefully the mountain of daily events will shock the USA to action soon.

Waiting for the vaccine seems to be our path now, but that would mean that many things we covet will be cancelled or lost while we wait for that medical quick fix.

The problem is that a vaccine is not a certainty, and it's effectiveness also isn't a certainty. Even more importantly what happens the next time we are hit by a novel virus? What if it has a 10 day pre-symptomatic contagious period? We need to restore our ability to manage epidemics at the county, state and federal level. We used to have it. It fell into disuse because we didn't get hit by anything "really bad" in recent memory. It will happen again. In today's world, you don't have time to figure it out on the fly. Lots of people travel a lot, or at least pre-COVID they did. Yet not much, if anything is being done, or even discussed.

[Farm93]

Goose,

I have full faith the USA will rebound.   No doubt in my mind.

However, the NCAA college football season looks lost while we wait for the rebound to start.   The 2020-2021 athletic year, and likely academic year, appear to be in the same category.

It is true Pearl Harbor, Sputnik and the financial market crash inspired the American exceptionalism examples I noted.   I would have though 120,000 deaths would be enough of a spark to get the USA to at least wear simple masks, but hopefully the mountain of daily events will shock the USA to action soon.

Waiting for the vaccine seems to be our path now, but that would mean that many things we covet will be cancelled or lost while we wait for that medical quick fix.

The problem is that a vaccine is not a certainty, and it's effectiveness also isn't a certainty. Even more importantly what happens the next time we are hit by a novel virus? What if it has a 10 day pre-symptomatic contagious period? We need to restore our ability to manage epidemics at the county, state and federal level. We used to have it. It fell into disuse because we didn't get hit by anything "really bad" in recent memory. It will happen again. In today's world, you don't have time to figure it out on the fly. Lots of people travel a lot, or at least pre-COVID they did. Yet not much, if anything is being done, or even discussed.

That complacency is likely linked to SARS, MERS and even Ebola.   Most in the USA just assumed the oceans would protect us.   Having excess hospital capacity and equipment for pandemics costs money.   And if something hasn't happened for 50+ years it begins to look like a decadent expense.

A politician at any level that said the citizens needed to spend money on those things instead of tax cuts, police on the streets or teachers would eventually get kicked out of office by someone that could fund more desirable things by trimming the fat.
 
A hospital operating with that level of underutilized capacity would be losing too much money each year as our procedure based reimbursement structure does not compensate for that type of inefficiency.

My guess is just like Korea and Japan the government and the citizens will be a bit better prepared for the NEXT pandemic, as long as it happens in the next 10-20 years.

The use of computers has really helped companies at all levels become very efficient with inventory, so my belief is the USA for the next pandemic will need a plan that assumes emergency-use only inventory and staff will not be available unless very clearly required by law.

For this pandemic POTUS45 is all-in on a vaccine.   A bit frustrating to me, but that seems to be our national plan.   Wearing masks seem like a cheap and fast mitigation step, but apparently that's now not a viable USA option because some believe those that wear masks are declaring they don't trust POTUS45 or whatever.

[Farm93]

Goose,

I have full faith the USA will rebound.   No doubt in my mind.

However, the NCAA college football season looks lost while we wait for the rebound to start.   The 2020-2021 athletic year, and likely academic year, appear to be in the same category.

It is true Pearl Harbor, Sputnik and the financial market crash inspired the American exceptionalism examples I noted.   I would have though 120,000 deaths would be enough of a spark to get the USA to at least wear simple masks, but hopefully the mountain of daily events will shock the USA to action soon.

Waiting for the vaccine seems to be our path now, but that would mean that many things we covet will be cancelled or lost while we wait for that medical quick fix.

The problem is that a vaccine is not a certainty, and it's effectiveness also isn't a certainty. Even more importantly what happens the next time we are hit by a novel virus? What if it has a 10 day pre-symptomatic contagious period? We need to restore our ability to manage epidemics at the county, state and federal level. We used to have it. It fell into disuse because we didn't get hit by anything "really bad" in recent memory. It will happen again. In today's world, you don't have time to figure it out on the fly. Lots of people travel a lot, or at least pre-COVID they did. Yet not much, if anything is being done, or even discussed.

That complacency is likely linked to SARS, MERS and even Ebola.   Most in the USA just assumed the oceans would protect us.   Having excess hospital capacity and equipment for pandemics costs money.   And if something hasn't happened for 50+ years it begins to look like a decadent expense.

A politician at any level that said the citizens needed to spend money on those things instead of tax cuts, police on the streets or teachers would eventually get kicked out of office by someone that could fund more desirable things by trimming the fat.
 
A hospital operating with that level of underutilized capacity would be losing too much money each year as our procedure based reimbursement structure does not compensate for that type of inefficiency.

My guess is just like Korea and Japan the government and the citizens will be a bit better prepared for the NEXT pandemic, as long as it happens in the next 10-20 years.

The use of computers has really helped companies at all levels become very efficient with inventory, so my belief is the USA for the next pandemic will need a plan that assumes emergency-use only inventory and staff will not be available unless very clearly required by law.

For this pandemic POTUS45 is all-in on a vaccine.   A bit frustrating to me, but that seems to be our national plan.   Wearing masks seem like a cheap and fast mitigation step, but apparently that's now not a viable USA option because some believe those that wear masks are declaring they don't trust POTUS45 or whatever.

[Goose]

That complacency is likely linked to SARS, MERS and even Ebola.   Most in the USA just assumed the oceans would protect us.

For sure true. There is a residual "chicken little" effect.

 Having excess hospital capacity and equipment for pandemics costs money.   And if something hasn't happened for 50+ years it begins to look like a decadent expense.


A politician at any level that said the citizens needed to spend money on those things instead of tax cuts, police on the streets or teachers would eventually get kicked out of office by someone that could fund more desirable things by trimming the fat.

While excess hospital capacity and equipment is certainly desirable, that is not where we blew it. We didn't (and don't) have a way to contain the spread of an epidemic through known epidemiological methods. Taiwan, Korea, etc. kept the number of cases down by having a good track and trace capability with adequate staff to handle a large initial surge of cases and also to continue for the long haul. You are preaching to the choir that previous successes have caused our capability to atrophy out of existence. Without that, SIP is the only tool available, and we know now the costs of doing that (if there was every any doubt). We need candidates at all levels that can remind the populace what happens if you let the county health department just inspect restaurants and have only 6000 USPHS officers for the entire country.

[Goose]

That complacency is likely linked to SARS, MERS and even Ebola.   Most in the USA just assumed the oceans would protect us.

For sure true. There is a residual "chicken little" effect.

 Having excess hospital capacity and equipment for pandemics costs money.   And if something hasn't happened for 50+ years it begins to look like a decadent expense.


A politician at any level that said the citizens needed to spend money on those things instead of tax cuts, police on the streets or teachers would eventually get kicked out of office by someone that could fund more desirable things by trimming the fat.

While excess hospital capacity and equipment is certainly desirable, that is not where we blew it. We didn't (and don't) have a way to contain the spread of an epidemic through known epidemiological methods. Taiwan, Korea, etc. kept the number of cases down by having a good track and trace capability with adequate staff to handle a large initial surge of cases and also to continue for the long haul. You are preaching to the choir that previous successes have caused our capability to atrophy out of existence. Without that, SIP is the only tool available, and we know now the costs of doing that (if there was every any doubt). We need candidates at all levels that can remind the populace what happens if you let the county health department just inspect restaurants and have only 6000 USPHS officers for the entire country.

[Farm93]

That complacency is likely linked to SARS, MERS and even Ebola.   Most in the USA just assumed the oceans would protect us.

For sure true. There is a residual "chicken little" effect.

 Having excess hospital capacity and equipment for pandemics costs money.   And if something hasn't happened for 50+ years it begins to look like a decadent expense.


A politician at any level that said the citizens needed to spend money on those things instead of tax cuts, police on the streets or teachers would eventually get kicked out of office by someone that could fund more desirable things by trimming the fat.

While excess hospital capacity and equipment is certainly desirable, that is not where we blew it. We didn't (and don't) have a way to contain the spread of an epidemic through known epidemiological methods. Taiwan, Korea, etc. kept the number of cases down by having a good track and trace capability with adequate staff to handle a large initial surge of cases and also to continue for the long haul. You are preaching to the choir that previous successes have caused our capability to atrophy out of existence. Without that, SIP is the only tool available, and we know now the costs of doing that (if there was every any doubt). We need candidates at all levels that can remind the populace what happens if you let the county health department just inspect restaurants and have only 6000 USPHS officers for the entire country.

A pandemic staff as you describe would be excess human resource capacity.   Same idea.

If you have 10,000 people sitting around for a decade waiting for a pandemic I promise you there will be a politician that will win an election claiming that by trimming the government fat he can give everyone a tax cut.

The staff you seek would need to do something else, but in the event of a pandemic would be called to service.

[Farm93]

That complacency is likely linked to SARS, MERS and even Ebola.   Most in the USA just assumed the oceans would protect us.

For sure true. There is a residual "chicken little" effect.

 Having excess hospital capacity and equipment for pandemics costs money.   And if something hasn't happened for 50+ years it begins to look like a decadent expense.


A politician at any level that said the citizens needed to spend money on those things instead of tax cuts, police on the streets or teachers would eventually get kicked out of office by someone that could fund more desirable things by trimming the fat.

While excess hospital capacity and equipment is certainly desirable, that is not where we blew it. We didn't (and don't) have a way to contain the spread of an epidemic through known epidemiological methods. Taiwan, Korea, etc. kept the number of cases down by having a good track and trace capability with adequate staff to handle a large initial surge of cases and also to continue for the long haul. You are preaching to the choir that previous successes have caused our capability to atrophy out of existence. Without that, SIP is the only tool available, and we know now the costs of doing that (if there was every any doubt). We need candidates at all levels that can remind the populace what happens if you let the county health department just inspect restaurants and have only 6000 USPHS officers for the entire country.

A pandemic staff as you describe would be excess human resource capacity.   Same idea.

If you have 10,000 people sitting around for a decade waiting for a pandemic I promise you there will be a politician that will win an election claiming that by trimming the government fat he can give everyone a tax cut.

The staff you seek would need to do something else, but in the event of a pandemic would be called to service.

[Goose]

That complacency is likely linked to SARS, MERS and even Ebola.   Most in the USA just assumed the oceans would protect us.

For sure true. There is a residual "chicken little" effect.

 Having excess hospital capacity and equipment for pandemics costs money.   And if something hasn't happened for 50+ years it begins to look like a decadent expense.


A politician at any level that said the citizens needed to spend money on those things instead of tax cuts, police on the streets or teachers would eventually get kicked out of office by someone that could fund more desirable things by trimming the fat.

While excess hospital capacity and equipment is certainly desirable, that is not where we blew it. We didn't (and don't) have a way to contain the spread of an epidemic through known epidemiological methods. Taiwan, Korea, etc. kept the number of cases down by having a good track and trace capability with adequate staff to handle a large initial surge of cases and also to continue for the long haul. You are preaching to the choir that previous successes have caused our capability to atrophy out of existence. Without that, SIP is the only tool available, and we know now the costs of doing that (if there was every any doubt). We need candidates at all levels that can remind the populace what happens if you let the county health department just inspect restaurants and have only 6000 USPHS officers for the entire country.

A pandemic staff as you describe would be excess human resource capacity.   Same idea.

If you have 10,000 people sitting around for a decade waiting for a pandemic I promise you there will be a politician that will win an election claiming that by trimming the government fat he can give everyone a tax cut.

The staff you seek would need to do something else, but in the event of a pandemic would be called to service.

You are for sure correct. Korea uses police offices, among others, as contact tracers. They are good at it because it is also similar to their day jobs.  San Mateo County has managed to do their contact tracing by re-purposing other employees. If they had practiced that a few times over the past 5 years, possibly they would have been ready when needed.

All that being said, we do need to overcome the idea that managing epidemics is unnecessary. We do maintain a large military that most of the time isn't engaged in a struggle with a near-peer competitor. The USPHS is a uniformed military service, believe it or not. We need to fund them adequately. States and counties need to do the same. I agree it is a tempting target to cut when it isn't used for a long time, as is the military. However, when you need it there isn't time to generate a new one. It is come as you are. Awareness has to be raised to the point we won't have another disaster next time. Epidemics are bad enough if you are "ready". If you are not, you have what we have now. We should be smart about it, but we should do it.

[Goose]

That complacency is likely linked to SARS, MERS and even Ebola.   Most in the USA just assumed the oceans would protect us.

For sure true. There is a residual "chicken little" effect.

 Having excess hospital capacity and equipment for pandemics costs money.   And if something hasn't happened for 50+ years it begins to look like a decadent expense.


A politician at any level that said the citizens needed to spend money on those things instead of tax cuts, police on the streets or teachers would eventually get kicked out of office by someone that could fund more desirable things by trimming the fat.

While excess hospital capacity and equipment is certainly desirable, that is not where we blew it. We didn't (and don't) have a way to contain the spread of an epidemic through known epidemiological methods. Taiwan, Korea, etc. kept the number of cases down by having a good track and trace capability with adequate staff to handle a large initial surge of cases and also to continue for the long haul. You are preaching to the choir that previous successes have caused our capability to atrophy out of existence. Without that, SIP is the only tool available, and we know now the costs of doing that (if there was every any doubt). We need candidates at all levels that can remind the populace what happens if you let the county health department just inspect restaurants and have only 6000 USPHS officers for the entire country.

A pandemic staff as you describe would be excess human resource capacity.   Same idea.

If you have 10,000 people sitting around for a decade waiting for a pandemic I promise you there will be a politician that will win an election claiming that by trimming the government fat he can give everyone a tax cut.

The staff you seek would need to do something else, but in the event of a pandemic would be called to service.

You are for sure correct. Korea uses police offices, among others, as contact tracers. They are good at it because it is also similar to their day jobs.  San Mateo County has managed to do their contact tracing by re-purposing other employees. If they had practiced that a few times over the past 5 years, possibly they would have been ready when needed.

All that being said, we do need to overcome the idea that managing epidemics is unnecessary. We do maintain a large military that most of the time isn't engaged in a struggle with a near-peer competitor. The USPHS is a uniformed military service, believe it or not. We need to fund them adequately. States and counties need to do the same. I agree it is a tempting target to cut when it isn't used for a long time, as is the military. However, when you need it there isn't time to generate a new one. It is come as you are. Awareness has to be raised to the point we won't have another disaster next time. Epidemics are bad enough if you are "ready". If you are not, you have what we have now. We should be smart about it, but we should do it.

[M T]

The staff you seek would need to do something else, but in the event of a pandemic would be called to service.

You mean like doing a census, or being part of the National Guard?

(I think it was March or maybe April, when I wrote my governor with those suggestions for contact tracers.  I believe the National Guard was purposed with food distribution, should it have come to that.  I think we all know why the census workers weren't diverted.)

But, we see how many people were out of work during a shutdown.  There must be groups of such people that could have been given this task, esp. if they had been trained previously.   For instance, if all the High School teachers were trained and ready to step into the job, they could have been deployed in March.

[M T]

The staff you seek would need to do something else, but in the event of a pandemic would be called to service.

You mean like doing a census, or being part of the National Guard?

(I think it was March or maybe April, when I wrote my governor with those suggestions for contact tracers.  I believe the National Guard was purposed with food distribution, should it have come to that.  I think we all know why the census workers weren't diverted.)

But, we see how many people were out of work during a shutdown.  There must be groups of such people that could have been given this task, esp. if they had been trained previously.   For instance, if all the High School teachers were trained and ready to step into the job, they could have been deployed in March.

[Goose]

For instance, if all the High School teachers were trained and ready to step into the job, they could have been deployed in March.

Good idea. It would also be possible to have something like a health department  auxiliary that met one weekend a month for practice/training. You would get paid for that, so people would be willing to do it. Cross training police and fire is a good idea too, but those people aren't quite as available as teachers would be. It is important that whatever structure that is created exercises frequently in order to ensure it actually works.

[Goose]

For instance, if all the High School teachers were trained and ready to step into the job, they could have been deployed in March.

Good idea. It would also be possible to have something like a health department  auxiliary that met one weekend a month for practice/training. You would get paid for that, so people would be willing to do it. Cross training police and fire is a good idea too, but those people aren't quite as available as teachers would be. It is important that whatever structure that is created exercises frequently in order to ensure it actually works.

[oregontim]

  For instance, if all the High School teachers were trained and ready to step into the job, they could have been deployed in March.

Hey, no! In our public high school district, teachers were responsible for planning and managing their classes via Zoom, Google Meet, with some shared time, some prep time, assignments, and grading time. They weren't just on vacation. The kids and their parents needed them.

[oregontim]

  For instance, if all the High School teachers were trained and ready to step into the job, they could have been deployed in March.

Hey, no! In our public high school district, teachers were responsible for planning and managing their classes via Zoom, Google Meet, with some shared time, some prep time, assignments, and grading time. They weren't just on vacation. The kids and their parents needed them.

[M T]

  For instance, if all the High School teachers were trained and ready to step into the job, they could have been deployed in March.

Hey, no! In our public high school district, teachers were responsible for planning and managing their classes via Zoom, Google Meet, with some shared time, some prep time, assignments, and grading time. They weren't just on vacation. The kids and their parents needed them.

Good point.  Not having kids in school, I forgot that teachers weren't really not working when the schools closed.

But the main point is to find some class of workers that are not in critical jobs and add a new task to their jobs.  Let's see,  park rangers, librarians, ...

[M T]

  For instance, if all the High School teachers were trained and ready to step into the job, they could have been deployed in March.

Hey, no! In our public high school district, teachers were responsible for planning and managing their classes via Zoom, Google Meet, with some shared time, some prep time, assignments, and grading time. They weren't just on vacation. The kids and their parents needed them.

Good point.  Not having kids in school, I forgot that teachers weren't really not working when the schools closed.

But the main point is to find some class of workers that are not in critical jobs and add a new task to their jobs.  Let's see,  park rangers, librarians, ...

[Goose]

  For instance, if all the High School teachers were trained and ready to step into the job, they could have been deployed in March.

Hey, no! In our public high school district, teachers were responsible for planning and managing their classes via Zoom, Google Meet, with some shared time, some prep time, assignments, and grading time. They weren't just on vacation. The kids and their parents needed them.

Good point.  Not having kids in school, I forgot that teachers weren't really not working when the schools closed.

But the main point is to find some class of workers that are not in critical jobs and add a new task to their jobs.  Let's see,  park rangers, librarians, ...

No matter who they are, if it is not the "primary" occupation of the trackers/tracers, some other functions will suffer. That is why the "main", everyday response has to be based on people who do the job full time. The "repurposed" employees can be used to get the situation under control when there is a big outbreak, but they can't be relied upon to handle the initial outbreak or the long haul containment at lower case loads. At the beginning of the outbreak, these repurposed people will be in their "day jobs" and unavailable. We need enough "standing" capability to credibly contain "small" outbreaks and/or detect that the outbreak is getting away from them. If it does get away from them, all hands on deck until the outbreak is reduced to the point the "standing" force can do the job. How big that standing force can/should be is a subject of discussion, but IMHO it is clear that at all levels it was entirely too small. The surge force needs to be much larger but can only be expected to be available for +/- a month or so. The amount of time even the National Guard can spend on state business is limited by how long the state can/will tolerate them not doing their "day jobs". Surge capability (a month or so) is necessary and possible, but maintaining it for a long periods (3-6 months) is very difficult.

[Goose]

  For instance, if all the High School teachers were trained and ready to step into the job, they could have been deployed in March.

Hey, no! In our public high school district, teachers were responsible for planning and managing their classes via Zoom, Google Meet, with some shared time, some prep time, assignments, and grading time. They weren't just on vacation. The kids and their parents needed them.

Good point.  Not having kids in school, I forgot that teachers weren't really not working when the schools closed.

But the main point is to find some class of workers that are not in critical jobs and add a new task to their jobs.  Let's see,  park rangers, librarians, ...

No matter who they are, if it is not the "primary" occupation of the trackers/tracers, some other functions will suffer. That is why the "main", everyday response has to be based on people who do the job full time. The "repurposed" employees can be used to get the situation under control when there is a big outbreak, but they can't be relied upon to handle the initial outbreak or the long haul containment at lower case loads. At the beginning of the outbreak, these repurposed people will be in their "day jobs" and unavailable. We need enough "standing" capability to credibly contain "small" outbreaks and/or detect that the outbreak is getting away from them. If it does get away from them, all hands on deck until the outbreak is reduced to the point the "standing" force can do the job. How big that standing force can/should be is a subject of discussion, but IMHO it is clear that at all levels it was entirely too small. The surge force needs to be much larger but can only be expected to be available for +/- a month or so. The amount of time even the National Guard can spend on state business is limited by how long the state can/will tolerate them not doing their "day jobs". Surge capability (a month or so) is necessary and possible, but maintaining it for a long periods (3-6 months) is very difficult.

[BostonCard]

In areas that were overwhelmed by COVID-19 (Northern Italy, Spain, New York, etc.), there were more cases than critical care trained physicians could handle.  So how did these regions deal with staffing issues?  First, they recruited physicians from out of area (I know I was contacted by several headhunters to see if I would be willing to work as a locus tenem, and one of my colleagues actually went to New York for a week).  This was aided by a relaxation of licensing rules (New York and Massachusetts both stated they would recognize licenses from out of state).  Second, New York recruited retired physicians to help out.  Third, hospitals moved critical care adjacent specialties to help out in the ICU.  For example, if the ICU census is twice what can be handled by a single critical care physician, that physician can supervise a team of three internists without critical care training, having the internists deal with most mundane tasks and allowing the intensivists (intensive care trained physicians) focus on the most challenging cases, or the management of aspects of patient care that are most challenging.

A similar model could be adopted by counties for public health emergencies, where a combination of recruiting contact tracers from elsewhere, bringing in previously retired public health experts, and using well trained experts to supervise those with less experience.  However, this system would need to be designed and periodically tested in other to ensure that the surge capability is ready to go and that the organizational structure is capable of being implemented quickly in times of crisis.

BC

[BostonCard]

In areas that were overwhelmed by COVID-19 (Northern Italy, Spain, New York, etc.), there were more cases than critical care trained physicians could handle.  So how did these regions deal with staffing issues?  First, they recruited physicians from out of area (I know I was contacted by several headhunters to see if I would be willing to work as a locus tenem, and one of my colleagues actually went to New York for a week).  This was aided by a relaxation of licensing rules (New York and Massachusetts both stated they would recognize licenses from out of state).  Second, New York recruited retired physicians to help out.  Third, hospitals moved critical care adjacent specialties to help out in the ICU.  For example, if the ICU census is twice what can be handled by a single critical care physician, that physician can supervise a team of three internists without critical care training, having the internists deal with most mundane tasks and allowing the intensivists (intensive care trained physicians) focus on the most challenging cases, or the management of aspects of patient care that are most challenging.

A similar model could be adopted by counties for public health emergencies, where a combination of recruiting contact tracers from elsewhere, bringing in previously retired public health experts, and using well trained experts to supervise those with less experience.  However, this system would need to be designed and periodically tested in other to ensure that the surge capability is ready to go and that the organizational structure is capable of being implemented quickly in times of crisis.

BC

[Goose]

In areas that were overwhelmed by COVID-19 (Northern Italy, Spain, New York, etc.), there were more cases than critical care trained physicians could handle.  So how did these regions deal with staffing issues?  First, they recruited physicians from out of area (I know I was contacted by several headhunters to see if I would be willing to work as a locus tenem, and one of my colleagues actually went to New York for a week).  This was aided by a relaxation of licensing rules (New York and Massachusetts both stated they would recognize licenses from out of state).  Second, New York recruited retired physicians to help out.  Third, hospitals moved critical care adjacent specialties to help out in the ICU.  For example, if the ICU census is twice what can be handled by a single critical care physician, that physician can supervise a team of three internists without critical care training, having the internists deal with most mundane tasks and allowing the intensivists (intensive care trained physicians) focus on the most challenging cases, or the management of aspects of patient care that are most challenging.

A similar model could be adopted by counties for public health emergencies, where a combination of recruiting contact tracers from elsewhere, bringing in previously retired public health experts, and using well trained experts to supervise those with less experience.  However, this system would need to be designed and periodically tested in other to ensure that the surge capability is ready to go and that the organizational structure is capable of being implemented quickly in times of crisis.

BC

Totally agree. Probably more staff augmentation needed for track and trace than in the ICU, but the same basic ideas can work. There are also more "layers" available to county health. The state can and should have significant staff that can be added to local staff in time of need. The Franchise Tax Board (or whatever they call it now) folks could even be "re-purposed". You are also quite right that this lash-up would need frequent exercises to make sure it would work when we need it.

[Goose]

In areas that were overwhelmed by COVID-19 (Northern Italy, Spain, New York, etc.), there were more cases than critical care trained physicians could handle.  So how did these regions deal with staffing issues?  First, they recruited physicians from out of area (I know I was contacted by several headhunters to see if I would be willing to work as a locus tenem, and one of my colleagues actually went to New York for a week).  This was aided by a relaxation of licensing rules (New York and Massachusetts both stated they would recognize licenses from out of state).  Second, New York recruited retired physicians to help out.  Third, hospitals moved critical care adjacent specialties to help out in the ICU.  For example, if the ICU census is twice what can be handled by a single critical care physician, that physician can supervise a team of three internists without critical care training, having the internists deal with most mundane tasks and allowing the intensivists (intensive care trained physicians) focus on the most challenging cases, or the management of aspects of patient care that are most challenging.

A similar model could be adopted by counties for public health emergencies, where a combination of recruiting contact tracers from elsewhere, bringing in previously retired public health experts, and using well trained experts to supervise those with less experience.  However, this system would need to be designed and periodically tested in other to ensure that the surge capability is ready to go and that the organizational structure is capable of being implemented quickly in times of crisis.

BC

Totally agree. Probably more staff augmentation needed for track and trace than in the ICU, but the same basic ideas can work. There are also more "layers" available to county health. The state can and should have significant staff that can be added to local staff in time of need. The Franchise Tax Board (or whatever they call it now) folks could even be "re-purposed". You are also quite right that this lash-up would need frequent exercises to make sure it would work when we need it.

[dabigv13]

https://www.politico.com/news/2020/06/22...rus-333122

Some posters on the board have "defended" our shitty response as being a factor of cultural or systemic issues, outside the scope of who the President is. There probably is some truth to it. But while you could wave away South Korea's success as due to prior SARS experience, how to square the much better state all of Europe is in compared to the US at present?

If we had Obama, or hell probably most any other president, I think our numbers would look more like Europe's than our present situation. This has been a failure from the top.

[dabigv13]

https://www.politico.com/news/2020/06/22...rus-333122

Some posters on the board have "defended" our shitty response as being a factor of cultural or systemic issues, outside the scope of who the President is. There probably is some truth to it. But while you could wave away South Korea's success as due to prior SARS experience, how to square the much better state all of Europe is in compared to the US at present?

If we had Obama, or hell probably most any other president, I think our numbers would look more like Europe's than our present situation. This has been a failure from the top.

[burger]

https://www.politico.com/news/2020/06/22...rus-333122



Some posters on the board have "defended" our shitty response as being a factor of cultural or systemic issues, outside the scope of who the President is. There probably is some truth to it. But while you could wave away South Korea's success as due to prior SARS experience, how to square the much better state all of Europe is in compared to the US at present?



If we had Obama, or hell probably most any other president, I think our numbers would look more like Europe's than our present situation. This has been a failure from the top.

The argument that the US was incapable of suppressing Covid falls apart as soon as you look at any other country (or even the US states that seem to be getting their initial outbreaks under control).  Yet people here keep telling us over and over that there was nothing we could've done to stop covid.  It's an argument that's so flimsy that it only takes a single sentence to dismiss it, but people just keep repeating it.

I don't want to hear about SARS-cov-1 anymore or early action in February.  If New York state can get their outbreak under control then anywhere can with good leadership.

[burger]

https://www.politico.com/news/2020/06/22...rus-333122



Some posters on the board have "defended" our shitty response as being a factor of cultural or systemic issues, outside the scope of who the President is. There probably is some truth to it. But while you could wave away South Korea's success as due to prior SARS experience, how to square the much better state all of Europe is in compared to the US at present?



If we had Obama, or hell probably most any other president, I think our numbers would look more like Europe's than our present situation. This has been a failure from the top.

The argument that the US was incapable of suppressing Covid falls apart as soon as you look at any other country (or even the US states that seem to be getting their initial outbreaks under control).  Yet people here keep telling us over and over that there was nothing we could've done to stop covid.  It's an argument that's so flimsy that it only takes a single sentence to dismiss it, but people just keep repeating it.

I don't want to hear about SARS-cov-1 anymore or early action in February.  If New York state can get their outbreak under control then anywhere can with good leadership.