Covid antibody test available at Stanford - Printable Version
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RE: Covid antibody test available at Stanford - dabigv13 - 04-13-2020
I dont think May 1 is realistic for California. It seems we have plateaued, but it is a plateau, not a significant drop we are seeing at the moment. We have enough ventilators, but we are still burning through PPE, reusing things that aren't designed to be reused, and lots of those supplies may not be able to be resupplied until July or August. And there may be upcoming issues with medication shortages that we may need to deal with that we haven't dealt with yet.
We will need to have essentially zero community transmission before we can significantly relax restrictions.
RE: Covid antibody test available at Stanford - teejers1 - 04-13-2020
(04-13-2020, 09:34 AM)magnus Wrote:(04-13-2020, 09:11 AM)Genuine Realist Wrote: I imagine we reopen about May 1st, with an enormous change in the manner of socialization, and many geezers (such as myself) relying on delivery services and avoiding possible infectious areas to the extent possible. There will be business opportunities that arise as well.Even if the federal government tries to reopen on May 1st, I'm highly skeptical that many states will follow suit, especially CA.
What I find a bit offensive: "we're all in this together." That's usually aired by politicians, medical experts, and perhaps a celebrity or two. None of those speakers have their livelihood in jeopardy. Please.
And frankly (and fortunately), that is probably the case for all (or almost all) of the posters here. What I give Mick great credit for is trying to share a perspective that many here are "above." There is lip service, of course, but none of us "feels it" the way the "jobless and in need" do.
So here's a separate question for you. If you told every American who lives paycheck to paycheck that he or she has one of two options: (a) quite possibly catch the Corona Virus and be laid up for a week or two, and feel terrible, with a .___ % chance of dying; OR, lose your job with no guarantee that you'll find other work for __ years, which option do you think people would take?
I think most here would admit - even those advocating for total shut down for forever (seemingly) - that the overwhelming majority of folks would opt for being laid up for a couple weeks. Indeed, the % might reflect, by demographics, the risk levels (and the way overwhelming majority of folks are not going to die from this).
Yes, it's an oversimplification; and yes, this isn't just about individual choices because of "overrunning the health care system/bodies on the streets," etc.
BUT, it does put the lie to "we're all in this together."
It especially is because, as everyone also admits, when and if restrictions are limited, there is going to be massive self-quarantining/distancing. Some are going to "stay in it," others will venture out more. We will not "all be in this together" then (as we are not now, other than by force of law).
RE: Covid antibody test available at Stanford - 2006alum - 04-13-2020
I've said this before and I'll say it yet again: your hypo is not an accurate reflection of the cost-benefit analysis, because diseased individuals are not just a risk to themselves - they are also a risk to others in the community, including the medical providers who must care for them, as well as those who work in essential services and do not want to fall ill and die.
So I will return back to my top-line conclusion I raised a while back: the only way we can responsibly permit individuals to take on this risk as you have proposed, without greatly enhancing the risk to the community at large, is:
Test them any time they go out in public; immediately isolate them if they test positive; and once they do, give them 20 ambien to take if/when their symptoms become unbearable, so that they are guaranteed to pose no burden to medical providers.
And for those of you who want every individual to be able to exercise this choice themselves, I sure would have thought you'd be more outraged that the federal government has shown no interest in prioritizing widespread testing and implementing social contact tracing and isolation protocols (and staffing) on nationwide basis. That's what it's going to take for this to work, and I have seen very, very little evidence it's happening.
And despite what you say, we are all in this together when it comes to maintaining functioning medical infrastructures. All of us depend on being able to walk outside and call an ambulance if we get hit by a bus, have a heart attack, etc.
RE: Covid antibody test available at Stanford - stupac2 - 04-13-2020
(04-13-2020, 10:48 AM)teejers1 Wrote: And frankly (and fortunately), that is probably the case for all (or almost all) of the posters here.
Can we cut it out with this shit? Virtually everyone is affected by this. My job isn't on the line now but if we're still doing this next March I have very little confidence that my company will survive. Does the former completely outweigh the latter when it comes to what I think about the wisdom of removing SiP restrictions before the public health experts deem it's appropriate? And, for that matter, why does my job need to be on the line for me to be unable to make this determination? I'm perfectly capable of sympathizing with those affected by job losses, as well as those who are infected and suffering and dying.
RE: Covid antibody test available at Stanford - 2006alum - 04-13-2020
(04-13-2020, 11:41 AM)stupac2 Wrote:(04-13-2020, 10:48 AM)teejers1 Wrote: And frankly (and fortunately), that is probably the case for all (or almost all) of the posters here.
Can we cut it out with this shit? Virtually everyone is affected by this. My job isn't on the line now but if we're still doing this next March I have very little confidence that my company will survive. Does the former completely outweigh the latter when it comes to what I think about the wisdom of removing SiP restrictions before the public health experts deem it's appropriate? And, for that matter, why does my job need to be on the line for me to be unable to make this determination? I'm perfectly capable of sympathizing with those affected by job losses, as well as those who are infected and suffering and dying.
Yeah, I'm not going to lie, I'm getting pretty tired of guys in their 50s and 60s telling me I don't adequately appreciate the pain of this, as if any of you knows anything about my personal circumstances. And speaking for both stupac and myself, it's our generation, not yours, that is effed:
[tweet]https://twitter.com/JillFilipovic/status/1249712865097003009?s=20[/tweet]
Here's an anecdote for you: one of my dear friends, an orthodontist, had to shut her business almost a month ago by state mandate. For 90 days, she can only see patients for emergencies. That obviously doesn't pay the bills, so she had to lay off all her staff, apply for emergency loans, and is exploring bankruptcy. She has $500k in education debt from dental school and ortho school. She has two kids under the age of five.
Yet she is one of the most ardent supporters of sheltering in place, even though this is absolutely destroying her financial future. One reason why? Her sister is the attending physician in her community hospital's emergency department, and she has reported firsthand just how devastating COVID-19 has been, already. And they live in an area that is not even remotely a "hot spot." Despite being $500k in debt, losing her income, and quite possibly her small business, she nevertheless donated $2k worth of PPE from her practice to the local hospital.
So please, do me the favor of not assuming that I or my loved ones are any more or less insulated from this than you and yours.
RE: Covid antibody test available at Stanford - BostonCard - 04-13-2020
Exactly, rephrase that hypothetical question as "you have a x% chance of killing your (parents, grandparents, spouse) let alone inadvertently killing some random stranger" and the calculus is a lot different, even if that x is a lot smaller than of you dying yourself.
BC
RE: Covid antibody test available at Stanford - Genuine Realist - 04-13-2020
(04-13-2020, 11:56 AM)BostonCard Wrote: Exactly, rephrase that hypothetical question as "you have a x% chance of killing your (parents, grandparents, spouse) let alone inadvertently killing some random stranger" and the calculus is a lot different, even if that x is a lot smaller than of you dying yourself.
BC
That's a bit too clean an analysis. The issue is that, as the shutdown goes on and on, indirect negative effects begin to accumulate - not as direct and measurable as infection and death, but extant and important. At some tipping point - and don't ask me exactly what that is - the indirect negative effects outweigh the measurable negative effects of the virus.
My own bet is that we are going to see a gradual relaxation of the shutdown, with more and more businesses permitted to reopening, conditional on sensible measures to protect employees and customers (gloves, masks, that short of thing.)
Or are you suggesting we all grown our own food? We have to keep basic distributions systems going, with profit enough to pay employees - and you don't make that kind of profit without substantial customer traffic. We have to keep the power grid active, and the Internet, which has become essential. We have to do basic maintenance to capital infrastructure, including vehicles. We have to keep our airlines and transportation systems viable.
I don't agree with Mick, because I don't think that tipping point has arrived. But it is very real, and it is coming.
RE: Covid antibody test available at Stanford - BostonCard - 04-13-2020
GR, I agree with you and in fact penned a somewhat lengthy post on the matter:
https://thecardboard.org/board/showthread.php?tid=19391
I think I was objecting to the rather simplistic analysis that the individual calculus is as simple as "x% chance of dying versus $y economic hit" and if you asked a bunch of people they'd say it was worth it for most reasonable values of x that have been put forth for Covid-19. That analysis is confounded by the collateral damage to older friends and relatives.
That doesn't mean that you have to shelter in place. Even with the additional considerations there will come a time where you will have to start opening and I completely agree with you that at some point, things that might not be considered "essential" are important enough that you would have to start them up again, especially if they are low-ish risk, and even some completely non-essential but very low risk (Teejers keeps bring up golf, and though I don't play, I agree) should be allowable.
I imagine it will be some time, however, before we see live, in person sports events in packed arenas. But live sports events over TV with well-screened participants is probably going to be OK.
BC
RE: Covid antibody test available at Stanford - teejers1 - 04-13-2020
(04-13-2020, 11:56 AM)2006alum Wrote: Can we cut it out with this shit? Virtually everyone is affected by this. My job isn't on the line now but if we're still doing this next March I have very little confidence that my company will survive. Does the former completely outweigh the latter when it comes to what I think about the wisdom of removing SiP restrictions before the public health experts deem it's appropriate? And, for that matter, why does my job need to be on the line for me to be unable to make this determination? I'm perfectly capable of sympathizing with those affected by job losses, as well as those who are infected and suffering and dying.
Hope you can hold on till next March . . . (If we're in shelter-in-place next March, not much will matter by then).
Your empathy, I'm sure, is limitless. But it's generally true that folks here can "afford" to take supposed moral high ground and think Big Picture because . . . well, we can generally afford it.
Separately, I could not give two $hits what someone's age is, and I don't even think about a poster's age (unlike you) when reading here. That has no bearing on much, if anything . . . except perhaps when it comes to "perspective" on Stanford sports (as in Darrin Nelson was the best Stanford RB ever . . . with possible exception of C-Mac. And Love was the most explosive RB of all time).
RE: Covid antibody test available at Stanford - 2006alum - 04-13-2020
(04-13-2020, 01:46 PM)teejers1 Wrote:I think you put words in my mouth - that was Stupac's comment, not mine. ;)(04-13-2020, 11:56 AM)2006alum Wrote: Can we cut it out with this shit? Virtually everyone is affected by this. My job isn't on the line now but if we're still doing this next March I have very little confidence that my company will survive. Does the former completely outweigh the latter when it comes to what I think about the wisdom of removing SiP restrictions before the public health experts deem it's appropriate? And, for that matter, why does my job need to be on the line for me to be unable to make this determination? I'm perfectly capable of sympathizing with those affected by job losses, as well as those who are infected and suffering and dying.
Hope you can hold on till next March . . . (If we're in shelter-in-place next March, not much will matter by then).
Your empathy, I'm sure, is limitless. But it's generally true that folks here can "afford" to take supposed moral high ground and think Big Picture because . . . well, we can generally afford it.
Separately, I could not give two $hits what someone's age is, and I don't even think about a poster's age (unlike you) when reading here. That has no bearing on much, if anything . . . except perhaps when it comes to "perspective" on Stanford sports (as in Darrin Nelson was the best Stanford RB ever . . . with possible exception of C-Mac. And Love was the most explosive RB of all time).
More generally, I am quite loathe to make ad hominem arguments on the basis of folks' identities, including age, work status, social class, etc. But you and Mick are the ones who keep alluding to the fact that those of us concerned about "re-opening the economy" must somehow be immune to the consequences of sheltering in place. I have no idea what else you can draw on but assumptions about my age, work status, social class, etc. And once you start down this road, my point is that, broadly speaking, Stupac and I have much more reason to be worried than most folks on these boards, whom I've generally gotten the impression have fewer years left between now and retirement than between now and when they did the Wacky Walk. If you guys want to call a truce on making assumptions about posters' backgrounds, I'll gladly shake your virtual hand and refrain from doing so going forward, because doing so is slippery logic, at best.
RE: Covid antibody test available at Stanford - BostonCard - 04-13-2020
Back to the matter at hand... Spain is relaxing some of its restrictions:
https://www.cnbc.com/2020/04/13/coronavirus-spain-lifts-some-lockdown-measures-fewer-deaths-in-italy.html
So, the good news is that we will have some idea of whether it can be done safely. If Spain's case numbers continue on their downward trajectory, there will be a strong case to reopen sooner rather than later. If there's a big spike in cases and deaths then we can point to Spain as a cautionary tale.
BC
RE: Covid antibody test available at Stanford - teejers1 - 04-13-2020
(04-13-2020, 01:56 PM)BostonCard Wrote: Back to the matter at hand... Spain is relaxing some of its restrictions:
https://www.cnbc.com/2020/04/13/coronavirus-spain-lifts-some-lockdown-measures-fewer-deaths-in-italy.html
So, the good news is that we will have some idea of whether it can be done safely. If Spain's case numbers continue on their downward trajectory, there will be a strong case to reopen sooner rather than later. If there's a big spike in cases and deaths then we can point to Spain as a cautionary tale.
BC
It's all about the definition of "big." There will be an increase in cases and deaths, though I suspect nowhere near early spread rates because (a) so many people will remain home, (b) those that venture out will take precautions, and © establishments hosting visitors will also be taking precautions. So the question is, how big is intolerably big? [Again, I go back to treatment capacity].
P.S. Apologies for mixing up stupac and 2006 . . .all you whipersnappers are the same to me (heh, heh)!
RE: Covid antibody test available at Stanford - BostonCard - 04-13-2020
At it's peak Spain was diagnosing 8000 people a day, and about 900 people a day were dying. Right now that is down to about 4000 diagnoses a day and 500 - 600 deaths. You can expect that the number of infected will continue to drop for at least a week (given the delay between exposure and diagnosis). So, figure they will get down to under 3000 diagnoses a day and under 400 deaths (deaths will continue to drop even if diagnoses pick up).
A spike back up to 4000/500 (where we are now) is likely tolerable. 8000/900 (the previous peak) is probably not. In between, I don't know, but I suspect the government might be forced to rescind some of the relaxations if more than 5000 people a day are diagnosed.
Maybe I'm unreasonably optimistic, but I have a feeling that even with a relaxation of some requirements, there won't be a second spike, and things will kind of remain flat after they relax things. Not ideal, but manageable.
BC
RE: Covid antibody test available at Stanford - dabigv13 - 04-13-2020
I disagree. I think we need community transmission to be functionally zero or close before considering reopening. I dont think we can keep our ICUs 2/3 full of covid at a constant plateau. No cushion for an unexpected outbreak, and we wouldn't be able to get back to seeing and taking care of even semi urgent noncovid health matters.
RE: Covid antibody test available at Stanford - magnus - 04-13-2020
This was mentioned in one of these threads, but it'd be bad news if any place reopened before we had enough PPE to safely protect our medical workers. Right now, I'll bet almost every hospital is reusing their N95 masks and stretching the rules as to when they're not needed.
RE: Covid antibody test available at Stanford - Genuine Realist - 04-13-2020
(04-13-2020, 07:51 PM)dabigv13 Wrote: I disagree. I think we need community transmission to be functionally zero or close before considering reopening. I dont think we can keep our ICUs 2/3 full of covid at a constant plateau. No cushion for an unexpected outbreak, and we wouldn't be able to get back to seeing and taking care of even semi urgent noncovid health matters.
I appreciate that that is the medically sound approach, but also that is a bit blinkered. Outside the realm of medical values is another universe of values, economic, societal, and so on, which are being damaged. At some point, the damage to the other values outweighs the basic medical calculus. At what point that is the big, unanswered - possibly unanswerable - question.
This is the reason why the present dismal state of political dialog concerns me. Forget the particular occupant of the White House for the moments. No matter how the balance is drawn, it is rhetorically possible to damn the decision, since the choice is between greater and lesser evils. Someone is going to get hurt no matter what - either scandalously high mortality rates, or scandalously high unemployment, the scandal being in the eye of the beholder. The media can be counted on to do maximum damage to any assumption of good faith. My trust is in the American people to rally through - certainly not in any political or media institution.
RE: Covid antibody test available at Stanford - dabigv13 - 04-13-2020
Do you want your cancer operated on? Or your heart attack treated?
There is no functional economy or society without functioning hospitals, just not realistic.
RE: Covid antibody test available at Stanford - Mick - 04-13-2020
(04-13-2020, 11:41 AM)stupac2 Wrote:(04-13-2020, 10:48 AM)teejers1 Wrote: And frankly (and fortunately), that is probably the case for all (or almost all) of the posters here.
Can we cut it out with this shit? Virtually everyone is affected by this. My job isn't on the line now but if we're still doing this next March I have very little confidence that my company will survive. Does the former completely outweigh the latter when it comes to what I think about the wisdom of removing SiP restrictions before the public health experts deem it's appropriate? And, for that matter, why does my job need to be on the line for me to be unable to make this determination? I'm perfectly capable of sympathizing with those affected by job losses, as well as those who are infected and suffering and dying.
Translation: You're super mean for even posing an uncomfortable question, Teejers...
(04-13-2020, 01:51 PM)2006alum Wrote:(04-13-2020, 01:46 PM)teejers1 Wrote:I think you put words in my mouth - that was Stupac's comment, not mine. ;)(04-13-2020, 11:56 AM)2006alum Wrote: Can we cut it out with this shit? Virtually everyone is affected by this. My job isn't on the line now but if we're still doing this next March I have very little confidence that my company will survive. Does the former completely outweigh the latter when it comes to what I think about the wisdom of removing SiP restrictions before the public health experts deem it's appropriate? And, for that matter, why does my job need to be on the line for me to be unable to make this determination? I'm perfectly capable of sympathizing with those affected by job losses, as well as those who are infected and suffering and dying.
Hope you can hold on till next March . . . (If we're in shelter-in-place next March, not much will matter by then).
Your empathy, I'm sure, is limitless. But it's generally true that folks here can "afford" to take supposed moral high ground and think Big Picture because . . . well, we can generally afford it.
Separately, I could not give two $hits what someone's age is, and I don't even think about a poster's age (unlike you) when reading here. That has no bearing on much, if anything . . . except perhaps when it comes to "perspective" on Stanford sports (as in Darrin Nelson was the best Stanford RB ever . . . with possible exception of C-Mac. And Love was the most explosive RB of all time).
More generally, I am quite loathe to make ad hominem arguments on the basis of folks' identities, including age, work status, social class, etc. But you and Mick are the ones who keep alluding to the fact that those of us concerned about "re-opening the economy" must somehow be immune to the consequences of sheltering in place. I have no idea what else you can draw on but assumptions about my age, work status, social class, etc. And once you start down this road, my point is that, broadly speaking, Stupac and I have much more reason to be worried than most folks on these boards, whom I've generally gotten the impression have fewer years left between now and retirement than between now and when they did the Wacky Walk. If you guys want to call a truce on making assumptions about posters' backgrounds, I'll gladly shake your virtual hand and refrain from doing so going forward, because doing so is slippery logic, at best.
Sure. Would be nice if people refrained from implying that I'm racist, particularly since I'm fairly certain that my circle of friends includes more people of color than most on this board.
RE: Covid antibody test available at Stanford - 2006alum - 04-13-2020
(04-13-2020, 08:43 PM)Mick Wrote: Sure. Would be nice if people refrained from implying that I'm racist, particularly since I'm fairly certain that my circle of friends includes more people of color than most on this board.
[tweet]https://twitter.com/jerrydbayless/status/1097149262779998209?s=20[/tweet]
Let's not go there. Since each of us went to Stanford, unless one attended back when the dinosaurs roamed the earth, my baseline assumption is that all of us have a diverse circle of friends, and that many of us are POC.
---
Turning back to the subject of this thread, can anyone with medical/biochemistry/(advanced stats?) training care to assess this statement:
[tweet]https://twitter.com/ImmunoFever/status/1249454273672302593?s=20[/tweet]
What would be an acceptable rate of false positives? 1%? Do we just need to wait until there's a sufficient percentage of the underlying population that has had the virus, i.e., a higher incidence rate? I recall seeing models suggesting we'd need incidence rates into the 20-30% range at least to bring a test with a 3-4% error rate down to sufficient accuracy that individuals could reasonably rely on the results.
I guess I'm starting to worry that a widely disseminated quasi-reliable antibody test might cause as much harm as good, but it's not clear to me who is going to stop such tests from being distributed and relied upon by people desperate to try to return to normal?
RE: Covid antibody test available at Stanford - Genuine Realist - 04-13-2020
(04-13-2020, 08:30 PM)dabigv13 Wrote: Do you want your cancer operated on? Or your heart attack treated?
There is no functional economy or society without functioning hospitals, just not realisetic.
That's almost comically myopic. Don't you realize that the converse is equally true? That there are no functional hospitals without a functioning economy?