7 ms·

Are just the ERs empty? Or the whole hospital as well? If hospitals are empty, it's time to stop sheltering in place, because it means it's working too well. Wh

by umvi 7y ago

Are just the ERs empty? Or the whole hospital as well? If hospitals are empty, it's time to stop sheltering in place, because it means it's working too well. What's the endgame? We can't just keep the country shut down indefinitely. Life must move on. Even though there's still a lot of fear, I think reopening the country is the best option (while still maintaining social distancing, etc).

6nf 7y ago
To echo your point: In New South Wales, Australia the medical sector had 1000 ICU bed capacity in January. When covid hit, it was rapidly expanded and currently over 2000 ICU beds are available. At the same time all elective surgeries got banned (e.g. hip replacements etc) because some of those would end up in ICU. At the peak of the outbreak NSW used 100 of those 2000 beds. Currently only about two dozen ICU beds are occupied. About 1% of capacity.
- roca 7y ago
  The good news for Australia is that you are probably eliminating the virus and will be able to reopen everything soon, safely. The key point of the comment you are responding to --- "If hospitals are empty, it's time to stop sheltering in place, because it means it's working too well" does not apply to Australia, because it assumes a "flatten the curve until we reach herd immunity" strategy which is not Australia's strategy. The real problem in the USA and most other Western countries is that there is no clear strategy to defeat the virus. The actions being taken are mostly consistent with "flatten the curve and wait for herd immunity", but that pretty much guarantees crippling economic damage and mass death.
  - jfnixon 7y ago
    Australia (and New Zealand) have no clear strategy to defeat the virus. They have won the opening battle and are claiming the war is over. Unless Oz and NZ cut themselves off from the rest of the planet, no, the virus war isn't over. Herd immunity through vaccine or infection is the only rational strategy for a disease like C19. There is no vaccine, and possibly will never be a vaccine. Sorry to be a realist.
    - 6nf 7y ago
      Australia's strategy started off as 'flattening the curve' and as far as I know officials never stated that eradication is now the strategy. There's still about a thousand confirmed live cases and of course there's many thousands more that are not symptomatic or otherwise carrying covid without being diagnosed. Eradication as far as I can tell is not realistic.
    - roca 7y ago
      NZ, at least, has a clear strategy to defeat the virus: eradicate the virus internally, mandatory 14-day quarantine for everyone entering the border (and only NZ residents plus a few essential workers are allowed to enter) to keep it out, intense contact tracing and testing to snuff out outbreaks from cases that slip through. (I think this is also the Australian govt strategy but I haven't been watching their press conferences.) Sure, the war isn't over, but it's at least plausible this will be effective for a long time. Versions of it are working in China and a number of other countries that were able to stop the spread in time. If there is never a vaccine, then there will be harder decisions for all these countries in the future about how to deal with countries that failed to defeat the virus. It seems fine to worry about that later.
pmiller2 7y ago
No, it doesn't mean "stop sheltering in place," unless cases of COVID-19 have peaked. In order to tell whether they've peaked, you need testing in place, as well. Even if they have peaked, it could mean "relax some of the restrictions, but not fully end SIP, while monitoring cases." Opening things back up prematurely, without sufficient testing, is just going to get people killed.
- manigandham 7y ago
  Why do cases matter? It should be the death rate that peaks, and that's measurable without testing. In fact it seems to be over-attributed since many deaths are now being classified to Covid even if there are many other factors.
  - pmiller2 7y ago
    Death rate is the proxy for cases. What matters when attempting to contain the disease is prevalence of the disease.
    - jfnixon 7y ago
      I think this is backwards. We have been using infection rates as a proxy for death rates, since deaths are a lagging indicator. It is certain we are missing a huge percentage of cases, and expanding testing will uncover those. It is completely unclear that uncovering more mild and asymptomatic cases will result in more deaths, so new cases are a bad proxy for future deaths.
      - pmiller2 7y ago
        Maybe in an ideal world, but we're not actually measuring infection rates. Dead is pretty objective, and easy to measure, and, we know that the number of deaths will roughly track the number of infections. That's why things like deaths and hospitalizations are what the state of California is watching closely.
    - manigandham 7y ago
fzeroracer 7y ago
I'm going to keep repeating this until people understand the risks: Opening up too early without adequate testing in place means we go through the same problem that Hokkaido did. Which is that you get a second wave of infections and are forced to back into lockdown. As for the article itself: Reopening the country wouldn't fix that either because it's a catch-22 situation. The people most at risk of dying from COVID-19 don't want to go to the hospital because of the risk. So they put off emergencies until it's too late. You don't solve this problem by reopening the country because the fear and the risk for said people is still there. My parents are a great example. They have breathing issues which makes them especially at risk. They're afraid of getting routine tests done because catching the coronavirus could be very deadly.
- umvi 7y ago
  So... you propose just staying on lockdown indefinitely until "adequate testing is in place?" And when will that be? It could be 6 months from now or more so long as the Trump administration is running things. Lockdown isn't "free" like you seem to think. It has a very heavy cost. And some day (if not already), that cost will outweigh the lives saved from doing it in the first place. Because the combined suicides/mental health/homelessness/domestic violence/etc. increases from lockdown will be greater than [people at risk of covid-19] deaths. Plus, if lockdowns are keeping hospitals empty, social distancing and masks without the lockdown part would allow us to utilize them more (without them going over capacity).
  - macintux 7y ago
    I have yet to hear anyone explain how we’re going to lose millions of lives due to the lockdown, whereas the risks of opening up without sufficient testing include that as a very real possibility. Yes, it stinks that people are suffering due to the lockdown, but the government could (if it were so inclined) pay people to stay home indefinitely. It clearly can’t manage the virus, however.
    - axguscbklp 7y ago
      >the government could (if it were so inclined) pay people to stay home indefinitely I'm a bit skeptical, and would be even if instead of "indefinitely" we were just talking about a couple of years. I'm not necessarily disagreeing, but I'm curious about how the math would work out, in your opinion.
rconti 7y ago
The hospitals largely shut down elective surgeries, tried to get rehab patients to other facilities to free up surge capacity, etc. So, generally, they're less busy than normal. The problem with opening back up is, we've already seen the growth curve, and that was 2 months ago. What happens when you multiple that same growth rate against a much higher baseline number of infected people?
- umvi 7y ago
  Two months ago people weren't wearing masks or practicing social distancing.

by umvi 7y ago

6nf 7y ago

To echo your point: In New South Wales, Australia the medical sector had 1000 ICU bed capacity in January. When covid hit, it was rapidly expanded and currently over 2000 ICU beds are available. At the same time all elective surgeries got banned (e.g. hip replacements etc) because some of those would end up in ICU. At the peak of the outbreak NSW used 100 of those 2000 beds. Currently only about two dozen ICU beds are occupied. About 1% of capacity.

roca 7y ago
The good news for Australia is that you are probably eliminating the virus and will be able to reopen everything soon, safely. The key point of the comment you are responding to --- "If hospitals are empty, it's time to stop sheltering in place, because it means it's working too well" does not apply to Australia, because it assumes a "flatten the curve until we reach herd immunity" strategy which is not Australia's strategy. The real problem in the USA and most other Western countries is that there is no clear strategy to defeat the virus. The actions being taken are mostly consistent with "flatten the curve and wait for herd immunity", but that pretty much guarantees crippling economic damage and mass death.
- jfnixon 7y ago
  Australia (and New Zealand) have no clear strategy to defeat the virus. They have won the opening battle and are claiming the war is over. Unless Oz and NZ cut themselves off from the rest of the planet, no, the virus war isn't over. Herd immunity through vaccine or infection is the only rational strategy for a disease like C19. There is no vaccine, and possibly will never be a vaccine. Sorry to be a realist.
  - 6nf 7y ago
    Australia's strategy started off as 'flattening the curve' and as far as I know officials never stated that eradication is now the strategy. There's still about a thousand confirmed live cases and of course there's many thousands more that are not symptomatic or otherwise carrying covid without being diagnosed. Eradication as far as I can tell is not realistic.
  - roca 7y ago
    NZ, at least, has a clear strategy to defeat the virus: eradicate the virus internally, mandatory 14-day quarantine for everyone entering the border (and only NZ residents plus a few essential workers are allowed to enter) to keep it out, intense contact tracing and testing to snuff out outbreaks from cases that slip through. (I think this is also the Australian govt strategy but I haven't been watching their press conferences.) Sure, the war isn't over, but it's at least plausible this will be effective for a long time. Versions of it are working in China and a number of other countries that were able to stop the spread in time. If there is never a vaccine, then there will be harder decisions for all these countries in the future about how to deal with countries that failed to defeat the virus. It seems fine to worry about that later.

pmiller2 7y ago

No, it doesn't mean "stop sheltering in place," unless cases of COVID-19 have peaked. In order to tell whether they've peaked, you need testing in place, as well. Even if they have peaked, it could mean "relax some of the restrictions, but not fully end SIP, while monitoring cases." Opening things back up prematurely, without sufficient testing, is just going to get people killed.

manigandham 7y ago
Why do cases matter? It should be the death rate that peaks, and that's measurable without testing. In fact it seems to be over-attributed since many deaths are now being classified to Covid even if there are many other factors.
- pmiller2 7y ago
  Death rate is the proxy for cases. What matters when attempting to contain the disease is prevalence of the disease.
  - jfnixon 7y ago
    I think this is backwards. We have been using infection rates as a proxy for death rates, since deaths are a lagging indicator. It is certain we are missing a huge percentage of cases, and expanding testing will uncover those. It is completely unclear that uncovering more mild and asymptomatic cases will result in more deaths, so new cases are a bad proxy for future deaths.
    - pmiller2 7y ago
      Maybe in an ideal world, but we're not actually measuring infection rates. Dead is pretty objective, and easy to measure, and, we know that the number of deaths will roughly track the number of infections. That's why things like deaths and hospitalizations are what the state of California is watching closely.
  - manigandham 7y ago

fzeroracer 7y ago

I'm going to keep repeating this until people understand the risks: Opening up too early without adequate testing in place means we go through the same problem that Hokkaido did. Which is that you get a second wave of infections and are forced to back into lockdown. As for the article itself: Reopening the country wouldn't fix that either because it's a catch-22 situation. The people most at risk of dying from COVID-19 don't want to go to the hospital because of the risk. So they put off emergencies until it's too late. You don't solve this problem by reopening the country because the fear and the risk for said people is still there. My parents are a great example. They have breathing issues which makes them especially at risk. They're afraid of getting routine tests done because catching the coronavirus could be very deadly.

umvi 7y ago
So... you propose just staying on lockdown indefinitely until "adequate testing is in place?" And when will that be? It could be 6 months from now or more so long as the Trump administration is running things. Lockdown isn't "free" like you seem to think. It has a very heavy cost. And some day (if not already), that cost will outweigh the lives saved from doing it in the first place. Because the combined suicides/mental health/homelessness/domestic violence/etc. increases from lockdown will be greater than [people at risk of covid-19] deaths. Plus, if lockdowns are keeping hospitals empty, social distancing and masks without the lockdown part would allow us to utilize them more (without them going over capacity).
- macintux 7y ago
  I have yet to hear anyone explain how we’re going to lose millions of lives due to the lockdown, whereas the risks of opening up without sufficient testing include that as a very real possibility. Yes, it stinks that people are suffering due to the lockdown, but the government could (if it were so inclined) pay people to stay home indefinitely. It clearly can’t manage the virus, however.
  - axguscbklp 7y ago
    >the government could (if it were so inclined) pay people to stay home indefinitely I'm a bit skeptical, and would be even if instead of "indefinitely" we were just talking about a couple of years. I'm not necessarily disagreeing, but I'm curious about how the math would work out, in your opinion.

rconti 7y ago

The hospitals largely shut down elective surgeries, tried to get rehab patients to other facilities to free up surge capacity, etc. So, generally, they're less busy than normal. The problem with opening back up is, we've already seen the growth curve, and that was 2 months ago. What happens when you multiple that same growth rate against a much higher baseline number of infected people?

umvi 7y ago
Two months ago people weren't wearing masks or practicing social distancing.