3 ms·

I totally agree with you, that the Federal response was pretty terrible. And I understand and am aware of the topics you provided. However, that does not chang

I totally agree with you, that the Federal response was pretty terrible. And I understand and am aware of the topics you provided. However, that does not change where we are today. It would have probably helped us get to "today" a lot earlier, and it would have probably saved many, many lives which were unfortunately lost. But my argument is how we respond _today_ to new information, and how the partisanship endemic in our culture today does not allow for us to pivot in a meaningful way. If we knew what we know today 160 days ago, I doubt we would still want to lock down in the same way that we did. But unfortunately, despite now being armed with that knowledge, we are not pivoting on the plan we made back in March. Even our knowledge of treating it has improved. The CFR is down across the board. We now know oxygen replacement therapy is better than invasive ventilators. We know that a majority of the spread is in nosocomial or in nursing homes. We know that remdisivir shows promise. We know that treating with anti-inflammatory drugs is helpful. We know better ways to prevent cytokin storms. We know better how to respond to clotting. Focusing just on the ventilator learnings, we can treat people with oxygen replacement therapy without them being in the ICU, while invasive ventilator treatment requires an ICU. This lowers the number of ICU beds needed, and thus should shift the hospital capacity discussion. But I am seeing none of that. It is all partisan bickering over "full lockdown" or "full reopen" and both sides claiming the other is "anti-science" I will ignore the personal attack, beyond saying that questioning someones understanding of a topic at such a basic level has no place in proper debate.

tunesmith 6y ago
> If we knew what we know today 160 days ago, I doubt we would still want to lock down in the same way that we did. I don't know how to respond to that - I technically agree with you, the loudest least educated voices probably wouldn't have wanted to lock down. The lack of info and the panic level probably positively contributed to saving more lives. I'm totally okay with that. I believe that knowing then what we know now, we absolutely should have done what we did, and then some. We didn't have enough testing capacity. We know that if we had locked down even earlier, we would have saved a significant number of additional lives. It's true that part of the argument was based on hospital capacity. But the models today are still consistent with the view that the capacity in many areas would have been overwhelmed in many places had we done nothing. I think the key there is that civilians were going to "do something" and stay at home even if the government didn't tell them to, no matter what. > But I am seeing none of that. It is all partisan bickering over "full lockdown" or "full reopen" and both sides claiming the other is "anti-science" It's best to step away from that kind of absolutist language (none, all) - it just tends to bait people.
matthewdgreen 6y ago
I think that you’re very wrong that the lack of a coordinated response by the Federal government was only an issue “in the early days”. I think the ongoing lack of Federal action (and particular economic support) has more or less trapped us into a long-term poor and fragmented state-by-state “whack-a-mole” strategy. The fact that CFR has dropped a bit does not mean there won’t be major second waves that flow back and forth between the states: we may already be seeing those in some southern and western states. It’s not too late to fix this, but we won’t.
- salmon30salmon 6y ago
  We are arguing over two different things. I am arguing the direct response to the virus. How the lockdowns were implemented, where and for who. I agree that the federal response was bad all over, and now it is most obvious in the lack of financial assistance to both individuals and states. Please keep in mind also, that for states that are not in (NY, NJ, CA, MI, LA) there hasn't been a _first wave_. We need to keep that in mind before we point to states like FL and GA as having a 2nd wave. Their waves were largely curtailed by the stay-home orders in place. We need to either admit we want these orders to last until there is a vaccine, or increase our threshold for acceptable case levels.
  - matthewdgreen 6y ago
    I don’t actually think we disagree that much. The problem is that we were supposed to use our early lockdowns in the “high cases” states (NY/NJ/CA) to control the epidemic and bring it down to manageable levels. At least in NY/NJ this seems to have worked. We were supposed to use our lockdowns in the “low cases” states to bring the caseload down near zero. This has not really worked that well, largely because the lockdowns were poorly implemented, and because states ended them before they had really crushed community spread to a level where testing and tracing could work. Now there’s superficial (early) evidence that many of the low-cases states are entering a second stage of exponential growth. There may not be much room for us to simply manage the caseload at some “acceptable level” if those states really catch fire. The problem is that the only tool we have to manage this — if indeed it bears out and hospitals become overwhelmed - is another lockdown. But the lockdowns have become a political hot potato, and at least one side is dead-set against them. It seems unlikely that we’ll be able to use this tool again until things get Very Bad. Compare this to most of continental Europe, where both high-case and low-case nations have succeeded with lockdowns, and governments are moving into a phase where careful management is likely to control the epidemic entirely going forward.

tunesmith 6y ago

> If we knew what we know today 160 days ago, I doubt we would still want to lock down in the same way that we did. I don't know how to respond to that - I technically agree with you, the loudest least educated voices probably wouldn't have wanted to lock down. The lack of info and the panic level probably positively contributed to saving more lives. I'm totally okay with that. I believe that knowing then what we know now, we absolutely should have done what we did, and then some. We didn't have enough testing capacity. We know that if we had locked down even earlier, we would have saved a significant number of additional lives. It's true that part of the argument was based on hospital capacity. But the models today are still consistent with the view that the capacity in many areas would have been overwhelmed in many places had we done nothing. I think the key there is that civilians were going to "do something" and stay at home even if the government didn't tell them to, no matter what. > But I am seeing none of that. It is all partisan bickering over "full lockdown" or "full reopen" and both sides claiming the other is "anti-science" It's best to step away from that kind of absolutist language (none, all) - it just tends to bait people.

matthewdgreen 6y ago

I think that you’re very wrong that the lack of a coordinated response by the Federal government was only an issue “in the early days”. I think the ongoing lack of Federal action (and particular economic support) has more or less trapped us into a long-term poor and fragmented state-by-state “whack-a-mole” strategy. The fact that CFR has dropped a bit does not mean there won’t be major second waves that flow back and forth between the states: we may already be seeing those in some southern and western states. It’s not too late to fix this, but we won’t.

salmon30salmon 6y ago
We are arguing over two different things. I am arguing the direct response to the virus. How the lockdowns were implemented, where and for who. I agree that the federal response was bad all over, and now it is most obvious in the lack of financial assistance to both individuals and states. Please keep in mind also, that for states that are not in (NY, NJ, CA, MI, LA) there hasn't been a _first wave_. We need to keep that in mind before we point to states like FL and GA as having a 2nd wave. Their waves were largely curtailed by the stay-home orders in place. We need to either admit we want these orders to last until there is a vaccine, or increase our threshold for acceptable case levels.
- matthewdgreen 6y ago
  I don’t actually think we disagree that much. The problem is that we were supposed to use our early lockdowns in the “high cases” states (NY/NJ/CA) to control the epidemic and bring it down to manageable levels. At least in NY/NJ this seems to have worked. We were supposed to use our lockdowns in the “low cases” states to bring the caseload down near zero. This has not really worked that well, largely because the lockdowns were poorly implemented, and because states ended them before they had really crushed community spread to a level where testing and tracing could work. Now there’s superficial (early) evidence that many of the low-cases states are entering a second stage of exponential growth. There may not be much room for us to simply manage the caseload at some “acceptable level” if those states really catch fire. The problem is that the only tool we have to manage this — if indeed it bears out and hospitals become overwhelmed - is another lockdown. But the lockdowns have become a political hot potato, and at least one side is dead-set against them. It seems unlikely that we’ll be able to use this tool again until things get Very Bad. Compare this to most of continental Europe, where both high-case and low-case nations have succeeded with lockdowns, and governments are moving into a phase where careful management is likely to control the epidemic entirely going forward.