We're All Doomed!™ (the Conquest, War, Famine, and Death Thread)

[2Fingers]

You should have let us choose your handle+avy Reef.

If you were going whisky, something like...

Jack Daniels? Jim Beam? Johnny Walker? Jose Cuervo? Gassy Jack?

With maybe a full glass of whisky on the rocks for an avatar?

This was something I found quickly. Looking for a better one but trying to figure out which picture

[Strangelove]

This was something I found quickly. Looking for a better one but trying to figure out which picture

Okay, fair enough, but that handle buddy!

Corn could help you...

Please Corn, I know you hate doing this, but the guy made a horrible mistake!

PLEASE... change it to Gassy Jack? You'll feel good about yourself buds, you'll be a doer of good deeds!

[Cousin Strawberry]

WTF is with the name change Reef?

2 sausages!

[Chef Boi RD]

WTF is with the name change Reef?

2 sausages!

The Spock

The ladies love the Spock

[Chef Boi RD]

WTF is with the name change Reef?

2 sausages!

A new thread needs to be started called - Mickey Links Reefers Sausages

[Cousin Strawberry]

WTF is with the name change Reef?

2 sausages!

A new thread needs to be started called - Mickey Links Reefers Sausages

It can be the gay friendly thread....you must be this gay to get in kinda thing

[2Fingers]

WTF is with the name change Reef?

2 sausages!

A new thread needs to be started called - Mickey Links Reefers Sausages

It can be the gay friendly thread....you must be this gay to get in kinda thing

Well there is a well know saying about those that argue the loudest....

[Mickey107]

WTF is with the name change Reef?

2 sausages!

A new thread needs to be started called - Mickey Links Reefers Sausages

It can be the gay friendly thread....you must be this gay to get in kinda thing

Well there is a well know saying about those that argue the loudest....

Yes, there is.

[Cousin Strawberry]

WTF is with the name change Reef?

2 sausages!

A new thread needs to be started called - Mickey Links Reefers Sausages

It can be the gay friendly thread....you must be this gay to get in kinda thing

Well there is a well know saying about those that argue the loudest....

[Topper]

[Strangelove]

[5thhorseman]

Recent COVID19 news items:

https://www.nytimes.com/2020/07/04/heal ... ticleShare

"... the Centers for Disease Control and Prevention released data suggesting that for every documented infection in the United States, there were 10 other cases on average that had gone unrecorded, probably because they were very mild or asymptomatic."

I'm guessing this means we are closer to herd immunity than we thought, thought the level required for herd immunity is unknown.

"On Thursday, after the World Health Organization held a two-day online meeting of 1,300 scientists from around the world, the agency’s chief scientist, Dr. Soumya Swaminathan, said the consensus for now was that the I.F.R. is about 0.6 percent — which means that the risk of death is less than 1 percent."

Contrast this with initial estimates of 3-4% when it was breaking out of China.

Also, based on cremation records, we now suspect that the Chinese massively understated their infections and death rate.

https://www.medrxiv.org/content/10.1101 ... 20116012v2

Results: For the cumulative infections and total deaths, under different assumptions of death rates (from 2.5% to 10%) and doubling time 6.4 days, the estimates projected on February 7, 2020 in Wuhan range from 305,000 to 1,272,000 for infections and from 6,811 to 7,223 for deaths - on the order of at least 10 times the official figures (13,603 and 545).

[Mickey107]

What a surprise.

[UWSaint]

I’d like to hear more UW views on the pandemic

Okay, Rats. I'll give you more. But honestly my biggest opinion on it all is that all prognostications involve considerable speculation (including those by the "experts") and my firmest opinion on this whole thing is that there is a lot that is still very much unknown and will take years to unpack. My second firmest opinion is that "listening to the experts" is the dumbest thing I've ever heard without additional context. Experts answer (to the best they can when they aren't compromised) the questions they are asked -- they can opine on disease spread, disease prevention, treatment possibilities, vaccine possibilities, etc. So when we "follow the experts," we better know whether the questions are the ones we have agreed to follow. But the questions they are asked are only components of a public policy analysis; "zero" risk is never the optimal public policy outcome (why speed limits are not 5 mph) and all costs and benefits get weighed (and if done smartly, while weighing costs to liberty, etc.) My third firmest opinion is that much of the expertise being offered is not "science," which I don't mean as an insult to those offering the expertise (but I do mean as an insult to the "trust the science" crowd who are actually making a "trust the scientists" argument -- which is different.) Science itself is testable and tenable; models and projections are not directly testable through the scientific method (a backward look-see on how we did is information is potentially valuable information, but not information from a well constructed experiment); and tenability means subject to better data and analysis. What passes in media imagination as science in this area are often just hypotheses -- informed ones, to be sure, but the first step in the scientific process. Have you, for example, wondered by social distancing is recommended as 6 feet by some authorities (in the US, e.g.), 3 feet in other countries, and 1.5 meters in other countries? Its because animal studies confirm airborne transmission; contact tracing has airborne transmission as likely means; but we really don't know from these sources what the safe distance is and so we build in some uncertainty allowance -- possibly measured with some degree of "what's practicable." For obvious reasons, we haven't done the double blind studies of humans coughing at various distances and testing for viral loads....

Where it started

I don't know, but I think the best evidence points to the lab in Wuhan province where coronavirus was being studied. A containment failure is more likely than intentional release. While there has been some discrediting of the theory, some (e.g., nobel prize winner Prof. Montagnier) claim the virus has indications it was lab created -- which is really just a fancy way of saying gain of function research was occuring in the Wuhan lab (and I don't think that's been discredited). My best guess is that the containment breach occurred sometime last fall, and that at least one thing that we know to have been "debunked" when it comes to conspiracy theories about China will actually turn out to be quite true. And my money's on artificial creation of the strain (though with unintentional release).

How it was handled there
How it was handled here

There isn't a monolithic answer to how it was handled in the US because it was handled at the state level. I don't know much about how Canada addressed it, or the differences between the provinces. In the US, the dominant approach was closing schools and partly quarantining the healthy (with some "essential" exceptions but always to allow getting food). (I'm calling stay at home orders "quarantining the healthy"). In a few states, some disastrous public policy calls were made, such herding corona virus elderly in nursing homes, and those decisions had unfortunate consequences.

I think its tough to evaluate how it was handled because I don't think that the data are nearly "in" and probably never will be. Statistics for this are laughably inconsistent because definitions are not uniform (corona-related deaths doesn't have a uniform definition over time or place). As far as confirmed cases, the biggest input into this is how many people are being tested. This is especially true as it appears that far more people are testing positive who are asymptomatic *and will continue to be asymptomatic* (which last I heard was 50%) than what was originally known. So before the tests were widely available, the only people getting tested were symptomatic people. One imagines far more New Yorkers had the disease than was reported (as well as Italians and Spaniards and other places that had early spikes). There are good arguments that rate of positive tests can give you a better indication, but this presumes a stable cohort of tested individuals. Who gets tested is not a random thing. A 5% positivity rate in April means something entirely different than a 5% rate in July as people are getting checked before going back to work, etc.

And a lot more economic data is going to come in that will be relevant to the question of "how was it handled." There's easy stuff to look at -- GDP contraction, unemployment claims, CPI, DOW, etc. But the total impact hasn't yet happened, to say nothing of being happened to a point of going through peer reviewed evaluation. The biggest issue for me is inflation -- it seems inevitable as corona (and more importantly, the public policy response) cause increasingly unfavorably debt-to-GDP ratios, and it is probably the mechanism that will have the least acute shock to the system. But it is increasingly puzzling to me how nations can manufacture inflation when (1) currency floats and value is relative to other currencies and (2) many many strong currencies are in countries are in the same general position with the same incentive to choose a modest inflationary period. In other words, increased inflation will benefit creditors and debtors (as compared to default -- can you imagine if the US said, "nope, not paying"), but can inflation really be controlled by monetary policy as easily as it once was?

I also think its foolish to play the hindsight game with how it was handled. There was a remarkable amount that was unknown about this virus as it began to spread, there is still a remarkable amount unknown, and the degree of economic shock was also a bit of an unknown. Public health people played all sorts of tabletop exercises for public health responses to potential pandemics, but these really tend to concentrate on controlling disease spread -- my guess is that the fed bank and wall street and manufacturers, etc., weren't doing pandemic tabletops beyond "what do we do it we can't get our employees into work." I think that most officials really were trying their best amid shifting information and competing valid interests. But my bottom line is that anyone making decisions for the public was going to be making a mistake by some measure in the decisions that they made. Because of the nature of the information that were the inputs to the decision, the timeline to make the decisions, and the fact that every big decision will affect some groups more adversely than others.

It is also no surprise that the bluer states tended for heavier restrictions -- if you vote for more authoritarian leftists, you are more comfortable being told what to do and how to behave. In addition, since these places tend to be more urbanized and their tax base comprised of more people who can work from home, the benefits of increased restrictions were greater and the costs of increased restrictions were less. In other words, the different public policies made sense not only as a function of representation but also in terms of doing them best you can with the available cost-benefit information.

The biggest "mistake" made in public policy is probably having shifting definitions (or no clear vision) of what is the goal. Initially, the goal was "flatten the curve." This goal I think made all kinds of sense. The theory is don't overwhelm the health infrastructure -- give us time to manufacture masks and the like, give us time to explore treatments (and down the line vaccines). Note that health care infrastructure isn't just beds -- it is something that can be expanded relatively quickly (more protective equipment, more ventilators, more knowledge about treatment courses, when hospitalization helps and when it doesn't, etc.) ("Infrastructure" is a poor term to have become popularized in this regard). I think by and large, the US response has been very effective *if this were the goal." The early spikes (New York, New Jersey, for example) experienced large failures because they were on the front of the curve before that infrastructure was expanded and while more was unknown about the disease. There's talks of "surges" nowadays, but honestly, the healthcare infrastructure is absolutely handling it.

At any rate, if the "goal" shifts to reducing cases just to reduce cases (as it seems to have), that's not huge a value in and of itself -- certainly not one that justifies a continual shut down of the economy. If its zero deaths (which was a talking point of Governor Cuomo), that's an impossible goal, and one we'd never accept in any other analysis (see cars, building buildings and bridges, having electricity, going outside in a thunderstorm). We don't like to talk about death vs. conveniences or abstract principles like liberty, but of course these tradeoffs are made and they are made all the time, expressly or implicitly.

While hindsight to cast blame is foolish, hindsight to learn better about what to do in the future is just plain common sense. It seems to me that we ought to seriously think about a system that focuses on quarantining the sick rather than the healthy, differentiates between high risk of death and low risk individuals, and where the broadest restrictions are geographically targeted on smaller units of geography -- all to balance the goals of maintaining the capacity of the health care system and minimizing the shocks to the economy to only those that are necessary. We should measure the health care component of success first by lives and not cases or hospitalizations (independently of the capacity question). And one lesson learned is that we need to consider resiliency over efficiency when it comes to sourcing essential goods. Drugs, health care devices, etc., these things need to have sufficient US (from my perspective) manufacturing capacity, even if it means paying more during the good times.

How it is still being handled
Prognosis ?

I think its being handled well now. I think the reopening in stages is good and necessary and INEVITABLE. We are learning more about the disease, we can move backwards on a stage if need be, and our system can handle a lot more than it could in March.

If a foreign invader came with an army and said when we take over your government and we promise you health but you can't gather in large groups (including to practice your religion or protest the government), you can't go to restaurants, you can't leave your home unless its absolutely necessary, you can't add new people to your household (neither friends over for socialization and you are stuck with that girlfriend/wife come hell or high water), I would take up arms, thereby risking my life. That's not a hard call. That my government did that instead of a foreign invader led a little civil disobedience here and there but isn't going to lead to revolution in the short term. But it is unsustainable as a long term policy. We will open up fully. Some habits might change that will minimally impact our lives -- more frequent handwashing, whatever. But if the coronavirus/covid-19 is chronic, we will accept the risk that coronavirus presents as if it is the flu as opposed to living much longer within this world of decreased liberty. Americans, and I believe Canadians particularly west of Toronto and east of Vancouver, are not well-conditioned for obedience to authority. Put in other terms, we value liberty, spurn control, and would rather have agency and be stupid than to have not other choice than to be "safe."

I don't spend a lot of time thinking about whether we will find better treatments for coronavirus or a vaccine. I expect that stuff will come; people are ingenious. But I think we won't be conditioning a return-to-near-normal on those events. Its going to come sooner that when the experts say, because the experts haven't accounted for the fact that freedom is a value greater than general public health, especially for a disease like this one that is bad, but isn't wiping out the planet.

[Topper]

UW, BC has been a poster child for suppressing the spread of the virus. Possibly too well.

Our constitution gives healthcare to the Provinces and in BC, our politicians have taken a backseat to our Provincial Health Officer, Dr Henry, has a warm motherly demeanour that has convinced most to follow her lead. With that demeanour, it also needs to be remembered she started her medical career in the Navy as the doctor aboard ships. There is a no nonsense chain of command thing going on with her as well and she is very much in charge. She was in Africa for ebola, Toronto for SARS and H1N1. She co-wrote Canada's Pandemic Response Plan. She is on the WHO working groups looking at distancing and crowd sizes. She has the experience to back up what she says.

She is asked a lot of mundane boring questions, but when one does come up that is scientific, her eyes light up and she gets down to the meat and potatoes of what they are looking at.

The politicians have gotten out of her way. The Minister of Health appears on stage with her and answers government policy questions and updates on their measures to support the response.

Federally has been a disaster. Parliament has been shuttered, the PM appears like a groundhog day in a tent outside his residence to hand out another billion dollars he does not have.

Near daily briefings from our Health Officer, straight forward facts with 40-45 minutes of questions. If she doesn't have the answer at hand, she'll have it the following day and lead with it. Follow through is thorough. Every couple of weeks there is a more detailed briefing with statistical modelling that they are using. A fascinating slide from a recent update had the genetic sequencing of various strains that have been detected and their origin graphed with time to show where the outbreaks came from through time. China was not significant here, though it was the initial case. Iran and Washington St were far more significant early on and followed by a European strain commonly found in eastern Canada.

All slides with extrapolations include a probability window and are governed by control measures and are heavily coached that these are NOT projections. Modelling into the future is only to give guidance for increased or decreased restrictions.

What I have seen from the US is far too much political interference with the added complication of election year points to score and not enough medical guidance. My friends in Wa still believe masks are for self protection, many still believe it is all a hoax. They have problems understanding a phased reopening of society.

The misrepresentation of data is horrendous. There is far too much confidence placed on extrapolations and way too much emphasis placed on fatality data.

She has been honest about crowd size restrictions and distancing from the beginning. There is data that goes back to the late 30's on droplet spread and while 3' is good, 6' (2m) is much better. A lot of the distancing measures come from experience with other corona strains and what was learned from SARS and H1N1. For crowd size, (50 max here) it is based solely on practicality. Fifty is a manageable number and she has been adamant that it depends on the facility. Some places 50 is too much and it is up to the host to decide.

From the start she spoke of the limits of testing and the false positive and false negative rates in asymptomatic people. We still don't have serology test that meets repeatability standards. She will only recommend masks where distancing is not an option. Testing here has been targeted. Initially because of a shortage of certified labs, then a shortage of reagents, it is now widely available.

For the most part things here have remained open except where distancing is not practical. So schools, bars, salons .... were closed. Dine in restaurant were not initially closed but were closed as soon as they proved unable to keep people apart. Schools reopened on a limited basis very early on. Enrolment was limited to children of healthcare workers and to those students who most needed a school environment. They later reopened on a voluntary basis with limited class size and part time schooling. There was only ~30% attendance.

From the beginning we have been encouraged to get out enjoy the outdoors. It isn't a quarantine or lock down. Roads along beaches have been closed and converted to bike lanes to ease congestion on the seaway paths. Limit close contacts to household members but don't be afraid to see others. just keep your distances.

She, in conjunction with the workplace health and safety folks, put out guidelines for businesses and let the businesses adopt their individual plans according to those guidelines. She is a great presenter. A week before any regulatory changes, the topic increasingly is discussed in her briefing along with the reasoning for her decision. Days before the change, people already are accepting her reasoning. She puts a lot of the onus on personal choice based upon responsibility to the community.

We are at ~155 active cases in BC, from a high of just over 700. We maxed out at just under 140 hospitalizations (back in April) and are down at a steady 15 - 20. Daily new cases reported are in the 10-20 range. Hardest hit areas of BC were seniors care homes in the Vancouver area and it has been grim for seniors in care homes.