stevenkesslar

And ................ it gets worse. One of the many things Dr. Birx says that makes sense is that reopening should be tied to 14 days of continuous reduction in new infections. I thinks she sees that as a minimum standard, or a threshold. So by that standard Spain and Italy have been mostly going down for a few weeks. The US has not gone down for even one day, at least based on a rolling average. The next standard she set is availability of testing and contact tracers adequate to the job at hand. On that one, absolute numbers are critical - not percentages or cases per million. One rule of thumb I've read about countries that have done it the best are one contact tracer can handle two cases. I'm not sure if that means two per day, or just two. In theory, every single infected person could require lots of contact tracing. But I'll go with a contact tracer being able to handle the tracing for two new cases per day. So at the rate of 30,000 new cases per day, we need 15,000 contact tracers. I very much doubt we have that, or anything close to it. Hong Kong and New Zealand have it much easier, since their new cases per day is a single digit. So we have 30,000 new cases a day, the Daily Death trend is still going up, and we are talking about reopening. http://24.media.tumblr.com/tumblr_m3gs4cqw0h1rqfhi2o1_400.gif While there is some evidence that new infections may have peaked in places like New York, in other areas - like South Dakota - we are just getting started, basically. The virus is now in massive exponential growth mode there. It's feeding frenzy time, basically. With 1 million people rather than 20 million people in South Dakota, there are obviously 95 % less infection opportunities. But seems like 1 million sets of lungs is really good feed for COVID-19, regardless. The virus can go a long way on those 1 million lungs alone. Granted, a bunch of those lungs belong to people who will be dead soon. So that kind of fucks things up for the virus a bit. But it's not that hard for COVID-19 to skip over the border to North Dakota, really. Person per person, those North Dakota lungs are just as good as far as virus feed goes. Those workers in meat processing plants are ending up in hospitals. So that's a bit of a drag for COVID-19, too. But as long as things stay pretty much open, COVID-19 can find its way around pretty good. So I'm sure the virus will do just fine. Add all this to the fact that the US hasn't even gotten to half the rate where Italy or Spain peaked, and things could get a lot worse here. What ultimately created the peak in Italy and Spain was a draconian and pretty harshly enforced lockdown. We haven't really had that. Which is why the rolling average of deaths in the US has kept growing every day. Running out of lungs to feed on could slow the virus down significantly. But there's really no danger of that yet. So I don't see how reopening makes the rolling Daily Death average go down. Maybe the idea is that we'll be the poster child for how you simply limit the increase in deaths every day so that the hospital system can more or less handle it. That's actually a great plan for the virus, since it makes sure it is very well fed with fresh lungs for the next year or two. The other problem is that our numbers in the US are as untrustworthy as China's. In the case of the US, it's because of two things. Some people die that are never tested for COVID-19. And a lot of people die at home of COVID-19, because there is no room in a hospital to go die. So maybe what we need to figure out in the next month or two is how to get that rate up to a manageable limit. Like maybe instead of 7 we can handle 10 or 20 daily deaths per million, like Italy or Spain, without disrupting the stock market too much. And then there's that whole dying at home thing that has to be factored in, too. That said, it probably all works out to 6000 or so deaths every day. That's like two 9/11's. I guess that's not that bad. There is good news, so I'd say we should focus on that. The Dow is back up to almost 25,000. Woo hoo!

Picky bitch! I noticed that. In a separate post a while ago, I did a direct comparison of New York and Seoul. So if you just Google that it says this about NYC: Seoul says this: So by just about any standard, I think those Asian cities are way more dense than the American cities. That chart was helpful because it compared major cities all over the world. By the standard it used, US cities are relatively less dense than large cities in many other countries. I also posted it several weeks ago, but Seoul has a public transit system that looks clean and is disinfected daily. They had to because they had a cluster outbreak at a call center and a lot of the people at that call center rode the subway to work. So they have mostly stayed one step ahead of it. There's no evidence that riding on the subway causes infection. But infected people may be riding on the subway. So they are doing everything they can to create a perception of safety in subways. It should be clear, but in that post I was comparing number of deaths in entire Asian countries (like Taiwan and Japan) to number of deaths in US counties (like New York and San Francisco) which is how the Johns Hopkins map works. So if I really went for a city to city comparison the number of deaths would be even more skewed on the US Side. I'm pretty sure most of the Korean infections are outside Seoul. The biggest driver so far has not been density, but membership in the Shincheonji Church of Jesus. If I recall right, they tested something like 10,000 church members and 4,000 were infected. Those 4,000 people infected a bunch of others. So most of the infection in South Korea has been behavioral: church members praying closely together.

Just be careful what you wish for, buddy. Georgia’s COVID-19 deaths surge, and a rural county coroner reels

That's a really interesting and perplexing question. I think we need to be more Asian, and less stupid. I buy the theory that if we were 50 % more Asian, and 25 % less ignorant, pretty much most dead people in America from COVID-19 would not be dead. So, for example: Largest cities in the world ranked by population density (1 to 125) Seoul, population density rank # 6 16,700 people per sq/km COVID-19 deaths: 230 (all of South Korea) Taipei, population density rank # 7 15,200 people per sq/km COVID-19 deaths: 6 (all of Taiwan) Singapore, population density rank # 29 8,350 people per sq/km COVID-19 deaths: 10 Tokyo, population density rank # 50 4,750 people per sq/km COVID-19 deaths: 190 (all of Japan) Los Angeles, population density rank # 90 2,750 people per sq/km COVID-19 deaths: 457 (LA County only) San Francisco, population density rank #104 2,350 people per sq/km COVID-19 deaths: 17 (San Francisco County only) New York City, population density rank # 114 2,050 people per sq/km COVID-19 deaths: 11,477 deaths (NYC only) New Orleans, population density rank # 116 1,950 people per sq/km COVID-19 deaths: 302 deaths (New Orleans only) There has been a raging debate about this among Asian scholars. Many have noted that, with the exception of San Francsico, lower density and less mass transit seems to lead to way more COVID-19 death. So Asian scholars have asked: does riding mass transit in cities like Seoul and Tokyo confer immunity to COVID-19? Do cars on LA and NYC freeways cause COVID-19? My question here is are we going to have to reconsider our emphasis on carbon producing cars and low density housing in urban areas to prevent future major virus outbreaks? What might the alternative be? Other Asian scholars have noted that correlation and causation are not the same. So just because Americans who die of COVID-19 are way more likely to drive cars or live in less dense housing, that may not be why they die. Asian scholars have looked to other behavioral patterns to determine causation. For example, gun deaths in the US exceed gun deaths in Japan by a huge order of magnitude: 3 deaths in Japan versus 40,000 deaths in the US in one year. Asian scholars theorize that this is caused by American behavior. Specifically, American ignorance: the idea that more gun ownership results in less gun death, even though - from a scholarly perspective - it clearly results in more gun death. Armed with this insight, Asian scholars have examined American ignorance and stupidity on COVID-19, to see if this could impact death rates. For example, does it impact mortality if Americans think, "This is a bullshit thing, I ought to be able to do whatever the fuck I want, and nobody has a right to close my business or my bar down?" Asian scholars have named this the "dip shit American" theory. They have studied whether there is a correlation between being an American "dip shit", and COVID-19 mortality. Asian scholars have compared Asian and American behavior around "test, trace, treat" practices such as: masks, social distancing, bans on social behaviors such as mass gatherings, avoidance of "church packing", and overall conformity with regulations meant to prevent death and keep the economy going. Asian scholars have generally found that Asian awareness of and adherence to public health guidelines seems to be a causal factor. It is believed to cause much lower Asian death rates, as well as much less economic destruction. To confirm this theory, Asian scholars studied behavior and public health awareness in San Francisco, which has an unusually low COVID-19 death rate and an unusually high Asian population. Asian scholars found that San Francisco residents, including those who are not Asian, act much more like Asians when it comes to responding to public health crises. This appears to correlate with less death and economic destruction from COVID-19. Meanwhile, Asian scholars found that 7 out of 10 American "dip shits" tested responded to the question, "Define test, trace, treat" with the answer: "What the fuck is that? Is that some fucked up Wuhan thing?" So the hot new academic theory all over Asia now is that America has a massive lead in global COVID-19 deaths because of American ignorance and stupidity. Asian scholars theorize that if all Americans were 50 % more Asian, and 25 % less ignorant, most COVID-19 deaths would have been prevented. My question here is are we going to have to reconsider our emphasis on ignorance and stupidity to prevent future major virus outbreaks? What might the alternative be? Any ideas and suggestions? And the good news is this. I read the footnotes on all these Asian studies. It said that even if we have to act a bit more like Asians, we don't have to eat bats, snakes, or dogs. Sorry if I offend anyone, but personally that was a huge relief to me.

So inquiring minds need to know, @Charlie. Are you saying you understand the nose bleeding procedure, but not the genital stroking one? I'm just surprised. You have a reputation, you know.

I'm sure God will find a way to comfort you. It's not a matter of IF you will enjoy a new puppy. It's just a matter of WHICH of the two puppies above you will choose.

That's actually why I asked, and sort of the answer I expected. That article about Germany mentioned blood testing people at home. I assume that would have to be a test that yields an immediate result. So maybe there are some markers they can use in home visits to make distinctions about who needs a hospital bed, and who should just stay home. But anecdotally I've read stories where doctors say the same thing consistently: one minute someone is fine, and then they take a sharp turn for the worse. So I also assume a lot of this is hindsight is always 20/20. My biggest takeaway from that article about Germany on treatment is it makes a huge difference if you are not slammed on resources. Because of what you said: scarce resources. In an ideal world, in a limited outbreak, maybe everybody with COVID-19 would be isolated in a hospital bed and monitored, so that you could either prevent a steep decline, or be on it right away when it happened. That's not possible in places like New York and New Jersey now. This is why flattening the curve makes a huge difference. As slammed as they are, Germany says it is taking patients from France and Italy. (Wonder how they get them there?) California's plan assumed that "hospital beds" would be needed for 20 % of all patients, including makeshift hospitals. It was never spelled out what that 20 % figure was based on. 20 % seemed on the high side to me, compared to what happened in at least some other countries. So my assumption was that the plan had built in the idea that they'd rather have anybody at the margin in the hospital under observation, as opposed to at home. I'm assuming this is why they put Boris Johnson in an ICU. Better safe than sorry when it is your Prime Minister. Chris Cuomo was talking a lot about breathing exercises on his show tonight. That surprised me. He said it was all he could do to force himself to get up, move around, do breathing exercises. But his attitude was clearly that this virus is going for my lungs, and I have to fight it. So after watching him I Googled breathing exercises, too, and came up with this. Even JK Rowling has some advice to offer: Lung exercises can help prevent severe coronavirus illness, doctor says -- and JK Rowling claims they worked for her [MEDIA=twitter]1247121896082157568[/MEDIA] Thank you again for sharing all this information and perspective. It is scary. Watching Cuomo and hearing your stories, as serious and sobering as they are, takes some of the scary unknown out of it.

Ezekiel Emanuel: U.S. Must Stay Locked Down For 12-18 Months Until There's A Vaccine This guy is a cancer doctor. It's a three minute video that I find sobering, and thereby somewhat reassuring. It's a bit like Bill Gates, but without the goofy smile. The headline is a bit inaccurate. At first I assumed he meant we all have to stay at home for 18 months. In fact, he says right up front that tens of millions of workers have to be in the middle of this, pretty much every day, because we rely on them for electricity, groceries, internet, etc. What I like about this is that he has the skill set to deal with this like he deals with cancer: sober, no bullshit, but also knowing it is better to lay it on the line and deal with the reality, rather than false hope. I've felt from the beginning of this that we should race toward what we need to do, rather than resisting it. We've now seen the high price we pay for resisting. The good news is that if we can all get our minds around racing to where we need to go, we'll actually get there quicker. And safer.

I Googled it and found this. Any reaction, based on your experience? Here are some of the existing drugs that may be repurposed to treat coronavirus Actemra and other rheumatoid arthritis drugs And while I am putting your medical expertise to work, I'm curious if you have any reaction to this: A German Exception? Why the Country’s Coronavirus Death Rate Is Low If you read the whole article, it makes it clear that treatment is not the biggest reason for Germany's "lower" death rate. And at 2 % of all confirmed cases now, Germany's 2 % death rate is only "low" relative to Italy or Spain's death rates of about 10 %, or the US death rate which is a little above 3 % now. It's amazing that we are now at the point where a 1 % lower death rate in the US would mean 4,000 fewer dead Americans today. That's the equivalent of 9/11. The two biggest reasons for the lower death rate are: 1) a lot more testing of the entire population, so they have more confirmed mild cases built into that percentage; and 2) a much younger average age of confirmed cases (49 in Germany, versus early 60's in France and Italy). That said, it makes intuitive sense to me that there are probably people showing up at hospitals in the US who should just stay home. And other ones that probably should have come in earlier, before they fell over the cliff. That said, that's a medical diagnosis that's above the pay grade of people like me. Does that line about "the chances of surviving that decline are vastly improved by being in a hospital when it begins" resonate for you? And if so, why? Is the issue that they can get you on a ventilator quicker? Or that if it is caught early enough, there are other interventions (like medication) that can prevent you from needing to go on a ventilator? Not asking for professional medical advice, or course. You can just respond, if you wish, as part of the peanut gallery who knows more than the rest of us. Thanks again for putting your heart into this, PK.

You are both right. Bill Gates Is Donating $50 Million to Speed Up the Development of a Coronavirus Treatment I'll say it again. Bill Gates is a national treasure. And, like the vaccine, I'm happy to share him with the rest of the world.

COVID-19 projections assuming full social distancing through May 2020 That is perhaps already starting top happen. These are the University of Washington models that I believe are the ones Dr. Fauci and Dr. Birx were using in saying that we'd have 100,000 to 240,000 deaths. A week ago they projected about 93,000 deaths nationally in this first wave. Now it's down to about 81,000 nationally. The different in California is particularly large. A week ago, they were projecting about 5300 deaths in California by June. Now its 1783 deaths by June. When state leaders first did the lockdown in mid-March, the worst case scenario, with zero mitigation, was that about 20 million of California's 40 million residents would be infected by Summer 2020. The hour long press conference was quite artful in avoiding the word "death", let alone a projection of the number of dead. No doubt part of the goal was to avoid panic. But people got the message. Even if you take the 1 % death rate, which is wildly optimistic when hospitals are filled to capacity, it still would have meant a few hundred thousand dead Californians. I agree with you that more sickness and death also means a sicker economy. I just don't see how 20 million sick people and 200,000 dead ones in California would have been good for the economy. What public health professionals have been saying for months is that they know they have done their job well when the worst case scenario never appears. So I'm sure in California critics will say this was all hysteria, and there never really was a crisis. Hopefully, it got bad enough that most people won't be persuaded that this was all just hysteria. Particularly because this was simply Round One. Assuming those models are right, I think the ongoing debate will be about whether we can and should continue to prevent lots of deaths. This isn't just about flattening the curve and spacing out the same number of deaths more evenly. It's about a massive reduction in the number of deaths. Everybody should go to those charts above and compare New York City and Austria. If these models are right, New York state will peak this week with 878 deaths in one day. They will have over 15,000 deaths by June. Austria peaked at 22 deaths per day on March 30. By June they are projected to have a total of 385 deaths. Austria has about the same population as New York City, and about half the population of New York State. I agree with @mike carey's point that these numbers and models are different enough that it is hard to make apples to apples comparisons among nations. Their greatest value is probably in understanding trends within each nation. That said, the difference between New York City and Austria is very striking. It is difficult NOT to conclude that Austria acted much more quickly and decisively. And in doing so, they reduced the number of illnesses and hospitalizations and deaths. They also probably reduced the amount of economic damage. They are almost certain to reopen long before the United States can.

And now for an opposing point of view. When I was looking at articles about the impact of COVID-19 on the NYPD, including the growing number that are seriously ill or dead, I ran across this very moving story about the value of one human life. NYPD ‘twerk cop’ Michael Hance honored at gay officers celebration NYPD Police Officer Michael Hance died on March 12, 2017 after battling 9/11-related cancer. He gained notoriety after he was caught on camera dancing with paradegoers at the 2015 Gay Pride Parade.(Twitter) Once again, like on 9/11, New York's finest have shown that they are America's finest. Thank you to the doctors and nurses and police officers or New York City.

Exactly. God you are smart @Corporate Shill! 12 NYPD members have died from suspected cases of coronavirus and nearly 20% of its uniformed workforce is out sick Now let's do some simple math here and everybody will realize how @Corporate Shill is 100 % correct and everybody needs to step up a little bit. We are all being freaked out by needless fear which is actually a conspiracy when you think about it. We need to be way more worried about THE CONSPIRACY than about Coronavirus. So in New York state right now there are 138,836 people who tested positive for COVID-19. Only 5,489 of them have died. That is nothing. Exactly. The dead people in New York are like 10 % of flu seasons deaths. Why should anybody give a fuck? This is good for the economy! So when you actually think smart about THE CONSPIRACY like @Corporate Shill the math is pretty simple. Those 138,836 people are maybe half of all New Yorkers infected by COVID-19. Many are mildly sick or even no symptoms. Because THIS IS NOTHING and all these fear mongerers won't admit that probably at least 1 % of New Yorkers are infected and EVERYTHING IS AWESOME IN NEW YORK other than fear mongerers trying to fuck up the economy. Now do the math. If 1 % of New Yorkers are infected, the obviously good plan for the economy is to multiply that by 100. That way we have 100 % infected and we can just get on with it. Herd immunity and shit. Party and shit. So instead of 12 dead NYPD, multiply by 100 and that maybe means 1200 dead NYPD. Who gives a shit! It's good for the economy. Those are really good numbers. Better yet, if 20 % of the NYPD is out now, if we can stop being such scaredy cat wusses and get that herd immunity up from 1 % to maybe 10 % or 20 % or even 30 % we'll have like 100 % of the NYPD out or dead. That would be great for the economy! It doesn't matter if they are sick or just have an allergy maybe and are in quarantine or maybe are dead stacked up in a refrigerator truck. The important thing is that they are not working because they are sick or dead and that is good for the economy! Exactly. It is a known fact that lots of NYPD have pre-existing conditions and some of them are quite old. Now we have all been through this before. We went through this on 9/11 when we lost a lot of NYPD like in that picture above. That was good for the economy, wasn't it? Did you all notice how the Dow is more than DOUBLE where it was around 9/11 so a few dead NYPD cops was not so bad for the economy was it? A few of us that are smart are correctly worried about THE CONSPIRACY which is the real threat. But other than that 1200 dead NYPD and maybe the whole police force out with the sniffles or whatever is just no big deal and try to get this through your head: IT IS GOOD FOR THE ECONOMY! Exactly. God you are smart @Corporate Shill. Obviously these lockdowns are very bad for the economy and we'd have a much better economy with 1200 dead NYPD and the whole police work force out with the sniffles or whatever. Then business could go on as usual. Yeah maybe a few fire fighters or pizza joint workers would get sick or whatever. Maybe a doctor or two. But those are the ones with pre-existing conditions anyway we can't stop the economy just for a few fucked up people with pre-existing conditions now can we? At Risk: Pre-Existing Conditions Could Affect 1 in 2 Americans When you actually look at the actual numbers you will understand we have nothing to worry about. Nothing! God you are smart @Corporate Shill. How did you ever get to be so smart? We are lucky to have you here to point out that we need to be fighting against THE CONSPIRACY not COVID-19.

[MEDIA=twitter]1247129769705177088[/MEDIA] I posted this video in another thread already. In the last minute of it (starting at 5:20) this doctor, who is now recovering from COVID-19, talks about proning herself.

Another very moving story dealing with the impact this has on the young. This doctor says she felt like 38 going on 90. [MEDIA=twitter]1247129769705177088[/MEDIA]

Interesting data that documents the impact of social distancing and closing things down on saving lives. Your Sacrifices are Saving Lives

In addition to everything else unique about your writing skills, PK, you probably just came up the weirdest compliment any escort has ever been given. Who knew that escorts would be so much on top of things when it came to fighting COVID-19? Or perhaps you meant we had a unique ability to help you get to the bottom of things. Either way, it's a very kind thing of you to say. And since we are being honest about touchy subjects like body positions and erections, would you mind if I asked for some medical advice relating to something we are probably all thinking about? We keep being told never to put our hands on certain sensitive parts of our bodies. Because we never know what is on our fingers. So to be on the safe side, I figured that I would try to do certain activities hands free, like this: https://thumb-p8.xhcdn.com/a/CHA1DZ7B_QOvbRqikdcTmA/000/134/573/838_450.gif I'm actually finding that it is harder [sic] to do this than it used to be. Do you have any medical advice for those of us trying to be careful about use of our hands? And if push comes to shove, as it were, is it okay if we do this, as long as we wash our hands for 20 seconds afterward? https://thumb-p9.xhcdn.com/a/VRDJjcd2ZD1-nn8vJLqcUg/000/097/022/439_450.gif

This is just an addendum to my numbers rant above. NYC COVID-19 Hospitalizations Those are really grim numbers. But look at the category of Millennials. Over 25,000 cases between 18 and 44. And you can say, yeah, that many people get the flu. So what? Except usually 2214 of them don't end up in hospital beds. That's 1 in 10. Even if you look at death rates, as of yesterday it was 140 young adult deaths out of 2472. There's nothing wrong with the argument that Millennials should be careful about killing Granny. But it misses the most important points. Millennials should also be worried about feeling like shit for a few weeks, or spending a few weeks in a hospital and maybe getting stuck with an unaffordable bill - even if they do have insurance. This is also an issue for when we reopen. The idea that Millennials can all just get COVID-19 and it builds up herd immunity is just total bullshit. It is actually dangerous. It endangers a lot of Millennials, as well as everybody they are around. The family of a 34-year-old father in a 2-week coma with COVID-19 says a 'bureaucratic glitch' has kept him from accessing potentially life-saving treatment This is just one example. There are 140 dead young adults like him in New York City alone. And even if you start with the idea that it's all being blown up out of all proportion, 2214 Millennials in hospital beds in NYC is a big fucking deal. I had a long talk with my escort buddy/tenant today. He has a friend who is part of this group online that is taking pictures of hospital parking lots of emergency room entrances to document that there is really no crisis. So this women he knows well went to local hospitals yesterday and took pictures to post online to "document" that this is all exaggerated bullshit. Then she invited my buddy over to her house to sit in the back yard and drink wine. He told her he wasn't going to come over. And that it just wasn't going to be okay to talk about the weather, or how this is all made up bullshit. He is a New Yorker, so he has a lot of friends who are right in the middle of it. Honestly, I wish these reality deniers would just have nice wine socials in their backyards. Odds are one of them is an asymptomatic carrier. Odds are in a few weeks one of them will end up in a hospital bed on a ventiliator. So that might be what it takes. Let them takes pictures of the youngish woman on the ventilator, or the refrigerated truck they will stack her dead body in. Let it get that bad. Let them post all the pictures they want online. And then maybe they will take it a bit more seriously. I don't wish death on anyone. But if they want to play with death, I'm good with it. Let them do whatever they want. And if they die, that's their choice. I wish them a very happy and joyous death, which is what they seem to want. I think a lot of them actually are going to have to die before they get the message that this is not just all bullshit. I'll even throw in a case of wine. Although I will not hand it to them personally.

Is there not a shortage of masks anymore? I've not once seen toilet paper in my grocery store since this started. I would think it would be hard to get masks. And didn't we just tell Canada to go fuck themselves because of something about mask shipments? I don't disagree with your basic point. If and when we have the supply issue worked out, I think it would be good for everyone to wear a mask - if only as a symbol that we are all in this together. And for people who have to ride trains or planes and sit in enclosed spaces for an hour or several hours to get to work, the potential benefit probably goes way up. All that said, this notion that people in some states can do whatever they want because this just is not their problem is about a 1000 % bigger impediment to achieving community protection. The more people that decide that this whole community spread thing just doesn't apply to them, the more sickness and death we will have. And the longer it will take to get to a point where we can all start to reopen. It's just that simple. But I agree with your end goal. If we could get to the point where we have "only" 1000 new infections in the US per day, and we have enough masks for everyone to wear when they go out in public, we'd be in the same situation as maybe half a dozen other countries is the world that are able to start to crank their economies back up - not to 100 %, but to a lot better than the hibernation we are in now.

Ok. So let's have the truth. I don't know what you read. But the journalism I've read is very clear. 1. Wear a mask if you are sick. Although, really, you should not be in public now if you are sick. 2. Wear a mask if you are a medical professional around COVID-19 patients, or anyone who happens to be around a COVID-19 patient. I've never read anything saying that wearing a mask is a bad idea, or that it offers no protection. What I have read is very consistent with the overall tone that we are all in this together. Stay at home as much as possible. The very limited benefit of wearing a mask when you are unlikely to be exposed to COVID-19 is tiny compared to the imminent risk of a doctor or nurse who is treating a COVID-19 patient. I don't see the message as changing that much. And I don't see this as having anything to do with propaganda. I still think we have an acute mask shortage, right? I think that's at best an okay message. I think there is a better one. It goes like this: If you walk into that gym, there is a 1 in 10 chance you will end up in a hospital for a week if you happen to pick up COVID-19. You will be very sick for two weeks. You will lose tremendous amounts of muscle mass and feel like shit. And you will have some hefty hospital bills. Is that what you want? Those NYC statistics suggest that statement is true. 10 % of young adults with COVID-19 end up hospitalized. None of this is propaganda. It's a serious illness. Including for twenty-somethings. That is a fact.

Hell also hath no fury like a 25 year old yuppie on a ventilator. I'm mostly doing this bitch in the politics forum. But the apolitical version of it is this: there is no testing - none - that confirms this notion that all these 20 year olds just skated through COVID-19 without knowing it. The anecdotal evidence is the opposite. A number of 20-somethings say it is a bitch of a flu. They survive it. But it is a pain in the ass. My best guess is about 20 % of everybody who gets this virus is completely asymptomatic. And they tend to be the young ones. This notion that there are maybe millions or even tens of millions of 20-somethings with antibodies to COVID-19 because they just didn't even notice they were sick doesn't even begin to make any rational sense. Cases, Hospitalizations and Deaths Rates by Age Check out that age-based chart on case loads. You can toggle between number of cases per 100,000, number of hospitalizations, and number of deaths - based on age. I think that gives us a pretty good picture of COVID-19. If there is some huge under-representation of infections, I suspect it is among children aged 17 or lower. There are few diagnosed cases. Maybe, for some reason, they can't catch COVID-19. More likely, they have very healthy immune systems that just wipe it out quicker. If they are able to shed virus, which is likely, we have a huge problem figuring out how they go to school without being huge pipelines for transmitting the virus exponentially in Fall 2020. Once you get into adulthood, everybody is a potential victim. Granted, that graphic lumps 22 year olds in with 44 year olds. But basically that entire group is younger and healthier. So they may get diagnosed at half the rate of 75 year olds. As of today it 753 cases per 100,000 for under 35 adults, and 1262 per 100,000 for over 75 adults. So there are lots of Millennials who are sick enough to go get diagnosed, apparently. When you toggle on to hospitalizations, the differences start to emerge. One CDC study in the US showed that 20 % or so of people hospitalized were under 45 years old. The NYC data suggests people in that age group that are diagnosed have maybe a 1 in 10 chance of ending up in a hospital bed. Even if you assume it is really more like 1 in 20, when you factor in young adults who get the virus and are not diagnosed, that is still a lot of people. It's not like 30 year old bodybuilders think that they have a 1 in 20 chance of landing in a hospital every time they drive their car to the gym, or every time they work out. But now they seemingly do have a 1 in 20 chance of being hospitalized from COVID-19, if they get the virus. For 75 year olds, that NYC data suggests about half of people diagnosed end up in a hospital. The good news for young adults is that your chances of being diagnosed with COVID-19 and actually dying are maybe about 1 in 200. So I suppose you could tell a 30 year old bodybuilder, "Hey. At least its not like AIDS was in the 1980's. You're probably not gonna die." That said, 30 year old bodybuilders still have a problem. If they happen to know anybody 75 or older - like if they are a personal trainer, or a waiter, or work in a retail store, or a hospital - the 75 year old they infect has a 1 in 6 chance of dying. If I were an escort, still, I would factor in that death is never a good way to build a client base. I am being a broken record on this, because I think this mythology is actually making life harder on everybody. And that's probably especially true for any small business that, in theory, could start to reopen in June - if we got our shit together, and acted like other countries who are taking the hit all at once, and beating the virus back much more effectively. This notion that 20 somethings and 30 somethings can just breezily work their way through this is total bullshit. Even if you assume that they just have no fucking concern that they will kill Granny, or some 75 year old client if they are an escort, there are still big problems. If 5 or 10 % of them end up in hospital beds for a week or two, they are kind of fucked financially. And even if you assume only 1 in 3 get sick enough that they have to stay home in bed for a few weeks, that kind of has an impact on the workplace. And the worst part is that the other 2 in 3 who are not as sick are out getting everybody else sick. Sorry, but you just can't have gyms open and restaurants thriving in that kind of environment. Even if some countries allowed it - which they pretty much don't - people would just hide in their houses. There is no history anywhere, anytime, of people just merrily working their way through a pandemic or plague. I am not saying you are wrong that some 20 somethings have not gotten the memo yet. Seemingly, in countries like Australia and Austria, they did get the memo much quicker. If for no other reason than because they got a fine. So maybe we need to start doing that here. Or maybe everybody who is 25 or 35 needs to know somebody who spent a week in a hospital, and now has a $5000 or $10,000 bill just from co-pays and deductibles.

Coronavirus death toll: Americans are almost certainly dying of covid-19 but being left out of the official count There is a counting problem. You describe it, accurately, both ways. In some cases, there is an overcount. In other cases, there is an undercount. Most likely, the academic issue is that there is a large undercount. In order to die of COVID-19 in the US, you have to test positive. Once you test positive, you can have a debate about whether it was the heart condition or COVID-19 that killed you. The answer is probably, "Both". But many people who die with COVID-19 without being tested will be undercounted. What is most amazing about this is the utter lack of pragmatism. A lot of the ways we are dealing with this does suggest that somehow ideology has infected people's brains. In this case, it is pragmatic to not be particularly concerned about knowing the exact cause of death. If you are dead, you are dead. The pragmatic thing, as people in that article above say, is to use test kits to diagnose people who are living, so that we can prevent death and prevent the spread of infection. That should be the priority, obviously. It is inconceivable to me that over three months after the HHS Director and CDC Director had a private conversation (in early January) saying this was a "very big deal", we still have zero random testing in the US, as far as I can tell. Data that we do have, from South Korea and India, suggest that maybe 20 or 30 % of infections are diagnosed when they are asymptomatic. It would help to know if those numbers are in the ballpark of correct. And what kind of characteristics these asymptomatic people have. How many remain asymptomatic? How many become symptomatic a few days after they are tested? In lieu of actual information, people are wisely guessing that the asymptomatics are probably likely to be the 20ish Spring Breaker types, or the college students who work in nursing homes. It isn't their fault that they are shedding a virus that they don't know they are infected by. But how is it possible, three months into a pandemic, that we still don't have very practical information like this? Small Businesses Are Almost Out Of Time, And It Matters To All Of Us Here's another one that seems almost inconceivable to me, in a country that prides itself on boot strap pragmatism. How is it possible to think that small businesses thrive during pandemics? And that what really hurts small businesses is steps to prevent death and sickness during a pandemic? How is it possible that pragmatic people could actually think that way? A few nights ago I got dinner from my favorite take out pizza place, where I usually order maybe once a month. I actually debated where it was safe to do that for an uncomfortably long time. I felt like a wuss for debating whether it was safe to go order a fucking pizza. This is a small take-out only place with no tables and maybe half a dozen chairs to wait. It is a non-branded, family-owned business. The husband and wife who own it are almost always the ones who work the register. I had assumed their business would be booming. They are tailor made for people who need take out food during a pandemic. So I was surprised when the woman co-owner told me business is about 50 % of normal. She said that was an improvement. Because when the lock down order in California first happened, in mid-March, business was about 25 % of usual. So I have to assume that I am not unique, and most people are thinking like me: Is it really worth touching the cardboard box the pizza was put in? Is it really worth being in a small space with other people who make contact with lots of people every day? For whatever reason, business is down by 50 % to 75 %. And I have to believe it is because people are just scared of going out, even to simply buy and bring home a pizza. The place I get my hair cut is across the street from the pizza joint, in a little strip mall. It is closed. But even before it closed, in early March, I debated whether to go get my hair cut. I just decided I wasn't going to. The woman who cuts my hair is a Mexican American immigrant who lives in my neighborhood. The owner is an Asian American immigrant. So pretty much everybody who works there is either first generation immigrant American, or a Gay man, as far as I can tell. So now they have no job-related income. But even if they were open (in Arizona hair salons are deemed "essential") business would still be down 50 % to 75 %, probably. About a year ago, my hair stylist, Alicia, was clearly fighting a "thing" and coughing while she cut my hair. She said it was an allergy. I just consoled her, and hoped I didn't get sick a few days later. I didn't. But I would not take the risk of the same thing happening today with COVID-19. And the bitch of this disease is that she could be sick and shedding virus on me without even knowing it. I live in Riverside County, California, which is the 4th largest county in my state. My county is one of the reasons that infections are going up in California. The urban areas that locked down first are where the infections now seem to be spreading at the slowest rate. In other parts of the state, which feel "safe", the infections are growing at a quicker rate. I haven't kept track, but I think a few weeks ago, when the lock downs started, there were about 50 COVID-19 cases in Riverside County. Now there are 665, which is more than in the City of San Francisco. Riverside County has more than double the population of San Francisco. So there is still a slightly lower infection rate per capita here. But it is still growing in both places, albeit at lower numbers and at a much slower rate than in many other places. It just defies reason to think that if we had 250,000 COVID-19 cases in Riverside County (10 % of the county population), somehow the economy would be working much better. And somehow small businesses would be in better shape. If people like me are choosing not to get their hair cut or go get a pizza when there are 50 or 500 cases, which is like 0.002 % of the county population, I doubt we'd be more likely to patronize a small business if there were 250,000 cases. And yet, if we let the pandemic run wild, we know for a fact that it would only take a month or so of exponential growth to get to that level. Do the math. Double 500 every three days, which is about the rate this virus grows at unchecked, and it take about 28 days to go from 500 cases to 250,000 cases. If Riverside County is 1/20th as smart as South Korea, we ought to be able to get the number of cases back down to 50 a day. And we ought to be able to keep it that way through testing and contact tracing. South Korea has a population twenty times the size of Riverside County. Somehow, they are able to keep it down to 100 cases a day, and still have the majority of businesses and restaurants open. If the idea is to help most small businesses survive, something like that has to be the pragmatic goal. What amazes me is the utter lack of pragmatism among people who really do seem to think that 250,000 sick people, maybe 50,000 of whom are in hospitals, is a good way to help small businesses and keep the economy going. Even if you assume not one of those small business owners or their employees will get sick, or require hospitalization, the idea just makes no sense. I'd call it cowboy capitalism, but it is too kind to refer to this kind of behavior as "capitalism". I think a better word for it is cowboy craziness. I think people in Japan and South Korea and Australia and Taiwan and Austria and Hong Kong probably do enjoy watching Westerns. Fortunately for them, they don't seem to want to act like cowboys when it comes to actually containing a pandemic. Americans seem to think if we just put on a mask and go to work, everything will be just fine.

Idaho’s Blaine County has more coronavirus cases per capita than Italy and New York City Idaho is shaping up to be a sort of Death Capitol of rural America. As that article explains, it is not quite rural. The characteristics that are leading to a high rate of infection are Sun Valley, lots of recreational tourism, and affluent people with second homes. I think this is actually a perfect metaphor for all these arguments about health versus wealth. The best way to shred wealth with incredible speed is turning out to be ignoring the fact that you have a deadly pandemic. It has now absolutely guaranteed that Sun Valley is dead, dead, dead, dead, dead an an economic factor in the Idaho economy. People don't want to die. So they will just stay away from Sun Valley for a long time. That's just based on normal human behavior. People will just avoid it like the plague. Granted, Sun Valley would have been fucked if it had gotten ahead of the curve and shut down in February. That could have cut the infection rate by 90 % or so, probably. If they has started in February and had really effective testing and tracing, they probably could be down to few or even no new cases by now. They have a population of a little over 20,000 people, and 400 COVID-19 cases. San Francisco has a population of close to 1 million, and 568 COVID-19 cases. The tourism industry in San Francisco and Sun Valley are both going to be crippled for a very long time. But I'm pretty sure that San Francisco will recover much more quickly. Of course, SF has a much smaller percentage of their economy that is based on tourism. But even people who live in SF need to feel like they are safe to go outside and go to work. If anyone still thinks that the economy of Sun Valley would be better if they just stayed open and had 4000 or 10,000 or 15,000 cases, you might want to check in with the people who are actually going to have to live through this for a very long time.

The US numbers show that. There's no longer any question, as long as you base your thinking on facts. We are already the national poster child for how to maximize death, maximize suffering, and maximize economic loss. So I've just accepted that. In the future, people all over the world will always look to the US as an example of how you just fuck this up super bad and kill as many of your own people as possible. Our stock market plummeted three times lower than China's. So it is just locked and loaded that our stock market will be hurt more than China's will, for much longer than China's will. All because of people who insist that the best way to save the US stock market is to assume that life can pretty much stay normal during a pandemic. And it seems like the idea now is that tens of thousands of new cases a day is insufficient. We probably need to have hundreds of thousands of new cases every day before people go, "Oh. Wow. Look at that. Lots more people are dying. Maybe we should try Plan B." Daily New Cases in the United States The US stands out for several reasons. First, the absolute number of new cases a day is off the charts. About 35,000 a day, and growing every day. There is no indication we are starting to plateau, like Italy or Spain, let alone decrease the daily growth in the number of people infected. China, at peak, had maybe 2000 or 3000 or 4000 new cases a day. That's because they did a coordinated and leak-free national shut down. In the US, people are saying that individual liberty is more important. So why would you stop an American from exercising her God given right to spend a few months slowly dying in a hospital bed from an untreatable virus? So we'll have hundreds of thousands of deaths, for sure. We'll drag this out longer than most other countries, for sure. At this point I've just resolved myself to the idea that we have to wait until more and more people notice how many Americans are sick and dying. We've already surpassed the death toll of every war American war fought in the 21st century. By the end of April, we should have beaten the death toll for every war going back to and including Vietnam. I'm guessing maybe that's what it will take for the light bulb to go off. At some point a critical mass of people will start to think, "Geez. Maybe this idea of trying to keep life normal during a pandemic just doesn't work out so well." Daily New Cases in Australia Daily New Cases in Austria Compare the way lock downs have worked in Australia and Austria. Outside of the East Asian countries, they are the two "Western" nations that are doing the best. In both cases, they have dramatically reduced the number of new cases. Australia's population is about 25 % bigger than New York. Austria's population is comparable to New Jersey's. I'm not 100 % sure what they did differently. But this is definitely a discussion Americans should be having. Unless you are super committed to the idea that 1 million dead Americans is way better than 100,000 dead Americans. Anyone who sees this as a really great opportunity to cull the herd should be very happy with the way things are going. Anybody else, maybe this is some good food for thought. I think there are at least two things Austria and Australia did that have worked. First, they acted immediately and urgently. As a very long and informative article @mike carey posted noted, Australia spent a little bit of time dithering with this, while people packed Bondi Beach. But then within a matter of a few days they moved to immediate and fierce nationwide lock down. From what I can tell, the tone in Australia is very sober and realistic. They are saying that people should just forget about international tourism, forget about packed stadiums, forget about a lot of things that used to be normal .............. for six months, one year, two years. Deal with the new reality, because that's what it is going to take to start to work out how we can gradually and carefully reopen things. Austria has done a similar thing, I think. If you go back a few weeks, the tone was very harsh. Thousands of people were being fined for violating very strict social distancing rules. The basic message, loud and clear, was STAY THE FUCK HOME. Auf Deutsch, of course. (Imagine Samuel L. Jackson's rant in German!) Austria Opens the Door to Easing Lockdown After Containing Virus This has nothing to do with politics. At this point, it seems so obvious that I think it is fair to say it simply has to do with common sense. You have to really work hard not to see that the countries and states that moved the quickest and the harshest are the ones that will be able to gradually think about getting their economy slowly started again. Bill Gates is dead right. And unfortunately, "dead" right means exactly that. If we ignore him, it just means deeper economic pain and more death.

I thought that was an interesting graphic on the number of traffic fatalities in the US, both as an absolute number and as a function of all vehicle miles traveled. People have said we don't ban cars because of car crashes, so why all this overreaction with COVID-19? Those numbers put the number of deaths in context. First, there were about 38,000 traffic deaths a year in the US at last count. If that suddenly jumped to 100,000 to 240,000 deaths, the "realistic" estimate for a first wave of COVID-19 deaths, that would certainly get people's attention. The number of traffic deaths are actually comparable to the number of seasonal flu deaths in a worse than average year. Second, 1 or 2 or 3 million deaths - meaning 25 % or 50 % or 100 % of Americans get infected and we have"only" a 1 % death rate - would be off the charts. If you assume all Americans get infected, or half of us do and we have a 2 % death rate (which is modest compared to what is happening in many countries) that is 3 million deaths, or about 100 times the number of annual traffic deaths in the US. Going for herd immunity that way, rather than a vaccine, is equivalent to driving a car into a brick wall at 100 miles an hour to see what happens. Go ahead, Shill. Be my guest. It's a free country. Give it a try and get back to us on how well it worked out, okay? Third, to say "well, we don't ban cars" because of car crashes would be equivalent to saying "well, we don't ban human relationships" because of COVID-19. Both those statements are true. Dying in a car crash does have something to do with driving a car. Dying from COVID-19 has something to do with being physically close to other human beings. Both are things people like to do. So the real issue isn't about banning anything. It's about regulating how we do things that they are safer. Fourth, the amount of regulation and investment that went into achieving the constantly declining traffic mortality rate is huge. There are the obvious things - like having speed limits, traffic lights, driving tests, penalties, campaigns against drunk driving. Then there are the countless investments we don't even notice: paved roads, median lines, barriers in between traffic lanes, speed bumps, roundabouts. The Economist ran an article several months ago about the huge number of unnecessary deaths in "middle income" countries like Thailand. Poor countries don't have cars and paved roads. Rich countries spend a huge amount on paved roads and physical things that improve traffic safety. The in between countries that have fast cars (and motorcycles) without the money to make things safe have as much as five times as much traffic deaths, relative to their population. As Bill Gates keeps saying, something similar is likely to happen due to COVID-19 in both middle income and poor countries, due to the fact that they have less money for medical and hospital care. Fourth, part of the shock of COVID-19 is that we have to spend all the money we spent on traffic century over the course of a century all at once. That's an exaggeration, of course. Part of why the US and Italy are "better off" is that we have spent enormous amounts on a good hospital system many other countries don't have. That said, we have completely underinvested in preparing for a pandemic. It's understandable, because we do drive cars every day. We only have pandemics this deadly once or twice a century or so. But we are having to play catch up in a way we don't have to with traffic safety. That's a lesson moving forward. No one alive today will ever forget this one as long as they are alive. In the future, we'll invest in vaccines and prevention the same way we do in traffic safety. The analogy I can think of to really equate traffic safety to COVID-19 would be something like this. Imagine that all cars is the US were driverless. And imagine somebody hacked the system so that instead of being very safe, cars just started constantly crashing into each other at 60 miles an hour. Imagine hospitals being filled to capacity with the dead and dying from car crashes. Imagine people suddenly being afraid to get into cars that used to be safe, but now seemed totally out of control. It's not the best hypothetical. But it is in the ballpark of what is happening. People would pretty quickly decide to stop getting in cars until we figured out what we going on. And that would have a huge impact on our economy, too. But in a hypothetical like that, a similar reaction would happen. Not because people don't give a shit about their lives, and traffic safety. It would happen because people obviously do give a shit about their lives, and traffic safety. We've spent a fortune on making it much safer to drive (and fly in airplanes.) And, mostly, we have been very successful.