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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsIs our fight against Corona Virus worse than the disease itself
We routinely differentiate between two kinds of military action: the inevitable carnage and collateral damage of diffuse hostilities, and the precision of a surgical strike, methodically targeted to the sources of our particular peril. The latter, when executed well, minimizes resources and unintended consequences alike.
As we battle the coronavirus pandemic, and heads of state declare that we are at war with this contagion, the same dichotomy applies. This can be open war, with all the fallout that portends, or it could be something more surgical. The United States and much of the world so far have gone in for the former. I write now with a sense of urgency to make sure we consider the surgical approach, while there is still time.
Outbreaks tend to be isolated when pathogens move through water or food, and of greater scope when they travel by widespread vectors like fleas, mosquitoes or the air itself. Like the coronavirus pandemic, the infamous flu pandemic of 1918 was caused by viral particles transmitted by coughing and sneezing. Pandemics occur when an entire population is vulnerable that is, not immune to a given pathogen capable of efficiently spreading itself.
Immunity occurs when our immune system has developed antibodies against a germ, either naturally or as a result of a vaccine, and is fully prepared should exposure recur. The immune system response is so robust that the invading germ is eradicated before symptomatic disease can develop.Importantly, that robust immune response also prevents transmission. If a germ cant secure its hold on your body, your body no longer serves as a vector to send it forward to the next potential host. This is true even if that next person is not yet immune. When enough of us represent such dead ends for viral transmission, spread through the population is blunted, and eventually terminated. This is called herd immunity.
[link:https://www.nytimes.com/2020/03/20/opinion/coronavirus-pandemic-social-distancing.html#click=https://t.co/0xebkqm2JV]
jberryhill
(62,444 posts)...its not a good idea to copy NYTimes content wholesale for reposting here.
SDANation
(419 posts)jberryhill
(62,444 posts)One of the site rules is:
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SDANation
(419 posts)yonder
(9,669 posts)Iggo
(47,564 posts)Aquaria
(1,076 posts)Is for the articles that are 20 short sentences as paragraphs, when the content would otherwise be three paragraphs.
Journalists seem to have forgotten how to construct a proper paragraph, but that's what happens when you fire the copy editors.
TheFarseer
(9,323 posts)Everything we are trying to do with shutdowns, quarantines can be undone by someone going to the grocery store or what have you and not being careful, not being sanitary, coughing all over and touching everything. It only takes a few people to fuck up everything. Then this just circulates slowly and most people still gets it, it just takes forever. Or maybe Im still pissed off about no sports and no one should listen to me! Im not even sure myself!
Phoenix61
(17,015 posts)people from eventually getting covid. Its to slow the numbers down so medical/hospital care will be available for those who need it.
But like in the article could be doing more harm than good. Exposing vulnerable populations in the home
jcgoldie
(11,639 posts)People staying apart does not do more harm than good when theres a disease rampant thats magnitudes more contagious than the flu. Why are you posting this fucking bullshit here?
SDANation
(419 posts)jcgoldie
(11,639 posts)Try again.
SDANation
(419 posts)Its shared by many epidemiologists and MDs who have spent their entire careers studying virology and vaccine science, including Dr Paul Offit. A man who has spent decades developing vaccines and research the spread of disease.
LanternWaste
(37,748 posts)And now this...
Quite a narrative you draw.
jcgoldie
(11,639 posts)The point of social distancing is that everyone doesn't get it immediately and overwhelm the heath care system and resources we have.
pat_k
(9,313 posts)... can in keep transmission level so low that, rather than increasing, the number of new cases decreases and a large percentage avoid getting it altogether.
It is NOT inevitable that 60% (or whatever percent) will ultimately end up infected and we are just "flattening the curve." We may see very different progression in different regions.
The worse case scenario models are not the only models.
babylonsister
(171,079 posts)Demonaut
(8,924 posts)elleng
(131,076 posts)David L. Katz
Dr. Katz is president of True Health Initiative and the founding director of the Yale-Griffin Prevention Research Center.
Might be 'better' if we had methods to 'isolate' hot spots, but without testing, not so easy.
pat_k
(9,313 posts)Clearly seen with a look at the numbers per capita within NYC vs. outside NYC.
It seems to me that logic would dictate that this would hold for other metro areas with high density. With lack of testing in CA, we can only assume that incidence per capita in the Los Angeles and San Francisco metro areas will be akin to NYC (i.e. more difficult to contain) than in lower density areas.
Perhaps it's too draconian, but limiting travel to/from metropolitan areas could be a way to accomplish one type of "hotspot" isolation and containment -- even in absence of testing data as evidence of increased incidence. If I were "in charge" I would advocate starting with boundaries defined by the Metropolitan Statistical Areas defined by the OMB. There are 392 of them.
Perhaps that is not the way to go, but if we really want to contain as far as possible, at some point, I think we will need to limit travel within the US in some way.
All that said, to the original post: Katz seems to have some notion that the most vulnerable can somehow be protected while the "low risk" go about their business. I can't see how that would be possible. (See post 54)
The Magistrate
(95,252 posts)Most of what is being done is aimed at buying time for researchers and scientists to work on developing anti-virals and vaccines effective against the ailment, in the hope they may achieve this before the bodies pile up too high.
SDANation
(419 posts)or more. We just dont have the time. Im a huge vaccine advocate but I sure as hell am not accepting a vaccine with less than a year of research.
The Magistrate
(95,252 posts)Holding actions often are desperate affairs. It may prove possible to contrive effective anti-viral drugs more speedily, the tools available to researchers worldwide are much more powerful than even a decade ago. This class of virus has been subject of a good deal of research already, as there have been two quite lethal outbreaks by viruses in the 'family'. Be sure I am not talking about things like synthetic quinine and the like. Slowing the rate of new infections may well save a number of lives, by reducing the strain on medical facilities and staff.
pat_k
(9,313 posts)... and using it to treat new, moderate to severe, cases (article)
Yes, getting recovered donors is job one. Testing to confirm COVID-19 is critical, so we know who actually had it and has recovered and could be a potential donor. Better testing for antibodies too.
Producing plasma products is a very expensive affair, but so is treatment. If treatment with plasma cuts hospital stays in half and saves lives, it may end up "cheaper" than the cost of the extra days that would be spent in hospital without such treatment.
Anyway, just wanted to point out that its is not just vaccines that could turn the tide.
The Magistrate
(95,252 posts)Seems to be dead or weakened viral material is no longer always necessary. It is possible to produce portions of the viral shell artificially, those which latch onto a living cell. This seems sufficient to provoke an antibody response, but at no point does the genetic material the virus feature in the potion. There would be no risk of taking the disease from such a vaccine, the questions would be those of its efficacy, in the main.
SDANation
(419 posts)I have no fear of falling ill from a covid vaccine, I do have fear though of long term side effect from a rushed vaccine. All of our vaccine readily given to our children and ourselves have gone through countless years of research and trials to get to the stage they could be given safely and remain highly effective. Right now, rushing past the the normal vaccine stages, by passing safety to assuage fear is terrifying. We are literally skipping years of animal trials and clinical trials to just get a vaccine.
The Magistrate
(95,252 posts)There is no room to doubt the situation is dire all over the world.
pat_k
(9,313 posts)jberryhill
(62,444 posts)magicarpet
(14,160 posts)WHO launches global megatrial of the four most promising coronavirus treatments [View all]
A drug combo already used against HIV. A malaria treatment first tested during World War II. A new antiviral whose promise against Ebola fizzled last year.
Could any of these drugs hold the key to saving COVID-19 patients from serious harm or death? On Friday, the World Health Organization (WHO) announced a large global trial, called SOLIDARITY, to find out if any can treat infections with the new coronavirus for the dangerous respiratory disease. Its an unprecedented effortan all-out, coordinated push to collect robust scientific data rapidly during a pandemic. The study, which could include many thousands of patients in dozens of countries, has been designed to be as simple as possible so that even hospitals overwhelmed by an onslaught of COVID-19 patients can participate.
https://www.sciencemag.org/news/2020/03/who-launches-global-megatrial-four-most-promising-coronavirus-treatments
tenderfoot
(8,438 posts)Haven't seen you in a dog's age.
LizBeth
(9,952 posts)dying from the flu. I hear it is the inside of the lungs being sliced, or feeling like being cut by glass. I am a 58 yr old woman. I prefer to take it seriously and will self isolate.
SDANation
(419 posts)jcgoldie
(11,639 posts)Wake up.
SDANation
(419 posts)Its not killing children or many young in general
jcgoldie
(11,639 posts)Not good at math huh?
SDANation
(419 posts)I never said it wasnt concerning. We dont know thats the true rate because there are probably hundreds of thousands walking around with it who are assymptomatic
Response to SDANation (Reply #34)
jcgoldie This message was self-deleted by its author.
The Magistrate
(95,252 posts)Surely you are not going to start the 'it's no worse than flu' wheeze?
SDANation
(419 posts)Im just saying this is a disease that so far, and I mean so far, has not shown to be as deadly as the flu across all age groups. The flu primarily kills the old and those with pre existing conditions. So does covid. But covid does not kill children or the young an healthy as is the flu does. When anyone gets the flu, you feel horrible. Youre gonna be symptomatic. Covid, thousand of cases of people who are symptomatic.
The Magistrate
(95,252 posts)A good many people, especially young and prime age adults, are quite capable of brushing off symptoms and carrying on through flu. The corvid-19 does indeed kill healthy younger adults, though at a far lesser rate than it does the elderly. The problem is that even that lesser rate, given how widely and rapidly a virulence spreads in a naive population, works up to a serious number. One of the reasons younger people do not come to much harm from flu is that when flu becomes serious, there are treatments for it which are more than palliative care, which is pretty much all that can be offered anyone, of any age, afflicted with the corvid-19.
blitzen
(4,572 posts)CountAllVotes
(20,878 posts)That is what the local paper wrote past week.
Two old and one with a chronic condition is what it said -- last to receive care due to only two ventilators and no PPE.
Genocide IMO!
and yes I am freaking out and yes I am and no I really don't care to die right now if I can avoid and no dump is not a leader, dump is a criminal that is killing people off as I type and he is making me quite sick!
Turin_C3PO
(14,033 posts)Look at Italy. 793 dead in one day yesterday.
Has the 2nd oldest population in the world. Where are you seeing the death? In the sparsely populated north. You arent seeing Rome get hammered. My guess is Italy is getting hit exceptionally hard due to population age and culture. Great article is you got a chance to read it:
http://www.google.com/amp/s/www.telegraph.co.uk/global-health/science-and-disease/have-many-coronavirus-patients-died-italy/amp/
LizBeth
(9,952 posts)Why even argue this? I do not remember any day of last year, during flu season, in Italy with the second oldest population having 793 die in one day. You?
John Fante
(3,479 posts)Just imagine what the numbers would look llke if they had continued like nothing was amiss. They'd be closing in on 100k dead easy.
SDANation
(419 posts)50-64 year olds: 6751 deaths
65+: 50,903 deaths
In the US alone
blitzen
(4,572 posts)Some of these deaths are worse than anything in a horror film.
https://www.propublica.org/article/a-medical-worker-describes--terrifying-lung-failure-from-covid19-even-in-his-young-patients
Turin_C3PO
(14,033 posts)well have a million deaths from corona virus, many orders of magnitude worse than the flu.
lapfog_1
(29,219 posts)hopefully you don't have children... so we can award you a Darwin if you happen to be one of the unlucky ones.
Oh, and try NOT to interact with anyone else on your way out. The rest of us would like to live.
Seriously... if we just let the pandemic run through the entire population on the planet, up to 10% might die (assume 20% get serious courses of the disease, fully 50% of that number do not have good outcomes without some sort of medical support... these are the numbers coming out of Italy now, where they DO test extensively).
Yes, this does disproportionately affect older adults, especially men with pre-existing conditions, but that doesn't mean if you are under 50 that you are immune.
But we should fight this as humans, all of us together.
LizBeth
(9,952 posts)SidDithers
(44,228 posts)South Korea had 104 deaths out of 8897 confirmed cases.
That's a 1.16% mortality rate. And he's saying that 99% of South Korea's cases are mild?
Those numbers don't make sense.
Sid
mr_lebowski
(33,643 posts)enki23
(7,789 posts).
KY_EnviroGuy
(14,494 posts)Article titles can even present dog-whistle dangers. I don't think we need a public attitude of "bring it on".
Reading this, one might dare get comfort from thinking this thing will gently disappear as herd immunity slips into the populace. The problem with that thinking is that epidemiologists tell us we never know the degree of herd immunity until the deed is done. So, we may not want to simply abandon all caution, let it run its course and see what happens because that recklessness could kill half the population in doing our little experiment. In addition, they tell us immunity effectiveness varies significantly between cultures and races around the globe.
The articles I've read by professionals simply say they believe this virus will eventually produce a degree of immunity in the general population but they cannot guarantee it, nor can they say how effective that may be. That's why they call it a "novel" virus because it is mostly unknown and had no track record.
Therefore, there seems to be consensus that we should test as much as possible so we better understand this outbreak and to work very hard to flatten the infection rate curve to minimize deaths and to improve the recovery quality of those who survive.
(*) Was not able to read the entire article as it requires log-in to NYT.
KY..........
pat_k
(9,313 posts).. that it is possible to "surgically" protect the most vulnerable while "the rest of us" get on with our lives and develop herd immunity.
I can't imagine what he could possibly be envisioning (more in post below.)
KY_EnviroGuy
(14,494 posts)We have no way to know ahead that it would work because there's no data on long-term effects from being infected (pulmonary, cardiac, etc.).
And, again we have no guarantee that effective herd immunity will develop.
This has the distinct odor of a right-wingism, set out to keep businesses open.
Being a very worried 72 YO male, I vote for the more cautious approach......
pat_k
(9,313 posts)... right-wingnut stuff too. However, when I poked around I found he appears to be an integrative medicine advocate with no particular political affiliation.
His main thing is self-promotion. For example, he wrote a Sci Fi book and then wrote a couple good reviews of it on HuffPo that were deleted because HuffPo became aware the reviews were from the author. (Wikipedia ref)
Apparently, he subscribes to the "there is no crime if you don't get caught" school of thought so many right-wingnuts subscribe to, but, at least to date, he hasn't been out there advocating standard right-wingnut talking points. (I wouldn't be the least surprised to hear reports that he had tho.)
Whatever this guy may be "up to," and however he may have gotten to the NY Times editorial page, the content of the piece offers nothing useful, as far as I can tell. My reasons for this conclusion are in other posts to this thread.
Like you, I'm afraid. It's pretty simple. I'm one of those multi-generation family units. Mine is composed of:
Me: 60, under RA treatment that suppresses immunity
Mom: 83, generally in good health but weighs under 90 lbs and seems to me to be very fragile
Mom's husband: 79, survivor of Amyloidosis that damaged organs.
Of course, I am doing all I can not to endanger my mom or her husband, I work remotely. I'm minimizing shopping with planning (tough because it's my habit to come up with, and pick up, stuff for the next day on my way home.).
Despite keeping "outside" contact to the bare minimum and washing my hands, face, and glasses several times a day, I have this horrible feeling I'm incubating the virus and have already passed it along. I stop these thoughts. They have no basis n current reality but keep popping up. I'm sure I'm one of more than 100 million doing the same thing... being periodically overcome by fear, but mainly just managing day-to-day stuff, keeping going, and staying ready for what may come as far as I am able.
KY_EnviroGuy
(14,494 posts)You have three lives to protect, all at high risk. I'm the only one here at 72 and high risk but my son lives here too and is pretty conscientious so far. It's those little careless slips that can get us, though. Thank goodness his college has switched to on-line classes although he missed the classroom experience.
My daughter the 5th grade school teacher with our 13 YO granddaughter is my most worrying, as I'm not convinced the SIL will be careful enough. Thank goodness schools are closed.
I just flat-out told both my kids if the virus comes into my house, I'll likely not survive. Too many lung and heart risks.
I see your big secondary challenge is keeping you and your family members from needed care for other health issues such as falls, or the flu. Please tell all to be very careful all day, every day to avoid hospital or doctor's office trips.
Thanks for the info on that author. I suspect he's a right-wing shill or simply not conscious of the danger of dog-whistle statements that our public takes seriously and may become lax in their behavior. He's also echoing what Trump has been suggesting.
KY.............
blitzen
(4,572 posts)the severe lack of hospital capacity or the utter horror of some of these deaths. To say that it is grim is an understatement:
https://www.propublica.org/article/a-medical-worker-describes--terrifying-lung-failure-from-covid19-even-in-his-young-patients
pat_k
(9,313 posts)Last edited Mon Mar 23, 2020, 03:02 AM - Edit history (6)
I have no idea what he thinks he is proposing. The article is incredibly vague.
If he has some vision of how to isolate and protect the vulnerable while allowing the virus free reign among the so-called "low risk," great. I wish he would describe it because I see no practical way of accomplishing his so-called "surgical" approach.
For example, how does a multi-generational family protect the vulnerable while allowing the "low risk" members to carry on as usual and get infected, or not, as they develop herd immunity?
I don't know about other people's experience, but my experience is that there are a lot more households with multiple generations living together in high density areas, where incidence is likely to be the highest, and where everyone should be following precautions to the letter to limit spread.
I've lived in, and visited friends in, buildings and walk ups in high density areas. If I can smell the smoke from a neighbor's cigarette, you can bet I am not "isolated" from virus laden droplets circulating in the air. How do you protect and isolate the vulnerable in such a building? The only way is for everyone in the building to do their best to minimize exposure and incidence within the building.
Does anyone else have a clue what he is actually proposing as the "surgical" approach??? (Maybe ship all the old folks along with other high risk people to tent cities in Wyoming or something?)
I'm not familiar with David Katz, but it sounds like from his credentials he should know better.
Crunchy Frog
(26,619 posts)I'd be willing to bet that the groups he's associated with are actually right wing think tanks.
Response to SDANation (Original post)
diva77 This message was self-deleted by its author.
Baclava
(12,047 posts)LisaL
(44,974 posts)we should protect the most vulnerable while allowing others to go on with their lives. How exactly do we protect those most vulnerable is unclear since they don't live in a vacuum.
Generic Other
(28,979 posts)Wherever it comes from. Thanks. Goodbye.
KewlKat
(5,624 posts)healthcare system? Well all get it at some point unless a vaccine is developed but by staying at home we slow the rate of infection to hopefully a manageable rate for the hospitals, staff and supplies.
As for me, if I must return to work rather than work from home I will retire then. My spouse is nearly 74, has Parkinsons, T2D and a heart that doesnt function well. I will not risk him getting infected thru me. Im praying I can keep him safe until they can vaccinate...I know, its a long shot, but thats my goal.
Drumpf is incompetent and we must vote him out in November.
Crunchy Frog
(26,619 posts)I have to wonder about both the writer and the poster who is apparently a medic in an er currently caring for older covid patients.