477 thoughts on “Politics open thread, November 15-21

  1. “What is your goal? I can’t see anything other than maximizing the number of deaths before the vaccine arrives. Is that what you want? I haven’t see you incorporate the vaccine into your worldview at all.”

    The vaccine does not yet exist; therefore, we can’t take it into account when making decisions right now.
    I can turn the question around — what is YOUR goal? I can’t see anything other than minimizing COVID cases (not necessarily deaths) indefinitely. For at least a year, likely much more, before the necessary number of people in the world get a safe and effective vaccine.
    My goal is to maximize public health, which requires an evaluation of the costs of mitigation efforts as compared with their benefits.

  2. The vaccine does not yet exist; therefore, we can’t take it into account when making decisions right now.

    I does exist. What an oddly stupid thing to say.

  3. A number of vaccines are in clinical trials.
    Until one is approved, it doesn’t exist. It’s just a hypothetical vaccine.
    And now Fauci says that people should still wear masks and socially distance even AFTER getting the vaccine. Is it any wonder that many people have decided to make their own decisions?

  4. On the idea that NZ has an “outbreak” – we currently have 58 cases, of which 53 were people in managed isolation who brought it from another country, mostly the USA (#thanksamerica). I’m not sure that reaches the level of “outbreak”. In the middle of this “outbreak”, I just dropped my kids off to ride a crowded bus to go to f2f school, like they have been doing every day since May.

  5. I agree with Scarlett that there is no use acting as if there is a vaccine until one has been proven effective and made widely available.

  6. I agree with Scarlett that there is no use acting as if there is a vaccine until one has been proven effective and made widely available.

    So you think we should let er rip, no masks, no lockdowns because this is the new normal and there is no hope? Or should we try our best, over the next several month, to limit spread so as few people die as possible until the vaccine is ready?

  7. Rhett, obviously, we need to do all we can to stop this thing without pretending that hope is coming any minute. All signs are that in a few months, there will be a vaccine available to the wealthy in the US. That is nowhere near sufficient to deal with the virus. As I said earlier, I am dismayed to see the extent to which the US seems to be banking on a vaccine, and expecting it to be distributed by the marketplace, instead of where it will do the most good.

  8. If everyone was going to get a vaccine tomorrow, we could party like it’s 1999 (boy, did Prince call that one wrong–he had no clue of the panic of Y2K). But as it is, it is dangerous for people to be putting themselves and others at risk.

  9. Rhett, obviously, we need to do all we can to stop this thing without pretending that hope is coming any minute.

    So you don’t think light at the end of the tunnel will help motivate people to stay the course just a bit longer?

  10. Ganz im Gegenteil. Seems to me that people in the US are hanging their hopes on a vaccine, so they figure the rest doesn’t really matter–be as irresponsible as you want, the vaccine will come save us anyway. (As I posted earlier, there is some sneakiness going on here too–they just don’t seem to think a vaccine will provide salvation. More likely they assume their “little” private affair won’t cause a problem anyway.)

  11. Seems to me that people in the US are hanging their hopes on a vaccine, so they figure the rest doesn’t really matter–be as irresponsible as you want, the vaccine will come save us anyway.

    My impression is the exact opposite. The ones who think this is the new normal and nothing can be done are the ones arguing for a let er rip policy.

  12. So you’re saying “ The ones who think this is the new normal and nothing can be done ” don’t think a vaccine is possible?

  13. This article brought up several of the points that Scarlett and Milo have made in the past week or so.

  14. “Highly educated” vs “less educated?” Does that mean if we just sent the “less educated” back to school we’d solve the problem? Or are they really not taking about education levels?

  15. “Seems to me that people in the US are hanging their hopes on a vaccine, so they figure the rest doesn’t really matter”

    I don’t get that sense at all. I don’t know anyone that is seriously thinking a vaccine is going to be the end of this. It does seem that most people think the vaccine will be great for healthcare workers, but everyone else will need to mask up, social distance. The non-mask wearers I know think that eventually the coronavirus will run its course.

  16. Update on another vaccine:

    When I think of all the needless deaths caused by those who advocated doing nothing, it’s staggering. This too shall pass.

  17. “I don’t know anyone that is seriously thinking a vaccine is going to be the end of this.”

    If the data holds up and the vaccines have decent durability, I think it will mostly be the end of this. At least from a practical perspective. It is always going to circulate, but it will just fade in to the background and we will get back to our old lives after a ramp up period of getting everyone vaccinated. I really think 2021 is going to be much better in the US by summer.

  18. Vaccines will not be the “end of this.” It may take up to a year, or longer, for there to sufficient doses for a significant portion of the population, assuming that everyone is on board with getting a vaccine with extremely limited clinical data and that may not actually prevent infections or (presumably) infectiousness, but only prevent a serious case. And if the vaccine isn’t tested on >85 year olds with serious health problems, is anyone in that population going to sign up for a shot?

    Fauci says that people will still have to keep up with the pandemic theater even after getting a vaccine. So, even though it’s good and encouraging news, it won’t be the end of this. There are a lot of people who would rather take their chances on the virus than a vaccine without much of a track record, and there will be real political/legal battles if governments or employers start trying to force vaccines on the unwilling.

  19. There are a lot of people who would rather take their chances on the virus

    Ghouls who are happy to kill 100s of thousands of other people as long as they are reasonably sure they won’t be one of the dead.

  20. employers start trying to force vaccines on the unwilling.

    If employees have a problem with forced vaccinations they can just find another job. Right, Scarlett?

  21. Rhett, how do you feel about the media and political elites who take their chances with the virus while advocating that people stay home?

    I’ve been thinking about the Cal governor birthday party, Chris Cuomo visiting his under construction home while sick, Trump deciding not to discuss how serious the virus is, the White House group activities, Nancy Pelosi’s haircut etc.

    These people have access to much better information about the spread and lethality of the virus than ordinary people. They all have families to protect and some are at high risk, but their actions indicate that the danger isn’t that great.

  22. Rhett, how do you feel about the media and political elites who take their chances with the virus while advocating that people stay home?

    They are hypocritical assholes.

    My friend with the boat is a financial advisor and he’s terrible with money. Terrible! But in his professional life he does a fantastic job advising his clients I used to have delightful yet heavyset PCP. Just because they struggle with eating too much or spending too much doesn’t mean their advice to eat and spend less is wrong, does it?

  23. Cassandra – One caveat:

    “These people have access to much better information about the spread and lethality of the virus than ordinary people. They all have families to protect and some are at high risk, but their actions indicate that the danger isn’t that great” TO THEM.

    Unfortunately their actions convey to the public that the danger isn’t that great generally when really the danger is not that great for them personally given their status, access to quality healthcare, etc. It’s a failure of leadership.

  24. @Cassandra – do you really think that Nancy and Chris have better information about spread and lethality that you (or I) do? I would suspect that Donald does, if he chooses to look at it, but not by much. It seems you are wobbling on the edge of some vast conspiracy thinking…

    Chris Cuomo going to a vacant property violated the restrictions at that time. I know blessedly little about the Cuomo brothers. However, I strongly doubt that his actions bely some insider information and carefully calculated risk. More likely, people in power think rules don’t apply to them because often, they don’t.

  25. I tried to tell the in laws about the issue of people in power being able to do things and go to places we can’t because we don’t have the same access to cutting edge treatments or the famous hospitals.

    When all this started, I was startled/shocked at how many tests the professional players had access to while tests were hard to come by in hard hit areas, that really needed the testing.

  26. At this point (as has been the case for months), they don’t have better access to information. They do have the ability to check themselves in to the hospital when they get a positive from a super spreader event at the White House and their BMI is 46. And get experimental treatments.

  27. Most healthy people under the age of 60, or even 70, don’t need to be hospitalized with this virus. And that fact is readily apparent to anyone willing to spend a few minutes looking at the data. So it’s not actually unreasonable or reckless for people in that category to decide — as the two weeks to slow the spread turns into ten months — that other things in their life have a higher priority than Not Getting Covid. We are seeing a lot of that now, all around the country.

    Those who need hospital treatment have access to same, despite the panic porn regularly appearing here and in the media. ICU beds are NOT full. Let’s check that much-cited Wisconsin field hospital, with a capacity of over 500 beds. It has 18 patients. https://www.dhs.wisconsin.gov/covid-19/alternate-care-facility.htm

    There seems to be a narrative that only the well-connected and wealthy have access to treatment, but there are no facts underlying that narrative.

  28. “There seems to be a narrative that only the well-connected and wealthy have access to treatment, but there are no facts underlying that narrative.”

    The drugs that are effective are severely supply constrained. We messed that up big time. Oops. Not to worry, though, because Trump and Chris Christie can get them.

  29. So it’s not actually unreasonable or reckless

    That’s exactly what it is. Especially if all they need to do is follow reasonable precautions for a few more months.

  30. The issue I’m hearing first hand is not the capacity of ICU beds, it is the staffing of the ICU. There are several local hospitals reporting that their units have beds, but they can’t move people to them because they don’t have enough nurses. So individuals that may need 1×1 care are still on floors receiving 1×10 or 1×12 care.

  31. “Vaccines will not be the “end of this.” It may take up to a year, or longer, for there to sufficient doses for a significant portion of the population”

    Given our current rate of infecting people, we won’t have to immunize all that many people with a highly effective vaccine to get to herd immunity.

  32. So, Wisconsin has a total of about 11,500 beds (unclear if that counts the 500 bed field hospital). There are currently 1,500 beds available (again, may not count the 500 beds). There are currently 2000 people in Wisconsin hospitalized with Covid. That is 42% higher than two weeks ago. Assuming things continue to grow at the same rate (which is likely a bad guess – I bet they will grow faster). In two weeks, there will be 2800 with Covid. In one month, 3900. In six weeks, 5500. In two months, 7700. That 500 person field hospital will help with some of that, as will cancelling elective surgeries. But they are going to exceed capacity in the next 6-8 weeks, I suspect.

    Also, did you know that the averaged hospitalized COVID patient in Utah is 57 years old?

  33. there are no facts underlying that narrative.

    There are some facts supporting that narrative as others have mentioned. Why do you destroy your credibility with such profoundly untrue statements? As Finn has mentioned all one has to do to prove you’re wrong is find one fact.

  34. The retired or near retired folks I know between the ages of 60 to 80 ish of varying income and health levels have adjusted and limited their lives if at all possible to ride this out. The oldest old are usually confined to house or elder residence by rules or diligent children or fear or lack of mobility or funds. An effective vaccine that we can obtain will change all of our elderly lives. We will get on planes and trains, gather for funerals and weddings, play bridge in person. It will not be without risk, since Covid is worse than the seasonal flu and even the 15 year flu epidemics, and no vaccine is totally effective. But it will be acceptable even for those more at risk. I also expect that schools and colleges will reopen widely when school staff and educators can obtain a vaccine.

    For my cohort, the vaccine IS the light that we think we glimpse at the end of the tunnel. Older people are rarely anti vax. We remember polio and childhood diseases too well.

  35. “That 500 person field hospital will help with some of that, as will cancelling elective surgeries. But they are going to exceed capacity in the next 6-8 weeks, I suspect.”

    If we hadn’t heard that claim so many times before — about Florida, Arizona, Texas, California most recently — it would be a bit more credible.
    But the field hospital was activated a month ago, as new COVID cases were surging in the state, and has never treated more than a handful of patients. The same thing has happened with nearly all of the field hospitals established in the country. https://www.npr.org/2020/05/07/851712311/u-s-field-hospitals-stand-down-most-without-treating-any-covid-19-patients

  36. Re: Chris Cuomo. I know this is a major trigger point for those on the right, and I honestly don’t know all of the details of what happened, so correct me if I’m wrong. My understanding is that, while recovering from COVID, he and his wife visited the construction site of a vacant house after hours, when all workers had already left. Can someone explain to me why this is a big deal? It does not sound like there was anyone present for him to expose other than his wife, who had been living with him throughout his illness.

  37. “That’s exactly what it is. Especially if all they need to do is follow reasonable precautions for a few more months.”

    There is little reason to believe it will only be a few more months. In April it was 15 days to slow the spread. Why would this time be different?

    I think Milo’s dad was correct. This will end when people have decided they aren’t going to comply anymore.

  38. “Also, did you know that the averaged hospitalized COVID patient in Utah is 57 years old?”

    The use of “average” ages is not usually helpful, as it fails to convey the percentage of hospitalized patients who are, say, over the age of 65. That number is likely close to 75%, but it makes for a far less alarming factoid.

  39. This will end when people have decided they aren’t going to comply anymore.

    And those people will have the blood of 100s of thousands of dead on their hands.

    There is little reason to believe it will only be a few more months.

    That’s when the vaccine will be ready. We have one that’s 90% effective and one that is 95% effective.

    Do you also have the same status quo bias that Milo does? You also don’t seem to want to incorporate the two new vaccine data points into your worldview.

  40. “This will end when people have decided they aren’t going to comply anymore.”

    Many people have already made that decision. Hearing Fauci say that it’s time to do what we’re told is not going to make anyone decide to skip Thanksgiving with their family members — if anything, those sorts of high-handed authoritarian declarations will have the opposite effect.

  41. City Mom – Chris Cuomo was pretending to be in his basement the whole time of his Coronavirus infection and pretending to quarantine to his viewers. Actually he was out and about when he was not done with his quarantine. His take was to illustrate to the average viewer somebody with Covid riding it out at home. This was at the end of March when everyone was locked down and panicked about Covid.,
    He was spotted by a bicyclist when he was at the construction site. The bicyclist reported the incident. I cannot stand the hypocrisy of people preaching one thing and doing something else when they think no one is looking.

  42. I had heard two years early on in the pandemic as a timeline for when we will be done and it sounds accurate given that it will take time for the vaccine roll out.

  43. Your bad faith discussion is ruining this for everyone.

    I just can’t figure out what she’s hoping to accomplish with all this misinformation.

  44. I stand corrected. Read the data too fast.

    “About a quarter (23%) of all Utahns hospitalized due to COVID-19 are between 25 and 44. Another third (34%) are between 45 and 64. while 29% of those hospitalized are 65 to 84. The rest come from those 15 to 24 (7%) and 85-plus (5%).”

    All we know from this information is that 34% are over age 65.
    It’s likely that the 34% between 45 and 64 are skewed toward the over 60 cohort.
    So it’s closer to half than 75% who are over 60.

    Knowing that the average age of a hospital patient is 57 tells a hypothetical 57-year old precisely nothing about her chances of ending in the hospital if she contracts COVID. We also know nothing about the average length of stay and the recovery prospects for those in the hospital.

  45. You’re moving the goal posts. It makes for 34% over 65. You didn’t read the data too fast. You made up numbers and got caught.

  46. At least from a practical perspective. It is always going to circulate, but it will just fade in to the background and we will get back to our old lives Is the white/UMC view. The populations that are hardest hit now are least likely to get any vaccine, particularly if it is distributed in the marketplace, and will have the majority of cases. That kind of bias is just wrong.

    Louise, 2 years was the time frame for Spanish flu, and there was no vaccine.

  47. No, I read the numbers too fast, from exactly the same article you linked to.
    Do you know the average length of stay of Utah COVID patients? And the mortality rate by age cohort? Daily new deaths still appear to be in the single digits.

  48. On the ages of Utahans with Covid—over here we are also seeing that early pronouncements about this affecting mostly old people were wrong. Anyone who is weaker will have a hard time with anything, obviously, but the virus does attack younger people, in strong contradiction to what was thought before.

    On Pelosi’s haircut, Cuomo’s house inspection, and White House super-spreader events, I see a real distinction. The first two were done in ways that, although against the rules, were unlikely to spread the virus further. The house was empty and didn’t Pelosi wear a mask? Seating people close together without masks on is very different from those. In general, I’m likely to try to understand the reason for rules and act in accordance with that, even if what I do is technically against the rule, so I “get” that other people do that too. Otoh, when there are loopholes, or just an absence of rules, allowing me to do things that could harm others, I generally don’t. See, for example, shopping/purchasing/consumption decisions that Rhett and Milo like to rob me about.

  49. Field hospitals were added in the summer during a period of exponential increase. The worst was averted, thankfully, and they were not needed.

    We are now in a period of exponential increase in MANY more places, and field hospitals are being prepped once again, to handle a worst-case scenario.

    Saying the field hospitals are a waste now because they weren’t needed before is like telling a seaside town in the southeast not to bother boarding up their windows when a hurricane is approaching because they boarded up the last time a hurricane threatened, but the storm took an unexpected turn and the boards weren’t needed.

    We can’t predict the future, but we can plan for contingencies. That the worst doesn’t come to pass does not make the planning useless.

  50. “The populations that are hardest hit now are least likely to get any vaccine, particularly if it is distributed in the marketplace, and will have the majority of cases. That kind of bias is just wrong.”

    States have been submitting their plans and those who are at highest risk and in high risk jobs are in the priority groups for receiving the vaccine first.

    I honestly don’t understand what is going on here. So much disinformation from so many. This pandemic is a huge problem. We are figuring out solutions. We have this super bright light at the end of the tunnel.

  51. SM – my issue is why have Covid rules at all when each person is free to interpret them the way they want to ?
    Each individual thinks that their actions are safe and have will have no consequence on the spread. But taken together the cumulative of all these individual decisions cause infections to rise.

  52. Each individual thinks that their actions are safe and have will have no consequence on the spread.

    Some number of folks know their actions are unsafe and will have consequences. They just think those consequences will occur to someone else. As long as their actions only hurt other people they don’t care.

  53. Louise, seriously, are you trying to say you see no difference between those?

    Reality, the headline about trump planning to get the vaccine to those who need it most that someone just posted (behind a paywall) is a welcome surprise. I know that in the beginning, there were predictions that the southeastern US would be hardest hit, and for a while it was the only region that was entirely red on Covid maps, the way much of the country is now. So that prediction was correct. I hope this one is wrong.

  54. “or employers start trying to force vaccines on the unwilling.”

    A few weeks ago, I was chatting (outdoors, masked, and from a distance) with the dad of a friend of DD. He is a physician at the local hospital. He said that for many years, the hospital policy has been that any staff member who refuses to get a flu shot has to wear a mask at all times at work during flu season (which I think is defined as about November through April). Maybe they’ll do the same once a Covid-19 vaccine is widely available.

  55. NoB, I like that approach. It balances the COVID risk with the risks of autoimmune issues from repeated mRNA vaccines in those vulnerable to autoimmune disease.

  56. SM – I don’t see any distinction in all three parties breaking the rules. A rule is broken, it doesn’t matter if the parties concerned think it might not have any consequences, a small consequence or a large consequence.
    I can decide tomorrow that instead of finishing my quarantine for Covid, I will go to church and sit socially distanced, wearing a mask, thanking the Lord that I am still here. I think enough time has passed, I am no longer infectious and it’s not that big of a deal.

  57. Building field hospitals was and is a good idea. That they haven’t really been needed is a separate point — hospital systems have not actually been overwhelmed. At least, not any more so than during a bad flu season, when hospitals have to deal with patient surges. And society has never shut down schools, churches, restaurants, and workplaces in response.

  58. And society has never shut down schools, churches, restaurants, and workplaces in response.

    We shut down and a quarter of a million people died. If we didn’t shut down in March how may additional people do you think would have died?

  59. Shutting down schools saved no lives. So there is that.
    And lockdowns kill. They deprive non Covid patients of essential medical care and lead to additional deaths from isolation and despair.
    Widespread and lengthy lockdowns are not wise public health policy, which is why they have *never* been part of pandemic planning guidelines.

  60. I don’t think there is any law or rule requiring people who are Covid positive to quarantine. I have always thought that there should be such a rule, but the last time I suggested it on this blog I was absolutely pilloried by the Usual Suspects, who insisted that any such mandatory quarantine would violate fundamental rights, and would never be tolerated by freedom-loving Real Americans. Yet those same people have thoroughly condemned Cuomo for leaving his basement to visit an empty house. Perhaps they should celebrate him for adopting the “balanced” approach to Covid that they always espouse on this blog.

  61. Scarlett,

    You seem to be saying if we did nothing the overall death toll would be the same. Is that your position? If that’s not your position how much excess mortality would we have if there had been no lockdowns?

  62. There is no way to defend the behavior of Chris Cuomo. None. He broke quarantine because he thought he could get away with it. And he basically did, because the rules are for the little people.

  63. “He broke quarantine because he thought he could get away with it. And he basically did, because the rules are for the little people.”

    Milo has stated that he knows people (presumably “little people,” insofar they don’t have their own prime time televisions shows) who continue to go about their lives despite testing positive. And they get away with it because it is not actually illegal to do so. I would argue that it should be. But unless you agree with me, then there is no reason to condemn Cuomo. He didn’t break any law, and he didn’t actually expose anyone.

  64. There was also that hairstylist in (I think) Missouri, who was covid positive and symptomatic, yet continued to go to work. She “got away with” breaking quarantine also, and, unlike Cuomo, actually put her customers and co-workers at risk. Do you condemn her as much as Chris Cuomo? Or is Cuomo somehow more blameworthy despite having had no contact with actual humans?

  65. Scarlett,

    No lockdowns would have resulted in no excess mortality? 10k more deaths, 25k? What is your position?

  66. Scarlett – you defended Trump’s joy ride because the Secret Service sign up for risk. So totally ok for him to expose a bunch so he could wave to his fans. But Cuomo, who didn’t actually expose anyone, is wrong? Okay.

  67. “No lockdowns would have resulted in no excess mortality? 10k more deaths, 25k? What is your position?”

    My position is that we’re not going to know about the effects of lockdowns until the dust settles and we can look at excess mortality during 2020-2022. But some of the initial data is concerning, suggesting that a third of excess deaths are NOT attributable to COVID.
    https://jamanetwork.com/journals/jama/fullarticle/2771761?guestAccessKey=92828e1e-363a-491b-83af-ec3ce0cde3f6&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=101220

  68. The prospect of a near-term vaccine is a game changer for me and has significantly improved my mood. Summer next year is fine, I will wait. Once a vaccine is widely available then I can protect myself and my family. If others want to take the risk then it is on them, although I am sure there are some who can’t get the vaccine for medical reasons and it would be nice if everyone would do there best to protect them, like we did for polio back in the day, but I have given up assuming others would go out of their way to help others.

  69. Scarlett,

    You argue a position with all the force and conviction in the world. But when I try to get a firm number out of you I get nothing but vague noncommittal responses.

    Seconding Ada’s comment, “ Your bad faith discussion is ruining this for everyone.”

  70. Rhett,
    At this point in time, there aren’t any numbers. Sorry. Correlation, causation. The dust hasn’t settled yet. This issue will keep legions of academics and graduate students busy for years.

    We do know that lockdowns are unpopular and, for that reason, unsustainable in this country. We know that millions of children have been deprived of meaningful education since March, with no end in sight, even though children are at virtually zero risk of serious outcomes with COVID.

  71. I don’t think we’re giving enough consideration to the psychic toll this is taking on healthcare workers. Anecdotally, I know of at least four nurses who weathered the first surge in hospital-based jobs that have since left (one retired, the others took new jobs) because of the stress associated with working through the pandemic. At least one took a substantial pay cut to take a “safer”, office based job.

    Many parts of the country had nurse and doctor shortages pre-COVID. I think this is going to become a broader issue over the next few years.

  72. Scarlet,

    How many times did you post vacuous link after vacuous link to some random bullshit and cry about data? Of the data! How you went on about the data. Today you even stooped so low as to make numbers up out of whole cloth. And now you’ve got nothing so you’re going on about nothing.

  73. “how do you feel about the media and political elites who take their chances with the virus while advocating that people stay home?”

    Angry. And disappointed.

  74. And just to remind everyone of what you’re trying to argue:

    If these continued to happen as if nothing was going on we can’t know if it would have increased fatalities:

    We just can’t know. It will take years to see if that had an impact.

  75. Flying everyone out to one location to mingle in close quarters. Maybe it slowed the progress of the disease maybe it didn’t. We really can’t know.

  76. “the hospital policy has been that any staff member who refuses to get a flu shot has to wear a mask at all times at work during flu season”

    I’ve heard this is the policy for local hospitals as well, but that very few don’t get a flu shot.

  77. “Most healthy people under the age of 60, or even 70, don’t need to be hospitalized with this virus.”

    Of course. If you need to be hospitalized, you’re not healthy.

  78. Rhett,
    There is no data demonstrating that lockdowns saved lives. It’s all models and speculation at this point. Certainly no basis for claiming that we need to do it AGAIN.

    Again, there is only so much that governments can do to “control” this virus. Until there is community immunity — either from natural infections or a safe, effective vaccine that protects the most vulnerable (and not just the healthy young and middle-aged) — the virus will remain among us.

  79. There is no data demonstrating that lockdowns saved lives.

    Could this increase transmission and swamp the healthcare system?

    How would you even begin to know? It’s just one of those unknowable mysteries.

  80. Rhett, I think when you think lockdown, you think of instances like the above. When I think lockdown, I think “people like my Dad unable to get cancer testing or treatment, even though there are currently zero cases in the county.”

    The interpretation of the word “lockdown” matters.

  81. people like my Dad unable to get cancer testing or treatment, even though there are currently zero cases in the county.

    A friend is currently dying of cancer and there has been no disruption in treatment. In Boston a place with a significant outbreak. So I’m surprised to hear that was the case in rural Iowa.

  82. WCE,

    Do you really think when people say lockdown they mean cancel chemo appointments? Is that what you actually think?

  83. Rhett – you live in the healthcare capital of the nation if not the world. At one point, I despaired of finding a second opinion for my kid here, all I could think of was we should fly to Children’s in Boston.

  84. A South Dakota emergency room nurse on Monday expressed frustration that many of her patients don’t believe they are dying of COVID-19.

    Jodi Doering’s tweet went viral on social media over the weekend after she tweeted about patients who “don’t believe the virus is real … while gasping for breath on 100% Vapotherm.”

    “It wasn’t one particular patient, it’s just a culmination of so many people,” Doering told CNN’s “New Day.” “And their last, dying words are, ‘This can’t be happening. It’s not real.’ ”

    South Dakota reported 821 new cases of COVID-19 on Monday, with 62,521 current confirmed cases statewide. The state health department reports 20 percent of hospital beds are currently occupied with COVID-19 patients.

    “People want it to be influenza, they want it to be pneumonia,” Doering said. “We’ve even had people say, ‘You know, I think it might be lung cancer.’ … Even after positive results come back, some people just don’t believe it.”

    Doering said multiple patients target nurses like her with their “anger and hatred.”

    “They call you names and ask why you have to wear all that ‘stuff’ because they don’t have COVID because it’s not real,” she tweeted on Saturday.

    “I think it’s just a belief that it’s not real and nursing happens to be on the receiving end of that,” she told CNN.

    “It just makes you sad and mad and frustrated and then you know that you’re just going to come back and do it all over again,” she added.

    https://www.msn.com/en-us/news/politics/south-dakota-nurse-says-many-dying-patients-still-insist-covid-19-not-real/ar-BB1b3Ljm

  85. Some data on missed cancer diagnoses:

    “Our results indicate a significant decline in newly identified patients with 6 common types of cancer, mirroring findings from other countries.5 The Netherlands Cancer Registry has seen as much as a 40% decline in weekly cancer incidence, and the United Kingdom has experienced a 75% decline in referrals for suspected cancer since COVID-19 restrictions were implemented.5

    While residents have taken to social distancing, cancer does not pause. The delay in diagnosis will likely lead to presentation at more advanced stages and poorer clinical outcomes. One study suggests a potential increase of 33 890 excessive cancer deaths in the United States.6 Our findings are consistent with previous research,1-3,5 and they call for urgent planning to address the consequences of delayed diagnoses. Planning may entail more robust digital technology to strengthen clinical telehealth offerings and other patient-clinician interactions, including self-service scheduling across specialties and well-designed collection processes.” https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2768946

  86. WCE, it would seem that otherwise healthy families and people who can WFH should accept some limitations on their activities and daily interactions, just so that people like your dad can get cancer screenings.

    I agree that some of this is branding – just like in the case of “defund the police”. The definition of “lockdown” or “shutdown” is open to interpretation. I do not believe we had “lockdown” in its true sense anywhere in the country.

    While I understand that the impact of restrictions on daily life. and whether the masks work or not may yet not be 100% proven beyond doubt, why is it so hard for people to accept some limitations on their freedom? If this were a war time and people were asked to sacrifice their personal freedom, wouldn’t we all do that? Would that not be patriotic? So how is this different?

  87. Rhett,

    When the lockdown started, my husband’s surgery was cancelled. My followup appointments for dental surgery were cancelled. My mammogram was cancelled.

    Elective surgeries were cancelled/postponed. Hospitals began losing money, nurses (including my niece) and other personnel were laid off.

    You don’t seem to acknowledge that lockdowns are costly. Why?

  88. “It wasn’t one particular patient, it’s just a culmination of so many people”

    How many is “so many?”
    In a state with not that many COVID deaths, I’m calling bs on her account. She’s an ER nurse, not an ICU nurse, and she’s in one (apparently unnamed) hospital in the state. How many of her own patients has she actually heard saying “this can’t be real” while they are gasping for breath and dying?
    She may well feel overwhelmed, but this story doesn’t pass the smell test.
    But it makes great panic porn.

  89. my husband’s surgery was cancelled.

    If it was a matter of life and death and they cancelled it then that was very wrong. If they made a profession judgement call that his surgery, your mammogram and my colposcopy could wait, then that’s what I would expect professionals to do under the circumstances.

  90. “While I understand that the impact of restrictions on daily life. and whether the masks work or not may yet not be 100% proven beyond doubt, why is it so hard for people to accept some limitations on their freedom? If this were a war time and people were asked to sacrifice their personal freedom, wouldn’t we all do that? Would that not be patriotic? So how is this different?”

    Because it’s not a war. It’s a respiratory virus, and — contrary to some of our initial understanding — one that is not particularly lethal to the vast majority of the population. That’s why.

  91. You don’t seem to acknowledge that lockdowns are costly. Why?

    They are costly but the end is now a few months away. If they hadn’t occurred back in March how many extra deaths would have occurred?

  92. That we allowed necessary medical surgeries and procedures to be cancelled while people went out to restaurants and got together for parties is a failure of the American people. That is what you get when everyone thinks he is a cowboy.

  93. Rhett, the CDC says a pediatric vaccine probably won’t be available in 2021 and because safety testing for children is more stringent, due to low risk, it is unclear when a pediatric vaccine is available.

    The end of this is not months away for my family; it’s almost certainly more than a year away and it could be a few years. We just don’t know.

  94. WCE, why are you worried about a pediatric vaccine? According to Scarlett, COVID poses no risks to kids.

  95. DD, I think the issue is that the schools in WCEs state may not open without a pediatric vaccine.

  96. WCE,

    I’ll second what DD said. And I wonder why you brought up that point. You’ve gotten a lot of mileage out of criticizing your governor for her desire to wait for a vaccine. That two effective vaccines have come out in the past two weeks represent two additional date points…potentially in her favor.

  97. Because it’s not a war.

    You’re right, it’s not – wars are safer. So far, about 50,000 more Americans have died from COVID than died in World War I, the Vietnam war, the Korean War, the Spanish American War, Afghanistan, the Iraq war, the War of 1812, the Revolutionary War, the Mexican-American war, and the 9/11 attacks combined.

    We’ve had 8,443 deaths in the last 7 days, so at this rate the total COVID deaths will surpass the number of American deaths in World War II (291,557) in less than 6 weeks. But it’s a pandemic, not a war, so we shouldn’t ask people to make the huge sacrifice of wearing masks or going to large gatherings to keep people from dying.

    https://www.nationalgeographic.com/history/2020/04/coronavirus-death-toll-vietnam-war-cvd/

    https://covid.cdc.gov/covid-data-tracker/#cases_deathsinlast7days

  98. Cass,

    I’ve Google Oregon governor pediatric vaccine and I didn’t find anything. I’ll await a link. If the governor does think a pediatric vaccine is required that at this point it sounds like she’s mistaken.

  99. “According to Scarlett, COVID poses no risks to kids.”

    No, according to CDC, since February there have been 20,616 deaths in children under age 15.
    Only 81 of those deaths have been COVID.
    That is statistically zero.
    Yet many schools are closed because #Science!

  100. “Because it’s not a war. It’s a respiratory virus, and — contrary to some of our initial understanding — one that is not particularly lethal to the vast majority of the population.”

    Historically, wars have not be particularly lethal to the vast majority of the US population.

  101. You may be aware that some 7000 Americans die each day.

    And if it suddenly jumped to 8,000 that would be a very grave problem, would it not?

  102. “Only 81 of those deaths have been COVID.
    That is statistically zero.”

    This is a real question: what is the definition of “statistically zero?”

  103. The governor hasn’t said anything about a pediatric vaccine to reopen schools. I assume that’s TBD, but given that my family’s status (low risk, unable to access vaccine) won’t change for a long time, “This is over in months” does not apply to us.

    The governor also hasn’t said whether a vaccine has to be widely available but I assume she intends that the vaccine be widely available, vs. only available to high risk individuals.

    We’ll see how the math of vaccine duration in high risk people, manufacturing and distribution shakes out. That’s the next hurdle.

  104. With regards to cancer treatment, I can tell you that life went on as usual on the peds floor at MSKCC, even in the worst part of April. I imagine it was the same on the adult floors as well. One of the relatives gets a yearly screen there because they are monitoring a mass that thankfully has been stable for several years. He was able to get his screen done in April.

    My kid’s late effects followup and neuropsych exam did get delayed by a couple of months but that seems like a reasonable decision.

    I do have a colleague whose father, who lives in Queens, needed joint surgery of some type, which got delayed during April. He was in a good bit of pain, so it was not pleasant, but at the same time, the hospital where he was supposed to have it done was overflowing with COVID cases. He did get the surgery done in May. And my kid couldn’t get his specialized root canal and reconstructive dental work until way into the summer. There is no question that in April into May, in the NYC region, many elective and semi-elective procedures got delayed, and it made sense in many cases because the hospitals were dealing with a lot. Dental work seemed to be even more delayed, but I always got the sense that it was more to do with the individual dentists. I wonder if that is what is going on right now -perhaps out in the middle of the country, many providers are just not that willing to see patients.

  105. “The definition of “lockdown” or “shutdown” is open to interpretation.”

    It’s more a matter of multiple definitions.

    “I do not believe we had “lockdown” in its true sense anywhere in the country.”

    I think what we’ve had in many parts of this country are restrictions on activities.

  106. The governor hasn’t said anything about a pediatric vaccine to reopen schools.

    Yet you defiantly implied that a pediatric vaccine was required. Then later you admit that you have little reason at present to believe that’s the case.

  107. The decision to restrict non-critical procedures in an area where COVID is common is completely different than the decision to restrict non-critical procedures where the COVID case rate (sewage measured!) is zero, which is what was done during the lockdown last spring.

  108. It would be helpful to KNOW how many years until schools reopen on their previous schedule. So far, the governor has not been accurate in her predictions.

  109. WCE,

    In an exigent circumstance where sewage testing is very much an untried technology can you not see the wisdom of delaying non-critical procedures? If you were in charge would you really have put lives at risk based on something as unproven as sewage testing?

  110. Rhett, based on a discussion with an actuary, the QALY impact of delaying cancer screening/treatment when the local case rate is ~<1 in 1,000 is worse than the COVID QALY impact.

    Have you talked to actuaries to get an estimate of the COVID QALY vs. other health issues? You used to be all about QALY for health/economic decisions until COVID hit and then you changed your metric.

  111. Rhett, based on a discussion with an actuary, the QALY impact of delaying cancer screening/treatment when the local case rate is ~<1 in 1,000 is worse than the COVID QALY impact.

    Am I correct that your basing the case rate on the totally unproven sewage testing method?

  112. Because if I recall the timeline properly various testing methods other than sewage testing were extremely supply constrained when these decisions were being made.

  113. “Historically, wars have not be particularly lethal to the vast majority of the US population.”

    Indeed, although World War II did kill at least 70 million people (3% of the world’s population in 1940).
    And estimates are that the 1918 flu killed 50 million people worldwide, including 675,000 in the US. HALF of those deaths were in adults under age 40.

    COVID is neither a war nor a pandemic like the 1918 flu. And yet many of you want us to pretend that it is both, and that we need to accept draconian restrictions on our daily lives — for more than a year — in order to deal with it.

  114. Rhett, we’ve had roughly one hospitalization/month from March to September, per an acquaintance who works at the local hospital.

    Regardless of whether my estimate is correct, what’s the point of shutting down routine medical care for 1 hospitalization/month?

  115. “In an exigent circumstance where sewage testing is very much an untried technology can you not see the wisdom of delaying non-critical procedures? If you were in charge would you really have put lives at risk based on something as unproven as sewage testing?”

    I’m with WCE on this. My guess is that sewage testing is just as untested as a lot of other aspects of the coronavirus and CV-19.

    The trajectory of the disease in this country suggests to me that if you have a window when there’s very little viral spread, that’s the time to take care of non-critical procedures, and more generally try to get your population as healthy as possible (e.g., get everyone all their vaccinations, even if it’s a little early) to make it easier to focus on CV-19 if/when that becomes widespread.

    I’m glad I had some medical and dental work (e.g., colonoscopy) done in our window when case rates were low.

  116. ” we need to accept draconian restrictions on our daily lives”

    Not everyone sees mask usage as draconian.

  117. Rhett, we’ve had roughly one hospitalization/month from March to September, per an acquaintance who works at the local hospital.

    That’s 20/20 hindsight. What would you have done in the moment? Do you put all you proverbial money on a unproven new technique or do you can err on the side of caution?

  118. Finn – agree about the face masks not being draconian. I do not understand the whining about wearing a mask. My kids had to practice soccer tonight while wearing a mask and didn’t complain. They don’t like wearing them but they deal with it. Kids are handling wearing masks with more maturity than adults.

    My news feed is full of stories about hospitals being pushed to capacity. Given that infections are rising, it doesn’t seem like hospitalizations will be going down any time soon. Hospitalizations must be different where some of you all live.

  119. “At this point (as has been the case for months), they don’t have better access to information.”

    Locally at least, those in government have access to a lot of information that they’ve chosen not to make available to the general public.

    Early on, there was regular release of information on the circumstances of infections, especially clusters. So we knew when an airline had a training class that spread the virus, and that when one person from that class took a class at a gym, 100% of those in the class were infected.

    But as time passed, that information stopped being released. There were some excuses about privacy, but I don’t see whose privacy is violated when the released information is just along the lines of, “twenty people who attended an indoor exercise class last week all tested positive for CV-19 this week.”

    And in the past week, some information like that has been released, which further tells me there’s no reason that information couldn’t have been released all along.

  120. And yet many of you want us to pretend that it is both

    You have literally lost your grip on reality. Think about what you said. Think long and hard.

  121. Rhett – we could not get a family member into MGH, BWH or BI all through the months of February to August. When we finally did, I already stated what the results were. You can argue that the cost to my family was well worth it because that one life was not as worthy to be saved compared to whomever you decree should be saved but for F**k sakes stop arguing that there wasn’t a cost .

  122. Rhett – we could not get a family member into MGH, BWH or BI all through the months of February to August. When we finally did, I already stated what the results were.

    So then you agree with me? The priority should have been matters of life and death and not Timmy 21st birthday party or Debbie’s 3rd wedding.

    What are you arguing with me about? Scarlett is the one you have a problem within. Not me.

  123. Used to lurk,

    Honestly hospitals are filling up all over the country as we speak and Scarlett is dismissing any concerns. And you’re mad at me? Why?

  124. I’m arguing we should be doing what we can to minimize exactly the situation your family found itself in…. as that very situation manifests itself across the country.

  125. “Rhett – we could not get a family member into MGH, BWH or BI all through the months of February to August.”
    Wait, in February and most of March, we were still (figuratively speaking) partying like it was 1999. The lockdowns didn’t happen until March 20 or so.
    I don’t know what was going on in the summer. I have lots of friends in Boston who were accessing hospital level care in the summer

  126. Finn, that sort of information was released in my parents’ area too. I don’t know if it is anymore, because I haven’t looked for it. But I assume one reason not to release it is sheer volume. If there were several similar cases, like 3 different people wiped out the entirety of 3 different exercise classes at the gym, doesn’t it make sense anyway for them to simply say that there is evidence that stopping exercise classes for a while is a good idea?

  127. Totally unscientific but my guess is our current spike is Halloween related. In the beginning of October our rates were hovering around the 5% mark. There was a large cluster at a church gathering and a brewery Mocktoberfest got out of hand. After that came Halloween. K-5 schools opened for in person learning but that’s not where cases are originating. It seems that people look at the increased rate, regulate their behavior and the spike comes back down.

  128. The local media is saying that hospitals are filling up.
    The state database reveals that 30% of ICU beds are empty in our county. I don’t pay attention to media reports when I can go to the source of the data.
    There are no plans for field hospitals, as there were in March. Yes, hospitals are seeing more patients, but they have surge plans in place for times like these.

    Hospitals routinely operate at close to capacity. The 2018 flu triggered a slew of media reports on overcrowded hospitals turning away patients or treating them in tents. We didn’t panic and shut down schools and close or drastically limit capacity at churches.

  129. In a state with not that many COVID deaths, I’m calling bs on her account. She’s an ER nurse, not an ICU nurse, and she’s in one (apparently unnamed) hospital in the state. How many of her own patients has she actually heard saying “this can’t be real” while they are gasping for breath and dying?
    She may well feel overwhelmed, but this story doesn’t pass the smell test.
    But it makes great panic porn.

    You sit at home and cast aspersions on people on the front line. There is a purity to simply labelling something as “panic porn” if it doesn’t fit your narrative. South Dakota has an average of about 20 deaths per day (in the entire state, many of those out of hospital, I suspect). They had 50 deaths from COVID alone on Friday. I don’t know what your experience has been like, but in my experience, ED docs and ED nurses are involved in most hospital deaths outside of an urban center. I can’t imagine working in that kind of environment right now. .

  130. “You sit at home and cast aspersions on people on the front line.”

    No. I’m criticizing this particular attention-seeking women, who has cast aspersions on her own patients, in a very public way, in service of her own narrative. And elements of her story don’t add up.

    If she only wants to care for sick people of whose behavior she approves, perhaps she is in the wrong line of work.

  131. “It would be helpful to KNOW how many years until schools reopen on their previous schedule.”

    Well, isn’t that the million dollar question.

    Not having adequate information and not being in charge of making the decision when you don’t fully trust the decision makers is stressful, isn’t it? Hearing a lot of fear and anger in these posts lately. I think I hit that point in April.

  132. Scarlett, have some empathy!!! Medical personnel are there to help, even when people hurt themselves–drink themselves into oblivion, cause the accident that injures them badly, smoke through their cancer-ridden tracheae, what have you. But in this case, the woman is criticizing patients who not only make themselves sick, but who actually put her life in danger by their stupid behavior around a deadly disease. No, it isn’t deadly in all situations, but thus far we have no sure way of predicting when and for whom it will be deadly. Medical workers are under incredible pressure and have been for a long time. Of course it’s not copacetic when people put their own lives and others in danger.

  133. No, according to CDC, since February there have been 20,616 deaths in children under age 15.
    Only 81 of those deaths have been COVID.
    That is statistically zero.
    Yet many schools are closed because #Science!

    Oh please! Now you’re trying to tell us that you don’t understand how kids could possibly make teachers sick, or be asymptomatic carriers who pass it on to other kids who take it home to parents? Somehow I don’t think you’re that dumb.

  134. when you think lockdown, you think of instances like the above. When I think lockdown, I think “people like my Dad unable to get cancer testing or treatment, even though there are currently zero cases in the county.”

    The interpretation of the word “lockdown” matters.

    Yes, it does.

    From what I can tell, much of the US has implemented shutdowns in really clumsy all-or-nothing ways, without paying attention to what we are learning about how this thing spreads, and what kinds of things can mitigate spread while allowing life to go on. So it’s too draconian in some situations, nonexistent in situations where some regulations would help. I’m sick of being asked to defend this illogic.

  135. S&M – Actually if you’re getting the impression that shutdowns are all-or-nothing here, it’s because we spend a lot time here discussing the extremes. I think in most places (not all!), there have been varying levels of orders and limits based on that community’s incidence rates and acceptance of the virus as real v. hoax.

    People like to focus in on the one thing that they really wish they could do – whether it’s a heartbreaking delay in a cancer treatment or their kid’s football season. Those are by no means equal complaints – but I use those examples to demonstrate the variability in how people feel limited. In the midwest, some hospitals are *actually* full and turning away patients. My mom’s DH is however, able to get his monthly cancer treatments without interruption, so the situation is really different everywhere.

  136. “I don’t pay attention to media reports when I can go to the source of the data.”

    So would you say that your declaration that many places had reached herd immunity and were (I believe your words) “done with the virus” was wildly incorrect?

  137. Only 81 of those deaths have been COVID.
    That is statistically zero.

    Why don’t you tell 162 parents that their child’s death is statistically meaningless. I’m sure that will make them feel much better.

  138. Not sure why Scarlett would question a nurse’s account because she works in an ER. The ER is usually the first — and sometimes the last — stop for people experiencing acute respiratory failure. My cousin is a PA in an ER at a medium-sized Long Island hospital. From the about middle of March through the middle of May, she devoted nearly all of her work hours to triaging COVID patients, incubating them, and monitoring them until ICU beds became available. Many died before getting to the ICU. Based on news reports, similar scenes were playing out in Houston over the summer, with backlogged patients dying in ERs, hallways, and ambulances, while hospitals tried to locate ICU beds for them to go to. ER nurses are very much on the front lines of this mess, and I am not at all surprised that they would be gobsmacked to hear patients who are dying of COVID continue to insist that the disease is a hoax.

  139. @WCE –

    What, exactly, is the state of medical care in Oregon? What is allowed and what isn’t? You keep saying it is all “shutdown”. But that is not the case anywhere that I am aware of, and it hasn’t been since the end of April (by any definition of shutdown). My neighbor had cancer treatment throughout the pandemic, and we’ve resumed all our normal preventive care – dental, vision, medical – since May. In fact, there are constant ads begging people to not fall behind on routine medical care or treatment. One of my coworkers had wrist surgery over the summer, and another had ACL surgery – both of these are would have been pushed out in March. Now, I don’t know what is going to happen in the coming weeks with cases and hospitalizations exploding here, but as of right now – I still have a dental appointment for a new crown for next week, and my annual checkup is set for December.

    ” Actually if you’re getting the impression that shutdowns are all-or-nothing here, it’s because we spend a lot time here discussing the extremes. I think in most places (not all!), there have been varying levels of orders and limits based on that community’s incidence rates and acceptance of the virus as real v. hoax.”

    @Sunshine – YES. And even in an evil Democrat city with a high level of restrictions, we haven’t been in anything resembling a “lockdown” since April. Restrictions are coming back (e.g., indoor dining was recently shut down), but the virus is exploding here again. But we are not in “lockdown”. Even the mayor’s recent Stay-at-Home order is only an advisory, which from what I can tell, is not really enforceable.

  140. When I drove by the CityMD location in town earlier today, I noticed a mile long line waiting to get in. All kinds of people. The line was so long that it didn’t fit in the small parking lot so it extended to the parking lot across the street and wrapped all around it. Since they offer COVID testing, I am assuming that is what the line is about. Depressing. I just can’t believe it. Fauci and his ilk warned all summer of the second wave to come, and they were right.

  141. MM – couldn’t agree more. Personally know 3 people currently hospitalized and just got a note that one of them got moved to ICU. She’s a poc with other health issues and I am really scared for her.

  142. “So would you say that your declaration that many places had reached herd immunity and were (I believe your words) “done with the virus” was wildly incorrect?”

    A lot of places *are* essentially done with the virus. New York, for example, currently has a 7-day moving average of 25 deaths. Sweden is at 9. Both places are reporting a steep rise in cases, but those cases aren’t turning into deaths, in part because many of those cases aren’t clinically significant.

  143. “Another interesting data point — influenza has virtually disappeared in the US”

    Well, yes. Because masks and social distancing works. The Southern Hemisphere had a virtually non-existent influenza season.

  144. When we talk about non Covid treatment being shut down in March and April, let’s not forget we were dealing with a massive shortage of PPE, which is required for all procedures (not just Covid related). With reports of nurses using trash bags and cloth masks due to a lack of supply, it seems wise to defer non-emergency care to preserve that equipment.

    That said, my family member in Mass. receiving cancer treatments saw zero interruption to his treatments. However, another friend awaiting a knee replacement saw his procedure pushed back from April to August. These seem like reasonable outcomes, from a public health perspective.

  145. Ivy, the state of medical care in Oregon is fine. However, last spring, the shutdown in states other than Iowa, Arkansas, North Dakota and South Dakota meant no non-emergency medical care was available, even when the local case rate was zero or nearly zero. My Dad was able to get cancer care in Iowa, because cancer care wasn’t shut down in Iowa, but those four states were vilified for allowing people to continue to receive care despite very low or zero COVID rates.

    Last spring is illustrative of the type of untargeted shutdown approach I oppose.

    One easy change I hope is made is that people with use-it-or-lose-it flex spending account dollars can roll them into 2021 vs. losing the money they set aside. Twin2 just got braces and I’ve been concerned that the money we set aside would be lost due to the shutdown.

  146. but those four states were vilified for allowing people to continue to receive care despite very low or zero COVID rates.

    Do you have a link? I certainly recall vilification for bike rallies and bars but I don’t recall and vilification for allowing routine care.

  147. Rhett, you can google better than I can. The implication was strong from the NY Times that shutdowns should occur. You can decide whether that is “vilified.”

  148. “Well, yes. Because masks and social distancing works.”

    Amazing. Masks and social distancing can prevent the flu, but not COVID?

  149. “A lot of places *are* essentially done with the virus. New York, for example, currently has a 7-day moving average of 25 deaths. Sweden is at 9. Both places are reporting a steep rise in cases, but those cases aren’t turning into deaths, in part because many of those cases aren’t clinically significant.”

    So you still maintain herd immunity has been reached? Are the cases that are not “clinically significant” false positives?

  150. “Amazing. Masks and social distancing can prevent the flu, but not COVID?”

    I don’t understand your confusion. When you decrease chains of transmission and there is a partially immunized population, you don’t get big epidemics. That is what we are trying to do with Covid.

  151. One reason that our local hospital is reporting higher occupancy (though not >100%) is that patients whose procedures were cancelled earlier this year are showing up now. There are consequences to calling a halt to elective procedures.

  152. shutdown in states other than Iowa, Arkansas, North Dakota and South Dakota meant no non-emergency medical care was available

    Yes it was. What are you talking about? My urgent care was open. My doctor’s office did telemedicine but they would also treat you in person if necessary. I had a couple of UTIs, which the medical establishment considers non-urgent but as the sufferer, I definitely consider urgent. I had no trouble getting them treated. My sister in California got medical care for non-urgent stuff too.

  153. Reality,
    Let me spell it out. If masks and social distancing can prevent the transmission of flu, why aren’t they preventing the transmission of COVID? Because, quite clearly, they are not.

  154. “So you still maintain herd immunity has been reached? Are the cases that are not “clinically significant” false positives?”

    I’ll put it this way — there aren’t going to be large numbers of new deaths in places like New York and Sweden, no matter how many new cases are reported. You can call it what you like.

  155. Are you being serious? For influenza, we have people with immunity from prior seasons and we have a vaccine. Those things along with masks and social distancing are sufficient to keep epidemics from happening. Masks and social distancing are not magical. They just help. I cannot believe we are still having this discussion 10 months in to this pandemic. This is why the vaccine is so important even though this coronavirus will become endemic.

  156. Hum dates April 12, 2020

    This led Sanford Health, which operates 44 medical centers throughout the Midwest, to postpone all non-essential surgeries in their Minnesota facilities, according to a statement provided to MedPage Today.

    But Sanford Health is continuing with procedures in states like South Dakota and North Dakota, which have less restrictive or no such policies in place.

    In states where procedures are still being done, decisions are made by providers and patients “based on patient symptoms, resources available and the clinical justification to proceed,” said Sanford Health Vice President and Medical Officer Douglas Griffin, MD, in a statement.

    “We are striving to ensure that all patients who need urgent medical care continue to receive it without delay while also preparing to care for those affected by COVID-19,” Griffin stated. “Balancing the health care needs of our patients with the anticipated needs of COVID-19 positive patients requires constant evaluation and a measured approach.”

    The article also mentioned, “The lowest tier, which should be evaluated using telehealth, includes primary or preventive care, according to CMS recommendations.”

    Tons of us have mentioned having telehealth visits. So saying “no non-emergency medical care was available” in North and South Dakota isn’t a true statement, is it?

    https://www.medpagetoday.com/infectiousdisease/covid19/85913

  157. I’ll put it this way — there aren’t going to be large numbers of new deaths in places like New York and Sweden, no matter how many new cases are reported.

    What would you consider a large number of deaths in Sweden or NY? An exact number would be nice so you can’t move the goal posts later. Because we all know what you’re going to do that when the numbers rise. Yes deaths are increasing but only in the elderly and those with co-morbidities…

  158. I’ll put it this way — there aren’t going to be large numbers of new deaths in places like New York and Sweden, no matter how many new cases are reported. You can call it what you like.

    Herd immunity is no new cases, not no new deaths. And when people start counting up the deaths for you, saying they’re “actually zero” is ridiculous.

  159. “You can call it what you like.”

    So, no to herd immunity? You were wrong about that? Because if herd immunity was reached, there shouldn’t be cases. The chains of transmission are broken and the virus cannot transfer.

  160. @WCE – I have no idea what you are talking about then. So you agree that your local medical services are available, and you aren’t debating that people on this board in the “shutdown” states resumed routine and non-essential care 6 months ago. So – what are you even arguing? That there shouldn’t have been a stoppage of non-essential medical treatment 6 months ago that lasted about 6 weeks? When we had no idea how/where the virus would spread at the time and there was a shortage of PPE? I haven’t heard of any impending blanket shut down in regards to medical treatment. I have heard that medical facilities are very rapidly becoming strained again, so I expect things will tighten. 9 months into the pandemic, with all we have learned, I imagine like most of these measures, they will be more local, strategic and targeted.

  161. Not sure why Scarlett would question a nurse’s account because she works in an ER.

    Because anything that doesn’t fit with Scarlett’s narrative is wrong.

  162. Never mind WCE you said other than North Dakota, etc. My apologies for my confusion.

    So we have two claims from you.

    1. “but those four states were vilified for allowing people to continue to receive care despite very low or zero COVID rates.” You link to a New York times article about stay at home orders which most reasonable people would assume apply to bars and nightclubs and gyms and such. But no reasonable person is vilifying anyone over “continue(ing) to receive care despite very low or zero COVID rates.

    Why did you make that statement?

    2. no non-emergency medical care was available Urgent medical care was certainly available, telehealth was available for any number of concerns, non emergency diagnostic imaging, lab testing, etc. was available. In person appointments were available if warranted.

    Who is telling you states were being vilified for allowing non-emergency medical treatment or that no (again you said no as in zero) non-emergency medical treatment was available?

  163. In other lies (/sarcasm), a cardiologist in our large hospital system was explaining that they’re about to take over the cardiac ICU to become COVID19 unit for more ICU patients…which will mean they stop taking transfers from rural areas for people experiencing heart attacks, heart failure, sudden cardiac arrests or doing heart transplants because they will have to severely limit access for cardiac patients. But sure, it’s all overblown. The hospitals in our biggest cities are full of patients from rural non-masking wearing areas. I’m reading it in letters to the governor from even mid-size cities, begging for help.

  164. Rhett, I’m done. We interpret the 7 month old information about whether Arkansas, Iowa, North Dakota and South Dakota should continue offering non-urgent, non-emergency cancer care differently.

  165. I can only relate that in high med density MA until Sept my husband could not get any level of medical person to pay attention to a problem that first cropped up in Feb and became much worse in later March. We were a major hotspot, so while frustrating, it was for the first three months at least a reasonable public health measure and did not end up being life threatening. It was not easy for him, tho for the six months. Had his symptom been an indication of something grave and time sensitive, it could have made a fatal difference. But since he is in the category of “dry tinder”, had he died in a public health sense it would have a “fair trade.” That is what Used to Lurk is complaining about above.

  166. “Are you being serious? For influenza, we have people with immunity from prior seasons and we have a vaccine. Those things along with masks and social distancing are sufficient to keep epidemics from happening.”

    Yes, I am.
    We always have a vaccine, which only about 50% of people get (maybe more this year?) and prior immunity from past seasons. Influenza cases are some 90% below the three-year average for prior years.

    “Masks and social distancing are not magical. They just help.”

    Keeping away from other people surely helps, but “social distancing” covers a wide range of behaviors, from standing obediently on the floor marks in stores to staying shut up at home and letting others shop for you.

    There is still no actual data that masks reduce transmission. I could post the graphs again, but there is no point. The statement that masks “just help” is essentially a religious belief, not a scientific one.

  167. We interpret the 7 month old information about whether Arkansas, Iowa, North Dakota and South Dakota should continue offering non-urgent, non-emergency cancer care differently.

    But you haven’t offered any evidence that anyone ever said or even thought what you claim. And your one of the most rational and sensible people here. So I honestly can’t figure out how you could have possibly interpreted “shut down biker bars” in ND to mean “stop elective surgeries.”

  168. Let me spell it out. If masks and social distancing can prevent the transmission of flu, why aren’t they preventing the transmission of COVID? Because, quite clearly, they are not.

    Because Covid is more contageous than the flu, d’oh.

  169. The statement that masks “just help” is essentially a religious belief, not a scientific one.

    For starters, there is a ton of mechanical evidence. As we’ve pointed out 1000 times.

  170. I’m not even sure why I’m posting this….but people that keep saying “there is no actual data that masks reduce transmission” continue to be part of the problem in this country. This is the CDC study that was released last week. Masks are not magic, they are but one tool in the fight. “Adopting universal masking policies can help avert future lockdowns, especially if combined with other non-pharmaceutical interventions such as social distancing, hand hygiene, and adequate ventilation.”

    https://www.cdc.gov/coronavirus/2019-ncov/more/masking-science-sars-cov2.html

  171. “For starters, there is a ton of mechanical evidence.”

    Sure. But there is no real world evidence.

    “The Centre for Evidence-Based Medicine at Oxford University summarized six international studies which “showed that masks alone have no significant effect in interrupting the spread of ILI or influenza in the general population, nor in healthcare workers.” Oxford went on to say that “that despite two decades of pandemic preparedness, there is considerable uncertainty as to the value of wearing masks.” They prophetically warned that this has “left the field wide open for the play of opinions, radical views and political influence.”
    A study of health-care workers in more than 1,600 hospitals showed that cloth masks only filtered out 3 percent of particles. An article in the New England Journal of Medicine stated, “[W]earing a mask outside health care facilities offers little, if any, protection from infection” and that “[T]he desire for widespread masking is a reflexive reaction to anxiety over the pandemic.”
    There are many other credible studies showing lack of mask efficacy, such as studies published in the National Center for Biotechnology Information, Cambridge University Press, Oxford Clinical Infectious Diseases, and Influenza Journal, just to name a few.” https://thefederalist.com/2020/10/29/these-12-graphs-show-mask-mandates-do-nothing-to-stop-covid/

  172. But there is no real world evidence.

    But that’s not what you said. You’ve repeatedly said “no evidence” If you say there is no evidence while admitting there is evidence that’s clear evidence that you’re full of shit.

  173. And again Scarlet, saying there is no evidence of something and proving that by posting conflicting evidence does not negate the existence of the contrary evidence.

  174. Laboratory evidence that cannot be replicated in real-world setting is worth….next to nothing.

  175. Here, testing went from easy and free to get to hours-long waits if you can find availability at all in a matter of a couple weeks. Things are getting extraordinarily bad at a very alarming rate. All the metrics are increasing rapidly, including deaths which have jumped in the last 3 weeks to double the average that we had been maintaining since May.

  176. Again Scarlett, as Finn has mentioned, you’ve grown fond of lines of argument that involve words like none, zero or no. To prove you’re wrong one only needs to find one counter example. Why are you using that totally nonsensical line of argument?

    Laboratory evidence that cannot be replicated in real-world setting is worthless

    It has been of course been replicated*. Posting one item of propaganda from The Federalist does not negate a mountain of evidence to the contrary. Yet you strangely continue to nonsensically argue that one piece of contrary evidence not only convinces you but removes from existence all items of contrary evidence.

    * Or are you back to insisting on RCT for anything you disagree with and nothing for things you do agree with?

  177. New York, for example, currently has a 7-day moving average of 25 deaths.

    One of them was my accountant, sadly. Apparently he died last week. We just found out.

    To say we have reached herd immunity in NY is absurd. Cases are rising again and so are hospitalizations. New Jersey, which had an even higher death rate than NY in the spring, is experiencing a rapid rise in cases now. Connecticut and Massachusetts are also experiencing second waves. And no, Scarlett, not all of the dry tinder has burned. There are still lots of elderly folks in the northeast. Sometimes I wonder where you get these ideas.

  178. “The hospitals in our biggest cities are full of patients from rural non-masking wearing areas”

    That must be infuriating.

  179. “The hospitals in our biggest cities are full of patients from rural non-masking wearing areas”

    Well, those people understand that it’s all a hoax.

  180. This is the CDC study that was released last week.

    Sunshine, surely you know this study means nothing because it contradicts Scarlett’s opinion.

  181. “However, last spring, the shutdown in states other than Iowa, Arkansas, North Dakota and South Dakota meant no non-emergency medical care was available, even when the local case rate was zero or nearly zero.”

    I live in a state other than those you listed, and was able to get non-emergency medical care last spring.

  182. “influenza has virtually disappeared in the US.”

    Since the pandemic started, there’s been a lot of electrons, ink, and air time given to calls to vaccinate against the flu as one way to mitigate against CV-19 and its impact on our HC systems.

    Perhaps this is due in part to many people responding to those calls to vaccinate.

    Also note that the website you referenced provides data based on visits to healthcare providers. Another possible contributor to those low flu numbers is people being more reticent about visits to HC providers in general due to fears of CV exposure.

  183. Looking at the flu data, it appears that we may simply be replacing flu deaths with Covid deaths.
    We won’t know for some time but excess death data for 2020-21 flu season will be instructive.

  184. “How can cases be increasing in NYC and Chicago with all of the masks?”

    Because as everyone who isn’t completely ridiculous understands, they aren’t magic. Just like some still die in car accidents despite wearing a seatbelt. Enclosed spaces and cold air increases the ability of the virus to transfer.

    I truly do not understand what you are thing to accomplish.

  185. “If she only wants to care for sick people of whose behavior she approves, perhaps she is in the wrong line of work.”

    I think many people in HC are there because they want to help people be healthy, get healthy, and stay healthy.

    So having patients get sick and die for any reason is disheartening to them, and having many patients die because of not taking some basic measures is even more disheartening to them, whether those measure are minimizing situations likely to facilitate coronavirus transmission, or taking meds regularly, or following dietary recommendations, or exercising.

  186. “How can cases be increasing in NYC and Chicago with all of the masks?”

    Colder weather and shorter days leading to more time spent indoors.

  187. “However, last spring, the shutdown in states other than Iowa, Arkansas, North Dakota and South Dakota meant no non-emergency medical care was available, even when the local case rate was zero or nearly zero.”

    I live in a state other than those you listed, and was able to get non-emergency medical care last spring.

    My parents have had their usual round of doc visits, my mom has had extensive dental work done, and my dad’s had a couple melanomas removed. They don’t live in those states either.

  188. My dentist’s office was shut down from March to August. My employee was not able to get physical therapies, my husband’s surgery was cancelled. We don’t live in Iowa, Arkansas, North or South Dakota.

    My son’s doctor tried to do teleheath, but the internet connection wasn’t strong enough.

    DD1 has a significant health concern. She underwent exploratory surgery, that might have been unneccesary, without actually seeing a health professional in person.

    Non emergency medical isn’t always available still.

  189. “She underwent exploratory surgery, that might have been unneccesary, without actually seeing a health professional in person.”

    Who performed her surgery? (I don’t mean to be flip. I just don’t understand what you’re saying.)

  190. Cass, I don’t think anyone is saying that there weren’t places where it was hard to get medical services last spring. We’re just pointing out that it wasn’t true that no non-emergency care was available outside of those 4 states.

  191. My son’s doctor tried to do teleheath, but the internet connection wasn’t strong enough.

    Just an FYI* you don’t need to use Skype or whatever they are telling you to use. You can just have them call you.

    * not that this applies in Cass’s son’s particular case.

  192. The notion that people are contracting COVID because they did something “wrong” is appalling. It’s a virus. It doesn’t actually care what you think about it. Some people take every possible precaution and still get it. Others are out and about without incessant hand sanitizing and distancing, and even come into close personal contact with positive cases and always test negative.
    Eventually, enough people will contract the virus in a community and cases will begin to decrease.
    Pretending that we can control the virus if everyone would only cooperate and behave is getting us nowhere. But it apparently makes the shamers feel superior to the déplorables. Hence the viral video from the nurse living in a county with one COVID death, who has somehow had a whole lot of Covid deniers perish on her watch.

  193. “My son’s doctor tried to do teleheath, but the internet connection wasn’t strong enough.”

    My first telehealth appointment was done via landline.

  194. From our posters, it seems that there were/(are ?) some areas of the country where it was hard to get medical issues taken care of in a timely fashion.

    I am glad we got MIL’s pacemaker in, in Feb and she had the necessary follow up appointments before the shut down. Our dentists and doctors opened right back up. Initially people were hesitant to go in but their protective measures seemed to have worked. I noticed that the pediatrician’s office has stopped taking temperatures upon entry, though my hair salon still takes temperatures.

  195. Eventually, enough people will contract the virus in a community and cases will begin to decrease.

    With two +90% effective vaccines due out in the next few months that seems highly unlikely to be how this ends.

  196. TCM ,
    She may well work outside her county, but the neighboring largely rural counties don’t have the death numbers to support her story either. Not that anyone is asking those questions.
    It has a Jussie Smollet vibe.

  197. Rhett,
    In what month do you suppose that half of Americans will have received a vaccine?
    I think you are greatly overestimating the numbers of people who will want to be guinea pigs. But we can revisit next May and see where things stand.

  198. I think you are greatly overestimating the numbers of people who will want to be guinea pigs.

    Anti-vax Scarlett is right around the corner. Of that I have no doubt.

  199. WCE,

    To quote your article:

    The theme? How to reopen states’ economies amid the public health crisis.

    Would that not tend to attract the kind of people who think reopening should be the priority?

    The 18th annual event was a third of its regular size,

    Presumably those who think public health should be the priority for the next few months until the vaccine is available stayed home. Could that be it?

  200. WCE….agree that is hypocritical and careless. Missouri legislators just held a retreat to work on priorities for 2021 (in the state, but gathered at one resort). You can predict – yes, there are now attendees who came down with covid. And the gov was nice enough to post photos from the event (before the covid positives emerged) where they are sitting around a horseshoe shaped table sans masks. Who does that these days??

  201. Scarlett – she is a traveling ER nurse working in rural SD hospitals according to one of the articles I read.

  202. “Lobbying powerhouses Pacific Gas & Electric, Southern California Edison and the Western States Petroleum Association sat out the conference this year. A spokesperson for Edison cited internal nonessential travel restrictions during the pandemic.”

    I can’t believe PG&E actually learned a lesson somewhere along the line.

  203. In what month do you suppose that half of Americans will have received a vaccine?
    I think you are greatly overestimating the numbers of people who will want to be guinea pigs. But we can revisit next May and see where things stand.

    The issue will be the supply, especially since you need two doses, not how many people are willing to get it.

  204. “From our posters, it seems that there were/(are ?) some areas of the country where it was hard to get medical issues taken care of in a timely fashion.”

    Yes. It would be correct to say that some people experienced and perhaps continue to experience delays and reduced availability of medical care due to Covid – whether through measures to prevent the spread or because medical resources are pivoting to Covid care because of local case/hospitalization rates. This does have a cost to society.

    What I am objecting to is blanket and definitive statements that there was a “shutdown” in non-essential medical treatment outside of 4 particular states that were “shamed” for continuing to treat cancer patients. It was also insinuated that this continued beyond a short window at the beginning of the pandemic. This is patently untrue – it’s an extreme exaggeration.

    We can’t have a discussion about cost/benefits based on extreme exaggerations of the truth. Or – if you prefer – “lockdown porn”.

  205. The do as I say, not as I do crowd, regardless of political alliance, make me really irate. Almost as irate as the Covid-deniers.

  206. The issue will be the supply, especially since you need two doses, not how many people are willing to get it.

    On NPR this morning, they were saying that the two different vaccines have different requirements, so would be used differently, one of them mostly for places like university campuses where there would be a lot of people to get it in a short time, the other at, I guess, doctors offices

  207. I saw this post on FB today. But he hasn’t died yet, so it’s nothing to be concerned about.

    Just for those of you who have said “I don’t know anyone who has ever had covid” or “young healthy people don’t get covid” or “young people don’t get that sick from covid”, here you go:
    My 27 year old son has covid. He’s miserably sick. Has been for daysssssss. He’s quarantined alone in Wisconsin. He’s coughing so much he hurts, he’s dehydrated, he’s exhausted and he’s hours away from everyone he knows.
    So please, just shut up with the pandemic politics. Stop with the hoax talk, the rights debates, the “only old people” rhetoric. One day you might be the parent who is helpless, miles away from your sick child who is struggling, all the while seeing insensitive memes and comments.

  208. On NPR this morning, they were saying that the two different vaccines have different requirements, so would be used differently, one of them mostly for places like university campuses where there would be a lot of people to get it in a short time, the other at, I guess, doctors offices

    But it’s still going to take quite a while to get the supply up.

  209. I think it’s going to be a while for the vaccines to arrive in significant numbers. However, those institutions that are operating in person now have developed significant knowledge to keep operating safely through the ups and downs. I don’t think the institutions that are remote currently are going to open up early next year and I would say this will extend to fall of next year. It’s not easy to get the momentum to be in person, it’s expensive and it’s easier to remain remote.

  210. I cited those four states as examples because their governors did not issue shutdown orders and, at the time, they were the only states without shutdown orders.

    I did not intend to make a definitive argument about every other county in the United States and I didn’t use the word “shame” anywhere.

  211. From the article WCE linked:

    “the stringent requirements in Hawaii’s mandatory Safe Travels program.”

    Many here think those requirements do not characterize those requirements as stringent at all.

  212. Vaccines are great, and have saved millions of lives. Sorry, Rhett, but I’m not an anti-vaxxer. My kids got all of their shots, but though I nag them about flu shots, as adults only the parent among them gets that vaccine.

    Operation Warp Speed has been truly amazing. But we are in uncharted territory with these vaccines. Considering that the vast majority of people will survive a bout of COVID with no real medical issues, it will be difficult to persuade many Americans to submit to these vaccines, even if approved (and they are not yet approved). By the time a vaccine is actually available to most people, the virus may well have peaked in many communities, which will further limit interest. And then there is the two-shot issue, plus refrigeration concerns with the Pfizer vaccine.

    Rhett, you suggested that employers may require a COVID vaccine, but the downside risks of such a requirement are significant, given the limited data on adverse side effects.

  213. @WCE – You’re right you said vilified rather than shamed. I am getting lost in your comments and all the other banter with Rhett between the hypothetical Dad who couldn’t get cancer treatments and the maybe real dad who did because he was in a different state. And claims of “shutdown” months ago vs the current state of things.

    In the end – if the argument you are making is that there is a cost to Covid prevention and treatment pushing out other necessary types of medical care – for a variety of reasons some of which were not necessary in hindsight – then we are in agreement. The question is – what to do?

    And the healthcare system here in Flyover country is seriously strained right now as Sunshine and others have said. So that’s a different situation which I know you have acknowledged. But from what I can tell, once the first wave started abating here, the Heath care machine ramped up quickly. It’s now that they are potentially dialing back as the number of seriously ill Covid patients is growing at an alarming rate again.

  214. Oops, Many here do not characterize those requirements as stringent at all.

    Many see them as minimal, and a tacit acknowledgement that TPTB have no intention of implementing measures to strictly enforce quarantine requirements on arrivals from off island.

  215. I certainly would support my employer rolling out a voluntary Covid vaccine program at work, would one come to market and be available to normal people. I picture it would be much like they do with annual flu shots. Participation in that program is around 50% in a normal year.

    That is more how I see it happening in a non-Heath care context. Especially when special Covid leave policies are rolled back. (e.g., my brother was out for 3 weeks with Covid and was paid the whole time – he would not have been if he had the flu. But then again, he was also exposed at work in an outbreak, and work slowed as >20% of the team were sick at the same time.)

  216. “the two different vaccines have different requirements, so would be used differently, one of them mostly for places like university campuses where there would be a lot of people to get it in a short time”

    Due to the stringent refrigeration requirement for the Pfizer vaccine, my guess is that vaccine will only be given at a small number of locations, mostly if not entirely in places that already have the refrigeration capacity to store the vaccine.

    Vaccination outreach efforts to take the vaccine to potential vaccinees would probably use the other vaccine, or a newer vaccine that does not have refrigeration requirements beyond what already commonly exists.

  217. Due to the stringent refrigeration requirement for the Pfizer vaccine, my guess is that vaccine will only be given at a small number of locations, mostly if not entirely in places that already have the refrigeration capacity to store the vaccine.

    That includes a lot of universities, though. The Santa Cruz community is gloating about UCSC having the correct kind of refrigeration in their labs and how the school will work with the community to store it.

  218. Ivy, I definitely agree with your comment, “In the end – if the argument you are making is that there is a cost to Covid prevention and treatment pushing out other necessary types of medical care – for a variety of reasons some of which were not necessary in hindsight – then we are in agreement. The question is – what to do”

    I think we need to have local responses to local conditions and to let medical professionals (dentists, nonemergency doctors) make their own decisions about reopening. Last spring, the most pessimistic modelers received the most attention and they were wrong about how fast the virus would spread.

    I had discussed COVID with people from China before Chinese New Year in January and it was apparent to I and my Asian colleagues by ~March that COVID would be present for years when the public health message was “15 days to stop the spread.”

  219. I think we need to have local responses to local conditions and to let medical professionals (dentists, nonemergency doctors) make their own decisions about reopening.

    That’s what happened. The only exception might have been some state level bans on elective surgery. But as an example my dentist was always open for urgent issues. If you wanted a cleaning that had to wait a few months of course. I just checked and that was the case on OR. My doctors office was also always open if needed. The same seems to be the case in OR.

    I looked a little deeper into OR and Kaiser was aggressive in transferring resources from outpatient care to inpatient care but that was a private organization doing what it thought was best.

    There is a nugget of miss-understanding here that I’m not quite getting. You seem to think things happened that didn’t happen and if they did happen you think the decision was made at a vastly different level than it actually was.

    And as you know I think you’re always well informed and have very well reasoned arguments so I’m just trying to find out where the disconnect is.

  220. Rhett, my point applied to routine, not urgent issues.

    My dentist acquaintance was not allowed to be open for routine visits and my dentist and my kids’ dentists were closed. No one (dentists, hygienists, assistants) got paid for ~6 weeks. There were almost no COVID cases during that ~6 weeks.

    I want to make sure that sort of economic hardship isn’t created unnecessarily.

    Not getting paid stinks.

  221. Dakota had the highest COVID-19 mortality rate of any other state or even any other country in the world last week, according to a shocking analysis by the Federation of American Scientists.

    South Dakota ranked third-worst in the world.

    Both states also have the lowest rates of face mask use in the nation.

    The rates are what health experts would expect in a war-torn nation — but not in the U.S., the scientists said.

    “How could we allow this in the United States to happen?” Dr. Ali Mokdad, a health professor at the University of Washington in Seattle, told USA Today. “This is unacceptable.”

    It’s a situation “as bad as it gets anywhere in the world,” complained Dr. William Haseltine, president of Access Health International, who blamed state leaders for failing to adopt lifesaving health measures.

    https://m.huffpost.com/us/entry/us_5fb30a6ac5b6a46646702d74

  222. South Dakota Gov. Kristi Noem
    Gov. Kristi Noem, a Republican in office since 2019, has adopted much of the language of President Donald Trump during the pandemic.
    She has resisted restrictions on gatherings and given credence to those who question whether masks are helpful in stopping an airborne virus.
    “There are many others who question the effectiveness of masks, and South Dakotans should take the time to read this information so they can make informed decisions for themselves and their families,” she wrote in an op-ed last month. “As I’ve said before, if folks want to wear a mask, they should be free to do so. Similarly, those who don’t want to wear a mask shouldn’t be shamed into wearing one. And government should not mandate it.”
    Noem has also encouraged crowded gatherings with no social distancing, in particular at a Trump rally at Mount Rushmore in July.
    The results have been devastating health-wise. South Dakota has averaged more than 1,400 new coronavirus cases per day over the past week in a state with about 885,000 people. Adjusted for population, it’s the second-highest number of new average cases in the country. The state’s seven-day positivity rate is a stunning 58%, and more people are hospitalized per capita than in any other state, according to the Covid Tracking Project.

    Wyoming Gov. Mark Gordon
    In the country’s least populous state, Gov. Mark Gordon, a Republican who took office in 2019, did not issue stay-at-home orders in the spring and has not required people to wear masks.
    Yet after months of advising residents to take “personal responsibility” to protect themselves, he admitted Friday that the strategy had failed. Wyoming has the fourth-highest number of daily new coronavirus cases per capita over the past seven days, along with sharply rising hospitalizations and deaths.
    In a news conference brimming with frustration and anger, he called people “knuckleheads” for their irresponsible actions and said it was “time that Wyoming woke up and got serious about what it’s doing.”
    The virus itself has compromised the workforce more than any government actions, Gordon said.
    “We’ve had more businesses around the state closed by sick workers than by any of our health orders,” he said.

    https://www.cnn.com/2020/11/17/us/coronavirus-midwest-northern-governors/index.html

  223. WCE,

    Or maybe I’m jumping to conclusions. Maybe you don’t know a lot of people who got the extra UI money or business owners who got the PPP money so it wasn’t something that immediate jumped to mind when thinking about what must have happened to the dentists, hygienists and assistants.

    Is that what happened?

  224. Rhett, many low-level staff didn’t get paid unemployment here for 2 months, because Oregon’s systems were so messed up.

    Less than $1200/week unemployment doesn’t begin to cover the expenses of a dental office, which include office rent, equipment rent/depreciation, utilities, etc. as well as staff pay so the dentists paid a disproportionate cost for the shutdown, compared to W-2 employees.

  225. Rhett, I’m not sure I ever thanked you when the extra unemployment news came out, but I should have because I tried to help my housekeeper apply for it. Oregon unemployment system was too outdated for her to submit an application as a non-W-2 employee.

    The dentists did not get PPP money that I know of; the system was very complicated and relied on rehiring ALL your employees, which is why the church daycare didn’t participate– too much risk that not ALL employees could be rehired.

    That was my experience; I know the theory of extra unemployment/small business support was different than the rollout, as is so often the case with government programs.

  226. WCE,

    You’ve spoke to your dental hygienist and they said their claim was delayed?

    It seems like you’re sticking together a series of edge cases and saying, “This is what happened to the average person.”

    For example you said, “ Rhett, many low-level staff didn’t get paid unemployment here for 2 months.” So I Google as one does;

    400k claims for unemployment benefits since March 15. Of those, 40,899 claims haven’t been processed as of May 22,

    40k is certainly many. So you are correct. But 90% didn’t have to wait that long. And it seems 64% got their money in 2 weeks.

    Is my impression that you’re using edge cases and mistaking them for the average case mistaken?

  227. Oregon unemployment system was too outdated for her to submit an application as a non-W-2 employee.

    Non-W2 employees getting UI had never happened in human history prior to March 2020 as far as I know so I’m not sure outdated is the right word to use.

    And maybe that was just a mistake in phrasing. We’re all not writing a legal brief or novel. But it does tie in to some of the other things you’ve said.

  228. Rhett, you are probably correct that the majority of unemployment claims were paid, but my experience trying to help my housekeeper (who couldn’t submit a claim and so doesn’t appear in the unprocessed claims statistic) is what affected me emotionally.

    I guess I have higher standards than “the average person received their unemployment in a timely manner.” I really care about the people who are disadvantaged by being poor, not able to appeal claims competently, etc. These are the same low aptitude people you often write about- the below average, and they were the people most hurt by the shutdown.

  229. I guess I have higher standards than “the average person received their unemployment in a timely manner.”

    Gov. Ron DeSantis said that result was by design.

    “Having studied how [the unemployment system] was internally constructed, I think the goal was for whoever designed, it was, ‘Let’s put as many kind of pointless roadblocks along the way, so people just say, oh, the hell with it, I’m not going to do that,’ ” DeSantis told a Miami CBS affiliate this week.

    https://www.npr.org/sections/coronavirus-live-updates/2020/08/06/899893368/gov-says-floridas-unemployment-system-was-designed-to-create-pointless-roadblock

    There seems to be only one side that wants to make UI hard to use.

  230. And to beat a dead horse:

    I believe that was an 11 sigma event. I think getting the average claimant their money in a reasonable amount of time pretty dam good under the circumstances.

  231. I certainly would support my employer rolling out a voluntary Covid vaccine program at work, would one come to market

    Ivy, your use of conditional gives me hope, but you don’t really mean that a different distribution system might be possible, do you?

    WCE, on the dentist and their W-2 employees not paying the same share of the costs of the practice shutting down, read up on progressive taxation. It’s a similar idea.

    Finn, correct, the storage requirements are the main reason one would be more limited in where it could be used.

  232. The home country:
    My older relatives are still isolating themselves as much as possible. There are advisories/ restrictions on people over 65.

    From the WSJ:
    As Covid-19 infections soar in the U.S., India, which has the world’s second-highest number of cases, has seen its numbers tapering off in recent weeks, even though it has loosened restrictions on activity.

    The country reported on Tuesday its lowest single-day increase in four months, with 29,163 new cases, according to the Health Ministry, and on Wednesday reported 38,617 new cases, its 11th straight day with fewer than 50,000 new cases.

    The number of daily cases peaked at 97,894 on Sept. 17. The national case total is at 8.9 million, according to the ministry.

    India began to loosen restrictions in May after a weekslong national lockdown and continued reopening in the following months, during which the number of cases surged and then began to decline.

    While there is no conclusive evidence as to why the number of new infections has been declining, officials have suggested rising awareness and wider use of masks as reasons.

    Some scientists also speculate that growth in cases has slowed dramatically because the virus has already spread through the most crowded and vulnerable communities. Blood tests show that more than 30% of people in some neighborhoods in Mumbai, for example, have had the virus.

    The Health Ministry said Tuesday that the lower rate of new infections demonstrates that people have widely adopted appropriate behavior.

    Prime Minister Narendra Modi has made frequent appeals to the public on the importance of wearing masks and maintaining social distance to slow the disease’s spread until a vaccine becomes available.

  233. The Danish RCT on masks was finally published in the Annals of Internal Medicine. The results were completely consistent with the previous published research on masks:

    “The recommendation to wear surgical masks to supplement other public health measures did not reduce the SARS-CoV-2 infection rate among wearers by more than 50% in a community with modest infection rates, some degree of social distancing, and uncommon general mask use. The data were compatible with lesser degrees of self-protection.” https://www.acpjournals.org/doi/10.7326/M20-6817

    The question whether masks protected OTHERS was not part of the study design.

  234. “Ivy, your use of conditional gives me hope, but you don’t really mean that a different distribution system might be possible, do you?”

    I’m just saying would because a vaccine is not actually approved or produced in quantities large enough for employer programs for office workers who have been WFH since March 13. I am not high on the priority list for a vaccine, and I understand that.

    @WCE – My friend who is a dentist in private practice received a PPP loan, but that program certainly had its problems. I know our UI system was completely overwhelmed and slow as well, and also was dealing with increased fraud. My friends who applied managed to get paid very quickly, but I know that was not the case for everyone – and I’m sure the independent contractors faced more challenges as the system was not set up for that.

    Anyway – hindsight on the blanket shut downs in March (which is what you seem to be the most concerned about). Yes, there was a real cost to those – financial, public health and personal. Was it worth it? I don’t know how we can ever know – the virus was so unknown at that point that dealing with more outbreaks in more places would have been worse then than it is now. Tests and PPE were limited. Treatments were primitive compared to what we know now. We were all still using hand sanitizer like crazy while talking 2 feet from strangers. We don’t really know what the “cost” was of the other options. Luckily, we haven’t had to take those kind of blunt measures again as we know more and can be more local. So to me, it seems like we have moved toward what you want – more local decision-making and more flexibility. Like I said – my dentist, eye doctor, ob/gyn office have all been open “normally” since May. With extra procedures – mask usage by all, temperature checks, emailed pre-appointment health questionnaires, capacity limits, and that horrible mouth vacuum contraption at the dentist that Kerri & I were complaining about. I do think the temperature checks and health questionnaires are a little silly, but maybe they stop a few people. Who knows – it’s a minor nuisance.

    Maybe it is different in Oregon. I have not consulted The Google (and I don’t know that The Google tells me what it is like on the ground anyway – that’s why I like these discussions).

    In the reports from the state, there isn’t a pattern of transmission at medical offices, so I don’t see that they will be shut down. Same with hair salons and other “non-essential” businesses where people are masked and not eating/drinking/lingering. Most of the cases that they can actually trace seem to be from private gatherings and restaurants – which makes a lot of sense.

  235. We have cases traced to workplaces and nursing homes but probably most cases aren’t traceable. Within household spread is probably most common. Portland, which is denser and where restaurants/coffee shops are more commonly visited, has higher case rates.

  236. @WCE – Yes, I forgot about workplaces, which is where my family members who work essential jobs have caught the virus.

    I just looked at the restrictions put in place for the end of this week, and medical offices do not have additional restrictions going into effect. Salons/spas have to discontinue beard trims/facials and other activities where a mask cannot be worn, and capacity limits continue, but they do not have to close like in the spring.

  237. I’m extremely aware of workplace transmission because I work in a loud manufacturing area, the type of place where lots of transmission have occurred elsewhere (but so far not where I work) and it frustrates me when people attribute spread to “people not wearing masks.” People have been wearing masks since March, but masks only reduce transmission by ~20%.

  238. Ranking the effectiveness of worldwide COVID-19 government interventions

    https://www.nature.com/articles/s41562-020-01009-0?utm_source=newsletter&utm_medium=email&utm_campaign=newsletter_axiosvitals&stream=top

    “Abstract

    “Assessing the effectiveness of non-pharmaceutical interventions (NPIs) to mitigate the spread of SARS-CoV-2 is critical to inform future preparedness response plans. Here we quantify the impact of 6,068 hierarchically coded NPIs implemented in 79 territories on the effective reproduction number, Rt, of COVID-19. We propose a modelling approach that combines four computational techniques merging statistical, inference and artificial intelligence tools. We validate our findings with two external datasets recording 42,151 additional NPIs from 226 countries. Our results indicate that a suitable combination of NPIs is necessary to curb the spread of the virus. Less disruptive and costly NPIs can be as effective as more intrusive, drastic, ones (for example, a national lockdown). Using country-specific ‘what-if’ scenarios, we assess how the effectiveness of NPIs depends on the local context such as timing of their adoption, opening the way for forecasting the effectiveness of future interventions.”

  239. We are now a week out from the event where a 20 year old with active (symptomatic) infection spent a day working at a clothing store while wearing a mask. As far as they can tell, no one has caught COVID from that person. (A neighbor has contracted it from her, but they had “close contact”). They’ve done 22000 tests in the Auckland area over the last week. We are at 4 cases of covid in the country (excluding imported cases who have been under managed isolation the entire time they have been in the country).

    I was definitely reluctant to endorse mask wearing in the beginning – I thought the amount of face touching that occurred with masks was too much to justify their use (as Ivy noted above – the bad old days when we were using lots of hand sanitizer and standing close to others to talk). However, as it has become more clear that it is aerosol/particles that are the bigger problem, I think masks are more valuable. I appreciate this group for the ongoing conversation – it helped me articulate my thoughts and change my mind.

  240. OK, not posting the text. From the page:

    “PLEASE NOTE
    The Washington Post is providing this important information about the coronavirus for free.”

    I take that to mean anyone, whether a subscriber or not, can access that page. If anyone can’t read it, I can post the text.

  241. “I was definitely reluctant to endorse mask wearing in the beginning”

    OTOH, I was not. I thought the potential benefits, of reducing transmission by capturing some of the virus being expelled by contagious people, far outweighed the likely downsides.

    I thought the concern that virus would collect on the exterior of the masks, then get transmitted by the wearers’ hands to their eyes, noses, or mouths, to be ridiculous. Where would all those viral particles come from other than the noses and mouths of infected people?

  242. Bill Gates has a new podcast with Rashida Jones, and they had Fauci on the first episode. Fauci also talks about the vaccines and the expectations of how things could go from here. Gates gives a great explanation of why masks were initially not recommended based on how other illnesses spread and why we learned that COVID is different and masks are effective. It’s well worth the listen or reading the transcript.

    https://www.gatesnotes.com/podcast

  243. Here’s an article on decreased hospitalizations following mask mandates in 1083 US counties. Masks work!
    Until they don’t. The article was withdrawn “because there are increased rates of SARS- CoV-2 cases in the areas that we originally analyzed in this study.” https://www.medrxiv.org/content/10.1101/2020.10.21.20208728v2

    It’s back to the drawing board. But if masks really do work, eventually some data will emerge to prove it.

  244. Scarlett,

    What is with your “gotcha” fascination with masks? Is it just some innate contrarianism? I just can’t wrap my head around how you think you’re helping with the vaccine potentially out in a few weeks.

  245. Scarlett, if you want evidence that masks work, you could look at the study WCE just mentioned says the reduce transmissions by 20%

  246. @Finn – if the primary source of infection was particles on fingers leaving particles on surfaces and getting picked up by other fingers and then eventually touching mucous membranes (which seemed like a good theory in the beginning), anything that substantially increased the amount of disease particles on fingers and disease particles on surfaces would increase the spread.

    So you (infected), touch your mask 3 times per minute and touch 47 surfaces in the grocery store. I, unmasked and uninfected, touch some of the same surfaces in the grocery store and then touch my face. I was at higher risk because of the disease particle sponge you were wearing on your face and touching all the time. However, it turns out that we mostly aren’t catching covid in the produce section of the grocery store, so I stand corrected.

  247. “So you (infected), touch your mask 3 times per minute and touch 47 surfaces in the grocery store.”

    And apparently the assumption is that if you (infected) were not wearing a mask, you would not touch your face at least 3 times per minute, and the outside of your mask would be more heavily contaminated with virus than your face would be if you didn’t wear a mask, and that the virus you were expelling onto your mask. e.g., to land on those same surfaces that would be contagious because you touched them after touching your mask, would be harmless if not stopped by your mask.

  248. Rhett,
    Just following the science. And the data.
    Vaccines are a long way off for most of us.

  249. Scarlett,

    That’s didn’t answer the question. You didn’t follow the science on charter schools but you did on the wisdom of vaccines. Why do you think masks set you off? Is it a partisan thing?

    Anti-vaxers, as far as I can tell run the gamut from old school John Birchers to hippie doulas. Is that it?

  250. S&M, the studies say masks reduce transmission by at most 20%. Here’s a link to the 2019 WHO report that says they don’t work for influenza, no longer available. :)

    The public health message around masks would be a lot more honest if it said, “If 5 of you are going to catch COVID at work, with masks, probably only 4 of you will catch it. Or maybe it’s still 5. We can’t tell if the cloth mask works or if people wearing masks change their behavior.”

    https://drive.google.com/file/d/1-bQve-xvNnXBpyASzTfSKW4SLzYHz1_p/view?fbclid=IwAR32KjrTmC80zZeRgCnuNbopobx7e9lDxzxqSOqd7EyzcTND7-8LHXDMheI

  251. WCE, I haven’t read the WHO report, but the 2019 date makes me suspicious that it focused on mask efficacy in protecting wearers, and ignored their efficacy in protecting others from the wearers.

  252. “If 5 of you are going to catch COVID at work, with masks, probably only 4 of you will catch it. Or maybe it’s still 5. We can’t tell if the cloth mask works or if people wearing masks change their behavior.”

    I don’t think that’s the way it works. In a given 200 person conducive environment a super-spreader might give it to 50 or 100 and with masks 10, 5 or in some cases 0. From what I can tell your mental model is that every contagious person is generating the same amount of virus and the same number of airborne particles. In terms of particles and virus the difference between any two people can be a factor of 1,000,000.

  253. Scarlett, we’re not having that discussion. As you may recall, the last time we did you ended it by saying you didn’t care what the data said. As long as the parents thought that it worked, that was all that mattered.

  254. WCE,
    I thought of you when I read this piece. It’s long, but you might enjoy it. The author is a chemistry PhD with a background in the pharmaceutical and biotech industries. Here is a sample:

    “Assuming that a person is shedding virus and they produce droplets that contain hitchhiking virus, and assuming the face covering actually stops ALL droplets (best-case scenario), the following molecular pathway will likely occur:

    The droplet will lose its moisture. The timing may be different than just going out into the environment but moisture will be lost. However, the expelled droplets may accumulate faster than evaporation. If that happens, the facial covering starts to become saturated with moisture, mucus, cellular debris, bacteria, etc. as well as virus molecules.
    The virus molecule DOES NOT EVAPORATE and no matter what happens as far as the droplet is concerned, the virus is now on the face covering, at least initially. This means that the face covering is now contaminated and is a possible source of transmission, both contact and airborne.
    The virus is not somehow magically “glued” to the mask but can be expelled, whether or not there is still moisture. This can happen the next time a person breathes, speaks, coughs, sneezes, hisses, grunts, etc. So, the virus can be expelled out INTO THE ENVIRONMENT from the face covering.
    So, the face covering acts as an intermediary in transmission. It can alter the timing of the virus getting into the environment, but it now acts as a contact source and airborne source; virus can still get into the environment. Since we know that the stability is good on most covering and mask materials, it does nothing to break down the virus until the covering is removed and either washed or discarded (appropriately).” https://www.aier.org/article/the-year-of-disguises/amp/?__twitter_impression=true

  255. Scarlett,

    Do you ever notice you only ever link to hyper partisan websites? AIER? The Federalist? And the articles are so often by people with no particular expertise on the the subject at hand.

    So very odd.

  256. Rhett, the superspreader model doesn’t account for the “threshold of infection” that we don’t know.
    Using made-up numbers, if it takes 10,000 to 100,000 virus units to make someone sick, and a cloth mask reduces the number of virus units per meter per hour from 200,000 to 100,000, you have doubled the time to make any one person sick and probably reduced transmission by 20%.

    I haven’t seen evidence that cloth masks prevent or affect superspreader events. I suspect it depends heavily on the cloth used in the mask, whether it’s wet, etc.

  257. I haven’t seen evidence that cloth masks prevent or affect superspreader events.

    By cloth masks do you mean these?

  258. My opinion is that we have reduced/eliminated superspreader events by eliminating the opportunity for people to gather in crowded places. I haven’t been in a crowded, poorly ventilated conference room since March. Masks probably help most in nursing homes, where close contact is unavoidable. I doubt they are affecting transmission in grocery stores because contacts are transient and a few feet apart so transmission in grocery stores rarely occurred. (WHO and CDC at least used to differ in their social distancing recommendations, 1 m vs 2 m. I suspect most of the benefit of social distancing accrues in the first meter.)

    Probably the best way to assess my hypothesis would be to review superspreader events on public transportation in areas with high COVID rates before and after mask use became widespread.

  259. “No, I consider those medical grade and are not washable.”

    Those are the type I used to use on planes, as well as when I was symptomatic with a cold or flu-like symptoms, as well as when I worked in the SC industry.

    My experience is that the cloth masks I’ve been using recently, especially the multilayer ones, seem to trap a lot more moisture than those you consider medical grade.

  260. Scarlett, that poster apparently is ignoring or discounting the possibility that some of the aerosols trapped between the mask and the wearer’s face get inhaled by the wearer.

  261. One of the reasons I regularly wear a mask on flights is to help keep my throat and sinuses from drying out. That the masks seem to do that suggests that I am inhaling some of the aerosols trapped between my mask and my face.

  262. “My opinion is that we have reduced/eliminated superspreader events by eliminating the opportunity for people to gather in crowded places.”

    We clearly haven’t eliminated them. E.g., https://www.washingtonpost.com/nation/2020/11/18/ohio-wedding-covid-coronavirus/.

    I’m pretty sure there’s been some of that going on in my neighborhood. Every so often, when we’re on our walk, we’ll see a bunch more cars than normal parked near a house, and as we walk past we hear sound consistent with a gathering of a bunch of people.

    “I haven’t been in a crowded, poorly ventilated conference room since March.”

    Neither have I, but I don’t think we can accurately extrapolate that behavior to the broader populace.

    “Masks probably help most in nursing homes, where close contact is unavoidable.”

    I think it also helps a lot in other situations, e.g., hair salons, dental offices.

    “I doubt they are affecting transmission in grocery stores because contacts are transient and a few feet apart so transmission in grocery stores rarely occurred.”

    I think that depends on how well the stores are vented, customer density, and amount of virus in the community. What I’ve read suggests that aerosolized virus can hang around for a long time if not vented, and it accumulates, so those who work there could be accumulating exposure from multiple contagious customers. If those customers wear masks, the amount of accumulated aerosols would be reduced relative to their not wearing masks.

    “(WHO and CDC at least used to differ in their social distancing recommendations, 1 m vs 2 m. I suspect most of the benefit of social distancing accrues in the first meter.)”

    What I’ve read suggests that is true for the larger particles, but not so much for the aerosols if they’re not dispersed.

  263. Gavin, you dumbass. This isn’t “outdoors.” Did you think no one would notice?

  264. This isn’t “outdoors.”

    Yet they are all bundled up. Of course the optics are terrible.

    Not to make light of the situation but I bet if we showed that pic to L she’s say, “What’s the big deal? They were out on the loggia. Wait…do you not have a loggia?”

  265. That’s outdoors-ish. I’d be comfortable sitting with a few people out there. But that’s not the situation at the French Laundry.

  266. But that’s not the situation at the French Laundry.

    Have you been there recently? I don’t know what they’ve done COVID wise.

  267. “Do you ever notice you only ever link to hyper partisan websites?”

    You mean, like the Annals of Internal Medicine?
    The CDC?
    MedRXiv?
    The WHO?
    State COVID databases?

    You are always free to challenge the data to which I link, and present your own. It’s all about the data.

  268. Rhett. Did you even look at the picture?

    Sure it’s from the least flattering angle. What would my loggia pic of RMS’s dinner party look like if my back was to the archway? It would look like we were in your living room.

  269. You mean, like the Annals of Internal Medicine?
    The CDC?

    You don’t link to those. You link to hyper partisan hacks.

  270. RMS,

    It could totally be exactly what you think it is. But it’s almost like the thought that the pic was the least flattering one possible never occurred to you.

  271. And before you start getting all worked up Gavin is a slick douchebag so it totally could be exactly what you think. No doubt about that.

  272. I’m still curious what will happen if/when the masks I linked to earlier catch on. They obviously change the whole dead-virus-on-your-face thing WCE & Scarlett are into.

  273. WCE- The senior center in my parent’s small town just hosted a private birthday party last week for someone. They’ve done this for ages – cook for for 50 people and make a little money on it. They’re in a state with very high rate of cases now. I told my mother (who was cooking) that she needed to cancel the event. She said, ” but we have $500 in groceries in the fridge. Don’t worry, I’ll just stay in the kitchen.”

    Your community may have shut down opportunities for super spreader events, but other mountain west states have not. And even if they have been forbidden, there is zero enforcement. I appreciate hearing about your experience, but I don’t think it is similar to most of rural America.

  274. Meanwhile, here’s our governor.

  275. Looking at the response people here gave me when I said anyone who’s overweight can lose it if they put in the time, I’m sure that comment from Cuomo will NOT be popular.

    Over here the anti-maskers are out demonstrating. Yesterday by the Brandenburg gate it apparently got nasty between them & police. Fire hoses were brought out, but only to spray in the air & get people wet; they weren’t aimed at anyone. And a member of the right-wing extremist AFD party wasn’t as respectful as cops thought he should be when they told him to put a mask on because his doctor’s note wasn’t detailed enough, so they tackled him. All quite different from the usual protests that go on in Berlin all the time.

  276. This is all running together in my head

    1. I would like to eat at a French Laundry type restaurant.
    I was just telling DD about tasting menus.
    2. But before I do that, I must NOT eat holiday sweets especially NY Cheesecake in the interest of beating Covid and getting to my tasting menu dinner.

    Our governor should say “No BBQ for U”

  277. Dangit, Rhett! I don’t even have a PERGOLA, much less a LOGGIA! ;) Now I’ll have to build at least a pergola over the pool!

  278. Here is the latest death data, for those who like data, and it’s the deaths because that is the only thing that matters. The surging number of cases is a good thing because it’s getting us closer to herd immunity. And the surging number of hospitalizations isn’t a problem because hospitals are supposed to be full, even though they are being strained to the point where several states have said COVID-positive nurses are allowed to work. So deaths it is.

    The seven-day moving average of deaths in the U.S. has been in the 1134-1214 range for the past week. In mid-October it was in the 686-708 range.

    So the number of daily COVID deaths has increased about 60% over the last month. We can debate whether that is exponential growth or not, but I don’t know how anyone can say it’s a good thing, although I’m sure some will try.

    https://covid.cdc.gov/covid-data-tracker/#trends_dailytrendsdeaths

  279. “So the number of daily COVID deaths has increased about 60% over the last month.”

    Dry tinder. And people who were going to die really soon anyway. And a lot of those people didn’t die of Covid, they died with Covid. In reality, things are going great in the US of A

    /S

  280. Gavin is a douche and a hypocrite, and Rhett shouldn’t waste his time defending him. Especially not for this “let them eat cake” BS.

    Agree with Minca that regardless of the airflow, that is too many people in a small area.

    And really, our leaders should be setting an example and being even more careful than they are asking their constituents to be. It’s disrespectful and bad leadership.

    That goes for all of them. I really don’t care about party when it comes to this.

  281. Rhett – you have posted so many imaginary pictures of L’Abbey that if I were to ever see it, I would be looking for a stately home with driveway trees, a decked out pool, outbuildings etc.

  282. One of my favorite things about the Totebag is Rhett’s posts about L’Abbey. It brings me great joy.

  283. 9:44 was the late Bunny Mellon’s farm in Virginia. Contained within are many treasures including Rothko’s “Yellow Expanse” which was sold after her death for a reported $200 million.

  284. “Sold after her deaths for $200 million”.

    I will never, ever in a million years understand that. I do appreciate art, very much enjoy going to the wonderful exhibits that make it to Houston, etc. But no matter how wealthy I was I could never get $200 million of joy out of a painting. I think of all the things I could do with it and it makes my head spin.

    Agree with all the comments re:hypocritical leaders throughout this. I find all of it, especially the refusal to begin informing the Biden administration about vaccine distribution plans, just exhausting.

  285. I think of all the things I could do with it and it makes my head spin.

    It’s an appreciating asset. Presumably, if you had $10 billion you’d have your billions in the form of TIPS, stock, stakes in office buildings, hotels, timber land, hedge funds, private equity, VC funds, etc. Why not, rather than $200 million in a REIT you have $200 million you an hang on the wall. You buy it for $200 million now and you sell it for $400 million in a few years.

  286. Using data from Masterworks.io, which tracks auction sales from Sotheby’s, Christie’s and Phillips, Citi found that between 1985 and 2018 the art market as a whole has returned an average of 5.3% annually. Contemporary art has been the top performer, returning an average of 7.4% annually, while art from the Impressionist period has returned 5%.

    The return on art most closely matches that of fixed income. In the same time frame investment grade bonds from developed countries returned 6.5%, while global high yield bonds returned 8.1%, Citi said. Developed-market equities and private equity returns 9.8% and 13.9%, respectively.

    Not bad and you can enjoy it in a way you can’t 20 million shares of VBTLX.

    https://www.cnbc.com/2019/12/07/art-has-shown-long-term-returns-that-rival-bonds.html

  287. Hey Rhett, here’s something for you to disagree with.

    “Summary: We estimate that each month of school closures in response to the COVID pandemic cost current students between $12,000 and $15,000 in future earnings due to lower educational quality. We also estimate total value-of-life, medical, and productivity costs per infection at $38,315 for September 2020. Using these costs, we calculate the cost-benefit threshold to keeping schools closed for October at over 0.355 new expected infections in the community per student kept out of school.”

    https://budgetmodel.wharton.upenn.edu/issues/2020/10/12/covid-trade-offs-in-school-re-opening

  288. RMS,

    If for whatever reason you’d skipped 6th grade, what do you think the long term impact would have been?

  289. I’m listening to Governor Walz press conference. Physicians are sharing their stories. Walz says blame him but do whatever you can to protect health care workers who are getting sick from community spread. The physicians are near tears. You can hear the anguish in their voices. Walz is a leader. He accepts responsibility. I’m guessing he will struggle to get re-elected because he will take the blame.

    At my last church meeting members have lost friends, one works in a hospital and is exhausted and stressed, senior pastors are overwhelmed from loss of parishioners.

    When some of you say something is “only” 20% effective, well every single percentage matters right now. I say FUCK YOU to everyone belittling and downplaying this virus and the impact. And FUCK YOU if you can’t wear a mask as a sign of respect to your neighbors and healthcare workers. Show some compassion.

  290. “One easy change I hope is made is that people with use-it-or-lose-it flex spending account dollars can roll them into 2021 vs. losing the money they set aside.”

    https://www.cnbc.com/2020/04/23/use-your-fsa-or-hsa-funds-for-over-the-counter-medications.html

    “you can use your FSA or HSA funds to buy over-the-counter medications without a prescription, like Tylenol and other pain relievers, heartburn medications, allergy relief and more, for the first time since 2011. You can also use your funds for feminine care products, including tampons, pads, liners, cups, sponges, etc., for the first time.”

  291. Interesting Rocky. They do say they are probably overestimating the earnings losses to students:

    These projections are high estimates of education losses because (1) distance learning likely provides some benefit over complete school closure, (2) educators and students may improve distance learning outcomes with more experience, and (3) schooling may have some signaling component which is not reduced if students are promoted regardless of education losses.

    I’m thinking the losses will hit the kids who end up not going to college because of this. Those who go (and finish) won’t have any decrease. Employers aren’t going to care that someone had a poor 4th grade because of COVID.

  292. “distance learning likely provides some benefit over complete school closure”

    E.g., being able to mute the disruptive kids.

    We’ve also discussed how distance learning is better for some kids that F2F.

    I would hope that one benefit that comes out of this is the realization, and changes based on that realization, that distance learning is in many ways and situtations better than F2F as done prior to the pandemic.

  293. If for whatever reason you’d skipped 6th grade, what do you think the long term impact would have been?

    Rhett, my feeling is that they’re really overestimating the cost (as Denver pointed out.) People can, and always have, played catchup. And how much will the test scores matter in a couple of years when 1) Tests have been eliminated at most colleges and 2) As Fred noted earlier, there will be a scarcity of 18-year-old college applicants?

  294. As frustrated and upset as I am about the arbitrary school closures in NYC, I don’t think this will have any impact whatsoever on children’s earning capacity in adulthood. The remote learning program is infinitely better this year than it was last spring, the kids are covering lots of material, and the teachers are quite accessible to students who are struggling. So I am sad that the kids are losing opportunities for socialization — which is critically important in itself — but I am not worried about their academic progress, college-readiness, or earning potential.

    Obviously, kids who would have gone to college but end up not going will take an earnings hit. But I question whether those kids would really have gone to college and finished in the absence of covid. If a student is motivated to go to college, she is not suddenly going to lose motivation because she had a remote semester in high school. If a student was not terribly motivated, the events of this year could provide a convenient excuse.

    Maybe I would be more concerned if I had very young kids, because it is harder to design a decent remote program for early elementary school.

  295. “When some of you say something is “only” 20% effective, well every single percentage matters right now. I say FUCK YOU to everyone belittling and downplaying this virus and the impact. And FUCK YOU if you can’t wear a mask as a sign of respect to your neighbors and healthcare workers. Show some compassion.”

    One can certainly wear a mask as a sign of respect. But there has been a mask mandate in effect in your state since July, which hasn’t stopped a surge of cases.

  296. So it is the partisan angle that’s driving your anti-mask zealotry. What a terrible way to live.

  297. Partisan?
    Just pointing out some apparently inconvenient facts. Cases are surging both in places with mask mandates and those without. You can look at the data, or you can continue to ignore it. The virus doesn’t actually care how you feel about it.
    Many countries in Europe are past the peak of this wave, no matter what particular measures their governments imposed. It is likely that the same thing will happen here. Wait two weeks.

  298. Most people are doing the best they can. Wearing masks in daily life is not normal. And they don’t actually work, as the data make clear.
    Shaming and blaming people who aren’t behaving the way you want them to is probably not going to change their behavior and even if it did, it would make little difference to the spread of the virus.

  299. And they don’t actually work, as the data make clear.

    That’s just total and compete bullshit.

  300. Just for clarification, when you say “as the data makes clear.” You’re taking about the AIER data, right? Because there is a ton of other data out there. Data that you completely ignore.

    Do you realize how flawed your arguments are?

  301. The data come from the states themselves.
    You didn’t read the Federalist article I linked. The charts and graphs are based on figures reported by state COVID databases.
    Cases and deaths rise and fall along a curve that is unaffected by mask mandate dates.

  302. I don’t think you are not fulling understand the reasoning for the surge of cases here. It is lack of masks amongst friends and family. It is the lack of masks at a funeral, it is the lack of masks at the bar. The surge in cases isn’t from wearing masks at work, or shopping at Target.

    if you can provide me with statistically relevant data that shows that infections were passed around by 10 kids at a sleepover that were all masked up all the time, then yes, maybe masks don’t work.

  303. Scarlett,

    You never link to any actual data just these hack websites. It would be like you arguing with someone about vaccines and they keep posting links to The Natural News saying, “The data clearly shows vaccines cause autism.” Yeh all the data at The Natural News not all the data in the world.

  304. Cases and deaths rise and fall along a curve that is unaffected by mask mandate dates.

    Mandates =/= compliance.

  305. I would hope that one benefit that comes out of this is the realization, and changes based on that realization, that distance learning is in many ways and situtations better than F2F as done prior to the pandemic.

    Finn, I’ve said this several times, there were distance/online school options in most states (if not all) before the pandemic. Not to mention home schooling was always an option everywhere.

  306. Rhett, my BIL works as a plumber in nearby jails/prisons, so it’s not just people in prison who are affected by those outbreaks. What’s your question?

  307. Healthcare workers are begging people to wear masks. I don’t feel sorry for people who refuse to wear masks having their feelings hurt by being shamed.

  308. What’s your question?

    Mask compliance among the prisoners obviously.

    1. They live there.

    2. They probably didn’t end up living there because they are so good at following the rules.

  309. DD,

    Just because something exists doesn’t mean people know about it or know that it can and has worked.

  310. Rhett, that’s a fair point about the prisons, but I observed everyone wearing masks, temperatures being taken, to enter, etc. at the seafood plant firsthand so “Not wearing a mask” isn’t the cause of the outbreaks there.

    I guess I’m sensitive because Totebaggers assume that “Not Wearing a Mask” is why essential workers like my BIL get COVID at higher rates than people who can work from home.

  311. “I guess I’m sensitive because Totebaggers assume that “Not Wearing a Mask” is why essential workers like my BIL get COVID at higher rates than people who can work from home.”

    I think masks aren’t great for stopping people like your BIL from getting COVID at work. I do think they are good at stopping people from getting COVID at the grocery store or during brief encounters. And that is why we need to use them. They help to stop our healthcare system from being overwhelmed. We need to be able to provide healthcare to people who have no choice but to be doing their jobs outside of their houses. And the people who keep getting together with people outside of their households for non-essential activities are terrible.

  312. I have an acquaintance in prison who had CV-19. His cellmate, who weighed 400 lbs, died from CV-19 last month. My acquaintance got some Tylenol.

    His new cellmate is very violent and has already cracked my acquaintance’s head open, but he can’t ask for the nurse, because then later the cellmate will kill him for ratting him out.

    Kids! Don’t go to prison.

  313. I guess I’m sensitive because Totebaggers assume that “Not Wearing a Mask” is why essential workers like my BIL get COVID at higher rates than people who can work from home.

    You actually think that?

  314. IMO, it’s mask and distance. If you are at close quarters with a bunch of people at work, all masked and one is infected your chances of getting infected are high. If you are grocery store shopping or other shopping with lots of space, mask and a very short time being close to others at checkout your exposure is very short. Family/friends gatherings indoors and unmasked is enough to spread infection. Socializing at a distance outdoors is better.
    Proper wearing of masks is important. It doesn’t help if lots of people have their noses popping out.

  315. Rhett, isn’t the argument about whether masks “work”?

    We don’t know how much of ongoing spread is because masks have limited effectiveness and how much is due to non-compliance. My historian friend observed that people always behave angrily toward one another during plagues because they are afraid, and that I was odd because I’m so dispassionate. It helped me understand how others perceive me.

  316. Rhett, isn’t the argument about whether masks “work”?

    Not that I’m aware of. The most common example I’ve seen is the hair stylist*. With masks you can reduce or in some cases eliminate transmission between people who are interacting closely for 20 min. It wouldn’t help you if you were in confined space with someone for 8 hours.

  317. “there were distance/online school options in most states (if not all) before the pandemic.”

    OK, so one result of the pandemic may be more people choosing to take advantage of those options, which might then lead to expansion of those options.

  318. WCE,

    Louise also raises a good point about social distancing.

    Kelly is a grocery store cashier with pre symptomatic COVID but she’s a super spreader and is emitting 500,000x times the virus as another person might.

    Scenario 1: It’s the before times and she’s chit chatting with the customer as she rings and bags. The customer behind her is putting his stuff on the belt, etc. The next cashier over is doing the same.

    Scenario 2: It’ now. There is a plexiglass shield in place. Kelly is masked as is the customer. The next customer has his cart in the aisle standing six feet away.

    Would you expect transmission in scenario 2 to be substantially lower?

  319. “Mandates =/= compliance.”

    Yes, it is actually not possible to force people to wear a fresh mask every day, all day long, covering both nose and mouth. The compliance is what it is, and authorities need to accept that reality. One of the many reasons that masks have *never* been part of pandemic guidelines either from the CDC or the WHO.

    “I don’t think you are not fulling understand the reasoning for the surge of cases here. It is lack of masks amongst friends and family.”

    Right. People aren’t going to wear masks at home. That’s a non-starter (except in PA, apparently).

    “It is the lack of masks at a funeral, it is the lack of masks at the bar.”

    We wear masks at our church, for every service.
    And obviously people don’t wear masks while eating and drinking.

    What many of you don’t seem to realize is that people need social contact to be healthy. Those who live alone — and there are many — cannot be expected to consume all of their meals in solitary confinement. They *will* gather together with others “outside their household” and if bars and restaurants are either closed or unwelcoming, they will do so in private homes.

  320. I forgot to include my main point. In general when people talk about masks they are using the word masks to mean overall COVID precautions. The social distancing, the plexy glass, the working from home when possible, the bar with two seats and a potted palm then another two seats and a potted palm, etc.

  321. “I guess I’m sensitive because Totebaggers assume that “Not Wearing a Mask” is why essential workers like my BIL get COVID at higher rates than people who can work from home.

    “You actually think that?”

    Perhaps she does have that low of an opinion of us.

  322. Scarlett,

    One of the many reasons that masks have *never* been part of pandemic guidelines either from the CDC or the WHO

    Let me quote from the 2007 CDC Pandemic Guidelines:

    All these interventions should be used in combination with other infection control measures, including hand hygiene, cough etiquette, and personal protective equipment such as face masks.

    Click to access community_mitigation-sm.pdf

    Why are you so full of shit? Why? What do you hope to gain by spreading misinformation?

  323. Yes, it is actually not possible to force people to wear a fresh mask every day, all day long, covering both nose and mouth.

    Right. But that doesn’t mean masks don’t reduce the spread, as you keep arguing.

  324. I’m sorry but Is Scarlett an actual living person? She/he sounds like a bot.

    Lolly for the win.

  325. What many of you don’t seem to realize is that people need social contact to be healthy. Those who live alone — and there are many — cannot be expected to consume all of their meals in solitary confinement. They *will* gather together with others “outside their household” and if bars and restaurants are either closed or unwelcoming, they will do so in private homes.

    Right. And if they wear masks and take other reasonable precautions that will not prevent the socialization, the spread of the virus will be reduced.

    It’s not all or nothing like you keep arguing. The problem is too many people are unwilling to take the precautions that will allow them to socialize safely.

  326. “All these interventions should be used in combination with other infection control measures, including hand hygiene, cough etiquette, and personal protective equipment such as face masks.”

    Did the CDC include masking of healthy people in community settings in its 2007 pandemic guidance?

    Once again, from the CDC in February 2020:

    “Face Masks

    In our systematic review, we identified 10 RCTs that reported estimates of the effectiveness of face masks in reducing laboratory-confirmed influenza virus infections in the community from literature published during 1946–July 27, 2018. In pooled analysis, we found no significant reduction in influenza transmission with the use of face masks (RR 0.78, 95% CI 0.51–1.20; I2 = 30%, p = 0.25) (Figure 2). One study evaluated the use of masks among pilgrims from Australia during the Hajj pilgrimage and reported no major difference in the risk for laboratory-confirmed influenza virus infection in the control or mask group (33). Two studies in university settings assessed the effectiveness of face masks for primary protection by monitoring the incidence of laboratory-confirmed influenza among student hall residents for 5 months (9,10). The overall reduction in ILI or laboratory-confirmed influenza cases in the face mask group was not significant in either studies (9,10). Study designs in the 7 household studies were slightly different: 1 study provided face masks and P2 respirators for household contacts only (34), another study evaluated face mask use as a source control for infected persons only (35), and the remaining studies provided masks for the infected persons as well as their close contacts (11–13,15,17). None of the household studies reported a significant reduction in secondary laboratory-confirmed influenza virus infections in the face mask group (11–13,15,17,34,35). Most studies were underpowered because of limited sample size, and some studies also reported suboptimal adherence in the face mask group.

    Disposable medical masks (also known as surgical masks) are loose-fitting devices that were designed to be worn by medical personnel to protect accidental contamination of patient wounds, and to protect the wearer against splashes or sprays of bodily fluids (36). There is limited evidence for their effectiveness in preventing influenza virus transmission either when worn by the infected person for source control or when worn by uninfected persons to reduce exposure. Our systematic review found no significant effect of face masks on transmission of laboratory-confirmed influenza.”
    https://wwwnc.cdc.gov/eid/article/26/5/19-0994_article

  327. “The problem is too many people are unwilling to take the precautions that will allow them to socialize safely.’

    I’m not seeing this around here. Every single retail establishment has multiple signs forbidding entrance without masks. Every one. Multiple signs. Masks are required on campus even outdoors. Our church requires masks. So does every medical facility, and I’ve visited several of them with my dad over the past two months. My gym now requires masks even while exercising.

    That people are not willing to wear masks at home, or in between bites at a restaurant, is a sign that they are being sensible human beings, not that they aren’t willing to take reasonable precautions against Covid.

  328. Scarlett,

    Of course let me refer you to the conclusion of the report:

    Changes in the technology and availability of personal protective equipment will influence guidance on community use of face masks and respirators.

    Why are you so full of shit? Why? What do you hope to gain with your misinformation?

  329. “Changes in the technology and availability of personal protective equipment will influence guidance on community use of face masks and respirators.”

    Where is the suggestion that governments should require community masking of healthy people for months?

  330. Scarlett,

    Do you not realize that a quarter of a million people have died and you’re spreading lies about a pandemic?

    What the fuck is wrong with you?

  331. Where is the suggestion that governments should require community masking of healthy people for months?

    Fuck off with your sophistry. It’s perfectly clear what the report said.

  332. Some questions about the South Dakota nurse’s account:

    “Doering’s statement that she’s watched “so many” people die from the disease even as they deny its very existence, endlessly repeated on social media and presented by news outlets without corroboration, would seem to represent a broader phenomenon.

    But other nurses who work in similar settings say they’ve seen nothing of the kind.

    I called a number of hospitals in the same part of South Dakota to ask emergency room nurses if they’d noticed the same, disturbing phenomenon. At Avera Weskota Memorial Hospital, about 20 minutes from Doering’s hometown of Woonsocket, an ER nurse told me, “I have not had that experience here.” At my request, Kim Rieger, the VP for communications and marketing at Huron Regional Medical Center, one of the four medical facilities where Doering works, spoke with several nurses at Huron to get their reactions to the CNN interview. None said they’d interacted with Covid patients who denied having the disease. “Most patients are grateful, and thankful for our help,” one told her. “I have not experienced this, nor have I been told of this experience, ever,” another said.

    This in no way means that Doering’s account is untrue. But it provides, at minimum, some important context that was completely absent from the CNN interview and from all the media amplification that followed. Little or no effort was made to assess the scope of the problem that Doering so memorably described. How many Covid-19 patients in South Dakota are really so blinkered by disinformation that they’re enraged at their caregivers and, in their final moments on earth, still dispute what’s happening? No one bothered to find out.

    Perhaps it’s worth considering that Huron Regional Medical Center has seen a total of six Covid-19 deaths to date. Beadle County, where Huron is located, has registered a total of 22 such deaths, 13 of which occurred since August 1. And in Sanborn County, where Doering lives, there’s been one Covid-19 death. It’s certainly possible that the other facilities where Doering works have seen a higher number of fatalities; she may indeed have watched a great many patients die, as so many frontline workers have. But when all we have is one person’s story, it’s hard to know exactly what it means.” https://www.wired.com/story/are-covid-patients-gasping-it-isnt-real-as-they-die/

  333. Rhett,
    You’re not answering the question.
    Which answers the question.
    If you can’t keep the discussion civil and avoid the F word, maybe you should discontinue.

  334. Here is a cut and paste:

    • Whenever possible, rather than relying on the use of facemasks or respirators, close contact and crowded conditions should be avoided during an influenza pandemic.
    • Facemasks should be considered for use by individuals who enter crowded settings, both to protect their nose and mouth from other people’s coughs and to reduce the wearers’ likelihood of coughing on others. The time spent in crowded settings should be as short as possible.
    • Respirators should be considered for use by individuals for whom close contact with an infectious person is unavoidable. This can include selected individuals who must take care of a sick person at home or as part of their duties at work.
    • Facemasks and respirators should be used in combination with other preventive measures, such as hand hygiene and social distancing, to help reduce the risk for influenza infection during a pandemic.

  335. “People aren’t going to wear masks at home.”

    I’ve read first person accounts of HCW who do wear masks at home.

    Austin has also mentioned that her family will do this when her DDs return home.

  336. Thanks Reality
    Nothing there about mask mandates though. Which is interesting, because masks aren’t new. Neither are respiratory viruses. The CDC cites studies on masks and pointed out the lack of evidence as to efficacy.
    Those who question the value of mask mandates would appear to have decades of research and pandemic guidance on their sides. Those in favor of mask mandates have a firm religious belief that they work.

  337. I don’t know of one person who thinks mask mandates work. Not with Americans. People here don’t care about how their actions cause others real problems. But masks work.

  338. “What many of you don’t seem to realize is that people need social contact to be healthy”

    Perhaps. But many of us realize that it’s possible to have social contact over Skype or Zoom or Line or some other online platform, or outdoors, at 6’ or greater spacing, while wearing masks.

    Or landlines FTM.

  339. Nothing there about mask mandates though

    That wasn’t your claim. Your claim was:

    One of the many reasons that masks have *never* been part of pandemic guidelines either from the CDC or the WHO

    So fuck you. You’re spreading lies during a pandemic that has killed 250,000 people. What the fuck is wrong with you?

  340. WCE, you’ve said yourself that it might be changed behavior as much as the physical barrier of the mask itself that lowers transmission rates. Now you’re saying that when people wear masks, they don’t keep their distance. Which is it? Seems to me that the point TCM has made so passionately is right on the money—every little bit helps. Personally, I’d like to see wide use of the masks that can actually kill the virus, but even without that, let’s get everything going that we can—the bit of fabric and filter in front of people’s faces, the lessened trips outside the home, the distance from others when we do go out. Why are you trying to make this all or nothing and say that if x doesn’t take care of the whole problem, then x isn’t worth doing?

  341. Scarlett, your 7:25 post is an amazing example of taking what one person said and asserting the exact opposite, pretending that you are referring to what they said. It is one frump tactic that I don’t think I will ever get used to. I realize that it is done out of brazen disrespect, not the simple stupidity of misunderstanding that it pretends to be, but damn, was that a masterful use of it! You directly quoted Rhett saying something about ALL the various measures, from a longer post where he gave examples of several measures in use, and then you continued on about masks alone, as if the thing you had quoted and the examples of it didn’t exist—even though they are right there. It’s amazing. That ability to bulls hit is what trump should have sold instead of his fake university.

  342. Someone on the physician moms group is asking for assistance in finding her dad an ICU bed. People often ask for recommendations for a surgeon, or to jump to the front of the line at the dermatologist, but this is a first. So far, none of the 70k members can help.

  343. “Nothing there about mask mandates though

    That wasn’t your claim. Your claim was:

    One of the many reasons that masks have *never* been part of pandemic guidelines either from the CDC or the WHO”

    Masks for sick people? Sure. Masks in medical settings? Of course.
    Mandatory mask mandates for healthy people in public places — both indoors and outdoors? For more than six months? Including children? Nope. That isn’t there, because it has never been part of CDC/WHO guidance, either for bad flu seasons or for pandemics.
    It also explains why both organizations were opposed to such mask-wearing when this pandemic began.

  344. I’m not sure anyone here would like to see personal info they have shared over the years aggregated and editorialized as in the 3:33 AM post. Maybe such posts could be removed if they are not posted by the subject him/herself?

  345. Scarlett – you are not making sense. It literally says that during the pandemic people should stay home when possible, use masks if they go in to crowded settings, social distance, and wash their hands.

    Using masks has been part of pandemic planning, at least since 2007. Probably before given that people were having these same arguments in the 1918 influenza pandemic.

    Masks work. I am sorry you don’t like them. They still work. We still have a pandemic that is out of control (and will get worse) because they don’t work perfectly and compliance with wearing them is a lot lower than it could be. And they are not meant to work alone. Staying home when possible is the #1 thing to do. Not gather with people outside of your household for Thanksgiving. Not go to the mall to browse for yoga pants. Not host a party for 20 people.

    My kids wore masks all day at school for almost 13 weeks. Everyone should stop being a baby and put on a freakin mask. The stupidity in this country and stupid contrarianism is literally killing people.

  346. Thanks HFN,
    One reason that I rarely share personal information now.

    Reality, it’s natural that people look for someone to blame for the pandemic. But the rise in cases and deaths even in communities/states/countries with strict mask mandates reveals that it makes little sense to keep on blaming those who question the effectiveness of mask mandates.
    Wash hands, avoid crowds, stay home when sick. That’s about all we can do. Telling people that they have to sacrifice everything that makes their lives worth living because of COVID is not working.

  347. HFN +1

    Highly inappropriate to speak for another poster in such a personal and revealing way. I’m sure it will be deleted by the mods – rightfully so.

  348. Scarlett – you should really stop trying to confuse the issue with mask mandates and masks. Are you doing this intentionally? It seems that you are. Which is very strange.

    Masks help. End of discussion.

  349. Scarlett, I apologize for posting info about you that you’d rather not be repeated. I’ll ask the mods to delete. I do think you and I have had experiences that we found quite isolating, and when I see the extreme emphasis you put on isolation in regards to staying 6’ from others, wearing masks, interacting virtually rather than in person as much as possible, and the rest, it does often bring to mind how very hard you said it was to stay at home with little ones.

  350. I’m too tired a dispirited to argue but I will say I am with Rhett in this one. A quarter of a million living, breathing, loving, laughing people dead SO FAR, doctors and nurses working themselves to the bone and weeping and begging us to do our part to stop this and Scarlett has decided that his/her contribution to this whole thing is to say things that are patently false and discourage actions that will help people. I asked if they were a real person because I couldn’t imagine someone so soulless. I am hoping that in reality they are just a person who is alone in their house and has chosen to fill their days by causing trouble. Maybe get a cat.

  351. Lolly, I hear where you are coming from and get it that she sounds like a crank or bot. There are specific things in her background that I think explain Scarlett’s reactions, humanize her, and can soften our responses to her.

  352. A quarter of a million living, breathing, loving, laughing people dead SO FAR

    Oh no, darling, those were “dry tinder”, not human beings, and anyway they didn’t die FROM CV-19, they died WITH CV-19, and anyway our pioneer ancestors would be ashamed of us for being afraid of death.

    Of course the old people isolated in the nursing homes that some people keep crying and crying about are also “dry tinder” instead of human beings.

  353. More data on the Dakotas, from the head of the largest hospital system, who says that South Dakota doesn’t need a mask mandate:

    “Kelby Krabbenhoft, president and CEO of Sanford Health, told the Argus Leader in an interview Thursday his healthcare system is positioned well to handle the amount of COVID-19 patients coming through the door.
    Krabbenhoft, 62, said as of Thursday, Sanford Health’s network of hospitals in the region were caring for a 1,400 patients, 390 of which are hospitalized with COVID-19. And while that has put a large burden on front-line workers, he said Sanford has capacity to handle even more patients should hospitalizations continue to go up before mass vaccination begins in January.
    “At this point, we feel we’ve got this under control,” Krabbenhoft said. “There’s not a crisis.”https://www.argusleader.com/story/news/2020/11/19/sanford-healths-kelby-krabbenhoft-covid-19-hospitalizations-theres-not-crisis/6345661002/

  354. And what’s happening in LA? True blue state, unlike the Dakotas, and the population has been living with mask mandates and various other restrictions since…. April. Cases are now doubling every six days:

    “For months, Angelenos have been prohibited from exercising inside gyms, watching movies in theaters and dining indoors at restaurants. It was with these restrictions in place that L.A. County in early October recorded its fewest cases since the spring.
    “The irony about right now is we are approaching our worst numbers with the same things open as [when] we … had our best numbers” a few weeks ago, L.A. Mayor Eric Garcetti said this week.
    The virus itself hasn’t changed, and there has been little relaxation of the rules. Interviews conducted with people who have recently tested positive for the coronavirus don’t show any significant shifts in behavior compared with a month ago, such as more visits to restaurants or other businesses, said Dr. Jeffrey Gunzenhauser, L.A. County’s chief medical officer.
    For the vast majority of people sick with COVID-19 in L.A. County, officials cannot determine where they contracted the virus, he said. This mirrors national data showing that fewer than half of people with the virus know where they caught it.” https://www.latimes.com/california/story/2020-11-19/los-angeles-coronavirus-surge-contact-tracing

    Testing and tracing? Forget about it. It’s not helping in LA — in part because not everyone contacted will actually respond. And there is no evidence that the infamous “small gatherings” is the culprit either:

    “The interviewer asks patients where they went for 14 days before falling sick, because it can take up to two weeks for someone to show symptoms after being infected. But with so many people in the county sick, and so many people asymptomatic, the long list of places they may have visited doesn’t usually provide an obvious culprit, Gunzenhauser said.

    Interviews show that people who have recently tested positive visited places such as restaurants, shops, workplaces and churches at the same frequency as people who tested positive a month ago, according to Gunzenhauser.

    There’s been a small increase in the percentage of people who had attended a social gathering where someone else had COVID — from less than 1% to 1.5% — but that “certainly doesn’t explain the jump,” he said.”

    But, sure, the virus can be contained with masks, school lockdowns, and curfews. And a generous dose of public scolding.

  355. Scarlett,

    At this point we can only assume that anything you post is just more lies. You have lost what tiny thread of credibility you might once have one had. Spare us and just shut the fuck up.

    Spare us all and shut the fuck up.

  356. Rhett, calm down. Scarlett is posting inconvenient facts. I know you don’t like them, but they are still facts. I’m amazed that Scarlett still posts given the vitriol that she receives.

  357. Scarlett is posting inconvenient facts.

    She posted a flat out lie. About a pandemic in which 250,000 people died. And when confronted with her lie she doubled down. That’s disgusting.

  358. Rhett, have some compassion. I get it that she’s off-base and you enjoy sparring with her, but think through what you know about Scarlett and I’m sure you’ll come up with some reasons why she’s terrified of isolation. I don’t understand clearly why she’s so skewed and distrustful in her read of medicine, but knowing that she is so unbalanced, as you do, it is really unkind of you to be so angry with her, as if she could help it and be reasonable. She clearly can’t, so back off.

  359. Rhett – Disengage. You’re just giving the person more air time by continuing to engage. Said with great concern for you. K

  360. I keep telling myself I have to stop reading and move on, because nothing new is being said.

    I will say however, that I don’t like mask mandates either. I wish I lived in a society where people would, using their free will, listen to the advice of health care professionals and refrain from gathering with people outside their households and wear a mask when they are out in public. The cases I’m familiar with (and I live in a county with a mask mandate) are from people seeing friends in a small group after work, dining together, getting it from their adult/son daughter who lives at home but has been socializing with their so-called bubble, etc. Mask mandates don’t fix everything either.

    And the Sanford Medical guy is on a PR tour bringing a big NCAA basketball tourney to their state and actually stated they want to use it to get more notoriety for their health care research. according to a WSJ article this week.

  361. And the Sanford Medical guy is on a PR tour bringing a big NCAA basketball tourney to their state and actually stated they want to use it to get more notoriety for their health care research. according to a WSJ article this week.

    That tourney is so stupid. They are saying it will be a bubble like the NBA had, but they are going to allow fans in. So no, it won’t be a bubble.

  362. Here’s a piece from another right-wing fringe site, saying that schools need to be opened:

    “What public-health institutes, including the United Nations University International Institute of Global Health, where I worked on a report on distancing in schools, have observed from these countries’ data is that school reopenings have not increased the level of transmission in the communities they serve. Child-to-child transmission in the classroom is uncommon, and children in school settings are not the primary transmitters of COVID-19 to adults.

    New York City’s own data on its partial reopening show similar results: Schools reflect the prevalence of the virus in the community, but do not drive community spread. According to New York City government data provided to me (I served as a resource for the school district in an informal, unpaid capacity), the city performed more than 74,000 tests in 1,224 schools during a three-week period in October, and just 45 students and 63 staff members tested positive. The percent of students and staff estimated to have had COVID-19 during this period is nearly 40 percent lower than the estimate for the general New York City population for the same period. In other words, both teachers and kids are at less risk of getting COVID-19 in school than they are elsewhere in their day-to-day lives.” https://www.theatlantic.com/ideas/archive/2020/11/ease-restrictions-schools-dont-close-them/617146/

  363. I have been posting on this forum for years, and have tried very hard to avoid personal attacks — such as calling others “unbalanced,” telling them to FO, etc” — and focusing instead on ideas and data.

    It would really be a wonderful thing if those of you who preach about compassion and tolerance and diversity could practice what you preach. It’s not that hard.

  364. I have been posting on this forum for years, and have tried very hard to avoid personal attacks

    You are absolutely vicious. The fact that you don’t drop F-bombs doesn’t stop you from being utterly vicious, and as many have pointed out to you, your placid cruelty and smiling endorsements of violence are repellent.

  365. “And the Sanford Medical guy is on a PR tour bringing a big NCAA basketball tourney to their state and actually stated they want to use it to get more notoriety for their health care research. according to a WSJ article this week.”

    Are you saying that the hospital CEO is lying about the capacity of that system?
    OK, then. I guess we should wait two weeks and see what the data tell us.
    But there is a fairly consistent pattern of the media screaming “hospitals are full!” that hasn’t turned out to be true. A prudent reader should not take the media seriously when actual hospital officials disagree.

  366. Are you saying that the hospital CEO is lying about the capacity of that system?

    I’m saying you’re lying. It’s been proven. You didn’t respond by saying the bullshit websites you’ve been reading have been feeding you misinformation and you were going to reevaluate your faith in them. You simply doubled with ridiculous sophistic arguments.

  367. @ Rhett – I want to suggest to you that by continuing to argue with Scarlett, you are helping to give a platform to her views. While she will never persuade you, there are people who read this blog and do not comment who may be influenced and by engaging you are encouraging the spread of misinformation. I understand it is a sport to you, but I think it is a dangerous one.

    This is not a case of policy discussion, or a sharing of ideas on how to interpret a set of shared facts. Everytime you argue with her, and she posts a right wing link to support her position, someone is clicking on that link, expanding the profile of that platform and misinformation. I think it would be best for you personally but also the greater good if you disengaged.

  368. I’ve been extremely impressed with Raffensperger. We need more people like him in office from both parties.

  369. and focusing instead on ideas and data.
    To quote Ben Shapiro, facts don’t care about your feelings.

    The facts and data are that daily COVID deaths are up 60% from a month ago, and trending higher. The 7 day moving average as of yesterday is 1357, the highest it’s been since May 18.

  370. “The facts and data are that daily COVID deaths are up 60% from a month ago, and trending higher. The 7 day moving average as of yesterday is 1357, the highest it’s been since May 18.”

    That is true.
    Also true that daily COVID deaths are rising steeply in Europe, where countries such as Spain, the UK, Italy and Belgium have deaths/million higher than the US. France is not far behind. https://www.worldometers.info/coronavirus/#countries
    The solution is….?

  371. I have to agree, with the many voices shouting “ignore!” (as someone who has not been ignoring much at all lately). I really enjoy the politics page – there are people here (hi Cassandra and WCE!) who I disagree with about almost everything, but I learn interesting things from. Sometimes, I even change my mind (hi Finn!). I often find new ways to see things and express ideas (hello Rhett! Lfb!! RMS!). And almost all the rest of you provide unique perspective that I can’t find anywhere else on the internet. But recent conversation has just been fruitless and is probably shortening my life with all the stress and vitriol.

    My strategy is going to be to put my fingers in my ears and say “la-lal-la I can’t hear you! I can’t see you!”and stop giving oxygen to fire. (Which is totally different than the dry tinder discussion).

  372. “And what’s happening in LA?”

    I’ve been following that, for obvious reasons.

    My guess is a lot of it has to do with the change in season, that as the weather gets colder people spend more time indoors. So if nothing else changes, I’d expect infection rates to increase.

    I also think that the country in general is seeing increased infection rates in part because people continue to move about, and some of them take the virus with them, so rates going up in one area will contribute to increase elsewhere, creating positive feedback loops.

  373. “They are saying it will be a bubble like the NBA had, but they are going to allow fans in. So no, it won’t be a bubble.”

    The NBA did allow fans into the bubble, in that they allowed family and friends in during the later rounds of the playoffs. Those fans had to follow the same protocols as the players.

  374. “Mandatory mask mandates for healthy people in public places”

    The problem with this disease is that we don’t know who’s infected and who’s not. Thus, the logical way to ensure infected people are masked, without knowing who’s infected, is to have everyone masked.

  375. “he said Sanford has capacity to handle even more patients should hospitalizations continue to go up before mass vaccination begins in January.”

    I wonder what happens if there are no mass vaccinations beginning in January.

    While there may be some vaccinating then, I’m dubious about mass vaccinations.

  376. “A quarter of a million living, breathing, loving, laughing people dead SO FAR, doctors and nurses working themselves to the bone”

    HCW workers not just overworked, there’ve been HCW deaths due to CV-19. Some were due directly to being infected, but others were triggered by the stress of the pandemic.

    People who choose to not use masks, but expect to have HCW treat them if they’re infected, are IMO extremely selfish.

  377. Finn, it’s true that there is a significant seasonality effect with case surges. The sunbelt surged in the summer when people headed indoors for ac.
    What is consistent is that lockdowns and mask mandates do nothing to slow the spread. Illinois looks pretty much like Iowa.
    There is a tendency among some to believe that we can stop this virus but the data say otherwise.
    And I agree that mass vaccinations are a really long way off, especially among the very old and frail.

  378. The NBA did allow fans into the bubble, in that they allowed family and friends in during the later rounds of the playoffs. Those fans had to follow the same protocols as the players.

    Right, they maintained the bubble. This tournament is just going to allow fans to go to games like normal.

  379. The solution is….?

    For people to take this seriously and behave accordingly. That means limiting unsafe face-to-face as much as possible.

  380. There is a tendency among some to believe that we can stop this virus but the data say otherwise.

    No, the data say we can stop the virus. They did it in places like NZ, South Korea, Japan, Singapore, etc. where people took it seriously and limited unsafe contact as much as possible. Americans don’t want to do that. They want to do stuff like this:

    A wedding in Washington state attended by over 300 people has been linked to nearly 40 COVID-19 cases so far, health officials said.

    https://www.msn.com/en-us/news/us/wedding-with-over-300-guests-linked-to-covid-19-outbreak/ar-BB1b7818

    A wedding and birthday party in suburban New York turned into two Covid-19 “superspreader” events that infected more than 50 people and left nearly 300 in quarantine, officials said.

    https://www.nbcnews.com/news/us-news/new-york-wedding-birthday-party-lead-56-covid-cases-nearly-n1245233

    Following the recent revelation that White House chief of staff Mark Meadows tested positive for COVID-19 and attended a White House election party on Tuesday, coming into close contact with members of the president’s family and not wearing a mask for days afterwards, Republican Representative Matt Gaetz, 6 White House workers and one Trump campaign worker have all contracted COVID-19 as well, according to Maggie Haberman, White House correspondent for The New York Times.

    Furthermore, Bloomberg News reports that other White House and campaign employees are upset that Meadows didn’t publicly issue a statement or tell other workers after testing positive for coronavirus, but rather just told a few close individuals within his personal circle.

    https://www.thenewcivilrightsmovement.com/2020/11/after-white-house-super-spreader-event-gop-rep-matt-gaetz-and-7-trump-staff-get-covid-19/

  381. “For people to take this seriously and behave accordingly. That means limiting unsafe face-to-face as much as possible.”

    People are already doing that.
    But life for many people involves contact with others. Adults can make their own decisions regarding the risks they are willing to take. Those who really don’t want to risk infection can and should stay home, isolated from everyone else. There is no other way to get through this in a free country.

    Remember how we were told that Europe crushed the virus by taking it “seriously” and staying locked down? The Czech Republic/Czechia was the poster child for face masks. https://www.usatoday.com/story/opinion/2020/07/14/how-czech-republic-beat-covid-require-everyone-wear-face-masks-column/5426602002/ They crushed the virus with face masks and advised the US to follow their example. Then the virus came back, and despite new mask mandates beginning in early September (indoors) and October (outdoors), deaths are increasing in that country. https://www.worldometers.info/coronavirus/country/czech-republic/

    There is only so much a government can do without destroying society, and we are already doing those things.

  382. HFN, thanks for posting that news.

    I completely agree with Rocky at 10:45, Lark at 11:11 and the similar comments, hope Denver and Finn take note of those posts.

  383. Another study on masks and handwashing to prevent the spread of respiratory viruses. The authors reviewed the results of 67 RCTs (none involving COVID) The conclusion:

    “The high risk of bias in the trials, variation in outcome measurement, and relatively low compliance with the interventions during the studies hamper drawing firm conclusions and generalising the findings to the current COVID‐19 pandemic.

    There is uncertainty about the effects of face masks. The low‐moderate certainty of the evidence means our confidence in the effect estimate is limited, and that the true effect may be different from the observed estimate of the effect. The pooled results of randomised trials did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks during seasonal influenza. There were no clear differences between the use of medical/surgical masks compared with N95/P2 respirators in healthcare workers when used in routine care to reduce respiratory viral infection. Hand hygiene is likely to modestly reduce the burden of respiratory illness. Harms associated with physical interventions were under‐investigated.

    There is a need for large, well‐designed RCTs addressing the effectiveness of many of these interventions in multiple settings and populations, especially in those most at risk of ARIs.” https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006207.pub5/full

  384. Don Jr hasn’t looked fine in quite some time. He looks bedraggled and strung out on coke.

  385. Newly published misinformation from Nature (a right-wing site), providing further support for lack of transmission from asymptomatic COVID patients:

    “Here, we describe a city-wide SARS-CoV-2 nucleic acid screening programme between May 14 and June 1, 2020 in Wuhan. All city residents aged six years or older were eligible and 9,899,828 (92.9%) participated. No new symptomatic cases and 300 asymptomatic cases (detection rate 0.303/10,000, 95% CI 0.270–0.339/10,000) were identified. There were no positive tests amongst 1,174 close contacts of asymptomatic cases. 107 of 34,424 previously recovered COVID-19 patients tested positive again (re-positive rate 0.31%, 95% CI 0.423–0.574%).” https://www.nature.com/articles/s41467-020-19802-w

    You may recall that a top WHO official suggested that significant asymptomatic transmission was unlikely, but was forced to walk back those remarks a few days later.

  386. Asymptomatic and presymptomatic are different things. The WHO rolled back their comment, because the nuance was lost.

    “The findings from systematic reviews, including ours [119–121], do not support the claim that a large majority of SARS-CoV-2 infections are asymptomatic [122]. We estimated that, across all study settings, the proportion of SARS-CoV-2 infections that are asymptomatic throughout the course of infection is 20% (95% CI 17%–25%). The wider prediction interval reflects the heterogeneity between studies and indicates that future studies with similar study designs and in similar settings will estimate a proportion of asymptomatic infections from 3% to 67%. Studies that detect SARS-CoV-2 through screening of defined populations irrespective of infection status at enrolment should be less affected by selection biases. In this group of studies, the estimated proportion of asymptomatic infection was 31% (95% CI 26%–37%, prediction interval 24%–38%). This estimate suggests that other studies might have had an overrepresentation of participants diagnosed because of symptoms, but there were also potential selection biases in screening studies that might have overestimated the proportion of asymptomatic infections. Our knowledge to date is based on data collected during the acute phase of an international public health emergency, mostly for other purposes. To estimate the true proportion of asymptomatic SARS-CoV-2 infections, researchers need to design prospective longitudinal studies with clear definitions, methods that minimise selection and measurement biases, and transparent reporting. Serological tests, in combination with virological diagnostic methods, might improve ascertainment of SARS-CoV-2 infection in asymptomatic populations. Prospective documentation of symptom status would be required, and improvements in the performance of serological tests are still needed [123].

    Our review adds to information about the relative contributions of asymptomatic and presymptomatic infection to overall SARS-CoV-2 transmission. Since all people infected with SARS-CoV-2 are initially asymptomatic, the proportion that will go on to develop symptoms can be derived by subtraction from the estimated proportion with true asymptomatic infections; from our review, we would estimate this fraction to be 80% (95% CI 75%–83%). Since SARS-CoV-2 can be transmitted a few days before the onset of symptoms [124], presymptomatic transmission likely contributes substantially to overall SARS-CoV-2 epidemics.

    https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003346

  387. But asymptomatic transmission is not a thing. One of the primary justifications for mandatory masking of healthy people. So let’s return to the well-established responses to respiratory pandemics that were abandoned wholesale in March: isolate the sick, wash hands, avoid large crowds. Keep the schools open. Allow people to make their own decisions regarding their risk tolerance.

  388. How do you tell the difference between asymptotic and presymptomatic people? What distinguishes the presymptomatic person? Can we agree to mask the presymptomatic contagious person?

  389. “Asymptomatic and presymptomatic are different things. The WHO rolled back their comment, because the nuance was lost.”

    Yes, they are different things, and presumably the head of WHO’s emerging diseases unit is well aware of that. Here is her initial comment:

    “From the data we have, it still seems to be rare that an asymptomatic person actually transmits onward to a secondary individual. It’s very rare.”

    And the data from the Nature piece confirms her statement.
    Fauci also said the same thing in January:

    “Even if there some asymptomatic transmission, in all the history of respiratory-borne viruses of any type, asymptomatic transmission has never been the driver of outbreaks,” he said. “The driver of outbreaks is always a symptomatic person.”

  390. It appears, in January, Fauci was wrong about some things.

    Now we know that presymptomatuc spread is a problem. Right? How do we tell if someone is presymptomatic?

  391. That is not what the CDC says now – from their scientific brief yesterday

    “SARS-CoV-2 infection is transmitted predominately by respiratory droplets generated when people cough, sneeze, sing, talk, or breathe. CDC recommends community use of masks, specifically non-valved multi-layer cloth masks, to prevent transmission of SARS-CoV-2. Masks are primarily intended to reduce the emission of virus-laden droplets (“source control”), which is especially relevant for asymptomatic or presymptomatic infected wearers who feel well and may be unaware of their infectiousness to others, and who are estimated to account for more than 50% of transmissions.”

    “Do the best you can until you know better. Then when you know better, do better.” —Maya Angelou

  392. He and the WHO were both right about asymptomatic spread not being a thing.

    Now the only justification for masks for everyone until 2022 is that some unknown number of people may have a 1-2 day window in which they are both infected and infectious?

    Is that any different than influenza?

  393. Presymptomatic is a subcategory of asymptomatic in the moment, and is a separate category in retrospect. Now, in November, we can tell who was asymptomatic on June 19 and never went on symptoms by the end of June. We can also tell who was asymptomatic on June 19 and went on to have symptoms by the end of June. On June 19, both were asymptomatic. On June 30, we would label one as having been presymptomatic on June 19 and one asymptomatic.

    Presence of symptoms is a binary function. People without symptoms may not have the disease (uninflected, asymptomatic) or they may have the disease and will never get symptoms (infected, asymptomatic) or they may be about to be sick (infected, asymptomatic BUT ALSO PRESYMPTOMATIC). Asymptomatic people who are infected with a disease and will have symptoms in a few days are labeled “presymptomatic”.

    Again, how do we tell presymptomatic people from uninfected people? From infected people who are never going to have symptoms?

    Please use the word “presymptomatic” in your answer. Please refer to the above journal article that notes presymptomatic people contribute substantially to spread.

  394. How is that neither the CDC nor the WHO have ever advised that healthy people should wear masks in public (indoors and outdoors) for the entirety of every flu season on the off chance that they are actually presymptomatic flu patients?
    Such advice has never been part of public health practices in most parts of the world.
    Why did COVID cause governments to forget what they had learned over decades of experience with respiratory viruses?

  395. Provide the data establishing that presymptomatic infections are a significant virus spread.
    There are a lot of estimates and “may” in the article earlier posted.

  396. Because we’re not talking about influenza.

    Household cohort studies have demonstrated that low levels of viral shedding occur one to two days prior to symptom onset, but peak shedding correlates with symptoms.

    […]

    A better understanding of transmission dynamics is essential in influenza pandemic planning. If a substantial proportion of transmissions were to occur during the presymptomatic phase or from asymptomatic individuals, then infection control measures such as contact tracing and quarantine of exposures would be of limited value. Infectiousness has been inferred based on the presence of influenza in the upper respiratory tract rather than from transmission experiments. Although asymptomatic individuals may shed influenza virus, studies have not determined if such people effectively transmit influenza.

    We performed a systematic review of published studies describing the relationship between viral shedding and disease transmission. Based on the available literature, we found that there is scant, if any, evidence that asymptomatic or presymptomatic individuals play an important role in influenza transmission. As such, recent articles concerning pandemic planning, some using transmission modeling, may have overestimated the effect of presymptomatic or asymptomatic influenza transmission. More definitive transmission studies are sorely needed.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4586318/

    How do we keep presymptomatic people with COVID from substantially contributing to the continuing epidemic?

  397. “Explain how asymptomatic and presymptomatic can be distinguished.”

    Observation over the succeeding week or two.

  398. “Presence of symptoms is a binary function. ”

    Perhaps, but IMO it is very likely that some people have symptoms that are mild enough to be nearly undetectable, or mistaken for symptoms of something other than covid-19.

  399. From an AP article about the Pfizer vaccine:

    “the 95% protection rate is based on people who developed symptoms and then were
    tested for the virus. Can the vaccinated get infected but have no symptoms, able to spread the virus?”

    I’m surprised that everyone in both sides of the trials wasn’t regularly tested.

    I’m now wondering if this was also the case in the Moderna vaccine trials.

  400. Is the WHO at it again?

    From an AP article:

    “On Friday a World Health Organization guidelines panel advised against using the antiviral remdesivir for hospitalized patients, saying there’s no evidence it improves survival or avoids the need for breathing machines.”

    IMO, it’s bad advice to advise against using a treatment just because there’s no evidence that it “improves survival or avoids the need for breathing machines.”

    TMK, there is evidence that it shortens recovery times. That means freeing up HC resources so others can be treated, whether for cv-19 or other medical issues, so IMO if HC resources are in short supply, that is a valid reason to advise its use.

  401. “How do we keep presymptomatic people with COVID from substantially contributing to the continuing epidemic?”

    Excellent question.
    The answer is simple — we can’t. Not without forcing everyone to stay home indefinitely, which is simply not happening.

    Mask mandates have not prevented surges in COVID cases in any state or metro area in the country. Take California. We know about LA. San Francisco has had mask mandates since April, schools and indoor dining have been essentially closed since March. Many people are working from home. And yet cases are climbing. https://www.wsj.com/articles/san-francisco-long-a-covid-19-success-story-struggles-to-hold-off-national-surge-11605877457

    Insanity is doing the same thing over and over again but expecting a different result.

  402. Finn,
    The vaccine trials are looking for positive tests plus 1 or 2 symptoms.
    You raise a good question — it appears that the vaccines are not intended to prevent infections, but to prevent serious symptoms in those who do become infected.
    This article is largely anecdotal, but is consistent with what I am hearing from doctor friends — they are not too keen to get the vaccine until a few million people have gone ahead of them:

    “A report released Thursday by the University of California at Los Angeles researchers said that 66 percent of Los Angeles health-care workers who responded to an online questionnaire (not a randomized sample) said they would delay taking a vaccine. The American Nurses Association, a national union, said one-third of its members do not intend to take the vaccine, and an additional third are undecided.

    New Jersey said last week that its data showed that 66 percent of the state’s doctors planned to receive the vaccine. Among professionals contacted by the state, “some did not want to be in the first round, so they could wait and see if there are potential side effects,” New Jersey Health Commissioner Judith M. Persichilli said at a Nov. 9 news briefing.

    “Of those who said they would not take the vaccine, many said they would be more than willing to get the vaccine at a later date, when more data is available,” she said.”
    https://www.washingtonpost.com/business/2020/11/21/vaccines-advocates-nurses-doctors-coronavirus/

  403. “it appears that the vaccines are not intended to prevent infections, but to prevent serious symptoms in those who do become infected.”

    Total guess on my part, but my guess is that the vaccines were intended to prevent infections, but the trials weren’t designed to test for all infections.

  404. “This article is largely anecdotal, but is consistent with what I am hearing from doctor friends — they are not too keen to get the vaccine until a few million people have gone ahead of them:”

    Fine. I’ll be more than happy to go ahead of them. I’d get the Moderna or Pfizer shot today, if they’d let me. I applied for the Moderna clinical trial, but was not chosen.

  405. NoB, I thought about doing that too, but the only trials I’ve found are for people 60 and older.

  406. Quick corrective: Scarlett’s first line makes it sound like docs don’t want the vaccine, but then she admits that two-thirds of them actually do.

  407. Essentially, the initial rollout of these vaccines will be the next stage in clinical trials.

    Maybe the key to getting volunteers for that stage is to pay them to participate.
    It does give pause that medical professionals are expressing more hesitation than is the general public, because their patients will be asking them for advice — are they going to tell them, “You first?”
    As the data emerges over the months ahead, it may not be as difficult to get people on board. But, by then, there will be millions more who have recovered from natural infections, so the pool of eligible vaccinees will shrink. And if the virus begins to burn itself out in the communities that have already experienced a high rate of cases, the urgency to get a shot will diminish. Unless and until the hospitalizations start rising again.

    There are still a lot of unanswered questions. The most vulnerable groups — nursing home residents and others over age 80, and those with serious health problems — have not been part of the trials.

  408. “This article is largely anecdotal, but is consistent with what I am hearing from doctor friends — they are not too keen to get the vaccine until a few million people have gone ahead of them.”

    Everyone I know is very much looking forward to getting the vaccine. As between a vaccine that has a very high efficacy and no known safety concerns and a virus that has known issues, I will absolutely take the vaccine. Demand is going to far exceed so supply, so the more people who are like Scarlett’s doctor friends, the better for the rest of us who want to get the vaccine. And vaccines always have a Phase 4 after they are approved and licensed.

  409. “the 95% protection rate is based on people who developed symptoms and then were
    tested for the virus”

    Finn, from reading the NY times article about Operation Warp Speed, my understanding is that of the total number of people in trial, they tested people who developed symptoms over the course of trial. 95% of the people who developed the symptoms were part of the group who were given placebo and not the actual vaccine. Only 5% of the people who developed symptoms were people that received vaccine.

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