Dire situation in New York State

[NameRedacted]

Governor Cuomo has been getting a lot of credit for daily briefing which have been factual and informative. However, credit should be given to the governors of Washington State and California who took action early to shut down the school system. Both Washington and California governors were smart to take the issue seriously from the beginning and consult both public health experts and bio-technology companies for their expertise. Their only mistake was to rely on the federal roll-out of the FDA approved test kits and using Qwest Diagnostics as the central lab for testing which became a serious bottleneck. This has been fixed. San Francisco was the first city to shut down followed by Los Angeles and then the State of California. So far the curves are much flatter in California but as the governor stated recently, testing has been lacking and low relative to the population size. However, he stated that testing will be ramping up (antibody testing) to better understand how many people have been infected followed to help understand who can return to work and who to isolate.

Yes, the only thing I can fault Cuomo on is that he got a bit of a late start but still much better than the Federal Government, but then again it's easy to say that with the benefit of hindsight.


In my opinion it was always going to be bad in NY City - densely populated and so many people reliant on crowded public transport.

 

[NameRedacted]

April has arrived, doesn't this whole thing go away with the warmer weather? I could have sworn I heard this somewhere by someone back in February.

In retrospect, it looks like the things that stop this are social distancing and wearing masks. It's a shame that we didn't get started on the latter until much later.

 

[GravitySucks]

Mostly good news on today's briefing.


The numbers of intubations, ICU admissions and hospitalizations have been falling for 2-3 days now. Sadly, the deaths are up but that is a lagging indicator. It's looking as if we've reached a plateau now.


A lab in New York has developed a 15 minute test to check if you've had the virus and they're looking for help scaling that up with a view for developing a plan to restart the economy.


This has been the most optimistic briefing I've seen so far.

Thanks for the update.
I missed the Governor's update today.
Doesn't look like my county will peak for a bit, but glad to see downstate getting better if not great news.

 

[Chuckanut]

That has been wishful thinking on the part of many folks. Tropical countries and Southern Hemisphere countries have had to deal with the virus, so it doesn’t “go away”.

From what I have heard and read, Corona viruses do not much care what the weather is. Hot, Warm, Cool, or Cold, it will get you if it can.

 

[youbet]

The reality of the situation is that there is a much greater need for ventilators Downstate and all that is happening is that the Governor is allocating resources more efficiently.

We'll know only in hindsight how efficient the Governor's resource allocation scheme is/was. And even then, the consequences of the move will have disparate impacts on different people, both within and outside of a particular region and over time.

I'm mostly curious about the Governor's sincerity when he says he's only "borrowing" the ventilators. Really? I don't have a dog in the fight but since it wouldn't work like that here in Illinois, it'll be interesting to see how it works in NY, if we ever know.

 

[copyright1997reloaded]

Left without comment other than it appears the WSJ agrees with my position:

Instead of moving ventilators to the patients who need them, move the patients to the ventilators.

Source: https://www.wsj.com/articles/operation-covid-airlift-would-be-medevac-in-reverse-11585695115?mod=searchresults&page=1&pos=1

 

[eytonxav]

Not sure I believe this point. FLA has 13k+ cases and it is already solidly into the 80's every day now.
The Dominican Republic has close to 2k cases and it is over 80 degrees there every day of the year and usually fairly humid.

Florida has many elderly residents and the Dominican is a 3rd world county with poor nutrition and probably many who do not know how to practice preventative measures.

 

[Freedom56]

Yes, the only thing I can fault Cuomo on is that he got a bit of a late start but still much better than the Federal Government, but then again it's easy to say that with the benefit of hindsight.


In my opinion it was always going to be bad in NY City - densely populated and so many people reliant on crowded public transport.

We have over 10 million people living in Los Angeles County. The city is more spread out than NYC but there are many population dense locations throughout Los Angeles that attract about 48M tourists every year. The lack of the availability of testing and when the first cases started to appear starting in late January and then the first community transmission in late February, caused officials to act quickly and shut the school system down. Many technology firms shut their offices down and asked people to work from home. This started in mid-February. Testing is still a bottleneck here and this is 100% the fault of the Federal Government as the private companies they contracted clearly did not have the capacity to deal with a state with a population of 40 million people. In today's conference , the governor stated that they will be moving to point of service and regional testing provided by multiple partners and will ramp up to 25,000 test per day over the next few days. The PCR swab and send to Quest Diagnostics (or other labs) and wait 2 weeks, rolled out by the Federal Government, will be replaced by other faster test in the coming weeks. Cepheid, a California-based biotech company, has also received emergency authorization for its point-of-care PCR coronavirus test that returns results in 45 minutes. The Abbott lab point of service test is being rolled out. Stanford University received FDA approval for their anti-body test this week so they will be rolling that out shortly to scale. They are targeting the end of April for a mass roll-out of the blood based test to determine who can go back to work and their normal life. We are fortunate to live in a state that has the brain trust and crisis management skills to deal with this pandemic. Many of the hospitals are also some of the finest in the country.

 

[Boho]

One of six soccer players in Brooklyn obeying social distancing.

 

[target2019]

One of six soccer players in Brooklyn obeying social distancing.

It's 3 on 3. The defender is staying home while his 2 team mates attack.
With all of the heavier breathing even at six feet they are at risk for sure.

 

[NameRedacted]

Nothing much new from today's call. The number of new cases, hospitalizations and intubations continues to fall, the number of deaths per day is still increasing, but it's more evidence that the curve is flattening.


All New Yorkers will be able to vote by absentee ballot in the June 23rd primary. Nothing on whether this will be extended to the GE.

 

[NameRedacted]

I haven't updated this for a while since there haven't been any significant changes in the last few conferences but there were today - so here are the latest updates.

• The number of new hospitalizations and intubations continues to fall as does the total number of current hospitalizations and intubations. The daily count of deaths has plateaued. It looks like we are at the apex if not past it.
• New York is going to give some ventilators to Michigan and Maryland. This would imply that we are past the peak.
• To re-open the economy we need to ramp up testing but there is not currently enough capacity in the existing labs to scale this effectively. The Governor is requesting federal help to manage this across the nation. He specifically mentioned the situation that arose with ventilators when all the states were bidding against each other for a limited resource. He wants to avoid that happening again.
• The Governor has issued an executive order requiring everyone in New York State to wear a mask or face covering in public in situations were you can't maintain social distancing. He gave examples such as on public transport, visiting the grocery store or even out walking if it's likely that you'll encounter busy intersections. There is a 3 day grace period before this takes affect. As yet there is no penalty for breaking this rule.

 

[Brat]

It seems to me that wearing a mask is in the self-interest of the wearer. After I started wearing a mask when I left my apartment the building is now requiring them.

 

[Tiger8693]

It seems to me that wearing a mask is in the self-interest of the wearer. After I started wearing a mask when I left my apartment the building is now requiring them.

Wearing a mask does little to nothing. When you breathe in (unless it is an N95 maks that is form fit to your face), the air intake is such that air is pulled in from the sides more than through the mask.

Some benefit is from breathing out, where the transmission is dampened.

 

[Winemaker]

Any of these masks is a joke. When w*rking in a coal mine for 35+ years, I wore various masks/filters/respirators when in dusty or return air courses. The only ones that don't leak have a rubber seal that rings around your mouth and nose. And if you are wearing a mask and can smell an aroma/scent then obviously you're not protected against aerosols.

 

[Brat]

What I think many are missing is that flattening out the peak only means that the hospitals won't be overwhelmed, not that the % of those infected won't need acute care. Basically, we are delaying the impact of the disease not curing it or preventing it.

 

[CardsFan]

What I think many are missing is that flattening out the peak only means that the hospitals won't be overwhelmed, not that the % of those infected won't need acute care. Basically, we are delaying the impact of the disease not curing it or preventing it.

Bingo! That was the whole point of flattening the curve.

As someone said earlier (in this thread or another) it is the AREA under the curve that matters regarding illness and death (that would be the total numbers for each).

Flattening the curve takes the pressure off healthcare, allowing more to get treated, fewer to die (hopefully) and leaving room for other medical care that is required.

There is the hope that maybe we will get better treatment options in the meantime. A vaccine is still more than a year away, maybe 2.

 

[audreyh1]

What I think many are missing is that flattening out the peak only means that the hospitals won't be overwhelmed, not that the % of those infected won't need acute care. Basically, we are delaying the impact of the disease not curing it or preventing it.

Yes and I think a lot of people understand that, but it also does in fact reduce the impact of the disease. It means fewer people die - whether from COVID-19 or from other illness - due to lack of access to medical care. That is the critical issue being managed.

 

[Boho]

It also means the longer I can stay virus free the less chance I'll get it because more people will become immune over time as they get it.

 

[garyt]

It also means the longer I can stay virus free the less chance I'll get it because more people will become immune over time as they get it.

There's still no proof you get immunity from contracting and recovering from the disease.

 

[Gumby]

It also means the longer I can stay virus free the less chance I'll get it because more people will become immune over time as they get it.

It is my understanding that the required percentage for herd immunity is described by the equation x = 1- (1/Ro), where Ro is the initial reproduction number (i.e. - the average number of new people each person infects absent countermeasures). Published estimates of Ro for COVID-19 range from 2.2 to 5.7. If it is the lower number, then you would need about 55% of the population to have become immune either by acquired immunity due to infection and recovery (if that works) or by vaccination => 1- (1/2.2) = 0.545. If it is the higher number, you would need about 82% for herd immunity to protect you.

 

[Boho]

It is my understanding that the required percentage for herd immunity is described by the equation x = 1- (1/Ro), where Ro is the initial reproduction number (i.e. - the average number of new people each person infects absent countermeasures). Published estimates of Ro for COVID-19 range from 2.2 to 5.7. If it is the lower number, then you would need about 55% of the population to have become immune either by acquired immunity due to infection and recovery (if that works) or by vaccination => 1- (1/2.2) = 0.545. If it is the higher number, you would need about 82% for herd immunity to protect you.

I'd have thought my theory applies once the curve flattens. IDK.

 

[Gumby]

I'd have thought my theory applies once the curve flattens. IDK.

Both herd immunity and social isolation can act to drive R below one, after which the virus eventually could die out because each infected person is in turn infecting less than one other person. It was contact tracing and ring vaccination that eventually killed off smallpox. For herd immunity alone, with no social isolation/contract tracing & quarantine/ or sanitation measures, you need the percentages I mentioned earlier.

 

[eytonxav]

Many past epidemics seem to die a natural death aside from the mitigations that are implemented. Hopefully this one will be impacted that way, at least until a vaccine can be developed.

 

[Brat]

I doubt it because this virus isn't a significant pathogen to kill itself.