Not So Fast-Here We Go Again

[REWahoo]

Local stats to date:

Confirmed cases: 3,840
Hospitalized: 489 (12.7% of confirmed cases)
ICU: 210 (5.5% of confirmed cases; 42.9% of hospitalized)

 

[cathy63]

Thank you for this site, very informative. Many states appear to have low ICU availability, including mine. I am assuming most Covid patients need ICU--is that correct? Does anyone know if it is possible to turn regular hospital rooms into ICU type rooms?

It's not correct that most hospitalized Covid-19 patients end up in the ICU. Here's a graph from the L.A. Times tracking page showing Covid patients in ICU vs non-ICU rooms in CA. I know it's not your state, but I'm guessing the percentages aren't going to be that different in NC. (source)

My county has a set of metrics that the health officer is watching, and if we exceed certain combination of thresholds they will tighten up again. (dashboard here) There are separate triggers for ICU capacity and hospital bed capacity. Currently 34% of ICU beds are available (about 2/3s of the occupied ICU beds hold non-Covid patients) and the trigger is 20%. The hospital bed trigger is if 80% are occupied and we're currently at 66%. The local officials seem comfortable with these numbers, and I know our hospitals have also taken patients from neighboring Imperial county, where their hospitals have been overwhelmed by U.S. citizens who reside in Mexico coming north for treatment.

 

[Spock]

Lock down was never meant to stop the disease nor empty the hospitals.
It was to manage the curve to not overwhelm the hospitals.
Yes. AZ has an increase in the number of cases (test positive) and an increase in hospitalizations. AZ hospitals have also have stated they can handle the increase.

We're going to be dealing with this virus in the community for years. Adapt. Starving in your home because all of the supply chains shutting down is not adapting.

If you're at risk, by all means please quarantine. But those who are at extremely low risk need to be able to go to work in order for you to have bread delivered to your home.

Pick a headline (all from the same news site):
(Banner UMC healthcare is the premiere hospital in the area that was formerly the UofA Medical School)

June 5: Banner says ICU beds are approaching 100% capacity: https://www.kgun9.com/news/coronavirus/banner-says-icu-beds-are-approaching-100-capacity

June 9: Banner Health: Number of COVID-19 patients on ventilators in our Arizona ICUs has quadrupled https://www.kgun9.com/news/coronavi...-ventilated-covid-19-patients-have-quadrupled
ALSO JUNE 9TH: Banner UMC is ready for rise in COVID-19 cases
https://www.kgun9.com/news/coronavirus/banner-umc-is-ready-for-rise-in-covid-19-cases

 

[Rianne]

No. Most covid patients do not need ICU. ~35% of cases (positive test) show now symptoms at all. Another big % manage their mild symptoms at home.
Of the patients that are hospitalized:
https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html

Thanks for that link. There are still many unknowns and noted. I'm interested in long term effects and we're just not there yet. Since I'm in the category of high risk, I shall remain vigilant and cautious.

 

[Aerides]

Adapt. Starving in your home because all of the supply chains shutting down is not adapting.

This is not being reported anywhere in the US. source?

To be clear we're not talking about those who cannot afford food, but to claim that there is such a supply chain issue resulting in starvation is false and hyperbolic.

 

[harllee]

Thanks for all the info on ICU beds, I had just assumed that most all persons admitted to the hospital for Covid 19 had to be in the ICU because the 2 people I know that have been hospitalized for Covid were both in the ICU (one died). One takeaway I have is to not wait to go the the hospital until you are so sick that you need ICU.

 

[EastWest Gal]

What we should all do is assume that there will be other waves in our area before there is an effective vaccine, or before there is herd immunity in any case. One of the thing the folks in this community is prepare for future events. We are doing this economically, but we should also do this personally.

And keep wearing your masks! Everyone, just wear your masks correctly! No excuses.

Today I went to a big box home store and got some solar landscape lights. We just went to "green" in our county today, and I saw most of the store workers with masks on but them tucked around their chin. After receiving help with another question, I asked a store worker (who was coughing into her elbow) about why so many store workers wore their masks ineffectively. She tried to explain that she moves boxes all day long and cannot wear the mask while doing so (the mask was tucked around her chin) but that she was required to "have" a mask. She was probably in her early 20s. I kept having to back up and say maintain 6 feet distance please.

Obviously she had no understanding of the effectiveness of the mask. I decided that being confrontational would not be effective and decided to walk away.

Then I saw a very cute family strolling through the outdoor garden area. They had a 2 yr old and a 3 yr old. The 3 year old had a mask and kept fussing with it. The 2 year old kept wandering off. Mom and dad were mortified and apologetic. I said you guys are doing great. They said it was the kids' first time away from home for weeks. I said they don't have COVID then, so no worries. Dad said they have to train the older one to wear a mask for school. I said we need to make masks a fashion statement and said I was really impressed with them.

I wanted to make their day. I think I did. Then I went into Target for a particular item and noticed everyone wearing masks appropriately, as there was a giant sign requiring everyone to do so out front.

But what can I do about the workers who refuse to wear masks effectively? Call management?

 

[Rianne]

This just posted in our local paper. The Q and A from HHS. I'd like to see the stats on this information. I understand we don't know what long term means yet. At least they could follow those infected in March and how they're faring today. And does it mean "mild cases" or cases admitted to the hospital? Are they following the "recovered" mild cases for long term effects?

"Q: On the daily updates, what is the definition of ‘recovered’?

A: “Recovered” in the daily updates refers to people who are no longer in isolation, as they are no longer infectious.
This does not necessarily mean they have fully recovered from the effects of COVID-19.
There are cases where people can have long-term health implications."

 

[Leo1277]

Lock down was never meant to stop the disease nor empty the hospitals.
It was to manage the curve to not overwhelm the hospitals.
Yes. AZ has an increase in the number of cases (test positive) and an increase in hospitalizations. AZ hospitals have also have stated they can handle the increase.

Why would you not want to eradicate the disease? That's what many countries are doing successfully (New Zealand, Australia, Taiwan, Hong Kong, China, Greece) and many others are working towards that and are getting closer (Germany, other European countries, Japan...). It only requires moving R(t) down a little below 1 for sufficient time, after already having succeeded in squeezing it down from its natural value of around 2.6, instead of letting it hover around 1 all the time which we currently have in the US. This would be a nice example where the US could show some real leadership instead of being behind the curve compared to many other countries.

There is an interesting article I came across about this question yesterday: https://covid19data.com/2020/06/11/...-a-new-normal-infectious-disease-expert-says/

1,000 coronavirus deaths a day in US is not a “new normal,” infectious disease expert says

The coronavirus pandemic is killing on average 1,000 Americans a day and 4,000 globally, and this should not be the new normal, Dr. Tom Inglesby, the director of the Bloomberg School’s Center for Health Security, said at a news briefing Thursday.“We can do better than this,” Inglesby said. “I’m worried that people have kind of accepted where we are as a new normal and it is not normal.”
Some states have hundreds or even thousands of new Covid-19 cases every day and Inglesby pointed out that countries like New Zealand and Thailand have driven their cases down to zero.
“Are we resigned to losing 1,000 Americans a day, until we have a vaccine?” he asked. “I hope we aren’t.”

 

[gwraigty]

But what can I do about the workers who refuse to wear masks effectively? Call management?

I don't understand this need to snitch or even confront an employee about it. In my state, there are some legal and legitimate reasons/exceptions for not wearing a mask. If wearing a mask for prolonged periods of time makes an employee ill, they can't be forced to do it. Do you know if that worker has a health condition? She didn't have to explain anything at all to you, especially if it's related to a health condition. Management may be fully aware of some things that you, as a customer, aren't privy to. Bottom line, you can't do much of anything that will accomplish much other than refuse to shop inside that store if it upsets you so much.

 

[Aerides]

But what can I do about the workers who refuse to wear masks effectively? Call management?

shop elsewhere. vote with your dollars. it's one thing if it's isolated but when it's too many for comfort there's no point in a conversation.

 

[gwraigty]

On a side note, I just had my first uncomfortable encounter with a neighbor who I seldom speak with. She's nice, but she's an absolute chatterbox who barely takes a breath between thoughts and switches topics so rapidly that her one-sided conversation becomes impossible to follow. I only went outside to water my garden. She happened to be walking by on the sidewalk. She came up my driveway and before I knew what was happening, she was within 3 feet of me and asking me about some things in my garden. I didn't want to be impolite. I answered her questions as briefly as I could. She didn't seem to notice that I wasn't actively encouraging conversation. Whenever I backed up a little from her, she moved back in on me to close the distance. I think she's probably always this way, but I didn't notice it much before. It made me think of that neighbor someone here has posted about a few times. I couldn't really focus much on what she was saying. She may have been within 2 or 3 feet of me for 10 to 15 minutes, talking just non-stop. That's the longest I've been in that close proximity to someone outside of my household since Christmas Day. I'm so used to keeping my distance when I can, or just passing people briefly. Maybe I should have asked her what she thought about how all this coronavirus stuff was going? I don't know...

 

[Leo1277]

Eradication vs Control

There is often the implicit assumption and acceptance that unless we have vaccine or treatment, we will continue to have to co-exist with this particular virus for an unforeseeable time. This may be connected to the fact that with many other infectious diseases, this is the case because it is very hard to eradicate the places where the germs can thrive. For example, with plague the virus also resides in the fleas of the rats that carry it; with malaria it lives in the mosquitoes; typhoid and cholera germs can live in water and on food.

But Covid is different: while being highly infectious, the virus can ONLY reproduce in humans as hosts. So compared to other diseases, where significant environmental remediation is needed, Covid is particularly easily controlled simply by sufficient distancing measures for a long enough time. You don't have to also kill the rats and fleas carrying plague, or all the mosquitoes carrying malaria, or clean all the water sources and delivery systems harboring typhoid and cholera. So this virus can in fact be eradicated much more easily than other vices, if all work together.

 

[Whisper66]

Why would you not want to eradicate the disease? ........

No one said they don't want to eradicate the disease. Likewise no one has said they actually want the severe impact on this country that lock downs have caused. But states and countries now have experienc with lock downs and their immediate impact. In the US, in the major effected areas have not accomplished virus eradication. Even accomplishing the stated goal (a much lesser goal) of avoiding hospital overloads has caused enormous damage to family's long term financial stability and ability to get goods and services (including non-covid hospital services) they want / need. We will only know the full extent of the impact as the next few months progress and we see what businesses go bankrupt with the associated job losses and supply chain disruptions.

 

[Spock]

This is not being reported anywhere in the US. source?

To be clear we're not talking about those who cannot afford food, but to claim that there is such a supply chain issue resulting in starvation is false and hyperbolic.

Source is my own, first hand, direct, personal experience in a city with 1M people. It is certainly not false. I personally have lost (as of now) 42lbs since mid-March driven by empty shelves and unaffordable prices for what I do find.

Hell I can't even buy a new pair of jeans for the weight loss because those #@$^%@ shelves at Walmart are stripped too! Can't even buy a shorter belt because the only ones left were either 6ft long for an elephant or 2 ft long for kids. So I'm paying 4x to buy a belt online and hope I'm guessing right on what size I'll end up at.

My shopping trip from last Thurs June 4: Fry's, Safeway, and Walmart
* I finally can buy potatoes again, but they are soft and spongy. So I either have to go to the store to buy them "day of use" (more trips to the store) or I deal with tossing larger and larger portions of a bag as they rot. (I've taken to planting the softest potatoes in buckets... I'm now out of buckets and potting soil).
* Onions: same thing. Not supposed to fondle produce, but most of them are moldy.
*Apples: Gone. none in stock
*Tomatoes: Gone. none in stock.
* Lettuce rotted in days before the crisis, I don't bother looking at it any more.
Entire produce section had been spread out into a thin single layer of products to make the shelves look stocked.
I did score a cantaloupe for $4. Don't know if my dirt will work but they grow them about 200miles west of here so I'm going to try planting the seeds I saved.
* meat: what meat? Some hole-in-the-wall local store published they had pork that morning. I was there before noon that same day and it was already gone. 70% hamburger is $6/lb with a limit of 1 package.


Rice has ~doubled in price every 2 weeks. Now the shelves are camouflaged with odd beans/lentils occupying what used to be rice shelf space that I have no idea how to cook. Yes.. I'll adapt and figure out how to eat them.

Last nights dinner consisted of rice cooked in some powdered chicken bullion and a single pork chop my wife and I split. Lunch is leftovers. Breakfast is skipped completely.

I found some flour in-stock online. One order placed April 8th still hasn't shipped. The other order shipped... arrived with the bag ripped open.
I scored a 20lb box of pasta, but nothing to put on it so we eat naked pasta with salt and pepper.

I am seriously considering loading what food (and TP) I have in our truck and moving 1700miles where the food chain is shorter, only the wife is scared of the trip due to no hotels/restrooms/food... so I guess its going to be pack food and camp in the truck. It smells a lot like "The Grapes of Wrath" in my corner of town.

[MOD EDIT]

Now... conversely, just because its happening to me doesn't me it's happening to you. Yet. People were able to FIRE by "living below their means". Get ready to "eat below your means". All over a virus with a 99.6% survival rate.

 

[Leo1277]

No one said they don't want to eradicate the disease.

Well, too often you hear people being content with just avoiding hospital overload etc. That was the very first goal when control started, as it represented the most imminent threat to most affected places. But once that was achieved, you have to keep going to the next step and not let complacency set in.

Likewise no one has said they actually want the severe impact on this country that lock downs have caused. But states and countries now have experienc with lock downs and their immediate impact. In the US, in the major effected areas have not accomplished virus eradication. Even accomplishing the stated goal (a much lesser goal) of avoiding hospital overloads has caused enormous damage to family's long term financial stability and ability to get goods and services (including non-covid hospital services) they want / need. We will only know the full extent of the impact as the next few months progress and we see what businesses go bankrupt with the associated job losses and supply chain disruptions.

I absolutely agree with this, the economic impact is severe, no question about it. But if we continue to have the virus in circulation, there will be a continued negative economic impact and no V-shaped recovery.

On the other hand, in New Zealand, they had a shut down that didn't last much longer than ours, but they were more aggressive and eliminated the virus very nearly completely. They can now totally safely eliminate all restrictions, and did so a few days ago. Australia, China and many other countries are not much different. But in the US, we will be limping along with restrictions for the foreseeable future unless we really significantly get below the "1000 deaths per day" scenario the article I quoted talks about.

 

[Sunset]

On a side note, I just had my first uncomfortable encounter with a neighbor who I seldom speak with. She's nice, but she's an absolute chatterbox who barely takes a breath between thoughts and switches topics so rapidly that her one-sided conversation becomes impossible to follow. I only went outside to water my garden. She happened to be walking by on the sidewalk. She came up my driveway and before I knew what was happening, she was within 3 feet of me and asking me about some things in my garden. I didn't want to be impolite. I answered her questions as briefly as I could. She didn't seem to notice that I wasn't actively encouraging conversation. Whenever I backed up a little from her, she moved back in on me to close the distance. I think she's probably always this way, but I didn't notice it much before. It made me think of that neighbor someone here has posted about a few times. I couldn't really focus much on what she was saying. She may have been within 2 or 3 feet of me for 10 to 15 minutes, talking just non-stop. That's the longest I've been in that close proximity to someone outside of my household since Christmas Day. I'm so used to keeping my distance when I can, or just passing people briefly. Maybe I should have asked her what she thought about how all this coronavirus stuff was going? I don't know...

She was probably totally unaware.

You could have told her: she should stay 6 ft away as you "might" have Covid.

That is going to be my line for personal space invaders...

 

[Chuckanut]

But what can I do about the workers who refuse to wear masks effectively? Call management?

Since masks are worn to protect others, I am wondering if an employee can refuse to work near other employees who won't wear a mask?

 

[brewer12345]

Spock, beans are easy. Soak overnight, simmer until tender, then add salt. I most frequently add garlic and onion to them while they are cooking, but whatever herbs or seasonings you like can be added.

I really wonder where you are because I haven't experienced anything as bad as what you are describing. Lots of stuff goes in and out of stock, but it isn't hard to buy most of what we need and things have gotten better in the last few weeks.

 

[harllee]

I don't understand this need to snitch or even confront an employee about it. In my state, there are some legal and legitimate reasons/exceptions for not wearing a mask. If wearing a mask for prolonged periods of time makes an employee ill, they can't be forced to do it. Do you know if that worker has a health condition? She didn't have to explain anything at all to you, especially if it's related to a health condition. Management may be fully aware of some things that you, as a customer, aren't privy to. Bottom line, you can't do much of anything that will accomplish much other than refuse to shop inside that store if it upsets you so much.

Vote with your money! I refuse to go into a retail establishment where the employees are not wearing masks and I tell the management about that. If they want my money they must enforce the mask rule. Plus our county requires everyone to wear a mask and if they do not you are suppose to report them. But even if your county/state does not require masks if a business looses enough customers they will start making employees wear masks. That is how we got the no smoking rule passed --people refused to go places that allowed smoking.

 

[aiken]

Well, too often you hear people being content with just avoiding hospital overload etc. That was the very first goal when control started, as it represented the most imminent threat to most affected places. But once that was achieved, you have to keep going to the next step and not let complacency set in.
I absolutely agree with this, the economic impact is severe, no question about it. But if we continue to have the virus in circulation, there will be a continued negative economic impact and no V-shaped recovery.

On the other hand, in New Zealand, they had a shut down that didn't last much longer than ours, but they were more aggressive and eliminated the virus very nearly completely. They can now totally safely eliminate all restrictions, and did so a few days ago. Australia, China and many other countries are not much different. But in the US, we will be limping along with restrictions for the foreseeable future unless we really significantly get below the "1000 deaths per day" scenario the article I quoted talks about.

It's hard to compare an out of the way country like New Zealand (population 4.9 million) with the United States (325 million). The US is an international hub for worldwide travelers....NZ, not so much. I would also be skeptical of the China numbers.

 

[cathy63]

On the other hand, in New Zealand, they had a shut down that didn't last much longer than ours, but they were more aggressive and eliminated the virus very nearly completely. They can now totally safely eliminate all restrictions, and did so a few days ago. Australia, China and many other countries are not much different. But in the US, we will be limping along with restrictions for the foreseeable future unless we really significantly get below the "1000 deaths per day" scenario the article I quoted talks about.

I am very happy for New Zealand, but they're an island nation with more than 20x the space and less than half the population of Los Angeles County. It's reasonable to compare their results to Hawaii (which is still more densely packed than NZ), but not to the continental U.S.

 

[EastWest Gal]

My goal is to change behavior that puts all of us at risk. Is that not a worthy goal?

To snitch is to secretly tell someone of authority that someone has done something bad. Since I have no idea who the person is, and since half the employees were disobeying their employer and violating state policy, I would not be a snitch. I would be informing the employer that their lack of enforcing the policy is violating state regulations and putting customers, including myself, at risk. If I repeatedly see such action, I will have to take my business to the other big box store half a block away, or online.

First, there is actually no health risk to wearing a mask. Your state provides exceptions. These exceptions most likely apply to machinery in the environment, not individual health risk, even though the language indicates otherwise. Your state also requires written justification. I'll see if my state requires it.

From Ohio's (your state) Department of Health website:

Q: Are there exceptions?

A: Yes. Employers and employees are not required to wear face coverings if it is not advised due to health reasons, against documented industry best practices, prohibited for a specific position by law or regulation, or a violation of a company’s safety policy. A face covering also is not required if an employee is working alone in an enclosed workspace or if there is a practical reason one cannot be worn. If any of these exceptions apply, written justification must be provided upon request.

Surely you don't believe that half the employees are exempt from wearing a mask because of a health concern. And if they were exempt from wearing a mask, why were the masks on but over the chin?, which is completely useless?

Second, there really are not health issues that preclude wearing a mask. It does not restrict oxygen supply or diffusion of carbon dioxide away from the person. If masks cause health issues, what about the health care environment, with its PPE and procedures for taking care of infected patients and in the OR?

Is it snitching to call out systematic violations of state health department policy? Of course not.

It's kind of like wearing your pants around your ankles or putting sunscreen on the bottom of your feet--kind of makes one look like a fool. Only this time, the lives of others are at risk.

 

[brewer12345]

It's hard to compare an out of the way country like New Zealand (population 4.9 million) with the United States (325 million). The US is an international hub for worldwide travelers....NZ, not so much. I would also be skeptical of the China numbers.

Plus they have all those Hobbits.

 

[braumeister]

before I knew what was happening, she was within 3 feet of me and asking me about some things in my garden. I didn't want to be impolite. I answered her questions as briefly as I could. She didn't seem to notice that I wasn't actively encouraging conversation. Whenever I backed up a little from her, she moved back in on me to close the distance.

Something similar has happened to me a couple of times with neighbors. I was able to nip it in the bud by quickly retreating to over six feet away, smiling and saying "Oops, almost forgot -- social distance, right?" They quickly got the message.