They are, along with anesthesiologist and public health providers, the tip of the spear.
I think it would be useful to compare the current flu concerns to the most problematic year in the last three, '17 - '18, to gain perspective. That year 61,000 deaths from common flu occurred. At that time we did not worry about how many had test for flu, how many caught the flu, most did not even notice how many died of the flu. I get that this is a bad flu. I just wonder if we have a few stops between unaware and full on panic. Possibly, we could be better off somewhere in between.
Couple points:
Long argument with lots of data. Is 682 deaths in one day a “normal” day in Italy? How many of the 5,000 or so Italians that died would have died since the outbreak?
He mentions 1-5% chance of transmission in casual contact but much higher with prolonged/multiple exposures. Those are hospital systems. Those are the people who keep survivable pts from dying.
Once vents are normally occupied by the Covid patients, standard patients that hospitals planned for need the same vents. That’s what is going on in Italy. How many vents are available at Dixie Regional? Rural communities are also at risk despite lower population. Everyone goes to the same gas pump…
Seems like a pretty antiseptic calculation of logistic curves. It’s another story to tell a 45 year old they aren’t getting a vent.
Hopefully, a number of contributing factors will minimize the “worse case” scenario, but as they say in public health, better to overreact than be underprepared.
POTUS said today “Nobody ever imagined this to happen.” Which is absurd. The previously disbanded Office of Pandemic Response “imagined” this scenario everyday.
Every time I see someone say we are overreacting, I think to myself, “But Italy. Italy!”
I knew nothing about the Office of Pandemic Response until a couple days ago. I finally Googled it just now and found this Washington Post fact-checker piece. The set-up of the issue:
“The Obama-Biden Administration set up the White House National Security Council Directorate for Global Health Security and Biodefense to prepare for future pandemics like covid-19. Donald Trump eliminated it — and now we’re paying the price.”
—Former vice president Joe Biden, in a tweet , March 19
Several readers have written The Fact Checker, saying they were confused by dueling opinion articles that appeared in The Washington Post concerning the National Security Council office highlighted in Biden’s tweet.
Read the whole thing (it’s short), but the conclusion is:
One can see the dueling narratives here, neither entirely incorrect. The office — as set up by Obama — was folded into another office. Thus, one could claim the office was eliminated. But the staff slots did not disappear and at least initially the key mission of team remained a priority. So one can also claim nothing changed and thus Biden’s criticism is overstated.
The question that cannot be answered — at least perhaps until a congressionally mandated commission examines the U.S. preparation for this crisis — is whether a separate directorate would have had more clout to bring the issue immediately to the president’s attention. That might have helped buy time to stem the spread of the disease by focusing the full attention of government on the emerging problem. (One example: China refused to let American experts into Wuhan — a discussion kept at the agency level. But early presidential pressure might have swayed Beijing to cooperate.)
For that reason, we will leave this unrated.
Last post for a while, then I will leave you all alone.
This is a very technical article, beyond my non-biology brain’s ability to grasp fully, but it does leave me feeling a little hopeful that at least a treatment for COVID-19 will emerge. A treatment is not a vaccine, but it’s my understanding that if some successful treatments do emerge, that will at least help people recover from the illness and could significantly reduce the pressure on healthcare facilities. It’s also my understanding that such a development would be huge.
Thank you LA for posting this. Yes, deep dive is the best way to describe it. When I was about 2/3 the way through, I could not help but think of that old adage about statistics. I believe you can use them to “prove” opposite points on the same thing. Mr. Ginn may be the smartest guy in the room; but I could not help but think he was intentionally working his piece to remove hysteria from our population. And maybe that is good. Truth, I wish everyone could read this document and understand it. The last part being operative.
On his recommendations, not sure what to think of them. Open schools. Open public places. Support businesses. Expand medical capacity. I don’t know the right thing to do but I am willing to listen to experts. He is right that some folks fear what government can do. I’ve read that hear in spades.
He has almost an “it is not a big deal” tone. Only 0.04% of the US population. Hard to catch. Dropping mortality rate. Likely to soon reach the backside logistics curve. Warmer weather will tamp covid down.
I sure hope he is right. I have a summer to enjoy.
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I guess I also find it hard to believe our State Dept and intelligence agencies weren’t picking up both electronic and human behavior to clue us in before the Chinese actually went public. Why is the public announcement the only reference point? I imagine our intelligence to be far better than that. But I’m not an intelligence expert.
When you factor in that all of the US “intelligence” agencies have been absolutely assailed by the top administration, even if they did find something, our president would have considered it evidence of a deep, deep state full of “liberals” working tirelessly to undermine his presidency. So no, I’m not surprised. They knew. An they were moribund to do anything except to watch with grimaces.
I think I inadvertently got us into a political discussion, which is not allowed here in this thread. I was trying to understand the claim that a White House office for pandemic response was abolished, and it looks like that is not true. At least the Washington post fact-checker is unwilling to say it was. I think confirmation bias runs rampant in these discussions. It just strikes me as far-fetched to say that the reason we are in this mess is because of something the Trump administration did or didn’t do.
I think I need to stop reading experts’ articles about what needs to be done before I blow a brain gasket. Here’s another guy, an apparently highly-qualified fellow, who thinks that we are not going to be able to flatten the curve sufficiently, and so we must expand the health system‘s capacity significantly, and with astonishing speed. He proposes pretty extreme measures to accomplish that.
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I guess this is one example of an effort to increase capacity. Seems like a great idea to me.
I hear you. Thanks for posting. I truly, truly hope Mr. Ginn (earlier excellent detailed article) is right and this guy, Mr. Gans, is off in his assessment.
The FDA approved a test for Corvid-19 that returns results in 45 min. The company that produces the test say they have over 5000 machines the test works with already in service across the country.
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That actually, pretty much well sums up my day. 
Sorry if already posted. This is an excellent article on how things have transpired in Italy.
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Italy is an anomaly. Italy’s textile industry recently turned to Chinese companies to come to Italy to setup and run Chinese techniques (which are very advanced) to benefit that industry in Italy. Sadly, lots of Chinese working there returned home to Wuhan for the Chinese New Year then back to Italy. They were returning just as the US banned travel from China. I expect Iran may have had military experts from China helping them in a similar way. It is for that reason I put these two countries in a different category for data analysis. The possible good news here may be other countries will experience something different than these countries.
Wired: March 19 – The Doctor Who Helped Defeat Smallpox Explains What’s Coming.
Epidemiologist Larry Brilliant, who warned of pandemic in 2006, says we can beat the novel coronavirus—but first, we need lots more testing.
Great interview.
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