FlyBitcoin

And tomorrow that procedure, in the affected counties, would be cancelled.
Venue does not matter.

Boggie Dog

Understood. Without injecting personal opinion should venue not be a factor?

FlyBitcoin

Good point.
In the first round of "lockdowns" it wasn't a factor in order to preserve PPE and use as overflow hospitals which never happened. That is why AZ is so behind in elective cases.
My friend's surgery center in AZ had to "donate" PPE to the state and was told to have OR anesthesia machines (to be used as vents) on standby for overflow patients when they had daily cases 1/10 of what they do now.

Politicians don't know how to run a hospital or an outpatient care center at all. They all wanted ventilators in March, and now none of them want ventilators.
Where are all of the GM ventilators?
But to hear a politician say they are avoiding closing down businesses and then stop elective surgery... Moronic.
And guess who gets rich? The insurance company that doesn't have to pay for that elective procedure.

boerne

This is from Austin/Travis County Medical Society. We have had a huge surge in admissions and clearly related to Memorial Day and easing restrictions. Enjoy.
Dear Colleagues,



Wednesday afternoon, the City of Austin and Austin/Travis County hosted a press conference featuring doctors and nurses who are concerned about the resurgence of COVID-19 in our community.



I participated along with critical care nurse, Frances Simpson, RN, and Drs. Kirsten Nieto, Chris Ziebell, Mike Pignone, Ann Buchannan, Ross Tobleman, Pete Zamora, and Mark Escott.



Our purpose was twofold: (1) to inform the public of the current surge of COVID-19 in our community and the dangers it poses to them and to our health care system; and (2) to appeal to the public to follow our advice and once again adhere to the masking, distancing, and hygiene practices that we’ve proven can flatten the curve.



Dr. Escott opened the conference showing graphs of the hockey-stick upsurge in all indicator trend lines since the relaxation of stay home/work safe orders.



I followed his introduction with the following message to our community.



"It’s important to understand what exponential spread of a virus means. We all know how things go viral on the Internet. You see a funny cat video and share it with 10 people. They each share it with 10 more. That’s 100 people now, who share it with 10 each, reaching 1000. The 1000 spread it to 10,000, then 100,000, then one million. In just six of cycles of transmission, one person affects one million people.



Real viruses, like the new Coronavirus, work in exactly the same way. When one person has been infected, he or she will spread it to several other people. They in turn infect many more, and on it goes.



We face another problem with the Coronavirus. It’s sneaky. It spreads very easily. You can have it for days or even a couple of weeks without knowing it and, all the while, you are unintentionally infecting family, friends, and coworkers.



It’s unpredictable because it affects people in different ways. Some barely feel sick at all, while others get so sick they end up gasping for air, and have to go on a ventilator with a plastic tube in your windpipe for days or even weeks. And many die - more than 120,000 so far in America, and worldwide the number is approaching half a million.



In one way though, the virus is not sneaky. It cares not whether its victims are Asian, Black, Hispanic, or White. It is equally eager to invade the lungs of a Christian, a Hindu, a Jew, or a Muslim. It won’t consider your gender. And it will infect you whether you are a Democrat or a Republican.



During the lockdown, we did something incredible. We proved that we can control the virus and flatten the curve simply by changing our behavior. For a couple of months, there was amazing cooperation among all of us to accomplish that goal.

Then we got tired, and a bit stir-crazy, and we lowered our guard. As a result, the virus has surged, and it’s taking lives as it multiplies.



But there is a middle ground between complete lockdown and uncontrolled viral spread.



It simply involves doing the things we know we should do: Distancing ourselves. Wearing masks. Washing our hands. Minimizing social excursions. And absolutely staying home if sick.



What happens over the next several days and weeks is completely up to us. How we behave – and how we cooperate with each other - will make a difference. The thousands of doctor’s, nurses, and other health care workers in the Austin area will be here to help you if you get sick, but we will only be successful if we have enough people, enough resources, enough hospital beds, and enough medicines to do it.



Good ideas can spread like a virus as well. It’s time now for this idea to go viral: Controlling COVID depends on each one of us, on how we cooperate, and on the actions we take."



The messages that followed from every doctor and nurse on our panel was clear and consistent. Do the right thing. Don’t wait to be ordered. Take care of yourself and others.



I was proud to be among the doctors and nurses coming together to speak to our community as the leaders they can trust to tell them the truth.



Feel free to share this with 10 friends and encourage them to share with 10 more, you get the idea.



The press conference was recorded for viewing here.



John Abikhaled, MD

TCMS President

FlitBen

Unless I misunderstood the story, there seems to be two general schemes being discussed observationally. The classic model narrowly concerns simple mitigation against transmission, i.e. widespread distancing measures that more frequently depress viral load/case severity during exposures.

The broader model posits 'mild' mutational variants that have long existed and quickly adapted to their host populations, a situation which should collectively benefit both genomes. In this theory, reproductively 'fitter' mild variants, if any, will overtake more virulent rivals due to certain extended effects of the same interventions, which in addition to reducing transmissions will also select against the latter in terms of host isolations and deaths, leading to the eventual prevalence of such milder strains.

Whether genetic analysis will support the second theory is for its proponents to show, i.e. from any such mapping vs. clinical trends and also differing pathologies.

Global Adventurer

I take an anti-TNF weekly, so this is good to know.

GUWonder

The two professions most over-represented in Sweden’s virus numbers: bus drivers and taxi drivers. Something to keep in mind if playing tourist at this time.

FlyBitcoin

This virus mutates less than flu and is already in a near-perfect form for survival/transmission with the asymptomatic spread.
Nexstrain says no significant mutations and not getting weaker. We will get to partial herd immunity in 2-3 years prior to significant mutations, IMHO.

radonc1

It appears that Texas is shutting down again.

https://www.texastribune.org/2020/06...s-greg-abbott/

Gov. Greg Abbott on Friday took his most drastic action yet to respond to the post-reopening coronavirus surge in Texas, shutting bars back down and scaling back restaurant capacity to 50%.

He also shut down river-rafting trips, which have been blamed for a swift rise in cases in Hays County, and banned outdoor gatherings of over 100 people unless local officials approve.

FlitBen

You probably have that part right. I just saw the news about one of the CDC's worst-case scenarios for disease spread. The current line is already spreading too fast to leave environmental niches for any late-arriving strains, however much its characteristic virulence is being countered by widespread distancing and better treatments.

fransknorge

22% of Arizona hospitalisation are in the 20-44 year old range:




Seems clear the virus is circulating a lot in the bar/club crowds, leading to high viral load plus other unknown factors and young people ends up in ICU, likely with organ malfunctions for life.

cesco.g

Overheard a news items yesterday pointing out, that deaths are down 90% from its peak in early April.
not sure, if this is "Good news" in view of the overall situation (?)

TTT

Deaths lag infections by a number of weeks so too early to tell based on the current infections.
The lower age of the more recently infected may keep the rate lower than in the initial outbreaks. That said, the number of people being infected now may make total death numbers similar. Time will tell.

FlyBitcoin

Some really good modeling work to show that a cheaper rapid cassette test that has a higher threshold for detection is more valuable than the current PCR testing that detects less virus earlier on, but has a 2-3 day delay in reporting.
Rationale is that we go from 10^3 to 10^5 viral load pretty quckly early in the infection, so little time is lost there but once we pass 10^5 we remain the biggest threat to infecting others, so speed of result really matters to get oneself isolated.

Therefore, we need to be developing more of the cheaper rapid tests than putting even more resources into lab-based PCR testing. However, good luck getting insurance to cover a rapid non-laboratory test, so that is one point of resistance in the USA.

https://www.medrxiv.org/content/10.1...309v1.full.pdf

Beautifully outlined in this Twitter thread:

Loren Pechtel

Isn't it about keeping capacity available for Covid-19 rather than the risk of spreading it?