Here on nearby Long Island cases are popping up all over the place with no known links to other diagnosed cases, including 2 school bus drivers. Despite this, barely anyone is being tested, even those who are symptomatic. This crisis is being terribly mishandled.
It's the lack of information and sense that there are no adults in the room among our leadership that is the most frustrating. It worries me more than the virus itself.
In a way that may be a good thing. I'm personally not very worried about this virus, and I think it does a great job of highlighting what various parties' motives are and efficacies are. (e.g. CDC, Bill Gates, NYC)
I don't know if this is still true but according to an article I read a few days ago, the US has the lowest testing rate of any affected country. Experiences of other countries seem to suggest that high testing rate may mitigate the need for measures like lockdowns.
That's misleading. The Feds state that they've sent several hundred thousand tests to private labs and hospitals which do not report their figures directly to CDC. They don't know how many have been used at this point (which is bad, but not as bad as them not sending out hundreds of thousands of tests).
"Earlier on Tuesday, Department of Health and Human Services Secretary Alex Azar said he couldn’t provide the figure. “We don’t know exactly how many because hundreds of thousands of our tests have gone out to private labs and hospitals that currently do not report in to CDC,” he said in a CNN appearance."
As of 4pm ET today https://twitter.com/covid19tracking (aggregating known state testing results) shows about 5100 tests performed, or 15 tests per million people.
Not saying this as an defense to your observation, but it's possible that they just don't have the capacity to manage that information, given the disparate nature of our health care system. Others have pointed out that the entire pandemic response org chain was fired a while back under the premise of cost savings.
Communicating that information back in a secure, consistent, and reliable way requires a "system" of some kind. It could be a secure website or even a phone war room ready to go and staffed with operators waiting for the test reports.
If such a system was available, you'd think they'd use it in heartbeat, which kind of implies it doesn't exist.
And it's not like systems of this sort - or more even more complex - don't exist. When my kids were born, we donated the umbilical cord blood to a stem cell bank. The organization sent me special bar-coded packaging with a refrigerated pack to be overnight posted back to them.
Those are total NY numbers, right? considering recent article about "Washington state authorities sent an urgent request for 233,000 respirators .. to be released from the federal", not to mention the fact Italy has 30K, and they ran out a week ago.
The CDC completely dropped the ball on providing test kits, so all the individual states and localities have had to source them themselves. Which, entirely predictably, they are not doing a great job at.
To reemphasize: the president fired the chain of command for handling pandemics and did not replace them. There is much more detailed information out there on it, but even Snopes rates it as a "True" https://www.snopes.com/fact-check/trump-fire-pandemic-team/
Considering CDC recommendations have been overruled at the executive level (HHS/cruise ship repatriation, which may have caused the CA cluster due to insufficient planning and training) and recommendations about seniors flying, it's reasonable to assume that chain of command is broken, not that the CDC itself is.
>To reemphasize: the president fired the chain of command for handling pandemics and did not replace them
There's a reason the Snopes piece is mostly based off a Twitter thread. If you actually read the NBC News and Washington Post articles the Snopes piece cites later, they describe the action as part of moving people to related departments as part of the new National Security Advisor's desire to restructure the hierarchy, and the head of the dedicated team resigning after not getting his desire to keep the team the way it was. Not "fired the chain of command".
COVID19 was not a surprise; that is, it was known to exist in China some time before the first cases appeared in the US. It is not unreasonable for a government to assemble a team to respond to something like a pandemic as needed, as opposed to having people dedicated solely to the purpose and nothing else.
You may or may not agree with this. But please don't claim that this is somehow prima facie proof of the Trump administration's malfeasance/evilness.
I've seen discussions of the faulty reagent (which happens, it's a production rollout under lots of stress and pressure). I've also seen through Foreign Policy Garrett's assertion that the Chinese-manufactured tests were rendering "up to" a 50% false negative rate, sometimes requiring 8 tests to render a valid result [1].
What I've yet to see is substantiation of claims online that because of what Garrett reported upon, the CDC chose to create its own PCR test instead of relying upon the Chinese version. If anyone can help me substantiate that, then that would be most welcome as it would explain a fair chunk of the CDC delays.
For awhile, I dropped into the rabbit hole of contemplating building my own PCR thermocycler and buying my own RT-qPCR supermix to try to run my own tests, then I acknowledged I didn't know what the hell I was thinking.
CDC would not authorize state and local labs to test. That seems to be an order coming from the White House to avoid economic panic (which is happening anyways).
It's actually worse than the administration just sticking their heads in the sand. The President has made multiple public statements where he's said his main objective in this is to keep the number of reported cases as low as possible. Every bureaucrat in the system is going to know exactly what that means: extensive testing will only surface more cases, so anyone who pushes for more testing will be performing what I heard described when I worked for the Air Force as "a career-limiting manuever."
A head-in-the-sand approach would at least be neutral. The administration has gone beyond that to actively putting a thumb on the scale.
(Ironically, this is the same type of "nobody ever prospered by upsetting The Boss" problem that lots of people were dunking on China for having a few weeks ago. The degree to which our supposedly open system has become vulnerable to it too should give us all a moment of pause.)
They are still restricting who can get tested. My son who has a fever and cough can't get tested because he doesn't have shortness of breath (you have to exhibit all 3 symptoms at the same time to be eligible for a test).
That's nuts. The federal government at this point has done far more harm than good.
Organizations that provide testing (public or private) should have just coordinated directly with the WHO on how to do those tests and just busted their butts to keep up with demand, which doctors deciding directly who to test and when. We'd have far more testing being done if we have just let markets do their thing.
It's not about markets vs government. It's about competency versus incompetency. South Korea has far more testing than about any country, it's not due to letting markets do their thing. It's due to competency: they had an imagination for this situation, from experience, and had a plan to deal with it, should it happen again. We have examples of authoritarian and democratic governments, some do the right thing, some do the wrong thing.
With markets, you have an opportunity to discover and reward competency. With government, you have all your eggs in one basket and if that basket isn't competent, you're shit out of luck.
With markets, you have an opportunity to discover conglomeration and monopolies who reward themselves. With government, you have elections, and if that doesn't work, well maybe you have an incompetent society, and all you have is luck.
A laughable shortage of test kits. Combined with a CDC ban on third-party testing that was recently lifted.
The retirement home in Kirkland that had 18 deaths from the virus over the last 2 weeks currently has ~30 patients in the ICU... Who still have not been tested for the virus.
This board doesn't like politics but frankly it is the administration. They fired the CDC's pandemic response teams a couple years ago because they didn't want to fund it. They don't like admitting there's a crisis because it looks bad for them, they want to sweep the whole thing under the rug. That has translated into the administration stopping the CDC from doing their jobs, whether implicitly ("if you make this into a big deal, we'll find someone else who is more willing to align with the administrations positions") or explicitly (stuff like cutting the funding for the CDC pandemic response teams).
It's basically the same thing as when Trump drew the hurricane on the map to an area where it wasn't going, and then fired all the people at the NWS who corrected him. Sticking your neck out and stating the emperor has no clothes is a fast track to getting replaced by someone who will play ball. Trump is exceptionally petty and has some paranoia that there is a “deep state” trying to undercut him. He doesn’t accept that these are professionals trying to do their jobs, because he is a moron who thinks he knows everything, better than the experts, and they are just trying to undermine him and make him look bad.
Trump is a uniquely stupid and incurious president, and he has absolutely no interest in listening to experts. The only people he allows to be around him are yes-men. He doesn’t understand what’s going on, and he doesn’t particularly care insofar as it makes him look bad, and tanks the stock market (makes him look bad).
Even Boris fucking Johnson is astonished by how bad the administration’s response has been.
In short - we elected a narcissistic, incurious, anti-intellectual, paranoid con man to be president, he is now facing a real, serious crisis, and he’s busy purging the career professionals that we need to be solving this crisis. He is that boss who can’t stand not being “the smartest guy in the room” even when he has no idea what he’s talking about, and he’s in charge of managing our response to basically Spanish Flu 2: Electric Boogaloo.
I think at this point it’s more helpful to think about what individuals and private organizations can do rather than look to a central government organization to solve all of our problems. See Gates Foundation decision(s) over past few days. I also know plenty of people in state orgs and can say I have a lot of confidence in them as well as the many healthcare orgs. I’m not downvoting this despite the obvious political nature in the hopes that by not turning on each other we might instead use HN to educate and drive awareness of what is being done and how we can help.
Establishing a completely parallel privatized set of epidemic response infrastructure, from scratch, with no official capacity/color of law/official powers, in the middle of an ongoing crisis isn't exactly a plausible suggestion.
Reality is there's effectively no containing it at this point, we're well past that stage of things. Get a vaccine going ASAP, sure, but it's already sweeping through the population. Official numbers are low because we don't have any meaningful quantity of testing in place. Wherever you test, you find that it's already there.
I'm not saying that to be hysterical, it's just a statement of fact. Just like my statements about how the administration has neglected and in some cases actively worsened the crisis.
It just is what it is.
You maybe could have significantly reduced it six or eight weeks ago, but back then we were in the "coronavirus is fake news by deep-state CDC to tank the economy" stage of things. Now, I guess you have mass quarantine, which Trump will also not do because that would tank the economy for real. People won't do it willingly because they need that money to pay rent and buy food, and you need to formulate a strategy for that too. Maybe Bill Gates can pay everyone's rent and grocery bills for a few months?
Best thing at this point is to do everything you can on a personal basis to prevent spread (wash your hands), protect specific vulnerable individuals (seniors, basically) from getting infected, and hope that vaccine comes real quick.
>This board doesn't like politics but frankly it is the administration. They fired the CDC's pandemic response teams a couple years ago because they didn't want to fund it.
There's a reason the Snopes https://www.snopes.com/fact-check/trump-fire-pandemic-team/ piece that calls this claim "true" is based on a Twitter thread. If you actually read the NBC News and Washington Post articles the Snopes piece cites later, they describe the action as part of moving people to related departments as part of the new National Security Advisor's desire to have his own hierarchy, and the head of the dedicated team resigning after not getting his desire to keep the team the way it was.
COVID19 was not a surprise; that is, it was known to exist in China some time before the first cases appeared in the US. It is not unreasonable for a government to assemble a team to respond to something like a pandemic as needed, as opposed to having people dedicated solely to the purpose and nothing else.
You may or may not agree with this. But please don't claim that this is somehow prima facie proof of the Trump administration's malfeasance/evilness.
Colorado has too. They said "I would assume that with testing ramping up it's no longer productive for the state to keep the number of administered tests count on a website as it will always be outdated."
NYC is seeing a crazy number of cases. Expect more quarantines in the city and around it in the next few days. They are not even releasing new numbers. They are too scary.
Might not sound like it, but the fact that they're taking this seriously is good news. If there are cases in New Rochelle, probably large numbers of other commuters taking the New Haven line down into Manhattan have been exposed.
We need to start practicing on what's coming, and right now, China's looking like the most successful model.
It's basically impossible to quarantine entire cities in a democracy, especially with an election coming up.
I mean, you can, but it's going to cost you so much political capital that you'll be out of the game entirely. And I don't see many politicians willing to put their jobs on the line for it.
> I mean, you can, but it's going to cost you so much political capital that you'll be out of the game entirely. And I don't see many politicians willing to put their jobs on the line for it.
Jesus. Putting people's lives at risk, just so you can keep your government job? How low can we can go?
why is it that everyone always releases the public from their half of the responsibility?
politicians are participating in game theory and acting out their best interests based on the other players. It takes two to tango.
I suppose this opens up a slippery slope whose neighbors are authoritarianism and will-less-ness and, in their innocence and ignorance, people cease to venture forth.
> We need to start practicing on what's coming, and right now, China's looking like the most successful model.
I truly can't believe how many people (including in my own hard hit country) praise the "Wuhan model" made by an authoritarian state. There are other successful models like the one in South Korea (after the disaster with that church, not before), which are far less authoritarian.
It's really true that vigilance needs to be kept up at all times, lest our freedom be taken away (and I don't mean not doing quarantine or lockdowns: I mean limitations of freedom "for your own good because you don't understand").
a) there is a huge diff between localities that act aggressively and prepare and those that dont
b) the ones that prepare and act aggressively to reduce exposure see death rates below 1%. This is still 5-10x more deadly than the flu, and is best case
c) the ones that dont see death rates above 5%. This is 50-100x worse than the flu.
In the US Washington and San Fran are failing to act aggressively enough in time.
The article doesnt discuss NYC, where I live, which has similar levels of infections as Washington tho far fewer deaths. The piece explains how the difference in death rate indicates NYC is in a far better position than Washington, and my own analysis is that we may still have time to stop the worst case, but it is really about what happens in the next several days.
Even in worst case, most people will themselves be fine, but everyone knows at least someone immune compromised or elderly or otherwise much more significantly at risk. So everyone's social or familial network will be impacted.
In terms of the future, it seems likely that even in best case, there will be subsequent waves that hit pockets that were missed the first time around. The difference in impact again will be in how overwhelmed the local hospital system will be. In the US this is likely to be highly variable as healthcare, bed availability, etc, is non-uniform.
And, yes, a vaccine in 12-18 months is pretty much the dream scenario. No guarantee we get there.
The dynamics of this are not something most of us have ever experienced.
I wonder what will happen after this first wave passes.
Will people then need to get 2 shots each year, once for flu and once for corona and it's descendants? Can the two be handled with a single shot?
I wonder also what will become of small population centers that manage to avoid the first wave. Will they suffer more greatly in the future, when the virus finally finds them?
66 comments
[ 2.1 ms ] story [ 120 ms ] threadhttps://www.fox5ny.com/news/two-long-island-bus-drivers-diag...
I'm hopeful change will come out of this.
Some other system constraints to think about are:
1M hospital beds 70k ventilators
"Earlier on Tuesday, Department of Health and Human Services Secretary Alex Azar said he couldn’t provide the figure. “We don’t know exactly how many because hundreds of thousands of our tests have gone out to private labs and hospitals that currently do not report in to CDC,” he said in a CNN appearance."
https://news.yahoo.com/only-5000-americans-have-been-tested-...
Communicating that information back in a secure, consistent, and reliable way requires a "system" of some kind. It could be a secure website or even a phone war room ready to go and staffed with operators waiting for the test reports.
If such a system was available, you'd think they'd use it in heartbeat, which kind of implies it doesn't exist.
And it's not like systems of this sort - or more even more complex - don't exist. When my kids were born, we donated the umbilical cord blood to a stem cell bank. The organization sent me special bar-coded packaging with a refrigerated pack to be overnight posted back to them.
So in a sense, the obstacle is (deliberately?) awful policy.
It didn't help matters either that those test kits the CDC did provide early on turned out to have flaws that caused inaccurate readings (see https://www.nbcnews.com/health/health-news/after-missteps-cd...).
Univ. of Washington seems to be an outlier as they were able to get approval under an existing research study they have.
This is new to me. Link?
https://www.nytimes.com/2020/03/02/health/coronavirus-testin...
https://www.latimes.com/science/story/2020-03-06/chaos-at-ho...
Considering CDC recommendations have been overruled at the executive level (HHS/cruise ship repatriation, which may have caused the CA cluster due to insufficient planning and training) and recommendations about seniors flying, it's reasonable to assume that chain of command is broken, not that the CDC itself is.
There's a reason the Snopes piece is mostly based off a Twitter thread. If you actually read the NBC News and Washington Post articles the Snopes piece cites later, they describe the action as part of moving people to related departments as part of the new National Security Advisor's desire to restructure the hierarchy, and the head of the dedicated team resigning after not getting his desire to keep the team the way it was. Not "fired the chain of command".
COVID19 was not a surprise; that is, it was known to exist in China some time before the first cases appeared in the US. It is not unreasonable for a government to assemble a team to respond to something like a pandemic as needed, as opposed to having people dedicated solely to the purpose and nothing else.
You may or may not agree with this. But please don't claim that this is somehow prima facie proof of the Trump administration's malfeasance/evilness.
What I've yet to see is substantiation of claims online that because of what Garrett reported upon, the CDC chose to create its own PCR test instead of relying upon the Chinese version. If anyone can help me substantiate that, then that would be most welcome as it would explain a fair chunk of the CDC delays.
For awhile, I dropped into the rabbit hole of contemplating building my own PCR thermocycler and buying my own RT-qPCR supermix to try to run my own tests, then I acknowledged I didn't know what the hell I was thinking.
[1] https://foreignpolicy.com/2020/02/15/coronavirus-xi-jinping-...
CDC would not authorize state and local labs to test. That seems to be an order coming from the White House to avoid economic panic (which is happening anyways).
A head-in-the-sand approach would at least be neutral. The administration has gone beyond that to actively putting a thumb on the scale.
(Ironically, this is the same type of "nobody ever prospered by upsetting The Boss" problem that lots of people were dunking on China for having a few weeks ago. The degree to which our supposedly open system has become vulnerable to it too should give us all a moment of pause.)
Organizations that provide testing (public or private) should have just coordinated directly with the WHO on how to do those tests and just busted their butts to keep up with demand, which doctors deciding directly who to test and when. We'd have far more testing being done if we have just let markets do their thing.
The retirement home in Kirkland that had 18 deaths from the virus over the last 2 weeks currently has ~30 patients in the ICU... Who still have not been tested for the virus.
It's basically the same thing as when Trump drew the hurricane on the map to an area where it wasn't going, and then fired all the people at the NWS who corrected him. Sticking your neck out and stating the emperor has no clothes is a fast track to getting replaced by someone who will play ball. Trump is exceptionally petty and has some paranoia that there is a “deep state” trying to undercut him. He doesn’t accept that these are professionals trying to do their jobs, because he is a moron who thinks he knows everything, better than the experts, and they are just trying to undermine him and make him look bad.
Trump is a uniquely stupid and incurious president, and he has absolutely no interest in listening to experts. The only people he allows to be around him are yes-men. He doesn’t understand what’s going on, and he doesn’t particularly care insofar as it makes him look bad, and tanks the stock market (makes him look bad).
Even Boris fucking Johnson is astonished by how bad the administration’s response has been.
In short - we elected a narcissistic, incurious, anti-intellectual, paranoid con man to be president, he is now facing a real, serious crisis, and he’s busy purging the career professionals that we need to be solving this crisis. He is that boss who can’t stand not being “the smartest guy in the room” even when he has no idea what he’s talking about, and he’s in charge of managing our response to basically Spanish Flu 2: Electric Boogaloo.
Reality is there's effectively no containing it at this point, we're well past that stage of things. Get a vaccine going ASAP, sure, but it's already sweeping through the population. Official numbers are low because we don't have any meaningful quantity of testing in place. Wherever you test, you find that it's already there.
I'm not saying that to be hysterical, it's just a statement of fact. Just like my statements about how the administration has neglected and in some cases actively worsened the crisis.
It just is what it is.
You maybe could have significantly reduced it six or eight weeks ago, but back then we were in the "coronavirus is fake news by deep-state CDC to tank the economy" stage of things. Now, I guess you have mass quarantine, which Trump will also not do because that would tank the economy for real. People won't do it willingly because they need that money to pay rent and buy food, and you need to formulate a strategy for that too. Maybe Bill Gates can pay everyone's rent and grocery bills for a few months?
Best thing at this point is to do everything you can on a personal basis to prevent spread (wash your hands), protect specific vulnerable individuals (seniors, basically) from getting infected, and hope that vaccine comes real quick.
It just is what it is.
Strong measures will still have an effect on the epidemic curve. Cancel the fucking St. Patrick's Day parade in Chicago, as an example.
There's a reason the Snopes https://www.snopes.com/fact-check/trump-fire-pandemic-team/ piece that calls this claim "true" is based on a Twitter thread. If you actually read the NBC News and Washington Post articles the Snopes piece cites later, they describe the action as part of moving people to related departments as part of the new National Security Advisor's desire to have his own hierarchy, and the head of the dedicated team resigning after not getting his desire to keep the team the way it was.
COVID19 was not a surprise; that is, it was known to exist in China some time before the first cases appeared in the US. It is not unreasonable for a government to assemble a team to respond to something like a pandemic as needed, as opposed to having people dedicated solely to the purpose and nothing else.
You may or may not agree with this. But please don't claim that this is somehow prima facie proof of the Trump administration's malfeasance/evilness.
https://www1.nyc.gov/site/doh/health//health-topics/coronavi...
if you pull up the cached version, they reported 300 tests done as of yesterday morning.
We need to start practicing on what's coming, and right now, China's looking like the most successful model.
I mean, you can, but it's going to cost you so much political capital that you'll be out of the game entirely. And I don't see many politicians willing to put their jobs on the line for it.
Jesus. Putting people's lives at risk, just so you can keep your government job? How low can we can go?
I mean, it's over-the-top nonsense, but compared to it, putting a city to hang is easy.
politicians are participating in game theory and acting out their best interests based on the other players. It takes two to tango.
I suppose this opens up a slippery slope whose neighbors are authoritarianism and will-less-ness and, in their innocence and ignorance, people cease to venture forth.
How about using a drone to bomb an underage citizen without trial?
Nah. You must be new.
I truly can't believe how many people (including in my own hard hit country) praise the "Wuhan model" made by an authoritarian state. There are other successful models like the one in South Korea (after the disaster with that church, not before), which are far less authoritarian.
It's really true that vigilance needs to be kept up at all times, lest our freedom be taken away (and I don't mean not doing quarantine or lockdowns: I mean limitations of freedom "for your own good because you don't understand").
https://www.realclearpolitics.com/video/2020/03/10/dr_drew_p...
The below is the best current analytical distillation I've seen of where we are:
https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
The upshot is:
a) there is a huge diff between localities that act aggressively and prepare and those that dont
b) the ones that prepare and act aggressively to reduce exposure see death rates below 1%. This is still 5-10x more deadly than the flu, and is best case
c) the ones that dont see death rates above 5%. This is 50-100x worse than the flu.
In the US Washington and San Fran are failing to act aggressively enough in time.
The article doesnt discuss NYC, where I live, which has similar levels of infections as Washington tho far fewer deaths. The piece explains how the difference in death rate indicates NYC is in a far better position than Washington, and my own analysis is that we may still have time to stop the worst case, but it is really about what happens in the next several days.
Even in worst case, most people will themselves be fine, but everyone knows at least someone immune compromised or elderly or otherwise much more significantly at risk. So everyone's social or familial network will be impacted.
In terms of the future, it seems likely that even in best case, there will be subsequent waves that hit pockets that were missed the first time around. The difference in impact again will be in how overwhelmed the local hospital system will be. In the US this is likely to be highly variable as healthcare, bed availability, etc, is non-uniform.
And, yes, a vaccine in 12-18 months is pretty much the dream scenario. No guarantee we get there.
The dynamics of this are not something most of us have ever experienced.
Will people then need to get 2 shots each year, once for flu and once for corona and it's descendants? Can the two be handled with a single shot?
I wonder also what will become of small population centers that manage to avoid the first wave. Will they suffer more greatly in the future, when the virus finally finds them?