Peon Awesome

You're right. NC isn't a hotspot right now. And our goal is not to become one. The cases steadily rising though requires us to keep our guard up. Don't forget that we've only been in phase 2 for a month and a half and it can take a couple weeks from exposure to hospitalization. We certainly could be worse, but we also shouldn't be high fiving and patting ourselves on the back for setting records for number of hospitalizations without a clear end in sight. Recently saw a video of Ron de Santis from a few weeks ago boasting defiantly how Florida had been open for weeks and were not seeing many cases. How everyone said their hospitals would get overwhelmed but they were wrong. Looks incredibly foolish now. The problem is if we ignore the trends and loosen all restrictions, the virus can and likely will spread exponentially and we'll join the ranks of Florida, Texas, and Arizona. I don't think we will because to this point, Roy Cooper has been following medical advice and holding off on opening the major niduses for spread like bars. But he's getting heavily opposed from the NC legislature and at some point the pressure may become too much. Guess we'll see.

For those asking about SC hospitalizations (taken from the SC department of health website): 7/7: 1324 7/6: 1260 7/5: 1251 7/4: 1190 7/3: 1148 7/2: 1125 5 straight days of steady increases with 200 more people hospitalized in less than a week. That's actually pretty staggering. And we still have the effect of 4th of July weekend to come.

In theory you could argue for this but in practice this isn't feasible or advisable for several reasons. 1) How do you ensure only young people get infected? They'd be congregating in groves, spreading the virus everywhere except where any elderly people might be? Elderly people wearing masks isn't going to protect them. The young people need to be wearing the masks for the elderly to avoid infection and then that would reduce your herd immunity plan. And elderly people are going to have a tough time avoiding all young people; at grocery stores, pharmacies, both other shoppers and the people at the register would pose a risk. 2. People are still forgetting that no one can say definitively that exposure = long-lasting immunity. It's possible people could fully recover from the infection and get infected again fairly quickly (although this seems less likely). But what's highly possible is they could recover from one infection and then 6 months later, the virus has undergone enough antigenic shift for them to get reinfected again by a slightly different version. So instead of having 1 huge peak, you have 2. And then you've also gotten a couple hundred million people infected with little benefit. 3. While young people are less likely to have severe disease, they're not immune from it. According to the CDC's latest published numbers, there are about 1,000 people under the age of 35 who have died from COVID in the US. Extend the age range to 44 and younger and it becomes 3,000 people. And that's highly unlikely to be enough to achieve herd immunity. Plus are you going to tell a 50 year old executive at his company to bunker down for 6 months? Cause add those 54 and younger and you're approaching 10,000 deaths. Now multiply those numbers by 10 since perhaps at most 10% of people have been infected so far. Now you'll have something close to 100,000 dead. And since a much higher percentage need hospitalization, let's say you've got 2 million or more hospitalized. Also recall that it's the 30 year olds who often are uninsured, no longer qualifying for their parents insurance, now many unemployed due to COVID without employer insurance or choose not to pay the high premiums since they've always been healthy. Now you've doomed hundreds of thousands of people to financial ruin with their insane hospital bills, stifling their economic contribution for decades. Look I don't know the right answer. Ideally we get an effective vaccine in 5 months, get everyone vaccinated over the following 3 months, and attempt to open up fully by next spring. Is that being highly optimistic? Yeah. Is it impossible? There have been no indications thus far that it is. And if there's a chance we can achieve that, we should hold the course until we know for sure that's an impossibility. Cause I'd rather function at 50% capacity with masks for another 8 or 9 months than commit over hundreds of thousands more to death and financial ruin who could otherwise avoid it. And if it becomes clearer a vaccine is not anywhere close, we can pursue other avenues.

I'd be willing to address the points made in the video. First let's take that doctor's point that many of these people have other medical problems that made them more susceptible to dying after getting COVID. That's already well known. People with health conditions like diabetes and heart disease are more likely to die if they get infected with COVID than a young person with no medical problems. But people with diabetes don't just randomly develop respiratory failure that kills them. If they never got COVID, they wouldn't have died then. It's that simple. And he loses me by bringing up people dying with flu and pneumonia. Remember how people quote that up to 60,000 people die of flu in the US? How does he think those deaths get counted? The flu virus takes an axe and chops their body up? Those people also had other medical conditions. How about people who die of cancer? The cancer may not have specifically did them in but it was the primary insult. This is the convention of how deaths are counted for any disease. There's no special conspiracy to change criteria for COVID. On the death certificate you have to decide what was the principle insult. In the case of COVID, people die of respiratory failure, heart failure, blood clots, kidney failure. All these things happen due to effect of the virus on the body and those whose organs are already affected by other medical problems have less reserve to survive those effects. That's how it works. The above also applies to the woman saying we are more liberal in counting our deaths than other countries. If true (which I doubt outside of shady places like China and Russia), that's more of a poor reflection of those other countries. As I alluded to, if you get COVID and it causes your kidneys to fail and you die, you're telling me we shouldn't list that as a COVID related death? If due to the pathologic coagulation associated with COVID you get multiple blood clots into your lungs and die, we should pretend like COVID wasn't the primary underlying cause of death? If we did that, we would be misleading the public in the other direction. Again the basic point is if those people never got COVID, they wouldn't have died like that. COVID can kill you in more than one way. Attributing the cause of death as one of the ways COVID can kill you but leaving out COVID altogether would be terribly disingenuous. As far as hospitals getting paid more for COVID patients on ventilators, of course that's true. It costs a ton of money to care for them. Not only the additional nursing and respiratory therapy care but all the PPE all the team members have to utilize. Also intubation is associated with higher rates of other medical complications in COVID like kidney failure that costs much more to treat. If we didn't charge more we would go into bankruptcy even faster. You have to cover your costs. That's another stupid thing to point out. Our hospital reported losses of several hundred million dollars related to COVID. It's going to take us a long time just to break even. But sure, we are using COVID as our cash cow. The Cook county health commissioner, that one was a head scratcher so I had to investigate. Not sure when that video was taken, but here's an article from May saying the opposite: https://www.nbcchicago.com/news/coronavirus/dr-ngozi-ezike-refutes-notion-that-illinois-is-over-counting-covid-19-deaths/2270810/ Maybe she realized her error and went back to correct it, but the point is, the current data is accurate. She even brings up the point that they likely undercounted cases from February and March when they didn't know as much about the virus and weren't testing as much. And finally as far as New York counting presumed deaths, our infectious disease chief showed us data that demonstrated that New York probably still underestimated by several thousand deaths. They used a model that showed how many people would be expected to die in a normal year factoring in ages and density of medical problems like kidney disease and diabetes and the actual deaths exceeded that by around 10,000. Don't forget that there was so little testing in the beginning. People were dying left and right in nursing homes out of the blue. In a city as huge as New York, 3000 some deaths they didn't get to test is a conservative estimate. Is the system perfect? No. Could there have been some people who died, had COVID, and their death had little to do with COVID? I can say at my hospital, I haven't seen that whatsoever. And as I demonstrated above, even the one publicized report of that was later refuted. But I'm willing to concede among 130,000+ deaths, there could theoretically be a small number of those that fall through the cracks. But there are undoubtedly people in March before we had enough testing who also died and never got tested and never got added to the totals. So I doubt the true number is much different, and in fact, is just as likely, if not more, to be higher than the published number. Even if you wanted to be ultra conservative and say the numbers are a bit off, is 120,000 bona fide COVID deaths and counting something to sneeze at and assume it's all an overblown hoax? At this point what is even the point of this? Hardly anyone is advocating for shutting down again. People are just suggesting we need to wear masks and social distance when we can. Do you think that's part of some liberal agenda to control people by inserting mind control chips in everyone's masks? What does anyone else get out of people wearing masks? Just do your part and we can keep the country running.

Yeah the way it was handled wasn't good but the issue is far more convoluted than it's being presented. Let's start with a fact that hasn't changed a lot from the beginning. Masks aren't great in and of themselves for protecting the wearer from the virus. The biggest benefit is protecting others from you particularly since there are people with minimal symptoms that can spread the virus. So now let's go back to late February/early March when there were very few known cases in the US and people are being told that it wasn't necessary to wear masks if you have no symptoms. That's because the chance you had the virus with no symptoms was pretty low for the most part, particularly outside of the couple major hotspots like New York. So the benefit had to be weighed against the risk of people buying out masks and there not being enough in hospitals where there were bona fide COVID cases. I can attest in our hospital, we were rationing masks the first few weeks or so at least, having to wear the same mask for 5 days straight. Doctors were getting COVID because they couldn't be properly protected. The recommendations were presented with that in mind: masks had marginal benefit to the general public but tremendous benefit to health care workers. All that being said, the situation was still undoubtedly bungled. The explanation for why widespread masks weren't being recommended needed to be clear. Instead it was presented like masks were just generally worthless. They could have made the recommendation from day 1 to use cloth masks, advising people of the need to reserve N95s and surgical masks for the hospital while still curtailing community spread from the very beginning. Second, the recommendation to start wearing masks universally needed to come much sooner. We were being reactive instead of proactive. We shouldn't have waited until we were getting widespread outbreaks throughout the country before we started stressing the importance of mask wearing. At that point, you've let thousands more get needlessly sick or die. All that being said, the recommendations are coming out almost universally for masks outside of Trump and some alt right fringe sites. Republicans nationwide that aren't completely up Trump's ass (and even some who are) are urging people to wear masks. It's become a bit silly to make an excuse for it now regardless of how much they messed up the handling up front.

Asheville does have a lot of breweries with at least a reasonable amount of outdoor seating. Wicked Weed, Burial, New Belgium, Asheville Brewing, Bhramari, Sierra Nevada, Funkatorium, among several others I'm sure. Not sure how/if they are operating; I think if they have some food options, they can potentially get away with being open during phase 2. I guess technically they also double as "retail" since they sell their beers to go on site. Haven't quite figured out all the stipulations but I know there are at least some breweries near me open.

The park thing doesn't necessarily make sense to me either although I'd be willing to hear the rationale for it and could be swayed if it's convincing enough. But as far as why not open everything, I don't agree with that necessarily. The big ticket items that are closed in NC are gyms and bars. I get that. In a bar, people are talking loudly over music, can't realistically stay masked with having to drink their drinks and the whole environment is built around close social interaction. Now I can see certain bars that have spacious outdoor seating being able to get by, but that's how many bars, 1%? Doesn't move the needle much. If they wanted to allow bars that could do outdoor seating only and maintain 6 feet with patrons, that makes sense. But you'd still have 99% of bar owners pissed they can't meet those kinds of requirements. As far as gyms, there is frequent touching of surfaces by dozens of different people. Regular handwashing is inconvenient and impractical. Are you going to wash hands in between every set, then walk back and find someone else using your equipment? People don't like wearing masks walking in the grocery store. How many want to wear one while running on the treadmill? The videos of people fighting gym staff over mask requirements is going to overwhelm social media more than anything we're seeing now. Now are both of those things feasible if we have things under better control? Perhaps. That's why in North Carolina they would be open in phase 3. When cases aren't exploding and half of the people aren't presumed to be actively infected, maybe you have a fighting chance with social distancing measures and frequent sanitation efforts limiting the potential explosion of cases. It's still risky and you could argue against it even until we have an effective vaccine but at least you can have the conversation about it. Until things are under control though, you're just adding another variable to allow things to spiral much worse like we're seeing in Texas and Florida

Perhaps you mean why is Hawaii doing better than other states in spite of Trump? Listen, we get it, New Zealand had an advantage by being a smaller island nation and with that advantage, they mounted a remarkable response. The US required a monumental effort with the strongest and most effective leadership to get a fraction of those results and they failed spectacularly on many levels due to inept leaders and Americans working against their self interests. You elect your leaders to rise to the occasion for whatever challenges get thrown your way. New Zealand did and the US didn't. Let's put it in terms you might understand. New Zealand is like a white person born with privilege that grew up to become a wildly successful businessman. It didn't mean they didn't have to work for it or have lots of smarts and drive. But if you find their response not commendable then you probably should also invalidate the accomplishments of anyone born white, into wealth, or with any other distinction that gave them some leg up over others.

It's possible you are referring to my post since there was mention of 4-5 weeks in there and if so you may have misunderstood me. I mentioned the lag time from cases to deaths is about 3 weeks but followed that up to say if cases keep doubling every week in Florida, the deaths are going to look even worse in 4-5 weeks. I wasn't saying it takes 4-5 weeks for cases to translate to deaths. I haven't read every single post in this million page thread so if you were referring to someone else's post, I apologize.

You'll have to first explain how a trend in the right direction would take us from 128,000 deaths to 1 million.

Yeah the message may be starting to click. We still have a ways to go, but when republican governors (e.g. Texas) are begging their citizens to wear a mask and social distance, some people are starting to figure out it's not a matter of politics, but a matter of sheer ignorance.

Few points: 1. Florida is entering a frightening trend in the last week or so, with no end in sight. That's what we should be worrying about and focusing on. Does it really matter how much worse it is than New York? If New York is doing just as terribly (which it isn't), it doesn't make Florida's situation any better or less scary or demanding any less urgency to correct. Trying to focus the conversation away from that point is counterproductive. 2. The links you posted actually demonstrate the stark difference in trends well. New York's new cases has dwindled down and stayed down for weeks while Florida's has shot way, way up. 3. Notice I didn't mention deaths, which while Florida has more, it's not as striking as the new cases. I know you tried to reference the similar deaths earlier when implying the states are in similar situations. Time of infection to death is often 3 weeks or so. It's only been in the last week that cases started erupting in Florida. So it'll be another 2 weeks before the deaths even start translating. And if cases keep doubling every week like they have been, then it's going to be even scarier 4 or 5 weeks from now. We should circle back around and put the deaths side by side a month from now and see how you feel about it. 4. New York had lots of cases before most anyone was taking COVID seriously and there was little to no testing available in the US. They're an international hot spot; thousands of people from overseas, including contacts through China and other COVID epicenters, were making their way into NYC back when our leadership was acting like COVID was nothing and wouldn't hit the US beyond a dozen cases or so. No testing and no guidelines for social distancing and mask usage in a city that is so densely packed made an environment ripe for mass spread. Meanwhile, the world has known about the dangers of COVID for months and the need for social distancing and mask usage has been spread far and wide. Despite that, Florida (among others) is seeing frightening exponential growth. To say both deserve equal blame for mishandling the situation, although while admittedly not the important thing to focus on, is also inaccurate. That's not to say New York couldn't have done better or that Florida didn't make any effort. But equating the two situations is painting quite a selective brush.