Machu Peach

It seems like you did

In this thread alone people have said 1) I don't believe in medical science 2) I don't believe in vaccination 3) I don't think that cases and deaths are increasing in WI 4) I consider WI a 'success'. I haven't made any of those statements. They're ridiculous on their face.

Two people discussing a bad dinner. Person A "Wow this chicken is awful." Person B "The beef is even worse." Person A "It seems like you're saying the chicken is good."

Is anyone making that claim? It sure seems like you are when you describe NYC in March as "this is what bleak looks like". Maybe that wasn't the intention, but it sure seems like the bar is being set awfully low. There's a nasty trend on this board where people are comfortable telling me what it "seems like" I'm writing. It's unfair and it should stop. Instead focus on what I actually write. If anyone is confused by what I write, please ask questions. It's fair more likely to further the discussion than this "seems like"/"seemingly" stuff. If one attempts to make me defend a position I haven't taken, I'm simply going to point out that I haven't taken that position. If you think I've declared the WI a "success" that's on you; I haven't used that word or any of it synonyms. I don't know what a successful response would look like. There are so many variables at play that I would have trouble even measuring success. Obviously one wants the death rate to be as low as possible. How low is possible? I can't predict with any confidence.

Is anyone making that claim?

I am going to correct when I'm being incompletely quoted or misquoted. In that response I list 1)Bad estimates of morality rate 2)Bad models 3)Bad estimates of infection rate 4)Bad understanding of incubation time 5)Numbers of deaths per million 6)Bad understanding of transmission 7)Hospital Capacity 8)"Widespread" PPE shortages.

This is not true. My actual response.

In March/April in NYC 1000 people per day were dying. There was very little know about the virus. The hospital system was actively overwhelmed. There was worries that everywhere in the US was going to end up as bad as NYC. There were worries it was going to continue to get worse and worries of a fall surge. In Oct in WI 40 people per day are dying. There is a lot more known about the virus. There are worries that the hospital system is getting overwhelmed. There is little worry that WI going to end up as bad as NYC. There are worries it is going to continue to get worse and worries of a fall surge. It's not binary. I don't see it as an either/or situation. One can simultaneously acknowledge that 1) the situation in NYC was far more dire by any objective measure 2) there are fewer unknowns now than in March/April and 3) the potential for further increases and a 'fall surge' were/are real concern(s), both in March/April and now. I don't know how to state it any more plainly and have little interest in continuing this discussion. If you disagree that's fine, but stating that I'm dismissive of "the plight of actual front-line healthcare workers" is inappropriate. ...particularly, as I am (arguably) one and my wife is inarguably one.

Didn't state or imply that. In fact, I state my worry about the upcoming 'fall surge.' ...which I actually am extremely concerned about. I was concerned about it March/April too. I'm pretty sure it was even discussed here at the time. Didn't state or imply that either. ...and I know one 'front line healthcare worker' quite intimately (I guess I'm sorta a front line worker too? I deal with cancer patients not COVID, but I haven't been furloughed or WFH a single day as our trial was deemed lifesaving, thus essential.)

Perhaps they (and I) don't share the confidence that you seem to have that those situations that you note from earlier in the year are actually behind us.

Maybe the medical professionals in WI didn't realize how bad the situations were in the initial hotspots? One would have hoped that they would have had the foresight to understand what was happening elsewhere. The mortality rate (~3000 per million in NYC and ~300 per million in WI) are an order of magitude different. ...and that's not even getting to the fact that there was very little known about the virus, both the pathology and epidemiology, at the time of NYC's outbreak. I'm guessing this is a case of seeing the effects firsthand. One can hear that 1000 people are dying per day in NYC, but it doesn't have the same emotional impact as 40 people dying per day in your area. "I think things look quite bleak in the healthcare industry right now." In NYC 4th year med students were pulled out of their programs to help with the pandemic. Retired MDs, nurses, and technicians were recalled to work. Volunteers were flown in from across the country. Two of my colleagues, MDs doing research who hadn't seen a patient in years, were called in to volunteer at their university's emergency dept and granted admitting privileges. They had ~40 people dying per day just at their hospital alone. That is what bleak looks like. ...anyways, I've said my piece and don't have any more to add.

I'm guessing this is a key difference. I'm looking at the entire US, including areas with much higher viral spread, whereas people here are understandably focused in on WI alone. Edit: I feel I should add, that I'm also concerned about an increase as fall progresses. However, that's not a new worry. People were worried about increases in the March/April too. I'm quite surprised this is an area of disagreement. So much more is known about almost every aspect. There's so much less panic and fearmongering in the media. A lot of worries remain, but the most of the more outlandish fears haven't occurred and there's good reason to think they won't occur.

While this is all true to some extent or another, one would have think that the majority of underreporting is due to asymptomatic people who don't even suspect they're infected, right? These factors were all true in hotspots in March and April too. People knew it was going to spread and get worse. Roughly half the residents in the MICU at my friend's hospital got COVID early on. They had to shorten shifts because of the emotional burden. Almost all non-COVID, non emergency resources were redirected. Are you saying these are new factors in Wisconsin?

227,000 deaths / 8,585,000 confirmed infections = 2.64% I'm not aware of anyone that thinks the confirmed infection count accurately reflects the actual number of infections. However if you do we'll have to agree to disagree, and yes using that logic the initial estimates were correct. I'm not 100% sure, but I believe no one in the US has been denied treatment because of a shortage of PPE, hospital beds, or ventilators. Please correct me if you have a citation that that's incorrect. That was a significant concern, particularly the PPE and ventilators, among many on this message board, if I remember correctly. Even with those caveats, I think the overall point "everyone is less worried" remains.

Second hand smoke isn't a great example as it is NOT tolerated in many places. You can't smoke in most public indoor places (and often outside of these places). The place it is tolerated is in the homes of smokers - where children and spouses and roommates get subjected to second hand smoke. To try and police people's homes is, frankly, a logistical impossibility, and runs into government overreach questions. "In Chicago, 2 out of 3 people infected knew the person that infected them. 3 out of 4 took place at home. So people are going out and catching the virus and then spreading it to their families in the majority of cases. This isn't a "I'm gonna live my life and if I die it's on me" thing. It's a "I'm gonna put my family in danger" thing." Given that people are most likely to infect their family members, it seems like second hand smoke is a good comparison. It kills an estimated 40,000 people per year so it's still a major public health problem that gets little attention anymore. Vaccine non-compliance is largely tolerated in our culture. Vaccination rates have been decreasing for a while now. Waivers are very easy to get in many areas. There are mainstream politicians promoting vaccine skepticism with almost no pushback. There are even people this board that have stated their vaccine skepticism, again with little pushback. Your argument that 'schools, the military, and hospitals require it' (pardon the paraphrasing) doesn't hold water. Schools, the military, and hospitals require COVID compliance too. Those facts strengthen the comparison. There are important differences between second hand smoke, vaccines, and COVID and I am not arguing that they are identical. However, they're not bad comparisons for many purposes and they are better comparisons than obesity.

There is absolutely 'a diminished concern or worry about the severity'. I hate to speak for others, but I think that's true for just about everyone. Back in March and April... The media were predicating a 1-3% (even higher in some cases) mortality rate. There were models that had millions dying. You had health directors claiming that 1% of people were actively infected at that time. There was an idea that a 14 day incubation period was typical. NYC had roughly 2000 deaths per million and some thought that would occur everywhere. There was an idea that the virus could live on surfaces for days, making the delivery of food and other essential items very risky. There was a great deal of worry about hospitals running out of beds and ventilators. There were worries about widespread PPE shortages... I'm sure there are other things I'm forgetting. Most of those worries have proven to be wrong or overexaggerated, but they were real worries at the time. Combine that with the fact that much much more is known about the pathology and transmission of COVID and I think most people are less worried.

"Her" not "his." Women can be MDs too. "I'm interested to know... ...whether there's an acknowledgement that other countries/governments HAVE had more success at containing this." I'd be happy to answer a less leading inquiry.

I've listed second hand smoke and vaccine non-compliance as examples of tolerated behaviors which harm the health of others who don't engage in 'risky behavior'. Those behaviors might make for a better comparison. I'm also 'in the medical industry' (though mostly unrelated to infectious diseases these days) and my best friend is an internal medicine MD in a MICU in a formerly major hotspot. There is a significant amount of discussion regarding the relative and absolute efficacy of various mitigation strategies among my and her circles. There is no consensus.

I'm not making the claims you're ascribing to me. I did not say "the reports are made up." You can quote me if you feel I did. I've previously mentioned I've worked for the Feds and still have many friends at CDC. Reporters aren't the only ones with 'sources'. I feel I've made my point. You can have the last word. Message me if you need to continue for some reason.

The statement that I had/have issue with, "CDC has been corrupted by politics now, eliminate them from the convo. It will be crazy the stories we hear once those people are allowed to speak freely." is significantly different than what you're saying now. I do think statements like that are conspiracy theory level nonsense. I don't necessarily completely agree with what you're saying now, but I wouldn't describe it as conspiracy theory level nonsense.

If you'd like to go through the issues I had with your statements a few weeks ago I'd be happy to do that, though that's probably best left to PMs. To summarize, I thought your statement "CDC has been corrupted by politics now, eliminate them from the convo. It will be crazy the stories we hear once those people are allowed to speak freely." was a good example of "trust[ing] the science" only when it supports your preconceived beliefs. It also appears you're confused on CDC's role in the vaccine approval process. FDA, not CDC, approves new vaccines.

That's depressing. ...but pandering to vaccine skeptics has it's consequences. I wonder what overlap between the "Trust the science/wear a mask/take this seriously" crowd and the "Vaccines aren't safe/I'm going to wait" crowd is?

Small nitpick on what I assume is a typo, but ~30,000 confirmed active cases / 5.8 million people = ~0.5%. Your overall point is very well taken.

I think that's very fair, but it's also fair to lament the selfishness/stupidity/stubbornness of those folks. Obviously it sounds like your friend is taking that to an unhealthy degree, but I don't think it's unfair to question why people are choosing to do what they're doing. I also think the examples you point to (smoking cessation, weight loss, etc.) are choices that effect one's own personal health. Stuff like mask wearing is about protecting the health of others, and noncompliance is all the more terrible from that standpoint. The dangers of secondhand smoke have been known for decades; an estimated 40,000 people die from it each year. ...I also mentioned flu vaccination, but you could extend it to any vaccine non-compliance (including people's predetermined reluctance or refusal to get an eventual COVID vaccine). All are about protecting the health of others. It is certainly fair to lament non-compliance to COVID measures. It's also fair to attempt to reduce non-compliance. However, I personally think getting angry or confrontational with an individual not wearing a mask will be about as effective as getting angry and confrontational with a fat person about their weight. I believe there are better approaches; others may disagree. Edit: I just wanted to make it clear that herd immunity applies to all vaccinations, not just COVID.

I see a ton of what one of my old professors called "If only... " thinking going on out in the world. "If only... overweight people lost weight we'd save 300,000 lives per year" "If only... people stopped smoking we'd save 500,000 lives per year" "If only... people got the flu vaccine every year we'd save 10,000 lives per year" This is all true, but it's not a very useful way of thinking from a public health point of view. Changing people's behavior is hard even when it directly impacts their health (like weight-loss) or the health of others (like smoking cessation or flu vaccination). One can get upset about it and maybe even feel morally superior (assuming they're an in-shape nonsmoker who gets a flu shot every year) but that doesn't change reality. Extensive efforts has gone into promoting weight-loss, smoke cessation, and increase flu vaccination rates and changes have been extremely slow. The point being: it's not very useful to focus on what's possible with ideal human behavior because you're never going to get it. I have a friend who is normally exceptionally empathic, non-judgmental, and kind ...just a good-hearted person. However this mask wearing thing has gotten her upset to the point where she's often bitterly ranting about how stupid people are and discussing different ways to punish them. It's clearly impacting her happiness and mental health in a big way. We're trying to help, mostly by trying to distract her from the 24/7 new cycle she's gotten into since being stuck alone at home, but with the pandemic restrictions it's difficult.