Coronavirus Coronavirus: In-Iowa General Discussion (Not Limited)

[1UNI2ISU]

Yeah that’d be the “glass is half empty “ response. There would also be a “glass is half full” line of thinking.

Yeah, Twenty1 doesn't deal in anything except the sky is falling and we have to lock everything down forever and everybody including my cat needs to be tested.

Its perfectly reasonable to start opening up the Western part of the state on the 30th and realitically everywhere except Des Moines, Waterloo/Cedar Falls, Cedar Rapids/Iowa City and Quad Cities. Once the numbers for the metros start generally stabilizing and moving downward you can look at a limited re-opening there to start no later than June 1.

Re-opening doesn't mean flipping a switch but allowing limited in person dining, re-opening offices with social distancing and limited staff and re-starting elective surgical and dental procedures.

 

[MeowingCows]

It's a real balance though, right? What happens if the economy crashes? It would likely be substantially worse than 2008. The number of deaths could end up far surpassing just the virus deaths. The health system could crash. We're already seeing stories about rural hospitals having to lay people off. It's a terribly fine balance and a difficult choice to make.

We don't have any historical data pointing to this, though. That talking point comes up a lot but never has any fact stashed with it, at least not that I've seen. We've had major health crises and major economic fallout before... but where is the massive spike in deaths from economic fallout? Maybe the issue is how do we even measure that? Maybe I've just never seen the data showing this, I could be missing something. If I am, tell me.

The health system could crash both by economics or by being overwhelmed with patients. The economy itself isn't going to fully recover, anyway, given that what's likely to be a sizable subset of it would still be largely avoiding activity due to still being unsafe (if it still is down the road, anyway). Both of these topics carry a lot of assumptions and guesswork, but that's pretty much all we have right now.

And at the end of the day, no, it's really not a balance. It's a delaying of the inevitable -- money always, always, always outweighs people's lives. This is true in pandemics, in general economics, wars/conflicts, trade (think sweatshop/child/slave labor), ...

 

[MeowingCows]

You should actually take some level of comfort in that. It's looking like substantially more people have this stuff and aren't even having slight symptoms. That's a good thing.

It's a good thing... if we can actually develop immunity or cures for it, neither of which have shown to be yet. Without that, we're continually spreading and eliminating those vulnerable to it.

Hopefully someday (soon), they do find ways to contain and destroy the virus, but it takes time.

 

[bawbie]

You should actually take some level of comfort in that. It's looking like substantially more people have this stuff and aren't even having slight symptoms. That's a good thing.

I don't get how it's a good thing - it's good for them, sure. But it's not good for everyone who they infected.

 

[cycloneG]

A lot, I'm guessing.

According to Forbes, the British Journal of Psychiatry estimates more than 10,000 suicides are directly related to the 2008 financial crisis.

https://www.bbc.com/news/health-27796628

"The number of people taking their own life was already increasing in the US, but the rate "accelerated" with the economic crisis, leading to 4,750 additional deaths."

 

[Urbandale2013]

I don't get how it's a good thing - it's good for them, sure. But it's not good for everyone who they infected.

It could be good because it shows signs that more people are infected and the death rates should be lower. It also would be a sign we are closer to herd immunity.

 

[cycloneG]

https://www.ksbw.com/article/stanford-study-shows-herd-immunity-is-long-way-off/32226060

"The study, which has not been peer-reviewed, estimates between 2.49 percent to 4.16 percent of people in Santa Clara County had been infected with COVID-19 by April 1, 2020. Those numbers are nowhere near the herd immunity threshold of 50 percent needed to slow down the transmission of a disease."

 

[bawbie]

Yeah, Twenty1 doesn't deal in anything except the sky is falling and we have to lock everything down forever and everybody including my cat needs to be tested.

That level of hyperbolic strawmanning doesn't help anything.

Re-opening doesn't mean flipping a switch but allowing limited in person dining, re-opening offices with social distancing and limited staff and re-starting elective surgical and dental procedures.

It would be helpful to define what "re-opening" means when you say it - because, as I said in another thread earlier, it's currently being used as a vague 'everything to everyone' device. The federal government laid out a 3 phase approach to re-opening, but the states are not following that advice. Georgia used it to open tattoo parlors and bowling alleys.

 

[bawbie]

It could be good because it shows signs that more people are infected and the death rates should be lower. It also would be a sign we are closer to herd immunity.

More people infected means that it will continue longer as it is spreading even with restrictions in place.

The focus on the IFR (Infection Fatality Rate) is misleading to me - because the denominator (how many are infected) is a very imprecise number. We know how many have died after testing positive - it's likely to hit 50k tomorrow. I don't see how the "death rate" is informative at this point - especially in terms of "re-opening the economy"

 

[jsb]

More people infected means that it will continue longer as it is spreading even with restrictions in place.

The focus on the IFR (Infection Fatality Rate) is misleading to me - because the denominator (how many are infected) is a very imprecise number. We know how many have died after testing positive - it's likely to hit 50k tomorrow. I don't see how the "death rate" is informative at this point - especially in terms of "re-opening the economy"

50,000 in 5 weeks with significant shutdowns in place. I know every day seems like a week and every week like a month, but the death count is very high.

 

[mynameisjonas]

Did you read it?

Everyone should buy an oximeter to check their oxygen levels.

 

[Urbandale2013]

More people infected means that it will continue longer as it is spreading even with restrictions in place.

The focus on the IFR (Infection Fatality Rate) is misleading to me - because the denominator (how many are infected) is a very imprecise number. We know how many have died after testing positive - it's likely to hit 50k tomorrow. I don't see how the "death rate" is informative at this point - especially in terms of "re-opening the economy"

But that is ultimately the number we have to figure out. You're right it is incredibly imprecise right now. The issue IMO is to figure out how to keep hospitalization and deaths under control.

If the severity is lower than our current assumptions then that suggests we should reopen faster than if the severity is higher. On a flattened curve the same amount of infections occur as a normal curve. The key is deaths can skyrocket if the levels peak above resources. At least in Iowa we don’t appear to be hitting that limit even at the peak. So that would suggest we could ease some restrictions to get closer to the max resources.

Now I’m not suggesting we make immediate changes. I think we see how we are at until early next week. Maybe at that point we can see about some limited easing of restrictions. Maybe we are still not to that point yet and we extend the restrictions.

 

[madguy30]

Yeah that’d be the “glass is half empty “ response. There would also be a “glass is half full” line of thinking.

The quicker that more people we can find to be positive without symptoms, the better and it seems it would allow for more places to be able to open up even at least a little bit for productivity. It just needs to be something that can be done frequently and timely.

 

[1UNI2ISU]

That level of hyperbolic strawmanning doesn't help anything.



It would be helpful to define what "re-opening" means when you say it - because, as I said in another thread earlier, it's currently being used as a vague 'everything to everyone' device. The federal government laid out a 3 phase approach to re-opening, but the states are not following that advice. Georgia used it to open tattoo parlors and bowling alleys.

The Georgia model isn't the one. That one is basically flipping a switch and pretending none of this ever happened or that the virus still doesn't exist.

My version would be encouraging restaurants to continue takeout and curbside but allowing 1/3 capacity in dining rooms for restaurants that seat over 60. Restaurants smaller than that would remain takeout only.

Allow movie theaters to open at half capacity with regulations on social distancing between groups of people that don't live in the same household.

Encourage businesses to stay work from home but allowing things like bank lobbys to re-open if they choose to with clearly defined social distancing guidlines.

Allow hospitals, clinics and dentist offices to resume appointments and elective procedures with guidelines on PPE usage.

Just some examples. There are things you can do, especially in rural areas, to get things going again.

 

[BillBrasky4Cy]

Oh okay. Has Reynolds said anything about when ramped up testing begins(which will obviously cause sky high case numbers) what the plan is going forward with opening things up? My first guess would she will likely extend things probably till mid May at the very least.

The number of tests doesn't matter, it's all about the percentage of positives....

 

[BillBrasky4Cy]

I’d like to know what she’s thinking as well. If she seriously doesn’t know, then she should just say that.

IMO she owes it to the small business owners. These people are in a really tough spot and have some difficult decisions to make.

 

[madguy30]

That level of hyperbolic strawmanning doesn't help anything.



It would be helpful to define what "re-opening" means when you say it - because, as I said in another thread earlier, it's currently being used as a vague 'everything to everyone' device. The federal government laid out a 3 phase approach to re-opening, but the states are not following that advice. Georgia used it to open tattoo parlors and bowling alleys.

While I think it's too early for places like Georgia, at least someone far, far away is the test group if they so choose. Like I needed another reason not to visit the south and I can't imagine a scenario where I'm going to want to go bowling in Georgia. Or get a tattoo for that matter.

Anyway some of the stuff that I've read about in states having retail and such be pick up is reasonable if we've been doing the same with restaurants for over a month.

 

[bawbie]

But that is ultimately the number we have to figure out. You're right it is incredibly imprecise right now. The issue IMO is to figure out how to keep hospitalization and deaths under control.

If the severity is lower than our current assumptions then that suggests we should reopen faster than if the severity is higher. On a flattened curve the same amount of infections occur as a normal curve. The key is deaths can skyrocket if the levels peak above resources. At least in Iowa we don’t appear to be hitting that limit even at the peak. So that would suggest we could ease some restrictions to get closer to the max resources.

Now I’m not suggesting we make immediate changes. I think we see how we are at until early next week. Maybe at that point we can see about some limited easing of restrictions. Maybe we are still not to that point yet and we extend the restrictions.

I agree with this - the key is to be proactive rather than reactive, IMO. The time lag between easing or tightening restrictions is in weeks - so if you ease restriction and then it starts spiking quickly it's too late to do anything to adjust.

As you said - hospitalization rate is really the key. It spiked in IA yesterday, if that's a trend then we can't do anything to ease restrictions until we better understand where the peak is. Hospitalization rate (and death rate) among the general population is a much better indicator than death rate among those infected, in terms of planning easing of restrictions.

Also, from a rhetorical perspective - "easing" is a much better word in my opinion than "re-opening".

 

[jsb]

The Georgia model isn't the one. That one is basically flipping a switch and pretending none of this ever happened or that the virus still doesn't exist.

My version would be encouraging restaurants to continue takeout and curbside but allowing 1/3 capacity in dining rooms for restaurants that seat over 60. Restaurants smaller than that would remain takeout only.

Allow movie theaters to open at half capacity with regulations on social distancing between groups of people that don't live in the same household.

Encourage businesses to stay work from home but allowing things like bank lobbys to re-open if they choose to with clearly defined social distancing guidlines.

Allow hospitals, clinics and dentist offices to resume appointments and elective procedures with guidelines on PPE usage.

Just some examples. There are things you can do, especially in rural areas, to get things going again.

this is all great.

let’s hope our governor does something like this. I have my doubts.

 

[madguy30]

I agree with this - the key is to be proactive rather than reactive, IMO. The time lag between easing or tightening restrictions is in weeks - so if you ease restriction and then it starts spiking quickly it's too late to do anything to adjust.

As you said - hospitalization rate is really the key. It spiked in IA yesterday, if that's a trend then we can't do anything to ease restrictions until we better understand where the peak is. Hospitalization rate (and death rate) among the general population is a much better indicator than death rate among those infected, in terms of planning easing of restrictions.

Also, from a rhetorical perspective - "easing" is a much better word in my opinion than "re-opening".

Yeah and it's something businesses can adjust to for new systems.

A spot I get take out regularly is usually not very busy when I go and it's been there for a really long time. If I've gotten take out from there over the last month, there's probably as many to-go orders ready on a table as there has been tables seated when I've been there and it looked like it was similarly staffed.