A Doc Sends

WRSA sends yesterday am:

Your SWAG on when the mortality sans advanced medical care here in USA will be known with reliability?

Doc sends:

An interesting thought experiment.

Testing kits will not be available to the state departments of health until early next week.

Further testing will be pushed out to obvious, but not state level locations late next week. Sending testing kits to New York City would be an example here.

Guessing it will be some time late next week before the CDC, with a slower OODA loop than the virus, changes the testing recommendations to include anyone with symptoms of a viral illness.

Testing will jump sharply thereafter. It will take a week or two after that to work through the backlog and get a feel for what is really going on. By then the virus will have spread quite a bit, and I think somewhere in the neighborhood of 3 week from now is when we will see the first pronouncements of quarantines, school closures etc. I would guess that will also be about the time we will have a decent feel for the actual spread in the US.

On a more hopeful note, that’s also about the same time we should hear back preliminary data from the monster number of clinical trials that are currently ongoing. Mostly run by the Chinese, these trials are looking as current FDA approved drugs that could be used off-label for treatment of the severely or critically ill. Based on computer based structural prediction models, there are quite a few candidates. That won’t slow down the spread but will probably drop the death toll.

In terms of when things will get bad enough to overwhelm medical care and inflate the mortality numbers here in the US, that is a complex question that involves significant amounts of “wild ass” in the guessing. I put the initiation of quarantines at about 3 weeks from now, as above. We would be early in the exponential phase at that point, I would guess we will see the number of cases rise about a week or two after that. Based on what I am seeing reported, the first week of the disease is the run-in to weeks 2-3, when you really get sick. It won’t take much of a rise in sick cases to overwhelm the medical system that is already strapped. So, my back of the napkin guess is about 7-8 weeks from now is when things will be ugly.

Reality, however, doesn’t care about my opinion, and there are lots of things that could throw this off. Finding a good drug that treats it, or even better could be used to prevent it, would be nice. It would have limited impact up front due to lack of availability, but that could ramp quickly. Maybe Trump is right and warmer weather will help. Maybe we will get a handle on the role of kids in the spread of the disease. Right now they are out of proportion UNaffected by the disease, but are they carrying it and infecting others?

Things could go the other way, too. What if we find out that the Chinese have been downplaying this all along and the numbers are actually much worse than presented? Too many variables to really know.

I predict that in the next 1-2 weeks, Trump will try to shut down a large part of the media reporting, similar to what Obama did with the first Ebola epidemic. Unlike Obama, however, the press is his enemy and they will almost certainly defy him on that issue. This will be a make-or-break issue for Trump, and at the moment he’s not being fed good info.

Americans being Americans, it will be near impossible to maintain an effective quarantine. The economy here will be in even greater straits than China, as only a very small percentage Of Americans will have adequate cash reserves to be able to tolerate 2-4 weeks without a paycheck. Simply finding child care will be an incredible hardship for working families.

(Does this give folks on welfare a competitive advantage in terms of exposure and ability to maintain lifestyle, avoid creditors, not default on loans? Probably. It may also favor the Bern. Making promises that favor safety over freedom will be very enticing to those staring down the possibility of repossession of their homes, cars, etc Most of the 3rd and 4th order effects of this pandemic are not favorable to Trump or Team Freedom)

The sign of a company with a quick OODA loop are the ones that are already determining what component of their business can be done via telework, creating flexible shift options so that people can hand off child care with another working spouse, those that have stocked deep hand washing equipment or sanitizer and cleaning solutions. The quick ones have already obtained alternate sources of parts and supplies, etc.

The slow OODA loops are those hospitals who only yesterday have started to review their PPE supplies and have discovered, to their horror, that all masks not under lock and key have grown legs and disappeared.

END TRANSMISSION

Gab may stay up.

Maybe not.

Hams, let’s try to get a net live this week. Volunteers really needed. LMK.

39 responses to “A Doc Sends

  1. END TRANSMISSION

    That’s the general idea.

    I have two dozen or more masks, all N95 or better bought on sale because I thought “If I have to drive through a forest fire, something stinky…”. I also have a supply of water, can power my home for a while…

    Aesop erred. In the Grasshopper and the Ant, it was something slow and expected. Not the Grasshopper panicking while the Ant had supplies “just in case”.

    • SemperFi, 0321

      Most masks won’t keep out smell.
      Am reminded of a story a friend told me. There was a suicide in Nevada, the victim was cooked from several days sitting in hot car, nobody wanted to open the car door. Sheriff storms in, call them names as he puts on gas mask and proceeds to open car, suddenly they see him clawing at his mask and as he turns around, both eye pieces on the inside are covered in vomit.
      There’s a lesson in there.

  2. Alfred E. Neuman

    Reblogged this on FOR GOD AND COUNTRY.

  3. nick flandrey

    3 weeks from now is the heart of Spring Break. That is an orgy of travel, an orgy of orgies, and a normal dramatic rise in infectious disease, due to all the co-mingled bodily fluids that are part and parcel to the Spring Break experience.

    I’m afraid that looking back, we’ll see that allowing Spring Break to happen was an almost criminal mistake and directly led to 10s of thousands of deaths.

    Or it could be nothing.

    I know which way I’m betting.

    nick

    • “directly led to 10s of thousands of deaths.”

      so where’s the problem?

      just more murkin scum polluting the fetid land.

      come on spring break!

  4. looks like the Chinese take-out I had on friday was a mistake…

    been sneezing and hacking up green stuff from my lungs since

    early this AM.

  5. Matt Bracken

    The key to N-95 masks is HEPA cloth. (High Efficiency Particulate Air)
    Most folks have not glommed onto the fact that many readily available mass-produced products like most vacuum cleaner bags are made of HEPA cloth.

    The pores are a little bigger than a virus, but the virus doesn’t float in the air by itself, it floats along with some vapor molecules, together, they won’t get through HEPA cloth.

    Please correct me if I’m wrong, I’m just putting it out there. I had no problem buying a bunch of HEPA vacuum cleaner bags online a few days ago, they arrived today. Each should make a half dozen or more masks.

    https://www.amazon.com/Kirby-Vacuum-Allergen-Reduction-Filters/dp/B01JP3B6YQ/ref=sr_1_2?crid=IE9GN4MIDSI0&keywords=hepa+filter+vacuum+cleaner+bag&qid=1583109715&sprefix=hepa+filter+vacu%2Caps%2C191&sr=8-2

  6. Here is part of a study so far:

    “We also noticed that the only Asian donor (male) has a much higher ACE2-expressing cell ratio than white and African American donors (2.50% vs. 0.47% of all cells). This might explain the observation that the new Coronavirus pandemic and previous SARS-Cov pandemic are concentrated in the Asian area.”

  7. Annon E Mouse

    Add to this social media/press guessing medical drummed up panic to be politically weaponized, a report of a new outbreak of a hemorrhagic fever in east Africa. Symptoms are a yellowing of the eyes and hands/fingers as in Jaundice, followed by bleeding from the eyes then death. The strain has not yet identified ,but similar to the Congo strain of these fevers. These issues along with the ongoing locust plague and ensuing famine, fires in Down Under,war and rumors of war in the fertile crescent, earthquakes and volcanoes, que all of the End Times prophets to come out of the woodwork. Oh and NASA is trying to figure out what was following the space station while sightings of mysterious objects multiply. Fun times eh

  8. Lina Inverse

    One major correction to “Doc”: state labs are already testing, probably with the original test kits skipping the third test for the virus, and they’re finding cases, latest announced today, Sunday March 1st, are Rhode Island, Illinois (their 3rd case), and New York. All discovered at state labs, have to be officially confirmed by the CDC.

    The FDA is also announced yesterday that they’re doing something to “allow hundreds of U.S academic hospital labs to immediately begin testing” according to the Wall Street Journal and other sources.

  9. Bro chill.

  10. SemperFido

    In my ICU we are already getting patients with non typical pneumonia who test negative on all the cultures. WE ARE NOT testing them for covid. Not yet. This is in Florida. I think it is already widespread in conus.

    • SemperFido

      Pt that I had this weekend. Wife caught the “bug” first. Was sick for several days and got over it. She doesn’t smoke. Husband caught infection from her. He is a heavy smoker. He winds up in the ICU intubated for two days. Afterwards he is still exhibiting severe respiratory symptoms. Is on high flow oxygen. A really harsh cough. The cough is unique compared to what I usually hear from the normal CHFers and pneumonia cases. Almost sounds like an adult with croup. They are in their 40’s. We lost two 70+ year olds this weekend from this atypical pneumonia.

  11. Hope@ZeroKelvin - Proud Deplorable

    The USA has 931K hospital beds, 95K ICU beds, 65K ventilators. That covers medical + surgical + pediatric patients. And most ICUs operate at 100% occupancy as it is pre COVID19.

    If 60% of the US gets infected (198,000,000 people), assuming 80% are mild and only 20% end up in an ER, that is 36,900,00 ER visits in a very short time. Of note, there are approx 145,000,000 visits per year as it is and the wait times are 6-10 hours for non trauma care.

    If only 10% of all infected are sick enough to be admitted, that is 19,800,000 possible admissions. For a total US bed capacity of 931,000 beds.

    Even only 5% of all admitted (19.8M) patients end up in an ICU, that is 99,000 patients. When we only have 95K ICU beds total already full of other patients.

    I have based this on the most conservative estimates of COVID19 patients of what we know so far.

    • Long before you get to those numbers the medical support system will be in 1st stage collapse. Medical staff will degrade as their number decrease by being infected as well from which they must be triaged out from treating patients.

      • Concur.

        We may already be headed down that slide to the bottom.
        With the latency period involved, we may already be 4th-degree FUBARed, and just haven’t realized it yet.

  12. We will need details on the net. Frequency and mode (voice or digital, and if digital what format)?

  13. Our host here has asked for amateur radio operators to jump up and do something. His request is at the end of the above post. Licensed people who can reach out regionally from their home places, might ping our host re level of willingness to help out.

    I don’t know much as to how a real-time HF FUSA-wide radio net might be accomplished. Others might, feel free to jump in.

    The usual shitbird ravens perching on this newly re-opened WRSA fence will note their opportunity and make their usual disruption. Enjoy your fun.

  14. Grey Ghost

    CA,
    I’ll volunteer as net control.

    Send me an email to work out initial details of net name, times and freqs.

    /r
    Grey Ghost

  15. a follower

    The U.S. has been touting low numbers of those effected. Trump and others seemed very proud of these low numbers!
    We were not testing? There were not many test kits?
    Well no wonder the numbers were low.
    The Chinese, Iran and South Korea however, have all been testing?
    What is the test? What is the difference between this Virus we should all be pointing at, and all the other viruses that are out there?
    How did they have a test for a “New Virus?”
    And we still do not know who was patient zero.

  16. RE “ham net” – inbound for you shortly.

  17. CA,

    Cannot figure out how to post a screenshot of some text messages, so will summarize what I am hearing near Omaha.

    -UNMC is pulling nursing staff from some of the clinics to work with the BLIV patients, showing that they are not staffed to manage at current level of just some extra cruise passengers.

    -As nurses stay in contact, local nurse told me her pal in Chicago (ER type) had a possible in the ER and got the text message to stay home and check her email for further instructions. Only staff in direct contact…floaters and those with other patients not notified.

    – Heard State leadership chatting at a function this weekend “Just the flu…wash hands…notify CDC if you feel unwell”. This coming from a guy who would have been invited to any high level briefings at UNMC. Did not hear any of the other elected or appointed officials even discuss CoVID. (I failed to stay away from crowds, but did pay attention at event).

    On a personal level, come Flugaloo, we have about 1,200 meals, MSR Guardian water purifiers, abundant wildlife, stacked PMs (not that silly jewelry type). Cold and flu meds, plenty of IFAKs, honey and silvadine, Ensure, gatorade, pedialyte, vitamin supplements, and household cleaning and personal care items.

    We have plans for capability to plus up to about 12PAX total, 1 a very accomplished hunter, 2 other are no-shit shooter type combat vets. At that point, my math puts us at able to contain and self sustain without power/water for 6 months, given what others will bring to the table, and bsic caloric and water needs.

    All of those plans include the assumption that it is already in the wild, and the skid steer is fuelled up for worst case graves registration duty.

    The Docs document makes sense, nut I think the timetable is going to be shorter than what he has outlined. The masses are slowly waking up from “it is just a flu”.

    KGH

    • Well till we reach half of 50m dead and 10% of the population infected I am just using basic precautions. Spanish flu had a better track record so far than this current emergency.

    • KGH: Skid steer and backhoe do not rhyme…..

      • Soapweed:

        You don’t bury casualties with the backhoe you want, you bury them with the skid steer you have.

        Brother owns a pizza franchise in Olathe, KS. They deliver to hospital. Sign in door today that if you or someone close has been to Wuhan, notify the staff. No warnings for Chicago, Wash state, San Antonio… too little to late.

  18. Like I have opined before my concern is a national freakout because of the WuFlu, not the virus itself. What I certainly don’t want is the urbanites flooding my countryside with their stupidity, entitlement and unmitigated panic.

  19. The slow OODA loops are those hospitals who only yesterday have started to review their PPE supplies and have discovered, to their horror, that all masks not under lock and key have grown legs and disappeared.

    Too late. BTDT.
    https://raconteurreport.blogspot.com/2020/03/welcome.html

  20. A relay station, say in southern Oregon or Northern California might work well to get the southwest in on the exercise. Band Conditions are iffy right now.