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Epidemiologist likes what he's seeing on the streets of Boston, but with a caveat

Dr. Michael Mina is a professor of epidemiology and immunology at Harvard Medical School and the Harvard T.H. Chan School of Public Health. He wrote last night:

Amazing to see so much #COVID19 social distancing! It is working!

He adds: Keep it up.

The better we do now, the less we will actively notice the benefits -> absence of infections isn’t interesting.

Let’s keep this in mind when we start wondering why we continue to shelter at home.

But then he continued:

H/t Lisa Johnson.

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An alternative response if you can get by the paywall. Essentially quarantine the vulnerable, let the rest get sick (yes there will be consequences), develop herd immunity (although we don't know how "immune" people are after getting the virus once - so big assumption). the key is you let people work without destroying the economy while protecting the vulnerable and the hospital system. will it work - who knows, maybe we'll never know, but as he says, we need to make sure we aren't suffering from groupthink with the current approach:

https://www.nytimes.com/2020/03/22/opinion/coronavirus-economy.html

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About 40% of hospitalized covid-19 patients are aged 20 to 54. That is far too much of a strain on our medical system for us to have some kind of big stupid national chicken pox party.

I have a friend who was scheduled to have surgery today for kidney stones. Canceled. I know another who was scheduled to have surgery for a brain tumor. Canceled. Canceled and denied needed medical care because of an overstrained system.

Don't be stupid. STAY HOME.

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this falls into the category of "I'll rely on the informed opinions of those who have thought about this a lot more than me". What is that 40% in people - 40? 400? 4000? The hospitals have a capacity - and for now we are well below it (those cancellations are a) to maintain capacity and b) to prevent infections - not because we are over capacity). Also - how many of those in that age bracket are "vulnerable" - given we only have 600 positives - assuming 20% hospitalization rate and 40% in that age bracket - we are talking 50 people - again so far. Highly possible/likely that these people are also for various reasons in the "vulnerable" category - which doesn't just mean people over 60. These people would also fall into the "must quarantine" category. not my idea - but there are a lot of VERY smart people that have recommended this as an alternative more workable approach.

for now - yes - stay home (we also don't need you going out and getting hurt or sick totally unrelated to coronavirus and putting additional burden on the system). But people need to work and pay bills. Transitioning to this strategy may ease a lot of financial burden, protect the vulnerable and still flatten the curve (which is the main reason we are doing this - barring a vaccine - even Andrew Cuomo says we'll ultimately see 40-80% infection rates - we are just postponing that unless a therapy or vaccine emerges in the very near future).

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Risk yourself if you want, Stevil - don't risk others.

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You can't risk yourself without risking others.

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In New York City*, as of last night, there were 10,764 confirmed positive, and 1,800 people had been hospitalized. Four hundred and fifty of those 1800 are in ICUs.

The hospitals there do not have the capacity: they're working on repurposing closed nursing homes and the convention center as COVID-19 hospitals. Maybe, I hope (but don't know), Boston-area hospitals have the capacity, if they postpone "non-urgent" elective surgeries until some of them become urgent, and if all of us are very careful not to catch the flu either, or fall down stairs, or crash a car or bicycle, and take all the good advice about how to reduce the risks of heart attack and stroke.

*New York City has a scary number of people sick with this. I'm using their numbers because I have the numbers of confirmed cases, hospitalizations, and people in ICUs handy, and because you're quoting Cuomo, not Charlie Baker, Gavin Newsom, or Jay Inslee.

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Buddy, I know you reflexively assume anyone with more money than you is smarter than you and visa versa but Friedman has been shown time again to be pretty much worthless on most topics and only has money because he married into it. Find another source for your opinions, please.

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Waiting for the deluge-and how patients needing care for other conditions are being impacted.

https://www.newyorker.com/news/dispatch/in-boston-doctors-wait-for-the-d...

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to announce in a week or so that he's positive.

Just like Rand Paul did this weekend.

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Wasn't England trying to do the whole "build herd immunity" thing until the epi disease modelers and scientists pointed out that the hospital system would collapse and instead of a six-figure death outcome they'd be into the 7-figure dead people realm?

This is a time when we need to listen to professionals, not pundits

Trump and minions are already making noises like this because their stock portfolios are down.

Expect to see more and more people "just asking questions ..." and trying to politely say that letting a hell of a lot more people die is totally cool if it makes things easier for the rich.

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My understanding is that they were working on herd immunity for 100% of the population. The key to human herd immunity is isolating the vulnerable (in this case pretty much everyone over 70 and others with various immunodeficiency, lung and heart problems and other issues). They didn't do that and now it just might be too late. You need to do the whole 2-4 week shut down and THEN convert over to this strategy given where we are.

Trust me - the rich will be fine. If they have a good advisor they already had at least a couple years of cash needs stashed in a bank or money market - probably more if they were really rich with a huge chunk in other conservative bonds - they have nothing to worry about for years. It's the 80% of the population that doesn't have any savings and now don't have jobs that we are worried about (and credit to Congress - different philosophies on approach - but both parties are trying to figure out how to keep people getting paid. The difference is mainly whether than money comes from the government (Dems) or their employer (Republicans). Some blend is probably the right answer.

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If people like Blankfein are starting to get worried about the 'economy' and you state that 80% of people will be wiped out and the rich will be fine, dig a little a deeper and you may come to the same conclusion as me - the very rich are looking at a black swan event which might actually lead to sustained push for wealth redistribution in this country after 4 years of straight up looting. I'd bet 1% of Lloyd's money (i.e. more money than I'd need in a life) that he's mostly concerned about another great Depression where he might have to have less than $1B in order for kids to, you know, eat.

Too bad your side didn't think testing was important or that healthcare systems should be robustly funded, eh?

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you do realize I didn't vote for Trump and I'm planning to vote for Biden? Oh, and in the election before that I voted for Obama. I'm also a huge proponent of universal healthcare (just not single payer).

So what's your point?

Wealth redistribution? Where you been the last three weeks. Trillions of dollars just got redistributed. Not to the poor or middle class. To the ether. And that's even before we start calculating what's happened to the value of our homes or will happen once this really starts to bite.

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... meaning people who equate wealth to personal worth.

Snark aside - you think people like Dimon and Blankfien are worried about the economy and the vast majority of Americans who have no financial safety net? Or you think that they are very, very afraid of a more equitable tax system like Sweden or Denmark where they and their families are only set for generations but perhaps not as rich as Tom Friedman's boy MBS?

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A) it's not going to happen. If you think it is, I've got a bridge to sell you.

B) Capital is very mobile. They'll move if it gets too bad. There are shelters all around the world and plenty of countries will be looking for cash that wants to park in their banks after this thing is done.

good think Bernie isn't going to win. His strategy of tax the 600 billionaires was weak to begin with and now there are probably only about 400 such unicorns, the most famous ex-unicorn probably being our Dear leader who was probably borderline to begin with and his properties have to be getting pummeled. So you can take solace in that.

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"I am not a medical expert."

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How about we don’t gamble with peoples lives? Yes this is hard and going to get harder since we will have to continue isolation for weeks not days. And yes it as a severe hardship on many but death is a more severe hardship.

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There's a pretty good argument to be made that throwing millions of people out of work is gambling with their lives.

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Do you know how many people become alcoholics, drug addicts, or commit suicide due to economic depressions or recessions? That's what we're ensuring is coming soon with this panic.

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and then there’s Thomas fucking Friedman wrong. The world is flat, Tom. Why don’t you go look for the edge and throw yourself off of it.

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Pretty clearly doesn't have a clue.

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During crises, it is of utmost importance to find humor every day.

Why I haven't heard anyone take Tom Friedman seriously since aught-four. And to think of him as some sort of public heath expert! Haha!

It's gold, Jerry!

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Basing his argument on an article by an epidemiologist who has been contradicted by the top names in the field. The UK, which was the only country using this herd immunity argument, has backed away from it.

The whole point of "flattening the curve" is to keep from having everyone get sick at the same time. We don't have the hospital capacity to handle that - we're going to run out of ventilators because "low risk" doesn't equal "no risk" and healthy younger people can and do still end up on ventilators. Following Friedman's advice will lead to people dying because care isn't available.

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Please?

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What is the community rate of infection?
How many people will get sick - how fast?
How many need to be hospitalized?
How many will need to be in ICU?

What are the facilities needed -
What can we expand

And so on and so on and so on.

And at the end of the day, unless we come up with a vaccine or therapy, on a human scale it's all for naught. About as many people will get sick and die in the long run.

we're not trying to save lives. We're trying to save the health care system. There might be a better way - if you did it right. A bit late for that, but perhaps you can mitigate the economic damage. The cure is no good if the patient just dies of something else.

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i don’t know why don’t you google what the fuck is happening in spain right now
germany and the uk just went to the 2 person only rule (outside living arrangements), anything over is not allowed. guess we know something they don’t. hmmmm

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What
How
How
How
What
What

No one knows. These things are unknown. You know that. You're being disingenuous.
We have to proceed without those answers. If we ever get more testing, we'll know the answers to some of these, but until we do, we can't sit around with our thumbs up our collective ass.

we're not trying to save lives. We're trying to save the health care system.

No, we're really not. We're trying to preserve the health care system, broken as it is, so that we can save as many lives as possible.

My god, you're bad at this.

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https://www.vice.com/en_us/article/mgg4ga/why-thomas-friedman-is-always-...

Also an early fan of Mohammad bin Salam so there's that too, mostly, he's a phony populist who lives a life of vast, unearned wealth who claims to care and speak for the greater good when in fact, he sucks just as much as Gladwell.

To give Friedman credit, he wasn't publicly defended Joe Paterno. Yet.

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Mental health professional here. As someone who specializes in fighting self-destructive and risky cognitive biases, and who is a medical professional, I would advise you that "groupthink" is a much, much less dangerous threat in the present situation than wishful thinking.

Ever since it became clear to me how much of a threat - to individuals, to society, and, let us not forget, national security! - this disease would be, I have been watching, disappointed as most of our society has slid, hard, into all the classic faults in thinking to try to reject the all evidence of something bad developing. Whether one looks at them from the perspective of the old Freudian classification (denial and other "ego defenses") or from the modern perspective of Cognitive Behavioral Therapy (minimization and other "cognitive distortions"), the effort to reject the knowledge of how bad this is has been nigh-ubiquitous.

Frankly, this article seems just like more of the same: emotionally motivated reasoning, grasping at straws to justify not doing what needs to be done.

And I say that because of a curious property of the article, itself: the author makes this argument about how our present approach is terrible and we need to do it terribly differently, but when he comes down to brass tacks, his "differently" is merely that we limit the shutdown to two weeks, "or whatever the CDC decides." Well, he'll be pleased to know that most of what is being done by governors of the US States is, as a matter of fact, based on CDC recommendations, so his "suggestion" is more of a insinuation of something false (that they're not). Overwhelmingly what elected officials at the state level are doing is trying to balance the needs of the working people - and the economy, generally - against what the medical professionals are telling them needs to be done.

And what the medical professionals are telling them needs to be done is based on the math of exponential growth, backed by the direct observation of how this has played out in every other country to have an outbreak ahead of ours so far. We don't have to guess about a bunch of this stuff. We can just ask. We don't even have to ask; Italian doctors have been pleading on the open internet for us to listen to them.

You say, of Friedman's article and its proposal, "will it work - who knows, maybe we'll never know". First, you're talking about dicing with human lives, so that's a breathtakingly irresponsible take - frankly somewhat sociopathic. But secondly, actually, the people who know are all the epidemiologists and medical professionals who study this for a living and who are charged with figuring out how to protect societies from this threat, and all the authorities who have already wrestled with this so far. We could listen to them. We could regard their unanimity as evidence that the answers are pretty clear, and not irrationally, wishfully attempt dismiss it as "possible groupthink".

And here's something else for you to think about, if you're so concerned about the economy: what do you think it will do to the economy if the general American populace becomes convinced that going shopping or going to work is a death sentence? Do you think business-as-usual will be possible once the body count starts to clime, once the videos of hospital wards full of patients gasping like fish out of water start showing up on the nightly news?

Taking aggressive action now, as harsh as it is on business, sends a strong signal that government is tackling this problem, which means the government can be trusted to take things seriously and tell the truth, and if the government says it's safe to go back to work, people will believe it. Taking a laissez faire attitude towards human life is a great way to incite an economic panic like you have never seen. Arguably a panic that runs the economy right off a cliff into another Great Depression.

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At least Jonathan Swift was both far more clever AND crafting satire.

Friedman is just another armchair amateur doing the "Well Actually ..." bullshit.

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As in, instead of eyeballing 6 ft worth of distance between you and others you just STAY INSIDE?

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7:00 AM and 8:00 AM I only saw like 20 people on my way home from work. I usually see 200 at least.

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