Hey Karl,
Any idea why California has cases rising so quickly? It was interesting to see
California do well early on but in about a week I expect to see the number of
cases in California exceed New Jersey where the rise in cases has dramatically
slowed.
-Curt
On Monday, June 15, 2020, 2:46:19 PM EDT, Karl Wittnebel via Mercedes
<mercedes@okiebenz.com> wrote:
At their root level, public health crises driven by highly infectious
diseases are a national problem. The response alwys needs to be carried out
by state and local entities, but particularly when dealing with a novel
pathogen, allowing the best scientific and public health experts to drive
the response is critical. That is what Iceland did. The public health
department drove the entire thing. Politicians were not involved at all in
telling them what to do or how to do it. There will always be political
ramifications from any action, but those cut both ways and if the
politicians drive it and get things wrong, they pay the price. So I would
argue it is best to just rely on the public health experts and let them
take any heat. Best for the politicians and best for the country in terms
of disease control.
Anyway State departments of health are highly variable in their resources
and levels of expertise and will therefore depend to varying levels on
national resources and guidance for their reponse plans and policies. New
York City is a world class health department on its own, for instance.
Their politicians chose not to listen to their public health officials
initially, and look at the result. Those few weeks of political dilly
dallying could have saved a lot of older people's lives, and some younger
people also, in and around NYC. But I digress. The main point is that most
of the country is not as well equipped as NYC. So their heaalth departments
need help with technical aspects as well as guidance on what policies are
most effective. Not that the guidance will always be perfect, but a
consistent, unified voice is always more reassuring during a crisis than a
fragmented response where politicians undermine what the public health
people say, whether it be about masks, treatments, business closures,
travel restrictions etc. You want the public to see everyone working
together consistently in an apolitical fashion to manage the problem.
Centralized, national leadership is a key part of getting the response
entites on the same page. Telling the states to figure it out for
themselves isnt using the available resources very well. Both FEMA and the
CDC have considerable expertise and resources that could be used in ways
they have not been so far.
Re The Prez: he would have been better served to stay out of the limelight
on the whole thing. Committing hard to specific ideas when the state of
knowledge is poorly developed is kind of like putting all your money on red
22: not likely to pay out. He made a lot of foolish statements that painted
him into a corner. He doesnt have enough technical depth to comment and
doesnt seem to appreciate how out of his depth he is. He should have relied
more on the CDC people to lead the response, but they were pretty much
muzzled. They would literally normally be telling everyone what to do,
mobilizing considerable resources to facilitate testing and telling states
what the test and trace policies and targets should be. Instead we have had
the JK crew telling everyone that the states are on their own for stockpile
and other resources and POTUS telling everyone the states are responsible
for dealing with their own epidemics and lockdown policies. CDC has
definitely been told to stand down or they would be out in front on all of
it. FEMA would definitely be driving the stockpile distributions and
policies, which should be transparent and non punitive. Basically this was
a big political opportunity for DT to let the machinery work and then
declare victory. Instead the epidemic is poorly controlled, dragging on
into election season, the economic impact is dragging on longer than it
should, and there is a high chance it will all get worse again. There is a
strong chance we will end up doing the usual public health test and trace
interventions anyway.
The lockdown was super draconian and largely unprecedented. It was never
going to be a workable long term strategy. The best thing for the economy
would have been to tell the nation that everyone needs to do their part to
fight this thing, train up contact tracing teams, ramp up testing on a
national level with proven tests and defined targets for positivity rate,
and push CDC people and federal stockpile resources into state and local
health departments as needed to provide support. Instead, testing lagged
behind tremendously for unclear reasons while the disease became more and
more established and the lockdown dragged on with no clear national
strategy or even any defined national goals for controlling the disease.
E.g. Do we tolerate a certain infection rate, or try for zero? Work it
through with the states until everyone has a set of goals they can live
with.
I think it is a mistake to look at this through a political lens primarily.
The virus doesnt care. The two sides in this are pro human and pro virus.
Yes the talking heads will try to score political points but trying to say
the CDC or doctors or hospitals acting deliberately to achieve political or
financial goals first ignores the reality which is that even though
everyone has political views, most of us don't talk about them at work. We
put that crap aside and do our jobs. Public health professionals, doctors,
hospitals etc. just want the disease to go away as much as possible. It has
been a huge pain in our asses and in our pocketbooks.
For now, wear a surgical mask when near other people if you can get them.
Try to limit indoor exposure to large groups of people unless there is
really good crossflow ventilation. We all take some personal risks in terms
of who we alllow inside our bubbles of exposure, but this should be
deliberate. Social interactions and larger group functions should be
outdoors as much as possible. Thankfully young kids do not seem to pass the
virus to adults very often, so granfkids seeing grandparents is less of an
issue than grandparents seeing their adult kids (adults should all mask up
during visits.)
Tbe surgical masks of spun polypropylene carry electrostatic charges and
are more comfortable to wear if you can get them fyi. Cloth is betterr than
nothing however. Airliners have ventilation systems that mix the air;
fixing it requires redesign of aircraft. Everyone should be wearing masks
on those planes. We are not flying commercial any time soon.
All this is meant to be a response to Scott's questions. We are driving to
the midwest in later this summer and I think we are going to camp the whole
way up and back. We will sleep downstairs at my folks place. Life goes on.
Hospital is quieter but we are all half expecting another uptick in cases.
We are at about half of what we were at peak in terms of numbers in the
hospital. 15% of people who are intubated die. Some studies going on e.g.
use of estrogen that will be interesting to follow.
On Sun, Jun 14, 2020, 7:37 AM Meade Dillon via Mercedes <
mercedes@okiebenz.com> wrote:
> Was FEMA activated for any of the past pandemics? What was different about
> this pandemic that rated FEMA to be activated?
>
> The main issue that I see is that we relied on a terribly flawed model at
> the start, and were operating without a clear understanding of the virus,
> and then the media began stoking the fear, and in every way that the
> President tried to lead, he was viciously attacked and resisted, called a
> racist and mocked.
> -------------
> Max
> Charleston SC
>
>
> On Sun, Jun 14, 2020 at 9:28 AM Dan Penoff via Mercedes <
> mercedes@okiebenz.com> wrote:
>
> > I can’t speak for Karl, but from what I’ve seen the places that were the
> > least affected were those that were aggressive about testing and contact
> > tracing as soon as things started. We may not be able to cure this
> > currently, but if we can accurately track the infections and those
> exposed
> > to it, we could control the spread far better than we currently have.
> >
> > FEMA has mobilization protocols for events such as this and they even
> > practice for it, but they weren’t mobilized nor involved for the most
> part,
> > other than being directed to intercept or impound supplies for states and
> > private entities for Federal use. FEMA also has very close coordination
> > with state, local and tribal government entities that allows them to
> > mobilize on short notice and with clearly defined framework and protocols
> > for a response to the event.
> >
> > Look up:
> >
> > NDMS (National Disaster Medical System)
> > NRCC (National Response Coordination Center)
> > DMAT (Disaster Medical Assistance Teams)
> >
> > I work with and have been trained as a part of my job to interact and
> > respond with FEMA for such events, so I’m very familiar with what could
> be
> > done and how it would be managed. No one ever gave the order or provided
> > direction. This is the direct responsibility of the office of the
> President
> > to DHS, under which FEMA acts. Period.
> >
> > -D
> >
> >
> > > On Jun 14, 2020, at 2:14 AM, Scott Ritchey via Mercedes <
> > mercedes@okiebenz.com> wrote:
> > >
> > > Karl, Your comments stimulate many questions in my mind.
> > > As individuals. What should we be doing that we are not doing
> > (behavior, supplements, etc)?
> > > Specifically what National leadership do you mean (CDC, POTUS,
> > legislators)?
> > > Does National leadership have jurisdiction or do state/local
> > authorities have jurisdiction?
> > > ...What has National leadership failed to do?
> > > Is contact tracing really viable (considering the virus was
> widespread
> > before we knew it was here)?
> > > Why were/are we (the US) so slow with tests, treatments, etc.
> > > How does this all end? Do we all get it eventually? Does it die
> out?
> > > What are we proles to make of the flip-flop guidance from the experts
> > (masks, isolate indoors, etc.)?
> > > Who can we believe? So much seems politically driven, even medical
> > "experts".
> > > I'm an 70+ year old asthmatic and SWMBO is in her 80s with heart
> > issues so we are hermits, mostly.
> > > Thanks for any insights,
> > > Scott (a skeptic)
> > >
> > >> -----Original Message-----
> > >> From: Karl Wittnebel via Mercedes
> > >>
> > >> It isnt really a balance. The shut down was just to buy time, and it
> > worked, but
> > >> at tremendous cost. The basics of mask wearing, testing and contact
> > tracing to
> > >> isolate and quarantine positives and their contacts involve relatively
> > minimal
> > >> cost, and no threat to civil liberties. And this works. Iceland never
> > shut down at
> > >> all. They just tested lots of people from the first reported case
> > onward, and
> > >> had a team of 50 people testing and tracing the contacts and telling
> > them to
> > >> stay home for two weeks. They have close to zero daily new cases. That
> > is all
> > >> we need to do nationally, but everybody is too busy whining to get on
> > board
> > >> and there is no real leadership at the national level.
> > >>
> > >>
> > >> On Sat, Jun 13, 2020, 9:08 AM Floyd Thursby via Mercedes <
> > >> mercedes@okiebenz.com> wrote:
> > >>
> > >>> The balance that is the main challenge is how to maintain an economy,
> > >>> allow personal rights, and mitigate disease spread. Everyone has the
> > >>> answer depending on various orientations but none of them seem to
> > >>> strike the balance effectively. I have just kinda decided to go
> about
> > >>> life, take some precautions, but recognizing sooner or later getting
> > >>> infected is a high probability no matter what. A vaccine is a long
> > >>> time away, if it would even be effective
> > >>>
> > >>> --FT
> > >>>
> > >>> On 6/13/20 11:58 AM, OK Don via Mercedes wrote:
> > >>>> Our numbers are still rising in this part of the country. With
> > >>>> little to
> > >>> no
> > >>>> testing we will probably never know the full extent of the disease.
> > >>>>
> > >>>> On Fri, Jun 12, 2020 at 9:47 PM Curt Raymond via Mercedes <
> > >>>> mercedes@okiebenz.com> wrote:
> > >>>>
> > >>>>> Still pretty hard to really prove that data isn't it? 100,000+
> > >>>>> deaths
> > >>> in
> > >>>>> the US in 4 months is 3x+ what the flu would get over twice that
> > period.
> > >>>>> It'll take a long time before we antibody test enough people to
> > >>>>> really prove those numbers.
> > >>>>> Based on how the US numbers continue to inch down I'm thinking that
> > >>> having
> > >>>>> a bad "early" COVID season might be a good thing for our later
> > results.
> > >>>>> Brazil's numbers are terrible and rising and thats after having
> > >>>>> very low numbers in the initial 4 months.
> > >>>>> -Curt
> > >>>>>
> > >>>>> On Friday, June 12, 2020, 4:20:37 PM EDT, Max Dillon via
> > >>>>> Mercedes < mercedes@okiebenz.com> wrote:
> > >>>>>
> > >>>>> https://swprs.org/a-swiss-doctor-on-covid-19/#latest
> > >>>>>
> > >>>>> 1. According to the latest immunological and serological studies,
> > >>>>> the overall lethality of Covid-19 (IFR) is about 0.1%[
> > >>>>> https://swprs.org/studies-on-covid-19-lethality/] and thus in the
> > >>>>> range of a strong seasonal influenza[
> > >>>>> https://www.ebm-netzwerk.de/en/publications/covid-19] (flu).
> > >>>>>
> > >>>>> 2. Even in global “hotspots”, the risk of death for the general
> > >>> population
> > >>>>> of school and working age is typically in the range of a daily car
> > >>>>> ride
> > >>> to
> > >>>>>
> > >> work[https://www.medrxiv.org/content/10.1101/2020.04.05.20054361v1].
> > >>> The
> > >>>>> risk was initially overestimated because many people with only mild
> > >>>>> or
> > >>> no
> > >>>>> symptoms were not taken into account.
> > >>>>>
> > >>>>> Max Dillon
> > >>>>> Charleston SC
> > >>>>>
> > >>>>>
> > >>>>> _______________________________________
> > >>>>> http://www.okiebenz.com
> > >>>>>
> > >>>>> To search list archives http://www.okiebenz.com/archive/
> > >>>>>
> > >>>>> To Unsubscribe or change delivery options go to:
> > >>>>> http://mail.okiebenz.com/mailman/listinfo/mercedes_okiebenz.com
> > >>>>>
> > >>>>>
> > >>>>> _______________________________________
> > >>>>> http://www.okiebenz.com
> > >>>>>
> > >>>>> To search list archives http://www.okiebenz.com/archive/
> > >>>>>
> > >>>>> To Unsubscribe or change delivery options go to:
> > >>>>> http://mail.okiebenz.com/mailman/listinfo/mercedes_okiebenz.com
> > >>>>>
> > >>>>>
> > >>> --
> > >>> --FT
> > >>>
> > >>>
> > >>> _______________________________________
> > >>> http://www.okiebenz.com
> > >>>
> > >>> To search list archives http://www.okiebenz.com/archive/
> > >>>
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> > >>>
> > >>>
> > >> _______________________________________
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> > >>
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> > >
> > >
> > > _______________________________________
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> >
> >
> > _______________________________________
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> >
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> >
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> >
> >
> _______________________________________
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>
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>
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