This is helpful Is there a scientific reason why you refer to it as Wuhan Red Death?
Dwight Giles Jr. Wickford RI On Tue, Jun 16, 2020, 5:04 PM Karl Wittnebel via Mercedes < mercedes@okiebenz.com> wrote: > Agreed about Iceland, in some sense. In general I am not a fan of such > comparisons, but actually their per capita international travel exposure is > far higher than ours. They had a lot of separate introductions of the > virus, and they were travelers from many countries. The useful bit of the > comparison is as a model of what a public health response should look like. > Let the health department solve communicable public health problems. For > more details of their experience, see: > > > https://www.newyorker.com/magazine/2020/06/08/how-iceland-beat-the-coronavirus > > The problem with the CDC is that they were not allowed to play their normal > role in either the public facing side of this or in the response. They > normally tell the administration what to say, rather than vice versa. Had > they been in control the response would have been far more classic "ramp up > the testing". True they messed up testing assay selection in the beginning, > but they should have moved immediately to a back up plan for increasing the > testing and this was not done. We can speculate about why this failure to > increase testing occurred, but I would submit that it was not because a > bunch of people at the CDC who basically live for epidemic response > suddenly decided it was not necessary. > > As mentioned, neither De Blasio nor Cuomo listened to the NYC health > department, who were telling them for over three weeks that they should be > closing schools etc. before NYC did so. Finally when deblasio agreed to > close schools, Cuomo stated he had no authority to do so because new jersey > and CT needed to be involved as well and only the state can coordinate > that. So they got into a pissing match after delaying longer than they > should have. The results were clear. The lesson should be: listen to your > technocrats and do what they tell you to do. > > There will always be disagreements about why things happen but this is how > I see it. The CDC is world renowned or has been. It has played huge roles > in outbreak investigation and control around the world for decades. How > this epidemic could be unfolding as it has under the CDC's nose in its own > backyard is a huge black eye for the organization and I would argue for the > country. It is sad state of affairs. For whatever reason they have not been > able to lead a world-class response to something that is their bread and > butter. > > Happy to contribute whatever I can in terms of practical steps. > > > On Tue, Jun 16, 2020, 10:57 AM Scott Ritchey via Mercedes < > mercedes@okiebenz.com> wrote: > > > Karl, > > > > Thank you for your thoughtful and extensive reply. The > personal-protection > > guidance (masks, groups, outdoors vs indoors, etc.) is particularly > useful. > > I agree that we need a much better National response for the day a truly > > evil bug comes along. > > > > I don't think the Iceland experience is comparable to the US; Iceland is > a > > remote island with little international travel and a population smaller > > than > > Bakersfield, CA. > > > > I find it hard to reconcile the NYC COVID experience and preparedness > with > > a world-class health department. > > > > Finally, being retired and having a smart phone, I watched the daily > > briefings from the COVID Task Force and Cuomo, at least until they became > > redundant. My recollection of the CDC doctors' role is quite different > > from > > your description. > > > > Thanks. > > > > Scott > > > > -----Original Message----- > > From: Karl Wittnebel > > Sent: Monday, June 15, 2020 2:04 PM > > > > 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. > > _______________________________________ > > 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 > > _______________________________________ 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
