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We’re about 9 weeks into the Great American Shut Down and maybe, just maybe we’re starting to see a light at the end of this tunnel? To help us parse this, call on an actual scientist, our good friend from Stanford Medicine, Dr. Jay Bhattacharya who helped write the Santa Clara Study and the just released MLB study. We discuss where we are now, where we might be going, the strategies different states are employing, and yes, at bit of the politics around all of this. And will we see the return of college and pro sports any time soon? You’ll have to tune in for the answer to that one. Also, a Ricochet first time poster gets the highly-coveted, much sought after Lileks Post of The Week badge, and we pay tribute to the great Reverend Richard Penniman. He was built for speed and good golly, we’ll miss him.
Music from this week’s podcast: Long Tall Sally by Little Richard
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In my business (healthcare and public health including Covid Testing) I regularly require transcripts of audio presentations. After listening today I decided to order up one for myself. I should have it by Tuesday sometime. I am happy to share it with the ricochetti as soon as I have it in hand.
If someone else is doing this and can deliver it sooner than I can. Let me know. I would be happy to use yours :-)
The problem with masks as a nurse friend of mine pointed out is that so few people know what they are doing, they can be worse than not wearing a mask.
Do those who wear reusable masks here, know they have to clean them and I mean put through the washing machine at least once a day?
Or wipe them down in the case of plastic?
I saw three people yesterday at the grocery store who had full beards and had masks on. Nope. Doesnt work.
The face shields that are coming into use in Ontario are much better. You can just dip them in windex after every use. They dont make it hard to breathe, and you can see peoples faces. I’ll wear one of those, when they become more available.
As to why the hospitals systems crashed. As I explained on my new vidcast with @namlliT_noD that as a someone who worked in Logistics the Hospitals crashed because of the Just in Time Inventory system.
Hospital systems are run like every other business in this world on really thin margins.
Think of it as a giant bathtub full of water. The water is all the things that can happen, you got car crashes, gun shot wounds, heart attacks and strokes. You got your normal flu season and all these things add up and suddenly the tub is near to the brim. You might have say a 3 percent safety margin factored in. Suddenly some takes a pail called Wuhan Flu and pours it very quickly into the tub. The water spills over the sides and the floor becomes wet.
In the grocery business where I worked for 20 years, we would miss deliveries and stores would go empty of certain items. But when it happens to the hospital system, people die.
Now we can factor into the Hospital system, more space and more beds to contain it. With more and better data, we will be better able to handle the virus in the future.
But we will have to make a decision. Do we want an efficient system or do we want one where can contain sudden shocks. We shall see what choices we make.
And hey if you want to watch our show, its here.
Near the beginning, Mr. Long said he had received a notice from New York City government officials that anyone who was going outside to enjoy the nice weather should (if I heard this correctly), while outside in the fresh air, stay 6 feet from anyone else and wear a face covering. Any one of those three (fresh outside air, 6 foot spacing, or face covering) puts any transmission risk so close to zero that the other two are pointless. Overdoing the recommendations may undermine useful compliance more than any benefit from thinking, “you can’t be too safe.”
Interesting, and I’ve heard it’s even worse with gloves.
I’ve been reading what little there is about how you were supposed to prepare for a pandemic and the capital costs are staggering. It’s like astronomy numbers. Plus, so much of the PPE has expiration dates. You can’t just store Tyvek suits forever etc. No politician would be rewarded for doing the right thing, here.
Funny thing about this, I don’t know if you have had a chance to listen to the podcast yet, but literally nothing said by the doctor on this podcast supported the idea that everyone should wear masks.
Guys, c’mon! You are missing a great opportunity to rename your new recurring feature The @jameslileks Fix-It-In-Post of the Week!
Oh, all right, if it’ll make one of my favorite Ricochet members feel better, I’ll go ahead and schedule the darned thing. But jeepers. There is no medical procedure I more thoroughly dread.
Take a long look at Trump’s face the next time you see him in an interview. This is a man who is scared to death, make no mistake about it. He knows this thing is serious and is between a rock and a hard place. The governors, eager to pass the buck from their own lack of knowledge in how to handle this crisis, criticize him for not giving more guidance, the press is on his back every day, and the business community is pushing him hard to reopen as they watch their businesses go down the tubes. Pay attention to the flack Macron and Johnson are getting in France and Britain. All leaders in Democratic countries are currently under the gun to create a miracle and make it all go away.
I was at the garden center today, and about half the customers were wearing masks.
And a significant fraction of those didn’t have it covering their nose.
You are misinformed about flattening the curve- it doesn’t work by just widening the curve while maintaining the area (deaths) under the curve- that was never the goal. If that was the case there is little reason to flatten the curve. Flattening the curve can save lives by at least 4 mechanisms:
1. We keep the sick population below system capacity-ie avoid being overwhelmed. An overwhelmed healthcare system will have preventable deaths as well as Darwinian rationing of care. Not only do unneeded deaths occur but we greatly coarsen our society.
2. it delays the number of sick people while we increase capacity (ICU beds, ventilators, PPE for providers). This saves lives of not only the patients but the healthcare providers. Typically, in pandemics the system capacity will DECREASE early on due to illness/deaths of providers-thereby causing increased deaths in the population (“civilian” patients b/c the system is overwhelmed at a lower level d/t provider shortages & sick healthcare providers die as well). By getting time for more PPE we saved the lives of patients and providers. We gained a greater margin of safety for providers and the population by avoiding the typical, early pandemic, decrease in capacity.
3. By spacing out the wave of infected patients the providers learn about the novel infection and learn techniques to care for them better.
4. by buying time we increase our chances of developing better meds and vaccines.
this was well know before the lockdowns- in fact there were arguments that the coronavirus was so contagious that even with lockdowns we couldn’t avoid overwhelming the healthcare system-but those arguments were based on No Italy and the healthcare system there is much less resilient than the US. The USA has the most ICU beds/capita in the world and by far the most ventilators/capita.
So my point stands- all the good evidence supports wearing masks.
Maybe we’re just more serious about getting rid of it here in Seattle, but I see about 99% of the customers at the grocery store wearing masks and have yet to see one with an uncovered nose.
I’m used to doing this on Twitter. I understood all of that already. You are getting more granular about the discussion of punishing commerce and social life versus what we are trying to do with the medical system more anybody else I run into. I never see anyone discuss the topic this intelligently.
Here’s my question: do you have any criticism of what they are doing in Florida or anywhere else where the conservatives are bragging about opening up?
This is exactly what I expected from public health officials and I don’t see it anywhere. This conversation. Minnesota is a disaster in this sense.
Did I miss who the Lileks podcast of the week was?
Wait, wait, wait…I didn’t know this was an option. I would vote for that.
http://ricochet.com/754614/irony-or-something-worse/
I dread the Golytely the day before the colonoscopy — mine was COVID-delayed from mid-March to June 1, so I already know May 31 is both totally and literally a wasted day.
You need to watch Billy Connolly’s skit on colonoscopy-check out the YouTube. It is great.
This is the kind of leadership we could use today.
My dad said it was the most pleasant experience of his life. I suspect he was exaggerating, but those must be some powerful drugs they give you!
“Good” meaning evidence you like? There is virtually no evidence that it will help this situation, far less evidence that mandatory masking, as a public policy, is in any way worth the cost. Or legal…
but as I said, if the evidence is good enough for you, I encourage you to wear one.
Winston Churchill is my hero and have often thought the world needs him today. Now, having said that, let’s remember that this wonderful orator who gave his people and many others on the side of the allies the courage to fight the Nazis was turned out of office by the Brits at the end of the war. They were tired of the misery of war and of sacrifice and along came Clement Atlee promising a chicken in every pot, the NHS, etc. Churchill also faced criticism at low points during the war from the House of Commons, within his own cabinet and from some in the press. All did not go smoothly for this great man, but he “kept buggering on.”
I have all along been arguing that we should not be required to do things “just because we should do something,” and that the burden of proof for mandates is very high. That is not a “knee jerk reaction,” or “blind adherence to ideology.”
I’ve been told to listen to the experts and follow the science. I am doing that. Thing is, I’m willing to admit that there is no consensus. That’s where my ideology kicks in. In the absence of facts, we err on the side of liberty.
https://pjmedia.com/news-and-politics/megan-fox/2020/05/14/neurosurgeon-says-face-masks-pose-serious-risk-to-healthy-people-n392431
p.s @henrycastaigne, I don’t think you’re being a jerk. It’s a perfectly legitimate question. See the link I posted above. Most doctors I’ve heard talk about it (including George Savage, on the podcast) say it is basically a showing of solidarity, a way to make people feel like they’re doing something, a sign to others that you take it seriously. It has become a fad and very symbolic… This craze is generally not being pushed by doctors, in spite of what some say. I also read a piece by some Canadian guy who compiled several actual studies showing that masks don’t work. I don’t have it off the top of my head, though.
The only time I did it, the drugs were great, and so were the doctors and nurses.
propofol is a game changer in endoscopy
when you say no evidence you mean “since i will countenance no evidence I already disagree with there is no evidence”-that isn’t an argument it is a perverse tautology. Again-the evidence for mask wearing is that is lowers the transmission of other respiratory viruses-including coronaviruses. I agree that there is no good evidence for or against mask wearing in the specific case of SARS-CoV-2, but that is to be expected with a novel virus. Your stand is equivalent to saying I shouldn’t fear jumping off a particular bridge if I have never done it before -since you disregard all prior experience with similar situations (which is ALL we had to go on). The retired neurosurgeon is also no expert in the field- and as I said if you listen to non experts you should require DATA-not the use of an MD degree as a talisman of knowledge (particularly by retired, non boarded, license expired MDs-ie at least one of which has been the case with the MDs that have been cited by mask opponents). Credentials aren’t the trump cards- but poor/lack of credentials isn’t reassuring except when you are basing your decisions on confirmation bias.
What actual logic is there in comparing Georgia to New York, let alone Sweden? Comparing apples and oranges makes sense, in contrast.