What do you think about "Can just slow the spread" notion? (i.e., will ultimately kill same number)

[pat_k]

What do you think about the notion that we "can just slow the spread."

The notion means that, ultimately, COVID-19 will kill the same number of people -- we just need to slow the rate of death so hospitals can cope.

This strikes me as an utterly bullshit excuse to implement less aggressive, less expensive efforts based on cost/benefit -- with the benefit side of the equation much reduced. The benefit of containment -- saving lives -- is out the window. This changes to "whatever we do, a vast majority will get infected anyway, and will ultimately kill the same number of people, so there is no real benefit to aggressive efforts to contain.)

Furthermore, the experience of China would indicate the the notion is utter bullshit. The total active and recovered is 143,000 or so. Unless my math is wrong, that's just a little over .01 percent of 1385 billion . Many areas in China are apparently far less affected. The spread is slowing. Do you really believe there are actually over 7000 times the number of "undiagnosed" cases there?

I don't buy it for a second.

We must undertake extremely aggressive efforts to CONTAIN, not just SLOW.

(And, with Merkel buying the "can only slow" notion, if I lived in Europe, I'd be a little concerned about spread from Germany due to moderated response.)

[The Velveteen Ocelot]

2. Slowing the spread means hospitals won't be so overwhelmed,

which means people with conditions other than COVID-19 can be treated, too. Other illnesses and injuries will still exist. If hospitals are swamped with seriously-ill COVID-19 patients, what will happen to people who have had heart attacks or strokes or need cancer surgery or have been in car accidents? Maybe the same number of people will ultimately get the virus but the seriously ill ones would be less likely to die because they would have access to adequate treatment by staff and equipment like ventilators. And the people who need other medical attention could get that, too.

[pat_k]

3. So you buy that containment is impossible?

I don't buy the notion that containment is impossible.

And efforts at containment have the same affect -- allow the hospital system to cope better, and as you say, save lives in that way.

But the can only slow spread (not contain) does lead to the conclusion that truly aggressive efforts to contain aren't necessary because they won't work. We only need to take just enough steps to slow. That is, no aggressive testing, tracing, quarantining. Just have people "self-quarantine" after they've already spread it. Just limit public events....

[The Velveteen Ocelot]

4. At this point, yes. Maybe it wouldn't have been

if CDC and Trump had their shit together when the virus was first identified, but they blew that opportunity by almost two months.

[pat_k]

11. I don't believe we have passed the point of no return.

Perhaps we have. Perhaps not.

I firmly believe concluding we are "passed the point of no return" at this point is uttlerly premature. I also believe it is a dangerous, self-fulfilling prophecy.

I do not believe it is time to throw up our hands on aggressive (and admittedly expensive) containment efforts. (Funding widespread sample collection, processing, and funding to recruit and hire people to engage in effective tracing.)

[Phoenix61]

7. I think it's way too late for that. I don't think

anyone seriously thought it was a solution. Slowing the spread will definitely increase survival. For example: There are only so many ventilators. If we can keep the number of people who need than below that number, they will survive. If not there will be many more fatalities.

[pat_k]

15. Same as #30

Last edited Wed Mar 11, 2020, 05:36 PM - Edit history (1)

[Phoenix61]

19. Believe what you want. I'm not suggesting

to stop trying but we need to be concurrently planning on the worst case scenario. That being said, we don’t have and aren’t going to have, the resources we need to stop the spread.

[Ms. Toad]

12. Containment is impossible at this point -

Containment requires identification of the individuals who have the disease. First, once it started spreading in the community there are no longer identifier we can reliably use to determine who should be tested v. who shouldn't - so identification is far less likely. Second, people are contagious before they have symptoms. If you acquired it from a person at the grocery store who was asymptomatic you would have no reason to know you might have it - and you will pass it on before you are aware you are ill. Finally, tests are still not available. My doctor - who has a pipeline to someone with access to tests cannot get tests for his practice group (as of 10:30 this morning).

Slowing down may have a side benefit of some reduction - but the containment battle was lost atleast 2 weeks ago when we did not have the tests to test those who were obviously at risk. It is now in the commmunity, and can no longer be contained - any more than the seasonal flu can be contained.

As or limiting the aggressive options to fight it - have you looked at the list of school closings, parades canceled, limitations on nursing home visitation, etc? We are (finally) taking this seriously. Too late for containment - but - perhaps still in time so that we don't have people suffocating when they can't breathe and there are no hospital beds, intubation equipment, or doctors to help them.

[pat_k]

16. Closures alone only slow. Aggressive testing, tracing, and quarantine contain...

...or at least have the potential to contain.

But containment efforts require recruitment of personnel, and setting up drive thru testing sites capable of collecting samples from large numbers of people, and home testing programs like what the Gates foundation is working to launch in Seattle, and set up of labs capable of processing tests rapidly. These types of efforts require the actual appropriation of funds. Closures cost in terms of lost business, etc., but you don't actually need to appropriate any money to pay for them.

I think concluding "we can just slow" is premature at this point -- and furthermore is a dangerous, self-fulfilling policy.

[Ms. Toad]

18. You missed my primary point.

Containment requires identification of who is ill. Once you have community transmission, it is impossible to identify those who are ill (or who they came in contact with). Containment works when you can identify people before they are contagious - or early enough that you can trace their contact. How many people did I contact when I went to the grocery store today - and how do you plan on identifying them? I touched the basked, the handles of the spoons in the olive deli, several bottles of disinfectants when I picked them up to read the ingredients, the handle on the refrigerator door when I grabbed a bag of string cheese, 2-3 bags of banana chips to check the nutrients, 3 bags of snickers to compare prices, the telephone key pad when I entered my loyalty card, the button on the credit card reader to accept. If I am pre-symptomatic with COVID 19, I potentially transmitted it to several individuals with each of those touches. How do you plan on identifying them?

By the time we have the tools to do the aggressive testing, there will be a million or more infected people in the country.

We are well past containment - but there is still time to slow the progress enough to ensure that anyone capable of surviving has the tools to help them do so. If we don't slow it, we will run out of hospitals, tools, and people - and many more will die, not because COVID 19 had to kill them, but becase we didn't have the resources to sustain them until their body could beat it.

Whatever testing we can do is great - I am not at all suggesting it is not important, or that it isn't important to do contact tracing, quarantining, and isolation. Merely that we are long past the point at which we can effectively contain it.

[Phoenix61]

20. Thank you. Said much better than I ever could. nt

[pat_k]

25. Same as #24

[pat_k]

24. As long as aggressive testing and tracing continue -- as far as it is possible..

...I'm happy.

My fear is that accepting "can't contain" prematurely is being used as an excuse NOT to fund aggressive testing, tracing, and so on. That it is being used as an excuse to limit measures to "social distancing" and other things that have a different sort of cost (lost revenue, economic downturn) than efforts that require proactive state, local, and national government action and funding. (More on this in other responses.)

[uppityperson]

5. It doesn't mean the same # of people will die. That's where you are wrong.

It means the same # of people will eventually get the virus, but fewer at a time. This means there will be fewer at any time that need hospitalization at any time. This means there will be care for them.

If more people get sick at the same time and there are not enough hospital beds, equipment, staff to care for them, there is a much larger number who will die. Imagine grampa is sick but the hospital is full. So are all the other ones in the area. What happens?






https://www.flattenthecurve.com/

[Phoenix61]

8. Thank you for posting this. nt

[The Velveteen Ocelot]

14. Exactly. The same number of people might get sick over a longer period of time,

but not as many sick people are likely to die, because with fewer sick people at the same time they will have access to medical treatment. In Italy they are having to triage patients because the hospitals became overwhelmed when so many people became ill in only a few weeks. And Italy has the oldest average population in the world (the average age of the patients who have died was 81). So basically they are having to put Granny out on an ice floe. We would hope to avoid that situation.

[pat_k]

33. See #30

https://www.democraticunderground.com/100213073804#post30

[pat_k]

30. "Same" is a misstatement. But certainly containment saves MORE lives than just "slowing"

As long as aggressive testing and tracing continue -- as far as it is possible -- I'm happy.

My fear is that accepting "can't contain" prematurely is being used as an excuse NOT to fund aggressive testing, tracing, and so on. That it is being used as an excuse to limit response to "slowing" measures, like "social distancing," cancelling events, and other things that have a different sort of cost (lost revenue, economic downturn) than efforts that require proactive state, local, and national government action and funding.

Effective containment efforts require recruitment of personnel, setting up drive thru testing sites capable of collecting samples from large numbers of people, home testing programs like what the Gates foundation is working to launch in Seattle, set up of labs capable of processing tests rapidly, and implementation of effective tracing efforts. These types of efforts require the actual appropriation of funds.

Perhaps we have passed the point of no return, perhaps not. I am not convinced we have. I see the "can just slow" as a premature conclusion, an excuse not to institute and pay for real containment, and therefore a self-fulfilling prophecy.

[totodeinhere]

6. The idea is to slow the spread so that everybody doesn't get sick at once and overwhelm our health

care system. If we can spread it out then the immediate burden on our facilities will be mitigated. And that will give us more time to prepare for it.

[pat_k]

17. So we give up on containment? (Which would save FAR MORE lives.)

Efforts to slow only cost us economically -- closures, working from home, cancel public events. These actions don't require the actual appropriation of funds.

Effective containment efforts require recruitment of personnel, and setting up drive thru testing sites capable of collecting samples from large numbers of people, and home testing programs like what the Gates foundation is working to launch in Seattle, and set up of labs capable of processing tests rapidly, implementation of effective tracing efforts. These types of efforts require the actual appropriation of funds.

I see the "can just slow" as a premature conclusion, an excuse not to institute and pay for real containment, and therefore a self-fulfilling prophecy.

[totodeinhere]

21. We should not give up on containment but I think the consensus among experts is

that it's too late to completely contain it. We might be able to slow it down but anywhere from 40 to 70% of the population word wide will eventually be exposed.

[pat_k]

31. Same as #30

https://www.democraticunderground.com/100213073804#post30

[intrepidity]

29. Containment can be seen in the rear view mirror

The horse has left the barn. Ship has sailed.

Mitigation is the word now.

[sl8]

9. Regarding "will ultimately kill same number"

What are you basing that conclusion on?

You're not talking about the "flatten the curve" concept are you?

[pat_k]

23. "Same" is a misstatement. But certainly containment saves MORE lives than "slowing"

Last edited Thu Mar 12, 2020, 02:23 AM - Edit history (1)

Additional thoughts in other replies.

[karynnj]

10. It will not kill the same number -- the same number will eventually get the virus

To slow the virus, you need the aggressive containment.

1) The hospitals would be more capable of handling everyone -- instead of being overwhelmed.

2) The longer time passes, the more likely that the medical experts will determine protocols that are better at healing people who get it.

3) If it lasts beyond a year or so , people will be able vaccinated.

[pat_k]

34. See #30

https://www.democraticunderground.com/100213073804#post30

[WhiskeyGrinder]

13. Slowing the spread is a vital part of controlling the outbreak. What more do you think should be

done? Whatever it is, it will slow the outbreak. This virus will not be eradicated until there's a vaccine. There will be a rebound in China, which is what happens after drastic measures are loosened.

Washing hands, social distancing and working at home for those who can is not a bullshit excuse. It's vitally important.

It's natural to feel like it's not enough. It's so simple! It's not roadblocks and martial law! But it's a huge part of being enough.

Educate yourself and quit spouting off. This kind of crap is dangerous.

[pat_k]

35. See #30

https://www.democraticunderground.com/100213073804#post30

[coti]

22. The time for containment is over. This thing is part of the population now.

If you don't accept that and problem-solve from there, you're not going to help anything.

[lapfog_1]

26. sorry - contain was in our back window like 2 weeks ago.

slow is all we got... and slow will save lives.

[pat_k]

40. I hope you are wrong... see replay #30

https://www.democraticunderground.com/100213073804#post30

[intrepidity]

27. Completely valid approach nt

[Demonaut]

28. it won't kill the same number, overwhelmed with patients they have to perform triage

some of those who will have died because of overrun hospitals will have more attention and may survive

That's why santellis comment was so terrible

[pat_k]

36. See #30

https://www.democraticunderground.com/100213073804#post30

[Demonaut]

37. that person is a pessimist

seriously, the ship's filling with water, we just have to provide the buckets to empty it... we have to try

[beachbumbob]

32. containment and limiting public events is a way to start, we don't have a way

to keep every american locked up like china has.

[kurtcagle]

38. I suspect we're really past the point where it makes a difference

What makes Covid so insidious is that it has few side effects during the incubation period, which is fairly long. What we're seeing in the US now are only those people who have been gestating for several weeks and have only just become sick enough to become aware that they have it. What's more, you're dealing with at least two strains (and I have to wonder if Italy actually represents a third, even more lethal strain).

If the CDC hadn't been gutted, it would have been working with the Chinese much earlier, and so would have been able to sequence and start testing early enough to keep it from spreading. As it is, we'll be dealing with travel restrictions, event closures and so forth for a while, if Seattle is any indication, at least until we can get a handle on it with a vaccine.

[pat_k]

42. Of course, you may be absolutely right.

I guess I'm an optimist at heart, but I don't think we know enough about the actual spread across the nation to conclude that we are "passed the point of containment." (Due to, what was effectively a 7 week DT admin blockade on testing).

That is, I don't think we know enough to conclude that 60% to 70% of people in every county across the nation are going to be infected, whatever we do, and that all we can do now is slow down the spread.

More thoughts in post #30 and post #41.

[customerserviceguy]

39. Aggressive containment

is only going to slow the curve, it is impossible to stop the number of new cases at this point in the game.

Also, it's erroneous to think that flattening the curve will lead to the same number of deaths. A healthcare system that can treat more people over a longer period of time is going to save more lives than a completely overwhelmed system.

And I wouldn't base any assumptions on what the Chinese say is happening. They have every incentive to lie their asses off now, as they have done since this thing started.

[pat_k]

41. True about likely "misrepresentation" of (or outright lying about) data from China.

And, as noted in reply #30, my use of the word "same" was wrong.

I expressed it badly, but nevertheless, I think we still have a shot at actually reducing the overall number of those who are infected through funding of widespread testing, tracing, and quarantine, to the extent possible. It seems to me that the belief that things are "beyond containment" is being used as an excuse to shift from proactively funding and implementing aggressive testing, tracing, and quarantine programs to more "passive" cancellation of events, etc." Things that may require "bailout" later, but don't cost in proactive action and money up front.

I am all for all the "slowing" measures -- social distancing, cancelling events, etc., but our efforts can't stop there.

I may be deluding myself. Maybe 70% in every county of the country will end up infected. However, there is so much unknown about where we actually stand in terms of spread, it seems premature to conclude that we have no way to reduce the overall number of people infected. Premature to conclude that all we can do is try to "flatten the curve."

[riversedge]

43. Of course we should slow the spread.

[pat_k]

47. Of course.

But do you think it is inevitable that 60% to 70% will ultimately be infected? That all we can do is slow the speed with which we get to that point?

Or do you think it is not to late to actually limit the number of cases to less that the predicted 60 or 70 percent?

More in post #'s 30 and 41.

[littlemissmartypants]

44. If, as in the case of Italy, some of the sick are or already have been, misdiagnosed as having flu?

If those cases are not being counted and tested as the Coronavirus then the horse has definitely left the barn. We aren't testing early enough or in the expansive numbers needed to accomplish either slow down or containment. We need test kits. They are in severely short supply. The deaths will be exponential as a result.

[pat_k]

45. Absolutely. Testing capacity if growing, no thanks to DT's CDC. FDA. or NIH.

https://www.democraticunderground.com/?com=view_post&forum=1016&pid=249123

[Recursion]

46. It *infects* the same number but kills fewer

What you see in Italy is why it's a good idea: people who would survive if the hospitals had had space and staff are dying because there isn't time, space, personnel, and equipment to treat them. Slowing the infection rate avoids that.

[pat_k]

48. Of course.

But do you think it is inevitable that 60% to 70% will ultimately be infected? That all we can do is slow the speed with which we get to that point?

Or do you think it is not too late to limit the number of cases to less that the predicted 60 or 70 percent?

More in post #'s 30 and 41.