Tweet perspective on Coronavirius and health care

[knowknow456]

As of now it’s a swab (oral and nasal). I hope you have good legal counsel.

We have reached out to our corporate counsel and our labor firm.

1. We are treating COVID-19 as a "foreseeable hazard" under OSHA
2. We have not officially (internally) called COVID-19 a disability under ADA
3. We are treating COVID-19 as a serious health condition under FMLA.

We have not considered (yet) anything in the Bill passed in Congress on Friday.

Fortunately we have not had a confirmed case inside the building and with any luck it will not get to that point. The question still unresolved is whether the individual right to refuse testing is superior to the need of the Company to protect it's employees.

 

[HALL85]

We have reached out to our corporate counsel and our labor firm.

1. We are treating COVID-19 as a "foreseeable hazard" under OSHA
2. We have not officially (internally) called COVID-19 a disability under ADA
3. We are treating COVID-19 as a serious health condition under FMLA.

We have not considered (yet) anything in the Bill passed in Congress on Friday.

Fortunately we have not had a confirmed case inside the building and with any luck it will not get to that point. The question still unresolved is whether the individual right to refuse testing is superior to the need of the Company to protect it's employees.

The CDC guidelines have a number of recommendations to relax sick time and leave policies. I would suggest if you are going to mandate testing, then if someone refuses and you send them home, you should be prepared to pay them while they self-quarantine.

 

[HALL85]

We have instituted a policy where employees can use sick time if they are obviously diagnosed, or have to care for someone who is sick and their family. In addition, we are giving them 10 days of additional sick time if they Don’t have any accrued. They would just need to return those hours as they accrue them going forward.

 

[knowknow456]

We have instituted a policy where employees can use sick time if they are obviously diagnosed, or have to care for someone who is sick and their family. In addition, we are giving them 10 days of additional sick time if they Don’t have any accrued. They would just need to return those hours as they accrue them going forward.

I believe the Corona relief bill includes a similar provision so the concept of sending employees home without pay is now off the table. Truthfully, bringing in a lab to test employees is a fantasy at the moment as there just are not enough tests to go around. Hopefully that will change in the near future. It is difficult to assess just how widespread the virus is until we have more information.

 

[HALL85]

I believe the Corona relief bill includes a similar provision so the concept of sending employees home without pay is now off the table. Truthfully, bringing in a lab to test employees is a fantasy at the moment as there just are not enough tests to go around. Hopefully that will change in the near future. It is difficult to assess just how widespread the virus is until we have more information.

I spent several days with a bunch of Health professionals with a great deal of experience in infection control last week. I know as a society, we like things to be perfect and wrapped up into a nice bone, but this is a disease that we are still learning a lot about.

Asking for everyone to be tested immediately is not realistic. We couldn’t test 330 million people for a basic lipid panel tomorrow if we wanted to. With a pandemic like this, the most important thing to do is to exercise common sense. Human nature is to take these things to the extreme especially when some politicians, social media and the MSM are fanning the flames.

Our entire family was supposed to participate in a cooking class in NYC this evening and just found out my daughter‘s fiancé was with somebody last night who has developed a high fever and flu like symptoms. Decided to cancel as a family and exercise caution… Not that hard really.

 

[knowknow456]

I spent several days with a bunch of Health professionals with a great deal of experience in infection control last week. I know as a society, we like things to be perfect and wrapped up into a nice bone, but this is a disease that we are still learning a lot about.

Asking for everyone to be tested immediately is not realistic. We couldn’t test 330 million people for a basic lipid panel tomorrow if we wanted to. With a pandemic like this, the most important thing to do is to exercise common sense. Human nature is to take these things to the extreme especially when some politicians, social media and the MSM are fanning the flames.

Our entire family was supposed to participate in a cooking class in NYC this evening and just found out my daughter‘s fiancé was with somebody last night who has developed a high fever and flu like symptoms. Decided to cancel as a family and exercise caution… Not that hard really.

I would love things to be perfect but we live in an imperfect world. I would love to be able to test all 330 million people but that is unrealistic. This is a disease we are still learning about and one of the ways we will learn is by testing people.

We are lagging behind other countries in the number of tests we are performing. I have not fact checked the accompanying link but number of tests on the CDC website is around 11,000. That is a far cry from 330 million. We needed to do better.

https://www.cdc.gov/coronavirus/201....gov/coronavirus/2019-ncov/testing-in-us.html

 

[Merge]

Our entire family was supposed to participate in a cooking class in NYC this evening and just found out my daughter‘s fiancé was with somebody last night who has developed a high fever and flu like symptoms. Decided to cancel as a family and exercise caution… Not that hard really.

Would you have gone if that guys symptoms didn't show up until tomorrow?

 

[HALL85]

Would you have gone if that guys symptoms didn't show up until tomorrow?

Sure, why not?

 

[HALL85]

I would love things to be perfect but we live in an imperfect world. I would love to be able to test all 330 million people but that is unrealistic. This is a disease we are still learning about and one of the ways we will learn is by testing people.

We are lagging behind other countries in the number of tests we are performing. I have not fact checked the accompanying link but number of tests on the CDC website is around 11,000. That is a far cry from 330 million. We needed to do better.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/testing-in-us.html?CDC_AA_refVal=https://www.cdc.gov/coronavirus/2019-ncov/testing-in-us.html

This is not meant to defend the CDC, but just from reported numbers, we have 1,600 reported cases and are testing close to 2,000 per day, and assume the vast majority are those that are experiencing symptoms. Could we be doing “better”? Sure. But what’s “better”, what protocol would be required and what effect would it have on further diagnosis and outcomes?

South Korea who has tested the most people has 5x the infection rate as the US with 1/7 of our population. Our focus on containment and social distancing should and is a priority. We also have a very different culture. Results ultimately will matter most.

I would like to see more tests available but the obsession with testing in some circles is over the top, especially with the way this disease manifests itself.

 

[knowknow456]

This is not meant to defend the CDC, but just from reported numbers, we have 1,600 reported cases and are testing close to 2,000 per day, and assume the vast majority are those that are experiencing symptoms. Could we be doing “better”? Sure. But what’s “better”, what protocol would be required and what effect would it have on further diagnosis and outcomes?

South Korea who has tested the most people has 5x the infection rate as the US with 1/7 of our population. Our focus on containment and social distancing should and is a priority. We also have a very different culture. Results ultimately will matter most.

I would like to see more tests available but the obsession with testing in some circles is over the top, especially with the way this disease manifests itself.

Better is more than 11,000 total tested after more than two months. Also the CDC per their own website is testing nowhere near 2,000 per day and even combined with US Public Health labs have only had 1 day with 2,000 recorded tests.

New cases have been falling since early March in South Korea.

The way the disease manifests itself is latency for five days on average. More tests properly targeted would find people who were in the public but not exhibiting symptoms. That would be a good thing.

 

[HALL85]

Better is more than 11,000 total tested after more than two months. Also the CDC per their own website is testing nowhere near 2,000 per day and even combined with US Public Health labs have only had 1 day with 2,000 recorded tests.

New cases have been falling since early March in South Korea.

The way the disease manifests itself is latency for five days on average. More tests properly targeted would find people who were in the public but not exhibiting symptoms. That would be a good thing.

Results. Let’s see how the numbers play out over time.

 

[Merge]

Sure, why not?

was just curious since we know people aren’t symptomatic for 2 weeks (if at all). Changing your behavior based on those who are symptomatic is good... but this is spreading because of the people with no symptoms, not the people with symptoms.

 

[HALL85]

was just curious since we know people aren’t symptomatic for 2 weeks (if at all). Changing your behavior based on those who are symptomatic is good... but this is spreading because of the people with no symptoms, not the people with symptoms.

As I said earlier, I was with a bunch of physicians earlier this week and we discussed the risks, etc. (a couple of which that we had dinner at The Capital Grill in DC which was full!!!). Common sense balanced with living your life...we make those decisions every day.

It was a cooking class of about 15 and they were holding it. The risk of spreading is similar to the flu. This is not like the plague. And the “spread” right now is not widespread at all.

Everything comes with a risk. Driving on I-78 is risky.

Going out to dinner tonight with my wife...supporting local business.

 

[knowknow456]

Results. Let’s see how the numbers play out over time.

Process. Because next time we might not be so lucky.

 

[HALL85]

Process. Because next time we might not be so lucky.

Lucky? lol

 

[Merge]

The risk of spreading is similar to the flu. This is not like the plague. And the “spread” right now is not widespread at all.

The data I have seen places the r0 about twice that of the flu.

Not sure why you are putting “spread” in quotes. There are 2,800 cases right now all across the country and we have only tested like 20k people. 2 weeks ago that number was like 15.

 

[HALL85]

The data I have seen places the r0 about twice that of the flu.

Not sure why you are putting “spread” in quotes. There are 2,800 cases right now all across the country and we have only tested like 20k people. 2 weeks ago that number was like 15.

CDC sites 1,629 as of today and vast majority are in NY, CA & WA. Most states have 0-5. Once again, not to be taken likely but giving perspective. Even the hot spots are nowhere near what is happening in Italy, South Korea, etc.

 

[Merge]

That 1,629 number was as of 4pm yesterday. We’re over 2,800 now. We are running the same trend line as Italy In regards to the growth, but We are about 10-12 days behind.

 

[NYShoreGuy]

 

[HALL85]

That 1,629 number was as of 4pm yesterday. We’re over 2,800 now. We are running the same trend line as Italy In regards to the growth, but We are about 10-12 days behind.

My original point was that while testing is important, the other strategies being deployed will have a greater impact on keeping the numbers down.

The maps show there are hot spots and if you have flu-like symptoms you should self-quarantine, try to use a telemedicine option first. Additional Containment measures are being practiced where necessary. (Westchester county).

Finally, I have not seen any data on the precision and accuracy of the tests being used, but that’s equally important. The last thing you want are false positives (or negatives). We need more tests, but availability is not going to materially move the needle nearly as much as hygiene, containment and distancing.

 

[anon_ezos2e9wn1ob0]

The data I have seen places the r0 about twice that of the flu.

Not sure why you are putting “spread” in quotes. There are 2,800 cases right now all across the country and we have only tested like 20k people. 2 weeks ago that number was like 15.

South Korea has tested 243,000 and has had 3.3% positive for 8,162 confirmed cases
In the US we have tested over 20,000 with 3,045 confirmed for a 15.2% infection rate. Once we get major testing I expect that number to drop precipitously. I am even more skeptical that 40-70% of the US population will be infected with this new virus.

 

[Merge]

The maps show there are hot spots and if you have flu-like symptoms you should self-quarantine, try to use a telemedicine option first. Additional Containment measures are being practiced where necessary.

Looking at heat maps is just not going to work in limiting the spread when there is a two week incubation period. The maps are on a two week lag of showing you the actual spread. Two weeks ago, this was only reported in 2-3 states but in retrospect we know it was in all of them already.

self quarantining after you get symptoms means in all likelihood you have already given it to 2-3 people.

 

[Merge]

South Korea has tested 243,000 and has had 3.3% positive for 8,162 confirmed cases
In the US we have tested over 20,000 with 3,045 confirmed for a 15.2% infection rate. Once we get major testing I expect that number to drop precipitously. I am even more skeptical that 40-70% of the US population will be infected with this new virus.

South Korea is being more proactive in identifying people who have it before they have symptoms which can limit how this is spreading. I’m guessing culturally they are probably taking it more seriously than we are as well.

We should be following their lead.

 

[HALL85]

South Korea is being more proactive in identifying people who have it before they have symptoms which can limit how this is spreading. I’m guessing culturally they are probably taking it more seriously than we are as well.

We should be following their lead.

on FTN Fauci and previous head of FDA (Gottlieb) were in studio and made a point of how countries/cultures are different and it would not be practical or recommended to do a complete lockdown like China did in Wuhan. We would have mass hysteria if we did that. Gottlieb, particularly said that even though he is no longer serving that the WH, has been in constant communication and that we were responding appropriately.

 

[knowknow456]

Lucky? lol

Yes lucky, although I do not find it as funny as you do. I want the results to matter and we escape COVID-19 as a nation relatively unscathed. However, I believe process also matters and we have much to learn and improve upon or next time we may not be so lucky.

 

[SHUHobbit09]

A lot of posts on this thread will age very poorly, when you have Dr. Fauci going on national tv today to tell you he wouldn't eat in a restaurant today you should probably listen.

https://www.mediamatters.org/corona...ace-nation-personally-i-wouldnt-go-restaurant

 

[HALL85]

Yes lucky, although I do not find it as funny as you do. I want the results to matter and we escape COVID-19 as a nation relatively unscathed. However, I believe process also matters and we have much to learn and improve upon or next time we may not be so lucky.

We should always go back and do lessons learned assessments anytime we go through a crisis. However, if the US gets through this pandemic with relatively few casualties, it will not be due to luck.

 

[NYShoreGuy]

 

[Merge]

on FTN Fauci and previous head of FDA (Gottlieb) were in studio and made a point of how countries/cultures are different and it would not be practical or recommended to do a complete lockdown like China did in Wuhan. We would have mass hysteria if we did that. Gottlieb, particularly said that even though he is no longer serving that the WH, has been in constant communication and that we were responding appropriately.

Gottlieb was also saying we don’t need a lockdown because we will close bars and restaurants and tell people not to have dinner parties etc.. and Fauci said he wouldn't go out to restaurants.

Seems pretty clear the advice should pretty much be stay home unless you need to be out.

 

[HALL85]

Gottlieb was also saying we don’t need a lockdown because we will close bars and restaurants and tell people not to have dinner parties etc.. and Fauci said he wouldn't go out to restaurants.

Seems pretty clear the advice should pretty much be stay home unless you need to be out.

Gottlieb said we will ratchet down as needed rather than force a lockdown. Fauci said he wouldn’t go to a restaurant because his job is too vital to have to self-quarantine. They also said that we were taking appropriate measures and said that it would be a good thing that if we looked back two months from now and said results were good even though we went too far with restrictions.

 

[Merge]

Gottlieb said we will ratchet down as needed rather than force a lockdown. Fauci said he wouldn’t go to a restaurant because his job is too vital to have to self-quarantine. They also said that we were taking appropriate measures and said that it would be a good thing that if we looked back two months from now and said results were good even though we went too far with restrictions.

I don't think we need to force a lock down, but only for the reasons Gottlieb mentioned. Nothing will be open, so we will have no where to go.

I hope we look back in 2 months and say we went overboard because I am looking back to 1 month ago, and it seems obvious we did not take it seriously enough. 3,700+ cases confirmed in the US now. If each of those people gave it to 2 people who gave it to 2 people etc... we could dwarf the numbers from China very quickly.

 

[shu09]

I don't think we need to force a lock down, but only for the reasons Gottlieb mentioned. Nothing will be open, so we will have no where to go.

I hope we look back in 2 months and say we went overboard because I am looking back to 1 month ago, and it seems obvious we did not take it seriously enough. 3,700+ cases confirmed in the US now. If each of those people gave it to 2 people who gave it to 2 people etc... we could dwarf the numbers from China very quickly.

I think the government is responding appropriately and is now drifting towards the point of overreaction. They and the media have been successful in scaring the public so the public is now demanding greater action.

3,700+ cases is *nothing* in a country of 327 million. You will have clusters of this breaking out locally and other cases spread around various areas. Even if the number of cases reaches 1 million (a far, far cry from 3,700), you realize that's only 0.3% of the population, right?

 

[Bud Boomer]

When smart people talk, I listen. Pretty much every smart person I know and follow is in agreement this is a nightmare of the highest order. The available data seems to support what these folks are saying (as is often the case with smart people), which has me firmly in the panic camp. Not optimistic at all for the weeks ahead.

 

[shu09]

When smart people talk, I listen. Pretty much every smart person I know and follow is in agreement this is a nightmare of the highest order. The available data seems to support what these folks are saying (as is often the case with smart people), which has me firmly in the panic camp. Not optimistic at all for the weeks ahead.

I'm a numbers guy and the numbers they're talking about just don't match up with the current situation on the ground. I think they are putting out worst case scenarios to light a fire under hospitals if that did happen (low probability in my estimation), but the public is also hearing that and freaking out. It's also to cover their behinds if the worst case actually did happen and if/when it doesn't, they can claim they were prepared and overly cautious and pat themselves on the back for a job well done.

 

[Bud Boomer]

I'm a numbers guy and the numbers they're talking about just don't match up with the current situation on the ground. I think they are putting out worst case scenarios to light a fire under hospitals if that did happen (low probability in my estimation), but the public is also hearing that and freaking out. It's also to cover their behinds if the worst case actually did happen and if/when it doesn't, they can claim they were prepared and overly cautious and pat themselves on the back for a job well done.

I really hope you’re right, but I don’t agree with you. I think bad days are ahead.

The only thing I’m struggling with is whether it’s worth shutting down the country for. Maybe it’s better to just let everyone get sick (and a lot of people die)? Brutal decision for the guys in government.

 

[knowknow456]

We should always go back and do lessons learned assessments anytime we go through a crisis. However, if the US gets through this pandemic with relatively few casualties, it will not be due to luck.

We're getting through this pandemic with massive personal and economic disruption. If we don't improve and the next pandemic has a slightly higher RO, slightly higher lethality and/or a slightly faster latency turnover, the delays we just endured getting our act together will have catastrophic consequences,

 

[Merge]

I think the government is responding appropriately and is now drifting towards the point of overreaction. They and the media have been successful in scaring the public so the public is now demanding greater action.

3,700+ cases is *nothing* in a country of 327 million. You will have clusters of this breaking out locally and other cases spread around various areas. Even if the number of cases reaches 1 million (a far, far cry from 3,700), you realize that's only 0.3% of the population, right?

I agree the response now is appropriate. Ramp up testing as quickly as possible and try to contain the spread. We are making progress.

Only point here was that if we are basing anything on people who are symptomatic, we will fail. It’s too late at that point.

Take a look at this model tool below and how quickly things take a turn from a small population infected to a huge one. If a million people get it, it’s not stopping there unless we shut down the country which would be fairly devastating... so yeah a million people getting it is a gigantic problem.

https://www.khanacademy.org/science...icine/ebola-outbreak/pi/modelling-an-epidemic

 

[HALL85]

We're getting through this pandemic with massive personal and economic disruption. If we don't improve and the next pandemic has a slightly higher RO, slightly higher lethality and/or a slightly faster latency turnover, the delays we just endured getting our act together will have catastrophic consequences,

It’s a worldwide pandemic. How do you avoid personal and economic disruption when you have to take steps to protect the population?

 

[shu09]

I really hope you’re right, but I don’t agree with you. I think bad days are ahead.

The only thing I’m struggling with is whether it’s worth shutting down the country for. Maybe it’s better to just let everyone get sick (and a lot of people die)? Brutal decision for the guys in government.

I think the economic and psychological damage has already been done with the relentless coverage and hype. We are headed for a recession. You saw that today from the Fed, cutting rates to nearly zero in nothing but a panic move.

The economic toll is going to be far greater than the human toll. Do what we can to stop the spread at this point. I have been impressed with the Vice President (not so much POTUS) and his team. I trust them.

 

[NYShoreGuy]

I think the economic and psychological damage has already been done with the relentless coverage and hype. We are headed for a recession. You saw that today from the Fed, cutting rates to nearly zero in nothing but a panic move.

The economic toll is going to be far greater than the human toll. Do what we can to stop the spread at this point. I have been impressed with the Vice President (not so much POTUS) and his team. I trust them.

What do you want news channels to do run infomercials in products? Look the news of the 80s and early 90s and long gun so each network gets a insider or area expert to give hypothetical situations based on their research criteria....people that need to go to work cant now that is a hugely significant issue...vegas casinos furloughing full time staff as of this week...think this though coins and cash are countless petri dishes of ability to spread this...this is gonna directly correlate politically to election season