My Brother Trace Searls's Response to Comments From Yesterday's Covid19 Post

Yesterday I posted Why Not an Aggressive Strategy to Covid-19? by my brother Trace Searls. I passed some of your comments on to him. Here are a some of his responses.

On the issue of the effectiveness and safety of Chloroquine and Hydroxychloroquine, and in particular Pluto's Republic's comment:

You're right, Steven, about Hydroxychloroquine.

These are the stats I've got. This is a global survey:

The three most commonly prescribed treatments by doctors dealing with the COVID-19

Epidemic, worldwide are:

56% analgesics,
41% Azithromycin,
33% Hydroxychloroquine

Hydroxychloroquine was overall chosen as the most effective therapy amongst COVID-19 doctors, from a list of 15 options.

The two most common treatment regimens for Hydroxychloroquine were:

(38%) 400mg twice daily on day one; 400 mg daily for five days
(26%) 400mg twice daily on day one; 200mg twice daily for four days

Prophylactic use is right on target. It is the most promising thing we could do for prevention. I read the details on how it works. It introduces genetic material into the the virus that causes it to fall apart in a unique way. Together with the Z-pac antibiotic, they teach the body's immune system how to recognize the virus and clean up the debris.

Globally, 19% of physicians prescribed or have seen Hydroxychloroquine prophylactically used to prevent infection in high risk patients, who tested negative. And 8% for low risk patients who were not yet infected.

When used to treat people who have the virus, the Drug is effective only on patients with mild to moderate symptoms. If the infection is serious and there are complications emerging or other active illnesses in the body, Hydroxychloroquine does not seem to be effective.

Doctors in the US are prescribing Hydroxychloroquine. However they are doing it wrong, according to what I read.

Hydroxychloroquine, which is sold under the brand name Plaquenil, was prescribed mainly in the United States for the most severe cases. “Outside the U.S., hydroxychloroquine was equally used for diagnosed patients with mild to severe symptoms whereas in the U.S. it was most commonly used for high risk diagnosed patients."

I recognize the sabotaging effect of the FDA in the above stupidity. Doctors are reluctant to use "Trump's Drug" unless the patient is going to die anyway. It could be political, or professional.

::

This drug could change the game. However in my opinion, until the US can provide masks and extensive testing for everyone — the virus cannot be contained.

Trace Searls responds: Yes exactly, earlier is better as with most therapies. Unless the treatment might kill you as well, then last resort.

Regarding the likely curve of the pandemic under the current protocols and regimen advocated by the CDC with social distancing, lock down (or shelter in place), etc.:

Trace Searls responds:

I took this data from CDC official site.

CDC 1.png

I am able to fit a curve to Infection Behavior from January 22 (1st case) to April 5th. This is just people exposed, show symptoms, and got tested as reported by CDC across the US. We are on day 77 now and the data goes through day 75. I am not sure we are seeing a flattening of the curve yet (perhaps slight model direction shift after on April 4th).

Now look at how the model expands across time. This maybe how the CDC is looking at it. I don’t know how to factor into the Stay-at-Home Orders which may change the curve for starving the virus. Question is would there be a change in Death Rate if we acted like Sweden [Link from Steve Searls for benefit of those who were not aware of what Sweden was doing], and will we risk a residual later without Herd Immunity?

CDC 2.png

Remember the reported Death cases lag behind reported infected but appears similar to the Flu (i.e., this year Oct-Mar CDC estimates 24.000 to 63,000 deaths). Also, if I use a logistic model I get a total of only 505,000 infected. As I said the devil is in how the Model may behave, and they are managing by model (downside by end of month).

The daily reported cases is somewhat strange below, see April 3rd. This is why some are touting the peak has arrived or stating the Stay-at-Home orders are taking effect. April 3rd is a strange reporting day.

CDC 3.png

Without a vaccine or building up the immunity, who knows how flat the curve will become. We may be beginning the flattening of the curve now, but then how long will it last. My model above will not quite fit that changing curve. See link below for Spain’s profile (this is a site that states it used WHO data): https://epidemic-stats.com/coronavirus/spain

.

# # #

Steve Searls: My brother's three points as I understand them are:

1. US must move forward with using existing drug treatments in the way other nations are doing. We should also be working on new drug treatments (such as this one: Promising Drug On The Horizon For COVID-19 - A new antiviral that may be taken orally rather than requiring IV such as remdesivir) and fast tracking those new drug treatments through the FDA process.

2. We need much more testing, both antigen and antibody tests. Testing will allow us to better understand the demographics of who is getting infected and how severely, and also who has developed antibodies to the virus and may safely return to normal activities.

3. Without any significant herd immunity, it's very likely the curve of new infections and deaths may plateau, but it will either stay at that high point for many months until we have a vaccine, or the curve will decrease, but we'll see new increases in the curve if state governments relax stay at home orders/social distancing restrictions, etc.

I would also add (again, my understanding), that Trace believes the current issues with not using Chloroquine as a prophylactic treatment for vulnerable populations, and for more moderate cases of the illness in the US, is more a function of how the FDA and CDC bureaucracies operate. He has had extensive experience with medical professionals that work at the FDA, and as a rule, he feels they err on the side of being very conservative. He also says that while many have some training in statistics as it applies to experimental work regarding new drug approvals, their training is not as advanced as individuals such as himself, who use higher level statistical methods that medical experts usually do not understand or trust.

He also doubts (rightly or wrongly) that the Trump administration's approach to not using drug treatments other countries have adopted is unlikely to be political in nature. His view is that this is more a function of the entrenched mindset of the FDA and CDC and the advice they are providing the administration. Under normal circumstances (development of new drugs, new lab tests, secondary uses for older drugs, etc.), he accepts that their institutionalized conservatism works well, but may not be the best way to deal with a fast moving crisis such as the COVID pandemic, and that we should be more willing to learn from the experience of other countries such as China, South Korea, etc.

# # #

My personal view is only speculative. I'm not a statistician nor a medical professional. I am curious to see what happens in Sweden, which has yet to impose a full lock down as other European countries have. It appears to me they are the one country, for better or worse, that is trying to build up herd immunity in the population while still attempting to protect their more vulnerable populations. Whether they stay with that approach, or move to a full lock down as has been done in other European countries is still up in the air. It is possible the political leaders in Sweden, which to date have been following the advice of their medical experts, may impose a full lock down if deaths increase there.

For myself, I'm torn. As both I and my wife are high risk, vulnerable individuals due to her diabetes and my autoimmune disorder, I am frightened. I'd like to see us use the same drug treatments as other countries as using them and not just as a last resort when all other hope is gone. It's my opinion that the CDC is being overly cautious in this area, especially in light of all the data we have from other countries as to which drug treatments are effective and when they should be employed.

On the other hand, I am not as convinced that Trace's herd immunity argument is the correct one, though I have no expertise to evaluate it.

In any case, the US is a different animal, with so many states making decisions independently of others. Further, the hands off approach that the Trump administration has taken in allowing States to decide for themselves how best to handle the pandemic means we have no central authority and no one policy for dealing with this crisis. Our states are essentially similar to the countries in the EU. Unlike the European countries, no state as yet has felt the need impose a travel ban to and from other states, nor has the federal government (though that may be coming - who knows?).

I suspect we will find ourselves in the end with many continuous spikes in the overall curve for the nation. Backflow cases (such as China has experienced) in states where the apex of the curve has been reached seem inevitable to me. These new cases will arise because of individuals who travel from states where the pandemic has not yet reached its peak to states where the peak has already passed. That is, as the pandemic advances at different rates across the nation, relaxation in lock down orders in states who have declining cases will see a new spike in their curve caused by infected people who travel from other states where the curve has not flattened.

And our election is another complicating factor for reasons I don't believe requires much elucidation from me at this point.

My personal, very pessimistic assessment is that, until we have a workable vaccine, the death rate in the US will remain at higher levels than in some other countries for many, many months, in large part because our national response is so chaotic and unorganized, and our political system so dysfunctional. I hope to be proven wrong.

# # #

Finally, if anyone has any specific questions or comments about the position my brother, Trace Searls advocates, feel free to put them in the comments and I will pass them along to him for his answers and/or reactions.

Thanks to all at C99 for reading.

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And Swedes are practical people.
Sunday I was line at Sam's Club. In line to get in. The village police were enforcing the line and a big sign said MAXIMUM CAPACITY 100 PERSONS BY ORDER OF THE VILLAGE COUNCIL.
We weren't six feet apart. We were shopping cart distance apart. A Sam's Club employee gave me a hard time about standing next to my wife. Jesus Christ, I SLEEP with the woman. what's the difference if I stand next to her with both of us wearing gloves and masks?
Inside I would estimate that no more than a dozen shopper's were inside. More in line outside in the cold wind waiting to get in. I was delighted to find that we could buy a package of paper napkins. Most of the lettuce had a sell by date of April 5 (that day!) I bought two packages dated April 9 that I found by rummaging through them.
What's with the line? To induce panic buying?

On the bright side, gasoline was only $1.679 nearly half of that tax. Not so bright side for people in Texas and Oklahoma I guess.
A thought that just occurred to me: Why not hire the unemployed to pump gas like High School students did in '60s? And forbid self-serve? That way there won't be hundreds of people all squeezing those handles. I'm glad I bought a pack of capacitive styluses (stlyli?) last month to handle the touch screens.
A thought I had back then:
After listening to an antique ad for butter on "Radio Classics" that mentioned "only one red stamp needed", I thought "Why doesn't the government issue ration books and freeze prices like in WW II?" That way people couldn't hoard by shopping several times a day buying the limit because you need to expend a stamp to buy. And stores couldn't gouge by charging $5.99 a pound for ground turkey and $2 a roll ($7.99 a four pack) for toilet paper.

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We are so screwed.

Centaurea's picture

@The Voice In the Wilderness

Why not hire the unemployed to pump gas like High School students did in '60s? And forbid self-serve?

If every state did that, then Oregon wouldn't be "weird" anymore.

(Well, okay, it still would be. Biggrin )

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"Don't go back to sleep ... Don't go back to sleep ... Don't go back to sleep."
~Rumi

"If you want revolution, be it."
~Caitlin Johnstone

Granma's picture

Is taken by Lupus patients. It is life saving for the ones taking it. It is now in very short supply. Those patients are having trouble getting it.
Also Trump has a financial interest in the French firm that makes it.

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Steven D's picture

@Granma However, the are two versions of the drug, the one you referred to is Hydroxychloroquine, which is what Lupus patients take, and the earlier version is Chloroquine.

Chloroquine could be easily manufactured by existing facilities in the US (a chemical plant could be converted to make it, for example). Of course, that would take an order by Trump under the National Defense Act, something he has yet to do for any drug treatments that I know of.

I'm not defending Trump. He has badly bungled the US response to the pandemic. I'm just providing information about drug treatments that are currently being used in China, S. Korea, France, the UK, and many other countries, to treat moderate to severe Covid-19 cases.

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"You can't just leave those who created the problem in charge of the solution."---Tyree Scott

Granma's picture

@Granma It was foolish of me to treat the two meds as one.

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https://blogs.sciencemag.org/pipeline/archives/2020/04/06/hydroxychloroq...

This is a good overview of where the current research stands. I really hope the chloroquine works but I think that the jury is still out on that. Counting on that to pay off and at the same time dropping social distancing is still too risky in my view.

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The food supply for the virus remains undepleted in any significant amount. The vaccine is 12 to 18 months away. The only factor we can manipulate is R0. By reducing it we can slow the infection rate, but it's still climbing. People are still congregating at the food store, and many are still going to work. Face mask usage is not impressive and we are told to make our own? I noticed that we had a huge jump in deaths today in the US. How many other countries will climb up the curve? Governor Cuomo had been showing an infection graph with a discrete peak, which he called the apex. He implied that the infection rate will take a big vacation after that and within a few weeks NY can go back to work. His latest "graph" shows the apex gone, instead a big broad flat area. He now talks about speculating as to how high the plateau will be. We need a good assessment as to how R0 is affected as a function of what counter-transmission methods are used, otherwise we are just guessing. If we want to significantly decrease the number of infections we will have to come up with a draconian protocol. No one leaves their house for so many weeks. No one on the street. No one at work except most critical functions. Everyone will be required to stock enough food and medicine for those weeks. We need to get to the point where there are no viruses living in the population. All of the infected have either recovered or died and there are no new infections, and no live viruses on hard surfaces. If we succeed then we have the heroic problem of keeping the infection out of the population from a new source. How is China doing this? Are their results as good as they report?

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Capitalism has always been the rule of the people by the oligarchs. You only have two choices, eliminate them or restrict their power.

Granma's picture

@The Wizard those draconian measures. Maybe some degree of those measures are or will be necessary in some places. It is a completely different scenario where I live, Oregon. People are staying home, distancing at grocery stores and stores set up things differently to make it simple.

There is no reason why people cannot go outside and take a walk as long as they stay spread out. And in many places that is simple to do too. Fresh air and sunshine will do people more good than being locked up inside their homes for weeks on end.

We don't have nearly as many active virus cases here, and since people are abiding by the guidelines for distancing, I think it will stay that way. I admit these local factors bias me.

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@The Wizard
Just starve quietly at home.

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We are so screwed.

Pluto's Republic's picture

...against the coronavirus was their use of AI, Big Data, and mass surveillance. Public health 'teams' could track back and "see" every social or casual encounter an infected person may have had over the prior two weeks. Then they would swoop in, round up the potential carriers, and put them into quarantine for a couple of weeks.

These social control systems acted as a very aggressive antiviral, more so than any pharmaceutical currently available. Taiwan was also very aggressive in similar ways, using social engineering to disable the virus. Every time someone entered a building in Taiwan, or an elevator, or a restaurant, their temperature was scanned and recorded. Anyone with an elevated temperature would immediately be pulled aside for further tests. Taiwan quickly gained the upper hand over the virus.

I hear that Americans will not permit an intrusive top-down approach. Their cultural reaction to a pandemic is to buy another gun and stock up on toilet paper. The fact is, Americans have been programmed to reject centralized or communal action. This was probably done to keep them weak and scattered and uncoordinated.

...the hands-off approach that the Trump administration has taken in allowing States to decide for themselves how best to handle the pandemic means we have no central authority and no one policy for dealing with this crisis.

.
The ideology of the Libertarian, to me, is the most quintessentially American. These "rugged individuals" are going to have the hardest time adjusting to the new century. Bootstrapping will not defy the law of gravity.

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Human salvation lies in the hands of the creatively maladjusted.

— Martin Luther King

@Pluto's Republic

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The Liberal Moonbat's picture

@Pluto's Republic No fucking way do I want Big Brother ruling the new century, certainly not in America (I do have a patriotic streak - it's simply for a country I haven't been allowed to see in almost 20 years). I have no interest in "adjusting" to a world where liberal freaking Enlightenment humanism is so eagerly tossed in the trash. In fact, I'd rather watch such a world burn.

Fortunately, Candidate Obama was correct when he called this sort of thing "a false choice".

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In the Land of the Blind, the one-eyed man is declared insane when he speaks of colors.

Pluto's Republic's picture

@The Liberal Moonbat

...was he speaking in the context of counteracting a deadly pandemic?

Fortunately, Candidate Obama was correct when he called this sort of thing "a false choice".

Actually, Candidate Obama lied right to your face. I grieve over Obama's systematic betrayal of our collective privacy rights. In the context of the stunted or revoked civil and human rights forwarded by Obama — Ed Snowden speaks for me. And Julian Assange. No one currently elected to the Federal government represents my interests in these matters.

I am not really directing this comment to you, #5.2, because it doesn't generally apply to your comments. I am complaining: Holding the only intellectually honest position in the room is exhausting. Training one's mind to walk this razor's edge is no mean feat. It's a thankless effort that leads to personal misunderstandings. But even more exhausting is the need to write a didactic preface in order to state an inconvenient fact without a reactionary attack. And the pointless disruption is my own fault. Inconvenient facts do not suddenly create objective space in a discussion.

In the example, above, Obama was delivering an opinion (an opinion that I agree with, as the proper default policy for government). Obama's opinion was then contrasted with my statement of fact. Someone with good mental hygene will naturally process facts and opinions in separate parts of the brain, and will never overlap the two. People in the US often stumble here because their legislative process and system of justice is based entirely on opinion and ulterior motives, and not on verifiable facts and intellectually unbiased statistical outcomes.

If I state the superiorities of a Chinese weapon based on speed and destructive power, in the context of its purpose — it is not safe to assume I am a proponent of war or that I am Chinese or that I would be on China's side in a conflict. All it means is that I am being intellectually honest.

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Human salvation lies in the hands of the creatively maladjusted.

— Martin Luther King

chloroquine and azythramycin, Z-Pack, treatments was a video sent to me by a Slovakian expat friend here in Cuenca. It was by some OB-GYN pushing them as some kind of miracle eliminator of the virus in some people. It appears this came from the dodgy French study. Not much seemed right but I'm far from an expert in the field. My best friend in the States is a mostly retired internist with a heavy infectious disease background. He did worked for the CDC early in his career working on AIDS and Hepatitus C. He went to private practice but continued work on both of those diseases clinically. They were something of a passion. I asked what he thought about the claims. He said there was some anecdotal evidence but that it seemed sketchy at best.

The minister of health in Ecuador was asked about chloroquine at one of his briefings. He said that it had been abandoned after trials on current COVID19 patients. He said that the drug is well known in Ecuador as quinine was produced here and chloroquine had been used as an antimalarial for years. He said there was little evidence it helped when used and that the sometimes severe side effects were a strong counter indicator in COVID patients. He cited heart problems as the primary reason.

That's only one small bit of data from a place with an overall low infection rate and a highly concentrated number of cases in a small geographic area. 70% of the known cases are in Guayaquil. The early and aggressive quedate en tu casa social distancing campaign seems to have a wider spread of the virus. Populations are much wider spread here too so I'm sure that has been a big factor in the success. The three big cities are distant from each other and only one has a severe problem. I don't know how or if there is much to take from what is happening here.

What bothers me is the amount of"You can't tell me what to do!" I'm seeing in the US. It's not unique there by any means but is almost universal. Some in the expat community here have been rather vocal. I'm pretty sure every one of them is from the US. The almost total concentration of people on themselves is a killer under these conditions. People being contrary and/or reckless doesn't just hurt them. Infected they are a threat to others.

It really hit home when a friend living in Austin sent a link to a medical site memorializing doctors known to have died from the virus. He was shocked that 45 Ecuadorian doctors had been reported dead when the deaths were still in the few hundred range. Doctors are usually only a small portion of the professional caregivers who perish in an epidemic. What must the death toll be in the medical community?

People who can't be bothered to isolate and/or take reasonable precautions put medical staff at risk. We're in this together like it or not. Cooperation is necessary not optional. People here are used to helping each other out. Most expats join in and flourish in normal times but now it's how to get through a tough time for everyone.

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@vtcc73
Just on WGN-TV an hour ago. The reason for the high death rate in the elderly is that doctors and nurses refuse tio treat or care for elderly people. They think our lives are not worth risking theirs. And that it's better to save supplies for young patients.
The lesson? If you get sick and you have gray hair, don't bother to call your doctor. Satay home. Maybe you will recover. Maybe you will die. It is literally a coin flip.

And of course, the hole up and don't go out at all order is coming. Gee now I can learn to starve like I was in a concentration camp. Maybe the first of us to die can eat the other.

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We are so screwed.

@The Voice In the Wilderness

The reason for the high death rate in the elderly is that doctors and nurses refuse to treat or care for elderly people.

I know a lot of doctors. I also know a lot of nurses. This statement is insulting.

Front line folks are absolutely NOT doing this in any significant way.

Sure, triage might happen at some point, and it may already be happening at some sites that are experiencing a huge influx of patients. And yes, triage decisions are extremely difficult and are not taken lightly. In my opinion, the blame, if any, should go to the management that did not have the needed number of doctors and nurses on staff, or the required numbers of ventilators or PPE equipment.

And to act as if there are any doctors or nurses out there that are going to just let you die because you are "old"? That does not fucking happen in my experience and to imply otherwise is simply shifting the blame from the past political choices that are truly responsible to the front line workers.

No. Don't do that.
Thanks.

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travelerxxx's picture

@peachcreek

peachcreek, I went looking to see whether I could find that WGN story that The Voice In the Wilderness referenced. I'm thinking this is it: Family says Northwestern Central DuPage Hospital did not do enough to help save loved one

If so, then TVitW is not doing much more than relaying what he saw. Now, I read it – not watched it on television – so I have an advantage, but what TVitW is relating is pretty damn close to what was said.

“She didn't feel it was worth treating a person with COVID-19 because he had co-morbidity. That it wasn't worth the risk to her staff to get infected is what she told us,” Chris Curdes, Katsaros’ son-in-law, said.

That's a clip from the article. The "she" mentioned was the "...attending physician in the ICU." Note that it's a family member saying this, but nevertheless they did indeed say it.

More, clipped from the article published by WGN:

Dr. Nathan Goldfein, chief medical officer for Wakefield Brunswick in Texas, just published an article called “The black art we practice in white coats,” discussing disaster medicine and the tough calls doctors are making in COVID-19 cases, particularly when it comes to elderly patients with underlying conditions.

“The odds of resuscitating them are almost zero even if you got their heart started again the reason their heart stopped is because they couldn't breathe we can't cure that,” he said.

Goldfein said even with elderly patients, they try to resuscitate them. He said the problem with COVID-19 is that by doing so, all the resuscitators, the doctors and nurses, are then exposed to the deadly disease.

Note that the above quote from Dr. Nathan Goldfein was dropped into the article as if Goldfein was associated with the hospital where the covid patient was taken. He evidently has no affiliation, although this isn't pointed out (poor journalism, in my opinion).

I don't think The Voice In the Wilderness is making this up, nor did he/she mishear what was being reported. Disturbed about what the report was saying? I think so. Maybe I would be, too.

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@peachcreek
They even interviewed ER nurses.

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We are so screwed.

@The Voice In the Wilderness @The Voice In the Wilderness “stay in your homes” restrictions taking effect. Driving restrictions and curfews have been ratcheted down four times since that Tuesday. Currently all non-essential businesses are closed and have been for some time. If the business doesn’t provide food, medical care, or fuel it’s closed. I get to drive on Thursdays, nobody drives on the weekends. People are supposed to be in their homes from 12:30 in the afternoon until 5:00 in the morning. Masks and gloves are now mandatory for those in public. Strict occupancy and spacing requirements as well as sanitizing procedures are in effect for the stores that are open.

The vast majority of people are in full compliance. There is positive evidence that the infection rate is being reduced. Why is that important? I shouldn’t have to give so much as a hint to get a correct answer. The resources of the country are limited especially medical facilities and trained doctors, nurses, techs, and caregivers/maintenance workers. An overwhelmed medical system would be devastating. Wait a little while. That’s coming to a town near you in the US. It’s already happening.

Complain all you want about doctors choosing to not treat the hopeless. What choice do they have in a system that is scaled to only treat the ones who can pay extravagant prices for care? It’s a system not meant for everyone in normal times. These aren’t normal. I hope. Triage is coming and if you think it is because doctors or any on the front lines of the flustercluck, one that didn’t need to be this fucking bad, like it or are doing it to save costs or a certain class of people is expendable think again. I can only imagine the nightmares and PTSD coming to medical people once this is less critical.

That’s the difference between a society where people know they have to work together and one where each individual only cares about themselves. I got mine pull up the ladder is what we get. Too bad if you don’t have a ladder. Suck it.

I’m not picking on you or scolding. I’m advocating a better way to live. It’s possible right now on a small scale if you put yourself out there. A major part of my day is spent communicating with friends and neighbors to ensure everyone is safe and help if they need something. That’s how most of these people operate every day it’s just a bit harder than usual.

The government is doing a pretty good job for people. Ensuring medical supplies and expertise as well as food is where it needs to be has been an obvious priority. Right now that’s in Guayaquil for medical care. Grocery stores are being kept stocked and other necessities like water and utilities are being provided with payments suspended until this is under control. There have been missteps and boneheaded edicts but those are being fixed in good time. Again, that’s how a society that values people functions. They work together and just find solutions even when they’re imperfect.

I don’t hear any whining or complaining unless it’s an expat. Usually people from the US who haven’t made attempts at integrating into their new home. They don’t have people to rely on or are willing to be relied on. They’re worried only about how something affects them personally. This attitude was old well before we moved here and now that we see what can be it’s sickening.

Wasting energy on being bothered about what we don’t have or don’t like about the inevitable instead of helping others in whatever way we can is a recipe for bad outcomes.

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@vtcc73 \
have to be restrained? I'd be quite happy to stay home and have food delivered. Even C-rations.
But if you have never come close to starving, you do not understand what it is like. I have. And I have come close to dying from asthma. I'll take asthma.

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We are so screwed.

@The Voice In the Wilderness You are probably scared right now. The report on TV would frighten anyone with compromised health and minimal resources. I wish you were here. I would help you and know people who would help you. Some of them are probably more vulnerable than you are but it's what they do. Not having that where you live is really hard.

I'll preface my next comment by acknowledging that I have not seen the report. It is possible that it is accurate. It is also at least as possible that it is not accurate as it was told to the public. How much do we take at face value from the news media in the US? How often are stories slanted or sensationalized to sell air time? If I don't trust reporting to be accurate and factual about things I don't agree with then why should I when I do agree with what is aired? I don't. An honest self assessment is hard when you skin is on the line but it may provide some perspective on which to base a choice to step back from fear.

Hospitals and doctors triage all the time. It is much more common and the results stark and foreboding when there is a severe crisis that stresses the health care system. Add in a distrust based on a lifetime of not being able to trust anybody to not take advantage of us and everything is a threat. I haven't felt that vulnerable since I was young but I do know it from my distant past.

Many plausible explanations are possible. Plausible, reasonable, or not, knowing that I might be someone who is in the position of being the one who couldn't be saved and allowed to die for someone who may be able to be saved is not likely as I see it right this moment. A severe case of the virus during a critical period of shortage could change that in a very short time. I've come to terms with that reality and am OK with it. Talk to me if it happens, I may have changed my mind.

Reasonable explanations abound. The one the story seems intended to show was this person was old and left to die because a cold hearted doctor/medical team was unwilling, afraid, or uncaring enough to save the patient. It is possible. It is also possible that the patient was to the point medically that he/she was unlikely to survive regardless and the expenditure of critical resources did not match the risk/result criteria for treatment. Think about that. It's harsh reality that will become more common in the US. Not everyone is a candidate for treatment or resuscitation during normal times much less this crisis and a stressed medical system. Another doctor might have been able to explain it better and/or a different family may have been able to take the news as delivered from a different perspective that enabled them to accept the reality if explained. Shock and grief doesn't improve our listening or thinking skills and fatigue/stress doesn't make doctors better at explaining a horrifying decision.

It's hard but look at the story from the perspective of the doctor and his/her team. She sees a patient who in her professional opinion is not going to survive and attempting to save the patient will put the team members at higher risk of contracting the disease. The choice is use extremely limited resources for a certain failure or preserve them for others. Medical professionals are the most important of the resources that risk assessment equation. A doctor, nurse, or med tech have skills that take years, often decades, to develop. The loss of each one reduces the ability of the team to function and save lives. There are no replacements available in time to do anything for future patients. More people will die if one of the team is lost. Losing irreplaceable people and resources for a known losing result isn't a reasonable choice, it's a bigger waste.

That choice isn't easy for doctor either. It's part of the job that most hate and have a hard time dealing with. I have a couple doctor friends who have been in this situation. They both have stories that they don't widely share and say the decisions bother them to remember. Being in a profession where your reason for existing is helping others but having to admit it's not possible has to be hard. To place put others, my team and future patients, at risk for nothing has to be the unavoidable decision.

I don't expect my explanation will make it any easier to accept and I sure don't suggest feeling sorry for any of the medical pros fighting this disease. They signed up for all of it, not just the easy stuff and the paycheck. If so, they need to find another line of work. That includes the doctor who made this decision if the real story is as told. I sincerely doubt it but it is possible.

Please try to stay safe. Nobody deserves such a fate.

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@vtcc73
From my birth, my "betters" have felt I was a disposable rag. I differ.

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We are so screwed.

travelerxxx's picture

@vtcc73

There was an article by Dr. Nathan Goldfein of Wakefield Brunswick mentioned in the WGN story. I found it last night and considered posting a link to it in this discussion. It's pretty good. It's coming from a doctor/health professional point of view and the talk is pretty straightforward. After sleeping on it, I've decided I'll post the link. Hopefully, the link address or availability won't change soon. Normally the information published by this consulting group (and that's what they are) is not available without a fee, but apparently Wakefield Brunswick has decided to forgo that for now.

By the way, here's what Wakefield Brunswick says about themselves: “Founded in 2009, Wakefield Brunswick is the only consulting firm exclusively dedicated to advancing resiliency in healthcare. Through our leading risk management, emergency operations and continuity planning practices, we advise and educate the top healthcare organizations in the country. Our team has decades of experience. We've responded to disasters and have held leadership positions at large health systems.

This is information published for professionals, not the general public, so I'm a bit surprised we can access it. If you "backup" one page, there is much more information made available. Here you go:

Physician's Personal Account: The Black Art We Practice in White Coats | COVID-19 Response

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The Liberal Moonbat's picture

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In the Land of the Blind, the one-eyed man is declared insane when he speaks of colors.