Central California SARS2 battlefield, personal experience included
The two brave emergency physicians (technically urgent care, which is usually dealing with lesser illnesses, at least during presentation) have dared to speak up. The gall. The utter disregard for the Moral Authoritarians, most often colored Smurf-blue is wondrous to behold. Their first video which was removed almost entirely from YouTube, and perhaps totally by now obtained 5 million views. But here is the sin: they told the truth.
Links to episode 6 in a series presented by Journeyman Pictures deals with re-iteration of their experience, international experience, conversations with CEOs of hospital chains and of businesses large and small in their Bakersfield community. They recite opinions of primarily Swedish virologists and epidemiologists concerning the inevitable course of infection.
The inevitable course of infection ends when either the entire host species dies or much more often host immunity becomes community-wide. This means herd immunity.
Herd immunity cannot occur as long a majority of the herd is sheltered in place, waiting for the next episode, possibly more lethal than the previous.
I practiced Neurosurgery and Neurology for 37.75 years in Santa Maria, 150 miles southwest of Bakersfield. In my practice, I both received follow-up patients from Bakersfield or sent my Bakersfield patients back home. So I know the lay of the land.
How about some facts: listen to the linked video(s). You'll get facts. I'll give some Santa Barbara County facts which is where my physicians are. And then I'll give your San Luis Obispo facts, which is where my current practice is located.
The figures I give are from yesterday, so may be outdated even 24 hours later.
SBCo has about 450 - 500 confirmed cases and about 45 deaths. Not too bad. Beds at my Northern SBCo. are empty except for about 12 SARS2 cases, some being in ICU. Elective procedures have disappeared, just like the jobs of people victims of collateral damage.
The SLOCo picture is much rosier: just a little more than 200 confirmed cases and 2 deaths.
So, as far as North SBCo and all of SLOCo, things are loosening up. This occurs not by governmental edict. It occurs because the big bad monster virus is statistically only bad for the elderly, comirbidity-burdened population.
Drs. Massihi and Erickson give fact-based assessments of what they see. This conforms pretty much to Cal's Central Coast where I live.
Doctors both, I congratulate you. After 38 years practicing Neurosurgery and Neurology in your neighboring community of Santa Maria, I appreciate first hand the utility of urgent care centers such as yours. I have two questions for you:
1. Do your Urgentcares function as a one-stop, then off to hospital if need be, or do you continue treating patients with non-hospital requiring care?2. You mentioned treating your Covid-19 patients with antibiotics. Does that include CQ or HCQ? If you fear repercussions from an affirmative answer, I can well understand your reluctance to so state.
This entire process has been politicized from the moment of arrival in the public awareness. This virus doesn't care if you're a Democrat, Republican, Independent. It can kill you just as dead.
Too many people believe that if a healthy person goes outdoors, social distancing or not, that this act diminishes their immediate safety. It doesn't. But delayed consequences of suppressing development of herd immunity will almost see a continuation of this disease through perhaps several disease cycles until herd immunity (whether or not vaccine-facilitated) occurs.
Thank you for taking a fact-based, apolitical position on the epidemic.
[video:https://www.youtube.com/watch?v=3f0VRtY9oTs]
Episode 1: https://youtu.be/d6MZy-2fcBw
Episode 2: https://youtu.be/lGC5sGdz4kg
Episode 3: https://youtu.be/VK0Wtjh3HVA
Episode 4: https://youtu.be/cwPqmLoZA4s
Episode 5: https://youtu.be/k0Q4naYOYDw
A transcript of this interview can be found https://www.thepressandthepublic.com/...
Just remember folks, people died for Fauci's sins:
No one needed to die except for Fauci
Note my statement is ambiguous, purposefully so.
Cheers and Good Day, Sunshine
Comments
Ode to Ra
[video:https://www.youtube.com/watch?v=NvPNYs7Baps]
One morning
at Boy Scout camp in Southern Oregon some older friends of mine
who were on staff somehow commandeered the PA system and in
place of morning reveille woke us up to "Good Day Sunshine".
And it was good.
Any hard data or research to back up the efficacy
Of herd immunity for covid-19, or are we suppose to die first to get that answered?
There is always Music amongst the trees in the Garden, but our hearts must be very quiet to hear it. ~ Minnie Aumonier
No, you're supposed to die to the tune
Who needs cheap non invasive morally responsible treatment when you can go straight to the treatment with a 76% fatality rate and make millions.
Capitalist medecine at its finest.
Make millions on medical materiel...
Then lose untold trillions on the markets and economy. Doesn't sound like a money making plan to me.
Not money-making for the people as a whole.
Data on SARS2 prevalence relative to community resistance
Using the 1918 flu pandemic as a base
2 1/4 million out a population of 330 million would die in one year to gain herd immunity. It would probably be less due to better health care today but that would quickly get swamped.
I'm assuming same R0 and death rate. I'm wondering if the Drs. consider Covid-19 better or worse than the 1918 flu.
Without disputing your statement
The reasons for the devastation wrought by the 1918 flu were manifold, including the deprivations on huge populations due to famine and other epidemic diseases including typhus, trench foot (yes, trench foot was a distinct comorbidity, open flesh with disrupted barriers to bacterial entry, leading to sepsis.)
I extrapolated the flu deaths in the US only
The US population was 130 million in 1918. The rest of the world, at that time were probably in worse condition (sanitation, living conditions, food supplies than the US.
The doctors should be able to get better info than I as to the R0, death rate and herd immunity % of the 1918 flu and give us a comparison.
I want to know what they believe the death rate would be for Covid-19 if no lock-downs were done at all or even it partial lock-downs were done for old folks. Don't forget that there are now more elderly with comorbidity that have been kept alive due to medical advances.
They are the ones advancing the proposal to go for herd immunity so I'd like to know more. They can't simply pick apart the current situation using facts and figures w/o giving us the alternative c/w facts and figures.
AE - what is your take on
the following:
(from a recent Brazilian study)
That looks (to me, the medical non-professional) to be a reasonable statement about the rationale for empirical treatment in a situation like this - but Fauci and company appear to reject it as illegitimate somehow?
The Brazilian article is worth noting
Empirical treatment with hydroxychloroquine and azithromycin for suspected cases of COVID-19 followed-up by telemedicine
Thanks, AE
One point about the Brazilian telemedicine study, though.
You wrote, "It might be argued that those refusing treatment had milder infections. But the data weren't presented by which to prove or disprove any self-selection bias. "
That's a little unclear to me - but the study did say this:
Excellent point which I missed
If I did not already know about these two doctors, the censoring
of them by YouTube would, by itself, make me seek out their videos just to find out why YouTube is crapping their pants.
I guess being "on the front lines" doesn't always get you a firetruck parade.
How do Drs. Massihi and Erickson account
for the deaths in excess of normal levels during this period if they have not been caused by the Covid-19 pandemic.
BTW, Sweden's economy will be affected just as much as their neighbors. The majority of Swedes actually self-quarantined to a large extent in spite of having no quarantine due to the fear factor. But a significant number did not. The country had 2,300 (28%) excess deaths. Norway, which had a strict quarantine had zero excess deaths.
Is there anything in their reports that estimate the number of deaths if there were absolutely no quarantines in the world (w/ or w/o the Wuhan lock-down)? What would the economies of the world be now if there were no quarantines?
Excess deaths in the absence of viral confirmation
The doctors musst have some estimation of those factors.
Have they done any reporting on how to account for excess deaths? From what I've read they seem to be basing all their information on where they live in California. Most people living in widely spaces houses in the suburbs, inordinately wealthy by world and even American standards, excellent health system with sufficient doctors, no travel on crowded subways/trains, fewer multiple occupant dwellings, well nourished, healthy and educated. Disease always ravages the poor no matter the country.
These doctors can't make their herd immunity proposals w/o estimating the true costs, not only in America, but around the world. We live in a highly mobile connected world. Can you imagine what would have happened in China if they hadn't done the extreme lock-down in Wuhan and let 5 to 10 million from the province to travel to every corner of the country and world for Chinese New Year. The highest demographic of tourists in the world now come from China - about 200 million going to every corner of the world. Over twice that number within China itself.
I think they are living in a bubble and extrapolating from that bubble.
There are probably also people who aren't dying.
You raise a valid point for further research
Future epidemiological surveys must involve economists, sociologists, psychiatrists, anthropologists as well as other medical professionals. I would hope that such future uncovering of the resultant health and societal ills could be performed in an apolitical fashion.
Speaking
of collateral damage
as reported in the UK Guardian
California must not follow New York's footsteps.
https://www.worldometers.info/coronavirus/country/us/
More than 0.13% of the population of New York has already died from Covid-19 in the last three months.
The death rate from the seasonal flu is around 0.1% of the people who get infected. Many people do not get the flu so the overall number of deaths from flu is much less than 0.1% of the population.
Three fourths of the people in New York with confirmed cases of Covid-19 have not yet had an outcome for their disease.
If only 1% of the people known to have Covid-19 in New York do not survive then we will lose another 25,000 people. If the pandemic completely stops tomorrow New York will still wind up losing more than 50,000 of its citizens to Covid-19.
This is not the seasonal flu. California needs to avoid becoming another New York.
It appears that there are a lot of papers
already done that could answer some of the questions I had. Do you know if the doctors have cited any?
https://www.medrxiv.org/search/Epidemiology%252Band%252BTransmission%252... 1,799 Results for term "Epidemiology and Transmission of COVID-19"
Risking lives on opinions and dubious data is problematic.
I agree with you about that.
The value for herd immunity I saw most often was 70%, but that looked like a guess. That was before the claims that a large number of people had already recovered without showing symptoms. If there are more asymptomatic individuals higher the percentages of immunity are necessary and I did see some estimates of 80% to 85%.
It sounds like the antibody tests were giving a lot of false positives. Apparently there have not been as many infected (and either dead or recovered) as the test vendors claimed. It is also not clear how long the immunity will last once someone recovers.
The coronavirus that caused a cold two years ago does not generally protect against the cold going around this year. Herd immunity might only last a year or two. Nobody knows.
Spreading the virus on purpose is not likely to make the population more immune to other coronaviruses or a mutant of this one.
I have not tried to do anything beyond simple, short-term modeling because there just is not good data. The deluge of papers that are not even refereed is just too much to follow. Even the refereed review articles are only good guesses at this point. There was a lot of good work on SARS so progress with this virus is impressive given the short time frame, but I think we share in opposing the idea of using a large number of people as guinea pigs.
I had trouble with the sound on the two videos I tried to watch, but there were a lot more opinions than facts presented. The two urgent care guys were generalizing about the situation in their wealthy, privileged neighborhood to the situation in places where there are a lot of poor people. Maybe they think it is OK to sacrifice the lives of a bunch of poor people to protect their profits.
This might get better papers on this topic although some of the papers probably have as much politics as science.
https://www.medrxiv.org/search/abstract_title%3ARo%2Bcontagious%2B%20abs...
Referencing your epidemiology citation
Model the transmission dynamics of COVID-19 propagation with public health intervention as published without peer-review on MedRxiv.
Each line of this MODEL represents a supposition based upon assumptions which may or may not be applicable to the current SARS2 epidemic. Yes, the variables inserted representing the various population groups might be reasonable and proper, but assumptions are made in the field--not by pathology / autopsy confirmation of total members in each class, as represented in figure 1. We have discussed this issue in multiple essays and comments before.
Populations S, H, I, Q, E, R are all based upon incomplete knowledge.
I distrust models because they are purported to be real-world related, which is what CNN purports to be. The Central California area is having a light go of it. But the model I see does not take into account population density, personal hygiene, economic status, occupation/employment, etc.
I just thought of other factors why we can't consider
Covid-19 just "another flu". We already have vaccines for the winter flu and they are in widespread use in the country. These vaccines will cover two of the most dangerous aspects of Covid-19: 1) asymptomatic spread by young, healthy people and 2) higher death rate in elders with comorbidity.
Another VERY important factor is that there is already a very high herd immunity with the winter flu. That's why we don't have to worry about a pandemic developing.
Once herd immunity and vaccines are developed THEN we can say Covid-19 is just like the flu.
Your comment is appreciated
In addition to agreeing
with those who point out the clear difference in outcomes between Wuhan and New York City, both with 11 million people, but where Wuhan closed all transportation into, out of, and around the province, but which New York still hasn't done, I hate to be the one who brings up the terrifying news of possible new problems. We're not aware of what we're dealing with yet.
The more we see, the more we know
In drug trials, the concept of Phase 4 evaluation is well-known. This is also called after-market experience. Such information cannot be obtained until a certain informational critical mass has been achieved. For drugs, this might require millions of doses of a particular medicine.
But the same concept can be applied to the emergence of of more case information. One example is Alzheimer's Disease. Dr. Alzheimer's did not discover the disease named for him but he was the first to comprehensively describe a disorder which was never well-enough represented in populations prior to the advent of the revolutions in technology and hygiene. These permitted greater numbers of patients to survive longer than the 65 year old age at which AD cases become progressively more common.
So, now with SARS2 we may be seeing an inflammatory disorder in younger patients due to multiple mechanisms, all of which have been described in adults:
conjunctivitis
cough
sore throat
pneumonia
cytokine storm
anti-phospholipid antibody disorders (of which there is a large spectrum, many of which target the nervous system both central and peripheral)
intravascular thrombosis-->disseminated intravascular coagulation-->micro emboli-->multi-organ involvement, also including brain and heart.
Thank you,
I know you're watching for everything relevant, and I look to you for insights of all kinds. I'm just weighing in on the side of instinct that may cause us to freeze in place when encountering an unknowable, unseeable, unpredictable predator. If you think we're cautious now, imagine how this will change if it threatens children.
wow, in the words of our dear leader,
you all did an excellent, magnificent job, in the essay as well the comments. So, I need to be the sheep in the herd that wants to get immunity, right? Do I (or we) want to decide on our own of how much risk we take to get infected (not even knowing if we have been infected or not) or do we want be ordered to do things, which hurts us otherwise, because politicians pee in their pants out of fear being blamed for the death rates, of which we even don't know yet of how much they have really increased due to covid-19 ?
As the guy in the video said, the virus is everywhere, with lockdown or without. And you guys in the US are members of a sophisticated society, (such lucky bunch you are indeed) and got a liberal education (forget that's just for the rich kids). So, the so-called collateral damage, that the lockdown causes, we do not have to accept. Yeah, we don't.
The discussion about the pro and cons are everywhere. Most people who get damaged through the lockdown, don't want to be damaged. The average Joe and Ann sense it and start to rebel against the collateral damage. Makes sense to me.
I hate to constantly try to figure out who has the better, more right, more sophisticated arguements, and it's too much for me. So, as much as I love you all, can't you all go along and/or shut up, at least for a couple of hours or so?
My personal opinion (have only listened to the full episode 6 interview posted in the essay so far) that the fear factor has increased sometimes to hysterical levels, which gives the revolutionary dreamers for freedom of expression and rebels against the oppressive government agencies regulation, a great festival in the parks to show up their heroism, while at the same time they give the extreme right-winger racist-based big mouths a nice come-back to fight the social-minded left.
Hallelujah, we live in totally not interesting times, but basically in the muddiest shithole swamps of no-man's land.
Thanks Alligator Ed and CB. I hereby allow myself to donate gold and silver medals and the reward for being the most
annoyinglovable mud-slinging doctors to you both. And the winner is: ... I have my opinion, but I don't want to influence your own choice, so I won't tell you. (Note to JtC, I am a good German and don't cause troubles. See?)Sigh, at a side note, having had fears to go to doctors in the US due to FUBAR costs, but the few times I actually did, compared to having no fears to go to the doctors in Germany, because it doesn't cost me a dime, I learned too, that the quality of a doctors analysis is not dependent on how much the patient has to pay for it. Socialized health care should be a right, but it doesn't guarantee higher quality analysis of individual doctors. Hugh, I have spoken.
Kudos for all the efforts to help us making our own decision what we should accept and what we should not. So far, I wear masks religiously and keep distance, but want to go everywhere I want and not allow that the lockdown ruins all people, who loose their income generating potential, because they loose their jobs, or have less paid working hours and simply can't make a living anymore. If I wouldn't fear some vandalizing right-wingers use the demonstrations against the virus lockdown, I would march with the anti-lockdown folks. But the frigging evil-doers lock the demonstrators down as well.
I can't stand it.
Thanks Alligator Ed.
https://www.euronews.com/live
Thank you, mimi
as long as you don't choke yourself swallowing
your beloved prey, I am ok with you being lovable and annoyable. No offense meant.
https://www.euronews.com/live