My thanks too, Karl. You've taken the time to give us very valuable information. Gerry
On Mon, 15 Jun 2020 15:39:22 -0500 OK Don via Mercedes <mercedes@okiebenz.com> wrote: > Thanks Karl, for taking the time to give us a simple, factual, explanation. > > On Mon, Jun 15, 2020 at 1:46 PM Karl Wittnebel via Mercedes < > mercedes@okiebenz.com> wrote: > > > At their root level, public health crises driven by highly infectious > > diseases are a national problem. The response alwys needs to be carried out > > by state and local entities, but particularly when dealing with a novel > > pathogen, allowing the best scientific and public health experts to drive > > the response is critical. That is what Iceland did. The public health > > department drove the entire thing. Politicians were not involved at all in > > telling them what to do or how to do it. There will always be political > > ramifications from any action, but those cut both ways and if the > > politicians drive it and get things wrong, they pay the price. So I would > > argue it is best to just rely on the public health experts and let them > > take any heat. Best for the politicians and best for the country in terms > > of disease control. > > > > Anyway State departments of health are highly variable in their resources > > and levels of expertise and will therefore depend to varying levels on > > national resources and guidance for their reponse plans and policies. New > > York City is a world class health department on its own, for instance. > > Their politicians chose not to listen to their public health officials > > initially, and look at the result. Those few weeks of political dilly > > dallying could have saved a lot of older people's lives, and some younger > > people also, in and around NYC. But I digress. The main point is that most > > of the country is not as well equipped as NYC. So their heaalth departments > > need help with technical aspects as well as guidance on what policies are > > most effective. Not that the guidance will always be perfect, but a > > consistent, unified voice is always more reassuring during a crisis than a > > fragmented response where politicians undermine what the public health > > people say, whether it be about masks, treatments, business closures, > > travel restrictions etc. You want the public to see everyone working > > together consistently in an apolitical fashion to manage the problem. > > Centralized, national leadership is a key part of getting the response > > entites on the same page. Telling the states to figure it out for > > themselves isnt using the available resources very well. Both FEMA and the > > CDC have considerable expertise and resources that could be used in ways > > they have not been so far. > > > > Re The Prez: he would have been better served to stay out of the limelight > > on the whole thing. Committing hard to specific ideas when the state of > > knowledge is poorly developed is kind of like putting all your money on red > > 22: not likely to pay out. He made a lot of foolish statements that painted > > him into a corner. He doesnt have enough technical depth to comment and > > doesnt seem to appreciate how out of his depth he is. He should have relied > > more on the CDC people to lead the response, but they were pretty much > > muzzled. They would literally normally be telling everyone what to do, > > mobilizing considerable resources to facilitate testing and telling states > > what the test and trace policies and targets should be. Instead we have had > > the JK crew telling everyone that the states are on their own for stockpile > > and other resources and POTUS telling everyone the states are responsible > > for dealing with their own epidemics and lockdown policies. CDC has > > definitely been told to stand down or they would be out in front on all of > > it. FEMA would definitely be driving the stockpile distributions and > > policies, which should be transparent and non punitive. Basically this was > > a big political opportunity for DT to let the machinery work and then > > declare victory. Instead the epidemic is poorly controlled, dragging on > > into election season, the economic impact is dragging on longer than it > > should, and there is a high chance it will all get worse again. There is a > > strong chance we will end up doing the usual public health test and trace > > interventions anyway. > > > > The lockdown was super draconian and largely unprecedented. It was never > > going to be a workable long term strategy. The best thing for the economy > > would have been to tell the nation that everyone needs to do their part to > > fight this thing, train up contact tracing teams, ramp up testing on a > > national level with proven tests and defined targets for positivity rate, > > and push CDC people and federal stockpile resources into state and local > > health departments as needed to provide support. Instead, testing lagged > > behind tremendously for unclear reasons while the disease became more and > > more established and the lockdown dragged on with no clear national > > strategy or even any defined national goals for controlling the disease. > > E.g. Do we tolerate a certain infection rate, or try for zero? Work it > > through with the states until everyone has a set of goals they can live > > with. > > > > I think it is a mistake to look at this through a political lens primarily. > > The virus doesnt care. The two sides in this are pro human and pro virus. > > Yes the talking heads will try to score political points but trying to say > > the CDC or doctors or hospitals acting deliberately to achieve political or > > financial goals first ignores the reality which is that even though > > everyone has political views, most of us don't talk about them at work. We > > put that crap aside and do our jobs. Public health professionals, doctors, > > hospitals etc. just want the disease to go away as much as possible. It has > > been a huge pain in our asses and in our pocketbooks. > > > > For now, wear a surgical mask when near other people if you can get them. > > Try to limit indoor exposure to large groups of people unless there is > > really good crossflow ventilation. We all take some personal risks in terms > > of who we alllow inside our bubbles of exposure, but this should be > > deliberate. Social interactions and larger group functions should be > > outdoors as much as possible. Thankfully young kids do not seem to pass the > > virus to adults very often, so granfkids seeing grandparents is less of an > > issue than grandparents seeing their adult kids (adults should all mask up > > during visits.) > > > > Tbe surgical masks of spun polypropylene carry electrostatic charges and > > are more comfortable to wear if you can get them fyi. Cloth is betterr than > > nothing however. Airliners have ventilation systems that mix the air; > > fixing it requires redesign of aircraft. Everyone should be wearing masks > > on those planes. We are not flying commercial any time soon. > > > > All this is meant to be a response to Scott's questions. We are driving to > > the midwest in later this summer and I think we are going to camp the whole > > way up and back. We will sleep downstairs at my folks place. Life goes on. > > Hospital is quieter but we are all half expecting another uptick in cases. > > We are at about half of what we were at peak in terms of numbers in the > > hospital. 15% of people who are intubated die. Some studies going on e.g. > > use of estrogen that will be interesting to follow. > > > > > > > > > > On Sun, Jun 14, 2020, 7:37 AM Meade Dillon via Mercedes < > > mercedes@okiebenz.com> wrote: > > > > > Was FEMA activated for any of the past pandemics? What was different > > about > > > this pandemic that rated FEMA to be activated? > > > > > > The main issue that I see is that we relied on a terribly flawed model at > > > the start, and were operating without a clear understanding of the virus, > > > and then the media began stoking the fear, and in every way that the > > > President tried to lead, he was viciously attacked and resisted, called a > > > racist and mocked. > > > ------------- > > > Max > > > Charleston SC > > > > > > > > > On Sun, Jun 14, 2020 at 9:28 AM Dan Penoff via Mercedes < > > > mercedes@okiebenz.com> wrote: > > > > > > > I can’t speak for Karl, but from what I’ve seen the places that were > > the > > > > least affected were those that were aggressive about testing and > > contact > > > > tracing as soon as things started. We may not be able to cure this > > > > currently, but if we can accurately track the infections and those > > > exposed > > > > to it, we could control the spread far better than we currently have. > > > > > > > > FEMA has mobilization protocols for events such as this and they even > > > > practice for it, but they weren’t mobilized nor involved for the most > > > part, > > > > other than being directed to intercept or impound supplies for states > > and > > > > private entities for Federal use. FEMA also has very close coordination > > > > with state, local and tribal government entities that allows them to > > > > mobilize on short notice and with clearly defined framework and > > protocols > > > > for a response to the event. > > > > > > > > Look up: > > > > > > > > NDMS (National Disaster Medical System) > > > > NRCC (National Response Coordination Center) > > > > DMAT (Disaster Medical Assistance Teams) > > > > > > > > I work with and have been trained as a part of my job to interact and > > > > respond with FEMA for such events, so I’m very familiar with what could > > > be > > > > done and how it would be managed. No one ever gave the order or > > provided > > > > direction. This is the direct responsibility of the office of the > > > President > > > > to DHS, under which FEMA acts. Period. > > > > > > > > -D > > > > > > > > > > > > > On Jun 14, 2020, at 2:14 AM, Scott Ritchey via Mercedes < > > > > mercedes@okiebenz.com> wrote: > > > > > > > > > > Karl, Your comments stimulate many questions in my mind. > > > > > As individuals. What should we be doing that we are not doing > > > > (behavior, supplements, etc)? > > > > > Specifically what National leadership do you mean (CDC, POTUS, > > > > legislators)? > > > > > Does National leadership have jurisdiction or do state/local > > > > authorities have jurisdiction? > > > > > ...What has National leadership failed to do? > > > > > Is contact tracing really viable (considering the virus was > > > widespread > > > > before we knew it was here)? > > > > > Why were/are we (the US) so slow with tests, treatments, etc. > > > > > How does this all end? Do we all get it eventually? Does it die > > > out? > > > > > What are we proles to make of the flip-flop guidance from the > > experts > > > > (masks, isolate indoors, etc.)? > > > > > Who can we believe? So much seems politically driven, even medical > > > > "experts". > > > > > I'm an 70+ year old asthmatic and SWMBO is in her 80s with heart > > > > issues so we are hermits, mostly. > > > > > Thanks for any insights, > > > > > Scott (a skeptic) > > > > > > > > > >> -----Original Message----- > > > > >> From: Karl Wittnebel via Mercedes > > > > >> > > > > >> It isnt really a balance. The shut down was just to buy time, and it > > > > worked, but > > > > >> at tremendous cost. The basics of mask wearing, testing and contact > > > > tracing to > > > > >> isolate and quarantine positives and their contacts involve > > relatively > > > > minimal > > > > >> cost, and no threat to civil liberties. And this works. Iceland > > never > > > > shut down at > > > > >> all. They just tested lots of people from the first reported case > > > > onward, and > > > > >> had a team of 50 people testing and tracing the contacts and telling > > > > them to > > > > >> stay home for two weeks. They have close to zero daily new cases. > > That > > > > is all > > > > >> we need to do nationally, but everybody is too busy whining to get > > on > > > > board > > > > >> and there is no real leadership at the national level. > > > > >> > > > > >> > > > > >> On Sat, Jun 13, 2020, 9:08 AM Floyd Thursby via Mercedes < > > > > >> mercedes@okiebenz.com> wrote: > > > > >> > > > > >>> The balance that is the main challenge is how to maintain an > > economy, > > > > >>> allow personal rights, and mitigate disease spread. Everyone has > > the > > > > >>> answer depending on various orientations but none of them seem to > > > > >>> strike the balance effectively. I have just kinda decided to go > > > about > > > > >>> life, take some precautions, but recognizing sooner or later > > getting > > > > >>> infected is a high probability no matter what. A vaccine is a long > > > > >>> time away, if it would even be effective > > > > >>> > > > > >>> --FT > > > > >>> > > > > >>> On 6/13/20 11:58 AM, OK Don via Mercedes wrote: > > > > >>>> Our numbers are still rising in this part of the country. With > > > > >>>> little to > > > > >>> no > > > > >>>> testing we will probably never know the full extent of the > > disease. > > > > >>>> > > > > >>>> On Fri, Jun 12, 2020 at 9:47 PM Curt Raymond via Mercedes < > > > > >>>> mercedes@okiebenz.com> wrote: > > > > >>>> > > > > >>>>> Still pretty hard to really prove that data isn't it? 100,000+ > > > > >>>>> deaths > > > > >>> in > > > > >>>>> the US in 4 months is 3x+ what the flu would get over twice that > > > > period. > > > > >>>>> It'll take a long time before we antibody test enough people to > > > > >>>>> really prove those numbers. > > > > >>>>> Based on how the US numbers continue to inch down I'm thinking > > that > > > > >>> having > > > > >>>>> a bad "early" COVID season might be a good thing for our later > > > > results. > > > > >>>>> Brazil's numbers are terrible and rising and thats after having > > > > >>>>> very low numbers in the initial 4 months. > > > > >>>>> -Curt > > > > >>>>> > > > > >>>>> On Friday, June 12, 2020, 4:20:37 PM EDT, Max Dillon via > > > > >>>>> Mercedes < mercedes@okiebenz.com> wrote: > > > > >>>>> > > > > >>>>> https://swprs.org/a-swiss-doctor-on-covid-19/#latest > > > > >>>>> > > > > >>>>> 1. According to the latest immunological and serological studies, > > > > >>>>> the overall lethality of Covid-19 (IFR) is about 0.1%[ > > > > >>>>> https://swprs.org/studies-on-covid-19-lethality/] and thus in > > the > > > > >>>>> range of a strong seasonal influenza[ > > > > >>>>> https://www.ebm-netzwerk.de/en/publications/covid-19] (flu). > > > > >>>>> > > > > >>>>> 2. Even in global “hotspots”, the risk of death for the general > > > > >>> population > > > > >>>>> of school and working age is typically in the range of a daily > > car > > > > >>>>> ride > > > > >>> to > > > > >>>>> > > > > >> work[https://www.medrxiv.org/content/10.1101/2020.04.05.20054361v1 > > ]. > > > > >>> The > > > > >>>>> risk was initially overestimated because many people with only > > mild > > > > >>>>> or > > > > >>> no > > > > >>>>> symptoms were not taken into account. > > > > >>>>> > > > > >>>>> Max Dillon > > > > >>>>> Charleston SC > > > > >>>>> > > > > >>>>> > > > > >>>>> _______________________________________ > > > > >>>>> http://www.okiebenz.com > > > > >>>>> > > > > >>>>> To search list archives http://www.okiebenz.com/archive/ > > > > >>>>> > > > > >>>>> To Unsubscribe or change delivery options go to: > > > > >>>>> http://mail.okiebenz.com/mailman/listinfo/mercedes_okiebenz.com > > > > >>>>> > > > > >>>>> > > > > >>>>> _______________________________________ > > > > >>>>> http://www.okiebenz.com > > > > >>>>> > > > > >>>>> To search list archives http://www.okiebenz.com/archive/ > > > > >>>>> > > > > >>>>> To Unsubscribe or change delivery options go to: > > > > >>>>> http://mail.okiebenz.com/mailman/listinfo/mercedes_okiebenz.com > > > > >>>>> > > > > >>>>> > > > > >>> -- > > > > >>> --FT > > > > >>> > > > > >>> > > > > >>> _______________________________________ > > > > >>> http://www.okiebenz.com > > > > >>> > > > > >>> To search list archives http://www.okiebenz.com/archive/ > > > > >>> > > > > >>> To Unsubscribe or change delivery options go to: > > > > >>> http://mail.okiebenz.com/mailman/listinfo/mercedes_okiebenz.com > > > > >>> > > > > >>> > > > > >> _______________________________________ > > > > >> http://www.okiebenz.com > > > > >> > > > > >> To search list archives http://www.okiebenz.com/archive/ > > > > >> > > > > >> To Unsubscribe or change delivery options go to: > > > > >> http://mail.okiebenz.com/mailman/listinfo/mercedes_okiebenz.com > > > > > > > > > > > > > > > > > > > > _______________________________________ > > > > > http://www.okiebenz.com > > > > > > > > > > To search list archives http://www.okiebenz.com/archive/ > > > > > > > > > > To Unsubscribe or change delivery options go to: > > > > > http://mail.okiebenz.com/mailman/listinfo/mercedes_okiebenz.com > > > > > > > > > > > > > > > > > _______________________________________ > > > > http://www.okiebenz.com > > > > > > > > To search list archives http://www.okiebenz.com/archive/ > > > > > > > > To Unsubscribe or change delivery options go to: > > > > http://mail.okiebenz.com/mailman/listinfo/mercedes_okiebenz.com > > > > > > > > > > > _______________________________________ > > > http://www.okiebenz.com > > > > > > To search list archives http://www.okiebenz.com/archive/ > > > > > > To Unsubscribe or change delivery options go to: > > > http://mail.okiebenz.com/mailman/listinfo/mercedes_okiebenz.com > > > > > > > > _______________________________________ > > http://www.okiebenz.com > > > > To search list archives http://www.okiebenz.com/archive/ > > > > To Unsubscribe or change delivery options go to: > > http://mail.okiebenz.com/mailman/listinfo/mercedes_okiebenz.com > > > > > > -- > OK Don > > "Whenever you find yourself on the side of the majority, it is time to > pause and reflect." Mark Twain > > “Basic research is what I’m doing when I don’t know what I am doing.” Wernher > Von Braun > 2013 F150, 18 mpg > 2017 Subaru Legacy, 30 mpg > 1957 C182A, 12 mpg - but at 150 mph! > _______________________________________ > http://www.okiebenz.com > > To search list archives http://www.okiebenz.com/archive/ > > To Unsubscribe or change delivery options go to: > http://mail.okiebenz.com/mailman/listinfo/mercedes_okiebenz.com > -- arche...@embarqmail.com <arche...@embarqmail.com> _______________________________________ http://www.okiebenz.com To search list archives http://www.okiebenz.com/archive/ To Unsubscribe or change delivery options go to: http://mail.okiebenz.com/mailman/listinfo/mercedes_okiebenz.com
