The caption of this post will come as no surprise to those of you who’ve been following my many posts about the long-term situation here in Illinois but in this particular case the disaster is COVID-19 and President Trump has declared the state a disaster area, making federal funds available to the state. ABC 7 Chicago reports:
CHICAGO (WLS) — President Donald Trump has approved Illinois’ request for a federal disaster declaration, making federal funding available for COVID-19 recovery efforts.
President Trump declared a major disaster exists in the state on Thursday.
It makes federal funding available for state, tribal and eligible local governments as well as certain nonprofits in response to the coronavirus outbreak. It also makes federal funding available for crisis counseling for Illinois residents affected by the crisis.
The announcement comes as Illinois’ COVID-19 cases topped 2,000 on Thursday.
Illinois health officials announced 673 new cases and seven additional deaths, bringing the state’s total to 2,538 cases and 26 deaths.
Sen. Dick Durbin joined Gov. JB Pritzker and Illinois health officials Thursday to provide an update on the spread of COVID-19 across the state.
I think that Gov. Pritzker owes us an explanation of the criteria he will use in lifting the directives he’s imposed and how he will know whether they are working or not. I suspect that there are no criteria for lifting the directives. The question that needs to be considered is what if the threat is with us forever?
72 hours turnaround on tests current average. If you want a test you can have one, but the results take so long to come back they are almost useless.
While I am not in the kill granny group like the conservatives here, I am all too aware that what we are doing could fail. We may reach the point where we say we cant control it so we just let people die. However, we just arent there yet. What we are doing looks like it can work. We are early in the efforts at looking for therapeutic drugs that work. I am actually kind of ashamed of people who just want to give up already. I am surrounded by wonderful people who are volunteering to work outside their specialties, work extra hours in places they don’t usually work, work with patients who have a contagious disease that if they take it home could harm their family. Then I read people who just want to stop and give up. It really is a different country than when I grew up.
Steve
Italy’s numbers at link.
https://talkingpointsmemo.com/edblog/this-is-very-important-from-italy-please-read
One of the issues this authors describes well is that people are likely dying because the hospitals and staff are all taking care of Covid patients. That 57 y/o who comes in with an MI and likely does pretty well under normal conditions wont live now since care is not available. What is notable is that death rates are way up.
Steve
I spoke with a colleague in Mexico City this morning. Mexico is not really taking any particular counter-measures at this point and it’s making some Mexicans, at least, nervous. Maybe they’re expecting their climate to spare them.
I guess that depends on your assumptions and your operative definition of “work”. I assume that COVID-19 will become endemic at least on a seasonal basis here and that it will take a long time to develop a vaccine (if ever). My definition of “work” is that we will be able to end the lockdowns within a couple of weeks.
To take the extreme case, a 30 year lockdown would not work even if it worked mathematically. It would be jumping off a 500 ft. cliff to avoid being hit by a car.
If you think works means two weeks, I don’t see that happening. I am just hoping we keep fatalities below 300k and get outbreaks to manageable levels.
Steve
If we remain shutdown for months, we will have graver worries than an overloaded health care system.
I think you’re confusing goals. My understanding of the goal of “bending the curve” is to avoid overloading the health care system by spreading the COVID-19 cases and deaths out over a period long enough. That doesn’t reduce the number of deaths. It just spreads them out. It reduces the collateral damage due to overloading the system but increases the damage to the economy, blighting lives along the way. Millions will be out of work, some permanently. Savings will be wiped out. People will, in fact, die—from suicide, malnutrition, exposure from living on the streets, diseases of poverty, etc.
Hereabouts we’ve already been locked down for two weeks (officially for one week but many people including me had been working from home before that). Let’s say six more weeks—two months in all. Can the curve be bent enough to avoid overloading the system in that period?
If making the plan work requires 100% compliance, offhand I’d say we need another plan.
Can we agree that if we lock down the entire country for a year that when the lockdown ends there won’t be much of an economy left? Assume that 10% of the population will contract COVID-19 over time and that 1% of those who contract it will die (330 million X 10% X 1% = 330,000). Over what period does that many sick people need to be distributed to avoid overloading the system?
Capacity wont be static in that period. I expect we see more PPE gear, more vents, etc. I think ICU capacity has big increases. Assume we bend this curve. Assume we do get a seasonal assist. In the fall we can cope with a surge with minimal and hopefully targeted lockdowns if we have adequate testing. If we don’t then maybe we put the old, sick, transplanted etc onto their reservations and hope for the best, a vaccine and a cure.
Steve
Killing granny is just cheap, irresponsible characterization, steve.
The notion is that mass quarantine will not be effective and will not protect granny in the end. Rather, targeted quarantine, by geography or perceived vulnerability, is the best we can do to save lives until a rather significant increase in medical resources can be achieved.
Countries with the best results seem to be following a targeted approach.
Of course, funding for planned parenthood, green energy or airplane emissions controls is a surefire way to save granny.
“Countries with the best results seem to be following a targeted approach.”
Which countries are those? China and S Korea took the broad approach.
“Killing granny is just cheap, irresponsible characterization, steve.”
Maybe, but accurate. (Coming from the guy who loves taking these cheap shots you seem a bit sensitive.)
If I had my own blog I would probably write a longish post about how the world changes and how we manage our lives if this becomes endemic and we don’t have a vaccine. I think it will totally change medical practice, but that is just one area of our lives.
Steve
(Putting off writing new protocol for a minute while waiting for phone call) I have always held off on calling Trump a moron. He is obviously knowledgeable about real estate, reality TV (make fun of it but there is lot of money there) and starting up fake universities to scam people, but no real evidence he is a moron. After listening to the bit with him telling Hannity that a major hospital would have only 2 ventilators? Ok, the guy is fuc%ing moron, not just a moron. The problem is that people actually believe him. So now the true believers are going to believe that no hospital actually needs more ventilators or extra stuff.
Steve
I don’t think he’s a moron. I think he’s poorly informed, incurious, and overly sure of his own opinions. You fight a pandemic with the president you have not the president you might want.
I don’t believe in the “Great Man” theory of history or, more precisely, I think that truly great men are much rarer, particularly in the United States. I don’t think that without FDR we wouldn’t have won World War II. I like to think that in World War II any president would have been Roosevelt.
Napoleon was a great man. American presidents? Not so much.
Funny you should mention that. I’m working on just such a post.
WRT the practice of medicine, I think there’s a fundamental tension between mass distribution of health care and artisanal production of health care. What I suspect will materialize is all sorts of people you wouldn’t expect monitoring people with COVID-19 in makeshift ICUs while physicians, PAs, and nurses act as supervisors. We’ll be producing masks in the billions and ventilators in the millions faster than you might suspect. People will be the bottleneck.
“I think he’s poorly informed, incurious, and overly sure of his own opinions.”
Sorry Dave. If you don’t know what you are talking about, make strong misleading statements based upon that ignorance and certainty you are always correct, you are a moron. A bad one. Maybe just some semantics going on here, but there is a time to tolerate stupidity and time to not do so. Understand the case that we just try to put with him as he is all we get, but in return we get to point out how harmful his behavior is for us.
Steve
I don’t find that productive. It may feel good but what does it accomplish? It is better to light a candle than to curse the darkness.
Modern-day historians who refuse to believe in the ‘Great Man’ theory of history are generally Marxists who believe in the inevitable ‘Arc of History’ theory, with far less evidence for their hypothesis. Were there no Alexander the Great, who knows how long the Persian Empire would have continued and how Rome would have expanded in the Mediterranean. No Temujin, and the history of the Middle East, the Russias, and Europe would have been radically different. No Ottoman Empire, no Duchy of Muscovy, and most importantly, no Black Death. One of Napoleon’s huge contributions to history was the injection of ethnic nationalism into the traditionally dynastic states of Europe, which led to the consolidation of Germany and Italy and was followed by the Great Wars of the 20th century and their bastard offspring Communism.
Great Men are the historical equivalents of additional Giant Meteors to the ones the Earth and the Universe already fling at us via plate tectonics, solar variability, and extraterrestrial bolides. Civilization (and Ecology) tend to settle into stasis, they don’t change significantly unless they’re forced to by events beyond their control. IMO the only significant arc of history are the ones over McD’s.
I’m not a Whig, either. I don’t believe that the arc of the universe bends toward justice.
Alexander and Napoleon great men who altered the course of history? Yes. Mohammed? Sure. FDR? No. Eisenhower? No. Either there are a lot fewer “great men” than the theory would require or there are many, many more of them. At 7 billion great men, does the theory make any sense?
I think that people respond to incentives and act in response to events.
I do believe in the “great man” theory, but doubt that any but a few of them would be considered “sane” by normal standards. They find the conviction to act when every choice brings ruin to thousands, and inaction may be worse.
Japan. And they didn’t test the hell out of everyone like accountants. They have fewer vents per million than anyone.
And Italy, NYC, New Orleans and so forth are the poster children for failure of the mass quarantine approach. Non-compliance. The achillese heel of the strategy.
“Sweeping statewide quarantine orders may not have been the most effective strategy to combat the coronavirus, Gov. Andrew Cuomo conceded on Thursday, as he weighed plans to restart the economy.
“We closed everything down. That was our public health strategy,†said Cuomo during an Albany press briefing. “If you re-thought that or had time to analyze that public health strategy, I don’t know that you would say ‘Quarantine everyone.’â€
It’s the third day in a row that Cuomo has publicly mused about quarantines and how best to eventually restart the Empire State’s shattered economy. …
“I don’t even know that that was the best public health policy. Young people then quarantined with older people, [it] was probably not the best public health strategy,†he said. “The younger people could have been exposing the older people to an infection.†”
Andrew Cuomo
Steve needs to send him his medical journals……..
One of the big differences between us. You are comfortable going to Trump for guidance on medical and public health issues. I cant think of any politician to whom I would turn to for advice and expertise. Cuomo is entitled to his own opinion, but I don’t really give a sh&t what he thinks. (That said, it is kind of refreshing to hear a politician admitting that he might have been wrong. Nice compared with “everything we are doing is perfect, beautiful, wonderful.”)
Steve
“Japan. And they didn’t test the hell out of everyone like accountants. They have fewer vents per million than anyone.”
You realize that there are now major concerns about Japan and their numbers? Also, it is a culture where people already wore masks whenever they got sick. Current CDC recommendation is that if you are Covid positive it is OK to go to work if you are asymptomatic and wear a mask. So, if there is any culture that might do OK, Japan is one of them, and we still need to wait to see what happens.
“And Italy, NYC, New Orleans and so forth are the poster children for failure of the mass quarantine approach. Non-compliance. The achillese heel of the strategy.”
And lets see what happens in areas where compliance was better.
Steve