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We’re retreating to a new strategy on covid-19. Let’s call it what it is. (Harm Reduction)

This article describes and puts a name to the stage of the process the United States has haphazardly reached in our battle with Covid-19. Hopefully, we can be more focused moving forward!
The administration has yet to use these words, but it appears that we’re adopting a strategy that I recognize from other aspects of public health: harm reduction.

We’re no longer trying to eliminate the virus. Instead, we are accepting that Americans will have to live with it.
If that’s the case, then our efforts should pivot from justifying why reopening is a good idea to figuring out how best to reduce the harm it is certain to cause.
https://washingtonpost.com/opinions/2020/05/13/were-retreating-new-strategy-covid-19-lets-call-it-what-it-is/







Comments

  • Less than 100 Thousand people dead out of 340 MILLION. I don't how DT got sucked into it. Now we are rescuing the economy spending TRILLIONS of BORROWED money.
  • Howdy folks,

    That's putting spin on the reality of asking the poor and elderly to be heros and commit suicide for the economy. From our response, or lack thereof, we're still looking at the high side worst case scenario and next winter is going to look like the Dans macabre.

    Sorry.



    And so it goes

    Peace and Flatten the Curve

    Rono
  • Put a name on it, and people will be against that too.

    There will be covid parties soon enough.
  • Most of the column is clear and informative, but Dr. Wen starts out by collapsing steps (just as most everyone else has). "Have we formally retreated from a goal of containing covid-19 to one of harm reduction?"

    She goes on to explain that between containment and harm reduction comes slowing the progression of the virus (aka "flattening the curve"):
    Instead of individual-level containment, which would have had minimal effect on the economy, we had to employ societal-level lockdowns to slow the explosive spread of the virus and buy us time until we developed the capacity to rein it in.
    The opportunity for the US to contain the virus passed months ago. What most people call "mitigation" is what Dr. Wen is calling "slow the spread" and what Boris Johnson called "delay".

    IMHO this distinction between contain and delay is important because it goes far in explaining why the US needs so much more testing. South Korea is fairly low on the testing per capita scale today because it doesn't need massive testing. It did its testing when it could contain the virus. Context matters. So do crisp, clear words.

    "Mitigation" was a good word for "harm reduction". Johnson used it, and Merriam Webster defines it as: the process or result of making something less severe, dangerous, painful, harsh, or damaging.
  • edited May 2020
    While in England they maybe sacrifice sick ones for prosperity economic recovery because they think they will achieve Herd immunity due to antibody immunity testings. Who knows. We maybe sayings covid19 could be new annual flu and let them run their course few years from now [possibly with new treatment paradime approaches, vaccines and better medical responses]


    https://www.google.com/amp/s/amp.theguardian.com/science/2020/may/14/uk-minister-hails-game-changing-coronavirus-immunity-test


    https://www.yahoo.com/news/coronavirus-antibody-test-065939982.html
  • Less than 100 Thousand people dead out of 340 MILLION. I don't how DT got sucked into it. Now we are rescuing the economy spending TRILLIONS of BORROWED money.

    You do know we are mostly borrowing it from ourselves? Huge debt is problematic chiefly when we spend it on the wrong things, like wealth taxcuts, instead of infrastructure investment or, in this case, disaster relief.

    And it can be grown out of, never 'paid back'. Start w the first bullet point in this:

    https://nymag.com/intelligencer/2020/04/the-coronavirus-crisis-is-swelling-the-deficit-thats-fine.html

    and then study this:

    https://www.collaborativefund.com/blog/who-pays-for-this/
  • T Rowe Price Health Science (PRHSX) manager chimes in:

    The Fatality Rate Is Likely at or Below 1%

    The accumulating evidence on the virus’s fatality rate is more encouraging. Early reports from China suggested that the fatality rate was as high as 3%, but it is clear now that this figure reflected a skewed denominator because of the lack of testing. Indeed, in those rare settings where over 10% of the population has been tested, the fatality rate has proved to be as low as 0.5% or less.

    The most important implication is that the number of infected people is far higher than the number of reported cases, and as the number of fatalities continues to rise, so does the likely percentage of the population that has been infected. Nevertheless, the number of current fatalities suggests that only a small part of the population now has immunity as a result of past infection—meaning that we are still far from achieving herd immunity.1 Based on experience with past epidemics, at least 60% of a population needs to be infected to stop the virus without a vaccine or other interventions. Assuming a 0.5% fatality rate, this would imply about 1 million fatalities in the U.S. (330 million x 0.6 x 0.005) if steps such as social distancing were not taken and no treatments developed.
    https://troweprice.com/personal-investing/resources/insights/coronavirus-the-signals-to-watch.html
  • Do you think poor and old can afford the treatment unless someone else is paying for insurance - company, govt, medicare, medicaid etc. They are doomed. We can't save them/everyone, death is natural phenomena. If NY people are afraid to OPEN, they should leave NY and move to Wisconsin, Dakota's etc. With millions not having employer provide insurance, things will become pretty interesting.
  • @kings53man: Not all counties in WI. are open. Some have been shuttered by local government. I would think that those that chose this will be tested again in court.
    Stay Tuned, Derf
  • In my opinion, all businesses should be allowed to OPEN. If people are not comfortable, they will not go. That's end of the story.
  • Aside from the mortality statistics, the insidious nature of this virus is the resulting long-lasting damage it does to internal organs, even if you survive. I don't think enough has been published on this.
  • In my opinion, all businesses should be allowed to OPEN. If people are not comfortable, they will not go. That's end of the story.

    ha, if only it worked like that

    @Press, totally concur in this view
  • Militias are providing protest security so we are good.
  • edited May 2020
    I don't think anybody has a real handle on the numbers. All we know is what we know at the moment. Big duh there WABAC. But the rest is speculation driven by a gamut of motives and emotions. Big duh there too.

    But knowing what we do know. What would it look like if we had a case load similar to the average annual flu?
    The 10-year average of about 28,645,000 flu cases per year has a 1.6% hospitalization rate and a 0.13% mortality rate. Unfortunately, CV19 is currently 47 times more deadly at 6.1% with a 20% overall hospitalization rate. If there were 28,645,000 cases...

    Flu Hospitalizations CV19 Hospitalizations
    458,320 5,729,000

    Flu Deaths CV19 Deaths
    37,239 1,747,345
    Those numbers are certain to change of course.

    But given what we know about your chances of surviving if you're fat, diabetic, or have hypertension or heart disease, they wouldn't all be old people. Forty percent of Americans are fat. Ten percent have diabetes. High blood pressure is north of forty.



  • In my opinion, all businesses should be allowed to OPEN. If people are not comfortable, they will not go. That's end of the story.

    The problem with this lone rider plan is that otherwise healthy people can go to bars & restaurants, become infected and then go to grocery stores where the health compromised Have to go. And the healthy may turn out to be not quite so healthy & will end up in hospitals, utilizing resources, infecting hospital employees.

  • The purpose of wearing masks and social distancing is to protect yourself from catching the virus and protecting others from getting the virus from others who are possibly infected. People need to keep that in mind.

    Look at the restaurants in the south. The workers are wearing masks; customers are not wearing masks.

    It is unfortunate that it will take family member to become sick with the virus to change people's attitudes.
  • The purpose of wearing masks and social distancing is to protect yourself from catching the virus and protecting others from getting the virus from others who are possibly infected. People need to keep that in mind.
    @TheShadow, Wearing face mask is to suppress RO, the infection factor, of COVID-19 virus from 2-3 to less than 1.0. Data indicated over majority of carriers are asymptomatic and thus continue to infected others in close environment (less than 6' distance) and large gatherings such as churches, sport events, restaurants, schools, and etc. When everyone is wearing face covering the probability of catching the virus from the aerosol particles from the of asymptomatic carriers.

    Agree with @PRESSmUP that for those who recovered sustain long term and permanent damages to internal organs including lungs, heart, and some level of central nervous system. Chris Cusmo's x-ray of his lungs indicated considerable scar tissue formation comparing to the healthy lungs. There is some indication that a second infection can occur for those who recovered. More study is underway to ascertain the situation. For sure this virus is considerable more deadly than the seasonal flu. Herd immunity does not work in this case other than high infection and fatality rate.
  • beebee
    edited May 2020
    Interesting Visual of how masking impacts a virus spread (move slide to increase/decrease mask use):
    Interactive Agent-Based Model Visualization for COVID-19 Masking



  • Good discussion of how influenza and Covid deaths are counted. You have to use the same marker. Influenza deaths are usually calculated from "excess pneumonia/respiratory deaths" ( Actual deaths with positive flu swab much less) vs covid deaths in many states are only counted if positive.

    "From our analysis, we infer that either the CDC’s annual estimates substantially overstate the actual number of deaths caused by influenza or that the current number of COVID-19 counted deaths substantially understates the actual number of deaths caused by SARS-CoV-2, or both."

    Statements above that there are "only 60,000 deaths ( now 85,000) make it like the flu" miss key points

    1) All of these deaths have occurred in two months while influenza lasts months

    2) Never Never in recorded history have 1/3 to 1/2 of hospital beds anywhere been full of flu cases like has happened in NY CT or Massachusetts, nor has there ever been this many people on ventilators.

    While you can write off NYC because of the density public transpiration etc etc, Connecticut is suburban and even rural like much of the US but Covid has almost overwhelmed hospitals and everyone else

    If the US opens up without contact tracing and many more tests to isolate new cases you all look like CT MA and NY

  • I can tell you that my wife and I are certainly going to maintain isolation (voluntary house arrest) for quite a while yet- at least until we get a decent picture of how things go out in the real world.
  • edited May 2020
    maybe many folks should be more proactive take HQC same as POTUS, for preventative measures

    https://www.msn.com/en-us/health/medical/trump-says-hes-taking-malaria-drug-to-protect-against-virus/ar-BB14gGDF?ocid=spartandhp

    maybe take extra spoons of Lysol with it
  • beebee
    edited May 2020
    @sma3,
    Help me out here. I have a close friend who was laid off at St Francis Hospital in Hartford, CT. She is basically a hourly worker, but her impression was that the hospital has been "as quiet as a church mouse" and that the hospital could not afford to keep her on (employed).

    Your thoughts?

  • lots of smaller and non-covid hospitals have to do this; it's awful

    normal patient traffic is down to nearly zero, very quiet, yes, for all the normal things of the past,

    rightly or wrongly patient behaviors

    PCP practices too, and dentists, et alia

    why we need just a flood of disaster-relief moneys, and then another flood, and then another

    and beyond

    (debt is not to be fretted now; that part will work out fine in the future w growth)
  • edited May 2020
    Reminiscent of the '29 Great Depression... those with money controlled the government until Roosevelt. They wouldn't borrow and spend money under any circumstance.

    Well, maybe one circumstance... to pay for Bush's Mideast war that no one needed.

    Same group is in charge today. Vote Democratic- it's our only hope.
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