The Official Coronavirus Discussion

[DLW]

Can you show me where you've seen the titer analysis? I wasn't aware that there was a uniform presentation of viral load with disease progression? Also, I don't think that viral titer has been meaningfully associated with severity of pathogenesis? Remdesivir is an interesting case. It's been tried with almost all recent viral outbreaks after showing promise in the lab / animal trials (practical application hasn't worked so well). The results so far with compassionate administration and the case/control study do indicate that there's some level of treatment efficacy. It's rather modest and far from anything that can be considered a gold standard treatment, though, so I think there's still much more that needs to be developed. I haven't heard much regarding successful prophylaxis treatments?

I think we're on the same page with everything else you wrote, so I'll limit my response to this paragraph. Both viral titer decline and correlation with disease severity have been reported in the literature. Here are a few examples that I quickly found. There are other studies out there I'm sure, too....
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30232-2/fulltext
https://www.atsjournals.org/doi/pdf/10.1164/rccm.202003-0524LE

Remdesivir is not the "Lazarus Treatment" people are hoping for, but it's definitely encouraging. The thing that I find most exciting about Remdesivir is that it was the first randomized, placebo controlled clinical trial to be completed for COVID-19, and it showed significant benefit. 30% reduction in time to recovery. 1000+ patients. Multicenter study. That's an accomplishment.

I know of at least 2 post-exposure prophylaxis studies involving hydroxychloroquine. Based on the putative mechanism of HCQ from model testing (interfere with viral entry), it seems more likely to have benefit as a prophylaxis than as a treatment for hospitalized COVID-19 patients. I'm not going to hide the fact that I think Trump is dangerously incompetent, and Trump pushing HCQ was reckless. However, all the shitty observational or retrospective HCQ studies that the media has latched onto are nearly as damaging to the credibility of science and public health. It will be great to see how HCQ performs in a legitimate trial.

[alanp]

But, the world doesn't operate according to public health programming. Economics and politics run the show. The demands of those are what is motivating us to relax the current guidelines and policies. The most likely result from doing this, though, is that all of the efforts thus far will have just put us in a limbo of sustained incidence that will give way to a larger spike. At that point, we will have to do the whole exercise over again. Countries with large case incidence that put much stronger interventions in place saw greater reduction. When the extreme measures were relaxed, they still kept basic distancing practices in place.

This. This, this, this. It all comes back to the same old problem -- who is going to pay for this?

If everyone is staying home under government lockdown (and that's another issue for some people -- when the government gets power, it almost never relinquishes it), then they aren't earning money, and are therefore not paying taxes into the gov't coffers, which in turn means, given the width and breadth of the lockdown, that the budget is going steeply red.

Describing lifting the lockdown as "economy vs lives" is too simplistic. It's "lives vs lives".

Let's say that we keep all food production workers going, so that people don't starve to death. How are their products going to be bought? With gov't stimulus checks? What happens when inflation due to rampant money-printing means that, given enough time, the value of the dollar has crashed? The government nationalizes the food market entirely?

I... think it was quantum physics, but I like a quote I heard once... "For every complex, hard to answer problem, there is an answer that is simple, straightforward, and wrong."

[DLW]

But, the world doesn't operate according to public health programming. Economics and politics run the show. The demands of those are what is motivating us to relax the current guidelines and policies. The most likely result from doing this, though, is that all of the efforts thus far will have just put us in a limbo of sustained incidence that will give way to a larger spike. At that point, we will have to do the whole exercise over again. Countries with large case incidence that put much stronger interventions in place saw greater reduction. When the extreme measures were relaxed, they still kept basic distancing practices in place.

This. This, this, this. It all comes back to the same old problem -- who is going to pay for this?

If everyone is staying home under government lockdown (and that's another issue for some people -- when the government gets power, it almost never relinquishes it), then they aren't earning money, and are therefore not paying taxes into the gov't coffers, which in turn means, given the width and breadth of the lockdown, that the budget is going steeply red.

Describing lifting the lockdown as "economy vs lives" is too simplistic. It's "lives vs lives".

Let's say that we keep all food production workers going, so that people don't starve to death. How are their products going to be bought? With gov't stimulus checks? What happens when inflation due to rampant money-printing means that, given enough time, the value of the dollar has crashed? The government nationalizes the food market entirely?

I... think it was quantum physics, but I like a quote I heard once... "For every complex, hard to answer problem, there is an answer that is simple, straightforward, and wrong."

Agreed. There are no easy solutions here and certainly no solution that pleases everyone. The economy will open, but slowly. Public health tracing/interventions and experimental therapies will do their best to fill the gap until herd immunity/vaccines arise. In the meantime, the virus will ebb and flow (or spike and drop), and an uncomfortable amount of people will die. Even those that are fortunate enough to not have their health affected by COVID-19 will be impacted financially.

Maybe the best way to look at this is by acknowledging the unprecedented stretch of health and economic prosperity we've had for the last 50+ years.  Be thankful for it and recognize that we have work to do to get it back on track.
*NOTE: I'm not saying that everyone's life is equally great. I'm saying that regardless of what segment of society you would've been part of >50 years ago, life is almost certainly better today in that same segment of society.

[matmosphere]

I don't know that this is hurting everyone the way a turndown caused by a weak economy does. This seems focused on low income workers. Only one person that I personally know has been laid off. Maybe I just have lucky friends, but most people are working from home, many say they are working a lot more than usual at the moment. I'm hoping that this means the middle class stays pretty strong during all of this, which will help come out of it a little more gracefully, but who knows.

Maybe the best way to look at this is by acknowledging the unprecedented stretch of health and economic prosperity we've had for the last 50+ years.  Be thankful for it and recognize that we have work to do to get it back on track.
*NOTE: I'm not saying that everyone's life is equally great. I'm saying that regardless of what segment of society you would've been part of >50 years ago, life is almost certainly better today in that same segment of society.

I don't know that this if 100% true. The changes in the distribution of wealth over that period would suggest otherwise, or at the very least the gains we have experienced have been heavily weighted towards the top earners.

[DLW]

Maybe the best way to look at this is by acknowledging the unprecedented stretch of health and economic prosperity we've had for the last 50+ years.  Be thankful for it and recognize that we have work to do to get it back on track.
*NOTE: I'm not saying that everyone's life is equally great. I'm saying that regardless of what segment of society you would've been part of >50 years ago, life is almost certainly better today in that same segment of society.

I don't know that this if 100% true. The changes in the distribution of wealth over that period would suggest otherwise, or at the very least the gains we have experienced have been heavily weighted towards the top earners.

Generalizations are never 100% true I don't disagree that income inequality has grown, but that doesn't necessarily mean peoples lives have gotten worse over the last 50 years. Could it be better for low and middle income earners? Of course. My point is that if you view life now from a historic perspective, it is (in general) prosperous and healthy.

It's perfectly natural to demand more. I get that. That's how progress happens. However, people can't expect progress without also accepting setbacks. I think now is the time that we should acknowledge life had been pretty good for a while, is not as good now, and there is adversity that needs to be dealt with. That means compromising between two impossible situations- strangle the economy or mass death. As others have eloquently pointed out, this is a political issue now. The scientists, ethicists, and economists have voiced their concerns. Hopefully, politicians heed that advice and make the best decision for their constituents. I'm much less bullish on that last point than I am on the issue of CoV-2 immunity. Haha!

[Govmnt_Lacky]

*NOTE: I'm not saying that everyone's life is equally great. I'm saying that regardless of what segment of society you would've been part of >50 years ago, life is almost certainly better today in that same segment of society.

I would have to disagree with this.

Look at life 50 years ago. A single-earning family could purchase a reasonable home, afford a car, vacation, raise a family, create a savings, and afford to send their child to the college of their choice.

Today... even dual-income households cannot afford most of that without living paycheck to paycheck.

[madbean]

Wife's company just laid off 10% of staff due to the downturn. She still has a job for now.

[matmosphere]

Wife's company just laid off 10% of staff due to the downturn. She still has a job for now.

That's scary, hope things stabilize a little at her work.

When I posted earlier I was thinking about asking what kind of impact others are seeing. There's always a chance the people I know have just been lucky so far.

[DLW]

*NOTE: I'm not saying that everyone's life is equally great. I'm saying that regardless of what segment of society you would've been part of >50 years ago, life is almost certainly better today in that same segment of society.

I would have to disagree with this.

Look at life 50 years ago. A single-earning family could purchase a reasonable home, afford a car, vacation, raise a family, create a savings, and afford to send their child to the college of their choice.

Today... even dual-income households cannot afford most of that without living paycheck to paycheck.

I agree with most of that statement. The college statement is factually incorrect, though. 8-14% of people had a college education in 1970 compared to >35% today. Although owning a car and a house are important, I think there is more to having a good life than that. I'll use the US as an example, because stats are easy to find and I'm familiar with the country. (a) The US has added +10 years to life expectancy since 1950. That's insane. (b) Virtually 100% of our society is literate. (c) High school and college diplomas have been a continuous upward slope for 100+ years. (d) We have more access to information via the internet than could have even been imagined 25 years ago. I'm a scientist. If I had to go to the library and dig through journals for info, it would drain all my enthusiasm for science. (e) Infant mortality has gone for 2.5% to nearly zero....There are hundreds of examples of how life has improved over the past 50+ years.

https://www.statista.com/statistics/184272/educational-attainment-of-college-diploma-or-higher-by-gender/
https://fred.stlouisfed.org/series/SPDYNIMRTINUSA
https://ourworldindata.org/life-expectancy

[Govmnt_Lacky]

I agree with most of that statement. The college statement is factually incorrect, though. 8-14% of people had a college education in 1970 compared to >35% today. Although owning a car and a house are important, I think there is more to having a good life than that.

Since this was on-point with the statement that I made, I will address this.

Although more people are college educated now than they were years ago, one has to look at the point I was making about affordability. Sure... a lot more people are college educated. How many of those "more people" are being crushed by student loan debt that was absent years ago?

And, of course home and car ownership are not the most important factors in life however, my point was that living "life" in general is much harder to afford today than it was years ago. Even taking inflation into account, there is almost no comparison to what a single income household can afford today compared to years ago.

[Bio77]

Wife's company just laid off 10% of staff due to the downturn. She still has a job for now.

I hope everything works out for her.  It might ease your mind a bit to look at the unemployment insurance rates in your state.  I got furloughed at the start of the stay at home order in CA.  Lasted a month before my company got a PPP loan.  First time I've ever filed for unemployment, so, I was worried and scared.  It ended up not being much of a hit to my family.  With the extra money the feds are paying on top of the regular state payment coupled with the natural reduced spending of being home most of the time, we got by. 

[dan.schumaker]

Wife's company just laid off 10% of staff due to the downturn. She still has a job for now.

I hope everything works out for her.  It might ease your mind a bit to look at the unemployment insurance rates in your state.  I got furloughed at the start of the stay at home order in CA.  Lasted a month before my company got a PPP loan.  First time I've ever filed for unemployment, so, I was worried and scared.  It ended up not being much of a hit to my family.  With the extra money the feds are paying on top of the regular state payment coupled with the natural reduced spending of being home most of the time, we got by. 

My company is talking about imminent permanent layoffs as well ("rightsizing" is the BS term they are using).  After being on the losing end in the 2008 layoff madness, I am still very much on edge about this one, hoping I don't end up on the same side of that line.  So hopefully in a few weeks I will still have a job, but we will see I guess...

[gordo]

Right there with you.  All of the small business owners I know, even the "rich" ones, applied for SB loans, were accepted, and then told that there was "no more money".  Then they read that business' like Ruth Chris Steakhouse got $30M.  Even as drastic as this situation is, the truth is that it's big business taking care of big business.  I'm still working, thankfully.  Got laid off after the last downturn, and I can't help but feel that this is a "feeler" for how tight business' on the upside of this can go.  Push the workers as hard as you can and see if the profits are still reasonable.

Welcome to corporate America I guess.

[pickdropper]

I agree with most of that statement. The college statement is factually incorrect, though. 8-14% of people had a college education in 1970 compared to >35% today. Although owning a car and a house are important, I think there is more to having a good life than that.

Since this was on-point with the statement that I made, I will address this.

Although more people are college educated now than they were years ago, one has to look at the point I was making about affordability. Sure... a lot more people are college educated. How many of those "more people" are being crushed by student loan debt that was absent years ago?

And, of course home and car ownership are not the most important factors in life however, my point was that living "life" in general is much harder to afford today than it was years ago. Even taking inflation into account, there is almost no comparison to what a single income household can afford today compared to years ago.

There's been a lot of research on the stagnancy of middle class salaries and the growing inequality of wealth.  I agree with quite a bit of what you've posted.  It is real and a considerable problem. 

But there is also the conspicuous consumerism that leads many households to have a car for every driver, a TV set for every room and often a house that is much larger than what they would've purchased in the 50's.  I am not excluding myself from this in any way, just noting that an increase in spending habits coupled with a decrease in middle class income is a bad combination.

Plus, for a while, folks adjusted to greater buying power from cheap imported goods but still retained relatively high salaries.  Ultimately, in the US, we want to have our cake and eat it too. 

There are quite a few reasons why things are shifting for the middle class.  Certainly the things discussed so far only begin to scratch the surface.  Dan's post about corporate layoffs is yet another frustration about the shift in the relationship between employers and employees.

[pickdropper]

Wife's company just laid off 10% of staff due to the downturn. She still has a job for now.

That's terrible.  Did they furlough or outright dismiss?