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CR: COVID-19 --Political Talk


Mrs Whiggins

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3 hours ago, Tuco said:

Small cities/towns are going to get ripped up too.  Currently, in Nebraska:

Adams County: 457 cases for a county of 61,000 people: (=7492 cases per Million)  And, the positive rate is almost 50% - 457 positives of 988 tests. 

Dawson County: 124 cases for a county of 23,600 people (=5254 cases per million). (124 positives of 310 tests)

By comparison, the national average is 2311 cases per million.  NY is 12,601 cases/mil, NJ 9,604 cases/mil.  

This shit is getting out to the smaller communities.  

 

 

I thought this was an interesting article about Covid and testing in rural Texas.  Unfortunately there are rural counties that don't even have a doctor full time.  Ours moves around like a Methodist circuit preacher.

Texas Tribune map of tests, cases and deaths by Texas counties.

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Is this rural community really Texas’ sickest county?

State data indicates that Donley County in the Panhandle has the highest coronavirus infection rate in Texas. But county Judge John Howard — also the only local doctor — believes that's because he's testing far more than other counties.

 

Coronavirus in Texas

As the coronavirus spreads across the state, The Texas Tribune is covering the most important health, economic and breaking developments that affect Texans, every day. Watch our Texas unemployment tracker, use our explainer on the coronavirus for essential information, and visit our map tracker for the number of cases, deaths and tests in Texas.

 MORE IN THIS SERIES 

It’s impossible to know for sure how the new coronavirus got to rural Donley County, but locals bet it took U.S. Route 287, like everything else.

The highway carries 14,000 cars through on a normal day, about four for each of the 3,387 people living in the perfectly rectangular county near the Oklahoma side of the Texas Panhandle. Drivers stop at the Allsup’s or Cornell’s Country Store as they blaze from Dallas toward Denver or back again.

When known coronavirus cases are mapped for each of Texas’ 254 counties, Donley County looks like a sickly glitch, an outlier: It was reporting nearly 7 cases for every 1,000 people as of Sunday. The state’s next-highest known rate of infection was under 5 per 1,000, also in a Panhandle county; in Dallas, that figure was less than 1 per 1,000.

But the statistical aberration may better reflect Texas’ limited coronavirus testing than Donley County’s poor health.

 

When it got there, the virus that has killed more than 100,000 people worldwide met with formidable opposition: a group of pastors now tending their flocks at a local drive-in theater; a one-family newspaper providing faster, more accurate information than the state health department; and a single local doctor, who also happens to serve as county judge, determined to protect his neighbors by testing as many as he can.

The way county Judge John Howard figures, this farming and ranching community 60 miles from the nearest hospital may actually be better off than some big cities and small towns with fewer confirmed cases. Well over 2% of Donley County residents have been tested; at most six-tenths of 1% of Texans have, although the state testing total includes some people who have been tested more than once. His coronavirus picture may be a grim one, but at least it’s clear.

“If I’m doing four times as many tests as they are for the state as a whole, I’m going to get more positives,” Howard said. “If I hadn’t done any tests, I wouldn’t have any positives. But as the only medical provider in the county, I decided early on that I wanted to know who has it.”

The first hints that Donley County would not be spared came in mid-March. As spring breakers made the long trek down from the Colorado mountains through the county seat, Clarendon, and its attractive rest stops, Roger Estlack, who runs the local newspaper, got a tip from his sister-in-law that the town’s few stores were being pillaged. Locals, used to recognizing their fellow shoppers, suspected the crowds emptying the shelves at their only grocery store came from out of town.

Life’s interruptions were just beginning. A local church postponed two fish fries; a drive-in theater delayed its opening. Perhaps most smarting, the Clarendon College Bulldogs had earned their first-ever spot in the National Junior College Athletic Association basketball finals, but the tournament was canceled before they could compete.

Howard watched warily as the outbreak spread across Europe. He knew early on he would need to test widely if he was to prevent the virus from spreading to aging neighbors it could kill. LabCorp, the private company Howard uses to run all his labs, initially gave him just five collection kits, and he administered the first on March 17.

A longtime Marine Corps flight surgeon, Howard moved to Donley County more than two decades ago to become the only doctor in town. He prefers rural medicine to big-city hospitals — it’s what he calls “high-touch versus high-tech.” In 2014, his community voted him county judge.

Before cases began to appear in the Panhandle, Howard warned those feeling “complacent” that even remote communities would not be spared.

“It’s bound to spread more easily in a place like [New York City] than if you’re a rancher in West Texas,” Howard said. “But even a rancher in West Texas has to come into the grocery store and go to the gas pumps.”

Things started to change in Clarendon on March 19, when the first cases were reported in Amarillo, just an hour’s drive away. The city and county issued disaster declarations.

Howard, meanwhile, was still waiting on test results as the promised five-business-day turnaround extended to seven, then eight, then 10.

“When you do a test on 3/17 and you get a report back on 3/24, and then you do a test on 3/19 and you get a report back on 4/2, how does that help me take care of that patient?” he questioned. “It doesn’t. It doesn’t.”

Frustrated, he turned on March 26 to a new company, Ipsum Diagnostics.

Soon, the city halted construction on two major projects, including Clarendon’s first-ever public swimming pool. Monroe’s Peach Ranch, a fruit stand on U.S. 287, saw slower traffic and lower profits. A school board election was postponed.

Leaders of several churches convened a joint service at the local drive-in on March 29. They broadcast their sermon to about 100 people and several dogs over FM radio, station 88.7, occasionally asking parishioners to honk their car horns in an ill-tuned “Amen” chorus. Volunteers in gloves and masks gathered collection envelopes in Kentucky Fried Chicken buckets.

“Somebody asked me, ‘How long are you gonna do this?’ And I said, ‘Until this is over or Jesus comes back,’” said Jim Fox, a Baptist pastor who coordinated the service.

The next night, Howard got a call from a state worker in Lubbock: Donley County had its first positive case, someone who had been tested in a hospital outside the county.

The news reached Estlack the next morning in his office, where he was readying the weekly print edition of the Clarendon Enterprise. He scrapped an article on a recent Clarendon College Board of Regents meeting and got to work on the virus news.

The Enterprise’s small staff is mostly Estlacks: Ashlee, Roger's wife, who helps with social media; Ella, his 11-year-old daughter, who takes photos; and Benjamin, his 13-year-old son, who has been authoring a “Cub Reporter” column since he was 6. The only full-time reporter as well as its editor, publisher, “janitor and bottle washer,” Roger Estlack quickly became a pivotal player in the county’s coronavirus response, calling and texting Howard constantly and updating the case count most days on the paper’s website.

On April 3, Estlack convened a virtual news conference featuring Howard, Donley County Sheriff Butch Blackburn and other local leaders — “new territory, not just for this newspaper,” Estlack said. With a bushy mustache and an even keel, Howard addressed his constituents, sitting in front of an American flag, a Texas flag and a list of the Ten Commandments. Beside him, in a bright blue button-down and a star-shaped gold badge, Blackburn interlaced his fingers over his belly, looking solemn.

Invited to comment on Facebook, locals fretted their questions up the chain. Did they need written permission to feed cattle just outside town? Could they still deliver eggs to customers? Could they have family over, even if they didn’t live in the same household? And what could Howard tell them about who was ill so far?

Howard offered little identifying information — describing a sick resident as a woman in her 30s limits the guessing pool substantially in a place like Clarendon — and less undue comfort.

“Everything you touch should be considered to be contaminated,” he said. Anyone might brush a contaminated gas pump, then touch her face because a “Panhandle wind blew some dust in your eye.” He was calm but serious: The virus could spread rapidly.

By then, Howard had begun receiving rapid test results from the new lab. Faster data made the spread look faster, too. By April 8, there were 13 cases in the county; two days later, there were 21. The county’s current total is 23. In a small town, most people knew who was sick even without public announcements. And even without doing robust contact tracing, Howard could make inferences: Three people seemed to have all gotten the virus after spending time together socially. Prayer chains formed among churches, naming the ill.

Meanwhile, the state still reports that surrounding counties remain healthy. Of the eight counties that ring Donley, four have not reported any cases at all.

“In a rural area, in farming communities, for all practical purposes they’ve been practicing social distancing forever,” said Kel Seliger, a Republican state senator from Amarillo who represents the vast grid of rural Panhandle counties.

Howard said counties that aren’t on a major thoroughfare may see less viral spread. An absence of testing also helps explain the disparity, local officials and medical experts say.

In some rural counties, “there’s no confirmed cases cause there’s no testing,” said John Henderson, the president of the Texas Organization of Rural and Community Hospitals and former executive of a hospital 60 miles from Clarendon in Childress.

“I dare say it’s widespread in other communities,” Howard said. “But they may not be testing at the rate that I’m testing.”

Ray Powell, judge of Donley’s neighbor to the south, said, “If we have anyone in Hall County with that virus, we don’t know it.”

A hospital in Hall County went bankrupt in 2002, and the county’s health clinic closed two years ago when the nurse practitioner running it retired. A couple of years ago, when Powell’s wife was diagnosed with lung cancer, they had to travel 90 miles each way to Amarillo for appointments.

“So if anybody gets tested, they have to leave the county to do it,” he said. “We’re just sitting here wondering — do we have any running around? Surely we do because of our neighbor, Donley County.”

Howard says his role as county judge informs his practice as a doctor as much as the other way around. A confirmed COVID-19 diagnosis doesn’t much change a patient’s course of care, but data guides government decisions.

“From a doctor standpoint, I don’t need to test them,” Howard said. “But from a judge standpoint, from a public health standpoint, from a trying to take care of my own community standpoint … this is epidemiological data that’s useful to me.”

Officials believe the high case count has helped them corral locals into following their stay-at-home order. Clarendon Mayor Sandy Skelton said his constituents are resilient, not scared. He and his wife have continued to deliver Meals on Wheels weekly, though his 101-year-old mother is furious that she’s no longer allowed to tag along.

At Monroe’s Peach Ranch, along the highway, Collin Monroe is selling fewer and fewer jars of peach butter, wondering whether his high school graduation this spring will have to be done as a drive-thru. Local businesses are hurting, but most are family-owned stalwarts likely to weather the outbreak.

Several Donley County patients had to be hospitalized, and two were put on ventilators. But by this week, many of the county’s 23 cases had made it into the coveted “recovered” category.

The husband of a pregnant woman was among those who tested positive for the virus. Doctors delayed her inducement date, and now mom, dad and baby are all testing negative and doing well, Howard said.

Howard predicts that when the outbreak subsides and antibody tests reveal who had the virus, Donley County won’t look like much of an outlier anymore.

“Some small cities and counties are not testing anybody,” Skelton said. “Maybe they don’t want to know. But we want to know in Clarendon.”

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Edited by pyrohornIII
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1 hour ago, Ghost of LL said:

Well, I don't know.  I think everyone in the urban areas is broadly maintaining the shutdown.  And that's where there's the greatest need to attenuate the spread.

If it sweeps through rural and exurban areas, then that's somewhat ok because it won't strain the healthcare system too much simply as a function of having fewer people in those counties.

But then these fucks travel to the big cities and clog up the hospitals making the margin for error for the big cities even less than they are now. 

I wish we could designate 3 states (Mississippi, Alabama, Georgia) to be "freedom states". Tell all these idiot protestors that feel it's not a big deal at all the govt will pay for them to go to one of these states until the pandemic is over. They can be totally open, nothing closed, and live their life. Only caveat is they cannot leave as every road in/out is guarded and have to fend for themselves 100 percent they way they claim to want. These fucks would never do it. Because deep down they know they're full of shit they're just horrible people who want to shit on every one else's lives. 

Edited by Wanker Bob
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3 minutes ago, jimmyjazz said:

What Trump failed to understand -- and I have to admit, there was no way of knowing this -- the virus in (at least) NYC came from Europe.

This is why failing to limit travel beyond China was a big mistake.  Doing so would have caused a giant shitstorm, but it would have been the smart move, regardless.

Not that I completely agree with your premise, but if he were capable of explaining the steps of their thought in a logical, humble, compassionate manner, then people would have more understanding.

Instead he stands arrogantly every day as people die praising himself and saying everyone is just amazed at his phenomenal job and he takes no responsibility.

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14 minutes ago, jimmyjazz said:

I was under the impression that many such areas actually have fewer ICU beds per capita than bigger cities.  Is that not true?

I don't know about ICU beds.  But I think I've seen that they actually have more hospital beds per capita than urban counties.

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Cities that eased restrictions early saw a spike in cases

Another point worth emphasizing from the research: Social distancing practices have to be sustained. As obstructive as it is that we might need to do some social distancing for months, that really might be what’s necessary to save as many lives as possible.

 

Markel’s study demonstrates this: As the pandemic appeared to subside, St. Louis pulled back its social distancing measures. But it turned out that the pullback was premature — and flu deaths started to rise once again. This graph shows that, with the line chart tracking flu deaths over time and the black and gray bars below showing when key social distancing measures were in place:

 

A chart showing St. Louis’s flu deaths during social distancing measures.JAMA

In a lot of cities, similar premature pullbacks produced a lot of “double-humped epi curves,” as Markel described them: Officials instituted social distancing measures, saw flu cases fall, then pulled back the measures, saw flu cases rise again, and reactivated the measures.

Notably, the second spike in deaths only appeared when cities removed social distancing measures, Markel’s study found: “Among the 43 cities, we found no example of a city that had a second peak of influenza while the first set of nonpharmaceutical interventions were still in effect.”

The PNAS study, which looked at 17 US cities, reported similar findings: “no city in our analysis experienced a second wave while its main battery of [nonpharmaceutical interventions] was in place. Second waves occurred only after the relaxation of interventions.”

The lesson here is to not take social distancing measures for granted. This will be a hard call to make, because it’s going to be difficult to predict when the coronavirus is truly gone. And the public health gains have to be weighed with the strain that social distancing is and will continue to put on families — especially those who need to leave their homes for their only source of income — and the economy overall.

But the hard lesson is that social distancing may be needed for months, maybe even until a vaccine is produced a year or so from now, to save lives. As the PNAS study concluded: “In practice, and until emergency vaccine production capacity increases, this means that in the event of a severe pandemic, cities will likely need to maintain NPIs for longer than the 2–8 weeks that was the norm in 1918.”

 

From a study on the 1918 flu pandemic

Edited by Mo Horn
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33 minutes ago, Anastasis said:

If the NYT's numbers are accurate, approximately 400k traveled on direct flights in from China in the one month prior to the travel restrictions, compared to <20k per month after. That is a 95% reduction in travel. Trump does his narcissistic thing when he used hyperbolic terms to puff himself up, so I get the push back, but the travel restrictions were absolutely the right call.  The real problem imo is that we didn't similarly restrict all international entries.

trump announced the restrictions after the airlines had already stopped flying to china.  it wasn't even him pulling the door a bit more closed, it was united, american, and delta.

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13 minutes ago, Ghost of LL said:

I don't know about ICU beds.  But I think I've seen that they actually have more hospital beds per capita than urban counties.

I'm sure it depends on the county, but the Johns Hopkins website lists number of beds (reg and ICU) and population by county so you can spot check.

https://coronavirus.jhu.edu/us-map

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19 minutes ago, pyrohornIII said:

I thought this was an interesting article about Covid and testing in rural Texas.  Unfortunately there are rural counties that don't even have a doctor full time.  Ours moves around like a Methodist circuit preacher.

Texas Tribune map of tests, cases and deaths by Texas counties.

Article link

 

I like this quote...

Quote

“Somebody asked me, ‘How long are you gonna do this?’ And I said, ‘Until this is over or Jesus comes back,’” said Jim Fox, a Baptist pastor who coordinated the service.

 

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What we need to do is think out the box and have some live experiments in real time.

Let's take a state, hypothetically take whoever whatever state, call it whatever you want I mean let's just call it let's say Oklahoma.

So we take Oklahoma, immediately stop any air travel in or out. Shut it all down.  Then we road block every single road that crosses the state line.  It could be done.

Then we immediately open every night club, bar, restaurant, massage parlor, toe-nail clipper, meth lab, all the schools & etc.   Everything is open.

Then we wait.  That's the plan.

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30 minutes ago, DigDug said:

So you're ok with the President constantly lying his ass off and saying no one got in because of the reduction in numbers.

And no one is saying travel restrictions were not something that was necessary.

What were saying is stop saying that completely cut off people from entering.  STOP FUCKING LYING!

I think that among the bundle of claims related to the China travel restrictions, the claims worth critical focus are the ones where he puts specific numbers to the number of lives saved.  I've seen claims he put out saying that the travel restriction saved 100s of thousands. That is nonsensical on its face.    

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12 minutes ago, elfenix said:

trump announced the restrictions after the airlines had already stopped flying to china.  it wasn't even him pulling the door a bit more closed, it was united, american, and delta.

I recall the airlines moving to draw down flights at roughly the same time.  You you have a timeline of the airlines stopping flying to China?

 

Here is an article from Jan 31, the broad cancellation of flights corresponded with the release of the travel restrictions: https://www.reuters.com/article/us-china-health-delta-air/major-us-airlines-cancel-china-flights-as-government-steps-up-warnings-idUSKBN1ZU25I

Major U.S. airlines cancel China flights as government steps up warnings

David Shepardson, Tracy Rucinski

3 MIN READ

WASHINGTON/CHICAGO (Reuters) - All three major U.S. airlines announced the cancellation of flights to mainland China on Friday as the U.S. government unveiled additional steps to curb the spread of the coronavirus, which originated in China.

The trio of carriers, United Airlines Holdings Inc, Delta Air Lines Inc and American Airlines Group Inc, had already moved to reduce flights to China amid a sharp drop in demand due to the flu-like virus.

The Trump administration on Friday declared a public health emergency over the coronavirus outbreak and said it would take the extraordinary step of barring entry to the United States of foreign nationals who have recently traveled to China.

As of Sunday, the United States will also limit flights from China to seven U.S. airports and U.S. citizens who have traveled to China’s Hubei Province within the last 14 days will be subject to a mandatory 14-day quarantine.

Edited by Anastasis
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1 hour ago, SameSame said:

And also when he kept arrogantly asking "Do you know how many cases were here in the US when I shutdown China?"

I wish she would have answered, Thousands!!

 

Trump: Do you know how many cases were here in the US when I shutdown China?

Reporter:  No sir, I do not.  Do you?

Trump:  There were 11 cases confirmed, so I have been told.

Reporter: So, at the time you put the travel restrictions on China inbound flights, you are saying that every single American had been tested and had results in hand that showed there were only 11 confirmed cases?  Is that what you are saying?

Trump:  We had a great, magnificent testing system in place and there were 11 cases.

Reporter:  So what you are saying is that 'no, not every one was tested, so we really don't know how many cases we had at any point in time.  In fact because our testing is so crappy, at this moment we can't even get close to an accurate number.'  Is that correct?

Trump: That's a nasty nasty question.  Who do you represent?

Reporter: So since you really don't know how many cases due to your botched testing plan, you can just make up numbers, right?

Trump: Very good numbers, yes, from my magnificent staff that stays up late...like until 2 AM sometimes!

Reporter: So we had 11 cases when you put on your China travel ban, and now we have 40,000 deaths, can you explain to me, because i am really slow, how that ban, the ONLY thing you did, was really effective, and all that needed to be done?

Trump:  Enough!  Get her out of here...if you rough her up, I'll pay the legal fees.

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12 minutes ago, Anastasis said:

I recall the airlines moving to draw down flights at roughly the same time.  You you have a timeline of the airlines stopping flying to China?

this article lays out a lot of it.  all this happened in a hurry the last full week of january.  basically, demand was already falling off a cliff so the airlines were dropping flights (united had announced flight cuts on tuesday, delta and american on wednesday), the FA union filed suit against delta to halt flights, the WH was leaking that it was considering a ban, then on friday afternoon the ban gets announced. 

 

Edited by elfenix
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1 minute ago, elfenix said:

this article lays out a lot of it.  all this happened in a hurry the last full week of january.  basically, demand was already falling off a cliff so the airlines were dropping flights (united had announced flight cuts on tuesday), the FA union had already filed suit against delta to halt flights, the WH was leaking that it was considering a ban, then on friday afternoon the ban gets announced. 

Right, that's the way I remember it. It all basically went down at the same time. 

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1 hour ago, Al Bundy's Napoleon Hand said:

"Mr. President, on March 13th you declared this global pandemic a national emergency. What other potential national emergencies do you believe are the primary responsibility of governors or is it limited to global pandemics?"

he'd start talking as soon as you finished the first sentence and you'd never get your question out.

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1 hour ago, elfenix said:

he'd start talking as soon as you finished the first sentence and you'd never get your question out.

I posted on that a while back. Reporters need to abbreviate or eliminate their lengthy pre-ambles and get right to the question.

What is the point to declaring a national emergency if you put all responsibility on the states? What other former national emergencies do believe now are soley problems of the states?

Why do you lie all the time, Mr. President?

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