Thursday, April 2, 2020

Equal Time

Or an opposing view to the conventional wisdom on Covid-19. 
 
Our old friend Karl Denninger over at the Market Ticker website wonders whether hospital workers are vectors for the Covid-19 virus. Karl is no doctor but is just a smart guy who comes up with rather interesting questions..  He penned a post on his website a few days ago that questioned the use of social distancing to fight the Covid-19 virus while positing it was infected health care workers who are becoming vectors.  His post is reprinted below with his permission.

Folks, we have to cut the bull**** right now.

We do work with very dangerous viruses all the time. We have to. We use truly extreme measures in doing so too, because the risk of a mistake, if made, is catastrophic to the person involved and, if the virus is person-person transmissible the outcome could be horrifying.

We do this sort of work in labs where strict controls are found. Think "Andromeda Strain" sort of lab.

There is not a hospital in the world that can maintain that level of isolation successfully.

Hospitals, generally, are not set up much to deal with highly-infectious and serious disease. Blood-borne diseases are one thing; there you need direct exposure, which means needle sticks and things like that. Diseases where vaccinations are available are another; health workers can be required to have proved immunity in the form of proof of vaccination. That works.

There are a handful of hospitals that are capable of treating Ebola patients. So far none have had a breach. But their capacity is very, very low. In addition Ebola is not generally airborne and that makes it materially easier. Ebola-level isolation is actually not enough for this virus to stop transmission to the health care workers yet even that level of protection is simply impossible to provide for thousands of people. For a handful that present while returning from the US, yes. For the general US population? Not a snowball's chance in Hell; we have neither the facilities or the staff.

There is no vaccine for this and one is never likely to work, despite the screaming. We've heard that lie out of the NIH, CDC and medicine before. There are times it is truthful but coronaviruses are not one of those areas. There is no record of such a successful vaccine with permanent immunity for coronaviruses and despite "the flu shot" that fails an awful lot of the time too.

Reliance on such is just flat-out insane.

There's some evidence that the method of action of this virus in the body leads to the potential for extraordinarily contagious "windows", likely coinciding with active symptoms, and low but non-zero infection capacity otherwise, at least in droplets. There is also plenty of evidence this virus is fecal/oral transmissible going all the way back to the first reports out of Wuhan, and that's nasty because some of the higher R0 viruses historically have been transmitted in such a fashion (e.g. Polio, R0 of approximately 5.)

Health care workers cannot social distance and do their jobs. PPE is not a panacea; other than a "moon suit" with positive-pressure ventilation it's inadequate when you have an actively-infectious patient and an easily-transmissible infectious agent. There's no way in hell you can run a hospital with everyone kitted up in a moon suit, connected to positive-pressure clean air sources. Forget it.

We keep seeing the same stats. A small number of cases which do not follow the expected geometric progression, then a sudden explosion. When reporting is actually done we see patterns where a huge percentage of the "first infected reports" are in hospitals. Medical workers in hospitals are a tiny fraction of the entire population and yet they often make up 1/5th to a 1/6th of the original infected population sample. This has happened repeatedly, beginning in Wuhan.

(FOX 9) - State health officials say one in five of the confirmed cases of COVID-19 in Minnesota are health care workers.

Of the state’s 503 confirmed cases of the coronavirus, 133 are health care workers, according to the Minnesota Department of Health. Article.

The data says that what is happening is that this virus spreads in the population but slowly until health care workers get it in a hospital, pass it around and then back into the general population as they are exempt from all of the social mandates. In cities with strong public transportation systems it's even worse as they can spread the love on buses and trains. While doctors may drive their nice cars orderlies and nurses are another matter, never mind that some of them are likely coming to work while sick and thus transmit back to the patient and other worker population, if any don't already have it, whether they realize it or not.

Minnesota is almost-certain to get reamed.

The data proving this is clear. When New York implemented its "shelter in place" and other towns and cities implemented "social distancing" we should have seen an immediate collapse in the R0 in those areas. We did not. We've seen a change -- about 0.4-0.5 on a national basis and approximately the same in NY, but out of 2.5-3.0 it's clear that casual social interaction being cut by 90% or more for the common person on the street is not stopping the transmission.

You can work in a warehouse and not get within 6' of anyone. You can stock grocery shelves and do likewise. And if you're laid off and staying mostly at home, since everything you want to do is closed, well, it's you and your cat. And so on.

So who's that leave?

HOSPITAL WORKERS who by definition cannot socially distance and do their jobs.

Singapore identified this immediately and stopped the madness by mandating washing of hands with soap and water, not so-called "sanitizers", before and after each contact with a person or thing that could potentially be infected. By doing that they dropped the infection rate of their hospital staff to a statistical zero and almost immediately thereafter the outbreak there was under control. They still get a case here and there, but the simple fact is that despite the screams of horror about community spread the facts are that it isn't that easy for social transmission of this bug to take place, except through super-spreading events.

If it was then the mitigating factors would have had an immediate and dramatic impact, and they have not. Further, Singapore couldn't have stopped transmission to health care workers by mandating strict hand hygiene standards, but they did.

We have repeatedly seen this pattern -- where you have a case here and there, a few people show up in the hospital and then the sudden exponential explosion occurs after failing to follow the predicted geometric progression for weeks -- and it happens in city after city. "Social distancing" doesn't stop or reverse it and neither do "stay at home" order, even when backed up with the threat of fines or worse.

We must stop the madness; the data on where the spread is happening is clear.

I have posted several times the basic mantra from what Singapore learned: ******n it, wash your hands!

Well, that apparently doesn't even manage to register. It also gets me hate mail since I'm "attacking" the "heroes."

You're not a hero if you're contracting, and thus becoming infectious, in a hospital from the bugs the patients have. You're a zero because by definition you can be, and probably are, giving it to others -- and quite probably a lot of of others.

And don't tell me medical workers, including doctors and nurses, wash their hands in hospitals generally. They most-certainly do not. My dentist's office is better at it (and yeah, I pay attention to it too) but in no hospital I've ever been in attending to family members and friends has every doctor and nurse, when entering the room, washed their hands right there, done whatever, and then done it again on the way out. Never once. Not when my mother was in having cancer surgery (!!!), not when I was visiting my sister in step-down, not when other family members and friends have been in a hospital, never, ever, anywhere with that protocol, period.

The only other way to stop this transmission is to arrange so all Covid patients go to hospitals (whether field expedient or otherwise) where nobody is allowed in the building unless actively ill, in which case they can't leave until not, or proved seroconverted by antibody test and thus immune.

We will not stop the outbreaks until we stop this. If we're not going to do it here and now we're far better to take the hit now coming into the spring and summer than to get hammered in the fall when co-infection with ordinary influenza will kill many more than would otherwise die.

28 comments:

Anon-E-Mouse said...

A person I know working at a rural hospital in LA said they’ve only got one patient. They are sending people home because of it.

Anonymous said...

Literal nothingburger that is exposing cucks who willingly give up their constitutional rights. Cucks are the real plague.

Anonymous said...

Never heard of him. Did some googling. Read half dozen sites regarding him. Nutjob and flat out wrong on so many levels. Ignorant of so many things he's wrong about.

Anonymous said...

"Conventional Wisdom" is a pathetic weasel term that really means Groupthink which is the antithesis of intellectual curiosity. A perfect example of this same anti-intellectual and anti-curiosity groupthink mentality would be @6:30. They cannot accept anything outside their programming and attack the character of the author.

Anonymous said...

@6:30 PM that's great but you're anonymous so it doesn't really matter.

Anonymous said...

6:05 is what’s wrong with America. Everything to them is a conspiracy.

EAB said...

Some low-hanging fruit to argue with here.

“We should have seen an immediate decrease in R0 from distancing”: we know that it takes up to two weeks to get from contagion to symptom, and several more to get from symptomatic to diagnosed since we are still mostly just testing hospitalized patients (and tests themselves are taking days to weeks to process). It’s 100% expected that you won’t see any real effect on the curve until 2-3 weeks after implementation. Only the west coast has really been locked down that long — and surprise, they are clearly starting to see a decrease in growth!

Second, I don’t understand how you can simultaneously claim that the virus doesn’t really spread through the community very well, and also that people are picking it up in the community from health care workers. Either it spreads from a vector or it doesn’t, and if it does, it makes no difference whether that vector was a health care worker or a traveler or a random person.

Several of the first cases in a couple places in CA were community spread with no known travel exposure, and since they were the very first cases, the HCWs couldn’t have been the initial vector. That’s definitely the case here in Georgia — you have places like Rome and Albany where an entire church got infected and basically all showed up sick at the hospital at the same time. It’s been easy to trace it to church picnics and funerals and choir practices, and nobody interacted with doctors until it was well and truly seeded.

HCWs were super vulnerable with other diseases like SARS and MERS too, but it was very obvious that the spread was happening primarily outside of hospitals. They got exposed in the course of their jobs but weren’t the major vectors.

The main reason this virus is behaving differently is because of the pre-symptomatic and asymptomatic transmission. That’s what let it get well and truly established in the community.

Anonymous said...

6:05 is what’s wrong with America. Everything to them is a conspiracy.

What is the conspiracy being espoused? Be specific.

Anonymous said...

Funny, seems like everyone with a PC is the absolute expert on this thing and has all the answers.

Anonymous said...

What do you propose healthcare workers to do then? Deny care? Open Seminary like TB?

Anonymous said...

I personally wish Covid-19 would really encourage social change on 3 fronts.
1.) Preparedness ready.gov has been around since Katrina. Americans need to keep 14 days of essentials and stop panic hoarding during emergencies.
2.) Healthier life choices Healthy adults use fewer healthcare resources.
3.) Acceptance of mask wearing in public The entire shutdown could've been prevented if we had a culture of wearing masks when sick in public like in Asia.

The public reaction to Covid-19 is a national shame. And the response will have long term effects far worse than the virus itself.

Anonymous said...

Y'all do realize that wearing a mask is against the law in many jurisdictions.

Anonymous said...

@8:20 I agree with all but #3. Forget the mask if you are sick and stay home.

One thing that I really hope comes from this in MS is change in the attendance policy in some school districts. Final exam exemptions should not be tied to attendance in any way. Too many kids who have the grades to be exempt go to school when they are sick because they do not want to miss class and risk not being exempt. They are afraid they may have to miss later in the year for an unavoidable reason and do not want to risk it. This is a contributing factor in my opinion to the flu and stomach bugs spreading in our schools. Telling kids to stay home until you are fever free for 24 hours and then tying absences to exemptions are contradictory messages.

Anonymous said...

Y'all do realize that mask laws have exceptions for public health:

To wit, VA Code:

(iv) wearing a mask, hood or other device for bona fide medical reasons upon (a) the advice of a licensed physician or osteopath and carrying on his person an affidavit from the physician or osteopath specifying the medical necessity for wearing the device and the date on which the wearing of the device will no longer be necessary and providing a brief description of the device, or (b) the declaration of a disaster or state of emergency by the Governor in response to a public health emergency where the emergency declaration expressly waives this section, defines the mask appropriate for the emergency, and provides for the duration of the waiver.

Anonymous said...

@8:36
Just🤧 Start🤒 Coughing😷

Anonymous said...

I think this crisis has emboldened the crackpots who think they are smarter than the experts to come out of hiding and try to prove it. It reminds me of someone with schizophrenia who won’t take his meds because he believes doing so would rob humanity of his brilliant mind. If nothing else, when the dust settles, we should have a better idea who needs psychiatric treatment and/or who should just be ignored.

Anonymous said...

@9:19, considers themself so brilliant but would never see the irony in their comment.

Because a madman never detects his own illness but thinks those around him are insane.

Anonymous said...

Rest easy @9:19, you'll continue to be ignored.

Anonymous said...

@8:57, I'm sick and need to go to a medical clinic. I should wear a mask. I'm sick and I need medicine from Walmart/Walgreens/CVS. I should wear a mask. I live in a major city were I have to use public transportation to do the first two. I should definitely wear a madk.

There is a big nation outside of Mississippi.

Anonymous said...

@9:50 Even in MS and the big nation outside of MS, we have home delivery of goods. Most of us have friends or relatives who will also bring us goods if we are sick and in need. In addition, we have telemedicine to triage. Again, forget the mask...stay home if you are sick with an infectious disease. Nobody wants your contaminated hands if you are sick on the rails of the subway in your big nation regardless if you are wearing a mask.

Anonymous said...

@10:10, neither you or anyone else will contain me. I have rights. If I want to buy a footlong coney, a fifth of Early Times, and a novelty from Romantic Adventures, I will most certainly do it!

Anonymous said...

Cool when I Rob the liquor store, my mask is legal in VA.

Anonymous said...

9:38 and 9:38, So do you agree with what was written above by Karl Denninger? Or are you just looking for opportunities to snipe fellow commenters?

9:19

Anonymous said...

@12:47
I agree that you are a putz. Buzz off.

Anonymous said...

This guy may be a crackpot but I wonder how many times this has happened. Check out https://apple.news/A8lzZDlznThSGSuyFrM5qWg

Anonymous said...

9:38pm That is not the standard for diagnosing mental illness. It's a pop psychology phrase.

You are overlooking things like " mass hysteria" and "cultural influences" and " denial".And, of course, add ignorance and stupidity.

Anonymous said...

7:31 a.m., the power of your logic and reasoning is underwhelming. -12:47

Anonymous said...

Ever noticed how people who use bold and italics as much as Karl Deninger does are all nutjobs?


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