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Dr. Michael Osterholm says a temporary (up to 6 week) SIP policy is necessary to get US out of our raging problem until a vaccine arrives

Muse

Lifer
Jul 11, 2001
29,121
3,099
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Here’s How to Crush the Virus Until Vaccines Arrive
To save lives, and save the economy, we need another lockdown.

By Michael T. Osterholm and Neel Kashkari
Dr. Osterholm is director of the Center for Infectious Disease Research and Policy at the University of Minnesota. Mr. Kashkari is president of the Federal Reserve Bank of Minneapolis.

Aug. 7, 2020

More than a third of all U.S. coronavirus cases occurred in July.

In just weeks we could almost stop the viral fire that has swept across this country over the past six months and continues to rage out of control. It will require sacrifice but save many thousands of lives.

We believe the choice is clear. We can continue to allow the coronavirus to spread rapidly throughout the country or we can commit to a more restrictive lockdown, state by state, for up to six weeks to crush the spread of the virus to less than one new case per 100,000 people per day.

That’s the point at which we will be able to limit the increase in new cases through aggressive public health measures, just as other countries have done. But we’re a long way from there right now.

The imperative for this is clear because as a nation what we have done so far hasn’t worked. Some 160,000 people have died, and in recent days, roughly a thousand have died a day. An estimated 30 million Americans are collecting unemployment.

On Jan. 30, when the World Health Organization declared Covid-19 a public health emergency, there were 9,439 reported cases worldwide, most in China, and only six reported cases in the United States.

On July 30, six months later, there were 17 million cases reported worldwide, including 676,000 deaths. The United States had four million reported cases and 155,000 deaths. More than a third of all U.S. cases occurred during July alone.

And the next six months could make what we have experienced so far seem like just a warm-up to a greater catastrophe. With many schools and colleges starting, stores and businesses reopening, and the beginning of the indoor heating season, new case numbers will grow quickly.

Why did the United States’ Covid-19 containment response fail, particularly compared with the successful results of so many nations in Asia, Europe and even our neighbor Canada?

Simply, we gave up on our lockdown efforts to control virus transmission well before the virus was under control. Many other countries didn’t let up until the number of cases was greatly reduced, even in places that had extensive outbreaks in March and April. Once the number of new cases in those areas was driven to less than one per 100,000 people per day as a result of their lockdowns, limiting the increase of new cases was possible with a combination of testing, contact tracing, case isolation and extensive monitoring of positive tests.

The United States recorded its lowest seven-day average since March 31 on May 28, when it was 21,000 cases, or 6.4 new cases per 100,000 people per day. This rate was seven to 10 times higher than the rates in countries that successfully contained their new infections. While many countries are now experiencing modest flare-ups of the virus, their case loads are in the hundreds or low thousands of infections per day, not tens of thousands, and small enough that public health officials can largely control the spread.

In contrast, the United States reopened too quickly and is now experiencing around 50,000 or more new cases per day.

While cases are falling in the hard-hit areas of Arizona, California, Florida and Texas because of the imposition of some physical-distancing measures, they are rapidly increasing in a few of Midwestern states. In Minnesota, we just documented the most new cases in a one-week period since the pandemic began.

At this level of national cases — 17 new cases per 100,000 people per day — we simply don’t have the public health tools to bring the pandemic under control. Our testing capacity is overwhelmed in many areas, resulting in delays that make contact tracing and other measures to control the virus virtually impossible.

Don’t confuse short-term case reductions in some states as permanent. We made that mistake before. Some have claimed that the widespread use of masks is enough to control the pandemic, but let us face reality: Gov. Gavin Newsom of California issued a public masking mandate on June 18, a day when 3,700 cases were reported in the state. On July 25, the seven-day daily case average was 10,231. We support the wearing of masks by all Americans, but masking mandates and soft limitations on indoor crowds in places such as bars and restaurants are not enough to control this pandemic.

To successfully drive down our case rate to less than one per 100,000 people per day, we should mandate sheltering in place for everyone but the truly essential workers. By that, we mean people must stay at home and leave only for essential reasons: food shopping and visits to doctors and pharmacies while wearing masks and washing hands frequently. According to the Economic Policy Institute, 39 percent of workers in the United States are in essential categories. The problem with the March-to-May lockdown was that it was not uniformly stringent across the country. For example, Minnesota deemed 78 percent of its workers essential. To be effective, the lockdown has to be as comprehensive and strict as possible.

If we aren’t willing to take this action, millions more cases with many more deaths are likely before a vaccine might be available. In addition, the economic recovery will be much slower, with far more business failures and high unemployment for the next year or two. The path of the virus will determine the path of the economy. There won’t be a robust economic recovery until we get control of the virus.

If we do this aggressively, the testing and tracing capacity we’ve built will support reopening the economy as other countries have done, allow children to go back to school and citizens to vote in person in November. All of this will lead to a stronger, faster economic recovery, moving people from unemployment to work.

We know that a stringent lockdown can have serious health consequences for patients who can’t get access to routine care. But over the past six months, medical professionals have learned how to protect patients and staffs from spreading the coronavirus; therefore we should be able to maintain access to regular medical care during any new lockdown.

This pandemic is deeply unfair. Millions of low-wage, front-line service workers have lost their jobs or been put in harm’s way, while most higher-wage, white-collar workers have been spared. But it is even more unfair than that; those of us who’ve kept our jobs are actually saving more money because we aren’t going out to restaurants or movies, or on vacations. Unlike in prior recessions, remarkably, the personal savings rate has soared to 20 percent from around 8 percent in January.

Because we are saving more, we have the resources to support those who have been laid off. Typically when the government runs deficits, it must rely on foreign investors to buy the debt because Americans aren’t generating enough savings to fund it. But we can finance the added deficits for Covid-19 relief from our own domestic savings. Those savings end up funding investment in the economy. That’s why traditional concerns about racking up too much government debt do not apply in this situation. It is much safer for a country to fund its deficits domestically than from abroad.

Congress should be aggressive in supporting people who’ve lost jobs because of Covid-19. It’s not only the right thing to do but also vital for our economic recovery. If people can’t pay their bills, it will ripple through the economy and make the downturn much worse, with many more bankruptcies, and the national recovery much slower.

There is no trade-off between health and the economy. Both require aggressively getting control of the virus. History will judge us harshly if we miss this life- and economy-saving opportunity to get it right this time.

Michael T. Osterholm is a professor and director of the Center for Infectious Disease Research and Policy at the University of Minnesota. Neel Kashkari is president of the Federal Reserve Bank of Minneapolis.

Moved from OT.
admin allisolm
 
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Muse

Lifer
Jul 11, 2001
29,121
3,099
126
The odds of the President doing this and deplorable states is exactly zero point zero.
Could be. But if we go exponential (we aren't already??? ) there may be quite the clamor. Fauci won't lie, why should he? He knows his reputation for telling it like it is is more valuable to him than any stature by virtue of Trump. Birx won't either at this point. Nobody else under the presidential canopy has any credibility, on the contrary we should cover our ears when any of them speak and turn our heads when they Tweet.
 

Mai72

Lifer
Sep 12, 2012
10,473
1,095
126
Dr. Osterhokm has been critized as a fear monger, and he's just looking to sell his book. Just look at the Joe Rogan video he did a few months ago. People don't have a grasp on time, and many were critical of his prediction. I believe he said over 500k dead, millions hospitalized. But, here is the thing. We are still in the the grips of this pandemic. We aren't even in the middle stage yet. So, his prediction could very well be true 1-3 years from now. As he has stated this is a COVID19 winter. It's going to be with us for a long time. Wait until the fall hits. We could be in for some real issues.

BTW, states aren't shutting down. We saw what that did to the economy so that will be a non issue. Schools on the other hand? Yea. I could see virtual learning taking place all year.
 

ultimatebob

Lifer
Jul 1, 2001
23,382
1,365
126
Dr. Osterhokm has been critized as a fear monger, and he's just looking to sell his book. Just look at the Joe Rogan video he did a few months ago. People don't have a grasp on time, and many were critical of his prediction. I believe he said over 500k dead, millions hospitalized. But, here is the thing. We are still in the the grips of this pandemic. We aren't even in the middle stage yet. So, his prediction could very well be true 1-3 years from now. As he has stated this is a COVID19 winter. It's going to be with us for a long time. Wait until the fall hits. We could be in for some real issues.

BTW, states aren't shutting down. We saw what that did to the economy so that will be a non issue. Schools on the other hand? Yea. I could see virtual learning taking place all year.
Home learning for kids kills business productivity as well, though. If the kids are home, at least one of their parents are stuck there as well, and they're going to be distracted.

I'd imagine that most of those people who said that their productivity skyrocketed while working from home this spring weren't parents of young children. In that case, you're basically doing the teacher's job as well as your own.
 
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Paratus

Lifer
Jun 4, 2004
14,535
7,591
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Dr. Osterhokm has been critized as a fear monger, and he's just looking to sell his book. Just look at the Joe Rogan video he did a few months ago. People don't have a grasp on time, and many were critical of his prediction. I believe he said over 500k dead, millions hospitalized. But, here is the thing. We are still in the the grips of this pandemic. We aren't even in the middle stage yet. So, his prediction could very well be true 1-3 years from now. As he has stated this is a COVID19 winter. It's going to be with us for a long time. Wait until the fall hits. We could be in for some real issues.

BTW, states aren't shutting down. We saw what that did to the economy so that will be a non issue. Schools on the other hand? Yea. I could see virtual learning taking place all year.
I don’t know who this guy is by he’s absolutely right. The only reason his predictions were wrong was “some” controls were put in place.

When my state reopened my county went from about 10 new cases a day to 20 the following week, to 40, then 80, then 160, peaking at just over 300 cases a day a month later. It doubled every week until they shut the bars down and enforced masks.

If those controls weren’t put back in place a month later we would have been at over 10,000 a day. Less than a month after that the entire population of my county would have been infected.

If we assume 80% don’t need medical care and of the final 20%, 5% need ICU care with 1-2% dying then the minimum dead would be between 3500-7000.

Of course with less than 100 ICU beds and less than 1000 overall hospital beds in the county most of the infected will not get medical care raising the death rate to somewhere above 5%. So maybe 20,000 dead in my single county.

So no people don’t understand the math.
 

Mai72

Lifer
Sep 12, 2012
10,473
1,095
126
An Aug07 interview w/ Osterholm. His main concern are the fall months. How this virus will explode during the cooler months when more people are forced indoors. He doesn't think that school age children are going to be greatly affected, but HS kids and colleges will be greatky impacted. As he has stated we are at a crossroads. I agree. I think we are in for a very nasty few months. Our sick and death rates will skyrocket. He also brought up a very important point. Just because the sick rate has gone down it doesn't mean that we have this virus beat. We aren't even close, and we need to take drastic measures. Probelm is, most people and our economy aren't able to stomach another lockdown.

 

Mai72

Lifer
Sep 12, 2012
10,473
1,095
126
I don’t know who this guy is by he’s absolutely right. The only reason his predictions were wrong was “some” controls were put in place.

When my state reopened my county went from about 10 new cases a day to 20 the following week, to 40, then 80, then 160, peaking at just over 300 cases a day a month later. It doubled every week until they shut the bars down and enforced masks.

If those controls weren’t put back in place a month later we would have been at over 10,000 a day. Less than a month after that the entire population of my county would have been infected.

If we assume 80% don’t need medical care and of the final 20%, 5% need ICU care with 1-2% dying then the minimum dead would be between 3500-7000.

Of course with less than 100 ICU beds and less than 1000 overall hospital beds in the county most of the infected will not get medical care raising the death rate to somewhere above 5%. So maybe 20,000 dead in my single county.

So no people don’t understand the math.
Dr. Osterholm is an epidemiologist with over 40 years of virus expertise. BTW, good points. When you put it like that, you can see how concerned scientist and health officials were. Yes, this virus will probably not kill you. But, it can cause real havock on local health care which would then raise the rate of COVID19 deaths. What's scary is you didn't even mention the long term health issues that many people face as well. People think they know it all. Ignorance. You have to love the internet doctors as well. Always good for a laugh.

 

ondma

Golden Member
Mar 18, 2018
1,931
656
106
Dr. Osterhokm has been critized as a fear monger, and he's just looking to sell his book. Just look at the Joe Rogan video he did a few months ago. People don't have a grasp on time, and many were critical of his prediction. I believe he said over 500k dead, millions hospitalized. But, here is the thing. We are still in the the grips of this pandemic. We aren't even in the middle stage yet. So, his prediction could very well be true 1-3 years from now. As he has stated this is a COVID19 winter. It's going to be with us for a long time. Wait until the fall hits. We could be in for some real issues.

BTW, states aren't shutting down. We saw what that did to the economy so that will be a non issue. Schools on the other hand? Yea. I could see virtual learning taking place all year.
I live in Minnesota and worked for the University of Minnesota. I dont know him personally, but have a fair amount of familiarity with Dr. Osterholm's views (I have listened to a couple of seminars presented by him). I would not call him a "fearmonger" exactly, but he does tend toward the pessimistic, worst case scenario viewpoint, to put it mildly. A total shutdown is simply not happening though, especially since a significant percentage of the population has been convinced Covid is a hoax, or at least only gives you the sniffles. Plus we must exercise our rights to infect others (oops, I mean our right to not wear a mask.)

I have not read his book, but unless we get an effective vaccine quickly, total death toll could easily reach 500k.
 

K1052

Lifer
Aug 21, 2003
35,937
9,602
136
It should be quite clear that the US doesn't have the ability to implement the needed mitigations. We didn't when all this first started either. We are simply not willing, interested, or smart enough to do it.

This is so much the case that I think if the Brit study of the Oxrford vaccine turns up efficacy without life threatening adverse effects that we should approve its emergency use immediately and as soon as AZ can get us the doses. Vaccines are the only viable exit ramp for the US from this situation.
 

hal2kilo

Lifer
Feb 24, 2009
16,381
4,327
136
It should be quite clear that the US doesn't have the ability to implement the needed mitigations. We didn't when all this first started either. We are simply not willing, interested, or smart enough to do it.

This is so much the case that I think if the Brit study of the Oxrford vaccine turns up efficacy without life threatening adverse effects that we should approve its emergency use immediately and as soon as AZ can get us the doses. Vaccines are the only viable exit ramp for the US from this situation.
Well, I guess we will do what we did before. Let millions of people die, then blame another ethic population for it. You know that Spanish flu that did not come from Spain in the first place. At least this time we know it came from China mostly by way of Europe though.
 

SteveGrabowski

Diamond Member
Oct 20, 2014
3,357
1,795
136
Dr. Osterhokm has been critized as a fear monger, and he's just looking to sell his book. Just look at the Joe Rogan video he did a few months ago. People don't have a grasp on time, and many were critical of his prediction. I believe he said over 500k dead, millions hospitalized. But, here is the thing. We are still in the the grips of this pandemic. We aren't even in the middle stage yet. So, his prediction could very well be true 1-3 years from now. As he has stated this is a COVID19 winter. It's going to be with us for a long time. Wait until the fall hits. We could be in for some real issues.

BTW, states aren't shutting down. We saw what that did to the economy so that will be a non issue. Schools on the other hand? Yea. I could see virtual learning taking place all year.
I think he was predicting 400k dead, assuming no vaccine for years. We're already more than halfway there on the death count according to an analysis by the NY Times

 

Mai72

Lifer
Sep 12, 2012
10,473
1,095
126
I live in Minnesota and worked for the University of Minnesota. I dont know him personally, but have a fair amount of familiarity with Dr. Osterholm's views (I have listened to a couple of seminars presented by him). I would not call him a "fearmonger" exactly, but he does tend toward the pessimistic, worst case scenario viewpoint, to put it mildly. A total shutdown is simply not happening though, especially since a significant percentage of the population has been convinced Covid is a hoax, or at least only gives you the sniffles. Plus we must exercise our rights to infect others (oops, I mean our right to not wear a mask.)

I have not read his book, but unless we get an effective vaccine quickly, total death toll could easily reach 500k.
Yea. I agree. We are going to learn the hard way unfortunately.
 

Steltek

Platinum Member
Mar 29, 2001
2,674
480
126
Well, I guess we will do what we did before. Let millions of people die, then blame another ethic population for it. You know that Spanish flu that did not come from Spain in the first place. At least this time we know it came from China mostly by way of Europe though.
Even if the stars manage to align and we get one or more vaccines, a lot of folks are still going to get sick and die from this. The politicians wave the idea of vaccines around like they are a magic fix, but they aren't.

Setting aside the anti-vaxxer morons, just based upon the fact that it is a coronavirus we'll be lucky if the vaccines (when they finally show up) are even 50-60% effective in immune response. And, again because it is a coronavirus, the immunity will likely wane and may not even last longer than a few months. I hope both effectiveness and immunological longevity are better, but I'm not holding my breath. There is a reason we still to this day don't have a vaccine for the common cold (the most common coronavirus), after all.
 

[DHT]Osiris

Diamond Member
Dec 15, 2015
8,180
4,071
146
It should be quite clear that the US doesn't have the ability to implement the needed mitigations. We didn't when all this first started either. We are simply not willing, interested, or smart enough to do it.

This is so much the case that I think if the Brit study of the Oxrford vaccine turns up efficacy without life threatening adverse effects that we should approve its emergency use immediately and as soon as AZ can get us the doses. Vaccines are the only viable exit ramp for the US from this situation.
Nah we have the ability to, just not the willingness or interest. There was a period early on when we didn't know the primary transmission vectors so we took an all-encompassing approach of 'stay the fuck home', similar to how China did (though not as aggressive obviously). Eventually we figured out it was primarily through droplets, and we could mostly forgo super-surgery masks/gas masks and gloves, and stick to hand washing and wearing cloth masks, and social distancing. At this point, that's all that's required. If everyone was social distancing and wearing cloth masks, we'd probably be in very good shape. If people went above and beyond (no non-essential travel, no meet and greets, all-expense paid vacations/work from home), we'd be infection free in 6 weeks, like NZ is.
 

ondma

Golden Member
Mar 18, 2018
1,931
656
106
Even if the stars manage to align and we get one or more vaccines, a lot of folks are still going to get sick and die from this. The politicians wave the idea of vaccines around like they are a magic fix, but they aren't.

Setting aside the anti-vaxxer morons, just based upon the fact that it is a coronavirus we'll be lucky if the vaccines (when they finally show up) are even 50-60% effective in immune response. And, again because it is a coronavirus, the immunity will likely wane and may not even last longer than a few months. I hope both effectiveness and immunological longevity are better, but I'm not holding my breath. There is a reason we still to this day don't have a vaccine for the common cold (the most common coronavirus), after all.
From what I have read, some of the vaccines are nearly 100% effective at eliciting an antibody response. How long it lasts and how effective it is at preventing infections is another story. Plus the ultimate disaster would be if the virus mutated so that the vaccine no longer works.
 

Jhhnn

No Lifer
Nov 11, 1999
61,657
13,735
136
Even if the stars manage to align and we get one or more vaccines, a lot of folks are still going to get sick and die from this. The politicians wave the idea of vaccines around like they are a magic fix, but they aren't.

Setting aside the anti-vaxxer morons, just based upon the fact that it is a coronavirus we'll be lucky if the vaccines (when they finally show up) are even 50-60% effective in immune response. And, again because it is a coronavirus, the immunity will likely wane and may not even last longer than a few months. I hope both effectiveness and immunological longevity are better, but I'm not holding my breath. There is a reason we still to this day don't have a vaccine for the common cold (the most common coronavirus), after all.
That's not accurate. There are at least 200 viruses that cause cold-like symptoms, many of them not corona viruses at all.


The reason why flu vaccines change is because the virus mutates constantly & hops back & forth across species barriers exceptionally well. It's a diverse family. It's a chameleon in the way it presents itself to the immune system. At this point, there's always some residual immunity in the population because of past exposure or immunization to a variety of strains.


Covid-19 isn't like that. While there are genetic variants, it's still one disease in the way it presents itself. That's unique, so there's no sort of limited immunity in the population at all. It's also quite contagious with a high mortality rate.
 

K1052

Lifer
Aug 21, 2003
35,937
9,602
136
What is their reasoning for not getting the vaccine? Is this comparable to flu shot participation?
I think a number of things are at work.

The internet ate the intelligence of middle aged Americans via memes on Facebook (many of your traditional even liberal antivaxxers plus now Q). Many non-white people are far more skeptical of US health policy because of long running enormous inequalities in care and how those demographics are treated within the system. Rural residents distrust the government even though it is almost entirely responsible for the viability of their lifestyles.

Fortunately we don't need everyone to get vaccinated.
 

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