(04-01-2020 10:11 AM)Owl 69/70/75 Wrote:  Unlike most of those people, I've been through a few crisis/emergency response rodeos as a military officer, government contractor, and citizen. People who have never been there simply do not realize how hard they are

One of the reasons I find you to be somewhat of an expert - at least more of an expert than our check cashing bureaucrat loving friends.

Ham and RU and you have levels of training and experience that qualify yall to have a say - a say that is ignored by the lefties because it is not anti-Trump enough.

(04-01-2020 04:42 AM)Fort Bend Owl Wrote:  To be honest, I just pay attention to the death totals now. It's pretty hard to manipulate those numbers. Sorry but it's easy to be cynical at 4:30 in the morning when you can't sleep.

I think we will probably have to wait until after the virus runs its course before epidemiologists give a clear picture of the death numbers. Obviously it seems China is lying about their numbers, while some European nations are only reporting hospital deaths. Even here, there are anecdotal reports of deaths that aren't being included in reports in timely manners. Meanwhile in the MAGA-twitterverse, the grifters have successfully sown the belief that the death numbers are inflated (the cause of death should be the co-morbidity, not the COVID-19) to make the President look bad.

This is not being posted as an 'I told you so'... it is being posted as a 'just because a CDC director didn't say it before, doesn't mean they won't.'

I said this weeks ago and some argued that 'what I'm saying, they haven't heard any 'experts' say'.

https://www.msn.com/en-ca/news/world/fac...li=AAggFp4

The tone of such claims ranged from condescending to frustrated, with the US Surgeon General Jerome Adams tweeting in late February -- in all caps -- "STOP BUYING MASKS!"

"They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can't get them to care for sick patients, it puts them and our communities at risk," he added, in a post that has since been retweeted over 43,000 times.

That same week, Robert Redfield, director of the Centers for Disease Control and Prevention (CDC), appeared before lawmakers. Asked if people should wear masks, he had a straightforward answer: "No."

Now he's not so sure. On Monday, Redfield said told NPR that the CDC was reviewing its guidelines and may recommend general mask use to guard against community infection. It's likely only a matter of time before other mask holdouts, most prominently the World Health Organization (WHO), follow suit.


SOMETIMES the answer depends on details of the question... timing etc... and sometimes people who are 'experts' just make mistakes.

(04-01-2020 11:28 AM)At Ease Wrote:  - Trump disbanded the NSC pandemic unit, weakening the speed by which we could respond to this threat
- NSC protocols are that procurement of PPE should be an immediate priority at the earliest possibility of a potential pandemic; Trump's administration didn't do this (remarkably, PPE was even being given away to China) and medical workers are facing shortfalls
- SARS-CoV2 testing has been and remains woefully inadequate; executive decision making in the CDC and FDA, as parts of the Trump administration, bear clear culpability
- Trump dismissed the threat of this virus at the earliest stages, calling it just a flu, saying it was a Democratic hoax, and making irrational predictions of the course of the disease, despite data and reports from intelligence stressing the potential severity

Taking them from the top:
- I would argue that "disbanding the NSC pandemic unit" (which is a more accurate description than "firing" them) had little or no impact. If you want to claim that it did, please indicate how and why. And no, "it stands to reason that it would have helped" is not responsive to that question. They don't actually DO anything. They just ponder and pontificate. And we were short doers, not ponderers and pontificators.
- As I understand the facts, the staff requested $2 billion in supplies purchases, and Trump agreed to $500 million. It's pretty unlikely that we would have gone through more than $500 million to date, and we have vastly ramped up production in the last week or so, by forming public/private partnerships that would not likely have happened with other more command-and-control regimes in place. As far as what was sent to China, it is less than one truck trailer load. If that little is a critical shortage, we have major, major problems.
- The testing was inadequate at the start because FDA refused to certify the WHO test, and CDC took forever to develop a suitable test, including sending out one batch that was flawed. I will argue that Trump should have told FDA to stuff it, but he is getting plenty of criticism for even pushing them to fast-track certification of chloroquine. I keep hearing that Trump should listen to his experts. Well, the experts screwed the pooch, and Trump had to intervene to take it away from them.
- Trump was trying to play down the threat in order to try to avoid panic. It was an attempted reprise of, "The only thing we have to fear is fear itself," probably with more substantive support to go on. But the left has been so firmly "Orange Man Bad" that any positive impact this would have had has been lost.

I am not saying that Trump has handled it perfectly. IMO he should have stifled CDC and FDA, and gotten state, local, and private organizations involved a lot sooner. But at least he did it eventually. I would also have done the 9/11 thing and done a universal shutdown for a week or so, including banning all international flights (except maybe to return US citizens) and having the exchanges suspend trading for a week. During that time I would have gotten state, local, and private leaders together to work out a response (maybe better a teleconference than a meeting, to set a proper example). But those things are all judgement calls, and with them I still give him a B+ overall.

If you've never done crisis or emergency response, you have no idea how difficult it can be.

+1 to what Owlnumbers just said above

(04-01-2020 11:38 AM)At Ease Wrote:  

(04-01-2020 04:42 AM)Fort Bend Owl Wrote:  To be honest, I just pay attention to the death totals now. It's pretty hard to manipulate those numbers. Sorry but it's easy to be cynical at 4:30 in the morning when you can't sleep.

I think we will probably have to wait until after the virus runs its course before epidemiologists give a clear picture of the death numbers. Obviously it seems China is lying about their numbers, while some European nations are only reporting hospital deaths. Even here, there are anecdotal reports of deaths that aren't being included in reports in timely manners. Meanwhile in the MAGA-twitterverse, the grifters have successfully sown the belief that the death numbers are inflated (the cause of death should be the co-morbidity, not the COVID-19) to make the President look bad.

To this, note that for H1N1 in 2009, we have round numbers like 60mm and 275,000 for the infected and hospitalized, but we have 12, 431 (or something close and that specific) for deaths.

These are estimates, except for deaths... and even deaths can be flawed if a doc doesn't put that they died from pneumonia that was the result of contracting H1N1

Very few people will actually die FROM Covid (or H1N1)... most will die due to complications related to it.

(04-01-2020 12:00 PM)Hambone10 Wrote:  This is not being posted as an 'I told you so'... it is being posted as a 'just because a CDC director didn't say it before, doesn't mean they won't.'

I said this weeks ago and some argued that 'what I'm saying, they haven't heard any 'experts' say'.

https://www.msn.com/en-ca/news/world/fac...li=AAggFp4

The tone of such claims ranged from condescending to frustrated, with the US Surgeon General Jerome Adams tweeting in late February -- in all caps -- "STOP BUYING MASKS!"

"They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can't get them to care for sick patients, it puts them and our communities at risk," he added, in a post that has since been retweeted over 43,000 times.

That same week, Robert Redfield, director of the Centers for Disease Control and Prevention (CDC), appeared before lawmakers. Asked if people should wear masks, he had a straightforward answer: "No."

Now he's not so sure. On Monday, Redfield said told NPR that the CDC was reviewing its guidelines and may recommend general mask use to guard against community infection. It's likely only a matter of time before other mask holdouts, most prominently the World Health Organization (WHO), follow suit.


SOMETIMES the answer depends on details of the question... timing etc... and sometimes people who are 'experts' just make mistakes.

Yes, experts can make mistakes, which is why not cowtowing to their opinions on internet message boards doesn’t mean someone isn’t listening...

The mask issue is an interesting one - I don’t remember the conversation on this board about it, but I’ve had a few with friends. We’ve all gone back and forth about whether we should/shouldn’t wear masks out, and their effectiveness. We definitely agreed that we didn’t need N95s for day-to-day use, but that any sort of mask would probably be best.

What was your opinion again?

My understanding of the masks is that they are not there to protect you from them, but to protect them from you.

(04-01-2020 01:45 PM)OptimisticOwl Wrote:  My understanding of the masks is that they are not there to protect you from them, but to protect them from you.

Yep, and it sounds like the tune is starting to change regarding public use because of the number of asymptomatic people is higher than thought.

Quote:In the US, an estimated 25% of coronavirus carriers have no symptoms, said the director of the Centers for Disease Control and Prevention.

"Information that we have pretty much confirmed now is that a significant number of individuals that are infected actually remain asymptomatic. That may be as many as 25%," CDC Director Dr. Robert Redfield told NPR.

To prevent further spread, the top infectious disease expert in the US says health officials are reconsidering guidance on face masks.

Dr. Anthony Fauci said he would "lean towards" recommending that the general public wear face masks "if we do not have the problem of taking away masks from the health care workers who need them."

"We're not there yet, but I think we're close to coming to some determination," Fauci said.

If federal officials recommend widespread use of face masks, it would be a stark reversal from recommendations by the World Health Organization and the CDC, who have said face masks should only be worn by health care workers, those who are sick, and those who are taking care of someone sick.

https://www.cnn.com/2020/04/01/health/us...index.html

(04-01-2020 09:08 AM)Hambone10 Wrote:  Big, I understand your 'that's how I view a President' opinion and I used to feel that way in the 80's. Not anymore. First, Do you honestly believe that Biden, Bernie, Hillary and Trump are among the best executives/problem solvers in this country? Second, do people elect a President based on things that might never happen during their tenure, or do they elect them based on what happens 95+% of the time?

So appoint a COVID czar now. Bill Gates on COVID

Based on your and RU's observations, we need a level of coordination that's not happening right now.

FDR had Harry Hopkins for Lend-Lease during WW2. Where's Trump's Harry?

Mnuchin? Meh. Maybe on the economy or infrastructure.

(04-01-2020 02:10 PM)ausowl Wrote:  

(04-01-2020 09:08 AM)Hambone10 Wrote:  Big, I understand your 'that's how I view a President' opinion and I used to feel that way in the 80's. Not anymore. First, Do you honestly believe that Biden, Bernie, Hillary and Trump are among the best executives/problem solvers in this country? Second, do people elect a President based on things that might never happen during their tenure, or do they elect them based on what happens 95+% of the time?

So appoint a COVID czar now. Bill Gates on COVID
Based on your and RU's observations, we need a level of coordination that's not happening right now.
FDR had Harry Hopkins for Lend-Lease during WW2. Where's Trump's Harry?
Mnuchin? Meh. Maybe on the economy or infrastructure.

I think Pence is the czar.

And I don't see where the problem is coordination. It's not having enough worker bees. We need more doers, not more administrators.

(04-01-2020 01:24 PM)RiceLad15 Wrote:  The mask issue is an interesting one - I don’t remember the conversation on this board about it, but I’ve had a few with friends. We’ve all gone back and forth about whether we should/shouldn’t wear masks out, and their effectiveness. We definitely agreed that we didn’t need N95s for day-to-day use, but that any sort of mask would probably be best.

What was your opinion again?

Post #31 in this thread of now almost 2000 posts... and little of my opinion has changed to any great degree.

I wouldn't listen a lot to news. There's no way NOT to panic if that is your source. I absolutely would listen to experts like the CDC etc in terms of facts, figures etc... but remember that their entire job is to play defense... and there is zero risk to them in being 'over-prepared'.
As to thinking about how to act...
now...
1) monitor your own health. You are much more at risk if you are otherwise compromised.
2) watch out for those with compromised immune systems just as you did/would through flu season.
3) practice good hygiene.

there are some other thoughts, but they would be more person/job specific.

as to what to do with a larger outbreak?
If you are not otherwise compromised or showing symptoms or have reason to think you are infected, DO NOT SEEK ATTENTION FROM HEALTHCARE PROVIDERS
1) they're busy caring for sick people 2) you would be going to a place where the virus is more prevalent..

Work from home if/as you can. Avoid crowds

beyond that, it depends on what you mean by larger. Healthy people who don't work in healthcare generally have little to worry about. Infants, the elderly and the compromised... masks and gloves etc etc etc


That was my advice 2.27. Still feel pretty good about it.

I wear a single glove to shop... gloved hand for 'their' things... 'clean' hand for mine. Touch my car, Put my credit card in the machine with clean hand, punch the numbers, push the cart with the glove... like you would dredging CFS.

I don't wear a mask as I am not symptomatic and don't have much reason to think I've been exposed.... but I would if I thought it would help keep others away from me.

N95's for healthcare workers or if you HAD to visit a compromised person.

(04-01-2020 01:45 PM)OptimisticOwl Wrote:  My understanding of the masks is that they are not there to protect you from them, but to protect them from you.

Mostly. It's also an outward sign to create social distancing without a panic or embarrassment. You see someone wearing a mask, you don't know if they intend it for you or themselves, but you avoid them.

If you work in healthcare, it's primarily for them, but it's better than nothing for you.

I don't know if I posted it here or on another forum, but I've been talking a lot about modeling Japan, with my only concern that we would take things to an extreme like we always do and masks would become status symbols for influencers... which means some people would wear them who didn't need them, which would discourage some people who did need them from wearing them... especially if they were 'generic'.

I did talk about how we should do this not just for COvid, but always as it would not only help us fight outbreaks like Covid and Swine, but also annual flu that has killed 500,000 Americans between the Swine and Covid... which is what the Japanese do...
AND it would do so without needing to engage in a shut down, especially of people who were not sick enough to stay home, but still sick or exposed.

(04-01-2020 12:00 PM)Hambone10 Wrote:  This is not being posted as an 'I told you so'... it is being posted as a 'just because a CDC director didn't say it before, doesn't mean they won't.'

I said this weeks ago and some argued that 'what I'm saying, they haven't heard any 'experts' say'.

https://www.msn.com/en-ca/news/world/fac...li=AAggFp4

The tone of such claims ranged from condescending to frustrated, with the US Surgeon General Jerome Adams tweeting in late February -- in all caps -- "STOP BUYING MASKS!"

"They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can't get them to care for sick patients, it puts them and our communities at risk," he added, in a post that has since been retweeted over 43,000 times.

That same week, Robert Redfield, director of the Centers for Disease Control and Prevention (CDC), appeared before lawmakers. Asked if people should wear masks, he had a straightforward answer: "No."

Now he's not so sure. On Monday, Redfield said told NPR that the CDC was reviewing its guidelines and may recommend general mask use to guard against community infection. It's likely only a matter of time before other mask holdouts, most prominently the World Health Organization (WHO), follow suit.


SOMETIMES the answer depends on details of the question... timing etc... and sometimes people who are 'experts' just make mistakes.

I agree. An important attribute of leadership is admitting your mistakes. And taking responsibility. TAKING RESPONSIBILITY.

Rice engineers


"The Rice team expects to have their prototype completed by Tuesday and for human trials to be underway a day or two later. By the end of the week, they’re aiming for something that would normally sound impossible: receiving Food and Drug Administration approval in a matter of hours—not days or months."

I guess somebody is cutting the red tape. According to people here, that could only be the man at the top - Trump.

(04-01-2020 11:25 AM)OptimisticOwl Wrote:  

(04-01-2020 09:59 AM)tanqtonic Wrote:  

(04-01-2020 09:53 AM)OptimisticOwl Wrote:  There are some people here who believe giant agencies turn on a dime with the installation of a new chief. Or a new anybody. I have seen no evidence that this is so. My experience with much smaller businesses would indicate this is not so. But apparently they are more expert in these things than I am.

So you fire the coach, and he installs a new strength coach and a new receivers coach. Wow, presto chang-o, the team starts winning. I wonder why we cannot do this at Rice. If it is so easy with national agencies like the CDC, it should be a snap in a little ole football program of less than 200 people all in one place.

It is frustrating trying to talk common sense to people who have no experience and no desire to learn, but are single minded in a goal that has nothing to do with the facts. I certainly understand ham's frustrations.

The goal here for the lefties is to replace Trump. They don't care if the replacement is a step up or a step or three down. But to bring down the stag, first they need to bleed him a little. So they pick at everything he does or doesn't do, everything he does or doesn't say, and how he says or doesn't say it. They do it with lies (he's Putin's puppet) and innuendo (lots of smoke there - we need to see what's up) So when they do it yet again, it has little force. Just more of the same. The guy who bitched in November 2016 is bitching now. BFD.

Elections always come down to the lesser evil. Nothing BigLad or any of the others can say can make me think Biden is the lesser evil. A person who says "it's OK to not pay your rent" is a damn fool. What's next, "It's OK to walk into a grocery store and take what you need without paying"? How about it is OK to walk into a bank and take what you need"?

I did not vote in the presidential race in 2016. Like Hillary and many others, I thought it just an exercise in futility, and we would be stuck with somebody whose entire agenda would be accomplished when she stepped off the inaugural platform, and I did not think Trump, even if elected, would be much more than a different kind of vanity President.

Boy was I wrong. Based on what he has done, I will vote for him in 2020, my first ever vote for him, despite the fevered desire of the lefties here to convince he is a (fool, idiot, evil genius, trust fund baby, corrupt, racist, xenophobic, ugly, ill mannered, puppet, yada yada yada) and therefore I should vote for (anybody else), including a doddering old fool who will be controlled by who knows who.

Sorry, BigLad, I do not see a better alternative to Trump, at least not one who is running.

It fits your agenda to criticize everything about him. All you have to do is show me somebody better. So far, you have an F- in that. Beta, Sanders, Deblassio, Biden, Harris - not worth a cup of warm spit. Collectively. All any of them can say is they are NotTrump. Or that they will pursue policies I think wrong, ill-advised, and unworkable.

I have somebody in mind that I think would be better than all of them. But he is not running this year. I hope he runs in 2024, regardless of how 2020 turns out.

I have someone in mind as well. But *she* is not running this year.

Condy?

Condi wont ever run.

(04-01-2020 02:10 PM)ausowl Wrote:  

(04-01-2020 09:08 AM)Hambone10 Wrote:  Big, I understand your 'that's how I view a President' opinion and I used to feel that way in the 80's. Not anymore. First, Do you honestly believe that Biden, Bernie, Hillary and Trump are among the best executives/problem solvers in this country? Second, do people elect a President based on things that might never happen during their tenure, or do they elect them based on what happens 95+% of the time?

So appoint a COVID czar now. Bill Gates on COVID

Based on your and RU's observations, we need a level of coordination that's not happening right now.

FDR had Harry Hopkins for Lend-Lease during WW2. Where's Trump's Harry?

Good reference! Hopkins was often described as FDR's "expediter" (and was detested by the Congressional opposition).

Exit quotation from Ben Sasse, commenting on news today on Chinese medical numbers: “The claim that the United States has more coronavirus deaths than China is false. Without commenting on any classified information, this much is painfully obvious: The Chinese Communist Party has lied, is lying, and will continue to lie about coronavirus to protect the regime. Beijing’s garbage propaganda shouldn’t be taken seriously by the World Health Organization, by independent journalists, or by the American epidemiologists who are going to beat this terrible virus.”

(04-01-2020 03:36 PM)OptimisticOwl Wrote:  Rice engineers


"The Rice team expects to have their prototype completed by Tuesday and for human trials to be underway a day or two later. By the end of the week, they’re aiming for something that would normally sound impossible: receiving Food and Drug Administration approval in a matter of hours—not days or months."

I guess somebody is cutting the red tape. According to people here, that could only be the man at the top - Trump.

Here is your ventilator lesson for the day:

The bag/mask is good to use when you are breathing for a patient unable to breath for themselves (unconscious and/or not generating spontaneous breaths on their own).
Unfortunately, with respiratory distress, the patient may be generating spontaneous breaths but due to increased alveoli fluid the breaths may not generate adequate oxygen and carbon dioxide transfer from the alveoli to the blood and vice versa. So, you need something to force the oxygen through the alveoli congestion and into the blood stream. A ventilator can do this by pressurizing the circuit of tubing. This is referred to as PEEP (positive end expiratory pressure). The bag mask circuit typically can't do this. In the picture of the system, it looks like a gear drive a rod on both sides of the bag. The gears allow for one to adjust the tidal volume (volume of the breath). It should be possible to generate some PEEP if the gears maintain some amount of compression on the bag and adjust the tidal volume to compensate for the volume loss due to this compression. But again, the bag only works with an unconscious patient or one who is unable to generate a spontaneous breath. Otherwise, you would have to sedate the patient to tolerate the bag's breaths. A ventilator can also sense a patient's spontaneous breath and supplement it with a specified tidal volume. I wonder if this is possible with the bag system shown.
Just a few things to kick around (that's for Hambone).

(04-01-2020 03:36 PM)OptimisticOwl Wrote:  Rice engineers


"The Rice team expects to have their prototype completed by Tuesday and for human trials to be underway a day or two later. By the end of the week, they’re aiming for something that would normally sound impossible: receiving Food and Drug Administration approval in a matter of hours—not days or months."

I guess somebody is cutting the red tape. According to people here, that could only be the man at the top - Trump.

I'm fortunate to have a somewhat inside look at this, and it really is an awesome story -- not just the original design (for which I served as a judge in the 2019 Engineering Design Showcase), but also the nearly round-the-clock work that the students (now alums), faculty advisors, and others have put into refining and improving it in the last week or so.

My own very small but still rewarding contribution is that I recently connected one of the key people in this effort with a key person at a critical government agency. I was able to do so within a matter of minutes because I have both their mobile numbers on my phone (I might be the only person who does). One of the few things I'm really good at is knowing people, which sometimes comes in handy.

(04-01-2020 05:16 PM)ruowls Wrote:  

(04-01-2020 03:36 PM)OptimisticOwl Wrote:  Rice engineers


"The Rice team expects to have their prototype completed by Tuesday and for human trials to be underway a day or two later. By the end of the week, they’re aiming for something that would normally sound impossible: receiving Food and Drug Administration approval in a matter of hours—not days or months."

I guess somebody is cutting the red tape. According to people here, that could only be the man at the top - Trump.

Here is your ventilator lesson for the day:

The bag/mask is good to use when you are breathing for a patient unable to breath for themselves (unconscious and/or not generating spontaneous breaths on their own).
Unfortunately, with respiratory distress, the patient may be generating spontaneous breaths but due to increased alveoli fluid the breaths may not generate adequate oxygen and carbon dioxide transfer from the alveoli to the blood and vice versa. So, you need something to force the oxygen through the alveoli congestion and into the blood stream. A ventilator can do this by pressurizing the circuit of tubing. This is referred to as PEEP (positive end expiratory pressure). The bag mask circuit typically can't do this. In the picture of the system, it looks like a gear drive a rod on both sides of the bag. The gears allow for one to adjust the tidal volume (volume of the breath). It should be possible to generate some PEEP if the gears maintain some amount of compression on the bag and adjust the tidal volume to compensate for the volume loss due to this compression. But again, the bag only works with an unconscious patient or one who is unable to generate a spontaneous breath. Otherwise, you would have to sedate the patient to tolerate the bag's breaths. A ventilator can also sense a patient's spontaneous breath and supplement it with a specified tidal volume. I wonder if this is possible with the bag system shown.
Just a few things to kick around (that's for Hambone).

Thanks, ru. Very well explained.

I can see it being useful in a situation where all the conventional ventilators are in use and you’re up against the wall. Or in the OR in a closely monitored situation if all the anesthesia machines have been commandeered for the ICU. Maybe in 3rd world hospitals or field hospitals.

how to stay sane at home