Coronavirus thread

[Leress]

https://www.insider.com/photos-video-de ... CLMSc35f3I

Denver health worker ain't taking the protester's shit.

[Kaelik]

I keep seeing the US split. I hope the chances of that are way smaller than what my imagination is creating. There are going to be states (South Dakota, Florida) that suck at this. And they're going to have cases long after the west coast slows way down. Which is why I asked my first question because I can see states that smashed it not wanting traffic from states that didn't. And if we get to that point, wouldn't all hell break loose just like the stupid people protesting?

The thing about arbitrary nonsense state boundaries with no restrictions about border crossings is that if you have them for a few centuries all the people on the inside come to identify way more with national group identifiers than states.

It may be the case on some level that when people aren't thinking about it you can get people to say "I don't want any ALABAMANS coming into my state and spreading the virus" but as soon as you ask them to look at an actual Alabaman trying to come to NJ because they are a black person trying to move in with family in Newark since they lost their job and apartment because of Alabama's shitty safety net and bad response to the virus, those same people are going to go "oh wait, I guess like, I might hate like 60% of Alabamans, but I LIKE the other 40% and I hate 40% of New Jerseians who are also out there calling this a hoax. Fuck, I guess I don't really want my governor to ban people from entering the state."

There just isn't any real continuity between people of a certain "state" that would lead to anyone having the political will to actually try to emphasize those distinctions.

[Orca]

Since it's apparently actually legal for states to put up barriers to free movement (given a decent excuse like quarantine), to actually break up the US you'd need something more. Like the immunity from covid-19 lasting only briefly and vaccines replicating that and quarantines starting to come into place for years rather than months. Or like a president rejecting the result of an election and some states going along with that; I could see Trump doing the first part but probably not the states backing him up, he's not a guy who inspires loyalty past the point where he can hand out rewards.

[phlapjackage]

With all the bullshit "Free XX" stuff from Trump and the "movements" to open states up, it seems there is/was a massive astroturfing campaign to build support for these movements. So powerful forces are sowing chaos and unrest in a country wracked by a pandemic. And Trump et al are aligned with them. Hmmmm.

https://www.reddit.com/r/maryland/comme ... e/fnstpyl/

https://www.nbcnews.com/tech/social-med ... s-n1188021

[Username17]

I keep seeing the US split. I hope the chances of that are way smaller than what my imagination is creating. There are going to be states (South Dakota, Florida) that suck at this. And they're going to have cases long after the west coast slows way down. Which is why I asked my first question because I can see states that smashed it not wanting traffic from states that didn't. And if we get to that point, wouldn't all hell break loose just like the stupid people protesting?

The thing about the stupid protesters is that their position is deeply unpopular and getting more unpopular. Actual polling grossly favors harsh quarantine measures.

"Cancel all meetings or gatherings of more than 10 people, like sports events, concerts, conferences, etc."

March: 85% support
April: 87% support

So it's really unlikely that a popular movement based on human sacrifice to try to make the Dow Jones lines go up would be able to get any real territory. Even in Iowa, a majority of people think the governor is insane and the economy is tanking anyway.

If the corruption and mass death causes the Republican regime to completely collapse, if it causes the entire United States to completely collapse, the most likely event is a successor state that includes most or all of the same territory.

We could very well transition to a system where there are no senators from any Dakota. But we'd still probably end up calling the new system "The United States" because that's all we know.

-Username17

[echoVanguard]

The thing about oppositional demographics in the U.S. is that it's not X location vs Y location, it's primarily urban vs rural. As a result, the various factions are reasonably evenly distributed across the geography, which prevents the sort of unified zones of control you'd need for any actual breakdown of polity. At worst you might have some of the areas without any major urban concentrations (like Appalachia) attempt to declare themselves "islands of patriotism", but those areas also don't have any industry or wealth to speak of so they aren't very likely to do so, because they gain more from being a part of a state they despise than they would from being outside of it.

Basically, in order to have any kind of meaningful territory-based insurrection, you need three things:

1. A geographically isolated region with people who want something that's not a good deal for the people outside of that region,
2. A sufficiently poor quality of life at least ostensibly caused by #1 that risking death is preferable to its continuation, and
3. A source of economic power capable of funding the war effort.

You can have situations where #3 comes from an outside source, but that outside source has to have something to gain. Currently it's much more profitable to continuously stoke people's anger and feed off their clicks and sales than it is to try to create and support a new state.

echo

[echoVanguard]

This link may help illustrate the mechanisms at work.

echo

[deaddmwalking]

This Onion Article is from 20 years ago, but I thought it might be relevant.

[OgreBattle]

This Onion Article is from 20 years ago, but I thought it might be relevant.

""The way things stand, things in the Deep South almost have to get better. Otherwise, the people who live there will devolve into preverbal, overall-wearing sub-morons within a century," said Professor Dennis Lassiter of Princeton University. "Either Southerners will start improving themselves, or they'll be sold to middle-class Asians as pets."

[Username17]

So about those protesters. First of all, they look horrifying. But then when you dig a little deeper, they are horrifying.

So that's the now iconic picture of the Ohio protesters looking like a fucking zombie movie. But remember, these aren't angry working class people demanding food and shelter. The woman on the left of the picture is Melissa Ackison, co-owner of Ackinson Surveying and current candidate to be the Republican nominee for Ohio's 26th state senate district. She isn't out there demanding that she be allowed to die for capitalism, she is out there demand that her employees be allowed to die for capitalism. And she's not the grassroots of anything, she's literally a Republican politician.

-Username17

[Kaelik]

Senate Democrats officially going to support another bailout, no money for states or cities, nothing for election protection or the post office, no oversight, no limits on fossil fuel bailouts, no food stamps, just give the banks another big pile of money.

This is what the democratic party is. They don't want to make anything better so if you give them the power to do so, an actual situation where McConnell will pass whatever they demand because he needs to bailout companies suddenly all their demands dry up in sun.

You can find Democratic Party Line Followers like Greg Sargent or Brian Beutler decrying this endless refusal to do anything but it's important we pretend that this is just good politics and act just like Democrats in Congress, always caving to the right and never even asserting problems that exist. Pretend they don't exist.

You can't be a democrat unless you preemptively surrender to the right wing without ever even trying. Pelosi has been doing this non stop for 2 years and it's important that we all prove we are true democrats by preemptively caving to her and pretending that she couldn't do anything about this.

[Korwin]

The woman on the left of the picture is Melissa Ackison, co-owner of Ackinson Surveying and current candidate to be the Republican nominee for Ohio's 26th state senate district. She isn't out there demanding that she be allowed to die for capitalism, she is out there demand that her employees be allowed to die for capitalism. And she's not the grassroots of anything, she's literally a Republican politician.

-Username17

While that might be her intention, still dumb action on her part.
(depending on how many in that crowd had covid-19)

I really don't understand those people the more half hearted the social distancing the higher the cost for the economy (to use their argument, the economy)...

[RadiantPhoenix]

Senate Democrats officially going to support another bailout, no money for states or cities, nothing for election protection or the post office, no oversight, no limits on fossil fuel bailouts, no food stamps, just give the banks another big pile of money.

Link, please?

[Username17]

The woman on the left of the picture is Melissa Ackison, co-owner of Ackinson Surveying and current candidate to be the Republican nominee for Ohio's 26th state senate district. She isn't out there demanding that she be allowed to die for capitalism, she is out there demand that her employees be allowed to die for capitalism. And she's not the grassroots of anything, she's literally a Republican politician.

-Username17

While that might be her intention, still dumb action on her part.
(depending on how many in that crowd had covid-19)

I really don't understand those people the more half hearted the social distancing the higher the cost for the economy (to use their argument, the economy)...

It's not about lives. It's not about the economy. It's not even about Trump's election. It's about their ability to push other people around. They want to be served and they honestly do not care what happens to the GDP or how many people die.

Those signs aren't poorly worded. That's their actual demands. The lady whose sign says "I want a haircut" is dead fucking serious. She wants another human being to serve her for forty five minutes at a time, and if she has to murder people in a violent revolution to make that happen so be it. Blink and you might miss it, but the sign next to hers is equally revealing: Save Our Small Businesses. You might think it's because it fits better than "save the small businesses" or "save main street" or whatever but the possessive is entirely intentional. These people literally own small businesses, and they want the businesses opened so that they can go back to bossing people around.

They aren't out their asking for a financial bailout or a guaranty of food and shelter. They want their power back. They want to hold out dollar bills while poor people caper for their amusement. That's it.

The reason this protest movement is so small is that it represents the interests only of the lowest members of the ruling class. The people who can demand the services of others in a capitalist society, but lack the wealth and power to order people around on Zoom. These fuckers own car dealerships and franchise restaurants. Or in at least one case: a surveying company that repeatedly cheats on its taxes. I mean, you don't see Bob Iger or Tim Cook shaking a sign at people. The real ruling class has no fear of losing their position waiting out a pandemic. But these JV petty tyrants fear that they won't be able to demand deference from the poors. And that's unacceptable.

In other news, if you compare total deaths from the last month to previous yearly averages it looks like the COVID deaths are being underreported by tens of thousands. So that's a thing. Also that's a sample of ten countries and a city, so by "tens of thousands" we probably mean "hundreds of thousands."

-Username17

[phlapjackage]

Life imitates SR/CP2020

https://www.salon.com/2020/04/21/states ... d-kushner/

[DSMatticus]

In other news, if you compare total deaths from the last month to previous yearly averages it looks like the COVID deaths are being underreported by tens of thousands. So that's a thing. Also that's a sample of ten countries and a city, so by "tens of thousands" we probably mean "hundreds of thousands."

Their sample was a pool of countries with 50,610 confirmed COVID-19 deaths and 78,200 estimated excess deaths, suggesting that about 35% of deaths are going uncounted. For the current global confirmed COVID-19 death toll of 177,641, that would indicate an actual death toll of 273,292. So just shy of a 100,000.

This kind of analysis is going to be real goddamn sensitive to the areas you're looking at, with hot spots and areas with poor health infrastructure missing way more deaths, so, grain of salt and all that.

[Username17]

In other news, if you compare total deaths from the last month to previous yearly averages it looks like the COVID deaths are being underreported by tens of thousands. So that's a thing. Also that's a sample of ten countries and a city, so by "tens of thousands" we probably mean "hundreds of thousands."

Their sample was a pool of countries with 50,610 confirmed COVID-19 deaths and 78,200 estimated excess deaths, suggesting that about 35% of deaths are going uncounted. For the current global confirmed COVID-19 death toll of 177,641, that would indicate an actual death toll of 273,292. So just shy of a 100,000.

This kind of analysis is going to be real goddamn sensitive to the areas you're looking at, with hot spots and areas with poor health infrastructure missing way more deaths, so, grain of salt and all that.

But a lot of countries aren't really admitting to any COVID deaths, and also aren't reporting their dead. The COVID deaths in North Korea, Cambodia, and Yemen are supposedly zero, and I'm willing to bet real money that the real number is infinity times higher than that. Less dramatically, most people seem to think the official undercount in the PRC is rather more than 35%.

While you got places like Sweden, where there isn't much evidence of there
being any undercount at all, the fact is that there are really a lot more countries like Indonesia than Sweden, and in these areas of poor record keeping and healthcare access the undercount looks to be something like 10:1 or more.

I suspect the absolute number of the undercount may be more relevant than the percentage, in which case it's like two hundred thousand extra dead. COVID is likely to beat Bush's occupation of Iraq within weeks, and will likely beat Pol Pot's killing fields within a few months.

-Username17

[deaddmwalking]

Yesterday I read an article in the New York Times from a doctor on the front lines who teaches intubation to other doctors. His finding is that otherwise apparently healthy people are suffering from extremely low oxygen. The way the Covid-19 infection impacts your lungs, it makes it harder to absorb oxygen, but it doesn't impact your ability to expel CO2. Having a build-up of CO2 you will notice. You will feel breathless and confused. If you're able to expel the CO2, but you're not getting enough oxygen, the symptoms are easy to overlook.

By the time you go to the hospital, you've further damaged your lungs by breathing deep and hard and you're more likely to have organ damage. A Pulse Oximeter is a device that clips on your fingers and measures your blood oxygen level. A single device can be used by everyone in a family easily and you can pick one up from a pharmacy for $25-50 usually. The device is completely painless. The screen is easy to read and it gives you a oxygenation level as a percentage (100% is good, below 95% is usually not great, below 90% is bad).

The idea here is that if you are able to monitor your blood oxygen level and it becomes dangerously low, you can contact your doctor and potentially get treatment before you'd have gone to the emergency room. You're more likely to avoid a ventilator. The article specifically mentions Boris Johnson and this as the reason why he was able to avoid a prolonged stay in the ICU.

[Whatever]

This is the article: https://www.nytimes.com/2020/04/20/opin ... monia.html

I have been practicing emergency medicine for 30 years. In 1994 I invented an imaging system for teaching intubation, the procedure of inserting breathing tubes. This led me to perform research into this procedure, and subsequently teach airway procedure courses to physicians worldwide for the last two decades.

So at the end of March, as a crush of Covid-19 patients began overwhelming hospitals in New York City, I volunteered to spend 10 days at Bellevue, helping at the hospital where I trained. Over those days, I realized that we are not detecting the deadly pneumonia the virus causes early enough and that we could be doing more to keep patients off ventilators — and alive.

On the long drive to New York from my home in New Hampshire, I called my friend Nick Caputo, an emergency physician in the Bronx, who was already in the thick of it. I wanted to know what I was facing, how to stay safe and about his insights into airway management with this disease. “Rich,” he said, “it’s like nothing I’ve ever seen before.”

He was right. Pneumonia caused by the coronavirus has had a stunning impact on the city’s hospital system. Normally an E.R. has a mix of patients with conditions ranging from the serious, such as heart attacks, strokes and traumatic injuries, to the nonlife-threatening, such as minor lacerations, intoxication, orthopedic injuries and migraine headaches.

During my recent time at Bellevue, though, almost all the E.R. patients had Covid pneumonia. Within the first hour of my first shift I inserted breathing tubes into two patients.
Debatable: Agree to disagree, or disagree better? Broaden your perspective with sharp arguments on the most pressing issues of the week.

Even patients without respiratory complaints had Covid pneumonia. The patient stabbed in the shoulder, whom we X-rayed because we worried he had a collapsed lung, actually had Covid pneumonia. In patients on whom we did CT scans because they were injured in falls, we coincidentally found Covid pneumonia. Elderly patients who had passed out for unknown reasons and a number of diabetic patients were found to have it.

And here is what really surprised us: These patients did not report any sensation of breathing problems, even though their chest X-rays showed diffuse pneumonia and their oxygen was below normal. How could this be?

We are just beginning to recognize that Covid pneumonia initially causes a form of oxygen deprivation we call “silent hypoxia” — “silent” because of its insidious, hard-to-detect nature.

Pneumonia is an infection of the lungs in which the air sacs fill with fluid or pus. Normally, patients develop chest discomfort, pain with breathing and other breathing problems. But when Covid pneumonia first strikes, patients don’t feel short of breath, even as their oxygen levels fall. And by the time they do, they have alarmingly low oxygen levels and moderate-to-severe pneumonia (as seen on chest X-rays). Normal oxygen saturation for most persons at sea level is 94 percent to 100 percent; Covid pneumonia patients I saw had oxygen saturations as low as 50 percent.

To my amazement, most patients I saw said they had been sick for a week or so with fever, cough, upset stomach and fatigue, but they only became short of breath the day they came to the hospital. Their pneumonia had clearly been going on for days, but by the time they felt they had to go to the hospital, they were often already in critical condition.

In emergency departments we insert breathing tubes in critically ill patients for a variety of reasons. In my 30 years of practice, however, most patients requiring emergency intubation are in shock, have altered mental status or are grunting to breathe. Patients requiring intubation because of acute hypoxia are often unconscious or using every muscle they can to take a breath. They are in extreme duress. Covid pneumonia cases are very different.

A vast majority of Covid pneumonia patients I met had remarkably low oxygen saturations at triage — seemingly incompatible with life — but they were using their cellphones as we put them on monitors. Although breathing fast, they had relatively minimal apparent distress, despite dangerously low oxygen levels and terrible pneumonia on chest X-rays.

We are only just beginning to understand why this is so. The coronavirus attacks lung cells that make surfactant. This substance helps the air sacs in the lungs stay open between breaths and is critical to normal lung function. As the inflammation from Covid pneumonia starts, it causes the air sacs to collapse, and oxygen levels fall. Yet the lungs initially remain “compliant,” not yet stiff or heavy with fluid. This means patients can still expel carbon dioxide — and without a buildup of carbon dioxide, patients do not feel short of breath.

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Patients compensate for the low oxygen in their blood by breathing faster and deeper — and this happens without their realizing it. This silent hypoxia, and the patient’s physiological response to it, causes even more inflammation and more air sacs to collapse, and the pneumonia worsens until oxygen levels plummet. In effect, patients are injuring their own lungs by breathing harder and harder. Twenty percent of Covid pneumonia patients then go on to a second and deadlier phase of lung injury. Fluid builds up and the lungs become stiff, carbon dioxide rises, and patients develop acute respiratory failure.

By the time patients have noticeable trouble breathing and present to the hospital with dangerously low oxygen levels, many will ultimately require a ventilator.

Silent hypoxia progressing rapidly to respiratory failure explains cases of Covid-19 patients dying suddenly after not feeling short of breath. (It appears that most Covid-19 patients experience relatively mild symptoms and get over the illness in a week or two without treatment.)

A major reason this pandemic is straining our health system is the alarming severity of lung injury patients have when they arrive in emergency rooms. Covid-19 overwhelmingly kills through the lungs. And because so many patients are not going to the hospital until their pneumonia is already well advanced, many wind up on ventilators, causing shortages of the machines. And once on ventilators, many die.

Avoiding the use of a ventilator is a huge win for both patient and the health care system. The resources needed for patients on ventilators are staggering. Vented patients require multiple sedatives so that they don’t buck the vent or accidentally remove their breathing tubes; they need intravenous and arterial lines, IV medicines and IV pumps. In addition to a tube in the trachea, they have tubes in their stomach and bladder. Teams of people are required to move each patient, turning them on their stomach and then their back, twice a day to improve lung function.

There is a way we could identify more patients who have Covid pneumonia sooner and treat them more effectively — and it would not require waiting for a coronavirus test at a hospital or doctor’s office. It requires detecting silent hypoxia early through a common medical device that can be purchased without a prescription at most pharmacies: a pulse oximeter.

Pulse oximetry is no more complicated than using a thermometer. These small devices turn on with one button and are placed on a fingertip. In a few seconds, two numbers are displayed: oxygen saturation and pulse rate. Pulse oximeters are extremely reliable in detecting oxygenation problems and elevated heart rates.

Pulse oximeters helped save the lives of two emergency physicians I know, alerting them early on to the need for treatment. When they noticed their oxygen levels declining, both went to the hospital and recovered (though one waited longer and required more treatment). Detection of hypoxia, early treatment and close monitoring apparently also worked for Boris Johnson, the British prime minister.

Widespread pulse oximetry screening for Covid pneumonia — whether people check themselves on home devices or go to clinics or doctors’ offices — could provide an early warning system for the kinds of breathing problems associated with Covid pneumonia.

People using the devices at home would want to consult with their doctors to reduce the number of people who come to the E.R. unnecessarily because they misinterpret their device. There also may be some patients who have unrecognized chronic lung problems and have borderline or slightly low oxygen saturations unrelated to Covid-19.

All patients who have tested positive for the coronavirus should have pulse oximetry monitoring for two weeks, the period during which Covid pneumonia typically develops. All persons with cough, fatigue and fevers should also have pulse oximeter monitoring even if they have not had virus testing, or even if their swab test was negative, because those tests are only about 70 percent accurate. A vast majority of Americans who have been exposed to the virus don’t know it.

There are other things we can do as well to avoid immediately resorting to intubation and a ventilator. Patient positioning maneuvers (having patients lie on their stomach and sides) open up the lower and posterior lungs most affected in Covid pneumonia. Oxygenation and positioning helped patients breathe easier and seemed to prevent progression of the disease in many cases. In a preliminary study by Dr. Caputo, this strategy helped keep three out of four patients with advanced Covid pneumonia from needing a ventilator in the first 24 hours.

To date, Covid-19 has killed more than 40,600 people nationwide — more than 10,000 in New York State alone. Oximeters are not 100 percent accurate, and they are not a panacea. There will be deaths and bad outcomes that are not preventable. We don’t fully understand why certain patients get so sick, or why some go on to develop multi-organ failure. Many elderly people, already weak with chronic illness, and those with underlying lung disease do very poorly with Covid pneumonia, despite aggressive treatment.

But we can do better. Right now, many emergency rooms are either being crushed by this one disease or waiting for it to hit. We must direct resources to identifying and treating the initial phase of Covid pneumonia earlier by screening for silent hypoxia.

It’s time to get ahead of this virus instead of chasing it.

Richard Levitan, an emergency physician in Littleton, N.H., is president of Airway Cam Technologies, a company that teaches courses in intubation and airway management.

[Koumei]

If you're able to expel the CO2, but you're not getting enough oxygen, the symptoms are easy to overlook.

This is how things like Carbon Monoxide work. It binds so well to your red blood cells that oxygen doesn't get any room, and then even though you feel fine, at some point you fall asleep and die. It's just like breathing oxygen except you die. That and the easy availability are what make it a popular choice for suicide. It's what I was preparing for more than ten years ago when my meds kicked in.

Anyway, GameStop has decided it wants to reopen so it can kill more people. The CEO is named George Sherman, and if you asked me to name the Sherman in charge of the most deaths just a year ago I would have assumed it was related to a tank or the man after whom the tank was named. Yet here we fucking are.

[Thaluikhain]

If you're able to expel the CO2, but you're not getting enough oxygen, the symptoms are easy to overlook.

This is how things like Carbon Monoxide work. It binds so well to your red blood cells that oxygen doesn't get any room, and then even though you feel fine, at some point you fall asleep and die. It's just like breathing oxygen except you die. That and the easy availability are what make it a popular choice for suicide. It's what I was preparing for more than ten years ago when my meds kicked in.

You get people dying from accidental Carbon Monoxide poisoning every so often. Often when they are asleep. There's a zillion survivalist type videos of homemade stoves on youtube but they never seem to address this point.

While we are at it, flood the room with nitrogen, displace the oxygen and you can suffocate without knowing about it even though it's not a poisonous gas itself. A guy at the place my dad used to work it had that happen to him and they needed oxygen sensors installed.

[Username17]

New Hampshire and Maine will obviously join the RAC shortly after Vermont does. They can't survive economically without New York and Boston. Idaho and British Columbia joining the Western States Pact is surprising to me, but I suppose at that rate we might as well reunify California because the Baja Californians have been behind the iron curtain for too long. The Midwest Partnership needs a better name: I suggest New Egypt because I am old timey like that.

All in all, this is the most dystopian thing I've seen in my entire life. I don't know whether to laugh or cry that the new Confederacy is so bumblefuck that the southern tip of Florida is seceding even from that.

-Username17

[Josh_Kablack]

All in all, this is the most dystopian thing I've seen in my entire life.

I find it gallows humorous that WV is among the last to be picked for a team.

[Username17]

All in all, this is the most dystopian thing I've seen in my entire life.

I find it gallows humorous that WV is among the last to be picked for a team.

On the map, its central location seems an ideal - even necessary stepping stone for imperial expansion. The map is different from the territory however. As many have learned, the harsh mountainous terrain, the fiercely independent warrior people, and the virtually incomprehensible clan politics make it virtually impossible for outsiders to maintain control for long. Historians call it the "graveyard of empires."

-Username17

[Kaelik]

Cuomo literally told people who can't afford food because the state is taking too long to respond to go get a job.

I really hate blue states that elect republican governors like Maryland, Massachusetts, and New York.