Coronavirus Math

[aquabliss]

@eyephone, sure I give Newsome credit on how he handled some things in the beginning, I actually saw some good moments in his press conferences and sided with him on a lot of those tough decisions.  So how does being pro life contradict with my statements?  I can mostly predict your answer will be "because I'm taking a position where people might be harmed by no fault of their own and in which they were not given an option".

It's a faulty extrapolation.  By the same measure, pro life individuals should be against people taking the bus because what if the bus driver goes off a cliff?  They should be against people going out for an evening walk around the neighborhood, because what if someone is texting and doesn't see them and hits them.  They should be against people ever flying on an airplane. 

I am certainly against any individual consciously choosing to negatively impact another individual (getting them sick, causing them pain, hospitalization, even worse death).  This is irresponsible to compare someone going to a boutique in the Irvine Spectrum and picking out a new sweater or coffee mug, to someone who is consciously and rationally choosing to end a life.

 

[irvinebullhousing]

Nobody on here think like,Trump, that the economy will comes roaring back and pent up demands will push it to normal. But remove the lock down to slowly start back and the engines will grinds one click at a time is NEEDED. Otherwise the depressions will run very long and money and bailout would end sooner than the virus. The middle class, many in the middle makes 250K didn?t get the the FED bonus and even with high wage have inadequate rainy days funds that last 6 months or more. And jobs with that pays will hard to come by going forward. If deflation is where we are now, do you think the next employer will offer equivalent? Everyone is on a life line including big corps.

 

[Liar Loan]

Lower mortality rate or higher rate of infection aren't even among the top concerns / indicators to what public health officials look at for re-openings in May. 

Re-opening in May doesn't hinge on lower mortality rate or 10% or even 20% rate of infection because we are far from herd immunity.

Re-opening in May hinges on key measures like # of Hospitalizations, #s in ICU, % of positive test results. They need to trend down in consecutive days below benchmark.

Yep, I'm aware of these benchmarks and have actually been tracking them on a daily basis.  Right now, they are a mixed bag:

# Hospitalizations - UP
# ICU - FLAT
% Positive Test Results - DOWN

 

[Kenkoko]

None of the people standing at the podium in front of the cameras have had their pay cut or their jobs taken away.  None of them are stressed about when their unemployment check will reach their mailbox or how they?re going to pay their May rent on Friday.

It?s so much easier to make decisions for other people that don?t have any negative impact on you or your family.  Tell Newsome and Garcetti we?re freezing their assets and cutting their benefits and pay until the restrictions are lifted.  Would they still take the same course of actions?  We?ll never know the answer unfortunately.

I understand the sentiment.

But to play devil's advocate, aren't better decisions made when they are based on just facts ,data and science?

No politics, no spin, no emotion, no conspiracies.

One thing we did learn from Ebola is that people lose when politicians function as public health professionals.

 

[eyephone]

Lower mortality rate or higher rate of infection aren't even among the top concerns / indicators to what public health officials look at for re-openings in May. 

Re-opening in May doesn't hinge on lower mortality rate or 10% or even 20% rate of infection because we are far from herd immunity.

Re-opening in May hinges on key measures like # of Hospitalizations, #s in ICU, % of positive test results. They need to trend down in consecutive days below benchmark.

Yep, I'm aware of these benchmarks and have actually been tracking them on a daily basis.  Right now, they are a mixed bag:

# Hospitalizations - UP
# ICU - FLAT
% Positive Test Results - DOWN

1. The GOP senators up for elections will not defend trump per memo that is public in the news.
2. You can do a Trump bet on red, black, and green.
(Protests/Open the economy/hold up Georgia do not open up the economy)
If you do it this way, then your never wrong. Lol

 

[Kenkoko]

To those who insist on "curve bending", where is the goalpost?  0 new cases?  0 new deaths?  Not going to happen, even post vaccine.  How about the goalposts on the other side?  Most (if not all) of us are willing to give up some freedoms in exchange for an open economy.  We'll maintain social distancing, we'll wear facemasks, we won't congregate.  Heck I'll even go so far as reminding people to be mindful of this. 

So with this in mind, can I go back to church on Sunday or let my kids play with their friends at the park next week?  Oh wait, too soon.

Maybe you haven't see waves of healthcare workers posting "we stay here for you, please stay home for us" on social media.

I am in healthcare so I understand why people insist on "curve bending".

Many healthcare workers resent these "my life, my choices, my consequences? thinking. It's almost as if they don't truly understand we are in a pandemic. Do these ?my life, my choices, my consequences? people stay home and die alone when they get infected? Most likely not. They go to the hospitals, use our public health resources, and put healthcare workers? life at risk jut like everyone else.

The unfortunate reality is that we are a long ways from herd immunity. Even in the hardest hit populations, like New York City, 20% prevalence is not 60-70%. If we lift lockdowns without proper precautions, we should expect a resurgence.

For now, the goalposts are # of hospitalizations, #s in ICUs, and % of postive test results. I don't think the government has done a good job of relating that to the public so I understand your frustration.

So much of sustaining the mental game for a high intensity effort is knowing the endpoint. My wife and I were running the other day and hit a hill. She said, ?how long does this go on? 1/2 mile? ? I answered that I had no idea. We both lost steam instantly.

 

[qwerty]

We all get paid for the jobs that we do. Healthcare workers get paid. You guys sign up for working with sick folks and taking care of others. That is great. But if a healthcare worker has an issue doing the job they signed up for then go do something else.

Plenty of jobs have ?hazard? pay because they put their lives on the line for the benefit of everyone. Back in the early 2000s I remember workers at the arco refinery in Carson making 6 figures  that had only high school diplomas. They made a lot of money because they new they would probably get cancer at some point. They didn?t complain that people should drive less so they didn?t have to work overtime. They knew the hazards of the job the they signed up for.

The ill are your customers. The customer is always right

 

[Kenkoko]

We all get paid for the jobs that we do. Healthcare workers get paid. You guys sign up for working with sick folks and taking care of others. That is great. But if a healthcare worker has an issue doing the job they signed up for then go do something else.

Plenty of jobs have ?hazard? pay because they put their lives on the line for the benefit of everyone. Back in the early 2000s I remember workers at the arco refinery in Carson making 6 figures  that had only high school diplomas. They made a lot of money because they new they would probably get cancer at some point. They didn?t complain that people should drive less so they didn?t have to work overtime. They knew the hazards of the job the they signed up for.

The ill are your customers. The customer is always right

Your argument would make a lot more sense if all healthcare workers were given proper amounts of PPEs to protect themselves.

Many are not even here in SoCal. This is why there's so much outrage.

 

[aquabliss]

What about the 14,000 health care workers in California that were just furloughed?  The reason they?re let go is because we?re all staying home and the California hospitals and ER?s are ghost towns.  Hospitals can?t afford to keep a high number of staff sitting around for weeks on end with no revenue and no patients (pun intended).

I bet those that just lost their jobs wish the stay at home order was lifted 3 weeks ago so that their ER?s and offices could get back to some sense of normalcy.  Oh but we would have overwhelmed the hospitals and run out of PPE, right?  Not sure the data supports that.  I don?t think we would have been like NY simply because we don?t live as densely and we don?t rely on mass transit here.  You?ll probably disagree but we don?t have the data to back up either hypothesis.

We did what we did 6 weeks ago because we didn?t have enough supporting data to prove otherwise, so it was a good move.  Now we have data and case studies to support a clearer way of thinking but we?re STILL acting like it?s 6 weeks ago. 

We don?t like walking around a room in the dark because we might run into a wall.  Now the light is halfway on and they still won?t let us walk around the room even though we see where the walls are at. 

 

[Kenkoko]

What about the 14,000 health care workers in California that were just furloughed?  The reason they?re let go is because we?re all staying home and the California hospitals and ER?s are ghost towns.  Hospitals can?t afford to keep a high number of staff sitting around for weeks on end with no revenue and no patients (pun intended).

I bet those that just lost their jobs wish the stay at home order was lifted 3 weeks ago so that their ER?s and offices could get back to some sense of normalcy.  Oh but we would have overwhelmed the hospitals and run out of PPE, right?  Not sure the data supports that.  I don?t think we would have been like NY simply because we don?t live as densely and we don?t rely on mass transit here.  You?ll probably disagree but we don?t have the data to back up either hypothesis.

We did what we did 6 weeks ago because we didn?t have enough supporting data to prove otherwise, so it was a good move.  Now we have data and case studies to support a clearer way of thinking but we?re STILL acting like it?s 6 weeks ago. 

We don?t like walking around a room in the dark because we might run into a wall.  Now the light is halfway on and they still won?t let us walk around the room even though we see where the walls are at.

We don't need the situation to get worse like NY. We don't even have enough PPEs now. Healthcare workers at nursing facilities don't have n-95s. Even facilities with positive Covid patient don't have enough N-95s for staff currently.

There are valid arguments on both sides regarding whether to re-open in May. This is a tough call because we're trying to pick the less sh*tty option. There's no slam dunk winner here.

I disagree we are acting like it's still 6 weeks ago in California. We already have plans and steps to re-open.

 

[qwerty]

@kenkoko - yeah the lack of PPE for healthcare workers is appalling. I don?t know the system well enough to know who is to blame, the hospitals, the states or federal govt. you still have a choice to do the job or not.

We have all been in situations where we have not the right tools or level of support (staff) to do our jobs the way we would like. We try to find a solution, if the company doesn?t help you find one, then the choice is up to the employee to leave or deal with it.

Right now there are so many people working more hours because companies have laid off or furloughed employees. They can either quit or deal with it. Most will just deal with because there are not many better options, if any.

I know healthcare workers are dealing some higher stakes because your health is involved. Just like non healthcare workers, you can either deal with it or quit.

 

[Kenkoko]

@Qwerty

I get your point. We do ultimately have a choice. But this is where we differ. I see it as a false choice.

Choice to go home and starve isn?t a real choice.

I get the outrage when millions were financially devastated by the government shut down. This is why I support a recurring bailout stimulus check to people / emergency UBI.

We need to do better by our people. At least give them an out, not just a false choice.

As to who to blame for the lack of PPEs, it' caused by systemic failure of having a purely profit driven system and exacerbated by federal government not seizing central control of production and distribution.

 

[OCtoSV]

Without a purely profit-driven healthcare system do you think compensation would be cut by 50-75% from current levels? Compare physician and nursing compensation to other 1st world countries and it's not even close.

 

[Kenkoko]

Without a purely profit-driven healthcare system do you think compensation would be cut by 50-75% from current levels? Compare physician and nursing compensation to other 1st world countries and it's not even close.

I think the overall compensation would go down a bit but not by much and not uniformly. Compensation wouldn't go down much because the primary drivers (cost of training, cost to cover liability and lawsuits, artificial constrains on the supply of doctors etc) for current level of compensation would still be in place even if we switch to a not for profit system.

Compensation for specialties would likely go down, but primary care compensation would go way up. Approx 30% of US are primary care deserts currently. It'd take sizable pay raises and perhaps even loan forgiveness programs to attract practitioners to serve these often remote areas.

The problem with physician compensation in our current system isn't really how much they are getting paid. It's how they are getting paid. Here's why

Physician salaries account for a whopping 8% of total US healthcare expenditure. So cut our salaries in HALF and you save a measly 4% on your healthcare bill while driving already demoralized doctors out of the profession.

How physicians are getting paid now is highly problematic. The more activities (prescriptions, procedures, tests etc) they do, the more they get paid. This is often not in the best interest of the patient and does drive up the cost. High costs of covering professional liability and malpractice also drive practitioner behaviors towards more unnecessary activities.

 

[sgip]

What If we were to assume that every posters employment types were now a "citizens right", how would everyone want their own pay re-structured? Would you want someone to arbitrarily re-order your income because they've been anointed the smartest people in the room? No? If not for you, why not?

So far this discussion about physician pay is killing plenty of pixels, but suggestions so far seem to be driven toward government force rather than the invisible hand of capitalism. Neither way forward is going to be able to take care of everyone's wants, but on whole, Government re-ordering isn't a smart way forward. If it was, I guess dear reader, everyone would be fine with a government stooge making changes to one's own income, right? Again, if not for you, why not?

It's pretty well known what I do for a living. After the 2008 crash, my industry was re-regulated. Compensation rules were imposed.... and within about 2 years it all went back to pre-crash business as usual. To analogize with a movie phrase "Life, uh... finds a way" Based on my personal experience with government intervention and re-ordering of business structure, it will become the same failure it's always ends up as in less time than one might think. 

Wishful thinking is fine. Reality ends up being something all together different.

My .02c

 

[Kenkoko]

You must have read my post wrong.

Nobody's saying for big government to step in and dictate physician pay.

I even gave an example. For primary care practitioners to go serve in these primary care deserts, they would need to get paid more. People respond to incentives.

We need to provide better incentives and properly aligned physicians incentives to patients health. Roughly 30% of what we spend in healthcare today is waste.

 

[irvinehomeowner]

What happened to the coronavirus math?

The math for healthcare and gov't controlled healthcare is like this:

wasteful + wasteful = more wasteful

Why would we want that?

 

[Kenkoko]

What happened to the coronavirus math?

The math for healthcare and gov't controlled healthcare is like this:

wasteful + wasteful = more wasteful

Why would we want that?

Because that's a misconception. You're probably confusing what I'm talking about with what Bernie Sanders is proposing.

What Bernie wants IS gov't controlled healthcare. I'm not talking about that.

What I (and many other doctors & healthcare workers) push for is more like a public option. That would introduce more competition and more transparancy into the space. Competition and transparency drives down cost and reduces waste.

 

[aquabliss]

I got tested at the clinic for the antibody test that AquaBliss posted about in Mission Viejo and the results were....

NEGATIVE

So looks like I didn't have the virus so I'll continue staying safe for all my clients, my gf, and my parents.

Got my antibody test at Hoag Woodbury yesterday and results today... NEGATIVE.

First time I?m kinda sad to not be infected with the virus.  I really thought I had it in Feb with mild symptoms. 

 

[irvinebullhousing]

I got tested at the clinic for the antibody test that AquaBliss posted about in Mission Viejo and the results were....

NEGATIVE

So looks like I didn't have the virus so I'll continue staying safe for all my clients, my gf, and my parents.

Got my antibody test at Hoag Woodbury yesterday and results today... NEGATIVE.

First time I?m kinda sad to not be infected with the virus.  I really thought I had it in Feb with mild symptoms.

Hmm. It?s not too late, you still have a chance.