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 Post subject: Re: Coronavirus
PostPosted: Wed Mar 25, 2020 11:33 am 
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You know what, **** it. This thread is now a training exercise.

Describe what steps you ("you" means anyone reading, since I'm an Engineer branch officer now in addition to my original artillery branch, and an Observer-Controller/Trainer, I get to be the grader)think would need to be taken to set up an ad hoc medical facility.

TASK: Describe a plan to set up, from scratch, a temporary 150-bed medical facility in the vicinity of New York City to manage Coronavirus cases

CONDITIONS: Set up a tent-based facility on a typical soccer field in a residential area. A site survey was completed in the last 48 hours determining that the field does not suffer from any known flooding issues and has adequate parking for approximately 50 passenger vehicles close by, as well as two permanent restroom huts with two toilets apiece. The nearest power substation is approximately 1/2 mile away. Streets are adequate for ambulance traffic and up to two full-size tractor trailers at a time.

Weather is as described in the real world at this time.

You have available 1ad-hoc company of U.S. Army engineers (of varying specific MOS), and can request up to 1 platoon of Infantry for additional manpower. You can expect support from a typical residential suburb streets and maintenance department as well as local police support for traffic control. You can request Civil Affairs support from higher headquarters. You have available 1 Army physician assistant who will be responsible for ensuring that construction and installation of the facility meet minimum acceptable medical standards (in other words, you can assume that all work will be completed correctly by your troops).

Necessary materials can be delivered from NY National Guard stocks within 24 hours; Medical equipment can be delivered within 24 hours once the PA certifies that the facility is ready to safely store such equipment.

STANDARDS: Describe, in plain English, the steps that must be accomplished, what steps depend on other steps being accomplished previously, and provide realistic time estimates for a timeline from your receipt of the initial site survey until the location is ready to accept the first patient. Use of military terminology, acronyms, or specific construction standards is not required. This is an exercise in identifying planning and time factors.

A GO will be achieved by providing generally realistic answers focused on the practical problems at hand. A NO GO will be a failure to identify significant issues or obstacles, or major steps that should be obvious to an untrained person.

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PostPosted: Wed Mar 25, 2020 3:30 pm 
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Taskiss wrote:
DFK! wrote:
Taskiss is generally incorrect that we should just ignore this and let the chips fall where they may.

Not exactly my position - isolate those at risk, let herd immunity work it's thing on the healthy like it did for smallpox. I've yet to see any simulation on that technique.


Fair enough, I was simplifying for brevity.

Also, that's not really how herd immunity works.


Finally, your assertion that only hits the old is not borne out in the data we know so far, and if we "only" include those with comorbidities, that's about 40% of the US population that is "at risk.


I don't agree with many public health assertions that the social distancing measures should go on, basically, until we get a vaccine - but I don't think Trump's assertion of easter is reasonable either.

The bottom line here is that the rapidity of the disease onset is the problem. Meaning, we have norms and society is built around decades of evolving norms - traffic fatalities, strokes, cancer, etc. all have a "normal" number of deaths in our society. And we're built to handle that. We aren't built to handle this on this rapid of a timeframe.

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PostPosted: Wed Mar 25, 2020 3:34 pm 
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Hopwin wrote:
DFK! wrote:
Now, regarding the cost of the shutdowns, the most reasonable analysis I saw on that indicated that the common ballpark of mortality in the US at 1.7-2.5 million deaths, plus morbidity impacts of long-term health damage in those who recover, may be as high as $4t. So, logically, around the time the isolation protocols cost us around $3.5t, we should back off because the residual will take us to $4t, at which point the cure is worse than the disease.

US GDP is $20t and we are projecting a negative -24% GDP for the quarter so are we already passed the $3.5t you back of the enveloped?

To be clear I don't think we should do nothing or turn the elderly and vulnerable lose to die but the trajectory we are on is going to bankrupt the nation and lead to riots and civil unrest that will probably rival the Civil War in terms of scope. We need a path to normalcy that doesn't rely on waiting 12 months for a vaccine to be developed, tested, and manufactured in sufficient quantities.


We might be. I am speculating but I would guess the "cure is worse than the disease" timeframe is probably mid-May.

Regarding your cival war point - the important caveat there is that happens in extreme versions of both the "let chips fall where they may" scenario AND in the "lock this **** down" scenario. The sweet spot is someplace in between, the finding of which sweet spot has literally no guidebook whatsoever, requires balancing political interests (including petty partison bullshit), and moves daily.

Finally, you should waive off anybody who says this shelter in place and social distancing **** is gonna last 12-18 months for a vaccine. That is unrealistic, fear-mongering horseshit for about 50 different reasons.

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PostPosted: Wed Mar 25, 2020 4:30 pm 
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Just saw a quantification in the 13T range based on CDC's worst case scenario.

https://reason.com/2020/03/25/trump-is- ... -measures/

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 Post subject: Re: Re:
PostPosted: Wed Mar 25, 2020 5:31 pm 
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DFK! wrote:

Finally, you should waive off anybody who says this shelter in place and social distancing **** is gonna last 12-18 months for a vaccine. That is unrealistic, fear-mongering horseshit for about 50 different reasons.

I think I agree with everything you said. May seems a bit further out than I would think for a tipping point economically but close enough that it’s not worth quibbling over.

And the uncivil are going to foment unrest either way is always the safest bet.

For that last bit though, all of the health experts I have seen have said a vaccine will not be available for the masses for at least 12 months and I have not seen anyone make a case for a sane middle ground between Trumps get back to work next week and Dewine’s indefinite stay at home plan. I catch a lot of crap for not advocating the stay at home forever course so if you could provide me some expert articles about why that is ridiculous I’d appreciate it. All I get is bleeding heart guilt trips about the dying with no empathy for people who can’t buy food, pay their rent or for the small business owners who are losing their life savings and dreams.

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 Post subject: Re: Re:
PostPosted: Wed Mar 25, 2020 6:28 pm 
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Hopwin wrote:
I have not seen anyone make a case for a sane middle ground between Trumps get back to work next week and Dewine’s indefinite stay at home plan.

Really? That's not been my experience so far. From what I've read, I would say the median position of experts and pundits is that we need to clamp down hard for a relatively short window - say 1-3 months - in order to get the initial wave under control and the testing regime ramped up and then switch to a strategy of mass testing and contact tracing with narrowly targeted quarantine measures to contain local flare-ups until we can get a vaccine rolled out. I've heard it referred to as "the hammer and the dance" strategy. Hammer the epidemic down with immediate, widespread social distancing measures then do the more delicate containment dance until we have a vaccine. In short, the idea is that the 1-3 months of hardcore measures is necessary to get us back to more or less where we were a couple of months ago and then implement the testing/containment strategy we should have done then to prevent another major outbreak.


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PostPosted: Wed Mar 25, 2020 9:23 pm 
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Most median opinions I've seen are in line with what RD mentioned.

Hopwin - I don't have immediate citations quick to hand, but FEE and Reason have both run multiple articles to that effect recently (not behind paywalls), and I think I've seen one or two starting to trickle out from NYTimes and WSJ (behind pay walls).

The bottom line is yes, a /safe/ vaccine may take 12-18 months (though there are 20 confirmed in testing as of today), but you cannot lock down an economy that represents 20-25% of the worlds economic churn without basically destroying the global economic and setting us up for not just a depression but probably a 50 year "dark age." That would likely kill more than this virus will.

And no, I'm not exagerrating. Evidence for non-exaggeration can be done simply be assessing how many "markers" get missed if the county basically just takes a year off.

So someplace in the 1-3 month range (we're already 1.5-2 weeks into the first month of that range, in the US) and then the mitigation measures become untenable and we basically just have to allow the virus to become "a thing we live with" after that.

Most of this is exclusively my opinion, but I can assure you that I'm about as informed as a lay person (non-physician/epidemiologist) can be on this right now I think.

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PostPosted: Thu Mar 26, 2020 9:50 am 
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DFK! wrote:
Most median opinions I've seen are in line with what RD mentioned.

Hopwin - I don't have immediate citations quick to hand, but FEE and Reason have both run multiple articles to that effect recently (not behind paywalls), and I think I've seen one or two starting to trickle out from NYTimes and WSJ (behind pay walls).


Where is this testing to occur? In China they have FLIR cameras installed everywhere to monitor the temperatures of people, take their temperatures when they leave and return to buildings and geofencing apps that red-square you if you wander too close to a hot-spot. How do we implement something similar in a country built around commuting from suburbs along freeways?

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The bottom line is yes, a /safe/ vaccine may take 12-18 months (though there are 20 confirmed in testing as of today), but you cannot lock down an economy that represents 20-25% of the worlds economic churn without basically destroying the global economic and setting us up for not just a depression but probably a 50 year "dark age." That would likely kill more than this virus will.

And no, I'm not exaggerating. Evidence for non-exaggeration can be done simply be assessing how many "markers" get missed if the county basically just takes a year off.


Go read the post I created this thread with, you are preaching to the choir :lol:

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So someplace in the 1-3 month range (we're already 1.5-2 weeks into the first month of that range, in the US) and then the mitigation measures become untenable and we basically just have to allow the virus to become "a thing we live with" after that.

Most of this is exclusively my opinion, but I can assure you that I'm about as informed as a lay person (non-physician/epidemiologist) can be on this right now I think.


As I said when I started the thread, I agree with you that we cannot continue this course of stay-at-home orders, if people don't start rioting in the streets then they are going to end up living on them permanently. With that said I'd like to see what the monitoring plan is for when we lift the restrictions. Will every public space have FLIR cameras set up? Will you be required to submit to a temperature check when entering a public building? Do you just advise the public that if you have any symptoms you are required to report to a hospital for a free test? What does the other side of the lock-down look like.

To be clear, not attacking I am genuinely at a loss :psyduck: to picture what that world looks like and this seems like as a good a place as any to try to imagine a solution as a thought-experiment.

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PostPosted: Thu Mar 26, 2020 2:01 pm 
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Ah, post-lockdown creates interesting questions. Not sure about that universe. Nobody is.

Also, here's an academic article on lockdown cost-benefit:

https://fb8280a8-a-62cb3a1a-s-sites.goo ... edirects=0

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PostPosted: Sat Mar 28, 2020 9:28 am 
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Sometimes LinkedIn feels like an abuse of power.

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PostPosted: Sat Mar 28, 2020 1:42 pm 
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We lost our first person from my NJ work site (in his 40s). His wife and 2 teens are still hospitalized.

My county in PA has about half of the cases from the state.

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PostPosted: Sun Mar 29, 2020 11:28 pm 
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Serienya wrote:
We lost our first person from my NJ work site (in his 40s). His wife and 2 teens are still hospitalized.

My county in PA has about half of the cases from the state.



You live in Moncto to?

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PostPosted: Tue Mar 31, 2020 9:51 pm 
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https://thehill.com/policy/defense/4899 ... oronavirus

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 Post subject: Re: Coronavirus
PostPosted: Wed Apr 01, 2020 6:08 am 
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Seasonal changes in temperature and humidity, as well as a return to school and indoor crowding during cooler months, are among factors that may increase transmission of the virus. Grad said the best-case scenario, based partly on achieving an optimistic doubling of ICU capacity, would mean social distancing measures need to be in place 25 percent of the time over the next 9 to 10 months. The worst-case scenario, according to the models, is two years of cycled social distancing.


https://www.thedailybeast.com/this-coro ... of-several

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PostPosted: Wed Apr 01, 2020 8:44 am 
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In my opinion, that's absurd. I'd file it under clickbait and fearmongering.

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PostPosted: Wed Apr 01, 2020 9:09 am 
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DFK! wrote:
In my opinion, that's absurd. I'd file it under clickbait and fearmongering.


Good opinion.

So back to the post-lockdown world, what does your model suggest?

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PostPosted: Thu Apr 02, 2020 7:57 am 
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Hopwin wrote:
DFK! wrote:
In my opinion, that's absurd. I'd file it under clickbait and fearmongering.


Good opinion.

So back to the post-lockdown world, what does your model suggest?


In terms of timing, or?

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PostPosted: Thu Apr 02, 2020 10:46 am 
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Elmarnieh wrote:
Serienya wrote:
We lost our first person from my NJ work site (in his 40s). His wife and 2 teens are still hospitalized.

My county in PA has about half of the cases from the state.



You live in Moncto to?


Yeah. I'm in Lansdale.

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 Post subject: Re: Coronavirus
PostPosted: Thu Apr 02, 2020 10:47 am 
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Hopwin wrote:
Quote:
Seasonal changes in temperature and humidity, as well as a return to school and indoor crowding during cooler months, are among factors that may increase transmission of the virus. Grad said the best-case scenario, based partly on achieving an optimistic doubling of ICU capacity, would mean social distancing measures need to be in place 25 percent of the time over the next 9 to 10 months. The worst-case scenario, according to the models, is two years of cycled social distancing.


https://www.thedailybeast.com/this-coro ... of-several


I think they're modeling that after the successive waves of infection seen with influenza, H1N1, and SARS.

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 Post subject: Re: Coronavirus
PostPosted: Thu Apr 02, 2020 11:12 am 
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DFK! Whatever you've got, like I said this seems as good a place as any to spitball the future over the next six-months to a year.

Serienya wrote:
I think they're modeling that after the successive waves of infection seen with influenza, H1N1, and SARS.


I think they are taking into account that until either everyone catches it to build a natural immunity or everyone is vaccinated then when you ease up on restrictions the infection starts to spread again in the same geometric pattern we are seeing now. Someone called this a hammer and spike or hammer and dance model because when the infections start to peak up you drop the hammer with lockdowns again. The peaks for each successive wave will be smaller as more of the population catches and recovers (or dies) from it. China just locked down another county today for this reason.

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PostPosted: Sun Apr 05, 2020 5:23 pm 
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Serienya wrote:
Elmarnieh wrote:
Serienya wrote:
We lost our first person from my NJ work site (in his 40s). His wife and 2 teens are still hospitalized.

My county in PA has about half of the cases from the state.



You live in Moncto to?


Yeah. I'm in Lansdale.



Hey neighbor, I'm in Eagleville.

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 Post subject: Re: Coronavirus
PostPosted: Thu Apr 09, 2020 4:44 pm 
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Hopwin wrote:
DFK! Whatever you've got, like I said this seems as good a place as any to spitball the future over the next six-months to a year.

Serienya wrote:
I think they're modeling that after the successive waves of infection seen with influenza, H1N1, and SARS.


I think they are taking into account that until either everyone catches it to build a natural immunity or everyone is vaccinated then when you ease up on restrictions the infection starts to spread again in the same geometric pattern we are seeing now. Someone called this a hammer and spike or hammer and dance model because when the infections start to peak up you drop the hammer with lockdowns again. The peaks for each successive wave will be smaller as more of the population catches and recovers (or dies) from it. China just locked down another county today for this reason.


Sorry, been swamped.

Phrased as a general question like that - Probably don't have space to talk about all the potential implications on a "post-COVID" world. So in the space here, I'll just say - don't expect a sudden release of social distancing. Expect that to take a gradual response over months.

Some elements may even be enduring - like not shaking hands, more teleworkers, etc.

So much more to potentially discuss about it. I'm willing to do a Hangouts or something sometime if people want to talk through and are willing to try and leave their politics at the door. I have no patience for politicking during this crisis.

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 Post subject: Re: Coronavirus
PostPosted: Thu Apr 09, 2020 4:57 pm 
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DFK! wrote:
Hopwin wrote:
DFK! Whatever you've got, like I said this seems as good a place as any to spitball the future over the next six-months to a year.

Serienya wrote:
I think they're modeling that after the successive waves of infection seen with influenza, H1N1, and SARS.


I think they are taking into account that until either everyone catches it to build a natural immunity or everyone is vaccinated then when you ease up on restrictions the infection starts to spread again in the same geometric pattern we are seeing now. Someone called this a hammer and spike or hammer and dance model because when the infections start to peak up you drop the hammer with lockdowns again. The peaks for each successive wave will be smaller as more of the population catches and recovers (or dies) from it. China just locked down another county today for this reason.


Sorry, been swamped.

Phrased as a general question like that - Probably don't have space to talk about all the potential implications on a "post-COVID" world. So in the space here, I'll just say - don't expect a sudden release of social distancing. Expect that to take a gradual response over months.

Some elements may even be enduring - like not shaking hands, more teleworkers, etc.

So much more to potentially discuss about it. I'm willing to do a Hangouts or something sometime if people want to talk through and are willing to try and leave their politics at the door. I have no patience for politicking during this crisis.


I'd be down. It'd be cool to talk again; it's been 10 years since we had that 40k game. Incidentally, I had just started working on my Eldar and Dark Eldar again; I was thrilled to discover they can be fielded together as Ynnari.

As to a conversation, I'd like to discuss these models in particular because they're changing pretty violently right now.

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 Post subject: Re: Coronavirus
PostPosted: Thu Apr 09, 2020 5:01 pm 
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Image


Yea - the model changes are dramatic. Undermining confidence, so interesting to see what happens there.

I'll wait a bit and see if others are willing/desire to link up. If so, I'll find a reasonable time and we can just do it as a town hall - meaning those who can join are welcome but I'm not gonna spend a ton of labor trying to pin down the "best" day/time.

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 Post subject: Re: Coronavirus
PostPosted: Thu Apr 09, 2020 7:27 pm 
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DFK! wrote:
Image


Yea - the model changes are dramatic. Undermining confidence, so interesting to see what happens there.

I'll wait a bit and see if others are willing/desire to link up. If so, I'll find a reasonable time and we can just do it as a town hall - meaning those who can join are welcome but I'm not gonna spend a ton of labor trying to pin down the "best" day/time.


Don't blame you; I have enough of that bullshit going on with 2 different semester project groups that can't meet in person any more and some Chinese kid freaking out because everyone else doesn't know Python like he does.

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