Some More Therapeutic Reality

h/t Herschel @ Captain's Journal

A report from 5 minutes into the future. More information to the low information chattering monkeys who think Death Rate is the big problem. (Hey, fucktards, the Dow dropped 10,000 points, but nobody died. So, nothing to worry about there either, I suppose...? Just checking. Idiots.)

Bear in mind this is in Louisiana, not Lombardy, Italy, from a Respiratory Therapist:

Since last week, he’s been running ventilators for the sickest COVID-19 patients. Many are relatively young, in their 40s and 50s, and have minimal, if any, preexisting conditions in their charts. He is overwhelmed, stunned by the manifestation of the infection, both its speed and intensity. The ICU where he works has essentially become a coronavirus unit. He estimates that his hospital has admitted dozens of confirmed or presumptive coronavirus patients. About a third have ended up on ventilators. 

His hospital had not prepared for this volume before the virus first appeared. One physician had tried to raise alarms, asking about negative pressure rooms and ventilators. Most staff concluded that he was overreacting. “They thought the media was overhyping it,” the respiratory therapist told me. “In retrospect, he was right to be concerned.” 

"I have patients in their early 40s and, yeah, I was kind of shocked. I’m seeing people who look relatively healthy with a minimal health history, and they are completely wiped out, like they’ve been hit by a truck. This is knocking out what should be perfectly fit, healthy people. Patients will be on minimal support, on a little bit of oxygen, and then all of a sudden, they go into complete respiratory arrest, shut down and can’t breathe at all.” 

"We have an observation unit in the hospital, and we have been admitting patients that had tested positive or are presumptive positive — these are patients that had been in contact with people who were positive. We go and check vitals on patients every four hours, and some are on a continuous cardiac monitor, so we see that their heart rate has a sudden increase or decrease, or someone goes in and sees that the patient is struggling to breathe or is unresponsive. That seems to be what happens to a lot of these patients: They suddenly become unresponsive or go into respiratory failure.” 

"It first struck me how different it was when I saw my first coronavirus patient go bad. I was like, Holy shit, this is not the flu. Watching this relatively young guy, gasping for air, pink frothy secretions coming out of his tube and out of his mouth. The ventilator should have been doing the work of breathing but he was still gasping for air, moving his mouth, moving his body, struggling. We had to restrain him. With all the coronavirus patients, we’ve had to restrain them. They really hyperventilate, really struggle to breathe. When you’re in that mindstate of struggling to breathe and delirious with fever, you don’t know when someone is trying to help you, so you’ll try to rip the breathing tube out because you feel it is choking you, but you are drowning." 

"Before this, we were all joking. It’s grim humor. If you are exposed to the virus and test positive and go on quarantine, you get paid. We were all joking: I want to get the coronavirus because then I get a paid vacation from work. And once I saw these patients with it, I was like, Holy shit, I do not want to catch this and I don’t want anyone I know to catch this." 

“I worked a long stretch of days last week, and I watched it go from this novelty to a serious issue. We had one or two patients at our hospital, and then five to 10 patients, and then 20 patients. Every day, the intensity kept ratcheting up. More patients, and the patients themselves are starting to get sicker and sicker. When it first started, we all had tons of equipment, tons of supplies, and as we started getting more patients, we started to run out. They had to ration supplies. At first we were trying to use one mask per patient. Then it was just: You get one mask for positive patients, another mask for everyone else. And now it’s just: You get one mask."

“I work 12-hour shifts. Right now, we are running about four times the number of ventilators than we normally have going. We have such a large volume of patients, but it’s really hard to find enough people to fill all the shifts. The caregiver-to-patient ratio has gone down, and you can’t spend as much time with each patient, you can’t adjust the vent settings as aggressively because you’re not going into the room as often. And we’re also trying to avoid going into the room as much as possible to reduce infection risk of staff and to conserve personal protective equipment.” 

“There is a very real possibility that we might run out of ICU beds and at that point I don’t know what happens if patients get sick and need to be intubated and put on a ventilator. Is that person going to die because we don’t have the equipment to keep them alive? What if it goes on for months and dozens of people die because we don’t have the ventilators?" 

“Hopefully we don’t get there, but if you only have one ventilator, and you have two patients, you’re going to have to go with the one who has a higher likelihood of surviving. And I’m afraid we’ll get to that point.”

RTWT

Yet again:

Batter Up

As of today, after about a week of testing, to the point that supplies of tests have been depleted, there are 35,241 Kung Flu cases in the U.S. There are 473 dead.

That's a CFR of 1.3% Not best. Certainly not the worst. But what it is, AFAIK, now.

Minor Problem (relatively):

If 100M people in the U.S. (out of a possible 330M people in the U.S.) get infected, using that CFR, we can expect 1,300,000 dead.
That's yuuuuuugley worse than "just the flu".

Bigger Problem:

If we get that many dead, based on other countries' experience, we can expect that another 5M will need hospitalization, and live.
That's over 5 times more beds than we have, nationwide. (Which is about 900,000, total.)

That crushes healthcare as you know it, if we try to treat this in all hospitals.

If we do that, we're Italy. Times twenty.
And not only do we lose 1.3M to Kung Flu, we lose everybody to everything else that's not normally lethal, until this is over. Because no beds, no hospitals, no doctors, no nurses, no medicine, no nothing.

Last night, two of the senior docs where I was working were discussing why we need to treat Kung Flu patients somewhere else than in the primary medical system.

Like designating someplace else, (like regional hospitals - probably those run by the county/state/etc.) as Kung Flu Treatment Centers. Thus saving all other hospitals for the normal ER patient load in this crisis.

Hmm. What a great idea.

Especially if we implement it before the expected tsunami of serious Kung Flu pneumonia cases swamps us.

Random Data Points:

Data point: Apparently, out of nowhere, the base hospital at a nearby military base was swamped with 100 cases of serious upper respiratory infections and shortness of breath in one night.

That's the second secondhand report (sources for both: coworkers with kin in each facility) I have of a local hospital getting swamped. Out of nowhere. Exactly as was described by the medical workers in those videos out of Italy.
(People with Kung Flu stay home and cope, until they can't cope no more, because full-blown pneumonia.) 
Data point: NYFS is apparently losing more people to Kung Flu per day than Chicago loses to gunfire. Also saw reports that they're running out of ventilators there.
If that's so, this is, yet again, a wee bit more than "just the flu".


Data point: People are idiots. FL finally closed its beaches; this weekend most of SoCal finally did the same, as hordes of jackholes all went there en masse to escape "stay at home" orders from Governor Gabbin' Nuisance.

Data point: National Guard units are starting to pop up here and there, preparing to...what, exactly? Equal time: I haven't seen any activity at the two units nearest me.

Data point: several po-po from different agencies reported that in L.A., TPTB expect another riot, and they are taking steps to head it off quickly. Including with the CA NG.
With ammunition issued from the start, this time.

Data point: After a whole week, people are already chafing under no work, and no leaving the house, and being stuck at home with their own families 24/7...?...
What happens, do you suppose, when they run out of food, or money, or patience, or all three?

What happens if TPTB decide to lift (mostly voluntary) shelter in place orders, just as this thing hits its stride, and hospitals are suddenly packed to the gills with really sick patients?

Alternatively, what happens if this becomes, despite official protestations, a mandatory "Stay your asses at home unless you're absolutely essential to life and limb" quarantine, enforced at bayonet-point, or worse?

Despite recent strip-mining at the local markets, most people still have neither 30 days' food, nor 30 days' cash, on hand at home.

Best Case.
Worst Case.
Most Likely Case.

Capabilities.
Intentions.

This is how you assess What Could Be.

What are your capabilities and intentions?
What are those of the .Gov, at every level?
What are those of Gilligan, and his family?
What are those of the Free Shit Army in your locale, and in general?
Most threats to your existence aren't flying in from deep space, or Washington D.C., they already live with 5 to 20 miles of where you're sitting right now.

If you haven't Culpered the sh*t out of this, best get cracking.

Panic? F**k no.
Take things heart attack-seriously? Hell, yes!

This is not as bad as things can get.
Nowhere near, in fact.
Nor anywhere close to over.

This is barely the first inning.

Me? I've got job security pretty much until I can't work anymore, and a magic get-through-the-roadblock pass.

What I don't got is Castle Anthrax, with walls and moat.

Do what you can, where you are, with what you've got.

And like infantry since Caesar's legions, always be improving your position.
If/Once things get sporty, it's too late to wish you'd done more beforehand.

Tell everyone in comments, without exaggeration, how things are looking better - or worse - where you are.

This isn't an Alex Jones/George Nouri/Black Helicopters/Illuminati doom and gloom party. It's an information exchange.

(For those with Short Attention Span, read the Comments policy to the right.
A case of Terminal Smart-Ass will be terminal to your comment.
Zero fucks given.)

Flying By The Seat Of Our Pants

h/t In The Middle of the Right

We're forced to look to things like the Imperial College paper linked on March 16th, to estimate how bad Kung Flu is going to get.

A physicist who knows nothing about cars, per se, can still tell you how fast one will go, by looking at the car's engine horsepower, weight of the vehicle, drag coefficient of the body, friction from the tires on the ground, air density, temperature, and a host of other things, and get a pretty accurate max speed for the car, because science.
And that's what the folks in that study have done.

But the reason they had to, in the case of the folks at Imperial, is because Top. Men., in this case, at the CDC, cleverly yanked out the speedometer. Because Top. Men.

So, wouldn't it be useful to know things the easy way, by directly measuring them, and seeing how they stack up?

Funny you should ask. Someone else is on the same track, and nailing it.

Credit Where It's Due Dept.:

"Another question:

(yeah, I was raised by my Dad and Mom (and a few other mentors) to ask a lot of questions. I question everything and I like to turn a lot of data over in my mind)

We get stats on the Media about "number of cases" of CororinaVirus, and we get stats for "number of deaths" (those I question...not that they are dead, but that they died from Covid-19...often they are already old, weak or otherwise compromised and have other complicating factors).

But one bit of data I don't ever see is the number of people needing little or no care, or some level of hospitalization because of the effects of Covid-19. In fact, if you look, the data is pretty much only aimed at "deaths" and not much else.

Out of the several thousand cases for any one given area that have shown enough symptoms that they are tested, how many need any level of hospitalization?
I guess because they aren't anything the media can sensationalize, they don't give us any of that data.

I do think it would be a good bit of data though.

People showing symptoms and tested vs people tested showing positive vs people needing actual care vs people needing hospitalization vs people needing intensive care vs people dying.

I think the numbers would be not as terrible as the media and our governments might like you to think.

Then again, until I see some data I just don't know."

1) You are correct that such specific data would be useful.
2) You will never get it.
3) Because the CDC buggered up the test kits months ago, and we don't have enough. Anywhere.
3a) L.A. County just told doctors there yesterday not to test anyone (because they're out of kits) unless the results would change their treatment of the patient. (Which is no one, because you treat the severity of symptoms, not the presence or absence of the virus. If someone is sick enough to admit, you admit them. If not, you send them home and tell them to self quarantine.)
3b) This ensures we'll never know how many people have Kung Flu, and we'll never know how many people who have Kung Flu we've launched back into the community, to re-infect 2, 4, 8, or 48 of their fellows.
4) Things like this are why all stats on this outbreak will be pure bullsh*t, going forward. Nothing published will be reliable, because lack of rapid and accurate testing for all suspected cases ensures we never know how widespread it is, how bad it is, and what percentage of people are uninfected, asymptomatic, mildly symptomatic, really sick, or dead, because you erased most of that pie chart from the start.

(V + W + X + Y + Z = Q)
Z = 340
Q = 330M
Solve for all other variables.
Impossible.

In mathematical terms, we have made it impossible to solve for X, when we have put V, W, and Y beyond knowing. Ever.

We know as of today that 340 people have died.
But we don't know whether that's out of 27K cases, or 270K cases, or 2.7M cases, or 330M cases.

So we know how bad it is for 340 people.
But we can never know how bad it's going to be for 330M people.

The people at CDC that bungled the testing kits should be hanging by their thumbs in Lafayette Park across from the White House, while passersby jeer and pelt them with rotten fruit.

The problem with knowing the numbers, isn't that we'd know how terrible this outbreak isn't.
The problem is that we'd know how bad the government is.

But you're asking the right questions.

So now, because of CDC incompetence, (stop me if you've heard this since 2014 here), we can either do the long work of trying to model the variables within known ranges.

Or we can strap ourselves onto the hood, wearing our trusty GPS wristwatch, and see what it says as we rocket across the days to come, and see how fast the GPS says we're going.

That's the only choices, at the moment.

Plan B UPDATES Today:
NYFC is reportedly running out of ventilators for patients.
One OC CA hospital last night got hammered with mostly acute respiratory distress patients.
(No, not mine.) We'll see if this is a blip, or the crest of the approaching tsunami, in the coming days.

Sunday Music: Killing Me Softly

After Clint Eastwood picked a song off her solo debut album for the soundtrack of Play Misty For Me in 1972, and it rose to become a Number 1 hit, Robert Flack followed it up with this song on her next album, and exploded into chart-dominating existence in 1973. Nearly 50 years later, it still drips with a monstrous amount of raw talent, brilliance, and  timeless beauty. (And sorry, youngsters, but the Fugees' middling cover is a pale, pale imitation of the original.) I picked this out way back last June, so it has nothing to do with what's going on now. It's just absolutely awesome, and every time I hear it, it's as if it was brand new yesterday. This is what it's like when a singer and a song slam into each other like plutonium reaching critical mass. Hearing it sung once by someone this good explains better than Simon Cowell ever could why most people should stay in school and keep their day jobs.
And it keeps killing me, softly.

More Math

Some people think we can do better than China, Italy, or other countries, because of various (mostly stupid, some not, but all fanciful) reasons, or they point to how well South Korea and Japan handled/are handling this outbreak. There's a reason for that performance.

Nota bene*:

SK has 22 {but probably closer to 12; see Comments. -A.}hospital beds per 1000 people. 

Japan has 13.4 per 1000. 

Italy has 3.2 per 1000. 

The US has 2.8 per 1000.

The UK has 2.8 per 1000.  

Canada has 2.7 per 1000.

We're not going to do as well as countries that have 4 to 7 times as many available hospital beds as we have.
To pull off a South Korea, we'd need 6.3M hospital beds, instead of 900K.
And BTW, we couldn't staff those beds (with doctors, nurses, etc.) in 30 years of WWII full mobilization effort. You'd need another 5M doctors and 10M nurses, which is also 500% more of either than we have right now.

So that's not going to happen.

We're going to be, more or less, like Italy.
So will the UK, and Canada.
We will not do this as well as Japan and South Korea.
We simply don't have that capacity.
We should be able to outperform Mexico.

The sooner people stop hanging on to magical thinking and thin reeds of fanciful wishes, the sooner they can start wrapping their heads around why we're doing what we're doing, and what may happen to us despite those efforts.

The short answer remains: Stay home, and don't catch this, so you don't give it to 4 other people.

And whenever this is all over, it might be an excellent time to have a chat with your nominal federal government representative about things like EMTALA requiring hospitals to care for everyone without regard to ability to pay (and then FedGov - which means you and me - not paying for it either, until we get our insurance premiums), and about letting 40M blood-sucking leeches come here illegally and camp out for 50 years and crank out kids like dandelions dropping seeds, all on the taxpayer's teat. Which has a lot to how we got where we are.
Just saying.

One other worst-case stat:
Probably more than 96% of everybody is going to live through Kung Flu, no matter what. Maybe even more than 99%.
Focus on that, if it's what it takes to grind through the crappy times. You should take this seriously. You should not be hysterical.





*{Don't believe me. As Casey Stengel said, "You could look it up." It's not like you're going to work or anything, right? You can look up most of those numbers per country here or here. On the WHO site, look "by country" and pull the slider bar down to the last couple of lines. Note that they don't precisely agree. Round it off. The SK number was courtesy of CNN. Wikipedia puts them at 12.3, not 22. Caveat emptor.}

RIP Kenny Rogers

At home in GA, at 81, of natural causes.
But in his final words I found an ace that I could keep.

It's A Hoax! It's Just Like The Flu!

h/t Peter

I hope this scares the shit out of you, wherever you are, and whenever you watch it. Maybe that'll finally be enough to shut up the naysayers  that're too smart to believe this thing might be a problem, beyond maybe their 401K (if they can count that high). (Nope. Some people are completely immune to anything less than this swimming up and biting them in the ass, talk smack the wronger they get, are allergic to reality, and spin fairytales like "this disease only seriously affects people in socialist countries/states/cities/places I don't like, but will magically not be like that where I am ensconced, because viruses are political like that. Go ahead and whistle past the graveyard. More than one person in history has died with one hellva surprised look on their face. Color me shocked.)

It does me, and I'm back at work tonight.
This is what's coming, sooner or later, in all likelihood.

Not from shakycam cell videos with no sound, not from massaged ChiCom news propaganda, but an in-depth SkyNews report on the Coming Reality, from a modern Western nation, a month or two farther along in this than we are now. Most patients in their 50s. Not 80s; not 70s; not 60s. In their 50s. (Show of hands out there: Who's here from before 1970?) Burials every 30 minutes in the town cemetery. Two weeks on life support vents without recovery. (Being on a vent means a medically-induced drug coma, too, kids.) Good times, if you like reading about the Black Death in the 1300s.

This isn't panic-mongering, it's rubbing your noses in the truth.
For some people, that kind of a head-slap is the only way to finally get their attention.
If you can't handle it, avert your eyes, and STFU, and let the grown ups deal with it.

You don't have enough supplies, ammo, and hard-hearted friends inside your perimeter to deal with what happens if this crushes healthcare, and then all the wheels come off civilization. Pray that doesn't happen.

You might have enough to make it through just the Kung Flu part, if no one loses their minds, and instead puts on their big boy pants, and deals with their own sh*t. For several months.

Say, howzat gonna work out for those in EBT-Land, over by South Gibbsmedat?
Just curious.

Qwitcherbitchin, stop going out to play in it, and ride it out.

And for the perpetually hard-headed, go back and read this post, from a lifetime ago, in this case two weeks exactly, and tell me afterwards how right or wrong I was in what I told you, plainly, then, versus what you're experiencing IRL, now.

I'll wait over here while you consider your replies.

A New Hope?

Not a vaccine, but a treatment. We’re somewhere between a year and forever from a vaccine.

Rumbles of an effective treatment from medicine available off-the-shelf:
PDF. Caveat: From ChiComia.
PDF: ChiComia again
PDF: Corroboration from France

I hope that pans out as true empirically. Chloroquine has been around for ages. (1934, in fact).

I’m also hoping the main supplier for it doesn’t turn out to be China, and it works as effectively as some posts have reported. Finding out we have the answer sitting on the shelf would be a literal godsend. And turn this from a probable disaster to a burp in about a week. If  it’s true.

Anyone who’s panicking is the result of utter stupidity.

Mortality from this has always been a secondary concern (except to the lottery losers themselves.) It’s the hospitalization rate that’s critical. My concerns have been the effects of anything over a million hospital cases (which swamps the healthcare boat), and the follow-on effects from exactly the official responses taken to curb the pandemic, which, contrary to the actual chicken littles and head-in-the-sand ostriches, were exactly what I did warn about, and suggest people prepare for.

Trump hasn’t been perfect in this – no one ever is – but his tone and demeanor have been, and his instincts are far better than most. Where he’s stumbled is mostly attributable to some of the idiots in the admin who should have been shown to the door three years ago, but are still hanging around. Most of the idiots at CDC et al are right where we left them in 2014, just as clueless now as then, and six years older and stodgier. The FDA is another fartsack of incompetence, and them squawking over EOs setting aside off-label use of chloroquine is proof that most of them need to be retired in haste. It either works, or it doesn’t, but starting a five year testing process isn’t the way to go amidst a world-wide pandemic.

If we try it, and it works, we’re done. If it fails, we’re no worse off than we are without it.
QED

Anyone, at any federal agency, that blathers against that now should be given a choice of immediate reassignment to the McMurdo Sound Research Project, or retiring in an hour. That’s exactly the sort of thing at which Trump excels.

And I leave it to anyone's best instincts regarding the fact that China, specifically the Wuhan bioresearch laboratories, have published studies already with an allegedly efficacious cure for the strain of coronavirus that originated in...Wuhan.

From a medicine that's been around since FDR was president.

Regardless of that, if it pans out, it would be an answer to a lot of prayers.

BONUS UPDATE:

IF this does turn out to work like gangbusters, THEN cue the Retard Posse to start caterwauling that "Aesop was WROOOOOOOOONG!!!!! It was all a total HOAX!" in 0.2 seconds. The ones, that is, that still haven't stopped yelling that 24/7 already, with cases worldwide, deaths rising, half this country on total lockdown, the economy in a shambles, and the stock market totally in the shitter.

I can make that prediction with 0% chance of being wrong.
Fucktards gonna fucktard.
Those fish in the barrel aren't going to shoot themselves.









__________

Side note: It's been illuminating to read elsewhere in the blogosphere how we've been a troll, a panic-monger, stole your lunch money, and made fun of your mother, for telling you about this outbreak, or Ebola, or whatever other pet peeve(s) chapped their tender asses,  as I live in their heads rent-free. And how dare we know more than you, for any value of "you" they deem important. Generally, themselves. Doubly so that when asked for specifics, the accusers generally fart, shuffle their feet, slither away like ghosts, or just flat-out confirm they were talking out their asses all along. You go, girls. Howzat workin' out for ya?

I can link to any number of times right on these pages we told you not to panic over the present pandemic, or where we told you that deaths from Kung Flu weren't the biggest problem, or that the subsequent effects of a pandemic (second-order through N-th order) are always the bigger deal. I can even point out all the places we told you to prepare, not freak out.

But that's all assuming, against copious evidence to the contrary, that everyone with a keyboard is not a gibbering monkey with the English language comprehension skills one expects of such thoroughgoing retards. (If:Then propositions clearly kick their ass to the North Pole and back twice a day, by most accounts.)

That is because for a certain subset on the Internet, fucktards will always be fucktards.
And cannot help showing their asses, eventually, if not perpetually.

And anyone telling them something is going to upset their daily applecart jiggles their existence out of kilter, fucks with their comfortable normalcy bias, pisses them off, and kicks in their Dunning-Kruger skills with a vengeance. Reality slapping you in the back of the head is a bitch like that.

Some people just never tried having an actual public debate, or a difficult chess match, nor stepped into a sparring ring, or fenced a match, so they don't understand that I can tell you your argument is stupid, and prove the point, without therefore necessarily thinking that you must be too. Unless you leave me no other options, long after you should have tapped out. 

I've disagreed the hardest with some of the people I respect the most on the Internet, because they bring expertise in other areas that I truly respect, and they know how to make a point, or take one. But I won't pull punches in making a point, because truth isn't something you shy away from. Anyone, including your humble bloghost, can make a stupid argument. I've seen me do it. But stupid should hurt, and I step aside to no one in bringing that pain if the opportunity arises, even if your panties are binding in tender places as a result.

If that's too much, lurk and learn from others' mistakes, but don't cry because you lost. 


Learn it. Love it. Live it.

Thank heavens the terminally stupid are always a small fraction of visitors anywhere, including here, but never underestimate the power of stupid people in large groups, or with loud mouths, and no self-awareness of their own shortcomings.
Stupidity is dynamite dangerous.
Envy is gasoline.
Butthurt added to the mix is generally the source of ignition.
In combination, they're a toxic stew, and the resultant blast warms our hearts.
Scars to those so afflicted are, to us, wholly irrelevant, and richly deserved.
Don't be a publicly ignorant jackhole with temper issues, and you'll get along in life just fine.
If not, well, suture self.

And maybe try the cream, instead of posting smack you can't back up from a dearth of anything worthwhile, just the over-abundant contents of your spleen, and the spackle from your diaper.

Kung Flu Quarantine Menu, Day 137

h/t Daily Timewaster

Come. And Go.

h/t WRSA

Per the JH Dashboard, 2919 new cases, and 36 new deaths, since yesterday.

The caseload is certainly anomalous from recently starting testing.
Nonetheless, they've doubled, in two days.
The deaths are what they are. 20% more in a day. So doubling in about 5 days.

If you're home, accept the New Normal, and go watch old movies.
After you check your property for security, inventory your food supplies, and tally up your cash float. And load some magazines.

The constant rumor is mandatory lockdown coming, everywhere, for everything non-essential.

If you're laid off, etc. stop watching this non-stop.
Stop net-surfing for stories every waking minute.

It's ugly, and it's liable to get worse.
Now you know it. Go on about your day.
Dwelling isn't helping.
Tomorrow will take care of itself, and you can look at things then, when it's then.

If this caught you pants around the ankles, well, sux to be you, don't it?

Offical Blog Of The White House Staff



'struth! Suck it, bitchez.

Thanks to frequent commenter Nemo for this news which, compared to the dismal tone from other sources lately, absolutely made my day:

"Aesop,

Your (I think it's yours, as this is the only place I've seen it other than me repeating the moniker on other sites) Kung Flu moniker finally made the big time. Just saw a head line on Breitbart.com (where else!) that included the term purported to have been asked by a PBS/NBC (of all people) newsperson. Right now it's the second headline down from the top."

And here it is at Breitbart:

PBS reporter Yamiche Alcindor also challenged the president’s rhetoric, noting reports that someone called the coronavirus the “kung flu” in front of an Asian-American White House reporter.
“I wonder who said that, do you know who said that?” Trump asked. “Say the term again.”
Alcindor repeated the term “Kung Flu” twice and asked again about his use of the term “Chinese virus.”

UPDATE: And it's on the FoxNews site too.

And the FakeNews mediots just can't shut up about it, @ the 13:42 mark:

 

They're like Quentin Tarantino using the N-word in a movie - they can't stop themselves.

Who said it? I plead guilty on all counts.

Dear Mr. President,

*I* said it. Keep up the good work. Glad to hear *you* don't have Kung Flu. And please express my thanks to your staff for reading my blog.

Best Wishes,
Aesop


February 7th, my blog. March 18th, national news from the White House.
Hilarious.

And a YUUUUUGE shout-out to poster elysianfields, from whom I originally stole it, and then posted here.

Congrats, buddy. Either we're getting signed photos in the Oval Office and MAGA hats, or federal persecution for "hate crimes".

Personally, I'm pleading the First Amendment.

If the media-tards want to take me to Instapundit levels of readership overnight, by all means, come call me out over this. You might want to peruse some of the site before you go that route. One of the tags for this post would be a major cluebat there, before you give me a platform to pull the curtain out from around your Wizard-Of-Oz antics. Just saying.

And if anyone thought I was insufferable before this over-the-moon happy news, well...brace yourselves.

Meanwhile, take it away, Carl:

Oh, and to the unnamed Asian WH reporter or reporterette from this alleged apocryphal story:

Please accept my sincere and heartfelt deepest wishes that you find a suitable hand tool and
untwist your panties!

There's an ointment for that:

 

Bonus: This blog may also be research material for the L.A.Slimes.

NTTAWWT.

Thanks, Phil.

 

 

Well, F##k Us All...

h/t Small Dead Animals

Why lockdown everything?

"Two fundamental strategies are possible:  

(a) mitigation, which focuses on slowing but not necessarily stopping epidemic spread – reducing peak healthcare demand while protecting those most at risk of severe disease from infection, and  

(b) suppression, which aims to reverse epidemic growth, reducing case numbers to low levels and maintaining that situation indefinitely. Each policy has major challenges.  

We find that that optimal mitigation policies (combining home isolation of suspect cases, home quarantine of those living in the same household as suspect cases, and social distancing of the elderly and others at most risk of severe disease) might reduce peak healthcare demand by 2/3 and deaths by half.  

However, the resulting mitigated epidemic would still likely result in hundreds of thousands of deaths and health systems (most notably intensive care units) being overwhelmed many times over. For countries able to achieve it, this leaves suppression as the preferred policy option.” - Imperial College, London - COVID-19 Response Analysis pdf {emphasis mine. -A.}

RTWT.

It's 20 pages long.
This was probably a lot of the basis for the EU suddenly going full BFYTW yesterday.

TL;DR?

Suppression (i.e. societal lockdown) : need for it could last for 18-24 months, until an effective vaccine is found. No guarantee that will happen by then, either.

Mitigation: (small-scale quarantines): won't work, and disease will blossom the minute you relax from suppression to mitigation.

Secondarily, all ICU beds are overwhelmed no matter what we do by May 1st, and from then until July 1st, medically, this is going to be a living hell.

(I love my job, I love my job, I love my job...O, hell!)

Prognosis:

Now see if you can suss out, all by yourself, why TPTB have been slow-rolling this thing out in bite-sized chunks, over the last 5-15 days (besides myopia when confronted by abnormal situations).

If this harshes your mellow, and offends your delicate feeeeeewings, take heart:
these are just doctors doing policy research that informs world leaders.
They could all be a bunch of pointy-headed idjits, all completely wrong.

Tomorrow, magical faeries riding enchanted unicorns could swoop down over the earth, pooping healing pellets of strawberry scented pixie dust, which cures cancer, wipes out Kung Flu, ends acid reflux, sweaty palms, toenail fungus, and the heartbreak of psoriasis. And your Panda Express fortune cookie fortune may have the winning numbers for Powerball, and the direct cell phone number of the Playmate of the Year.

So do whatever seems right to you.
And let us know how that usually works out for you and yours.

The Day The Paradigm Shifts

Papieren? Nein. Rausmachen! Schnell!!

And just like that, borders suddenly matter a great deal.

Maybe, now that they've plugged the leaks, they can start bailing out the boat, and shipping their refugee problem RTF back to Sh*tholia and Trashcanistan.

For a two-fer, we could do the same thing.

Anybody willing to bet me a roll of toilet paper that we can't deport 40M illegal aliens now?
There will never be a better opportunity.

Imagine Gov. Gabbin' Nuisance and House Speaker Alzheimers waking up in a week and finding out that after the go-backs, Dems in CA were suddenly back in the minority.

O, the humanity.

You Really Have No Idea

And so is Kung Flu.

This isn't a ramble. I have a number of lines of thought I've been stewing over at work all weekend, and I'll be going down each one until I'm done.
Let's begin.

          4000

          8000

        16000

        32000

        64000

      128000

      256000

      512000

    1000000

    2000000

    4000000

    8000000

  16000000

  32000000

  64000000

128000000

256000000

512000000

4000 is the number of confirmed cases of coronavirus in the U.S. now.
(That we know about. Reality could be 100,000 or more.)

If that original number doubles seventeen more times, the product is a number larger than the populations of the U.S. (330M), Mexico(137M), and Canada(37M), combined. IOW, it's virtually everywhere in North America at that point. (No, I'm not particularly concerned about the banana republics between Mexico and South America in this regard. They can lump it.)

What I've read is that the outbreak is doubling every 4-6 days. So somewhere between 68 and 102 days from today, the shit sandwich on this continent reaches full maturity.

If the spread of the disease is moving at that rate.
If the current voluntary measures don't halt that growth, or even slow that pace.
If it doesn't run out of people stupid enough to keep doing things to spread it.

With the above caveats:
May 22nd, to June 26th, give or take.
It crests 100M cases a week to two earlier.

Long before then, we'll have a great view of how lethal it is, and how many cases are serious. So by somewhere between mid-May and Mid-June, we'll either have metric f**ktons of people requiring hospitalization, and dead, or not. How much better or worse it is then will be a foolproof look at whether this is a nothingburger, or Spanish Flu. Oh, and if there are really 100,000 cases now, we get there a full month earlier.

Now maybe you can figure out why POTUS said this will last through July or August, at minimum.

And remember, the 85% (or more, or less) of all infected people who have symptoms ranging from none, to moderate flu, aren't the problem. They never were. They'll be just fine.

It's the hordes dying in droves, and crashing the entire U.S. medical system that could put a kink in this country that'll last for decades. And crashing the stock market. And everyone going broke. And crashing the economy even after this passes. And so on. And so on. And so on.

That's 5 1/2 months from now.
How much food do you have?
How much cash on hand do you have?
How much of each of those does Gilligan's family have, and how far are they from you?
So, how much ammo do you have??

That little thought exercise should concentrate your minds wonderfully.

----------

Now, a reminder about some other numbers.
900,000 staffed  hospital beds.
93,000 staffed ICU beds.
60,000 ventilators.
1,000,000 medical doctors.
2,800,000 registered nurses.
106,000 respiratory therapists.
That is the army you're gong to war with, in this pandemic.

And when I say staffed beds, I don't just mean doctors, nurses, and RTs. I also mean D.Os, PAs, EMTs, CNAs, pharmacists, radiology techs, facilities engineers, clean-up crew, supply workers, registration clerks, administration people, IT geeks, and hundreds of other clerks and jerks, without whose constant efforts and hard work, plus medical supplies in small mountains every single day, Dr. Hero and Nurse Awesome are just a couple of people in funny pajamas, and with about as much lifesaving ability on their own as there is actual magical ability in Rupert Grint and Matthew Lewis.

If it was just beds we needed, we could take all the surplus army cots from the 2M guys RIFFed from Uncle Sam in the 1990s, unfold them, and Presto!, have another 2M spots to dump patients. It doesn't work like that.

I bring this up because if "only" 10% of Kung Flu victims require a hospital bed, because they're really that sick, then long about the time we hit 16,000,000 victims, in (44 to 66 days, so let's average it to) 55 days, we have more patients than we have beds for them. At that point, we're Italy. Say about May the 12th or so. (We may also have up to 480,000 dead, which if it happens would have crushed every ICU in the country 5 times over long before that point.)

We've covered this before, but it bears keeping in mind. Keep your thumb in this spot, as we move along.

----------

This weekend, all considered, from purely a Kung Flu cases standpoint, was just ducky.
We had maybe half a dozen to ten "rule-outs" (meaning "maybe it is, maybe it isn't"; look for other things that rule out Kung Flu. Like actual influenza flu.) Given the abysmally slow return time of Kung Flu test samples, I believe at least one was positive for Kung Flu.

"Ten patients? Is that all?!? Aesop is fulla sh*t! This is a big conjob nothingburger!" - every two-digit IQ soopergenius who ever read a word I wrote on this topic.

And herewith, we digress for a bit.

Scenario One: You're in the military. In a combat zone. The enemy is known to have chemical weapons. One day, a shell whistles over from the enemy side of things, and goes off with a less than enthusiastic bang. Then another, and another. You see a hazy white cloud forming at each impact site, coalescing into a large white cloud, now drifting lazily towards your position.

Do you
a) send the company dumbass Gilligan over there to have a sniff for you, and report back
b) send the whole company of men over, and see what happens
c) put Gilligan in temporary command, and have him lead the whole company over there
d) Yell "GAS! GAS! GAS!", while clanging metal-on-metal, and then rapidly don your MOPP gear and gas mask, before the cloud blows into your position, and prepare to treat anyone nearby who was slower on the uptake.

Scenario Two: You're working in a hospital. An ambulance arrives, and unloads a patient spurting blood everywhere, who tells you he just arrived from the Congo, where he runs an HIV and Ebola Survivors Clinic, and tripped on the jetway and cut his leg open.

Do you
a) run over and apply direct pressure with your bare hands, while fountaining blood cascades into your eyes, nose, and mouth, and lick yourself clean afterwards
b) yell at all your other co-workers to join you in performing "a"
c) Both "a" and "b"
d) put on appropriate gown, gloves, and mask with splatter shield, and apply an emergency tourniquet

In case you were wondering, the correct answer to both scenarios is "d".
You always assume the worst, from common sense, and institutional policy, and over-prepare, so you can deal with it easily if it turns out to be less-than.
You don't grab your .22 to go take on that African Cape Buffalo, and then find out you needed a bit more to get it done. Unless you're a farking moron.
I told you that story so I could tell you this one:

----------

Some days back, I stated that I didn't think we'd bring Kung Flu patients into the hospital, but instead, triage them in tents outside, then send the ones meeting criteria to some FEMA-set-up Kung Flu Treatment Center, staffed as possible, and serviced by dedicated Hazmat 9-1-1 ambulances, whisking members of the community there as appropriate, in full protective gear, 24/7/365.

Because, as I argued with flawless logic, to do otherwise would be to
a) risk our entire healthcare system being overwhelmed and destroyed, a la Italy, and
b) make every other medical emergency impossible to deal with, thus doubling casualties from every other treatable and preventable cause of death, from heart attacks and strokes to appendicitis, because the entirety of any and every hospital would be filled with Kung Flu-infected plague petri dishes, in every nook and cranny.

Turns out, TPTB, top to bottom, make the Italians look like Leonardo da Vinci.

1) We're not putting tents up everywhere.
2) We're not segregating people out of the hospital.
3) We'll do a half-assed triage assessment outside the building somewhere (fill in the blank where___________)
4) Using screening criteria overtaken by reality a month ago, because the CDC, no matter how asinine, is always the CDC
4a) to wit, asking about foreign travel, even though homegrown community-acquired cases outstrip foreign travel candidates, and have for two weeks
4b) ask about exposure to known Kung Flu patients, even though the CDC and local public health  departments refused to test for Kung Flu until four days ago, in most cases, (due to jackassery, fuckwittery, and a dearth of functional kits for two months) thus insuring via Catch-22, that if you never test for King Flu, nobody anyone was in contact with ever officially has Kung Flu
5) then bring the infected into an appropriate sealed negative airflow room
5a) which cleverly has no patient monitoring equipment
5b) will not allow you to get portable chest x-ray equipment into the room with the patient with respiratory problems (which, also cleverly, no one thought about prior to then)
5c) which would contaminate said portable x-ray equipment every time you got it into the quarantine room
5d) which would require an extensive, nigh impossible decontamination of said X-ray equipment for each and every subsequent patient
5e) thus leading to shooting x-rays outside the building, or in other places that probably violate 27 hospital safety policies, local health and safety codes, and probably eleventy Nuclear Regulatory Commission regulations regarding radiological safety of patients, staff, and bystanders, in a slow-rolling Chernobyl sort of way
5f) and taking them to CT scanners which are then contaminated, and failing to do a full terminal clean of said rooms and equipment each and every time, which would take them offline for hours each shift, and necessitate closing the hospital to ambulance traffic, so why bother cleaning?
6)unless you're fresh out of negative airflow rooms, in which case you
7) put them into open rooms with no protection or containment
8) thus insuring that all staff members and other patients are exposed over and over again
9) to cases which will not be tested for Kung Flu unless they're first proven negative for the flu
10) Or not.
11) All such "policies" being rather more like the Pirates Code ("just guidelines, really"), purely at the whimsy and caprice of whatever doctor(s), charge nurses, or cranky old bat nurse has phone duty that day at the Public Health office, and their personal and capricious interpretation of the current (of four or five or six, so far) CDC guidelines
12) which apparently are changed every hour, if not more frequently
13) while the managers, and senior management, who should be living in the same shoes and underpants 24/7/365 in the hospital until they sort this shit out, weekend or no, but whom are instead nowhere to be seen, heard from, or in any wise directly involved, until the total colossal clusterfuck falls over from its own weight seven or eight times over, between Friday afternoon and the middle of the following week.
14) while staff and patients, having to deal with the results of people with Acute-on-Chronic Head-Up-The-Ass-Syndrome, are repeatedly subjected to potential pandemic exposure, leading to sickness, preventative quarantine, lawsuits, and death
15) as the Low IQ staff members, who still think this is no big deal, continue to half-ass every bit of their response, 24/7/365, because half of them were below the upper/lower cut in their graduating classes as well.

THAT'S WHAT YOU'RE GETTING.

The CDC (as per usual, going back years decades) has no f**king idea that it doesn't even know what it doesn't even know, including how to find its own ass with both hands, a map, a compass, and a rearview mirror.
Hospital ManageManglement has no idea the CDC can't find its own ass either, and is looking for their own as well.

Supervisory staff puts on its Lemming Suicide Squad Crash Helmet and blinders, and announces that the Light Brigade will smartly charge right over the cliff.

Grunt-level staff, doctors, nurses, ancillary members, etc. will continue to work until
a) they can't take the bullshit
b) they get sick
c) they realize their own family's safety trumps a paycheck.

Instead of learning from Italy's mistakes, and trying to save people and the overall healthcare system, we're going to keep on half-assing this until we're in it over our heads, and then drown, because stupid. Instead of making the hard call early, and working the kinks out now, when it would have been easy, when it's five patients a week, we'll wait until it's 500 patients an hour, and then crash and burn in a glorious orgy of stupidity.

I expect people to hit the wall.
This is all new to everyone.
There hasn't been a pandemic like this in 100 years.

BUT I ALSO EXPECTED THEM NOT TO BE SO GODDAMN STUPID AFTER THEY HIT THE WALL ONCE AS TO NOT THEN RUN HEADFIRST INTO IT TEN OR TWENTY MORE TIMES, IN RAPID SUCCESSION, SIMPLY BECAUSE THEY CAN.

That last expectation was misguided, being most clearly irrational hubris overcoming a solid and well-founded pessimism about people in general, the universality of the Peter Principle, and the inevitability of people, left to their own devices, shooting themselves in the feet until they run out of feet, or ammunition. And then, reloading.

Having said (and witnessed, firsthand) all of the above, and after understating it by at least half (you really have NO idea) there's only one way to deal with this, for me:

I mean that last, most sincerely. We're all going to go through this. Harden the fuck up.

Take care of yourselves.
Take care of your families.
Take care of your friends.
Take care of Your People.

No one is coming to save you.
Not me.
Not the government.
Not. Any. One.

Everything is Your Responsibility.
Deal With your Shit.
Get It Done.

YOYO = You're On Your Own

Best Wishes. Really.

And if, watching the economy do a SMOD impact into your life, and the entire nation go onto a (mostly voluntary) full lockdown quarantine, you still think this is just a hype and a nothing burger, I can't help you.

If you're right, I don't need to; and if I'm right, no one will miss you.