Big green candle at market open. All is well, carry on.
Dear all,
I’m sure I’m not alone in experiencing severe cognitive dissonance at the moment. I live in London and my wife and I are due to go on our long-awaited honeymoon tomorrow evening (to the Maldives and Sri Lanka). Here in London it’s business as usual. Nobody is wearing facemasks and the only sign of anything untoward is that hand-sanitser is sold out in most of the pharmacies. There has been no official warnings about travel (other than to China), so it would seem that all is well for us to fly out tomorrow. Yet when I look at the reports from Chris I can see that the situation could potentially explode over the two weeks while we are away. We could be coming back to a very different London to the one we are leaving now. Rather than jetting off on honeymoon, should we in fact be getting our preparations in place for a lockdown of the city? I dont’ want to be rash and cancel our trip (at considerable loss) for this pandemic to turn out to be no worse than a bad flu. And equally, I don’t want to be sitting on a beach watching the news unfold and realise that we are in a precarious position.
Advice and insights greatly appreciated.
E
First patient, less than thirty years old. Admitted for pneumonia, prolonged mechanical ventilation, had strep pneumo and influenza A. Required tracheotomy and dialysis and likely month or two of physical rehab . What they don’t tell you, patient had ttp (thrombotic thrombocytopenia purpura) and it required a splenectomy. Spleens a good thing, strep is for most part taken care by spleen and one gets very septic often requiring mechanical ventilation and dialysis, vasopressors, etc. With spleen, one rarely requires hospitalization. Patient two, morbidly obese male, less then forty years old with undiagnosed right sided heart failure and sleep apnea. Admitted for shortness of breath and presumed viral pneumonia. Extremely poor response to pneumonia with ARD’s (acute respiratory distress syndrome) that required extreme mechanical ventilation and dialysis. Patient didn’t recover with less than three weeks of hospitalization. What they didn’t tell you, sleep apnea was so bad that patient slept straight up in chair and would prop himself on some kind of table. Patient had difficulty staying awake and heart was pretty much shot due to pulmonary hypertension. Patient three, less than 60 year old male with metapneumovirus. Patient required ICU admission due high oxygen requirements. What they didn’t tell you, patient had lymphoma five years previous with stem cell transplant and recovery coarse going poorly with graft verses host disease and other problems associated with treatments. See, three benign viral infections that had very severe reactions cause they had significant other health problems they don’t going into on. Meanwhile, enjoy your Cheerios loaded with roundup, cause we don’t care about quality and health. If anyone thinks we remotely care about health, purposely ignores how awful the quality of food we choose to consume. To me, all the emphasis on this infections and vaccines is a joke, cause high consumption of sugars and vegetable oils and CAFO meats causes far more deaths that by huge margins and nobody caress. Sure is good for business though, costs have never been higher with very poor return in the buck.
A good debate and well reasoned arguments and responses.
It is interesting that Andy’s stand against fear is based on his own fear that people’s actions (or over-reactions) to this virus might harm the economy.
I agree with the sentiments of Granny and Snydeman about fear versus ignorance or respect. We treat too much in this world as either this or that (false dichotomy) versus one of degree between points.
I don’t see that Chris is peddling fear so much as educated concern about an emerging problem to be managed, whereas Andy seems to be arguing for complacency in the hope that nothing bad will happen.
As I see it, concern leads to becoming more informed and allows for a measured level of preparation. Stated otherwise, a person has power (agency – in science lingo) to make rational choices. If everything works out fine then what is the problem? People have more masks, hand sanitizer and food than they would have had. They are better prepared for any future pandemics and, hey, they stimulated the economy a bit more in the mean time.
Complacency, on the other hand, leads to sleepwalking right up until a potential crisis. People will remain totally unprepared and ignorant of what the virus is or how to deal with it. This is exactly what will lead to the unreasoned fear response Andy is concerned about, since a populace that is totally unprepared that suddenly realizes or suspects they are in danger will respond out of unreasoned fear. The only way this works out well is if the current virus is totally benign.
Color me skeptical that this outbreak is much ado about nothing. I don’t think that China is quarantining 50 million people and sabotaging their own economy for the fun of it. Time will tell what the final spread rates and mortality figures are for this virus but the chances that this is just another flu are vanishingly small. It is a serious health challenge. Neither is it the Black Death though. The question is where in between things are and who is most at risk.
We can comfort ourselves in thinking that our medical systems and government actions will be much better than the Chinese but the main advantage that we have is time to plan and learn about the virus before it becomes a major problem for our countries so we can respond more effectively. The “ineptness of the response of the Chinese government” (PaulJam) will become a case study for the future but would the US or any other nation have done better given the circumstances? Perhaps, but just look at the US response to Hurricane Katrina and the flooding of New Orleans for another example of government ineptness spawning a debacle.
Given what I’ve learned to date, I am less likely to run to the emergency room if anyone in my family gets ill, barring more serious complications, but I am concerned for my mother and other elderly relatives.
I see what Chris is doing here as providing an inoculation against unreasoned fear for those who actually listen to what he is saying and who act accordingly to take actions in accord with their personal situations and levels of concern.
My two cents…
I am only proposing this for places that actually have the pandemic running loose. (Which could be a number soon).
Instead of shutting down whole cities and whole economies - we tell people to isolate those who are most vulnerable - the old, the sickly - and only let certain people (with washed hands) in to see them. They are cared for in quarantine until the virus blows over.
This is better by far than telling EVERYONE to stay home - or shutting whole cities down.
Why could not this be done?
-Andy
Not every old person has others who check in on them, and therefore who would need to get out to get medications and food? Just throwing it out there…I came up with that in about 5 seconds, by the way. I suggest doing some deep thinking about solutions and writing a pro-con list after some solid research and pondering.
Case studies are nearly worthless in concluding anything meaningful. Baffling people with fancy medical language does not lend support to one’s position.
BTW, I totally agree with you about the irrational thinking & behavior people have in regards to their long term health…not being obese, not smoking, flossing, minimizing consumption of simple carbohydrates, eating healthy meats in moderation, not eating the unhealthy fats, eating the healthy fats such as avocados & walnuts almonds cashews etc., regular physical activity, etc. , eating plenty of vegetables and some fruits.
However, I believe your post is mixing issues & says nothing about the issue at hand.
Congratulations to you and your wife on your nuptials.
No one can make the decision for you regarding your honeymoon. The two of you will have to decide together how you will approach your life. Cautiously, pragmatically, taking advantage if the calm or are you more prone to live life to its fullest, take some chances and enjoy the thrill of adventure. There is no right or wrong just an opportunity to decide how you, together, will approach your life.
Best of luck, happy deciding - together!
AKGrannyWGrit
PS - we would live to know what you decide.
https://www.cnbc.com/2020/01/30/ezekiel-emanuel-on-coronavirus-americans-need-to-stop-panicking.html
I don’t see anyone in a panic lol
That assumes you can find them. But seriously, here’s a write up about super-spreaders and includes one anecdotal case of a 2019-ncov spreader that is reported to have infected at least 14 people.
https://theconversation.com/what-is-a-super-spreader-an-infectious-disease-expert-explains-130756
Btw, for those who do not know what I was referring to I was referring to this Clint Eastwood movie…
https://youtu.be/8Xjr2hnOHiM
Somebody mocked this idea - without suggesting anything else instead. But just think about it. The only option being tried right now is shutting EVERYTHING down - whole cities and economies.
Why not just isolate those most at-risk until it blows over? (I know you can’t protect everyone this way - but at least a high number).
If you have a better plan, I am all ears. But you need to spell it out.
three cases of severely poor responses to benign viral infections. For the vast majority of the population, these infections are not a problem, in fact a benefit, because a person builds antibodies and has immunity with exposure, as explained in the interview. I felt that the devil is in the details. If we don’t see that only people with underling health problems are the ones that show up in the stats, then we tend to overestimate severity of problem. Fear is created to control us, the less informed we are, the more easily we are controlled. We are spending huge amounts of money with very little to show with it. If a society thinks it’s more important to spend huge amounts of money on people that are chronically sick and ignore foods and habits that lead to sickness, we will be on a treadmill to a bankrupt society. We are there now, fear has allowed us at the whims of medical establishment and their partners in the insurance industry. See all those commercials for medications for auto immune diseases, they only manage them, are no cure and leave you at risk other problems like infections. Does anyone care why we have them, they don’t cause it’s the golden goose, those med’s are at the top for profit’s for big pharma.
As a doctor with an MPH degree, I would like to point out that many Americans do have at least one chronic illness. Over 10% have type 2 diabetes, millions have an autoimmune disease (most hypothyroidism is autoimmune, and many have colitis, MS, psoriasis, 1% have celiac disease, etc.) Morbid obesity rates are high, in some states more than others, and the population has been aging. So, yes, I think we are relatively susceptible, though perhaps pollution in China makes the disease worse for them.
On the topic of censorship, the Event 201 website has a 12 minute video worth watching. In their remarkably prescient pandemic exercise, one topic that generated abundant discussion was the control of information and misinformation. I think the argument on this site is that one might want to secure one’s investments as part of preparation, and some might believe that that would unnecessarily crash the stock market. I think TBTP are saying that it’s better overall for us to be unprepared - either they’ll figure out someway to help us, or there’s nothing that can be done anyways. Of course it would be better if everyone were prepared to spend a couple of months sheltering in place, but that isn’t going to happen, and if that’s a fact, then it will be chaos anyways.
I also have some thoughts on the death toll. As Chris has been doing, we need to factor into our calculations the fact that only about 4% of the American population gets influenza every year. That’s because most of us already have some level of immunity. But this is a new virus that most of us will be susceptible to. And the flu doesn’t go away when coronavirus strikes. So we’re looking at potentially tripling or worse the number critically ill people in this country. And you need supplies and medications or at least IVs for these patients. And 80% of raw materials for medications come from China. And how about staff, you can’t just triple everyone’s workload in ICUs across the nation without critically overworking them. With all due respect for my colleagues, I don’t see how this is going to go well.
“Somebody” didn’t mock you, I did. Not because you proposed an alternate solution, but because you didn’t seem to spend any time thinking it through; a process that you will find will get you eviscerated 'round these parts. The solution you propose has many flaws that can be exposed with a minimum of thought.
Answer for me these questions:
What age is the cut-off line?
Who decides that?
What about older people without family supports, or anyone who could actually come to care for them?
How do you propose we enforce your proposal?
What would be the consequences for those old people who go out anyway?
Why are you ignoring the facts that young people are catching this virus too?
I mean, are you willfully ignoring the data showing it isn’t just elderly catching this thing? Or do you mean to only prevent the elderly dying from it? Because what I’m seeing tells me the young die too, if not given adequate and intense medical attention.
Here’s my proposal: Cut off all flights inbound or outbound from China. Isolate and quarantine those who are arriving, under humane and livable conditions. Educate the populace to take this seriously and change their hygiene, social patterns, and behaviors a little now, so they won’t have to change them a lot later.
For the record I think it’s too late. The cat is out of the bag. But I hope I’m wrong.
My proposal was in the case of full pandemic - simply an alternative to shutting down EVERYTHING. I still think it is better than complete lockdown.
Hi E,
First of all, congratulations on your marriage. How untimely all this is for you.
I have several trips scheduled in the next little while including a major vacation in a couple of weeks, so I appreciate your question. Here’s what I think is worth considering in no particular order:
~ How prepared are you already for the pandemic? Would you be better off staying home and preparing further in case this situation really does become major where you live.
~ Where are you going and what will you be doing when you get there? From my perspective this probably isn’t the greatest time to be sightseeing in the middle of Bangkok for example. If you will be doing something more remote that does not involve large crowds, then that’s a different story. If you are going to a country that typically gets lots of visitors from China for Chinese New Years, they may have more Corona virus cases than are currently reported.
~ What level of trust do you have in the medical system of the countries you are visiting should you get sick?
~ Will you have access to news where you are going and can you abort your trip if necessary and return home early? Will you be able to communicate with friends and family from where you are going?
~ How important is it for you to stick to your planned schedule or would you be okay if your return home was delayed by the events at hand? Along with that consider your level of emotional & financial resilience if you were to suddenly be stranded in an unfamiliar city for a period of time.
~ How healthy are you currently? Someone with a history of lung issues or a compromised immune system would likely be taking more of risk traveling right now than at other times.
~ Are you prepared for flying at this time? In my opinion people flying should have at a minimum a supply of N95 masks, hand sanitizer and disinfectant wipes. I would also bring all of my own food for the plane travel portion of the trip.
~ Will you be able to enjoy your trip or will your attention be split because of what’s going on? This is a big one for me personally with the vacation and not so much for the work trips I have scheduled.
This is a tough and very personal decision. We just don’t know what will happen since we are at the beginning of this pandemic. I have not yet decided what I will do.
I wish you well in your decision making.
–Suzie
As some of you have asked previously, I too have a vacation cruise in 2 weeks exactly. I woke up this morning and the quarantined cruise from Italy is the headliner. I live in Texas…wondering if I should skip this highly anticipated trip. It’s a 4 day cruise from the port here in south Texas to Cozumel and then back?
I guess we will see where we’re at as the day gets closer but i’m honestly upset there maybe a chance I wont be going after all. Any input? By the way, I’m grateful I found your videos Chris which led me here. 
Andy, you might be right. Perhaps rather than a lockdown would be to give people information and a choice.
For instance in John Barry’s 1st podcast with Chris he talked about the shutting down of schools. But then young people would do what young people do and go out and say, play some basket ball. So quarantines help but the long-term outcome may, possibly be very similar to no quarantines. However, many people want the truth and to make their own informed decisions.
Perhaps its a crap shoot, but I want the odds in my favor.