Semi-OT: Coronavirus (COVID-19) Discussion Thread VI (Don't Read Post 1 & FAQ)

[LKN]

I've seen a few posts in here but I think more should be spoken about a good death, it might good timing as a society to talk about it. Could relieve hospital pressure even more.

Why I hope to die at 75
https://www.theatlantic.com/magazine/archive/2014/10/why-i-hope-to-die-at-75/379329/

Let's see how he feels 18 years after writing that. My father is 76 and still lives a full/rich life and my kids don't want their "poppy" going anywhere anytime soon.

[MagicBagley18]

I've seen a few posts in here but I think more should be spoken about a good death, it might good timing as a society to talk about it. Could relieve hospital pressure even more.

Why I hope to die at 75
https://www.theatlantic.com/magazine/archive/2014/10/why-i-hope-to-die-at-75/379329/

Let's see how he feels 18 years after writing that. My father is 76 and still lives a full/rich life and my kids don't want their "poppy" going anywhere anytime soon.

Agreed. My dad is 74- runs his company not bc he has to but because he wants to and damn sure ain’t ready to go

[zimpy27]

Why I hope to die at 75
https://www.theatlantic.com/magazine/archive/2014/10/why-i-hope-to-die-at-75/379329/

Let's see how he feels 18 years after writing that. My father is 76 and still lives a full/rich life and my kids don't want their "poppy" going anywhere anytime soon.

Agreed. My dad is 74- runs his company not bc he has to but because he wants to and damn sure ain’t ready to go

Of course, no one is saying die at 75, the argument is about changing your approach to healthcare after that age and letting your life play out naturally. Without constant fear and vigilance, while preparing to have a peaceful death without machines, one that comforts your loved ones after you're gone.

Most people get to this point anyway. The relevance right now is about vocalising the issue to take the emotional pressure off doctors and nurses. It's a good time to think about how we can protect them more.

[chrismikayla]

I called the golf course near me because I was sure it would be sparse. I was told to come out and they would try to "fit" me in because they are crowded. I'll stay in and watch Netflix.

[NoDopeOnSundays]

Read on Twitter

Incredible.

These people are doing acts of defiance like the virus gives a ****.

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[Dirk]

Let's see how he feels 18 years after writing that. My father is 76 and still lives a full/rich life and my kids don't want their "poppy" going anywhere anytime soon.

Agreed. My dad is 74- runs his company not bc he has to but because he wants to and damn sure ain’t ready to go

Of course, no one is saying die at 75, the argument is about changing your approach to healthcare after that age and letting your life play out naturally. Without constant fear and vigilance, while preparing to have a peaceful death without machines, one that comforts your loved ones after you're gone.

Most people get to this point anyway. The relevance right now is about vocalising the issue to take the emotional pressure off doctors and nurses. It's a good time to think about how we can protect them more.

If anyone is ever bored

Spoiler:

This is also another good read.

His dad fell. Aged 92. Tumor found.
https://www.theatlantic.com/ideas/archive/2020/01/we-protected-my-terminally-ill-father-system/604312/

Once my father was admitted to a hospital, it took all my expertise and experience to arrange the kind of care he needed—and prevent the medical system from taking over and prescribing unnecessary interventions.

The hospital was no place for my father to spend his last days. To thwart the medical system’s momentum to lard on ever more costly, unnecessary, and unwanted interventions—and to convince the medical staff we were serious about no—I took my father’s oxygen monitor off his finger, disconnected his cardiac monitor, insisted that the nurse remove his IV, and asked the physician to discharge him as soon as possible.

He spent the rest of his time at home and was able to say goodbye to everyone. And being at home was cheaper. We still don’t have all the bills, but the tab just for about 12 hours in the hospital came to $19,276.83. In contrast, the more than 200 hours of home care he got over the next 10 days cost only $6,093.

For providers, ordering tests and consultations and prescribing antibiotics is easier than listening to and diagnosing the particular needs of the person in front of them. It is easier for the medical system to marshal all sorts of costly interventions—MRI scans, hospital admissions, neurosurgeons, cancer chemotherapy, and the rest—but harder, if not impossible, to accept the inevitable and provide symptom management, grief counseling, and home care to patients and their family. Until the system takes account of the whole patient and provides the whole package of humane care as the default—so that it’s routine and made available 24/7 with one physician’s order, just as chemotherapy or an MRI would be—Americans will not be able to finally change end-of-life care and reduce those costs.

Some passages from the I want to die at 75 article (2014),

I am talking about how long I want to live and the kind and amount of health care I will consent to after 75. Americans seem to be obsessed with exercising, doing mental puzzles, consuming various juice and protein concoctions, sticking to strict diets, and popping vitamins and supplements, all in a valiant effort to cheat death and prolong life as long as possible. This has become so pervasive that it now defines a cultural type: what I call the American immortal.

I reject this aspiration. I think this manic desperation to endlessly extend life is misguided and potentially destructive. For many reasons, 75 is a pretty good age to aim to stop.

Many people, especially those sympathetic to the American immortal, will recoil and reject my view. They will think of every exception, as if these prove that the central theory is wrong. Like my friends, they will think me crazy, posturing—or worse. They might condemn me as being against the elderly.

It is true, people can continue to be productive past 75—to write and publish, to draw, carve, and sculpt, to compose. But there is no getting around the data. By definition, few of us can be exceptions.

Cutting to the end

Seventy-five years is all I want to live. I want to celebrate my life while I am still in my prime. My daughters and dear friends will continue to try to convince me that I am wrong and can live a valuable life much longer. And I retain the right to change my mind and offer a vigorous and reasoned defense of living as long as possible. That, after all, would mean still being creative after 75.

The article isn't recent, but some passages now have connections with what we're living through.

Mentions pneumonia

My attitude flips this default on its head. I take guidance from what Sir William Osler wrote in his classic turn-of-the-century medical textbook, The Principles and Practice of Medicine: “Pneumonia may well be called the friend of the aged. Taken off by it in an acute, short, not often painful illness, the old man escapes those ‘cold gradations of decay’ so distressing to himself and to his friends.”

At 75 and beyond, I will need a good reason to even visit the doctor and take any medical test or treatment, no matter how routine and painless. And that good reason is not “It will prolong your life.” I will stop getting any regular preventive tests, screenings, or interventions. I will accept only palliative—not curative—treatments if I am suffering pain or other disability.

This means colonoscopies and other cancer-screening tests are out—and before 75. If I were diagnosed with cancer now, at 57, I would probably be treated, unless the prognosis was very poor. But 65 will be my last colonoscopy. No screening for prostate cancer at any age. (When a urologist gave me a PSA test even after I said I wasn’t interested and called me with the results, I hung up before he could tell me. He ordered the test for himself, I told him, not for me.) After 75, if I develop cancer, I will refuse treatment. Similarly, no cardiac stress test. No pacemaker and certainly no implantable defibrillator. No heart-valve replacement or bypass surgery. If I develop emphysema or some similar disease that involves frequent exacerbations that would, normally, land me in the hospital, I will accept treatment to ameliorate the discomfort caused by the feeling of suffocation, but will refuse to be hauled off.

Flu epidemic, antibiotics

What about simple stuff? Flu shots are out. Certainly if there were to be a flu pandemic, a younger person who has yet to live a complete life ought to get the vaccine or any antiviral drugs. A big challenge is antibiotics for pneumonia or skin and urinary infections. Antibiotics are cheap and largely effective in curing infections. It is really hard for us to say no. Indeed, even people who are sure they don’t want life-extending treatments find it hard to refuse antibiotics. But, as Osler reminds us, unlike the decays associated with chronic conditions, death from these infections is quick and relatively painless. So, no to antibiotics.

No assisted breathing

Obviously, a do-not-resuscitate order and a complete advance directive indicating no ventilators, dialysis, surgery, antibiotics, or any other medication—nothing except palliative care even if I am conscious but not mentally competent—have been written and recorded. In short, no life-sustaining interventions. I will die when whatever comes first takes me.

Puts his recent opinion here in an interesting perspective
https://www.nytimes.com/2020/03/28/opinion/coronavirus-economy.html

[Tony Franciosa]

I'm not super rich - but I won't lie I've started glancing at beach condo prices (my wife and I have talked about buying one for a few years).

As grim as it sounds, I've been keeping an eye on the housing market, and looking at Crypto just in case Bitcoin bottoms soon, after printing trillions of dollars out of thin air I have to consider cryptocurrencies in the future.

Not concerned about regular people as yourself. Moreso the corporations buying condos and single family homes and putting them in Real Estate Investment Trust, then just jacking up rents and screwing everyday people.

capitalism is a **** system. it's time the US woke up to that fact.

[marco102]

Hey guys. If you're interested in a summary of the stimulus bill, my firm put together a nice write up below.

https://www.aprio.com/whatsnext/the-coronavirus-aid-relief-and-economic-security-cares-act-what-does-it-mean-for-you-and-your-business/

If you know of any small businesses that may need help applying for stimulus assistance PM please. Check my signature for free cashflow workshop for small businesses.

[BallSacBounce]

Sad thing about all this is that the wealthy real estate people are licking their chops because they see opportunity to buy tons of foreclosed properties cheap once the foreclosures start. Same thing happened after the great recession but this may probably will be much worse.

I'm not super rich - but I won't lie I've started glancing at beach condo prices (my wife and I have talked about buying one for a few years).

As grim as it sounds, I've been keeping an eye on the housing market, and looking at Crypto just in case Bitcoin bottoms soon, after printing trillions of dollars out of thin air I have to consider cryptocurrencies in the future.

The upheaval will be immense.

[Doug_12]

An interesting article & idea:
https://dash.harvard.edu/bitstream/handle/1/42639016/How%20to%20accelerate%20Coronavirus%20vaccine%20testing_020.pdf?sequence=2&isAllowed=y

The idea is to ask a hundred volunteers who are young, healthy and has a high risk of infection (because of their everyday life for example) to get artificially infected and test the efficacy of the proposed vaccines w/ isolation & close health monitoring. If a vaccine is found to be efficient then increase the number of volunteers to 3000 and perform a placebo controlled trial. If the trial works well,start an accelerated licensure and parallely monitor those 3000 people to check if the vaccine has any long term adversary health effect (that was seen among neither the 100 other people nor in animal studies). By this it would take a few months' less to produce a vaccine than otherwise.

At a first sight it raises ethical questions (the author admits this as well), but after a second thought this seems to be the right approach. 2 months can mean 20-100 thousand people depending on which stage of the disease we are. The first argument is that if the volunteers' condition is closely monitored and they have access to intensive care units then none of them might die while the world saves 20-100k people. The other argument is that even the 3100 volunteers are better off with this approach: among them 30-150 would most probably die otherwise (depending on what care they could get), and by participating they would ensure that they get the best possible care which significantly increases their chance for survival.

[BallSacBounce]

My most selfish objective view is that again i’m screwed on timing.

Had no money after the 2008 recession as i just left undergrad and was broke and had a lot of debt.

Again, now I finished masters and have paid off all debts and have just been working a few years. Have some emergency savings and normal money but absolutely do not have a huge chunk of cash or money market funds.

Would of loved to buy some real estate on the low side or throw a lot of money into the markets on this huge dip.

Again, that’s just selfish objective thoughts. I’m very content and lucky to have my health and for all of my close friends and family to also not have been directly impacted or gotten the virus yet.

aw, you poor baby. Feel really sorry for you and your "bad timing". Now let me tell you about some actual bad timing. In 2008 I bought my first condo in Chicago. A week later the bottom fell out of the real estate market. A month ago I sold that condo for $20,000 less than I paid. A few days after that I upgraded and bought a house in the suburbs. A few weeks later, all this happened. Closing on both properties Monday. We'll see how much my house holds its value when this is all said and done.

The good news is I plan to live there a long time, maybe forever. so hopefully by the time i go to sell it will get its value back. Also on the plus side is at least I got my condo sold before that price dropped as well.

so yea, that's what actual bad timing looks like.

Told my friends, if you ever want to know when to get out of the market just wait till I buy property and then dump everything.

I could've been in that same spot in 2008. The monthly total numbers didn't match what I was initially quoted by the RE agent so I backed out. Thankfully he was an ****.

[LKN]

An interesting article & idea:
https://dash.harvard.edu/bitstream/handle/1/42639016/How%20to%20accelerate%20Coronavirus%20vaccine%20testing_020.pdf?sequence=2&isAllowed=y

The idea is to ask a hundred volunteers who are young, healthy and has a high risk of infection (because of their everyday life for example) to get artificially infected and test the efficacy of the proposed vaccines w/ isolation & close health monitoring. If a vaccine is found to be efficient then increase the number of volunteers to 3000 and perform a placebo controlled trial. If the trial works well,start an accelerated licensure and parallely monitor those 3000 people to check if the vaccine has any long term adversary health effect (that was seen among neither the 100 other people nor in animal studies). By this it would take a few months' less to produce a vaccine than otherwise.

At a first sight it raises ethical questions (the author admits this as well), but after a second thought this seems to be the right approach. 2 months can mean 20-100 thousand people depending on which stage of the disease we are. If there are 3100 low-risk volunteers (among which 3000 take less risk) whose condition is closely monitored and have access to intensive care units and respirators then we might lose none of them while saving that 20-100k people.

So basically they'll pay young poor people to get infected? That's pretty dystopian although I can see why people would suggest it..... definitely would be an effective way to test a vaccine

[Doug_12]

An interesting article & idea:
https://dash.harvard.edu/bitstream/handle/1/42639016/How%20to%20accelerate%20Coronavirus%20vaccine%20testing_020.pdf?sequence=2&isAllowed=y

The idea is to ask a hundred volunteers who are young, healthy and has a high risk of infection (because of their everyday life for example) to get artificially infected and test the efficacy of the proposed vaccines w/ isolation & close health monitoring. If a vaccine is found to be efficient then increase the number of volunteers to 3000 and perform a placebo controlled trial. If the trial works well,start an accelerated licensure and parallely monitor those 3000 people to check if the vaccine has any long term adversary health effect (that was seen among neither the 100 other people nor in animal studies). By this it would take a few months' less to produce a vaccine than otherwise.

At a first sight it raises ethical questions (the author admits this as well), but after a second thought this seems to be the right approach. 2 months can mean 20-100 thousand people depending on which stage of the disease we are. If there are 3100 low-risk volunteers (among which 3000 take less risk) whose condition is closely monitored and have access to intensive care units and respirators then we might lose none of them while saving that 20-100k people.

So basically they'll pay young poor people to get infected? That's pretty dystopian although I can see why people would suggest it..... definitely would be an effective way to test a vaccine

The argument is not about (or not only about) the money. They are neither talking about the wealth of those people nor about the money they would pay for participation.

The emphasis is more on choosing those people who would anyways catch the disease (or who are very likely to catch) and who are volunteering. Those can be anyone: politician, waitress, sportsman, delivery guy etc... Anyone who meets a lot of people and therefore if there is no vaccine, he can't really avoid being infected. Of course, politicians and sportsmen would have access to the best possible care, so their incentives are not that high compared to a waitress, but in case of emergency who knows if a doctor will switch an average guy off of a respirator to save someone famous' life. It's not that evident or at least it shouldn't be.

[chrismikayla]

This was last updated yesterday and gives a breakdown of positive, hospitalization, and fatality rates in New York.

https://www.businessinsider.com/new-york-city-coronavirus-cases-deaths-hospitalizations-by-age-chart-2020-3

[EH15]

(Albany, GA)

Read on Twitter

?s=20

Correlates with that cellphone map. GA has a big cluster. MI has a massive cluster. East coast. And then the midwest. The midwest is gonna boom.

[LKN]

We are currently on a worse trajectory than Italy death wise. This is damn scary - I hope we see some leveling off soon. These states (FL, GA, etc) that still aren't on full shelter in place are really playing with fire

[EH15]

Here's that heat map. It was only one beach data through March 15. Does not capture the second week of spring break. Barely a snapshot of the entire picture.



Here's a map of what each States' restrictions are.
https://www.nytimes.com/interactive/2020/us/coronavirus-stay-at-home-order.html

[NoDopeOnSundays]

Here's that heat map. It was only one beach data through March 15. Does not capture the second week of spring break. Barely a snapshot of the entire picture.



Here's a map of what each States' restrictions are.
https://www.nytimes.com/interactive/2020/us/coronavirus-stay-at-home-order.html

DeSantis not closing the beaches is just asinine

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[Ayt]

This was last updated yesterday and gives a breakdown of positive, hospitalization, and fatality rates in New York.

https://www.businessinsider.com/new-york-city-coronavirus-cases-deaths-hospitalizations-by-age-chart-2020-3

Looking at that data, the overall hospitalization rate in NY is around 17%. The regular flu has a hospitalization rate of around 1% for the sake of comparison.

[NirvanaFC]

Here's that heat map. It was only one beach data through March 15. Does not capture the second week of spring break. Barely a snapshot of the entire picture.



Here's a map of what each States' restrictions are.
https://www.nytimes.com/interactive/2020/us/coronavirus-stay-at-home-order.html

God damn it, is there ANY hope of getting this thing under control in months instead of years?