Official Covid-19 Discussion Thread

[nikster]

thing is it doesnt hit all areas equally or at the same time.

Yesterday Florida reported 56 hospital ICUs at capacity, another 35 with 10% or less capacity left available

Source?

Sure, some hospitals are at capacity, but the vast majority are not.

There are 306 Florida hospitals listed in the CSV you can download from the link provided earlier.

If 56 of them are at ICU capacity and another 35 have 10% or less capacity remaining, that's 91 hospitals at critical capacity levels.

91 of 306, or 29.7% of the hospitals in Florida are currently at critical capacity levels. The remaining 215, or 70.3% of the hospitals in Florida are not at critical capacity levels.

Unless the ambulances at these hospitals are broken and people can't be taken to a nearby hospital that doesn't have capacity issues or hospital officials can't to direct them to a nearby hospital before being admitted into one whose capacity cannot support them, what evidence is there to suggest there isn't enough capacity within the Florida hospital system to support the even more patients than currently tasked?

Transferring patient who need ICU level of care isnt easy in normal circumstances, especially if you dont have the systems in place for these kind of transfer. Now consider that outbreaks tend to group in regions, so if you are at capacity other hospitals nearby are likely at or near capacity as well. add all the difficulties of maintaining infection control. Now try doing it on a significant scale.

https://bi.ahca.myflorida.com/t/ABICC/views/Public/ICUBedsCounty?%3AshowAppBanner=false&%3Adisplay_count=n&%3AshowVizHome=n&%3Aorigin=viz_share_link&%3AisGuestRedirectFromVizportal=y&%3Aembed=y

I found a more deatiled source shows they only have about 17% availability of ICU beds in the whole state. The other thing to consider is that not all hospitals are equipped with ICU beds

[dohboy_24]

Transferring patient who need ICU level of care isnt easy in normal circumstances, especially if you dont have the systems in place for these kind of transfer.

Hospitals have ambulances. Should someone require transport, they can be used to do so long before they reach the point of being admitted to an ICU bed in the first place.

Which % of the patients being admitted into hospital require direct admission into the ICU level of care?

Should a prospective patient arrive at a hospital that is at ICU capacity when they arrive, are they not able to be transferred at that time for admission to a hospital that would have the capacity to serve them? Why admit them to a hospital that does not have the capacity to serve them?

If you found all of the tables at the nearest McDonald's were filled upon your arrival, would you order anyways and wait for your meal to get cold before getting an empty seat? Would you order anyways and find a place to lean up against the wall to eat? Would they even let you order the meal unless you agreed to take it outside to eat for fear of exceeding their fire code?

After being made aware of the situation, would you drive down the street to another restaurant? Would you drive all the way to the next McD's to get your Big Mac fix?

While not a true apples-to-apples comparison since a covid-19 attack is presumably more deadly than a Big Mac attack, but are these kinds of alternative options not available to the medical professionals in the state of Florida?

What about non-invasive medical treatments that don't require the use of ventilators and ICU beds and wouldn't put such a burden on the system? Given the viability of those options, why aren't the medical professionals responsible for these protocols able to better manage the burden placed on the system by their treatment decisions?

[beanbag]

thing is it doesnt hit all areas equally or at the same time.

Yesterday Florida reported 56 hospital ICUs at capacity, another 35 with 10% or less capacity left available

Source?

Sure, some hospitals are at capacity, but the vast majority are not.

There are 306 Florida hospitals listed in the CSV you can download from the link provided earlier.

If 56 of them are at ICU capacity and another 35 have 10% or less capacity remaining, that's 91 hospitals at critical capacity levels.

91 of 306, or 29.7% of the hospitals in Florida are currently at critical capacity levels. The remaining 215, or 70.3% of the hospitals in Florida are not at critical capacity levels.

Unless the ambulances at these hospitals are broken and people can't be taken to a nearby hospital that doesn't have capacity issues or hospital officials can't to direct them to a nearby hospital before being admitted into one whose capacity cannot support them, what evidence is there to suggest there isn't enough capacity within the Florida hospital system to support the even more patients than currently tasked?

All these stats to make the point that....what? Things could be worse?

[nikster]

Transferring patient who need ICU level of care isnt easy in normal circumstances, especially if you dont have the systems in place for these kind of transfer.

Hospitals have ambulances. Should someone require transport, they can be used to do so long before they reach the point of being admitted to an ICU bed in the first place.

Which % of the patients being admitted into hospital require direct admission into the ICU level of care?

Should a prospective patient arrive at a hospital that is at ICU capacity when they arrive, are they not able to be transferred at that time for admission to a hospital that would have the capacity to serve them? Why admit them to a hospital that does not have the capacity to serve them?

If you found all of the tables at the nearest McDonald's were filled upon your arrival, would you order anyways and wait for your meal to get cold before getting an empty seat? Would you order anyways and find a place to lean up against the wall to eat? Would they even let you order the meal unless you agreed to take it outside to eat for fear of exceeding their fire code?

After being made aware of the situation, would you drive down the street to another restaurant? Would you drive all the way to the next McD's to get your Big Mac fix?

While not a true apples-to-apples comparison since a covid-19 attack is presumably more deadly than a Big Mac attack, but are these kinds of alternative options not available to the medical professionals in the state of Florida?

What about non-invasive medical treatments that don't require the use of ventilators and ICU beds and wouldn't put such a burden on the system? Given the viability of those options, why aren't the medical professionals responsible for these protocols able to better manage the burden placed on the system by their treatment decisions?

Sure but they have ambulances, but that'd have to be non-ICU patients. Most patients aren't direct ICU admissions, but The patients that are in regular non-ICU beds we aren't sure when or if they will degenerate to requiring ICU. The distanced could be huge, if your In a city that's surging could mean most or all hospitals are overwhelmed. If your in a rural town you could be quite a distance from the nearest hospital, and out of luck if that one is at capacity. Who pays for an ambulance ride a county or 2 over to the next hospital? Do you even have the ambulance capacity to constantly ferry every single COVID patient long distances?

Yes alternatives to ventilators would be great. But they're a last line because there's no other options. You need oxygen, when your lungs can't bring enough you need a machine to do it. Or you die rather immediately. If they didn't need ICU care they wouldn't be there.

Your options are not viable. The system sucked even before covid. Your asking Why can't medical professionals, who's budgets are already tight, quickly come up with an efficient system from scratch that can quickly and safely transf medically acute covid patients all across the state and implement and coordinate this with a huge number of privately or Independently run hospitals....

Even if it were feasible it would require immense support from state and local government

[hankscorpioLA]

Hard to say while cases are still spiking. Also may vary by region. Some areas may be pushed to the limit while others may be fine.

Why postulate and guess at the answer when you can take 15 minutes to download the file for ICU beds and see for yourself?

Why?

[hankscorpioLA]

thing is it doesnt hit all areas equally or at the same time.

Yesterday Florida reported 56 hospital ICUs at capacity, another 35 with 10% or less capacity left available

Source?

Sure, some hospitals are at capacity, but the vast majority are not.

There are 306 Florida hospitals listed in the CSV you can download from the link provided earlier.

If 56 of them are at ICU capacity and another 35 have 10% or less capacity remaining, that's 91 hospitals at critical capacity levels.

91 of 306, or 29.7% of the hospitals in Florida are currently at critical capacity levels. The remaining 215, or 70.3% of the hospitals in Florida are not at critical capacity levels.

Unless the ambulances at these hospitals are broken and people can't be taken to a nearby hospital that doesn't have capacity issues or hospital officials can't to direct them to a nearby hospital before being admitted into one whose capacity cannot support them, what evidence is there to suggest there isn't enough capacity within the Florida hospital system to support the even more patients than currently tasked?

All these stats to make the point that....what? Things could be worse?

+1

I have no idea what his point is.

[beanbag]

Source?

Sure, some hospitals are at capacity, but the vast majority are not.

There are 306 Florida hospitals listed in the CSV you can download from the link provided earlier.

If 56 of them are at ICU capacity and another 35 have 10% or less capacity remaining, that's 91 hospitals at critical capacity levels.

91 of 306, or 29.7% of the hospitals in Florida are currently at critical capacity levels. The remaining 215, or 70.3% of the hospitals in Florida are not at critical capacity levels.

Unless the ambulances at these hospitals are broken and people can't be taken to a nearby hospital that doesn't have capacity issues or hospital officials can't to direct them to a nearby hospital before being admitted into one whose capacity cannot support them, what evidence is there to suggest there isn't enough capacity within the Florida hospital system to support the even more patients than currently tasked?

All these stats to make the point that....what? Things could be worse?

+1

I have no idea what his point is.

Like everytime I check this thread this guy has 8 new posts at 10 paragraphs of data a pop and I keep waiting for the conclusion.

It's the real gm equivalent of that dude writing formulas on the wall from the movie Pi.

[Dennis 37]

It is simple. I give credit to politicians who trust the information given to them by health experts and use that information to inform their decisions. Invariably the rate of infection will be lower than in jurisdictions where politicians care more about the economy than people dying.

The Republican governor of Massachusetts has done a good job. He listened to and followed the advice of health experts, not unlike Rob Ford. New cases each day are low compared to the rest of the US, 162 today, and he just announce that anyone, without reason, may apply to receive a ballot in the mail for the upcoming primaries and the November election. He is a Republican who cares about people, a rare combination.

[OAKLEY_2]

It is simple. I give credit to politicians who trust the information given to them by health experts and use that information to inform their decisions. Invariably the rate of infection will be lower than in jurisdictions where politicians care more about the economy than people dying.

The Republican governor of Massachusetts has done a good job. He listened to and followed the advice of health experts, not unlike Rob Ford. New cases each day are low compared to the rest of the US, 162 today, and he just announce that anyone, without reason, may apply to receive a ballot in the mail for the upcoming primaries and the November election. He is a Republican who cares about people, a rare combination.

It is a hopeful sign. I really do not know how one can insist on being part of a national "family" with so many disfunctional members. The real disease in America, the real Pandemic, are those so culturally wired that they do not value their fellow citizens. The all God's creatures contingent. They do not value it enough to have modern state health care, they do not value it enough to see their taxes on their labours go to butter vs. guns, they do not value it enough to make sure weapon manufacturing and distribution is controlled so people, their fellow citizens, are truly safe.

Every "man" for himself seems to be truly "a guy thing" stateside and we still know many many people there, quiet voices, do not think like this and at a bare minimum want some of the things Canadians have fought for and continue to fight for. Rather than fight for programs and institutions of value, much of the amplified discourse south of the border is divisive and polarized. The discourse is controlled by commercial interests in so many places. When I see those divide and conquer tactics exported to Canada to build political brands I find that beyond distressing. We can forge our own path, must forge our own path and maybe if getting past all the chaos south of the border we can export our ideas because they are in a bad way at the moment and yet we must isolate from something starting to look like a massive humanitarian disaster. It may be pockets of disaster but a disaster none the less.

[Vaclac]

It is simple. I give credit to politicians who trust the information given to them by health experts and use that information to inform their decisions. Invariably the rate of infection will be lower than in jurisdictions where politicians care more about the economy than people dying.

The Republican governor of Massachusetts has done a good job. He listened to and followed the advice of health experts, not unlike Rob Ford. New cases each day are low compared to the rest of the US, 162 today, and he just announce that anyone, without reason, may apply to receive a ballot in the mail for the upcoming primaries and the November election. He is a Republican who cares about people, a rare combination.

I don't generally think it's fair to judge governors by their case counts, but since you are doing so, I have to point out that Massachusetts is a terrible example of a successful state in that regard. It got a lot less attention than NYC, but the result was nearly as bad in Boston. 1.6% of the entire state has had confirmed positive tests. Given the usual estimate that 10x as many people have had the virus than confirmed by positive tests, that puts about 16% of the entire state having been exposed to the virus. Antibody tests in particular hard hit parts of the state showed a third of residents having been exposed. So yes now they are doing better, but that's just because they already went through their horrible period. I actually think Massachusetts makes a point I made in another thread even better than I did there using NYC as an example, that places that have been especially hard hit provide pretty good evidence that having a percentage of people like 10%-20% exposed already slows infections more than simple models would suggest. New daily cases continued increasing in Massachusetts for a month after full lockdown measures were implemented. If anything, over this time, lockdown effectiveness slightly decreased as people experienced lockdown fatigue, so the explanation for why new cases eventually turned the corner when they did so cannot be the lockdown. Instead, just like the other places that were extremely hard hit like NYC, Milan, and Montreal, the progression slowed down eventually once enough people had already gotten it.
The high herd immunity thresholds commonly cited are based on a simple idea that if people on average infect 3 others when there is a fully susceptible population, then you would need 2/3 of the population to no longer be susceptible in order for the rate of transmission to drop below 1 on account of herd immunity. This is where the 60%-70% threshold numbers commonly cited come from. But, it's actually quite unrealistic, as we know that there is great variation in how many people each infected person infects, with most people infecting no one, and a relatively small number being superspreaders responsible for the majority of infections. Indeed, researchers estimate that 10-20% of people cause 80% of the infections (https://www.scientificamerican.com/article/how-superspreading-events-drive-most-covid-19-spread1/). This turns out to matter a lot, since the people who interact the most with others are both more likely to get the disease (and therefore get it and become immune earlier on average) and more likely to spread it to more people. Here's a paper by epidemiologists explaining why this variation in how much different people interact with others lowers the herd immunity threshold substantially below the commonly cited numbers
https://www.medrxiv.org/content/10.1101/2020.04.27.20081893v1.full.pdf
I don't think we should be praising places like New York or Massachusetts specifically for their current case numbers because those are aided in large part by the fact that they already had their waves. The West Coast (California, Oregon, Washington) wasn't hit as hard the first time, and those leaders are at least as cautious as the Northeast leaders are currently with regards to their reopenings (most things are actually open again in Massachusetts). The difference is that a small percentage of residents in the west coast have yet been exposed as compared to the Northeastern states, not the superior policies of the Northeast governors relative to the west coast governors.

[Lord_Zedd]

Florida just broke their record on daily deaths today at 120 along with another 409 being hospitalized.

Whether it's 35k or 85k+ tests, Florida's percent positivity for new cases has been consistent around 12-15%. Today that mark is 18.39%. No matter how much Florida is testing, the percent positivity being consistent for weeks - which means whatever they're doing hasn't been working. But let's open up Disney World anyway and see how that goes!

http://ww11.doh.state.fl.us/comm/_partners/covid19_report_archive/state_reports_latest.pdf

[raptorstime]

NBA was too hasty on choosing Orlando as the hub city. I wonder if choosing Toronto as the hub was ever on the table.

[Johnny Bball]

thing is it doesnt hit all areas equally or at the same time.

Yesterday Florida reported 56 hospital ICUs at capacity, another 35 with 10% or less capacity left available

Source?

Sure, some hospitals are at capacity, but the vast majority are not.

There are 306 Florida hospitals listed in the CSV you can download from the link provided earlier.

If 56 of them are at ICU capacity and another 35 have 10% or less capacity remaining, that's 91 hospitals at critical capacity levels.

91 of 306, or 29.7% of the hospitals in Florida are currently at critical capacity levels. The remaining 215, or 70.3% of the hospitals in Florida are not at critical capacity levels.

Unless the ambulances at these hospitals are broken and people can't be taken to a nearby hospital that doesn't have capacity issues or hospital officials can't to direct them to a nearby hospital before being admitted into one whose capacity cannot support them, what evidence is there to suggest there isn't enough capacity within the Florida hospital system to support the even more patients than currently tasked?

All these stats to make the point that....what? Things could be worse?

Do y'all think your insurance or lack there of means you can just be transferred to any hospital in the US with space? Just no, so much no.

[Dennis 37]

It is simple. I give credit to politicians who trust the information given to them by health experts and use that information to inform their decisions. Invariably the rate of infection will be lower than in jurisdictions where politicians care more about the economy than people dying.

The Republican governor of Massachusetts has done a good job. He listened to and followed the advice of health experts, not unlike Rob Ford. New cases each day are low compared to the rest of the US, 162 today, and he just announce that anyone, without reason, may apply to receive a ballot in the mail for the upcoming primaries and the November election. He is a Republican who cares about people, a rare combination.

It is a hopeful sign. I really do not know how one can insist on being part of a national "family" with so many disfunctional members. The real disease in America, the real Pandemic, are those so culturally wired that they do not value their fellow citizens. The all God's creatures contingent. They do not value it enough to have modern state health care, they do not value it enough to see their taxes on their labours go to butter vs. guns, they do not value it enough to make sure weapon manufacturing and distribution is controlled so people, their fellow citizens, are truly safe.

Every "man" for himself seems to be truly "a guy thing" stateside and we still know many many people there, quiet voices, do not think like this and at a bare minimum want some of the things Canadians have fought for and continue to fight for. Rather than fight for programs and institutions of value, much of the amplified discourse south of the border is divisive and polarized. The discourse is controlled by commercial interests in so many places. When I see those divide and conquer tactics exported to Canada to build political brands I find that beyond distressing. We can forge our own path, must forge our own path and maybe if getting past all the chaos south of the border we can export our ideas because they are in a bad way at the moment and yet we must isolate from something starting to look like a massive humanitarian disaster. It may be pockets of disaster but a disaster none the less.

I pretended to be an American on twitter from August of 2018 to September of 2019. It was quite an experience. My main motivation was to plant seeds that life could be better in America if corporations didn't have total control of the system. I came up against a guy who was extremely anti-Trump. I had followed him for months. He had all the talking points, he seemed very intelligent, was solidly in the Democratic camp, but whenever the topic of Medicare for All came up he fought against it. He spouted crap about how it wasn't the success in Canada that Michael Moore and other voices claim it to be. Eventually he was outed as being a marketing consultant who had worked for big pharma, medical insurance, and oil companies. That's when I started to discover how many Democrats are corrupted by corporate money. I would push Bernie Sanders and the push back was fierce. There was a "Vote Blue No Matter What" slogan which was really one sided. It really didn't mean Establishment Democrats would vote for Sanders if he won the nomination It was clear they would sit on their hands, let Trump have a second term, rather than let a socialist run their party. Their hate for Sanders was clear. He challenged their status quo and demonstrated how far corporate money had corrupted the population via direct payment or paid for propaganda.

I actually had an argument with someone, claiming to be a Canadian, telling me I knew nothing about the Canadian health care system because I didn't live there.

They are supremely messed up down there.

[Dennis 37]

Source?

Sure, some hospitals are at capacity, but the vast majority are not.

There are 306 Florida hospitals listed in the CSV you can download from the link provided earlier.

If 56 of them are at ICU capacity and another 35 have 10% or less capacity remaining, that's 91 hospitals at critical capacity levels.

91 of 306, or 29.7% of the hospitals in Florida are currently at critical capacity levels. The remaining 215, or 70.3% of the hospitals in Florida are not at critical capacity levels.

Unless the ambulances at these hospitals are broken and people can't be taken to a nearby hospital that doesn't have capacity issues or hospital officials can't to direct them to a nearby hospital before being admitted into one whose capacity cannot support them, what evidence is there to suggest there isn't enough capacity within the Florida hospital system to support the even more patients than currently tasked?

All these stats to make the point that....what? Things could be worse?

Do y'all think your insurance or lack there of means you can just be transferred to any hospital in the US with space? Just no, so much no.

Americans have a thing called networks. That means their medical insurance is only accepted by certain hospitals, specialists, or doctors. If you go to a hospital, not in your insurance network, you will have a massive bill to pay for which your insurance will pay nothing.

[Dr Positivity]

Don't like what I'm seeing this week in terms of cases and death count in Cali, Texas and Florida

I think corona hits different parts of the US at different times. So it's already gone through places like NY and Michigan, but Cali, Texas, Florida who were able to avoid bad numbers for months, may be entering their peak period right now.. For their population of old people all things considered Florida's death rate had been very good so far (ignore the media), but not sure there's anything they can do. They are the closest thing to Italy in the US for having seniors.

[Dennis 37]

It is simple. I give credit to politicians who trust the information given to them by health experts and use that information to inform their decisions. Invariably the rate of infection will be lower than in jurisdictions where politicians care more about the economy than people dying.

The Republican governor of Massachusetts has done a good job. He listened to and followed the advice of health experts, not unlike Rob Ford. New cases each day are low compared to the rest of the US, 162 today, and he just announce that anyone, without reason, may apply to receive a ballot in the mail for the upcoming primaries and the November election. He is a Republican who cares about people, a rare combination.

I don't generally think it's fair to judge governors by their case counts, but since you are doing so, I have to point out that Massachusetts is a terrible example of a successful state in that regard. It got a lot less attention than NYC, but the result was nearly as bad in Boston. 1.6% of the entire state has had confirmed positive tests. Given the usual estimate that 10x as many people have had the virus than confirmed by positive tests, that puts about 16% of the entire state having been exposed to the virus. Antibody tests in particular hard hit parts of the state showed a third of residents having been exposed. So yes now they are doing better, but that's just because they already went through their horrible period. I actually think Massachusetts makes a point I made in another thread even better than I did there using NYC as an example, that places that have been especially hard hit provide pretty good evidence that having a percentage of people like 10%-20% exposed already slows infections more than simple models would suggest. New daily cases continued increasing in Massachusetts for a month after full lockdown measures were implemented. If anything, over this time, lockdown effectiveness slightly decreased as people experienced lockdown fatigue, so the explanation for why new cases eventually turned the corner when they did so cannot be the lockdown. Instead, just like the other places that were extremely hard hit like NYC, Milan, and Montreal, the progression slowed down eventually once enough people had already gotten it.
The high herd immunity thresholds commonly cited are based on a simple idea that if people on average infect 3 others when there is a fully susceptible population, then you would need 2/3 of the population to no longer be susceptible in order for the rate of transmission to drop below 1 on account of herd immunity. This is where the 60%-70% threshold numbers commonly cited come from. But, it's actually quite unrealistic, as we know that there is great variation in how many people each infected person infects, with most people infecting no one, and a relatively small number being superspreaders responsible for the majority of infections. Indeed, researchers estimate that 10-20% of people cause 80% of the infections (https://www.scientificamerican.com/article/how-superspreading-events-drive-most-covid-19-spread1/). This turns out to matter a lot, since the people who interact the most with others are both more likely to get the disease (and therefore get it and become immune earlier on average) and more likely to spread it to more people. Here's a paper by epidemiologists explaining why this variation in how much different people interact with others lowers the herd immunity threshold substantially below the commonly cited numbers
https://www.medrxiv.org/content/10.1101/2020.04.27.20081893v1.full.pdf
I don't think we should be praising places like New York or Massachusetts specifically for their current case numbers because those are aided in large part by the fact that they already had their waves. The West Coast (California, Oregon, Washington) wasn't hit as hard the first time, and those leaders are at least as cautious as the Northeast leaders are currently with regards to their reopenings (most things are actually open again in Massachusetts). The difference is that a small percentage of residents in the west coast have yet been exposed as compared to the Northeastern states, not the superior policies of the Northeast governors relative to the west coast governors.

No jurisdiction has been perfect. Remember, we are evaluating Americans here, and they are one messed up people.

Why do I see Massachusetts as a good news story, compared to some of the other states? It has nothing to do with total cases or being slow off the mark. It is what is the response is once they realize this thing is real.

This article from March places Massachusetts as sixth best in their response. https://www.usnews.com/news/best-states/articles/2020-03-17/10-states-with-the-most-aggressive-response-to-coronavirus

This is a respected left-leaning US Youtube commentator, who lives in Massachusetts, gives his Republican governor credit. A Democrat, giving credit to a Republican, does not happen often.

Watch on YouTube

[Kevin Willis]

Herd immunity should only be applied with the distribution of a vaccine. It's also not the best way to handle the situation if you look at countries like S. Korea, New Zealand, Australia, Taiwan, etc. - the ideal way is to implement correct measures of safety quickly.

However if the desire is to cull a population then herd immunity without a vaccine is the way to go and let the stronger ones live. NY was ground zero for the US - it is expected a city like that to be hit the hardest. Just as in the past pandemics, port cities always get whacked. Arizona is not a port city. Oklahoma is not a port city. With proper diligence these areas should not have received the swelling they have now. The policies of the Mass. governor were helpful because shockingly it could've been worse. We're seeing worse in Brazil. The proper implementation of effective policies has been the biggest reason for limiting the spread with minimum casualties.

[Vaclac]

Herd immunity should only be applied with the distribution of a vaccine. It's also not the best way to handle the situation if you look at countries like S. Korea, New Zealand, Australia, Taiwan, etc. - the ideal way is to implement correct measures of safety quickly.

However if the desire is to cull a population then herd immunity without a vaccine is the way to go and let the stronger ones live. NY was ground zero for the US - it is expected a city like that to be hit the hardest. Just as in the past pandemics, port cities always get whacked. Arizona is not a port city. Oklahoma is not a port city. With proper diligence these areas should not have received the swelling they have now. The policies of the Mass. governor were helpful because shockingly it could've been worse. We're seeing worse in Brazil. The proper implementation of effective policies has been the biggest reason for limiting the spread with minimum casualties.

I don't think herd immunity is "applied", it is simply the end result if containment measures aren't enough to stop the virus on their own, then it keeps going until it eventually turns the other way because enough people ended up getting infected to do that. That's what has happened in places like New York and Boston where cases continued to rise long after lockdowns were implemented, but did not go on rising forever and eventually turned the corner once enough of the population had gotten it. I don't think herd immunity was intended, or some sort of strategy, it's just an explanation for why we see the patterns in those places that we did. It is on the other hand wrong to attribute their current success as compared to places that have not yet faced as large a wave to their supposedly superior policies, when they have a big advantage if you just look at current case counts from the fact that a lot more of their people have already had it.

[Dennis 37]

Herd immunity should only be applied with the distribution of a vaccine. It's also not the best way to handle the situation if you look at countries like S. Korea, New Zealand, Australia, Taiwan, etc. - the ideal way is to implement correct measures of safety quickly.

However if the desire is to cull a population then herd immunity without a vaccine is the way to go and let the stronger ones live. NY was ground zero for the US - it is expected a city like that to be hit the hardest. Just as in the past pandemics, port cities always get whacked. Arizona is not a port city. Oklahoma is not a port city. With proper diligence these areas should not have received the swelling they have now. The policies of the Mass. governor were helpful because shockingly it could've been worse. We're seeing worse in Brazil. The proper implementation of effective policies has been the biggest reason for limiting the spread with minimum casualties.

I don't think herd immunity is "applied", it is simply the end result if containment measures aren't enough to stop the virus on their own, then it keeps going until it eventually turns the other way because enough people ended up getting infected to do that. That's what has happened in places like New York and Boston where cases continued to rise long after lockdowns were implemented, but did not go on rising forever and eventually turned the corner once enough of the population had gotten it. I don't think herd immunity was intended, or some sort of strategy, it's just an explanation for why we see the patterns in those places that we did. It is on the other hand wrong to attribute their current success as compared to places that have not yet faced as large a wave to their supposedly superior policies, when they have a big advantage if you just look at current case counts from the fact that a lot more of their people have already had it.

I disagree that we can claim a jurisdiction turned the corner on the number of cases per day due to herd immunity being reached. We can only claim that if a jurisdiction has zero restrictions and the number of cases drops. Since Massachusetts did take aggressive steps, I would be quite confident to claim that there exists quite a number of citizens who would have gotten the disease had steps not been taken. The steps saved lives.

Where steps are not taken, and continue not to be taken especially in areas where cases are spiking, we are fully justified in criticizing those jurisdictions.

The South Dakota July 3rd Trump "every one else is bad" festival in front of Mount Rushmore should not have been allowed to take place as it did. People driving in form all over, sitting side-by-side with no mandatory masks. The governor failed there and deserves criticism.