D&D and the rising pandemic


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If you're drinking it straight, yeah, I imagine that's a one-way ticket to Hangover Central. But the Rusty Nail is a classic.

Gary Con is starting to look really iffy. The Wisconsin government just released a memo that "The Wisconsin Department of Health Services (DHS) recommends that all non-essential gatherings of 250 or more people be cancelled or postponed statewide..."

No official word as of yet, but I fear it's coming. It would figure that this would happen the year I finally get motivated enough to go. Still, compared to the risk posed to attendees, I'll not complain. Not much, anyway.

Do you know what goes great with Drambuie?

A hangover.
 

You are living in a community. You gain benefits from that. So, in return, some responsibility for the community's health does fall upon you.

You do have Agency. There are choices you can make. And just continuing to "live your life normally" in an abnormal moment is not living up to your responsibilities.

Umbran, you left out the end of my post which states:
All we can do going forward, (and now),is take reasonable actions, and keep taking reasonable actions, when the dice go against us.

I live in Los Angeles. Asymtomatic Transmision within a two week window is a possible scenario.

Within that timeframe I have voted, engaged in political gatherings, utilized public transportation, gone to restaurants, and visited friends and family members.

I was Not morally wrong, for my quotidian actions at that time, Even if a spread of the infection resulted. (in the subset of the view of infectious disease).

There was no local, nor state, nor Federal government prohibition on such activities. Local Authorities advised caution, to minimize extended public gatherings, and to wash your hands and have good Coughing hygiene form. I did that.

So where is my Agency, if presuming, I took all reasonable and informed steps to limit transmission, but transmission still occurred ?

Someone responsible for asymptomatic transmission within the last 2 weeks is not in abrogation of the social contract, or being an irresponsible citizen.

Your statements seem better directed towards another target.

One can be as safe as possible, and still spread infection. That is statistically true, but probabilistically unlikely. Hence all we can do now is be reasonable, and continue to do so in the future.
 
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So, for a fun clock. The end point is "you have 10,000 cases in your community in the wild", assuming no measures as extreme as Italy (local travel bans, social distancing).

  • First community transmission detected because someone went to the hospital feeling unwell: 32 days
  • First community-infected death: 16 days
  • 10th community-infected death: 0 days, roughly 10,000 people in community infected
  • 100th death: -16 days, roughly 100,000 people in community infected
  • You need 500 new free ICU, 1500 Oxygen beds: -20 days
  • You need 1000 new free ICU, 3000 Oxygen beds: -26 days (total 1500)
  • You need 2000 new free ICU, 6000 Oxygen beds: -32 days (total 3500) about 1 million infected
  • You need 4000 new free ICU, 12000 Oxygen beds: -38 days (total 7500)
  • You need 8000 new free ICU, 24000 Oxygen beds: -44 days (total 15000; first few patients are now stable)
  • It is everywhere. -48 days
  • You need 16000 new free ICU, 48000 Oxygen beds: -50 days (total 30000)
  • ICU need reaches steady state, way over supply. -68 days

USA as a whole has 65,000 ICU beds, or 1 per 5000 people. They tend to be in 80%+ utilization, so you have 1 "free" ICU bed for every 25,000 people. So, in a region of 25 million people, you might about 1000 beds they can free up at this moment. It is probable they can cobble a few more together by turning surgical equipment into ICU beds or similar.

When you introduce drastic measures, the number of new beds needed levels off 3 weeks later. Patients needing beds need them for up to 4 weeks.

This kind of curve hasn't been flattened without drastic measures.

Patients who need ICU/Oxygen basically die if they don't get it. Some that need it die anyway. You get a <1% death rate if you have enough ICU/Oxygen/etc. You get a 4%+ death rate if you don't.

So suppose modest measures are taken at the 10,000 people infected mark.

  • First community transmission detected because someone went to the hospital feeling unwell: 32 days
  • First community-infected death: 16 days
  • 10th community-infected death: 0 days, roughly 10,000 people in community infected
  • 100th death: -16 days, roughly 20,000 people in community infected
  • You need 500 new free ICU, 1500 Oxygen beds: -20 days
  • You need 650 new free ICU, 2000 Oxygen beds: -26 days (total 1150)
  • You need 850 new free ICU, 2500 Oxygen beds: -32 days (total 2000)
  • 40,000 people infected: -32 days
  • You need 1100 new free ICU, 3300 Oxygen beds: -38 days (total 3100)
  • You need 1400 new free ICU, 4300 Oxygen beds: -44 days (total 4000; first few patients are now stable)
  • 80,000 people infected: -48 days
  • You need 1800 new free ICU, 5500 Oxygen beds: -50 days (total 5150)

Suppose drastic measures are taken at the 10,000 people mark.

So suppose modest measures are taken at the 10,000 people infected mark.

  • First community transmission detected because someone went to the hospital feeling unwell: 32 days
  • First community-infected death: 16 days
  • 10th community-infected death: 0 days, roughly 10,000 people in community infected
  • 100th death: -16 days, roughly 20,000 people in community infected
  • You need 500 new free ICU, 1500 Oxygen beds: -20 days
  • You need 450 new free ICU, 1350 Oxygen beds: -26 days (total 950)
  • You need 400 new free ICU, 1200 Oxygen beds: -32 days (total 1350)
  • 12,000 people infected: -32 days
  • You need 350 new free ICU, 1000 Oxygen beds: -38 days (total 1700)
  • You need 300 new free ICU, 900 Oxygen beds: -44 days (total 1500; first few patients are now stable)
  • 7,000 people infected: -48 days
  • You need 250 new free ICU, 750 Oxygen beds: -50 days (total 1200)

A downslope starts. But it starts ~10-20 days after measures start, because the people in hospital are the people infected 2-3 weeks ago.

Model: 5% of sick need a ICU in 20 days, 15% need oxygen, and they need it for 4 weeks. Base is 10x new cases every 16 days. Modest intervention makes it 2x new cases every 16 days. Serious intervention makes it x0.7 new cases every 16 days.
 

If you're drinking it straight, yeah, I imagine that's a one-way ticket to Hangover Central.

Actually drinking clear liquor straight with no mixer chased with water is the best way to avoid a hangover. Its the sugar in mixers, and brown liquor that gives you a hangover. Obviously you drink enough nothings going to prevent it though.
 

When we were kids we'd go out and party whether we had a 103 degree fever or not, and usually felt better the next day.

This isnt' a general "kid is sick" disease, or even a standard flu. Covid-19 is nastier than most things most of us may have been exposed to in our lifetimes.

We always used to say that alcohol killed the sickness. I wonder if there is any truth to that or not?

Good gods, no!
 



Emergency supplies.

IMG_20200313_001343.jpg


Got a little bit of wine. Problem is I don't like wine.
 

Umbran, you left out the end of my post...

The problem with that is you didn't establish what "reasonable" is, and that is TERRIBLY important. If you say, "take reasonable precautions" you are leaving what that means up to the audience. A month ago, even two weeks ago, that was okay. By the numbers... we are at the point where such a statement is no longer responsible. We need to all have an understanding of what is effective, not what seems reasonable.

I live in Los Angeles. Asymtomatic Transmision within a two week window is a possible scenario.

Within that timeframe I have voted, engaged in political gatherings, utilized public transportation, gone to restaurants, and visited friends and family members.

I was Not morally wrong, for my quotidian actions at that time

At the time. The world looked different two weeks ago. Ethics (not morals, ethics) of choices kind of have to be based on what was known at the time. What made sense two weeks ago may seem like a Really Bad Idea (TM) two weeks from now.

Now, having just been in a talk on how covid-19 moves through social networks....

Going to small gatherings (like 10 people or less) right now, in the US on average, has a really low chance that someone with coronavirus will be present. That may change, but for now it is unlikely to be momentous.

But, we are at the point where a matter of days establishing social distancing on the larger scale may make the difference in the shape of the infection curve from "our hospitals can handle it" to "hospitals get overwhelmed". This is why I say that leaving it with "reasonable measures" is no longer a good approach.
 

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