Wisconsin governor drops MOAB on his state economy

Everskyward said:
I was wondering the same thing. It still doesn't really make sense to me (the acronym).
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Saddam Hussein is the first one I remember using it. He threatened our troops with the MOABs if we attacked him during the Gulf war. It was more like the disadvantaged little sister of all bombs.
 
JOhnH said:
Saddam Hussein is the first one I remember using it. He threatened our troops with the MOABs if we attacked him during the Gulf war. It was more like the disadvantaged little sister of all bombs.
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OK, I initially thought it was some acronym invented for the current situation, especially because it was used in two threads about similar actions.
 
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DFH65 said:
We could do this smarter but we are choosing not to and just killing the economy in the process. The reality is this thing is in the wild there is no stopping it now. We are only trying to slow it down which makes sense because otherwise we could overwhelm the healthcare system. But even if we all hole up for three months this is eventually going to come back around we are not going to eliminate it completely.

What should be done is in places with higher counts NYC for example people should be quarantining. In places where cases do no reach a certain threshold we should leave them open until they do of course maintaining good social distancing and hygiene practices.

Everyone needs to assess their own personal risk profile and act accordingly. My brother is high risk he needs to be locked down. I am somewhere in the middle and my kids are super low risk. Each of us need to do something different and protect ourselves accordingly.

Comparing us to Italy is not exactly an apples to apples comparison.
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I think this is a very fair take. I’m from Long Island where according to the recent press conference, 1 in 1,000 are likely infected. Makes it difficult to think we should be going back to work because, for example, I commute on a train and subway each morning with likely close to that number of people that share those spaces. Seems absurd to thrust people back into that right now. A week or so might be very different.
 
wsuffa said:
I'm sick of hearing "better safe than sorry". With no economy, there's no money to pay to treat people. There needs to be a balance somewhere.
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JPow's got this, fam.

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@jspilot yes, unfortunately it is a one size fits all "solution" for example lets look at two different areas in NY. Allegany county in NY has 2 confirmed cases and a population of 47,000 people the county is 1,034 mi². Long Island, actually 4 counties, according to the interwebs has 7.5 Million people and is 1,401 mi². So the population densities aren't even in the same league but both are doing the same things. It just seems to me we could probably be smart enough to manage the different risk levels of both places.
 
Fiveslide said:
You don't think they tried to be nice about this? Like I said, they gave people the chance to voluntarily stay home and slow this thing, people blew it.

To put it in perspective, say you have an apartment complex with 40 units, 5 buildings and everyone gets it. An entire building is going to have severe symptoms and likely require hospitalization and one unit is going die. That's with enough hospital beds available for all the ones that get sick.
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Spare me the lecture. Some have done well with this, and some haven't. Virginia, for example, has done fairly well, by DC hasn't. But that hasn't stopped the mayor of DC and some other states from insisting that Virginia needs to do what they do - because.
 
DFH65 said:
@jspilot yes, unfortunately it is a one size fits all "solution" for example lets look at two different areas in NY. Allegany county in NY has 2 confirmed cases and a population of 47,000 people the county is 1,034 mi². Long Island, actually 4 counties, according to the interwebs has 7.5 Million people and is 1,401 mi². So the population densities aren't even in the same league but both are doing the same things. It just seems to me we could probably be smart enough to manage the different risk levels of both places.
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One size fits all is what government does. And that does cause problems.
 
DFH65 said:
@jspilot yes, unfortunately it is a one size fits all "solution" for example lets look at two different areas in NY. Allegany county in NY has 2 confirmed cases and a population of 47,000 people the county is 1,034 mi². Long Island, actually 4 counties, according to the interwebs has 7.5 Million people and is 1,401 mi². So the population densities aren't even in the same league but both are doing the same things. It just seems to me we could probably be smart enough to manage the different risk levels of both places.
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Totally agree and I think the pathway forward is exactly as you mention— allow certain areas to return to the way things were but not everywhere. One size fits all never works.
 
DFH65 said:
What should be done is in places with higher counts NYC for example people should be quarantining. In places where cases do no reach a certain threshold we should leave them open until they do of course maintaining good social distancing and hygiene practices.

Everyone needs to assess their own personal risk profile and act accordingly. My brother is high risk he needs to be locked down. I am somewhere in the middle and my kids are super low risk. Each of us need to do something different and protect ourselves accordingly.
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The problem isn't whether YOU are high risk. It's how quickly you will spread it to high risk individuals. Even if all of the high risk individuals are locked down, all of the low risk individuals will be quickly infected, the virus will be EVERYWHERE, and then how are the high risk individuals supposed to, I dunno, eat?

And even "low risk" isn't zero risk. I keep seeing that 40% of the people who are *hospitalized* for this are under 50... That means even the "low risk" population isn't as low risk as they may think.

jspilot said:
Totally agree and I think the pathway forward is exactly as you mention— allow certain areas to return to the way things were but not everywhere. One size fits all never works.
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It's not ideal, but... In thinking about alternative solutions that would allow rural areas to go about business as usual, I got to thinking about the lack of hospitals available in rural areas. Say you shut down Des Moines but let the rest of Iowa go about their business. It won't spread as quickly as it would in a city, but it'll still spread fairly quickly, and then all of those people have to to a bigger city where there's a hospital, and we likely still get overwhelmed.
 
Here's an example of where one-size-fits-all fails.

In our state, non-essential businesses may stay open if no more than 10 people are in the place at a time. So a small, neighborhood outdoor/outfitter/gun store might stay open, limiting staff and customers to 10 and keep them 6 feet apart. But a store like Cabelas, which might be 50 times as large inside, is bound by the same limit -10- meaning that they will have to close because the store staff at minimum levels might be 9 or 10.
 
wsuffa said:
Here's an example of where one-size-fits-all fails.

In our state, non-essential businesses may stay open if no more than 10 people are in the place at a time. So a small, neighborhood outdoor/outfitter/gun store might stay open, limiting staff and customers to 10 and keep them 6 feet apart. But a store like Cabelas, which might be 50 times as large inside, is bound by the same limit -10- meaning that they will have to close because the store staff at minimum levels might be 9 or 10.
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Because government
 
flyingcheesehead said:
The problem isn't whether YOU are high risk. It's how quickly you will spread it to high risk individuals. Even if all of the high risk individuals are locked down, all of the low risk individuals will be quickly infected, the virus will be EVERYWHERE, and then how are the high risk individuals supposed to, I dunno, eat?

And even "low risk" isn't zero risk. I keep seeing that 40% of the people who are *hospitalized* for this are under 50... That means even the "low risk" population isn't as low risk as they may think.



It's not ideal, but... In thinking about alternative solutions that would allow rural areas to go about business as usual, I got to thinking about the lack of hospitals available in rural areas. Say you shut down Des Moines but let the rest of Iowa go about their business. It won't spread as quickly as it would in a city, but it'll still spread fairly quickly, and then all of those people have to to a bigger city where there's a hospital, and we likely still get overwhelmed.
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Great point about the rural areas and lack of hospitals. I do think we are going to have to figure out a way to gradually allow people back but it can’t be an all at once type thing. Maybe you go to every other day working or go to some “if your last name starts with A-F you work this day— whatever works.

The real key here is we need to know who has anti-bodies for this virus and who does not. It’s a travesty we don’t have that ability yet.
 
Salty said:
Trying to keep from taking this political, but this has begun to make me sick to my stomach. Our society will never fully recover from this. We have accepted the unacceptable to "preserve our safety"
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Of course we will recover. And infecting everyone to 'preserve society' will do exactly the opposite. This is a few month's worth of 'glitch'. People are resilient. And you need to read and understand the ramifications of _not_ containing the spread.
 
jspilot said:
Great point about the rural areas and lack of hospitals. I do think we are going to have to figure out a way to gradually allow people back but it can’t be an all at once type thing. Maybe you go to every other day working or go to some “if your last name starts with A-F you work this day— whatever works.

The real key here is we need to know who has anti-bodies for this virus and who does not. It’s a travesty we don’t have that ability yet.
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Not clear whether we have the ability or not. As quoted on a different site, this article claims that we are further along in the pandemic than previously thought and, at least in the UK, should begin antibody testing right away.

(Unfortunately the article is paywalled and I can't even read it directly, but it was quoted as linked to above.)
 
By the way - Even if you think this is the "MOAB," @Datadriver, it technically was not the governor (Tony Evers). The order was written and issued by the Secretary of the Department of Health Services, Andrea Palm.
 
azure said:
Not clear whether we have the ability or not. As quoted on a different site, this article claims that we are further along in the pandemic than previously thought and, at least in the UK, should begin antibody testing right away.
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The Oxford study is not a study based on measured data - it's a hypothetical mathematical "what-if" model.

It assumes things like a 0.1% hospitalization rate across the the entire population.

This is off by at least 1 order of magnitude. Italy already reached the point where 1% of their population is hospitalized.
 
deonb said:
The Oxford study is not a study based on measured data - it's a hypothetical mathematical "what-if" model.

It assumes things like a 0.1% hospitalization rate across the the entire population.

This is off by at least 1 order of magnitude. Italy already reached the point where 1% of their population is hospitalized.
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Not to pick nits, but they're all hypothetical mathematical "what-if" models.
 
SoonerAviator said:
Not to pick nits, but they're all hypothetical mathematical "what-if" models.
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Sure but there is a difference between a model that's based on actual data vs. one that's based purely on theory.

I think that even actual data is the wrong input for models, seeing how inaccurate the actual data is. What we need is sampling data.

But the only place I know where cross-population random sampling is taking place is Bill Gates's study in Seattle, which is still very small at this point (300/day).
 
SoonerAviator said:
Not to pick nits, but they're all hypothetical mathematical "what-if" models.
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I don't know about "all", but it's quite true that many studies use mathematical models (along with certain "reasonable" assumptions) and then try to see if the model's predictions agree with the actual evidence.

The article is paywalled so I'm not entirely sure what the assumptions were. If they assume a 0.1% hospitalization rate across the population, I agree that that appears to be dubious in some places. But the part that Brian quoted said that it was based in part on case and death reports from Italy, so unless the study is more than a couple of weeks old, I'd be surprised if that was the case.
 
Washington Post had an article today whining about the lack of data - seems they want the data to write more articles. Self-serving. Let the medical professionals do medical stuff, the data will get reported when able.

I do agree without data we're just making guesses - but even if every scintilla of data were available now it would be wrong as there is such a huge portion of people that weren't even tested.
 
deonb said:
Sure but there is a difference between a model that's based on actual data vs. one that's based purely on theory.

I think that even actual data is the wrong input for models, seeing how inaccurate the actual data is. What we need is sampling data.

But the only place I know where cross-population random sampling is taking place is Bill Gates's study in Seattle, which is still very small at this point (300/day).
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Right, but I was just pointing out that everyone uses assumptions and best guesses. As more and more data become available, it obviously allows the model assumptions/constraints to be adjusted based on new data. It's why we have predictions that run the gamut of 100K deaths worldwide to millions of deaths. Assumptions with exponential effects can result in wild data. If the assumption was too narrow, everyone says "you weren't conservative enough in your doomsday prediction, how could you let that happen?!". If the assumption is too wide, everyone says "thank God the curve flattened, otherwise we would have ended up at your models prediction". Truth is usually somewhere in between, hard to cast stones at either method until all the dust settles.
 
Datadriver said:
She will have a job when this is all over. The rest of us won't. There will be suicide, child abuse, more drug abuse, crime, and death that accompany a higher unemployment rate.
We are literally killing the chemo patient with too much radiation.

Maintain social distancing, ramp up production of needed medical equipment, complete quarantine of nursing homes, temperature checks on more public spaces, let the rest of us work.
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Some people will spend a month in the hospital and be on a ventilator. Some won’t be alive when this thing is over. Quit the whining. Your plan will have dead people lying in the halls of hospitals.
 
We are not testing enough people to have any idea what’s going on. Our leaders are guessing at what the best corse of action is at this point. The data indicates approximately 90% of those infected show no symptoms. The blind are leading us. What we are doing may be excessive or may be pointless. No one knows.
We need wide spread testing.
 
Tarheelpilot said:
We are not testing enough people to have any idea what’s going on. Our leaders are guessing at what the best corse of action is at this point. The data indicates approximately 90% of those infected show no symptoms. The blind are leading us. What we are doing may be excessive or may be pointless. No one knows.
We need wide spread testing.
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Totally agree we need more wide spread testing, but the asymptomatic rate isn't 90%.

We know that from South Korea, which has pretty close to 100% testing. (Can't have less than that in a test-and-track strategy without a lockdown, it will lead to exponential growth, which they don't have).

But they still have a 10% hospitalization rate. So to have 90% asymptomatic it would mean you're either asymptomatic, or in the hospital. But that doesn't leave any room for the scores of people in the middle who have some symptoms but don't need hospitalization.
 
The only population I’m aware of that was locked down and had near 100% testing was Vo in Italy. They found ~90% of cases were asymptomatic... to the best of my recollection. It was a small remote village of 3000ish people.

edit:

but screw Italy.

We really need to ramp up our testing.
 
Tarheelpilot said:
The only population I’m aware of that was locked down and had near 100% testing was Vo in Italy. They found ~90% of cases were asymptomatic... to the best of my recollection. It was a small remote village of 3000ish people.

edit:

but screw Italy.

We really need to ramp up our testing.
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50% - 75% not 90%

https://translate.googleusercontent...esh_ce&usg=ALkJrhjtl_z8XLDvKWmZLYnDR3LBaMn9Ug


The 90% number of Vo is that after 10 days 90% of those who had symptoms were clean.
 
deonb said:
I meant their tests found close to 100% of their cases.
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oh, sorry. I wonder if some of these other Asian countries reacted so quickly because they were thinking of SARs and told themselves, oh no not again!
 
 
 
Datadriver said:
oh, sorry. I wonder if some of these other Asian countries reacted so quickly because they were thinking of SARs and told themselves, oh no not again!
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This is SARS, COVID-19 is AKA SARS-CoV-2.
And the US has proven itself a world power, taking the lead in cases overnight.
 
Fiveslide said:
You don't think they tried to be nice about this? Like I said, they gave people the chance to voluntarily stay home and slow this thing, people blew it.
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Not really much choice to "blow it" when your job tells you that you have no choice but to come in. That's an awfully 2 (1?) dimensional view of the situation.
 
Mtns2Skies said:
Not really much choice to "blow it" when your job tells you that you have no choice but to come in. That's an awfully 2 (1?) dimensional view of the situation.
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I'm not talking about that. I'm talking about the people that still went to the beach, the gym, the bars, the salons, until the government made the choice for them and closed the doors to those places.

I'm still trying to work as much as I can. I wear a mask and gloves when I enter people's homes to do repairs, I can't fix apartments from home.

Apologies if I was unclear. I may have had a beer or two that evening.
 
kayoh190 said:
I dunno man, hookers have been around for a loooong time.
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The profession has, the current work force usually is HIV positive and will probably suffer an over dose and death. Am in women's health. Here on the border a few years ago there were quite a few Russian females that were in bad shape being pimped for their "coyote" fees.
 
In the absence of widespread testing to guide isolation policy or determine who can go back into the general population, the only tool we have in the toolbox is widespread social distancing policy. The purpose of widespread isolation policies is to preserve healthcare capacity by spreading out the impact of critically ill patients over time. It works. Ten days after imposing stay-at-home policy in NY state, the doubling time for caseload growth has increased from less than 2 days to a frightening but more manageable 4 days. Isolation policies are more effective in the early stages of an epidemic, not after your caseload is raging.

Here are some sobering statistics:
  • NY had fewer than 200 cases on March 10. Stay-at-home policies were implemented on the 17th, when we had 1700 cases. As of the 26th, we had 39,000 total cases. That's the tyranny of exponential growth.
  • The growth rate of cases nationwide shows no signs of decline yet. It is doubling every 3 days. Based on this data and known lag time between infection and realization of diagnosis, it seems highly likely that the current nationwide caseload of 83,000 will reach a 500,000 in a week or two. We will easily surpass a million in a month's time, unless we do something to decrease transmission.
  • The case fatality rate is around 2% and hasn't changed much since the beginning. So if there are 500,000 known cases there will likely be 10,000 deaths. But we won't stop at 500,000 cases, because that's just next week or so.
  • About 15% of cases will require hospitalization. That is the NY experience. It is slightly down from 20% that was seen in some other countries.
COVID-19 will eventually reach every corner of the country. NY and WA got an early start. The rest of America will catch up in 2, 3, 4 weeks or so. A little pain early (social distancing) will prevent a lot of pain later (collapsed health care system).

To get out of this mess and get back to something closer to normal we need:
  • A vaccine (12 months off) to create widespread herd immunity
  • Effective therapeutics (at least several months off) to reduce the length of hospital stays and fraction of individuals with critical illness.
  • Widespread testing to determine the extent of exposure, identify who should be isolated, and identify those who have recovered and can return to the workplace.
These three things should be our highest priorities as a nation, in addition to providing necessary medical supplies to get through the first wave of the epidemic. If we don't get cracking on these things YESTERDAY, there will be no quick path back to "normal." The good news is that once we get past this, there is nothing fundamentally wrong with the U.S. economy, and a relatively quick recovery of economic activity can ensue. The idea that we can fight mother nature and avoid the laws of physics, math, chemistry, and biology is laughable. Disney's Law ("Wishing will make it so") does not apply in the real world. We have the biggest, baddest, scientific community in the world. (I was privileged to work in that community for 35 years, including two stints at NIH.) We can get 'er done if we focus on the priorities that matter.
 
Tarheelpilot said:
The only population I’m aware of that was locked down and had near 100% testing was Vo in Italy.
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The 3700 passengers of the Diamond Princess was one of the first excellent studies of an infected population for which everyone was tested. This population spanned a large range of ages. From that data, the case fatality rate was 2% (similar to that seen worldwide) for all ages, and the infection fatality rate was around 1%. That is, about 50% of individuals who tested positive were asymptomatic.

The more recent Vo Italy study was about the same size, 3300 individuals, and also showed that about 50% of individuals who tested positive were asymptomatic. What they were able to do was show that they could halt the spread of the virus by intensive, widespread testing and selective isolation. (That's a lesson about how to get out of our mess in the U.S.) After a few rounds of testing and isolation, they found that 90% of the population was infection-free. Not cured, not asymptomatic, but not infected.
 
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