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  • TER's Avatar
    Today, 07:20 PM
    I am happy to hear Carol is doing well. I hope she continues to improve. I’ve posted enough about this. I guess we all have to see things through whatever prism we are in. Going to sign off for a while. I wish everyone the best.
    32 replies | 657 view(s)
  • TER's Avatar
    Today, 04:40 PM
    Believe what you will. Come to New York and ask someone if this is over exaggerated. Everyone I know knows people (friends, family members) who have been hospitalized or died. This isn’t the flu, this is a bioengineered virus which for some still unclear reasons, some people get extremely sick. Young included. Many 30-50 yo intubated at my hospital. Many with no former medical problems. To say this is like the flu is inaccurate. If they didn’t do these mitigation procedures, many many more people would have died than any flu season you have ever lived through. Maybe I wouldn’t believe it if I wasn’t living in the thick of it. But I know what I know and I see what I see. If someone doesn’t want to believe me, that’s fine. God is my witness.
    32 replies | 657 view(s)
  • TER's Avatar
    Today, 01:41 PM
    Relatively speaking, it will be an insignificant number (less than 5-15% I think). The majority of deaths are people with known disease on vents with all the classic findings on history, physical exam and more importantly imaging and lab work.
    32 replies | 657 view(s)
  • TER's Avatar
    04-05-2020, 03:37 PM
    It will not be a significant number. The characteristics are getting more solidly indentifiable. History, physical exam, imaging studies and labs are extremely reliable in suggesting who has the disease without confirmatory testing. Will many be counted that actually had another similar looking process? Sure, but overall, I don’t think it will be that much of a significant factor. I could be wrong. Hopefully they do postmortem testing to get more accurate results.
    32 replies | 657 view(s)
  • TER's Avatar
    04-05-2020, 03:31 PM
    It certainly doesn’t look to have the same mortality rate compared to the flu when looking at the numbers coming out of Western Europe and the US. Until we get more testing done (and importantly serological testing to see who has had it and didn’t know it which is still an unknown though I think a small relative number), it is just speculation. What we do know is that this is a true and vicious pandemic, serious and deadly, and because it is novel and there is no herd immunity, it will continue to spread and cause lots of death. Even if it’s final mortality rate is close to the flu at 0.1% (which I think is very much on the lower end because of its fast spread and overcoming of the health care system because of it being novel), if everyone gets it, that is 350,000 people dead. I don’t think that it will get that high but only because I think many states are getting better prepared and new treatment strategies are coming out every week.
    55 replies | 849 view(s)
  • TER's Avatar
    04-05-2020, 03:04 PM
    That is true, which is why they modeled that without mitigation, if it does have such a mortality rate, upwards to 2 million Americans could die. Time will tell after more data what the true rate is. But with so many unknowns, it is better to assume the worst and then scale back as needed. We may find out it’s rate averaged out is closer to a bad flu, but in hotspots with overrun medical care, that number could be relatively higher.
    55 replies | 849 view(s)
  • TER's Avatar
    04-05-2020, 02:57 PM
    And that is for a very serious flu. Our last flu pandemic in 2009 (swine flu) had a mortality rate of 0.02% So this could go up to 100 x increase in mortality rate if it ends up at 2%
    55 replies | 849 view(s)
  • TER's Avatar
    04-05-2020, 02:45 PM
    No. Seasonal flu mortality rate is about 0.1%
    55 replies | 849 view(s)
  • TER's Avatar
    04-05-2020, 02:36 PM
    It’s all speculation at this time until broad surveillance serological studies are performed to see who has antibodies. But I won’t be surprised if it is 1-2% case fatality rate which is very high for a highly contagious respiratory illness. Again, ultimately the case fatality rate also depends on medical services available. In a perfect system with endless resources, the rate would be lower than during a severe pandemic.
    55 replies | 849 view(s)
  • TER's Avatar
    04-05-2020, 02:33 PM
    One of the factors that determine how sick you get is the initial viral load you receive. For example, if you touch a contaminated service and then touch your mouth, you may receive a smaller initial load of virus. By the time this multiplies to become a formidable army and overtake your immune system, you have a chance to build antibodies and fight it off. However, if someone who is teaming with virus coughs in your face or you sit close to someone for a while who is breathing/coughing, you can’t get exposed to a large viral load initially. Because of that, this army grows very quickly and can overtake your immune system before you can develop antibodies. Most of the very sick young front line patients are because they were exposed to a large viral load all at once (intubating someone, getting coughed on, etc). Other factors also weigh in (ones baseline immune status/co morbidities/genetics etc), but it seems one of the greatest factors is how high of an initial viral load you are exposed to.
    55 replies | 849 view(s)
  • TER's Avatar
    04-05-2020, 02:17 PM
    I can tell you that the numbers infected in the US is significantly higher than what is being recorded due to the lack of testing up until recently. Even now, we are not testing patients suspected with mild symptoms, as the tests are limited and the treatment up until now has been the same. I would guess half the patients I see and I suspect don’t get tested because they do not fit criteria. As we get more tests, this should change and then we can get more accurate data.
    55 replies | 849 view(s)
  • TER's Avatar
    04-05-2020, 02:11 PM
    The problem is that it is a novel virus. No one has encountered it before. So even if the final case fatality rate is closer to the flu (which so far it looks to be worse than the flu), the problem is that because there is no herd immunity to it, it is spreading like a wildfire and causing many who contract it to get sick and a high percentage, very sick. This cannot be compared to the a bad flu season because much of the population has some immunity to the flu and thereby it naturally mitigates the spread and virulence. No flu season in recent memory has done anything close to this. The Spanish flu was extremely bad, but you must also factor in that at that time there was little in terms of effective supportive treatments or antibiotics to help with super infections. The Spanish flu now would look like the H1N1 pandemic of 2009. Yes it was bad, but nothing like this.
    55 replies | 849 view(s)
  • TER's Avatar
    04-05-2020, 01:01 PM
    Oh hell no I won’t take it
    55 replies | 849 view(s)
  • TER's Avatar
    04-05-2020, 12:15 PM
    I am not one to easily take a vaccine. My children do not get the flu vaccine every year. I have to at work because it is mandated and I have little choice. With regards to a Covid vaccine, it all depends on what is going on at that time. If there seems to be more understanding of this disease and better treatment options, I may opt out (unless it become mandatory for my job). If I get sick and recover, I wouldn’t. If it continues to demonstrate little therapy options and significant mortality rate, and the vaccine is shown to be safe and effective, I may be more inclined to voluntarily take it. Too early to tell for me, personally. As for tracking capabilities, I’m not sure what you are referring to.
    55 replies | 849 view(s)
  • TER's Avatar
    04-05-2020, 11:15 AM
    Yes, they are. At first, before the FDA gave the okay, it was given only to the sickest and didn’t show much improvement probably because it was given so late. Now, pending availability of the medicine (which is a big issue), is it routinely being given much earlier in the course. I hope and pray it helps. Still not 100%clear it has at our site.
    55 replies | 849 view(s)
  • TER's Avatar
    04-05-2020, 11:13 AM
    I have seen seasoned ER docs break down in full blown panic attacks and in tears, and these are strong people who have more fortitude than the average person. Staff members are quitting mid shift. Colleagues on ventilators and worsening daily. No one, I repeat no one I know, including those gray haired doctors who have been working for over 40 years, have ever seen or thought they would see something like this. No one working in the medical field in those current hot spots would downplay this or say it is being overblown or a hoax. Only those who are comfortably sitting at home, in areas where it has not yet hit to that extreme, would suggest such a thing. I hope and pray it stays that way for them. But all I and my colleagues would ask is, do your part to flatten the curve, not only for the protection of many thousands of lives, but for your own sakes so that your own community doesn’t get hit so bad. Yes the economy is suffering, and there are consequences. But no one I know living in the hotspots is as worried about that. They are just hoping no one else they know gets sick or dies from this.
    55 replies | 849 view(s)
  • TER's Avatar
    04-05-2020, 10:57 AM
    I am not revealing personal info. I will say I am in the NY metro area. My hospital has seventy Covid intubated patients spanned out within the hospital in makeshift ICUs. The majority of admitted patients are Covid patients on oxygen. People dying at record pace (It is most definitely the number one cause of death in my area right now). Many die in the ER waiting days for an inpatient bed. We are sending patients home with oxygen saturation that are 92% and only admitting those who have lower sats. Staff is getting sick, some extremely so. All elective cases have been cancelled and we are resorting to surgical specialists/medical students managing icu medical patients. We’ve changed policies on who can get on a vent because of lack of equipment/support staff. All former restrictions have been abandoned (licensures/hospital privileges) and anyone willing to work is given a mask and caring for patients. There are freezers getting filled with the deceased. Everyone working is going to have some form of PSTD when this is over. Are people recovering? Sure, the majority are not getting as sick. No one has immunity to this novel virus and most will be able to form antibodies in time before the cytokines storm hits. But when that happens, it is near 85% mortality rate. So it is a numbers game. The vast numbers have overwhelmed the resources available. Flattening the curve is essential. It buys time for treatments to be found and importantly, helps lower the volume of sick patients at any given time. When that critical threshold is reached, mortality skyrockets like you see in Italy and Spain. Even those who have unrelated sicknesses die because of the dirth of medical resources. So the mortality rate of the run of the mill bacterial pneumonia or urosepsis or chf etc goes up as well. The anecdotes people will have is dependent on the community outbreak they are in and their own personal exposure. So someone living in the sticks with low prevalence of the disease can see this as not serious. Or have known a couple of people who got it and recovered. But pray it stays that way, because if it happens like it has happened in Italy, Spain, France, NY, NJ and now more growing numbers of cities, many many people will die. I don’t want to fear monger. I’m just laying out what I see, what I know, and what I believe will happen if this continues unchecked. Be happy that your local ERs and hospital are quiet and they seem over supplies and over staffed. Because if it hits in earnest, you will need everything you have to keep people alive.
    55 replies | 849 view(s)
  • TER's Avatar
    04-05-2020, 08:44 AM
    Whoever thinks this virus is a hoax and a nothingburger obviously does not work on the front lines or live in areas with high prevalence. I am seeing these patients coming in extremely sick and have colleagues on ventilators. Pronouncing multiple patients daily in the ED. The hospitals around me have entire floors filled with Covid patients on oxygen and struggling to hang on. Is it not as crazy in other parts of the nation? Of course. It hasn’t hit them yet. When and if it does at the intensity it is hitting the hot spots right now, everyone here will likely know of someone who has been hospitalized for it or has died of it. I personally know several already who have. Is Dr. Fauci duplicitous? Maybe. Is the media instilling panic and fear? Sure, they always do. Is this virus serious and deadly? Oh hell yes.
    55 replies | 849 view(s)
  • TER's Avatar
    03-18-2020, 10:27 AM
    TER replied to a thread Prayers Welcome in Peace Through Religion
    You are both in my prayers, friend.
    19 replies | 636 view(s)
  • The Rebel Poet's Avatar
    03-12-2020, 10:09 AM
    You would consider collectively condemning and mocking an entire cohort based on a couple of anecdotes to be wise?
    41 replies | 1366 view(s)
  • The Rebel Poet's Avatar
    03-11-2020, 04:29 PM
    Goddamn ! What's wrong with them! You've become quite bitter and collectivist over the last few years and haven't been acting like yourself. Obviously something has been changing for the worse in your life that has nothing to do with millennials, weirdosexuals, or Democrats.
    41 replies | 1366 view(s)
  • The Rebel Poet's Avatar
    03-10-2020, 05:24 AM
    Two down now: http://www.ronpaulforums.com/showthread.php?543991-Democratic-attorney-drops-bid-to-unseat-Justin-Amash&p=6930119#post6930119 Seven left to go.
    9 replies | 653 view(s)
  • The Rebel Poet's Avatar
    03-09-2020, 11:21 AM
    Ignore his malarkey; he's a lying, dog-faced pony soldier.
    34 replies | 2488 view(s)
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Recent Entries

Comrade SwordShill

by PierzStyx on 08-05-2019 at 09:33 PM
[QUOTE=PierzStyx;6838727][QUOTE=PAF;6838633]Oh, SwordShill! You have convinced me and I have just now had a change of heart! Rather than to rally a few thousand gun-toters to [B]inform[/B] those crooked bureaucrats that they can't and won't muck with us and the 2nd Amendment, we are instead going to ask them to pretty please write up some nice legislation that we can all compromise on! And then everything will be daffodils and roses!

You are so smart! Thank you![/QUOTE]

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16 Marines arrested on charges ranging from human smuggling to drugs, officials say

by PierzStyx on 07-28-2019 at 01:34 AM
[QUOTE=PierzStyx;6834861][QUOTE=Swordsmyth;6834856]That isn't what we will create.

Your commie buddies will create a police state, your support of it makes you a traitor to the Constitution, liberty, and basic humanity.[/QUOTE]

Yep. I'm an anarchist who hates all forms of centralized states- you know the very opposite of Communism- so somehow that makes me a Communist. While you champion the murder of innocent people engaging in free market exchanges of goods and services

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What It Means To Be Rich

by PierzStyx on 05-21-2019 at 12:24 PM
[QUOTE=PierzStyx;6800489][QUOTE=Superfluous Man;6800430]Yeah, I'm sure that Amash would vote yes on a bill to ban manufacturing in the US.[/QUOTE]

Obviously he wouldn't. It amazes me how much these people want to trap America in the Industrial Age though. If they were around in the 1800s they would've opposed farming technology because it put field workers out of a job and have fought against Edison because they were afraid the light bulb would destroy the work of candle-making market.

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Vote Trump, Endorse Everything He Does

by PierzStyx on 10-12-2018 at 11:52 AM
[QUOTE=PierzStyx;6692053][QUOTE=Anti Federalist;6691977]This has been one of my "pet issues" for years now.

Let's assume something comes out of this, and reforms that include reducing plea bargain that railroad innocent people, and mandatory sentencing and abolition of capital punishment get signed into law by Trump, does that further my "warming up" to Trump?

If I voted for him based on that, would that make me a "Trump Humping" fascist

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Updated 10-16-2018 at 10:58 AM by PierzStyx

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The State is Chaos

by PierzStyx on 10-11-2018 at 02:02 PM
[QUOTE=PierzStyx;6691719][QUOTE=thoughtomator;6691341]Basically what you are saying is that you are completely unable to grapple with the real world trade-offs involved in securing liberty, so you have to create extreme strawman scenarios to justify obstinance.

What you will need to seek is not the permission of a centralized government per se, but the permission of your countrymen who seek to strike a rational balance between the conflicting imperatives of maximizing personal liberty

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