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Author: Subject: Opening Up America Again

True Peach





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  posted on 4/16/2020 at 07:06 PM
Plan unveiled, widely available online news outlets.

So what do we think?

I think it is pretty good.

Must overcome hurdle of 14 days declining trajectory of flu-like symptoms and coronavirus cases where hospitals are able to treat their patients without crisis care (does this mean not overwhelmed with extra capacity?), with testing and screening procedures before entering phase 1. Phase 1 has many of the things that most states are currently adhering to already. If there is no "rebound" and cases are still declining for 14 days, enter phase 2. No rebound with 14 days of declining cases, enter phase 3.

It sounds pretty responsible, I liked when Birx and Fauci explained it rather than Trump.

Some states have the talent and resources to develop their own guidelines, perhaps improving upon these. Some states may want to follow them as is. Governors and health professional in each state get to determine when and how they do this - exactly as it should be.

Some vague areas in the phase guidance, but this seems like a good way forward. The shortest timeframe out is 42 days if a state is ready to enter phase 1 today. If the hurdles haven't been met yet then is will be at least a 56 day process.

The most glaring issue is the fact that testing efficiency and availability is still pretty awful, that plays a key role in this.

 
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True Peach



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  posted on 4/16/2020 at 07:09 PM
Here is one link with plan in pdf format.

https://context-cdn.washingtonpost.com/notes/prod/default/documents/f70115f 7-a330-49d8-b0a9-ff6b3ce56ae1/note/8cb9b5df-b98d-4382-a7e8-9ca2fa6c9038.#pa ge=1

 

Maximum Peach



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  posted on 4/16/2020 at 07:11 PM
Looks good to me. Thx for post
 

Ultimate Peach



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  posted on 4/16/2020 at 07:11 PM
I support this, and I also support Gov Cumo if he says that the timeline would compromise the safety of New Yorkers. I leave it to Cumo and his advisors if they say its too soon than its too soon. I dont care what Trump thinks should be done if he is outside of a hot zone. Leave it too the governors to manage their local hot zones.

 

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True Peach



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  posted on 4/16/2020 at 07:18 PM
Dr Facui's comments on the plan:

My apologizes for the all caps, it is a C-Span copy and paste.

-edit - actually that looked awful and unreadable, let me see if I can find a normal version

-edit- I can't find a noncap version, even tried to change the format in word, but couldn't. Here is the link, Fauci starts talking at about the 35 minute mark where he describes this plan as a "natural evolution".

https://www.c-span.org/video/?471257-1/trump-administration-issues-guidelin es-reopen-economy&live=

[Edited on 4/17/2020 by nebish]

 

Zen Peach



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  posted on 4/16/2020 at 07:24 PM
quote:
Some states have the talent and resources to develop their own guidelines, perhaps improving upon these. Some states may want to follow them as is. Governors and health professional in each state get to determine when and how they do this - exactly as it should be.


So, NO State to State travel at first?

 

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True Peach



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  posted on 4/16/2020 at 07:32 PM
quote:
quote:
Some states have the talent and resources to develop their own guidelines, perhaps improving upon these. Some states may want to follow them as is. Governors and health professional in each state get to determine when and how they do this - exactly as it should be.


So, NO State to State travel at first?


State to state travel is not currently prohibited. It might be discouraged with a 2 week self quarantine request. Nothing here changes that. I think there would be some interstate commerce problems with prohibiting travel across state lines.

 

Universal Peach



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  posted on 4/17/2020 at 04:52 AM
quote:
quote:
quote:
Some states have the talent and resources to develop their own guidelines, perhaps improving upon these. Some states may want to follow them as is. Governors and health professional in each state get to determine when and how they do this - exactly as it should be.


So, NO State to State travel at first?


State to state travel is not currently prohibited. It might be discouraged with a 2 week self quarantine request. Nothing here changes that. I think there would be some interstate commerce problems with prohibiting travel across state lines.


Seems reasonable but as you said above, without enough testing, no plan to reopen will be a safe one.

 

Zen Peach



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  posted on 4/17/2020 at 07:32 AM
I live in a county that has had 1 new case in the last 6 days and 7 total active cases. It does border a county with 38 active cases. Our governor has extended the "safer at home" order until April 30. I think we could phase-in the easing of restrictions in the non-hotspot areas beginning pretty much immediately. I do realize that with increased mobility, the virus has an opportunity to put a hump in the curve, but you can't just flip a switch and say "tada!!" to restart things even now. It will take a lot longer to start it up than it did to shut it down.

 

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World Class Peach



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  posted on 4/17/2020 at 09:16 AM
I won't feel safe until there is a vaccine.
I will continue to practice social distancing.
I will continue to have my groceries delivered. (Had never done before)
I will continue to do most of my shopping online.

That said, as soon as Australia opens its borders I'm heading back.

 

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True Peach



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  posted on 4/17/2020 at 09:35 AM
As I see it, there is one problem with this immediate plan. Americans.

In the Land of the Free and the Home of the Brave - we tend to take things like social distance requirements personally - often as some sort of personal affront. Think of that scene in the Monty Python film (The Meaning of Life (I think)) where the Grim Reaper comes to call and is put off by the American's, "I'll have you know" attitude.

We either don't take this stuff seriously or we imagine that the dangers only apply to those who are less sophisticated than ourselves.

I've just returned from the grocery store. They've done a great job of urging customers to space out while shopping, but the cash register lines? Something about America? Whenever there's a line we tend to move forward to compress the line. This will make it move faster, right?

In a post in another thread, people argue that "concerts would be safe if the attendees would stay 7 feet apart." I laughed so hard reading that one that I may have to return to the grocery to see if they have any toilet paper! Y'all know for a fact that 2 minutes into the first song the audience would be jammed up against the stage. You DO know this, right?

Personally, I will not return to restaurants, bars or non-grocery shopping until I have seen a significant drop in new cases - at least in a 100 mile radius of my home. Y'all are free to pick your own poisons.

Peace.

RB

 

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Zen Peach



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  posted on 4/17/2020 at 09:40 AM
quote:
I support this, and I also support Gov Cumo if he says that the timeline would compromise the safety of New Yorkers. I leave it to Cumo and his advisors if they say its too soon than its too soon. I dont care what Trump thinks should be done if he is outside of a hot zone. Leave it too the governors to manage their local hot zones.


I agree with you.

 

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World Class Peach



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  posted on 4/17/2020 at 10:47 AM
Looks like a good plan.
Unfortunately, not reality right now

I'm a physician in NH
Right now, we have enough PPE . We have this thanks to private donations and aggressive actions by our health system for purchasing and re sterilizing. Some local companies have also been very innovative in helping. We haven't gotten anything from the Feds. However 4 hospitals in our state have critical shortages of masks and gowns

There is clearly not enough testing. Until this week, testing was essentially only available to people who were sick enough to be hospitalized, or to health care or chronic care workers (for public health reasons). We have gotten some more kits and criteria for testing has been liberalized a bit, but not nearly enough.
The scary thing is that people are infectious before they have symptoms, and asymptomatic carriers may be infectious also. Without a vaccine, imo it won't be safe until we can test pretty much everyone on a regular basis and then trust them to self quarantine.

Hopefully, we will have enough testing (including serum testing) soon so we can all get on with life

 

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True Peach



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  posted on 4/17/2020 at 11:41 AM
There just is not going to be testing on the scale that are going to make people 100% comfortable.

So then, do we wait...and how long will that take?

It will be interesting to see how the governors interpret the testing, screening and surveillance "gates" or hurdles before phase 1 can begin. I don't think by strict interpretation that many or any states would be able to pass that requirement would they?

Absent of that can we enter into phase 1, assuming flu-like symptoms and confirmed cases are on downward trajectory for 14 days?

I think it can be tried. A lot of this is going to come down to personal decisions and willingness to potentially be exposed and infected. You almost have to act like and assume that you could or would be infected any time you do something outside the home in a public type place. The gas station, anywhere. So I think with precautions, face masks, distancing, either gloves or hand sanitizer with frequent washing of hands - how many are willing to start to try and do things we haven't been able to do? It's going to depend on many variables that only individual people can answer. Should we be given that opportunity? It's up to our governors and their team of medical professionals and advisors that are looking at the data. There is danger and risk in being too protective and there is danger in risk in being too willing to open things up.

In the state I'm in, up to this point we have plenty of people going to work each day in essential business (which is somewhat open to interpretation). So either these workers, or their employers have already accepted the risk they are putting themselves at to service us and/or fulfill their duties for society - as have the customers and other commercial businesses that supply and interact with them. Acceptable risk decisions have already been made. Soon, based off the data, it will be time for the governors to decide how and when to expand that acceptable risk with relaxed restrictions and then everyone else will have to decide what they want.

I think the biggest thing that needs to be weighed in whatever the governors or us as individuals decide is what risk are we placing upon the health care system. The facilities, the equipment and the stress on the personnel that serve and help the sick. If county and regional and state hospitals and medical providers have the free capacity and supplies, then we can proceed with caution. When or if, infections get to the point where the system is going to be stressed, we should pause.

There are going to be new infections as we go through this. Fauci has said as much. If we can manage it properly, is this acceptable risk tolerable? There just isn't going to be the testing necessary in the short term. So if we wait solely for that we might be waiting a long time still.

 

World Class Peach



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  posted on 4/17/2020 at 12:51 PM
the new data on remdesivir, if it pans out, has the potential to change things

 

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Universal Peach



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  posted on 4/17/2020 at 04:24 PM
I think Cuomo explained the testing dilemma pretty well in today's press conference.....The states simply haven't the ability to scale this requirement up enough to even make a dent in the required numbers needed.

His call to action by the federal government and Trump was met with the usually stupidity from Caligula in Chief....Maybe it's better that dear leader spends most of his time not actually doing anything but watching Faux news and texting. Less for him to f*ck up that way.

That's probably how his henchman handle him...Just give him his cell phone and place him in a room with a television and a McDonald's lunch.

 

World Class Peach



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  posted on 4/17/2020 at 08:37 PM
This afternoon's news- Covid rapidly becoming #1 killer in US

It is claimed we need 2-3x the testing capacity

ID LOVE For the country to be open for so many reasons
Iím concerned about people ill with things that have nothing to do with this virus not getting the health care they need, in addition to the obvious financial concerns
I just donít think most of the country is close to getting there

 

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True Peach



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  posted on 4/18/2020 at 06:55 AM
Great News! As part of opening up America again, some beaches have reopened in Florida - up here, Gov Scott said employees w/little contact w/others, like construction etc can return to work next week

Radio reported a festive scene at the beaches, w/people running, fishing, swimming, cycling, beach combing in a welcome return to normal -
outdoors & fresh air is the way to say goodby to the pandemic & that was just the atmosphere at the beaches, where there was no hint of virus worry, people interviewed on the radio said

People have cabin fever, theyíre itching to get outdoors just like every spring - this fever is the right antidote & must be accommodated - Ďsocial distancingí can be too

The economic devastation continues tho - three colleges in the Vt state system are set to consolidate next year, closing two of the campuses, in Lyndon and Johnson

Lyndon has basically been closed this spring, like many others - its campus is high on a hill w/spectacular views, dynamite riding trails etc - itís major bad news, just as the closure of the ski areas & everything else has been - itís been chilly & the ski conditions would have been sweet - what will become of those campuses, heaven only knows

Good wknd, all the best



[Edited on 4/18/2020 by Stephen]

 

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True Peach



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  posted on 4/18/2020 at 07:09 AM
Oh yeah - flocking to the beaches for some fun and sun and volleyball and stuff sounds great! Unless you live in a coastal resort area like I do. We were Corona-free until the Spring Break a few weeks ago. We had a couple of cases pop up immediately after - then the exponential build-up that often follows pandemic outbreak ensued.

So, hell yeah! Send us your bored and infected. By the end of summer we'll know just how good an idea this was.

 

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True Peach



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  posted on 4/18/2020 at 08:39 AM
And yet, Iíd bet most merchants & business community were glad to greet the kids on spring break & get it in under the wire - a win-win-lose this year, kids partied, local economy got its annual boost - & the coronavirus appeared also

Many happy stoked concert goers attended a show at MSG a short 5 weeks ago - also just b4 the pandemic began - hopefully the vibe of the awesome smoking show isnít replaced by the worrisome possibility of having contracted what was at the time an active virus

Am Not Downplaying It - the stats are there, hundreds of thousands dead worldwide, tens of thousands in this country - but the desire for a return to normal is understandable too



[Edited on 4/18/2020 by Stephen]

 

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"I know y'all came to hear our songs, we like to play 'em for you but without Gregg here it's really hard for us to do. He sings & plays so much & does such a good job. He's really sick, 103* He might've come, but no one would let him." Duane

 

True Peach



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  posted on 4/18/2020 at 09:46 AM
I'm hearing and reading A LOT of premature openings and planned openings.

Ohio has done a good job, we have really flattened the curve. They estimate we are now, currently, in the peak plateau time. Dewine says he plans to relax some restrictions May 1st. But we haven't experienced a 14 day trajectory of declining numbers yet. Maybe by May 1st we will be on that path, but it is hard to see it now. Same with other states that have yet to peak or are in their peak, with no evidence of declining cases a bunch of these states are already jumping to phase one.

So these governors can do what they want to unwind this, just as they could on the front side to mitigate. To me, it seems like there is a pretty decent federal guidance plan, I think the "gates" or the hurdles before you can get to phase 1 were key for health professionals like Fauci to get onboard, but it is like that is being ignored already.

 

Universal Peach



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  posted on 4/18/2020 at 09:50 AM
quote:
I'm hearing and reading A LOT of premature openings and planned openings.

Ohio has done a good job, we have really flattened the curve. They estimate we are now, currently, in the peak plateau time. Dewine says he plans to relax some restrictions May 1st. But we haven't experienced a 14 day trajectory of declining numbers yet. Maybe by May 1st we will be on that path, but it is hard to see it now. Same with other states that have yet to peak or are in their peak, with no evidence of declining cases a bunch of these states are already jumping to phase one.

So these governors can do what they want to unwind this, just as they could on the front side to mitigate. To me, it seems like there is a pretty decent federal guidance plan, I think the "gates" or the hurdles before you can get to phase 1 were key for health professionals like Fauci to get onboard, but it is like that is being ignored already.


It is being ignored....Which is not surprising given the President sends mixed messages every 5 minutes and contradicts everything that comes out of his mouth.

 

World Class Peach



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  posted on 4/18/2020 at 09:58 AM
Yep
Itís one thing if people were putting only themselves at risk. Thatís their decision. But, if someone goes out, parties, gets infected, that person will likely infect some other innocent person (or people) in the next few days before he even knows heís infected, putting innocent people at risk. And then someone will go to the hospital and put nurses and doctors at risk.
If I ski without a helmet and get a concussion, thatís all on me. This is different. One person infects other people, and lives are lost.
I hate this now- I do. But itís too early to relax. Social distancing works.

[Edited on 4/18/2020 by stormyrider]

 

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True Peach



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  posted on 4/18/2020 at 10:02 AM
I really really want some additional economic activity. I want to push for it. But I also see waiting for cases declining as being very prudent. It's a way to justify, a way to explain what is happening and why and what is not happening and why. I'm anxious too, but I understand this. Cases declining is a key metric.

Lots of protests now. Ohio has had protests outside the capital for 2 weeks now.

 

True Peach



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  posted on 4/18/2020 at 10:41 AM
Without trying to look at every state's graph, I found this which cites the IHME model for projecting 4 states having the ability to relax their orders. Even though they had a rather controversial projection of no covid-19 deaths after June, otherwise, I have found following data and projections from their model to be better than the rest.

quote:
At least four states may be able to loosen social distancing measures next month, an influential model tracking the coronavirus pandemic says.

The model's new projections show that Vermont, West Virginia, Montana and Hawaii could open as early as May 4.

While most states could open mid-to-late May, some states including Iowa, North Dakota, South Dakota, Nebraska, Utah, Arkansas and Oklahoma may need to wait until late June or early July.

Dr. Christopher Murray, the model's maker and director of the Institute for Health Metrics and Evaluation at the University of Washington, said some of those states should not relax social distancing because the outbreak is still "unfolding."

"You gotta wait until the level of cases in the community is at a manageable level," he said.
Murray said the challenge will be figuring out how to reopen the US economy and allowing people to get back to work without sacrificing mitigation.

"Each state is different," Murray said. "Each state has a different public health system, and different capabilities. This is not a 'one decision fits all' situation."

The model is now estimating a total of 60,308 deaths in the US by August 4. That's about 8,500 fewer deaths than predicted on Monday.

https://www.cnn.com/2020/04/17/health/us-coronavirus-friday/index.html



 
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