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  • in reply to: tweets … 3/13 thru 3/16 #112323
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    from This coronavirus is unlike anything in our lifetime, and we have to stop comparing it to the flu

    Business Insider

    https://www.yahoo.com/news/coronavirus-unlike-anything-lifetime-stop-201955346.html

    Our health care system doesn’t have the capacity to deal with this.

    Epidemiological experts keep talking about the need to “flatten the curve.” What they mean by that is that we need to slow the speed at which new cases are reported. We may not be able to stop the spread of the coronavirus, but we have to try to manage it. If 1,000 new cases happen over a month instead of a week, the health care system is more able to handle them.

    Here’s why this is a worry: Overall, our hospitals have fewer beds than other developed countries, according to recent data from the Organization for Economic Cooperation and Development. The United States had 2.8 beds per 1,000 residents. By comparison, Germany had 8 beds and China 4.3 per 1,000.

    The United States looks better when it comes to intensive care beds, but there’s tremendous variation between regions and states. If we experience what parts of China and Italy saw, we won’t have anywhere for sick patients to go. We will quickly run out of capacity.

    Even if we have the capacity, we may not have enough supplies.

    In a crisis moment, supplies like ventilators and N95 face masks will be key. But as National Geographic and other media have reported, the United States has only a fraction of the medical supplies it needs.

    “Three hundred million respirators and face masks. That’s what the United States needs as soon as possible to protect health workers against the coronavirus threat. But the nation’s emergency stockpile has less than 15 percent of these supplies,” the magazine reported.

    Others have reported shortfalls as well, and ProPublica has been hearing from health care professionals across the country who say their own institutions are running short of supplies. (Share your story here.)

    U.S. Surgeon General Jerome Adams tweeted at the end of February, “Seriously people- STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!”

    Another challenge: Hospital staff have been exposed too.

    And if that weren’t enough, there’s another problem. Health care workers who have been exposed to the virus are now quarantining themselves, further reducing available staff at hospitals. Kaiser Health News reported on the effects of this:

    “In Vacaville, California, alone, one case — the first documented instance of community transmission in the U.S. — left more than 200 hospital workers under quarantine and unable to work for weeks.

    “Across California, dozens more health care workers have been ordered home because of possible contagion in response to more than 80 confirmed cases as of Sunday afternoon. In Kirkland, Washington, more than a quarter of the city’s fire department was quarantined after exposure to a handful of infected patients at the Life Care Center nursing home.”

    This week, Banner Health in Colorado informed employees that a co-worker is among those with the coronavirus, The Colorado Sun reported. “People who came into prolonged, close contact with the woman in a Banner Health emergency room are being notified and asked to home-quarantine for 14 days, according to a source close to the investigation who spoke to The Sun on the condition of anonymity.”

    And my ProPublica colleagues reported Friday how some EMS workers are also being quarantined because of exposure. (It didn’t help, of course, that the EMS system was slow to get up to speed on the threat.)

    More than that, many health care workers have children and as schools begin to close, they have to figure out how to care for their own families.

    People in rural areas will have little care nearby should they be affected by COVID-19.
    Rural areas in the U.S. are losing their hospitals entirely, and residents are having to travel hours for care. According to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill, 126 rural hospitals have closed since 2010, including six so far this year. That’s about 6%.

    An analysis by the Chartis Center for Rural Health and iVantage Health Analytics this year found that about a quarter of the nation’s 1,844 open rural hospitalsare vulnerable.

    As The Washington Post described it last year, “Hospitals like Fairfax Community [in Oklahoma] treat patients that are on average six years older and 40 percent poorer than those in urban hospitals, which means rural hospitals have suffered disproportionately from government cuts to Medicaid and Medicare reimbursement rates. They also treat a higher percentage of uninsured patients, resulting in unpaid bills and rising debts.

    “A record 46 percent of rural hospitals lost money last year. More than 400 are classified by health officials as being at ‘high risk of imminent failure.’ Hundreds more have cut services or turned over control to outside ownership groups in an attempt to stave off closure.”

    in reply to: politics & the virus #112316
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    ‘Stealth Attack on Social Security’: Trump Condemned for Exploiting Coronavirus Crisis to Push Payroll Tax Cut

    from Facebook:

    Bob Metzger: I dug deeper into this, and the “payroll tax cut” that he has proposed is simply and solely an elimination of the Social Security tax paycheck deductions, and evidently both the employer and employee halves. So, regardless of any positive affect it might have, it would severely accelerate the demise of the Social Security system. So, seniors who rely on the monthly checks from the system that they paid into for ~50 years, to live indoors and eat, would soon be SOL, and likely told they should have planned better. Yet those who DID accumulate savings of their own over those same 50+ years have seen them battered over the past few weeks by the 20%+ drop in the equities markets. He must be relying on this virus to pretty much wipe out huge numbers of us gov’t-teat-sucking, unproductive retirees…

    in reply to: Exit poll discrepancy & other voter suppression news #112314
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    Maricopa County cuts some polling places, won’t mail extra ballots for Tuesday’s election
    Jessica Boehm and Andrew Oxford, Arizona RepublicPublished 1:04 p.m. MT March 13, 2020 | Updated 5:40 p.m.

    https://www.azcentral.com/story/news/local/phoenix/2020/03/13/maricopa-county-mailing-ballots-democratic-presidential-preference-tuesday-election-coronavirus/5044933002/

    Maricopa County’s election leaders announced conflicting plans to address coronavirus concerns surrounding Tuesday’s Presidential Preference Election — but a judge quashed one of them.

    The Maricopa County Board of Supervisors and the Maricopa County Recorder’s Office split authority over elections. The board controls Election Day voting and emergency voting, and the recorder controls voter registration and early voting.

    The Board of Supervisors announced that it will cut about 80 polling locations on Election Day due to polling locations and poll workers canceling, and a lack of needed cleaning supplies to stock all locations.

    The remaining 151 polling locations will be converted to vote centers, meaning a voter can vote at any location — not just the one nearest to them.

    “Folks should come on Election Day if they want to vote,” Supervisor Bill Gates said. “It’s going to be safe and there will be many places to do that.”

    Hours earlier, Recorder Adrian Fontes announced that his office would mail ballots to registered Democrats who have not yet cast ballots in Tuesday’s Democratic Presidential Preference Election.

    “We are in unchartered territory with the COVID-19. My first concern is to protect the health of the voters and staff who work in the polling places while maintaining the integrity of the election. Anything we can do to minimize human interaction in the polling place is what we must do,” Fontes said in a statement.

    As a public service, The Arizona Republic is offering all coverage of the pandemic free of charge. Support The Republic by subscribing to azcentral.com.

    Fontes’ plan was for ballots to arrive in mailboxes Monday and Tuesday, and encourage people to fill them out at home and drop them off at bins stationed at the entrance of polling places.

    That would have limited contact with poll workers or other individuals. Health experts have recommended this kind of “social distancing.”

    The Board of Supervisors said that while it can’t control what Fontes does, it did not agree with his plan and feared it would cause confusion for voters.

    Legal authority unclear

    It’s not clear whether Fontes, a Democrat, actually had the legal authority to do what he wanted to do — he admitted that “there is no authority to mail ballots to all voters under the law, but there is no prohibition either.”

    Arizona Attorney General Mark Brnovich, a Republican, disagreed with Fontes, saying the recorder “cannot unilaterally rewrite state election laws.” Brnovich filed a lawsuit against Fontes and sought a temporary restraining order to prevent him from sending out the ballots.

    Mark Brnovich@GeneralBrnovich
    We are on our way to court now to file a motion for TRO and a Preliminary Injunction against Adrian Fontes and Runbeck Election Services to stop them from violating Arizona law.

    The Maricopa County Recorder cannot unilaterally rewrite state election laws. In times of crisis, the public looks to our elected officials to follow the law and to not make reactionary decisions for political gain.

    “Fontes is creating chaos in our elections during an already difficult time. In times of crisis, the public looks to our elected officials to follow the law — not make reactionary decisions for political gain,” Brnovich said.

    Friday night, a Maricopa County Superior Court judge agreed with Brnovich and granted the restraining order, stopping Fontes from sending out ballots.

    The state’s top elections official, Secretary of State Katie Hobbs, also told Fontes that he did not have the authority to mail a ballot to voters who have not requested one.

    “As you know, I fully agree with you that authority for counties to conduct all-mail elections is good policy, and certainly an appropriate contingency plan in the event of a public health emergency like this. Unfortunately, it is not currently authorized by the law,” she wrote in an email to Fontes provided to The Republic.

    Hobbs, a Democrat like Fontes, said she is working with others on legislation that would allow election officials to authorize all-mail elections in emergencies and move certain election-related deadlines.

    in reply to: Exit poll discrepancy & other voter suppression news #112313
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    the vid:

    • This reply was modified 6 years, 5 months ago by Avatar photozn.
    in reply to: politics & the virus #112307
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    in reply to: Social aspects of the Virus situation #112304
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    .

    Typical kind of argument you find out there

    .

    Sam Monson@PFF_Sam
    They’ve shut down the St Paddy’s parades IN IRELAND.

    If the Irish themselves think it’s time to knock the Paddy’s day celebrations on the head for the moment, maybe hold fire.

    Tom Schuba@TomSchuba
    “I’m not about to put my life on hold because this is going around,” said Kyle Thomas, a nurse from Colorado who flew in to celebrate St. Patrick’s Day with his Chicago friends.

    Alex from Chicago@SKOL_doctor
    Some people made plans to see friends that they may only be able to see once per year. I’m not gonna criticize people for not following your agenda. To each their own.

    Sam Monson@PFF_Sam
    It’s not my agenda, jackass. It’s the agenda of medical experts that value the lives of the vulnerable over some guy’s trip to see friends

    Eric Eager@PFF_Eric
    “To each their own” is literally someone demonstrating that they don’t have a clue about what’s going on

    in reply to: draft delayed till May? or not? #112302
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    They’ve Contained the Coronavirus. Here’s How.
    Singapore, Taiwan and Hong Kong have brought outbreaks under control — and without resorting to China’s draconian measures.

    March 13, 2020

    link https://www.nytimes.com/2020/03/13/opinion/coronavirus-best-response.html

    HONG KONG — While the spread of Covid-19 is picking up speed in Europe and the United States, among other regions, the outbreaks in some countries in Asia seem to be under control.

    The epidemic in China appears to be slowing down after an explosion in cases followed by weeks of draconian control measures. And other locations have managed to avert any major outbreak by adopting far less drastic measures: for instance, Hong Kong, Singapore and Taiwan.

    All have made some degree of progress, and yet each has adopted different sets of measures. So what, precisely, works to contain the spread of this coronavirus, and can that be implemented elsewhere now?

    In late January, after a sluggish — and problematic — initial response, the government of mainland China put in place unprecedented containment and social distancing measures. It locked down major cities, notably Wuhan, the epicenter of the outbreak, and imposed various travel restrictions throughout the country.

    The testing capacity of laboratories was rapidly expanded. To relieve pressure on hospitals, patients with milder symptoms were placed in temporary isolation facilities set up in gymnasiums and event halls. New hospitals were constructed.

    People who had come into contact with anyone infected were sent to designated facilities, typically converted hotels or hostels, for prophylactic quarantine. Home quarantine was advised only for those only at slight risk of infection.

    Initially, almost all residents of Wuhan and other affected cities were required to stay at home; schools and workplaces remained closed well after the end of the Lunar New Year festival, around Jan. 27.

    The scale of these measures has been extraordinary: Almost 60 million people were placed under lockdown in Hubei Province alone, and most factories in the province are expected to remain shut until March 20. The economic costs are enormous. Already in early February, about one-third of approximately 1,000 small and medium-size businesses interviewed for one survey said they had only enough cash to survive for a month.

    But the restrictions seemed to have worked to contain the spread of Covid-19 in China: The number of new cases reported every day is now consistently much lower than it was a few weeks ago.

    But lockdowns and forced quarantines on this scale or the nature of some methods — like the collection of mobile phone location data and facial recognition technology to track people’s movements — cannot readily be replicated in other countries, especially democratic ones with institutional protections for individual rights.

    And so Singapore, Taiwan and Hong Kong might be more instructive examples. All three places were especially vulnerable to the spread of the infection because of close links with mainland China — especially in early January, as they were prime destinations for Chinese travelers during the upcoming Lunar New Year holiday. And yet, after all three experienced outbreaks of their own, the situation seems to have stabilized.

    As of midday Friday, Singapore had 187 cases confirmed and no deaths (for a total population of about 5.7 million), Taiwan had 50 confirmed cases including 1 death (for a total population of about 23.6 million) and Hong Kong had 131 confirmed cases including 4 deaths (for a total population of about 7.5 million).

    Since identifying the first infections (all imported) on their territories — on Jan. 21 in Taiwan and on Jan. 23 in both Hong Kong and Singapore — all three governments have implemented some combination of measures to (1) reduce the arrival of new cases into the community (travel restrictions), (2) specifically prevent possible transmission between known cases and the local population (quarantines) and (3) generally suppress silent transmission in the community by reducing contact between individuals (self-isolation, social distancing, heightened hygiene). But each has had a different approach.

    Singapore, an island, could readily take aggressive measures to block the arrival of the infection from China — and it did. Three days after the Chinese authorities alerted the world about the outbreak in Wuhan, Singapore started referring inbound travelers from Wuhan with a fever and respiratory symptoms for further assessment and isolation. It was also one of the first countries to cancel all inbound flights from Wuhan after identifying its first imported case.

    Travelers coming from affected areas were placed under mandatory quarantine; three university hostels were promptly converted into facilities to host them. The government compensated individuals and employers for any workdays lost.

    The Singapore authorities undertook especially intensive efforts to trace the contacts of people known to be infected. Hospital staff went to great lengths to interview patients about their recent whereabouts; when information was unclear or unavailable, the Ministry of Health retrieved additional data from transport companies and hotels, including by consulting CCTV footage.

    Large gatherings have been suspended. But to minimize social and economic costs, schools and workplaces have remained open. The Singaporean Ministry of Education — on an extensive FAQs web page — calls the closing of schools “a major, major decision” that would “disrupt many lives.” Instead, students and staff are subjected to daily health checks, including temperature screenings.

    Public-health campaigns were also reinforced to further improve Singapore’s already exemplary standards of cleanliness and public hygiene. A special government task force recently recommended five personal hygiene habits:using a tissue when coughing or sneezing; using designated serving spoons during group meals; using trays when eating or drinking to limit contamination in case of spills; keeping public toilets clean and dry; and regular hand washing. From the outset, the government has recommended the use of masks only for people who already are unwell.

    Taiwan, also an island, took a slightly different tack. Instead of promptly banning travel from China, it undertook a comprehensive effort to screen newcomers from suspect areas. As soon as early January — just days after the news of the outbreak in Wuhan — Taiwanese medical authorities would board incoming flights from Wuhan and inspect and screen travelers on the planes.

    It was only after the first imported case was identified on Jan. 21 that four major airlines suspended flights between Taiwan and Wuhan. A ban on all but flights from Beijing, Shanghai, Xiamen and Chengdu was implemented three weeks later.

    Taiwan has also taken a rather mixed approach in its efforts to reduce transmission within the community.

    Some state-run facilities have been used for quarantines, but home quarantine has been the predominant method of isolation even when state facilities were available. To ensure compliance, the government has enforced strict penalties against anyone who breaks an isolation order, including fines up to about $33,200.

    Organizers of mass events were encouraged to defer or cancel events; some religious institutions suspended services. It was announced that elementary schools and high schools would remain closed after the end of the Lunar New Year holidays, but only for two weeks. In fact, classes resumed on Feb. 25.

    The Taiwanese authorities also oversaw the controlled distribution of surgical masks from existing stockpiles through community stores, having also fixed their price. Taiwan’s main health messages — “Wear a surgical mask when coughing or sneezing,” “Wash hands thoroughly with soap” and “Avoid crowded places, including hospitals” — were displayed prominently on the Centers for Disease Control’s website.

    As of Friday, about 58 percent of all confirmed cases in Taiwan were believed to have resulted from local transmission. This is an important marker of success for Taiwan’s containment strategy: In many other places, local cases outnumbered imported infections by a far greater margin.

    Hong Kong adopted yet another approach, presumably in part because, unlike Taiwan and Singapore, the city shares a border with mainland China and is formally part of China, as a Special Administrative Region. (An average of 300,000 people crossed the border every day last year.) The authorities here focused less on completely blocking the entry of possibly infected people into the territory than on preventing transmission within the community.

    On Jan. 3 — again, very soon after the first declared case in Wuhan — existing temperature-screening stations at ports of entry were expanded, and local clinicians were asked to report to the city’s health authorities any patient with a fever or acute respiratory symptoms and a history of recent travel to Wuhan.

    But it took five days after the first imported case for travel restrictions to be placed on visitors from Wuhan and other affected areas and for six of the territory’s 14 border crossings with the mainland to be closed. (Another five crossings were closed later.) The number of visitors to Hong Kong from mainland China fell to a daily average of 750 in February.

    Starting on Feb. 5, anyone coming across the border — or arriving from elsewhere who had been in mainland China in the preceding 14 days — was required to undergo a mandatory 14-day period of self-quarantine.

    Extensive efforts have also been made to track down and quarantine the close contacts of confirmed cases. And in the event transmission might occur before an infected person displayed any symptoms, tracing included all contacts starting two days before the onset of the patient’s illness.

    Of Hong Kong’s 40,000 hospital beds, some 1,000 are negative-pressure beds, allowing confirmed cases to be properly isolated. Holiday camps and newly constructed public-housing units that were still vacant were rapidly repurposed into quarantine facilities.

    As of March 12, 62 of the city’s 131 confirmed cases were thought to have resulted from close contact with other confirmed cases. More than 24,700 people were still under quarantine this week.

    Hong Kong has also deployed very extensive measures to encourage social distancing. As early as Jan. 28, many civil servants were asked to work from home for the following month. Most large-scale events have been canceled or postponed. On Jan. 27, all kindergartens and schools were closed until Feb. 16; the decision was extended several times, most recently to at least April 20. Many classes have been conducted online.

    Although it’s still not clear whether or how much children contract and spread Covid-19, they are known major contributors to the transmission of influenza, and Hong Kong has been effective in stemming outbreaks of the flu by suspending classes four times over the past 12 years (in 2008, 2009, 2018 and 2019). Closing schools is a very invasive measure, but Hong Kong has a social structure that helps cushion some of the burden: Many families with two working parents already rely on domestic helpers or grandparents for child care.

    The government has mounted a public-education campaign to promote hand hygiene and environmental hygiene. Nearly everyone in Hong Kong wears a face mask in public.

    And now, the caveats. Singapore, Taiwan and Hong Kong, as well as China, all had to contend with the SARS outbreak of 2002-3 and they internalized the lessons of that experience. Institutionally, this has meant, among other things, that they developed testing capacity for new viruses as well as hospitals’ ability to handle patients with novel respiratory pathogens. At the individual level, the experience of SARS has prepared people to voluntarily display a tremendous amount of self-discipline in, say, avoiding crowds and heightening their personal hygiene. These places were better equipped to face an outbreak of the new coronavirus than many others.

    At the same time, if the inroads Singapore, Taiwan and Hong Kong — China, too — have made against Covid-19 are promising, these gains also are fragile. These governments will need to keep at their containment measures for many more months or else risk a surge in infections. Taiwan seems especially vulnerable because it appears not to be testing people enough.

    The Chinese government has taken something of a victory lap recently, prematurely. But even it seems to know that, despite its bluster: Judging from bans China is now imposing on travelers from certain European countries, it is well aware that cases of infection could be reintroduced from abroad.

    Containment, however valiant an aim, also comes with very high costs, social and economic, and it might be an impossible goal for some countries, especially by now. In some places, Covid-19 could already be too widespread to be stopped. The vast majority of infections still appear to be mild, though; many might not even require medical attention. In such cases, it would be better to forgo trying to contain the disease and instead focus on mitigating its worst effects, for example, by concentrating resources on preventing an overwhelming surge in demand for hospital care, particularly intensive care.

    Still, the central point is this: Each in its own way, Singapore, Taiwan and Hong Kong — three places with markedly different socioeconomic and political features — have been able to interrupt the chain of the disease’s transmission. And they have done so without embracing the highly disruptive, drastic measures adopted by China. Their success suggests that other governments can make headway, too.

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    Italy’s Health Care System Groans Under Coronavirus — a Warning to the World
    In less than three weeks, the virus has overloaded hospitals in northern Italy, offering a glimpse of what countries face if they cannot slow the contagion.

    link https://www.nytimes.com/2020/03/12/world/europe/12italy-coronavirus-health-care.html

    ROME — The mayor of one town complained that doctors were forced to decide not to treat the very old, leaving them to die. In another town, patients with coronavirus-caused pneumonia were being sent home. Elsewhere, a nurse collapsed with her mask on, her photograph becoming a symbol of overwhelmed medical staff.

    In less than three weeks, the coronavirus has overloaded the health care system all over northern Italy. It has turned the hard hit Lombardy region into a grim glimpse of what awaits countries if they cannot slow the spread of the virus and ‘‘flatten the curve’’ of new cases — allowing the sick to be treated without swamping the capacity of hospitals.

    If not, even hospitals in developed countries with the world’s best health care risk becoming triage wards, forcing ordinary doctors and nurses to make extraordinary decisions about who may live and who may die. Wealthy northern Italy is facing a version of that nightmare already.

    “This is a war,” said Massimo Puoti, the head of infectious medicine at Milan’s Niguarda hospital, one of the largest in Lombardy, the northern Italian region at the heart of the country’s coronavirus epidemic.

    He said the goal was to limit infections, stave off the epidemic and learn more about the nature of the enemy. “We need time.”

    This week Italy put in place draconian measures — restricting movement and closing all stores except for pharmacies, groceries and other essential services. But they did not come in time to prevent the surge of cases that has deeply taxed the capacity even of a well-regarded health care system.

    Italy’s experience has now underscored the need to act decisively — quickly and early — well before case numbers even appear to reach crisis levels. By that point, it may already be too late to prevent a spike in cases that stretches systems beyond their limits.

    With Italy having appeared to pass that threshold, its doctors are finding themselves in an extraordinary position largely unseen by developed European nations with public health care systems since the Second World War.

    Regular doctors are suddenly shifting to wartime footing. They face questions of triage as surgeries are canceled, respirators become rare resources, and officials propose converting abandoned exposition spaces into vast intensive care wards.

    Hospitals are erecting inflatable, sealed-off infectious disease tents on their grounds. In Brescia, patients are crowded into hallways.

    Get an informed guide to the global outbreak with our daily coronavirus newsletter.

    “We live in a system in which we guarantee health and the right of everyone to be cured,” Prime Minister Giuseppe Conte said on Monday as he announced the measures to keep Italians in their homes.

    “It’s a foundation, a pillar, and I’d say a characteristic of our system of civilization,” he said. “And thus we can’t allow ourselves to let our guard down.”

    For now, Italian public health experts argue that the system, while deeply challenged, is holding, and that all the thousands of people receiving tests, emergency room visits and intensive care, are getting it for free, keeping a central principle of Italian democracy intact.

    But before the region of Lombardy centralized its communication on Thursday and seemed to muzzle doctors and nurses who spoke out about the conditions, there emerged troubling pictures of life inside the trenches against the infection.

    A photo of one nurse, Elena Pagliarini, who collapsed face down with her mask on in a hospital in the northern town of Cremona after 10 straight hours of work, became a symbol of an overwhelmed system.

    “We are on our last legs, physically and physiologically,” Francesca Mangiatordi, a colleague who took the picture said on Italian television on Wednesday, urging people to protect themselves to avoid spreading the virus. “Otherwise the situation will collapse, provided it hasn’t already.”

    A doctor in a hospital in Bergamo this week posted on social media a graphic account of the stress on the health system by the overwhelming number of patients.

    “The war has literally exploded and battles are uninterrupted day and night,” the doctor, Daniele Macchini wrote, calling the situation an “epidemiological disaster” that has “overwhelmed” the doctors.

    Fabiano Di Marco, head of pulmonology at the Papa Giovanni XXIII hospital in Bergamo, where he has taken to sleeping in his office, said Thursday that doctors literally “draw a line on the ground to divide the clean part of the hospital from the dirty one,” where anything they touch is considered contagious.

    Giorgo Gori, the mayor of Bergamo, said that in some cases in Lombardy the gap between resources and the enormous influx of patients “forced the doctors to decide not to intubate some very old patients,” essentially leaving them to die.

    “Were there more intensive care units,” he added, “it would have been possible to save more lives.”

    Dr. Di Marco disputed the claim of his mayor, saying that everyone received care, though he added, “it is evident that in this moment, in some cases, it could happen that we have a comparative evaluation between patients.”

    On Thursday, Flavia Petrini, the president of the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care, said her group had issued guidelines on what to do in a period that bordered on wartime “catastrophe medicine.”

    “In a context of grave shortage of health resources,” the guidelines say, intensive care should be given to “patients with the best chance of success” and those with the “best hope of life” should be prioritized.

    The guidelines also say that in “in the interests of maximizing benefits for the largest number,” limits could be put on intensive care units to reserve scarce resources to those who have, first, “greater likelihood of survival and secondly who have more potential years of life.”

    “No one is getting kicked out, but we’re offering criteria of priority,” Dr. Petrini said. “These choices are made in normal times, but what’s not normal is when you have to assist 600 people all at once.”

    Giulio Gallera, the Lombardy official leading the emergency response, said on Thursday that he hoped the guidelines never needed to be applied.

    He also said the region was working with Italy’s civil protection agency to study the possibility of using an exhibition space abandoned by canceled conventions as a 500-bed intensive care ward.

    But, he said, the region needed doctors, and respirators.

    “The outbreak has put hospitals under a stress that has no precedents since the Second World War,” said Massimo Galli, the director of infectious diseases at Milan’s Sacco University hospital, which is treating many of the coronavirus patients. “If the tide continues to rise, attempts to build dams to retain it will become increasingly difficult.”

    Dr. Galli pointed out that while the government’s emergency decrees had sought to boost the hiring of thousands of doctors and health workers — including medical residents in their last years of medical school — it took time to train new doctors, even those transferred from other departments, who had little experience with infectious diseases. Doctors are also highly exposed to contagion.

    Matteo Stocco, the director of the San Paolo and San Carlo hospitals in Milan, said 13 members of his staff were home after testing positive for the virus. One of his primary emergency room doctors was also infected, he said, “after three weeks of continuous work, day and night on the field.”

    Dr. Puoti, of Niguarda hospital, said the doctors kept distance from one another in the cafeteria, wore masks during staff meetings and avoided gathering in small rooms. Still, he said, some had been infected, which created the risk of greater personnel shortages.

    “We’re trying to keep a humanly sustainable level of work,” he said. “Because this thing is going to last.”

    He said the hospital was trying to buy more respirators and preparing for the possibility that patients would come not only from the surrounding towns, but because of a wave of infections in Milan.

    Dr. Stocco said that moment had already arrived.

    Fifty people showed up in the emergency room on Thursday afternoon with respiratory problems, he said. The hospital had already canceled surgeries and diverted beds and respirators to coronavirus patients, and doubled its intensive care capacity.

    “The infection is here,” he said.

    Carlo Palermo, president of the association representing Italy’s public hospital doctors, said the system had so far held up, despite years of budget cuts. It also helped, he said, that it was a public system. Had it been an insurance-based system, there would have been a “fragmented” response, he said.

    He said that since about 50 percent of the people who tested positive for the virus required some form of hospitalization, there was an obvious stress on the system. But the 10 percent needing intensive care, which requires between two and three weeks in the hospital, “can saturate the capacity of response.”

    Many experts have noted that if the wealthy and sophisticated northern Italian health care system cannot bear the brunt of the outbreak, it is highly unlikely that the poorer south would be able to cope.

    If the virus spread south at the same rate, Dr. Palermo said, “the system won’t hold up, and we won’t be able to assure care.”

    Many experts have warned that Italy is about 10 days ahead of other European countries in the development of its outbreak. Chancellor Angela Merkel of Germany has raised the alarm that about 70 percent of Germans could get the virus.

    And reports of the overwhelmed Italian system have resonated in the United States, where President Trump closed flights to foreigners coming from Europe on Wednesday night.

    “The Italian disease is becoming a European disease and Trump, with his decision, is trying to avoid that this becomes an American disease,” said Romano Prodi, a former Italian prime minister and president of the European Union commission.

    “In any case I think that coronavirus is already also an American problem,” he said, adding that, because of the difference in the health care system, “it may be more serious than the European one.”

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    in reply to: US health care system costs 4X more than Canada’s M4A #112295
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    Briahna Joy Gray@briebriejoy
    Regretfully, Joe Biden’s healthcare plan discriminates against those too poor to pay. It leaves 10 million Americans behind, & will result in 125k unnecessary deaths over 10 years.

    Either healthcare is a human right, or it isn’t.

    #MedicareForAll
    #Bernie2020
    #LeaveNoonebehind https://twitter.com/JoeBiden/status/1238957075637497856

    in reply to: politics & the virus #112292
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    Mel Moorer Rainbow flag@knownforms
    For those of you who didn’t live through AIDS killing 25,000 people while your president laughed and joked about it and did nothing before the government even acknowledged the disease, we’ve seen this before. For those of us reliving this trauma, know that your pain is real.

    in reply to: politics & the virus #112289
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    in reply to: sports & the Coronavirus (Rams, NBA, etc) #112281
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    in reply to: politics & the virus #112280
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    Chris Murphy@ChrisMurphyCT
    Imagine the hourly worker with a low fever and cough, but no paid sick leave. He can’t afford to miss a day’s paycheck. He’s thinking of going to work Monday.

    There’s a bill, sitting on the Senate floor RIGHT NOW, that solves his problem.

    But McConnell says the bill can wait?

    in reply to: tweets … 3/13 thru 3/16 #112274
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    in reply to: tweets … 3/13 thru 3/16 #112273
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    in reply to: tweets … 3/13 thru 3/16 #112272
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    in reply to: sports & the Coronavirus (Rams, NBA, etc) #112256
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    in reply to: sports & the Coronavirus (Rams, NBA, etc) #112245
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    in reply to: Exit poll discrepancy & other voter suppression news #112231
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    I don’t know what to make of this. Sounds so Conspiracy Theory.

    And yet…before 2016, exit polls were really accurate.

    I dunno.

    But I am pretty darn full of suspicion. Spidey sense goin off.

    in reply to: tweets … 3/13 thru 3/16 #112226
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    in reply to: signs, comics, memes, & other visual aids #112218
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    in reply to: sports & the Coronavirus (Rams, NBA, etc) #112216
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    Deadpool

    I have to imagine with travel restrictions amongst teams rising, here are some problems that will arise:

    1. I imagine the 30 player individual meetings will get cancelled. So you lose a chance to meet a guy in person.

    2. Medical rechecks that happen back in Indy down the road for anyone that had a medical red flag. Not great for the injured kid.

    3. Any player that couldn’t/wouldn’t test at the combine and was waiting for a Pro Day or personal workout day. Pro days are done or will be poorly attended.

    A team like the Rams that didn’t do a ton of combine interviews and didn’t have coaches at the combine are going to feel this. They now probably won’t have the chance to meet these kids in person, or have them in for a workout.

    Its unfortunate, and totally understandable, and at the same time impossible to predict, but it could be a real scramble coming down the stretch for Rams FO and scouting dept.

    The kids in the draft that are going to feel this the most are the ones with medical issues, kids with character issues and kids that flat out didn’t work out. I could really see some of these kids slide as the information teams usually can gather isn’t there.

    Anyhow, some food for thought as the draft and FA approaches.

    in reply to: This President has got to go #112214
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    ZN,

    Thanks for rescuing my post from Purgatory.

    ;>)

    Hope everyone is healthy and safe.

    Wash your hands, people!!

    Sry sometimes I can’t get to the board as soon as I would like.

    Keep postin tho, I’ll keep things moving from my end.

    in reply to: virus news … (+ some dark humor) #112213
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    in reply to: tweets … 3/6 thru 3/12 #112211
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