The Walls Come Down: No Travel Betwen US and Europe for 30 Days

[LaCroix]

What the fuck, UK?

38k cases, 3.6k deaths already and 7-800 deaths per day?

So much for the herd immunity approach...

[ray245]

What the fuck, UK?

38k cases, 3.6k deaths already and 7-800 deaths per day?

So much for the herd immunity approach...

That's what happens when the data scientists and mathematicians became the dominant voice amongst the scientists, because they base their assumption on this virus being similar to H1N1 Flu.

[Captain Seafort]

7-800 deaths per day?

No. Not yet anyway. We had 500-odd for the last couple of days, and 600-odd today. I'll be pleasantly surprised if we don't break 700 tomorrow, but we're not there yet.

So much for the herd immunity approach...

Herd immunity is the only possible way out of this. How long it takes, how many people die in the interim, what the economic effects are, and whether we achieve it through vaccination or infection are all variables, but it's the only possible solution.

[MKSheppard]

As of around 4 PM Eastern:

[MKSheppard]

It looks like a comprehensive answer to all the questions about sterilizing and reusing masks.

Information and FAQs on the Performance, Protection, and Sterilization of Face Mask Materials

Covers filter materials, construction, sterilization methods, and results

ETA: some interesting take-aways include the facts that both steam and boiling water can be used for sterilizing N95s WITHOUT compromising the electret properties, but alcohol is a no-go.

[MKSheppard]

Microwaves may be useful:

LINK 1

LINK 2

Basically, it appears standard home microwaves 700 to 800W are useful in killing viruses; but there are some provisos:

You need to nuke it for 3 minutes to be really sure (particularly if you have a lower watt one).

N95 masks can't be nuked unless metal parts are removed. But surgical masks could be nuked.

I think microwaves and small ovens most useful task would be in sterilizing mail if you live with someone who ABSOLUTELY MUST read their mail today, and not wait 24 hours.

Basically, nuke mail for maybe 30 seconds?

It goes without saying that if you use microwaves or heat (ovens) to sterilize mail or masks, you better watch it and have a fire extinguisher handy.

[Ziggy Stardust]

That's what happens when the data scientists and mathematicians became the dominant voice amongst the scientists, because they base their assumption on this virus being similar to H1N1 Flu.

There's nothing even remotely true about this statement, speaking as a statistician who works in global health studying infectious diseases.

[mr friendly guy]

Herd immunity is the only possible way out of this. How long it takes, how many people die in the interim, what the economic effects are, and whether we achieve it through vaccination or infection are all variables, but it's the only possible solution.

I don't think anyone aside from anti vaxxers objects to herd immunity via vaccines. Boris's plan of herd immunity by infecting 60% of the population and shrugging when people die because the health system was overburden is a problem though.

Berlin says that US confiscated 200,000 masks (FFP2 and FFP3) at airport in Bangkok that were ordered for Berlin police. Masks were produced by a 3M factory (US company) in China. City of Berlin says this is "modern piracy" and urges Merkel government to address this with the US.

https://t.co/2kXfFCGOHq

More details

https://www.reuters.com/article/us-heal ... SKBN21L253

U.S. coronavirus supply spree sparks outrage among allies
Richard Lough, Andreas Rinke
6 MIN READ

PARIS/BERLIN (Reuters) - From Europe to South America, U.S. allies are complaining about the superpower’s “Wild West” tactics in outbidding or blocking shipments to buyers who have already signed deals for vital medical supplies.

In France and Germany, senior officials said the United States was paying far above the market price for medical-grade masks from No. 1 producer China, on occasion winning contracts through higher bids even after European buyers believed a deal was done, and Brazil’s health minister reported a similar incident.

“Money is irrelevant. They pay any price because they are desperate,” one high-level official in German Chancellor Angela Merkel’s ruling CDU/CSU group told Reuters.

A German government source said: “Americans are on the move, carrying a lot of money.”

Since the virus was first recorded in China late last year, the pandemic has spread around the world. Governments in Europe, the Americas and elsewhere are desperately trying to build up supplies for medics, nursing home staff and the public.

Now, with global cases surpassing one million and the outbreak exploding in the United States, the competition for precious stocks is intensifying further.

U.S. President Donald Trump said on Friday that the U.S. government is now recommending Americans wear cloth face coverings on a voluntary basis to stem the spread of the virus, but the guidance from the Centers for Disease Control and Prevention (CDC) does not recommend wearing medical-grade masks.

He also said he was signing a directive to stop the export of N95 respirator masks, which provide essential protection for healthcare workers, and other U.S. medical equipment.

U.S.-listed multinational 3M Co said Friday that the White House had ordered it to stop all shipments to Canada and Latin America of respirators that it manufactures in the United States, despite what 3M called “significant humanitarian implications.”

Canadian Prime Minister Justin Trudeau said the blocking the flow of equipment across the border would be a “mistake” that could backfire, noting that the country’s healthcare professionals go to work in Detroit every day.

In another case, an order of 200,000 masks bound for Germany from a 3M factory in China were “confiscated” in Bangkok, Berlin Secretary of Interior Andreas Geisel, said in a statement, calling it an “act of modern piracy.”

“Even in times of global crisis you shouldn’t use Wild West methods,” he said.

A U.S. Department of Homeland Security official told Reuters this week that U.S. companies and the government have been paying above market price for much of the gear purchased overseas.

The official, who requested anonymity to discuss the matter, said the United States would not stop buying “until we have way too much” and could still be searching out protective gear abroad through August.

“We’ve gotten our hands on every bit of it that we can,” the official said.

Lea Crager, a spokeswoman for the Federal Emergency Management Agency (FEMA), the agency coordinating the search for medical supplies abroad, said disasters often lead to price increases for certain goods.

“If it causes some sort of a supply chain disruption, you’re going to see costs rise for an essential commodity,” Crager said. “It just happens.”

In Brazil, Health Minister Luiz Henrique Mandetta said this week that China had ditched some Brazilian equipment orders when the U.S. government sent more than 20 cargo planes to the country to buy the same products.

“Our purchases, which we expected to complete in order to be able to supply, many were dropped,” said the minister in an interview on Wednesday.

Slideshow (4 Images)
On Thursday, Mandetta said Brazil had finally succeeded in placing a 1.2 billion reais ($228 million) order for equipment, although it will only be delivered in 30 days.

CASH IN HAND
A second German source employed by a company now helping Merkel’s government to order masks said the last weekend of March had been a turning point, and drew a link with the United States’ increased presence in the market.

Contracts no longer guaranteed delivery, the source said, adding: “Demand is much, much bigger than supply.”

In France, three regional leaders painted a similar picture. Jean Rottner said it was a constant fight to ensure mask orders arrived in his Grand Est region, where the outbreak first took hold before spreading west towards Paris.

He said consignments were changing hands at the last minute.

“On the (airport) tarmac, the Americans get out their cash and pay three or four times what we have offered,” Rottner told radio RTL France on Wednesday.

Rottner’s counterpart in the greater Paris region, Valerie Pecresse, said she had been beaten to an order by a country with deep pockets, although she did not name the United States.

“We found supplies a few days ago but failed to buy them after others outbid us,” Pecresse told Franceinfo radio on Friday. “They were prepared to pay three times the market price.”

The French Foreign Ministry said it was verifying the reports. But one official doubted that action would be taken.

“It boils down to market forces,” the official said. “The one who pays the most gets the prize.”

So this article suggests that the US is intercepting packages to Canada, France and Germany (which already has been posted here) and now also add in Brazil. Trump, making Chinese medical manufacturers great again.

[aerius]

Speaking of masks, I like how everyone in the US is screaming about how they need more ventilators to save those dying patients, but other than the front line medical personnel who need them, no one gives a shit about masks or mask production to help prevent the spread of the disease.

It's like we'll sell you these super expensive drugs to control your HIV/AIDS, but we don't care about condoms that can help prevent the spread of HIV.

Welcome to the US healthcare industry.

[The Romulan Republic]

The seizure of medical supplies already ordered by other nations is nothing short of an act of war against the world. Fuck international cooperation, since we're clearly not getting any from the US. Every affected country should expel US diplomats and start seizing US assets.

Berlin says that US confiscated 200,000 masks (FFP2 and FFP3) at airport in Bangkok that were ordered for Berlin police. Masks were produced by a 3M factory (US company) in China. City of Berlin says this is "modern piracy" and urges Merkel government to address this with the US.

Hostis humani generis (Latin for "enemy of mankind") is a legal term of art that originates in admiralty law. Before the adoption of public international law, pirates and slavers were already held to be beyond legal protection and so could be dealt with by any nation, even one that had not been directly attacked.

[The Romulan Republic]

Trump is robbing the world and dooming more people to death to cover for the cost of his own incompetence and corruption. Every nation will remember that the US took the supplies their people needed. By the time this is done, there won't be a nation left on Earth that wouldn't wipe its ass with the American flag. And I can't blame them.

[mr friendly guy]

Elon Musk tries to help. Oops he screwed up.
https://ftalphaville.ft.com/2020/04/01/ ... machines-/

Basically he promised ventilators but sent BiPAP machines. As I mentioned earlier, BiPAP and CPAP do non invasive ventilation, ie where pt is still conscious and the machine helps you breath. Ventilators do all the breathing for you, patient is unconscious and intubated.

Now BPAP and CPAP machines are sometimes called “non-invasive ventilators”, but these are not the ventilators that can be used in intensive care units, which are invasive ventilators that deliver oxygen to the lungs and are used as part of life support.

These invasive ventilators are the ones that much of the world is in such desperate need of. BPAP and CPAP machines are not normally called ventilators at all, and are far more common: according to Forbes there are more than 8 million CPAP users in the US alone.

As we wrote in an article last week, some techy types have been looking at ways in which CPAP machines could be repurposed to help with Covid-19. But even this would not be for the severe cases that require intensive care.

And there have even been warnings that CPAP or BPAP machines could make things worse. The American Society of Anesthesiologists on February 23 issued guidance warning that CPAP and BPAP machines “may increase the risk of infectious transmission”.

To give you an idea of quite how different a BPAP machine is from an ICU-grade ventilator, one of these bad boys will set you back around $800. That’s if you can still buy them — the machines that Musk and Tesla appear to have delivered to New York are the ResMed S9 Elite, which have now been discontinued. A ventilator, meanwhile, can cost as much as $50,000. So over 60 times more, in other words.

At least he isn't offering to build a submarine and calling people "pedo guy" when they think his attempt isn't helping.

[mr friendly guy]

More details on the US trying to stop other countries getting supply. 3M the company acknowledges the administration asked them to, but they declined for obvious reasons.

https://news.3m.com/press-release/compa ... -act-order

In the course of our collaboration with the Administration this past weekend, the Administration requested that 3M increase the amount of respirators we currently import from our overseas operations into the U.S. We appreciate the assistance of the Administration to do exactly that. For example, earlier this week, we secured approval from China to export to the U.S. 10 million N95 respirators manufactured by 3M in China.

The Administration also requested that 3M cease exporting respirators that we currently manufacture in the United States to the Canadian and Latin American markets. There are, however, significant humanitarian implications of ceasing respirator supplies to healthcare workers in Canada and Latin America, where we are a critical supplier of respirators. In addition, ceasing all export of respirators produced in the United States would likely cause other countries to retaliate and do the same, as some have already done. If that were to occur, the net number of respirators being made available to the United States would actually decrease. That is the opposite of what we and the Administration, on behalf of the American people, both seek.

[Zaune]

Elon Musk tries to help. Oops he screwed up.
https://ftalphaville.ft.com/2020/04/01/ ... machines-/

Basically he promised ventilators but sent BiPAP machines. As I mentioned earlier, BiPAP and CPAP do non invasive ventilation, ie where pt is still conscious and the machine helps you breath. Ventilators do all the breathing for you, patient is unconscious and intubated.

The thought was in the right place, I'll give him that much.

And is it possible they might still be somewhat useful for less acute cases, who need more than a simple O2 mask but can just about manage without a full ventilator?

[mr friendly guy]

And is it possible they might still be somewhat useful for less acute cases, who need more than a simple O2 mask but can just about manage without a full ventilator?

For COVID 19 patients, most probably not since we think it spreads the virus around.

[aerius]

The thought was in the right place, I'll give him that much.

And is it possible they might still be somewhat useful for less acute cases, who need more than a simple O2 mask but can just about manage without a full ventilator?

The only thought in Musk's mind was "SHIT I GOTTA DO SOMETHING TO GET CASHFLOW NOW THAT MY COMPANY GOT FUCKED BY THE LOCKDOWNS!!"

That's why he wants those ventilator contracts at $50k a pop which will save comparatively few lives since 85-90% of the people who end up on them end up dead instead of cranking up the production lines for cheap & cheery masks which will save way more lives by preventing infections and slowing down the spread of the disease.

Musk is as much of a sociopathic piece of shit as a Wall Street banker.

[mr friendly guy]

https://www.thelancet.com/journals/lanr ... 7/fulltext

A letter to the Lancet on why non invasive ventilation like BiPAP isn't currently advised for COVID 19 patients. I suppose Musk thoughts could have been in the right place even if he got the wrong device, but given his um, conduct in other cases you got to wonder.

[Zaune]

The only thought in Musk's mind was "SHIT I GOTTA DO SOMETHING TO GET CASHFLOW NOW THAT MY COMPANY GOT FUCKED BY THE LOCKDOWNS!!"

That's why he wants those ventilator contracts at $50k a pop which will save comparatively few lives since 85-90% of the people who end up on them end up dead instead of cranking up the production lines for cheap & cheery masks which will save way more lives by preventing infections and slowing down the spread of the disease.

Musk is as much of a sociopathic piece of shit as a Wall Street banker.

I think Musk's too self-aware about his public image to be a complete sociopath, but you're probably not wrong.

[Solauren]

Unfortunately, once you start having investors and shareholders, you pretty much have to become a sociopath to keep those investors and shareholders happy. (Because most of them are rich sociopath's themselves). Otherwise, they pull their money, or worse yet, use their money and influence to take over your company, and then kick you out.

[Jub]

How worth it is ventilating people at the current time anyway? Are the recovery rates for those that get that far worth the time spent caring for them when there are other priorities not being met?

[aerius]

How worth it is ventilating people at the current time anyway? Are the recovery rates for those that get that far worth the time spent caring for them when there are other priorities not being met?

According to the stats out of China, somewhere between 81-97% of the patients who end up on ventilators leave the building in a body bag. I'm guessing North America will probably be towards the lower end of that range outside of hot spots like NYC.

Problem is an extra 10,000 ventilators ain't gonna save nearly as many as you'd expect since we don't have the trained technicians to run them. According to my doc friend they're not set & forget machines, it takes a team of technicians to run them & monitor the patients and there's only so many machines they can handle at once.

[loomer]

Aren't the majority of the deceased with this either on vents or ventilator candidates anyway, because of how it kills?

[Jub]

How worth it is ventilating people at the current time anyway? Are the recovery rates for those that get that far worth the time spent caring for them when there are other priorities not being met?

According to the stats out of China, somewhere between 81-97% of the patients who end up on ventilators leave the building in a body bag. I'm guessing North America will probably be towards the lower end of that range outside of hot spots like NYC.

Problem is an extra 10,000 ventilators ain't gonna save nearly as many as you'd expect since we don't have the trained technicians to run them. According to my doc friend they're not set & forget machines, it takes a team of technicians to run them & monitor the patients and there's only so many machines they can handle at once.

Based on that it seems like it would be better to give the patients that need ventilation a nice overdose of some strong painkiller and let things run their course. Saving under 20%, with who knows how much function left, seems a waste of resources and manpower.

[loomer]

How worth it is ventilating people at the current time anyway? Are the recovery rates for those that get that far worth the time spent caring for them when there are other priorities not being met?

According to the stats out of China, somewhere between 81-97% of the patients who end up on ventilators leave the building in a body bag. I'm guessing North America will probably be towards the lower end of that range outside of hot spots like NYC.

Problem is an extra 10,000 ventilators ain't gonna save nearly as many as you'd expect since we don't have the trained technicians to run them. According to my doc friend they're not set & forget machines, it takes a team of technicians to run them & monitor the patients and there's only so many machines they can handle at once.

Based on that it seems like it would be better to give the patients that need ventilation a nice overdose of some strong painkiller and let things run their course. Saving under 20%, with who knows how much function left, seems a waste of resources and manpower.

Jesus christ, and you call my position garbage.

[whackadoodle]

How worth it is ventilating people at the current time anyway? Are the recovery rates for those that get that far worth the time spent caring for them when there are other priorities not being met?

According to the stats out of China, somewhere between 81-97% of the patients who end up on ventilators leave the building in a body bag. I'm guessing North America will probably be towards the lower end of that range outside of hot spots like NYC.

Problem is an extra 10,000 ventilators ain't gonna save nearly as many as you'd expect since we don't have the trained technicians to run them. According to my doc friend they're not set & forget machines, it takes a team of technicians to run them & monitor the patients and there's only so many machines they can handle at once.

Yup. 1 RT per 4 ventilators. Beyond that, fatality rate goes way up. No, you can't draft an orthopedic surgeon to paralyze, intubate and put mostly elderly patients on respirators.

Buy a billion ventilators, you can't shit out enough people to trank and intubate them.

Friend of mine at NYU: "Those refrigerator trucks are not Sysco food trucks."