CAN WE AUDIOPHILES DO OUR PART?

@millercarbon is spot on. As a physician I've been following the data very closely. We got this all wrong. Regardless of what any political wonks say.

So this is a thread about what we can do. millercarbon is right. We can do whatever we can to undo the mess that our response to COVID has caused. If that requires protests then so be it. The suffering caused by the response is worse than the disease in scale and scope. It is funny that those who cry "politics" never want to acknowledge the staggering amount of suffering we have caused with unproven tactics that even as we speak are proving ineffective. If you are not seeing the economic devastation of small businesses and the healthcare sector then you aren't paying attention. When jobs are lost people lose their homes and health insurance.


millercarbon is also right about our hospitals. Ours are empty. Ghost towns. Staff laid off. And some of these hospitals may not recover. You have to see that empty hospitals DURING a pandemic are a sign that someone got something wrong.

Currently I cannot get care for my patients. My office is open and we are seeing patients. We have seen zero COVID. But many specialist offices are closed for anything but emergencies. I'm having a hard time getting tests and studies. Subsequently many of my patients are suffering and at risk. THAT is NOT how you respond to a pandemic.

But, what can we do? We paid our housekeeper (who comes once every two weeks) even though she has not been coming. Our small church elected to pay staff and pre-school teachers even though they aren't working. We get take out from our local restaurants, many of which will not survive this, and give tips that are more than the cost of the meal. My wife paid her hair guy even though her appointment got cancelled. I'm seeing my newly uninsured patients for free. We go buy growlers from the 4 new local breweries that are walking distance from my home, most of which will not survive this either.

Finally, we have to educate an American public that believes whatever they want to believe and that will give up what is precious for specious and empty promises of safety.

@snarbut2, Empty hospitals during a pandemic are, in fact, a sign that we got things wrong and I think it is typical of the narrow thinking that is going on that it is not a real issue. A pandemic of its own. You, of course, know that people's healthcare needs do not stop just because there is a pandemic. Downplaying the significance of delayed care is not a responsible response. That suffering, morbidity and mortality is no less real than those suffering from COVID. And, once we know the numbers may turn out to be worse.

The fact that your experience has been different is THE main issue. The response to the pandemic was general and central. THAT was the mistake. Counties in northern California with ZERO cases never needed the same measures as New York City.

@geoffkait Thanks for those mortality rates. That clears up everything. Well, at least it clears up why so many people don't seem to have a clue about this pandemic.

@snarbut said: Right, they aren’t that bad in the setting of dramatic measures taken to stop the further spread of the virus. That is not the same as saying they never would have been that bad. I suppose this is my biggest point. Don’t use the fact that things didn’t explode in the setting of drastic measures being taken to downplay the seriousness of the situation."

Well that's just the problem. First, as you say, came the dire predictions. They did not pan out. Not anywhere close. You suggest that is because of the stringent response. But, as a physician you understand that because two things are true does not mean they are related. And in the case of stay at home orders, shutting down schools and closing businesses (but not Walmart of course) there is no solid evidence that it worked or even could work. Recent data of testing all the members of large groups is showing that large percentages of those testing positive were completely asymptomatic. Much larger than previously thought. This shows several things including that the virus is more pervasive than previously thought, less deadly than previously thought and probably around longer than thought. This, coupled with the fact that an increasing number of cases are being found in those who have strictly followed social isolation as well as new cases in nursing homes that have followed strict guidelines.


But there is an even much bigger problem in your reasoning here. As soon as nationwide measures were put in place and regularly thereafter the predictions continued to be spectacularly wrong even with the preventive measures taken into account. And by spectacularly wrong, I mean staggeringly wrong. Day after day and week after week. And yet, the policy makers continued to cite those numbers as the reason for their policies without ever addressing the failures of those projections. This continues today. I am following them in my state daily. They are simply bizarre and they have not come close. Not even once. Not even as it winds down here.

Further, the goal of lock down measures was said to be to "flatten the curve". In our state it was predicted that we would have peak cases sometime in mid May and could overwhelm the hospital capacity at that time. Then , suddenly in the third week of April the CDC and IHME announced that we had past our peak on or before April 11! AND, that there was no possibility whatsoever that we would come anywhere close to overwhelming the hospitals.

And given all that the rhetoric and the recommendations never changed! In fact, the rhetoric (social and regular media) escalated to a fever pitch. Then it incorporated virtue shaming to indicate that everyone should be wearing masks despite zero good evidence to that effect!
The point is that we based our response on projections that were NEVER and still are not accurate and some, like you seem to be, are claiming that measures based on those projections were effective when it is not clear that they were AND raise the specter of a population without herd immunity OR a vaccine.
When you put that in the balance with staggering blows to the economy, the healthcare sector, small businesses and the mortality and morbidity associated with social isolation then it is very clear that we might have handled things differently. You demur about a correct path and that is fine, and probably reasonable. But there have been many voices among top epidemiologists and researchers that the path we took was the wrong one. Those voices were there from the beginning.
They were shouted down and silenced.

A few thoughts about masks:

First, we know that coronavirus is spread by droplets. Virtually any barrier in front of the face will keep droplets out of the nose and mouth of the wearer. In that regard, the mask being worn is primarily to protect the wearer and is effective in that role. So if you need a mask you should wear one to protect yourself. Sure there may be some added protection for others if you wear a mask. But not much over the mask they should be wearing if they need one. So in this case the idea that we should wear a surgical or homemade mask to protect others is not really logical.

Second, there is some concern that the virus is spread as an aerosol. There is no confirmation of this and even Fauci has said he cannot prove it. An aerosolized virus can linger in the air like a mist. To be protected from an aerosol you would need to have a custom fitted N95 medical mask that allows no air in around the nose and chin area and filters better than typical masks. Virtually no one has these. With all other masks, even surgical masks, air can be drawn in around the edges and thus would not protect you from an aerosolized virus. For that very same reason a regular or homemade mask worn by someone with COVID will not effectively protect someone else. If that person coughs or sneezes then aerosolized particles will shoot out of the edges of the mask into the room. Again, it might provide some protection for others, but not much. And again….there is currently no proof that this virus is spread by aerosol anyway.

So unless we are all wearing fitted N95 masks then the idea that we should wear a surgical mask or homemade mask to protect others is flawed. It might even make things worse since it will give at-risk people the idea that they can go out in public when they shouldn’t.

Which brings me to the most important technical consideration: If a person has risk factors that make them more likely to contract the virus and/or suffer dire consequences they should not be relying on the typical or homemade masks they are wearing and even less so on the mask that someone else is wearing to protect them. It is a false sense of security. They are the ones who need to stay home for their own safety.