Hypothesis: Hospitals ARE The Vector @RealDonaldTrump
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2020-03-28 10:58 by Karl Denninger
in Covid-19 , 3702 references Ignore this thread
Hypothesis: Hospitals ARE The Vector @RealDonaldTrump*
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This virus is not being spread the way we're told.

Social distancing is close to worthless.

NY's data makes this quite clear.  So does Florida's.

Both slammed the door; SE Florida and NYC.

The bend should be evident in one viral generation time.  The new case rate should collapse in two viral generation times.  If Community Transmission via bars, restaurants and "social interaction" was more than 2/3rds of the total the effective R0 would go under 1.0 and community transmission would collapse.  If it was half then R0 would be 1.5 and we'd have transmission approximately equal to a bad seasonal flu.

IF you actually bent the curve.

These measures did not bend it to any material degree.  Enough time has passed to know this is true; at most they have lengthened a "turn time" by one day (in other words, R3.0 to R2.5.)  That's effectively nothing!

Why not?

It's being spread in the medical environment -- specifically, in the hospitals -- not, in the main, on the beach or in the bar.

When Singapore and South Korea figured out that if as a medical provider you wash your damn hands before and after, without exception, every potential contact with an infected person or surface even if you didn't have a mask on for 30 minutes during casual conversations with others (e.g. neither of you is hacking) transmission to and between their medical providers stopped.

Note -- even if you didn't have a mask on and were not social distancing in the work environment, which of course is impossible if you're working with others in a hospital, you didn't get infected.

And guess what immediately happened after that?  Their national case rate stabilized and fell.

The hypothesis that fits the facts is that a material part of transmission is actually happening in the hospital with the medical providers spreading it through the community both directly and indirectly.

Remember that all disease R0 is a composite of all the elements of transmission.  If any material part of transmission is happening in hospitals and other medical settings stopping that will stop or greatly attenuate community transmission.  Every medical provider goes home and interacts with the public.

Then the hospital fills up and guess what -- they call in more doctors, nurses, orderlies and other people.  In fact they've done exactly that; in hard-hit places they're getting volunteers.  Excellent, they need the workers, except every one of those new workers in the place is also a brand new vector to the rest of the community too unless they wash their damn hands before and after every contact with any item or person as well.

What's worse is that the data is that if you wind up on a vent you die nearly all the time.  They had a doc on Tucker Carlson last night confirming that we are not doing materially better than Wuhan in this regard.

 

We're wrong about how this thing is spreading and we're wrong about the silent attack rate.  The step functions in the data here in the United States cannot be explained by ordinary community transmission but they are completely explained if the transmission is happening not among ordinary casual contact -- that is, not "social distancing", but rather through the medical system itself.  That explains the step functions that are seen in places like Florida since it takes several days before you seek medical attention after infection and it also explains why NY, despite locking down the city and more than one viral generation time passing -- in fact two -- has seen no material decrease at all in their transmission rate.

In addition it further is supported by the fact that what we've seen here, in Italy, in Wuhan -- indeed everywhere is not an exponential curve.  It's a step-function flat acceleration graph.  Broad community transmission doesn't happen this way (you instead get a straight and continual exponential expansion until you start to obtain suppression via herd immunity) but if the spread happens as each "generation" gets driven to hospitals for testing and medical attention and the spread is largely happening there what we see here and in other nations in the case rate data is exactly the function you produce in terms of exposure rates.

In other words there should be no straight-line sections in the case rate graphs -- but there are.

Fix the protocols in the hospitals right damn now.  PPE is not the answer if your hands, gloved or not, become contaminated and not immediately washed off.  Hand-washing at an obsessive level -- before and after each patient interaction and before and after each contact with a piece of equipment that might be contaminated is.  In other words the monster vector (remember, R0 is a composite, not a single number) which I've hypothesized since this started is not oral droplets -- it's fecal.

This also correlates exactly with the explosive spread in nursing homes where many residents are incontinent.

Folks, by definition medical facilities concentrate sick people into small spaces.  If what's wrong with them is not infectious this doesn't matter.  But if it is you had better not transmit anything between them or between you and them or you instantly become one of the, if not the only vector that matters.

Then as the place fills up you have more people working and thus more vectors into the rest of the community.  Even if you have gotten the virus as a nurse or doctor and recovered and thus are immune if you have it on your hands and go down the escalator to the subway you can still contaminate the railing and the grab-rail in the car unless you wash your damn hands before and after any contact with any thing or person!

The presence of step functions and apparent linear-fit line segments in what should be a clean parabolic curve says this is exactly what has happened.

That in turn explains why the lockdowns are not doing a damn thing -- except destroying the economy, that we must do everything in our power to keep people out of the hospital in the first place and that, in turn, means using even potentially-valid prophylaxis and promising (but not yet proved) treatments early in the course of the disease so as to keep people out of the damned hospital in the first place while fixing the protocols in the hospitals so they stop transmitting the bug.

Don't tell me about all the doctors and nurses doing this already.  That's a lie.  I've been in plenty of hospitals (and worse, in nursing homes) in my years and in exactly zero instances have I seen any evidence that before and after each contact, with zero exceptions, those hands go under a stream of water with soap.

And reopen the damned economy.

Now.

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User Info Hypothesis: Hospitals ARE The Vector @RealDonaldTrump in forum [Market-Ticker-Nad] *
Jack_crabb
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inline

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Molon Labe
Where is Henry Bowman when you need him?
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Workerbee
Posts: 3570
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Yes!!!!!!!!!

Preach!!!!!

smiley

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"****'em ALL! I'm rooting for the virus now"
~Obseedian
"Keep pushing ****ers, you'll find the trip wire eventually"
~ Quik49
Redjack
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Iowa
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My kid was in the NICU for 71 days.

The nurses told me "Most infections in the NICU start with medical staff not washing their hands!"

I was an ABSOLUTE NAZI on making sure ANYONE touching my kid washed and sanitized their hands. To the point I told a doctor she WAS NOT going to touch her until I see her wash her damn hands.

My bear never had an infection, and should have been out sooner but the vent techs were pretty nervous on backing her off (once you get on a vent, it takes weeks to get off). Kid decided to pull her tube out, and the attending doc and vent tech sat in the room with her for a day to see if it would hold. It did.

What is interesting is my GP has gone to almost 100% online now. She said "we may be spreading this in the hospitals, and I am not doing it here!" For most things, that will work. For the exceptions that can't they are setting aside "clean" buildings for everyone else. But God have mercy if you get the flu.
Pharmadude
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NC
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US health'scam' system is run by the TBTF banks, and not just the corporate run hospitals.

HHS along with the many state and local health departments, are essentially run by politicians sponsored/controlled by the TBTF banks.

The sheeple follow the politicians giving away the most and best goodies. Once every so often, the sheeple are scared and forced to their pens by the TPTB. Because everything is very, very "baa-d, baa-d"!

First comes the fleecing, soon followed by the slaughter.

Poor, poor sheeple; before they know it they're naked yet safe again. Some unlucky ones lost it all. For the lucky ones though, it's back to the secure pasture to live free, to grow more wool and to get fat once again.

However, the ruling class have nice new clothes and blankets to stay warm and full bellies.
Pharmadude
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Google has had these same five simple steps out for weeks:

DO THE FIVE
Help stop coronavirus
1. HANDS Wash them often
2. ELBOW Cough into it
3. FACE Don't touch it
4. SPACE Keep safe distance
5. HOME Stay if you can

If 1-4 are too hard to follow, then #5

Nothing about destroying the economy.
Tickerguy
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A True American Patriot!
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The problem is that by definition all medical facilities always concentrate sick people into a confined, small space.

If what's wrong with them isn't infectious then this isn't a big deal. But if it is then you had better make ******ned sure you don't transmit anything between them or to and from yourself OR YOU BECOME THE LARGEST VECTOR INSTANTLY.

Well, the data says that is EXACTLY what is happening and the other "steps" are NOT making a difference.

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Twainfan2
Posts: 331
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MN
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if only orange man listened. Let me correct that, if only orange man listened to common sense instead of the idiot brigade.

Hopefully there's someone in DC with some common sense that sees this and starts to ask some questions.
Schoolboy13
Posts: 30
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Preach it, Mr. Denninger!

I'm an acute care RN that works with immuno-compromised patients (solid-organ transplants), and hand sanitizer isn't enough, especially when you're dealing with nasty bugs transmitted via the oral-fecal route. Wash your damn hands, people. Frequently. It's not rocket science.

Further, how many more lives are we putting at risk by crashing the entire world economy in response to the virus than by letting the virus run its course and taking appropriate precautions?

The media fear-mongering needs to stop!
Tickerguy
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Yep.

The only way to get step-function linear line segments in what should be a parabolic curve is if there are concentration points where enough of the transmission is being initiated so what would otherwise be a smooth parabola is interrupted.

Well, we closed all those potential places - mass gathering, etc. All gone. Bars and restaurants aren't big enough to produce that sort of concentration point but we closed those too anyway and played "social distancing" in the (false) belief that this was where the transmission was coming from.

What's left?

HOSPITALS.

The step function line segments are still there and haven't changed. In fact they're what has driven the curve since the beginning of this.

Hospitals haven't taken over from other sources they've been the primary source since this started.

That's where it was always coming from.

****ers.

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Rickylc
Posts: 1878
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Is Everywhere
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I was looking at this last night and wondered about the steps, China and Japan seem to be outliers to this. I assumed it was massaging the numbers.

China we know did that, and I figured Japan was also while the Olympics were still on the line.
Gianmarko
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Bern, Switzerland
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italy and spain have a very centralized and bureaucratic health care system. big hospitals and offices and people routinely have to queue for hours to get a piece of paper and then queue for more hours to deliver it to another office. and apparently they havent discovered stuff like "appointments" as is normal that you are told to show u at 8AM and then you have to spend hours in crowded waiting rooms.
last year i was in spain in holidays and my son got sick with high fever. we had to spend some 10 hours in a waiting room of maybe 250 sqft together with at least 40 ppl.
you can clearly see the results of all thisin the death toll.
i have family in spain. one relative lives in a retirement house. one folk there got sick and was hospitalized. they tested him for the virus only after 4 days he was in, they had to quarantine the whole ward.
14 out of 50 ppl got infected and a few passed away already.
italian and spanish hospitals are veritable bacteriological bombs.
here in switzerland they were smart enough to close down hospitals quite early. first you call, then they will tell you what to do. it works much better.
Pharmadude
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As our host has highlighted several times, case numbers are evident that some basic hygiene has not been followed.

Hospitals have always been concentrated centers for disease, and spreading diseases from and within the hospital wards has been a 'problem' for a very long time.

Quote (note stat from CDC):

In American hospitals alone, the Centers for Disease Control (CDC) estimates that HAIs account for an estimated 1.7 million infections and 99,000 associated deaths each year. Of these infections:

32 percent of all acquired infection are urinary tract infections
22 percent are surgical site infections
15 percent are pneumonia (lung infections)
14 percent are bloodstream infections

... many HAIs can be prevented through the strict adherence to evidence-based best practices. Recommendations include:

* healthcare providers cleaning their hands with soap and water or an alcohol-based hand rub before and after caring for every patient;
* catheters being used only when necessary and removed as soon as possible;
* cleaning the skin where the catheter is being inserted or the surgical site, and
* providers wearing hair covers, masks, gowns and gloves when appropriate.

Source:
https://patientcarelink.org/improving-pa....
Geckogm
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Data Project on global growth interactive charts
http://91-divoc.com/pages/covid-visualiz....
T7rader
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Carlsbad
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Karl- Long time reader but 1st time poster. I appreciate greatly your insights and views

It sees the most of the docs we're seeing on TV are referencing the social distancing that took place during 1918 and specifically showing the results of Philadelphia (did not implement and had a parade) versus St. Louis (did social distancing). Even if you take into consideration the different size of the population, the results were very dramatic. What would you say to counter the argument that social distancing did prove its benefits then?
Workerbee
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I have to admit our local hospitals instituted a lockdown almost immediately after this COVID hype began.
It's damn near Hotel California style.....if ya go in, ya ain't coming out. Our local hospitals are reportedly ghost towns.. no one WANTS to go, even if they are sick.
Of our 4 affiliated hospitals, only one will allow suspected and/or confirmed cases, and they are on one floor at the moment. And there were not many of as of yesterday's report.
Also, one set of Doctors that visit our facility no longer visit physically, but by facetime as they are limiting their exposure at our facility because they are rounding at the hospitals.

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"****'em ALL! I'm rooting for the virus now"
~Obseedian
"Keep pushing ****ers, you'll find the trip wire eventually"
~ Quik49
Mannfm11
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DFW, Tx
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So, the carriers are the very people we are begging for more. The curve ends when they all get sick, recover and wash their hands. This is a good explanation why Trump doesn't have it. It was already said he was an obsessive hand washer. Trump had the solution from the start.

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The only function of economic forecasting is to make astrology look respectable.---John Kenneth Galbraith
Tickerguy
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@T7rader -
Quote:
"Thats not to say that St. Louis survived the epidemic unharmed. Dehner says the midwestern city was hit particularly hard by the third wave of the Spanish flu which returned in the late winter and spring of 1919"

They concentrated the nasty strains and got ****ed the next year.

The problem is that eventually you HAVE TO remove the curbs and when you do the infection comes back. If, as with most influenza bugs, it's seasonal then what do you do NEXT fall? If it's not then what? Keep them forever and live with a permanently destroyed economy?

For a seasonal bug you MIGHT get some benefit. But assuming R0 is a constant so is the suppression point with immunity in the population. If R0 is NOT a constant (e.g. you're getting a LOT of transmission in the hospitals, for example) you WANT to keep people out of the damned hospital as that's how you depress R0 enough so that herd immunity hits the threshold FASTER.

You CAN'T do two+ months of an economic shutdown. You just can't. Further, even if you did, GO RUN THE MATH -- it doesn't matter because while you suppress R0 when you drop it you're no further along with herd immunity.

All of these premises count on a vaccine rescuing you.

There has never been a persistent-immunity coronavirus vaccine.

Note that we were promised the same bull**** with HIV. It's nearly 40 years later -- where's the vaccine?

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I don't give a flying **** if you're offended.
Bluemarrow
Posts: 38
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Earth
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"Well, we closed all those potential places - mass gathering, etc"

From the moment the President declared a state of emergency, two things happened:

CostCo, Sams, Walmart, Target, and all grocery stores were mobbed. Crowds gathered at the front doors and stormed the aisles when the doors were opened.

At the same time, hospitals became ghost towns. My Niece is an ICU nurse who moonlights in the ER of a 1,000 bed hospital in Central Illinois. She says that even now, the ER is less than half as busy as normal, because all of the people who normally use the ER as a walk in clinic for non emergent attention, and the drug seekers, are afraid to come in. She began to see an uptick in "R/O C19 beginning Tuesday, but the hospital is otherwise well below normal census.

Incidentally, the hospital admin told her she can't wear the N95s that she bought for herself, and that she needs to turn them over so that they have enough for the Doctors and Residents, even though they don't even go in the ICU rooms of her C19 patients. She heard that yesterday, and is currently deciding whether or not she's going to erect the middle finger, and quit.
Bagbalm
Posts: 6185
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Just North of Detroit
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Look at the list of doctors in your hospital. Unclean left handers like crazy. I had one of those third world docs give me an infection because he couldn't be bothered to give me prophylactic antibiotics for a very invasive biopsy. My regular doc was furious.
Workerbee
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Bluemarrow, that is bull****!
Your niece should contact every news outlet and spread her story on social media.

I hope that hospital admin DIAF ASAP while suffering from c diff,anal fissures, COVID and bubonic plague.
That's pitchfork and torches criteria for me.

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"****'em ALL! I'm rooting for the virus now"
~Obseedian
"Keep pushing ****ers, you'll find the trip wire eventually"
~ Quik49
Clay3482
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Alaska
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I agree KD.

My mom has this.

But this is exactly why we decided as a family not to take her to the hospital. She did get emergency treatment one time with Oxygen but no one, not even the doctor would come into the room, they stood at the door.

One nurse who is a family friend and has known my mom since she was born was the only person allowed in the room. She washed her hands and had new ppe and did not leave until my mom was discharged.

Stay out of the hospitals. They can not do anything.

IMHO
Try to get antibiotics, hydroxyclonaquin and / or Oxygen if you have to have anything. Try to stay out of the hospital because there is nothing they can do. A vent will not help and chances are you will get infected with something else at the hospital while you are trying to get well and you will die.
Happyapricot
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My question is, is it safe to go to the store? I really don't need anything, but there are a few things I would like. But they are not worth dying for.

I don't know how to time this. In my state there are only around 50 confirmed cases. At this rate it will probably be another month or two before they lock down.

Do you buy supplies now before the first wave or wait? Do you risk being one of the people sick in the first wave? How do you use the data from the vectors?

Is it safer to order online and let the supplies sit in the box?

I did place an order and they ship almost everything in a separate box and ship from a different state. I had soup traveling from the west coast and ritz crackers coming in from the left coast. It doesn't really seem safe. But then again, do you risk walking down the store isles? I don't know.....
Ktrosper
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ft collins co
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Mannfm wrote..
So, the carriers are the very people we are begging for more.

AND the people who benefit the most financially from spreading it...

Perverse incentive there.

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The unexamined life is not worth living.-Socrates
The only stable state is the one in which all men are equal before the law.-Aristotle
Liberty exists now in the spaces government has not yet chosen to occupy.-Doc Zero
I anticipate that 10 Dallas Cowboys Cheerleaders will blow me this evening.-K.D.
Drifter
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Vectors-- I feel badly for people that own restaurants, but one benefit of this 'social distancing' is that, I would imagine anyway, fewer people are eating out. Fewer people eating out means fewer people getting exposed to food touched by dirty hands, from fields, to Food Service of America, to the restaurant, and to your t-go order.

I know quite a few people that like to just pop in and eat lunch at the local hospital cafeteria. They are f'ing insane.

So in a hospital setting-- who is the real vector for Wuhan: medical personnel, food service or all of the above? What ****show ****storm.

If I had a loved one in that place, I would bring them food from home.

From what I gather... with little data, health departments track who covid people come in contact with, but are they also tracking *what* they came in contact with? In other words, are the government worker bees asking the right questions? My hunch is-- no.
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