We have shut the world down for a virus with a lower fatality rate, in most places at least, than the measles. Measles. A disease we allow people to opt out of vaccinating for, and go to Disneyland to spread it.

Idiotic and unfathomable.

Measles. A disease we allow people to opt out of vaccinating for, and go to Disneyland to spread it. ~ Momof4 at April 4, 2020 5:54 AM

For measles we have a vaccine. If you're unvaccinated and go to Disneyland, chances are the people with whom you come into contact will have been vaccinated. That means, the person you might have infected will not be subsequently carrying the disease to other non-vaccinated folks. And, if that person is not vaccinated, chances are the people with whom he will subsequently come into contact are vaccinated. Any spread he initiates will be contained.

For COVID-19 we have no vaccine. That means the asymptomatic carrier coming into contact with another person is coming into contact with an unvaccinated person who will carry the disease home to other unvaccinated people.

It's not just the people with whom the infected person comes into contact, but the ones with whom those folks subsequently come into contact. Herd immunity means that the odds of an infected person coming into contact with an unvaccinated person are low. But herd immunity can be easily destroyed when a significant portion of the population remains unvaccinated.

Now, could we have found a different way to combat the virus without shutting down the economy? Yes, without a doubt. Could we have enforced it? Doubtful.

As has been pointed out by a few here, the lockdown is not to prevent the spread of the disease, but to slow it enough that our treatment systems can ramp up - mobile field hospitals, masks, ventilators, etc. We're not trying to control the "if," but the "when."

Momof4's regard for the well-being of others is somewhere between "venomously contemptuous" and "unpersuasive"… Look at that chart.

But at this hour — and be sure to check in tomorrow for the latest updates— it seems likely that the vast majority of flourishing and fulfillment lost from the Wuhan virus will be consequent to incompetent policy responses rather that the monstrous infection itself.

We might like to have been surprised by this, but there's a game show host in the White House. Is it any surprise that our protective agencies, public and private, would prefer to grind their careerist scams into the ground rather than respond with integrity?

"It will go away. Just stay calm. It will go away."

As has been pointed out by a few here, the lockdown is not to prevent the spread of the disease, but to slow it enough that our treatment systems can ramp up - mobile field hospitals, masks, ventilators, etc. We're not trying to control the "if," but the "when."

Conan the Grammarian at April 4, 2020 6:50 AM

Here is hoping that as we get warmer weather, the rate of infection slows. Although I suspect we will see a resurgence next fall. By that time at least we may have figured out what treatments work and what doesn't.

I do think the damaged civil liberties are going to be somewhat harder to claw back. Governments love to cement in power grabs.

> somewhat harder

Besides, momof4, what would you have suggested? That clinics and hospitals refuse anyone with such symptoms, even when the patient is under 70 and/or highly useful to the community? Tell them to stay home and die? Jeez.

In the meantime, something occurred to me. We're not supposed to use cash right now, but maybe we should. Why? Because, with more and more people losing jobs and their businesses, chances are many supermarket systems and other, online businesses are going to be hacked. Not to mention ATMs. So I would suggest walking up to the bank teller once a month - with all precautions, of course - and withdrawing whatever amount you might need for that month.

(Even if a whole supermarket ISN'T hacked, individual credit card machines at the checkout just might be. I've heard of disgruntled cashiers doing just that, long before this year. Plus waiters.)

Voting. I'm worried about voting.

Someone should take a moment to acknowledge that "lifted like a bad girl's skirt" is a wonderful metaphor. Unless it's a simile, because I don't know the difference, but will be stealing it anyway.

Raimondo wanted to hunt for New Yorkers; now Cuomo wants to confiscate other people's property ("If you have a ventilator - we will confiscate it to save lives").

Yep, scratch off the surface of most politicians and you will find a brown shirt fascist underneath.

The problem is these clowns are playing to their home audience; but, the home audience doesn't realize what Gerald Ford said is true:

"A government big enough to give you everything you want is a government big enough to take from you everything you have."

You know Lenona there are a lot more options than 'shutdown the entire US' and 'refuse medical service to those under 70'.

How about only quarantining those with a high risk for the disease. Or you could quarantine areas experiencing an outbreak. There are lots of other choices as well.

Wrote Ben:

How about only quarantining those with a high risk for the disease. Or you could quarantine areas experiencing an outbreak.

Serious question: which groups would be "high risk"? Of the three people I know who have tested positive so far, all of them are women — and it's said to hit men harder.

One is a woman in her 60s with lupus, another a woman in her late 40s with no underlying conditions, and the third a woman in her mid-30s who lives an exceedingly healthy life.

Bloomberg: Sweden Girds for Thousands of Deaths Amid Laxer Virus Response

There are signs that the death rate in Sweden is growing faster than elsewhere in Scandinavia, raising pressure on the government to abandon its controversial hands-off approach in tackling Covid-19.

The Swedish experiment has drawn international bewilderment as schools, restaurants and cafes have remained open. And while other countries passed laws restricting movement, Sweden’s Prime Minister Stefan Lofven relied on the common sense of his fellow citizens to carry his country through the pandemic.

But after a week of sobering data, Lofven now seems to be striking a darker tone. In an interview published on Saturday by Dagens Nyheter, he warned that Sweden may be facing “thousands” of coronavirus deaths, and said the crisis is likely to drag on for months rather than weeks. Meanwhile, newspaper Expressen reported that his Social Democrat-led government may be seeking extraordinary powers to bypass parliament and force through a sterner response to the virus.

"Serious question: which groups would be "high risk"? "

Out of staters. People who vote wrong. Queer-lookin' folk what ain't got no religion.

Them.

Kevin, as of the last data I have high risk groups are those with other health issues (your friend with lupus for example) as well as those over 60. Will deaths be limited to only those groups, no. Even with quarantine people are dying. So zero isn't an option. But as of the last numbers I have under 40 means a less than 0.08% risk of death.

Yes I've seen the news report about all the 30 year old in New York dying. But it didn't come with any real numbers. Just that some 30 year olds died in New York.

The bloomberg story below the one JD links to is perhaps more significant than the one he picked.

----

When, and How, Does the Coronavirus Pandemic End?

There’s a consensus that the pandemic will only end with the establishment of so-called herd immunity. That occurs when enough people in a community are protected from a pathogen that it can’t take hold and dies out. There are two paths to that outcome. One is immunization. Researchers would have to develop a vaccine that proves safe and effective against the coronavirus, and health authorities would have to get it to a sufficient number of people. The second path to herd immunity is grimmer: It can also come about after a large portion of a community has been infected with a pathogen and develops resistance to it that way.

----

So, when does this end? The hope for human herd immunity to kill off this virus in the US appears far fetched to me. After all this virus supposedly originated in bats. Well, we have lots of bats in the US. Do they have this disease? It seems likely given it's contagious nature. What is to prevent the bat population from reinfecting the human one?

If instead you were hoping for everyone to become immune, well quarantine doesn't help with that. The same number of people will die with or without any quarantine. The only question is when.

If you are holding out for the development of a vaccine, there are a lot of people working on it. But the shortest expected timeline is 12 months. I doubt the US can maintain a quarantine like this for more than 3 months.

So there is my serious question for others, how does this end?

From a 2014 Reason article about the debate among libertarians over requiring people to get vaccinated:

As central to libertarian thinking as the non-aggression principle is, there are other tenets that also inform the philosophy. One such is the harm principle, as outlined by John Stuart Mill. In On Liberty, Mill argued that "the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others." Vaccination clearly prevents harm to others.

Although this article is about vaccinations, Mill’s harm principle can also apply to a epidemic/pandemic situation.

So there is my serious question for others, how does this end?

Ben at April 4, 2020 1:44 PM

Based on history, I say, it ends with a whimper, not with a bang.

Seriously, one governor after another will reduce or eliminate restrictions because nothing he or she can do, or should do legally will stop interstate movement of goods, people and the virus.

Right now you have 300 truckers a day all using the same infected restroom at Flying J on I10. Multiply that by thousands.

They can keep the public facilities closed sure, But any governor up for re-election in November democrat or republican is going to cave. You can count on it.

That same Reason article begins with this:

Few issues divide libertarians so emphatically as government-mandated vaccinations against communicable diseases,

A couple things I wonder:

• What is that divide? Libertarians differ on the issue but what’s the split? Roughly 50/50? Are more libertarians opposed to mandatory vaccinations than are in favor? Or the reverse?

• Assuming libertarians also differ on government-mandated “social distancing” orders and business closures, does that split tend to mirror the split regarding mandatory vaccinations? Are those libertarians who support government-mandated vaccinations the same ones who tend to support mandates in our current situation?

Partially agreed Isab. I think school is done for the year. I get repeated claims from my district that they are 'open' just not to students. I.e. we aren't doing our job but we still want to get paid. As for the work closures I've repeated said on here I think they've got 1-2 more months and then things will start reopening, legally or not.

But given all the 'Damn Ben' and other stuff I think it is a fair question to ask.

"Libertarians differ on the issue but what’s the split?" ~JD

That is a hard question to answer. Mainly because what do you count as a libertarian? Only people in the Libertarian Party (or recently voted for it)? People who are philosophically libertarian leaning? Some other metric?

Your second question looks like it is more answerable. At least then you don't need to know the population size, just correlation.

• What is that divide? Libertarians differ on the issue but what’s the split? Roughly 50/50? Are more libertarians opposed to mandatory vaccinations than are in favor? Or the reverse?

• Assuming libertarians also differ on government-mandated “social distancing” orders and business closures, does that split tend to mirror the split regarding mandatory vaccinations? Are those libertarians who support government-mandated vaccinations the same ones who tend to support mandates in our current situation?

JD at April 4, 2020 2:13 PM

Kudos to you, for opening a discussion on this. I call myself a small l libertarian, and my feeling on vaccinations is that no state should force anyone to vaccinate because there are always going to be legitimate exceptions. Children who are born severely premature or with compromised immune systems are not good candidates for vaccinations. Then the constitution allows for a religious exemption, and I’m afraid that mandatory vaccinations over a religious objection won’t fly under the current constitutional standards.

So forget the ideal of vaccinating everyone. Now, however, there should be severe restrictions on travel especially in times of an epidemic on unvaccinated people. If you are unvaccinated for example, and want to travel outside the US, you should be subject to a self funded rigorous quarantine on your return. There should be a stamp on your passport indicating that you are unvaccinated and some countries might chose not to let you in.

If there is an outbreak of measles for example, all unvaccinated kids should be immediately removed from the public schools, and placed in home quarantine. And I am fine with public schools refusing to admit unvaccinated individuals but again, that would almost certainly run afoul of both state and federal constitutions.

I think most libertarians would agree that the economic costs of being an anti vaxer , should fall squarely on the people choosing it.

However, no system is perfect and there will always be cases of people who contract diseases in their home country from unvaccinated people who have entered the country legally or illegally. Since vaccines are not a hundred percent effective, you improve your chances with a vaccine, but there are no guarantees.

Until the government declares martial,law, and they haven’t yet, I’m going to assume that these mandates don’t have the force of law. Since I am well aware that the process is the punishment, I am disinclined to volunteer to be the test case for litigating this issue.

“That is a hard question to answer. Mainly because what do you count as a libertarian?”

You’ll have to ask the people at Reason. They say “libertarians” without defining what they mean by that.

“I call myself a small l libertarian, and my feeling on vaccinations is that no state should force anyone to vaccinate because there are always going to be legitimate exceptions.”

Do you consider individual liberty to be a legimate exception or are you more inclined to take John Stuart Mill’s position?

Ronald Bailey at Reason, arguing for the “evil” (i.e. supporting government-mandated vaccinations) libertarians:

Oliver Wendell Holmes articulated a good libertarian principle when he said, "The right to swing my fist ends where the other man's nose begins." Holmes' observation is particularly salient in the case of whooping cough shots.

To borrow Holmes' metaphor, people who refuse vaccination are asserting that they have a right to "swing" their microbes at other people. There is no principled libertarian case for their free-riding refusal to take responsibility for their own microbes.

Do you consider individual liberty to be a legimate exception or are you more inclined to take John Stuart Mill’s position?

JD at April 4, 2020 3:22 PM

I don’t really view it as a philosophical question, but as a functional question, I think the state should recognize that someone might not want to vaccinate their child for either a legitimate or illegitimate reason. Since the reason is always going to require a subjective judgment by the state as to the reasonableness of a refusal, it is most likely not a legitimate exercise of state power to try to differentiate between a religious objection and a strongly held personal belief. I think *individual liberty* equals “freedom of conscience” which is protected by the constitution.

Therefore it is up to the state to protect as best it can, public institutions from spreading epidemics, by excluding those who either are, or might be vectors of disease, from places of easy transmission without any judgment about their stated reasons for being unvaccinated.

Probably would be a great con law exam question....

“To borrow Holmes' metaphor, people who refuse vaccination are asserting that they have a right to "swing" their microbes at other people. There is no principled libertarian case for their free-riding refusal to take responsibility for their own microbes.”

I think this is a very poor argument for many reasons, and tort law is not particularly applicable to being a potential hapless and unknowing vector for a disease.

I don’t want to turn all the germaphobes into Howard Hughes, But there is only so much the government can do to make public places safe, and clean. Even vaccines as I have said before, aren't all that effective. For example many years the flu vaccine is less than 20 percent effective at preventing infection.

If you are so fragile that you can’t survive contact with all the known and unknown pathogens out there, you need to stay home. The government has no legal duty to protect you, even if they could.

You know, everywhere she goes, Barbara Streisand takes her own RV and uses her own bathroom. I’m starting to think that is a very smart idea.

I suspect if you looked into it 'Libertarian' differs from author to author. It probably even differs from story to story depending on which point the author is trying to make.

I personally consider myself libertarian leaning and take many of the positions Isab outlined.

On the vaccination issue I side against forced vaccination and I accept the individual liberty argument. But I agree with Isab on requesting people so identify as unvaccinated at appropriate areas (passport and such). I also would be happy with schools refusing service to the unvaccinated. That is the place and way I think pressure should be put. And yes I recognize the legal issues with doing things that way.

As for Holmes argument, I view it as flawed. This isn't a binary situation. Should people be forcibly vaccinated against STDs for example? They aren't swinging microbes at the public at large. Also vaccinated isn't a binary situation. Some will get vaccinated and have adverse reactions. That typically runs in families but not always. Some will get vaccinated and not acquire immunity. Some cannot safely be vaccinated due to age. Is your grandmother 'free-riding'? How about your newborn? Some lose their immunity sooner than others.

The whole point of vaccination is to artificially induce herd immunity. What percentage of vulnerable people a group can handle depends on the disease. For measles the minimum vaccination rate is around 93-95%. After all measles is a very contagious disease. The actual immune rate is lower (around 90% I think). For less contagious diseases you can handle a lower vaccination rate. So you run into the same problem as you have with voting. Not every unvaccinated person is imposing the same cost. With only 2% of the population unvaccinated there is near zero cost. But as you approach the tipping point the cost of each unvaccinated person goes up.

So I find Holmes's argument flawed. Things are much more complicated than he gives it credit.
Then again I never was a strict libertarian in the first place.

Ben, have you failed to notice that despite all the allegedly extreme measures such as shutdowns, we still had to BUILD makeshift hospitals in more than one location - and the workers there are struggling for supplies? When has that ever happened in a flu season, with no lockdowns?

In other words, no, this isn't anything like the regular flu, which, even though it has killed thousands of elderly people each year, is still relatively easy not to catch or pass on, by accident, to Grandma. That is, the coronavirus is far more tricky to stop before it kills someone, even if all the elderly people and those with health problems stayed home. (Right now, we're even supposed to decontaminate any packages we receive in the mail!)

Lenona, have you failed to notice there are many areas with no hospital congestion? There are lots of hospitals without a single person in the ER. Why must everything be the same everywhere at the same time? Life doesn't work that way.

You're still dancing around the fact that what we're seeing right now doesn't happen, even with NO government orders, in a regular year.

Those who have not yet lost any loved ones to the virus may find it too easy to take it for granted that they're still alive and kicking - but they shouldn't. Even if those loved ones are young-ish and able-bodied.

...but, the home audience doesn't realize what Gerald Ford said is true:

"A government big enough to give you everything you want is a government big enough to take from you everything you have."

~ charles at April 4, 2020 11:59 AM

If you'll all forgive my bit of pedantry, I'll lay some etymology on ya.

It's a wise saying, but when Gerald Ford said that in 1954, he was repeating something he told his assistant "he'd heard early in his political career" at the Economic Club in Chicago.

The earliest version in print was found in a 1952 book by Paul Harvey, but Harvey did not claim authorship. In fact, it was unattributed in Harvey's book.

All this comes courtesy of Politifact.

It has also been attributed to Barry Goldwater. He used variations of it frequently in his 1964 presidential campaign.

Not to mention that time and resources are so tight right now that, in many communities, doctors can't even make time for...patients' cancer screenings. (Among other serious procedures.) How often does THAT happen?

Not to mention that time and resources are so tight right now that, in many communities, doctors can't even make time for...patients' cancer screenings. (Among other serious procedures.) How often does THAT happen?

Lenona at April 4, 2020 5:06 PM

You don’t want to be in the doctors office right now, I’m telling you. Maybe you would prefer to move to Canada? Wait six months for cancer screening, another six for an appointment for a biopsy, and then six more to see a specialist?

“As for Holmes argument, I view it as flawed. This isn't a binary situation.”

I believe your disagreement is not with the principle that Holmes articulated but, rather, with Bailey’s application of it to vaccinations. Is that correct?

Holmes’s example points out what I think almost everyone understands and agrees with: that individual rights are not unlimited. The devil, of course, is in the details. Where, exactly, does someone’s swinging fist meet another’s nose?

Call it a hunch, but if that were the NORM in Canada, I would think most people in developed countries would have very little praise for the system - and a lot of harsh criticism. I have yet to hear that.

Umm, a quick search is easy to do Lenona.

https://www.cbc.ca/news/canada/montreal/colon-cancer-screening-program-bogged-down-by-wait-times-1.2789624

One lady had to wait 5 years. That is an extreme. But a multimonth wait is normal for cancer screens in Canada. And most of the western world. For hip, knee, or cataract surgery wait times are usually (but not always) under six months. In the US you are typically talking about 2-4 weeks, in Canada it is 2-4 months.

Sorry, your hunch is wrong.

As for resources being tight everywhere, they aren't. That isn't true. Here in Houston at least you can't do elective surgery or 'non-essential' medical care. It isn't that there aren't doctors available. It is that the procedure is currently illegal. Our critical care wards are mostly empty.

I take it you live in New York, Lenona. They are getting hit very hard by this. But New York isn't the US. I sorrow for your loss. But that doesn't mean the current policy is the right one.

JD, yes my disagreement with Holmes is less on the principle and more on the application of it.

Holmes implicitly claims you can stop "'swing' their microbes at other people" by using vaccines. That isn't true.

But on the question you are focusing on, 'do individual liberties have limits', yes, I agree. But as I said I only lean libertarian. I'm not in the same philosophical place as Kent who sometimes shows up here. At the same time I recognize there need to be limits on governmental liberties and those limits need to be clearly marked.

Using the commerce clause to regulate any and all business activity is clearly incorrect. Just because you could cross a state line doesn't mean you did. Same with the war on drugs. Having cops steal from people because they could use that money to buy drugs is immoral. Governments that justify their use of force based on what could have happened have no limits on what they can do.

About "civil liberties": they are easy to dismiss. Here's a quote for you:

"...voice or no voice, the people can always be brought to the bidding of the leaders. That is easy. All you have to do is tell them they are being attacked and denounce the pacifists for lack of patriotism and exposing the country to danger. It works the same way in any country."

You (plural) still fly on airplanes despite your being presumed guilty and watching children be groped by people who don't always change their gloves. You sit quietly while Congress tells you whom you may hire, what you must pay them and how you must insure them. Likewise while Congress pads a "COVID-19 relief bill" with sweetheart deals for pet causes.

You've given away every possible way to identify and punish you for disobeying the State.

Now, the First Amendment is being stolen from you, and that's just dandy if you feel safe, and you cheer Daddy Government for protecting you.

The nation is just too stupid and fearful to endure, while secure in the certainty that nothing bad can happen, we are just too smart.

Ben, my guess is it will go like this:

As curves flatten, restrictions will be lifted. Then the curves wll go back up, and restrictions will be in place again. It will be on again, off again for a year or two, at which point a vaccine will be developed, or medications that mitigate the symptons, or other solutions will be found.

There will be in-between situations, like factories half-staffed because of the need for distance between workers.

What was the death rate of measles before the vaccine, in non-virgin populations?

As curves flatten, restrictions will be lifted. Then the curves wll go back up, and restrictions will be in place again. It will be on again, off again for a year or two, at which point a vaccine will be developed, or medications that mitigate the symptoms, or other solutions will be found. ~ NicoleK at April 5, 2020 7:49 AM

I'd say we would likely follow the old polio model with localized outbreaks resulting in localized lockdown protocols, but people and goods travel more freely and frequently today than they did then, so any localized outbreak of a virulent pestilence becomes a national concern.

Thank you both for at least answering the question.

The current response is fine for a quick short reaction. But it is long term nonsustainable. Where do we go from here needs to start being asked now so we aren't just reacting when people become civilly disobedient.

Two relevant things to keep in mind: First, young people also die from the flu. In the 2016-2017 flu year, according to CDC website, about 3500 people under the age of 50 died from flu, including 528 in the 5-17 year category. Secondly, according to an article I just read about social media and its impact on degrees-of-separation, we are now only a few degrees of separation apart instead of the probable six degrees of separation. In real terms, that means that in a typical flu season, the average person would learn through social media of six deaths of younger people due to flu, just from the two degrees of separation "friend of a friend" chain of information. If the article's math is off, the point still stands as far as social media resulting in everyone hearing about many more instances of negative events than we have in the past. The flow will depend on what everyone happens to be talking about. If there is a famous news story about a dog attacking its owners, then you will soon hear about how your sister's co-worker's nephew was severely injured by their family dog.
Before anyone jumps to conclusions, I am NOT asserting the this COVID is just like the flu. I am saying that society has a risk tolerance for every single activity and we will somehow have to evaluate (especially with better data) how our risk tolerance for COVID compares to our risk tolerance for similar problems. We have to then balance that with our risk tolerance for economic ruin. We will need to keep in mind that it's hard to be objective, especially because our perception of the comparative risks is going to be skewed by social media.

Umm, a quick search is easy to do Lenona.
____________________________________

OK. Trouble is, I often don't know which is the most efficient way to phrase the question, when I google, and so I lose patience.
____________________________________

One lady had to wait 5 years. That is an extreme. But a multimonth wait is normal for cancer screens in Canada. And most of the western world.
_______________________________________

Most? Well, that would explain why Canada doesn't get criticized much, right?
________________________________________

As for resources being tight everywhere, they aren't. That isn't true.
________________________________________

Will you please learn to read what people say? I said "many communities." Not "everywhere."
________________________________________

I take it you live in New York, Lenona.
________________________________________

No, I don't. (As I've said before.)

I can see you are in a rather foul mood today Lenona. Very well.

The median wait time for those procedures in Canada is 3 months. The limit they try to beat is 6 months, hence Isab's choice of that number. A but under 25% of Canadians don't get service within the 6 month time window. By comparison in the US the median is 3 weeks, not months. Yes most of the western world has roughly the same metrics as Canada. The British system is notably worse, the Scandinavians are on the better side. But if you want timely treatment the USA is the place to be. The USA also has some of the best health outcomes. The only issue where the US medical system performs poorly is on cost.

As for reading:
"Not to mention that time and resources are so tight right now that, in many communities, doctors can't even make time for...patients' cancer screenings."

This line is false. Cancer screening are not being performed because they are currently deemed illegal not because of any resource shortage.

To repeat my question to you, why does it matter if one place resources are tight? Why do people in areas where there is plenty of excess capacity need to react the same and horde resources that are in ample supply? You think people in Denver need to avoid the hospital because there aren't enough doctors in New Jersey?

And to repeat my more significant question: How does this end? What criteria need to be met for things to return to normal?

You inferred something that wasn't there. I merely pointed out your mistakes.

In answer to the question, my point was simply that things would likely be a lot worse without the shutdowns - and that what we're already seeing is likely a good indicator.

Would you please give me a source on screenings being currently illegal? I searched just now and neither Komen or Cancer Health said anything about its being "illegal." Even cms . gov only said "recommending." Not even "ordering."

Here's what I found at cms:

To aggressively address COVID-19, CMS recognizes that conservation of critical resources such as ventilators and Personal Protective Equipment (PPE) is essential, as well as limiting exposure of patients and staff to the SARS-CoV-2 virus. Attached is guidance to limit non-essential adult elective surgery and medical and surgical procedures, including all dental procedures. These considerations will assist in the management of vital healthcare resources during this public health emergency.
Dental procedures use PPE and have one of the highest risks of transmission due to the close proximity of the healthcare provider to the patient. To reduce the risk of spread and to preserve PPE, we are recommending that all non-essential dental exams and procedures be postponed until further notice.
A tiered framework is provided to inform health systems as they consider resources and how best to provide surgical services and procedures to those whose condition requires emergent or urgent attention to save a life, preserve organ function, and avoid further harms from underlying condition or disease. Decisions remain the responsibility of local healthcare delivery systems, including state and local health officials, and those surgeons who have direct responsibility to their patients. However, in analyzing the risk and benefit of any planned procedure, not only must the clinical situation be evaluated, but resource conservation must also be considered. These recommendations are meant to be refined over the duration of the crisis based on feedback from subject matter experts. At all times, the supply of personal protective equipment (PPE), hospital and intensive care unit beds, and ventilators should be considered, even in areas that are not currently dealing with COVID-19 infections. Therefore, while case-by-case evaluations are made, we suggest that the following factors to be considered as to whether planned surgery should proceed:
Current and projected COVID-19 cases in the facility and region.
consider the following tiered approach in the table below to curtail elective surgeries. The decisions should be made in consultation with the hospital, surgeon, patient, and other public health professionals.
Supply of PPE to the facilities in the system
Staffing availability
Bed availability, especially intensive care unit (ICU) beds
Ventilator availability
Health and age of the patient, especially given the risks of concurrent COVID-19 infection during recovery
Urgency of the procedure.

https://www.miamiherald.com/news/coronavirus/article241415916.html

There you go Lenona. Depending on where you live cancer screening counts as nonessential. CMS doesn't have the authority to do this. Your mayor, county, or governor is the one making this decision. States rights and all that.

As for correcting me, the only real correction I see is where you live. If you think you were correcting me on hospital load issues then you are wrong.

You still haven't said how you think this will play out.

Here’s how I think it will play out.

If things turn out to be better than expected, Trump will claim all the credit.

If things turn out to be worse than expected, Trump will avoid any responsibility.

Welcome to politics JD.

As a side note, I think he can do both at the same time? ;)

Ben, I understand that’s basically the politician’s playbook but I also believe the guy takes both of those things to the extreme.

Not really. You can look at other politicians for reference and it's all the same stuff. Look at Cuomo for a current example. About a third of both the house and the senate. (The other two thirds are too forgettable to bother.) Trump really isn't anything special in that regard.

Ben,

Since you think this is just par for the course would you mind telling the group of any politician who has gone on record saying anything remotely close to the following:

"I don't take responsibility at all"

JD is correct... he is an extremist when it comes to hording credit for positive outcomes and blaming everyone else for negative outcomes.

That isn't how one defines leadership.

Artemis, I bet most other Republican politicians realize what an egregious liar Trump is but, of course, they're hardly going to say so on the record because to say or do anything remotely against him is to incur the wrath of the Republican base.

Well, you've both made up your minds. I doubt you've convinced anyone else. But then again I doubted JD would listen to me either. He's made clear in the past how partisan he is.

Give it a few years and you won't think Trump was that bad. Instead the new Republican will be the devil incarnate instead. Meh.

But then again I doubted JD would listen to me either.

Ben, you reminded me of a former girlfriend. Whenever I didn't agree with her about something, she'd exclaim, "You're just not LISTENING to me!"

I will admit that Trump is better in one way than his Republican predecessor: he has not sent young men (and women) to die in two wars.

JD I don't mind you not agreeing with me. You can find lots of people I disagree with on here. But it wasn't that many days ago where you made clear you have no contact with people who hold differing political views than you other than this blog. When I mentioned you might want to get primary data and actually get to know some instead of just making assumptions about them you then made clear you weren't interested in that. Hence I doubted you would listen to any opposing views about Trump.

I still expect in a decade or so when the next Republican president pops out Trump will be no big deal and the new guy will be evil incarnate. It is an old pattern. Amy does the same thing. When Romeny was running for president she thought he was the worst thing ever. Once he no longer was a candidate and Trump took his place she pined for the old days when Romeny was running. Personally I never cared much for Romney. Still thought he had a chance to win. So I got that one wrong. Mostly I just find the repeated pining for the impossible Republican amusing and confusing.

I would find it interesting if you actually tried to prove your bet with Arty that Republican politicians find Trump to lie excessively.

Ben, I said I don't know anyone personally who supports Trump except for one former co-worker. I've read (i.e. "listened to") numerous Trump supporters in the NY Times comments section and on other blogs.

As for lying, all lying politicians are not the same.

Trump’s Lies vs. Obama’s

After we published a list of President Trump’s lies this summer, we heard a common response from his supporters. They said, in effect: Yes, but if you made a similar list for previous presidents, it would be just as bad.

We’ve set out to make that list. Here, you will find our attempt at a comprehensive catalog of the falsehoods that Barack Obama told while he was president. (We also discuss George W. Bush below, although the lack of real-time fact-checking during his presidency made a comprehensive list impossible.)

We applied the same conservative standard to Obama and Trump, counting only demonstrably and substantially false statements. The result: Trump is unlike any other modern president. He seems virtually indifferent to reality, often saying whatever helps him make the case he’s trying to make.

In his first 10 months in office, he has told 103 separate untruths, many of them repeatedly. Obama told 18 over his entire eight-year tenure. That’s an average of about two a year for Obama and about 124 a year for Trump.

Also Ben, don't forget Trump's truly abhorrent and shameful promotion of the debunked, fringe view that Obama was born in Kenya.

He knows he can lie like a dog and his supporters don't give a damn. Hence his infamous comment:

"You know what else they say about my people? The polls, they say I have the most loyal people. Did you ever see that? Where I could stand in the middle of Fifth Avenue and shoot somebody and I wouldn’t lose any voters, okay? It’s like incredible." -- at a 2016 campaign stop in Sioux City, Iowa"

That was one time that Trump told the truth.

Ben Says:

"Well, you've both made up your minds."

I am pretty certain I asked you to provide evidence of other politicians who have gone on record saying anything remotely like the following:

"I don't take responsibility at all"

That is your opportunity to provide evidence that Trump isn't extreme in this way and is accompanied by many other politicians who so brazenly declare they don't take responsibility for things that occur while they are president.

I'll even ask another question. Can you provide examples of Trump taking responsibility for something that has gone wrong while he has been president?

You are the one claiming that this is just par for the course in politics and that Trump isn't deviating from the norm here.

If that is true you should have examples to demonstrate what you are talking about.

Ben Says:

"I still expect in a decade or so when the next Republican president pops out Trump will be no big deal..."

I get the feeling that you knew next to nothing about Trump prior to his candidacy.

There is a reason that Sesame Street has continually made fun of him for decades:

1988 - Ronald Grump
2005 - Donald Grump

He has always been portrayed as a grouch who is busy swindling people and/or bragging about his trash.

All of this took place long before he was the Republican nominee for president.

He has long been described as a con-artist and all around shitty human being.

It's not like everyone loved Trump, thought he was fantastic, and then turned against him once he started running for office.

People who have been tracking his career know and understand that none of what we are seeing now is unexpected... it takes a special kind of business man to bankrupt a casino.

JD, when I said I didn't think you would listen I ment that quite literally. I don't think I can tell you what I observe in a way you can accurately comprehend. I have no issue with you disagreeing with me but I don't actually think communication is possible. So here is an example.

-------

1. When I said Trump was as honest as most politicians I was actually being generous to you. I actually view Trump as one of the more honest presidents we've had for a while.

2. There is no significant cult of personality for Trump. There is a huge cult of personality against Trump. Much of it he earned honestly as a nouveau riche in New York. But as for a pro-Trump cult of personality it really isn't a significant thing. Even less than Bush had.

3. Conversations like this and above is exactly how Trump got elected. So I thank both you and Arty for your contributions to get Trump reelected.

-------

Now I expect you think I'm some crazy MAGA guy who has very little touch with reality. Don't worry about it. I'm just one vote. You do you and vote for whoever you think is best.

Ben,

The independent bipartisan fact checking organization known as politifact has only rated 14% of his statements as being mostly true or better.

It also rates 14% of his statements as being "pants on fire" lies.

This isn't a minor deviation from all other politicians they track.

Barack Obama for example was rated as having 45% of his statements as being mostly true or better.

It also rates 1% of his statements as being "pants on fire lies".

By every objective measure Trump is a fraction as honest as other politicians and when he lies his lies are larger and more outrageous.

That you view things as completely opposite to the available fact checking data is concerning but not surprising.

"independent bipartisan fact checking organization known as politifact"

Any joke will be funny with a setup like that!

2. There is no significant cult of personality for Trump.

"You know what else they say about my people? The polls, they say I have the most loyal people. Did you ever see that? Where I could stand in the middle of Fifth Avenue and shoot somebody and I wouldn’t lose any voters, okay? It’s like incredible." -- at a 2016 campaign stop in Sioux City, Iowa

I actually view Trump as one of the more honest presidents we've had for a while.

Well, I certainly acknowledge that Trump is honest in one way: in "telling it like it is." He has no filter.

A younger Barack Obama and a younger Donald Trump have been invited over to their girlfriend Julie's parents' house to meet her parents (the Novaks) and to have dinner. The dinner is now over.

Obama says: "That was a delicious meal, Mrs. Novak. Thank you very much. If you opened a restaurant, I'd be a regular customer. And it was very nice talking with both of you. Julie has talked a lot about both of you so I'm glad I finally got to meet you. Also, I must compliment you on raising a lovely daughter. I consider myself blessed that I've met her."

Trump says: "Thank you for making the dinner, Mrs. Novak but, to be honest, I've had many better meals. Many many better meals. I mean, this one is probably in the bottom twenty percent of all the meals I've had. My mother is a much better cook. And also, quite frankly, I was pretty bored talking with both of you. You really didn't have anything interesting to say. And that probably explains your daughter. I like her but, to be honest, I've dated a lot of girls -- I mean a lot of girls -- who were much more interesting. Not to mention much hotter. Quite frankly, Mr. & Mrs. Novak, your daughter just isn't that hot. I'd say she's probably about a 4. I mean, I don't refuse to have sex with her or anything -- I'd only refuse to have sex with a girl who was a 1 or a 2 -- but, let me tell you, to be perfectly frank, there are plenty of other girls I'd rather have sex with."

Alex Trebek: "Jennifer?"

Jennifer: "I'll take 'Two-Letter Words" for $200, please."

Trebek: "And the answer is 'No'"

[buzzer]

Trebek: "Marcus?"

Marcus: "What is 'Has Anyone Found Trump’s Soul?'"

Trebek: "Yes. You're now up to $2,300, Marcus."

JD,

Have you also noticed that all the folks talking about how honest Trump is never actually use facts evidence to demonstrate any of it and reject out of hand all facts and evidence that demonstrate otherwise?

I don't get the feeling they recognize they are the gullible marks in this con job.

JD, good one with the Trump meal joke. That really does sound like him. Repetition and all.

I'll try to explain it further:

Besides the sudden, desperate need for respirators, I have never seen so MANY doctors in developed countries - especially in Italy, right now - having to make the awful choice as to which patients, and how many, will even get the chance to live. Why does anyone believe that the scene in Italy couldn't happen in the US - or that the restrictions we have right now are the wrong way to prevent such a scenario?

Btw, I don't understand the point of the Miami Herald article - it didn't even say anything about restricting medical appointments, per se.

And I never claimed to know how things will play out. I do think it's better to be safe than sorry. We obviously need to protect (and not overload) our health care workers. Not to mention he lives of those essential blue collar workers who are putting their lives on the line every day. You don't do that by living a normal life.

From the WaPo:

https://www.msn.com/en-us/news/us/grocery-workers-are-beginning-to-die-of-coronavirus/ar-BB12eFSF

Thanks, Ben. Glad you appreciated that Trump-at-dinner scenario.

Yes, he does repeat things over and over. Sometimes over and over and over and over. Another tactic, which I find very slimy, is to say things like this: "Many people have said that [so-and-so] is a pedophile. Now, I'm not sure that he is, or I don't know that he is, but this is what many people have said."

By the way, here's conservative Republican Ross Douthat in his most recent NY Times column:

Not because it misdiagnoses Trump himself: Our chief executive is, indeed, bumptiously dishonest, a manure-shoveler without precedent in the modern presidency, a man with little capacity to handle even a mildly inconvenient truth. No one expects a truthful and realistic appraisal of the crisis from this president; any sensible person should look elsewhere for the truth.

It isn't so bad when you don't notice it. But once someone mentions it to you the speaking in triplicate thing is really annoying.

As for so called conservative Douthat, guess I'm not a conservative then. You should have gone with a Mitt Romney or a John McCain if you wanted to go with a never trumper. I doubt you'll convince anyone with that argument.

As just for the record, no Trump isn't a conservative. I don't think there are many people who think he is.

Once you understand how both these statements can be true you are on the path to defeating Trump at he polls.

1. There is no significant cult of personality for Trump.

2. I could stand in the middle of Fifth Avenue and shoot somebody and I wouldn’t lose any voters.

Someone should take a moment to acknowledge that "lifted like a bad girl's skirt" is a wonderful metaphor. Unless it's a simile, because I don't know the difference, but will be stealing it anyway. ~ Crid at April 4, 2020 11:03 AM

It's a simile - and it's a metaphor. All similes are metaphors, but all metaphors are not similes. A simile contains the words "like" or "as." A metaphor can contain them, but does not have to.

And yes, it is a wonderful metaphor - and a wonderful simile.

The NJ response is one of the most sound ones I've seen to a pandemic - don't admit people from a hot zone to your jurisdiction.
Evacuating even our own citizens from China at the outset was not an epidemiologically optimal response. That said, I don't think the way he pursued this goal was constitutional.

"scratch off the surface of most politicians and you will find a brown shirt fascist underneath."

Only someone with a strong impulse to coercively control other people would ever bother seeking political office. It's way too much trouble. Douglas Adams wrote about the president of the galaxy being a figurehead, and the real leader being a conscript who wasn't aware that the solutions he gave for the problems presented him were anything more than a hypothetical parlor game.

"Vaccination clearly prevents harm to others."

Theoretically, only to other un-vaccinated others. If the vaccine's protection is so unreliable that un-vaccinated people place vaccinated people at risk, then where do you get off forcing people to use something you know doesn't work as advertised?