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wartownfalcon

Kirk Herbstreit says....

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On 3/30/2020 at 5:37 PM, FalconsIn2012 said:

That’s the White House that rolled it out today

 

March 30, 2020 - 11:00 AM EDT

Birx: US could see up to 200,000 coronavirus deaths if 'we do things almost perfectly'

Loading video BY JUSTIN WISE TWEET SHARE EMAIL

 

 

White House coronavirus response coordinator Dr. Deborah Birx on Monday warned that up to 200,000 people in the U.S. could die from the coronavirus outbreak if "we do things almost perfectly."

In an appearance on NBC's "Today," Birx stressed that the Trump administration remains "very worried" about every city in the United States and the possibility that the virus could get "out of control." She also noted that some metropolitan areas "were late in getting people to follow" social distancing requirements and that it had an effect on the virus's spread.

"If we do things together well, almost perfectly, we could get in the range of 100,000 to 200,000 fatalities," Birx said after being asked about U.S. projections related to the outbreak. "We don't even want to see that."

She added that the administration's models show a worst-case scenario of between 1.6 million and 2.2 million deaths if the U.S. were to enforce zero restrictions on travel and gathering. 
 

 

It’s important to point out as more information comes in, the apocalyptic numbers keep being reduced. Just in the past two weeks Fauci dropped the death counts 80%, then today said they could be under 100,000. 

For instance, just today Fauci mentioned we could have 100,000 deaths then said it could be under that. 

The next two weeks the number of deaths are going to spike, it will get really ugly, then they expect the death counts to peak April 23, then start to plummet.

Another media trick to install panic and sensationalize and already horrible situation, is to focus always on the highest outside amount number. You never see a headline “deaths could be under 100,000” when they say that, but you will always see the big bold blazing headline “BIRX SAYS 200,000 could die!!!!”

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3 hours ago, Vandy said:

Wow, look what I just dug up!

In its approval letter for the use of hydroxychloroquine Sunday evening, the FDA wrote that ”based on the totality of scientific evidence available to FDA, it is reasonable to believe that chloroquine phosphate and hydroxychloroquine sulfate may be effective in treating COVID-19.

BOOM

media still is saying  today no evidence 

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23 minutes ago, gazoo said:

Wow, look what I just dug up!

In its approval letter for the use of hydroxychloroquine Sunday evening, the FDA wrote that ”based on the totality of scientific evidence available to FDA, it is reasonable to believe that chloroquine phosphate and hydroxychloroquine sulfate may be effective in treating COVID-19.

BOOM

media still is saying  today no evidence 

 

 

Quote

may be effective

 

 

dude...

...

 

dood...

 

 

read that again...

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Just talk to my sister who went to help in NY.  They’re using Hydrochloroquine and experiencing some success.  She didn’t know about the Z-pack usage.  I’ll continue to update this thread as she feeds me info.  I sent her the following link and asked if she was Familiar.  
 

https://techstartups.com/2020/03/28/dr-vladimir-zelenko-now-treated-699-coronavirus-patients-100-success-using-hydroxychloroquine-sulfate-zinc-z-pak-update/

 

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14 hours ago, gazoo said:

From the economists I’m hearing from, we can sustain a national shutdown through April, possibly a week or two more, before we are rolling the dice to a complete meltdown of our economy and way of life that could thrust us into a depression not unlike 1929 that lasts several years, maybe a decade or more. 

Since vaccine a year away, and since it’s not feasible to all stay locked in our homes hoping the virus dies on its own, we simply aren’t going to be bale to completely stop it from spreading. That said, over 84% of people that get it down even get symptoms, another 10% have light symptoms. 

So to me, if we single out the high risk category and nuke them with these promising treatments the moment they feel tightness of breath or flu like symptoms, and keep their symptoms from escalating into the cytokine storm that requires hospitalization and death, we can dramatically lower the crisis part of this pandemic, get back to work in phases I believe starting May 1st. Also, testing for those who already had it which I think is way more of the population than is known at this point, and letting them get back to work now, we don’t have to worry about creating another Great Depression.

 

Regarding the numbers, where have you come across those?  I've seen consistently 15% hospitalized, 5% on ventilators.  And of the 85% no hospitalized, many many of those are quite sick (like you would be with a bad flu or worse) but just don't need hospitalization.  And as you said, some are less symptomatic.

But if there are more up to date numbers, shoot them on.

Regarding economy, it's much like the pandemic in terms of how bad it gets depends on how it's managed.  We can go a little longer if they kept employees connected to employers by guaranteeing a percentage of payroll instead of waiting until people are laid off and then beefing up unemployment.  

If people know they still have their job when we're on the other side of this, that gives way more stability and confidence than having enough money this month but not knowing about next.  Plus, people would retain their insurance.

The other aspect is making sure people don't have to pay mortgages (including businesses) for a short period of time.  That lets a lot more businesses stay open if they're hot having to pay their hard fixed costs, and they know their payroll is being subsidized.

That process lets you "bail out" businesses at the same time as helping individuals.  Basically, the businesses only get help if they keep their employees.

That also means, as soon as the pandemic lifts a little, businesses are immediately ready to go, instead of having to hire and train new people.  

I'm hoping they'll do something more like this in the next stimulus.  We've attacked it in a piecemeal fashion, which is better than nothing.  But our economy is so interconnected, that they really need a "whole hog" version that doesn't try to guess which industries need help, which groups.  Just essentially "pause" on mortgages, spend the money you would have spent on unemployment to keep people with their jobs instead.

We're of the same mind in terms of what needs to be done (shut everything down, then test and quarantine) but have different ways of going about it.  The above version it seems like more than doubles the time we could "be shuttered" if need be, which is worthwhile leverage to have if we need it.

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On 3/31/2020 at 1:10 AM, Sn4tteRBoxXeR said:

Someone on my street died from it. So yeah... it's not overblown or a hoax.

I've been as concerned about this Coronavirus as anybody. I got the message loud and clear this shlt was serious. Not to disrespect those that have died from it so far and will die from it before the hot weather burns it out, but this is not even all that memorable in terms of average flu deaths in the US since 2010.

The range is from 12,000 to 61,000 deaths per year. The average year seems to be about 25,000 to 35,000 deaths. I do not have the latest count, but it seems to be about 4,000 Covid-19 deaths in the US so far. Let's compare that number to those who have died so far this winter in the US from influenza, the "regular" yearly flu bug, and the figure through mid-March is between 29,000 and 59,000. There are apparently no hard figures for that because nobody's worried much about a known virus even though it kills about 30,000 each year without any great hoopla.

The medical experts, including the President's advisors, are still projecting Coronavirus will kill 240,000 in the U.S. before it abates some time in early May. Excuse me if I find that death toll projection hard to believe, but yeah, that figure seems way overblown by gigantic orders of magnitude considering where we are today.

These "experts" always make sure they cover their aszes by predicting the worst case scenario. In 2009 during the H1N1 flu epidemic after it had been going on for months, President Obama's medical experts were predicting between 30,000 and 90,000 people would eventually die. Actual deaths: about 13,000. If the pharma companies can produce enough hydroxichloroquine to treat people, my prediction is 25,000 US Covid-19 deaths maximum, not 250,000. 

Again not to belittle the Coronavirus pandemic, but I guess the point of this post is that the numbers ~ so far ~ have not amounted to the level of emergency that was predicted. Most of the deaths have been to those with previous medical conditions. I am grateful for that. However, the predictions of Doom have seriously damaged the US and world economy. Many individuals will be living with the financial devastation long after Covid-19 has disappeared into the dustbin of history.

Maybe this kind of financial catastrophe can be averted and the entire country won't have to be locked down next time if the federal health authorities and CDC will make dam sure it has the test kits, ventilators, hospital supplies available to meet this level of need. Obviously, New York needs to be way better prepared for this kind of situation as well, but that goes for the rest of the country too.

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On 3/30/2020 at 3:38 PM, tactician said:

The fatality rates are being dramatically over inflated due to lack of testing. If asymptomatic cases were including the fatality rate would drop like a rock, to well below 1%.

150k confirmed cases in the US so far. In a nation with 350,000,000 people that's around .05% of the population. So a disease that has infected only 5/100 of 1% of the population would have somehow also infected Kevin Durant, Rudy Gobert, Doris Burke, Donovan Mitchell, James Dolan, Rand Paul, multiple congressman, Tom Hanks, Idris Elba and others? No, that would defy all reason. The disease has already infected millions, most of whom will never be tested. If you tested every person in America the number of positives would probably be in the low 8 figures. These things spread incredibly quick, H1N1 infected 60,000,000 in the US in 2009. The true fatality rate is much, much, much lower than being reported. 

I have worked in medicine for 14 years....I haven't had to make decisions about which people may have 'time' to intubate later in the hopes that other people currently intubated may come off of their vent...and I am in a state that is not as severely hit as the ones around me...yet. You can come up with whatever numbers you want, but this entity unfortunately is tipping the scales on our critical care system in this country that it has not seen in modern history. 

I agree that the infection has likely hit millions as we are significantly undertesting at this time due to lack of testing capabilities and/or flat out actual need to test.

About fatality numbers...we are seeing people become severely ill around days 5-10 in many cases, so there is often a delay between diagnosis in the ill, and when they decompensate completely into ARDS/cardiopulmonary collapse.

-------------

To Gazoo's point; position statements from various entities like ACP are pumping the breaks on hydroxychloroquine and chloroquine, because of the paucity of rigorous study of their utility in COVID-19, and that positive studies are a combination of anecdotal/case based or non-peer reviewed, etc. 

BUT, show me in any novel fast developing situation where there are multiple rigorous studies in the course of 3 months, and I will give you a zillion dollars...because there is no way to roll out rigorous studies in a short time frame in this environment.

Nebraska has some of the best ID medicine in the world, let alone the US, and they are utilizing these medications in situational trials.

They are pushing remsdesivir right now as their preferred treatment modality...as it does have noted in-vitro capability against COVID-19, and had previously shown to be effective on coronaviri in animal trials. 

Biggest problem I foresee with remsdesivir is cost, in comparison to generic antiinflammatory/antimalarias that have been around for 50 years.

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1 hour ago, takeitdown said:

Regarding the numbers, where have you come across those?  I've seen consistently 15% hospitalized, 5% on ventilators.  And of the 85% no hospitalized, many many of those are quite sick (like you would be with a bad flu or worse) but just don't need hospitalization.  And as you said, some are less symptomatic.

But if there are more up to date numbers, shoot them on.

Regarding economy, it's much like the pandemic in terms of how bad it gets depends on how it's managed.  We can go a little longer if they kept employees connected to employers by guaranteeing a percentage of payroll instead of waiting until people are laid off and then beefing up unemployment.  

If people know they still have their job when we're on the other side of this, that gives way more stability and confidence than having enough money this month but not knowing about next.  Plus, people would retain their insurance.

The other aspect is making sure people don't have to pay mortgages (including businesses) for a short period of time.  That lets a lot more businesses stay open if they're hot having to pay their hard fixed costs, and they know their payroll is being subsidized.

That process lets you "bail out" businesses at the same time as helping individuals.  Basically, the businesses only get help if they keep their employees.

That also means, as soon as the pandemic lifts a little, businesses are immediately ready to go, instead of having to hire and train new people.  

I'm hoping they'll do something more like this in the next stimulus.  We've attacked it in a piecemeal fashion, which is better than nothing.  But our economy is so interconnected, that they really need a "whole hog" version that doesn't try to guess which industries need help, which groups.  Just essentially "pause" on mortgages, spend the money you would have spent on unemployment to keep people with their jobs instead.

We're of the same mind in terms of what needs to be done (shut everything down, then test and quarantine) but have different ways of going about it.  The above version it seems like more than doubles the time we could "be shuttered" if need be, which is worthwhile leverage to have if we need it.

I’m thoroughly enjoying this conversation thread with you and others here. I can tell irrespective of one’s politics, everyone is sincere and open minded. My hope is this may be indicative of how things might shake out in the country on a larger level. IOWs, the epidemic may help mitigate some of the polarization in the country.

Here is the link to the scientific study, let me know your thoughts . 

According to the study six of every seven coronavirus cases – 86% – of the people were walking around and driving the spread of the deadly virus. Another good case study we have is the Diamond Princess Cruise Ship where they were afloat for over two weeks before they knew the virus had been spreading around like wildfire on it. They were then quarantined another 2 weeks on the boat together. It ended up, half the people who tested positive for the virus were asymptomatic, and that cruise was mostly older Asian couples. There were a few hundred Americans on board I believe, but mostly older Asians.

https://science.sciencemag.org/content/early/2020/03/24/science.abb3221.full

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1 hour ago, takeitdown said:

Regarding economy, it's much like the pandemic in terms of how bad it gets depends on how it's managed.  We can go a little longer if they kept employees connected to employers by guaranteeing a percentage of payroll instead of waiting until people are laid off and then beefing up unemployment.  

The economists I heard talking on this issue were saying some parts of the economy, many critical parts of the supply chain, cannot hold off much longer.

They used an example of a tree farm start up. For the first few years you have to grow the trees, so upon starting the business you have no product for a few years. Then, each year after you start selling your first harvest,  you plant new ones to replace those sold to keep the pipeline filled for each year. 

In the United States, we have many businesses going bankrupt or losing senior management and critical employees even as we speak. These type of businesses don’t just open back up September first and start cranking at full production. Many will be closed for good, others will take months or years to get back to full production. If they are producing certain materials in a supply chain of certain industries,  has a domino effect all the way to the finish line.

In other words, there are some critical parts of our supply chain for economic sustainability in the areas of agriculture, technology, Medicaid etc that have long start back up up periods to get back to full production if they had to shut down for too,long, and these guys were saying while the economic engine and production of the US can sustain a shutdown lasting through end of April for sure, perhaps another week or two after that, there is a point where many of the underlying things needed start to collapse, which impacts the entire spunky chain of economic sustainability. The entire economy can implode to a point of no return at a certain point, thrusting the country into a long term depression. 

That was their argument, and these guys weren’t partisan hacks. It was an excellent interview and I could tell they weren’t pushing  narrative. 

 

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1 hour ago, ki46dinah said:

They are pushing remsdesivir right now as their preferred treatment modality...as it does have noted in-vitro capability against COVID-19, and had previously shown to be effective on coronaviri in animal trials

Ki46dinah,

I’ve  been hearing good things about the Remdesivir as well, other countries have had a lot of success with it.  I knew they were using it here in the States on some level, whether it was experimental, compassionate etc. I don’t think the FDA has approved it yet as they have the Chloroquine have they? We were using chloroquine and azithromycin prior to FDA approval as well.

The chloroquine has actually undergone a controlled, peer reviewed clinical trail in France, just not here in the States yet.  My understanding is chloroquine by itself is nowhere near as effective as chloroquine AND azithromycin. Also, this protocol is most effective if given to patients prior to acute symptoms, prior to hospitalization. You ha e to hit them as soon as flu like symptoms or shortness of breath besets them. 

Once the onset of acute symptoms hit my understanding is it’s results are negligible from anecdotal evidence.

Im curious as to how you are using the Remdesivir. Since you are in a hospital setting, I assume your experience with it is it’s shown promise once a patient has been hospitalized with acute symptoms. 

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11 hours ago, mfaulk57158 said:

Just talk to my sister who went to help in NY.  They’re using Hydrochloroquine and experiencing some success.  She didn’t know about the Z-pack usage.  I’ll continue to update this thread as she feeds me info.  I sent her the following link and asked if she was Familiar.  
 

https://techstartups.com/2020/03/28/dr-vladimir-zelenko-now-treated-699-coronavirus-patients-100-success-using-hydroxychloroquine-sulfate-zinc-z-pak-update/

 

Exactly. I was reading somewhere yesterday that doctors all over the US are stocking up on Hydroxychloroquine for themselves and their families. While the clinical trials are still very limited, in practical use this stuff has shown to be very effective.

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1 hour ago, gazoo said:

Ki46dinah,

I’ve  been hearing good things about the Remdesivir as well, other countries have had a lot of success with it.  I knew they were using it here in the States on some level, whether it was experimental, compassionate etc. I don’t think the FDA has approved it yet as they have the Chloroquine have they? We were using chloroquine and azithromycin prior to FDA approval as well.

The chloroquine has actually undergone a controlled, peer reviewed clinical trail in France, just not here in the States yet.  My understanding is chloroquine by itself is nowhere near as effective as chloroquine AND azithromycin. Also, this protocol is most effective if given to patients prior to acute symptoms, prior to hospitalization. You ha e to hit them as soon as flu like symptoms or shortness of breath besets them. 

Once the onset of acute symptoms hit my understanding is it’s results are negligible from anecdotal evidence.

Im curious as to how you are using the Remdesivir. Since you are in a hospital setting, I assume your experience with it is it’s shown promise once a patient has been hospitalized with acute symptoms. 

Heres the most updated Nebraska Med protocol, where they are doing Remdesivir research at the moment. 

https://www.nebraskamed.com/sites/default/files/documents/covid-19/antiviral-and-pharmacotherapy-information.pdf

There is a lot of conjecture about azithromycin in this whole situation, as it has antiinflammatory factors anyways(why it is hypothesized to be helpful in non-infectious COPD exacerbations) and some ID docs/ICU docs are using it in conjunction with hydroxychloroquine.

FDA did approve Hydroxychloroquine and chloroquine on 3/28 for emergent use on COVID tx.

Remdesivir has not been approved yet, but there are ongoing research trials on ill and nonill patients in hospital systems(like Nebraska Med)..hopefully will be fastracked or given orphan status soon if things continue to go well.

In the mean time, early intubation in critically ill, or at the very least high flow nasal cannula(not to be confused with normal nasal cannula administration) to stave off days spent on a ventilator. 

Some places are using ECMO as well...but even regular ECMO centers don't have a ton of these available for the surging numbers.

We continue to hope to receive critically ill in a spread out fashion; New York has not had such luck unfortunately. 

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3 hours ago, gazoo said:

The economists I heard talking on this issue were saying some parts of the economy, many critical parts of the supply chain, cannot hold off much longer.

They used an example of a tree farm start up. For the first few years you have to grow the trees, so upon starting the business you have no product for a few years. Then, each year after you start selling your first harvest,  you plant new ones to replace those sold to keep the pipeline filled for each year. 

In the United States, we have many businesses going bankrupt or losing senior management and critical employees even as we speak. These type of businesses don’t just open back up September first and start cranking at full production. Many will be closed for good, others will take months or years to get back to full production. If they are producing certain materials in a supply chain of certain industries,  has a domino effect all the way to the finish line.

In other words, there are some critical parts of our supply chain for economic sustainability in the areas of agriculture, technology, Medicaid etc that have long start back up up periods to get back to full production if they had to shut down for too,long, and these guys were saying while the economic engine and production of the US can sustain a shutdown lasting through end of April for sure, perhaps another week or two after that, there is a point where many of the underlying things needed start to collapse, which impacts the entire spunky chain of economic sustainability. The entire economy can implode to a point of no return at a certain point, thrusting the country into a long term depression. 

That was their argument, and these guys weren’t partisan hacks. It was an excellent interview and I could tell they weren’t pushing  narrative. 

 

Yeah, this is not far off.  You can imagine it like being in a long line at a red light.  The moment the light turns green, you should, in theory, start moving.  But the reality is, it may take 2 or 3 minutes before you start to go.  That's because you're relying on dozens of links in the chain to get started moving ahead of you.  

If you're a manufacturer...you may have customers ready to go to buy your product (they're the last car) and stores ready to receive (2nd to last car).  But you can't make anything until the raw materials and next stages are done (the 1st and 2nd car).  So you may be waiting awhile.

The people losing jobs now is what shouldn't be happening.  We should be guaranteeing payroll and keeping companies together.  We shouldn't do that normally as a rule.  But the government is asking these people to shut down, so this isn't a normal time.  And it would radically reduce the lag time once the economy ramps back up.  Keeping those chains intact (supply chains, etc) is critical, so keeping companies in the middle of the chain from going bankrupt during this time is necessary even though it's expensive.  Any solution right now is going to be expensive.  But having our supply chains (it's more complicated than this and is complete industry chains going up the entire vertical) severed will be more expensive.

We need to get very comprehensive against this.  People are still thinking of this in terms of an airline problem, or a this problem or a that problem.  This is a whole world Pause.  You can't fix this or that.  You have to do a fundamental coverage of the pause time, all over...then you have a lot more leeway in how you handle the rest.

And on your previous message, agreed.  I would love nothing more than partisanship to go away, and facts become facts, and things that are projections be based on reasonable discourse.  Even have some Republicans believe Climate change is a big issue, and some Democrats believe that work should be required for assistance.  We used to have more variety within the parties.  A lot of issues aren't actually partisan, but as soon as the heads of the parties decide their stance, all the supporters get in lock step.  It makes coming together over an issue impossible because it seems like a betrayal.  It's a wrongheaded way to do things.

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Check this out, the New York Times is now reporting on the success of hydroxychloroquine.  We now have a successful randomized trial.  It’s they said it was administered prior to onset of severe symptoms. This is what I’ve been reading from many other sources.

Cough, fever and pneumonia went away faster, and the disease seemed less likely to turn severe in people who received hydroxychloroquine than in a comparison group not given the drug. The authors of the report said that the medication was promising, but that more research was needed to clarify how it might work in treating coronavirus disease and to determine the best way to use it.

“It’s going to send a ripple of excitement out through the treating community,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University.

The study was small and limited to patients who were mildly or moderately ill, not severe cases. Like many reports about the coronavirus, it was posted at medRxiv, an online server for medical articles, before undergoing peer review by other researchers.

But the findings strongly support earlier studies suggesting a role for the drug, Dr. Schaffner said.

“I think it will reinforce the inclination of many people across the country who are not in a position to enter their patients into clinical trials but have already begun using hydroxychloroquine,” he said.

https://www.nytimes.com/2020/04/01/health/hydroxychloroquine-coronavirus-malaria.html

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Everyone keeps saying Trump didn't act fast enough but Trump has been listening to the advice of people from the CDC and WHO and when they say stuff like this how in the world can people blame this on Trump? Check out the date on this, January 14th.

The Chinese are the ones that have lied about this from the very beginning and put the whole world at risk from not telling the truth. If China had been honest about this whole thing from the very beginning the reaction by other countries would have been much different and we could have nipped this in the bud and kept going about our daily lives like nothing ever happened. Instead China has irresponsibility has led to the death of thousands of people in other countries around the world.

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39 minutes ago, AUTiger7222 said:

But why are you obsessed with this conspiracy theory? BTW conspiracy theories don't have to be false, only that they are theories about conspiracies. So why are you obsessed about prove it true? So many people in this thread desperately need it to be true, but it's like, that's the past, and people can't drop it for some abstract reason.

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40 minutes ago, AUTiger7222 said:

And please read your own **** link dude:

Quote

Coronavirus likely originated in November, was first in U.S. in January

Researchers have tied the origin of the virus to a live animal market in Wuhan, China. The World Health Organization first received a report of the outbreak on Dec. 31, but the virus originated in China more than a month earlier than that. A study published in early March by researchers at ETH Zurich puts the origin of the virus in the first half of November

 

Quote

January

 

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On 4/2/2020 at 0:56 AM, Falcanuck said:

Nothing changes until preventative drugs are synthesized. Treatments are great and will absolutely lower death counts, but they do not help in containing this and hence the shutdown continues.

Not entirely true because once enough people survive and become immune, they can resume normal activities without worrying about spreading the virus.

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8 hours ago, Sn4tteRBoxXeR said:

 

Not entirely true because once enough people survive and become immune, they can resume normal activities without worrying about spreading the virus.

Well no. Being immune does not mean you can’t be a carrier. Normal activities resume upon a vaccine or literally the majority of the population becoming infected and recovering (a long time). 

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