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COVID-19 - NoEnzLefttoSplit - Mar 30, 2020 - 12:57am
 
What Makes You Laugh? - BlueHeronDruid - Mar 29, 2020 - 11:38pm
 
Trump - KarmaKarma - Mar 29, 2020 - 9:55pm
 
YouTube: Music-Videos - oldviolin - Mar 29, 2020 - 8:07pm
 
• • • The Once-a-Day • • •  - oldviolin - Mar 29, 2020 - 7:52pm
 
Cooking for Friends.... - oldviolin - Mar 29, 2020 - 7:06pm
 
The Obituary Page - oldviolin - Mar 29, 2020 - 6:41pm
 
Friends of Bill W? - buddy - Mar 29, 2020 - 5:43pm
 
Radio Paradise Comments - GeneP59 - Mar 29, 2020 - 5:42pm
 
John Prine - Paradise - Peabody Energy on verge of Ch... - triskele - Mar 29, 2020 - 5:19pm
 
• • •  What's For Dinner ? • • •  - Antigone - Mar 29, 2020 - 5:08pm
 
What Are You Going To Do Today? - GeneP59 - Mar 29, 2020 - 4:59pm
 
Poetry Forum - Proclivities - Mar 29, 2020 - 4:38pm
 
Joe Biden - Steely_D - Mar 29, 2020 - 3:01pm
 
Canada - haresfur - Mar 29, 2020 - 2:57pm
 
Pernicious Pious Proclivities Particularized Prodigiously - R_P - Mar 29, 2020 - 2:55pm
 
Things You Thought Today - Steely_D - Mar 29, 2020 - 2:24pm
 
what the hell, miamizsun? - haresfur - Mar 29, 2020 - 1:46pm
 
Strips, cartoons, illustrations - R_P - Mar 29, 2020 - 1:44pm
 
Acoustic Guitar - R_P - Mar 29, 2020 - 1:29pm
 
Recommended documentaries - Ohmsen - Mar 29, 2020 - 12:11pm
 
More reggae, less Marley please - Ohmsen - Mar 29, 2020 - 11:49am
 
Lyrics that strike a chord today... - oldviolin - Mar 29, 2020 - 10:38am
 
Name My Band - oldviolin - Mar 29, 2020 - 10:12am
 
• • • BRING OUT YOUR DEAD • • •  - oldviolin - Mar 29, 2020 - 9:47am
 
Positive Thoughts and Prayer Requests - miamizsun - Mar 29, 2020 - 8:12am
 
Today in History - Red_Dragon - Mar 29, 2020 - 7:16am
 
Vinyl Only Spin List - kurtster - Mar 29, 2020 - 12:25am
 
Nice playlist now.. - spotr - Mar 28, 2020 - 6:30pm
 
Flower Pictures - kcar - Mar 28, 2020 - 12:22pm
 
The Dragons' Roost - triskele - Mar 28, 2020 - 11:49am
 
how do you feel right now? - Coaxial - Mar 28, 2020 - 11:03am
 
Baseball, anyone? - GeneP59 - Mar 28, 2020 - 10:51am
 
Mixtape Culture Club - miamizsun - Mar 28, 2020 - 10:18am
 
Airplay - jbuhl - Mar 28, 2020 - 9:47am
 
Favorite Quotes - oldviolin - Mar 28, 2020 - 8:22am
 
All Dogs Go To Heaven - Dog Pix - oldviolin - Mar 28, 2020 - 8:17am
 
What Did You See Today? - Paul_Andreev - Mar 28, 2020 - 2:52am
 
Funny Videos - kcar - Mar 27, 2020 - 4:28pm
 
Last gas price paid? - katzendogs - Mar 27, 2020 - 3:39pm
 
Counting with Pictures - ndg - Mar 27, 2020 - 1:24pm
 
Economix - R_P - Mar 27, 2020 - 1:13pm
 
songs that ROCK! - Lazy8 - Mar 27, 2020 - 10:29am
 
Automotive Lust - Red_Dragon - Mar 27, 2020 - 8:34am
 
Change mix channel on RP app - BillG - Mar 27, 2020 - 7:56am
 
Rhetorical questions - oldviolin - Mar 26, 2020 - 10:38pm
 
What are you listening to now? - Steely_D - Mar 26, 2020 - 2:32pm
 
Quick! I need a chicken... - ScottFromWyoming - Mar 26, 2020 - 1:26pm
 
Help!!!!!!!! - NoEnzLefttoSplit - Mar 26, 2020 - 1:26pm
 
Tech & Science - R_P - Mar 26, 2020 - 11:12am
 
RP Daily Trivia Challenge - KurtfromLaQuinta - Mar 26, 2020 - 10:20am
 
Public Messages in a Private Forum - kurtster - Mar 26, 2020 - 6:49am
 
Music Videos - whatshisname - Mar 25, 2020 - 10:48pm
 
Trump Lies - kurtster - Mar 25, 2020 - 9:45pm
 
Strange signs, marquees, billboards, etc. - jahgirl8 - Mar 25, 2020 - 5:38pm
 
Democratic Party - jahgirl8 - Mar 25, 2020 - 5:18pm
 
What did you have for dinner? - jahgirl8 - Mar 25, 2020 - 5:14pm
 
THANK YOU GUYS - dawnbland - Mar 25, 2020 - 7:07am
 
Republican Party - Red_Dragon - Mar 24, 2020 - 6:30pm
 
Preferred media player? - gvajda - Mar 24, 2020 - 4:05pm
 
Get the Quote - oldviolin - Mar 24, 2020 - 11:54am
 
Unresearched Conspiracy Theories - miamizsun - Mar 24, 2020 - 6:17am
 
Graphs, Charts & Maps - sirdroseph - Mar 24, 2020 - 2:42am
 
HALF A WORLD - oldviolin - Mar 23, 2020 - 5:12pm
 
Marijuana: Baked News. - westslope - Mar 23, 2020 - 3:16pm
 
Derplahoma Questions and Points of Interest - Red_Dragon - Mar 23, 2020 - 9:42am
 
Things that make you sick - sirdroseph - Mar 23, 2020 - 2:36am
 
Art Show - ScottFromWyoming - Mar 22, 2020 - 11:33pm
 
Amazon Products (May Contain Spam) - BlueHeronDruid - Mar 22, 2020 - 4:01pm
 
RP Windows Desktop Notification Applet - gvajda - Mar 22, 2020 - 11:52am
 
Thanks Bill, Rebecca, and crew! - steeler - Mar 22, 2020 - 10:33am
 
Cryptic Posts - Leave Them Guessing - Isabeau - Mar 22, 2020 - 8:56am
 
Coffee - ScottFromWyoming - Mar 21, 2020 - 9:20am
 
Celebrity Deaths - ScottFromWyoming - Mar 21, 2020 - 12:22am
 
Pick a sport, any sport - haresfur - Mar 20, 2020 - 11:38pm
 
Index » Radio Paradise/General » General Discussion » COVID-19 Page: 1, 2, 3 ... 43, 44, 45  Next
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NoEnzLefttoSplit

NoEnzLefttoSplit Avatar

Gender: Male


Posted: Mar 30, 2020 - 12:57am

 Lazy8 wrote:
R_P wrote:
R.F.A.? Fake News! CDS! I'd recommend a wheel barrow of salt...

Unfortunately the reporting on this story mostly originates from one of the few independent news sources in China, Caixan. That's where RFA picked up the story, along with Newsweek and Time, AsianNews,  and the Daily Telegraph and a number of others. The Japan Times is doing their own reporting—and getting mostly "no comment" from those they ask

Official figures from the Chinese government on cremations in Wuhan aren't yet available for this quarter, but show higher numbers for the preceding quarter than explained by official reports. There is good reason for skepticism about the rosy news coming from official Chinese sources.

We'll likely have a better picture in the next few weeks, but it's a little early to be celebrating good news from Wuhan.
 
There is a lot of room for discretionary judgment when deciding whether someone died of corona or with corona. I wouldn't be surprised if the death count were way higher than reported.
kurtster

kurtster Avatar

Location: drifting
Gender: Male


Posted: Mar 29, 2020 - 11:56pm

 kcar wrote:
kurtster wrote:

"I was going to keep my nose out of this one until you actually posted the plan and got snotty about it."
D)  Where the f$^# was I snotty?!?

Quote: bill13's: can you point us towards a better plan to combat this pandemic or are just here to distract and spread FUD?

That is what I interpreted as being snotty.  Granted I was already in a mood when I made that remark ...

 kurtster wrote:

kcar wrote: 
I stand by my assertion that bill13's reference to Emanuel's article in The Atlantic was irrelevant to the subject at hand.

kurtster replied:
IZZAT SO ? You are the final arbiter of relevance here ?

 

Much as I would love to prance around wearing a crown emblazoned with "Final Arbiter of Relevance", I cannot say that I am. But I am entitled to my opinion just like the rest of us. 

E)  If you can explain how Emanuel's Atlantic Monthly essay on his desire not to live past 75 (the essay that bill13 mentioned) has much to do with his recommendations on containing this pandemic, PLEASE: explain in detail. 
kurtster wrote: 

"First, between what he wrote in his Public Health sections and testing section, he is essentially advocating Martial Law. "

Here's what Emanuel wrote:
President Trump needs to immediately order the closing of all schools and nonessential businesses and impose a shelter-in-place policy for the entire country. The majority of the population is already experiencing some version of this protocol or feeling the effects economically; we need to standardize these protocols for the full public health impact.

If these measures are complied with fully, then we may be able to lift them slowly in two to three months, when the percentage of people infected has plateaued and the number of new infections is near zero.
I'd agree that Emanuel doesn't seem to be aware of how much opposition Trump would face if he imposed a nationwide shelter-in-place policy. But as he wrote, most areas of the country have closed schools and non-essential businesses already. And Trump already has invoked the Defense Production Act. I would not call that part of martial law. In fact, the DPA has been re-authorized over 50 times and has been used many times—including by Trump in 2017:

https://en.wikipedia.org/wiki/...
kurtster wrote:
"You just cannot order a company to do something that they may have no expertise in because they are the first company someone thinks of. "
Did Ezekiel Emanuel call for such a thing? No he did not. Frankly I think he again was being politically naive to suggest as he did that "The federal testing director needs expanded authority so he can invoke the Defense Production Act to secure the emergency production and national distribution of testing components like swabs and viral culture media. "

It may be possible that Trump would grant such DPA authority to a "federal testing director" but I doubt it. Trump has already invoked the DPA by the way. No martial law suggested, imposed or worried about. 
BUT KURT: here's the big takeaway from the two-paragraph quote of Emanuel I included just under my words "Here's what Emanuel wrote:"
If these measures are complied with fully, then we may be able to lift them slowly in two to three months, when the percentage of people infected has plateaued and the number of new infections is near zero.
Those are Emanuel's words and that his estimate of how long it would take to beat the coronavirus if Trump imposed a strict quarantine policy and everything else went right. Two to three months. 

Now, there may be epidemiologists and pandemic specialists and public health experts who disagree with Emanuel. I invite you and others to find evidence and informed voices who have opinions on this matter, even if they disagree completely with Emanuel. 

But I haven't seen that many assessments of how long we'll have to fight Covid-19 and what we'll have to do to maximize our chances of success. That's why I posted the piece. To get people to comment and find other informed voices who have weighed in on this matter. 

Emanuel isn't the only voice in town. Who else with knowledge and experience has offered a plan of action? I don't know but I would like to read more informed opinions on this. 


A) Finally, you strongly objected to this quote from Emanuel's piece: 

"All hospitals must be directed to institute policies that decrease demand for supplies. For instance, intravenous machines for Covid-19 patients should be kept outside their room when possible so workers can adjust medications without donning protective gear. Hospitals that comply with such rules should be guaranteed interest-free loans for operating expenses."

.
A)  Kurt, look again at the quote. Emanuel included the term "when possible" in his idea of keeping IV machines outside of the rooms holding Covid-19 patients. Apparently volumetric pumps exist to push liquids into patients. I have no idea of how from how far away they can push IV solution into a patient. My guess is that Emanuel as an oncologist has at least some idea of the capabilities of IV machines.

You wrote:

"Do you have any idea how much fluid it is going to take to fill up a 3mm ID 50 foot hose (in reality you would need a minimum of 100 feet) just to have liquid between the pump and the patient ? "

I have no idea of how you come up with the measurement of at least 100 feet of hose. 33 yards of hose? My mom was in a very good recovery facility for her hip replacements. She had lots of room. She was no more than 30 feet away from the main door and she was as far from the door as possible. 

C)  Here's what you do: ask your oncologist or nurses you see/know about whether Emanuel's notion is idiotic or possible. It could be as foolish as you say. Quite honestly, I'd be interested to hear what they have to say. 

But do you have a problem with the general idea behind it? The idea you quoted? Here it is again: 
"All hospitals must be directed to institute policies that decrease demand for supplies. "

Frankly, it's a bit of a no-brainer. But it does make sense.

B)  Don't get hung up on the feasibility of his IV machine suggestion. 
You wrote : 

"Go ahead and put all of your faith and confidence in your source because it came from an approved liberal rag professed by an approved unimpeachable liberal doctor with friends in high places to further his credibility. "
Stop being such an angry child. This isn't about liberal vs. conservative. Emanuel is suggesting things we can do to save lives and get the country past this pandemic crisis. 

If you can find other informed proposals for action in the months ahead, point us to them. Because Trump isn't coming up with such a proposal. 

A lot of what Emanuel proposed on March 23 has already started to happen. Some of his ideas won't happen. But he's coming up with ideas to help us. 
 
Thank you for actually reading my post.  I just woke up from a 5 hour nap and will try and address your reply the best I can.

A)  Those volumetric pumps are the ones I was referring to when I said that I had 5 pumps and 7 bags daisy chained into me during one (more than one actually, but having 3 pumps going all the time was average and many of the pumps failed every so often) particularly lengthy and arduous round of chemo.

from your link ...

a volumetric pump, unlike a manual IV setup that depends upon gravity, will continue to force fluid into the patient's tissues, even if the cannula has become dislodged from the vein; this can cause the patient a lot of pain and damage surrounding tissues, and it prevents the medication from being properly distributed and absorbed by the bloodstream, so peripheral IVs which use volumetric pumps must be checked regularly for infiltration

That means that someone must come into the room every so often as described by protocol to visually check the status of the med bag, the pump and the actual attachment to the patient, no matter what.

I stated the minimum length needed would be 50 feet didn't I ?  You would need 10 feet of slack at either end for the machine and the patient.  There is your 30 + 20 feet and then the 10 feet to the patient may not be long enough for the patient to maneuver in the room.  Do you really think that a hose length would be tailored for each room and patient ?  These things come in standard lengths and the use of off the shelf stuff must be done in order to have everything predictable and reliable.  The length of those hoses in anything over 10 feet will have to consider added fluids in the equation just to take up the extra volume needed to fill all of the additional hose.  And so on.

New edit: Additionally, It would clog up hallways even more creating obstacles and trip hazards, and then there would be all the additional electrical rewiring necessary to handle all of these devices now in the hallway.  The rooms are already designed with these considerations including placement of all such outlets and devices.  

B)  sorry but I cannot get past that.  It is a total nonstarter.  It is so totally 101 level and fundamental level wrong before he even gets started.  Yet he cites it as his premise for knowledge and insight to base his whole notion on that follows.  It is not practically possible and is never going to be practically possible no matter how hard he wishes it to be.  Yet that is his example.  And you and everyone else, says yeah, Bravo, such a no brainer solution that there must be many more like it to find and put in place.  Which is what you did, right ?   Your own words,  Frankly, it's a bit of a no-brainer. But it does make sense.  You still cannot understand how wrong that idea is from the get go, look at his credentials and assume that everything that follows is also worthy and correct.  He is writing a politically based opinion piece about how he would handle things if he were in charge, nothing more and nothing less, imho.  He succeeded in taking you in, hook, line and sinker, by your own admission.

If you go back and read my post from 9 days ago, (which predates the doctor's article) regarding my lockdown during my test for CV19 you will see where I specifically addressed my own concerns based upon first hand experience and observations of the use of PPE's and the hazards of repeated entry into a patient's room (in the very same context the doctor was speaking about in his article), complete with free and common sense recommendations.  I am always looking at the big picture to the best of my ability with an attention to what are or should be some of the true priorities.  To me, my recommendations were a no brainer.

CLICKY


C)  You are overlooking more than a couple of things with that remark. 

1)  I do have a medical license that restricts me from saying and doing certain things, period, no matter where I say them, because if anyone acts on what I say, it is possible that I can be held legally responsible for it if acted on and causes harm.  Everything I say here medically is with that in the back of my mind, at all times.  I also have a recent (2007) BBA in Organizational Management, or problem solving to over simplify, so I have credentialed training in this area.

2)  We have an actual well respected doctor here amongst us.  I do read what he has to say and he seems to read the things that I say here.  I am very sure that if I said anything patently or fundamentally wrong, he would speak to me, either publicly or privately here.  I consider that he is always looking over my shoulder when I speak about specific medical things.  I know what I don't know and stick only to things that I do know when getting specific

3)  The demonstrated experience on the subject matter at hand as having been directly involved in IV therapy over many, many years.  FWIW, in the middle of my first round of chemo, the standard quick connects were being changed throughout the entire US medical system as well as changing protocols for there correct usage.  I had to help and instruct some nurses that I encountered in places such as the ED, when they were confronted with these new devices they had not yet seen.  I had both new and old going on in me at the same time.  For example, the protocols for flushing these devices after use had changed.  An ED nurse put me into isolated lockdown for a week having IV heparin pumped into me 24 / 7 to deal with the blood clots I got when she refused to flush my port and connectors the old way, with heparin, using saline instead, because that is the way we do it here.  I have told this particular story here over and over again.  Bitch damn near killed me.

4)  I am also a patient advocate and a damn good one for myself, wife and mother and even my sister who commutes from Dallas to Cleveland, to be treated by the same doctor who treats me for her own different NHL.  My wife is even better at it than I am.  We work the system and help guide many others through it as well every damn day.  We have too many friends dealing with cancer at this very moment, that it is heartbreaking.  We just lost our daughter to it a couple of weeks ago on 3 /17.  We have recommended doctors and locations for treatment to too many lately quite frankly.  I am sick of cancer and dealing with it everywhere I look.  Another reason not to panic and keep that glass half full.

So if it makes you happy, I will bring up that notion of your good doctor's suggestion a week from Wednesday at my next regularly scheduled appointment.  I can already predict the responses, but I will go through all the motions and follow through just for you.

So there you have it from me for now.  This whole thing centers around the credibility of Dr Emmanuel, right ?  That is where you stepped in and objected to bill13's remarks  Point D)  to start all of this off.  I think that I demonstrated how fundamentally wrong and even deliberately misleading Dr Emmanuel was to discredit him to my satisfaction and saying in no uncertain terms how I thought of him as being a possible oncological caregiver to me. 

If I had to have him be my oncologist to save my life, I would sooner slide down razor blades into a bucket of alcohol and then cut my dick off and bleed to death than let him get anywhere near me.  I stand by that opinion and put my own life behind it.  Would you trust him with your life ?  That is what you are doing in essence in defending his statements in the light of what I have illustrated above, imho.

E)  This is somewhat amusing as the past few days I have been thinking hard about how really crazy everyone is with their expectations of our government and leaders in handling this whole crisis and all of the pandering and posturing underway.  At the beginning of the discussion about the multi trillion dollar emergency relief plan, I privately predicted to my wife that somehow carbon footprints would be inserted into the solution even though they have absolutely nothing to do with dealing with the emergency right now.  I turned out to be correct

So here is my next prediction, made publicly and fearlessly ...  It will not be too very long before someone says we have a human right for our government to guarantee us a certain life expectancy length.  We must rise up and demand it !  And I have no problem what so ever to consider more than a few to actually think that it A) is within reason and B) should be mandated.  The thought about Emmanuel living past 75 made me think to bring this up here and now before closing.

I do welcome your's or anyone else's response to this overall post.  Thank you for taking the time to read it.

All of my editing is now complete. *  Please reread if you finished before this was said.  Things got rearranged and changed a lot in between.

{#Meditate}
Lazy8

Lazy8 Avatar

Location: The Gallatin Valley of Montana
Gender: Male


Posted: Mar 29, 2020 - 10:51pm

KarmaKarma wrote:

The evidence for hydroxychloroquine's effectiveness is wobbly at best*. If it's effective it's not a miracle drug, it may have some benefit but Donald Trump's expert medical opinion is worth less than nothing.

I have no idea what FDA is basing its action on or what that action even means; hydrochloroquine is already available to any prescribing physician, and any physician can write a prescription for off-label use. They didn't need to "authorize" it.

It's being hyped by people who don't know what they're talking about to people who don't know what they're hearing. That doesn't mean they're wrong. It might help. It might be as effective as homeopathy. Guess we're about to find out how many doctors believe what they hear on Fox, and a month from now we might have real data to make the call.

*Requires a (free) subscription, which is totally worth it if you have any interest in medical issues. Great site.
KarmaKarma

KarmaKarma Avatar



Posted: Mar 29, 2020 - 9:24pm



 Lazy8 wrote:
R_P wrote:
R.F.A.? Fake News! CDS! I'd recommend a wheel barrow of salt...

Unfortunately the reporting on this story mostly originates from one of the few independent news sources in China, Caixan. That's where RFA picked up the story, along with Newsweek and Time, AsianNews,  and the Daily Telegraph and a number of others. The Japan Times is doing their own reporting—and getting mostly "no comment" from those they ask

Official figures from the Chinese government on cremations in Wuhan aren't yet available for this quarter, but show higher numbers for the preceding quarter than explained by official reports. There is good reason for skepticism about the rosy news coming from official Chinese sources.

We'll likely have a better picture in the next few weeks, but it's a little early to be celebrating good news from Wuhan.
 
This is very promising.  Now watch all the hoarders run for the drugstores and natural health shops.

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


https://docs.google.com/document/d/1SesxgaPnpT6OfCYuaFSwXzDK4cDKMbivoALprcVFj48/mobilebasic



FDA seems to think its worthwhile to try.

https://theconservativetreehouse.com/2020/03/29/fda-issues-emergency-authorization-for-the-use-of-hydroxychloroquine-to-combat-coronavirus-effective-immediately/





Lazy8

Lazy8 Avatar

Location: The Gallatin Valley of Montana
Gender: Male


Posted: Mar 29, 2020 - 9:06pm

R_P wrote:
R.F.A.? Fake News! CDS! I'd recommend a wheel barrow of salt...

Unfortunately the reporting on this story mostly originates from one of the few independent news sources in China, Caixan. That's where RFA picked up the story, along with Newsweek and Time, AsianNews,  and the Daily Telegraph and a number of others. The Japan Times is doing their own reporting—and getting mostly "no comment" from those they ask

Official figures from the Chinese government on cremations in Wuhan aren't yet available for this quarter, but show higher numbers for the preceding quarter than explained by official reports. There is good reason for skepticism about the rosy news coming from official Chinese sources.

We'll likely have a better picture in the next few weeks, but it's a little early to be celebrating good news from Wuhan.
kcar

kcar Avatar



Posted: Mar 29, 2020 - 8:05pm

kurtster wrote:

"I was going to keep my nose out of this one until you actually posted the plan and got snotty about it."


Where the f$^# was I snotty?!?



 kurtster wrote:

kcar wrote: 
I stand by my assertion that bill13's reference to Emanuel's article in The Atlantic was irrelevant to the subject at hand.

kurtster replied:
IZZAT SO ? You are the final arbiter of relevance here ?

 

Much as I would love to prance around wearing a crown emblazoned with "Final Arbiter of Relevance", I cannot say that I am. But I am entitled to my opinion just like the rest of us. 

If you can explain how Emanuel's Atlantic Monthly essay on his desire not to live past 75 (the essay that bill13 mentioned) has much to do with his recommendations on containing this pandemic, PLEASE: explain in detail. 


kurtster wrote: 

"First, between what he wrote in his Public Health sections and testing section, he is essentially advocating Martial Law. "



Here's what Emanuel wrote:
President Trump needs to immediately order the closing of all schools and nonessential businesses and impose a shelter-in-place policy for the entire country. The majority of the population is already experiencing some version of this protocol or feeling the effects economically; we need to standardize these protocols for the full public health impact.

If these measures are complied with fully, then we may be able to lift them slowly in two to three months, when the percentage of people infected has plateaued and the number of new infections is near zero.


I'd agree that Emanuel doesn't seem to be aware of how much opposition Trump would face if he imposed a nationwide shelter-in-place policy. But as he wrote, most areas of the country have closed schools and non-essential businesses already. And Trump already has invoked the Defense Production Act. I would not call that part of martial law. In fact, the DPA has been re-authorized over 50 times and has been used many times—including by Trump in 2017:

https://en.wikipedia.org/wiki/...


kurtster wrote:
"You just cannot order a company to do something that they may have no expertise in because they are the first company someone thinks of. "


Did Ezekiel Emanuel call for such a thing? No he did not. Frankly I think he again was being politically naive to suggest as he did that "The federal testing director needs expanded authority so he can invoke the Defense Production Act to secure the emergency production and national distribution of testing components like swabs and viral culture media. "

It may be possible that Trump would grant such DPA authority to a "federal testing director" but I doubt it. Trump has already invoked the DPA by the way. No martial law suggested, imposed or worried about. 


BUT KURT: here's the big takeaway from the two-paragraph quote of Emanuel I included just under my words "Here's what Emanuel wrote:"


If these measures are complied with fully, then we may be able to lift them slowly in two to three months, when the percentage of people infected has plateaued and the number of new infections is near zero.


Those are Emanuel's words and that his estimate of how long it would take to beat the coronavirus if Trump imposed a strict quarantine policy and everything else went right. Two to three months. 

Now, there may be epidemiologists and pandemic specialists and public health experts who disagree with Emanuel. I invite you and others to find evidence and informed voices who have opinions on this matter, even if they disagree completely with Emanuel. 

But I haven't seen that many assessments of how long we'll have to fight Covid-19 and what we'll have to do to maximize our chances of success. That's why I posted the piece. To get people to comment and find other informed voices who have weighed in on this matter. 

Emanuel isn't the only voice in town. Who else with knowledge and experience has offered a plan of action? I don't know but I would like to read more informed opinions on this. 


Finally, you strongly objected to this quote from Emanuel's piece: 

"All hospitals must be directed to institute policies that decrease demand for supplies. For instance, intravenous machines for Covid-19 patients should be kept outside their room when possible so workers can adjust medications without donning protective gear. Hospitals that comply with such rules should be guaranteed interest-free loans for operating expenses."


Kurt, look again at the quote. Emanuel included the term "when possible" in his idea of keeping IV machines outside of the rooms holding Covid-19 patients. Apparently volumetric pumps exist to push liquids into patients. I have no idea of how from how far away they can push IV solution into a patient. My guess is that Emanuel as an oncologist has at least some idea of the capabilities of IV machines.

You wrote:

"Do you have any idea how much fluid it is going to take to fill up a 3mm ID 50 foot hose (in reality you would need a minimum of 100 feet) just to have liquid between the pump and the patient ? "

I have no idea of how you come up with the measurement of at least 100 feet of hose. 33 yards of hose? My mom was in a very good recovery facility for her hip replacements. She had lots of room. She was no more than 30 feet away from the main door and she was as far from the door as possible. 

Here's what you do: ask your oncologist or nurses you see/know about whether Emanuel's notion is idiotic or possible. It could be as foolish as you say. Quite honestly, I'd be interested to hear what they have to say. 

But do you have a problem with the general idea behind it? The idea you quoted? Here it is again: 


"All hospitals must be directed to institute policies that decrease demand for supplies. "

Frankly, it's a bit of a no-brainer. But it does make sense. Don't get hung up on the feasibility of his IV machine suggestion. 


You wrote : 

"Go ahead and put all of your faith and confidence in your source because it came from an approved liberal rag professed by an approved unimpeachable liberal doctor with friends in high places to further his credibility. "


Stop being such an angry child. This isn't about liberal vs. conservative. Emanuel is suggesting things we can do to save lives and get the country past this pandemic crisis. 

If you can find other informed proposals for action in the months ahead, point us to them. Because Trump isn't coming up with such a proposal. 

A lot of what Emanuel proposed on March 23 has already started to happen. Some of his ideas won't happen. But he's coming up with ideas to help us. 
rgio

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Location: West Jersey
Gender: Male


Posted: Mar 29, 2020 - 6:34pm



 R_P wrote:
 Lazy8 wrote:

R.F.A.? Fake News! CDS! I'd recommend a wheel barrow of salt...
 
Check the Steele dossier!

I think in the long term it is important to have accurate data, but whether 10,000 or 100,000 people in China died doesn't change the speed at which the US government responded, suggestions of control, lack of support for purchasing/organizing needed supplies, and the constant focus on avoiding facts to attempt to prop up the markets.

We now have a daily variety show that in return for saying "we want to thank the President for his leadership", corporate CEO's get 30 seconds of airtime to sell the American people on their brands.
miamizsun

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Location: (3261.3 Miles SE of RP)
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Posted: Mar 29, 2020 - 5:43pm


jacob glanville's team over at distributed bio has been working  non-stop on an antibody based treatment/therapeutic 
buddy

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Location: Denver
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Posted: Mar 29, 2020 - 5:34pm

This stuff in here is getting ridiculous.  

R_P

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Posted: Mar 29, 2020 - 5:19pm

 Lazy8 wrote:

R.F.A.? Fake News! CDS! I'd recommend a wheel barrow of salt...
haresfur

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Location: The Golden Triangle
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Posted: Mar 29, 2020 - 4:23pm

I think when all is said and done, there will be lots of lessons learned from the strengths and weaknesses of every country's response. China made a mistake early on (initially a local official) but they really didn't understand what they were dealing with. I don't agree with sugar-coating numbers, if that is what happened, but I can understand the impulse if you want to keep people from freaking out. The Italians got overwhelmed so quickly, I don't know what else they could have done. The rest of Europe probably should have ramped  up sooner, especially Spain and Great Britain. US and probably Australia fucked up royally. A few early words from Trump and our PM #ScottyFromMarketing about the potential seriousness would have damped down the denial and made it easier to get people to take appropriate measures. I feel like I have been slightly ahead of the curve, but just barely. Could have started sheltering more, earlier. Would it have mattered? Hard to say.

And if you are ok with Trump acting like requests for aid from states with large population centers are business negotiations that he can win by pushing back, I have nothing but contempt.
kurtster

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Location: drifting
Gender: Male


Posted: Mar 29, 2020 - 4:05pm

 miamizsun wrote:

New coronavirus test provides results in 5 minutes — and could arrive this week

By 3 minutes ago

Abbott Labs plans to get this new coronavirus test in doctors' hands by April 1



 
And to think I started a flame war over getting excited about a 45 minute test over a week ago, that is still set to be delivered Monday.  I guess that my expectations are seriously out of touch with reality.  I just set my expectations too low.  I should have been angry that it took almost 2 months starting from scratch for the test for a newly discovered virus that took 45 long minutes for results, instead of elated.  

So, 5 minutes is too long.  There, now I'm in instep with everyone else.
Total Recovered
149,076
Coaxial

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Posted: Mar 29, 2020 - 3:59pm

 katzendogs wrote:
um. Is it just me or is this page just so wide I need a 105" screen to view the conversation?
 
Yes, it's Richard's graphs.
Proclivities

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Location: Paris of the Piedmont
Gender: Male


Posted: Mar 29, 2020 - 3:57pm



 katzendogs wrote:
um. Is it just me or is this page just so wide I need a 105" screen to view the conversation?
 

There are probably some widely-formatted, pasted items.  It renders on my laptop - using Chrome - but I remember that happening before.
katzendogs

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Location: Pasadena ,Texas
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Posted: Mar 29, 2020 - 3:53pm

um. Is it just me or is this page just so wide I need a 105" screen to view the conversation?
kurtster

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Location: drifting
Gender: Male


Posted: Mar 29, 2020 - 3:47pm

 Lazy8 wrote:

Estimates Show Wuhan Death Toll Far Higher Than Official Figure


As authorities lifted a two-month coronavirus lockdown in the central Chinese city of Wuhan, residents said they were growing increasingly skeptical that the figure of some 2,500 deaths in the city to date was accurate.

Since the start of the week, seven large funeral homes in Wuhan have been handing out the cremated remains of around 500 people to their families every day, suggesting that far more people died than ever made the official statistics.

"It can't be right ... because the incinerators have been working round the clock, so how can so few people have died?" an Wuhan resident surnamed Zhang told RFA on Friday.

"They started distributing ashes and starting interment ceremonies on
Monday," he said.

Seven funeral homes currently serve Wuhan — a huge conurbation of three cities: Hankou, Wuchang and Hanyang.

Social media users have been doing some basic math to figure out their daily capacity, while the news website Caixin.com reported that 5,000 urns had been delivered by a supplier to the Hankou Funeral Home in one day alone — double the official number of deaths.

Some social media posts have estimated that all seven funeral homes in Wuhan are handing out 3,500 urns every day in total.

Funeral homes have informed families that they will try to complete cremations before the traditional grave-tending festival of Qing Ming on April 5, which would indicate a 12-day process beginning on March 23.

Such an estimate would mean that 42,000 urns would be given out during that time.

Various calculations

Another popular estimate is based on the cremation capacity of the funeral homes, which run a total of 84 furnaces with a capacity over 24 hours of 1,560 urns city-wide, assuming that one cremation takes one hour.

This calculation results in an estimated 46,800 deaths.

A resident of Hubei province, of which Wuhan is the capital, said most people there now believe that more than 40,000 people died in the city before and during the lockdown.
 

In the funeral home, more than a dozen male staff members came to the truck to move the piles of ashes to the side hall of Jingya Hall for storage. There were 7 stacks for every 500. Photo / Caixin reporter Bao Zhiming    Click on photo credit for more and higher definition pictures
Proclivities

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Location: Paris of the Piedmont
Gender: Male


Posted: Mar 29, 2020 - 3:38pm



 Antigone wrote:
Prine
 
Yeah, I just heard about that...

Antigone

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Location: A house, in a Virginian Valley
Gender: Female


Posted: Mar 29, 2020 - 3:35pm

Prine
Lazy8

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Location: The Gallatin Valley of Montana
Gender: Male


Posted: Mar 29, 2020 - 3:20pm

Estimates Show Wuhan Death Toll Far Higher Than Official Figure


As authorities lifted a two-month coronavirus lockdown in the central Chinese city of Wuhan, residents said they were growing increasingly skeptical that the figure of some 2,500 deaths in the city to date was accurate.

Since the start of the week, seven large funeral homes in Wuhan have been handing out the cremated remains of around 500 people to their families every day, suggesting that far more people died than ever made the official statistics.

"It can't be right ... because the incinerators have been working round the clock, so how can so few people have died?" an Wuhan resident surnamed Zhang told RFA on Friday.

"They started distributing ashes and starting interment ceremonies on
Monday," he said.

Seven funeral homes currently serve Wuhan — a huge conurbation of three cities: Hankou, Wuchang and Hanyang.

Social media users have been doing some basic math to figure out their daily capacity, while the news website Caixin.com reported that 5,000 urns had been delivered by a supplier to the Hankou Funeral Home in one day alone — double the official number of deaths.

Some social media posts have estimated that all seven funeral homes in Wuhan are handing out 3,500 urns every day in total.

Funeral homes have informed families that they will try to complete cremations before the traditional grave-tending festival of Qing Ming on April 5, which would indicate a 12-day process beginning on March 23.

Such an estimate would mean that 42,000 urns would be given out during that time.

Various calculations

Another popular estimate is based on the cremation capacity of the funeral homes, which run a total of 84 furnaces with a capacity over 24 hours of 1,560 urns city-wide, assuming that one cremation takes one hour.

This calculation results in an estimated 46,800 deaths.

A resident of Hubei province, of which Wuhan is the capital, said most people there now believe that more than 40,000 people died in the city before and during the lockdown.

kurtster

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Location: drifting
Gender: Male


Posted: Mar 29, 2020 - 3:00pm

 kcar wrote:


 Proclivities wrote:

 kcar wrote:
 
In the Atlantic piece, Ezekiel Emanuel largely writes about his own desire not to live past 75, given the drop-off in health, mental capacity and general levels of function. He is strongly against euthanasia and physician-assisted suicide.

Emanuel is an oncologist and a highly respected voice about public health matters. 
https://en.m.wikipedia.org/wik...

He's also brother to former Chicago Mayor Rahm Emanuel and Hollywood agent Ari Emanuel.

In the piece I cited, Emanuel writes about a strong plan to contain the coronavirus, treat the infected and limit economic damage. bill13's dredging up of Emanuel's thoughts on aging is irrelevant to discussions on pandemics and the enormous challenges our health care system is dealing with.

bill13's: can you point us towards a better plan to combat this pandemic or are just here to distract and spread FUD?
 
I don't think bill13's post was to spread any fear, uncertainty, or doubt - it seems to me that he was just calling the source into question (maybe not, but whatever).  Yes, apparently Dr. Emanuel is an oncologist and a bioethicist - he is not an epidemiologist, an expert in contagious diseases, or a biostatistician.  That of course does not mean his opinions or conclusions are invalid or incorrect - he's still a medical expert (and I do not disagree with his assertions) -  but there are a lot of projections and predictions out there (and here) from so-called "professionals"; I think it's good to have a little concern about where they're coming from.
 

I stand by my assertion that bill13's reference to Emanuel's article in The Atlantic was irrelevant to the subject at hand.

IZZAT SO ?  You are the final arbiter of relevance here ?  

I take your point about Emanuel's apparent lack of formal training focused on epidemiology and public health initiatives geared to combat pandemics. However, here are his five proposed initiatives to combat the pandemic. I think they are on-target and widely supported by other medical experts:

PUBLIC HEALTH

President Trump needs to immediately order the closing of all schools and nonessential businesses and impose a shelter-in-place policy for the entire country. The majority of the population is already experiencing some version of this protocol or feeling the effects economically; we need to standardize these protocols for the full public health impact.

If these measures are complied with fully, then we may be able to lift them slowly in two to three months, when the percentage of people infected has plateaued and the number of new infections is near zero.


TESTING


The federal testing director needs expanded authority so he can invoke the Defense Production Act to secure the emergency production and national distribution of testing components like swabs and viral culture media. Over the next two weeks, all Covid-19 testing should be removed from hospitals and clinics so these institutions can focus on treating patients.

Instead, we should immediately use the military, the National Guard, and even a new Public Works Corps made up of unemployed Americans to erect thousands of walk-up and drive-through testing sites nationwide.

We must immediately begin to conduct random samplings of people in a community to determine the percentage of the population
with coronavirus and the percentage of people with the virus who die.
EQUIPMENT PRODUCTION

 

We need a national manufacturing director to assess and allocate national supplies and ramp up production and distribution of what is needed. After ordering all hospitals to conduct an inventory of their needs, the director could prioritize the shipment of supplies to the ones that need them most.

The director should provide congressional appropriations to manufacturers to transform production facilities while issuing necessary regulatory approvals to speed production and
using the F.D.A.’s emergency use authorization powers to enact liability protections for firms willing to produce new products. Production could be on a cost-plus basis, as it is for defense contractors already.
HOSPITALS AND HEALTH CARE PERSONNEL

All hospitals must be directed to institute policies that decrease demand for supplies.

For instance, intravenous machines for Covid-19 patients should be kept outside their room when possible so workers can adjust medications without donning protective gear. Hospitals that comply with such rules should be guaranteed interest-free loans for operating expenses.

Any physicians, nurses and other clinicians who are working less because of restrictions on their practices should be encouraged to work at hospitals. We should encourage the reactivation of all retired and nonpracticing physicians, nurses, respiratory therapists and other clinicians who can work. Duke University is already working to train volunteers to assist in a clinical setting. Offer foreign-trained physicians and nurses who cannot practice in the United States an opportunity to work. Grant 12-month extensions to all foreign physicians on J-1 educational exchange visas, with special state licenses.

We should ask for volunteers to travel to cities with more urgent demand, providing salaries and housing stipends. A national hospital oversight director could reposition those clinicians for maximal impact. A coronavirus compensation program could ensure no hospital or clinician is held liable for adverse events during the outbreak unless there is clear negligence.

Nurse practitioners and physician assistants should be allowed to prescribe medications without restrictions.



THE ECONOMY

 

Businesses need to retain workers and keep up their facilities so they can rapidly return to operation when Covid-19 is under control. The Treasury Department should issue grants for up to 12 months to closed businesses with fewer than 1,000 workers to cover 80 percent of the equivalent of 2019 wages and benefits for their furloughed employees. These companies should also be allowed to borrow at zero interest up to last year’s revenue.

States should get block grants to create temporary jobs needed to control the public health crisis, such as workers for testing centers, thermal screening in public places, widespread contact tracing, quarantine monitoring and disinfecting public transportation and public places.

 

 
I was going to keep my nose out of this one until you actually posted the plan and got snotty about it. Thank you for doing so.  But not for the reasons you hoped to accomplish.

The good doctor is out of his effing mind and is pandering to an agenda with his "plan".

First, between what he wrote in his Public Health sections and testing section, he is essentially advocating Martial Law.  Trump just yesterday, spoke of a lockdown of NY, NJ, and parts of CN and was almost immediately shot down by everyone being led by Gov Cuomo of NY is also threatening legal action against Florida for its desire to keep fleeing NY residents out of the state.  It ain't gonna happen.  It should, but it ain't, and it won't happen but not because of any failure by Trump for not trying.

You approve of what will essentially be a declaration of Martial Law ?
The DPA was already authorized and invoked earlier this past week.  Trump already ordered GM to get busy on making ventilators several days after their statement that they would jump on the team and get right on it was determined to be just empty do nothing virtue signaling.  He has promised other use of the DPA and I have no doubt that he will.  trump has also spoke widely on the matter explaining that it is not as simple as saying make it so or else.  To use it as a blunt force object and have a government take over of manufacturing is going to result in more bad outcomes than good ones.  You just cannot order a company to do something that they may have no expertise in because they are the first company someone thinks of.  I could go on a lot more on this, but there is too much other to discuss.  FEMA already is coordinating distribution of supplies at the national level and is doing well AFAIK.  Tell me it is not keeping it up to the task with references and I'll consider another look at FEMA on this.

Lastly and where the good doctor loses all credibility is Hospital section.

It will never, ever, ever even be a possibility of keeping IV trees and pumps outside of a critical care patient's room.  Ever in the near term future.  To even think that this is possible claiming to have medical knowledge is beyond any understanding I have.  And then to attach some political financial motivation to "incentivise" its implementation, is immediately discernible as another useless layer of redtape and political agenda pushing

So I'm glad you asked what my knowledge of IV infusion is as I call your doctor a Witch Doctor.  First off being intimately familiar with your basic standard and specialized hospital rooms, you are going to add 100 feet of tubing to the chain.  I have danced with IV pumps and trees for weeks at a time rolling them around the room as I got out of bed to the bathroom and to anywhere else, including outside of the room on long walks with it for exercise. 

The record for the number of pumps and power cords on one tree pumping shit into me all at once was 5 of them with 7 bags of all sizes and goodies ranging from just 50ml to the jumbo 500ml that would give you hypothermia ( IIRC, I had a couple 1 liter bags that took more than 24 hours to push), daisy chained down into two separate simultaneous feeds into my port which was a Double Lumen version.  I also had a 3 port hickman line at the same time until it got infected and had to be removed in an unscheduled operation.
 
Here's a 2 port Hickman.  Mine had three of them little cat toys dangling out of my chest. Lot's of fun, eh ?  Try sleeping with one with or without all kinds of hoses attached, for months.


Pretty, ain't it ?  Beside those two types of ports, I've had pick and com lines as these other ports failed over time.  My veins are so shot even with all of the ports I've had to stay away from my veins.  I've got one good one left in my right arm that is saved for phlebotomies when my blood levels get out of whack and the only way to get them back to where they should be is by draining 500 ml of blood and tossing it away.  Once that vein is gone we start looking at the legs as an option.  The phlebotomy needle fucking sewer pipe for that is so huge, you can look down into it and see Ed Norton (SWAK, sewer workers are king) waiving back at you.  Due to an interruption of manufacturing after the hurricane hit Puerto Rico and an outfit in Miami, Fla. there was period when we were using improvised rigs to get it done.  The reason they must be so big in diameter is that they will allow all the cells, including platelets, the largest pass through without coagulating.  Need a blood sample from me, you're gonna have to use a Butterfly on the top of my hand.  Butterflies are much more expensive than those big straight line rigs that they plug the vials into for ordinary draws that you are most likely familiar with. 

So can we agree that I have at least a modicum of knowledge on the subject of IV infusion and exfusion without any internet references ?

Now let's get into just the practicality of having the pump outside of the room.  Do you have any idea how much fluid it is going to take to fill up a 3mm ID 50 foot hose (in reality you would need a minimum of 100 feet) just to have liquid between the pump and the patient ?  I'll keep going while you do the math.  A lot.  More than a potential bag / dose of a med for starters.  You do need something to push that dose through to the patient and the less you use, the more certain that the drug you needed to send got there as undiluted as possible and as quickly as possible.  Just this one extra hose is going to add a huge weak link into the equation.  Common sense tells you that gravity must be dealt with in moving liquids.  The pump and hose would have to be elevated outside the room and gradually slope downhill to the patient.  That would require a brand new specialized piece of equipment.  Then even when viscosity, fluid dynamics and simple physics are not in the way, a new, special more powerful pump would be needed to push the sheer mass of fluid all that extra distance.  These lines can also easily clog for the most minor of reason or even get a vapor lock.  Lines are rapidly changed when things go wrong all the time.  How many nurses is it going to take to change a clogged line run along high on a wall or hung from a ceiling on its lengthy route to the patient and how much new fluid is it going to take to prime that line ?  and how quickly ? Then there is the minor detail that all of that pusher fluid must enter the patient to make sure that all the prescribed dosages are properly administered.  OBTW, that pusher fluid is not tap water, it is at the very least sterile saline.  Some meds require other solutions to push.  Remember that we also had a shortage of certain IV bags of simple saline after the that stupid hurricane a couple of years ago that disrupted the hardware part of the IV equation ?  I do.

The very notion that an idea like this was even a fantasy of a doctor (and an oncologist who must have at least a basic understanding of administering IV therapy)  playing expert for your benefit and came out of his mouth for proud publication is beyond astonishing.  This man, a renowned and highly regarded oncologist, that he could let such a preposterous idea loose on the public as an example of a liberal scientific solution to a real medical situation, should be enough to get his license revoked for being dangerous to public health and safety.  I cannot take anything that I may ever hear him utter about anything medical seriously ever again.

If I had to have him be my oncologist to save my life, I would sooner slide down razor blades into a bucket of alcohol and then cut my dick off and bleed to death than let him get anywhere near me.

Now this is the part where as arbiter and determiner of common sense here that you tell me that I have no clue about what I am talking about.   All of this is just stream of consciousness straight off of the top of my head based upon personal experience.  That I did not use any internet sources to support my words (other than for pictures) or have any relevant medical credentials that allow me to challenge the edict of an MD discredits all that I just wrote. 

Go ahead and put all of your faith and confidence in your source because it came from an approved liberal rag professed by an approved unimpeachable liberal doctor with friends in high places to further his credibility. 

Also just to touch on The Federalist, even being the Trump supporter that I am, I learned a long time ago that The Federalist is not a site to be trusted for facts but can have some valid opinions and provide links to actual facts.  But I will never go there looking for support of anything I'm trying to offer.

I see that our doc is nearby and am willing to be corrected about any of the things I may have gotten wrong with my information about IV's.  The last thing I ever want to be is wrong or misleading on some thing so serious.
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