bigredbeta
Why am I in this handbasket?
- Joined
- Aug 4, 2019
Pediatric ICU doctor here.
Have a trip planned for this fall.
Really not worried about my kids getting particularly sick as they are both healthy (now would not be the time for a Make-a-Wish trip though...have a friend in the PICU of one of the Orlando Children's hospital who has some horror stories of those kids getting sick on vacation...not great). While not a complete count, the best available PICU database for North America (www.myvps.org) shows only 250 PICU admissions of children <18 as of today (May 5th). The dashboard doesn't show it but most of the reported deaths are of adults who were placed in pediatric ICU's as overflow. So based off of this understanding, it's very low risk for them.
Risk factors for my wife and I are low, though not zero, but truthfully, I'm likely at significantly greater risk going to work compared to the parks/hotel/restaurants.
Other than diligent and frequent disinfection, I struggle with the utility of other social distancing measures being worth it almost to the point of nihilism. Temperature scans are too easily circumvented with Tylenol/Motrin, 6 feet spacing is nearly impossible to enforce at the hardware store let alone for a theme park, people are terrible with wearing masks properly. Getting on ride vehicles or sitting in show theaters seems to destroy the spacing argument almost immediately. Reducing capacity sounds great from a parks experience standpoint, but at some point, the overall risk of large groups plateaus - is there that much risk increase between 50 people and 500? It's certainly not a linear increase. 50000 people sounds like a lot, but is it that much different than 10000? The most important thing I think Disney can do to decrease their liability is to take care of their Cast Members, and make sure that they have a lenient enough sick policy that CM's don't come to work ill.
I'm not counting on any treatment options to become available anytime soon. There are some flaws in the remdesivir data that I think will come out in the larger post-approval data collection. The critical care literature is littered with drugs that were supposed to be the saving grace for critically ill patients that did well in early trials only to be found useless once exposed to larger, more diverse patient volumes/pathophysiology. From a healthcare resource utilization standpoint, some sort of post-exposure prophylaxis to prevent hospital admission would be the best thing but with so many people having "mild" illnesses it would be really hard to get a study together that can demonstrate that effect. And that still wouldn't necessarily change your risk for feeling like absolute garbage for 2 weeks, just that you could stay home and not need the hospital.
Vaccines are the best hope, and I'm more encouraged by their promise. I believe the worst case scenario will be a seasonal SARS CoV-2 vaccine that'll be like the flu vaccine. Hopefully it'll only be yearly and not every 6 months but that wouldn't surprise me either.
Have a trip planned for this fall.
Really not worried about my kids getting particularly sick as they are both healthy (now would not be the time for a Make-a-Wish trip though...have a friend in the PICU of one of the Orlando Children's hospital who has some horror stories of those kids getting sick on vacation...not great). While not a complete count, the best available PICU database for North America (www.myvps.org) shows only 250 PICU admissions of children <18 as of today (May 5th). The dashboard doesn't show it but most of the reported deaths are of adults who were placed in pediatric ICU's as overflow. So based off of this understanding, it's very low risk for them.
Risk factors for my wife and I are low, though not zero, but truthfully, I'm likely at significantly greater risk going to work compared to the parks/hotel/restaurants.
Other than diligent and frequent disinfection, I struggle with the utility of other social distancing measures being worth it almost to the point of nihilism. Temperature scans are too easily circumvented with Tylenol/Motrin, 6 feet spacing is nearly impossible to enforce at the hardware store let alone for a theme park, people are terrible with wearing masks properly. Getting on ride vehicles or sitting in show theaters seems to destroy the spacing argument almost immediately. Reducing capacity sounds great from a parks experience standpoint, but at some point, the overall risk of large groups plateaus - is there that much risk increase between 50 people and 500? It's certainly not a linear increase. 50000 people sounds like a lot, but is it that much different than 10000? The most important thing I think Disney can do to decrease their liability is to take care of their Cast Members, and make sure that they have a lenient enough sick policy that CM's don't come to work ill.
I'm not counting on any treatment options to become available anytime soon. There are some flaws in the remdesivir data that I think will come out in the larger post-approval data collection. The critical care literature is littered with drugs that were supposed to be the saving grace for critically ill patients that did well in early trials only to be found useless once exposed to larger, more diverse patient volumes/pathophysiology. From a healthcare resource utilization standpoint, some sort of post-exposure prophylaxis to prevent hospital admission would be the best thing but with so many people having "mild" illnesses it would be really hard to get a study together that can demonstrate that effect. And that still wouldn't necessarily change your risk for feeling like absolute garbage for 2 weeks, just that you could stay home and not need the hospital.
Vaccines are the best hope, and I'm more encouraged by their promise. I believe the worst case scenario will be a seasonal SARS CoV-2 vaccine that'll be like the flu vaccine. Hopefully it'll only be yearly and not every 6 months but that wouldn't surprise me either.