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Old 06-09-2020, 03:57 PM   #76
Tiny
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Quote:
Originally Posted by oeb11 View Post
Tiny - Ur enthusiasm for "contact tracing" is, i believe, mis-placed.

It is an epidemiologic tool for use early in epidemics to identify and isolate those exposed to a disease - usually a disease without effective medical treatment.

Wuhan virus is long since out of the box - and I believe that home isolation to attempt to restrict infecting others - yet accompanied by services such as mail, delivery, and essential careers which exposed people regardless of home isolation - let the Virus out of the box - it is uncontrolled and will not be controlled by any other means than herd immunity.

we will not have a virus vaccine in this calendar year - most likely.

Effective medical treatment - no clearly effective anti-viral drugs on the horizon.


'Contact tracing - is too far behind the scope of the outbreak to be effective - it might have been in China early on - and perhaps in places like Singapore where it was used with home isolation early on - and anti-contact measures - but is very much like trying to shovel back the ocean tide with a space.
Further - it has been politicized - and used as a legal hammer to forcibly isolate individuals who may or may not have had any significant contact with an infected individual - and the reliability of testing for Wuhan virus has a storied history of poor reliability - particularly the Chinese tests.

The politicians have grabbed at "Contact tracing" as a panacea - and an excuse to keep the country isolated in lockdown - for very little -if any- clinical benefit to the population.



This epidemic has long since gotten out of the box - and leaves the politicians with nothing to hld on to their justification for a cure that is worse than the disease.



e should simply open the country up - the people at major risk are the elderly and those with chronic disease and immunosuppression - and allow and support those who wish to isolate who are at risk.

We have screwed ourselves with panic from Liberal models that were touted as "Millions of deaths" - something many Liberals devoutly desired as something to use to "Beat Trump". And authoritative politicians loved exercising authority to restrict the population with little risk of 'blow-back".



Time to open up - offer support and protection for those at risk - and rebuild the economy.

If the current wave of "Anti- Racism" permits the country to do so.
Well reasoned post Oeb. Given the way we behave in the USA you may be right, unfortunately. There aren't many people wearing masks where I live, and Cornavirus cases are spiking. 25% of our total cases were announced in the last 10 days. While I believe the tracing is working well here now, that may not be the case in the future as cases increase for reasons you cite.

My disagreements, I don't think this is a liberal vs. conservative thing. And don't believe you've got or would have people being forcibly isolated. I've read about a couple that had to pay fines and don't think that's an issue. If people have the coronavirus, yeah, they should stay home, or at least shouldn't be running around in close proximity to people who don't know they have it. And if they don't they should get a fine. This analogy probably isn't the best, but someone who has HIV shouldn't be banging people without telling them she's got the disease.

Most importantly I think there's enough evidence from other countries, including European ones, that this will help that we're foolish not to do it given how little it costs and how badly our economy is being effected.

Finally, as you know, we disagree about how rapidly this is spreading and the % of the population infected, which is a large part of why we come to different conclusions. I believe there will be a vaccine in time so that we won't have to get to herd immunity by transmission of the disease.
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Old 06-09-2020, 06:51 PM   #77
oeb11
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Tiny - Thank You for thoughtful discourse - the coronavirus has been politicized as a weapon against Trump by the dems - desperate for a recession as their only weapon again st him in the nov election.



HIV - IMHO- is not a good analogy - HIV is treatable - not curable - but is not spread by cough droplets - but by sexual contact or needle use - much easier to contact trace than "who has been within 6 feet of you in the last two weeks". HIV infected remain infective - unless their viral load is reduced by meds to zero - and I remain skeptical that virus does not remain and is not possibly infective even under that circumstance.

Wuhan virus cannot be treated to make a person non-infective - a short ( usually couple of weeks) course of the progress of viral disease produces antibodies to resolve the infection - just as with a common cold coronavirus. HIV remains for life.



yes - an individual with HIV who infects another individual during sexual contact or with needles without disclosing their HIV infection - in many states has committed a serious crime. State laws may vary.

Should individuals with wuhan virus infection be fined for being in public - first define when a person with the virus infection is infectious - when are they shedding virus and putting other people at risk - Likely the period most at risk of sheddinig virus is very early in the stage of infection - when most people are minimally symptomatic and know NOT that they are infectious. .

I think it unfair to criminalize people who know not their infectious status - not can a person's medical status of infectiousness be medically proven across the population of America. There are not facilities to do viral cultures on the entire American population.



I wish i shared your confidence that a vaccine will arrive - but I do not think it can happen within a year. Please refer to the thalidomide debacle in Europe before folks go picketing the FDA to relax standards of safety for medications and vaccines. ( not directed at u - i think u are more level headed than that).


Given that the infected and undiagnosed cohort is unmeasurable in America - I think it is larger than given estimates - and suspect we will see 50% infections rate - a level for her immunity - already in some areas in America. NY City - they are so tightly packed in and close contact unavoidable with transport systems that I think a 75-80% infection rate is required for her immunity. That plus the dumbass mayor and governor they have making things worse.



Anyway - good discussion - i do not think we have accurate or available enough testing to effect reasonable contact tracing - nor an accurate enough definition of course of disease and infectivity status to reasonably take contact tracing identified people off the streets for quarantine with any confidence that the action positively affects public health.
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Old 06-09-2020, 10:57 PM   #78
Tiny
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Quote:
Originally Posted by oeb11 View Post
Tiny - Thank You for thoughtful discourse - the coronavirus has been politicized as a weapon against Trump by the dems - desperate for a recession as their only weapon again st him in the nov election.



HIV - IMHO- is not a good analogy - HIV is treatable - not curable - but is not spread by cough droplets - but by sexual contact or needle use - much easier to contact trace than "who has been within 6 feet of you in the last two weeks". HIV infected remain infective - unless their viral load is reduced by meds to zero - and I remain skeptical that virus does not remain and is not possibly infective even under that circumstance.

Wuhan virus cannot be treated to make a person non-infective - a short ( usually couple of weeks) course of the progress of viral disease produces antibodies to resolve the infection - just as with a common cold coronavirus. HIV remains for life.



yes - an individual with HIV who infects another individual during sexual contact or with needles without disclosing their HIV infection - in many states has committed a serious crime. State laws may vary.

Should individuals with wuhan virus infection be fined for being in public - first define when a person with the virus infection is infectious - when are they shedding virus and putting other people at risk - Likely the period most at risk of sheddinig virus is very early in the stage of infection - when most people are minimally symptomatic and know NOT that they are infectious. .

I think it unfair to criminalize people who know not their infectious status - not can a person's medical status of infectiousness be medically proven across the population of America. There are not facilities to do viral cultures on the entire American population.



I wish i shared your confidence that a vaccine will arrive - but I do not think it can happen within a year. Please refer to the thalidomide debacle in Europe before folks go picketing the FDA to relax standards of safety for medications and vaccines. ( not directed at u - i think u are more level headed than that).


Given that the infected and undiagnosed cohort is unmeasurable in America - I think it is larger than given estimates - and suspect we will see 50% infections rate - a level for her immunity - already in some areas in America. NY City - they are so tightly packed in and close contact unavoidable with transport systems that I think a 75-80% infection rate is required for her immunity. That plus the dumbass mayor and governor they have making things worse.



Anyway - good discussion - i do not think we have accurate or available enough testing to effect reasonable contact tracing - nor an accurate enough definition of course of disease and infectivity status to reasonably take contact tracing identified people off the streets for quarantine with any confidence that the action positively affects public health.
As I understand it they don't try to contact trace people who've spent a few minutes around an infected person, as probability of transmission isn't that high. In my community they average 10 contacts per infected person. Also, no one in this country is trying to use cell phones and the like to contact trace.

You wouldn't necessarily have to criminalize behavior to make contact tracing work. While I've been wrong about peoples' willingness to wear masks, in Texas at least, I believe most people who are made aware that they have the infection as a result of testing after tracing would isolate themselves without the threat of being penalized. Many or perhaps most would also isolate between the time they're contacted and when they get the test results back.

As you noted transmitting HIV under certain conditions in certain states is a serious crime. Not only that, but there are crimes like possession of drugs and prostitution where arguably you're not putting anyone in danger except yourself, but many people are jailed for committing them. If you had fines to enforce isolation at home from the time a person tests positive to the time they test negative or, if you want to be more nebulous, until symptoms are gone, that would be a good idea IMHO. Yeah, it does go against Libertarian philosophy, but I think it's merited under current conditions.

As to the first point in your post, Democrats weaponizing the coronavirus and Trump's re-election prospects, what if you're wrong as to how this epidemic will progress? If cities and states do a good job of contact tracing, it may (should in my opinion) reduce the number of coronavirus cases significantly over what they'd be otherwise. This will have positive effects on the economy. People will have more confidence about getting out in public, and cities and states will be less inclined to impose more lockdowns. That's good for Trump. And how much does tracing cost? A drop in the bucket compared to what this pandemic is costing us.

On the other hand, say you're right. We progress steadily towards herd immunity with more and more of the population infected and more people dying from the disease. Say Trump were to discourage contact tracing, which he's not going to do. (Actually he's doing the opposite, he's encouraging it, although not as much as I'd like him to.) If he did, he'd give the Democrats that much more ammo to come after him. Many are blaming the crisis on Trump and ignoring the role of the CDC, the FDA, certain governors and mayors, etc. Discouraging contact tracing would give them something concrete to point to, that would go against the advice of most epidemiologists and public health experts.
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Old 06-10-2020, 06:31 AM   #79
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Oeb I was wrong about the cell phone contract tracing. People are voluntarily downloading apps that help with tracing in the USA. I’m not aware of places in this country that are forcing people to do that but they may exist
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Old 06-10-2020, 07:30 AM   #80
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Tiny - thanks for the comments.

i am not a Trump supporter - but the alternative is DPST fascism. turns my stomach.

A shame the wuhan virus was politicized - on both sides.
I do think it is mostly over - and will peter out over the summer.

we shall see.
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