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Comment by PragmaticPulp | Hacker News Reader

The premise of this article is that we should essentially press the “panic button” now, to get people through the shock of preparing for a pandemic while we know it’s safe to do so.

> Suggesting things people can do to prepare for a possible hard time to come doesn’t just get them better prepared logistically. It also helps get them better prepared emotionally. It helps get them through the Oh My God (OMG) moment everyone needs to have, and needs to get through, preferably without being accused of hysteria.

> It is better to get through this OMG moment now rather than later.

The preparedness tips in the article are generic enough, but worth skimming. Basically:

- Get extra prescription medicine now if you might need it

- A couple months of non-perishable food storage is a good idea

- Practice band washing and avoid touching your face.

- Cross train employees at work to minimize the impact of absences.

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> - Get extra prescription medicine now if you might need it

I hate this advice. It's not "wrong," in the sense that technically it would be a good thing to do, but it's also so wrong that it transcends categories of right and wrong.

Your refill schedule will not allow you to get extra prescription meds early. And if it did, your insurance wouldn't pay for it - which means paying sticker price, which means ... well, depends on the med, right? I used to take an antacid that had a sticker price of about 800/mo.

For almost anyone, "stock up on an extra month of prescription meds" isn't a thing. It's just not a choice. For it to /be/ a thing, someone actually needs to write a law stating something like "once per calendar year, a physician can write an extra parallel prescription for a supply of medications not exceeding three months, and insurers must pay for it," or somesuch.

Until that happens, I don't even know what to /do/ with that kind of "advice."

Ask the doctor to write your prescription for three months. Call up insurance company and get a "vacation" flag/whatever which will pay for three months. (Source: I used to do this)

Great now try it with Adderall. It won’t be allowed.

Just because not everyone will be able to do it for every medication does not mean that it is not good advice for those who can act on it. It keeps healthy people from needlessly exposing themselves to higher risk of illness by standing in long pharmacy lines with potentially sick people, and it makes lines shorter for sick people who need to go to the pharmacy.

What you're saying is true in the United States, but perhaps things work differently in Australia?

I guess buying sofas “isn’t a thing” by your logic since an insurance company doesn’t buy sofas for people.

You don't need a doctor to write a prescription for you to go out and buy a sofa. A pharmacy cannot by law let you refill a 30 day prescription less than about 30 days after the last time you refilled it for many medications, so you can't use your existing prescription to go stock up either.

Pharmacies seem to cheerfully dispense larger quantities even if it's not indicated on the prescription.

> But increasingly, the psychiatric association has heard from members that smaller quantities specified on prescriptions are being ignored, particularly by CVS, according to Dr. Schwartz, the group’s president.

> CVS has created a system where doctors can register and request that 90-day supplies not be dispensed to their patients. But doctors report that the registry has not solved the problem, Dr. Schwartz said. In a statement, CVS said it continued to “refine and enhance” the program.

> Dr. Charles Denby, a psychiatrist in Rhode Island, became so concerned by the practice that he started stamping prescriptions, “AT MONTHLY INTERVALS ONLY.” Despite those explicit instructions, Dr. Denby said, he received faxes from CVS saying his patients had asked for — and been given — 90-day supplies.

> Dr. Denby, who retired in December, said it was a “baldfaced lie” that the patients had asked for the medication, providing statements from patients saying as much.

https://www.nytimes.com/2020/01/31/health/pharmacists-medica...

> Until that happens, I don't even know what to /do/ with that kind of "advice."

My wife asked once, and was told that 3 month supply prescriptions are common for people that use mail order pharmacies, and was happy to write one. Insurance covered it too, since the refill schedule was every 3 months -- it comes out to the same cost in the end.

Again, that depends on the med. Your monthly allergy prescription? Sure! Your oxy Rx? No way. My spouse and I are on some meds (not oxy) that they absolutely would not refill for 3 months at a time. My other meds do come in 3 month prescriptions from a mail order pharmacy.

Yep, I'm on a medication that is commonly abused so they only allow 30 day prescriptions, and you can't pay with cash, it has to go through insurance.

I imagine such medications must be very important to take as prescribed, but the only other option I can think of is one day out of every two/three/four weeks, take less of it so that you can save it and slowly stockpile it.

It's an ADHD medication, so there's no health risk associated with not taking it, they're just really strict about the amount given out at once because they don't want people getting a 90 day supply and selling it. Sometimes I won't take it on weekends to keep some extra just in case I might not be able to get a prescription filled on time due to no doctor appointments being available, or the pharmacies being out of stock for a few days.

Whats to stop you stockpiling them at home for a year, and then taking them all at once and getting hooked?

Nothing. To be more clear about the potential for abuse, it's an ADHD medication, so they don't want you selling it to other people to abuse. It's not physically addictive, so you can only really get hooked on the benefits, there aren't any withdrawals or anything if you don't take it.

There's a medication that's not available to people who don't have insurance? That sounds terrible.

Sure, It really depends on the potential for abuse and the doctor's decision. There are a lot of critical medications that aren't likely to be abused. If you check with your doctor they may very well write you the prescriptions you need if you ask and explain why.

This advice is coming from Australia where prescriptions are subsidized by government not insurance so this is possible.

Your refill schedule will not allow you to get extra prescription meds early.

I hate your advice, seriously. You can't speak for every person and every prescription. You are talking people out of taking action when you are outright wrong for some, if not most, situations. Literally yesterday just got an extra 30-day subscription for a handful of prescriptions. Not for coronavirus, but because we are planning to be visiting family in Europe next month. Fingers crossed that travel won't be disrupted.

If you are on a critical medication, talk to your doctor and insurance company. You can probably work it out.

How? I once went to three different urgent care clinics and two different emergency rooms begging for an Augmentin prescription. I felt a stabbing pain in my gut hours after eating bacon for the first time in 10 years, and I had strong reason to believe Augmentin was the solution. They all refused to prescribe me Augmentin. I even tried bribing a few doctors with two thousand dollars in cash. They all said no. They all insisted I needed a CT scan before they’d do anything else. I finally obtained Augmentin by finding a discord server full of Mexicans who I paid to mail me some Augmentin they simply ordered over the counter there. After a month of extreme pain, I felt fine again 24 hours after taking the Augmentin.

If your prescription medicine isn’t a scheduled substance you can get it in advance, usually.

This depends on the doctor, patient, location, and reason.

I have never been turned down for additional medications. My roommate just got a 3 month supply of all of controlled painkillers upon request.

Also, If you have a life-sustaining medication and can afford it, it is probably a good idea to have a supply even if you have to pay out of pocket.

I think there is a real need to understand how much of a vector our phone screens are. People touch their phones, wash their hands, and then touch their phones again.

Yes, we should wash our phones too. It's very simple when the phone is waterproof.

All the telephone sanitizers left on the B arc.

That was another planet in another time. We (Earth) are the descendants of the B arc.

Ark.

Besides that, I wonder how many people missed that bit of circular reasoning in thhg.

> Ark

Yes, thanks! I knew arc didn’t look quite correct, but my spelling is sketchy enough without being under-caffeinated.

Argh! Yes, ark of course.

That bit really drives the joke home, it's a shame if people missed that.

I suspect cases are even worse. Screens are at least smooth and easy to clean.

Good point. I go caseless so I just spray both sides of my phone with an alcohol-based solvent and wipe with kimwipes (the same way I clean my glasses).

But I certainly haven’t been conditioned to do this as often as I wash my hands.

Sporklenz for the phones and keyboards?

I have a UV sterilizer (phonesoap XL) at home and put my phone and keys in once a day for 15 minutes. No water involved.

There is also a need to look at it the other way around, what problems are we causing by being overly obsessed with disinfecting everything?

Are you conflating the overuse of antibacterial soaps (risky, likely harmful), with cleaning surfaces that people touch (helpful, mandated in hospitals)?

I'm not talking about keeping children inside instead of letting them play in the dirt. I'm talking about people accidentally exposing themselves to a thin fecal veneer on their phones because of usage patterns.

Isn't this true for anything that you regularly touch but don't regularly wash? Like your wallet, your keys, your headphones, your car steeringwheel and on and on.

Why single out the phone?

I single it out because (1) we touch it much more often than anything else, and (2) people often touch it in the bathroom.

The specific advice for food storage is "weeks" not couple months - the couple months is directed at prescription meds. The different timelines allocated is likely due to the relative feasibility, the risk of running out, and the ease of resupply.

Advising people to store food en masses is quite irresponsible. We have had rice, noodle, pasta, bleach and toilet paper shortages for around a month in Hong Kong caused by panic buying triggered by a rumour that there would be a supply disruption. We also went weeks where all of the fresh food was being bought out and frozen.

It's responsible to have built up the food supply over long periods of no shortage. Unfortunately the people who have that foresight are often called paranoid.

Assuming the pandemic will happen, people will buy in bulk and cause shortages anyway. So we are better off getting people to buy food sooner rather than later. This gives more time for stores to replenish stocks.

Sounds like the people who thought there would be a supply disruption were right, and the people who didn't see it coming are blaming the people who did see it coming.

No, sounds like there wasn't any "supply disruption", rather a "demand excess" from people who thought there might be one. Those are different things.

Bill Gates could cause a potato shortage if he started buying up all the potatoes in America. But that wouldn't be a supply disruption if farmers are still growing potatoes at the usual rate.

We can argue about the exact definition of the word "supply", but the bottom line is that when the suppliers are no longer capable of providing goods to stores, it's kind of pedantic to say "it's not a supply disruption!".

Okay but if Bill Gates says "there's gonna be a potato shortage!" and then causes it by buying up all the potatoes, it's a bit backwards to say "wow that Bill Gates is so smart, however did he predict the future potato shortage while those stupid poor people couldn't?"

Probably illegal for him to do it with onions though.

There was no supply disruption, in fact the supply increased. The shops just couldn't keep up with huge numbers of people buying more than they needed because they knew that panic buying was taking place.

This point of view is reasonable only if food disruption is actually very unlikely. If there were food supply disruption in Hong Kong, having a great deal of nonperishable and frozen food on hand would be a good idea for most residents, wouldn't it? The fact that rumors were enough to generate shortages for a month in itself confirms a certain degree of insecurity...

That's just how densely populated islands function. If you're a doomsday prepper on a densely populated island, your first step should probably be to move somewhere that's not a densely populated island.

Doomsday prepping on the "densely populated island" requires a great deal more wealth than it does elsewhere (also, offshore speedboats and firearms!), but one needn't be a doomsday prepper to react to credible rumors of upcoming food shortages.

The insecurity was just caused by people literally filling their trolleys with rice as soon as the store opened every day. The government keeps a huge buffer supply which can be released in the event of genuine emergency.

Why didn't the government use some of the buffer to smooth out this apparently artificial demand spike? That is what every other nation on earth uses its agricultural surplus to do.

Because there was no emergency and people weren't starving. It just became very inconvenient to go shopping.

Then it doesn’t sound like this was “quite irresponsible” as you claimed, either.

The best time to panic is before everyone else does.

I didn't see the article making the case for "pressing the panic button". It made a case for having an open dialogue in places of power, to educate the public, and it provides a great number of practical tips on how to do so.

> Over-alarming risk messages are far more forgivable than over-reassuring ones.

The risk of panic is that if there ends up no need to panic, then folks won't listen later when there is a need to panic.

I see this all the time with fire alarm tests. No one takes them seriously -- when a real fire comes they will not take the necessary steps to evacuate fast enough.

What medicine should we purchase? What antivirals work well on it?

They mean prescription medicines, that your doctor has prescribed for things unrelated to the virus.

During an outbreak you can expect a pharmacy to be super busy and possibly mobbed. Not ideal if you're out of medicine you're dependant on.

None yet. Make sure you have an adequate supply of whatever other meds you need.

As I understand it, this advice is about prescription meds you have to take on a regular basis due to specific conditions you have.

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