COVID-19 Shutdown Exit Strategy?

[Markola]

A lot of thoughtful comments here. One assumption above seems to be that someone who has had the virus becomes immune. Do scientists know that yet?

 

[audreyh1]

A lot of thoughtful comments here. One assumption above seems to be that someone who has had the virus becomes immune. Do scientists know that yet?

I think they do, and the main unknown seems to be how long the immunity lasts.

 

[Nemo2]

I think they do, and the main unknown seems to be how long the immunity lasts.

As indicated here:

https://www.scientificamerican.com/article/what-immunity-to-covid-19-really-means/

It is less clear what those antibody tests mean for real life, however, because immunity functions on a continuum. With some pathogens, such as the varicella-zoster virus (which causes chicken pox), infection confers near-universal, long-lasting resistance. Natural infection with Clostridium tetani, the bacterium that causes tetanus, on the other hand, offers no protection—and even people getting vaccinated for it require regular booster shots. On the extreme end of this spectrum, individuals infected with HIV often have large amounts of antibodies that do nothing to prevent or clear the disease.

At this early stage of understanding the new coronavirus, it is unclear where COVID-19 falls on the immunity spectrum. Although most people with SARS-CoV-2 seem to produce antibodies, “we simply don’t know yet what it takes to be effectively protected from this infection,” says Dawn Bowdish, a professor of pathology and molecular medicine and Canada Research Chair in Aging and Immunity at McMaster University in Ontario. Researchers are scrambling to answer two questions: How long do SARS-CoV-2 antibodies stick around? And do they protect against reinfection?

Early on, some people—most notably U.K. Prime Minister Boris Johnson (who has the virus and is currently in intensive care) and his government’s scientific adviser Patrick Vallance—touted hopes that herd immunity could be an eventual means for ending the pandemic. And although it appears that recovered COVID-19 patients have antibodies for at least two weeks, long-term data are still lacking. So many scientists are looking to other coronaviruses for answers.

 

[JoeWras]

Recovery has to be patchwork and local, with umbrella guidelines.

The situation in dense NYC is different than suburbia.

 

[audreyh1]

As indicated here:

https://www.scientificamerican.com/article/what-immunity-to-covid-19-really-means/

I think some tests on primates indicates immunity lasts longer than two weeks. That was from a Peter Attia interview with a virologist and vaccine researcher from a few weeks ago.

From that same article:

Antibody testing shows SARS-CoV immunity peaks at around four months and offers protection for roughly two to three years. As Preeti Malani, chief health officer and a professor of medicine at the University of Michigan, said in a video interview with JAMA Editor in Chief Howard Bauchner,this period presents “a pretty good time line for thinking about vaccines and therapeutics” for COVID-19.

That’s what I had been hearing. That’s the original SARS virus.

 

[LRDave]

I can't make any sense in my mind of how a partial return to businesses that are shut down would even work. No dine-in restaurant can work financially with either spaced out seating or some limited demographic for clientele. Planes can't fly at 50% load factors and not lose $, even in this time of cheap fuel. Either you are cutting hair, giving massages, doing nails, etc., or not. Brick-and-mortar retail - same as restaurants - fixed costs are the same but fewer customers? And being open doesn't mean there is demand for the things one sells.

Our consumer-based economy is fine-tuned to maximize profit and therefore optimize efficiency.

And I find the idea of localized open areas vs. shut-down areas unfathomable. One town (county, state....) over, the Hobby Lobby or sit-down restaurant is open but my local version is closed? How has the US consumer usually responded to such situations? Gas is cheap!

 

[mrfeh]

But other than that, what’s the problem?

Right, which is why it's gonna take 12+ months for true normalcy. Until there's a vaccine, the economy is gonna have a wet blanket thrown over it.

 

[donheff]

There is no exit strategy, at least not one that will be well-coordinated. There are numerous state governors and big city mayors who apparently get to make the decision to rescind their individual shutdown orders.

There will be people who will fear for their own life if their area opens up, and there will be people who will fear for their family's livelihood if their area doesn't open up. This is going to get far, far worse.

I agree that this may get worse but the bolded text makes it sound like the governors are at fault since they "get" to make their own decisions. The problem is there is no real national effort to give them a solid plan. I suspect most of those governors would be glad to join into a well thought out Federal plan if one was forthcoming.

There is no perfect plan, but we have to restart sooner or later. We should weigh all the risks, but we can’t wait to eliminate every risk. Some people will die, but nothing like an uncoordinated effort. Over 2 million people die in the US every year due to various illnesses and accidents (excluding old age) and we accept that without much thought. As usual, we can’t let the perfect be the enemy of the good. Some people will go back to soon, some people will choose to stay away (long) after we’re allowed.

And some businesses may be forever changed, e.g. large concerts, festivals, sporting events, weddings and funerals, restaurants and bars, museums and galleries, movies and theater, air travel and hotels - anything that involves crowds of strangers and/or communal use without extensive verifiable cleaning. I think the latter has been more common in Asia, and will become more common in the West now.

+1 And, again, without a national strategy this will be far worse than it need be. Using the logistical capabilities of the military and procurement authorities of the DPA to pay for and distribute tests is critical to enable testing of symptomatic (but not seriously sick) people with quick followup on positives (e.g. tracing and testing their contacts).

 

[ncbill]

One depressing article I read recently estimated 75% of independent restaurants will not reopen.

Potentially leaving us with a continuing dystopia of nothing but fast food and chain restaurants...

 

[P.S.]

There have been about 80 deaths from Covid, and about 80 deaths from the 2019/2020 flu season.

Dwhit, when you are comparing the #80, does your mind equate the two diseases?
Flu season starts in Sept-Oct. Most medical personnel are req. to have flu shot in Oct. -> 80 deaths/6mo
First confirmed COVID death in OK: 3/18 -> 80 deaths/3wks

Overall, it appears that OK has a comparable fatality rate as NYC (this is very rough b/c a lot of factors): 80/1684 vs. 7067/159,937

NYC though, is completely overrrun from a medical perspective where they are allocating resources and deciding who gets a ventilator (read subreddit r/ medicine for first hand accounts). OK is a medical system that has ALOT of room still. Furthermore, in places where you have 1-20 patients, like most counties in OK, you won’t necessarily see a death until you reach a critical mass. If you look at those places or counties that do have a enough cases, you actually see CFR’s of >5% (look at gisanddata COVID map), which is concerning.

This implies that when the numbers do ramp up in OK, that the outcomes may be not as optimistic as you imply.

Also, nail services would probably be the last place to open, and even if they did, would prob be best avoided until one is vaccinated. Sitting 18” from another face and breathing in the same airspace for a half an hour, even if both parties were wearing N95 and gloves, would be risky. If the other person was an asymptomatic shedder, I would bet on guaranteed transmission.

 

[P.S.]

...Even if this virus goes into hibernation for awhile and infection rates drop significantly...

Viruses do not hibernate. Viruses continue only as long as they remain viable on a host. So during the usual flu season, influenza tends to move across continents, eg. when flu season “ends” in NA, it actually has moved south of the equator. Some viruses can be carried by multiple species, like SARS CoV2 has been found to be carried by cats (house cats, and the lion/tigers at Bronx zoo). This potentially could serve as a reservoir for later re-emergence in a human population. If a virus could no longer find a naive host, it would die out.

 

[Ready]

I can't make any sense in my mind of how a partial return to businesses that are shut down would even work. No dine-in restaurant can work financially with either spaced out seating or some limited demographic for clientele. Planes can't fly at 50% load factors and not lose $, even in this time of cheap fuel. Either you are cutting hair, giving massages, doing nails, etc., or not. Brick-and-mortar retail - same as restaurants - fixed costs are the same but fewer customers? And being open doesn't mean there is demand for the things one sells.

Our consumer-based economy is fine-tuned to maximize profit and therefore optimize efficiency.

And I find the idea of localized open areas vs. shut-down areas unfathomable. One town (county, state....) over, the Hobby Lobby or sit-down restaurant is open but my local version is closed? How has the US consumer usually responded to such situations? Gas is cheap!

Many manufacturing and construction jobs can be done while still maintaining six feet of separation. Those will likely be the first jobs to come back. And many office jobs can be performed with appropriate separation as well as long as they eliminate group meetings and break room activity.

Unfortunately, restaurants, nail salons, massages, and other personal consumer services are going to be very difficult to reopen any time in the near future.

 

[target2019]

I think generations being imprinted with social distancing at this time will find ways to continue down that road for a very long time.

In the pharmacy a distracted customer (just 3 of us in-store) came down the aisle, with no mask. I had mine on, with gloves.

He came back to the aisle, saw I was still there, and took a different aisle to get to the cashier.

If you survive this, your current avoidance behaviors will become part of future routine.

 

[gwraigty]

I can't make any sense in my mind of how a partial return to businesses that are shut down would even work. No dine-in restaurant can work financially with either spaced out seating or some limited demographic for clientele. Planes can't fly at 50% load factors and not lose $, even in this time of cheap fuel. Either you are cutting hair, giving massages, doing nails, etc., or not. Brick-and-mortar retail - same as restaurants - fixed costs are the same but fewer customers? And being open doesn't mean there is demand for the things one sells.

Our consumer-based economy is fine-tuned to maximize profit and therefore optimize efficiency.

And I find the idea of localized open areas vs. shut-down areas unfathomable. One town (county, state....) over, the Hobby Lobby or sit-down restaurant is open but my local version is closed? How has the US consumer usually responded to such situations? Gas is cheap!

Bolding mine, and cram as many people as possible into the available space, whether customers or employees.

Earlier this week, our governor suggested that businesses that can comply with social distancing might be able to open up when he starts to lift restrictions, while those that can't maintain social distancing would have to remain closed. Forgetting for the moment public establishments, that's not even possible in many offices. Think cube farms.

Localized solutions would backfire when people from a more infected area choose to drive to the store or restaurant in the next town or county or state that's reopened.

Our governor said that they're going to be releasing a detailed plan for Ohio's reopening sometime next week. They're close to finalizing it. Our health director claims that we'll all be happy with it. We'll see.

 

[donheff]

Here is an easy to read article that outlines what should be done but probably won't be done as 50 governors are left to do it themselves.

 

[Ready]

Dentists are going to have a tough time reopening. Much of their business is routine cleaning and exams. Having someone’s face inches from yours while their hands are in your mouth does not fit the definition of social distancing. And since cleanings are preventative, they are easy to put off.

My dental cleaning is scheduled for next week. My dentist beat me to it by sending me a text letting me know it was cancelled.

 

[neihn]

Dentists are going to have a tough time reopening. Much of their business is routine cleaning and exams. Having someone’s face inches from yours while their hands are in your mouth does not fit the definition of social distancing. And since cleanings are preventative, they are easy to put off.

My dental cleaning is scheduled for next week. My dentist beat me to it by sending me a text letting me know it was cancelled.

+1.

My niece is dental hygienist, she was asked to stay home from March 30th til June 1st. She thinks even June 1st is a stretch.

 

[MRG]

Dentists are going to have a tough time reopening. Much of their business is routine cleaning and exams. Having someone’s face inches from yours while their hands are in your mouth does not fit the definition of social distancing. And since cleanings are preventative, they are easy to put off.

My dental cleaning is scheduled for next week. My dentist beat me to it by sending me a text letting me know it was cancelled.

My Dentist's office closed before social distancing was implemented. Nothing but emergency services. DWs brother is a dentist in SW SW Florida. He's finally closed, middle of March, for all except emergency services.

He's been trying to get a small business loan to allow him to pay his workers. That's been an interesting saga to follow.

 

[Mr._Graybeard]

We just have to get over this "hump" thing and go back to business so everyone can get infected at a lower rate and get the immunity thing going.

Survive it or die. Natural selection.

I keep thinking the virus may take some of the strain off the public-sector pension system.

 

[JoeWras]

Earlier this week, our governor suggested that businesses that can comply with social distancing might be able to open up when he starts to lift restrictions, while those that can't maintain social distancing would have to remain closed. Forgetting for the moment public establishments, that's not even possible in many offices. Think cube farms.

Cube farms would be a luxury. For many, you can maintain 6 ft, and you have built in splash guards.

The problem is many business have gone to open office setups. Wonderful rows of tables where you all get chummy. Then you go into your scrum room and stand shoulder to shoulder to have a standup meeting.

Oh, my blood pressure is up even thinking of it. Glad I'm retired. Hopeful for those left in the trenches that they rethink this nonsense of open office space.

 

[Winemaker]

I agree that this may get worse but the bolded text makes it sound like the governors are at fault since they "get" to make their own decisions. The problem is there is no real national effort to give them a solid plan. I suspect most of those governors would be glad to join into a well thought out Federal plan if one was forthcoming.

+1 And, again, without a national strategy this will be far worse than it need be. Using the logistical capabilities of the military and procurement authorities of the DPA to pay for and distribute tests is critical to enable testing of symptomatic (but not seriously sick) people with quick followup on positives (e.g. tracing and testing their contacts).

The Federal government has no power to issue an edict/order to do so, unless Congress gives the President to do so. In this current environment, it isn't going to happen. Lawyers were chomping at the bit to go to court the moment a nationwide quarantine was put into effect. Elected governors/mayors do have that power to do that in their jurisdictions. The Federal government can only issue guidelines. Also, one size does not fit all, and I would rather have a more local elected politician make the decision for their constituents because they are/should be more responsive to there own. It is the basic principle of Federalism. Also, as it has been stated in the press conferences, there is not enough data to make a clear decision yet. NY's data is not going to work for WY or OK, the data for the Philadelphia area going is not the same for the Pittsburgh area.

 

[Gumby]

The Federal government has no power to issue an edict/order to do so, unless Congress gives the President to do so. In this current environment, it isn't going to happen. Lawyers were chomping at the bit to go to court the moment a nationwide quarantine was put into effect. Elected governors/mayors do have that power to do that in their jurisdictions. The Federal government can only issue guidelines. Also, one size does not fit all, and I would rather have a more local elected politician make the decision for their constituents because they are/should be more responsive to there own. It is the basic principle of Federalism.

To be fair, a virus does not care about state borders.

 

[dd564]

The Federal government has no power to issue an edict/order to do so, unless Congress gives the President to do so. In this current environment, it isn't going to happen. Lawyers were chomping at the bit to go to court the moment a nationwide quarantine was put into effect. Elected governors/mayors do have that power to do that in their jurisdictions. The Federal government can only issue guidelines. Also, one size does not fit all, and I would rather have a more local elected politician make the decision for their constituents because they are/should be more responsive to there own. It is the basic principle of Federalism.

+1

 

[dd564]

To be fair, a virus does not care about state borders.

To be fair, Governors sometime have common sense.
Minnesota went on lockdown, and so did WI because we share a border with people traveling between the two states. Major metro close to WI border.

MN other bordering states SD, ND, and Iowa did not go on lockdown at that time.

The difference? Many acres of open farmland. Very low density population on those borders.

A little common sense "can" go a long way.

 

[doneat54]

Thought I had, interested in comments.

Does it seem like the businesses that are (going to) take the biggest hit, maybe even go under, like mom and pop shops, salons, restaurants, independent hotels etc., are not the types of businesses that drive the economy/markets the most. And the ones that do are the bigger corporations/chains, many/most of which can ride out the virus by having people work remotely?