COVID-19 Shutdown Exit Strategy?

[2177V]

The conservative AEI is out with a comprehensive recovery strategy. It implies a lot of Government involvement and, interestingly, calls for us all to start wearing masks.

I agree with using masks.

If you are infected and you cough and sneeze, the masks helps contain the infected airborne water droplets.

If you are not infected, it adds an additional barrier from those same infected airborne water droplets. Common sense IMO.

There are a lot of reports stating that masks are not needed for the general public or that masks are not 100% effective. I disregard those reports because even if the masks are only 10% effective, that is better than not wearing a mask at all.

BTW, I really like the bubble a UK woman was using to go shopping in the following link...

https://www.yahoo.com/lifestyle/202...e-bubble-zorb-ball-kent-england-23963388.html

The problem will be solved if everyone does this!

 

[Independent]

The conservative AEI is out with a comprehensive recovery strategy. It implies a lot of Government involvement and, interestingly, calls for us all to start wearing masks.

The mask thing is interesting.

Their standards for moving to Phase II (when we can start re-opening stuff)

• A sustained reduction in cases for at least 14 days,
• Hospitals in the state are safely able to treat all patients requiring hospitalization without resorting to crisis standards of care,
• The state is able to test all people with COVID-19 symptoms, and
• The state is able to conduct active monitoring of confirmed cases and their contacts.

IMO, those things are so far in the future that it's hard to start talking about Phase II.

I think that before the gov't gets involved, we'll see a twitter hashtag #isurvivedcovid19. People who know they survived will want to get back to life as normal and will be frustrated with the restrictions. They may volunteer for "moderate risk" things like delivering food.

There will be a lot of people, especially in places like New Rochelle, looking for antibody tests to confirm their suspicions that they are survivors.

Note that the FDA said last week it has been notified by 25 firms that they are intending to distribute antibody tests, and that the FDA "does not intend to oppose" them.

There will be pressure for a gov't issued "certified positive antibody" card. We'll have young people who are okay with getting the virus so they can get immunity.

 

[statsman]

Wouldn't individuals who develop an immunity to the virus still be able to carry it to other individuals? Also, is the medical community certain COVID-19 won't mutate?

 

[Nemo2]

Wouldn't individuals who develop an immunity to the virus still be able to carry it to other individuals?

Mary Mallon perhaps?

 

[nativenewenglander]

The use of "counting new cases" in my comment #266 came from Dr Fauci in minute 1 of the following video:

Do you mind citing a reference or video from a reputable source of using the "number of deaths" as better data to use?

This the best Dr. Fauci interview I have watched. It was done yesterday.
Dr. Mike aks all great questions without any news spin to it.
Doctor to doctor 14 minutes long

 

[Gumby]

The use of "counting new cases" in my comment #266 came from Dr Fauci in minute 1 of the following video:

Do you mind citing a reference or video from a reputable source of using the "number of deaths" as better data to use?

I think your two positions can be harmonized. Dr. Fauci says we can know if we have turned the corner when the number of "new infections" stabilizes. New infections are determined by the native infectiousness of the virus, the efficacy of our social isolation countermeasures, and (eventually) by the presence of herd immunity.

The problem is that the number of "new positive results" likely is not equal to the number of "new infections". In fact, at this point it is likely to be higher due to the rollout of more and better testing. Actual infections may not be going up while positive results may still be climbing. That is, you can have exactly the same number of infections yesterday as you did today (i.e - zero new) but if you test more people today than you did yesterday, you will show more positive results, because you missed some yesterday.

If instead you use deaths from COVID-19 as your measure, that is unlikely to be substantially impacted by improvements in the testing regime. It is a lagging indicator, to be sure, because people who ultimately are going to die will linger in the hospital for some time before succumbing to the virus. But I think at this point it is probably more accurate.

As I have noted before, if the hospitals become overwhelmed, more people may die from simple lack of treatment and using deaths as the measure could become inaccurate. Additionally, if some of the new therapeutic measures (e.g. chloraquine) prove to work, then the death rate will change and may not accurately reflect the number of new infections. Similarly, if we reach the point of widespread, rapid, and accurate testing, such that the number of new positives really is equal to the actual number of new infections, then we may want to reconsider using the number of deaths as a lagging proxy.

I don't have any particular video or article to point you to, but thinking hard about this has led me to the conclusion above.

 

[2177V]

Similarly, if we reach the point of widespread, rapid, and accurate testing, such that the number of new positives really is equal to the actual number of new infections, then we may want to reconsider using the number of deaths as a lagging proxy.

Testing is the key to a successful shutdown exit strategy.

Number of new cases vs deaths are of secondary importance. However, we do not have widespread testing at this time.

If they do lift the shutdown, I would prefer that the waiter and cook who is serving my food have been tested negative for the virus in order for me to be comfortable. The number of new cases or deaths would not matter to me if I got infected by someone who has not been tested and is infected.

If they lift the shutdown without widespread testing, this implies that I have to accept the risk the government expects me to take in order to re-start the economy. This is what happened in China when the CCP told everyone people in the low risk areas to go to work. There was not 100% compliance because people were still fearful. Widespread testing will reduce these fears.

 

[Independent]

Wouldn't individuals who develop an immunity to the virus still be able to carry it to other individuals? Also, is the medical community certain COVID-19 won't mutate?

It seems that an immune person can pick up virus particles from a surface, then transfer them to a different surface, including another person's hands.

But, an immune person is not going to add to the total virus particles in the environment by coughing them out.

Mutation doesn't seem to be a big issue.

Scientists now are studying more than 1,000 different samples of the virus, Peter Thielen, a molecular geneticist at the Johns Hopkins University Applied Physics Laboratory who has been studying the virus, told The Washington Post.

There are only about four to 10 genetic differences between the strains that have infected people in the United States and the original virus that spread in Wuhan, he said.

“That’s a relatively small number of mutations for having passed through a large number of people,” Thielen said. “At this point, the mutation rate of the virus would suggest that the vaccine developed for SARS-CoV-2 would be a single vaccine, rather than a new vaccine every year like the flu vaccine.”

https://www.washingtonpost.com/heal...6522d6-6dfd-11ea-b148-e4ce3fbd85b5_story.html

OTOH, immunity to other coronaviruses just seems to wear off with time

Researchers do know that reinfection is an issue with the four seasonal coronaviruses that cause about 10 to 30% of common colds. These coronaviruses seem to be able to sicken people again and again, even though people have been exposed to them since childhood.

"Almost everybody walking around, if you were to test their blood right now, they would have some levels of antibody to the four different coronaviruses that are known," says Ann Falsey of the University of Rochester Medical Center.

After infection with one of these viruses, she says, antibodies are produced but then the levels slowly decline and people become susceptible again.

"Most respiratory viruses only give you a period of relative protection. I'm talking about a year or two. That's what we know about the seasonal coronaviruses," says Falsey.

https://www.npr.org/sections/goatsa...y-after-recovering-from-a-case-of-coronavirus

 

[Gearhead Jim]

The use of "counting new cases" in my comment #266 came from Dr Fauci in minute 1 of the following video:
...

Do you mind citing a reference or video from a reputable source of using the "number of deaths" as better data to use?

My "sources" are the number of tests performed so far in the US, which all the doctors say are a tiny percentage of our population, and mostly done on people who already show symptoms. If we don't know how many cases we have today, how can we tell whether tomorrow's number indicates an actual increase or just the result of more testing?

Hospital admissions might be used as a proxy for actual cases, and has the advantage of being more "real time", because people usually don't die immediately. The results might be skewed somewhat by moderately sick people avoiding the hospital because they can't get in or believe it's so overwhelmed that they won't get much treatment and just left to die.

I've seen several reports on the news saying something like "Italy may have turned the corner, the number of deaths per day is trending downward".

Nothing is a perfect metric, but daily deaths seem a much more reliable indicator than testing as it's done in the US. South Korea has done much better than us.

 

[USGrant1962]

In the news today, the German Interior Ministry has drafted a plan to exit lockdowns, and Austria has announced plans to allow some shops to open on Easter Monday with spacing/size restrictions.

Both seem to intend on masks, social distancing, etc. continuing.

 

[Dalmore]

Both seem to intend on masks, social distancing, etc. continuing.

I think masks, and social distancing will be a way of life until a vaccine is developed and distributed to the point where herd immunity can take over.

Could be a year or two......

 

[JoeWras]

Could be a year or two......

Yep.

Even if the real herd number is 10x the reported number, we still don't have a big enough herd.

These are going to be very interesting times indeed.

 

[RobLJ]

I've been trying to explain this point on Twitter (to no avail). Late last week even symptomatic nurses in Reno could not get tested, because of the lack of availability of tests, so test are rationed. As per capita test numbers go WAY up, the testing stats will start to tell us something very valuable.

For example, test result data look OK in Texas, but hospitalizations in Houston/Dallas are exploding, as in Reno.

So the test data, while nice and no doubt will tell us more as we start to get 10x more tests widely available, don't tell us a great deal at this point. And in states like Oklahoma (my home state) and Arkansas that haven't really tested, test data will tell you virtually nothing.

My "sources" are the number of tests performed so far in the US, which all the doctors say are a tiny percentage of our population, and mostly done on people who already show symptoms. If we don't know how many cases we have today, how can we tell whether tomorrow's number indicates an actual increase or just the result of more testing?

Hospital admissions might be used as a proxy for actual cases, and has the advantage of being more "real time", because people usually don't die immediately. The results might be skewed somewhat by moderately sick people avoiding the hospital because they can't get in or believe it's so overwhelmed that they won't get much treatment and just left to die.

I've seen several reports on the news saying something like "Italy may have turned the corner, the number of deaths per day is trending downward".

Nothing is a perfect metric, but daily deaths seem a much more reliable indicator than testing as it's done in the US. South Korea has done much better than us.

 

[Ready]

Here is what Anthony Fauci said today at the WH Press conference when asked when life would return back to normal:

“When we say ‘getting back to normal’ we mean something very different from what we’re going through right now, because right now we are in a very intense mitigation,” Fauci said. “If ‘back to normal’ means acting like there never was a coronavirus problem, I don’t think that’s going to happen until we do have a situation where you can completely protect the population” with a vaccine, he said.

The best estimates for a vaccine are 12-18 months out. So I think what Fauci is telling us here is not to expect any return to pre-COVID19 conditions in the next 12-18 months.

That doesn't mean a complete lockdown of course. But it's not clear where he is heading with his thinking.

 

[PatrickA5]

Here is what Anthony Fauci said today at the WH Press conference when asked when life would return back to normal:

“When we say ‘getting back to normal’ we mean something very different from what we’re going through right now, because right now we are in a very intense mitigation,” Fauci said. “If ‘back to normal’ means acting like there never was a coronavirus problem, I don’t think that’s going to happen until we do have a situation where you can completely protect the population” with a vaccine, he said.

The best estimates for a vaccine are 12-18 months out. So I think what Fauci is telling us here is not to expect any return to pre-COVID19 conditions in the next 12-18 months.

That doesn't mean a complete lockdown of course. But it's not clear where he is heading with his thinking.

I'm not sure what Fauci thinks or says is going to matter as much after this first wave slows down. I think there will be huge pressure from all sides to get things up and running - maybe sooner than it should be. But, if we open the economy too fast we'll end up having to close it down again when things go south. Maybe we'll figure out a way to open things up and keep this thing in check. I don't know. All I know is you won't see me in a crowded theater or on a packed plane until there's a vaccine.

 

[Ready]

I'm not sure what Fauci thinks or says is going to matter as much after this first wave slows down. I think there will be huge pressure from all sides to get things up and running - maybe sooner than it should be. But, if we open the economy too fast we'll end up having to close it down again when things go south. Maybe we'll figure out a way to open things up and keep this thing in check. I don't know. All I know is you won't see me in a crowded theater or on a packed plane until there's a vaccine.

And what if we don’t come up with a vaccine?

 

[statsman]

And what if we don’t come up with a vaccine?

Or even if there is one and it takes 12-24 months? Or if by that time the virus has mutated? Or another deadly virus is hoisted on the planet?

Don't get me wrong, I am not pushing for an immediate opening of the entire country. But when? Are we really going to keep the country shut down the entire Summer of 2020? Because for some, it will never be safe enough. Flattening the curve and being on the downside of it won't be enough.

 

[JoeWras]

The vaccine is going to take time. We all need to take a breath and be ready for that reality. Even when one is proved safe and effective, there will likely be a world-wide process of priority vaccinations. The whole manufacturing and administering is also going to take time. As for mutations: we'll have to wait and see. Not every virus acts like flu. (See smallpox, for example. A vaccine for smallpox was "easy" because it was vulnerable to a wide range of similar antibodies, like Cowpox.)

Meanwhile, what I'm hearing is there is hope that this summer things are calm in the northern hemisphere, with only occasional outbreaks. We'll be on high alert, meaning, probably no large gatherings, etc. But also no complete lockdown. During this time, preparations must be in full gear for the next wave in cooler weather. Testing must fully ramp up. Treatment plans must come out of trial, and be staged and ready for the next waves.

The next waves will hopefully be managed as county-sized outbreaks. Extensive testing must be in place. Contact tracing will be key.

So, yeah, we'll live more normal while managing the beast running around.

Restaurants? I haven't heard a decent plan for their return.

Sporting events? Good luck.

But typical goods and service based commerce? There's hope it can be managed around the outbreaks.

 

[doneat54]

Here is what Anthony Fauci said today at the WH Press conference when asked when life would return back to normal:

“When we say ‘getting back to normal’ we mean something very different from what we’re going through right now, because right now we are in a very intense mitigation,” Fauci said. “If ‘back to normal’ means acting like there never was a coronavirus problem, I don’t think that’s going to happen until we do have a situation where you can completely protect the population” with a vaccine, he said.

The best estimates for a vaccine are 12-18 months out. So I think what Fauci is telling us here is not to expect any return to pre-COVID19 conditions in the next 12-18 months.

That doesn't mean a complete lockdown of course. But it's not clear where he is heading with his thinking.

I also think that studies and data on antibody and immunity are going to play a big role. If you have the means to ID people accurately and therefore remove them from the risk pool, these restrictions can be reduced. The down side of that might be some social disorder if you now have identified one set of people who are restricted and another set who are not. I read an article of one country using wristbands to ID (what they think are immune people, but I don't think that science is there yet) the "safe" people. It wasn't going well...

 

[Chuckanut]

And what if we don’t come up with a vaccine?

Herd immunity. Even smallpox came to an end without a vaccine, at least for a while. But, why would we not get a vaccine? Our buddy, Billionaire Bill, is going to build a number of facilities to test and manufacture treatments and a vaccines.

Microsoft Corp. co-founder Bill Gates said his foundation will spend billions of dollars to fund the construction of factories for the most promising efforts to develop a vaccine to combat the novel coronavirus.

Our hope is that we develop treatments for the disease between now and the time there is a vaccine. We might still get it, but we won't have to fear it like we do now.

 

[Gearhead Jim]

I'm healthy but old enough to be in the high risk group, so I certainly want to get this under control.


But looking at the economic and political pressure to get things moving again, a US covid-19 death toll of 250,000 seems to be the upper limit of current "responsible" projections, that's less than 1/10 of 1% of the US population.


At some point the politicians will have to use the old philosophy of "You've got to break some eggs to make an omelet", and decide what is an acceptable level of casualties.


I hope it works out well for the country, and maybe for me too.

 

[aja8888]

Well, I am 76 1/2 and healthy, and DW is 75 and has COPD and a host of other ailments. Plus, she's on pure oxygen 100% of the time. I wonder what "getting back to normal" is for us (and others like us)?

 

[statsman]

Well, I am 76 1/2 and healthy, and DW is 75 and has COPD and a host of other ailments. Plus, she's on pure oxygen 100% of the time. I wonder what "getting back to normal" is for us (and others like us)?

If a virus similar to COVID-19 can be hoisted on the planet and notification to the world delayed for two months, you may not like the new normal. I know many who won't.

 

[USGrant1962]

Well, I am 76 1/2 and healthy, and DW is 75 and has COPD and a host of other ailments. Plus, she's on pure oxygen 100% of the time. I wonder what "getting back to normal" is for us (and others like us)?

I think that the vulnerable population will need to maintain isolation for a while. At the same time, the majority of the population will maintain protective measures (social distancing, masks in high density situations, etc.) as we slowly normalize (after a noticeable drop in infections - looks like after May 1). Otherwise we will have much worse repercussions than COVID-19.

 

[aja8888]

I think that the vulnerable population will need to maintain isolation for a while. At the same time, the majority of the population will maintain protective measures (social distancing, masks in high density situations, etc.) as we slowly normalize (after a noticeable drop in infections - looks like after May 1). Otherwise we will have much worse repercussions than COVID-19.

I think "our world" just got a lot smaller, even after the CV19 "lift off". But that's OK at our ages.