Anyone else questioning the extent of "social isolation"?

First of all, it should be understood that all of the guidelines about washing hands, keeping a 6 foot/2 meter distance, avoiding gatherings of more than an arbitrary number of people, et cetera, are just general guidance based upon prior experience with public health measures and will in no way guarantee to improve your odds of not being infected. In fact, there are no really good estimates of the behavior and transmissibility of the virus because of the significant delay in some patients between being exposed to SARS-CoV-2 (the coronavirus) and the onset of COVID-19 (the medical nomenclature for the disease that some people suffer). The media and general public continue to conflate the two but in fact there appear to be a substantial number of people who have tested positively for antibodies to the SARS-CoV-2 virus (indicating that they have had a significant viral load) but have exhibited no signs or symptoms of COVID-19. Given how limited testing has been and continues to be, and that it has been restricted to people either exhibiting signs and symptoms or have been in the immediate proximity of COVID-19 sufferers, there is a strong possibility of asymptomatic transmission, and that the incidence in the population of anyone in or near a major population center could be far greater than suggested by public health numbers. It also seems apparent that the virus can be transmitted by aerosol vector as the original SARS-CoV virus responsible for the 2003 Hong Kong outbreak.

Second, while you may not be concerned about the consequences of being exposed to SARS-CoV-2 or contracting the COVID-19 illness, and the people you gather with may be equally indifferent, the reality is that by engaging in unnecessary social contact you may transmit or receive the virus and then transmit it to other people by incidental contact. Even though it is likely that you will eventually come into contact with the virus, the fewer paths it has to spread, the lower overall rate of effective spread (as measured by the R-0 value you have been hearing the talking heads yammering on about in the past few days). Even reducing transmission rates by a factor of two will have a significant impact upon the overall rate of infection which gives more time for people who may have severe reactions to the virus to be distributed in time and thus not overloading our increasingly fragile critical health care systems and underequipped facilities and requiring critical patient triage as has been seen in China, Iran, and Italy. Even shifting the average rate of infection by a week or two across a significant amount of the population allows freeing up beds and respirators for patients in critical need and reducing the case fatality rate due to an avoidable lack of respiration support or other care measures.

Third, you should be concerned about contracting the illness right now because while you may not be in a high risk demographic, it is simply not possible to be assured that some aspect of the viral interaction does not provoke a strong response in you. Respiratory infections can progress from benign to lift-threatening in a matter of hours depending on cofactors, including the presence of previously weakly pathogenic bacteria. There is also the reality that coronaviruses as a class are particularly prone to mutation, and there have in fact been reports of researchers in China reporting evidence of mutation. Since the CDC only started growing the virus in their labs in early February (and it is unclear to the extent they have been able to cultivate multiple samples) the variability that this novel coronavirus, which is previously uncharacterized and strongly suspected to be recently zoonotic (transferred from animal host to human, and therefore has not evolved to co-exist in a human host without reaction as thousands of existing viruses do in every person) is unknown, as is the effectiveness of antibodies developed against one strain in fighting off another. In other words it is possible that you could be infected and develop a resistance to one strain of SARS-CoV-2 only to be infected with a different strain for which you have little or no inherent resistance, as it is with the various families of enteroviruses, coronaviruses, adenoviruses, parainfluenza viruses, and other viruses that cause seasonal colds, or the families of influenza A and B viruses that cause ‘the flu’.

And again, the goal of social distancing and isolation is to slow the spread of these viruses. This has a critical effect in addition to blunting the peak rates of COVID-19 illness; it also allows the virus to adapt to be more benign within the population, as well as developing better care measures and (maybe) an effective vaccine. As more virulent strains burn out, more benign strains may become predominate and offer at least some protection to build up immunity even if someone is exposed to a more virulent strain. By participating in the recommended public hygiene and social distancing measures you are helping to blunt the rate of infection giving people with a potentially higher likelihood of contracting a severe case of COVID-19 a better chance, even if in just the aggregate. Or, you can ignore these guidelines and contribute to a situation like that in Italy, where people are dying while waiting just to get into a hospital, or Iran, where satellite images show the excavation of mass grave sites. But realize that by doing this, you are putting people like ThelmaLou at greater risk. The impact may be lost in the aggregation, but the effects are very real and personal to people at high risk for contracting the disease.

By the way, everyone should be absolutely outraged about the public health response to this pandemic and going right up to the top. It is certain that the unwillingness of the Chinese to share information about the extent of the outbreak and their inability to control it has had significant effects on allowing the disease to get a foothold outside of Wuhan (and I’m not convinced that their most recent response to reopen businesses and schools will not result in a mass flareup) but the United States, Japan, and Europe had plenty of warning to at least start a public health informational campaign. In retrospect, completely containing the virus was probably never possible given the long latency period and likelihood of asymptomatic and aerosol transmission, but starting an education campaign about the need for social distancing back in January, giving lead time for businesses and institutions to make plans for remote work and interaction, and otherwise educating and indoctrinating the public in the need for public hygiene measures could have gone a long way toward limiting the rate of spread, and could have been done in a way to minimize public panic. Instead–and in the interests of not making this political I won’t name any names, but I think everyone is aware of the biggest and absolute best perpetrators–certain leading figures have spoken to the public in manner and word dismissive of the potential hazard, spreading factually untrue information about how the virus may be spread, and seemingly intentionally undermining the efforts of public health officials to inform the public. This is absolutely criminal negligence of the most absurd kind.

This is not some unexpected threat that came out of nowhere to blindside officials; epidemiologists have been warning about this very type of pandemic for decades as the degree and rate of zoonosis has been better understood. A major motion picture starring all those pretty people you see at the Oscars every year was made by Steven Soderbergh back in 2011 which presented this threat in a very realistic fashion, and popular science books from Richard Preston’s The Hot Zone to David Quammen’s Spillover have warned about the potential for unconfined zoonotic viruses to emerge into pandemic status in a world in which an infected patient can travel from Singapore to Amsterdam (or Sri Lanka to San Francisco) in a matter of hours with no controls, no truly global medical information network, and health systems that are fragile to these kinds of major health epidemics. There should have been existing plans in place for dealing with a public epidemic which are shared with educations institutions, businesses, and other impacted parties instead of the mad panic of post-equine-barn-door-closing ‘directives’ which sequentially contradict each other or will have little-to-no effect, and in the case of travel bans and trade restrictions may have a negative effect on the ability of the epidemiological community to effectively communicate. By the point that your pandemic has reached New Zealand there is exactly no point in a blanket travel ban or shutting borders down except to be seen doing something, anything, just make it look like we’re not as clueless as the bureaucrats in that Scottish zombie movie with Discount Kate Beckinsale.

As for the o.p., you are presumably an adult and will do as you please, but consider that your actions do have consequences even if they are not personally apparent to you. The guidelines for social distancing aren’t crafted just to ensure that you do not get to have a good time; they are the best if belated measures that you can personally take to help retard the spread of an infectious pathogen you can neither see nor restrain. You may not get a medal or public adoration for making a few sacrifices now in your social life, but the decisions that you make in this regard and at this time matter, even if they don’t seem meaningful to you.

Stranger

But it’s not that simple. The chances of my neighbor, who is practicing social distancing, and myself, who is practicing social distancing, having it is very, very low. As we get out into the world, into places that are more traveled, that knob has been touched by dozens or hundreds of people, instead of a handful. The chances of it being contaminated are much higher. Furthermore, if I contaminate it, the chances of me infecting others are much higher. I’m not saying it is an acceptable risk–I don’t have the information to judge, and frankly, I don’t think anyone else does either–but it’s not the same risk, it’s not basically identical.

I think there is a difference between “social distancing”–which, in my mind, is stay out of public places, don’t go to work or school if you can help it–and “shelter in place” which is what they are doing in Santa Clara right now. Shelter in place is definitely no contact outside your household with anyone. In your mind–and this is a sincere question, because I honestly have no opinion–should the whole nation be moving to “shelter in place”?

Also, what do you think about my earlier question about groceries. We are “allowed” out for groceries–but should we be rationing how much we eat and breaking into emergency supplies in order to prevent going back for as many weeks as possible? Because I feel like a single trip to a grocery store–however careful I am–has to risk more people than sitting in a neighbor’s kitchen. At the grocery store, I am potentially directly infecting dozens or hundreds and then all of them may infect others. At my neighbors, the initial number is much much smaller–and I can contact him if I develop symptoms.

Everybody shut up and listen to Stranger.

OP, you DON’T want it to build to where you have a shelter-in-place decree. How do you think it spread so far in all these other cities? It will happen in Chicago, too. Small gatherings spread germs just like large ones. They know that asymptomatic people are spreading the virus just by breathing.There’s a ER doc in his 40s here in Seattle area in critical condition - he caught it in the community, not at work.

Fer chrissake, you’re the one always going on about people’s lack of responsibility and trying to cheat the system. Yet you’re putting yourself above everyone else.

I’ve canceled all my usual activities except for outdoor walks and necessary groceries. I can work from home mostly, although I can go in early to work where I have my own office before anyone else is there and leave before anyone gets there. It’s not going to kill me, but doing anything else could kill someone else.

And then you’ll all come back to your wives, after your get together? Is that right?

And if one of you loses a wife, as a result, how will you feel then? Is it so important as to be worth that risk?

Willing to roll the dice for your own self is one thing, but unless you live alone, you’re risking that person’s health too, are you not?

I hadn’t heard that. Wow. When did that happen?

duplicate… timeout malfunction

But you’re drawing a line, too–you’ve decided that walking alone outside and getting groceries is acceptable. And I tend to agree with you that those are reasonable precautions. But you’ve still made a judgment call: you aren’t doing the utmost possible to isolate yourself from all other human beings, because at some point it’s not worth it.

Well, then, why don’t we push people to limit contact at home? Sleep apart, don’t eat from the same dish, no affection, constant wiping things down. I think it’s because we know that the slight reduction in risk we might gain isn’t worth the incredible distress such a policy would cause. And that’s okay. But with the larger issue, so much is simply unknown: it’s not about high risk or low risk, it’s about uncertainty. We just don’t know. Which leads to this weird absolutism where people are declaring it socially irresponsible to go to the park and take a walk a meter or more from a friend, but go to the grocery store because they are out of milk, even though they could get by with dry cereal if they needed to.

Again, I’m practicing a severe social isolation. No visits, no visitors. I was on the fence when the thread started about small-scale private visits, but there’s been some explicit guidance not to do that in the places that are “shelter in place” ,and I think that’s coming in my area if it’s not already here.

But I don’t think it’s crazy to want to discuss, explore, see if we can get a handle on relative risk. It is, if nothing else, super interesting. And I know that some of the most egregious things I have ever seen in my life were things put in place because someone not directly affected thought that everyone else should do something “just in case”. Not because they had any strong evidence that it was required or anything, but “just in case” they got in trouble if it was done that way. “Just in case” thinking is what gets us hide-bound bureaucracies that can’t adapt to a pandemic, that gives us petrified authorities who take the most conservative course possible “just in case” doing something.

I am still waiting for anyone to tell me if it’s acceptable to go to the grocery store if you still have food you could eat. Are y’all eating all your apocalypse food before you go back? I have to be honest, right now I am not planning to. I won’t go more than once a week, I will literally take a shower before I leave, touch as few things as possible, and wash again when I come home, but I am not going to live on rick and beans until they are all gone.

And all Richards across the country breathe a sign of relief.

Stranger

At least it wasn’t dick and beans.

You’re joking, right? (In bad taste, if you are.) This has been part of the equation all along.

Manda JO, to answer your question about going to the store, I went last Friday afternoon and it was so jam-packed, I decided I wouldn’t be coming back anytime soon. And that was also the point we were instructed to say home. I’ve got enough staples to last a very long time. If I need anything vital, I would consider running into a 7-Eleven.

And this morning my phone died and I stopped into a phone store because I considered that a necessity. But that’s really about it. Remember, I’m in Seattle where we’re all pretty cognizant of the dangers. An old neighbor of mine from across the street is in the retirement home where someone died last week.

Virtually everyone in this thread has had several colds in their life. So think to yourself: where did you get them? I think most people get more from friends, family and coworkers than these large public gatherings. So I don’t understand the belief that some of you have that large public gatherings must be avoided while there is virtually no risk from the small get-togethers.

Maybe this will help convince the skeptics.

COVID-19 spread is fueled by ‘stealth transmission’

My bold.

More backup at the link.

No, not a joke at all. Everywhere I’ve seen it requires respiratory droplets and it isn’t airborne. CDC says it is mostly likely passed by coughing and sneezing. Breathing? I hadn’t heard that.

From The New York Times: https://www.nytimes.com/2020/03/17/opinion/coronavirus-1918-spanish-flu.html

The Single Most Important Lesson From the 1918 Influenza
Containment — the attempt to limit spread of a virus and even eliminate it — has failed.
By John M. Barry
Mr. Barry is the author of “The Great Influenza: The Story of the Deadliest Pandemic in History.”
March 17, 2020

Long article. I tried to cut without losing the main points.

Cosigned.

I’d like to ask (probably going to regret this) but I work from home all the time. For over a year. I live alone, so I always enjoy going… anywhere after work. Even in rush hour. Now I can’t do that, it’s for the better good. No problem.

But running out of things you don’t think of right away, as a single person, I’ve been to the grocery store three times since Saturday. I’ve given up looking for TP and the basic shit I used to get. I’ll make do. I’m asymptomatic NOW… but even if that changes, I’ll need runs to grocery/pharmacy for prescriptions.

And I’m VERY afraid of us going on full lockdown here in Los Angeles County. (I’m betting we will have to for a few days.) So I am thinking that now is the time to scourge the stores and grab stuff. I’ll have no choice if a lockdown starts. And still waiting for paycheck, so the bills are going up.

And there’s many people here in LA County who are also single, or stuck with roommates in the same situation. So does anyone consider it wrong that after work I check the stores for more things I might need while I can? I guess I’m asking, is that too late? I really don’t want to be any part of contracting or spreading this crap. So the line I’m drawing, I guess is, better late than never?

I’m not questioning it. We know that it is effective.

I’m immunocompromised from a recent battle with cancer and I currently have a cold. If I get it, It will be bad. Or rather, when I get it, it will be bad. I’m exceedingly grateful to everyone who is pitching in to flatten the curve. A month or two from now, we’ll have more knowledge, more testing kits, etc. and hopefully my immune system will be in better shape.

The question of whether you should continue to socialize in groups is a no-brainer. No, you should not. If you’re so desperate for company that it’s affecting your mental health, than do what you must in the safest way you can. Those of you who want to hang out with your friends to play music or have a dinner party don’t seem to be in this category. You know it’s a bad idea. Be strong.

As far as limiting trips to the grocery store and whatnot - Let’s all just do the best we can.

I wonder if this will give “A Second Life” (or equivalents) a…second life. This 2017 Atlantic Monthly article described how the pre-Facebook interactive online platform has remained popular among some people who, for psychological or physical reasons, have difficulties interacting with others IRL.