Current Coronavirus US upsurge

I’m not into schadenfraude, and my heart goes out to Americans and businesses in some states that are experiencing a dramatic rise in cases. I understand there is some compassion fatigue on this topic. I hope fellow Dopers are staying safe.

There has been a claim that if everyone wears a mask for 4 weeks - problem solved. I personally doubt this very much. I hope Covid does not become endemic and a vaccine is soon available.

I do wish, in times of uncertainty and strife, the US would stop badmouthing WHO and “cutting out” the CDC despite their flaws and imperfections.

You limit, slow, or even terminate a pandemic by reducing (even eliminating) as many transmission routes as possible. Wearing masks won’t hurt and could actually help.

COVID-19 is not going away soon. Don’t think weeks or months. Think years.

I’m not anti-mask. The N95s are helpful. Other masks do protect other people to some degree. They need to be worn when social distancing is not possible. Local laws should be followed. Masks do not replace hand washing, social distancing and once properly on should not be adjusted or touched. Because this is difficult, they can give people a false set of security. Alone, they are only a part of the solution.

If Covid becomes endemic, this means it is here to stay. I hope not. I do not see a vaccine being developed very soon - it’s very hard.

I’m so afraid. Every state around Arkansas is in serious upswings of cases, hospitalizations and deaths.
Our Governor has his head in a bucket. I can’t see where starting school and opening bars and restaurants is gonna help.
I feel like we’re doomed.

You’ll be okay. Things will look a lot better in a few months. But Canadians are confused by the American habit of politicizing everything - even public health. Hopefully, things will change for the better soon.

As others have said, this seems a bit much to hope for. However, the theory at least is clear: If you can reduce R0 to less than 1, it means that on average each infected person passes it on to less than 1 other person. Thus, if you can sustain that rate, the prevalence of the disease gets steadily less and less. Assuming the virus doesn’t remain indefinitely in the environment, it will eventually totally die out.

So the thinking is that if everyone wears masks, then you can cut R0 down well below 1. This would have approximately the same effect as quarantining everyone. And four weeks of that should be time enough for everyone who is currently infected to get over being contagious, and the virus to die out of the environment. So that should be long enough to eliminate the virus.

So goes the theory.

ETA: A counter-example would be tetanus (a bacteria). It remains in the environment indefinitely (residing on rusty nails of legend, but actually on dirty surfaces everywhere). Eliminating it entirely from the human population all at one time does nothing to eliminate the disease.

I expect things to look a lot worse in a few months. At the rate we’re going. New policies from The Top may help, but people seem to resist restricting themselves even slightly to curb this thing. Maybe when half a million people have died from it? [shrug] Maybe not even then.

I’m not anti-mask. The N95s are helpful. Other masks do protect other people to some degree. They need to be worn when social distancing is not possible. Local laws should be followed. Masks do not replace hand washing, social distancing and once properly on should not be adjusted or touched. Because this is difficult, they can give people a false set of security. Alone, they are only a part of the solution.

If Covid becomes endemic, this means it is here to stay. I hope not. I do not see a vaccine being developed very soon - it’s very hard.

It’s important to look at this from a public health standpoint and not an individual perspective. As individuals we want guarantees that if we do X, the outcome will by Y (virus protection). The reality, though, is that people will get the virus regardless of protection. However, by taking a comprehensive public health approach, we reduce the overall incidence, and thus, over time, reduce the risk to the individual. We don’t eliminate that risk of contracting the virus - not even with a vaccine. But we greatly reduce it. By doing that, we give individuals who do get sick ready access to use the health system and we give healthcare workers all of the resources they need to treat the cases they do see.

What’s happening in countries that have serious problems - like the US, like Brazil, like China initially - is that they have largely fumbled the public health response by trying to accommodate individual ‘rights’ and ‘needs’. Consequently, they’ve put the entire population at risk by failing to bring down the number of disease vectors.

Epidemiology is all about math. Person A has the virus, and now can transmit it to any number of people in his or her vicinity. If we’re lucky, that person lives alone and either doesn’t work at all or works from home and rarely goes out. If we’re unlucky, that person lives with a family of 10 in a crowded apartment complex, goes to a mega church two or three times a week, works at a grocery store 6 days a week, and regularly socializes and shops around town. One person can spread it to hardly anyone over a 7-10 period, or they can spread it to literally hundreds of people within a 24-hour period. And once that person has transmitted it to even just one person, you have the same situation all over again. So in theory, it’s possible for one person to be responsible, both directly and indirectly, for hundreds, if not thousands, of cases.

Epidemiology is concerned with trying to control disease vectors. If we’re talking about a virus like malaria, dengue, or West Nile virus, then the vector is the mosquito, and the efforts focus on trying to remove disease-transmitting mosquitoes from the area, which is accomplished by doing things like removing standing water, spraying chemicals in the air, and cutting down on weed growth - all that. In the case of a virus, the vector is us. The focus becomes controlling human behavior to reduce the number of disease vectors.

Why do I go off on a tangent about epidemiology? To explain the purpose of wearing masks. It is NOT to guarantee that you don’t get sick. It is to reduce the number of droplets that can escape from your mouth. This is important because from a public health standpoint, we’re trying to use math against the virus. We’re trying to reduce the number of droplets that escape into an environment where people may come into contact with each other. If nobody is wearing a mask, you’ve got maximum number of droplets and the environment is risky. If everyone is wearing a mask, then you’ve minimized risk, at least relative to the situation.

But of course, wearing a mask is one factor in the entire equation. If you want to really, really reduce your risk of catching coronavirus, stay home as much as possible – period. Of course there is the intervening reality of needing a job, needing occasional social activity, needing to shop and all that - I get it. But still, the absolute best way to reduce an illness that relies on human-to-human transmission is to greatly reduce human-to-human interaction. Full stop.

We’re a few weeks away from the scheduled reopening of schools and we’re collectively confused about whether to reopen or not, and if we reopen, how best to do it. In short, we’re a few weeks away from an absolute public health disaster. We’re a train that’s rolling slowly toward a cliff, and we’re debating whether to stay on or jump off, knowing full well that it’s a cliff. We’re a few weeks away from a disaster that will not only impact public health but the economy for years to come - years and years to come.

Along the lines of what asahi is saying, when I read this in the San Antonio paper this morning, I wanted to tear my hair out.


The headline is truncated, but the whole thing is:
"Medical adviser to Gov. Abbott says regional stay-home orders ‘worth considering’"

Right. Let’s consider it. Doing it is yukky, but I’m pretty sure considering it will work just fine.

…“It’s clear that the state has not been on a sustainable course and it’s worth considering a regional approach,” said [Mark] McClellan, a physician and economist at Duke University and a former commissioner of the Food and Drug Administration. He added, “It’s so hard to stay ahead of the pandemic when it’s in a growth phase.”

[Texas Gov. Greg] Abbott again refused Tuesday to issue lockdowns, even as a growing number of local officials pleaded for the ability to impose stay-at-home orders. The governor had reasoned on Monday that it’s unlikely lockdown orders would be enforced. On Tuesday, he said in a TV interview that infections would spike again as soon as the orders are lifted…

My bold.

So, no point in doing it. But we get official points for considering it.

Agree. Absent a unified response to contain it (from the federal level), you can put out the fire in one state but it will spill over from other places and reignite.

Isn’t that the definition of “staying ahead”—stopping it from growing?

And then there’s Florida.

The latest I’ve seen is that they protect you too.

N95 masks protect a lot better than basic ones. No mask protects you well if you touch your face a lot and ignore other practices. But if cases are going up in your area, it is not a bad idea to wear a mask; maybe a good idea.

There is much about this whole ordeal that has me flummoxed, but this little nugget is exemplary of the biggest one. Why should anyone believe that everyone should blindly follow ‘the science’ when it takes a pandemic like this – and six months of it, no less – for something so seemingly basic to become news? If the people working on this kind of problem were so on top of things, wouldn’t this point have been settled a long time ago?

Wtf? No, why in the world would it be settled a long time ago? As far as the world knows, this is a 6 month old virus. By what standard are you judging “we shoulda known by now”?

I’m not sure if you’re serious. Or maybe you didn’t get me. I’m saying that I expect the pros in the field to have long before now figured out for sure whether masks are effective against airborne viruses. This or any other one.

Why do you think that? Is it like a “if they can put a man on the moon…” type thing or what?

I think you’re looking at this wrong. You’re looking at how we can maximize protection for the individual so that individual can go on and life live as he or she pleases, but that’s not the way to look at it.

Again, controlling a pandemic requires collective thought, collective cooperation, not individual flexibility. In the end, while it’s highly unlikely that we will have 100% cooperation, if we can get 75-80% cooperation (or even slightly better), then we’re going to have much slower growth if we can sustain the behavior over the longer term. We’ll fare even better if we can get another 75-80% to either minimize their trips out of their homes and if we can get that same number to eat outdoors only really stay 6-10 feet apart. We can simultaneously exercise caution while gradually reopening. We can have good things - if people can behave themselves.

If not…well, look at Florida, look at Arizona, look at Texas, look at metro Los Angeles. They’ve known the dangers for months. They, like the rest of us, all saw how dire the situation was in New York City, in Wuhan, China and in Lombardy, Italy. They chose to assert their individual rights, and now everyone, including many of them, are paying a heavy price for it.

I think it because it seems like a really easy thing to test with controlled experiments. Or at least, if it wasn’t before now then it would have been a big priority at the beginning. Instead we are getting news articles at the six-month mark that say ‘evidence is mounting’?

I guess you’re saying that this is yet another one of those ‘we just don’t know’ things? That’s really what flummoxes me in this whole ordeal. I expected we would have known more – more than we evidently do.