U.S. Government releases three phase plan to return to normalcy..

Hot off the presses. So, from my understanding, if things go well, Phase 1 is May 1, if things continue to go well Phase 2 is May 15, and if things again continue to go well, Phase 3 is June 1 at which time, from my limited reading will mean that everything is back on, except for perhaps large gatherings at sporting events.

Until any given state has the capacity to test at least 10-20x more samples in a day and has the epi tracing and hospital surge capacity to deal with the situation if their testing doesn’t keep up, this is a complete pipe dream.

Reopening states with “beautiful” coronavirus numbers sounds like a fantastic way to uplift them.

The only thing I see about testing is on page 2 and it mentions a “robust testing program for at-risk healthcare workers.” Are you saying that is a pipe dream? I’m really asking, because I was pretty encouraged by this.

Is there anything more to this ‘plan’ than that 5-minute Powerpoint presentation?

Because that is no kind of plan.

Can’t it take up to 14 days for symptoms to show up? Assuming 15 days after a change that everything’s okay is remarkably shortsighted.

Right, but that is an “up to.” Wouldn’t you see an uptick prior to 14 days (because many people have symptoms sooner) and therefore not proceed to the next phase and/or go back to the previous one?

I would assume that it is more comprehensive than the Powerpoint, but this is a general outline. I do notice some weasel words in there like at each phase restaurants and other venues can open with (in descending order) “strict, moderate, and limited” physical distancing.

The document doesn’t define those terms. What does a restaurant look like with “moderate” physical distancing, for example?

Not even a pipe dream - a fever dream. Literally the second sentence of the document should have been “we jacked up testing badly - here’s how we’re fixing that”.

The fact that Trump still thinks that testing only needs to cover health care workers shows that he still has no idea what we’re dealing with: robust and widely available COVID-19 testing on a massive scale (most states would need to be able to test 1-3% of their population every week) is literally the only safety valve we have until an effective vaccine is available (9-12 months…if we throw money at the problem with wild abandon and we get lucky).

This document has zero basis in reality.

Sure - if you have a solid, well-trained and well-staffed public health system. And if your testing infrastructure is fast and accurate and scalable.

Roughly 5-8 U.S. states have that kind of capability right now (and that’s being generous).

But, and I’m not here to argue Trump. For the purposes of this thread, I’ll just say it is all Trump’s fault. However,I really am ready to get back in public again. So:

Even without the testing, wouldn’t you see hospital admissions with Covid-19 symptoms jump?

I realize not everyone who is infected has symptoms, nor does everyone go to the hospital, but if the relaxed standards are not working and causing more infections, wouldn’t you see the increase there, even without the testing?

So,

1 May = “A slightly softer lockdown, with a phased reopening of some offices and social distancing still encouraged.”
15 May = “For non-vulnerable population, life largely returns to normal. Non-essential travel can resume for non-vulnerable populations.”
1 June = “For vulnerable populations, life can begin to normalize, but with social distancing for those people.”
Phase 1 is possible by 1 May, if you accept a resurgence of cases. It might not be a good idea but it could happen.

Phase 2 : Like enalzi said, symptoms take about half a month to show up and, iirc, about half a month to subside/be treated if they’re bad. A phase has to last at the very least 1 month but even that won’t be enough because most new cases won’t get infected on the first day of the new phase. If the restrictions are too loose, the healthcare system is liable to get swamped at least 1 month into the future.

Phase 3 is a non-starter. Old people with medical conditions aren’t going to start to have normal lives for 6 months at best, probably 1-2 years.

Here’s the problem: without a vaccine, you essentially have no safety net. And without widespread surveillance of the population - not symptomatic folks, but wide-swaths of the general public - the time course will look like this:

Day 1-8: Everything looks fine.
Day 9: Hmmm, a few folks in the hospital. Test more.
Day 10: Okay, call in the extra staff.
Day 11: Holy crap the testing from day 9 looks bad!
Day 12: ER at 150% of capacity
Day 13: Public Health Emergency
Day 14: Now it looks like NYC.

So, yes, you will notice an increase in hospital admissions. And by then it’s too late to “fine tune” the system because Bad Things are happening.

The above is not particularly speculative - it’s pretty much what most countries/cities that didn’t lock down hard and fast have been through. Not just NYC, but Louisiana, Detroit, parts of TN, etc, etc, etc.

But as noted in the guidelines, you have to continue to see a downward trajectory of new cases (and that’s just one criteria). Moving to the next phase is not automatic.

So let’s say that against your better judgment, we start Phase 1. Let’s assume it was a terrible idea. Although we wouldn’t catch the extent of our grave error by day 14, but there would be some indication of more infections and there would be no more downward trajectory. So not only do we not proceed to Phase 2, we reassess whether we should even be at Phase 1.

What am I missing?

ETA: I posted before I saw Super Abe’s post above mine. But in that case, couldn’t we go back to Phase 1 on day 9? Yes, it would have been a screw up to go to Phase 1 in the first place, but we have to start sometime.

Yeah, it’s pretty messed up.

You need not JUST healthcare workers but EVERY person at the hospital, especially the people who do the cleaning who might not actually be hospital employees but employed by a company that holds a contract for cleaning.

You need all police and fire personnel to have robust testing because they are “first responders” who have contact with a lot of people for a lot of reasons, including emergency calls.

That’s at a minimum.

I’d also add in transit workers if for not other reason than they come into contact with so many people during the day, so just one bus driver shedding virus can create a brand new hotspot. Ditto for grocery store workers, postal workers, delivery drivers, Uber/Lyft/taxi drivers, all for the same reasons - lots of contact with lots of people being an inescapable part of their jobs.

The more you open up, the more people having many contacts with many people the more people you need to test.

If you don’t do this you’ll miss “spreaders” - who in most cases will have absolutely no idea they’re shedding virus - and you’ll keep having outbreaks.

Without massive testing we can’t safely re-open the economy.

More details: https://nypost.com/2020/04/16/trump-unveils-opening-up-america-plan-aims-for-may-1/?utm_source=NYPFacebook&utm_medium=Native&utm_campaign=NYPFacebook&fbclid=IwAR09JLcGn74ZSFciCWeDH6bWRRUfIZxcrEZpyPjYE-Qi2y57HqZyfKjHR-w

I mean, Fauci is on board.

I’ll be the first to say that I am arguing from ignorance on this. I’m just looking for hopeful signs. If it is unsafe, then I am all for staying shut down, but…Fauci? That’s good, right?

As others have already said, the key to being able to safely reopen the economy – both from the standpoint of limiting infections, as well as reassuring the public that they will be safe – is widespread testing. Trump’s plan apparently doesn’t address actually getting to that point, and the federal government has done little to address testing in general; even if Fauci is “on board” with the recommendations, I suspect that that’s primarily at a conceptual level.

From today’s Washington Post (yes, I know, there’s a paywall):

Fauci has obviously made the decision that he wants to stay a part of the federal response. And that means placating the person who is making decisions based on “his gut” rather than on science.

It would be imprudent to assume that this plan was authored by Fauci or that he believes it to be the wisest course forward. By signing on, he’s simply protecting his chance to make a difference in this pandemic.

^All of this.

The long incubation for this virus makes any plan with two-week phases invalid. Unless the goal is to maximize deaths, of course.

The fact that the virus is being spread by people who show no symptoms is another reason that the new plan is a guarantee of increasing deaths:

So how do we realistically get to millions of tests per day. In the article I cited, Trump told Gov. Inslee of Washington that he could get all states 5.1 million tests by the end of the month.

Are millions of tests per day remotely feasible? Just for giggles, I found that about 24 million chickens are killed every day for human consumption in the United States: https://www.quora.com/How-many-chickens-are-killed-everyday

And chickens are about the easiest thing in the world to produce and there is a known industry doing it that has operated for thousands of years. With this test, we are talking about something very expensive and very novel and must be analyzed by health professionals.

If we are talking 9 months to a year before that sort of thing happens, if it ever happens, then it will not be feasible. The public will demand to be let out even if it means more deaths.

Do you have an estimate of when those millions of tests per day might be available?

The safest bet in all of this is that Trump will oppose any expansion of testing with every means he has available.

More testing means higher (and more accurate) numbers of infected Americans. And that is bad for Trump’s reelection chances.

So he will place every roadblock he can in the way of testing.