As we are going thru this it seems like some areas should have this under control pretty soon while with others, I’m not sure if it could take a year or more (thinking big cities).
However just because its still in some areas I wonder if some areas the quarantine could be lifted? Maybe rural areas?
For example, lets say a county goes 30 days or more with no new cases. Could they lift part of the ban? For example, allowing kids to play at playgrounds or tennis courts to re-open? How about local restaurants?
Or perhaps a company could allow people back to work if the employees have gone say 30 days or more with no exposures?
This quarantine would work a lot better, and be effective much faster, if people would actually comply with it. We havent even locked down the entire country yet, but people are already (and have been since the day shelter in place was first announced anywhere in the US) talking about ending it, trying to find ways around it, or straight up ignoring it. The quarantine could have been over in 2-3 weeks from when it began if we all (ALL) actually comply. The more people try to find ways around it, the worse things will get, the more people will die, and the longer we will need to be sheltering in place.
What you are saying is objectively correct, but no human endeavor has ever had anything approaching a 100% compliance rate and it is not practical for any proposed solution to rely on that. We might as well say that roads would be much safer if everyone obeyed all traffic laws at all times. True, but impossible.
I found this article which talks about cellphone companies using location tracking data to see how well people are complying with stay-at-home orders. The short and the long of it is that some areas are doing a better job than others. This article says that “mobility” (the range people travel) in Oregon has dropped 91% compared to all of 2019.
You don’t need 100% compliance. You need enough compliance to bring the infection rate to below 1. As to how compliant you need to be for that, depends on the length of time people are infectious, and the distribution of non-compliance between infected and non-infected. I suspect you need about 90% compliance among infected (knowingly or not).
As to lifting social distancing, I see no reason not to lift it in unaffected areas, provided testing + tracing is available and in place - so that if any cases arise, this mini-outbreak can be controlled like we should have done from the start. At present, I don’t think there are enough tests available, but I’d be surprised if by mid-may this doesn’t become technicall possible for some areas. It still won’t happen - as we wouldn’t have enough tests to do it everywhere, and our system of government will not allow us to apply this (allocate the tests) rationally. So to start doing this anywhere will require more tests than you strictly need for that area. So, june?
I definitely agree with you. When testing becomes available the quarantine situation can change very quickly. Especially if you look at maps that list infections by counties. There are some areas without no cases or a couple of cases. But because they have a large city, like Chicago or Las Vegas, that have the cases clustered around it, it seems like the whole state is infected, when it’s really not.
You could try easing some situations, for instance, sit down restaurants are better able to control seating and distance than a bar would.
As far as I can tell, this has consistently been the opinion of the experts and not really sinking in everywhere - an early and critical requirement to ease restrictions with relative safety is widespread availability of testing + contact tracing. Improved stocks of medical gear and steady supply chain would also be good to have.
I think the key here isn’t necessarily the number of infected within a given area, but an actual strategy to contain outbreaks.
I don’t give a flying fuck if some podunk town in where ever doesn’t have any cases reported. A guy who lives there and has the disease and we (and he) don’t know about it so he picks up his door-to-door sales job again is a danger. I mean, how many people did it take to START the pandemic in the first place?
Now, if we are testing the shit out of this mother and we have a way of determining who a carrier has been in contact with, so all those people could be sent home under penalty of law, then let’s start loosening things up.
But what we are seeing now is the results of incompetence a poor preparation. We need an even higher degree of competence and outstanding preparation to get the genie back in the bottle. Call me a cynic, but that may have to wait until January 2021 to take root.
So people in COVID-free areas would not be allowed to travel to COVID-present areas and vice-versa? Or they’d have to be tested
and quarantined somewhere while awaiting results) before allowed (back) into a COVID-free zone?
(1) Vaccination. If you have a vaccine, you are pretty much free and clear.
(2) Comprehensive testing returns a very low positive rate (like less than 1%) then you track and identify cases individually and quarantine the sick people and implement social distancing rules and curfews on a local basis. You have to continually monitor the population for outbreaks and be ready to lock things down quickly.
New York Times article: How Will We Know When It’s Time to Reopen the Nation?: Experts offer four benchmarks that can serve as a guide for cities and states, eliminating some of the guesswork.
The thing is, to get people to follow a plan, first there has to be a plan. So far in the US, there hasn’t been. All there’s been is “Let’s all hold our breath until we pass out, and hopefully we won’t pass out”. With a “plan” like that, of course compliance has been poor.
It does not require a 100% compliance rate, but implying that it does and is therefore impossible to achieve is a great way to get people not to try. So, good work!
That’s all well and good to say – in early February. Right now, its FAR too late for that. If someone lights a match and you empty a fire extinguisher on them, they can accuse you of overreacting. But right now, the building is on fire, and you’re telling the firemen to watch where they’re spraying the hose – you’ve got a nice painting on the wall and you don’t want them to ruin it.
In NZ we’v been following a plan, guided by the science and great leadership. We set up an alert system. We are currently at Level 4, and we will stay there until we’ve been through 2 full incubation periods at the very least. if at the end of the 2 full incubation periods (or four weeks) the metrics have changed, then we drop to the appropriate Alert Level. If we get an outbreak or a new cluster then we can isolate that cluster at the appropriate level, and expand it again nationwide if need be.
So yeah, we’ve got a plan, almost everyone is on board, we all know what part we have to play to get the country open again (we are all craving KFC, Mince Pies and Fish and Chips so we don’t want this to last any longer than it has to) and we all know what the endgame is. There is of course no way that this would work in America (with current leadership), and its too late now anyway. With each State, heck, with each town essentially doing their own thing America probably won’t get this properly under control until the vaccine appears.
Here in Oz things look to be on a similar track to NZ, although due to our size and generally more difficult to control borders, it isn’t nearly as easy or assure. There has been no discussion about where to from here, but I suspect that behind it all is a hope we are on a parallel path*.
But you have to be able to hold things down. That means closed borders, and almost certainly restricted internal travel. Plus testing, lots of testing.
After lots of pressure our government released the modelling used to guide their choices. It was a trifle underwhelming. It did not provide any guidance on where to. I suspect they are still keeping that under wraps.
Abundance of beds isn’t the problem. If you only need a bed you will probably be OK. There is much talk of ICU and ventilators. Currently it seems if you need ventilation you only have 50/50 or worse chance of surviving. Hospitalisation isn’t a magic way of coping. Even with infinite medical resources lots of people will still die. And we don’t have that anyway.
Further, one of the big problems is that there isn’t a linear relationship between how open the gate is and how many infections and hospitalisations you get. It is finely balanced and can tip badly. Moreover we don’t have enough information to understand just where the tipping point is. Maybe things are not as badly conditioned as we fear, maybe they is worse. Maybe as time goes on we will gain enough of an understanding of the dynamics to perform a more managed easing - lets hope so. But right now, with the information we have, you are, at best, taking a leap in the dark opening things up. What we do know suggests that there may be a large drop and a skip filled with broken glass at the bottom of the jump. We don’t know for sure, but we have reasonable suspicion.
Life would be fabulous with perfect information. But that just isn’t how it works.
I am tracking the number of US deaths per day. It is a number I can understand. We are now about 2,000/day. I have decided to keep tracking this until we are under 100/day. That is still a beastly number, but it will be a happy milestone.