COVID COVID-19 Coronavirus Containment Efforts

[russ_watters]

It's important to remember that the https://annals.org/aim/fullarticle/2762808/incubation-period-coronavirus-disease-2019-covid-19-from-publicly-reported of the virus is about 5 days, so we don't expect to see new cases subside until about a week after imposition of social distancing methods. In some locations, distancing measures (like closing schools, restaurants and theaters) were not imposed until the beginning of this week.

Edit to add: also remember that testing is becoming more available, so we should see US numbers go up just from increased testing.

Understood.

I simply copied the title of the article and url.

I know. And on the news last night, I heard again a reference to the Johns Hopkins prediction of 2.4M deaths "if nothing is done". It's overblown, but that's normal for the media...though in this case it may not actually be a bad thing if it helps cause people to take it seriously. Still annoys me though.

With respect to social distancing, my place of employment implemented practices starting a month ago, two weeks before it started being implemented in different parts of the country, and three weeks before it started becoming nationwide, and as of last weekend, quarantine/isolation and social distancing practices have not been implemented uniformly across the country. I have observed this first hand while traveling last weekend.

Only this week have there been announcement of closing of stores, malls, businesses, industries, that were not closed last week. So the virus has plenty opportunity to spread.

Yes, obviously the national policy has lagged the local policy. I offer no judgement for now of if it should or shouldn't, but I will say that state governors have considerable power; in some cases more than the federal government. I'm not sure if that's different from other countries.

The first major business closures I heard of in my area were on Tuesday, March 10. My company first started implementing voluntary/encouraged work-from-home this week, and the office has gradually emptied-out.

Just for record purposes, here's how it all went down in my county (Montgomery County, PA):

Patient zero in my county was a doctor at Children's Hospital, who returned from overseas travel and went back to work. A timeline:

• ~Sunday, March 1 - Wed, March 4: Patient Zero works and sees patients.
• ~Wed March 5+: Patient Zero quarantined and contact tracing starts.
• Sunday, March 8: Patient Zero tests confirm diagnosis.
• Monday, March 9: Contact tracing complete.
• Tuesday, March 10: Schools linked in contact tracing are closed (announced on Monday).
• Friday, March 13: All schools in county are closed (announced on Thursday).
• Monday, March 16: All Schools in Pennsylvania are closed (announced on Friday)
• Tuesday, March 17: Most public-assembly type businesses (bars/restaurants, gyms, retail) in populous counties closed.

Story from March 10, when 8 cases had been confirmed ("presumptive") in the county:
https://patch.com/pennsylvania/norristown/chop-doc-coronavirus-had-contact-2-dozen-kids-17-staff
Story from March 12, when 13 cases had been confirmed in the county:
https://patch.com/pennsylvania/lans...ntgomery-co-schools-some-public-places-closed

The county is adjacent to Philadelphia, has a population of 830,000 people and a radius of about 12.5 miles (20 km).

The only way I can see for that timeline to have been compressed/altered much is if the travel restrictions had been tighter or if the contact-tracing step were skipped entirely and we went straight to general social distancing. It wasn't announced what country he had returned from, only that it was a country with known cases but no high alert/restrictions yet. Note that by nature the first case is only identified after symptoms arise, not by early testing (unless travel restrictions require it). I don't know to what extent testing of his contacts started late in the week of March 1-6, but I assume it was insufficient.

 

[kadiot]

Not everyone will voluntarily comply with social distancing. We should expect more cases where force is used. For example, police breaking up a wedding gathering. That's regrettable, but necessary.

Right now in Florida, the students on spring break are ignoring the calls to social distance. The governor told them, "Don't come." They came anyhow. Closing the beaches, hotels, bars, and restaurants, and stopping sale of alcohol in stores, may convince them. If not, then use of police force may be necessary.

@Dr. Courtney take note. You can sue in Federal Court that it would violate your rights. Your case might get to trial in 2026.

I agree. In Philippines, some violates lockdown and quarantine policy. Some stays home. However, this is what happens when everyone stays home - information overload.

 

[gmax137]

But what shocks me so far is that, in the US, I have received no direct emergency government messages. We have systems to send people texts, emails, interrupt television broadcasting, etc. As far as I know that hasn't happened. How do we know they even got the message?

Are you kidding? The 4 hours of local TV news is entirely devoted to this, as is the 1/2 hour evening national news (staggered, so I can see an hour of that) plus the 2 hours of national "morning" news. It is all anyone talks about, not to mention the social media (see this 1400+ post thread on PF for example). Here in Nevada, the Governor told all non-essential businesses to close (and many are doing that, including the casinos, big & small) -- so the uninformed are presented with locked doors on closed stores. Also, if any of your doctors, dentists, etc. have your email address you get messages from them notifying you to forget about routine or non-emergency appointments.

 

[kadiot]

Perhaps the effective way to implement social distancing is for people to stop putting on deodorant. Drastic measures, for sure. Now, I'm joking.

 

[Rive]

Perhaps the effective way to implement social distancing is for people to stop putting on deodorant. Drastic measures, for sure.

Where I live garlic is an often recommended medicine for prevention in times with flu or cold

 

[Dr. Courtney]

@Dr. Courtney take note. You can sue in Federal Court that it would violate your rights. Your case might get to trial in 2026.

My 1st Amendment attorney has advised me that there is no need for that. For church closure orders to be enforceable, an executive branch representative needs to first get a court order from the applicable courthouse, in this case in the rural Georgia county where the church is located. In that process, the church closure order will face "very strict scrutiny" regarding whether it is "narrowly tailored" and as unintrusive as possible to meet the stated goal of "flattening the curve." No need to wait for a Federal court to overturn it years from now, all I need is a county court to say "no" in 2020.

But the fact is, even in Louisiana, where the governor has given the order to cancel church meetings above a certain size, neither the police nor the National Guard have been willing to enforce the order in Parishes (political subdivisions like counties) where it is unlikely to survive court scrutiny due to very low COVID-19 rates at the present time. Everyone remembers the Feds overturning an ordered gun confiscation after Katrina and the fact that enforcement was career suicide for most involved. Sheriffs, judges, and DAs are all elected in Louisiana. At current levels of COVID-19 in most parishes, no one wants to fall on their sword to enforce an order from a term-limited governor. And neither is the governor eager for an adverse court ruling from a parish with low COVID-19 rates. The governor needs the first ruling to be favorable, which is most likely to come from Orleans or Jefferson Parish where the COVID-19 rates don't make the order so unreasonable and where it may not be a career ender for the local elected officials.

The governor of Georgia has taken the wiser course, leaving the ordered closures for the mayor of Atlanta while the rest of the state is working with recommendations for private churches and businesses and schools. (Public schools have been ordered closed.) There was also due care for the Atlanta mayor not to overstep her authority as egregiously as the mayor of New Orleans, who gave herself the power to ban guns and liquor. Barak Obama wisely observed that lots of folks cling to their "guns and Bibles." One could add liquor to that list in some places. You get much higher compliance with everything you ask for if you don't dare touch those.

Keep in mind, what matters most from a scientific viewpoint is not the enforcement of orders, but rather widespread compliance with the actual steps needed to "flatten the curve." If higher levels of compliance come from trust, dissemination of good information, and reluctance to use unneeded government force, then that is the wiser play.

Since science is about testable predictions, I'll make one: By summer's end, rural counties in Georgia will have lower COVID-19 fatality rates than rural parishes in Louisiana. The lighter hand Georgia is using (and has used historically), and the better dissemination of information without implied threats will lead to better compliance and be more effective at "flattening the curve."

 

[russ_watters]

But what shocks me so far is that, in the US, I have received no direct emergency government messages. We have systems to send people texts, emails, interrupt television broadcasting, etc. As far as I know that hasn't happened. How do we know they even got the message?

Are you kidding? The 4 hours of local TV news is entirely devoted to this, as is the 1/2 hour evening national news (staggered, so I can see an hour of that) plus the 2 hours of national "morning" news. It is all anyone talks about...

Yeah, I see no need for direct/pushed messaging. It's lunch and I turned on the local news radio station and there's Trump and his team giving a briefing. This isn't an imminent surprise like a tornado. I consider staying informed to be an affirmative individual responsibility.

 

[phinds]

I've looked it up and explained what it means. I believe that I would be at great risk if I were in a country that decides to do "herd immunity".

You have misunderstood it, or have been given incorrect information. You would be MUCH more safe in a country that achieved herd immunity.

 

[kadiot]

You have misunderstood it, or have been given incorrect information. You would be MUCH more safe in a country that achieved herd immunity.

Ok. Thank You.

 

[russ_watters]

I would advocate for their voluntary closure according to the CDC guidelines that call for that once the presence of COVID-19 in their community is "substantial."...

I am checking every day for the latest available local information. If there is a significant uptick in cases within the draw radius of the church, I can change my plans. I am capable of extrapolating the data forward to account for the incubation period and new information regarding risks of non-symptomatic carriers.

Glad to hear that, at least.

"Uniquely resisted" is an odd description in a county where 20% of the churches remain open. "Resisted" is an odd choice of words for a church that is exceeding recent CDC recommendations applicable to churches given the level of outbreak in the local community (none to minimal)...

My current intent is to attend. In the recent CDC guidance for churches that I provided above, there is no recommendation to not attend given the level of outbreak in the local community.

The statement was more forward looking: You have strongly implied a willingness to use legal and physical force to defy government orders, when they come. Obviously this hasn't happened yet in your case, but this sub-discussion started when you posted a story of a church who did exactly that and then took umbrage to our negative reactions. But you do seem to be softening your stance a bit.

Note also that the CDC isn't the only applicable guidelines. The state of Georgia has this to say:

Religious organizations should consider alternatives to mass gatherings to support their congregations’ social and spiritual well-being...

[but in another section:]
To slow the spread of Coronavirus disease (COVID-19) and reduce the number of people infected, DPH recommends that organizers of events that draw more than 50 people cancel, postpone or modify these events or offer online streaming services until further notice.

https://dph.georgia.gov/community-events-and-information-groups

Do you anticipate more than 50 people to attend your church on Sunday?

No. There is no evidence that...
[snip]
I'm not depending on faith.

You continuously cite examples of gaps in data and from there argue against the trend that the known data was on where it ended.

If I buy 10 lottery tickets, I'm pretty unlikely to win the lottery. If I buy 5, I'm much more unlikely. But what if I only by 1? Your argument is that there is no evidence that buying 1 lottery ticket is any less likely to result in a win than buying 5, therefore we should assume there is no reason not to buy 5.
[in this lottery, "winning" is getting sick]

 

[Ygggdrasil]

You have misunderstood it, or have been given incorrect information. You would be MUCH more safe in a country that achieved herd immunity.

In this context, herd immunity describes a strategy proposed by a few countries (most notably by Prime Minister Boris Johnson of the UK), in which a country eliminates the disease by letting a large fraction of the population contract the disease and therefore become immune to it:

Herd immunity is a phrase normally used when large numbers of children have been vaccinated against a disease like measles, reducing the chances that others will get it. As a tactic in fighting a pandemic for which there is no vaccine, it is novel – and some say alarming.

It relies on people getting the disease – in this case Covid-19 – and becoming immune as a result. Generally it is thought that those who recover will be immune, at least for now, so they won’t get it twice.

But allowing the population to build up immunity in this way – rather than through widespread testing, tracking down the contacts of every case and isolating them, as many other countries in Asia and Europe have chosen to do – could increase the risk to the most vulnerable: older people with underlying health problems.

https://www.theguardian.com/world/2020/mar/13/herd-immunity-will-the-uks-coronavirus-strategy-work

An analysis from Imperial College London suggests that such a strategy, even with the best efforts to mitigate the effects, such as quarantining the elderly and other susceptible populations would overwhelm hospitals with a surge of critically ill people eight times larger than the health system in the UK could deal with.

Sure, herd immunity would make a country safer, but achieving herd immunity (in the absence of a vaccine) requires getting 60-70% of the population infected, which would be very dangerous and deadly.

 

[BillTre]

just as some background, the term herd (not heard as some have been spelling it) immunity comes from the veterinary field. Many vets are not so involved with treating dogs and cats, but work with farms which have herds of animals (keep closely together). This is a situation in which a disease can rapidly spread through a population.

As @Ygggdrasil said herd immunity is when a large percentage of the susceptible population develops immunity through either exposure to the disease in question or by vaccination.

If enough of the population is immune, then the disease can not effectively spread through the population, because the infectious units (viruses in this case) have a much more difficult time finding a susceptible host (victim).

 

[anorlunda]

Do you anticipate more than 50 people to attend your church on Sunday?

In Florida the orders have been modified to more than 10 people.

 

[DennisN]

just as some background, the term herd (not heard as some have been spelling it) immunity

For others reading this, heard immunity is only developed among deaf people.

 

[PeroK]

In this context, herd immunity describes a strategy proposed by a few countries (most notably by Prime Minister Boris Johnson of the UK), in which a country eliminates the disease by letting a large fraction of the population contract the disease and therefore become immune to it:

If you will forgive some black humour at this stage, the UK may need to adopt this strategy to get COVID over and done with so we can get on with BREXIT.

 

[anorlunda]

If you will forgive some black humour at this stage, the UK may need to adopt this strategy to get COVID over and done with so we can get on with BREXIT.

Hey, I didn't think of that. BREXIT is just a form of social distancing.

 

[bhobba]

Here in Australia the island state of Tasmania has introduced a total lockdown - not allowing the rest of Australia to enter without a 14 day quarantine. It's blatantly against our constitution, but most think its a good idea so it's unlikely to be legally challenged. Also there is the issue of enforcement of quarantines. Evidence is in it's mostly an honours system. Police can enforce it of course, and IMHO should, but our PM announced, basically, he was disgusted with things like toilet paper hoarding. A minster then said - basically - I am sick of this - so police are now patrolling stores and when they see hoarding literally doling out the items to customers. Hoarding solved - but of course it interferes with the work of checking that people are actually isolating themselves. IMHO that's much more important. Tracing of new cases is still revealing only a small amount of local transmission, so we must be vigilant in ensuring quarantines. But IMHO the horse has already bolted and we are heading down Italy's road - God help us.

Thanks
Bill

 

[Jarvis323]

Are you kidding? The 4 hours of local TV news is entirely devoted to this, as is the 1/2 hour evening national news (staggered, so I can see an hour of that) plus the 2 hours of national "morning" news. It is all anyone talks about, not to mention the social media (see this 1400+ post thread on PF for example). Here in Nevada, the Governor told all non-essential businesses to close (and many are doing that, including the casinos, big & small) -- so the uninformed are presented with locked doors on closed stores. Also, if any of your doctors, dentists, etc. have your email address you get messages from them notifying you to forget about routine or non-emergency appointments.

Most young people tune out of the TV news, and for understandable reasons. They have been a constant source of misinformation about this. At first they were telling people it's nothing to worry about. They're now contradicting themselves. Online, there are hundreds of thousands of low quality, low information articles to sift through. Social media is just worse, full of memes and misinformation. The recommendations are changing daily, and we are expecting them to get the word through facebook?

They need concise, official direct messages from the government to each person.

 

[anorlunda]

Most young people tune out of the TV news,

That's a very good point. Like it or not, it must be partially true. They are right. There is good reason to distrust the news.

But emergency texts pushed to the phone are not the answer unless the text says "WATCH THE NEWS". The information you need to know requires too many sentences to be practical for a short text.

In this case, I think the young people must put their distrust aside and watch the news. Even web sites are of limited value because the information changes so quickly and you can't know if the web page has been updated in the past hour. I too do not trust much of the news, but I do trust it to be up-to-the-hour with the latest info.

 

[gmax137]

They need concise, official direct messages from the government to each person

I can't think of a way to implement that, nor can I think of a single time in the ~240 years of our government's existence when that has happened.

 

[Jarvis323]

I can't think of a way to implement that, nor can I think of a single time in the ~240 years of our government's existence when that has happened.

It's already implemented though.

 

[gmax137]

It's already implemented though.

How?

 

[Jarvis323]

How?

https://www.ready.gov/alerts
https://www.fema.gov/emergency-alert-system
https://www.fcc.gov/consumers/guides/emergency-alert-system-eas

 

[Ygggdrasil]

For the US, the government has setup https://www.coronavirus.gov/ as an online resource w/ information about the outbreak.

 

[phinds]

An interesting take, suggesting that things might not get as bad as a lot of sources are predicting:

ZDnet article

The media regularly refers to "exponential" growth in the number of cases of COVID-19 respiratory disease, and deaths from the disease, but the numbers suggest something else, a "small world" network that might have power law properties. That would be meaningfully different from the exponential growth path for the disease.

and some discussion to back up that point of view

 

[Jarvis323]

For the US, the government has setup https://www.coronavirus.gov/ as an online resource w/ information about the outbreak.

I've been binging on tracking the flow of information about COVID-19, and I didn't even know that website existed. This is an example of the ineffectiveness of the US government to communicate to the public. In my opinion, the EAS should have been used starting one month ago. Text messages should have been sent each time the official recommendations change.

 

[Jarvis323]

In this case, I think the young people must put their distrust aside and watch the news. Even web sites are of limited value because the information changes so quickly and you can't know if the web page has been updated in the past hour. I too do not trust much of the news, but I do trust it to be up-to-the-hour with the latest info.

I believe the news is good for alerting you to unfolding events, but in my experience it is horrible at informing people beyond that. In the past I've binge watched the news for weeks (e.g. during 911, Iraq war, the last financial crisis, etc.), and then found that I learned more in 10 minutes reading a Wikipedia article. I've also been shocked how little actual information others who have watched the news obsessively have actually absorbed. Most of the coverage is focused on some small aspect at a time for extended periods, and most of the content is skewed opinion. People get tidbits of information scattered redundantly and inconsistently over time and source. Those tidbits are often contradictory. All that many people seem to get out of it is a low information opinion.

 

[gmax137]

I'm sorry @Jarvis323 -- I'm really not trying to be argumentative, but when you said

But what shocks me so far is that, in the US, I have received no direct emergency government messages. We have systems to send people texts, emails, interrupt television broadcasting, etc. As far as I know that hasn't happened. How do we know they even got the message?

Can you provide an example piece of information you think should have interrupted radio & TV, and been sent to every cell phone / email account? What is a specific message you feel people are unaware of?

 

[Jarvis323]

I'm sorry @Jarvis323 -- I'm really not trying to be argumentative, but when you said
Can you provide an example piece of information you think should have interrupted radio & TV, and been sent to every cell phone / email account? What is a specific message you feel people are unaware of?

For example, the shelter in place orders. At least I should have received some kind of official communication that it was happening. I mean, how can you even call something mandatory if you never even told people about it? I'm just saying, how much blame can we put on the youth in this case. It's arguably just as much, or more, the fault of our governments communication strategies, and the news media for misinforming so many people early on.

But like I said, I think we should have been alerted in some direct way to each new change from the start. Some more examples:

1) The fact there was a virus spreading
2) What to do in the case you have the symptoms
3) Travel restrictions as they are planned and implemented
4) Having enough food and supplies on hand
5) New social distancing guidelines
6) Shelter in place orders
7) Conserving resources (e.g. masks)

You would be surprised how many people were/are in the dark about these things.

 

[anorlunda]

1) The fact there was a virus spreading
2) What to do in the case you have the symptoms
3) Travel restrictions as they are planned and implemented
4) Having enough food and supplies on hand
5) New social distancing guidelines
6) Shelter in place orders
7) Conserving resources (e.g. masks)

How did you become aware of those 7 things without an alert on your phone?