COVID COVID-19 Coronavirus Containment Efforts

[nsaspook]

https://www.imperial.ac.uk/media/im...-College-COVID19-NPI-modelling-16-03-2020.pdf

Whilst our understanding of infectious diseases and their prevention is now very different compared to in 1918, most of the countries across the world face the same challenge today with COVID-19, a virus with comparable lethality to H1N1 influenza in 1918. Two fundamental strategies are possible2 :

(a) Suppression. Here the aim is to reduce the reproduction number (the average number of secondary cases each case generates), R, to below 1 and hence to reduce case numbers to low levels or (as for SARS or Ebola) eliminate human-to-human transmission. The main challenge of this approach is that NPIs (and drugs, if available) need to be maintained – at least intermittently - for as long as the virus is circulating in the human population, or until a vaccine becomes available. In the case of COVID-19, it will be at least a 12-18 months before a vaccine is available3 . Furthermore, there is no guarantee that initial vaccines will have high efficacy.

b) Mitigation. Here the aim is to use NPIs (and vaccines or drugs, if available) not to interrupt transmission completely, but to reduce the health impact of an epidemic, akin to the strategy adopted by some US cities in 1918, and by the world more generally in the 1957, 1968 and 2009 influenza pandemics. In the 2009 pandemic, for instance, early supplies of vaccine were targeted at individuals with pre-existing medical conditions which put them at risk of more severe disease4 . In this scenario, population immunity builds up through the epidemic, leading to an eventual rapid decline in case numbers and transmission dropping to low levels. The strategies differ in whether they aim to reduce the reproduction number, R, to below 1 (suppression) – and thus cause case numbers to decline – or to merely slow spread by reducing R, but not to below 1.

 

[nsaspook]

This is not good news.
https://www.ft.com/content/859e9336-68db-11ea-a3c9-1fe6fedcca75

The number of Coronavirus cases has spiked across Asia, crushing hopes that the region had contained the outbreak. Officials in South Korea, Taiwan and parts of China and south-east Asia are rushing through new measures after a second wave of new infections following weeks of declines.

 

[Astronuc]

For those tracking the numbers - https://ncov2019.live/data

Be careful of unfamiliar sites. I've heard of at least one site that will put malware on one's computer if one clicks on the site url. Visit trusted sites only.

 

[mfb]

Coronavirus: Experiment in northern Italian town halts all new infections after trial
They tested all 3300 people and isolated people who tested positive. A second round of testing found only a small number of new cases, and the last round of testing found no new cases.

This doesn't scale, at least not at the moment* - but the study demonstrates how powerful testing is. Not just of people who have symptoms, but also their contacts, because that way you catch the people with no or very subtle symptoms that would otherwise spread the disease further.
This is not coming from me, obviously, I'm just reporting what the experts say.

The World Heath Organisation this week called on all countries to ramp up testing programmes as the best way to slow the advance of the pandemic.

WHO Director General Tedros Adhanom Ghebreyesus said: "We have a simple message to all countries - test, test, test.

*It's possible that tests for everyone become available in the future. This small German company can produce a million per week now, after just two months. Multiply it by the number of companies with that capability and expect future improvements in the rate.

 

[Dr. Courtney]

Would local law enforcement be enough to enforce those quarantines?

I doubt it. The local law wasn't willing to close a church that defied a closure order from the Louisiana Governor. Ability requires willingness. Local law realizes there are both constitutional and public relations issues in play, and that "following orders" is no excuse for violating constitutional rights. The local police in East Baton Rouge Parish (my primary residence) kicked it to the National Guard for enforcement.

https://www.wafb.com/2020/03/18/bat...RXmBxTPbn6PNA2USZ50g10tw8Y7nDnhBfXJnQt2yIkwsY

An email from a 1st Amendment attorney explained yesterday that the most likely response of local law is to ask you to stop and then seek a court order if you don't. With a court order in hand, they are enforcing an order of the court which protects them from legal retribution if the executive branch emergency orders are later held to be illegal.

 

[Evo]

I doubt it. The local law wasn't willing to close a church that defied a closure order from the Louisiana Governor. Ability requires willingness. Local law realizes there are both constitutional and public relations issues in play, and that "following orders" is no excuse for violating constitutional rights. The local police in East Baton Rouge Parish (my primary residence) kicked it to the National Guard for enforcement.

https://www.wafb.com/2020/03/18/bat...RXmBxTPbn6PNA2USZ50g10tw8Y7nDnhBfXJnQt2yIkwsY

I can't tell you how disturbing it is to hear that large groups of people have gathered against the common sense not to, regardless of being asked not to in order to try and contain the spread of this virus. While others are giving up the things they enjoy for the good of the many, some people couldn't give a damn about the health of others. SHAMEFUL!

 

[russ_watters]

I doubt it. The local law wasn't willing to close a church that defied a closure order from the Louisiana Governor. Ability requires willingness. Local law realizes there are both constitutional and public relations issues in play, and that "following orders" is no excuse for violating constitutional rights. The local police in East Baton Rouge Parish (my primary residence) kicked it to the National Guard for enforcement.

https://www.wafb.com/2020/03/18/bat...RXmBxTPbn6PNA2USZ50g10tw8Y7nDnhBfXJnQt2yIkwsY

An email from a 1st Amendment attorney explained yesterday that the most likely response of local law is to ask you to stop and then seek a court order if you don't. With a court order in hand, they are enforcing an order of the court which protects them from legal retribution if the executive branch emergency orders are later held to be illegal.

Oy. I was expecting this, but they should ask the South Koreans if faith protects one from coronavirus.

 

[Astronuc]

Coronavirus: Experiment in northern Italian town halts all new infections after trial
They tested all 3300 people and isolated people who tested positive. A second round of testing found only a small number of new cases, and the last round of testing found no new cases.

An excellent article on the Italian (Bergarmo, Lombardy) experience.
https://www.wsj.com/articles/every-...ons-from-italys-hospital-meltdown-11584455470

They found high rates of infection in first responders, who are being exposed to many ill folks.

From WSJ: Many of the lessons relate to public health, to avoid overwhelming hospitals. “Mild-to-moderate cases should be managed at home, not in the hospital, and with massive deployment of outreach services and telemedicine,” he wrote. Some therapies could be delivered at home, he said, via mobile clinics.

Another lesson: Italian emergency-medical technicians have experienced a high rate of infection, Dr. Cereda said, spreading the disease as they travel around the community.

Calls to 112, Europe’s equivalent of 911, are answered within 15 to 20 seconds. Ambulances from the hospital’s fleet of more than 200 are dispatched within 60 to 90 seconds. Two helicopters stand by at all times. . . . Now, people wait an hour on the phone to report heart attacks, Dr. Giupponi said, because all the lines are busy.

Best course of action is to stay home, if possible, and telework. Practice social distancing if one has to go out in public or to work.

 

[Klystron]

Yesterday they announced our gyms and association swimming pools will remain closed. Today the county closed public libraries indefinitely. No swimming and no new books. Clean pools and libraries are my church, no offence intended to believers.

Adaptations: floor exercises and Yoga; purchase a Kindle. Not remotely the same.

 

[Dr. Courtney]

I can't tell you how disturbing it is to hear that large groups of people have gathered against the common sense not to, regardless of being asked not to in order to try and contain the spread of this virus. While others are giving up the things they enjoy for the good of the many, some people couldn't give a damn about the health of others. SHAMEFUL!

Science is about data, not authoritative decrees.

Where is the convincing scientific data that a group of more than 50 people is more dangerous than a smaller group as long as all the other precautions are taken? If the sick people stay home, everyone washes their hands early and often, avoids touching common surfaces, and practices other procedures relative to the spread of respiratory illnesses, what is the problem?

Until I see the data, I'm going to church. Because my faith tells me I should, and the 1st Amendment tells me I can.

Show me the data, or keep your shame to yourself.

 

[BillTre]

Science is about data, not authoritative decrees.

Where is the convincing scientific data that a group of more than 50 people is more dangerous than a smaller group as long as all the other precautions are taken? If the sick people stay home, everyone washes their hands early and often, avoids touching common surfaces, and practices other procedures relative to the spread of respiratory illnesses, what is the problem?

Until I see the data, I'm going to church. Because my faith tells me I should, and the 1st Amendment tells me I can.

Show me the data, or keep your shame to yourself.

Well, you don't seem to need "the facts" to recommend that: "sick people stay home, everyone washes their hands early and often, avoids touching common surfaces, and practices other procedures relative to the spread of respiratory illnesses".
So what is the problem with not getting together in large groups of people (where statistically it is more likely (just because it has a larger sample size) a not yet diagnosed but infected person will be spewing on infections particles for others to get and spread around the community.

To me this is just another sad case of its OK for others but not my group.
This is just like one of the factors in Iran's rapid increase of Corona virus (people continuing their normal religious practices and licking religious relics or whatever).

Some of the shame will be on people using these lame kind of excuses!
Adapt to the demands of the times.

 

[DennisN]

Another chilling, sobering report from the frontline in Italy.
(Note: I would suggest those who are feeling particularly worried/anxious at this moment maybe should not read it)

Special Report: 'All is well'. In Italy, triage and lies for virus patients (Reuters, March 16, 2020)
http://www.reuters.com/article/us-h...age-and-lies-for-virus-patients-idUSKBN2133KG

One quote:

What struck her most about her father’s last week of anguish was the look on the doctor’s face when she met him.

“I couldn’t tell whether it was worry or sadness,” she said.

“All he said to us was, ‘Stay home.’”

 

[Astronuc]

Coronavirus can persist in air for hours and on surfaces for days: study
https://www.reuters.com/article/us-...-and-on-surfaces-for-days-study-idUSKBN2143QP

On plastic and stainless steel, viable virus could be detected after three days. On cardboard, the virus was not viable after 24 hours. On copper, it took 4 hours for the virus to become inactivated.

I wonder about wood. And does plastic apply to all plastics?

Think about high contact surfaces with which one comes in contact. Wash hands and use alcohol based hand sanitizers periodically.

 

[Evo]

Science is about data, not authoritative decrees.

And why do you think people are asked to limit social contact? Some whim? Are you saying that there is no evidence that the Coronavirus can be transmitted through airborn bodily fluids like a sneeze or cough, which is why people have been asked not to gather and maintain social distancing if there is a need to go out, like a need to buy food and medicine, most of which I'm trying to do online.

 

[russ_watters]

Science is about data, not authoritative decrees.

Public health policy is authoritative decrees, not [directly] science.

 

[Dr. Courtney]

Well, you don't seem to need "the facts" to recommend that: "sick people stay home, everyone washes their hands early and often, avoids touching common surfaces, and practices other procedures relative to the spread of respiratory illnesses".

1) These were all well established for respiratory viruses for a long time, even back when I took microbiology.
2) I am recommending, not shaming, and not threatening legal action.

So what is the problem with not getting together in large groups of people (where statistically it is more likely (just because it has a larger sample size) a not yet diagnosed but infected person will be spewing on infections particles for others to get and spread around the community.

I have no problem with people making that choice. I would not criticize churches than have closed or people who have stayed home. Fact is, in Georgia, where I am now, over 80% of churches above the specified size are closed and holding their services online. Even if asymptomatic carriers can spread the disease, the recommendation from government should be very effective. Thinner crowds allow for a larger radius.

To me this is just another sad case of its OK for others but not my group.

Not at all. I don't object to the busses running, the planes flying, the restaurants being open, Walmart and other retail establishments being open, and so on. Voluntary compliance with recommendations seems sufficient (at least where I am in rural Georgia) to "flatten the curve." I see no need in rural Georgia (or Louisiana) for mandatory closures, especially not of activities protected by the 1st Amendment.

Of course, if the 1st Amendment is repealed, then I would stop classifying those activities differently from others.

This is just like one of the factors in Iran's rapid increase of Corona virus (people continuing their normal religious practices and licking religious relics or whatever).

No licking in the churches I've attended.

Some of the shame will be on people using these lame kind of excuses!
Adapt to the demands of the times.

I took an oath to support and defend the Constitution of the United States against all enemies. The "demands of the times" shall never change that. If you regard the Constitution of the United States as a "lame excuse" then you are an enemy.

 

[BillTre]

I took an oath to support and defend the Constitution of the United States against all enemies. The "demands of the times" shall never change that. If you regard the Constitution of the United States as a "lame excuse" then you are an enemy.

Actually the the demands of the times do result in the interpretation of the constitution. such happened in the civil war as well as in WWII (but not a really great example).

No good luck with your efforts to spread disease, whether its your right or not.

 

[StoneTemplePython]

trying to defuse this a bit
Is there a consensus on people physically gathering in a church but everyone maintaining at least a 6 foot distance from everyone else?

 

[russ_watters]

Where is the convincing scientific data that...

Until I see the data, I'm going to church. Because my faith tells me I should...

Your statement moots your question: yes, you choose faith over science here. At least own it!

...and the 1st Amendment tells me I can.

In many cases the 1st Amendment guarantees your right to follow your faith. Maybe you're right that this is such a case, but I'm pretty sure you're not. But I expect this to be tested, so we'll see.

Potential legal angles where the state may shut down a church:
-Building codes
-Health codes
-State/federal disaster declarations (+FEMA, CDC powers)

It may be harder if you have your service in the field of a privately-owned farm, but activities that happen in buildings are fairly heavily regulated.

 

[russ_watters]

trying to defuse this a bit
Is there a consensus on people physically gathering in a church but everyone maintaining at least a 6 foot distance from everyone else?

Unless a church is poorly attended, I don't think that is possible.

 

[Astronuc]

We are well into the phase of community-spread.

The 50-year-old man was confirmed Tuesday as the first “community spread” case of the virus in New York. His wife, 14-year-old daughter, 20-year-old son and a neighbor who drove him to the hospital have all now contracted the virus, bringing the total number of New York cases to six.

The man, who has an underlying respiratory condition, remains hospitalized in the intensive care unit. It is still unclear how he contracted the virus having not traveled recently to the countries on the CDC watchlist.

https://www.politico.com/states/new...chester-man-confirmed-for-coronavirus-1265184

Back on March 4 - Just a day after a Westchester County man was confirmed as New York’s second case of the new coronavirus, the authorities revealed on Wednesday just how readily it was spreading, saying that nine people connected to the man had all tested positive.
https://www.nytimes.com/2020/03/04/nyregion/coronavirus-nyc-yeshiva-university.html

Hence the 'authoritative decree' to limit large gatherings, especially in confined places. Many people are contagious/infectious while being asymptomatic. From the office of Governor of New York, "
Eighty percent of people who contract COVID-19 self-resolve — and may not even have symptoms."
https://www.newrochelleny.com/CORONAVIRUS

March 12 - Down the block from Young Israel of New Rochelle, the synagogue linked to many of the cases, restaurants on North Avenue were nearly empty; among the few people standing at bus stops or walking down the sidewalks nearby, a few face masks could be spotted.

https://www.nytimes.com/2020/03/12/nyregion/coronavirus-new-rochelle-containment.html

Besides, the statistical analyses and epidemiology come after the fact, and the damage to health, and certainly death, cannot be undone.

As of March 18, 2020, 14:34 EDT, there were 538 confirmed cases of COVID-19 in Westchester County, most tied to the first case of community-spread infection, and NY City confirmed 1,339 COVID-19 cases. The gentlemen from New Rochelle had commuted to NY City, and some of those cases are tied to him.
https://www.cnn.com/2020/03/11/us/new-rochelle-attorney-containment-area/index.html
"The 50-year-old attorney, who works near Grand Central Station in Manhattan, tested positive for the virus on March 2 and was hospitalized at New York-Presbyterian/Columbia University Irving Medical Center, Cuomo said."
https://www.cnn.com/2020/03/10/us/new-rochelle-coronavirus/index.html
"The containment zone surrounds a synagogue believed to be the epicenter of the outbreak. A man who lives in New Rochelle, works in Manhattan and attends the synagogue tested positive for the virus last week. The man's 20-year-old son attends Yeshiva University in Manhattan, and his 14-year-old daughter attends SAR Academy and High School in the Bronx."

I just happened to be in NY when all this was developing, but further north from Westchester. The rural area where I was staying saw the first COVID-19 case about March 12. On March 14, there were 4 cases, on March 16, 10 cases, and today 20 cases. There are several thousand people who commute to NY City from the county, and the infections likely happened with those commuting to the common destination in NY City, as well as those traveling across Westchester County. It is also possible that someone returning from a trip out of town brought the virus to the area.

It will take time and resources to develop an understanding of the transmission of the virus, but in the meantime, to prevent further spread, we must take precautions and limit public exposure.

 

[Ygggdrasil]

Getting closer. But not out of the woods just yet. Good onya, Australia! This is great news.

https://www.heraldsun.com.au/lifestyle/health/coronavirus-australia-queensland-researchers-find-cure-want-drug-trial/news-story/93e7656da0cff4fc4d2c5e51706accb5?fbclid=IwAR2aRzgviKmf1kNBoEXyCX2nwVxHq3JoJ4g28advkESEnp3ThqHE_S3tUgk

"One of the two medications is a HIV drug, which has been superseded by “newer generation” HIV drugs, and the other is an anti-malaria drug called chloroquine which is rarely used and “kept on the shelf now” due to resistance to malaria."
These are currently registered and available drugs..so testing would only be to verify their efficiency at combating Covid-19. Testing for side effects would already have been completed.

Some quotes from the link you provided:

University of Queensland Centre for Clinical Research director Professor David Paterson told news.com.au today they have seen two drugs used to treat other conditions wipe out the virus in test tubes.

There are plenty of drugs that look like they work in the test tube that don't end up working (for any number of reasons) in humans.

He said one of the medications, given to some of the first people to test positive for COVID-19 in Australia, had already resulted in “disappearance of the virus” and complete recovery from the infection.

In ~98% of diagnosed cases, the virus completely disappears and patients completely recover from the infection without the drug, which is why a large clinical trial is needed to judge the efficacy of the treatment.

Regarding the actual drugs, there are other published studies that suggest chloroquine could be a treatment for COVID-19 (e.g see https://www.nature.com/articles/s41422-020-0282-0). It is worth noting that chloroquine has some fairly significant side effects (seizures, hearing damage, retinopathy and sudden effects on blood glucose, see https://blogs.sciencemag.org/pipeline/archives/2020/03/06/covid-19-small-molecule-therapies-reviewed) that could limit its effectiveness in people (whereas such side effects would not be seen in test tube studies).

The article does not actually specify which anti HIV drug is being used, but I know that various groups are studying the use of HIV protease inhibitor drugs (like lopinavir and ritonavir) against COVID-19, but there is no particular reason to think that these would work against COVID-19 because the COVID-19 protease is quite different from the HIV protease. However, there is some evidence that the combination of HIV protease inhbitors shows some efficacy in SARS and COVID-19 patients (https://www.sciencemag.org/news/202...r-other-existing-drugs-outwit-new-coronavirus).

Another good candidate for anti-COVID-19 therapy is Remdesvir, which also showed it can effectively stop viral replication in test tube studies (e.g. see https://www.nature.com/articles/s41422-020-0282-0). There are some promising anecdotes about it's potential (https://www.sciencemag.org/news/2020/03/did-experimental-drug-help-us-coronavirus-patient) but also other reports questioning its effectiveness (https://www.statnews.com/pharmalot/2020/03/13/gilead-coronavirus-covid19-clinical-trials/). There are clinical trial ongoing to test the efficacy of Remdesvir against COVID-19, so hopefully we'll have a more definitive answer soon.

Drugs that can help avoid the need for patients to be placed on ventilators or other specialized equipment would be a great help in addressing the current outbreak.

For those interested in the drugs being tested against COVID-19, here are two great articles summarizing ones being considered (though this is a rapidly moving field and others may have been identified in the meantime):
https://blogs.sciencemag.org/pipeline/archives/2020/03/06/covid-19-small-molecule-therapies-reviewed
https://blogs.sciencemag.org/pipeline/archives/2020/03/09/covid-19-biologic-therapies-reviewed

 

[russ_watters]

We are well into the phase of community-spread.

So, what exactly does that mean? I heard on the radio on the way home from work that my county, Montgomery County, has decided that since we are now in the "community-spread" phase, that contact tracing is no longer useful, and it has been suspended.

While at first glance that feels defeatist, if we're truly in a "community-spread" phase and as a result everyone is recommended to avoid contact with everyone else, then contact tracing really should be moot: anyone you would quarantine after identifying them is already supposed to be quarantined.

This isn't much, but it is the best confirmation I could find:
https://www.inquirer.com/health/cor...rmed-case-updates-testing-sites-20200318.html

 

[kyphysics]

This is not good news.
https://www.ft.com/content/859e9336-68db-11ea-a3c9-1fe6fedcca75

https://www.wsj.com/articles/singap...-second-wave-of-coronavirus-cases-11584445836

Possible counter-point:

Some of those nations may be seeing spikes due to travelers abroad returning home (and carrying the infection into the contained areas). See article I posted (not a subscriber, so I cannot see past the preview).

 

[Astronuc]

So, what exactly does that mean? I heard on the radio on the way home from work that my county, Montgomery County, has decided that since we are now in the "community-spread" phase, that contact tracing is no longer useful, and it has been suspended.

I edited my post to add information on the particular case of one man (an attorney who lives in New Rochelle and works in NY City) who spread the infection to at least 50 others (directly or indirectly) by March 11. 'Community-spread' means that the origin of the infection cannot be determined (at this time), and it is not clear at this time, how the attorney who transmitted the virus to others was infected. He may have had interaction with a traveler through Grand Central Station, or on the train, or on the sidewalk to or from work.

With limited resources and an ever increasing number of infections, health departments likely have to discontinue tracing backwards and focus on treating the ever increasing number of cases, as well as trying to encourage the population to isolate and/or distance in order to prevent continuing spread of the virus.

 

[Dr. Courtney]

And why do you think people are asked to limit social contact? Some whim? Are you saying that there is no evidence that the Coronavirus can be transmitted through airborn bodily fluids like a sneeze or cough, which is why people have been asked not to gather and maintain social distancing if there is a need to go out, like a need to buy food and medicine, most of which I'm trying to do online.

My wife, myself, and most folks we at our church have already reduced social contact by over 90%. For example, my social contact this week consists of an errand trip (spending 3x the usual amount to reduce needs for future trips) and a few hours with a group of less than 15 people maintaining all the social distancing recommendations. Next week, I plan to attend church for about an hour. I might buy gas, but I plan to pay at the pump, and I'm using gas at a rate that I may need to fill up once every couple months. Just about everyone else in church has refrained from the germ factories (public schools) and normal workplaces.

I'm keen to avoid sick people. I pay out of pocket for a whole year of my prescription meds so I only have to go to the pharmacy once a month. And I try and make my medical appointments and annual pharmacy trip at times to minimize interactions with sick people.

Are you trying to say that reducing social contact by 90+% is insufficient to "flatten the curve" even with all the other practices? You might as well try and ban new sexual partners. The human being is a social creature. We can reduce social interactions, but trying to force it down to zero is an unrealistic expectation. People will rebel. 90% reduction (with safe practices for the remaining 10%) should be enough.

Actually the the demands of the times due result in the interpretation of the constitution. such happened in the civil war as well as in WWII (but not a really great example).

No good luck with your efforts to spread disease, whether its your right or not.

I'm at greater risk of an injurious car accident on the way to Walmart than I am of spreading the disease in church. The Constitution I swore to "support and defend" is no more a "living, breathing document" than my marriage covenant or an employment contract. You may want to let your wife and employer know if your agreements "change with the times" without mutual consent.

Unless a church is poorly attended, I don't think that is possible.

Most folks are attending "online" these days. It's not hard to find a seat with a 6 ft distance from other people (except for my wife, of course.) It's easier to maintain that distance in church this week than in a most check-out lines.

 

[anorlunda]

This article is by one of our most staunch defenders of the 1st Amendment, Eugene Volokh. He explains why quarantines and other restrictions are constitutional and lawful.

https://reason.com/2020/03/18/why-i...ctions-flowing-from-the-coronavirus-response/

Why I'm Not (Yet?) Much Worried About the Civil Liberties Restrictions Flowing from the Coronavirus Response
The restrictions are less dangerous precisely because they are so broad and onerous.
EUGENE VOLOKH |THE VOLOKH CONSPIRACY | 3.18.2020 2:15 PM

 

[anorlunda]

I live in close quarters with about 900 old people. Many of them have health problems. The man next door is recovering from open heart surgery. The man across the street is in chemo-therapy. For people like that, the Coronavirus has been described as a nearly 100% efficient killing machine.

I don't want to be responsible for killing my friends and neighbors. That is why I am cutting all external activities. I may be able to avoid leaving this RV park at all for 6 weeks. I'm shamed by some other neighbors who insist on their right to do as they please and leave the park to play golf almost every day.

 

[Ygggdrasil]

Science is about data, not authoritative decrees.

Where is the convincing scientific data that a group of more than 50 people is more dangerous than a smaller group as long as all the other precautions are taken? If the sick people stay home, everyone washes their hands early and often, avoids touching common surfaces, and practices other procedures relative to the spread of respiratory illnesses, what is the problem?

Until I see the data, I'm going to church. Because my faith tells me I should, and the 1st Amendment tells me I can.

Show me the data, or keep your shame to yourself.

There is quite a bit of data supporting the effectiveness of instituting social distancing policies on stopping disease spreads from studies of past pandemics/epidemics, such as the 1918 flu pandemic ("This reduction in the clinical attack rate translates to an estimated 260 per 100 000 lives having been saved, and suggests that social distancing interventions could play a major role in mitigating the public health impact of future influenza pandemics") or the 2014 ebola outbreak ("Among all the control measures, we find that social distancing had the most impact on the control of the 2014 Ebola epidemic in Libreria followed by isolation and quarantining").

A study of the 1918 flu pandemic shows the "flattening the curve" strategy exemplified in studying two cities, Philadelphia (which did not ban public gatherings until late in the epidemic) and St Louis which was early to ban public gatherings and institute social distancing:

Lets you believe that this is cherry picking data, here's a chart from a study comparing death rates from the 1918 flu in various cities based on when they began to institute government-enforced (not voluntary) responses such as closing schools or instituting social distancing through bans of large gatherings:

(images taken from: here)

There is very strong data supporting the effectiveness of government imposition of social distancing (defined by the CDC as "remaining out of congregate settings, avoiding mass gatherings, and maintaining distance (approximately 6 feet or 2 meters) from others when possible") in attenuating the spread of an epidemic/pandemic disease.

 

[Mary Conrads Sanburn]

17 MARCH 2020

NEWS
First US clinical trial of Covid-19 vaccine candidate begins

The first US clinical trial of a Covid-19 vaccine candidate, which is Moderna’s mRNA-1273, has started at Kaiser Permanente Washington Health Research Institute (KPWHRI) in Seattle.

Funded by the National Institutes of Health (NIH)’s National Institute of Allergy and Infectious Diseases (NIAID), the trial has dosed its first participant.

mRNA-1273 is an mRNA vaccine designed to target SARS-CoV-2 encoding a prefusion stabilised form of the Spike (S) protein. Moderna selected the candidate in alliance with the Vaccine Research Center (VRC) at the NIAID.

The Coalition for Epidemic Preparedness Innovations (CEPI) funding supported the production of the first clinical batch.

During the Phase I trial, the safety and immunogenicity of 25μg, 100μg, 250μg dose levels of mRNA-1273 given on a two-dose vaccination schedule 28 days apart will be assessed in a total of 45 healthy adults aged 18 to 55.

The study involves a follow-up of 12 months after the second vaccination.

The primary objective is the safety and reactogenicity of a two-dose vaccination schedule, while the secondary objective is immunogenicity to the SARS-CoV-2 S protein.

Moderna chief medical officer Tal Zaks said: “This study is the first step in the clinical development of an mRNA vaccine against SARS-CoV-2, and we expect it to provide important information about safety and immunogenicity. We are actively preparing for a potential Phase II study under our own IND.

“We are grateful to NIH for their ongoing collaboration and to CEPI for funding the initial manufacturing of mRNA-1273 and are proud to be included with the many companies, worldwide health agencies and NGOs working on a possible response to the novel Coronavirus outbreak.”

The potential Phase II and any subsequent trials will further evaluate the safety and immunogenicity of the vaccine candidate in a larger population. Moderna has already started manufacturing the mRNA-1273 material for the Phase II study.

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https://www.clinicaltrialsarena.com/news/first-us-covid-19-vaccine-trial-moderna/

Geez Wiz, I need to walk my doggie GRACIE Girl! She makes me happy and Merlina the cat just hates it when she is all alone in our house. Oh my, there has got to be love!