COVID-19 Coronavirus Containment Efforts

[PeroK]

In the coming years, I'm sure that we'll hear a lot more about such decisions.

Should each continent/country/state/county/town/city/neighborhood/family/person be able to choose their own strategy independent of others? If yes, we have no containment. If no, we have a single world government with total authority. Freedom versus survival is not a nice choice to make. See #2979 about China.

This isn't about survival. This is about minimising deaths. What's the total world population doing at the moment? This virus, bad though it may be, will have a negligible effect on world population.

 

[Astronuc]

TALLAHASSEE, Fla. -- Governor Ron DeSantis announced Wednesday afternoon that the state of Florida is being shut down amid the Coronavirus pandemic. Stay-at-home declaration will take effect Thursday, April 2 at midnight (So technically Friday, April 3, 0000) and be in effect for 30 days.
https://weartv.com/news/local/gov-desantis-issues-stay-at-home-order-for-entire-state-of-florida

The numbers in NY state and city show that the state acted 7 to 10 days to mitigate the spread of the virus, and probably they should have started imposing restrictions during the first week of March.

As of Wednesday, April 1, this afternoon:

• 83,712 total cases in New York State
• 1,941 deaths from the Coronavirus in the state
• 47,439 cases in New York City, including 1,096 deaths
• 12,226 people with COVID-19 are hospitalized, including 3,022 in intensive care — 6,142 Coronavirus patients have been discharged
• 18,997 cases in New Jersey, with 267 deaths
• 3,128 cases in Connecticut, with 69 deaths

https://nymag.com/intelligencer/article/new-york-coronavirus-cases-updates.htmlWashington state Dept of Health has not reported numbers (cases and deaths) since March 28! They are approaching a 4-day lag. The number of positive cases should be greater than 5500 cases by today.

 

[bhobba]

Does anyone of you have any thoughts about why this could be the case?

No secrets. They have a team of 400 in Queensland alone tracing and testing all cases. Recently the criteria to test when traced has been relaxed so even asymptomatics are tested. It's too early yet to say anything for sure, but as of now it looks like the asypmtomatics are a small percentage - certainly not the 80% I have heard from some sources. I suspect it will rise, but the large percentages some are touting is looking doubtful - still one never knows. So it's simply the denominator here in Aus is greater. It must also be said Australia has an excellent medical system so those in intensive care are being really well looked after. BTW we are planning even more testing:
https://www1.racgp.org.au/newsgp/clinical/government-flags-expanding-coronavirus-testing

Thanks
Bill

 

[morrobay]

Nothing to say that viruses that diluted over space can still cause an infection.

Yes, the exposure gradient, concentration,seems to be overlooked in the risk of infection from various exposures.

 

[BillTre]

Here is a link to a NY Times DIY article on making your own face mask.

The article also a link to a pdf for the sewing pattern.

 

[mfb]

Some discussion how reliable numbers from some countries are.

Italy:

 

[kyphysics]

https://www.nytimes.com/2020/04/01/nyregion/coronavirus-new-york-update.html

Other developments on Wednesday:

• Confirmed cases in New York State: 83,712, up from 75,795.
• Currently hospitalized in New York State: 12,226, up from 10,929.
• In intensive care in New York State: 3,022, up from 2,710.
• In New Jersey: There were 22,255 cases, up from 18,696, and 355 deaths, up from 267.
• In Connecticut: There were 3,557 cases, up from 3,218, and 85 deaths, up from 69. Among the newly dead, Gov. Ned Lamont said, was a 6-week-old infant.
• The latest projections for the state put the peak of the outbreak at the end of this month.

Some numbers of the U.S. Northeast as of 4/1/2020 (yesterday).

When the deaths get into the hundreds (let alone, thousands) range for a state, it just feels scary for me. My state has less than 100 at this point, but we'll probably get there.

 

[kadiot]

Sweden's no lockdown policy is based on the recommendation of the country's leading epidemiologist. The strategy is totally opposed to what the rest of the world is doing. Let's see how this experiment turns out.

 

[atyy]

[response to deleted post deleted]

We are not given enough detail to understand Deborah Birx's statement. It is not obviously correct, since what is going on in Italy or Spain is consistent with China's numbers.

Deborah Birx recently made another bizarre statement that Singapore followed Trump's guidelines.
https://mothership.sg/2020/03/singapore-took-trump-guidelines-covid-19/

 

[wukunlin]

Ah indeed. Sorry for the tunnel vision.

 

[atyy]

Sweden's no lockdown policy is based on the recommendation of the country's leading epidemiologist. The strategy is totally opposed to what the rest of the world is doing. Let's see how this experiment turns out.

Well, I believe South Korea also has no lockdown, and they've been successful so far. I think the two successful cases so far are China and South Korea. China's problem was bigger because the outbreak started there and they mishandled things initially. Nonetheless South Korea also handled a great challenge. So it seems that depending on how out of control things are, both countries show the range of potentially successful policies.

Hopefully Italy will become another example of success, but it's too early to say at the moment.

 

[atyy]

Ok, I know people in many countries will be thinking "child abuse", but here in Singapore it is still normal for parents to discipline their children by caning (and yes, I was caned by my parents). Anyway, just for laughs (which is how most Singaporeans will understand this article):

S’porean mum discovers canes sold out at 2 stores as side effect of work-from-home
Kids all over the country quaking in fear.
https://mothership.sg/2020/04/canes-sold-out-work-from-home/

 

[DrClaude]

Sweden's no lockdown policy is based on the recommendation of the country's leading epidemiologist. The strategy is totally opposed to what the rest of the world is doing. Let's see how this experiment turns out.

While there is no lockdown, there are many recommendations to limit contact and people are following them. Even if Sweden's approach succeeds, it won't necessarily mean that it would have worked everywhere. The overall low population density appears to be helpful here.

 

[bhobba]

Ok, I know people in many countries will be thinking "child abuse", but here in Singapore it is still normal for parents to discipline their children by caning (and yes, I was caned by my parents).
https://mothership.sg/2020/04/canes-sold-out-work-from-home/

So was I at school, not so much at home, although other forms of punishment were used such as the handle of a feather duster. It was considered normal in Australia. But for some reason it went by the wayside here, but obviously not in Singapore. The only thing my parents disliked about it (as a child I just thought it normal) was at school when someone in a class would not own up to something they would cane the whole class. My mother had a very 'strong' talk to the principle about that practice - my son did nothing and you punished him.

Thanks
Bill

 

[wukunlin]

Ok, I know people in many countries will be thinking "child abuse", but here in Singapore it is still normal for parents to discipline their children by caning (and yes, I was caned by my parents). Anyway, just for laughs (which is how most Singaporeans will understand this article):

S’porean mum discovers canes sold out at 2 stores as side effect of work-from-home
Kids all over the country quaking in fear.
https://mothership.sg/2020/04/canes-sold-out-work-from-home/

I'm more shocked that there are canes made specifically for that purpose. Most parent I know use whatever's at hand.

 

[gleem]

In the past decade, a lot of drugs have come on the market that are immunosuppressants: Humera, Embrel, Xeljzanz, Cosentiyx, Taltz, to name some well advertised drugs. And then there is the ever present prednisone that has been around forever. Those taking these drugs are often fairly young too. These people must be very concerned.

Not only prescription drugs have immunosuppressant effects. Over the counter drugs like aspirin and acetaminophen have been shown to affect the immunological response. https://www.hindawi.com/journals/mi/2015/349176/ reviews the immunological response and the effect on vaccination efficacy of many substances both pharmaceutical, environmental and nutritional.

So are we making ourselves as a population more vulnerable to infectious diseases?

 

[bhobba]

These people must be very concerned.

You think? I take Cosentyx a newer biologic and both me and my GP are really scared with this virus. Plus I have Diabetes. Join those together - and its up there with the angels, hopefully not down there with the other lot if I get it. Best to not dwell on it. Must practice my Cognitive Behaviour Therapy

Thanks
Bill

 

[atyy]

So was I at school, not so much at home, although other forms of punishment were used such as the handle of a feather duster. It was considered normal in Australia. But for some reason it went by the wayside here, but obviously not in Singapore. The only thing my parents disliked about it (as a child I just thought it normal) was at school when someone in a class would not own up to something they would cane the whole class. My mother had a very 'strong' talk to the principle about that practice - my son did nothing and you punished him.

Oh that's going to change my view of Aussies as easy-going people!

In school caning was not done for the whole class, just individuals. I don't think we do it in schools here anymore, just at home. For the whole class, the punishment was usually something like go and stand in the sun or stand on your chair.

 

[wukunlin]

In the past decade, a lot of drugs have come on the market that are immunosuppressants: Humera, Embrel, Xeljzanz, Cosentiyx, Taltz, to name some well advertised drugs. And then there is the ever present prednisone that has been around forever. Those taking these drugs are often fairly young too. These people must be very concerned.

Not only prescription drugs have immunosuppressant effects. Over the counter drugs like aspirin and acetaminophen have been shown to affect the immunological response. https://www.hindawi.com/journals/mi/2015/349176/ reviews the immunological response and the effect on vaccination efficacy of many substances both pharmaceutical, environmental and nutritional.

So are we making ourselves as a population more vulnerable to infectious diseases?

I wonder if that is in any way related to the decrease in body temperatures?

 

[wukunlin]

...deleted...

Yeah I realized it was unnecessary, deleting the post now.

[mod note: responses to the deleted content deleted. Thanks, @wukunlin ]

 

[russ_watters]

[response to deleted post deleted]

We are not given enough detail to understand Deborah Birx's statement. It is not obviously correct, since what is going on in Italy or Spain is consistent with China's numbers.

Deborah Birx recently made another bizarre statement that Singapore followed Trump's guidelines.
https://mothership.sg/2020/03/singapore-took-trump-guidelines-covid-19/

Birx's statement was:
"The medical community made -- interpreted the Chinese data as: This was serious, but smaller than anyone expected,” she said at a news conference on Tuesday. “Because I think probably we were missing a significant amount of the data, now that what we see happened to Italy and see what happened to Spain.”

My interpretation is that she's referring to the response in those other countries, not the statistics themselves. The early inaccurate data likely led most other countries to under-estimate the disease, partly resulting in slow/insufficiently aggressive responses. Point being, it should have been possible for basically every other country in the world to avoid the first-phase ramp-up that China had. My understanding is that only one country did: South Korea.

 

[peanut]

America reports one of the youngest persons to have died from COVID-19.

An infant girl in Connecticut who was just seven weeks old was brought unresponsive to a hospital. It was found out that she was infected with corona virus.

The death shatters the observation that only senior or older people are vulnerable to COVID-19. (NBC)

 

[atyy]

Birx's statement was:
"The medical community made -- interpreted the Chinese data as: This was serious, but smaller than anyone expected,” she said at a news conference on Tuesday. “Because I think probably we were missing a significant amount of the data, now that what we see happened to Italy and see what happened to Spain.”

My interpretation is that she's referring to the response in those other countries, not the statistics themselves. The early inaccurate data likely led most other countries to under-estimate the disease, partly resulting in slow/insufficiently aggressive responses. Point being, it should have been possible for basically every other country in the world to avoid the first-phase ramp-up that China had. My understanding is that only one country did: South Korea.

That was my interpretation too. But under that interpretation, her statement does not make sense. The early inaccurate data had been corrected quite a bit before Italy's ramp up. South Korea strengthens the case that Birx's statement makes no sense, since it was able to deal with it with the same amount of information. Italy did have enough time to to react and enough data to know that it had to react seriously.

I should also note that I have not seen similar statements from the Italian government yet. In fact, Italy has accepted help from China. It is by no means apparent that Italy would criticize China the way Birx, a representative of the current American administration, has done.
https://mothership.sg/2020/03/china-italy-help-covid-19/ citing this Twitter post:
"A China Eastern Airlines' A350 departed for Rome, Italy from Shanghai, bringing 9 Chinese medical experts and 31 tons of medical supplies, including plasma of recovered Coronavirus patients, to help Italy fight against the #COVID19 pandemic"

 

[Stephen Tashi]

Some discussion how reliable numbers from some countries are.

The mortality rate of a new disease doesn't indicate its net effect on the mortality rate of a population, especially in the case when the disease kills people who were likely to die of other causes anyway. In addition to posting links about Corvid 19 cases and fatalities, it would be useful to discuss comparisons with current death rates and historical death rates.

As far as I know, this page from a is non-political organization. In the section on Italy, it asserts that Italy has overestimated deaths due to Covid 19: https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/

 

[russ_watters]

That was my interpretation too. But under that interpretation, her statement does not make sense. The early inaccurate data had been corrected quite a bit before Italy's ramp up. South Korea strengthens the case that Birx's statement makes no sense, since it was able to deal with it with the same amount of information. Italy did have enough time to to react and enough data to know that it had to react seriously.

"Enough time" and "enough data" are highly uncertain things. The data is thin and vague in some ways, overwhelmingly large and unwieldy in others, so it is perfectly reasonable and completely unsurprising that different countries/entities reacted very differently from each other. Yes, South Korea shows that it was *possible* to use a catch-and-contain strategy, but in order to accomplish that they reacted much faster and more aggressively than any other country I'm aware of.

History may judge South Korea's reaction "right" and everyone else's "wrong", but when an awful lot of people independently come to the "wrong" conclusion, I think you have to accept that reality at face value: under most systems of logic, political philosophy, risk tolerance, institutional inertia, etc. the data did not support an aggressive response. Being "right" makes South Korea the outlier - the one who's reaction doesn't make sense - not the rest of the world.

 

[russ_watters]

IMO, the situation with the cruise ship industry is one of the more head-scratching/shaking components of the crisis.
https://www.npr.org/sections/corona...th-covid-19-cases-to-stay-away-from-u-s-ports
https://www.businessinsider.com/trump-cruise-ships-zaandam-rotterdam-holland-america-2020-4

Passengers and cruise lines have been under-reacting to the issue for two months. From a strictly business-risk standpoint, the risk of a ship getting stranded over the virus has been obvious since the Diamond Princess incident started in the last week in January. Two months later, there are as best I can tell, dozens of stranded ships, with tens of thousands of passengers confined to a in a near-perfect virus-spreading environment. The cruise lines screwed-up.

And governments screwed-up: the US for example only shut down the cruise industry locally 2 weeks ago. Now, stranded ships are piling-up off the coast of Florida. Somehow, President Trump and the Coast Guard are not in alignment on what to do (I'm not clear how direct his authority is there...). The Coast Guard is refusing to let the ships dock and disembark and refusing to airlift passengers. IMO, this is morally and practically wrong. All countries should be taking it upon themselves to rescue their citizens in exactly the same way they did with the Diamond Princess and similarly, to regular tourists in foreign countries. We should let them dock and disembark as those arrangements are made. If those ships have American passengers, they should be removed and quarantined -- again, similar to how we did it with the Diamond Princess.

 

[kadiot]

Researchers from the University of Nebraska Medical Centre and the National Strategic Research Institute at the University of Nebraska took air samples from 11 rooms where 13 confirmed cases were being treated.

As well as finding genetic material from the Coronavirus on lavatories and on everyday items, 63.2 per cent of air samples taken inside the rooms and 66.7 per cent of those taken outside also showed traces.

 

[gmax137]

I think the mess with the cruise ships continues only because it is possible to say "no" to a ship coming into port. I have not heard of airliners being told "no you cannot land here." (of course flights are cancelled, but that doesn't happen when they are halfway to their destination).

I don't see any real difference; the craft should "land" and disembark the passengers. What happens to them afterwards is a different question than just saying they must remain aboard the petri-dish.

 

[BillTre]

History may judge South Korea's reaction "right" and everyone else's "wrong", but when an awful lot of people independently come to the "wrong" conclusion, I think you have to accept that reality at face value: under most systems of logic, political philosophy, risk tolerance, institutional inertia, etc. the data did not support an aggressive response. Being "right" makes South Korea the outlier - the one who's reaction doesn't make sense - not the rest of the world.

My understanding of the S. Korea situation is that they were strongly affected by the events of their SARS infections years ago. This lead them to:

• get ready for another epidemic
• take things seriously when the situation looked like a potential epidemic

The US medical experts are not stupid and could also learn from SARS. In response, they did things like set-up a pandemic response unit of some kind. The Trump admin. got rid of this (because Obama?) and made other "stupid" decisions that were not the actions recommended by the experts.

I guess this would be in the set of things you are calling "systems of logic, political philosophy, risk tolerance, institutional inertia, etc.".
I'm OK with that if you realize that it has a lot to do with the political philosophy and their lack of foresight and consideration of effects on people as a population rather than as economic entities.
To many medically trained people (in the same country), the available data did support an (more) aggressive response.
I don't think it is something that should be forgotten since they will be doing this over and over again if not called out on it and similar things.

 

[Vanadium 50]

Somehow, President Trump and the Coast Guard are not in alignment on what to do (I'm not clear how direct his authority is there...)

The President is Commander-In-Chief of the Coast Guard. So it's pretty direct. The real issue is that USCG officers swear to follow lawful orders, and it's less clear what the law allows. The problem is that these cruise ships are not US-flagged, and that limits American authority. This is the responsibility of the Bahamas or Malta or wherever.

Now, as a practical matter, Malta does not have the resources to sort this mess out. So it's going to end up on the US' lap one way or another. But one can understand the annoyance at the position of the cruise lines: we don't want to pay US taxes and fees, so we'll pretend we're Maltese, but if we ever get in big, big, trouble, we expect the US to bail us out."

 

[anorlunda]

Could the two Holland America cruise ships be sent to Guantanamo Bay? I don't know if they have the right facilities there to dock a cruise ship. Does anyone else know? But if it is possible, President Trump could order that without asking for permission or cooperation from anyone else.

 

[atyy]

History may judge South Korea's reaction "right" and everyone else's "wrong", but when an awful lot of people independently come to the "wrong" conclusion, I think you have to accept that reality at face value: under most systems of logic, political philosophy, risk tolerance, institutional inertia, etc. the data did not support an aggressive response. Being "right" makes South Korea the outlier - the one who's reaction doesn't make sense - not the rest of the world.

Well, you may have a point in that one not so traditional element they used was to use mobile phones to help with contact tracing. This has now been suggested by many. I just came across a new article on the strategy.

https://science.sciencemag.org/content/early/2020/03/30/science.abb6936
We conclude that viral spread is too fast to be contained by manual contact tracing, but could be controlled if this process was faster, more efficient and happened at scale. A contact-tracing App which builds a memory of proximity contacts and immediately notifies contacts of positive cases can achieve epidemic control if used by enough people. By targeting recommendations to only those at risk, epidemics could be contained without need for mass quarantines (‘lock-downs’) that are harmful to society. We discuss the ethical requirements for an intervention of this kind.

 

[russ_watters]

The President is Commander-In-Chief of the Coast Guard. So it's pretty direct.

I don't think that's true. The USCG is essentially a civilian police force under the department of Homeland security. The President can transfer it to the Navy, but that's a rare and unpalatable order.

DHS is under the executive branch, but the pathway of orders is much less direct.

[edit] Hmmm...the wiki on it says the US Code lists it as a "US Armed Force", but I'm not sure there's a practical reality in that. The laws (both federal and international) under which the USCG operates are very different from that of the US Navy.

 

[anorlunda]

I don't think that's true. The USCG is essentially a civilian police force under the department of Homeland security. The President can transfer it to the Navy, but that's a rare and unpalatable order.

DHS is under the executive branch, but the pathway of orders is much less direct.

The commandant maintains operational command over the Coast Guard, unlike the chiefs of the other services, who serve only administrative roles. Thus, while the operational chain of command for the other services (per the Goldwater–Nichols Act) goes from the president through the secretary of defense to the combatant commanders of the unified combatant commands, command and control of the Coast Guard goes from the president through the secretary of homeland security (or secretary of defense, when the Coast Guard is acting as a service in the Department of the Navy) through the commandant.

Even thought the chain is different, the President is still at the top.

 

[Vanadium 50]

I don't think that's true.

It is. Ask any Coast Guardsman. Go Bears!
COC is President, Secretary of DHS, Commandant of the Coast Guard.

Could the two Holland America cruise ships be sent to Guantanamo Bay? I don't know if they have the right facilities there to dock a cruise ship.

The entry is mined. I hope the cruise ships have very, good navigators. Very good indeed.