COVID-19 Coronavirus Containment Efforts

[dlgoff]

TOPEKA, Kan. (WIBW/AP) --- The Legislative Coordinating Council voted to overturn Gov. Laura Kelly’s newest executive order restricting the size of religious gatherings.

Update:
BELLE PLAINE, Kan. — UPDATE, 9:17 p.m. | The Kansas Supreme Court "invalidated" a legislative panel's decision to overturn Gov. Laura Kelly's order that banned religoius and funeral services of more than 10 people.

 

[DennisN]

Yes, many countries have a downwards trend, but it's a really slow trend. At this rate the healthcare system can handle it but it means we need very long lockdowns unless something else reduces the spread. That will come with many other problems.

(my bolding)

I think we could be heading for that scenario, i.e. long lockdowns (but I'm not making any prediction ).

I read the entire article in a previous post by @Mary Conrads Sanburn in this thread, and I remember a particular part in the article, quote:

I’ve heard that the peak may not be until June or later. Do you agree with these estimates?

Nicholas Jewell: Yes, unchecked and without any steps to mitigate it, the models tend to show that the peak would be around June. Then there’s the ironic fact of trying to flatten the curve in that, while that’s a very good thing to do, it will make the epidemic last longer and will push the peak out. But probably not more than by a month or two.

Source: https://alumni.berkeley.edu/california-magazine/just-in/2020-03-27/dos-and-donts-health-experts-answer-your-covid-questions (California Magazine, UC Berkeley)

Edit: On a second thought, maybe you meant longer lockdowns than this, @mfb , I don't know.

 

[peanut]

Is a potential food shortage due to not growing enough locally or not having enough workers available to process and distribute it?

Both the above factors and this is exacerbated by disruptions to the global and local supply chains. Case in point, in my country we have adequate supply of fish, but do we have enough tin, tomato sauce, oil, labels and cartons to bring the canned sardines to the grocery shelves? Are workers, managers, delivery trucks and drivers coming to office for their tasks? Remember without a label, canned sardines won't make it to grocery shelves. The entire ecology of fishing, canning, warehousing, marketing, distribution, accounting and collection must be complete. Food security will be a huge problem as much as public health safety. Ergo, any and all sources to ensure this basic requirements must be tapped ASAP.

 

[chemisttree]

Yes, which is why I don’t think we can afford as much as a two month lockdown. That is too long for people to be out of work. People in Italy are already organizing raids on grocery stores in Italy. It could get very ugly in the US with such an armed population.

 

[DennisN]

Interestingly, just watching 60 minutes now, the new worry is people are basically doing the right thing, but will over time get sick of it so it may not remain controlled. This worries a lot of people, especially the police.

This worries me too. And the danger of a growing complacency/overconfidence.

 

[Ygggdrasil]

Is a potential food shortage due to not growing enough locally or not having enough workers available to process and distribute it?

Many farmers and food producers are reporting having to destroy crops or dairy products due to decreased demand from schools and restraunts:

The closing of restaurants, hotels and schools has left some farmers with no buyers for more than half their crops. And even as retailers see spikes in food sales to Americans who are now eating nearly every meal at home, the increases are not enough to absorb all of the perishable food that was planted weeks ago and intended for schools and businesses.
The amount of waste is staggering. The nation’s largest dairy cooperative, Dairy Farmers of America, estimates that farmers are dumping as many as 3.7 million gallons of milk each day. A single chicken processor is smashing 750,000 unhatched eggs every week.

Many farmers say they have donated part of the surplus to food banks and Meals on Wheels programs, which have been overwhelmed with demand. But there is only so much perishable food that charities with limited numbers of refrigerators and volunteers can absorb.

https://www.nytimes.com/2020/04/11/business/coronavirus-destroying-food.html

FWIW, government officials do not see food shortages as an issue in the US (of course, the credibility of the US government is no so high right now):

In recent days, top U.S. government officials have moved to assure Americans that they won't lack for food, despite the coronavirus.

As he toured a Walmart distribution center, Vice President Pence announced that "America's food supply is strong." The Food and Drug Administration's deputy commissioner for food, Frank Yiannas (a former Walmart executive) told reporters during a teleconference that "there are no widespread or nationwide shortages of food, despite local reports of outages."

"There is no need to hoard," Yiannas said.

In fact, the pandemic has caused entirely different problems: a spike in the number of people who can't afford groceries and a glut of food where it's not needed.

(source: NPR)

 

[Vanadium 50]

Interestingly, just watching 60 minutes now, the new worry is people are basically doing the right thing, but will over time get sick of it so it may not remain controlled.

But how long is "the right time" to do the "right thing"?

(Using US numbers). "The right thing" was decided when it looked like it might save millions of lives. Now it looks like that was at least an order of magnitude too high. Do we keep going if it saves 10,000 lives? (Remember, the potenial number of lives saved drops over time) 1000? Do we lock down the entire country when there is a single sick person - waiting until he recovers or dies?

If we don't start having this discussion now about when and how to end this, the answer by default will be "we'll end this when it feels like the right time to end this."

 

[peanut]

Yes, which is why I don’t think we can afford as much as a two month lockdown. That is too long for people to be out of work. People in Italy are already organizing raids on grocery stores in Italy. It could get very ugly in the US with such an armed population.

In my country farmers are discouraged to plant, growers discouraged to raise, and fishers discouraged to fish. All because they are having difficulty to get raw materials and to sell their harvest. Generally, economy is an integrated ecosystem, you stop one part it may still function with a bit of difficulty, If you stop half of it then it will affect what is left. Can our country afford a two months lock down? The answer is Yes and No. NO because it will kill a good part of the economy, YES because people survive. This may be a start of something good if people manage it correctly.

 

[DennisN]

British Prime Minister Boris Johnson who fell ill with Covid-19 and was taken to intensive care, is now out of the hospital. It seems to have been a quite close call... :

Sources:

• Out of hospital, UK's Johnson says "it could have gone either way" (Reuters, April 12, 2020)
• Boris Johnson says medics saved his life as UK deaths pass 10,000 mark (Reuters, April 12, 2020)

“It is hard to find the words to express my debt to the NHS (National Health Service) for saving my life,” he said in a video message posted on Twitter on Sunday, shortly after it was announced he had been discharged from St Thomas’ hospital in London.

 

[chemisttree]

Any word on what they treated him with? Antivirals like Remdesivir or hydroxychloroquine and azithromycin and zinc?

 

[DennisN]

Any word on what they treated him with? Antivirals like Remdesivir or hydroxychloroquine and azithromycin and zinc?

I haven't heard anything about that. I just read the two articles from Reuters and I did not see any specification about medicines, only that he was given oxygen.

 

[chemisttree]

In my country farmers are discouraged to plant, growers discouraged to raise, and fishers discouraged to fish. All because they are having difficulty to get raw materials and to sell their harvest.

Interesting. Does your country have enough reserves to miss a planting season without it causing a famine? I don’t think international trade will be available when it’s needed most. Tough times all over. Very precarious!

Plant a garden if you can!

 

[chemisttree]

I haven't heard anything about that. I just read the two articles from Reuters and I did not see any specification about medicines, only that he was given oxygen.

So, three days in intensive care and on the third day he rose ... on Easter?

 

[Astronuc]

Another cruise ship stranded with COVID-19 cases on board. Back on March 27.
April 7 - https://www.theguardian.com/world/2...ralian-passengers-from-covid-19-stricken-ship

The Greg Mortimer has been anchored 20km (12 miles) off the coast of Uruguay since 27 March, but authorities in the South American country had until now refused to allow passengers off.

On Tuesday, the ship’s operator, Aurora Expeditions, said that of 132 passengers and 85 crew, 128 people had tested positive for Covid-19. Most on board are understood to be Australian, although there are also citizens of New Zealand, the US and the UK.

The ship set out on 15 March from the Argentinian port of Ushuaia, the southernmost city in the world. It was to have undertaken a 16-day cruise to Antarctica and South Georgia, christened “In Shackleton’s Footsteps” after the Irish polar explorer, Ernest Shackleton.

Symptoms of Coronavirus started to appear soon after departure, and the ship diverted to the Uruguayan capital Montevideo. Even the ship’s doctor fell ill with a fever and was left unable to perform his duties.

On April 10, NY Times reported

Uruguay evacuated 112 Australians and New Zealanders Friday from a cruise ship that has been anchored off the South American country’s coast since March 27 with more than half its passengers and crew infected with the new coronavirus. Officials say the evacuees will be flown to Australia early Saturday.

At least six Americans, five British citizens and passengers from other countries, as well 83 crew members, remain aboard the Greg Mortimer, a ship operated by Australia’s Aurora Expeditions, while arrangements for their evacuation are made.

https://www.nytimes.com/aponline/2020/04/10/world/americas/ap-lt-virus-outbreak-uruguay-cruise-ship.html

 

[mfb]

Perhaps you could adjust your thinking?

Yes, but not based on two random Youtube videos. You'll need a study.

$20 per patient to treat sounds very promising to me.

Only if it works.

All received remdesivir for up to 10 days on a compassionate use basis, a program that allows people to use unapproved medicines when no other treatment options are available. Over 18 days, 68% of the patients improved, with 17 of the 30 patients on mechanical ventilation being able to get off the breathing device. Almost half of the patients studied were ultimately discharged, while 13% died.

How does that compare to the control group?

(Using US numbers). "The right thing" was decided when it looked like it might save millions of lives. Now it looks like that was at least an order of magnitude too high. Do we keep going if it saves 10,000 lives? (Remember, the potenial number of lives saved drops over time) 1000? Do we lock down the entire country when there is a single sick person - waiting until he recovers or dies?

How do the impact go down? If you let this spread (R>>1) without a vaccine in reach you still get the worst-case scenario over time.

 

[atyy]

But how long is "the right time" to do the "right thing"?

(Using US numbers). "The right thing" was decided when it looked like it might save millions of lives. Now it looks like that was at least an order of magnitude too high. Do we keep going if it saves 10,000 lives? (Remember, the potenial number of lives saved drops over time) 1000? Do we lock down the entire country when there is a single sick person - waiting until he recovers or dies?

If we don't start having this discussion now about when and how to end this, the answer by default will be "we'll end this when it feels like the right time to end this."

It depends on the country. You can look at China and South Korea for examples that seem to be succeeding. Here in Singapore, we've been open to various degrees most of the time, until last week when it seemed that there might be an increase in the number of cases beyond the reach of contact tracing. The idea is that the latest much stricter measures can start to be relaxed when that threat seems to have passed. Of course there's a long way to fully relaxing all measures. For example, elective medical procedures have been postponed for many months now - eventually they must resume, but only when it seems there is not a threat on supplies for medical emergencies.

The stricter measures buy you time to prepare so that you can reopen. The measures don't work unless people understand them and there is buy-in from society at large. Some of the things that might be done to prepare to relax social distancing are to increase contact tracing capability (maybe the effort by Apple and Google to coordinate the contact tracing apps will help), and build up medical supplies.

 

[russ_watters]

But how long is "the right time" to do the "right thing"?

(Using US numbers). "The right thing" was decided when it looked like it might save millions of lives. Now it looks like that was at least an order of magnitude too high. Do we keep going if it saves 10,000 lives? (Remember, the potential number of lives saved drops over time) 1000? Do we lock down the entire country when there is a single sick person - waiting until he recovers or dies?

If we don't start having this discussion now about when and how to end this, the answer by default will be "we'll end this when it feels like the right time to end this."

My hope is that we end the social distancing when the number of active cases gets low enough and testing available enough that they can be tracked and managed individually like in Korea. But as you suggest, I haven't seen real discussion of such plans*, and my fear is that we'll lift the restrictions when "it feels like the right time" and without a management strategy, and we'll just have another spike.

*Keeping the shutdown too long has negative implications for the economy, but tracking and quarantining individuals is onerous from a liberty standpoint. In some ways I think the general semi-voluntary shutdown is easier than mandatory, forced quarantines for individuals. Are people really going to accept the federal government using our cell phones as ankle bracelets as if we are all criminals on house arrest?

 

[kyphysics]

WHO has specifically warned about the improper use and interpretation of tests, particularly lateral flow IgM/IgG assays (these are the blood tests that look like pregnancy tests and require a drop of blood). The only thing WORSE than NO TEST is a BAD TEST, which will give people a false sense of security and may increase their risk of contracting disease.

Although I think that could happen - the false sense of security thing - I also think some people would know that they could STILL get the virus (precisely b/c they didn't have it on their test).

At least, that's how I would take it. The only thing that would make me feel more safe is an immunity test. Then, at least, I know I'd already had it and beaten it once. But, if some doctor said I tested negative, that WOULD NOT make me (personally) feel all safe to go out.

But, yeah, for some ...that could be the case.

 

[atyy]

Although I think that could happen - the false sense of security thing - I also think some people would know that they could STILL get the virus (precisely b/c they didn't have it on their test).

At least, that's how I would take it. The only thing that would make me feel more safe is an immunity test. Then, at least, I know I'd already had it and beaten it once. But, if some doctor said I tested negative, that WOULD NOT make me (personally) feel all safe to go out.

But, yeah, for some ...that could be the case.

The test that @peanut was referring to was (I think) a test related to immunity (but one may not be using it as the sole test on which a decision is made; and one may be using it for diagnosis, rather than to certify immunity). In principle, one could also get a false positive on an immunity test, which would make one think one is immune when one is not. So if one is trying to use it to certify immunity, one would also like to know the false positive and false negative rates.

 

[bhobba]

But how long is "the right time" to do the "right thing"?

Very true, and yes we are having the discussion here in Aus now. We started out hard, and police have been 'over exuberant' (there was a story in the local paper where many fines have been revoked). Now is the time to slowly remove restrictions, wait a couple of weeks to see what happens, then reevaluate. But I would rather, with lives at stake, be over cautious initially, then gradually reduce, waiting for the vaccine (yes I know it is not 100% sure we will even get one - but a number of people working in the area are confident it will be here by years end).

I wrote about the Ruby Princess fiasco in a previous post and mentioned I think 10 people had died - now it has risen to 18. And still nobody has been held to account about letting the people off. They all just keep finger pointing. This is not good enough. Any person with a brain can see you should not do that when you had more than 150 with illness confined to their cabins, with at least 26 tested for flu and found negative. This makes me so mad I can't on this forum say what I really think. This is a case where the opposite happened - not imposing even basic restrictions of simply testing people highly likely to have it before they were let go.

We must find the right balance - but I would rather err on the side of caution than have a Ruby Princess.

Thanks
Bill

 

[bhobba]

Keeping the shutdown too long has negative implications for the economy,

Having a shutdown at all has negative impacts to the economy. Some say the cure is worse than the disease. This is a value judgement, not science. All science can say is here in Aus we have it under control and hence should look at the exit strategy. The priorities that are bought to such a discussion are for each individual to decide.

Thanks
Bill

 

[russ_watters]

Having a shutdown at all has negative impacts to the economy. Some say the cure is worse than the disease. This is a value judgement, not science.

Yes; too long = more negative than we thought we wanted.

All science can say is here in Aus we have it under control and hence should look at the exit strategy.

There I disagree: that's a value judgment too. That's a lot of the problem I have with choices made so far. Most of what people have judged to be logical/obvious choices have in reality been value judgments. But it is only on the backside that people seem to be accepting that value judgments even exist.

The priorities that are bought to such a discussion are for each individual to decide.

And on that, I strongly disagree. This issue requires united solutions. Governments must make the decisions and force them on their citizens. Otherwise we have a situation where smoking is allowed in restaurants, so one person smokes and everyone else has to breathe smoke. But instead of smoke, they breathe COVID-19.

 

[atyy]

There I disagree: that's a value judgment too. That's a lot of the problem I have with choices made so far. Most of what people have judged to be logical/obvious choices have in reality been value judgments. But it is only on the backside that people seem to be accepting that value judgments even exist.

I'm not sure that is universally the case - if by value judgements we mean non-economic judgements. I would be extremely surprised if the actions taken in China and South Korea did not have a large element of economic consideration - bring or keep things under control so that as much of normal daily life - normal economic activity - can go on.

 

[bhobba]

There I disagree: that's a value judgment too. That's a lot of the problem I have with choices made so far. Most of what people have judged to be logical/obvious choices have in reality been value judgments. But it is only on the backside that people see to be accepting that value judgments even exist.

Yes - these things are recursively triky - shades of Godel, Escher, Bach.

on that, I strongly disagree. This issue requires united solutions. Governments must make the decisions and force them on their citizens. Otherwise we have a situation where smoking is allowed in restaurants, so one person smokes and everyone has to breathe smoke. But instead of smoke, they breathe COVID-19.

True - but discussing, then deciding on those solutions, can be a 'free for all' so to speak. That's what democracy is all about. The elected representatives then decide on what is implemented - and at that point you are of course correct.

Thanks
Bill

 

[phinds]

I'm not sure that is universally the case - if by value judgements we mean non-economic judgements.

What makes you think that economic judgements are not value judgements? A few simple ones may not be, but most are.

 

[kyphysics]

The test that @peanut was referring to was (I think) a test related to immunity (but one may not be using it as the sole test on which a decision is made; and one may be using it for diagnosis, rather than to certify immunity). In principle, one could also get a false positive on an immunity test, which would make one think one is immune when one is not. So if one is trying to use it to certify immunity, one would also like to know the false positive and false negative rates.

Oh, I see.

If so, that's a bit more concerning. The article I posted, though, was on false negatives on a COVID-19 carrier test (not immunity).

I do think doctors seeing OBVIOUS COVID-19 symptoms + a negative on the carrier test should instruct patients to act as if they have it. From a spreading standpoint, that helps. From a coding standpoint, it's harder to say what to do. Maybe come up with a new category: "negative, but presenting with positive symptoms" ??

 

[atyy]

What makes you think that economic judgements are not value judgements? A few simple ones may not be, but most are.

I mean the terms in the context of the discussion. In the broadest sense, all judgements are value judgements, so it doesn't make sense to say that any judgement is not a value judgement.

 

[phinds]

I mean the terms in the context of the discussion. In the broadest sense, all judgements are value judgements, so it doesn't make sense to say that any judgement is not a value judgement.

I don't see where context has anything to do with it. Can you be more specific? That is, what part of the discussion could make an economic judgement not be a value judgement? I'm not trying to extend this as an argument, and I'm willing to be wrong, but I can't see it.

 

[atyy]

I do think doctors seeing OBVIOUS COVID-19 symptoms + a negative on the carrier test should instruct patients to act as if they have it. From a spreading standpoint, that helps. From a coding standpoint, it's harder to say what to do. Maybe come up with a new category: "negative, but presenting with positive symptoms" ??

The protocol varies from place to place, and from time to time as we get a better idea of how to handle things. In a sense most cases already escape a little bit, because people are infectious just before they become symptomatic and when they have only mild symptoms, at which point they may not realize that they should be isolated as a precaution. Here is an interesting article about a case where they did multiple tests to ensure a true negative, and all the while keeping the person in isolation until they were pretty sure it wasn't COVID-19: https://www.asiaone.com/singapore/n...ed-covid-19-case-shares-behind-scenes-details

 

[kyphysics]

It depends on the country. You can look at China and South Korea for examples that seem to be succeeding. Here in Singapore, we've been open to various degrees most of the time, until last week when it seemed that there might be an increase in the number of cases beyond the reach of contact tracing. The idea is that the latest much stricter measures can start to be relaxed when that threat seems to have passed. Of course there's a long way to fully relaxing all measures. For example, elective medical procedures have been postponed for many months now - eventually they must resume, but only when it seems there is not a threat on supplies for medical emergencies.

The stricter measures buy you time to prepare so that you can reopen. The measures don't work unless people understand them and there is buy-in from society at large. Some of the things that might be done to prepare to relax social distancing are to increase contact tracing capability (maybe the effort by Apple and Google to coordinate the contact tracing apps will help), and build up medical supplies.

Surprised Singapore got a spike in cases (233 on April 12: https://www.cnbc.com/2020/04/13/coronavirus-live-updates.html).

Your country has been a model thus far (still is). Hoping not a trend and things go back down.

 

[kyphysics]

Yes, which is why I don’t think we can afford as much as a two month lockdown. That is too long for people to be out of work. People in Italy are already organizing raids on grocery stores in Italy. It could get very ugly in the US with such an armed population.

a.) Can we address that with adequate stimulus checks to every American?
b.) Can we have a lockdown, but with a delivery (of goods) infrastructure built?

What I mean for the second point is, suppose everyone stays in except essential workers. Could we have a delivery system, whereby people order what they need from home and just have delivery workers bring it to them (instead of going out)?

I will say that the biggest issue in my mind is how to address schooling interruptions. I cannot envision a prolonged lockdown, given the need for students to continue on with their educations. College students, in particular, are in no-man's land. No job. Yet, technically adults and not supported by their parents anymore. Online education might not work well for some students.

 

[atyy]

Surprised Singapore got a spike in cases (233 on April 12: https://www.cnbc.com/2020/04/13/coronavirus-live-updates.html).

The spiking began some time ago. Most of it is due to construction workers living in dorms in which social distancing is very difficult. So as temporary measures, new housing has been set up eg. housing some of them in military camps, so that social distancing is possible. It's a huge logistical effort as there are 20,000 workers. My own guess is that this part of the spike is not that worrying, as the cases are all linked by contact tracing, and manageable in time. Also, construction workers tend to be fit (but there is one worrying case from much earlier, a 39 years old construction worker who was (is?) in critical care for months now - his wife in Bangladesh gave birth while he was (is?) still under sedation - all of us really hope he gets to see his baby boy and makes a full recovery).

The more worrying part is that there is also an increase in the number of cases where contact tracing does not find a link to earlier cases. This suggests things may be getting out of control, which is why we now have everyone (except essential businesses) working from home.

Your country has been a model thus far (still is). Hoping not a trend and things go back down.

Yeah, me too.

 

[atyy]

I don't see where context has anything to do with it. Can you be more specific? That is, what part of the discussion could make an economic judgement not be a value judgement? I'm not trying to extend this as an argument, and I'm willing to be wrong, but I can't see it.

Not what I was thinking and not important - it's just semantics - let's just change terminology to try to be clearer about what we mean - the discussion is about how to weigh the things (that are not necessarily independent) like lifespan, ability not to collapse the health system, access to healthcare, ability to earn a salary, ability to go to concerts, in different age groups across the whole population and over various time scales.

 

[russ_watters]

I'm not sure that is universally the case - if by value judgements we mean non-economic judgements.

Yes, I believe @bhobba was referring to moral value, and that's what I was responding to.

I would be extremely surprised if the actions taken in China and South Korea did not have a large element of economic consideration - bring or keep things under control so that as much of normal daily life - normal economic activity - can go on.

I guess it's possible, but it would surprise me. In the West we're seeing people even recently essentially claiming the moral-to-economic value conversion of a human life is infinity dollars. In that way, it doesn't matter that the actionable death estimates a month ago were probably wrong by a factor of 10: the financial value of saving 200,000 or 2,000,000 lives is the same; infinity. As people have said, that makes the judgement easy. Because if we actually tried to use financial value it would be harder than people think because the early estimate of the loss of life were way too high.

In the US and in this forum we've called people crazy for making moral-moral value judgement on liberty vs life that didn't pick life. But we'll see if people still feel that way if the federal government pushes a tracking-app to everyone's phone as if we were all just released from prison on bail (as S. Korea did).

Current estimates are for something on the order of 60,000 deaths in the US. Perhaps if we'd done our shutdowns a week or two earlier we could have cut that in half. And perhaps if we rolled tanks into every city and put a Humvee on every suburban street corner with a few soldiers armed with machine guns (as some have also suggested, and China did) we could have cut it in half again. In China, the government doesn't even blink at such actions; liberty has very little value to them. But here I think people would put a lot more thought into the value of their liberty if they saw armed soldiers patrolling their streets in an effort to save 15,000 lives.

 

[kyphysics]

Yes, I believe @bhobba was referring to moral value, and that's what I was responding to.

I guess it's possible, but it would surprise me. In the West we're seeing people even recently essentially claiming the moral-to-economic value conversion of a human life is infinity dollars. In that way, it doesn't matter that the actionable death estimates a month ago were probably wrong by a factor of 10: the financial value of saving 200,000 or 2,000,000 lives is the same; infinity. As people have said, that makes the judgement easy. Because if we actually tried to use financial value it would be harder than people think because the early estimate of the loss of life were way too high.

In the US and in this forum we've called people crazy for making moral-moral value judgement on liberty vs life that didn't pick life. But we'll see if people still feel that way if the federal government pushes a tracking-app to everyone's phone as if we were all just released from prison on bail (as S. Korea did).

Russ, et. al:

Would the response "calculus" change for you if the deaths from COVID-19 were primarily children?

Sandy Hook was a national tragedy, which claimed the lives of 20 children. This is an act of nature and certainly not comparable in kind to the actions of a deranged murderer. But suppose, nonetheless, that COVID-19 affected children under 12 the most and we had 15,000 of the 20,000 U.S. deaths thus far be children.

Would that warrant the current and/or greater clamp down response for you all?