COVID-19 Coronavirus Containment Efforts

[peanut]

I think he's right: A new clause in our social contract is required because until a vaccine or cure is found, our behaviour will control our fate.

"Achieving this degree of social protection will require a new clause in our social contract that will mean fewer contacts with others and wearing protective gear. Just as we obey the most basic laws in order to protect all of us, everyone needs to accept responsibility for not only our circle of friends, family and colleagues, but for the wider community. Our collective behavior will be the primary determinant of whether we can keep this virus in check. We each hold the health of our neighbors in our hands."

https://www.nytimes.com/2020/04/20/...uJnoeZSDR0U-XrQAY0-L0_NZxHI2MgRu8gAwqqXRQM2z8

 

[Vanadium 50]

Can you say the death rate would have been similar without the social distancing?

Nope.

I also can't say if mandating it (where it is mandated) makes a difference or not.

I can't say that the lockdown was a net benefit or not. I suspect less beneficial than will be claimed because, at least in NY, it started late. As I said in another thread "If someone proposed ahead of time that the plan is to let the infected and uninfected mingle for two weeks and once things are good and spread and the symptoms start appearing, then we lock everything down, I don't think we'd all be cheering this on as a great idea."

I also can't tell that banning the sale of vegetable seeds in Copper Harbor, Michigan is saving lives. But I have my suspicions.

 

[peanut]

There seems to be evidence suggesting that there may be a correlation between a policy of BCG VACCINE FOR ALL and lower infection and fatality rates from Corvid...

1. BCG is a vaccine that consists of weakened or attenuated bacteria related to tuberculosis;
2. I think this is part of a host of vaccines that we get when we were children;
3. The result of these studies should be most useful as the race to produce an anti Corvid vaccine continues...

https://theaseanpost.com/article/ca...Cqg2tjTVyYtbfDalD30xYNEPR-jIQ_djqwes_JOpPESMc

 

[russ_watters]

A lesson on exponential function

https://centerforinquiry.org/blog/i...-vuGmtoe_W-DYwuAZmK6W10XBDGyrijcgPA5wZQLHiFDE

That author's opinions seem to be based on the idea that management of the virus isn't possible. That the only two options are actual-full lockdown and just letting it run wild. He even suggests the current partial shutdown approach won't eliminate exponential growth (e.g., is functionally equivalent to letting it run wild)...which it appears he wrote the day after the peak growth rate in the US.

To me the key to management is getting the infection rate low enough that test-trace-quarantine can be effective like it is in South Korea and a few other places.

 

[kadiot]

Angela Merkel, chancellor of Germany, has PhD in Quantum Chemistry.

https://www.theatlantic.com/interna...a-merkel-germany-coronavirus-pandemic/610225/

 

[TeethWhitener]

Angela Merkel, chancellor of Germany, has PhD in Quantum Chemistry.

https://www.theatlantic.com/interna...a-merkel-germany-coronavirus-pandemic/610225/

For some reason I (mis)remembered her PhD being in biophysics.

But yes, of all the world leaders, she is probably the most scientifically qualified to deal with this pandemic.

 

[kadiot]

For some reason I (mis)remembered her PhD being in biophysics.

But yes, of all the world leaders, she is probably the most scientifically qualified to deal with this pandemic.

She studied Physics first and then Quantum Chemistry. But they are still in the top 10. Looks like all the best human brains combined will not win against this virus.

 

[atyy]

Physicists Design Emergency Ventilators
https://physics.aps.org/articles/v13/58
Using their experimental expertise, three groups of physicists are developing ventilators that could help in the struggle against the COVID-19 pandemic.

 

[chirhone]

Do you personally know someone with Covid and died? I know 2. One is an anesthesiologist, another is a neighbor in the province. The latter is 74 hears old. He suffered fever and cough. And improving when he suddenly encountered difficult breathing and then later died 2 days ago from heart attack. I don't know if the virus directly affects his heart.

There is something I don't quite understand. Is the mode of transmission still controversial? Isn't it like the flu? Why are Georgia, South Carolina, Tennessee easing up restrictions and allowing people back to the mall or movie houses when positive Covid in the US can reach 1 million next week and 45,000 death? Can't there be increased transmission and infection by easing up restrictions?

Are their mindset about developing herd immunity by just getting everyone infected? In this case, the victims are expendable or collateral damage? But thinking of the two people I know. The victims in Italy and the USA are not really expendable, are they?

If Covid is transmitted similar to the flu. Then by wearing full face respirator that can protect your mouth, nose and eyes (and washing all parts of your body). You can protect yourself from all kinds of flu and coronavirus, right? Or since virus are particles and fields. Are there other modes of transmission like tunneling such that the governors in George, South Carolina, Tennessee and even some of you think the death is similar with or without lockdown (with or without social distancing)?

 

[atyy]

There is something I don't quite understand. Is the mode of transmission still controversial? Isn't it like the flu?

There is some uncertainty, but the major points are established.

Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations
https://www.who.int/news-room/comme...plications-for-ipc-precaution-recommendations

 

[morrobay]

Which denominator? There are at least three probabilities being bandied about:

1. The probability of death once exposed
2. The probability of death once infected
3. The probability of death once symptomatic

The working assumption is that 1 and 2 are nearly equal, and 3 is smaller. That may or may not prove to be the case.

Shouldn't number one be: 1. The probability of infection once one is exposed. IE There is an exposure gradient with brush surface contacts that do not result in infections. And then there are viral loads variables with initial exposure ,the less the viral load the better ones immune system can handle it. Edit: Is there any data that quantifies what exposures result in infection.

 

[kadiot]

Pasteur Institute: 5.7% of the French population will have been contaminated by SARS-CoV-2 by May 11 (and only 1.8% in Brittany.)

The study was carried out by modellers from the Institut Pasteur, the CNRS (National Scientific Research Centre) and Inserm (National Health and Medical Research Institute).

According to the study, the statistics are not nearly high enough to prevent a second wave of infection cases spiking following deconfinement.

The models also showed that number of hospitalisation and ICU cases will have dropped significantly in Brittany by 11 May. This is largely due to Brittany population's general adherence to confinement measures that are in place.

https://www.letelegramme.fr/france/...1-mai-selon-une-etude-21-04-2020-12541794.php

 

[Vanadium 50]

Shouldn't number one be: 1. The probability of infection once one is exposed

I said at least three numbers. Lots of numbers are being bandied about. You want to add a fourth or a tenth to my list, have at it.

 

[Vanadium 50]

Why are Georgia, South Carolina, Tennessee easing up restrictions and allowing people back to the mall or movie houses when positive Covid in the US can reach 1 million next week and 45,000 death?

Like so many of your other posts, this one is untrue. South Carolina is not "allowing people back into movie houses". Entertainment venues were closed April 1st, are not subject to the reopening, and even if they were would be limited to 5 customers per 1000 square feet, which means only a dozen or so people could watch a movie.

I didn't check the others. Since you can make up a falsehood faster than I can check it, this is a losing proposition for me. But if you keep saying things that aren't true, people will stop taking you seriously.

If they haven't already.

 

[bhobba]

Why can't the US use the armed forces (like us) to implement the lockdown. We don't have protest anymore because those who did initally we still in jail.

Different countries, different approaches to priorities. It's a balance between individual freedom, protecting people, plus the economy. For example although Australia and NZ are very similar, NZ went for level 4 lockdown, Australia level 3, yet have about the same level of the virus. One can argue level 4 is not necessary - although I would not because other differences come into play eg population density.

Thanks
Bill

 

[TeethWhitener]

I didn't check the others

Georgia seems to be getting the most press right now: https://www.npr.org/sections/corona...conomy-lifting-some-coronavirus-crisis-limits

Employees at "gyms, fitness centers, bowling alleys, body art studios," as well as "barbers, cosmetologists, hair designers, nail care artists, estheticians, their respective schools & massage therapists," will be allowed to return to work on Friday but will have to operate under restrictions.

The mandatory conditions at the workplaces include social distancing, enhanced cleanings, screening workers for fevers and respiratory illness, wearing gloves and a mask if appropriate, moving workplaces 6 feet apart, staggering work shifts and, if possible, teleworking.

Edit: specifically about movie houses:

On Monday, April 27, sit-down restaurants, theaters and private social clubs will be allowed to reopen, "subject to specific social distancing & sanitation mandates," according to the governor.

 

[chirhone]

There is some uncertainty, but the major points are established.

Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations
https://www.who.int/news-room/comme...plications-for-ipc-precaution-recommendations

As a biology expert. Can you comment on this:

https://www.sciencemag.org/news/202...rJMlNWALvltglsFpAGDSubnDX2fUbIrZa1wMN-aM-m-c#

"How does Coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes"

"Despite the more than 1000 papers now spilling into journals and onto preprint servers every week, a clear picture is elusive, as the virus acts like no pathogen humanity has ever seen."

Not an exaggeration?

I have seen the following (from the article above) directly on the family friend. The virus made him suffer a heart attack and he didn't die from pneumonia but the virus directly damaging the heart.

"In Brescia, Italy, a 53-year-old woman walked into the emergency room of her local hospital with all the classic symptoms of a heart attack, including telltale signs in her electrocardiogram and high levels of a blood marker suggesting damaged cardiac muscles. Further tests showed cardiac swelling and scarring, and a left ventricle—normally the powerhouse chamber of the heart—so weak that it could only pump one-third its normal amount of blood. But when doctors injected dye in the coronary arteries, looking for the blockage that signifies a heart attack, they found none. Another test revealed why: The woman had COVID-19."

Is Covid-19 like a transient HIV/AIDS.

Tomorrow I'll accompany someone to a laboratory for routine medical checkup. I'll be wearing full PPE frontliners use (like 3M half face respirators, medical googles, face shield, etc.). But still nervous.

 

[bhobba]

But they are still in the top 10. Looks like all the best human brains combined will not win against this virus.

I disagree. We have the technology, our scientific knowledge is advancing quickly, we have well trained and smart people, some very smart eg Nobel prize winners. We have people like Bill Gates, who, along with Warren Buffet, are going to spend billions of their own money on a 'gamble', by in parallel bulk manufacturing the 7 most promising vaccines, so when the best one is identified it's ready to inoculate the world. This is a test of the human spirit - I believe, and I know it sounds schmaltzy, but I believe we will not fail.

Thanks
Bill

 

[Vanadium 50]

Why can't the US use the armed forces (like us) to implement the lockdown.

Once again, false. https://www.cnbc.com/2020/03/10/new...s-containment-center-to-stem-coronavirus.html

If you don't like that one, Google says there are 7,200,000 links just like it.

 

[DennisN]

Looks like all the best human brains combined will not win against this virus.

I disagree.

I disagree too.

Furthermore, it is worth remembering that humankind has survived quite many pandemics, including the worst one in history, the Black Death in the 14th century. And the scientific and medical expertise of humankind is much, much better today than in the 14th century .

 

[atyy]

As a biology expert. Can you comment on this:

https://www.sciencemag.org/news/202...rJMlNWALvltglsFpAGDSubnDX2fUbIrZa1wMN-aM-m-c#

"How does Coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes"

"Despite the more than 1000 papers now spilling into journals and onto preprint servers every week, a clear picture is elusive, as the virus acts like no pathogen humanity has ever seen."

Not an exaggeration?

Overall that is an excellent article. One of its minor flaws might be that it is arguably an exaggeration to say it acts like no pathogen humanity has ever seen (depends on how one defines "like"). However, it is true that we don't yet know what the most common mechanisms of severe disease are (eg. if the heart is damaged, is it because of a cytokine storm or does the virus damage the heart directly?), and that we don't know how to identify which patients are at risk for severe disease in a way that we can act to prevent their deterioration. However, there are general principles of advanced life support that one applies in other situations (heat stroke, heart attack, acute kidney failure), and doctors can use their experience to guess what might work.

I have seen the following (from the article above) directly on the family friend. The virus made him suffer a heart attack and he didn't die from pneumonia but the virus directly damaging the heart.

"In Brescia, Italy, a 53-year-old woman walked into the emergency room of her local hospital with all the classic symptoms of a heart attack, including telltale signs in her electrocardiogram and high levels of a blood marker suggesting damaged cardiac muscles. Further tests showed cardiac swelling and scarring, and a left ventricle—normally the powerhouse chamber of the heart—so weak that it could only pump one-third its normal amount of blood. But when doctors injected dye in the coronary arteries, looking for the blockage that signifies a heart attack, they found none. Another test revealed why: The woman had COVID-19."

Yes, from reports it seems sometimes the heart symptoms even show up before any respiratory symptoms. I'm sorry to hear about your friend.

Is Covid-19 like a transient HIV/AIDS.

I don't think so. Earlier in the thread a paper was mentioned that made some comparison with HIV, but I think the resemblence is superficial since SARS-CoV-2 doesn't seem to replicate in the immune cells.

Edit: Removed video that is copied in @chirhone's reply to an earlier version of this post.

Tomorrow I'll accompany someone to a laboratory for routine medical checkup. I'll be wearing full PPE frontliners use (like 3M half face respirators, medical googles, face shield, etc.). But still nervous.

That should be good. Make sure you wash your hands before putting these things on, and before taking them off, and after taking them off.

 

[Vanadium 50]

Different countries, different approaches to priorities.

First, pretty much nothing that has come out of Mr. Chirhone has been correct.

But I think it's worth remembering that the US is the 3rd largest country in the world. South Carolina is 700 miles away from New York. Farther than London and Milan. Georgia is farther still.

As the data shows us, population density is an important factor. Barnwell County, SC has 40 people per square mile. Manhattan has a daytime population density of 120,000. Does it make sense that the same level of precautions be applied? Think Northern Territory far away from Darwin or Alice Springs (I don't even know what the next largest city in the Northern Territory is. Katherine maybe?)

 

[chirhone]

Overall that is an excellent article. One of its minor flaws might be that it is arguably an exaggeration to say it acts like no pathogen humanity has ever seen (depends on how one defines "like"). However, it is true that we don't yet know what the most common mechanisms of severe disease are (eg. if the heart is damaged, is it because of a cytokine storm or does the virus damage the heart directly?), and that we don't know how to identify which patients are at risk for severe disease in a way that we can act to prevent their deterioration. However, there are general principles of advanced life support that one applies in other situations (heat stroke, heart attack, acute kidney failure), and doctors can use their experience to guess what might work.
Yes, from reports it seems sometimes the heart symptoms even show up before any respiratory symptoms. I'm sorry to hear about your friend.
I don't think so. Earlier in the thread a paper was mentioned that made some comparison with HIV, but I think the resemblence is superficial since SARS-CoV-2 doesn't seem to replicate in immune cells. Here is a video summarizing that paper: .
That should be good. Make sure you wash your hands before putting these things on, and before taking them off, and after taking them off.

The elderly I'm accompanying for blood checkup will only wear surgical mask. I think I'll cancel the appointment and let him order another set of this so we both wear this.

I find it easier to breathe than an N95 mask. Do you have any background in this? Have you tried one yourself? Are cartridges in such devices easier to breathe in than the fabric in N95?

I'm serious in the above. Those of you in lockdown who need to go to hospital. These are one of the surest way to avoid getting infected. I won't trust just handkerchief over the mouth.

 

[atyy]

I find it easier to breathe than an N95 mask. Do you have any background in this? Have you tried one yourself? Are cartridges in such devices easier to breathe in than the fabric in N95?

I don't. Maybe @chemisttree ?

BTW, I edited my post above to remove the video that was originally in there, as I'm not sure if everything he says is accurate.

 

[atyy]

But I think it's worth remembering that the US is the 3rd largest country in the world. South Carolina is 700 miles away from New York. Farther than London and Milan. Georgia is farther still.

As the data shows us, population density is an important factor. Barnwell County, SC has 40 people per square mile. Manhattan has a daytime population density of 120,000. Does it make sense that the same level of precautions be applied? Think Northern Territory far away from Darwin or Alice Springs (I don't even know what the next largest city in the Northern Territory is. Katherine maybe?)

I guess the problem in the US is central coordination. For example, suppose Barnwell is sure it has no cases so has no movement restrictions. To prevent new cases entering, it might like to require all visitors to the county to be isolated upon entry. Would that be possible? In other words, could Barnwell treat itself as a country like New Zealand, which has an overall population density close to Barnwell, is now lifting many lockdown-like measures, but is still keeping the requirement that visitors be isolated soon after entry.

 

[hmmm27]

I think I'll cancel the appointment and let him order another set of this so we both wear this.

I think that's socially very irresponsible. And - bluntly - foolish : you may not get a chance at a second appointment.

 

[bhobba]

Does it make sense that the same level of precautions be applied? Think Northern Territory far away from Darwin or Alice Springs (I don't even know what the next largest city in the Northern Territory is. Katherine maybe?)

Neither do I actually. Only 27 in the entire NT last time I looked. The worry is the number of aboriginal communities in the NT. I do not think anybody knows for sure, but it is thought if it got in those communities it could devastate them.

Thanks
Bill

 

[Vanadium 50]

I think our international community might be unaware of certain facts about the US.

It's big. Really big. It's the 3rd largest country in the world both in size and population. The distance from one end to the other is about the same as from Taipei to Delhi. Miami is closer to Lima, Peru than it is to Seattle.

Covid has hit three localities particularly hard: New York City, Detroit, and New Orleans.

Somewhere between one-third and one-half of the fatalities have been in the greater NYC metropolitan area, depending on what you call "greater New York".

To get an idea of the disparity in rates, if you compare NYC metro (20M people, and 15-18K fatalities) with the states with the lowest incidence, adding them up until you get 20M people (WY, HI, SD, UT, MT, WV, AK, AR, ND, NE and half of NC) , you get 245 fatalities. So there is a factor of ~60-75 difference across the country.

 

[WWGD]

Pasteur Institute: 5.7% of the French population will have been contaminated by SARS-CoV-2 by May 11 (and only 1.8% in Brittany.)

The study was carried out by modellers from the Institut Pasteur, the CNRS (National Scientific Research Centre) and Inserm (National Health and Medical Research Institute).

According to the study, the statistics are not nearly high enough to prevent a second wave of infection cases spiking following deconfinement.

The models also showed that number of hospitalisation and ICU cases will have dropped significantly in Brittany by 11 May. This is largely due to Brittany population's general adherence to confinement measures that are in place.

https://www.letelegramme.fr/france/...1-mai-selon-une-etude-21-04-2020-12541794.php

I wonder if it would be possible, albeit arguably unethical, to set up a control group to measure the effects of distancing, by letting the protestor crowd set up a colony without confinement, though allotting fewer med resources if things start going down fast.

 

[Bystander]

If they haven't already.

+10

 

[Vanadium 50]

To prevent new cases entering, it might like to require all visitors to the county to be isolated upon entry. Would that be possible?

Probably not. The US is big. It looks like if you took ever single person and had them stand sentry around the perimeter, people would be ~100 feet apart, assuming 4 shifts. The population density is 1/500 that of Singapore - imagine Singapore with 10,000 people.

But does it make any sense to lock down a county in the middle of nowhere? Their neighbors also have a very low rate of infection. Within the county, people aren't shoulder-to-shoulder on the subway. There is no subway. Maybe not even buses. So the transmission rate will be far lower as well. Is this the place to be expending resources on?

 

[Ygggdrasil]

As the data shows us, population density is an important factor. Barnwell County, SC has 40 people per square mile. Manhattan has a daytime population density of 120,000. Does it make sense that the same level of precautions be applied? Think Northern Territory far away from Darwin or Alice Springs (I don't even know what the next largest city in the Northern Territory is. Katherine maybe?)

You suggest that regions with lower population density face lesser risks to the disease and therefore lesser social distancing measures are required in these rural regions versus the urban regions which have shown large outbreaks of the disease. Is there data to support these claims?

First, here's an interesting study analyzing recent influenza outbreaks in Australia. They observe that influenza spread throughout the country in two waves, a first wave that spread throughout major cities (where international airports likely seeded infections) and later waves in less populous outlying areas:

Therefore, observing major COVID-19 outbreaks primarily in urban areas is consistent with these data. Later in the outbreak (in the absence of social distancing measures) we would expect COVID-19 outbreaks to spread to more rural regions in the US. Observing early outbreaks only in regions with high population density does not mean regions with low population density will be spared.

What about the spread of the disease in low population density/rural areas? If R for the disease is lower in these areas, then perhaps less restrictive policies are required for these areas to keep R < 1. There are plenty of reasons to think why this could be the case as having fewer people/area would seem to make it harder to spread the disease. However, remember that the disease spreads primarily from close contact between people. Do people in rural areas have fewer close contacts than people in urban areas? Are bars, restaurants, schools and churches less crowded in rural areas than in urban areas? For many of these settings, it seems like the number of social gathering places changes greatly, but not necessarily the number of people/establishment.

What does the data say? Here's a study comparing the transmissibility of influenza in urban vs rural settings in regions of Canada, a country that, like Australia, would also seem to serve as a good model for the geographic vastness of the US. Interestingly, they found that the disease spread faster (had a larger R) in rural regions vs urban regions:

Using published values of the exposed and infectious periods specific to H1N1 infection, corresponding to the average generation time of 2.78 days, we estimated a mean value of 2.26 for R0 (95% CI 1.57 to 3.75) in a community located in northern Manitoba. Estimates of R0 for other communities in Nunavut varied considerably with higher mean values of 3.91 (95% CI 3.08 to 4.87); 2.03 (95% CI 1.50 to 3.19); and 2.45 (95% CI 1.68 to 3.44). We estimated a lower mean value of 1.57 (95% CI 1.35 to 1.87) for R0 in the Winnipeg health region, as the largest urban centre in Manitoba. [...] Influenza pH1N1 appears to have been far more transmissible in rural and isolated Canadian communities than other large urban areas.

While limited, these data suggest that rural communities won't necessarily have lower rates of disease transmission than urban communities.

What about the US? I could not find studies comparing urban vs rural transmissibility of influenza in the US (though I did not do an exhaustive search), but I did find this article from the Washington Post which provides data suggesting that rural communities in the US are more vulnerable to disease outbreaks than urban communities. As others have noted, rural communities often have older populations than urban communities, which means they a higher fraction of people vulnerable to more serious outcomes from COVID-19. However, independent of these demographic differences, rural communities appear more vulnerable; for example, many rural regions show higher flu mortaility among those over 50 years of age versus urban regions:

These data therefore suggest that rural communities face greater risks from the disease than urban cities.

In summary, these data suggest that, in the US, the next stage of the pandemic could be the spread of the disease from urban centers to rural communities, where the disease could spread quickly, overwhelm sparse healthcare resources, and cause greater per capita mortaility than outbreaks in urban regions.

 

[Vanadium 50]

You suggest that regions with lower population density face lesser risks to the disease and therefore lesser social distancing measures are required in these rural regions versus the urban regions which have shown large outbreaks of the disease.

The suggestion is not to avoid social distancing, but that the degree of lockdown should depend on the risk and benefit.

In message 2271 I say:

Illinois has statistics based on ZIP code of residence. I aggregated by county (I am too cheap to buy the demographics by ZIP code) and in some cases city. Roughly, each order of magnitude in population is a factor of 1500 cases per million. It appears to be somewhat non-linear with a trend above the curve for the largest cities.

One very interesting feature is that nearby population density matters. Aurora, Naperville and Rockford are comparably sized. Aurora and Naperville are close enough for people to commute to Chicago, and they have a case rate per million about 950. Rockford really is not, and it's at 350.

I would argue that the relevant number is not directly population density, but the number of people one interacts with. In metropolitan NY, one might take the commuter train in, then the subway and finally a bus, and potential infect (or be infected by) hundreds of people before even getting into work. This seems to me to warrant more attention than buying a pack of vegetable seeds in Copper Harbor, Michigan.

 

[Ygggdrasil]

The suggestion is not to avoid social distancing, but that the degree of lockdown should depend on the risk and benefit.

I know you are not suggesting to avoid social distancing. That's why the section of my text that you quoted says "lesser social distancing measures" and not "no social distancing measures."

However, you keep claiming lower risk in rural communities and benefit from early lessening of social distancing measures. Do you have data suggesting lower risk in rural areas? I just posted evidence suggesting greater risk to rural communities. Similarly, do you have evidence of substantial economic benefits? In our discussion of Sweden, I cited projections suggesting that Sweden's more relaxed social distancing policies did not seem to suggest economic benefits over other neighboring countries with more strict social distancing policies. Others in the thread have also pointed to studies of the 1918 influenza pandemic which suggests that stronger pandemic responses promoted slightly greater economic recovery (discussed in my post on a different thread here). There are of course, many reasons to think that relaxing social distancing would produce many short term benefits to the economy, but if we are to balance risk and benefit, we need good projections of the magnitude of the long-term benefits.

I would argue that the relevant number is not directly population density, but the number of people one interacts with. In metropolitan NY, one might take the commuter train in, then the subway and finally a bus, and potential infect (or be infected by) hundreds of people before even getting into work. This seems to me to warrant more attention than buying a pack of vegetable seeds in Copper Harbor, Michigan.

Yes, I also pointed to the number of close contacts as being more relevant than population density in my post and argued that the number of close contacts may not differ so much between rural and urban communities (e.g. school sizes and class sizes are probably similar between urban and rural communities, which would drive similar transmissible in schools).

I do agree with the public transportation point, however, which may explain why the oubreaks have been more severe in metro areas with good public transportation (e.g. New York & Boston) vs those where people mainly commute by car (e.g. Los Angeles, San Francisco and Seattle).

 

[gmax137]

Why can't the US use the armed forces (like us) to implement the lockdown.

Google this:
Posse Comitatus Act
In the US the individual states are responsible for maintenance of peace, conduct of orderly elections, and prosecution of unlawful actions. The US Army is generally prohibited from police action. This notion has a number of consequences, most of which (IMO) are to the good.