I was going to make a separate post this morning claiming that my June 15th prediction had been realized. The 'straw' was 19 Governor's of states with rising rates, stated that restrictions would continue to be lifted on schedule and the rise in rates could be handled. All said there would be no return to lock down.Utah is the only state that delayed, by two weeks and for the Salt Lake City area, complete lifting of restrictions. The word "spike" is seldom seen in headlines — replaced with "rise."
Poker rooms are opening, even in CA, with 5-6 person tables instead of 9-10 Travel is not mentioned in the missive Nick included because people are simply traveling. The highways in southern Utah and the parks is typical summer volume already. RV parks are full. Campgrounds are full. Greyhound and FlixBus are reopening. Carnival operators in Holland blocked a major highway today demanding, and evidently getting, permission to open for the summer traveling season. (talk about a vector!) davew On Thu, Jun 11, 2020, at 11:35 AM, [email protected] wrote: > I wonder what The Congregation, including the Diaspora, thought about this. > Nothing very dramatic, here, but that’s just the point. Nothing on travel. > > From Dr. James Stein, Professor of Cardiovascular Research at the University > of Wisconsin School of Medicine and Public Health… > COVID-19 update as we start to leave our cocoons. The purpose of this post > is to provide a perspective on the intense but expected anxiety so many > people are experiencing as they prepare to leave the shelter of their homes. > My opinions are not those of my employers and are not meant to invalidate > anyone else’s – they simply are my perspective on managing risk. > In March, we did not know much about COVID-19 other than the incredibly > scary news reports from overrun hospitals in China, Italy, and other parts of > Europe. The media was filled with scary pictures of chest CT scans, personal > stories of people who decompensated quickly with shortness of breath, > overwhelmed health care systems, and deaths. We heard confusing and widely > varying estimates for risk of getting infected and of dying – some estimates > were quite high. > Key point #1: The COVID-19 we are facing now is the same disease it was 2 > months ago. The “shelter at home” orders were the right step from a public > health standpoint to make sure we flattened the curve and didn’t overrun the > health care system which would have led to excess preventable deaths. It also > bought us time to learn about the disease’s dynamics, preventive measures, > and best treatment strategies – and we did. For hospitalized patients, we > have learned to avoid early intubation, to use prone ventilation, and that > remdesivir probably reduces time to recovery. We have learned how to best use > and preserve PPE. We also know that several therapies suggested early on > probably don’t do much and may even cause harm (ie, azithromycin, > chloroquine, hydroxychloroquine, lopinavir/ritonavir). But all of our social > distancing did not change the disease. Take home: We flattened the curve and > with it our economy and psyches, but the disease itself is still here. > Key point #2: COVID-19 is more deadly than seasonal influenza (about 5-10x > so), but not nearly as deadly as Ebola, Rabies, or Marburg Hemorrhagic Fever > where 25-90% of people who get infected die. COVID-19’s case fatality rate is > about 0.8-1.5% overall, but much higher if you are 60-69 years old (3-4%), > 70-79 years old (7-9%), and especially so if you are over 80 years old (CFR > 13-17%). It is much lower if you are under 50 years old (<0.6%). The > infection fatality rate is about half of these numbers. Take home: COVID-19 > is dangerous, but the vast majority of people who get it, survive it. About > 15% of people get very ill and could stay ill for a long time. We are going > to be dealing with it for a long time. > Key point #3: SARS-CoV-2 is very contagious, but not as contagious as > Measles, Mumps, or even certain strains of pandemic Influenza. It is spread > by respiratory droplets and aerosols, not food and incidental contact. Take > home: social distancing, not touching our faces, and good hand hygiene are > the key weapons to stop the spread. Masks could make a difference, too, > especially in public places where people congregate. Incidental contact is > not really an issue, nor is food. > What does this all mean as we return to work and public life? COVID-19 is > not going away anytime soon. It may not go away for a year or two and may not > be eradicated for many years, so we have to learn to live with it and do what > we can to mitigate (reduce) risk. That means being willing to accept *some* > level of risk to live our lives as we desire. I can’t decide that level of > risk for you – only you can make that decision. There are few certainties in > pandemic risk management other than that fact that some people will die, some > people in low risk groups will die, and some people in high risk groups will > survive. It’s about probability. > Here is some guidance – my point of view, not judging yours: > 1. People over 60 years old are at higher risk of severe disease – people > over 70 years old, even more so. They should be willing to tolerate less risk > than people under 50 years old and should be extra careful. Some chronic > diseases like heart disease and COPD increase risk, but it is not clear if > other diseases like obesity, asthma, immune disorders, etc. increase risk > appreciably. It looks like asthma and inflammatory bowel disease might not be > as high risk as we thought, but we are not sure - their risks might be too > small to pick up, or they might be associated with things that put them at > higher risk. > People over 60-70 years old probably should continue to be very vigilant > about limiting exposures if they can. However, not seeing family – especially > children and grandchildren – can take a serious emotional toll, so I > encourage people to be creative and flexible. For example, in-person visits > are not crazy – consider one, especially if you have been isolated and have > no symptoms. They are especially safe in the early days after restrictions > are lifted in places like Madison or parts of major cities where there is > very little community transmission. Families can decide how much mingling > they are comfortable with - if they want to hug and eat together, distance > together with masks, or just stay apart and continue using video-conferencing > and the telephone to stay in contact. If you choose to intermingle, remember > to practice good hand hygiene, don’t share plates/forks/spoons/cups, don’t > share towels, and don’t sleep together. > 2. Social distancing, not touching your face, and washing/sanitizing your > hands are the key prevention interventions. They are vastly more important > than anything else you do. Wearing a fabric mask is a good idea in crowded > public place like a grocery store or public transportation, but you > absolutely must distance, practice good hand hygiene, and don’t touch your > face. Wearing gloves is not helpful (the virus does not get in through the > skin) and may increase your risk because you likely won’t washing or sanitize > your hands when they are on, you will drop things, and touch your face. > 3. Be a good citizen. If you think you might be sick, stay home. If you are > going to cough or sneeze, turn away from people, block it, and sanitize your > hands immediately after. > 4. Use common sense. Dial down the anxiety. If you are out taking a walk and > someone walks past you, that brief (near) contact is so low risk that it > doesn’t make sense to get scared. Smile at them as they approach, turn your > head away as they pass, move on. The smile will be more therapeutic than the > passing is dangerous. Similarly, if someone bumps into you at the grocery > store or reaches past you for a loaf of bread, don’t stress - it is a very > low risk encounter, also - as long as they didn’t cough or sneeze in your > face (one reason we wear cloth masks in public!). > 5. Use common sense, part II. Dial down the obsessiveness. There really is no > reason to go crazy sanitizing items that come into your house from outside, > like groceries and packages. For it to be a risk, the delivery person would > need to be infectious, cough or sneeze some droplets on your package, you > touch the droplet, then touch your face, and then it invades your respiratory > epithelium. There would need to be enough viral load and the virions would > need to survive long enough for you to get infected. It could happen, but > it’s pretty unlikely. If you want to have a staging station for 1-2 days > before you put things away, sure, no problem. You also can simply wipe things > off before they come in to your house - that is fine is fine too. For an > isolated family, it makes no sense to obsessively wipe down every surface > every day (or several times a day). Door knobs, toilet handles, commonly > trafficked light switches could get a wipe off each day, but it takes a lot > of time and emotional energy to do all those things and they have marginal > benefits. We don’t need to create a sterile operating room-like living space. > Compared to keeping your hands out of your mouth, good hand hygiene, and > cleaning food before serving it, these behaviors might be more maladaptive > than protective. > 6. There are few absolutes, so please get comfortable accepting some > calculated risks, otherwise you might be isolating yourself for a really, > really long time. Figure out how you can be in public and interact with > people without fear. > > > Steven W. Tabak, M.D., F.A.C.C. | Medical Director, Quality and Physician > Outreach > ____________________________________________________________________________________________________________________________________________________________________________ > > > Nicholas Thompson > Emeritus Professor of Ethology and Psychology > Clark University > [email protected] > https://wordpress.clarku.edu/nthompson/ > > > > - .... . -..-. . -. -.. -..-. .. ... -..-. .... . .-. . > FRIAM Applied Complexity Group listserv > Zoom Fridays 9:30a-12p Mtn GMT-6 bit.ly/virtualfriam > un/subscribe http://redfish.com/mailman/listinfo/friam_redfish.com > archives: http://friam.471366.n2.nabble.com/ > FRIAM-COMIC http://friam-comic.blogspot.com/ > > > *Attachments:* > * image001.jpg
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