Arizona and Texas are "spiking" as of today. We're surrounded. --- Frank C. Wimberly 140 Calle Ojo Feliz, Santa Fe, NM 87505
505 670-9918 Santa Fe, NM On Thu, Jun 11, 2020, 1:45 PM Prof David West <[email protected]> wrote: > 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 > > > - .... . -..-. . -. -.. -..-. .. ... -..-. .... . .-. . > 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/ >
- .... . -..-. . -. -.. -..-. .. ... -..-. .... . .-. . 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/
