"spiking" according to ... ? Governor? Health department? Official or semi-official (or media) analyst? And how isolated is the spike?
davew On Thu, Jun 11, 2020, at 1:56 PM, Frank Wimberly wrote: > 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/ > > > *Attachments:* > * image001.jpg > * image001.jpg
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