Martin has been kind enough to put together a Guest Post on Data Modeling in the Epidemic. Part 2 will be posted on Thursday afternoon.
Martin is standing by in case we have questions.
Take it away, Martin!
Questions on Data Modeling in the Epidemic: Part 1
So, like Cheryl (such good company I find myself in!) I thought I’d provide some information on data modeling this grand experiment we find ourselves all in. I do have a statistics background and do a fair bit of data modeling of population behavior. I’m not an epidemiologist, but good data modeling always requires some degree of understanding the context the model operates in so that means spending some time becoming a ratchet epidemiologist – knowing just enough to understand how to make the model work.
Epidemiologists arm us with a bit of information regarding the behavior of this particular virus. We have the R0 (r naught) or the reproduction number that says that each person who is infected will infect R0 other people. That is determined by the infectious period (how long you can give it to someone else), the mode of transmission (air, water, touch, etc.), and the contact rate (how many people you are likely to interact with). We also know how long before symptoms appear, how long before fatality is likely, how long to recovery. These are statistical values and vary from person to person. Early in an epidemic you have fairly small sample sizes so it often just looks like chaos, but later when sample sizes are much larger those statistical values start to really show up.
Why is this such a big thing?
Well, there’s a few things going for it. An incomplete list:
1) Nobody has natural immunity, so for the contact rate above, every person an infected person comes in contact with is a potential new infection. One reason why the flu doesn’t do this is that depending on the strain of flu, there’s people walking around immune, so it doesn’t spread through them. That’s what herd immunity does – if enough people are immune, an infected person can’t find enough others to pass it along to for it to explode through the population. (This is a good place to ask Cheryl about how nuclear reactions and nuclear moderators work – basically the same process)
2) Nobody has artificial immunity. No vaccine. Again for the flu, that flu shot not just protects you personally, but helps add to the herd immunity.
3) Good modes of transmission – inhalation, contact, and fecal transmission. Hong Kong had some apartment blocks spread it through the sewer system, even when people were locked down. This is a combo that is notoriously hard to protect against.
4) Durability – it can hang in the air for hours and on surfaces for days, boosting that contact rate. It can live long enough that if the stocker at the grocery store spread it to the jug of milk overnight, it can still be there when you put it in your refrigerator.
5) It looks like other diseases – early symptoms are flu-like, so rather than rush off to the doctor, we tend to keep acting like it’s the flu, treating it like the flu, and protecting ourselves like it’s the flu. But it’s not the flu, so those things don’t work sufficiently. Ebola struggles to spread because it’s in the ‘holy fuck this guy is dying’ category, not the ‘take some Advil and go to work’ category.
6) It doesn’t affect everyone the same way. This is more important than it might seem. The 1918 flu killed young people more than old people. That allowed old people to unknowingly spread it much further than if they had fallen ill at the same rates. Covid is the opposite. Where that really matters is with testing. If you only test people who are really sick, you leave a whole bunch of people only slightly sick to run around and spread it. And it’s hard to get people to stay home sick if they don’t feel sick.
R0 is important because it tells us roughtly just how fucked we are. An R0 value of 1 means that everyone who gets it will give it to one other person. That leaves you with a fairly constant population of sick people which is very easy to deal with. An R0 value that is less than one will eventually die out on its own, or at least shrink to the size that it’s no more than a nuisance. An R0 greater than 1 means that the population of people who get infected will grow expoentially until you see things like herd immunity show up and start to knock that rate down by shrinking R0 by slowing the contact rate. An R0 value well above 1 means we’re going to go through some shit. The estimates out of China was that Covid had an R0 of around 2.7.
But R0 is not a property just of the virus but also of the population and their behavior. We calculate it for the population at large but every context will be different. A highly dense city like NYC will almost certainly have a higher R0 than a less dense city like Des Moines. When I lived in NYC we lived in a 5 story walk-up. There was no elevator, so you had to climb the stairs to our 4th story apt. There were about 100 people living in that building, all using the same front door handle, all touching the same mailboxes, all running their hands along the same handrails. That’s a lot of contact. I now live in a detached single family house. Only 4 people ever touch the front door or the railings. Much lower contract rate. When my wife comes home with a week to two weeks worth of groceries everyone heads out to unload the car and bring them in. But when you live in a 5 story walk up, you don’t do multiple trips to haul in 2 weeks of groceries, instead you maximize each trip. You know you’re going to climb those stairs at the end of every work day so you bring a single load of groceries with you every time – about a days worth. That means you’re going to the store roughly every day, interacting with others, etc. Again, that’s a lot of contact. In a university, a 500 seat lecture hall has roughly 10x more contact than a 30 seat K-12 classroom. That’s why universities moved to online instruction so early. Our R0 value was going to be massively higher than your kids 2nd grade classroom. Nurses have more contact than accountants, etc.
Why are some places blowing up worse than others?
Well, for NYC, the population density and community behavior of more regular store trips, more frequent eating out, and so on means that their R0 value could be much higher than 2.7, while a lot of California which saw the virus earlier than NYC has a value that might be somewhat lower than 2.7. Italy is denser than the US on average, so they’re having a bit harder time with it. Canada is lower than the US, so they’re having a bit easier time.
Containment
A containment strategy basically means to identify and isolate the infected so that their R0 reaches 0. For ebola that might mean a perimeter around the village so nobody goes in or out until nobody is infectious. You’re going to knock down the contact rate to 0 until the infection period is over, and it can’t be spread. For measles, it means isolating the person’s home the same way. But it relies on being able to identify who is infected, and then tracing where they’ve been, who they’ve been in contact with and prophylactically isolating those people before they become infectious and only releasing them after testing.
This strategy failed in the US because we couldn’t test and isolate as fast as the infection spread. It succeeded in South Korea because they could. It failed in Wuhan for a few reasons – a little bit of denial at first, but that was only a few days, but then a lack of a test.
The goal of containment is R0 = 0.
Mitigation
When containment fails, you mitigate. You’re giving up on R0 = 0. You can’t do it. But you can do R0 < 1, so you’re trying to get the number of cases to shrink to a small enough value that you can either maintain that state until something like a vaccine shows up, or you get the problem to be small enough that you can try to make containment work again.
That’s what China did. They mitigated, shrank the problem, and outside of Wuhan appears to have achieved containment. Jury is still out on whether they can get there for Wuhan as well.
That’s what the US is doing – reduce the contact rate. What is needed? Well, probably more for NYC than for Des Moines. Social distancing and hand washing might work in Montana but not Des Moines. A lockdown sufficient for Des Moines might not be sufficient for NYC. And if people don’t follow the rules, you might need to do more.
The goal of mitigation is R0 < 1
So, how do we know if containment is working and for how long do we need to do this?
That’s where the modeling helps us in Part 2.
~Martin
Fair Economist
What kind of models are you using? Just equations or sim individuals?
Martin
@Fair Economist: I’m just modeling off of the data reported in the Johns Hopkins dataset. I’m not trying to do a simulation – too complicated, and I don’t remotely have the data.
A lot of the time a very simple model is sufficient to tell you where you are headed for decision making purposes. You know the model will break, so you estimate the point where it’s time to throw it away and build a new one.
My assumption here is that our actions will break the model before the model would naturally break down. The question is when, and can we see the model break at that time.
No One of Consequence
This was great Martin, thank you.
But reading this, leaving me hanging for Part II is a little denouement.
So, a great many thanks, and a great many pleases for the quick arrival of Part II.
Peace, and wash your hands,
– NOoC
Goku (aka Amerikan Baka)
I know you’ve said you’re not an epidemiologist, Martin, but I’d like your take on this:
So let’s say you have a virus that makes a zoonotic leap to humans. Further, it is as contagious as measles and as lethal as ebola with an incubation period similar to the novel coronavirus as well as being airborne and as durable as the SARS-COV-2 virus.
Let’s say that a 20-something stumbles into a hospital, exhibiting the above symptoms and dies days later even with extensive ICU interventions. Would the CDC be called in immediately? What are the steps in the public health chain? How long would it take to recognize what is being dealt with? And would it be kept under wraps as long as possible? Would you hear about it on the evening news
Also thanks for this explainer!
When do your models suggest the peak will be and where we will be in terms of hospitalizations and fatalities?NVM, that’s in Part II
Martin
i didn’t want it to be an hour long read.
Mr. Mack
Appreciate the time and effort to do this.
No One of Consequence
@Martin: Most of us have time right about now. ;)
I kid, but not entirely. I appreciate the knowledge that so many different jackals bring to the table here. You among them, of course.
Thanks again,
– NOoC
Mr. Mack
Also, while you may not know the answer, I have a question: Are we closer to a blood test that can quickly determine who has had it and is now immune? I would think that test is a priority if we want to keep asking some people to go to work.
Martin
@Goku (aka Amerikan Baka): The CDC probably would be. In China, the time from the first doctor suspecting they had a new disease to their CDC equivalent being notified was 1 day. Tracing started 2 days later. The WHO was notified 1 day after that. They moved pretty fast.
A number of years ago we had a bit of a West Nile outbreak here. My aunt was case #2 in the county. I bought her into the ER at around 4PM and there was a CDC worker interviewing me and her at 10AM the next day to do tracing.
The hospital notified the county public health agency within an hour of the diagnosis, and that got to the state and feds within hours. Not sure if the county notified the feds, or the state did.
They moved fast in part because they knew what it was. Not sure if an unknown would cause them to move that fast though. How would we know that 20-something was contagious? Or that it was the result of a virus (that we may not know how to test for), etc. But my experience was that once they thought they had an infectious agent on their hands, they moved fast.
I know this because my aunt was a nurse at the hospital I took her to so we got to ask a lot of questions and get answers. She was hospitalized for 2 months, so there was plenty of time to ask questions.
WereBear
Any thoughts on people transmission vs objects? I understand in Wuhan everyone stayed in and the military brought everyone food. This seemed to have stopped the spread: so how much should we worry about the groceries we bring home or getting takeout?
I go out every 3-4 days and get groceries alone, wearing a mask, and full shower after. My clothes go in the hamper, my coat hanging where Mr WereBear can’t get at it. He doesn’t use that bathroom. I’m hoping that’s enough to keep him safe. He is locked up for the duration :)
raven
dmsilev
Thank you.
A point which should be emphasized is that an R0 > 1 means exponential growth, and that means that the longer you wait before implementing countermeasures, the harder it becomes. By a lot. So, we lost a huge amount of valuable time because Trump dithered around all through January and February. Florida is going to lose a lot more time because the wingnut governor there is still refusing to implement shelter-in-place. Etc.
trollhattan
Thanks Martin, heavy lifting and yet, understandable. Like from an ed-you-ka-tor or something. :-)
Encouraging local development is drive-through testing. It’s not a free-for-all in that there…wait for it…an algorithm and phone app to determine who’s eligible but the model can be expanded as test facilities expand. IIUC Germany has a crapton and a transmission rate a tenth of Italy’s. (Acknowledging more testing affects the data directly.)
Sunny today and the dog needs walking (whether he knows it or not).
nwerner
I’ve been downloading the Johns Hopkins data as well and used it to forecast a 30 day trend. Almost every optimistic model shows that deaths will be peaking on or within a day or two of April 12/Easter. Is that what you are seeing?
WereBear
Every day that passes I worry more about that state. It’s going to wind up like one of those 1970’s era drive in horror movies.
Cheryl Rofer
Thanks, Martin.
You’ve said a few things that I’ve thought I should add in, so now I don’t have to do that.
You and I are coming at this from different, but complementary, viewpoints. I like the more detailed models, so I think about all the things you load into R0 as separate lines in the model. But the net is the same, and your way gives a single parameter to think about. And yes, it’s very much like the modeling of nuclear fission reactions or chemical reactions. Chemical reactions in particular were modeled the way you are doing it back when I was in college. We’ve gained methods to look at them in more detail since then, but still there are times when it’s useful to go back.
@Goku (aka Amerikan Baka): I’ve been thinking about writing a post about that, but now I think I’ll wait until I see what Martin gives us tomorrow.
NotMax
Uneven or inconsistent implementation of mitigation procedures among states a concern.
Not to single one state out, merely an example that goods (groceries and others) packaged in Iowa might be shipped all across the country.
Martin
@Mr. Mack: Yes. They are already rolling out those tests now. CDC/FDA approved one last week that’s hitting hospitals this week. More are coming.
So, our goal is to get this lockdown strategy to do its thing. Basically, get the epidemic to calm the fuck down, to buy us some time to do all of this other stuff – blood tests, treatments so that people don’t die if they catch it, and then strategies to keep it from spreading while allowing people to leave their house and life semi-normal lives, because we can’t do this for a year.
What we need to look for next, after lockdowns, are how do we manage this. How do we send kids back to school, identify the ones that are sick daily, isolate them. China is taking the temperature of everyone who goes to the grocery store, goes into a school, gets on a train or plane, etc. It’s not as accurate as the swab, but you can effectively test the entire country daily. If you have a fever, you’re quarantined until a proper test result comes back. Knock it down as fast as you can, everywhere, constantly.
That’s going to be hard in the US. They need to get working on it.
WereBear
@Martin: I got us a thermometer and we take our temps every morning. Have a baseline.
Another Scott
@raven: I’d be careful about taking those studies as gospel. (Not that you are!)
E.g. the SARS-CoV-2 is apparently more complex and fragile than other coronaviruses. And even the experts get it wrong sometimes:
https://twitter.com/aetiology is a good resource.
(Thanks Martin!)
Cheers,
Scott.
Martin
@nwerner: Depends on when lockdowns went in place. CA should peak around then. NYC a bit later. States that went into lockdown today, around the 15th.
Mind you, that doesn’t mean you can stop doing this. It’s going to take time for the number of infected to go down to manageable numbers – weeks. My question is then what? Mitigation doesn’t get us to 0. As soon as you open up, you’ll just blow back up again. So then what?
Hong Kong is going into a 3rd wave of this after trying to open up. They knocked it down, put some measures in place to keep the numbers low, opened up, and it didn’t work as well as they expected.
It’s going to be hard. I don’t think they’re going to be able to open up really large events like sports for quite a while because it’s just too hard to protect people. But smaller events like K-12 classes could. You have authority, it’s a controlled environment, etc.
Another Scott
@Another Scott: (sigh) Too many links I guess.
Help?
Thanks.
Cheers,
Scott.
Jinchi
That’s an interesting point. Has anyone made a prediction on what this means for Liberty University returning to business as usual. It seems like they’re creating an incubator filled with potentially asymptomatic people ready to unintentionally spread it throughout the community.
West of the Rockies
This was a very informative (and greatly appreciated) post. Thank you, Martin (and Watergirl for facilitating).
As has already been said on BJ, there will be some fascinating dissertations to come from this event.
HRA
Thank you, Martin.
The question I have is how does this disease compare to the Asian flu medically. I knew there was a scare in the public although nothing changed in people’s daily lives if they did not get it.
dmsilev
@Jinchi: Liberty, as I understand it, is doing their instruction (or indoctrination if you prefer) online but has brought their students back to the dorms. Absolutely absurd and totally indefensible, but at least they won’t be crowding students into the lecture halls. Not yet, anyway.
Cheryl Rofer
@Another Scott: I’ll re-up my post on reading scientific papers on the epidemic. I am not sharing anything that comes from one single scientific paper on Twitter. I mentally file them away for further reference. There will be conflicting results from various places. There will be errors made in good faith or otherwise. And there will be misreadings because of lack of context – one of those cycled through the past couple of days.
We’re seeing science as it is being made, and all those things are part of the process. Better to wait a while.
Kent
Just the dining halls. Dorm rooms don’t have kitchens.
Lacuna Synecdoche
Martin @ Top:
Plus Canada has, you know … competent leadership. And a functioning, rather than dysfunctional, health system. And a functional, rather than dysfunctional, president. And … so on.
Martin
@Cheryl Rofer: Degree in physics here as well, so I’ve done my fair share of quantum mechanics and kinetic reactions math. Lots of similarities. The nice thing about infections is that unlike chemical reactions they normally spread slowly enough that you can ignore a bunch of stuff early on – like how the infection rate slows down when you run out of people to infect. I mean, when you’re running up against that the specifics don’t really matter much, you’re pretty fucked.
dmsilev
@Kent: That’s true. If they were organized and they cared, they could have students eat in shifts or similar to enable some degree of distancing. Big ‘if’ though.
We have some students still on campus, mostly internationals who can’t go back home. A lot of effort went into spreading them out, basically do the best we can to minimize the risk to both the students and the skeleton staff needed to keep the lights on and the students fed.
Martin
@Jinchi: That is exactly what they’re doing.
But let’s not pretend that hasn’t been their business model all along. They were just spreading an ideology before.
trollhattan
@dmsilev:
The Only folks I feel sorry for in the Liberty U mess are the support staff and suppliers, who are forced to interact with this pack of morons. If they wish to hold a corona party, please proceed, governor.
cain
Hi Martin
Some of the open source projects are trying to build models but it’s been hard to find public data from the states. Any suggestions on how one can get these data?
This is the best we could fine – https://public.tableau.com/profile/cnbc5283#!/vizhome/CoronavirusMap/US
This app shows the historical spread of the Corona Virus – https://app.developer.here.com/coronavirus/
As you can see, getting state data has been very sparse. I suspect that some of that is due to the lack of testing kits and facilities to record them. Our govt has not been very forthright with numbers to begin with. Looking forward to any comments from you.
mad citizen
@Mr. Mack: Heard the doctor on ABC news say last night that Duke and some other place were working on an antibody test and it could be available as soon as two weeks. Better information here, though (it’s reuters via nytimes): https://www.nytimes.com/reuters/2020/03/25/business/25reuters-health-coronavirus-immune-test-insight.html
Sure Lurkalot
@WereBear: I have the same question. Every time we go out or bring something in is another vector of anxiety, along with the what did I touch, what didn’t I clean, etc. and now that more people are sick….
Kent
Boxed meals for pick-up would be the way to go. Swing by the dining hall or other location, pick up your boxed meal, and head back. Any dining hall could do that kind of thing if they wanted. Kids might gripe. But the would still be fed.
Martin
@dmsilev: True, but in additional to lecture halls, you have common dining areas, you have shared bathrooms in the dorms, lots of shared spaces for it to spread.
We were assuming all of our in-state students would go home, leaving the dorms mostly empty other than our international students who couldn’t get home.
Plans were drawn up to deliver food to the residence halls and closing the commons, stuff like that. Universities are designed to encourage student interaction and freedom of movement. That’s sort of the point. That’s why they are liberal – you can’t hide from the gay students or the black students. Turns out they’re pretty damn normal if you just eat lunch with them now and then. But it also means that they’re damn near impossible to control in a situation like this.
But we also actively think about these problems at a level of detail that most organizations don’t.
Jinchi
Do the students have to be in the dorms or are they keeping the dorms open for those with nowhere else to go? (I think I already know the answer)
WereBear
@Sure Lurkalot: That’s why I appreciate the science based articles and this good explanation (thanks Martin!)
But we know social distancing works. I’m leaving the deliveries for people who really need them, but I see a lot more social distancing now.
I also make a habit of getting out to the store as soon as they open. Seems to be fewer crowds. And more choice.
Martin
@cain: I’ve been using this one: https://github.com/CSSEGISandData/COVID-19/tree/master/csse_covid_19_data
They’ve been changing the format as they adapt, so it might require some manual piecing together. I haven’t bothered to turn my ETL tools on it.
Goku (aka Amerikan Baka)
@Martin:
Well, Patient Zero would be exhibiting flu-like symptoms (high fever, coughing, severe dyspnea, etc), which would be indicative of infection in most cases. Cultures (sputum, blood, etc) would be taken for sure. I’m sure once all of the standard tests came back negative and other causes were ruled out, the hospital microbiologists and the lab would probably scour samples. I imagine the patient would immediately also be put under isolation precautions (airborne, droplet, contact) as soon as they were stabilized (as much as possible). The trouble though, is that any medical personnel that came into contact with that patient would then need to be quarantined. If they don’t know what they’re dealing with at first, then that wouldn’t happen, and if it’s as contagious as measles…yikes. I would expect spikes of hospitalizations and deaths within 2-3 weeks based on the incubation period
Thanks for the info by the way. I’ve read about West Nile virus and I’m sure it wasn’t fun for your aunt.
Immanentize
This is great Martin, thank you!
I am just driving by as a break from my brief writing, but I wanted to share a nifty bit of info. on herd immunity — It seems that in the 1918 flu pandemic, the hardest hit demographics were the young and otherwise presumed healthy. So workers, mothers,, fathers, kids were the most likely to get very sick and die. Older folks over 65 were much less likely to succumb. So, the theory goes that another similar influenza must have taken off across the world back about 1855 or so leaving the olds with some immunity to the 1918 strain. Hope for our yutes!
WaterGirl
@WereBear: I have seen recommendations (no link) that say we should be going out for groceries much less often than that.
Martin
@mad citizen: Yeah, the US biotech industry and research institutions are on this. I worry a bit about distribution. The US relies VERY heavily on market forces to sort of magically do that, with seemingly no acknowledgement from the free marketeers that when markets break down that government needs to fill that gap.
Another Scott
@Sure Lurkalot: My impression – just an impression – from the WHO (and CDC) recommendations is that infection via surfaces is a very low probability event. Most infection is via close contact with an infected person (or their fluids). The most important thing to do is wash your hands, especially before touching your face. We have to assume that there will be virus on surfaces, but it will die out relatively quickly. Washing your hands so that it doesn’t get in your body is most important.
Of course, social distance from people who are coughing and sneezing is a must as well!!
Repost – BlueVirginia.us (from a nurse):
:-(
Wash your hands!!
Cheers,
Scott.
Martin
@Goku (aka Amerikan Baka): Yeah, in that case I’m sure the county would get a call that they have a case they can’t diagnose.
Martin
@Immanentize: My understanding was that young people suffered because the flu triggered a cytokine storm. Basically, a strong immune system kind of overreacts and effectively poisons the patient. People with weaker immune systems can’t overreact as badly.
But regardless, if everyone suffers equally you usually get a more even public health response than if some parts of the population suffer more than others.
Sister Golden Bear
@WaterGirl: Agreed. But the challenge is that for products that frequently run out of stock — like paper products* — I’ve ended up having to go more frequently, often to different stores, hoping they’ll have them in stock. Yesterday was the first time I’d seen tissue and TP in a week, the market was limited sales to one box and one roll per customer.
Likewise, I finally saw eggs and milk again yesterday, and they were also limited to one carton per customer.
So it’s a bit of dilemma, especially since I live by myself, don’t have a lot of friends nearby who could help out, and the grocery delivery services are still maxed out. If I get sick and need to fully quarantine, I need to have a good amount of food on-hand, so I’m trying to keep things topped off.
*I’d bought of few extra tissues and regular sized package of TP, but deliberately didn’t buy hoarding-sized quantities of either. I’m not out of either yet, but both are running lower than I’d like.
cain
@Martin:
I suspect I have that kind of immune system.. I think it attacked my thyroid which is why it has not been working as well. So speculates my doctor. But I don’t get sick very often and especially not the flu where it has been about over a decade since I’ve gotten the flu.
chopper
@Goku (aka Amerikan Baka):
most definitely, with the sort of symptoms a hemorrhagic fever kills a person with. if it was something more generic like ARDS then it may take a few cases in a cluster to cause the CDC to get involved, tho a healthy 20-something dying would raise eyebrows.
Kattails
Martin, thanks for this. I’ll keep those numbers in mind as to how long the virus is likely to be on surfaces. I’ve been good in many ways but apparently lax in cleaning things that are coming into the house. Eek. Looking forward to the next post.
@WaterGirl: @WereBear: One thing I’ve thought to do is change my routine from running a bunch of errands at a time to only doing one place. My idea, which may be bogus, is to map out my shopping list more than usual, hit one store as efficiently as possible, and go home. This would prevent me from picking it up one place and carrying it into another. Probably minor, but again this is a numbers game. And go out absolutely minimally, every 8-10 days or longer.
stinger
Martin, this is fantastic! Thank you!
joel hanes
for NYC, the population density and community behavior
IMHO, mass transit, including cabs and Uber/Lyft, plays a significant role in NYC’s problem.
Sprawling LA, in which most people go everywhere alone in a car that is only ever occupied by themselves, is seeing a far lower rate of infection.
We need mass transit for environmental reasons, but when this is all over, we should rethink some things about it in light of what we learn about pandemic spread. In particular because climate change and the resulting migration of human populations and displacement of wild animal populations will make emergence of another pandemic disease more probable.
Sab
I have a spray bottle of alcohol that I use before and after every transaction ( bank window, grocery store, pharmacy.) How effective is that?
joel hanes
@Goku (aka Amerikan Baka):
You’re looking for this book:
https://smile.amazon.com/Hot-Zone-Terrifying-Story-Origins-ebook/dp/B007DCU4IQ
or maybe this one
https://smile.amazon.com/Outbreak-Plagues-That-Changed-History-ebook/dp/B004C43FRA/
Michael Cain
@mad citizen: The Guardian is reporting a home test that might be available as early as next week.
VFX Lurker
Question for folks here: is curbside pickup where I stay in my car, pop the trunk and just chat for a minute safe for the grocery worker who reviews my order and fills up my trunk?
I’ve been working from home since last Wednesday, but a co-worker reached out to let me know they’d tested positive for COVID-19. The last time I saw this co-worker was for four hours last Wednesday morning (they were out the previous Friday-Tues for non-COVID-19 reasons). I feel fine, but I do not know if I am an asymptomatic carrier.
I messaged my primary care physician and asked the same question. I’m running low on groceries and scheduled a curbside pickup for Friday morning. I think it should be OK, but I want to make sure.
Brachiator
@joel hanes:
Might be a factor, but no one really knows yet. NYC is much more densely populated than Los Angeles, and also the stats are more for all of California, not any precise breakdown of cities or counties.
San Francisco may be more like NYC.
Also, I don’t see Uber and cabs being more of a problem than subways, trains and buses.
Brachiator
@VFX Lurker:
Who knows. I think you are OK as long as the grocery worker doesn’t spit on you.
Most of what I keep hearing about social distance suggests that proximity and prolonged contact are problems, not brief encounters.
joel hanes
@VFX Lurker:
If you have no manufactured mask, at least wear an improvised one made from a bandana, multiple thicknesses of cloth.
Stay more than six feet from the person you interact with if at all possible. If you have to get closer, be aware of the wind direction, and arrange it so the line between you is at right angles to the wind.
Martin
@Brachiator: Oh, mass transit is well known for increasing contact rate, so it’s safe to assume that it makes this harder to deal with.
I’m very worried about NYC. They had their first fatality 10 days ago and they’re already above 50/day. If that trend continues that suggests most of the city is infected and we’re just waiting for symptoms to appear.
My fear is that NYC might be close enough to a worst case scenario that their ability to prevent going the rest of the way won’t be possible.
Feathers
A group of Harvard Medical School students started a COVID-19 response team and created “a curriculum for the medical community and a public facing social media campaign ( @FutureMDvsCOVID )” They’ve put it together on a Google doc(s). More than I want to delve into right now, but it seems like it will have answers for many people. The students have have given it to experts to review and will update as needed. MEDICAL STUDENT COVID-19 CURRICULUM
VFX Lurker
@Brachiator:
@joel hanes:
Will do. I want to be clear that I’m concerned about harming the grocery worker without realizing it. I will follow your suggestions in case I am not infected, however, because it is good advice.
J R in WV
Thanks Martin, for the well done write-up!
Thanks WaterGirl for enabling this reporting and educational exercise!
I have since retirement done mostly one (sometimes a couple if we run low on something) weekly shopping trip. When I worked I would stop most evenings on the way home for fresh greens and veges, no more! Since this Trump Plague was in the news I’ve been in every couple of weeks, massive shopping, carts full.
Now we’ve accumulated enough food to stay home for weeks, which I intend to do. Greens, frozen green beans, edamame, gnd beef, canned ham and chicken, rice, beans, pasta and sauce, canned chiles and tomatoes, etc. I scored a 6-pack of toilet roll (love that Brit term…) yesterday, one to a customer. That’s a big deal as I am prone to digestive events caused by my IBS. (has anyone mentioned that getting old sucks yet today?)
There was a Kroger’s employee in the entry way, spraying carts and providing a cleaned cart to incoming shoppers, which was new and good to see. And a sign, 7-9 am every day for immune impaired/old shoppers… now if I could get up and be composed at that time of day!
Many shoppers wore masks, more wore gloves. I wish the store could supply masks and gloves to all the employees, but planning, not so much… Thanks
ObamaTrump !!WereBear
@Kattails: good ideas. I pick one store, go there, come back.
Brachiator
@Martin:
Yep, but cabs and Uber present different issues than buses, trains and the subway. You cannot just say “mass transit”
Los Angeles and the Bay Area may be different as well.
I would like to see what is happening with Las Vegas, where there is a lot of use of cabs, Uber and shuttles.
This is sobering. All we can do is watch and see how authorities respond. It is sad and maddening to see the uneven co-operation between federal and state authorities.
ETA: In Los Angeles, there have been complaints that social distancing is not being practiced on Metro trains and buses. But ridership is down dramatically, which in itself might help.
Feathers
@Martin: The interesting counterpoint will be Tokyo. They are larger than NYC, with the same density and have only recently passed 200 cases. I read someone pointing out that the Asian mask wearing may be making a difference. Also, changing into indoor clothes, vending machines instead of bogedas. I’m sure people are looking into this.
Miss Bianca
Thank you for this, Martin. My goodness, between you and Suzanne and other commenters we have had a magnificent run of guest posts! And thanks to WaterGirl for setting these up!
joel hanes
@Brachiator:
I’m thinking elevators may be a significant vector, and to a lesser extent, the shared hallways in apartment buildings.
joel hanes
@VFX Lurker:
Wearing an improvised mask protects other people from your exhalations more than it protects you from theirs.
But safest would be if everyone simply assumed that they are already infected and infectious, and do the things that might prevent transmitting it to other.
Brachiator
@joel hanes:
Life in big cities increases the risk of falling ill due to pandemics. But I think that social distancing could help, even spacing out the number of people who pack into elevators.
They are trying to shut down the entire country of India. It will be interesting to see how a “maximum city” like Mumbai adjusts.
joel hanes
@J R in WV:
Here in Silicon Valley, during my Tuesday AM foray to Safeway (union shop, paid sick leave!) at the 7-8 AM “seniors hour”, I was terribly disappointed to see only about 1 in 5 shoppers wearing any kind of mask.
I don’t have a good mask, but I did my best with a large, really beautiful bandana that my granddaughter gave me for Christmas, and stayed away from others to the extent possible.
Another Scott
In case anyone is wondering, the Senate still hasn’t passed the bill. TheHill:
It’s good that Bernie (and others) are pushing back. It’s not over until it’s over.
Cheers,
Scott.
Miss Bianca
@Another Scott: OK, now that I see what Bernie’s beef is, I no longer have a problem with it. Beef away, Bernie – on this issue, you are on the side of the angels!
J R in WV
I suspect that that until Ms Pelosi and the House Democrats pass a bill, we won’t see decent respect paid to workers, and as little respect paid to Big Business as they deserve, which is next to none.
Boeing got billions in the last rescue legislation, and now, after wasting all that money on failed aircraft design, stock buy-backs and executive bonuses, they want another $50 billion ~!!!!~ Nope, never gonna happen!!!