On Monday, the Cuomo Administration classified most of Monroe (Rochester), Erie (Buffalo) and Onondaga (Syracuse) counties as “yellow zones”, because of our rising infection rates. Monroe, where I live, has gone from the best positive rate for a metro area in the US (well under 1%) to a 7-day average of 3.9% positive. Our yellow designation is part of the New York State “micro cluster” strategy, where instead of shutting down the entire state, we increase restrictions on specific areas that are spiking.
I want to write about it a bit because I think it is a smart strategy, though I’m of course concerned about the rate of spread in my area.
The full strategy is detailed in this PDF. Briefly, the state defines thresholds for percent positive and number of cases for densely populated (NYC, Nassau County, etc), less densely populated (Monroe, Onondaga, Erie, etc.), even less densely populated, and very rural counties. Each tier has three possible cluster colors: red, yellow and orange. Here are the restrictions for each:
In Monroe County, the health department will test 15,000 students per week using the new Abbott BinaxNOW antigen test, which is delivered on a card that shows a reading (similar to a pregnancy test) in 15 minutes, and requires a less-invasive nasal swab versus the nasopharyngeal swab. In other words, a school nurse or other trained personnel can administer and read the tests without special machinery. These tests are also claimed to have a lower false negative rate than earlier rapid tests.
Our spread has not been in schools – the tests are being deployed to protect schools by finding asymptomatic carriers. Spread here has been driven mainly by small gatherings, both at colleges and in homes. A couple of small private colleges in my town, Pittsford, had significant spread due to unmasked and un-distanced gatherings, and one of them had to go to online education. Halloween parties also drove spread. The twenty-something demographic is the biggest one for new cases.
I wanted to share this because it’s what a COVID response looks like in a state that gives a shit. Note that the 15,000 tests are in addition to the pretty extensive testing we already done across the state (we did 128K tests on Monday, for example).
Another point is that Cuomo has already been setting expectations and doing planning for 40 million dosings (2 per person) of the COVID vaccine. It’s a herculean effort — more vaccinations will have to be given than all the tests that New York State has performed to date.
I think that Trump broke the COVID response so badly that no red state will voluntarily do anything like this, and they will be woefully unprepared for the vaccine. The water that’s already under the bridge in terms of excess death and suffering is probably just a fraction of what we’ll see in due to overcrowded hospitals, undertesting, and vaccination fuckups. Biden, of course, will get the blame for it, but at least he might be able to get it done.
germy
Possibly lots of people in red states will refuse the vaccine anyway? Maybe that’ll take some stress off the system.
cintibud
I’m very curious about the recourse Biden will have if red state governors undermine or actively defy federal directives to control the pandemic, for example, a national mask mandate or testing/contract tracing. I remember in the past highway funds were withheld from states who refused to have mandatory seat belt laws. Did that actually require legislation? Is there much Biden can do without actual legislation? Something that a supreme count wouldn’t rule against?
Jeffro
Hopefully, please FSM, let the Biden/Harris team be smart enough to both 1) “pin it” – fully, loudly publicize now, before taking office, just what a disaster the trumpov non-response non-plan for Covid has been, including all infection/hospitalization/death numbers, and 2) give regular Cuomo-ish Covid briefings that highlight which states are doing well and which ones have
horrible fucking Republicanbad leadership/responses to the pandemic.Because otherwise yes, you’re right, Biden will get the blame for the shitty Covid response and shitty economic recovery.
The Moar You Know
San Diego County hit 10% last week (with the bullshit fudge factor they’ve been using, 8.9). The situation here in a couple of weeks will be dire.
Another Scott
@germy: I hope and expect that the fever will break once vaccine(s) are actually being distributed on a large scale. There will be a few people who will attempt to be noisy and drum up outrage so that they can continue the grift, but it will be a small group. Remember that an “army” of tens of thousands was going to turn up at the polls…
We’ll see.
Cheers,
Scott.
FlyingToaster
I suspect Executive Orders and “buy-in”, a la Medicare Expansion, is the politics of the possible. Plus I suspect both the insurance industry and much of corporate America really wants as their workforce protected by vaccine.
Moscow Mitch’s grift would be hampered if he gets in the way of corporate-approved vaccinations. So if there is obstruction, it’s likely to hurt the GOP more than anyone.
The biggest problem right now is that we’re facing a government shutdown next month, right at the peak of the current COVID spike. I’m afraid Trump’s “2 million Dead” bullshit is about to come true.
Woodrow/asim
I’m pretty sure Biden’s already made clear that there’s no legal national mask mandate he can do — or will try. He has said he sees implementing one on the Federal level — civil service + military.
And holding back funds won’t fly with anything but a Congress very different than the one we have today.
His tools will be a rebuilt CDC, as part of a Federal system that can get REAL information and protective gear to Americans. It’s gonna be hard, yes, and we’re going to lose a lot more lives to the propaganda of the current mis-Administration, yet there’s a good chance for a sea change — in the majority of the media’s discussion on this, if nowhere else.
Doug R
Here in BC, we got over 500 cases in one day, over 400 from Fraser Health-which is generally the suburbs of Vancouver up to Hope. So we’re getting more restrictions but especially Fraser Health-travel is extremely limited in the area and no gatherings.
COVID-19: What the new health orders mean for Fraser Health residents, businesses
Yarrow
Finally today I saw something on the news that the CDC is now saying that wearing masks not only protects other people but also offers some protection to the wearer. Not 100% of course, but some, which is better than none.
It’s been so obvious for so long that this is the case and it’s baffled me as to why it wasn’t talked up more. Wearing a mask to help protect other people is a harder sell than wearing a mask to help protect yourself. Wearing a mask helps protect you! That’s a much easier way to get people to do it.
trollhattan
Sacramento County went from California’s red to purple (worst) designation yesterday because new cases are up significantly, not far below the peaks we hit in July.
It was fucking Halloween parties.
No indoor dining and numerous service-type business will have to reclose. I hope folks are rethinking their Thanksgiving plans.
WaterGirl
@Yarrow: I may be wrong, but I’m pretty sure they have been saying that for quite some time.
MazeDancer
Anyone who wants to travel or gather for Thanksgiving ought to be required to sign a waiver giving up all rights to medical care if they get COVID. No hospital admissions. Nothing
Sometimes it feels like people are either complete fools or they want to die.
trollhattan
@Woodrow/asim:
Is there precedent for withholding federal support in how they leveraged states into complying with driving regulations, such as legal age, mandatory seatbelt use, legal BAC levels, etc? e.g., if you do not mandate masks and social distancing, you go to the back of the line for COVID fight funds, PPE, ventilators, behind states who do?
Lord only knows how vaccine distribution will occur. If they prioritize “hot” states they reward bad behavior.
jonas
Yep, I’m in upstate too and while people have generally been pretty good about masking up in supermarkets and stores and stuff, apparently they’re also perfectly happy to then hit a big house party or backyard bbq over the weekend and hug and cough all over everyone. Our county supervisor, a Republican, but not an insane one, is pleading with people to knock this shit off or we’re next to get yellow carded by Cuomo. As he put it, what are you going to do this winter if we have a weather emergency and all the city workers are in quarantine?
Eric S.
Illinois has a similar set up. The state is broken into 11 regions. Based on the positivity rate, hospital utilization, and availability of ventilators each region is put into a tier. Each tier has defined restrictions that look a lot like the chart in the original post.
In the past month or so as more stringent restrictions have been implemented many business, especially restaurants and bars, are openly and loudly giving the rules the middle finger. The City of Chicago has shut down some places but in the suburbs and more rural areas I haven’t heard of any enforcement happening.
dogwood
Love the Cold Play reference. That’s my favorite CP track. Here’s hoping your county doesn’t go beyond “Yellow.”
Yarrow
@WaterGirl: Nope. New guidance as of yesterday. Link. Totally ridiculous that it took this long.
PsiFighter37
@The Moar You Know: Great – San Diego had been exactly where we were planning on going for a few weeks in December…
Goku (Amerikan Baka)
@Yarrow:
This. If it protects others it stands to reason (as well as evidence) that it will work the other way too
PsiFighter37
@trollhattan: Unlikely. I think we are in for a shitstorm until late January, because you have Thanksgiving, then the holidays, then New Year’s…just massive amounts of days where people, going against better judgment, will congregate indoors.
mrmoshpotato
And, according to the Aussies (and most of the world), Donny can go get fucked.
randy khan
I am worried about the red states, but I do think that one thing that will help with vaccination is that insurers will be pushing it everywhere. They have a very strong interest in reducing COVID-19 claims, and already have a history of wanting everyone to get vaccinated for everything.
HinTN
@Yarrow:
The fucking idiots where I live are sure the whole damn thing is FAKE NEWS, plus it won’t get them really sick, anyway.
zhena gogolia
@mrmoshpotato:
That’s very cute.
Enhanced Voting Techniques
@germy: These states voted to die in the election. The people have spoken.
Reminds me a bit of The Onion of the future was talking about how Wyoming voted to nuke itself rather than allow it’s packs of feral children grow up around gay marriage.
Geoboy
In terms of making sure that everyone knows where the blame lies, we need something that’s simple and easy to understand, remember, and repeat. My favorite so far is: “The United States – four percent of the world’s population, twenty percent of the world’s coronavirus deaths.”
Hoppie
@The Moar You Know: Yes, the situation is getting bad, but that is the wrong comparison.
The comparable testing positivity rate to Monroe county’s rate is 2.8 %.
10 is the case rate per 100,000 population rate with a week lag (not a percentage). The adjustment is to account for different levels of testing.
Still pretty bad.
HinTN
@MazeDancer: I’ll take complete fools for 500, Alex.
WaterGirl
@Yarrow: Maybe new from the CDC, but that has been common knowledge for at least 2 months, maybe more.
Appalling that it apparently took the CDC all this time to say that out loud on their website.
Enhanced Voting Techniques
@Jeffro: These people believe the only reason Trump lost was because of super computer that Soros has in his basement changed everyone’s votes from Trump to Biden along with the world being flat and Jesus worked on a Dinosaur Ranch. The survivors of the 2020 COVID/ Snakehead Carp/ Lizard Apocalypse next Spring will look at the disproportionate deaths in the winter and just claim it was some Liberal conspiracy to kill Conservatives.
Lacuna Synechdoche
mistermix @ Top:
Yep.
“We wouldn’t have felt compelled to go maskless everywhere, and ignore social distancing, and throw CoVid parties, to protest Libtards and Demonrats if they hadn’t been so mean to us and if Joe Biden hadn’t been so condescending. Plus, they cheated by going out and getting more people to vote for them! People who illegally voted while non-white!”
Yarrow
@Goku (Amerikan Baka): It has since this whole thing started. Even if masks only helped the wearer 5%, that’s better than zero. It’s been stupid that it has taken this long before some organization finally said, “Oh, yeah. Masks help the wearer too.” Ugh.
mrmoshpotato
@FlyingToaster:
Government shutdown? Just more destruction from the Rethuglican trash before the Soviet shitpile mobster conman gets thrown out on his fat, orange, fascist face?
Chetan Murthy
@Goku (Amerikan Baka):
There were always (IIRC) two reasons that masks protects the non-wearer: (1) the wearer’s breath starts out moist; the mask is able to keep humidity up close to wearer’s mouth/nostrils, and hence condense that moisture, trapping it in the fabric, where the virus particles will be caught. This reduces the amount of contagion spread into the air. (2) the mask is a baffle against the outbound -stream- of air, so instead of spreading out in a directed stream, it goes up-and-down in a much more dispersed manner, and with much less energy (b/c a lot of that got caught by the mask). Both of these mean that immediate neighbors are at less risk.
But neither of these mechanisms have any real effect for the wearer: (3) air they breathe in is typically not humid; (4) virus particles are too small to get caught by typical fabrics (unless supplemented with special materials); (5) unless masks are specially form-fitted, air will come in the sides, b/c it’s a fluid, and it’ll follow the path of least resistance (you might remember that there have been a number of efforts to use household bits-and-pieces to make masks more form-fitting (e.g. https://www.designboom.com/design/former-apple-engineers-seal-your-surgical-mask-05-29-2020/ ) ; (6) the “air baffle” effect of a mask is of course useless to the wearer: it just causes air to route around the mask unless it’s properly sealed.
In a sense, East Asians have know these facts forever: the discourse around masks has been that East Asians wear them when -they- feel ill, as a form of courtesy to their neighbors and interlocutors: this is a tacit admission that it’s not about protecting the mask-wearer.
My memory is that as long ago as the spring, when people started talking about the above positive qualities of masks, they mentioned that masks had some modest-but-nontrivial rate of trapping virus particles, so they weren’t *useless* to the wearer.
namekarB
Somewhat the same strategy in California. The biggest problem is
What the State says: We are easing restrictions slightly in your county
What people hear: We can take our masks off and go back to normal
Then they get pissed when the cases spike and the state brings down the hammer
Spanky
@HinTN:
Mr. Alex, he daid.
Yarrow
@WaterGirl: That’s what I mean. It’s been obvious from the beginning that masks help the wearer – public health data from Asia showed that. It’s been common knowledge for several months here that masks help the wearer. But for the CDC to take this long? Inexcusable. It should have been part of the mask “marketing strategy” from the beginning. So dumb and dangerous that it took this long.
Jim, Foolish Literalist
writers… timeline… taking it too far…. et cetera
lethargytartare
@Yarrow:
I’ve been having this fight on reddit for 6 months. There’s a large “well akshuly” crowd on the internet that can’t wait to derail mask discussions with their professional medical opinion that masks only protect others, and then only if they’re the exact right kind of mask worn perfectly correctly 100% of the time.
they’re not helping anyone.
namekarB
@trollhattan: Placer County here. Just downgraded from Orange to Red (should have been purple). Not just Halloween. When they eased restrictions:
What the State said: We are easing restrictions slightly in your county
What people heard: We can take our masks off and go back to normal
Mallard Filmore
@cintibud:
He could shutdown or mothball military bases in recalcitrant states. Same for other federal agencies.
“Houston, we have a problem.” can become “Denver, we have a problem.”
Cowboy Diva
I know this is not an open thread, and so my apologies for the potential hijack.
Has anyone had a chance to review this list yet? It seems remarkably detailed and complete to me, especially compared to what the current administration had ready to go from its first week. Without deferring to Google, do folks recognize any of the names listed? Do people have an impression as to what those on the list would bring to the table in terms of competency and values?
Thanks.
jl
Thanks for great post with great info. Very much appreciated. I agree that high prevalence complicates immunization programs. I think there has been a fantasy that immunizations are a magic bullet. People seem to think that everyone gets immunized instantly like magic, boom!, vaccine induced herd immunity, all covid-19 problems solved. But not enough is known about how the vaccines will work yet to understand the safest way to schedule delivery. For example, what does the vaccine do for transmissibility? If the vaccine protects against severe disease, but doesn’t do anything for transmissibility of disease from vaccine protected people (which sounds weird but can happen, vaccine protection may results in people with low grade harmless infections that are still transmissible), then funny things can happen with the spread of the disease over the 5 to 6 months it will take to get a substantial proportion of the population immunized. For example, surges of infection may occur in some segments of the population not yet immunized. Recent whooping cough vaccines are an example: solved all problems for children through teens, but pushed more infection into infants and toddlers and adults.
The golden rule of basic infectious disease control to save both dollars and health, get prevalence down as low as possible as quickly as possible, has been ignored in too many places in the country. So more dollar cost, more long term health consequences, more premature death, than necessary. A real economic and health crisis and a historic scandal, a disgraceful national failure.
debbie
@Jeffro:
They did your first point throughout the campaign. It won’t stop the Rethugs from trying to rebrand the blame, but Biden/Harris will need to stay vigilant and shoot it down every single time.
The GOP is as persistent as goddamn Canada geese trying to nest in your yard. They never let up, and we can’t either.
Immanentize
@Woodrow/asim: The executive has many $$$ levers they can pull — both carrot and stick — in order to coerce compliance. Even if someone objects or takes it to court, money is delayed for a significant period. Given the State coffers are so low from revenue drops — especially in federal welfare states — executive purse strings have serious leverage.
debbie
@WaterGirl:
I remember that they were forced to change their website at one time.
WaterGirl
@Cowboy Diva: BIden has been working on the transition since he got the nomination, maybe even before that. Doesn’t surprise me a bit.
Trump? They threw out the transition plans from Obama and they had none of their own. They talked about it on one of the podcasts I listened to last night – I don’t recall whether it was Pod Save America, Lawfare. or Preet.
WaterGirl
@debbie: And that’s only the time we heard about.
debbie
@WaterGirl:
Exactly. It was in late August and had to do with testing recommendations. Faucci was in surgery when the change was made and knew nothing about it.
rikyrah
A laugh for today
jl
@debbie: Not surprising. I trust Fauci. He is one of the few people in the country who have outstanding clinical and public health expertise, and also has the brutal practical experience in on the ground in-the-trenches control efforts for an emerging and mysterious infectious disease, HIV/AIDS. There are more like him in the country, men and women who combine both, but I think not enough of them have been tapped for their skills.
Chetan Murthy
@lethargytartare: First, I’m not a “well, acksually” person about masks. As far as I’m concerned, people not wearing masks (or carrying them when outside) should be shot on sight. open fucking season.
But I don’t think the CDC’s guidance has changed as much as you might think. I did a quick search, and found (for instance) this article: https://www.cnn.com/2020/11/10/health/masks-cdc-updated-guidance/index.html and also the guidelines https://www.cdc.gov/coronavirus/2019-ncov/more/masking-science-sars-cov2.html .
I read the CDC guidelines carefuly. Two of the cited studies could be interpreted as one where infected were maskless and uninfected were masked. Otherwise, it was all universal masking. The cited description of “filtration for personal protection” as well only describes “cloth mask materials” as effective for filtration, leaving aside completely the issue of fit, which is critical — air is a fluid and flows around barriers, and this is a big issue in mask use in many settings, not just covid.
I don’t think this is wrong: everything the CDC says is true, but it’s also carefully couched to convey a false impression: that masking is more personally beneficial than …. well, than the evidence they cite, or the evidence I’ve read elsewhere, would support.
But really, none of this matters. We wear masks to protect the people around us, just as we drive cars with special bumpers designed to protect pedestrians we might hit, and obey speed limits in school zones. People who say “but my freedoms” can get fucked. They. Can. Get. Fucked.
debbie
@jl:
Absolutely. Some of the recent bad-mouthing about him has been totally misplaced and unjustified.
catclub
very small consolation for the under 50% of Democrats in red states.
mrmoshpotato
@zhena gogolia: BoJo or the Aussies telling the Soviet shitpile to get fucked?
Yutsano
@mrmoshpotato: The very first tweet after has Labour beating ol’ Boris around the noggin. There’s a bonus name drop that is of interest to a certain retired Airman round these parts.
jl
@debbie: Thing is the bad faith of the criticisms. Fauci has made mistakes, but in this kind of crisis everyone makes mistakes. Another person at WHO, like Fauci, with expertise in public health and on-the-ground experience controlling emerging disease epidemics, I forget who, said that it is impossible to get an A in epidemic control, but if you keep on plugging then you should be able to get a B.
So, I guess in the epidemic control line of work, a B is an A plus anywhere else?
mrmoshpotato
@Enhanced Voting Techniques:
Hahaha
VOR
@Yarrow: As a colleague says “If it’s not logical, it’s political”. The CDC didn’t make this statement months ago due to fear of contradicting the Great Leader.
The Moar You Know
@PsiFighter37: Don’t. Just stay away. The rate of increase is tracking two weeks behind school reopenings and Halloween parties, and the schools will keep doing the “open one week, closed for three because covid, but God Emperor Trump wants the schools reopened and so we must” and it seems like they’re just going to keep doing that until a vaccine shows up or they run out of teachers willing to die. But the biggie is going to be Thanksgiving. Most people I know avoided Halloween parties like they were the plague, because, well, they are…but every single damn person I know is planning “something small” for thanksgiving that’s going to involve a dozen people.
So stay out of SD, I’m sorry, but we’re going to be having a bloodbath here from about December 1 through February as far as I can tell.
catclub
Too bad he couldn’t also change some senate races while he was at it.
mrmoshpotato
@Geoboy:
And 100% of the world’s Trump trash Rethuglican party who let hundreds of thousands die unnecessarily.
WaterGirl
@catclub: Plus, states are not silos. People travel all the time, even now. Unless there’s a damn good reason, I just don’t understand why people think it’s a good idea to be doing that.
cintibud
@Woodrow/asim: Thanks for the reply. I’m just worried about a gop governors actually undercutting the CDC. What if they throw up all kinds of roadblocks to increased testing? Or tell people (maybe indirectly) not to cooperate with contact tracing? Even in the reddest states there are many people who recognize the truth and don’t want to be sacrificed on the alter of gop radicalism
Sure Lurkalot
Blue Colorado has those color coded charts calling for greater restrictions up to a stay at home order. Many counties have met the stay at home criteria and the result is? County level health officials urging the governor to act, the governor urging the counties to act and finger wagging at the populace to please wear masks and please avoid gatherings. It’s exploding here…over 10% positive last I looked. The most that has happened is a 10 pm curfew in Denver…which has had and I believe will have no effect.
Why did the state set up these parameters if they weren’t to be followed? At this point, the governor should say urging didn’t work, it’s on you, citizens…you’re not children, so we have to lock down. Do better.
Ksmiami
@trollhattan: what Thanksgiving?
mrmoshpotato
@Jim, Foolish Literalist: These shitpiles in the White House are really going all in on this hoax. I’m almost convinced it’s a – REAL VIRUS!
Ksmiami
@cintibud: then let Darwin reign
Enhanced Voting Techniques
@catclub: Going by the maps West Virginia apparently been able to find a way to keep the Virus under control without getting into culture war nonsense. So apparently there is a way to get the point across to the stupid and the real problem is with the leadership in these States.
jl
@Sure Lurkalot: Compared to other countries, the effort in the US to educate the public and encourage public engagement absolutely sucks. In Estonia, after the public health establishment rejected their (very good) universities, and (world class) epidemiology departments offers of help, they changed their minds after half of Saaremaa island got sick. Then they went further and held a nationwide hackathon, where public forum was established and anyone could submit ideas for control, and there was public discussion.
Edit: and Estonia, along with Finland and Norway, which had similar approach are the few countries in Europe that don’t have a serious resurgence yet (knock on wood). The excuse that they are less densely populated, or that Finland and Norway and parts of Estonia are quite prosperous isn’t really an excuse. Saaremaa is a rural, low density. Still got hammered in first wave. Though it is far poorer than other parts of the country.
In the Czech Republic, everyone from prime minister on down took questions from the public on a regular basis. Can you imagine Trump and Fauci having to answer public questions. I imagine Fauci would be all in for that, but Trump? After amazing initial success, Czech Republic led the way in Europe in a disastrous resurgence, but that was because national government wanted to act like covid was eradicated, and fired public health officials gave advice that they didn’t want to hear.
Can’t shoot all the people who don’t wear masks, can’t arrest them, or cite them, at least in countries like the US. Need to build a consensus through public engagement.
The US has a serious problem with public participation and engagement. Maybe because for decades, the average person is just a chump to be pushed around and forced to cough up more and more money and resources to more powerful and wealthy (which is me editorializing).
mrmoshpotato
@debbie:
So we have to tie up the GOP and catapult them into Canada?
I’m game.
mrmoshpotato
@WaterGirl:
Oh it’s going to feel so good to throw these bastards out of the people’s house (and hopefully into the slammer.)
Mary G
California is similar, with four tiers instead of three. Tier 1 is the worst. Eleven counties were just demoted from Tier 2 to Tier 1, including San Diego, San Bernardino, and LA, but we here in the OC still have good enough numbers to stay in Tier 2, for now. My next door neighbors who let their college-age kids have wild drunken parties there during the summer got shamed by the neighborhood into knocking it off. Moar is right that it’s not a good place to visit.
Bill Arnold
I see that Vermont has gone to mandatory quarantine for all non-essential travelers. (I liked Vermont’s by-county map of active infection per million that covered the Northeast, the map being referred to. It’s still at the link below, last updated Nov 10.)
https://accd.vermont.gov/covid-19/restart/cross-state-travel
(unless an essential/authorized worker)
Jeffro
@debbie: right…they kept bringing up the issue, the spread, the lack of seriousness by the maladministration in getting Covid-19 under control…I guess I am kind of picturing more of a singular event just prior to the Inauguration with a detailed look at how bad it has been, casualties to date, infection rates by state, etc.
All part of being persistent, as you noted.
Benw
Suffolk NY was at 3.6% positive results yesterday and trending up. Our school district is getting 1 or so new positive student case per day.
The US as a whole is well into a third rise in cases, hospitalizations, and deaths. Even NE states are trending up but starting in a much better place than other states. We’re not getting any help from the feds until Biden/Harris are sworn in. I don’t understand why responsible states aren’t already trying to get as much of the state into Red and Orange shutdowns now to head it off. Why wait until it’s really bad AGAIN?
jl
Here is the thing about Holidays: we know when they are, and we’ve known since Memorial Day that they cause serious outbreaks. What programs have been developed to deal with regular calendar dates when we know that problems will occur?
At least in my area of California, each holiday has turned into Groundhog Day. Officials give warnings about the holiday, the holiday happens, officials complain about public behavior and coming spike in hospitalizations and deaths, and then there is a spike in hospitalizations and deaths. If anyone has a different experience in their area, let me know.
There are real and persistent problems with the US approach to control, and I think that includes many places with more enlightened policies. I’m not sure why. I think countries that do better promulgate very clear guidelines, almost checklists, on rules for socializing, and big public information campaigns. In New Zealand, they had a big public program so everyone knew what stage of emergency their area was in, what risk level, and clear instructions on what to do. Anyone see anything like that in their area?
Another Scott
@Enhanced Voting Techniques: I think WV was “lucky” early on because it’s mostly rural and away from the coasts and major cities. CovidExitStrategy.org shows WV’s daily positive cases taking off on the usual exponential now, albeit from a low level. They don’t have an obvious secret sauce.
Cheers,
Scott.
Elizabelle
@mrmoshpotato: Out of the People’s House and into the Big House.
mrmoshpotato
@rikyrah: Haha, nice!
Also this.
mrmoshpotato
@Elizabelle: Sadly, Michigan Stadium is also the Big House.
Fair Economist
@trollhattan:
Plausible, but do we actually *know* this, or is it a hypothesis?
(Says the guy whose son went to a Halloween party over my objections…)
@jl:
The holiday season scares the **** out of me. Even people who’ve been relatively good are going to say “I miss people so much. Just *one* party won’t hurt.” But then we get 100 million Thanksgiving parties and 100 million Christmas parties and that is going to HURT.
Cheryl Rofer
@Fair Economist: I was reminded this morning that we’re one to two weeks from Halloween, the incubation time for covid. But things were getting out of hand earlier. It’s going to be hard to separate Halloween effects from Thanksgiving effects from having uncontrolled spread, which means you don’t know where you got it.
Bill Arnold
@lethargytartare:
They’re also full of shit. And they are lazy, and have not read the scientific literature on the subject of masks vs COVID-19 done during the last year. They’ve at best skimmed somebody’s “masks don’t work” article. that cherry-picks the very very thin pre-COVID-19 literature on masks vs respiratory viruses and ignores the scientific literature generated in the (close to) last year, and ignore that the virus spreads from asymptomatic individuals, and ignore that larger-droplet spread from people close-by that is blocked even by cloth masks, etc.
Another Scott
The next big reason why cable/satellite/web subscriptions should be ala carte:
https://juanitajean.com/trumps-end-game/
IIRC, a similar TV venture was Donnie’s plan in 2016 after he lost to Hillary. Since The Apprentice was the only thing he actually made money on, it’s natural that he wants to head back there…
Cheers,
Scott.
Fair Economist
@Mary G:
Wait, I thought LA County had been Tier 1 already?
Here’s a link saying they were staying in it in mid-October. LA County’s poor performance under Tier 1 has been one of the things that really scares me.
Also, don’t worry, OC will be Tier 1 soon enough. Cases are climbing and near the top of the Tier 2 range. Two more weeks, tops. (Or maybe DO worry…)
WaterGirl
@Benw: We are apparently at 12% here where I am in IL. Holy shit.
Chetan Murthy
@Fair Economist:
Amen, bruv or sis. A-fuckin’-men. I had an optometrist’s appt[1] for 10 Dec, and was starting to get second thoughts (it’d be the first time entering a foreign building since the spring) and they just called, moving the date up to 24 Nov, which is a relief. I still have to watch the numbers to see if it’s safe, but I’m hoping since it’s *before* T-day, it will be. Ugh.
[1] My eyes have slowly deteriorated over the last 10yr, and it’s far, far overdue for a new scrip. Without going into details, far, far, far overdue. Probably some of it is due to staring at monitors too much, TBH. But some of it …. well, yeah, *overdue*.
jl
@Fair Economist: “Plausible, but do we actually *know* this, or is it a hypothesis?”
I think in California we know some of the resurgence is due to Halloween, because there is a regular pattern of outbreaks following holidays. I don’t think we know how much, since Halloween closely followed California’s second reopening, at least in SF Bay Area, and the US hasn’t been able to reopen substantially anywhere that I know of and not have it fall apart soon afterwards. NY and NYC are also having a resurgence.
MA may be a place to follow. That state is trying the Japanese cluster busting approach: focus outbreak control on superspreading events, which some recent research indicates is driving force of spread (little gatherings under 10 people are transmission channels, not source of most infections, but if superspreading events seed enough cases in the community, those smaller person-to-person, small household gatherings can produce enough infections to cause trouble). MA is also adapting its contract tracking to a method that is best to squash superspreading events. That state will be interesting to watch.
A physician with a lot of practical outbreak control experience KJ Seung is in charge of their contact tracing and quarantine/isolation program.
https://twitter.com/kj_seung
jl
@Fair Economist: IMHO, the problem is that after 7 months, the authorities shouldn’t be doing the same thing over and over again. They need to develop a response.
I know I am riffing off a maxim with a dubious origin, but ‘you go to an epidemic with the population you have, not the population you want.’ Control experts need to find a response, that is their job. Yes, it is difficult, but to do the same thing over and over again? They need to try harder.
The Moar You Know
@Benw: I hate saying this because it makes me so fucking angry, but Newsom has done all he can given the circumstances. Some of this has to be driven by the people. If he locks the state down hard again without the voters asking for it, he’s going to have a mammoth revolt on his hands, and it won’t just be the hick counties, it’ll be everyone. And that really would be the worst case scenario, and we are all trying to avoid that. If I were in charge I’d lock it all down hard and enforce it with the state National Guard and a “shoot if resist” order, but that’s why he’s the governor and I never will or should be.
jl
@Fair Economist: Julia L Marcus is an epidemiologist who specializes in managing population response to epidemics and control efforts. She is worth reading on the problem I am talking about, and she links to other experts who know about it.
https://twitter.com/JuliaLMarcus
Enhanced Voting Techniques
@catclub: Yes, if we did fix an election Yertle the Turtle would be top of the list.
Chetan Murthy
@The Moar You Know:
As much as I want to disagree with you, as much as I want to point out -why- our current policies have failed to contain this epidemic …. you’re right. And so, those of us with science on our minds, sit in our houses, and fret, sit in our houses and wish for heavy weaponry mounted on drones so we can go murder the maskless. Sit in our houses and slowly go stir-crazy.
It. Is. What. It. Is. It does no good whatsoever to analyze -why- we’re in this shitty, shitty place. Maybe President Biden can inspire renewed vigor in our populace to fucking abide by basic public health rules. Maybe. Idunno. I fear he cannot, though he can make the mitigations more effective by using the DPA and other executive actions. It’s a fucking national emergency, maybe he can just institute income support for the quarantining/isolating by fiat. Idunno.
dmsilev
@Fair Economist: LA County has never left Tier 1. We came close in September, but cases started trending back up and now we’re something north of double the threshold for Tier 2. And rising.
Sigh.
The Moar You Know
@jl: We in San Diego are also seeing outbreaks tied to secondary school reopenings. Otherwise, just as you say.
Enhanced Voting Techniques
@Another Scott: Well the same is with these Midwest States that are now at NYC last spring levels. But the Governor of WV was famous for that speech he made explaining why WV couldn’t afford to just let the virus run it’s course.
mrmoshpotato
@Another Scott:
DO IT! DO IT! DO IT! DO IT!
Tie your traitorous, shitpile, manbaby ass around the neck of the GOP, you fucking fascist orange albatross!
Captain C
The library branch I work in has been closed back down for a month, after being opened for grab-n-go service, due to it being smack in the middle of the Brooklyn red zone. While I do enjoy working from home, it’s not a long-term solution for a librarian.
jl
@Fair Economist: Two problems in understanding causal flow and how specific local factors work in epidemics is that so much is correlated. Unless done very early, shutdowns are correlated with population response to initial deaths and hospitalizations. Studies have been done of possible factors that effect the severity of the epidemic, there are dozens of candidates, and they are highly correlated from place to place.
And Cheryl is correct, the higher the prevalence, the harder it is to figure out what is going on. High prevalence of infectious disease is basically SOL.
Ha ha, it’s sort of like trying to do macroeconomic statistics to figure out effect of monetary and fiscal policy.
PsiFighter37
@Bill Arnold: Yeah, I saw the same thing. Maine is also kicking out everyone except folks from VT, MA and NH.
I am unsure what to do, because being (effectively) locked indoors for 4-5 months in the Northeast is highly unappealing, and both my wife and I need a change of scenery to keep ourselves mentally sane. Honestly – just an AirBnB with space and a view of the fucking ocean, or something like that. No interest or intention in hanging out with crowds of people. Sigh.
Benw
@WaterGirl: fuuuuuuuck sorry WG!
jl
One problem is that US seems to have blinders on. Scott Gottlieb was on some news talky last weekend, and he said we should look to states that have a good track record at controlling the epidemic for polices that work. He got a lot of pushback from US experts who have done field work in practical epidemic control around the world. They said ‘And what states would those be? There are none, compared to what other countries have done.’
So, sure you can’t just transplant a policy package wholesale, but you can get ideas about what works better, and try to adapt them. And I don’t buy the line that the US has special conditions that mean anything from other countries won’t work. Some of those other countries have their own problems, and some of them are similar to those in the US.
Enhanced Voting Techniques
@Another Scott: Supposed this whole mess in GA with the run offs is Trump demoing The New Order to the GOP. My bet is Trump is going to force them to kiss his ring, send Trump a Love Donation and then Trump will screw them anyway. Good news for Conservatives as they say.
trollhattan
@Fair Economist:
Don’t know how effective contract tracing is currently but they do incorporate cellphone location data to get a general idea where and when people are gathering.
mrmoshpotato
@Enhanced Voting Techniques: Fixed the election, but forgot to win the Senate! Whoops! ??
Another Scott
@mrmoshpotato: (Oooh. Italic emojis. Don’t think I’ve seen that before.)
Cheers,
Scott.
mrmoshpotato
@Another Scott: Hehe, I discovered it on accident a few weeks ago.
Benw
@The Moar You Know: @Chetan Murthy: I can’t say Cuomo has done his absolute best because of his weird pissing war with DeBlasio (man, f him). And I get that people will howl (I’m about ready to howl myself) but they CAN move all schools to remote learning, they CAN close the bars and make restaurants only takeout/delivery. Even if we don’t go full Rambo on the maskless asshats, that would make a huge improvement, just cause people won’t have anywhere to go!
The problem is cratering the economy (again!) without federal help, but honestly if I was in charge I’d just run a huge state budget deficit until the new Biden admin can help out. Sure that’s “unconstitutional” in most states, but they can freakin arrest me when it’s all over!
DougJ
Great title.
jl
@Benw: California has a balanced budget clause in the constitution, but in the past has developed great expertise in evading it. I think in one budget crisis, they issued state IOUs to school districts and strongly suggested that major banks honor them, which they mostly did.
And I do remember reading that the feds have slapped down what they considered California attempts to run its own monetary policy, though I forget the details.
I have California stays creative.
Benw
@PsiFighter37: there’s always upstate! :)
In August we got an AirBnB up by Lake Placid for a week. Didn’t have to leave NY and it was real nice.
PsiFighter37
@Benw: Warm weather is part of the consideration, as is getting to see my grandmother (despite her dementia getting worse, she is still hanging on longer than nurses and family thought she would – so getting my daughter out to see her great-grandmother one more time is important to me, personally).
Mary G
@Fair Economist: @dmsilev: I was going by this LA Times article, but now that I reread it, it’s not super clear which 11 counties had changed back. My mistake.
I see covidexitstrategy.org has moved CA back into their dark red zone, uncontrolled spread, with 46 other states. Only Vermont is yellow, caution warranted, with Maine and Hawaii lighter red, trending poorly. So basically WASF.
mrmoshpotato
@Benw: Lake Placid? Be careful.
Fair Economist
@jl:
I’d lol at that except goofs in either cause lots of unnecessary death and suffering. Oh, and conservative “intellectuals” spend a lot of time distorting evidence to favor their policies, which make things worse.
Yeah, depressingly similar.
WaterGirl
@mrmoshpotato: I had the same reaction – sounds good to me. Drag them all down with you. Every republican traitor. Works for me.
Ruckus
@Chetan Murthy:
They should be fucked, with a 4×4 wooden post, with splinters. Even if a mask only helps others, if everyone wore one, everyone else would be protected, and that includes them. And let’s say that a mask is only 80% effective for anyone within 6 ft, but 99% for 12 ft. That is a MASSIVE amount better than nothing at all.
jl
@Fair Economist: Well, macro is hopeless. You can make a lot progress in infectious disease epidemics if you can get prevalence down as low as possible. And if even staying home as much as possible, or fleeing to the remotest village imaginable, doesn’t help much, like 1918 pandemic flu, then that tells you a lot too.
Feathers
@rikyrah: As my mother always used to say “He’s got the map of Ireland written on his face.”
@catclub: Also, not switching votes to match the polling, which was skewed much more heavily Dem.
@debbie: So we all need border collies to chase them off?
@Fair Economist: The education system’s whole “think for yourself, consider the sources, etc.” has massively backfired. When I took an educational design class, the main thing we learned is that education policy is developed by teachers, who because they love learning, think everyone else does too.
Hoppie
@jl: Yesterday’s San Diego information update is here.
Benw
@mrmoshpotato: lol I prefer the one about hockey!
Ruckus
@jl:
A program like that would take a lot of effort in concert with the federal government. Which we really haven’t had for the last 4 years. The countries that did those things was not in the hands of a complete and utter fuckstick who only knows how to screw up everything.
Mrs. D. Ranged in AZ
AZ has a 9.7% positive test rate and there’s still too many people running around like everything is normal. Some of the popular restaurants are packed. I’m honestly surprised the state flipped blue because there are still too many nincompoops running around here.
And my Trump lovin’ neighbors STILL haven’t taken down they’re Trumpenfuhrer flags. A-holes…
Roger Moore
@jl:
I think a big part of the problem here in the USA is a poor social safety net. Poor people who live in crowded households are stuck every way. They’ve been forced to keep going to work, so they’re constantly exposed. They and their coworkers don’t have any sick leave, so even if they get sick they often wind up going to work anyway and exposing everyone around them. They don’t have decent health insurance, so they are unlikely to get tested. Even if they are tested and stay home, they often live in such crowded housing that they can’t effectively isolate and wind up exposing their whole household. The net result is that once we get substantial community spread, it’s almost impossible to get it back under control.
jl
@Roger Moore: I agree. From the news reports, sick workers forced to work for economic reasons, and maybe pressure from bosses, is still a big problem in SF North Bay. They are still getting programs off the ground 7 months into the epidemic.
Other countries in Europe and Asia, and even sub-Saharan Africa despite the poverty of some of those countries, have responded more effectively more quickly.
WereBear
@mrmoshpotato:
That is essentially what is going on.
In the book The Impostors: How Republicans Quit Governing and Seized American Politics, Steve Benen makes a persuasive case that the GOP has become a “post-policy” party. They don’t want to govern. Full stop. And their voters, after generations of “government is the enemy” doesn’t want them to, either.
So Trump really is the essence of the party now. If they try to reverse course and come up with policy (which we all know is disastrous anyway) how much of the Base will they pry loose? I’m thinking… not much.
J R in WV
@Chetan Murthy:
Just as your freedom to swing your arms around ends near my face, a person’s freedom not to wear a mask ends when it may have a severe/fatal effect on others’ health.
I personally agree, it should be open season on everyone not wearing a mask out in public, shot on sight. After a day or two, everyone out and about will be wearing a mask.
J R in WV
@Cowboy Diva:
Regarding the list of Transition Team members, few of the names are known to me, but the vast majority of their previous employment positions give me great relief. Unions, the ACLU, serious universities, research foundations, nothing that rings a Republican Bell at all.
Most with work experience directly related to the federal agencies being reviewed. Postal Service team has two members who were previously with Postal Unions, a great thing to see. A progressive and forward looking bunch of people.
J R in WV
@Enhanced Voting Techniques:
While Gov Justice (R) switched from (D) is an ass, he has imposed a mask requirement that has been in effect for months now, and on the rare times i go to town, it is mostly being observed.
I do see stupid people pulling their mask below their nose, which is so fucking stupid I can’t believe it, but that too is rare, and I run away from them. Although with the respirator I wear they probably aren’t a threat to my health.
Uncle Cosmo
@Yarrow: Anyone who’s paid any attention to news stories on the Net summarizing the various studies coming out in the med journals has known for weeks that masks offer some protection to the wearer. Whatever the federales are saying officially just now.
FTR, back in September I shared with my PCP the conjecture that ‘Rona is primarily entering through the nose & setting up shop in the nasal cavity before moving on & he replied, “We’ve known that for awhile.” My doc also holds an MPH so I get the feeling he’s wired into the latest.
(Whenever I see someone with their mask below their nose I cordially relate this bit of information & suggest the mask would be doing them much more good if it covered their nose. So far no one has taken offense at the advice and many have hitched it up.)