Louisiana.
So 1-2 weeks ago our hospital group decided to change from daily updates to weekly as the state began to open up again. Todayās update indicated that two of the last four days had the biggest number of new cases reported since the outbreak began. Everyone just decided that they were done with quarantine and were going to will the virus away and open for business and shockingly it hasnāt worked. Apparently weāll be going back to more frequent updates because staff requested to bring them back.
I went to pick up lunch today at a restaurant that I usually get takeout from once a week. Since the outbreak started I have never seen more than one person in there. Today there were probably 15-20 people in there, half of them crowded into a line, and zero wearing a mask. We are really fucking this thing up.
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Thanks for the update - which state are you in?
I donāt know anyone who thinks that. Most people either never took it seriously or they still are. Whatās sad is those who are still taking it seriously being forced back to work against their better judgment. Either work and put yourself and family at risk or lose your job. Demās the choices for many
AZ
Wait until the new rates come out on the exchange and a bronze plan is $1,400 a month for one person in their 30s, and God knows what for a Boomer.
Turns out COVID-19 and Fascism may not be the Boomers final parting gift to America. Bankrupting the entire country on the way out the door because so many of us have long term medical issues from COVID-19 may be their final fuck you. Weāre drawing live to economic collapse from that even if we survive the rest.
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Not sure if serious about boomers being responsible for COVID.
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Debt forgiveness a la post-WW2 is much, much more likely than US economic collapse. Only small nations are allowed to collapse these days. When you basically ARE the IMF and the reserve currency for the whole planet you can write off pretty much any amount.
A huge chunk of the Boomers are the no mask crowd or denial crowd or āSure Iām taking it seriously Iām only going to Applebeeās twice a week instead of three times,ā crowd. Theyāre largely responsible for the spread, and also largely responsible for giving us Trump.
Fair point about debt forgiveness.
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Trump, yes but anecdotally most boomers here (neighbours) have socially isolated more rigourously than others, I think. YMMV there ofc.
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White men are largely responsible for Trump more so than Boomers, I think.
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Oh and by the way a hospital will absolutely charge $18000 for a test. They will charge whatever they like so they and the insurance company can play their games, as Hobbes said itās basically just Monopoly money to them. It certainly seems excessive but I wouldnāt dismiss it out of hand either.
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We look like a lock for 5 straight days of week over week growth/increases in the 7 day moving average of new cases and 4 days for the same metric in deaths. As I said yesterday and Dan pointed out, this may be noise in the data but it is worth keeping an eye on. The āsecond waveā probably wonāt be a sharp upswing like the first one it will be a more gradual upswing due to the lower R than in early March. Whether or not this is it or just variance in the data will be interesting to see.
The most important number is the number of ventilators and ICU beds. Until we start to bump up against that Iām not sure the public will care much.
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Remember when the entire food supply chain was going to grind to a halt due to a pork shortage?
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$100 is $100 too much for a test
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And best case itās flat. Which is not good any what you slice it.
I am forcing myself to not look until Wednesday or Thursday.
Update from the data modeler:
Iāve updated the mortality data and it continues to conform to the expected curve. Over the last three weeks there has been about a 3.2% variance between the actual death rate and model prediction, which were expecting a mild decline in death rates over time before achieving a relatively stable linear increase in early July. Thatās the equilibrium model described below. I described some concerns last week that the various Memorial Day celebrations around the country might have the effect of launching a second wave of the pandemic because there were almost certainly going to be revelers at these events who were asymptomatic and contagious, and we are now starting to see individual cases appearing in the news. Contact tracing is virtually impossible when the individual moves through crowds for extended periods, so the local news media are being asked in some cases to get the word out as to where infected partiers had been. Inefficient, but better than nothing.
The protests add a terrifying additional layer to the problem. Before I begin, I want to make it clear that this post is about public health related to the COVID-19 pandemic and how to reduce the likelihood that the protests as a vector for disease transmission. This is, by design, NOT intended to serve as a forum on the merits of the protest or their participants. I am also not advocating for or against the attendance of these protests here, Iām just acknowledging that they exist. I do have opinions on whatās going on, of course, but my writing here is related solely to the containment of the virus and so Iām not going to discuss the political elements. Anyone that chooses to be overly political, rude, or offensive will be invited to take those conversations elsewhere. There is no shortage of space on social media to do so, you donāt need my blog for that.
SHORT VERSION: If you went to a protest, please self-quarantine until either you have a negative test or fourteen days have passed. This is not the time visit your grandparents. If you intend to go to a protest, wear a mask for the protection of the people around you. REMEMBER, YOU DONāT NECESSARILY KNOW IF YOUāRE SICK AND CONTAGIOUS. Strap in, tl;dr as always.
Like the Memorial Day events, the protests that have emerged across the country are filled with younger people who are more likely to be asymptomatic or lightly symptomatic if infected. The protesters are often crowded together and there is very little social distancing in practice. When there is police involvement, the crowds can be pushed into higher density groups either through the use of barriers or through attempts at containment. All of these conditions and activities are great for the virus, but not so great for the health of the population. Because the protests are mostly outdoors, there is ample additional airflow which is a good thing for diluting the airborne droplets of virus. Itās also helpful from a transmission perspective that many people are wearing masks. Some protesters are doing so for protection from the virus, some due to the potential of tear gas, and others simply to protect their identities. Videos from the events suggest that masks are not in use for the majority of the protesters unfortunately. Most but not all of the officers appear to be wearing some form of protection, especially facial shielding. I canāt speak to any real estimates of mask use because, like many of you, Iām watching this on TV. Suffice to say that masks arenāt likely to be in widespread or sufficient use.
People are also yelling. A lot. Understandable, of course, but research shows that raising oneās voice either by yelling or singing helps to aerosolize the droplets in which the virus travels by air. This process both increases the viral load in the air from contagious individuals AND increases the time the virus stays in the air before falling to the ground or other surfaces. When people raise their voices, they also breath deeper, inhaling much larger volumes atmosphere, and therefore a larger load of any virus that happens to be present. Complicating the matter further, there are a lot of people running, jumping, and otherwise exerting a good deal of physical energy. This causes deeper respiration which again increases the viral load one inhales or exhales. All of these in combination create the possibility of the protests to become super-spreader events. These concerns are the reason we still donāt have baseball games or other large stadium events right now.
The protests have been happening and are likely to continue to happen for a while, so āstay home and donāt protestā isnāt a meaningfully helpful approach to resolving the public health side of things. It is simply a fact that the combined effect of these protests along with the general relaxation of mitigation highlighted by Memorial Day throws gasoline on the fire for that early 2nd wave Iāve warned about in the model. As a result, Iād like to offer some practical advice to protesters and response personnel.
- WEAR A MASK. Itās vital for the prevention of additional disease spread with people so close together. Never forget that you can be contagious for days before symptoms and some people never become symptomatic. Much of the spread of COVID-19 is a function of asymptomatic spread. Tight coverings are good, but even your V for Vendetta mask is better than nothing.
- If you are arrested, request a mask, social distancing, or whatever other mitigation procedures are available from local authorities. Being cramped indoors is MUCH more dangerous than being cramped outdoors.
- When you go home after the protests STAY AWAY FROM VULNERABLE PEOPLE until you can be sure whether or not youāve become infected. This means until after youāve had a negative test or been in quarantine for 14 days. Because you may be contagious without ever having symptoms, these are really your only options.
- If you are protesting, do your absolute best to social distance. I understand this may not be possible in all situations, but where you can do it, do it.
- AVOID HIGH RISK BEHAVIOR to the extent possible Anything we can do to prevent injury to self or others keeps hospital beds empty and reduces the strain on an already exhausted health service. Give the doctors and nurses a break from treating injuries that should never have happened in the first place.
- If you are a member of a vulnerable group, like the elderly or asthmatics, please stay home. I recognize that protesting carries risks for anyone, but if you can find a way to contribute to the effort that you feel passionate about without risking infection, please do that.
- If you arenāt protesting or responding to the protest, stay the hell away from them. That much Iād hope would be obvious, but there seem to be nonparticipant sightseers (as opposed to people recording and/or reporting on the events) in virtually all of the coverage Iām seeing. IF YOU ARENāT THERE FOR A REASON PLEASE DONāT SHOW UP.
Letās not forget the lessons of the Spanish Flu pandemicās second wave. After the first wave, several things happened that created a kind of perfect storm for a second run of the flu that turned out to be far deadlier than the first wave. People became tired of government required or suggested mitigation efforts, and as the first wave subsided became overly confident that those efforts were no longer necessary. Anti-mask protests became more common, and behavior more consistent with pre-pandemic activities. International travel resumed. A lot of this should sound familiar right now. A third wave was initiated at the end of WWI with the return of soldiers from all over the world who not only carried disease with them, but whose return also sparked many spontaneous and organized mass public gatherings across the countries.
We donāt want a second wave, and we can do things to prevent one. We definitely donāt want a third or subsequent wave.
Stay safe everyone, be smart.
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We are going yellow here in the greater Philly area this weekend, will be interesting to see how behaviors change. People have been very good in this area so far. Iām hoping masks in stores remains mandatory.
+1,000,000 
Seems like most are wearing masks while protesting which will hopefully keep R not too much above 1 for now.
School and sports and fatigue in August scare the crap out of me.
Put me down for purple.
Daily confirmed COVID hospital and nursing home deaths since peak (from Cuomo press conference)
April 8: 799
ā¦
May 1: 299
ā¦
May 26: 74
May 27: 74
May 28: 67
May 29: 67
May 30: 56
May 31: 54
June 1: 58
Weāve really made a lot of progress. I support the protests, but I also hope they donāt lead to a spike in new cases.
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