[Health] The Infectious Diseases Thread

[msduncan]

Kids were also just told they will have a 2.5 week spring break.

I'm expecting all these closures to be extended. If I were a betting man, I'd say most school years are effectively over.

I tend to agree with you. I'm not sure how they will handle this in terms of education and grade levels.

[Smoove_B]

Per my wife -- the lack of drive through testing up until this point is because of stringent US laws and regulations concerning who can medically test people, how they can be tested, etc. These are rules for peacetime. She is a lab manager and follows these rules every day. The national state of emergency yesterday allowed these rules to be waived. Drive through testing is being set up over the next week all over the country. Alabama just opened theirs.

Kinda? It's mainly logistics. There's nothing prohibiting drive-up vaccinations (like for annual influenza) in states during the normal course of events, and yet people were losing their grip when certain communities started doing it 10+ years ago. We don't have drive-up sample collection because there's no need. I am not aware of state of emergency powers that would impact this in any specific way, but I can only speak to my own state.

Regardless, for drive-up testing it means localities need to figure out how to determine which people can attend (no different than in-person testing) and then coordinate with police/OEM services to set up in an area that makes sense - public park, municipal lot, etc... Finally (as pointed out) making sure PPE is being supplied to the front-line staff and that other protocols are in place to minimize risk overall.

NJ will have drive-up testing available starting tomorrow in a major meto area (Secaucus for those that care), but only for patients that below to the specific medical practice that offers it. I believe this will slowly expand as the logistical issues are figured out.

[Smoove_B]

I'm expecting all these closures to be extended. If I were a betting man, I'd say most school years are effectively over.

I don't know anything official (and I guess if did I'm not sure I could say), but there's a window where it *might* be possible for in-person classes to resume in June, though I understand many schools (not NJ) are out that first week. NJ schools typically end 2nd to 3rd week (for reference). So much depends on what happens over the next ~30 days.

Above and beyond grades, there's the larger issue of standardized testing, placement exams and things like the SATs. We're rightfully focused on health and safety right now, but this is going to ripple out in ways we haven't even started to consider (or appreciate).

We should be doing everything we can right now to protect front-line medical staff, police/fire/EMT/solid waste/electrical/water workers to make sure that the very basics of society can continue. If the fabric of our society starts to shred (which unfortunately seems to happen during disaster events), the problems are now much, much worse.

Given what I'm seeing on Twitter, I am genuinely concerned for some communities. The Governor of Oklahoma essentially bragging online about defying public health recommendations. Schools in New Orleans ordered closed but Bourbon Street packed on a Friday night. Italy is begging US officials to take more aggressive actions. A few communities in NJ have announced curfews, but I'm telling everyone - widespread disruption is coming. Prepare.

[Zaxxon]

Colorado ends in May. We're toast.

[Jeff V]

So wife reported an incident at work where a coworker has a friend who has a friend that tested positive. This coworker touched things others have, including the time clock. The rest of the employees, when they found out, ran the guy out and told him to stay home until he gets tested (and AFAIK no testing is going on). Wife is still awaiting definitive action from the company leadership -- she is already complaining because they have no masks and she works in a nursing home where an outbreak could be devastating. I'm waiting for some assurance because if the virus is successfully passing along this chain, that would make me exposed now as well. Currently, my wife's job issued the ever-so-helpful instruction "if you have a fever, stay home." If you have a fever and it's from this virus, then it is already too late to put that genie back in the bottle.

Not sure yet if I should notify my employer of this possible 4-degrees separation exposure.

[Blackhawk]

Above and beyond grades, there's the larger issue of standardized testing, placement exams and things like the SATs.

FWIW, Ian was scheduled for his SATs yesterday. They cancelled Friday night about an hour after school was closed.

And around here school ends the second week of May.

[Jeff V]

Colorado ends in May. We're toast.

Our town ends in May too (it's not a state-wide thing, Chicago goes to late June). I thought my son's kindergarten teacher lost it when she sent home a packet of assignments to do over spring break, which isn't for another week yet. But they first announced Monday teacher institute day (to workout e-learning plan) then Tuesday was mandatory, but the state then said closures are mandatory Tuesday until the end of the month. Yesterday we got an email survey to assess our e-learning ability (internet, what sort of devices, etc.).

Daughter's dance class is canceled for at least 2 weeks. No word yet on son's Taekwondo, although attendance has been down to around 6 for the past month (typically as high as 16).

[msduncan]

So wife reported an incident at work where a coworker has a friend who has a friend that tested positive. This coworker touched things others have, including the time clock. The rest of the employees, when they found out, ran the guy out and told him to stay home until he gets tested (and AFAIK no testing is going on). Wife is still awaiting definitive action from the company leadership -- she is already complaining because they have no masks and she works in a nursing home where an outbreak could be devastating. I'm waiting for some assurance because if the virus is successfully passing along this chain, that would make me exposed now as well. Currently, my wife's job issued the ever-so-helpful instruction "if you have a fever, stay home." If you have a fever and it's from this virus, then it is already too late to put that genie back in the bottle.

Not sure yet if I should notify my employer of this possible 4-degrees separation exposure.

I would say no. Not unless you are exposed to someone who tests positive. Being exposed to someone who knows someone who knows someone who tested positive isn't enough in my opinion.

[Jeff V]

I would say no. Not unless you are exposed to someone who tests positive. Being exposed to someone who knows someone who knows someone who tested positive isn't enough in my opinion.

This is where the dearth of testing is a real problem. Unless either of the two people in the chain (one being my wife) actually tests negative, then exposure can't be definitively ruled out.

[Kraken]

widespread disruption is coming. Prepare.

Tomorrow night we're going to a small restaurant that has publicized its enhanced health/cleanliness measures, and we're bringing sanitary wipes of our own, so I'm comfortable with making one more saving throw. That will be our last night out until the all-clear sirens go off -- weeks at least, and probably months. I do intend to keep making quick, targeted weekly grocery runs to bring in fresh foods and stretch the stockpiles for as long as that seems reasonable. If it seems unnecessarily risky, I'll order them online for delivery instead.

Except for the most essential services, I'm expecting the whole economy to shut down by the end of next week.

[Jeff V]

widespread disruption is coming. Prepare.

Tomorrow night we're going to a small restaurant that has publicized its enhanced health/cleanliness measures, and we're bringing sanitary wipes of our own, so I'm comfortable with making one more saving throw. That will be our last night out until the all-clear sirens go off -- weeks at least, and probably months. I do intend to keep making quick, targeted weekly grocery runs to bring in fresh foods and stretch the stockpiles for as long as that seems reasonable. If it seems unnecessarily risky, I'll order them online for delivery instead.

Except for the most essential services, I'm expecting the whole economy to shut down by the end of next week.

The inherent risk of going to the grocery store is not what bothers me...it's the event I test positive and couldn't go to the grocery store. We go through a lot of fresh foods here and while we can survive some weeks on pantry and freezer reserves, missing out on fresh foods would definitely put a crimp in things.

[$iljanus]

I would say no. Not unless you are exposed to someone who tests positive. Being exposed to someone who knows someone who knows someone who tested positive isn't enough in my opinion.

This is where the dearth of testing is a real problem. Unless either of the two people in the chain (one being my wife) actually tests negative, then exposure can't be definitively ruled out.

Yup. There are of course many factors which can influence actual infection but essentially that's how infections spread where someone has contact with an infected person, goes off and interacts with someone else and so on, and so on and so on...

I wonder who the person had direct contact with, what shared spaces did this person occupy, etc.

Hence the call for social distancing and the need for testing so people can go back to work and feel reasonably sure they aren't a risk to others.

[stessier]

SC governor is supposed to close the schools at 4pm today with an exception of one extra day for any county without a rsported case so they can setup distance learning. There is wailing and gnashing of teeth.

Better late than never I guess. I wonder what changed his mind...one week ago he said there was no concern and was planning on attending our city St Patty's day parade.

[Kasey Chang]

China apparently turned the corner: only 18 new cases reported in past 24 hours (as of yesterday).

Italy is getting ugly. 2547 new cases in 24 hours. And their death rate so far is alarming at 7.2%, which suggests they have a large number of unconfirmed cases and their medical system is overwhelmed. And it's pretty easy to guess that they went to neighboring countries... Spain has 1266 new cases, which is high growth, and so does France and Germany (780 and 693 respectively)

Iran has 1289 new cases in 24 hours, death rate is on the high side, but lower than Italy.

US numbers is starting to look a bit alarming now that tests are getting done. Expect this to continue for another couple weeks when the testing kits becomes even more widely available.

[Daehawk]

I have to go to town Tuesday. Im betting I have to go to 3 or 4 stores where 1 would usually do. So I have to expose myself even more. And I probably still wont find what I need.

[Defiant]

Iran has 1289 new cases in 24 hours, death rate is on the high side, but lower than Italy.

No doubt because their median age is a lot lower than Italy's. What I don't get is how many recovered cases Iran has.

[Blackhawk]

Just treat stores as if you were walking into a contaminated zone. Keep your hands away from the rest of you, handle only what you need to, and when you're done wash like you're a surgeon and open the door with your shoulder. When you get home and put the stuff away, do it again.

[Daehawk]

https://twitter.com/jonathansfrakes/sta ... 8059488256

[Max Peck]

The number of confirmed cases here in Ottawa doubled from 5 to 10 in the last day. The latest update from Ottawa Public Health is that we are now probably in the community spread stage.

Community spread of COVID-19 in Ottawa likely, says OPH

Community transmission of the COVID-19 respiratory illness is likely taking place in Ottawa, according to the city's chief medical officer of health.

That pronouncement from Dr. Vera Etches comes as the province's Ministry of Health reported five new confirmed cases of COVID-19 in Ottawa Sunday morning, bringing the city's total to 10.

The ministry said Ontario has 39 new cases of the respiratory illness, increasing the total infected to 142.

All five local cases are in self-isolation, according to the ministry.

Ottawa Public Health (OPH) confirmed that all 10 cases of COVID-19 in Ottawa are related to travel or contact with someone who has a confirmed case, including some who had contact with cases in Toronto.

At a press conference Sunday, Etches urged people to cancel events of all sizes in order to reduce transmission.

"I recommend that they don't go out for non-essential reasons," Etches said.

[Ralph-Wiggum]

School for my non-CC brother’s kids was just canceled until April 13. He lives in the town right next to New Rochelle (NY hotspot) and three kids in his town just tested positive. I imagine the school cancellations in other places will soon be extended until April as well.

[gameoverman]

I think there will be enormous pressure in this country to get things back to normal ASAP once the two week period is up. So I would expect that as soon as it appeared the lockdown 'worked' everyone is going to want it to be over. Who gets to decide that? I hope it's someone who knows what the hell is going on. It would be disappointing to see 'mission accomplished' declared only to see a surge in infections once people started mingling again.

[Smoove_B]

t would be disappointing to see 'mission accomplished' declared only to see a surge in infections once people started mingling again.

This is exactly what happened in the biggest outbreak I ever worked on (inside a jail). We figured out what was happening and told the warden and staff how to stop spread. They nodded politely and I guess did that for a day or so. Then three days later we were called back in because it had spread to a completely different area. Why? They stopped doing what we said to control spread.

[Daehawk]

Soon as normal comes back it may just start all over again.

[Jeff V]

China apparently turned the corner: only 18 new cases reported in past 24 hours (as of yesterday).

Maybe they stopped testing. Or ran out of kits.

Italy is getting ugly. 2547 new cases in 24 hours. And their death rate so far is alarming at 7.2%, which suggests they have a large number of unconfirmed cases and their medical system is overwhelmed. And it's pretty easy to guess that they went to neighboring countries... Spain has 1266 new cases, which is high growth, and so does France and Germany (780 and 693 respectively)

Iran has 1289 new cases in 24 hours, death rate is on the high side, but lower than Italy.

I have to believe there's a large number of unreported cases among the less risky groups. The mortality rate seems to be fairly well established, are there any reports of younger or healthy people dying? If not, I would not suggest there is any material change in lethality.

US numbers is starting to look a bit alarming now that tests are getting done. Expect this to continue for another couple weeks when the testing kits becomes even more widely available.

Tests are being done? Where? There are lots of reports of circle-jerking, ending in not being tested at all. AFAIK, there's still a trivial number that's been tested and there's no indication major labs have yet started testing.

On the store front, just had to go get carrots...having corned beef and cabbage for dinner and wife said yesterday we were fine...but today we have none. Got the last bag, which was largely broken. Only milk available was the sort that cost $7.50 or more per gallon. And, of course, still no asswipes. It was notable that the checkout girl greeted me with "how's it going?" as opposed to "did you find what you're looking for?"

[mori]

The Ohio governor ordered all restaurants, bar, and brewery to close indefinitely at 2100 (carry-out is still an option). All the servers, cooks, and other staff that will be let go living from paycheck to paycheck will put a terrible hurting on the economy for years to come.

[Kasey Chang]

The mortality rate seems to be fairly well established, are there any reports of younger or healthy people dying? If not, I would not suggest there is any material change in lethality.

There are basically two kinds of mortality rates for COVID-19: a medical system pressured, but not broken: about 1% death rate, and a medical system broken by demand... about 3-4% mortality rate.

We saw the latter in Wuhan, China.

Tests are being done? Where? There are lots of reports of circle-jerking, ending in not being tested at all. AFAIK, there's still a trivial number that's been tested and there's no indication major labs have yet started testing.

Somebody is getting the tests to get all these new "confirmed cases" on the board.

With that said, someone is apparently shipping fake test kits to the US. Customs intercepted a whole bunch at LAX

[Anonymous Bosch]

Britons could be forced to put their lives on hold for THREE MONTHS under coronavirus 'battle plan' that would see troops on the streets, police ignoring minor crime and patients turfed out of hospitals amid warning that one-in-five workers could go sick

• The Government has published its 'battle plan' for responding to a major outbreak of the coronavirus in the UK
• The total number of UK cases has risen from 39 to 51 in the past day, Health Secretary Matt Hancock revealed
• The blueprint sets out a three-month drive to delay the spread of disease until the main threat is over
• The action document says police could ignore low-level crime if the disease does take hold in the country
• Military personnel could be deployed to 'backfill' gaps in emergency services left by impact of coronavirus
• Hospitals could turn away non-urgent patients and send people home to recuperate to free up more capacity
• Government officials are urgently trying to speed up the six-month process of becoming a hospital volunteer
• Border officials could be handed powers to detain travellers if they are suspected of carrying the deadly virus
• Should the contagion spread, big public gatherings may be suspended as part of a 'social-distancing' strategy

Britons could be forced to put their lives on hold for three months under a 'battle plan' to combat Coronavirus amid warnings today that the deadly disease could incapacitate a fifth of the UK's workforce.

Boris Johnson today set out the Government's blueprint to deal with a mass outbreak of the bug that includes a raft of socially and economically costly contingency moves as a last resort.

Sporting events could be axed and a 'social distancing' strategy would see people encouraged to work from home to avoid unnecessary travel, while an army of NHS volunteers could be recruited to help ease the burden on the health service.

As the number of confirmed UK cases passed 50, it revealed police could ignore low-level crime and troops could be deployed on the streets if officers are incapacitated through illness.

Hospital patients not suffering from the disease could also be sent home to free up beds, and local authorities will be helped with the 'challenge' of dealing with increasing numbers of deaths among the elderly and vulnerable.

These measures could be in place of up to 12 weeks in a bid to contain the spread of the virus and treat those affected.

The striking scenario emerged as Boris Johnson published the action plan, warning at a press conference that it was now 'highly likely' there would be a major outbreak of coronavirus in the UK.

The threat was underlined this afternoon as it emerged the number of confirmed cases has jumped from 39 to 51 in the past day.

The PM said the government would take all 'necessary and reasonable steps', but appealed for the public to keep 'going about our business as usual'.

Asked whether he thought the UK still had the 'bulldog spirit' to combat the virus, the premier said: 'I do think that this is a national challenge. The potential is there for this to be something that our country has to get through.

'But I have absolutely no doubt that we have the resources, we have the health service to get through it.'

The report stresses that the response is still in the 'containment' phase, with just 39 confirmed cases in this country so far. But expert fear that they will have to shift to 'delay' tactics - effectively damage limitation - within days or weeks after a rising infections across Europe.

A reasonable 'worst case scenario' would see 80 per cent of the UK population contract the virus, with up to a fifth of employees unable to work in 'peak weeks'. Such an outbreak could take hold within weeks, and it would be three months before its highest point was reached.

Scientists are still hoping that if rapid spread can be staved off until the summer warmer weather will help, but are becoming increasingly pessimistic about the prospects of avoiding a major outbreak in the UK.

The 28-page 'action plan' published by the government today was agreed at the first emergency Cobra meeting to be chaired by the PM yesterday.

[Jeff V]

https://twitter.com/jonathansfrakes/sta ... 8059488256

That is the exact opposite of O'Hare right now.

[mori]

https://twitter.com/jonathansfrakes/sta ... 8059488256

That is the exact opposite of O'Hare right now.

Does not sound like you will be going out to eat anytime soon in Illinois.

[LawBeefaroni]

https://twitter.com/jonathansfrakes/sta ... 8059488256

That is the exact opposite of O'Hare right now.

Does not sound like you will be going out to eat anytime soon in Illinois.

Soon, yes actually. After tomorrow, no.

[Jeff V]

Does not sound like you will be going out to eat anytime soon in Illinois.

Went to a banquet at Buca de Beppo yesterday. Otherwise, eating out is not really a big thing, we can generally make much better food at home.

[LawBeefaroni]

Does not sound like you will be going out to eat anytime soon in Illinois.

Went to a banquet at Buca de Beppo yesterday. Otherwise, eating out is not really a big thing, we can generally make much better food at home.

I think mori is talking about JBs edict shutting all in-restaurant dining and bars.

[Moat_Man]

https://twitter.com/jonathansfrakes/sta ... 8059488256

That is the exact opposite of O'Hare right now.

Does not sound like you will be going out to eat anytime soon in Illinois.

Soon, yes actually. After tomorrow, no.

That's Vancouver by the way, not the US.

[Kurth]

Paging Smoove: one-on-one play dates for kids? Yes or no? I’m seeing conflicting “expert” advice on this.

Do I need to tell my family that it’s time to seriously just hunker down and not go see friends, even if a small scale get together for basketball at a local court?

This is not easy to navigate.

Edit to add: I just mentioned to a friend that I let my daughter go skiing today with her friend and let my younger son have a friend over to hang out. He politely told me I am screwing everything up and sent me his town’s health department email about this, which says no social interaction, pretty much.

[Kraken]

The Ohio governor ordered all restaurants, bar, and brewery to close indefinitely at 2100 (carry-out is still an option). All the servers, cooks, and other staff that will be let go living from paycheck to paycheck will put a terrible hurting on the economy for years to come.

Restaurants run on tight margins. With no time to prepare for closing, they'll lose a lot of their inventory. Maybe they can get through a week or two, but many of them will never reopen. If it drags on for a month or longer, most of them won't.

[Smoove_B]

Paging Smoove: one-on-one play dates for kids? Yes or no? I’m seeing conflicting “expert” advice on this.

What I'm seeing is that hanging out in an outdoor environment (going to a park for example) is low risk. Skiing (in theory) would be low risk except for the crowd situations at the base of the mountain, in the lodge, waiting for the chair lift, etc...

I'm on record for being aggressive with my recommendations, yes.

No play dates.

[Isgrimnur]

[Blackhawk]

For the record, as of today I cancelled next week's tabletop session and have begun the process to transition online to Roll20 for the next couple of months (or more, as needed.)

I adulted.

[Kasey Chang]

California Governor Newsome just issued a directive... ALL 65 year or older or anyone with chronic conditions should just "stay home"... and all bars, nightclubs, wineries, and brewpubs have to close.

[Z-Corn]

I bought my wife a massage for her birthday that I'm going to have to cancel in the morning.