It’s not exactly a roadmap but it’s a start. California Gov. Gavin Newsom outlined six criteria for reopening the Golden State:
California’s six indicators for modifying the stay-at-home order are:
- The ability to monitor and protect our communities through testing, contact tracing, isolating, and supporting those who are positive or exposed;
- The ability to prevent infection in people who are at risk for more severe COVID-19;
- The ability of the hospital and health systems to handle surges;
- The ability to develop therapeutics to meet the demand;
- The ability for businesses, schools, and child care facilities to support physical distancing; and
- The ability to determine when to reinstitute certain measures, such as the stay-at-home orders, if necessary.
Since I have been calling for just such criteria to be promulgated, I found this an encouraging first step. I was disappointed, however, because none of the criteria were quantified. Without that you cannot determine whether progress is being made. That’s the sort of commitment that I think is needed rather than simple aspirational goals. Does anyone actually disagree with any of them? The devil is in the details.
“The devil is in the details.”
This week on “How to Do It” Nigel will tell us how to split an atom………..
Start with principles then agree on specifics. These are fine but we arent making much progress toward them. The “lets open back up” crowd doesnt seem to care much about preparation. Neither does POTUS.
Steve
The six demands were designed to be vague sliding goalposts that can be moved in any direction. I’m not good at fisking, but here goes:
1. The ability to monitor and protect our communities through testing, contact tracing, isolating, and supporting those who are positive or exposed.
By the time we have enough tests (assuming that they are 95% accurate or better) and have tested enough people to make a difference the pandemic will likely be over. Even South Korea and Hong Kong had to give contact tracing when Kung Flu got too widespread. We are talking about literally tens if not hundreds of thousands of people dedicated solely to performing these tasks. This can’t be ramped up quickly. Hiring, training, transportation all have to be arranged. We are talking several months at a minimum. And who pays for it? More fellas behind the tree?
2. The ability to prevent infection in people who are at risk for more severe COVID-19
Steve, you of all people know very will that this is completely unattainable unless we put the ‘at risk’ in isolation wards. There’s probably not enough of those in the whole country to handle just NYC’s ‘at risk’. And of course ‘at risk’ is not defined. I’m at risk, 60, male, diabetic, though healthy and was pretty social isolated even before this whole thing blew up.
3. The ability of the hospital and health systems to handle surges
And what quantifies as a surge? And how big a surge must the hospitals and health systems be capable of handling? Logistics, logistics, that pesky word logistics.
4. The ability to develop therapeutics to meet the demand
Hell, we’re still scrambling to figure out how the damn thing kills people (other than cytokine storm), much less hit upon a reliable drug or treatment other than possibly plasma transfers. Vaccine? 18 months out, I’ve heard.
5. The ability for businesses, schools, and child care facilities to support physical distancing
This one IMO is the saddest demand. I’ll just pick on schools. So we rebuild all the schools to accommodate 6′ physical distancing in classrooms, auditoriums, gymnasiums, locker rooms? No more contact or aquatic sports? Or build more schools? Can you imagine the cost? The time it would take to build/remodel them? Get the plans, approvals, etc. etc.? Doesn’t Newsom realize how powerful the Green lobby is in California? They’ll fight to the death to stop 1% of that from happening.
6. The ability to determine when to reinstitute certain measures,such as the stay-at-home orders, if necessary.
Completely at the whim of Governor Newsom. The first five demands show how nuts this one is. Absolute safety is unattainable.
I think the whole exercise is similar to what Pelosi did when she larded up the COVID relief bill. Go for the grand slam, and negotiate down.
“Steve, you of all people know very will that this is completely unattainable unless we put the ‘at risk’ in isolation wards. ”
We cant let the perfect be the enemy of the good. We do have to open up some time. We cant stay on lockdown until we have a vaccine. We may never have a vaccine. But we can try to do better. Let look at our data from this outbreak. DO we do better lumping the at risk together and trying to protect them or are we better off separating them. CO keeps noting that Asian countries have separate facilities into which they quarantine people who test positive. Maybe we try that. We go broke trying to protect 100% of the at risk, but maybe we a pretty good job of protecting 80% with a $4 billion investment. Drop a few F-35s and kill a few less Muslims and we are there. Eliminate the special tax breaks for 7 or 8 billionaires and it is paid for. Good deal I think.
“5. The ability for businesses, schools, and child care facilities to support physical distancing
This one IMO is the saddest demand. ”
What I think this probably morphs into is us doing a better job of not sending sick kids to school. So again, we look at our data and figure out how to optimally do that. It looks to me like younger kids are largely just not affected by this disease. In fact, there are a couple of papers (kind of esoteric so I dont link them here) suggesting that kids probably arent even vectors bringing it to their parents. So maybe just concentrate on older kids. Again, this will cost money but it is probably doable if we have realistic goals and down have to 100% safety.
“By the time we have enough tests (assuming that they are 95% accurate or better) and have tested enough people to make a difference the pandemic will likely be over.”
If we are doing surveillance testing based upon sampling then we dont need as many tests or people to do them. We do need to be able to surge tests to hotspots. What this will take is a level of cooperation we have never had before. We have built our hospital systems to compete with each other, not cooperate. If you read the Science article I linked, one of our problems is that every hospital has a different computer system so they cant communicate well with each other or with the labs to which they are not contracted. If Abbott comes up with he best gee whiz, cheap, always works tests, a lot (most I bet) dont have the infrastructure to communicate with Abbott products. We would have to go manual. I dont even want to attempt to try to tell you the problems with integrating paper into electronics.
Besides, Trump said if you want a test, you can get a test. I am sure that science expert Drew can explain and resolve this seeming discrepancy. Trump and Drew cant both be wrong. There must be plenty of them around.
Steve
Several nursing homes around the country have reported nearly complete CO-19 infection, and this Sioux Falls, S.D. packing plant with over 500 out of 2000 employees positive so far make me think the virus is just hanging in the air and circulating through the highly efficient closed heating systems. Wouldn’t everyone be safer if they just opened all the windows and doors?
Sure. But the criteria being set out by governors and mayors are not conducive to lifting the lockdowns ever. They can only be accomplished by testing everyone in the world not just once but many times. Or else there must be a vaccine that will prevent contracting the virus.
I don’t think that we can test Americans frequently enough to reach their goals not just now but ever. Not letting the perfect be the enemy of the good cuts both ways. If the objective is zero risk, the lockdowns are permanent.
Agreed. But that will not provide zero risk. Even were we to eradicate SARS-CoV-2 completely from the United States we’d still need to control our borders, have an infallible test for the virus, and test everyone coming into the country or be willing to quarantine them for several weeks to achieve zero risk.
“in people who are at risk for more severe COVID-19;” is but one example of the bad grammar that will no doubt be with us long after the virus is conquered. In proper English one says “in people who are at risk of more severe COVID-19;” Think, “chance of” and “probability of” and “risk of.”